According to this definition, a girl who plays football is trans-sexual.

A number of transsexuals are beginning to admit that opting for surgery ruined their lives. "I was a messed-up young gay man," says Claudia McClean, a male-to-female transsexual who opted for surgery 20 years ago. "If I had been offered an alternative to a sex change, I would have jumped at the chance." A number of transsexuals I have spoken to tell me how easy it is to be referred for surgery if they trot out a cliche such as, "I felt trapped in the wrong body."

Transsexualism is becoming so normalised that increasing numbers of children are being referred to clinics by their parents. Recently, an 18-month-old baby in Denmark was diagnosed as suffering from GD. Last summer, a primary school headteacher held an assembly to explain that a nine-year-old boy would return as a girl. 

Ten years ago, there were an average of six child and adolescent referrals per year in Britain, but in 2008 numbers had increased six-fold. Although the minimum age for sex-change surgery is 18, puberty-blocking hormones can be prescribed to those as young as 16, and transsexual rights lobbyists want that age to be reduced to 13. 

James Bellringer is a surgeon at Charing Cross Hospital, which has the largest gender identity clinic in the UK. He believes that children should be allowed to self-diagnose as GD. "It is not the doctors saying, ‘You are a transsexual, let's get you on hormones,' it is the children saying, ‘I don't like my breasts, I feel like a girl'." 

There is, however, a dispute within the medical profession about whether puberty-blockers should be prescribed. Some doctors say that children need to experience puberty to know whether they are misplaced in their bodies. I would describe preventing puberty as a modern form of child abuse. Two-thirds of those claiming to be, or diagnosed as, transsexual during childhood become lesbian or gay in later life. "I would be happy living now as a gay man, comfortable in the body I was born with," says McClean. "The prejudice against me for being an effeminate boy who fancied other boys was too much to bear. Changing sex meant I could be normal."

Medical science cannot turn a biological male into a biological female — it can only alter the appearance of body parts. A trans-sexual "woman" will always be a biological male. A male-to-female transsexual serving a prison sentence for manslaughter and rape won the right to be relocated to a women's jail. Her lawyers argued that her rights were being violated by being unable to live in her role as a woman in a men's jail. Large numbers of female prisoners have experienced childhood abuse and rape and will fail to appreciate the reasons behind a biological man living among them, particularly one who still has the penis with which he raped a woman. (Some transsexuals choose to retain their genitals.)