IN the old days, when I was a medical student, if a man wanted to have his penis amputated, my psychology professors said that he suffered from schizophrenia, locked him up in an asylum and threw away the key. Now that I am a professor. my colleagues in psychiatry say that he is a “transsexual,” my colleagues in urology refashion his penis into a perineal cavity they call a vagina, and Time magazine puts him on its cover and calls him “her.” Anyone who doubts that this is progress is considered to be ignorant of the discoveries of modern psychiatric sexology, and a political reactionary, a sexual bigot, or something equally unflattering.

Because “transsexualism” involves, is indeed virtually synonymous with, extensive surgical alterations of the “normal” human body, we might ask what would happen, say, to a man who went to an orthopedic surgeon, told him that he felt like a right‐handed person trapped in an ambidextrous body and asked the doctor to cut off his perfectly healthy left arm? What would happen to a man who went to a urologist, told him that he felt like a Christian trapped in a Jewish body, and asked him to re‐cover the glans of his penis with foreskin? (Such an operation may be alluded to in I Corinthians, 7:17‐18.)

“But,” the medically informed reader might object, “isn't transsexualism a disease? Isn't it — in the grandly deceptive phrase of the American psychiatric establishment used to characterize all ‘mental diseases’ — ‘just like any other illness'?” No, it is not. The transsexual male is indistinguishable from other males, save by his desire to be a woman. ("He is a woman trapped in a man's body” is the standard rhetorical form of this claim.) If such a desire qualifies as a disease, transforming the desiring agent into a “transsexual,” then the old person who wants to be young is a “transchronological,” the poor person who wants to be rich is a “transeconomical,” and so on.

Such hypothetical claims and the requests for “therapy” based on them (together with our cognitive and medical responses to them) frame, in my opinion, the proper background against which our contemporary beliefs and practices concerning “transsexualism” and transsexual “therapy” ought to be viewed.

Clearly, not all desires are authenticated in our society as diseases. Why the desire for a change in sex roles is so authenticated is analyzed with great sensitivity and skill by Janice Raymond in “The Transsexual Empire.” Arguing that “medicine and psychology ... function as secular religions in the area of transsexualism,” she demonstrates that this “condition” is now accepted as a disease because advances in the technology of sex‐conversion surgery have made certain alterations in the human genitals possible and because such operations reiterate and reinforce traditional patriarchal sex‐role expectations and stereotypes. Ostensibly, the “transsexers” (from psychologists to urologists) are curing a disease; actually, they engage in the religious and political shaping and controling of “masculine” and “feminine” behavior. Miss Raymond's development and documentation of this thesis is flawless. Her book Is an important achievement.

The claim that males can be transformed, by means of hormones and surgery, into females, and vice versa, is, of course, a lie. ("She‐males” are fabricated in much greater numbers than “he‐females.") Chromosomal sex is fixed. And so are one's historical experiences of growing up and living as boy or girl, man or woman.

What, then, can be achieved by means of “transsexual therapy"? The language in which the reply is framed is crucial — and can never be neutral. The transsexual propagandists claim to transform “women trapped in men's bodies” into “real” women and want then to be accepted socially as females (say, in professional tennis). Critics of transsexualism contend that such a person is a “male‐to‐constructed‐female” (Miss Raymond's term), or a fake female, or a castrated male transvestite who wears not only feminine clothing but also feminine‐looking body parts. Miss Raymond quotes a Casablanca surgeon, who has operated on more than 700 American men, characterizing the transsexual transformation as follows: “I don't change men into women. I transform male genitals into genitals that have a female aspect. All the rest is in the patient's mind".

too bad this is from 1979: https://archive.is/gQFec