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Many transsexual people also desire various types of medical alterations to their bodies.These physical alterations are collectively referred to as sex reassignment therapy and often include hormones and sex reassignment surgery.If untreated, it can lead to mental and emotional problems, and sometimes, suicide.Dutch researcher Peggy Cohen-Kettenis estimates that 40% of untreated transsexual people are either institutionalized or die prematurely.Transsexualism (also known as transsexuality) is a complex condition that is defined differently by different people.Many terms have been proposed through the years to describe transsexual people and the processes they go through.People may consider the use of such labels offensive whether they are or are not transsexual, or involved with Western religions, themselves.Transsexualism is often included within the broader term transgender, which is generally considered an umbrella term for people who do not conform to typical accepted gender roles, for example cross-dressers, drag queens, and people who identify as genderqueer.
The latter defines the term based on actual or planned operative status and makes it more an external label than a term of self-definition.It has become more widely known in Western nations in the late 20th century due to the sexual revolution, but remains a highly controversial topic.Transsexualism often manifests itself as a dysphoria toward one's biological birth sex, as well as conflict living in one's social role.International research suggests that 3-18% of them come to regret switching gender.The Guardian Saturday July 31, 2004  Currently, the causes of transsexualism are unknown, and estimates of prevalence vary substantially.
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As with any terms used by a group, or to refer to a particular group, some of these terms are controversial, or have become controversial, not only to society at large, but even among the transsexual community.