English transcript

What people don't really understand, at least we're having great difficulty understanding it,

is that it's not a free choice, it's not a moral issue. And in years past we've always treated

these things as if they were moral and if you punish people enough they could change. But I'm

very fond of saying over and over again, it's just like your native language. It's not there the day

you're born and when you get it, it gets glued in and you cannot pull it apart. And the same is true

with your gender identity and role. Once it gets fixed, it's extremely fixed. And that is a major

lesson that we have to learn about transsexuals. That they can't change by voluntary choice. And so

to be as decent and humane as possible, we attempt to see how well they can be adjusted in society,

in spite of the fact that what their brain and their mind is telling them is different than

what their sex organs down between their legs is telling them, and us.

Transsexuality is not a free choice. Homosexuality is not a free choice either. Sexual oddities, let's put it that way, are also not a free choice.

On a certain day, you meet someone like that. There's no way you can change that. One of the most important

things is that your sexual origins are fixed for eternity, as long as you live. And the critical period for gender identity, and probably

also for other things that people call sexual oddities, is most likely the first three to five years of your life.

After that, it can't be changed. There are several parallels in the medical field of similar processes. Before birth, your

hormones were what you wanted, but you can't change them anymore. And in a similar way, gender identity is created.

Once it's fixed, there's nothing more to do about it. And experience has shown that people who seek psychiatric help

to get rid of a gender identity problem, that can't be achieved, because it's just fixed. It doesn't mean that

psychiatric help can't be useful, to show them how it went wrong, and how they need to move on. As John Mennie often says,

it's a kind of revalidation process. People end up in an enormously handicapped situation. And what medicine can still do, is to

help them to move on as best they can in their lives. To offer them the maximum help they need, to lead a happy life,

with this handicap that they have experienced in the first years of their lives, as we all want to do in medicine.