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Environmental Cause

Despite this seemingly clear
evidence for an unclear
environmental cause, many
doctors insist that
transsexualism defies
explanation. "Mothers who
want a girl tended to raise the
child with some unconscious
slant in that direction," Dr.
Edgerton said.

"But the evidence is not
very strong that the
environment has been the
cause," he continued. "Many
of us working in this field
suspect that there is a genetic
factor. The reason for this is
that it begins at such a young
age and it seems so far to be
totally irreversible – very
unlike most conditions that are
environmental in nature."

The actual surgery itself,
primarily the construction of
genitalia, is an intricate
process. It is easier to construct
female genitals then male
genitals, according to Dr.
Edgerton who has personally
operated on 26 patients. This
may account for the greater
number of male transsexuals
reported in America.

To supplement a sex
change, most transsexuals also
receive hormones and other
operations to alter their
outward appearance. Karen
had her nose and chin
re-shaped, her breasts enlarged
and electrolysis performed on
her face and body for a more
feminine appearance.

Most sexual transformations
have been successful.
"We've not had a single patient
who has regretted the surgery,"
remarked Dr. Edgerton. "They
seem to be the happiest
patients that I see after
surgery." For the first time in
their lives, many of them are
able to be fulfilled sexually as a
true member of their preferred
sex. "Both male and female
transsexuals after surgery
rather consistently report
successful sexual intercourse
and reach orgasm," Dr.
Edgerton said.

Although for many
transsexuals a lifelong need has
been cured by surgery, their
problems do not vanish as
easily as their scars. Dr.
Edgerton was unsure of
whether the problems were
greater or less after surgery,
but in any case, legal and moral
tangles abound.

"Before surgery, the police
are unlikely to be sympathetic
if they (transsexuals) happen to
be arrested while they are
living in the gender of their
need," said Dr. Edgerton. After
surgery relatives and friends
are often unable to accept the
patients' new identity, forcing
many transsexuals to seek
another part of the country
after their operations with new
names, new bodies and new
legal birth certificates to start
life over again.