Surgery and hormonal therapy are increasingly common treatments for gender dysphoria, but the prejudice and discrimination transgender individuals face post-transition can cause significant psychological distress, says Marci Bowers, MD, a surgeon who performs gender reassignment surgery in Trinidad, Colo., and is herself transgender.

Post-change, many men and women deal with rancorous divorces, custody battles, job loss and rejection by family members, she has found. Some even commit suicide, continues Bowers, who will speak about the psychological impact of transgendersurgery at APA's 2007 Annual Convention.

"It's a wonder that anyone transitions-the penalties are so severe," she says.

Bowers wants to help dispel the myths and misperceptions surrounding transgender surgery-among them that transitioning individuals are really gay men or lesbians in denial or that they are mentally ill.

"Because dysphoria is currently listed as a psychological disorder, transgender [people] are assumed to be mentally ill," she explains. "This doesn't allow them to be treated equally, no matter how visually compelling the change is."

This stigma can have far-reaching psychological effects, Bowers says. "The transition provides great barriers to intimacy, and for a person's psychological well-being, intimacy is very important."

Psychologists can help transgender people overcome such barriers as therapists and also by researching and raising awareness about the social and economic barriers transgender people face.

--L. Meyers