Transsexuals are diagnostically divided into the sub-categories of Primary or Secondary. Primary transsexuals display an unrelenting and high degree of gender dysphoria, usually from an early age (four to six years of age). Secondary transsexuals usually come to a full realization of their condition
in their twenties and thirties, but may not act on their feelings until they are much older. Typically, secondary transsexuals first go through phases that would be self-assessed as being a “crossdresser or transgenderist.”
Transgendered The Five Layer Model of Gender38
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