Transgender

Transgender (pronounced /trænzˈdʒɛndər/) is a general term applied to a variety of individuals, behaviors, and groups involving tendencies to vary from the usual gender roles.

Transgender is the state of one's "gender identity" (self-identification as woman, man, neither or both) not matching one's "assigned sex" (identification by others as male, female or intersex based on physical/genetic sex). "Transgender" does not imply any specific form of sexual orientation; transgender people may identify as heterosexual, homosexual, bisexual, pansexual, polysexual, or asexual; some may consider conventional sexual orientation labels inadequate or inapplicable to them. The precise definition for transgender remains in flux, but includes:

• "Of, relating to, or designating a person whose identity does not conform unambiguously to conventional notions of male or female gender roles, but combines or moves between these."^[1]
• "People who were assigned a sex, usually at birth and based on their genitals, but who feel that this is a false or incomplete description of themselves."^[2]
• "Non-identification with, or non-presentation as, the sex (and assumed gender) one was assigned at birth."^[3]

A transgender individual may have characteristics that are normally associated with a particular gender, identify elsewhere on the traditional gender continuum, or exist outside of it as "other," "agender," "Genderqueer," or "third gender". Transgender people may also identify as bigender, or along several places on either the traditional transgender continuum, or the more encompassing continuums which have been developed in response to the significantly more detailed studies done in recent years.^[4]

Evolution of the term transgender

The term transgender (TG) was popularised in the 1970s^[5] (but implied in the 1960s^[6][7]) describing people who wanted to live cross-gender without sex reassignment surgery.^[8] In the 1980s the term was expanded to an umbrella term,^[9] and became popular as a means of uniting all those whose gender identity did not mesh with their gender assigned at birth.^[10]

In the 1990s, the term took on a political dimension^[11][12] as an alliance covering all who have at some point not conformed to gender norms, and the term became used to question the validity of those norms^[13] or pursue equal rights and anti-discrimination legislation,^[14][15] leading to its widespread usage in the media, academic world and law.^[16] The term continues to evolve.

Transgender vs. transsexual

Billy Tipton was born in 1914. He began living as a man full-time by 1940 at age 26, had a career as a jazz and swing pianist and entertainer, a common law marriage (unregistered but publicly accepted), and three sons by adoption. He was discovered to have been female-bodied after he died in 1989 due to a hemorrhaging ulcer (that he refused to have treated). Like many female-to-male transsexuals of this day he did not have genital surgery.

The word transsexual, unlike the word transgender, has a precise medical definition.^[17] It was defined by Harry Benjamin in his seminal book "The Transsexual Phenomenon".^[17] In particular he defined transsexuals on a scale called the "Benjamin Scale", which defines a few different levels of intensity of transsexualism; these are listed as "Transsexual (nonsurgical)", "True Transsexual (moderate intensity)", and "True Transsexual (high intensity)".^[17] Many transsexuals believe that to be a true transsexual one needs to have a desire for surgery. ^[18] However, it is notable that Benjamin's moderate intensity "true transsexual" needs estrogen, or testostorone medication as a "substitute for or preliminary to operation."^[17] There also exist people who have had sexual reassignment surgery (SRS) but do not meet the definition of a transsexual, such as Gregory Hemingway,^[19][20] while other people do not desire SRS yet clearly meet Dr. Benjamin's definition of a "true transsexual".^[21] Beyond Dr. Benjamin's work, which focused on Male to Female transsexuals, there are cases of Female to Male transsexuals for whom surgery is often considered to be not practical.

Outside of the above medical definition there is a wide range of gender expressions which are contrary to the norm. Cross dressers, drag queens, transvestites, transvestic fetishist etc. It is notable that many transsexuals go through one of those self identifications before realizing that they are in fact transsexual.

Some transsexuals also take issue with the term because Charles "Virginia" Prince, the founder of the cross dressing organization Tri-Ess and coiner of the term "transgender",^[22] did so because she wished to distinguish herself from transsexual people. In "Men Who Choose to Be Women," Prince wrote "I, at least, know the difference between sex and gender and have simply elected to change the latter and not the former".^[23] There is a substantial academic literature on the difference between sex and gender, but in pragmatic English, this academic distinction is ignored and "gender" is used mostly to describe the categorical male/female difference while "sex" is used mostly to describe the physical act.^[24]

There is political tension between the identities that fall under the "transgender umbrella." For example, transsexual men and women who can pay for medical treatments (or who have institutional coverage for their treatment) are likely to be concerned with medical privacy and establishing a durable legal status as men and women later in life. Extending insurance coverage for medical care is a coherent issue in the intersection of transsexuality and economic class. Most of these issues can appeal even to conservatives, if framed in terms of an unusual sort of "maintenance" of traditional notions of gender for rare people who feel the need for medical treatments. Some trans people might express this by saying "I don't challenge the gender binary, I just started out on the wrong side of it."^[25]

Transgender identities

Albert Cashier, a trans man who served as a soldier in the US civil war.

While people self-identify as transgender, transgender identity includes many overlapping categories. These include cross-dresser (CD); transvestite (TV); androgynes; genderqueer; people who live cross-gender; drag kings; and drag queens; and, frequently, transsexual (TS).^[26] Usually not included are transvestic fetishists (because it is considered to be a paraphilia rather than gender identification). In an interview, artist RuPaul talked about society's ambivalence to the differences in the people who embody these terms. "A friend of mine recently did the Oprah show about transgender youth," said RuPaul. "It was obvious that we, as a culture, have a hard time trying to understand the difference between a drag queen, transsexual, and a transgender, yet we find it very easy to know the difference between the American baseball league and the National baseball league, when they are both so similar."^[27] These terms are explained below.

The extent to which intersex people (those with ambiguous genitalia or other physical sexual characteristics) are transgender is debated, since not all intersex people disagree with their gender assigned at birth. The current definitions of transgender include all transsexual people, although this has been criticized. (See below.)

The term trans man refers to female-to-male (FtM or F2M) transgender people, and trans woman refers to male-to-female (MtF or M2F) transgender people, although some transgender people identify only slightly with the gender not assigned at birth. In the past, it was assumed that there were far more trans women than trans men, but a Swedish study estimated a ratio of 1.4:1 in favour of trans women for those requesting sex reassignment surgery and a ratio of 1:1 for those who proceeded.^[28] There is a school of thought that says terms such as "FtM" and "MtF" are subjugating language that reinforces the binary gender stereotype.^[29]

The term cisgender has been coined as an antonym referring to non-transgender people; i.e. those who identify with their gender assigned at birth.^[30]

Transsexual

Transsexual people identify as, or desire to live and be accepted as, a member of the sex opposite to that assigned at birth.^[31][32]

Many trans people desire to undergo gender transition. People who have transitioned, who do not necessarily identify as transgender or transsexual any longer, may identify as simply a man or a woman. Those that continue identifying as transsexual men or women may not want to ignore their pre-transition life, and may continue strong ties with other trans people and raising social consciousness.^[33]

Many transsexual people have a wish to alter their bodies. These physical changes are collectively known as gender reassignment therapy and often (but not always) include hormone replacement therapy and sex reassignment surgery. References to "pre-operative", "post-operative" and "non-operative" transsexual people indicate whether they have had, or are planning to have sex reassignment surgery, although some trans people reject these terms as objectifying trans people based on their surgical status and not their mental gender identity.

Cross-dresser

The term 'cross-dresser' is not exactly defined in the relevant literature. Michael A. Gilbert,^[34] professor at the Department of Philosophy, York University, Toronto, offers this definition: "[A cross-dresser] is a person who has an apparent gender identification with one sex, and who has and certainly has been birth-designated as belonging to one sex, but who wears the clothing of the opposite sex because it is the clothing of the opposite sex." This excludes people "who wear opposite sex clothing for other reasons". Also, the group doesn't include "those female impersonators who look upon dressing as solely connected to their livelihood, actors undertaking roles, individual males and females enjoying a masquerade, and so on. These individuals are cross dressing but are not cross dressers."^[35] Cross-dressers may not identify with, or want to be the opposite gender, nor adopt the behaviors or practices of the opposite gender, and generally do not want to change their bodies medically. The majority of cross-dressers identify as heterosexual.^[36]

Transvestite

A transvestite is somebody who cross-dresses.^[37][38] The term "transvestite" is used as a synonym for the term "cross-dresser",^[39][40] although it has been stated that "cross-dresser" is the preferred term.^[40][41] The term "transvestite" and the associated term "transvestism" are conceptually different from the term "fetishistic transvestism" (a.k.a. "transvestic fetishism"), as "transvestic fetishist" describes those who intermittently use clothing of the opposite gender for fetishistic purposes,^[42][43] and "transvestite" does not. In medical terms, transvestic fetishism is differentiated from cross-dressing by use of the separate codes 302.3^[43] in the DSM and F65.1^[42] in the ICD.

Drag kings and queens

New York City drag king Murray Hill with drag queen Linda Simpson.

Drag is a term applied to clothing and make-up worn on special occasions for performing or entertaining as a hostess, stage artist or at an event (e.g. Lypsinka). This is in contrast to those who cross-dress for other reasons or are otherwise transgender. Drag can be theatrical, comedic, or grotesque, and female-identified drag has been considered a caricature of women by second-wave feminism. Within the genre of drag are gender illusionists who do try to pass as another gender. Drag artists explore gender issues and have a long tradition in LGBT culture. Drag has been regarded as an area where transgender people can find more acceptance and financial support than mainstream work environments. Generally the terms drag queen covers men doing female drag, drag king covers women doing male drag, and faux queen covers women doing female drag.

Genderqueer

Genderqueer is a recent attempt to signify gender experiences that do not fit into binary concepts, and refers to a combination of gender identities and sexual orientations. One example could be a person whose gender presentation is sometimes perceived as male, sometimes female, but whose gender identity is female, gender expression is butch, and sexual orientation is lesbian. It suggests nonconformity or mixing of gender stereotypes, conjoining both gender and sexuality,^[44] and challenges existing constructions and identities.^[45] Genderqueerness is unintelligible and abjected in the binary sex/gender system.^[46]

People who live cross-gender

People who live cross-gender live always or mostly as the gender other than that assigned at birth. If they want to be or identify as their gender assigned at birth, then the term "crossdresser"^[47] may be used. If they want to be or identify as the gender they always or mostly live in, then the term "transsexual" may be used.^[31] The term "transgender"^[48][49][50] or "transgenderist"^[51] has been applied to people who live cross-gender without sex reassignment surgery.

Androgyne

An androgyne is a person who does not fit cleanly into the typical gender roles of their society. It does not imply any specific form of sexual orientation. Androgynes may identify as beyond gender, between genders, moving across genders, entirely genderless, or any or all of these. Androgyne identities include pangender, bigender, trigender, ambigender, non-gendered, agender, Gender fluid or intergender. Androgyny can be either physical or psychological; it does not depend on birth sex and is not limited to intersex people. Occasionally, people who do not define themselves as androgynes adapt their physical appearance to look androgynous. This outward androgyny has been used in fashion, and the milder forms of it (women wearing men's pants or men wearing two earrings, for example) are not seen as transgender behavior.

The term androgyne is also sometimes used as a medical synonym for an intersex individual.^[52]

Transgender people and the LGBT community

Gender identity and transgender identity are fundamentally different concepts to that of sexual orientation. Transgender people have more or less the same variety of sexual orientations as cisgender people.^[53] In the past, the terms homosexual and heterosexual were used for transgender individuals based on their birth sex.^[54] Professional literature now uses terms such as attracted to men (androsexual), attracted to women (gynosexual), attracted to both or attracted to neither to describe a person's sexual orientation without reference to their gender identity.^[55] Therapists are coming to understand the necessity of choosing terms with respect to their clients' gender identities and preferences.^[56][57]

Despite this distinction, throughout history the gay, lesbian, and bisexual subculture was often the only place where gender-variant people were socially accepted in the gender role they felt they belonged to; especially during the time when legal or medical transitioning was almost impossible. This acceptance has had a complex history. Like the wider world, the gay community in Western societies did not generally distinguish between sex and gender identity until the 1970s, and generally perceived gender variant people more as homosexuals who behaved in a gender-variant way than as gender-variant people in their own right.

In the years following the sexual revolution of the 1960s, transgender sexuality has often been accepted into the fold of the burgeoning LGBT movement. The nature and degree of this acceptance has not been without controversy, however, and has drawn criticism from LGB and transgender people alike. A large part of the discomfort of becoming the "T" in LGBT is that the first three letters refer to sexual orientation, while the "T" refers to gender identity.

Pride symbols

The transgender pride flag

A common symbol for the transgender community is the transgender pride flag, which was designed by Monica Helms, and was first shown at a pride parade in Phoenix, Arizona, United States in 2000.

The flag consists of five horizontal stripes, two light blue, two pink, with a white stripe in the center.

Monica describes the meaning of the flag as follows:

The light blue is the traditional color for baby boys, pink is for girls, and the white in the middle is for those who are transitioning, those who feel they have a neutral gender or no gender, and those who are intersexed. The pattern is such that no matter which way you fly it, it will always be correct. This symbolizes us trying to find correctness in our own lives.

Other transgender symbols include the butterfly (symbolizing transformation or metamorphosis), and a pink/light blue yin and yang symbol.

Transgender people and feminism

Some feminists and feminist groups are supportive of transgender people. Others are not.

Feminist writer Janice Raymond asserts that sex determines gender, and that there is no practical difference between the two. In her view, genitalia or "birth sex" or chromosomes deeply and permanently determine one's essential identity as a woman or man; trying to violate this divide is impossible, unnatural, and unhealthy. She argues that while transpeople may claim to feel like a certain gender, only a biological female can genuinely feel what it is to occupy a woman's body, including having experiences such as childbirth.^[58]

Transgender healthcare

Mental healthcare

Beginning therapy is recommended for all people who are frustrated by their gender, especially if they desire to transition. People who experience discord between their gender and the expectations of others or whose gender identity conflicts with their body benefit by talking through their feelings in depth with someone who will listen indefinitely. However, gender identity is new to psychology and research is still in its infancy.^[59]

Transgender people may be eligible for diagnosis of gender identity disorder (GID) "only if [being transgender] causes distress or disability."^[60] This distress is referred to as gender dysphoria and may manifest as depression or inability to work and form healthy relationships with others. This diagnosis is often over-simplified to mean that simply being transgender means a person suffers from GID which is not true. This has caused much confusion to transgender people and those who strongly seek to either criticize or affirm them. Transgender people who are comfortable with their gender, whose gender does not directly cause inner frustration or impair their functioning, do not have GID and are not applicable for a related mental disorder. Further, GID is not permanent and is usually resolved through therapy and transitioning, especially its social aspects. GID does not refer to people who feel oppressed by the negative attitudes and behaviors or others including legal entities in the same way that racist institutions do not create a "race disorder." Neither does GID imply an opinion of immorality - the psychological establishment holds the position that people with any kind of mental or emotional problem should not receive stigma. The solution for GID is whatever will alleviate suffering and restore functionality; this often, but not always, consists of undergoing a gender transition.^[59]

The terms "transsexualism", "dual-role transvestism", "gender identity disorder in adolescents or adults" and "gender identity disorder not otherwise specified" are listed as such in the International Statistical Classification of Diseases (ICD) or the American Diagnostic and Statistical Manual of Mental Disorders (DSM) under codes F64.0, F64.1, 302.85 and 302.6 respectively.^[61]

In February 2010, France became the first country in the world to remove transgender identity from the list of mental diseases.^[62][63]

The issues around psychological classifications and associated stigma (whether based in paraphilia or not) of cross dressers, transsexual men and women (and for that matter lesbian and gay children who may be difficult to tell apart from trans children early in life) have recently become more complex since it was announced that CAMH colleagues Kenneth Zucker and Ray Blanchard would serve on the DSM-V's Sexual and Gender Identity Disorders Work Group ^[64]. CAMH aims to 'cure' transgendered people of their 'disorder', especially in children. Within the trans community this has mostly produced shock and outrage with attempts to organize other responses ^[65]. One of the reasons there is so much controversy about Kenneth Zucker and Ray Blanchard's work group is because many people believe that gender identity disorders/homosexuality are incurable as they are genetic and/or occur as a result of events occurring before birth (therefore already "solidified" by the time of birth). If this is the case, then trying to 'cure' said condition(s) could lead (and in some individuals already has led^[66][67][68]) to increased confusion, more intense dysphoria later in life, and perhaps even suicide (likely due to the fact that the younger the transgendered individual, the greater the effect of hormones). While some cases of individuals partaking in these sessions seem to show success, the long term repercussions (if any) of some of these individuals being 'cured' have not yet been observed, due to an indefinite amount of time before negative reactions could possibly occur.

Transgender issues are both new in the scientific field and affect relatively few people, so understandably many mental healthcare providers know little about transgender issues. People seeking help from these professionals often end up educating the professional rather than receiving help.^[59] Among those therapists who profess to know about transgender issues, many believe that transitioning from one sex to another – the standard transsexual model – is the best or only solution. This usually works well for those who are transsexual, but is not the solution for other transgender people, particularly genderqueer people who do not identify as exclusively male or female.

Physical healthcare

Medical and surgical procedures exist for transsexual and some transgender people. (Most categories of transgender people as described above are not known for seeking the following treatments.) Hormone replacement therapy for trans men induces beard growth and masculinises skin, hair, voice and fat distribution. Hormone replacement therapy for trans women feminises fat distribution and breasts. Laser hair removal or electrolysis removes excess hair for trans women. Surgical procedures for trans women feminise the voice, skin, face, adam's apple, breasts, waist, buttocks and genitals. Surgical procedures for trans men masculinise the chest and genitals and remove the womb and ovaries and fallopian tubes. The acronyms "GRS" and "SRS" refer to genital surgery. The term "sex reassignment therapy" (SRT) is used as an umbrella term for physical procedures required for transition. Use of the term "sex change" has been debated.^[69] Availability of these procedures depends on degree of gender dysphoria, presence or absence of gender identity disorder,^[70] and standards of care in the relevant jurisdiction.

Transgender people and the law

Dr. Camille Cabral, a transgender activist at a demonstration for transgender people in Paris, October 1, 2005

Legal procedures exist in some jurisdictions allowing an individual to change their legal gender, or their name, to reflect their gender identity. Requirements for these procedures vary from an explicit formal diagnosis of transsexualism, to a diagnosis of gender identity disorder, to a letter from a physician attesting to the individual's gender transition, or the fact that one has established a different gender role.^[71] In 1994, the DSM IV entry was changed from "Transsexual" to "Gender Identity Disorder." In many places, transgendered people are not legally protected from discrimination (such as occupational) based on their condition.^[72]

In Canada, a private members bill protecting the rights of freedom of gender expression and gender identity is anticipated in Spring 2010. This will amend the Canada Human Rights code to help protect gender-variant people from discrimination by including gender identity and expression in the list of prohibited grounds for discrimation, as well as including gender identity and expression in the description of identifiable group, so that offences deliberately against gender-variant people can be punished to a similar extent as a racial-based crime.^[73]

Transgender people and religion

The world's religions display great diversity and their interpretations of and reactions to transgender people demonstrate equal diversity. Even within one specific religion, Christianity, different groups have very different interpretations of gender identity and socio-cultural gender roles as well as very different attitudes toward and reactions to transgender people (see the main article on this topic). More generally the scriptures of Abrahamic religions include both texts^[74] sometimes interpreted as condemning transgender persons as well as texts^{[75][76][77][78]} sometimes interpreted as challenging conservative views of gender and of the possibilities open to transgender people as well as offering encouragement, support and hope to people who are trangendered.

Transgender people and science

Some recent findings have provided clues and possibly answers as to how or why some or most cases of transsexuality occur. In 1997, J.N. Zhou, M.A. Hofman, L.J. Gooren and D.F. Swaab conducted tests on the brains of transgender individuals. Their tests showed that the volume of the central subdivision of the bed nucleus of the stria terminalis (BSTc), a brain area that is essential for sexual behaviour, is larger in men than in women. A female-sized BSTc was found in male-to-female transsexuals. The size of the BSTc was not influenced by sex hormones in adulthood and was independent of sexual orientation. Their study was the first to show a female brain structure in genetically male transsexuals and supports the hypothesis that gender identity develops as a result of an interaction between the developing brain and sex hormones.^[79] Perhaps confirming why this brain difference occurs, in 2008 at Prince Henry's Institute of Medical Research in Melbourne, biological studies were performed to attempt to find a link between genes and transsexuality. Their study shows male to female transsexuals are more likely than non-transsexual males to have a longer version of a receptor gene for the sex hormone androgen or testosterone. The research suggests reduced androgen and androgen signaling contributes to the female gender identity of male to female transsexuals. They say that it is possible that a decrease in testosterone levels in the brain during development might result in incomplete masculinization of the brain in male to female transsexuals, resulting in a more feminized brain and a female gender identity.^[80]

Autogynephilia

The controversial^[81] Blanchard, Bailey, and Lawrence theory characterizes trans women as having one or another sexual motivations for transition.^[82][83][84] For example, Anne Lawrence, an openly autogynephilic transsexual ^[85], has hypothesized that the desire by persons with autogynephilia, including some cross dressers and some transsexuals, to alter their body can be compared with apotemnophilia (alternately body integrity identity disorder if framed as an identity issue rather than a fetish).^[86] Characterizations related to libido like these have been criticized by many in the medical and transgender communities alike as being potentially unscientific^[87] and transphobic.^[88]

Transgender people in non-Western cultures

Nong Tum, a Kathoey internationally recognized for her portrayal in the film Beautiful Boxer.

Asia

In Thailand and Laos,^[89] the term kathoey is used to refer to male-to-female transgender people^[90] and effeminate gay men.^[91] The cultures of the Indian subcontinent include a third gender, referred to as hijra^[92] in Hindi. Transgender people also have been documented in Iran,^[93] Japan,^[94] Nepal,^[95] Indonesia,^[96] Vietnam,^[97] South Korea,^[98] Singapore,^[99] and the greater Chinese region, including Hong Kong,^[100][101] Taiwan,^[102] and the People's Republic of China.^{[103][104][105]}

North America

In what is now the United States and Canada, many Native American and Canadian First Nations peoples recognised^[106] the existence of more than two genders, such as the Zuñi male-bodied Ła'mana,^[107] the Lakota male-bodied winkte^[108] and the Mohave male-bodied alyhaa and female-bodied hwamee.^[109] Such people were previously^[110] referred to as berdache but are now referred to as Two-Spirit,^[111] and their spouses would not necessarily have been regarded as gender-different.^[109] In Mexico, the Zapotec culture includes a third gender in the form of the Muxe.^[112]

Other

In early Medina, gender-variant^[113] male-to-female Islamic people were acknowledged^[114] in the form of the Mukhannathun. In Ancient Rome, the Gallae were castrated^[115] followers of the Phrygian goddess Cybele and can be regarded as transgender in today's terms.^[116][117]

Among the ancient Middle Eastern Akkadian people, a salzikrum was a person who appeared biologically female but had distinct male traits. Salzikrum is a compound word meaning male daughter. According to the Code of Hammurabi, salzikrūm had inheritance rights like that of priestesses; they inherited from their fathers, unlike regular daughters. A salzikrum's father could also stipulate that she inherit a certain amount.^[118]

Mahu is a traditional status in Polynesian cultures.

See also

• Cisgender
• Gender identity disorder
• Genderqueer
• List of transgender people
• List of transgender-related topics
• List of transgender-rights organizations
• List of transgender, transsexual and intersex fictional characters
• List of unlawfully killed transgender people
• Queer
• Transgender Day of Remembrance
• Transgender musicians
• Transgender publications
• Transgenderism
• Transphobia
• LGBT

References

External links

• Transgendered at the Open Directory Project
• "Lesbian, Gay, Bisexual, and Transgender/Transsexual Individuals" - Chapter on LGBT issues and public health (co-authored with Emilia Lombardi). Social Injustice and Public Health (eds. Barry Levy and Victor Sidel), Dr. Talia Mae Bettcher, Dr. Emilia Lombardi, Oxford University Press, 2005.

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