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Both transsexual and transgender women may experience gender dysphoria , distress brought upon by the discrepancy between their gender identity and the sex that was assigned to them at birth and the associated gender role or primary and secondary sex characteristics. A major component of medical transition for trans women is estrogen hormone replacement therapy , which causes the development of female secondary sex characteristics breasts , redistribution of body fat, lower waist—hip ratio , etc. This, along with sex reassignment surgery can bring immense relief, and in most cases, rids the person of gender dysphoria. However, she elaborates on it by saying that being a trans woman often has a negative connotation. Levitt provides a simpler description of trans woman. She defines trans woman as "the sex of those who transition from one sex to the other.
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These numbers are much larger than commonly assumed by the public because a veil of invisibility hides the true nature and extent of the transsexual condition. Especially hidden are large numbers of highly successful women who have fully transitioned. The reason is that most successful women live in "stealth mode" or are "woodworked". They leave their pasts behind and hide in plain sight in order to avoid social stigmatization and get on with their new lives. Their personal successes insure that they assimilate and blend right into society. The social invisibility of successful women who have undergone gender corrections supports the notion that male-to-female transsexualism is extremely rare.
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