Transsexualism and a new type of psychosurgery.

A discussion of "The Transsexual Wish in a Psychotic Character" by Katherine MacVicar, M.D. Patients in increasing numbers are seeking sex-reassignment surgery. The topic receives coverage in both the lay and professional press; many advocate surgery as the only "cure". Clinical study reveals that these patients have borderline personality organization and are seeking to discard bad and aggressive features and to replace them with a new idealized perfection. Surgical procedures in these cases can usefully be conceptualized as a new type of psychosurgery.