People who feel that they were born in the wrong body may have been unhappy even when young. Depressive feelings, feeling not understood, rebellion and isolation may have existed since that time. The sex change treatment can lead to fear of intimacy, fear of discovery, loneliness, reactions of mourning, insecurity, excessive consumption of alcohol and depression. Psychological problems often occur. Counselling by a specialized social worker is important in learning how to deal with these feelings before and after the sex change.