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Transsexualism: Sex and Gender Dilemma (1991)

Transsexualism: Sex and Gender Dilemma (1991)

©1991, 2013 by Dallas Denny

Source:  Transsexualism: Sex and gender dilemma. (1991). Decatur, GA: American Educational Gender Information Service, Inc.

Between 1990 and 1998, I mailed many thousands of these tri-fold brochures.





AEGIS Transssexualism Tri-Fold Brochure


Sex and Gender Dilemma


Transsexual people have a gender identity—a sense of being a woman or a man—which differs from their anatomical sex. This clash of sex and gender causes them much emotional pain, and they must ultimately deal with the issue in some way.

Nobody knows how many people have transsexual feelings, but certainly there are more than one hundred thousand in the United States. Only a small minority choose to begin the transitional process. Even fewer actually have sex reassignment surgery.

Professional gender counseling and support groups are the best places for a transsexual person to talk about these feelings and get help, but even an empathetic friend is a good start.

There are many sources of information about transsexualism, but there is also much misinformation. It is important to get the most accurate data you can. We at AEGIS attempt to provide you with the information you need in order to make informed choices.

Important Sources of Information

A well-informed therapist and peer input via a support group are very important for making the kind of difficult decisions that sex reassignment requires, for the transition process is fraught with many potential hazards that should be considered before committing to any plan of action. Sex reassignment surgery (SRS) is an irrevocable step, for the surgery is irreversible. A calm, patient, thoughtful approach will lessen the possibility that you will make a decision that you might later regret.


Therapy is a vital part of dealing with and making decisions about transsexualism. Your therapist should have experience with transsexual people. A responsible surgeon will require that you see a licensed therapist who follows the Standards of Care of the Harry Benjamin International Gender Dysphoria Association. Without a letter from such a therapist, plus a peer review by another, you will need to go to a less reputable doctor for your surgery. This can lead to catastrophe.

The HBIGDA Standards of Care are minimum guidelines for sex reassignment. They require a ninety day evaluative period by a therapist before referral to a physician for hormonal treatment, and a minimum of one year of full-time living and working In the new gender before SRS. This period is coniirnonly called the “Real Life Test.”

A therapist can provide referrals to many of the resources needed for transition, Including endocrinologists for hormones, cosmetic surgeons, and, for male-to-female persons, electrolysis.


Electrolysis is the destruction of hair roots by an electric current. It should be performed only by a competent, registered electrologist. There are several methods available, including thermolysis, “The Blend,” and galvanic electrolysis. People report varying levels of success, expense, and pain with each of these methods, and it Is debatable which is best. For this reason, we suggest you select an electrologist from a referral list maintained by gender-concerned organizations. This will increase the likelihood of getting competent and sensitive treatment. Be a careful consumer by asking questions and requiring references.

Electrolysis to remove a beard can cost thousands of dollars and take a year or longer. Once the real-life test is begun, it is very difficult to find time to grow facial hair long enough for removal by electrolysis. Consequently, electrolysis should be close to complete before beginning the RLT.

Hormonal Therapy

Not enough caution can be given about the use of hormones. These powerful chemicals have achieved an almost mystical status as “magic bullets” that will turn you into a woman or a man. They should not be taken without proper medical supervision. The HBIGDA Standards of Care require that you undergo a period of evaluation before you are referred to a knowledgeable physician to begin hormone therapy.

While hormones are an important part of transition, they will not accomplish miracles, and it often takes years for their cumulative effects to be fully realized. it is a common myth that taking more hormones will speed along this process, but it will not. Taking extra hormones will be at best a waste of money, and at worst it will cause physical damage.

Sex hormones should not be taken lightly. The obvious desirable effect a transsexual person expects from hormones is either feminization or masculinization. However, there are a number of possible side effects, including liver dysfunction and permanent sterility. It is very important to get hormones from a reputable doctor who does periodic analysis of your blood to ensure that your health is not adversely affected.

After taking a high enough level of hormones over a long period of time, you will become sterile, so be very sure of your decision to take them. Also, it is very typical for hormones to cause emotional fluctuations; be sure to have a support network.

Important Information

  • Transition will not solve all of your problems. Your appearance may change, but you will still be the same human being.
  • Set reasonable goals for your transition. A change this large should not be rushed.
  • The emotional pain is far worse than any physical pain involved.
  • Rejection by family and friends is very painful and not uncommon. You must be prepared to deal with this possibility.
  • Losing your job is quite possible, so build up as much savings as you can. You may need them when you begin the RLT.
  • You may find your transition to be easiest when you blend in with the rest of society. This could involve unlearning some of the gender traits— voice, mannerisms, and so on— that you had before your transition.
  • Societal prejudice may result in harassment, job discrimination, and exclusion from church and social organizations.
  • Male-to-female transsexual persons experience the same second-class status as any woman. They are in increased danger of rape and may find they receive less money for the same work.
  • Female-to-male transsexual persons may find that women perceive them to be threatening and that men behave more aggressively toward them.


Important Notice

It is possible to live productively as a member of the other sex without desiring or having sex reassignment surgery. Few people see your sexual organs, and their perception of your genital status will be influenced more by your general appearance than by whether you have or have not had SRS.


  • Requires you to be in good physical and mental health.
  • Most SRS surgeons subscribe to the HBIGDA Standards of Care.
  • If you are married, then some surgeons may not operate unless you are divorced. However, there is no legal requirement that you be divorced before surgery.
  • The surgery will not cure all of your problems. For example, most people will treat you just as they did before surgery.
  • The surgery does not guarantee complete sexual pleasure, and the results could appear less than convincing, especially with female-to­-male surgery. There may also be medical complications.
  • There are relatively few surgeons who perform SRS. Be sure that your surgeon is experienced and reputable. HBIGDA membership Is usually a good indication.
  • It is important to become as well‑informed about SRS as possible.

Legal Information

Have your driver’s license, social security card, credit cards, bank account, insurance, and other legal documents changed to reflect your new name. Some states will issue a new driver’s license to show your new gender during the RLT. Check with your therapist, the department of motor vehicles, and possibly an attorney for help with these issues.

Some Transition Costs

Male to-female
$4000 – $50,000 SRS
$2000 – $ 8,000 Electrolysis
$1200 – $ 2,000 Hormones (2 years)
$2500 – $ 6,000 Breast Implants *
*77??? Other Procedures

* (If needed; usually, they aren’t necessary) Plastic surgery, tracheal shave, etc.

$1500 – $3000 Hormones (2 years)
$4000 – $5,000 Mastectomy
$10,000 – $ 60,000 SRS
$???? Other Procedures *

* Hysterectomy, oophorectomy, etc.

Transsexual people may be legally oppressed In a number of ways, from restroom usage (though a letter from a therapist may be helpful) and job discrimination to being cited for traffic obstruction just for walking down the sidewalk. A transsexual person could also be cited for creating a public disturbance, being a disorderly person, prostitution, or any of a number of other crimes because of police officer bias.


We are the American Educational Gender Information Service, Inc. (AEGIS), Box 33724. Decatur, GA 30033. Our phone is (404) 939­0244. We publish Chrysalis Quarterly journal and a variety of other materials. Subscription to Chrysalis is $36 for four issues.

We would like to thank Christine Beatty of San Francisco Gender Information Service for her permission to adapt her materials for this brochure.