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Transsexual people experience a gender identity that is inconsistent with, or not culturally associated with, their assigned sex and desire to permanently transition to the gender with which they identify, usually seeking medical assistance including hormone replacement therapy and other sex reassignment therapies to help them align their body with their identified sex or gender. Transsexual is a subset of transgender ,    but some transsexual people reject the label of transgender. Norman Haire reported that in ,  Dora R of Germany began a surgical transition, under the care of Magnus Hirschfeld , which ended in with a successful genital reassignment surgery. In , Hirschfeld supervised the second genital reassignment surgery to be reported in detail in a peer-reviewed journal, that of Lili Elbe of Denmark. In , Hirschfeld introduced the German term "Transsexualismus",  after which David Oliver Cauldwell introduced "transsexualism" and "transsexual" to English in and Cauldwell appears to be the first to use the term to refer to those who desired a change of physiological sex. True transsexuals feel that they belong to the other sex, they want to be and function as members of the opposite sex, not only to appear as such. For them, their sex organs, the primary testes as well as the secondary penis and others are disgusting deformities that must be changed by the surgeon's knife. Benjamin suggested that moderate intensity male to female transsexual people may benefit from estrogen medication as a "substitute for or preliminary to operation.
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He has been on hormones for 8 years so his growth down there was pretty developed. Apart from the physical side, the emotional side can be pretty intense. A lot of pre-surgery trans people have issues around dysphoria during sex, and this stopped sex dead in its tracks a few times for us. That was a bit awkward, and it made me feel like shit afterward. Overall, even though he had female genitals, it was pretty much just like being with a cis guy physically. It is different because of different hardware, but still quite enjoyable. She cums from anal quite a bit, and I enjoy it as well. Mechanically, it would be very much like regular anal, but the emotional component and feelings behind it all is like any other relationship. She had a penis when we met and we did everything anally for a few months. She took a few months maybe close to a year to recover.