Doctors are trained to treat people according to the sex designation on a piece of paper. This is the birth certificate. At birth, the baby is assigned it's sex by, until recently*, a male doctor. This doctor then determines the sex of the newly born infant by noting the presence or absence of a penis. This then, determined the sex and was printed upon the infant's birth certificate. For this child, sex is now 'carved in stone' as far as the State is concerned and cannot be changed except by petition of the courts. Some cities (NYC) and some States (Penn.) will never change the designation of sex by the original doctor although some may make an 'amended' birth certificate only after proof of sexual-reassignment surgery. Those who choose not to have this surgery, for whatever reason, can
never have the sex designation changed. How the sex is listed on this piece of paper determines everything in this child's life: how they are treated (what dress and toys are bestowed upon them by the family, or accepted by society), what educational and job opportunities are presented to them, who they are 'allowed' to marry. This list will go on.
As far as I know, there is no known cause for transgender/transsexualism. The doctor/patient stigma of the transgender person begins at birth, when a doctor assigned the sex without first consulting the child, who would then have to wear that sex for life. As anyone can see, there is no way the doctor can ask the child what sex it is, but could there also not be a rush to decide such a vital decision? Should we not observe the child for a while before setting a designation that is so life-long as sex 'in stone'?
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*For recently, I mean within the last thirty years.
To start to read up about transgender/transsexual people I would first suggest reading about how psychological community treats the transgender/transsexual on the
Harry Benjamin website. After familiarizing with the standards of care that the medical community provides in this field, check out
a 'gender center' nearby to fill in the gaps.
I hope this post helps clear up any confusion.