Nine, asked to take off the beard of the man dressed in a colorful, well-dressed patients into my office. Ear short hair, necklace, earrings, chiffon shirt, painted nails, just like a modern girl. I was about to ask for a consultation when I saw that the registration form clearly stated the gender: male. But it’s not uncommon for the wrong gender to be entered in the registration room, and as I was about to look up and scrutinize him, he took the initiative to speak, “Doctor, I heard that you can do laser hair removal, and I want to get rid of my beard.” It was clearly a low male voice. Fixing my eyes on it, although the beard was cleanly shaved, there was indeed a bruise on his chin. Trying to suppress my inner horror, I zoomed in on his entire face; he did have very delicate features, with well-trimmed eyebrows, large curved eyes, a high nose, and the corners of his mouth slightly upturned. I probably understood a few points in my heart, but still said, “We are semiconductor laser hair removal, once removed can not grow back, you have to think carefully oh.” “I just want it permanent! Doctor, I’ve always been a woman at heart, and I really can’t stand the way I look with a beard.” As he said this he actually curled up and trembled slightly. Looking at his tender appearance, I couldn’t help but sympathize with him, “Don’t worry for a moment, let’s think about it, assuming that if you were to be happy by making your looks completely female, would you get into any more trouble?” “I’ve thought about it, uh, actually it’s really painful for me to be like this now, I get into all kinds of trouble every day. I get strange looks every time I go to the men’s restroom, and I often get talked about when I go clothes shopping and try on clothes. I am now very divided, and there are times when I can’t help but be afraid and tremble ……” He trembled even more, and his whole body shrank into a ball. I held his shoulders tightly and told him to rest for a while while the student poured him a glass of water. After a minute or so, he relaxed a little. I then asked, “So have you been to a psychiatrist?” He pulled out a thick pile of medical records, was seen in a psychiatric hospital, including the Minnesota Multiple Personality Test, “masculinity/femininity” a score as high as 85, indicating a clear female tendency. There were also high scores for psychasthenia and social introversion, which were also consistent with his tendency to be nervous, anxious and fearful. This was a classic case of gender identity disorder, in which he was psychologically unable to recognize his innate male gender, but was convinced that he belonged to the female gender and craved feminine characteristics. In the course of my careful review of his medical records, he slowly recovered from the state of panic he had just experienced, and continued to recount his pain and anguish, stating that his next step would be to undergo gender reassignment surgery to become a real woman. This was really beyond my expertise and I really had a hard time deciding whether to help him or not. To be prudent, I still suggested that he should see a psychiatrist first, and he could also try to live like a real woman first, and feel it for a while before deciding whether or not he should ultimately make a permanent change in his body. I told him that transgender people may encounter many unexpected problems and are more prone to depression, anxiety, suicide or self-abuse than the general public. After I sent him away, I was left with a mixed feeling that this was not a simple question of right and wrong, and that perhaps it was not even a disease, but simply a manifestation of biodiversity. As this manifestation deviates from the mainstream mode of perception and is not accepted by most people, the person concerned is destined to receive more criticism and torture. But how can we, as doctors, understand and help?