The man wearing the Adidas hooded sweatshirt just paid a prostitute $20 for a dome job that lasted about 40 minutes. After the session was over and she stepped out into the light, he realized that she was a he and things got real.
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Trans people experience a gender identity that is inconsistent with, or not culturally associated with, their assigned sex, and desire to permanently transition to the gender with which they identify, usually seeking medical assistance (including hormone replacement therapy and other sex reassignment therapies) to help them align their body with their identified sex or gender. Transsexual is generally considered a subset of transgender, but some transsexual people reject the label of transgender. A medical diagnosis of gender dysphoria can be made if a person expresses a desire to live and be accepted as a member of their identified sex, and if a person experiences impaired functioning or distress as a result of their gender identity.Norman Haire reported that in 1921, Dora R of Germany began a surgical transition, under the care of Magnus Hirschfeld, which ended in 1930 with a successful genital reassignment surgery. In 1930, Hirschfeld supervised the second genital reassignment surgery to be reported in detail in a peer-reviewed journal, that of Lili Elbe of Denmark. In 1923, Hirschfeld introduced the (German) term “Transsexualismus”, after which David Oliver Cauldwell introduced “transsexualism” and “transsexual” to English in 1949 and 1950.
Cauldwell appears to be the first to use the term to refer to those who desired a change of physiological sex. In 1969, Harry Benjamin claimed to have been the first to use the term “transsexual” in a public lecture, which he gave in December 1953. Benjamin went on to popularize the term in his 1966 book, The Transsexual Phenomenon, in which he described transsexual people on a scale (later called the “Benjamin scale”) of three levels of intensity: “Transsexual (nonsurgical)”, “Transsexual (moderate intensity)”, and “Transsexual (high intensity)”. In his book, Benjamin described “true” transsexualism as the following: True transsexuals feel that they belong to the other sex, they want to be and function as members of the opposite sex, not only to appear as such. For them, their sex organs, the primary (testes) as well as the secondary (penis and others) are disgusting deformities that must be changed by the surgeon’s knife.
Benjamin suggested that moderate intensity male to female transsexual people may benefit from estrogen medication as a “substitute for or preliminary to operation.” Some people have had SRS but do not meet the above definition of transsexual (e.g. Gregory Hemingway). Other people do not desire SRS although they meet the other element’s of Benjamin’s definition of a “true transsexual”. Transsexuality was included for the first time in the DSM-III in 1980 and again in the DSM-III-R in 1987, where it was located under Disorders Usually First Evident in Infancy, Childhood or Adolescence. Beyond Benjamin’s work, which focused on male-to-female transsexual people, there are cases of the female to male transsexual, for whom genital surgery may not be practical. Benjamin gave certifying letters to his MTF transsexual patients that stated “Their anatomical sex, that is to say, the body, is male. Their psychological sex, that is to say, the mind, is female.” After 1967 Benjamin abandoned his early terminology and adopted that of “gender identity.