The restrictions and expectations placed on males and females are not the same. The occurrence of transsexualism is therefore not the same either. In midlife it is almost entirely one-way traffic.
Recent BMJ letter by medical clinicians:
Published 29 October 2018
'Redesigning gender identity services: an opportunity to generate evidence'
authors: Richard Byng, general practitioner and professor in primary care research, Susan Bewley, emeritus professor of obstetrics and women’s health, Damian Clifford, consultant liaison psychiatrist, Margaret McCartney, general practitioner and freelance writer
(extracts)
"A recent feature in The BMJ implied that new services are all that’s needed to improve transgender healthcare. Providing timely, sensitive services for all, including those who decide to not pursue treatment or detransition, is important. But the article did not question the steep rise in referrals of mainly young women or the potential harms of medical overdiagnosis and overtreatment" (continues)
"Regulated medical practitioners should follow a framework of evidence, not simply respond to client expectations. Creating that evidence to inform quality standards is an ethical imperative. We need research to explore the interplays between gender identity, mental health and neurodevelopmental problems, sexual orientation, autogynephilia, and unpalatable gender roles" (continues)
open access link here:
www.bmj.com/content/363/bmj.k4490.full?ijkey=6lX93kQA0lz5YoB&keytype=ref
www.mumsnet.com/Talk/womens_rights/3410257-BMJ-article-We-need-research-to-explore-the-interplays-between-gender-identity-mental-health-and-neurodevelopmental-problems-sexual-orientation-autogynephilia-and-unpalatable-gender-roles