**Transgender Perception: Understanding the Causes of Male Homosexuality, the Challenges of Transgender Surgery, and the Identity Crisis [i]**

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What are the sexual preferences of men? It is estimated that about 5% of men are homosexual or bisexual, and this figure can reach 10% in densely populated cities [i]. Homosexuality is not a modern discovery; pedophilia was prevalent in ancient Greece [i]. Today, in the medical and psychological communities, it is generally accepted that homosexuality is neither a pathology nor a condition requiring treatment, nor is it a sign of depravity or sexual immaturity [i]. Homosexuality simply indicates that the desire for love and sex is directed toward people of the same sex [i].

There is still no consensus on how homosexuality arises[i]. Genetic researchers have found that homosexuals are often present in maternal families where the son is homosexual[i]. However, no "homosexual gene" has been found so far, and this claim seems unconvincing because, in addition to innate factors, there are also environmental influences[i]. Psychologists believe that whether a person develops into a homosexual depends on their experience living with their early caregivers before the age of three or four[i]. It is worth noting that homosexuality also involves health issues. A European study confirmed that men who have sexual relations with other men may have a 20-30 year shorter lifespan[i]. The main cause of this is AIDS[i]. Therefore, homosexual men should be informed of these consequences, rather than being condemned[i].

If a biologically male feels like a woman, he will experience complex inner conflict[i]. Gender transition refers to a person living like the opposite sex for at least two years and hoping to change his sex to his ideal sex through hormones or surgery[i]. Gender transition affects 1% to 2% of the total population[i]. The reasons for this contradiction between the self-perception of gender change and biological genes are also widely debated[i]. Some say it is due to frustration in heterosexual relationships, while others say it is a form of gender role disorder[i].

For the individuals involved, not only is discrimination from family and friends a challenge, but many who accept gender reassignment surgery also bear the pressure of undergoing surgery that drastically alters their appearance [i]. Furthermore, they must endure hormone therapy, psychotherapy, and so-called "daily life tests" [i]. These "daily life tests" require the patient to experience their new sexual role in real life for a year before surgery [i]. In male-to-female gender reassignment surgery, female hormones are administered to the man to make him more voluptuous like a woman, and multiple surgeries are performed to remove unwanted female hair, transforming the penis and testicles into a female vulva [i]. In addition, a series of other surgeries are required, such as facial plastic surgery [i]. Complications are almost inevitable during these complex surgeries [i]. Nevertheless, for the individuals involved, gender reassignment surgery still signifies that they have finally achieved their desired outcome [i].