Transsexualism and Sex Reassignment

497 reason, and justice tell me I ought to do." This may still be sage counsel, but to the list of humanity, reason, and justice should be added a fourth item: this book. was founded in 1976. In the ensuing ten years, approximately 120 gender reassignments have been performed. Motivated by the recent change in the climate of opinion surrounding sex reassignment surgery and by the growing popularity of their clinic, the editors (an obstetrician and a psychiatrist) organized this text. Drawing upon their own experience and upon clinical trials conducted by others, they produced a modest volume that is aimed at non-physician health care professionals, transsexuals, their friends and families, and the interested lay public. The editors' goal was to present a general overview that would contribute to a better understanding of the problem of gender pathology. In general, I believe they have succeeded. The book is organized into 14 brief chapters-the work of 19 contributors, among them a plastic surgeon, a lawyer, a social worker, and a transsexual. The first six chapters are educational; they deal with the demography of transsexualism, definition of terms, theories of etiology (from endocrine to psychodynamic), and descriptive aspects of the diagnostic, differential diagnostic, cross-cultural, and psychological components of gender identity disturbance. One of the chapters is a moving, intelligent, and fascinating autobiographical account of an individual who successfully "crossed over" from male to female. The next series of chapters is practically oriented; it focuses on the multidisciplinary approach to assessing an individual for candidacy and managing the sex change (surgically, psychologically, and cosmetically) and its consequences. A chapter is devoted to surgical technique and is explicit with photographs and technical language that only a physician or medical student could follow. There is another chapter, written by a speech therapist, describing strategies to aid the transsexual with patterns of "voice, speech, and language" of the desired sex role. Two chapters concern the legal and ethical aspects of sex reassignment, and the final one assesses the outcome of gender reassignment. There are two appendices which catalogue health care services and hormone preparations that are available in Australia. As one can imagine, these appendices, as well as the chapters on legal aspects and welfare services, are of limited relevance to the American reader. A glossary, containing over 200 terms, is included and, I imagine, will be well used by the non-medical reader. As a psychiatrist, …