I don't get it.

By far, not an expert here. However, my understanding of transgendered is NOT that they desire to be the other sex, they already feel they are the other sex. From my limited understanding (and there are disagreements within the medical community), we are hard-wired in our brain to be who we are. I believe there can be chromosome abnormalities and lead to the belief that trans people are the "wrong" sex. You say there is no changing biological make-up. That biology not only lives in our bodies (vagina vs. penis) but in our brains. There are children who believe they are the wrong sex and know that from an early age.

You may find this interesting:

Australian DNA study during 2008:

Australian researcher Professor Vincent Harley has led an Australian-American study of transsexuality. He acknowledges that the cause(s) of transsexuality have been debated for years. He said:

"There is a social stigma that transsexualism is simply a lifestyle choice. However our findings support a biological basis of how gender identity develops."

He was the lead researcher in the an Australian-American genetic study of transsexuals -- the largest to date. Included were several research groups in Melbourne Australia and in the University of California in Los Angeles (UCLA). It was funded by the National Health and Medical Research Council in Australia, and the National Institutes of Health in the U.S.

They compared DNA from 112 MTF (male-to-female) transsexuals with DNA from 250 males who did not experience gender dysphoria. Results of the study were published in the 2008-OCT-27 edition of the journal Biological Psychiatry.

The researchers found that the transsexual subjects were more likely to have a longer version of the androgen receptor gene in their DNA.

Lauren Hare, a researcher at Prince Henry's Institute said:

"We think these genetic differences might reduce testosterone action and under-masculinize the brain during fetal development."

Professor Harley said:

"Studies in cells show the longer version of the androgen receptor gene works less efficiently at communicating the testosterone message to cells. Based on these studies, we speculate the longer version may also work less efficiently in the brain." 1

Commenting on the lives of transsexuals, Prof. Harley said:

"It's a very tough condition. These people are often on the margins of society, are ostracised, poor, unemployed. It's not something you would want to choose yet still some people think it's a choice when it's more likely transsexuals are born like that." 6

The report stated:

"It is possible that a decrease in testosterone levels in the brain during development might result in incomplete masculinisation of the brain in male to female transsexuals, resulting in a more feminised brain and [later] a female gender identity."

Terry Reed from the Gender Identity Research and Education Society said:

"This study appears to reinforce earlier studies which have indicated that, in some trans people, there may be a genetic trigger to the development of an atypical gender identity."

"However, it may be just one of several routes and, although it seems extremely likely that a biological element will always be present in the aetiology of transsexualism, it's unlikely that developmental pathways will be the same in all individuals."

Researcher Trudy Kennedy, director of the Monash Gender Dysphoria Clinic, said the study supported previous evidence that genetics and brain gender were important in transsexuality. She said:

"This is something that people are born with and it's certainly not a lifestyle choice as some have suggested."

A Ground Report article commented on the conflict over the causes of transsexuality:

"People develop an inner sense of being male or female from an early age but transsexuals identify with a physical sex opposite to their biological sex. Some theories suggest some causes that include psychosocial factors including dysfunctional family dynamics and traumatic childhood experiences. But research is increasingly implicating biological factors including family history and genetics."

"The present study would disapprove the social stigma that trans-sexualism is simply a lifestyle choice; the findings support a biological basis of how gender identity develops." 2

Julie Peters is one of the MTF transsexuals who took part in the study. She said that at the age of three or four years, she was aware that she did not behave as a typical boy. She said:

"I have always had the personality of a girl, I suppose is the way I perceive it and even from a very young age, three or four, I was really mad at people for making me a boy. ... I personally think it (gender) is a combination of both (nature and nurture). You are born with a predisposition to have a certain personality and then depending on the culture you are brought up in your personal situation it becomes active in a particular way." 3

Researchers are now planning to replicate the study with twice the number of volunteers. It will also examine investigate whether other genes are involved.

Demetris Taylor, a reader of the Ground Report article, posted his concern over this type of research:

"It is truly amazing that this research is upon us. My fear is those 'mad scientists' may take this information and begin to play God will begin to find ways of CHANGING the "TRANS-baby" and perfect the child according to what society says is NORMAL............I would love to see more conclusive information about this study and read the DEFINITES they conclude." 1 (Capitals in the original).

Trans people can have mental illnesses as well. And being picked on/alienated/misunderstood most of your life would not help.

My trans friend says the key is hormones, when she took those she finally felt OK. She is now post-op and living happily and embracing a new career as an artist. My friend is highly intelligent, extremely witty and in no way mentally ill.

So yes, medication in the form of oestrogen is helpful for MTF, and testosterone for FTM.

Trans people can have mental illnesses as well. And being picked on/alienated/misunderstood most of your life would not help.

My trans friend says the key is hormones, when she took those she finally felt OK. She is now post-op and living happily and embracing a new career as an artist. My friend is highly intelligent, extremely witty and in no way mentally ill.

So yes, medication in the form of oestrogen is helpful for MTF, and testosterone for FTM.

As someone who's gone through the entire process, I can tell you that it's no walk in the park. Several years ago, the insurance companies made it very difficult, if nigh impossible, to have the surgery covered under an insurance policy that claims to cover trans/intersex surgery. They did so because they wanted to rule out/sift out/weed out all the people who did not fit their profile of what a "real" trans/intersex patient is supposed to be. They were the gatekeepers and a lot of transgender people hated this because they did not qualify. A lot of my peers looked at me and said "why did YOU get approved and not me?"

Nowadays, it seems that insurance companies relaxed a lot of the requirements and many more trans/intersexed people are allowed to get the surgeries they "need" (quotes because some of these people are the very ones you read about who seem to have regrets after transitioning). The point of the gatekeeping is there's supposed to be a weed out process to prevent people from having regrets. No insurance company wants to pay surgeons money for surgeries that ultimately fail to achieve what they're supposed to "cure." Some people have way too many psychological problems that need to be addressed before they can even deal with the issue of transition. I've told many people "If your life sucks as a man, it's going to suck as a woman, too," but people never listen.

Even if you get all of the psychological problems addressed, there are the physical problems, too. Some people just don't fit into everyone's profile of what a woman is supposed to look like. It's partially subjective, but very real and many trans/intersex people ignore these issues for some reason. This might also lead to regrets. I believe this is why some trans/intersex women continue therapy after transition, to cope with any possible negative outcomes from the transition process.