Transsexuals are unique in the Rainbow. They must, as part of their search for identity, seek out medical intervention in the form of therapy and surgery. For most transsexuals, this search is not done in the wilderness. As a group, one distinguishing feature of transsexual patients is that they know their material. Fully eighty per cent, perhaps more, have read much and some all of the professional information available. Many know more than those that treat them. It is a situation of self-diagnosis followed by confirmation by professionals.

As there is no known physical marker for a transsexual, the therapist must rely upon what is told to them by the patient. The patient, in the case of a transsexual, knows what the therapist is looking for either from reading, the Internet, or word of mouth.

Adding to the complexity of this mandated relationship, the therapist is designated by the "Standards of Care" to both treat the transsexual and to serve as "gatekeeper" for further, and patient desired, treatment. Simply, unless the therapist is convinced that the patient is a transsexual, further care, from hormones to surgery, are not permitted.

This complex patient/therapist relationship is a large part of the transsexual pattern. Several small volumes have been written on Gender Loving Care (Ettner) and Transgender Care (Israel, et al.et al) which offer but a small taste of the evolving clinical practice. Lev's book, by comparison, is a complete text that retains compassion and clinical perspective.

In addition, Lev carries on from transsexual to gender variant in all it's forms as well as family and friends. She adds one chapter for youth and another for the special issues that are faced by the intersexed.

Of all parts of the relationship, the most debated is the issue of "lying". After all, the patient wants the treatment, and knows that only by mirroring the known clinical guidelines will he or she be able to proceed, and that depends on the judgement of the therapist.

The tension of such a relationship is obvious. Lev discusses this at length, citing any known study and providing practical and valid uggestions for treatment that avoid the stigma of "lying". She very correctly points out that when any of us try to tell the story of our lives, we stress certain elements and omit others, the process is a normal one. Then she goes on, accepting this, to explain the role of the therapist in directly assessing this inner journey.

A very lucid and thickly packed book that should be on your therapist's shelf, and yours as well if you wish to understand this strange drive shared by those who are gender variant.

While the intended readers are those in the helping professions, relatives, the patients themselves, and even friends could gain understanding by reading this very informative book. It is by far the best of such therapy guides to appear in print.

When transsexuals enter transition, we affect the lives of those close to us. In far too many cases, those close to us seek distance and often leave our lives altogether.

This is especially so for family members. Far from finding the "unconditional love" that parents are assumed to have for children, many transsexuals find parents, siblings and others abandon them. In fact, it seems that parents will stand by a son who becomes a mass murderer or rapist, but abandon totally a transsexual child.

Polare is published in Australia by The Gender Centre Inc. which is funded by the Department of Community Services under the S.A.A.P. Program and supported by the N.S.W. Health Department through the AIDS and Infectious Diseases Branch. Polare provides a forum for discussion and debate on gender issues. Advertisers are advised that all advertising is their responsibility under the Trade Practices Act. Unsolicited contributions are welcome, though no guarantee is made by the Editor that they will be published, nor any discussion entered into. The editor reserves the right to edit such contributions without notification. Any submission which appears in Polare may be published on our internet site. Opinions expressed in this publication do not necessarily reflect those of the Editor, The Gender Centre Inc.I, the Department of Community Services or the N.S.W. Department of Health.