Disorders of gender identity: transsexualism

In this rare disorder, called transsexualism, the person has the conviction of being of the opposite sex to that indicated by the external genitalia. This is getting more and more common in Sydney. The person wishes to alter the external genitalia to resemble those of the opposite sex, and to live as a member of that sex. Most transsexuals are men; most women who cross-dress and imitate men are homosexual, not transsexual. In transsexuals, the conviction of being a woman usually dates from before puberty, but medical help is not requested until early adult life, when most transsexuals have begun to dress as women. Unlike transvestites (also called transvestitism is the practice of dressing and acting in a style or manner traditionally associated with the other sex.) they report no sexual arousal from cross dressing, and unlike the homosexuals who dress as women, they do not seek to attract people into a homosexual relationship.

Transsexual men may take a series of steps to become more like women. They practise female styles of speaking, gesturing, and walking, they remove body hair by electrolysis, they attempt to increase breast tissue by taking estrogen or by obtaining a surgical implant, and they may seek an operation to remove the male external genitalia and form an artificial ‘vagina’. Requests for such operations are often made in a determined and persistent way reflecting the person’s great distress, and may be accompanied by threats of suicide or self-mutilation if surgery is not provided. Since such threats are carried out occasionally with serious consequences, a specialist opinion should be obtained.

It might be thought that a logical treatment of transsexualism would be a psychological procedure to alter the person’s beliefs about his gender identity. No form of psychotherapy, however, has been shown to succeed in this aim. In any case, most transsexual patients reject this approach, hoping instead to alter their body to conform more closely to the gender they feel is theirs. In a few specialist centres operations with this purpose are carried out on selected patients (gender reassignment), and good results have been reported. However, there is no high quality evidence of the long-term effectiveness of the procedure.

Decisions about such treatment are therefore taken on an individual patient basis with thorough assessment, and are made jointly by an experienced psychiatrist and surgeon, in consultation with the general practitioner.

STDs and summer period

During the summer period, mostly because of the sunny and warm weather, good mood, new social and sexual contacts with different unknown persons, the number of sexual and skin infections is significantly increased. Some of the most common sexually transmitted diseases include gonorrhea, AIDS, syphilis and Chlamydia.

Rough estimates made after a scientific research on a representative sample in Australia confirms that about 15% of Australian have some sexually transmitted disease and the most vulnerable population are young people aged 16 to 26 years.

Genital warts and Chlamydia most common STDs

Many dermatologists claim that most patients complain about genital warts. Genital warts are soft warts, usually the size of a pin, elongated or cauliflower shaped. They appear on the skin and mucous membrane of the genitals in the area of the anus and sometimes on the mucous membranes of the mouth. They have to be removed by radio waves (high-frequency power) or laser. The treatment can be time-consuming and laborious and the virus that causes genital warts is particularly dangerous for women because it can cause malignant changes in the cervix.  

Doctors appeal especially to young people to take care of their sexual health because what is most dangerous is the fact that many sexually transmitted diseases usually do not show any symptoms. An additional risk is that some sexually transmitted diseases, if not detected and treated on time, can lead to infertility or malignancy. According to the data found at Public Health institutes, the most common genital infection is the one caused by the bacterium called Chlamydia. 

This disease begins to develop a week or two after the sexual intercourse with an infected person and the first symptoms are stinging, itching and burning sensation in the urethra and slightly whitish discharge. Chlamydia is treated with antibiotics. The best prevention is visiting an urologist and gynecologist at least twice a year.

What is even worse is that the hospitals have registered a significant increase in the number of patients with gonorrhea. The symptoms of gonorrhea occur within two or seven days after the person gets infected through sexual intercourse. In women, the symptoms come in the form of whitish and yellowish discharge from the vagina that can also have an unpleasant smell, then a burning sensation or pain during urination, cramps and pain in the lower abdomen.

Symptoms in men are whitish and yellowish discharge from the penis and burning sensation or pain during urination. People should also take syphilis into account. This disease can affect all tissues and all organs in the body. The symptoms of this disease vary and depend on the location of infection, the duration of infection and treatment. Any person can be diagnosed with syphilis. There is no innate or acquired immunity to this disease that can even be fatal if it is not treated.

Doctors suggest that prevention is the most important activity. Most STDs are transmitted by sexual contact without protection. The infected person should visit a doctor (women-gynecologists, men – urologists) as fast as possible. 

HIV – How to lower the risk?

The decisions you make regarding your sexual life control the risk of infection with HIV (and other similar infections). Once you know how HIV is transmitted, it is very important that you can reveal your attitude about what kind of sex you want.

How is HIV infection transmitted through sex?

HIV is a virus that can be found in body fluids of an infected person. These are the fluids that contain sufficient amount of HIV to be transmitted to other persons:

In men:

- semen

- pre-ejaculation ( a transparent fluid that is secreted from the penis when a man is sexually excited).

- blood (as well as anal mucus)

In women:

- milk

- vaginal discharge

- blood (as well as anal mucus)

If during an intercourse, any of these fluids is passed from an infected person to another, there is a great possibility of a transmission of HIV. In order for HIV infection to occur, it is necessary for the infected fluids to enter the bloodstream of another person through the sensitive and thin lining of the penis, vagina or rectum and in some cases through the lining of the mouth and throat. A person cannot become infected through sweat, tears, urine, feces and saliva (spitting).

What is actually safe sex?

Safe sex is a type of sex in which people prevent the transmission of bodily fluids from one person to another. Safe sex is an excellent way to prevent the spread of HIV and a good way to lower the risk of other sexually transmitted infections too.

Penetrative sex is sex where the penis enters the vagina, anus or mouth. In case partners are not using a barrier (condom), they can become infected with HIV. Vaginal and anal sex are the types of penetrative sex that bring the greatest risk of HIV transmission. Oral sex is penetrative sex, but it comes with a significantly lower risk of HIV infection. If you are afraid of infection via the oral cavity, you can always use a condom. In case partners are using an object (sex toy) and this object is used in both partners, this is a type of penetrative sex and it can transmit infected body fluids from one person to another. To prevent this type of transmission of infections, sex toys such as dildos and vibrators should be covered with a new condom every time they are used.

Sex without penetration is also considered to be a form of safe sex. Masturbating with a partner is a clear example of a low-risk non-penetrative sex in which many people enjoy.  

   

It is very difficult to pay attention to safety when people are under the influence of drugs and alcohol. It is much harder to talk about condoms and safe sex once the sexual intercourse has started which is why it is highly recommended to talk about this before sex. It is wrong to assume that based on someone’s years or appearance you can successfully determine whether some person has HIV or not.