Transsexualism and Flight Safety

A case of a male-to-female transsexual pilot with questionable judgment affecting flight safety is reported. The definition, etiology, and presenting symptoms are discussed. Three theories of etiology include the following biologicalimprinting, nonconflictual identity, and conflictdefense. Therapy is pointed out, to include psychotherapy, cross-dressing and living as a member of the opposite sex, hormones, cosmetic surgery, and surgical sex reassignment. Aviation safety issues involve all the phases of therapy and can be significant. Though the transsexual tends to have more episodes of anxiety and depression than the norm, the conclusion is that, through practitioner awareness and rapport with the patient, the transsexual need not be considered unsafe to fly.