Abstract
Transsexualism (TS) is a mismatch between sexual auto-identification and biological and genetic sex.
 This is a rather rare pathology. According to most authors. male TS significantly prevails over female (3:1 ratio).
 Over the period from 1980 to the present, we have observed 149 patients with TS, including 124 with female TS (transgender women and men) and 20 with male TS (transgender men and women). According to our observations, female TS prevails over male in a 3:1 ratio, which is at variance with data from researchers in other countries. The question of the reasons for this discrepancy remains to be answered.
 The essence of the TS is still completely unclear. However, attempts to interpret the pathogenesis of TS from a purely psychiatric perspective, that is, within the framework of a depersonalization syndrome, are now completely abandoned. Recently, much attention has been paid to genetic and endocrine factors that can create the prerequisites for the development of TS.
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