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“The cumulative evidence of our study. Is consistent with the view that gender dysphoria is a disorder of the sense of self as has been proposed by Beitel (1985) or Pf (1993). The central problem in our patients is about identity and the self in general and the transsexual wish seems to be an attempt at reassuring and stabilizing the self coherence which in turn can lead to a further destabilization if the self is already too fragile.

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