| dc.description.abstract | Transsexualism denotes a condition in which the gender identity-the personal sense of being a man or a woman-contradicts the bodily sex characteristics. This thesis is based on three independent surveys about transsexualism. FIRST, all 233 subjects applying for sex reassignment in Sweden during 1972-1992 were retrospectively examined through medical records. The incidence of applying for sex reassignment was 0.17/100,000 individuals over 15 years of age and per year. The male-to-female (M-F)/female-to-male (F-M) ratio was 1.4/1. With the exception of an incidence peak related to the legislation regulating sex reassignment in the early 1970s, the incidence has remained fairly stable since the first estimates in Sweden in the late 1960s. The M-F (n=134) and F-M (n=99) groups were phenomenologically compared. M-F transsexuals were older, and more often had a history of marriage and children than their F-M counterparts. M-F transsexuals also had more heterosexual experience. F-M transsexuals, on the other hand, more frequently reported cross-gender behaviour in childhood than did M-F transsexuals. It is concluded that transsexualism is manifested differently in males and females. The regret frequency (defined as applying for reversal to the original sex) was 3.8%. Prognostic factors for regret were, 'a poor support from the family', and 'belonging to the secondary group of transsexuals' (denotes people who develop transsexualism only after a significant period of transvestism or homosexuality). SECOND, 28 M-F transsexuals and 30 male controls were investigated. To test the hypothesis that genes coding for proteins involved in the sexual differentiation of the brain influence the susceptibility of transsexualism, we analysed (1) a tetra nucleotide polymorphism of the aromatase gene, (2) a CAG repeat sequence in the first exon of the gene coding for the androgen receptor, and (3) a CA repeat polymorphism of the estrogen receptor beta gene. Results support the notion that the gender identity is related to the sex steroid-driven sexual differentiation of the brain, and that certain genetic variants of three of the genes critically involved in this process, may enhance the susceptibility for transsexualism.THIRD, a questionnaire comprising questions about attitudes towards transsexualism and transsexuals was mailed to a random national sample (n=998) of Swedish residents, 18-75 years of age. The response rate was 67%. The results showed that a majority supports the possibility for transsexuals to undergo sex reassignment. However, 63% thought that the individual should bear the expenses for it. In addition, a majority supported the transsexuals' right to get married in their new sex, and their right to work with children. Transsexuals' right to adopt and raise children was supported by 43% whereas 41% opposed this. The results indicated that those who believed that transsexualism is caused by psychological factors had a more restrictive view on transsexualism than people who held a biological view. | en |
