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Transsexuals fall into two groups: primary and secondary. The former are transsexuals throughout the course of their development; the latter are effeminate homosexuals and transvestites who become transsexuals under stress. The authors delineate the syndrome of primary transsexualism. They present clinical examples and discuss gender identity, family history, childhood development, clinical course, and personality structure.
Person et al. (Tue,) studied this question.