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The transsexual (TS) male or female is deeply unhappy as a member of the sex (or gender) to which he or she was assigned by the anatomical structure of the body, particularly the genitals. To avoid misunderstanding: this has nothing to do with hermaphroditism. The transsexual is physically normal (although occasionally underdeveloped). These persons can somewhat appease their unhappiness by dressing in the clothes of the opposite sex, that is to say, by cross-dressing, and they are, therefore, transvestites too. But while "dressing" would satisfy the true transvestite (who is content with his morphological sex), it is only incidental and not more than a partial or temporary help to the transsexual. True transsexuals feel that they belong to the other sex, they want to be and function as members of the opposite sex, not only to appear as such. For them, their sex organs, the primary (testes) as well as the secondary (penis and others) are disgusting deformities that must be changed by the surgeon’s knife. This attitude appears to be the chief differential diagnostic point between the two syndromes (sets of symptoms) - that is, those of transvestism and transsexualism. No genetic cause has as yet been proved for any transsexual manifestation. In a few rare cases of the Klinefelter syndrome, being complicated by transsexualism (or vice versa), the usual genetic fault was found, the patients showing 47 chromosomes (instead of the normal 46), with a chromosomal constellation of XXY instead of XY. At the same time, there were the usual clinical findings (see Chapters II and III). All transsexual patients without complicating disorders so far reported showed a normal chromosomal sex. (Harry Benjamin).
Anchersen quotes Kallmann from his studies of homosexual twins as follows: "In 40 monozygotic pairs of twins there was not only a complete

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