At least one was a narcissist. It's not really about gender identity so much as being obsessed with needing to have a certain look. The saddest part of this IMHO is that they will never be happy. There will always be something wrong, some other procedure needed to make them 'perfect.'

I wonder if the news stories about people who try to change back after surgery aren't in that category. Most of those had bypassed the standards of care set up by Benjamin. Yeah, it's a pain sometimes to have to jump through the gatekeeper's hoops, but the standards are there for the patient's protection, too.

It must really be sad to be driven like that. Tough enough just being trans.

Janet

Mistress of the Guild of Evil [Strawberry] Blonde Proofreaders

To be or not to be... ask Schrodinger's cat.

People who are Body Dysmorphic are often seen as plastic surgery junkies. They often have at least one procedure done each year. One I met through my therapists had three breast augmentations, 4 face lift procedures, a "body lift", body sculpting with liposuction, a nose job, Laser resurfacing, and was still wanting more changes. It is in the nature of a kind of Obsessive Compulsive Disorder, just with trying to achieve a particular image, or sometimes, from a fear of aging. Kinda like Michael Jackson. Usually the person focuses on a particular physical attribute at a time, like deciding if they could just modify their nose they would be perfect, then move on to other attributes. There are also BDD folks who want parts of their body amputated, like legs, fingers, etc., sometimes thinking there is something wrong with having them, and a few doctors that will remove healthy limbs under the same concept as SRS. Usually the people with an amputation fixation do not stop with just one thing, but want more body parts removed, as the plastic surgery junkies also want just one more thing modified.

There are people, like Dr. Ray Blanchard at the CAMH in Canada, who attribute being TS to being a kind of Body Dysmorphic Disorder in that TS want to be rid of their genitals as they were born. Along with that, many want to have Facial Feminization surgeries, and Breast Augmentation. At least the latter two surgeries are part of the social pressures mentioned previously for most, though for younger people it can be the desire to be competitive in the search for a mate by appearing as sexually desirable as possible. Having surgeries associated with being TS can be viewed as BDD, but TS are usually satisfied once they meet the criteria of society for being acceptable looking females and are no longer called "sir". Most do not continue to seek additional surgeries beyond what a normal woman might (face lift in the 50's, boob lifts, etc.). Not all use of plastic surgery is about BDD, and within our society there is the concept of aging gracefully. Or disgracefully in the case of Joan Rivers!!

CaroL