But the barriers are starting to lift on our old and very rigid binary model.
As you can see by all of my recent blog posts on the wonderful work of Harry Benjamin, he went to his death bed after a lifetime of treating close to a thousand patients knowing just as much scientifically about this condition/desire as we do today; which is to say not very much. What I have learnt in my reading about him and his published work is that he was empathetic and respectful of his patients and saw in them a bravery and dignity for dealing with this anomaly in the best way they could. He was a believer in a biological explanation that we have yet to find. He also recognized that gender dysphoria is different for each person and thus required a unique response.
There is no conclusive diagnostic exam for what some people like to call “true transsexualism” simply because there are currently no identifiable biological markers to speak of - zero. The only thing we have to rely on is the insistence on the part of the person themselves. If anyone tells you different they are misleading you.
Conversely transvestism is not as disassociated from transsexualism as some people would like to believe and is certainly more than about men wearing dresses for the sole purposes of fulfilling erotic fantasies.
I go out every evening dressed as a woman and encounter all kinds of people including gaggles of teenage girls; nothing ever happens. The other night, however two playful and slightly rude teenage girls were standing close to me in a store and one asked me loud enough for everyone nearby to hear: “Hey are you a man or a woman?”
My immediate instinct was to be miffed but then I thought the better of it and turned to them and smiled. I then continued about my business.