With the publication of Green and Money's Transsexualism and Sex Reassignment (1969), clinicians were provided with the first source book for evaluating, diagnosing, and treating people with profound gender identity disturbances (i.e. diagnosed transsexuals). Only two of fourteen chapters, however, focused on female transsexuals, and one of those (Money and Brennan, 1969) had been previously published (two other chapters of the remaining eighteen focused on surgical aspects, which will discuss later).

The contribution by Pauly was represented by a series of articles on female transsexualism which he published over a decade (Pauly, 1963, 1974a, b). After reviewing the literature Pauly presented four case histories of female transsexuals (one of whom was Mexican American). While he felt that it was too early to pinpoint the etiology of female transsexualism, he did speculate on its possible pathogenesis:

“During childhood there is an identification with a strong, masculine father figure. This father daughter relationship is not an excessively close one, as is the case between mother and son in male trans sexualism. The mothers are perceived by their daughters as weak or ineffectual, or less admirable than father, in much the same manner that fathers of male transsexuals are perceived by their sons. A protective attitude toward mother develops with all the dynamics of a reverse oedipal situation.”

Pauly also speculated that sometime in the future researchers may discover a neuroendocrine hypothesis to explain some of the variants of these conditions.

Pauly stated that "female transsexuals seem better adjusted in their male roles. ..[and that] they demonstrate less psychopathology [than male transsexuals] ." This view exerted a strong influence on subsequent investigators (some of whom seemed to have taken Pauly too literally, confusing adjustment in the male role and a more repressed constricted inhibited style with being "normal" and without apparent psychopathology). Pauly concluded that a combination of supportive counseling, testosterone therapy, and surgery should be considered. He believed that "until further evaluation suggests contrary results, one must accept sex reassignment surgery as the only available means of alleviating the suffering of the transsexual individual".