It should be emphasised that transsexualism itself is not a psychiatric disorder, although it may be a contributory factor for other psychiatric conditions such as depressive conditions. Furthermore, some delusional conditions may mimic transsexualism, making diagnosis by a Consultant Psychiatrist experienced in gender identity issues advisable.
Transsexuals vary greatly in their need for counselling or psychiatry. At one extreme, one could see a patient who has detailed knowledge of the condition, has planned exactly how she intends to deal with it, and only requires the diagnosis to be confirmed by a Consultant Psychiatrist who will start her on the appropriate treatment.
Conversely, a patient might have a severe depressive disorder and a history of suicide attempts and might need extensive support from a counsellor and/or psychiatrist before or during their gender role changeover. They may also be uncertain as to whether they are genuinely transsexual or not.
Patients with severe psychiatric problems associated with their GID should be referred to a psychiatrist experienced in transsexual issues. Other patients will probably find the services of a counsellor sufficient, again it must be emphasised that it is important to refer patients to a counsellor experienced in transsexual issues. Attempting a psychiatric 'cure' on a genuine transsexual is disastrous and must be avoided at all costs; an experienced gender counsellor will be able to help the patient explore her own issues and experiences and decide for herself whether she is indeed a genuine TS who should undergo sex reassignment, or if she is in fact a transvestite who merely requires support in learning to accept her own nature.