The gender identity movement: a growing surgical-psychiatric liaison.

The evaluation and treatment of individuals with gender identity problems has resulted in an interesting and productive collaboration between several specialties of medicine. In particular, the psychiatrist and surgeon have joined hands in the management of these fascinating patients who feel they are trapped in the wrong body and insist upon correcting this cruel mistake of nature by undergoing sex reassignment surgery. Over the last two decades, some 40 centers have emerged in which interdisciplinary teams cooperate in the evaluation and treatment of these gender dysphoric patients. The model for this collaboration began at The Johns Hopkins Hospital, where the Gender Identity Clinic began its operation in 1965 (Edgerton, 1983; Pauly, 1983). This "gender identity movement" has brought together such unlikely collaborators as surgeons, endocrinologists, psychologists, psychiatrists, gynecologists, and research specialists into a mutually rewarding arena. This paper deals with the background and modern era of research into gender identity disorders and their evaluation and treatment. Finally, some data are presented on the outcome of sex reassignment surgery. This interdisciplinary collaboration has resulted in the birth of a new medical subspecialty, which deals with the study of gender identification and its disorders.