He played with Hot Wheels, wore combat boots and, after college, joined the military, vicariously living a male life in a female body. “Am I bi? Maybe I’m lesbian?” Sydney Mason, a female-to-male transsexual, asked himself as he went through life as a female. Romance never came between Mason and a man, and although he was attracted to and comfortable in a relationship with another woman, it was within his own female body that he could not relate to a female and feel content. “I always knew who I was. I just got stuck in the wrong body,” he says.

It wasn’t until Mason stumbled across the Female-to-Male International (FTMI) organization that he knew it was possible to change his life and to legally live as a man. “When I found FTMI it was like I had an epiphany. Everything throughout my childhood just made sense. I was male trying to live as a female,” he says.

A typical misconception about transgender identity is that it’s about sex. Many believe that someone who is transgender chooses to live as the opposite sex, whether by cross-dressing or having complete sex reassignment surgery, in order to fulfill their sexual desires. The underlying concerns, however, are more often with identity itself. Someone may question their identity when the gender in their own mind and their physical appearance do not agree.

“As far back as I can remember I knew I was supposed to be a girl,” says Lisa Rae Dummer, a male-to-female transsexual who has undergone a full transformation with hormone treatment, electrolysis for unwanted facial hair and sex reassignment surgery.

Growing up with certain social standards and family values was confusing for Dummer, who at a young age was expected to play sports and with toy cars. She was unhappy in the body she was in, but continued through life, struggling between how she felt in her mind and what society had instilled in her as "normal behavior" for a man. Dummer married into a heterosexual relationship and started a family as father to a son and daughter. As she continued through her life as Bill, Dummer began to question her experiences and started researching on her own to find out why she didn’t feel comfortable in the male body she was in.

“Sometimes it’s about how they are feeling about their own identity,” says William D. Henkin, Ph. D., a psychotherapy and sex therapist in San Francisco. “Sometimes it’s what they have been told all their lives that make them question who they think they are. That can be very confusing.”

With support from online social networks, doctors and organizations with members going through similar experiences, Dummer came to accept herself for who she is, which also meant altering her outer appearance to match.

“Our brains develop as female,” Dummer says about the male-to-female transsexual community. However, Dummer says there is no scientific evidence to explain why she didn’t feel comfortable in her own skin.

Dummer is now free of the insecurities she endured while living in a body she did not feel comfortable in. However, the path to liberation was not an easy road or one that she would recommend for anyone that didn’t have to go through it. “This is not something I would wish upon my worst enemy,” she says.

“Some people have the same issues but are married, have a wife and kids. They think, ‘What do I tell my family, my parents?’ ‘Will I lose my job, my friends, and my position in society?’ You don’t do this for fun. Most people lose loved ones that can’t deal with it,” Henkin says.

On Christmas day in 2002, Dummer told her family that she would live the rest of her life as a woman. Her children no longer speak to her, but she says that others are more accepting than she expected.

When a woman at Dummer’s office had a problem using the same bathroom as her, it was Dummer’s co-worker that was told to walk to the back of the building to use the toilet that Dummer respectfully said she would stay clear of. “My boss told me that if she can’t accept it then she will walk all the way to the back of the building if she wants to,” Dummer says.

One of Dummer’s now-close friends was only an acquaintance before her transition. “My friend told me, ‘I like this you. This is who you truly are,’” says Dummer. “I am finally being true to myself.”

Henkin says that many people, not just transsexuals, have concerns that lead them to see a therapist. With a little outside perspective, those feelings of anxiety, stress, depression, fear and sorrow can be changed to love, joy, excitement, knowledge and peace as the individual comes to accept who she or he is. Transgender individuals not only have the same issues that everyone else has, but they also have to deal with their gender identity.

It wasn’t until Dummer decided to transition that her doctor recommended she see a gender therapist to discuss her sexual identity concerns. “Even though I knew when I was young that I was supposed to be a girl, seeing a therapist gave me someone to talk to,” she says. “There are so many degrees of identity issues. A therapist helps you decide only as far as you have to go.”

“It’s not about who you like or what you want [sexually]. It’s about who you feel yourself to be,” says Henkin. People who are transsexual seem to be at odds about how they look and how others perceive them, he says.

In his clinical career, Henkin has seen a variety of transgender people that have come to many different conclusions about their own sexual identity. He has seen lesbian women come out as heterosexual men, heterosexual women come out as gay men, heterosexual men come out as lesbians and cross-dressers that dress in drag for gender expression. “As a therapist, I am just there to help them figure out what’s right for them,” he says.

Becky Benton, a male-to-female transsexual has been seeing a therapist for more than five years to discuss her gender identity concerns. Some of the time spent in therapy, though, was in marriage counseling with her wife of 15 years. She had thoughts that she may be transsexual but kept the ideas to herself. “It was dangerous to face. I thought it would destroy my life,” she says. “I didn’t want to be a sideshow freak.” Benton eventually told her family of her decision to live as a woman. “My ex-wife came to be very accepting of my decision and said, ‘I always expected you might be [transsexual].’” says Benton.

Everyone who enters Dr. Henkin’s office has his or her own unique story. Some are confident in their decision to make a complete transition and are only there for a letter of referral, a request in the code of conduct that professionals abide by within the transsexual community, known as the HBIGDA Standards of Care. But some are more confused with their feelings and are hoping a therapist can shed some light.

“In therapy it was safe to examine what I felt,” says Benton. “I was able to discover this part of myself. This is me.”