[The place of endocrinology in the management of transsexualism].

Transsexualism is not a sexual perversion but rather a gender identity disorder. The patient claim for his personal and public image and condition. The diagnosis problems arise from the lack of clinical, biological or hormonal typical signs. The pathogenesis is unclear but works in progress suggest somatic alterations. These alterations might be pre or perinatal hormonal changes and/or alterations in cerebral structures involved in sexual differentiation. Transsexualism is not a treatable disease using currently available treatments. Only hormonal and surgical treatments with sex reassignment might answer to the patient's request and improve his mental condition. Hormonal treatment might only prescribed after a consensus statement of about the sex reassignment of the patient and under medical follow-up. An early and strict medical follow-up of the patients by a multi specialist medical team is required and have to warrant the etic aspects. This is mostly important for the approval for sex reassignment from the authorities.