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One of the hallmarks of mental health is to accept the circumstances in life that cannot change, which is why a man who claims to be Napoleon is deemed mentally unstable. One of the goals of any psychiatrist would be to guide that would-be Napoleon to accept the fact that he is not Napoleon. Sexual identity is fixed at birth: a person who is born biologically as a male or female — with the rare exception of those born with sex chromosome disorders — is male or female, and always will be, regardless of his or her so-called “gender identity”. Any “sex change” operation, no matter how skillful or elaborate, does not change that fact, a fact that is evident in every one of the trillions of cells in the transsexual’s body, which will still show as being XX (female) or XY (male) under a microscope… – Gregg B.