[Transsexualism].

Transsexuals correspond in terms of their chromosomes, hormones and anatomy to their phenotypic sexual characteristics, but feel, with respect to their sexual identity that they unmistakably belong to the opposite sex, and wish for this reason to be reassigned to their psychological sex by means of endocrinological and operative treatment. They have a complete and permanent transposition of their sexual identity. The cause of transsexualism is unknown. There are male-to-female and female-to-male transsexuals. The diagnosis is made by a psychiatric evaluation. Hormonal treatment before operation and lifelong substitution after castration are described. The surgical technique in male-to-female consists in castration and construction of a neovagina by inversion of the penisskin, evtl. mammaplasty -in female-to-male: mammatransformation, vaginal colpohysterectomy and adnectomy and in a second step perineoplasty and construction of a phallic urethra up to the glans of the enlarged clitoris.