  Now Raymond is right that the medicalization of transsexuality involved the perpetuation of sexist (and heterosexist) norms. Yet the actual struggle of some scientists and surgeons to make surgeries available to transsexuals is ignored in Raymond's account (Riddell 2006). Such advocates for transsexual surgery were in the minority (certainly in the U.S) and themselves experienced hostility and marginalization. This means that what Raymond calls the transsexual empire was not monolithic. And given the marginalization of these advocates for transsexual surgery, it seems that the medical establishment was not especially friendly to transsexuality (Riddell 2006). Generally transsexuality was and remains largely unaccepted in society. Contrary to Raymond's view, it is largely not endorsed by “the patriarchy.”