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These professionals routinely evaluate their patients for these and similar problems. A growing number of transsexual and transgender people therefore resent or even refuse psychological treatment which is mandated by the Standards of Care, because they believe that gender dysphoria itself cassell is untreatable by psychological means, and that they have no other problems that need treatment. This, cassell however, can cause significant problems when cassell they try to obtain physical treatment. Therapists' records reveal that most transsexuals do not believe they need psychological counseling, but acquiesce to legal and medical demands in order to gain rights which are granted through the medical/psychological hierarchy. Legal issues such as a change of sex on legal documents, and medical issues, such as sex reassignment surgery itself, are usually impossible to obtain without a doctor's and/or therapist's approval.
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