SEX CHANGE SURGERY: Gender Dysphoria Syndrome, Chapter One

“I don’t want my sex changed; I already am a (wo) man.”
-Words of the typical transsexual. I have heard them from 2,000 patients

Starting over would be sex change surgery! The reaction of the human being is a negative one. It is against the natural law to change what God has made. It is arrogant and sinful. In fact, in Paul 3 in the bible, he mentions about wearing opposite clothes. This is an entirely different diagnosis, transvestitism.

God made good, and also made bad. “Mistakes” are not possible for God. He looks at the bigger picture, and that is the reason we perceive mistakes on his part. The bad on this earth exists because we are made to the image and likeness of God and therefore have some of the power in our free will to make a lawful choice in the negative direction. Cleft lip, genital birth defects and anomalies that is hypospadias exists. Hippocrates, founder of our sacred profession of medicine in 431 BC made the instruction to us to perfect ourselves with a skill or science toward ourselves and to help the other person. And this is the profession of medicine; and there is no greater personal medical problem than 301.285 Gender Identity Disorder, or preferably, Gender Dysphoria Syndrome, a bonafide scientific and professional human condition. Not knowing to which sex you belong, not knowing if you are a boy or a girl, man or a woman, is the worst, and most severe affliction, worse than cancer. Let us discuss in other words.

*Mortal sin erased by the science of psychiatry:

DMS-5, DX 302.81. Handbook of Psychiatric Diagnoses,

Edition 5, specific diagnosis 302.81,

Gender Identity Disorder, variety Transsexualism.

*A bona fide academic pursuit.

*Safety & efficacy in surgery for palliation of gender dysphoria.

There is a human condition worse than cancer, worse than the mutilation of torture, worse than posttraumatic stress disorder. Can this be true? If you say there is such a disease I would, out of curiosity, like to know about it. And I, as a physician deep into the service aspect of medicine, would like to lend a hand, to try to help such souls out of their suffering. I have the power and glory of medicine in my armamentarium. And I love extending medicine into the psychomotor/physical, helping with my hands as would a master carpenter in love with his craft, taking on the worst—to him the best—challenges in structural revisions, about which others have said, “Impossible! No one has ever accomplished such a fixer-upper.” The human disease that is homologue to the most difficult carpentry job is gender dysphoria syndrome, which is the exact opposite of gender euphoria.

If you attain the most ecstasy imaginable in sexual things, then imagine the worst, the most awful things. In fact, imagine if you did not know to which sex you belong, if you have consulted others and they could not help your condition; think not only of the opposite of sexual pleasure but of sexual disgust and displeasure to the “super max.” Think of the accompanying social retardation, the educational barriers, the mental anguish, the emotional depression and/or rage, the spiritual difficulty in believing that there is a merciful Power greater than yourself. The American Psychiatric Association has a number for you: 302.85, Gender Identify Disorder.

If you carried this diagnosis at birth, your mother might have felt that even though the nursing staff brought to her a nice baby boy (or girl), when you were in your mother’s arms she might have had the thought that perhaps you behaved as the opposite sex. Or perhaps later she might have noticed that although you were designated and named as the gender of your anatomy, you seemed to feel uncomfortable with that gender. And you felt you were, actually were, the other sex.

But because your body was not what your gut feelings told you, you told yourself it’s impossible; it can’t be true. You might think, I must be gay, and I will try to be that. But that didn’t work either. How awful. Ridicule. A pariah. Nowhere. Nothing at all. What to do? Suicide? Alcohol? Overeating and obesity to hide my body? Concentration on technology, being a nerd in relative isolation? All of these are palliative measures and make an uncomfortable life. By age fifteen you may have figured out: Transsexual! Yes! That’s it!

In an extreme fundamentalist society, you would be spiritually “stuck” as a sinner, a foregone conclusion because you are different. Or if you are Roman Catholic, mortal sin would have been attached to you, to suffer in hell through eternity. Oh my goodness.

But your kind psychiatrist, well-schooled in understanding human behavioral aberrations, would have informed you and your family that you actually have a “disease,” a condition that is not a sin, not of your own doing, not of your volition, not a sin of any type; you would be freed from guilt. You and your parents would have been “forgiven” of sin and given a diagnosis with a name. You would have a sexual identity that is consistent, and the same as what you had sensed soon after birth. But your body is vastly different; you need to be taken in for repairs. You would be sailing in relatively uncharted waters.

Safeguards regarding the diagnosis you carried would be strict—you or they, the carpentry or surgery professions, would not want to cut off parts or make opposite parts, in case there had been a huge mistake in diagnosis. Not only your life, but the lives of many would be in ruin. Therefore, a protocol was developed to confirm the GDS diagnosis. For two years you as a surgical candidate will live as the gender you believe yourself to be. No one should be aware of your bodily gender. The world will experience the “real” you. The world will see the real you in a paying job, having a social life, having friends, passing well. You may even have a romantic life with someone who cares for you as his or her opposite anatomic gender. Living as the same sex as your brain tells you will be satisfying at last.

If you are still of the same mind after these two years, you are ready for the repair shop for your surgical/behavioral condition, and you may confide in your very small social network of confidants. Keep in mind, however, that the repair work and reconstruction will be palliative, and “cure” will never be 100% in appearance or function. The surgery usually includes removal of one set of apparatuses and fabrication of the other apparatuses to look similar in the opposite way and to act somewhat like you would want. There will always be imperfections, but you can be happy and productive with a good body image. No one need know.

The GDS condition is a genuine condition, occurring in 1/30,000 births. This gender identity situation constitutes a bona fide academic pursuit as far as diagnosis is concerned, including various permutations of that diagnosis. The palliative treatment is also bona fide, including surgery, hormonal therapy, and behavioral science advice and support systems.

Safety and efficacy in surgery for this major condition compare with other major rehabilitation projects such as organ transplant, AIDS, TB, joint replacement, scoliosis repair, and heart-lung transplant. My cases are representative.

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