The acceptance and the implementation of Sex Reassignment Surgery as a treatment for transsexuals evokes a number of considerations and questions about the medical-ethical aspects of transsexualism and its therapy. In this paper considerations about an ethically justified therapeutic strategy are centred around six discussion topics: the cultural particularity of transsexualism, the necessity of an organic-medical approach to the problem, the relationship of transsexualism to psychiatry, the significance of the diagnosis, the patient's participation in the decision making process and the implications for health care funding.