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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.
Photo by GIC, via Stocksy. After I began transitioning about a year and a half ago, it took me many months before I felt comfortable enough to have sex. Every time I have sex, I have to wrestle with all the insecurities that stem from my dysphoria, and that can make me want to avoid it.