IN THE treatment of the transsexual the clinician faces unique problems. This is especially true for the adolescent transsexual who finds himself in conflict inwardly because of the impact of pubertal development which he does not want, and outwardly because of the opposition of his family and society to his cross-gender aspirations. Problems arise for therapists in diagnosing the disorder in adolescence, in conceptualizing the nature of transsexualism and its development, and in providing a feasible and humane treatment program. The following report, based on the study of child, adolescent, and adult transsexuals at the Gender Identity Research and Treatment Clinic of UCLA, offers one approach to these difficulties.

Transsexualism is a unique condition in which an individual of one sex, because of a profound identification with the opposite sex, chooses to live his life as a member of that sex.¹ The male transsexual feels inwardly like a woman