In this author's view, an individual's wish for sexual transformation (transsexualism) does not constitute an independent diagnostic category. It is found in association with several clinical conditions and is a consequence of the inability to develop appropriate gender identity in accordance with anatomy. The transsexual desperately seeks radical surgical procedures and endocrinological treatment. In this author's opinion, however, such surgical intervention constitutes a sanctioning of the transsexual's pathological view of reality and cannot resolve the underlying conflict.Abstract Teaser