In , Hirschfeld supervised the second genital reassignment surgery to be reported in detail in a peer-reviewed journal, that of Lili Elbe of Denmark. In , Hirschfeld introduced the German term "Transsexualismus",  after which David Oliver Cauldwell introduced "transsexualism" and "transsexual" to English in and True transsexuals feel that they belong to the other sex, they want to be and function as members of the opposite sex, not only to appear as such. For them, their sex organs, the primary testes as well as the secondary penis and others are disgusting deformities that must be changed by the surgeon's knife. Beyond Benjamin's work, which focused on male-to-female transsexual people, there are cases of the female to male transsexual, for whom genital surgery may not be practical. Benjamin gave certifying letters to his MTF transsexual patients that stated "Their anatomical sex, that is to say, the body, is male.
He has been on hormones for 8 years so his growth down there was pretty developed. Apart from the physical side, the emotional side can be pretty intense. A lot of pre-surgery trans people have issues around dysphoria during sex, and this stopped sex dead in its tracks a few times for us. That was a bit awkward, and it made me feel like shit afterward. Overall, even though he had female genitals, it was pretty much just like being with a cis guy physically. It is different because of different hardware, but still quite enjoyable. She cums from anal quite a bit, and I enjoy it as well.