Gender reassignment, changing your sex with hormones and genital surgery, has never been a step that anyone in their right mind would take lightly. Nor is it ever likely to be. Putting aside the sheer magnitude of discrimination which transsexual people know to expect, there are few things in life which are quite so irreversible.
Marriages can be annulled. Careers turned around. Even tattoos can be removed these days. When it comes to gender switching, however, the irrevocability starts long before a surgeon has reached for a scalpel. Tell someone you even just plan to switch gender roles and life is changed irrevocably from that moment.
If you doubt me then try it on your friends. Then count how many you still have tomorrow.
Non-transsexual people seem unable to conceive why anyone would take that step. Whole documentaries have made light entertainment from watching people fail miserably at being a member of the opposite sex for just one day - let alone one whole life. That alone should be a big clue to an essential difference contained in people like myself. We find that switch intuitively easy. It's the previous role that's the hard act to pull off.
For the right sort of person gender change is a path to the liberation of one's very essence. It is the thing that enables you to interact with and understand the person I am, rather the kind you'd otherwise assume me to be.
People sometimes ask if I couldn't have been just a very feminine man - or indeed whether I could have changed roles without accompanying surgery. The answer in both cases is that for some people with less intensive discord between mind and body that might work. Such people, who live full-time in their desired gender role without having surgery, call themselves transgendered rather than transsexual. Paradoxically, society often finds transgendered people harder to accept - especially anywhere near a toilet!
Personally, however, I would prefer not to have to negotiate the whole basis of how to perceive me with every new stranger who comes along. If other people's perception of your sex, and the assumptions that go with that, isn't a problem for you then why assume that I should want my existence dominated by having that argument at every turn every day?
If you can be comfortable starting our most fleeting of encounters on the same basis as you do for any other feminine spirited person, then we have a chance of understanding one-another. Negotiating the alternative kind of arrangement - in which I correct your every word, gesture and assumption - is exhausting and futile. The fact that I meet the basic criteria for perceiving me as a woman makes life easier for you - as much as it does for me.
Gender reassignment works very well when undertaken by someone who is really transsexual. In a follow-up survey earlier this year I asked 45 transpeople who had changed between 10 and 35 years ago how they felt now, looking back on the long term effects of that step. Finding them wasn't hard. Transsexual people are closely networked these days around the world. I often wonder why other researchers offer lame excuses that it is difficult to do.
All 45 respondents presented readily verifiable examples of extremely active and well-integrated lives - both at work and in their free time.
Most had permanently changed role and undergone gender reassignemnt decades ago, when public disapproval was at its worst. Many had lost a great deal in the process and had the scars to show. Significantly, however, they all said they would take the same step again if they had the chance to relive the decision. Their identity had stopped being a nagging and persistent issue every minute of their waking lives and they were set free to explore the potential that had been stifled. Some were also very candid about what would have happened to them if compelled to remain as they had been.
In a separate survey I questioned 65 people who were undergoing gender change or had completed the process within the last five years. Similarly positive evidence was offered that all of those people looked on the change as a life-enhancing move; if there was any negativity at all then it was towards medical professionals who had treated them poorly. Many had struggled against their nature for years before taking the plunge and felt that the constant itch of feeling out of place in their former role had eventually become unbearable.
In a third survey for the Guardian, I looked hard for people with actual regrets. The only two cases I could find didn't regret changing role. They regretted listening to people who had encouraged them to try to change back.
The acid test of gender reassignment lies in whether it leads from a negative prognosis to a positive one - from thoughts of suicide to happy functioning people. Alternative therapies - psychotherapy, electric shocks, exorcism have all been advocated - fail this test hands down.
How do you tell if someone is "happy" or "happier"? Objective measures include the activities and relationships which people are involved in - at work, at home and in the community. The people I've surveyed are if anything busier than average, often doing valuable work at the heart of their communities and embedded in family life. It's easy to measure and verify.
In the modern world, happiness is far from commonplace. So, if someone looks happy and says they are happier for asserting their true identity then why on earth would anyone want to oppose that?
· Christine Burns is a campaigner for the transgender lobby group Press for Change
