From He To She

Transexuals don't actually have a choice. It's the way they're born. Something happens when they're developing in the womb that ultimately leads to them feeling that they are a woman stuck in a man's body, or a man trapped in a woman's body. The feeling isn't a learned auto-erotic arousal like transvestitism - a male transsexual actually has a woman's brain.

By Joe Gardiner

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STEP ONE: Counselling

"Clients undergo many hours of counselling to determine that they are really transsexual and to rule out other psychiatric problems," says Springfield. The only specialist nurse gender counsellor in the country, she has worked in the gender field for ten years, and is a member of the Harry Benjamin International Gender Dysphoria Association, an organisation which governs the treatment of transsexuals. The client is then referred to a psychiatrist for further evaluation.

STEP TWO: Hormone Treatment

Transsexual-to-females are given oestrogen which prompts them to develop breasts and a smaller waist. They will see more fat on their hips and smoother skin along with a reduction of body hair and loss of libido. Hormones do not usually stop beard growth which has to be removed by electrolysis. It can take up to 1,000 hours of electrolysis at £35 per hour to remove a full beard. Hormones do not alter voice pitch either, although speech therapy can help in that respect.

STEP THREE : Changing gender role

Patients will have to live in their new gender role for at least 12 months before an operation can be performed. During this time, all documents relating to the client are changed - driving license, National Insurance, everything except birth certificate. The patient must also come out at work - following the case of P vs Cornwall Council in the European Court in April 1996, transsexuals are now protected against discrimination in the workplace. A Home Office working party is expected to report in 2000/2001 on changing the birth certificates of post-operative transsexuals to reflect their new gender identity.

"The real life experience is important," says Springfield. The 12-month period is a duration laid down by Harry Benjamin, who actually coined the term transsexual and, on a quite unrelated point, lived to be 102 years old. During this time transsexuals are checked up on to make sure that they are not cheating.

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