It can help transsexuals simultaneously express and control their paraphilia, by creating desired feminization, and by moderating ego-dystonic paraphilic arousal. I believe we must begin to look at sex reassignment as a form of sex therapy for this sexual problem, in addition to its accepted role as a treatment for gender identity problems. One of the most effective ways to treat any paraphilia is to lower testosterone levels. That is why we treat paraphilic sex offenders with antiandrogen medications. Lowering testosterone does not change the direction of paraphilic sexual desires, but it reduces their intensity.
Transsexuals often report that their paraphilic sexual feelings can be oppressive, and ego-dystonic.
Hormone therapy and genital surgery makes these sexual feelings less painfully intrusive. My sexual urges have virtually disappeared since surgery. I hope I get horny again, but I am very happy not to be as driven as I once was. While autogynephilic transsexuals all share a desire to feminize their bodies, I believe they run the gamut in terms of their desire to actually live full-time in female role. Some are obviously eager to live in role, particularly if they can pass reasonably well.