This paper explores existential themes encountered in therapeutic practice with transsexual (trans) people. Drawing from her experience as a clinician within a large NHS clinic concerned with transgender care the author outlines the nexus of transsexualism with choice, freedom, authenticity, the existential 'givens', facticity and the making of a 'leap to faith'. Key Words Transsexual, trans, transvestite, transgender, authenticity, facticity, gender, givens.
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