 On the basis of these two theses, Raymond is led to see the medicalization of gender variance and the gender identity clinics as nothing but vehicles to further secure sexist sex roles. Thus, for her, a sexist society is “the first cause” of transsexuality (1979, 16). The role of the medical treatment of transsexuality is to turn men into “women” and women into “men” when they cannot be normed into their natally assigned sex roles. For Raymond, the phrase transsexual empire applies to the patriarchal medical establishment which perpetuates sex-role oppression through surgical intervention. (She uses the word empire to refer to “a political unit having a territory of great extent, or a number of territories under a single sovereign authority” (xv). She sees the medical “empire” as including numerous specialties such as urology, gynecology, endocrinology, and so forth.  She also sees the collaboration of psychology and psychiatry in hiding what she calls the sovereignty of the medical “empire” by making it appear that there is some need for transsexual medical intervention, as well as the involvement of lawyers and legislators.  However, it is the medical establishment, for Raymond, which possesses this sovereignty. So it is the medical establishment which is the unifying authority of the “transsexual empire” (ibid.)).