Transsexuality

What does the term transsexuality stand for?

Transsexuality refers to the presence of gender incongruence between one's biological and perceived gender. What this means is that transsexual persons do not identify with the gender of which they show physical characteristics.

Transsexual people are also colloquially described as being "born in the wrong body".

Generally speaking, it is believed to affect around 0.5% of the population. It is estimated that there are around 25 million transsexual people worldwide. It is however thought that there is a high number of unreported cases.

Even today, acceptance of transsexuality in society is sometimes still low, so transsexual people experience a high level of suffering.

How does transsexuality occur?

It is still not clear what exactly causes gender incongruence. Various hypotheses have been proposed to explain the development of transsexuality. It is believed that transsexuality is already established in the womb.

One possible cause could be changes in the hormonal influence of the unborn child with sex hormones of the opposite gender. In addition, changes in specific areas of the brain or in the fetus' protein metabolism are also being discussed.

Which doctor for transsexuality?

Transsexual people can turn to psychotherapists or psychiatrists for help. They are intended to support trans people during their transition and help them with issues like the coming out process, sorting out their social relationships and establishing a support network.

The "diagnosis" of transsexuality should also be confirmed by specialists, including trained psychiatrists. This matters because, in addition to transsexuality, other gender development disorders exist with symptoms similar to transsexuality but with different treatment.

In Germany, healthcare for trans people is organized differently. There are specialized outpatient clinics and points of contact at university hospitals, where further treatment and psychotherapeutic support are organized.

Moreover, doctors and psychotherapists in private practices have also specialized in this topic and provide trans people with a large network of experts in a wide range of disciplines who can support them in their transition, for example speech therapists or cosmetologists.

Counseling for transsexuality

The purpose of counseling sessions is to discuss various topics and situations that affect the life of the transsexual person. The counselor will provide information and support on topics like identity development, coming out and dealing with existing social contacts. In most cases, these people are also able to establish links with a network and other trans people so that support can be provided here too.

A further task of the counselor is to inform trans people about the options for changing their body and the various treatment options. They must also explain the boundaries of the respective therapies and any risks they entail.

Besides counseling sessions, so-called "everyday tests" are also planned, during which the trans person goes through everyday life in the desired gender role for a longer period of time before receiving hormone treatment or undergoing body-modifying surgery. The aim of this is to give the trans person confidence as to whether and how they can best manage the transition in their social environment.

Hormone therapy for transsexuality

A key step in the treatment of transsexual people is hormone therapy. It involves administering the sex hormones of the opposite sex. Trans women, meaning male-to-female transsexuals, are given an oestrogen drug.

They also receive an anti-androgen which is a hormone that suppresses the male sex hormones in the body. As a result, trans women have breast growth, diminishing body hair, altered or even more feminine facial features and a decrease in the size of the testicles and prostate during the course of treatment.

Trans men, or female-to-male transsexuals, are receive the male sex hormone testosterone to "masculinize" their appearance. As a response to the testosterone, there is a lack of periods, more body hair, beard growth and a change in the distribution of body fat and muscles, resulting in a masculine body shape.

Gender-affirming hormone therapy (GAHT) is supervised by a specialist in endocrinology, a doctor who deals with hormones and the associated organs.

As hormone therapy is generally a safe form of treatment, but does involve certain risks, it should only be administered in consultation with and under the supervision of a doctor. For instance, the hormones administered can damage the liver or result in the formation of hormone-related tumors. In particular, too high doses or uncontrolled intake can also lead to thrombosis and depression. This is why regular follow-up care is crucial.