The Departments of Psychiatry Neurology, Gynecology, Urology, and Plastic and Reconstructive Surgery play a central role in the operation of the Okayama University Gender Clinic. At the Gender Clinic, physical treatments such as hormonal therapy and surgical therapy for gender dysphoric people are performed in accordance with “The diagnostic and therapeutic guidelines for patients with gender identity disorder (The Japanese Society of Psychiatry and Neurology)”. The motivation for seeking these treatments is the strong discomfort arising from having physical characteristics opposite to one’s own experienced gender. The dysphoria experienced by the person involved stems from both a subjective sense of discomfort and a suspicion that others may be uncomfortable with an appearance that does not resemble the desired gender. This is because when the individual is certain that they perceive themself as male (female) and at the same time are certain that those around them perceive them as male (female), they will be insecure when acting as a male (female) in society. This situation is not only insecure but also leads to disadvantages in social life. Mastectomy, facial feminization, masculinization or feminization of appearance through hormone therapy, etc., and female voice through vocal cord surgery are thought to improve subjective gender discrepancy and at the same time improve social discomfort and reduce disadvantages in daily life. Of course, we must not forget that the essential solution is to create a tolerant society that accepts a person in the gender that they desire, no matter what their appearance may be.
