transsexualism n : condition in which a person assumes the identity and permanently acts the part of the gender opposite to his or her biological sex
- The state of being transsexual.
- For the electronic music EP by Mr. Oizo, see Transexual (EP).
Gender dysphoriaMany transsexual people agree with the idea proposed by Harry Benjamin, that gender is hard-wired in the brain before birth. As such, many transsexual people believe that being transsexual is instead an intersex condition, a congenital birth issue unseen by others due to its location in the brain: a mis-match in the sex of a person between that of the brain and that of the body. The main symptom of this condition is a unique type of depression, anxiety or even psychological pain: Gender Dysphoria. Commonly, transsexual people assert that their brain-based inner perception of their sexual self, their identity, is who they really are, and so change their physical sex in an effort to be on the outside as they feel they are on the inside. If untreated, it can lead to mental and emotional problems, and sometimes suicide.
Most transsexual men and women desire to establish a permanent social role as a member of the gender with which they identify. Many transsexual people also desire various types of medical alterations to their bodies. These physical alterations are collectively referred to as sex reassignment therapy and often include hormone replacement therapy and surgery. The entire process of switching from one physical sex and social gender presentation to the other is often referred to as transition, and usually takes several years.
To obtain sex reassignment therapy, transsexual people are usually required to receive psychological therapy and a diagnosis of gender identity disorder in accordance with the Standards of Care (SOC) as issued by the World Professional Association for Transgender Health (formerly and until 2006 the Harry Benjamin International Gender Dysphoria Association). These are guidelines as the medical community struggles in how to deal with the treatment, and the nature of the treatment population changes, and are not obligatory. Some doctors may waive the psychotherapy requirement as an unnecessary expense in an emotionally mature and stable individual, or require only a psychological evaluation. The intentions of the standard are to prevent people from transitioning when such a transition would be inappropriate (as a dramatic example, a person seeking to transition in order to veil their identity from police), or ill-advised (e.g., a strong crossdresser, who still identifies themselves as their assigned gender), and other cases where if a transition were undertaken, it would be expected to have strongly negative consequences for the patient.
These standards are open to the criticism of being ineffective, or being too strict, discouraging genuinely transsexual people from seeking treatment. It is claimed that Meta-reviews of post-operative transsexuals prior to 1991 reveal a rate of serious regrets of less than 1% for transsexual men and less than 2% for transsexual women, while studies published after 1991 have reported a decrease in the rates for both, likely due to improved psychological and surgical treatments and increasing acceptance from society.
Against the statistic above indicating that 1% to 2% of post-operative persons have serious regrets, the Report itself states: Paradoxically, a growing number of post-operative transsexuals are scathing about their medical care. International research suggests that 3-18% of them come to regret switching gender.
For both men and women, medical treatment typically begins with hormone replacement therapy. Transwomen are usually required to live as members of their target sex for at least one year prior to genital surgery (so-called Real-Life Test or Real-Life Experience), although this time may be longer if the psychotherapist has concerns about the transsexual person's readiness. Transmen must generally wait two to three years after beginning testosterone treatment in order to allow for sufficient clitoral growth. However, some transsexuals, especially among men, may not wish to have this surgery. Others can spend years or even decades saving up enough money to pay for it. Some women may have only orchiectomy and forego vaginoplasty. There are many reasons why some transsexuals opt out of genital surgery. Among these are cost (female-to-male (FTM) surgery can cost up to $80,000), surgical risks, (including genital nerve damage), and acceptance of a certain amount of physical deformity.
For female-to-male (FTM) mastectomy and chest reconstruction, the requirement is only either 3 months of psychological therapy or the same amount of time of Real-Life-Test. The latter may be impossible for transmen with large breasts, and while binding smaller breasts is partially effective, this can cause many health issues if done over a long period of time. Many transsexuals find these requirements to be unjust as cisnatal men and women are not required to undergo any psychological evaluation or wait times to undergo chest reconstructive surgery. However, an 18 month requirement for transwomen to have breast augmentation is typically to allow enough time for breast development due to hormones. Breast augmentation before the breasts have finished developing can result in poor shape.
Currently, the causes of transsexualism are unknown, and estimates of prevalence vary substantially. It is commonly believed that it is a multifactorial condition, having many and different causes, some of which may include a naturally occurring variation in fetal sex differentiation and development. Causes may include some medications or hormones given to pregnant mothers, such as diethylstilbestrol. According to a medical advisory bulletin from Gender.org (Sep. 2002), as many as 25% of the FTM population has polycystic ovarian syndrome, a condition known to cause hormonal fluctuations.
Defining transsexualismTranssexualism (also known as transsexuality) is a complex condition that is defined differently by different people. Many terms have been proposed through the years to describe transsexual people and the processes they go through. As with any terms used by a group, or to refer to a particular group, some of these terms are controversial, or have become controversial, not only to society at large, but even among the transsexual community.
The definition of "transsexuality" is somewhat debated. One common definition is that a transsexual is a person who believes that his or her body does not reflect his or her true 'inner' identification of physical sex or gender. Another common definition is that a transsexual is a person who has had or plans to have medical or surgical treatments that alter his or her body to better reflect what the individual believes is his or her true gender. The first definition allows greater freedom for individuals to self-identify as a transsexual. The latter defines the term based on actual or planned operative status and makes it more an external label than a term of self-definition.
The two terms of sex and gender have become popularly used as one concept, which blurs distinction, but they have different meanings. Physical sex refers more to one's biology and anatomy (that is, male or female) where gender is a more socio-cultural term of how a person presents or is taken (that is more at man or woman, or "like" a male or female" (see Milton Diamond, Ph.D. 2001 or U.S.S.C. Justice Antonin Scalia saying "The word gender has acquired the new and useful connotation of cultural or attitudinal characteristics (as opposed to physical characteristics) distinctive to the sexes. That is to say, gender is to sex as feminine is to female and masculine is to male.")
When genital surgery is undertaken it is commonly referred to as sex reassignment surgery or genital reconstructive surgery or even gender reassignment surgery by some health care providers and community members. An older term, sex change surgery may be seen as disrespectful.
The Diagnostic and Statistical Manual of Mental Disorders accepts the expression of desire to be of the opposite sex, or assertion that one is of the sex opposite from the one with which they were assigned at birth, as sufficient for being transsexual. The ICD-10 states in a similar way that transsexualism is defined by, "the desire to live and be accepted as a member of the opposite sex, usually accompanied by the wish to make his, or her body as congruent as possible with the preferred sex through surgery and hormone treatment." In contrast, transgenderists do not identify as being of, or desiring to be the opposite sex, but as being of or wanting to be another gender.
Transsexualism has been variously described as a trait, disease, behavior, desire, mental illness, perversion, paraphilia, political identity, and lifestyle. The term perversion is often used in a derogatory manner (especially by Western religions). People may consider the use of such labels offensive whether they are or are not transsexual, or involved with Western religions, themselves.
Transsexualism is often included within the broader term transgender, which is generally considered an umbrella term for people who do not conform to typical accepted gender roles, for example cross-dressers, drag queens, and people who identify as genderqueer. However, some transsexuals object to this inclusion. Historically the reason that transsexuals rejected associations with the transgender or broader LGBT community is largely that the medical community in the 1950s through the late 1980s encouraged (and in many ways required) this rejection of such a grouping in order to be a 'good transsexual' who would thus be allowed to access medical and surgical care. The animosity that is present today is no longer fed by this same kind of pressure from the medical community (indeed, today many gender therapists actively encourage their clients to explore support within the broader community.)
However, where some of the beliefs of modern day transsexual people that they are not transgender, is reflective of this historical division (Denny 176), other transsexual people state that someone choosing to retain their former physical sex (no SRS) is very different from someone who needs to be of "the other sex", that the groups have different issues and concerns and are not doing the same things. The latter view is rather contested, with opponents pointing out that merely having or not having some medical procedures hardly can have such far-reaching consequences as to put those who have them and those who have not into such distinctive categories.
Regardless of definition, transsexualism should not be confused with cross dressing or with the behaviour of drag queens and drag kings, which can be described as transgender but not transsexual. Also, transvestic fetishism usually has little, if anything, to do with transsexualism. As a general rule, transsexual people tend to dress and behave in a manner consistent with the gender they identify with, crossdressers tend to dress (and sometimes behave) in a manner consistent with stereotypical ideals of the opposite gender as opposed to the real-life behavior of that gender, and "drag queens" or "drag kings" tend to dress and behave in a flamboyant manner which parodies rather than emulates the opposite gender.
Gender terminology for transsexual peopleTranssexual itself is most respectfully used as an adjective. In other words, one who wishes to be respectful would refer, as this article does, to "transsexual people," "transsexual men," or "transsexual CEOs," but would not use phrases like, "Transsexuals prefer pistachio to rocky road." This more respectful usage appears to have resulted as a response to cumulative dehumanization. The idea appears to be that if used only as an adjective, transsexual will inevitably be paired with words such as "people," "women," and "men" in ways that help to reemphasize transsexual humanity and increase sympathy.
Transsexual people almost universally prefer to be referred to by the gender pronouns and terms associated with their target gender. For example, a transsexual man is a person who was assigned the female sex at birth on the basis of his genitals, but despite that assignment identifies as a man and is transitioning or has transitioned to a male gender role and has or will have a masculine body. Transsexual people are sometimes referred to with "assigned-to-target" sex terms such as "female-to-male" for a transsexual man or "male-to-female" for a transsexual woman. These terms may be abbreviated as "M2F", "F2M", "MTF", "F to M", etc. These terms are particularly helpful in preventing confusion, because to some people the term "transsexual woman" is a female transitioning to become a male, and to others a male transitioning to become a female. When the terms transmen and transwomen are used though, it is typical for them to be used to refer to the gender that the person identifies with, regardless of their appearance or state of transition.
Transsexual people are often considered as part of the LGBT community, and although many do identify with this community, others do not, or prefer not to use the terms at all. Transsexual people typically feel it important for people to understand that transsexualism neither depends upon, nor is related to, sexual orientation. Transsexual men and women exhibit a range of sexual orientations just as non-transsexual (some times referred to as Cisgender) people do, and they will almost always use terms for their sexual orientation that relate to the sex with which they identify. For example, someone assigned to the male sex but who identifies as a woman, and who is attracted solely to men, will identify as heterosexual, not gay. Likewise, someone who was assigned to the female sex, identifies as a man, and prefers male partners will identify as gay, not heterosexual. Transsexual people, like other people, can also be bisexual or asexual as well.
Older medical texts often referred to transsexual people as members of their original sex by referring to a male-to-female transsexual as a "male transsexual". They also described sexual orientation in relation to the person's assigned sex, not their gender of identity; in other words, referring to a male-to-female transsexual who is attracted to men as a "homosexual male transsexual." This usage is considered by many to be scientifically inaccurate and clinically insensitive today. As such someone who would have been referred to as a "homosexual male transsexual" would now be called and most likely identify herself as a heterosexual transsexual woman. Although the original usage is dwindling, some medical textbooks still refer to transsexual people as members of their assigned sex, but now many use "assigned-to-target" terms.
The transsexual community typically use the short form "trans", or simply "T" as a substitution for the full word "transsexual", e.g. TS, trans guy, trans dyke, T-folk, trans folk. Some may even use terms that have become controversial to some, such as tranny and/or trans, despite others considering these terms to be offensive. Those who do use these terms claim that they are diminishing the power of the term as an insult, just as some members of the gay and African-American communities have embraced slurs directed at them. Others feel that the terms are insulting or inaccurate regardless of the context. Some feel that such words are problematic because they do not differentiate between transsexual people, and people who are merely "playing" with gender.
Some individuals may prefer to spell transsexual with only one s, thus writing transexual. They will typically assert that they are attempting to divorce the word from the realm of psychiatry and medicine and place it in the realm of identity. This trend is most common in the United States, and is almost never used in the United Kingdom.
Some prefer the term transsexed over transsexual, as they believe the term sexual found in transsexual is misleading and implies that transsexualism is a sexual orientation. Another justification made for this preference is that they feel it more closely parallels with the term intersex, which is considered by them to be important as more transsexual groups are welcoming them because they feel both groups have much in common. It is, by some definitions, possible to be both intersexed and transsexed. Other attempts to avoid the misleading -sexual have been the increasing acceptance of transgender or trans* and in some areas, transidentity.
Some transsexual people may also prefer transgendered over transsexual, because this minority sees the issue to be about gender rather than sexuality. (Note that this distinction, violating norms of gender vs. violating norms of sex, is precisely why crossdressers, as one of many examples, are classified as transgender rather than transsexual.) This subset of transsexual people make a parallel with intergender, whose issue is about being between (inter) the genders rather than "intersexual". It is often assumed, particularly by transsexual people, that transsexualism is a subset of intersex. "Intersex" previously referred only to those who are physiologically intersexed, e.g., with genitals that do not look classically male or female. (Despite the fact that human genitals show an extremely wide variation in general, intersexed people typically have genitalia that frustrate attempts to assign them within a binary sex system.) However, since sex in humans is composed of many different attributes, such as genes, chromosomes, regulatory proteins, hormones, hormone receptors, body morphology, brain sex, and gender identity, any variation among any of those attributes could fall under the rubric of "intersex." Transsexualism, in this view, simply becomes a form of being neurologically intersexed that was mistakenly categorized outside of the rubric of intersex because of the historical lack of proof for a specific etiology. (See below for research of physiological causes of transsexualism).
This stance is also seen in countries such as Brazil and Thailand. Thailand is thought to have the highest prevalence of transsexualism in the world. In Thailand, kathoey (who are often, but not always, transsexual) are accepted to a greater extent than in most countries, but are not completely free of societal stigma. Feminine transsexual kathoey are much more accepted than gay male kathoey; this may be seen as an example of heteronormativity. Due to the relative prevalence and acceptance of transsexualism in Thailand, there are many accomplished Thai surgeons who specialize in sex reassignment surgery. Thai surgeons are a popular option for Western transpeople seeking surgery, largely due to the lower cost of surgery in Thailand.
Transsexual people are gaining acceptance in much of Latin America, and sex reassignment surgeries are on the rise in Mexico, Argentina and Brazil.
Transsexual- (and tg-) related issues remain largely taboo in much of Africa and in developing countries around the world.
- Burns, Christine: Why Phrasebook Diversity is not Enough (Press for Change)
- True Selves: Understanding Transsexualism - For Families, Friends, Coworkers, and Helping Professionals
- Trans Liberation : Beyond Pink or Blue
- Standards of Care for Gender Identity Disorders, Sixth Version. - World Professional Association for Transgender Health (2001)
- Xavier, J., Simmons, R. (2000) - The Washington transgender needs assessment survey, Washington, DC: The Administration for HIV and AIDS of the District of Columbia Government
- Human Sexuality in a World of Diversity
- Denny, Dallas, (2006); Transgender Communities in Transgender Rights.
- Basic TG/TS/IS Information - including Successful Transwomen and Successful Transmen
- FTM International - Female To Male International: practical and medical information
- FTM Australia - Comprehensive information for all men identified female at birth in Australia.
- Hudson's FTM Resource Guide - Comprehensive information for female to male trans men and allies - USA-based
- Gender.org - The home of Gender Education & Advocacy, a nonprofit corporation using the web to provide education and advocacy for transsexual and transgender issues.
- Definition and Synopsis of the Etiology of Adult Gender Identity Disorder and Transsexualism - prepared by 24 internationally recognized experts, published by the Gender Identity Research and Education Society (GIRES)(See: http://www.gires.org.uk)
- How to Respect a Transsexual Person
- The International Journal of Transgenderism - The Official Journal of the World Professional Association for Transgender Health (formerly HBIGDA)
- Transsexuality - Jennifer Diane Reitz's Help & Support Site. Home of the COGIATI gender test, a controversial assessment of gender identity and transsexuality.
- TransParentcy - Organization to support transgender parents and their advocates (lawyers, mental health professionals, friends, family) by providing information and resources to diffuse and/or disspell the myths about any adverse impact being transgendered/transsexual might have on ones children.
- Transsexual Road Map - practical and medical information for those interested in finding out more
transsexualism in Simple English: Transsexual
transsexualism in Bosnian: Transseksualnost
transsexualism in Breton: Treuzrevelezh
transsexualism in Bulgarian: Транссексуалност
transsexualism in Catalan: Transsexualitat
transsexualism in Danish: Transseksualitet
transsexualism in German: Transsexualität
transsexualism in Estonian: Transseksuaalsus
transsexualism in Spanish: Transexualidad
transsexualism in Esperanto: Transseksulo
transsexualism in Persian: تراجنسی
transsexualism in French: Transsexualisme
transsexualism in Croatian: Transseksualnost
transsexualism in Italian: Transessuale
transsexualism in Hebrew: טרנסקסואליות
transsexualism in Macedonian: Транссексуалност
transsexualism in Dutch: Transseksualiteit
transsexualism in Japanese: 性転換
transsexualism in Norwegian: Transkjønnethet
transsexualism in Polish: Transseksualizm
transsexualism in Portuguese: Transexual
transsexualism in Russian: Транссексуальность
transsexualism in Serbian: Транссексуализам
transsexualism in Finnish: Transsukupuolisuus
transsexualism in Swedish: Transsexuell
transsexualism in Turkish: Transeksüel
transsexualism in Yiddish: טרענסעקסואליזם
transsexualism in Chinese: 變性