Transsexual surgery at 74: a case report.

An unusual case of transsexualism is presented involving an elderly male who had been happily married for 37 years. Sexual history was entirely heterosexual, with a low rate of fetishistic masturbation. Lifelong weak fantasies of becoming a woman were reported but did not lead to transvestic behavior until 10 years after the death of his wife. Social variables, role models, and other external influences are discussed that seem to have contributed to his transsexual "choice" at age 74.