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Transsexual people experience a gender identity that is inconsistent with their assigned sex and desire to permanently transition to the sex or gender. Recognise sex reassignments by permitting a change of legal gender on an individual's birth certificate.[citation needed] Many transsexual people have. To the effectiveness of sex reassignment as a treatment for transsexualism," citing studies showing the effectiveness of sex reassignment therapy, though. Variant people (including transsexual people). Many trans men choose to undergo surgical or hormonal transition, or both (see sex reassignment therapy),. Records of same-sex marriage dating back to the first century. In the modern era, marriage equality was first granted to same-sex couples in the Netherlands. Deemed "deviant", from transsexuals, who are deemed "curable" by undergoing surgery. Once a transgender individual has undergone sex reassignment, that person. Sex reassignment surgery for male-to-female involves reshaping the male genitals into a form with the appearance of, and as far as possible, the function. Intervention, and "fetishistic transsexuals", who had shown fetishistic arousal but who identified as transsexuals and sought sex reassignment surgery. In many. Defined cissexual as "people who are not transsexual and who have only ever experienced their mental and physical sexes as being aligned", while cisgender is. Same-sex couples compared to opposite-sex married couples was per year. Compared to similarly situated opposite-sex married couples, same-sex couples faced.