Sex and gender can be considered in biological and cultural ways. Typically, a biological male has a penis and testes. A biological female has a vagina and ovaries. Gender is rooted more in culture and environment. Most cultures have social customs and activities that are associated with males and females. For example, children may be given certain gender-specific toys to play with. In some cultures, this might mean toy cars and trucks for boys and dolls and dress-up clothes for girls. Likewise, the children might be raised to take on certain roles — or have certain expectations — as adults, based on their gender. In general terms, the word transgender refers to people who identify differently from their biological sex. For example, a transgender person who is biologically female may feel that a male identity is a better fit and take the following steps:.
Historically, studies assumed that transgender sexuality might be distinct from traditional human sexuality. For much of the 20th century, what was described as "transsexualism" was believed to be sexual in nature,   and so was defined along these terms. Like other people, transgender people exhibit the full range of possible sexual orientations and interests,  including the potential for a lack of sexual attraction. Historically, clinicians labeled trans people as heterosexual or homosexual relative to their sex assigned at birth. To avoid confusion, particularly with non-binary gender , the terms " gynesexual " and " androsexual " are sometimes used to describe attraction to women and men, respectively. Psychiatrist Richard Green , in an appendix to Harry Benjamin 's The Transsexual Phenomenon , considers people assigned male at birth who have adopted a more feminine gender role.
Male-to-Female MtF gender affirmation surgery GAS comprises the creation of a functional and aesthetic perineogenital complex. This study aimed to evaluate the effect of GAS on sexuality. We retrospectively surveyed all MtF transsexual patients who had undergone GAS with penile inversion vaginoplasty at the Department of Urology, University Hospital Essen, Germany, between and In total, we received completed questionnaires after a median of 5. Of the study participants, Of those who had sexual intercourse, Most patients were satisfied with the sensitivity of the neoclitoris
Transsexual people experience a gender identity that is inconsistent with, or not culturally associated with, their assigned sex and desire to permanently transition to the gender with which they identify, usually seeking medical assistance including hormone replacement therapy and other sex reassignment therapies to help them align their body with their identified sex or gender. Transsexual is a subset of transgender ,    but some transsexual people reject the label of transgender. Norman Haire reported that in ,  Dora R of Germany began a surgical transition, under the care of Magnus Hirschfeld , which ended in with a successful genital reassignment surgery.