Transgender activism is based on the premise (or claim) that a person who feels they have been "born into the wrong body" has a right to a sex change. Through cosmetics, grooming, clothing and an official name change, such a person can adopt the opposite sex's gender role.
The link between seeking a sex change and sexual orientation is hotly disputed in the political arena of Western countries, where sex changes have had the most attention and debate. The medical field has established the mental disorder of Gender identity disorder in order to establish a diagnosis for treatment of people seeking to get a sex change. Many people use this medical diagnosis, in order to justify sex change therapies, but the treatment of a psychiatric condition by giving in to a patient, as well as treating them with physical surgery are the most contraversial issues.
J. Michael Bailey, a psychology professor and sex researcher at Northwestern University, published a book called The Man Who Would Be Queen which sharply disagrees with commonly proposed transsexual models. Dr. Bailey argued that sex changes are motivated primarily by sexual interests and not by the idea of a gender identity of one sex in the body of the other.
Dr. Alice D. Dreger wrote:
- In his work on transsexualism, Blanchard argued that there are actually two types of male-to-female transsexuals, with autogynephiles being one type and “homosexual transsexuals” being the other. ... he argued that male-to-female homosexual transsexuals who opt to undergo sex reassignment do so, in part, because being a woman makes more sense than trying to live as a very effeminate man attracted to heterosexual men.
While critical of the common transsexual model, Bailey states in his book that he believes sex changes should be performed. Homosexual transsexuals being extremely effeminate to begin with come into constant conflict against society's expectations, although after taking up the gender roles of a woman, they are then able to express themselves more naturally, and typically integrate with society better afterwards. Autogynephiles though, do not integrate better with society after changing to a woman, however the empirical evidence shows a typical positive change in the person's mental health, despite their regressing from general society.