# Are Transsexuals Mentally Ill? **URL:** \ **Category:** Cecil's Columns/Staff Reports\ **Created:** [August 17, 2012, 9:13am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759 "2012-08-17T09:13:00Z")\ **Posts on this page:** 20\ **Page:** 14
**Author:** ![Aji\_de\_Gallina](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aji_de_gallina/32/260_2.png) [@Aji\_de\_Gallina](https://boards.straightdope.com/u/Aji_de_Gallina)\ **Post date:** [September 12, 2012, 2:48pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/261 "2012-09-12T14:48:17Z")
> [@Una\_Persson](#): > > Yes. I am highly biased towards treating all people in general with dignity and respect, and towards vehemently defending one of the most mistreated and abused communities, transsexuals. If one is to have a “schtick”, then there are likely few more honorable to have. > > And I’m heavily biased, being an actual scientist myself, towards agreeing completely with the widely-recognized scientific consensus of the disconnect between physical and mental gender, and towards giving mental gender precedence. Something you have serious issues with for some strange reason. > > But thanks for noticing! 🙂 …and now you’re reaching for the Nobel Peace Prize, I get it. I understand that if I don’t measure to your standards, I’m the CEO of UNIT 731. If you want to martyr yourself for science (which no one here has refuted, ergo it is accepted), or treating transsexuals correctly (which no one here has said no to) or hormonal treatment (which everyone has accepted as a treatment option) or sex reasignemnt surgery (which everyone has accepted as an treatment option) or even the use of the correct pronoun (which no one here has objected to), knock yourself out, but the OP asked a question and the answer was Yes. All your ohter causes fall flat because nobody was against them. BTW; “giving precedence” is a treatment option for a mental disease to improve outcomes. ---
**Author:** ![Una\_Persson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/una_persson/32/346_2.png) [@Una\_Persson](https://boards.straightdope.com/u/Una_Persson)\ **Post date:** [September 12, 2012, 5:06pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/262 "2012-09-12T17:06:53Z")
> [@Aji\_de\_Gallina](#): > > …and now you’re reaching for the Nobel Peace Prize, I get it. No thanks; one was enough. ---
**Author:** ![Aji\_de\_Gallina](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aji_de_gallina/32/260_2.png) [@Aji\_de\_Gallina](https://boards.straightdope.com/u/Aji_de_Gallina)\ **Post date:** [September 12, 2012, 5:15pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/263 "2012-09-12T17:15:26Z")
> [@Una\_Persson](#): > > No thanks; one was enough. Apparently not, the quest is still on, the enemies haven’t been vanquished. Or was it a “nice try” Peace Prize? ---
**Author:** ![Una\_Persson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/una_persson/32/346_2.png) [@Una\_Persson](https://boards.straightdope.com/u/Una_Persson)\ **Post date:** [September 12, 2012, 5:45pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/264 "2012-09-12T17:45:40Z")
> [@Aji\_de\_Gallina](#): > > Apparently not, the quest is still on, the enemies haven’t been vanquished. > Or was it a “nice try” Peace Prize? I already responded to your initial dig with humor; if you want to continue this off-topic…whatever…take it to another forum. Oh, unofficially, of course. ---
**Author:** ![Irishman](https://avatars.discourse-cdn.com/v4/letter/i/b487fb/32.png) [@Irishman](https://boards.straightdope.com/u/Irishman)\ **Post date:** [September 12, 2012, 8:28pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/265 "2012-09-12T20:28:52Z")
> [@Aji\_de\_Gallina](#): > > I’m not ignorant on the topic. You response was that not being ignorant meant being a transsexual. To a certain degree, I think that is true. But ignorance is a matter of degrees, and I don’t know how well read you are on the topic, I don’t know how many transexuals you know personally, etc. I made a generic comment that I think most people’s objections come from fear and ignorance. If yours do not, then I guess you are an outlier. Congrats. > [@](#): > > For every other aspect, body takes precedence. > Transexuality is a disease of the mind, not the body. The body is right. I very carefully separated genitals from mental identity. I did not speak of the body. Which is more the body, the genitals or the brain? The brain is a physical organ, too, rooted in biochemistry. Right now, the evidence points at the brain biochemistry defining sexual identity based upon hormonal balances during formation. Right now, the evidence supports that sexual identity is as much rooted in physical processes as vision. (Vision is a process in the brain, that relies on inputs from the eyes. You can’t have vision without input, but the eyes can work perfectly and the brain still malfunction on vision.) Ergo, the body is right, but which part of the body? > [@](#): > > I do not accept the validity of the common concept of gender. Sex is gender. Science recognizes that there are people who have a mismatch between their self-conception of their identity and their gonads. Scientists need a way to make the distinctions in order to understand and treat this condition. So they define a concept, “gender”, and differentiate it from another concept, “sex”, so they can talk about the issues clearly and concisely. You seem to be disputing that self conception of sexual identity occurs. But you state that you are a man, and that if your brain were transplanted into a female body, or if you were drugged and surgically altered, you would still be a man. This is inconsistent. If your mind is set by who you are now, and changes to your body would not change your identity, then the concept of “gender” is real. If your “gender” is determined by your body, then if someone surgically altered your body to have female genitals, you would be a woman. Against your will, but still be a woman. You can’t have it both ways. Either gender is not real, in which case you would become a woman, and then I guess be a lesbian\*, or gender _is_ real, in which case you would still be a man in a female body, and thus in need of some form of treatment - perhaps surgery to “correct” what was done against your will. > [@Aji\_de\_Gallina](#): > > So it comes down to “should transsexuals be treated as the gender they present.” Why shouldn’t they? You claim not to be bigoted. Can you give a reason that isn’t bigoted? > [@](#): > > If John wants to be called Mary, I’ll call him Mary, but out of courtesy and not because I really think John is a woman. Okay, so if I understand you correctly, this boils down to a matter of perception. You don’t mentally accept that a person’s internal identity matters, you think that “reality” is defined by the gonads over the brain biochemistry. Therefore, conceptually, the person will always be the sex they were born rather than however they identify. Even if they get hormones early, get surgery early, look like a woman to all outward appearances, and have a vagina and breasts, you will still think they are a “man” underneath it all because their chromosomes are XY and/or their body started out with a penis and scrotum. I guess I can understand that. I have a certain mental struggle myself when I encounter someone who looks mostly masculine wearing makeup and a dress. It triggers a discombobulation, a sense of discomfort, a social awkwardness. I’m trying to remap my personal conception to think of them as female rather than male because it helps me mentally map my expectations to theirs, so I’m less likely to get confused on pronouns and the like. If I try to keep the conceptualization as “That’s a man I’m supposed to treat like a woman” I’ll get confused, whereas if I conceptualize “that’s a woman who looks like a man” I’ll be more likely to keep it straight. To me, it’s all about mental compartmentalization to create a map of expectations, how to interact. Experience breeds familiarity breeds comfort with the situation. * * * \*I’m assuming you still accept sexual orientation as different than sexual identity. ---
**Author:** ![Una\_Persson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/una_persson/32/346_2.png) [@Una\_Persson](https://boards.straightdope.com/u/Una_Persson)\ **Post date:** [September 12, 2012, 10:19pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/266 "2012-09-12T22:19:21Z")
> [@Irishman](#): > > I guess I can understand that. I have a certain mental struggle myself when I encounter someone who looks mostly masculine wearing makeup and a dress. It triggers a discombobulation, a sense of discomfort, a social awkwardness. I’m trying to remap my personal conception to think of them as female rather than male because it helps me mentally map my expectations to theirs, so I’m less likely to get confused on pronouns and the like. Would the concept of “uncanny valley” describe how you feel? ---
**Author:** ![Docta\_G](https://avatars.discourse-cdn.com/v4/letter/d/2bfe46/32.png) [@Docta\_G](https://boards.straightdope.com/u/Docta_G)\ **Post date:** [September 12, 2012, 10:52pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/267 "2012-09-12T22:52:18Z")
Yes, everyone different from you is insane, immoral, and intolerable. ---
**Author:** ![Revenant\_Threshold](https://avatars.discourse-cdn.com/v4/letter/r/f1d935/32.png) [@Revenant\_Threshold](https://boards.straightdope.com/u/Revenant_Threshold)\ **Post date:** [September 12, 2012, 11:23pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/268 "2012-09-12T23:23:45Z")
I know I am! ---
**Author:** ![John\_W.Kennedy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/john_w.kennedy/32/1031_2.png) [@John\_W.Kennedy](https://boards.straightdope.com/u/John_W.Kennedy)\ **Post date:** [September 13, 2012, 1:37am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/269 "2012-09-13T01:37:34Z")
> [@Una\_Persson](#): > > Would the concept of “uncanny valley” describe how you feel? I suppose that I, for one, might describe it so. In my 64 years I’ve known only a handful of lesbians (known to me to be so), none well, and only one transsexual (a co-worker that I barely knew enough to say “Hello” to), and so, when faced with one, I tend to feel a little—off-balance, shall I say? On the other hand, as a theatre habitué, as a semipro opera/operetta singer, and as an active participant in Oz (as in “Wizard of”) fandom, I’ve known more “out” gay men that I can count, so I’m entirely at my ease. As Jack Point says, “Use is everything.” ---
**Author:** ![RTFirefly](https://avatars.discourse-cdn.com/v4/letter/r/c77e96/32.png) [@RTFirefly](https://boards.straightdope.com/u/RTFirefly)\ **Post date:** [September 13, 2012, 2:17am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/270 "2012-09-13T02:17:35Z")
> [@Una\_Persson](#): > > Yes. I am highly biased towards treating all people in general with dignity and respect Well, _there’s_ your problem! Now if only you could get past that silly scruple, you could become a right-thinking sort of person like **Aji**! ---
**Author:** ![Una\_Persson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/una_persson/32/346_2.png) [@Una\_Persson](https://boards.straightdope.com/u/Una_Persson)\ **Post date:** [September 13, 2012, 4:57am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/271 "2012-09-13T04:57:47Z")
> [@RTFirefly](#): > > Well, _there’s_ your problem! Now if only you could get past that silly scruple, you could become a right-thinking sort of person like **Aji**! To tell the truth, I’m having some difficulty making sense of what their position actually is. I’d like to give them the benefit of the doubt based on some things they’ve written, and hope that IRL they actually would treat a trans person quite well. But there seems to be a communication gap here. ---
**Author:** ![Aji\_de\_Gallina](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aji_de_gallina/32/260_2.png) [@Aji\_de\_Gallina](https://boards.straightdope.com/u/Aji_de_Gallina)\ **Post date:** [September 13, 2012, 2:58pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/272 "2012-09-13T14:58:33Z")
This will be my last post on this thread. > [@Irishman](#): > > To a certain degree, I think that is true. But ignorance is a matter of degrees, and I don’t know how well read you are on the topic, I don’t know how many transexuals you know personally, etc. I made a generic comment that I think most people’s objections come from fear and ignorance. If yours do not, then I guess you are an outlier. Congrats. Sure, but your reply was “are you a transsexual”. My comments are not out of ignorance. > [@](#): > > I very carefully separated genitals from mental identity. I did not speak of the body. Which is more the body, the genitals or the brain? The brain is a physical organ, too, rooted in biochemistry. Right now, the evidence points at the brain biochemistry defining sexual identity based upon hormonal balances during formation. Right now, the evidence supports that sexual identity is as much rooted in physical processes as vision. (Vision is a process in the brain, that relies on inputs from the eyes. You can’t have vision without input, but the eyes can work perfectly and the brain still malfunction on vision.) If you have a male body (and normally, but not always, that means XY and penis) you are a man. > [@](#): > > Ergo, the body is right, but which part of the body? The whole body. The brain is part of the body, but perception while resideing in the body, is not a part of it > [@](#): > > Science recognizes that there are people who have a mismatch between their self-conception of their identity and their gonads. Scientists need a way to make the distinctions in order to understand and treat this condition. So they define a concept, “gender”, and differentiate it from another concept, “sex”, so they can talk about the issues clearly and concisely. Gender is a social construct, and in my opinion, useless. > [@](#): > > You seem to be disputing that self conception of sexual identity occurs. But you state that you are a man, and that if your brain were transplanted into a female body, or if you were drugged and surgically altered, you would still be a man. This is inconsistent. If your mind is set by who you are now, and changes to your body would not change your identity, then the concept of “gender” is real. If your “gender” is determined by your body, then if someone surgically altered your body to have female genitals, you would be a woman. Against your will, but still be a woman. You can’t have it both ways. Either gender is not real, in which case you would become a woman, and then I guess be a lesbian\*, or gender _is_ real, in which case you would still be a man in a female body, and thus in need of some form of treatment - perhaps surgery to “correct” what was done against your will. I’ve given enough examples, I wuill not repeatr them. I’m sorry if they are not clear enough or if you can’t understand them. > [@](#): > > Why shouldn’t they? You claim not to be bigoted. Can you give a reason that isn’t bigoted? Read my “John-Mary” posts. > [@](#): > > Okay, so if I understand you correctly, this boils down to a matter of perception. You don’t mentally accept that a person’s internal identity matters, you think that “reality” is defined by the gonads over the brain biochemistry. Therefore, conceptually, the person will always be the sex they were born rather than however they identify. Even if they get hormones early, get surgery early, look like a woman to all outward appearances, and have a vagina and breasts, you will still think they are a “man” underneath it all because their chromosomes are XY and/or their body started out with a penis and scrotum. > [@](#): > > ## I guess I can understand that. I have a certain mental struggle myself when I encounter someone who looks mostly masculine wearing makeup and a dress. It triggers a discombobulation, a sense of discomfort, a social awkwardness. I’m trying to remap my personal conception to think of them as female rather than male because it helps me mentally map my expectations to theirs, so I’m less likely to get confused on pronouns and the like. If I try to keep the conceptualization as “That’s a man I’m supposed to treat like a woman” I’ll get confused, whereas if I conceptualize “that’s a woman who looks like a man” I’ll be more likely to keep it straight. To me, it’s all about mental compartmentalization to create a map of expectations, how to interact. Experience breeds familiarity breeds comfort with the situation. > > \*I’m assuming you still accept sexual orientation as different than sexual identity. No struggle, no uncanny valley. If a two-armed person wants me to traet him as if he had only one, I’ll do it. He still has two, though. > [@RTFirefly](#): > > Well, _there’s_ your problem! Now if only you could get past that silly scruple, you could become a right-thinking sort of person like **Aji**! > [@Una\_Persson](#): > > To tell the truth, I’m having some difficulty making sense of what their position actually is. I’d like to give them the benefit of the doubt based on some things they’ve written, and hope that IRL they actually would treat a trans person quite well. But there seems to be a communication gap here. I fboth of you get from the thread that I wouldn’t treat a person with dignity and respect, then there is nothing more I can do that’ll convince you. ---
**Author:** ![Irishman](https://avatars.discourse-cdn.com/v4/letter/i/b487fb/32.png) [@Irishman](https://boards.straightdope.com/u/Irishman)\ **Post date:** [September 13, 2012, 6:50pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/273 "2012-09-13T18:50:05Z")
> [@Una\_Persson](#): > > Would the concept of “uncanny valley” describe how you feel? That’s fairly accurate. It captures a similar kind of discomfort. The signals are self-contradictory, and not fitting into the expected niche. Ergo, social discomfort. > [@John\_W.Kennedy](#): > > I suppose that I, for one, might describe it so. In my 64 years I’ve known only a handful of lesbians (known to me to be so), none well, and only one transsexual (a co-worker that I barely knew enough to say “Hello” to), and so, when faced with one, I tend to feel a little—off-balance, shall I say? On the other hand, as a theatre habitué, as a semipro opera/operetta singer, and as an active participant in Oz (as in “Wizard of”) fandom, I’ve known more “out” gay men that I can count, so I’m entirely at my ease. As Jack Point says, “Use is everything.” That is exactly my point. If you encounter early in life and deal with regularly people who have differences, you figure out how to fit them into your mental map and how to deal with them. But if you encounter someone else with a different difference, then that is more awkward because you don’t have a place for them. > [@Aji\_de\_Gallina](#): > > Sure, but your reply was “are you a transsexual”. > My comments are not out of ignorance. That was me conceding the point. > [@](#): > > If you have a male body (and normally, but not always, that means XY and penis) you are a man. As I said, you are defining “male body” by genes and genitals, and ignoring any brain chemistry as “not the body”. > [@](#): > > Gender is a social construct, and in my opinion, useless. Your opinion is useless to the scientists, counselors, and patients who actually have to deal with the topic. > [@](#): > > I’ve given enough examples, I wuill not repeatr them. I’m sorry if they are not clear enough or if you can’t understand them. As I just explained your position in detail, I do understand. If you do not agree with the implications, then you need to examine your position more carefully. Or expalin where my analysis is incorrect. > [@](#): > > Read my “John-Mary” posts. I have read the posts; they do not answer the question. Actually, you have stated that you will treat them as the gender they present, out of courtesy, not out of conviction. I can accept that answer. But it doesn’t address the question: is there a non-bigoted reason to not treat them as the gender they present? I am trying to give you the benefit of the doubt here, to assume you have no ill will toward transexuals, but that it is merely a matter of definitions. It is easy to assume the other person has a hidden motivation for the definitions they choose, but I am trying to take it that it is just your perception, not a judgment. I can see why you might be frustrated at people implying motives on your part that you don’t feel. ---
**Author:** ![Powers](https://avatars.discourse-cdn.com/v4/letter/p/edb3f5/32.png) [@Powers](https://boards.straightdope.com/u/Powers)\ **Post date:** [September 13, 2012, 7:35pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/274 "2012-09-13T19:35:24Z")
> [@Una\_Persson](#): > > Are you certain you read it right? Let me quote it: > > How do the two “my’s” in the quote not signify clearly and unambiguously that Serano is talking about herself and her Y chromosomes and her body? Yes, I read it right. Clearly she’s talking about her body, and her chromosomes, but it carries the connotation of “I don’t want these Y chromosomes because Y chromosomes are lame-ass”, rather than “MY PERSONAL Y chromosomes are lame-ass because they’re in my body instead of not”. Perhaps I interpret the connotation differently because I possess Y chromosomes myself, and I don’t think they’re at all lame-ass. Powers &8^] ---
**Author:** ![Una\_Persson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/una_persson/32/346_2.png) [@Una\_Persson](https://boards.straightdope.com/u/Una_Persson)\ **Post date:** [September 13, 2012, 7:58pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/275 "2012-09-13T19:58:48Z")
> [@Powers](#): > > Yes, I read it right. Clearly she’s talking about her body, and her chromosomes, but it carries the connotation of “I don’t want these Y chromosomes because Y chromosomes are lame-ass”, rather than “MY PERSONAL Y chromosomes are lame-ass because they’re in my body instead of not”. We’ll have to agree to disagree on this point, I fear. > [@](#): > > Perhaps I interpret the connotation differently because I possess Y chromosomes myself, and I don’t think they’re at all lame-ass. I agree that is a very valid possibility. ---
**Author:** ![Inner\_Stickler](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/inner_stickler/32/318_2.png) [@Inner\_Stickler](https://boards.straightdope.com/u/Inner_Stickler)\ **Post date:** [September 13, 2012, 8:03pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/276 "2012-09-13T20:03:23Z")
Well, I possess a y-chromosome and I didn’t feel maligned by it. It seemed clear to me that she was speaking of her experience and not generalizing to the population as a whole. ---
**Author:** ![Powers](https://avatars.discourse-cdn.com/v4/letter/p/edb3f5/32.png) [@Powers](https://boards.straightdope.com/u/Powers)\ **Post date:** [September 14, 2012, 3:11pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/277 "2012-09-14T15:11:24Z")
> [@Una\_Persson](#): > > We’ll have to agree to disagree on this point, I fear. No need to fear, since I never tried to claim it was the only possible interpretation; merely that it was a valid one. Powers &8^] ---
**Author:** ![Powers](https://avatars.discourse-cdn.com/v4/letter/p/edb3f5/32.png) [@Powers](https://boards.straightdope.com/u/Powers)\ **Post date:** [September 19, 2012, 8:52pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/278 "2012-09-19T20:52:53Z")
Relevant to this topic: **Oklahoma judge refuses to let men planning sex-change operations have feminine names** > [@](#): > > “A so-called sex-change surgery can make one appear to be the opposite sex, but in fact they are nothing more than an imitation of the opposite sex,” the judge wrote in a seven-page order last year. > > “Here, petitioner has not even had the surgery by which his sex purports to be changed. Thus, based on the foregoing and the DNA evidence, a sex change cannot make a man a woman or a woman a man all of which, the Court finds is sufficient in and of itself to deny petitioner’s request for a name change,” Graves wrote. > > “To grant a name change in this case would be to assist that which is fraudulent,” Graves wrote. “It is notable that Genesis 1:27-28 states: ‘So God created man in his own image, in the image of God created he him; male and female created he them. And God blessed them, and God said unto them, be fruitful, and multiply, and replenish the earth …’ The DNA code shows God meant for them to stay male and female.” > > The judge also wrote about not wanting to be “complicit in legitimizing sex changes through changes of names.” Read more: [oklahoman.com: Local News, Politics & Sports in Oklahoma City, OK](http://newsok.com/oklahoma-judge-refuses-to-let-men-planning-sex-change-operations-have-feminine-names/article/3710063#ixzz26x1t61rE) Powers &8^] ---
**Author:** ![DocCathode](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/doccathode/32/18773_2.png) [@DocCathode](https://boards.straightdope.com/u/DocCathode)\ **Post date:** [September 19, 2012, 9:36pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/279 "2012-09-19T21:36:08Z")
Besides all else, I’m positively thrilled when rather than citing case law, a judge cites the Bible. ---
**Author:** ![John\_W.Kennedy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/john_w.kennedy/32/1031_2.png) [@John\_W.Kennedy](https://boards.straightdope.com/u/John_W.Kennedy)\ **Post date:** [September 19, 2012, 10:47pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/280 "2012-09-19T22:47:56Z")
For God’s sake, why hasn’t this flagrant traitor been impeached? [Previous page](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759.md?page=13) [Next page](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759.md?page=15)