The notion that disturbances in sexual identity and desire for sexual change are accompanied by severe defects in ego structure were examined. Findings from 3 in-depth case studies with psychological tests and MMPI data for 34 individuals who presented problems in gender identity, with choice of sexual partner, and transvestism. Data suggest no consistent MMPI pattern to confirm the above contention. There was evident psychopathology but no clear evidence of personality disorganization in those seeking sexual change or having difficulties in sexual identity It was concluded that the presenting symptom of difficulty in gender identity or a wish for gender change is not prima facie evidence of distortion of reality or conspicuous ego defect.