title: Increasingly Ruth: toward understanding sex reassignment.
abstract: Both the clinician and the patient present accounts of a 44-year-old male's search for a comfortable gender identity. The juxtaposition of these two perspectives illustrates many of the dilemmas inherent in the therapy of gender dysphoria. Ruth underwent sex reassignment surgery in 1976--one year after the assumption of a full-time female gender role. Six months after surgery, she made a serious suicide attempt. At age 50, she has now consolidated her feminine gender identity and has become a thoughtful, unusually honest, articulate person. The physician's "objective" and the patient's retrospective perspectives provide evidence of the psychodynamic nature of transsexualism and the limitations of evaluation criteria for sex reassignment surgery.
mesh_terms: D000328:Adult; D005783:Gender Identity; D006801:Humans; D007062:Identification, Psychological; D008297:Male; D012917:Social Adjustment; D014189:Transsexualism / Q000523:psychology / Q000601:surgery*