Five patients who presented at the Veterans Administration Mental Hygiene Clinic, Brentwood Hospital, Los Angeles, California, are described. All claimed to be transsexuals and requested estrogens and sex reassignment surgery on admission. They created great difficulty at the time of their admission and follow-up because of lack of precedents for such eventualities in government medicine. These veterans, displaying a mosaic of psychologic problems, were followed up for a period of three years. The federal social medicine system, particularly the VA, is not equipped psychologically or physically to deal with unusual requests.