I am six months post-op now, and still get sexually aroused when I think of the transformation that I just completed. It may seem surprising that transsexuals are willing to admit that they have a paraphilia. I believe my respondents' candor reflects their relief at learning that they are not alone, and that there is a theory that speaks to their experience. They are gratified that someone has recognized the enormous risk they have taken, in order to integrate their sexuality with the rest of their lives. Their path is risky because at present, there is no medically approved script for seeking sex reassignment as a way of dealing with paraphilic eroticism.
Sex reassignment is a logical and effective treatment for paraphilic transsexuality.
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.