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Revision as of 11:13, 4 April 2004
A transsexual (sometimes transexual) is a person who establishes a permanent identity with the opposite gender to his or her assigned (usually at birth) sex. The stereotypical explanation is of a "woman trapped in a man's body" or vice versa, although many transsexuals reject this formulation. A transsexual makes or desires to make a transition from their birth sex to that of the opposite sex, with some type of medical alteration to their body.
Gender terms used to describe transsexuals relate to the target. For example, a transsexual man is a transsexual who identifies as a man and who may be transitioning to a male body (an alternative term is female-to-male).
There has been preliminary, but still controversial, evidence to suggest that transsexuals' brains are gendered opposite to their birth sex (ie. transsexual women have a female brain, and transsexual men have a male brain). This evidence concerns only some tiny sexually dimorphic nuclei (SDN). The overall structure (e.g. size and hemispheric differences) of transsexuals' brains is not significantly different from that of other members of their birth sex. See references.
Whether hormonally induced changes, without surgical changes, are sufficient to qualify for the label transsexual, or whether a certain set of procedures to be fulfilled to be labelled transsexual is currently a debated topic, both among the transsexual and transgender community and health care providers. However, it is generally accepted (and is also evident in the Diagnostic and Statistical Manual) that to express desire to be of the opposite sex, or to assert that one is of the opposite sex to which they were born, constitutes being transsexual.
Some people prefer to spell transexual with one s, in an attempt to divorce the word from the realm of psychiatry and medicine and place it in the realm of identity.
Definitions
Transsexuality or transsexualism is one of a number of behaviours or states collectively referred to as transgender. However, many transsexuals do not identify as transgendered. Some see transgender as subsuming and erasing their identity. Some reject the term for themselves because to them it implies a breaking down of gender roles, when in fact they see themselves as fitting a gender role - just not the one they were assigned at birth.
Transsexuals are often construed as belonging to the Queer community, and many identify with the community; others do not, or prefer not to use the term to describe it. It should be noted that transsexuality is not associated with sexual orientation. Transsexuals exhibit a range of sexual orientations just as non-transsexuals do. Transsexuals almost always use terms for their sexual orientation that relate to their target gender; for example, a transsexual assigned to the male gender at birth but who identifies as a woman, and who is attracted to men, will identify as heterosexual, not gay.
Transsexuals should not be confused with cross-dressers or drag queens who can be described as transgender, but usually not transsexual. Also, transvestic fetishism has usually little, if anything, to do with transsexuality.
Transsexual Youth
An individual may begin to come to terms with his/her gender identity at many stages in their life. In many cases, it becomes apparent at childhood, some, in very early childhood, where the child may be expressing behaviour incongruent with and dissatisfaction related to their assigned gender.
Coming out
Since transsexualism is still not widely accepted in many countries, transsexual youth may feel they need to remain in the closet until they feel that there is a time appropriate to reveal to their parents their gender identity - understandably this is so as parents have a great deal of influence in their children's life, and some parents can react negatively towards such news. Other parents can be very supportive, initially, or after such news has been broken to them.
Ensuring the child's security
Families with a young member who is trans or trans curious and who have chosen to transition between the sex roles through dress and behaviors may decide to relocate their child and home to another area in order to afford the young person the best opportunity to live in the desired gender role and among a new set of peers and a community to whom they have had no previous acquaintance.
Choosing to remain and live within an intolerant society where the local community has had previous experience of the child's assigned sex may raise many challenging issues. Gwen Araujo of Newark, California is such a young person who had attempted to cross-live in the gender opposite the sex to which she was assigned at birth (male). She became the victim of violent crimes that resulted in her death, as she attended a party where it was discovered that she was in fact anatomically male.
Ma Vie En Rose (1997), by Alain Berliner, depicts a similar scenario including a trans curious youth whose gender play brings about both family and community conflicts causing them to relocate to a new community.
Creature (1999), a documentary film directed by Parris Patton, tells the story of Stacey "Hollywood" Dean, a young transsexual woman who grew up in rural North Carolina. It follows her through four years and includes interviews with her conservative Christian parents.
The necessity to relocate, however, depends very much on the social environment. There are also several cases where this was not necessary, particularly in Western Europe.
Many transsexual men and women find that the only recourse that exists to them, to alleviate the pain and trouble they face with their gender identity and the body that does not match this, is to take some course of sexual reassignment surgery, which can include taking hormones, to having surgery to their genitals.
Sexual reassignment surgery
Sexual reassignment surgery is the processes transsexual women and men take in order to match their anatomical sex to their gender identity. Almost all transsexuals take a course of hormone replacement therapy, however, further surgery to correct genitalia (SRS proper), is also very expensive and not everywhere covered by public or private health insurance.
However, it is not only economic reasons that determine whether a transsexual has SRS - other, more diverse reasons may exist. "Gender refusenik" is a slang term among transgender people for those who are prevented from having SRS by financial, legal, medical, or other considerations. Among the people not recommended to have sexual reassignment surgery are diabetics. In the case of persons with Diabetes, the hormone change could be too dramatic for their bodies to take and may result in premature complications or death.
Those who have not undergone SRS are known as pre-operational ("pre-op") and those who have, post-operational ("post-op"). Some choose to describe themselves as non-operational ("non-op"), indicating that they have not undergone SRS, nor do they intend to do so (for personal or financial reasons). A more modern development in transsexual theory is the notion that the focus on surgery status is misplaced, and therefore more and more people are refusing to define themselves in terms of operative status.
Requirements
Generally speaking, physicians who perform sex-reassignment surgery require the patient to live as the opposite gender in all possible ways for at least a year ("cross-live") prior to the start of surgery in order to assure that they can psychologically function in that life-role. This period is sometimes called the Real Life Test (RLT); it is part of a battery of requirements. Most professionals in the USA who provide services to transsexuals follow the controversial Standards of Care for Gender Identity Disorders put forth by the Harry Benjamin International Gender Dysphoria Association. Outside the USA, many other SOCs, protocols and guidelines exist, although the Harry Benjamin SOCs are certainly the best known. There exists a significant and growing political movement to redefine the SOC, asserting that they do not acknowledge the rights of self-determination and control over one's body, and that they expect (and even in many ways requires) a monolithic trans experience when in reality there are as many different ways of being transsexual as there are transsexuals. In opposition to this movement is a group of transsexuals and caregivers who assert that the SOC are in place to protect transsexuals from "making a mistake" and causing irreversible changes to their bodies that will later be regretted -- though few post-operative transsexuals believe that sexual reassignment surgery was a mistake for them.
Procedures
For transsexual women, taking estrogens causes the growth of breasts, with concomitant enlargement of the nipples, and redistribution of body fat, among other changes. Permanent removal of unwanted body hair is accomplished with electrolysis or laser hair removal. Transsexual women may also undergo surgical procedures such as breast augmentation since the amount breast tissue gained through taking hormones may not be desired. For female-to-male transsexuals (commonly abbreviated to FTM), transsexual men taking androgens (i.e. testosterone) causes a shrinking of breasts, usually some enlargement of the clitoris, growth of body and facial hair, and redistribution of body fat, deepening of the voice, further muscle development and conditioning, among other changes. Many FTMs may require bilateral (mastectomy) designed to create a male contoured chest. Some individuals choose to self-administer their medication ("do-it-yourself"), often because available doctors have too little experience in this matter, however this route is potentially dangerous.
The sex-reassignment surgery is not always completed in a single session but requires multiple procedures and surgeries. For changing anatomical sex from male to female, the testicles are removed and the penis is usually inverted to form a vagina (vaginoplasty), or, if additional depth or self-lubrication are desired, a section of colon may be grafted in (the colovaginoplasty). In rare cases, the penile tissue may be removed altogether (penectomy)and vagina tissue created from grafts. For additional vaginal depth, pubic hairs are removed from scrotal tissues via electrolysis prior to the SRS procedure which is then incorporated by the surgeon to extend the vaginal shaft where penal tissues alone were found insufficient. For changing anatomical sex from female to male, a penis can be constructed by using host tissue from the inner forearm, the thigh or belly (phalloplasty). Alternately, the clitoris can be released from the hood to form a small phallus (metoidioplasty). In either case, the urethra can be rerouted through the phallus to allow urination through the reconstructed penis. However, a hydraulic insert is required in order to achieve erection. The labia (see vulva) are united to form a scrotum, with prosthetic testicles being inserted.
Legal and social aspects
Many Western societies today have some sort of procedure whereby an individual can change their name, sometimes also their legal gender, to reflect their gender identity. Medical procedures for transgender people are also available in most Western countries. However, because gender roles are an important part of many cultures, those engaged in strong challenges to the prevalence of these roles, such as many transgender people, often have to face considerable prejudice. One such case is chronicled in the movie Boys Don't Cry.
A few persons undergoing sexual reassignment surgery will adopt or provide foster care for children in the corresponding sex role which they have assumed. Societies are in some instances challenged to assimilate these men and women into their social institutions such as marriage and the role of parenting. Also, often children exist from the time before SRS. Many of these children stay with their transgender parent. A recent report shows that this does not harm the development of these children in any way.
Style guides used to publish more accurate information about the public and private lives of individuals pursuing or having changed gender and/or undergone sexual reassignment surgery to assist journalists or news reporting agencies to use the appropriate pronouns. Family members often confused about pronoun usage or the definitions of sex are frequently corrected by either the transsexual or the professionals who assist them as they approach that point at which they begin to "pass" as a member of the sex they wish to adopt.
Stealth
After this level of transition and development has been achieved, many transsexuals may wish to blend back in with other members of their new sex and will avoid revealing their past preferring the relative peace and security they find on the other side of a stressful and potentially dangerous transition.
This behaviour is known as stealth, and is somewhat a contentious issue. Some people, including some transsexuals, feel that they should be upfront about their past, and that stealth living is somehow dishonest, however others claim that transsexual men and women should be able to live in their true gender role in a normal way, and be in control of whom they choose to tell their past to.
Retransitions
As with every transition, in children and in adults, "experts" often raise the spectre of transitions gone wrong, that is people transitioning back to their original sex. These cases do in fact exist, however, every recent study done on the number of these cases states that their number is below 1%, and that the reasons for retranstioning are very diverse. See this article for examples.
References
- Zhou JN, Hofman MA, Gooren LJ, Swaab DF (1997). "A Sex Difference in the Human Brain and its Relation to Transsexuality." International Journal of Transsexualism, 1(1)
- Kruijver FPM, Zhou JN, Pool CW, Hofman MA, Gooren LJ, Swaab DF (2000). "Male-to-female transsexuals have female neuron numbers in a limbic nucleus." Journal of Clinical Endocrinology and Metabolism, 85(5): 2034-2041.
- Chung WCJ, De Vries GJ, Swaab DF (2002). "Sexual Differentiation of the Bed Nucleus of the Stria Terminalis in Humans May Extend into Adulthood." Journal of Neuroscience, 22(3):1027-1033.
Compare to: transgender, intersexual, autogynephilia
See also: Legal aspects of transsexualism, transphobia, gender identity disorder, List of transgendered people, Heteronormativity
External links
General
- Above and Beyond Gender Resources
- Transsexual Road Map
- What transsexuality is
- Report on Transsexual's Children
- Successful Transsexual Women
- Successful TransMen