I think that if you could get honest answers, a lot of heterosexual guys would probably admit to having had at least a passing desire to be a girl. If they were honest, they would probably admit they thought of it "when I first noticed a girl's breasts" or "when I first felt a girl orgasm with me," but of course, most men would lie and deny it for fear of impugning their masculinity.
I think that's the reason why most therapists who treat male-to-female transsexuals believe that their transsexual patients are really gay, and that their claimed transsexuality is really just a defense against powerful feelings of guilt about their homosexuality. Thus, therapists make transsexuals jump through flaming hoops such as the so-called "one-year real-life test," the requirement that a patient live as a woman and undergo intense psychotherapy for at least a year before for sexual reassignment surgery.
Therapists have incorporated this dogma into the so-called "Harry Benjamin Standards of Care." But they adopted the real-life test without any empirical evidence, based solely on their supposition that many self-described transsexuals must be liars or delusional, reasoning that: "If anyone ever asked me if I wanted to become a member of the opposite sex, I would lie. Therefore, when this purported transsexual claims to be a girl inside, and wants a sex change, he is probably lying, because that's something all men lie about."
This logic is ridiculous: who could endure the expense, pain, humiliation, discrimination, and victimization that transsexuals experience unless she really felt her outward gender was wrong? But just try telling your therapist you're transgendered, and see what he does.
The real-life test makes even more intolerable the cruel dilemma that confronts the MtF transsexual: should the transsexual attempt to pass through a life of misery masked in the outward appearance of her birth gender, or should she adapt her outward appearance to her soul's gender, and attempt to "pass" in the eyes of the outside world?
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