The term transsexuality refers to the urge to live as a member of the opposite sex, as well as to be recognized as such on all levels.  Gender identity refers to our individual view, that is, how we see and define ourselves. The majority of people identify with their innate gender — as male or female, which is also referred to as binary gender identities. However, about 0.5% of people feel that their gender identity does not match their biological sex. For example, some people are born with male genitalia, facial hair, etc., but do not see or feel like a man. Others may have female genitalia as well as breasts, long hair and other features, but do not identify as a woman and do not feel female. In these cases, one speaks of transsexuality. Furthermore, there are also people who do not define themselves as having a binary identity. They do not want to or cannot identify as either a man or a woman. These people are called non-binary. Many affected people are opposed to the term transsexuality. From their point of view, it is not sexuality but identity that is at the centre of their personality. They therefore prefer to call themselves transident. Gender congruent is another term that can be used alternatively for transsexuality.

Unlike the concepts of heterosexuality and homosexuality, transsexuality does not define the sexual inclination or behaviour of the person concerned. If a person feels that they are in the wrong body, this is not an indication that they are attracted to the same or the opposite sex. Individual preference is independent of (trans)sexuality Transsexuality has been historically documented in various cultures and was already present in ancient times. Some transsexuals like to wear clothes and hairstyle of the gender they feel they belong to. We already know such phenomena from Ancient Egypt. Nevertheless, transsexuality must not be confused with transvestitism. Transvestites are people who wear clothes that are not normally worn by the gender to which they are physically assigned. However, not all transvestites are transsexual.

Many transsexuals feel they belong to the opposite sex, even as children. They show this, for example, when playing by displaying gender-atypical behaviour. In most cases, the environment tries to educate children more or less intensively according to the genders assigned to them. In this way, the corresponding gender role is to be imposed on them. As a rule, children affected by transsexuality try to fulfil the expectations of their environment as much as possible and to live the corresponding gender role. The pressure on transsexual girls (biological boys) is usually greater than on transsexual boys (biological girls). The social pressure on transsexual people and thus also the psychological pressure they feel increases, especially during puberty. Besides psychosomatic illnesses, depression is one of the most common consequences. Sooner or later, many transsexual people are forced to disclose their transsexuality. With the so-called “outing” they officially and permanently change their gender role. At this point, the desire for gender reassignment measures is already very strong in most transsexual people. The change of gender role usually leads to major social problems for the person concerned, at least in the beginning. Many transsexuals additionally undergo psychological treatment on the occasion of their gender role change to obtain the necessary expert opinion for the use of medical and legal accompanying measures.

Medical treatment methods for gender reassignment include hormone therapy, surgical interventions on the genitals and other measures, such as permanent removal of the beard. In Germany, transsexual people can adjust their first name and/or the gender indication in the registry office registers to their perceived gender identity. This process, which takes many years, involves a lot of effort, as several expert opinions have to be drawn up. However, the result is that the transsexual person then lives in the gender role they feel they belong to.

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