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The present paper reports on the course of 15 young female-to-male transsexual applicants followed for 1 to 9 years after initial evaluation. Each patient completed a lengthy evaluation process including detailed semistructured interviews and a battery of psychological tests.Of the 15 applicants, 10 went on to live full time in the male role; however, one of these later returned to living as a female. This woman and three others were living as lesbians at last follow-up, while the two other patients continued to live in a more ambiguously male-female role. Psychosocial functioning at the time of follow-up in terms of employment, partners, and psychiatric status is reviewed. A supportive problem-solving psychotherapy program was offered to all of these patients and seven became actively involved in therapy. The potential benefits and limitations of psychotherapy with female gender dysphoric patients are discussed.