manuscript version: 1.43
In his book Pichler looks at transsexualism as a behavioral addiction, much like a sex addiction, Internet addiction or pathological gambling addiction, which is caused by a faulty reward system in the human brain. Pichler further reports that the medications that effectively treat behavioral addictions show good results in treating transsexualism. In fact modern research shows that the drugs that effectively treat epilepsy treat behavioral addictions. Further, a study by Jan Wålinder [Göteborg, Sweden], dated 1967, shows that epilepsy is effectively absent in transsexuals, who are successfully treated for epileptic seizures according to 207 case studies dating back to 1954. The incidence of Epilepsy in the G12 nations is 0.82% of the population. 
Pichler found that male-to-female transsexuals that were effectively treated for ancillary mental disorders and took anticonvulsant medications, watched their proclivities towards a gender transition evaporate, indicating the underlying cause of transsexualism is in fact an addiction, e.g., a mental disorder, that can be effectively treated with medication.
Pichler accepts Dr. Ray Blanchard theories into Autogynephilia as the explanation in the early stages of the vast majority of male to female transsexual narratives (both heterosexual and asexual), but Pichler is not persuaded that Blanchard's theories explain the persistent addictive behavior on the event the individual advances to undergoing hormone replacement therapy and later undergoing surgical procedure after surgical procedure to alter their outward appearance. (Dr. Ray Blanchard coined the term, autogynephilia, to denote a male's paraphilic tendency to be sexually aroused by the thought or image of himself as a woman.) In the case of a male to female transsexual the more prevalent motivator that remains years after undergoing an initial invasive procedure that protracts the testes is a behavioral addiction (which is firmly established) and not simply an autogynephilic disorder.
Further, Pichler sees no distinction in the sexual orientation of a person with an affected autogynephilic addiction in sharp contrast to Blanchard. Whereas Blanchard subdivides male-to-female transsexuals by sexual orientation (e.g., a so-called homosexual transsexual versus a so-called autogynephilic transsexual) Pichler sees the sexual orientation of a male-to-female transsexual as irrelevant. Pichler is of the opinion that all male-to-female transsexuals exhibit sexual-spurred addiction, regardless of sexual orientation. In the case of an otherwise gay, male-to-female transsexuals the sexual impetus is typically role play, which is sexual in nature. In extremely rare cases the sexual impetus is a romanticized addiction to plastic surgery appropriate for the opposite sex (e.g., automorphophilia, or the love of change in the context of the opposite sex). Further, Pichler explains that the differences in the average age that a person transitions between gay and straight are more a function of social environs and community acceptance than anything neurological.
The implication for medical practitioners is simple. Break the behavioral addiction, underlying transsexualism, and you break the disorder, irrespective of sexual orientation.
In his book Pichler recommends health jurisdictions affect sweeping and dramatic changes to the Standards of Care, requiring transsexual candidates, who seek a gender reassignment surgical procedure (GRS), to undergo non-invasive therapy, involving medications that deal directly with behavioral addiction for at least one year prior to undergoing hormone replacement therapy (HRT). Given the dramatically high incidence of male to female transsexuals, who not only fail, but fail miserably to benefit from invasive transsexual procedures that otherwise corroborates with the disorder, Pichler also recommends that health jurisdictions order rogue practitioners and third-wave health care providers to cease all medication protocols to their transsexual patients and refer these patients to the centralized Gender Identity Clinics. Pichler also recommends that health jurisdiction remove all personnel at the centralized gender identity clinics who possess a transsexual background from their positions of authority over transsexual care and replace them with unbiased, unaffected clinicians.
The book includes a number of case studies of male to female transsexuals, who were effectively treated for transsexualism with medications normally prescribed for epilepsy in lieu of invasive procedures, like GRS procedures and orchiectomies.
In 2007 CTV News recognized Eugene Pichler, the author, as an expert on the trans subject matter. Prior to publishing the book, Acceptable Losses, in 2008 Pichler published numerous articles on the subject of transsexuality on transgression.com. He has interviewed over thirty individuals, including transsexuals, political activists, media personalities, academics and medical professionals for the website. From his research, Pichler came to the opinion that a surgical procedure of great interest to the transsexual community, gender reassignment surgery, is often performed based on medical misdiagnosis, without adequate screening procedures and with disastrous effects on its recipients.
Pichler, through transgression.com, began to advocate against public funding for gender reassignment surgery. Pichler's message was that gender reassignment surgery is a dramatic and irreversible surgical procedure that should not be publicly funded until more research has been completed on the underlying psychological and medical need for the surgery and the effect of the surgery.
Special thanks to clinical researcher, Maxine Petersen of the CAMH, Dr. J. Paul Federoff, M.D. of the Royal Ontario Hospital, Dr. Keith Loukes of the Sherbourne Health Centre, Rupert Raj of the Sherbourne Health Centre, Krista Scott-Dixon, Ph.D. York University, Shadmith Manzo of the TS Support Group of the 519 Community Centre, male to female transsexual Kassandra and male to female transsexual Michaela.
The book is not written exclusively for a transsexual audience, but rather anyone with an interest in the transsexual phenomenon.
 Jan Wålinder's research paper, Transsexualism, A Study of Forty-Three Cases, Review