People sometimes seek sex reassignment because of advantages and opportunities which, they believe, are enjoyed by the other sex. This rather unrealistic (fantastic) view of the other is faintly narcissistic. It includes elements of idealised over-valuation, of self-preoccupation, and of objectification of one's self. It demonstrates a deficient ability to empathise and some grandiose sense of entitlement ("I deserve to be taken care of") and omnipotence ("I can be whatever I want to be - despite nature/God").

This feeling of entitlement is especially manifest in some gender dysphoric individuals who aggressively pursue hormonal or surgical treatment. They feel that it is their inalienable right to receive it on demand and without any strictures or restrictions. For instance, they oftentimes refuse to undergo psychological evaluation or treatment as a condition for the hormonal or surgical treatment.

It is interesting to note that both narcissism and gender dysphoria are early childhood phenomena. This could be explained by problematic Primary Objects, dysfunctional families, or a common genetic or biochemical problem. It is too early to say which. As yet, there isn't even an agreed typology of gender identity disorders - let alone an in-depth comprehension of their sources.

A radical view, proffered by Ray Blanchard, seems to indicate that pathological narcissism is more likely to be found among non-core, ego-dystonic, autogynephilic transsexulas and among heterosexual transvestites. It is less manifest in core, ego-syntonic, homosexual transsexuals.

Autogynephilic transsexuals are subject to an intense urge to become the opposite sex and, thus, to be rendered the sexual object of their own desire. In other words, they are so sexually attracted to themselves that they wish to become both lovers in the romantic equation - the male and the female. It is the fulfilment of the ultimate narcissistic fantasy with the False Self as a fetish ("narcissistic fetish").

Autogynephilic transsexuals start off as heterosexuals and end up as either bisexual or homosexual. By shifting his/her attentions to men, the male autogynephilic transsexual "proves" to himself that he has finally become a "true" and desirable woman.

next: The Narcissist's Addiction to Fame and Celebrity