Basic TG/TS/IS
by Lynn Conway
Copyright @ 2000-2006, Lynn Conway.
All Rights Reserved.
Part I:
Gender Basics
& Transgenderism

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[Update from V2-17-06 to V4-16-06.

See TS-New for deletes/adds in this update]



 Photo of Lynn and her boyfriend (now husband) Charlie, in late summer 2000.

We learned in Lynn's story that she was born and raised as a boy, and later in life was changed into a girl by female sex hormone treatments and major surgical procedures. Because of this past, Lynn is sometimes called a "transsexual" woman. Why did this happen to Lynn, and what is transsexualism anyway?
In order to understand transsexualism, we must first answer some basic questions about gender. What is Gender Identity? Where does it come from? What events occur in nature that interfere with correct assignments of gender? These pages aim at answering these questions. Links are then provided to further information on gender identity, transgenderism, transsexualism and intersexuality, and to information about methods and technology for physical gender modification.
Knowledge in this area is under rapid development. There are challenges in defining, separating and "labeling" the different phenomena, and in making estimates of frequencies of occurrence. There are also differing interpretations of the underlying science, and differing points of view about the evolving social and medical protocols for resolving these conditions.
However, much more is known about gender identity than just a few short years ago, and those new understandings are very much worth sharing and building upon. The taboo on this area has also been broken, so that we can openly discuss these important issues without fear, shame or embarrassment.
As we'll see, far more people suffer from gender-identity conditions than previously suspected, and the lives of millions of people are impacted by gender-identity issues. The key to improving the quality of those lives is better knowledge and more widespread understanding of that knowledge.

Part I: Gender Basics & Trangenderism

Part Ia: (TG continued)

Part II: Transsexualism (MtF)

Part III: Life as a Woman After TS Transition 

 TS Womens' Resources

 TS Women's Successes (es)

 Facial Feminization Surgery (FFS) (es)

 TG/TS/IS Info Links

 Successful TransMen (es)

 Sex Reassignment Surgery (SRS) (es)

Part I - Contents:
 What makes us a boy or a girl? What determines our gender identity?
 Intersex conditions - including intersex babies whose gender is ambiguous at birth.
 The practice of "surgically correcting" the genitals of intersex infants to make them "normal".
 How these attempted "corrections" reveal that old theories of gender identify formation were wrong.
 More lessons from intersex people about gender identity.
 The theory that gender identity is socially constructed is finally shattered
 The theory that prenatally established brain and CNS structures determine innate gender feelings.
 Counseling and medical treatment of transgender and transsexual women.
 Other conditions overlapping with or often conflated with transgenderism and transsexualism:
 Ex: Being gay, drag queens, female impersonators, transvestites and crossdressers, travestis, fetishists, others.
 Why do some react to transgender and transsexual people with such hostility?
 Shades of gray: Combinations and intergradations of gender and partner-preference.
 Getting beyond "labels", and thinking of gender feelings, gendered behaviors and gender trajectories instead.
 Part I continued - in Part Ia:
 ContrastingTransgender (TG) transitions and Transsexual (TS) transitions.
 Rethinking discrimination and hate crimes against gay and transgender people.
 Sadly, transphobia is also often projected by gays, lesbians and feminists (and how that is changing now).
 The transgender kids who are run away or are"thrown away".
 The transgender kids who are helped by their families.
 However, even those transgendered kids who are accepted by their families face many dangers right now.
 Efforts at extending full human rights protections to transgender people.
 Sketch of the differences in the situations of TG and TS people in different countries around the world.
 The powerful role of the internet is now playing in helping transgender and transsexual people.
 Hopes for the future.

Gender is the most fundamental part of one's identity as a human being. The very first question everyone asks about us is "Is it a boy or a girl?"
Important though it is, most people never think much about gender. They have no idea what causes their sense of being a boy or a girl, a man or a woman. Having never suffered mis-gendering, they take their gender for granted like the air that they breathe, never giving it a second thought. It is an unquestioned birth privilege to have a gender.
Conventional wisdom says that people are either boys who grow up to become men, or they are girls who grow up to become women. There are only two possibilities, and you are either one or the other. It's obvious at birth from your "genital sex", and that's all there is to it! However, as we will see, reality is not that simple.
What makes us a boy or a girl? What determines our gender identity?
During early pregnancy, a fetus that has male genes (XY chromosomes) usually develops into a boy with male genitals. It develops into a girl with female genitals if it has female genes (XX chromosomes). This happens well over 99% of the time. Doctors and parents look at an infant's genitals at birth, and simply declare it to be a boy or a girl.
Those declared to be boys usually grow up into men having a male gender identity, and those declared to be girls usually grow up into women having a female gender identity. Again, it all seems pretty straightforward.
Although more than 5% of all men and women will grow up to be gay, and will seek love partners of the same sex and/or gender as themselves, they too usually have normal male and female gender identities as men and women, respectively.
Intersex conditions - including intersex babies whose gender is ambiguous at birth:
Although most infants appear to be either normal boys or normal girls, various genetic and developmental effects can lead in some cases to infants having ambiguous genitalia, so that even the doctors can't be sure whether it's a boy or a girl. In other cases, the genitals look correct for one gender, but aren't consistent with the infant's genes. In yet other cases the child's genes are something more complex than just XX or XY, and the child's gender identity and physical gender trajectory as they mature may be difficult to predict in advance. Children having these genital and/or genetic variations are called "intersex".  Intersex babies are produced in about one in every 1000 births.
For example, in about one in 13,000 births an XY (genetic male) fetus is unresponsive to fetal male hormones, and develops genitals that look like a girl's, except for a lack of internal reproductive organs. These XY "complete androgen insensitivity syndrome" (cAIS) infants are simply declared to be girls and are raised as girls. Although they cannot bear children, they often develop into slender, attractive women who have a female gender identity. It's rumored that a number of beautiful models have been cAIS girls.
In other births, a "partial androgen insensitivity syndrome" (pAIS) results in the external genital appearance may lie anywhere along the spectrum from male to female. (See the Androgen Insensitivity Syndrome Support Group (AISSG) website for more information about AIS conditions). Incredibly, many of these girls are never told about the true nature of their conditions, because their doctors and families feel such shame and embarrassment about thes "terrible secret" that these girls have male genes. Instead they are usually told things like "you didn't develop any female internal organs, and thus can't have babies", and often discover the truth about themselves by accident later in life (for example, read Sherri's Story on the AISSG website).
Our society is almost completely unaware of the existence of cAIS girls, and this had led to many problems for them. For example, for more than thirty years the International Olympic Committee (IOC) has conducted genetic "gender-testing" on all women athletes to make sure that they were "really female" (this was done to prevent "sex changes" from competing). In quite a number of cases these tests turned up cAIS girls, identified them as "males", and disqualified them from competition. These were truly tragic mis-identifications, since the presence of the Y chromosome in AIS girls does not make them males either genitally or in gender identity, nor does it confer any strength advantage to them. These mis-genderings were often made public, resulting in total humiliation for the women involved.
In a significant recent reversal of this dreadful policy, the IOC dropped all such gender-testing, starting with the summer games in 2000.  Then on May 17, 2004, the IOC announced that postoperative transsexual women and men will be allowed to compete, after meeting certain conditions, starting with the summer games in 2004.  Therefore, discrimination against participation by IS and TS people in the Olympics is finally over.
For an overview of the many categories and prevalence of intersex conditions, see the Intersex Society of North America's page entitled "How Common Are Intersex Conditions?". For more information, see Wikipedia’s excellent page on intersexuality, which includes links to many websites about specific conditions.
The existence of XY (genetic male) intersex infants who have female genitals and who grow up to have female gender identity (the cAIS girls), was one of many early-known facts of intersexuality that led scientists years ago to recognize that gender identity IS NOT determined directly by having XY vs XX genes. Instead, they theorized that gender identity must be neutral at birth, and is determined later in early childhood by one's genitalia and upbringing. The leading proponent of this theory was John Money of Johns Hopkins University.
According to this theory, a child having a vagina and raised as a girl will grow up to have a female gender identity, independent of her genes. Similarly, it predicted that a child having a penis and raised as a boy would grow up to have a normal male gender identity, independent of his genes. If the child's gender identity didn't turn out according to this scheme, psychologists and psychiatrists assumed that something "went wrong" in the child's upbringing, or that the child was mentally disturbed or delusional in some way (i.e., "mentally ill"). Corrections to any gender identity problems were sought through psychiatry, on the assumption that this "mental disturbance" could be reversed.
The practice of "surgically correcting" the genitals of intersex infants to make them "normal":
By the 1960's, advances in plastic surgery combined with the "Genitals + Upbringing" theory of gender identity led physicians to recommend "corrective" surgeries on many types of intersexed infants. The idea was to make the genitals look cosmetically correct for a boy or girl, and then raise the child in the corresponding gender, believing that the child would grow up to have a correspondingly normal gender identity.
John Money of Johns Hopkins University, who gradually became the medical community's dominant authority-figure in "gender-identity studies", was the leading advocate of such treatments. A believer in behaviorist psychology, in which the mind of the infant is thought to be a blank slate having no inherent personality characteristics, John Money theorized that gender identity was solely the product of upbringing and socialization.
The motive for doing "corrective" surgeries on infants was to solve the "social emergency" caused by an intersex birth. The very existence in nature of many intersex babies, with their many variations of genitalia, breaks down the strict male-female gender dichotomy of our culture. Thus the existence of intersex babies brings into question many deep religious and legal strictures. Parents and doctors are under incredible social pressure to eliminate these variations. John Money provided a theoretical rationale which validated intersex infant "corrective" surgeries, and made them appear to be "scientifically sound".
Since it was easier to surgically "make a girl" than to "make a boy", it frequently happened that XY intersex boys having small or missing penises were turned into girls. The fact that sensitive genital tissue was lost in the process didn't deter the surgeons, because for many years our society did not openly recognize that most women have strong sexual feelings and a capacity for orgasm. If the infant was turned into a girl, doctors didn't worry about whether she would later have strong erotic genital sexual feelings and enjoy lovemaking; they only worried about whether she would function sexually for her male partner's pleasure.
Surgeries on intersex infants have been done for many years now, with a frequency of about 1 in every 2000 births. In most cases the surgeries create girls. Amazingly, there was never any organized scientific follow-up to see how these cases turned out!
Even in the early years of these surgeries, there were people urging caution, most notably a young researcher named Milton Diamond, now a Professor at the University of Hawaii. While still a graduate student, Diamond made an audacious challenge to Money's theories in a 1959 paper entitled "A Critical Evaluation of the Ontogeny of Human Sexual Behavior". Diamond's insights were based on his own observations in animal experimentation. He further marshaled "evidence from biology, psychology, psychiatry, anthropology, and endocrinology to argue that gender identity is hardwired into the brain virtually from conception" (see As Nature Made Him, p.44).
However, the notions that human beings had "advanced beyond the influences of biological evolution in matters of sexuality", and that one's sexuality and gender were socially constructed, had already been deeply imprinted in the medical community. Under the influence of the "gender prophet" John Money, this view dominated medical and psychological thinking for the remaining decades of the 20th century. Infant intersex surgeries were performed by the thousands during those decades, and again without any follow-ups. Only as the century was closing did awful questions begin to arise, as occasional rare follow-ups revealed things hadn't turned out as Money predicted.
How these attempted "corrections" reveal that old theories of gender identify formation were wrong:
In recent years, many intersex people have "found each other" via the internet and begun to compare notes about their situations. As a result, it's become clear to intersex people themselves that many of the "corrective" surgeries didn't work out according to their doctors' theories. Instead, many intersex people were left genitally maimed by those infant genital surgeries. Many were also suffering from gender identity crises, because of having undergone arbitrary gender reassignments based on what it was "easiest for the surgeons to do".
Under pressure from intersex activists, especially the newly formed ISNA, follow-up studies have finally begun on infants who were "surgically corrected" over the years. The first such study, of 25 genetically XY boys who had missing penises as infants (cloacal exstrophy syndrome) and who had been surgically turned into girls and raised as girls, revealed that all 25 developed MALE gender identities.
Those kids, although raised as girls, had all exhibited the rough and tumble play of boys when young. By their teens, each of these kids insisted against all evidence of their female genitalia and upbringing that they were boys, and wanted to be changed into boys. Many of them desperately sought girlfriends, just as might any other teenage boys.
Instead of reversing their innate gender identities and turning these intersex boys into girls, the infant surgeries effectively turned them into the equivalent of female to male transsexuals! Many of these boys have since undertaken hormonal and social gender reassignment from female to male. Tragically, the effects of their infant genital surgeries preclude the surgical reconstruction of male genitalia and in many cases even preclude them from experiencing sexual pleasure and orgasm.
More lessons from intersex people about gender identity:
These recent studies call into question the entire existing practice of genital surgery on intersex infants.
The studies then do something even more awesome: They turn on its head the theory that genitals and upbringing determine gender identity, triggering a paradigm shift in the medical community's overall thinking about the underlying nature of gender identity. The personal experiences of intersex people who have traveled different gender trajectories (some "corrected" as infants, and some not) are now becoming more widely known about, and are helping build a deeper understanding of the many variations in gender identity that are independent of one's physicality.
For example, in intersex conditions such as XY-Turner mosaic (mixed gonadal dysgenesis) a child may appear to have normal male genitalia at birth and be raised as a boy, but then not masculinize at puberty and instead remain slight and feminine appearing. These teens can face great difficulties if their condition goes undiagnosed and/or if they do not become aware of good options for treatment. If they do not have a well-established male gender identity, they may face a difficult choice of whether to undertake testosterone treatments to masculinize and become men, or undertake estrogen treatments and genital surgeries to become women. In some cases, XY-Turner teens have female gender identities and if given a choice in the matter will chose reassignment as females.
The article "What do children know?", by Jane Spalding tells the compelling story of such a child who was raised as a boy, but who had a female gender identity and who sought hormonal and surgical reassignment as a female during her twenties. The existence of such cases further refutes John Money's proclamation that genitalia and upbringing establish gender identity:
Jane Spalding
Misguided by Money's theories for many decades, the medical profession has caused the irreversible physical maiming of thousands upon thousands of intersex babies. For compelling insights into the traumatic life experiences of an intersex person who was surgically "corrected" at birth, and who grew up without ever being told what had been done, see the recent interview of Cheryl Chase in Between the Lines: coming to terms with children born "intersexed", by Victoria Tilney McDonough.
Cheryl was the founding Director of the Intersex Society of North America (ISNA), and the early leader of the movement to end shame, secrecy and unwanted genital surgeries for people born with atypical reproductive anatomies. ISNA is working to end the idea that intersexuality is shameful or freakish. In the U.S. alone, five children are subjected to harmful, medically unnecessary sexual surgeries every day. ISNA urges physicians to use a model of care that is patient-centered, rather than concealment-centered. For more insight into these issues, see the Discovery Channel documentary "Is it a Boy or a Girl?", which was produced with ISNA participation.
Cheryl Chase, Founding Director of ISNA
"When an intersex baby is born, the default is usually to
perform surgery," says Cheryl Chase, who was surgically
"reassigned" female when she was 18 months old.
"Doctors want to 'fix' what is not right, then slap a diaper
on the baby, close the file, and send it off into it's life."
The theory that gender identity is socially constructed is finally shattered:
The breakaway from John Money's paradigm escalated rapidly after the scientific community learned that Money had suppressed for many years clear evidence that his theories were wrong. The final straw was the highly publicized case of "John/Joan", presented in the book As Nature Made Him: The Boy Who Was Raised as a Girl, by John Colapinto.
Decades ago, John Money had advised the parents of an infant boy who had lost most of his penis in a medical accident to have the boy surgically changed into a girl - under the theory that "she" would then grow up to be a normal girl instead of an "abnormal boy". This was a very noteworthy case for scientific researchers because the child was born with an identical twin who could serve as a basis of comparison in the study of gender development. As a first step, the child was castrated and the rest of his penis removed. He was then raised as a girl. However, clearly exhibiting an innate gender identity as a little boy, "she" began to declare that "she" was "really a boy" and rebelled against efforts to make "her" behave like a girl. At puberty, still unaware of "her" childhood surgery, she resisted her parent's and physician's efforts to feminize her with estrogen and further surgeries. Eventually, she underwent gender transition to become male, much as would an FtM transsexual. In this case, raising a boy-child with apparently female genitals as a girl clearly did NOT alter the child's inborn sense of his own true gender.
Over many decades, John Money continually referred to the John/Joan case as a victory, fabricating facts to indicate that this case had been a "complete success". Money never "allowed" anyone to get close to "Joan" to learn more details about her life, begging off any contact in the name of "privacy". The case gradually became so legendary that it became the cornerstone of support for Money's entire theory of gender.
And then the shattering news came down, in the revelations that John Money knew full well that the infant's reassignment had not worked at all. And worse yet, he had deliberately concealed this counter-evidence to his theories for decades - decades during which thousands more infants had been subjected to infant intersex surgical maimings. Fittingly, it was Professor Milton Diamond, the scientist who'd bravely challenged Money as a young graduate students decades earlier, who uncovered the deception.
Professor Diamond had always been suspicious of Money's results. Over the years he had tried in numerous research studies and papers to persuade others to at least consider the possibility that gender identity was inborn. However, his efforts were to no avail, given Money's intellectual dominance of the field.
Finally, in the early 1990's, Diamond managed to track down the child "Joan", now presumably a grown woman, whose case had been the foundation of Money's entire viewpoint. Wanting to simply confirm what had or had not happened to her, Diamond had stumbled into the incredible fact that "she" had never felt like a girl at all, and was now a married man!*

[*The story later came to a very tragic end.  Although "John" had been able to socially and surgically reverse his childhood reassignment and become a male, "he acknowledged a deep well of wrenching anger that would never go away. "You can never escape the past," he told the Seattle Post-Intelligencer in 2000. "I had parts of my body cut away and thrown in a wastepaper basket. I've had my mind ripped away.""  "John" committed suicide on May 4 2004.]

Diamond and a colleague, Sigmundson, then worked tirelessly to document what had happened in this case, and they wrote a journal paper to reveal the results. The paper was so controversial that many research journals simply turned it down! So great was the influence of Money and the knee-jerk buy-in into his now established paradigm of thought about gender identity. The various journals simply could not believe the evidence that was staring them in the face!
The paper, "Sex Reassignment at Birth: Long Term Review and Clinical Implications" by Milton Diamond & H. Keith Sigmundson, was finally published in 1997 in the Archives of Pediatric and Adolescent Medicine. There was a firestorm of reaction in the media and the research community to its astonishing news. John Money was publicly revealed to have falsified evidence and suppressed counter-evidence in the case that was the cornerstone of his entire theory of gender identity. Within two years the writer John Calapinto's published a detailed account of the overall story, bringing it to the public at large.
The story of John/Joan obtained early public notice in an article by John Colapinto in The Rolling Stone on Dec. 11, 1997 entitled "The True Story of John/Joan". Here's an excerpt from the last page of that article:
" - - - His story has shaken to its foundations the edifice constructed on John Money’s theories from the 1950s. And it has exposed a central flaw in a theory that has held sway for most of the 20th century. It was Sigmund Freud who first stated that a child’s healthy psychological development as a boy or a girl rests largely on the presence, or absence, of the penis – the notion central to Money’s theory of sexual development and the ultimate reason that John Thiessen was converted to girlhood in the first place. It is a notion that, today, has also been called into question by neurobiological research that, in the sexual realm, is leading scientists toward the conclusion that, as Dr. Reiner puts it, "the most important sex organ is not the genitals; it’s the brain - - - "
John Money, Ph.D.
Gender "theorist" who claimed that gender identity is socially constructed.
Purveyed his views by personal dominance of his field and by falsification and suppression of research data contrary to his views.
Milton Diamond, Ph.D.
Professor of anatomy and reproductive biology who shattered Money's long-held theory that gender identity is socially constructed.
His work instead strongly suggests that gender identity is biologically innate.
Professor Diamond has since won important awards for his work. Director of the Pacific Center for Sex and Society at the University of Hawaii, he has written widely on issues of gender identity and intersex surgical interventions. I highly recommend his papers to you (see for example Sex and Gender are Different: Sexual Identity and Gender Identity are Different and An Emerging Ethical and Medical Dilemma: Should Physicians Perform Sex Assignment on Infants with Ambiguous Genitalia? ).
The refutation of John Money's theories is finally leading to a paradigm shift not just in the scientific community, but also in the medical community - although progress there will be slower, given the lingering influence of Money's views among medical "elders". It is also leading to legal assaults on the continuation of infant genital surgery by "traditional surgeons". See in particular the recent article in the Yale Law Review which outlines the emerging understandings of the medico-legal issues in this area.
The theory that prenatally established brain and CNS structures determine innate gender feelings and gender identity:
Well now, if it isn't the genes that determine gender identity (cAIS girls disprove that), and if it isn't the genitals and upbringing that determine it (cloacal exstrophy boys disprove that), then what the heck does determine a person's gender identity?
Scientific evidence has been growing that somehow certain brain-structures in the hypothalamus (the BSTc region) determine each person's core gender feelings and innate gender identity. These structures are "hard-wired" prenatally in the lower brain centers and central nervous system (CNS) during the early stages of pregnancy, during a hormonally-modulated imprinting process in the central nervous system (CNS).
It appears that if those brain and CNS structures are masculinized in early pregnancy by hormones in the fetus, then the child will have male percepts and a male gender identity, independent of whether the genes or genitalia are male. If those structures are not masculinized in early pregnancy, the child will have a female percepts and a female gender identity, again independent of the genes or genitalia. As in the case of intersex infants having ambiguous genitalia, there are undoubtedly many degrees of cross-gendering of brain and CNS structures, so that while some infants are completely cross-gendered others are only partially cross-gendered. 
More recent research indicates that the brain begins to differentiate in embryonic males and females even earlier, possibly before embryonic sex hormones come into play, and under mechanisms still not yet understood - with gender identity then becoming a complex effect of the interaction between earlier brain differentiation and later embryonic hormones. For more on this emerging research, see: "Brain development: The most important sexual organ", in Nature magazine, January 29, 2004  (Nature 427, 390 - 392)


That is why it is possible for some children to have gender identities inconsistent with their genes. In cAIS cases, for example, those girls’ brain structures are likely insensitive to the masculinization effects of fetal testosterone, as were their genitals. Therefore, they develop the brain structures and gender identity of females, even though they are XY genetically.
That is also why it is possible for some children to have gender identities inconsistent with their genitalia and upbringing. In the case of the boys with cloacal exstrophy ("micropenises"), their brain-structures and CNS presumably did masculinize under the influence of fetal testosterone, leading to later male gender identities even though they had been surgically "turned into girls" as infants and raised as girls.
Those recent cloacal exstrophy observations are already having a profound impact in the medical research community. They are to the science of gender much like the Galileo's observations of the moons of Jupiter.
These are dramatic, unprecedented, undeniable observations that shift the previous paradigm of thought, and do so in an area of science that had been subject to much misinformation and taboo. In Galileo's case, the shift was from an 'earth-centered universe' to a 'sun-centered universe'. In the cases here, the shift is away from a 'genitals + upbringing' theory of gender identity to a 'CNS neurobiological developmental' theory of gender identity.
The implications of this paradigm shift are far reaching, especially for those who suffer from cross-gender identities. Instead of those gender feelings being considered to be "psychological", they can now be understood as being "neurological" in nature.
Listen carefully to the conclusions of William Reiner, M.D., a pediatric clinician and researcher at The Johns Hopkins Hospital, based on his work with intersex children (Reiner is now an investigator in the Cloacal Exstrophy follow-up study, which now confirms these conclusions):

 "In the end it is only the children themselves who can and must identify who and what they are. It is for us as clinicians and researchers to listen and to learn. Clinical decisions must ultimately be based not on anatomical predictions, nor on the 'correctness' of sexual function, for this is neither a question of morality nor of social consequence, but on that path most appropriate to the likeliest psychosexual developmental pattern of the child. In other words, the organ that appears to be critical to psychosexual development and adaptation is not the external genitalia, but the brain."

William Reiner, M.D., To Be Male or Female--That is the Question, 151 Arch Pediatr. Adolesc. Med. 225 (1997)].

It is amazing that psychiatrists completely missed all of this in the past, and so long assumed that gender identity was neutral at birth and later established by social interactions. Mis-gendered people themselves have long reported their problem not as one of THOUGHTS, but of cross-gendered percepts and BODY FEELINGS - as a little child the gendered feelings of how your body wants to move, how you respond to being touched, how aggressive or cuddly you are, how you interact with other little children. Then, after puberty, one's feelings upon being sexually aroused, and whether those deep urges are male (mounting urges) or female (urges of being manipulated and penetrated).
One doesn't "think up" these CNS-produced male/female gender and sexual feelings, one simply perceives them! The basic perceptual mechanisms involved are hard-wired, and cannot be changed by psychiatric means any more than one could permanently change one's sense of feeling hot into that of feeling cold and vice-versa.
Whatever in-utero process produces it, a person's gender feelings and gender identity are at the very core of their being. Gender identity is fixed, immutable and irreversible by any known medical or psychological means. We also now know that there is only one method for determining your gender identity. We have to ask YOU! Your gender is a percept: You are the only one who knows for sure what it is, and no one else can tell you what it is.
Now that we know some basics about gender and gender identity and have some insights into the difficulties faced by intersex people, we're prepared to learn about and understand transgenderism and transsexualism.
In this webpage we focus on male to female [MtF] conditions, since those are within Lynn's direct experience. However, there is a completely symmetrical set of female to male [FtM] gender conditions that are almost as common as MtF conditions. For more information about FtM transgenderism and transsexualism, see the websites of FtM International and The American Boyz. The article "Girls will be Boys", by T. Eve Greenaway discusses the sudden emergence of FtM trangenderism out of the shadows and into the open in many U.S. colleges and universities. For in-depth background on FtM transgenderism and transsexualism, see the book by Jason Cronwell, Transmen & FtMs, and also Jamison Green's book "Becoming a Visible Man". See also Lynn's webpage listing weblinks and photos of Successful TransMen (es).
Hidden away and seldom talked about is the fact that some apparently normal boys aren't boys at all, but should have been girls. Although they have normal XY genes, normal male genitalia, and are raised as boys, they nevertheless have the gender feelings, body feelings and gender identity of girls. Similarly, some girls aren't girls at all, but should have been boys. It doesn't happen very often, but it does happen. And it's always been that way.
Perhaps once in every 200 to 400 births something must go amiss in the early stages of pregnancy so that sex hormones do not have the usual action on the integration of the fetus's brain. In these cases, children are born having a brain-sex (neurological sex) and innate gender identity opposite to that indicated both by their genes and their genitalia. Since these infants look normal, they will be raised in the wrong gender for their brain-sex (neurological sex). Being raised in the wrong gender causes them profound gender dysphoria and mental anguish as they grow up. These are the "transsexuals" (TS), the most intensely affected of the "transgendered" (TG).
In many more cases, perhaps as many as one out of every 50 children, it appears that the "transgendering effect" is less pronounced but still present to some degree - and this occurs in both boys and girls. We can estimate these numbers from the numbers of gender-variant people who have always coalesced in and around the gay community. Although a small fraction of that community, they are perhaps as much 1% to 2% of the overall population. This group of children presents a wide range of variations in cross-gender feelings (just as the group of intersex children present a wide range of genital configurations). Many of these transgender children will have major adjustment problems if forced into too strict a gender role.
Women notice these cases, especially the very feminine little boys who really should have been girls. They'll often even say among themselves "he should have been a girl". These common-sense reactions to feminine boys are seldom discussed outside the closed company of women. Fathers especially will make every effort to "straighten out" such boys. The feminine boy is mistakenly thought of as "pre-homosexual". Every effort is then made to "save the boy from that fate". On the other hand, the girl who feels like a boy can often become a "tomboy" and not get criticized for that - in fact she may even gain approval for being outgoing and aggressive and tomboyish in our male-dominated society. However, she may still feel the same degree of gender angst about her assigned gender role as does the MtF transgender boy.
There is no social script for such a boy to tell someone "I feel like I'm a girl", and to get active assistance with their gender problem. Instead, transgender youngsters often pick up the idea from parents and school-mates that they are "going to be gay men". Some may later even try to "become gay" and be accepted in the gay male community, when in fact that very seldom works. Gay men seek men as partners, not people whose gender identity is female. The last thing in the world that an MtF youngster could ever become is a gay male who is into his masculinity and his male parts even more than the average guy!
Many other transgender youngsters will secretly find ways to cross-dress in girls' and women's clothes as a way of exploring and enjoying their feminine gender feelings, often starting to do this well before puberty. The denial of opportunities for openly expressing their gender longings and the need to maintain complete secrecy about their crossdressing are often the source of tremendous angst, anxiety and depression among these kids.
A few MtF transgender and transsexual teenagers will try to appear openly as pretty girls, and may attract straight boys as love partners (i.e., boys who will love them as girls). Other MtF teens will seek the company of girls, and will become attracted to them and love them as if they themselves were lesbian. In such cases, if their girl friends are accepting of them, they can be wonderful and attentive lovers and partners. However, many transgender youngsters will become so ashamed and humiliated by their female tendencies that they will hide their "terrible secret longings" from everyone, sometimes even from themselves, for a long, long time.
For those who are strongly transgender or transsexual, living without having a properly assigned gender produces a nightmarish separation from the dance of life. Whether it's dating, finding love, courting, marrying, raising children, and generally doing all the little everyday things that continually celebrate one's own gender, the transgendered are often left stranded on the sidelines, to watch as spectators. Or worse yet, while feeling ugly and ludicrous in their male social appearance, they are forced to "act out" empty of all feeling a role that is alien to their inner female nature.
The overall name for the intense form of these cross-gender feelings is "gender dysphoria". (This condition is often called "gender identity disorder" (GID). However, we refrain from using the word "disorder", because we consider this condition to be a natural variation in human gendering. Instead we use the phrase "gender dysphoria", referring to the angst felt at being forced to live in the wrong gender).  For a more formal description of "GID" and background on exploratory research in this areas, see the following links at the Gender Identity Research and Education Society (GIRES) website:

GIRES Main Page

Gender Dysphoria [2004]

Definition and Synopsis of the Etiology of Adult Gender Identity Disorder and Transsexualism.


"In conclusion, transsexualism is strongly associated with the neurodevelopment of the brain...The condition has not been found to be overcome by contrary socialisation, nor by psychological or psychiatric treatments . . . Individuals may benefit from an approach that includes a programme of hormones and corrective surgery to achieve realignment of the phenotype with the gender identity, accompanied by well-integrated psychosocial interventions to support the individual and to assist in the adaptation to the appropriate social role . . . Treatments may vary, and should be commensurate with each individual's particular needs and circumstances." 


- Quote from the GIRES synopsis of current research on the etiology of GID; this document was signed by the world's leading researchers in the field.

Counseling and medical treatment of transgender and transsexual women:
Gender counseling services and support groups now exist in many major cities to help the transgendered diagnose their conditions and become aware of options for social gender-change and for medical help. The web now offers a large number of transgender and transsexual support sites that provide a wide range of practical information regarding counseling and transitions. Many of those sites keep up-to-date lists of service providers for TG/TS people (counselors, electrologists, endocrinologists, surgeons). Some of these websites (such as the TG Forum) also list clubs, support groups and important national-level events where TG people can congregate for mutual support.
In many cases, relaxed gender constraints and flexibility of dress, mannerisms and presentation can ease the discomfort of the transgendered and greatly improve their opportunities for honest self-expression and for a sense of well-being and happiness. In many cases where the individual finds some degree of inner peace and self-acceptance that way, they can go on to find love and enjoy life fully without further gender modification efforts.
However, people having very strong transgender feelings may consider making physical changes by taking sex hormones and social changes by permanent cross-dressing, and thus undergoing a "transgender transition", usually with the advice and guidance of a practical-minded gender counselor. Many people now pass through transgender transition each year, and then live out their lives in the social gender they feel most comfortable in, while remaining somewhere in the middle of the physical gender spectrum (i.e., without undergoing sex reassignment surgery to modify their original genitalia).
The gender trajectories of TG women vary considerably from person to person, depending upon many factors including the intensity of their condition and the initial timing and method of openly expressing their condition.
For example, in past decades it was very common for intense young TG girls to migrate towards the gay "drag scene" (see below), where they had opportunities to openly cross-dress and perform in public, and to experience being attractive to men and in gaining the favors of men (albeit gay men, who thought of them as boys). It was no secret that there was always a minority of the gay "drag queens" who were not gay boys at all, but who were actually transgender (or even transsexual) girls.
With the recent proliferation of heterosexual male crossdressing clubs and groups (see below), and the many opportunities these days for safe crossdressing in such environments, it has nowadays become even more common for young TG people to initially think of themselves as being male crossdressers and to be attracted to the crossdressing scene. Only over time do they realize that they are not solely interested in crossdressing for the autosexual sensual buzz. Sensing that they are not really like the majority of male crossdressers (who usually have wives and girlfriends at home), they begin to confront their underlying gender dysphoria. Once this awareness of difference develops, the TG person usually migrates away from the CD scene, and on into interactions with gender counselors and TG support groups.
National-level gender conferences also now enable people who are just beginning to explore their gender issues to anonymously attend one big event and get an introduction to the entire range of transition options. Conferences such as Southern Comfort and the Colorado Gold Rush, although mainly being big gatherings for heterosexual crossdressers, also include excellent clinics and workshops to help people get started on gender transition. Anyone questioning their gender identity can attend one of those conferences (in boy or girl mode), meet and talk with people in all stages of transition, and quickly gain a lot of information into the how-to's, challenges and possibilities of transition.
The web has had a profound effect on the TG world by stimulating very rapid propagation of knowledge about transition, and by helping people network and share information. With the emergence of the web and the widespread availability of electronic information of transgenderism and transsexualism, many TG people now bypass the gay drag clubs and heterosexual male crossdressing scenes for their first gender explorations. Instead they go directly to the big gender conferences, to gender counselors and to TG support groups for assistance, and quietly and rather anonymously explore their options for gender modification and possible transgender transition. Intensely transsexual (TS) girls also sometimes undertake TG transition and live as TG women for extended periods of time before undergoing sex reassignment surgery (see Part II: Transsexualism).
Transgender transition doesn't require anyone's or any authority's "permission", although it is usually done with the coaching of a gender counselor. The MtF TG transitioner works hard to feminize their appearance and manners as much as possible by taking female hormones, removing facial hair via electrolysis, and making adjustments to the voice and many other behaviors. Some TG transitioners will also undergo cosmetic surgery to improve facial features and/or augment their breasts. Once these changes have proceeded far enough, the person then transitions socially by permanently dressing in their new gender, legally changing their name, and getting all their identification shifted into their new name and gender (which is now relatively easy to do in many states in the US). There are still many difficulties on this path, because society does not yet readily accommodate someone who is physically "in-between" the two standard genders. However, in some cases transgendered women who have transitioned have become very successful in life, have gone on to fine careers and have found wonderful love-partners too.
Some examples of TG women and their stories are found in the following photos and weblinks. These photos show the possibilities for successful transgender transitions without SRS (although some of these women have or will go on to complete transsexual transitions, by also undergoing SRS):
Calpernia Addams in 2000:
A beautiful transgender woman
who has been feminized by taking estrogen
For more about Calpernia, see Part Ia.
Since this photo was taken Calpernia has undergone SRS.
See Calpernia's new webpage and her new book Mark 947.

Her story is also told in the movie Soldier's Girl.




Chrysis, a stunning TG woman who was a cabaret

performer in New York City in the 70's and 80's.

Here we see Chrysis with Nick Nolte, on the set
of the movie Q&A (in which she appeared)
Carla Antonelli, a beautiful trans actress from Spain.
Miriam, a stunning transgender woman from the UK.
Miriam is very happy as she is, and is not planning to have SRS.
Miriam was the subject of a controversy recently
regarding her appearance in a "reality TV show" in the UK.
In the more intense cases of transsexualism, the TS girls' initial trajectories may appear similar to those for TG people. However, the ultimate resolution of their condition requires more than just a hormonal and social-gender change. The only way for them to resolve their condition is to also completely change the physical sex of the body to match their innate gender feelings. This means undergoing a "transsexual transition", which in the case of a male to female (MtF) transsexual involves completely changing the body from that of a boy to that of a woman. This is done by taking female sex hormones AND by undergoing sex reassignment surgery (SRS) to reconstruct the genitalia from male to female. Transsexual transition in the U.S. is conducted under formal medical protocols that require counseling, hormone therapy, and a "real life experience" of at least a year of living and working in the new gender before the patient is recommended for SRS (see Part II. Transsexualism)
Harisu, a pretty young Korean transsexual girl who transitioned in her teens with the help of her mother and had MtF sex reassignment surgery at age 19. Harisu thus underwent 'transsexual transition' and is now a postop TS woman.


Dana International, a pretty young Israeli girl who transitioned during her teens and had SRS at age 22 . Dana was a drag cabaret performer in her teens, and went on to become a world-renown singer as a postop TS woman.


There are at least 32,000 to 40,000 post-operative transsexual women in the U. S. (see TS Prevalence information, in Part II ). About 1500-2000 U. S. residents now undergo male to female sex reassignment surgery each year, so the overall number is expanding fairly rapidly. As we'll see, many of these women have gone on to very successful lives after TS transition.
The numbers of transgender women and the numbers undergoing transgender transition are many times those numbers for transsexuals. Therefore, it is likely that many hundreds of thousands and perhaps several millions of people in the U.S. are transgendered.
Other conditions that overlap with or are often conflated with transgenderism and transsexualism:
(i) being Gay (ii) Drag Queens, (iii) "Female Impersonators", (iv) Crossdressers ("Transvestites"), (v) Travestis ("She-males"), (vi) Fetishists and (vii) Others
Transgenderism and transsexualism are often mixed up with other common conditions involving cross-gender behaviors or appearances. We can learn more about transgenderism and transsexualism by contrasting them with these other conditions, and by visualizing the sometimes blurred boundaries that exist among these conditions.
As we discuss these conditions, remember that "labeling" is very imprecise in this field. Different people label things differently. Some people consider ALL situations involving cross-dressing as being under the "overall transgender umbrella". However, there are fundamental differences between those people who have cross-gender identities significant enough to lead them to transition (TG and TS people), as compared to those transvestites or gay male drag queens who are male-gendered. Unless those differences are well understood, lumping these situations together under one label can cause major confusion.
These confusions can also affect young TG/TS kids themselves as they struggle with their gender issues early in life. As we'll see, many TG/TS kids initially think that they must "be gay", or that they are "drag queens" or "crossdressers", as they try to pattern on something that seems to speak to their issues. As a result, many young TG/TS people migrate through the gay club scene and the crossdressers' clubs, on the route to working out their gender issues.

Also note that the emotions and feelings of gender variance are expressed in different ways in different cultures, depending on available social roles in which transgender people can exist in each culture.  Different words may be used to describe of gender-variant people in a particular culture.  These “types” vary widely from culture to culture, and evolve over time within each culture. See Lynn's page regarding the situations of TG/TS people in different countries and also the TransgenderAsia website, for examples of widely varying transgender typing in many different cultures.


See also the following page concerning the difficulties in cross-cultural communications and language translations regarding gender variance. As one example, that page discusses how the word “travesti” in Romance languages (such as Spanish, Portuguese, Italian, etc.) is very often confused with the word “transvestite” in English (a word that has a very different meaning). As we will learn, gender-variation typing and labeling are highly culture-dependent and language-dependent, and are very inexact practices.


The Wide Spectrum of Gender-Variant People and the Words Used to Describe Them (es)

(i) confusion of TG'ism and TS'ism with being Gay:
Over 5% of all men and women are gay, and prefer to mate with love-partners of the same sex and/or gender. This innate feeling of same-sex attraction in many people is a part of human nature. It has always been so, in spite of ongoing efforts by various religions and societies to stamp it out. It seems that love always finds a way to thrive, in spite of all obstacles.
Because being gay is so common, transgenderism and transsexualism are most often confused with simply being gay, and in fact confused with being "really, really gay". The first thing that pops into the people's heads when they hear that someone is transsexual is, "wow, I didn't know 'he' was gay".
It's easy to see how people might jump to this conclusion. Seeing an MtF TS woman with a straight man as her partner, they simply think that she is (or was) a "gay man". They jump to the conclusion that "he" changed sex simply in order to attract men as partners. However, this is a totally mistaken idea rooted in ignorance about gender identity. And as we'll see, this idea totally mixes up and conflates two totally different kinds of people: transsexual women and gay men.
How did the confusions get started? One possibility is that years ago many gay people got into "role-playing". For decades and decades there have been gay men who act "effeminate", and who emulate the "woman's" role in a relationship, even though they are strongly male-gendered and don't feel like women at all.
Gays and lesbians have also often allowed themselves more freedom than heterosexuals to break the rules of gender behavior as well—especially within closed or “friendly” social environments. Even so, the majority of gay and lesbian people have gender expressions difficult or impossible to distinguish from that of heterosexuals. 
However, effeminate gay men as a minority of the gay male community have been far more publicly visible than TG/TS women, because the gay male community is so large to begin with. After all, over 5% of all men and women are gay, and prefer to mate with love-partners of the same sex and/or gender. Meantime, TG/TS women have mostly had to live in stealth in the past, staying as "invisible" as possible just to survive, and they were much smaller in number than gay men to begin with. All this led many straight folks to confuse "role-players" and feminine-acting gays as being gay men who "really wanted to be women."
Now, here's the deal: A gay man has a male gender identity. He is attracted to males who also have a male gender identity, and who are attracted to him because he is a male. The last thing on earth that a gay man would want to do is change sex and become a woman. To do so would be a catastrophically self-destructive act, because of his male gender identity and his love of masculinity both in himself and in his partners.
In contrast, an MtF TG or TS woman has a female gender identity. She may be either straight or gay after she transitions. She is either attracted to males who have a male gender identity or to females who have a female gender identity, and who are attracted to her because she is a female. She is desperate to change her body so that she can fully feel like and be perceived to be a woman - both by herself and her lovers. If it turns out that she is "gay" after her transition, it is because she is a lesbian in her new role, not because she is a "gay man".
(ii) Drag Queens:
Some gay men occasionally dress in "drag" for fun and as a kind of caricature of women (DRAG = "DRessed As a Girl"). They'll sometimes they "go in drag" to bars and clubs, and sometimes on special occasions and for various fun events. Gay men who are particularly skillful female impersonators perform in drag in various gay nightclubs (such as the club "Oz" in New Orleans). Some of these gay men, such as Ru Paul, have great skills as "illusionists" and have become famous mainstream drag performers.
RuPaul - a famous drag performer
The origins of this fairly common practice go way back in gay culture. These men are called "drag-queens" (DQ) and are usually completely male-gendered gay men. Many of them started in drag as gay teenagers when they discovered it was a way to attract lots of attention from men in gay clubs. They make no permanent body modifications by hormones and rely on great performance skills and skill with clothing, prosthetic props and makeup to create their female bodily images. As gay men they tremendously value their masculine genitals. They are totally turned off by the concept of "sex changes", and would never consider such a thing themselves, any more that any other gay man would.
There is a rather large gay-male subculture of drag performers and drag contests all across the U.S., and there is always some small fraction of young gay men who are attracted to the "lifestyle" as it is sometimes called. For many of these young men, even those who aren't particularly attractive as boys, performing in drag in a gay club is a sure-fire way to attract gay male lovers and attention, at least while they are still young. However, outside the clubs these gay boys are almost always boys again, and since they do not take hormones or make major body-feminization modifications very few could pass as women in the light of day.
Many transgender and transsexual youths, on learning that they could dress and perform as "girls" in local gay clubs, feel a strong tug to join that scene and initially may even self-identify as drag queens. This has always been a common path for TG/TS kids who are beginning to explore their gender issues. After going to these clubs for a while, these TG/TS girls usually realize that they aren't gay male "queens" after all. Many tire of the attention of gay men who want them precisely because they "are boys", instead of wanting them to love them as women. They gradually learn about other girls who've taken hormones and had electrolysis and breast implants, and who can "pass" as women outside the clubs. Better yet, they hear that some of those girls are finding straight boyfriends who love them as girls. As they learn about the possibilities of "going full-time" by undertaking a TG or TS transition, they may begin to plan their own transition too - and work to move on beyond the part-time gay drag scene and out into heterosexual society as a transitioned woman.
Thus there has long been a mixture of DQ, TG, and TS girls in the gay drag scene, because so many TG and TS girls continually migrate through that scene and on out into the world beyond it. Although the majority of girls performing at the gay clubs are gay queens, there are always a few TS's in among them. This isn't a bad way for some TS girls to get started, because drag clubs are often a fun-loving, uninhibited, non-judgmental environments where they can feel very liberated and able to explore their gender issues. For an inside look into "the lifestyle" by a transsexual girl who passed through the gay club scene, see Calpernia Addams' wonderful book Mark 947.
For more insight into the world of drag queens, drag performances and drag contests, you can explore the links to drag clubs from many gay male community websites. Of special interest are the major beauty and performance contests, such as the famous Miss Continental pageant (more), which provide opportunities for the expression of feminine beauty by large numbers of DQ's and TG girls. QUEENMOTHER.TV , the online outpost of New York City's thriving drag performance community, is another good window into the drag community.
Drag queens (DQ's) themselves are often confused by the public as being "transsexuals", and vice-versa. The extravagant caricatures of femininity presented by many drag queens tends to propagate a misleading image of transgender people as being male-gendered people who like to caricature women in flamboyant ways. Then too, people familiar only with MtF transsexualism may mistakenly assume that a drag queen has a female gender identity, which he generally does not.
Some gender theorists consider drag queens to fall under the "transgender umbrella", a term that lumps all gender-variant people together. Lynn finds this over-inclusive terminology very confusing, since the majority of drag queens unquestionably self-identify as male-gendered, do their crossdressing just for fun, and seldom self-identify as "transgender" since they do not have any issues with gender identity. The best way to learn whether a drag queen considers themself to be "transgender" is to ask them, rather than automatically label them that way just because they do drag.



(iii) Female impersonators (FI's), and the historical role of FI clubs in disseminating knowledge about gender transition:


Back in the 1950's and 60's, many people's only encounters with drag queens and trans girls was by attending gay nightclubs that featured "female impersonators".  The girls were seldom seen outside of such clubs, because it was against the law in most places for "males" to dress as girls in public back then. As a result, "female impersonator" (FI) became a common public perception of (and label for) drag queens and TG/TS girls back then. 


In those very inhibited and incredibly homophobic years, the idea of going to a nightclub where young "men" performed as beautiful young women struck a deep chord in many socially conformist heterosexuals.  Perhaps a sampling of what appeared to them to be "forbidden and decadent" ways of life gave them a sexual buzz or made them feel very sophisticated.  Whatever the reason, some of the female impersonation clubs in larger cities began to attract lots of straight tourists.

Certain clubs, such as Le Carrousel in Paris and Finocchio's in San Francisco, became world famous attractions by featuring the most beautiful and talented of DQ's and TG/TS performers.  Those clubs then became magnets for many young trans girls, because as performers they had "an excuse" to be seen as girls by the public at least some of the time. Even more importantly, the social network of trans girls working in such clubs provided newcomers with access to many then-emerging secrets and methods (hormones, electrolysis, silicone, etc.) for feminizing their bodies.

It was while working at Le Carrousel in the mid-1950's that several young, intensely transsexual girls began taking the estrogen just then becoming available in pharmacies. As a result, they developed beautifully shapely bodies and delicately soft features that stunned audiences at the club.  One performer, named Coccinelle, went to Dr. Georges Burou of Casablanca, Morocco in 1958, and became one of the first patients to undergo the modern form of sex reassignment surgery (which Burou had just invented).  Two years later another Le Carrousel showgirl, named Bambi, also went to Dr. Burou for SRS. 


Coccinelle and Bambi continued to perform at Le Carrousel following their surgeries, where they were seen by large audiences that included many famous and wealthy people. As a result, the news of their successful "sex changes" spread like wildfire, adding to their fame and to the mystique of the club.


The TS transitions of Coccinelle and Bambi triggered a sudden and widespread dissemination of knowledge out into the transgender world about how to undertake and carry out a gender transition.  Up until then, although many people had heard of Christine Jorgensen's "sex change", there was little detailed practical information about how to undertake such a transition on one's own. The girls at Le Carrousel changed all that, by talking with others about what they had done and how they had done it.  Their performances at the club also spread the beguiling and culturally revolutionary image of "transsexuals" as being very beautiful, talented and sexually desirable women (which unfortunately later led to a vicious backlash against trans women by feminist thought-leaders).


Coccinelle and Bambi (Marie-Pier Ysser) went on to live wonderful lives over the longer term, and you'll now find links to their stories in Lynn's TS Successes pages (at the end of photo gallery 4).  Historical information about Le Carrousel can be also found at this link 


The wonderful website of David de Alba provides a memorable look back into the female impersonation clubs and the FI culture of the past.  His site includes a page about Finocchio's, and additional background on that club can be found in this articleVicki Rene's website also spotlights many of the beautiful nightclub performers of yesterday and today, in her fabulous "Showgirls pages (more)".


The tradition of "female impersonation" continues on even today at famous big-city nightclubs such as The Baton Show Lounge in Chicago, where you can see performances by talented and beautiful entertainers such as Mimi Marks (more).  While some of the performers at such clubs are drag queens who live as men outside of work, others such as Mimi are socially transitioned trans women. 


Mimi Marks - a famous transgender showgirl

featured at The Baton Show Lounge in Chicago

Crowned as "Miss International Queen" in 2005

(photos, more, more, more)


(iv) Crossdressers (Transvestites):
Many heterosexual men occasionally engage in partial or full crossdressing* (CD'ing) as a means of feeling sensual and as a fun sexual turn-on. This has long been called transvestism* (TV'ism), and perhaps as many as 20% to 30% of ALL males do it sometime during their lives.
[*See Lynn's page "The Wide Spectrum of Gender-Variant People and the Words Used to Describe Them" for a discussion of such terminology, and how the meanings of such words have shifted over time. For example, the word "transvestism" in English has gradually fallen out of use due its social and psychiatric stigmatization in the past, and the word "crossdressing" has gradually replaced it. Then too, the old word "transvestite"" in English is often confused with the term "travesti" in the Romance languages - which refers to an altogether different form of gender variance (see below)]. 

It is important to realize that this is a very, very common practice, and thus we need to put it clearly in perspective in the overall picture of gender issues.

Crossdressing is often simply a regular expression of male sexuality similar to the use of pornography for pleasurable visual arousal and auto-sexual release, and in these cases is not a gender issue at all. Sexually active males who are turned on visually by females may get very excited by seeing part of themselves as female by wearing a bit of women's clothing. Some of these men then gradually get into fully crossdressing as a means of experiencing more sensuality and turn-ons than they otherwise might. However, it is important to note that crossdressers and transvestites generally do NOT modify their bodies through surgical or hormonal means.

As transvestic males mature, perhaps 1/10th of them (2% to 3% of all males) progress to occasional full crossdressing, and do this either in private or in clubs for crossdressers. There are millions and millions of regular "straight" guys who are transvestic, and this form of full-crossdressing is actually very common. Past and present public figures who are widely known as transvestites include J. Edgar Hoover, Jeff Chandler, Milton Berle, Flip Wilson, Dennis Rodman, Marv Albert and a huge list of other rather masculine and often very sexy men.
Some of these men may appear quite attractive dressed up as "women" in photographs or in the dim light of club settings, but their mannerisms and manly-type assertiveness usually reveals that they don't feel like or think of themselves as women, nor do they really try very hard to act like women. These folks simply do this for sensual fun. By dressing his body in soft, seductive female clothing, the crossdresser can experience a wonderful male sensuality upon seeing his own apparently feminized body. Because of this focus on self-arousal, transvestites often dress in a "glamorous" manner that is rather stereotypically female and even provocatively sexy - dressing in fancy gowns, stockings, high-heels, etc., in ways that most women do only on rather special occasions.
There are many other crossdressers who do have transgender feelings to one degree or another. In these cases, transgender feelings and the need to ease gender angst often loom as primary motivations for crossdressing.  These persons may refer to themselves either as crossdressers or as "transgender".
Some crossdressers, especially among those who have fairly strong transgender feelings, long to cross-dress more freely in public and also part-time at work. A few may even undergo a transgender social transition in order to crossdress "24/7" (i.e., all the time) and then self-identify as being transgender.
Years ago, it was difficult for men to easily acquire women's clothing, because of fears of being thought of or "outed" as a crossdresser. Fortunately, it's much easier these days. In addition to many catalog and web-based suppliers of women's clothing (including many comprehensive catalogs such as the J.C. Penney catalog), there is now a huge infrastructure of stores, services and catalog-order firms supplying clothing and fetish wear specifically for crossdressers. One of the oldest and best-known suppliers of such fetish wear is Frederick's of Hollywood. In recent years, ordering via the web has become an ever easy way for crossdressers to obtain clothing and supplies (for examples, see: TGNOW Shopping Directory, TG Forum Shopping Mall, Glamour Boutique, Fantasy Girl ). These TV/CD suppliers provide some important advantages over traditional women's clothing sources such as J.C.Penney, because they stock large sizes of everything, including shoes, and their clothing also covers a wider and more sensually exotic range of styles.
Furthermore, many clubs and support groups have been formed to enable transvestites and crossdressers to meet and enjoy crossdressing in safe, fun social environments. The oldest and perhaps most influential national club for male crossdressers is named Tri-Ess. Founded decades ago by Virginia Prince, a self-identified transvestite who was publicly out back then, Tri-Ess now has chapters all over the U.S.

Unfortunately, Tri-Ess chapters (and many other old-time CD clubs) only accept avowed "normal heterosexual males" as members, and they specifically exclude "homosexuals" from membership. Transgender and transsexual women who are just beginning to crossdress and come out , but who are bisexual or attracted to men, are NOT allowed to become members because they are considered to be "homosexuals" by Tri-Ess.
This exclusion should not be surprising. Tri-Ess's founder, Virginia Prince, was a frequent speaker about "sex and gender" at the early medical conferences on transsexualism in the 1960's and 70's. Prince portrayed transvestism as a "love of the feminine" by normal heterosexual males, to differentiate them not only from “ordinary” homosexuals but also from transsexuals, who were thought by most behaviorist psychologists of the time to be an extreme form of homosexual. (This was yet another byproduct of John Money's faulty theory of gender as a conditioned social construct, leading psychologists and psychiatrists to envision transsexual women as intensely gay men who sought SRS so they could more easily have sex with men. See the following link for more modern views about the causes of transsexualism).
Prince's talks implicitly exploited transsexualism as a foil to elevate the image of transvestism by characterizing it as having higher, purer, more intellectual motivations. Since those talks echoed and reinforced the old paradigm that transsexualism was "about sex" (and in particular "gay sex"), Prince's views were taken quite seriously by many male psychiatrists of the time.
As a side-effect of that activity, Prince embedded an intense homophobia and transphobia into Tri-Ess culture where those phobias still linger today. One senses that the internal feelings of shame and embarrassment felt by many Tri-Ess crossdressers have long been eased by proclaiming "I may wear dresses, but at least I'm not a faggot or a sex change". In addition, the Tri-Ess exclusion of TG/TS members may also be designed to calm fears of members' wives and girlfriends that their men may be tempted into "homosexuality" or even into transitioning if any TG/TS women managed to get into Tri-Ess.
Exclusion from many CD clubs presents a problem for young TG and TS girls who try to enter the crossdressing scene early in their transitions, thinking of that as a way to "try out their wings" at gender crossing. Some even initially think that they are just CD's, and only later sense their deeper gender issues. Occasionally a young TG/TS girl just coming out to herself may try to join Tri-Ess, thinking that she might find help there. This can lead to awful rejection, and can damage a young TG/TS woman's feelings at a most critical time in her life. Therefore, young folks who think there is any chance they might have transgender or transsexual feelings are strongly advised to NOT join Tri-Ess, but to seek other more inclusive CD clubs that openly welcome TG/TS people. Of course, transvestic men who want to join a CD club that only includes other "normal heterosexual men" will feel very much at home in Tri-Ess.
Fortunately, the paradigms of crossdressing are changing rapidly now, and more fun-loving, openly inclusive CD/TG/TS clubs are forming and gaining widespread membership. Finally, in the early years of the 21st century, it seems that crossdressing is beginning to move beyond the fear, shame, embarrassment and secrecy of the past and is becoming a warmly-fulfilling pastime for many people - frequently with the loving support of partners and spouses.
An example of a much more "TG-oriented" CD club that welcomes TG and TS women is Crossdressers International (CDI), in New York City. They are a CD support group having an apartment in the City where they meet, and where new sisters can come out. Every Wednesday night, TS or TG or CD folks can join them and socialize and have a little dinner. People can dress in the apartment and feel free to express their femme side, and some go out to dinner or a club in NYC after the meeting.
There are now also wonderful "makeover services" offered in many cities now, such as at FemmeFever on Long Island, NY, where crossdressers can go for very personal, skillful, knowledgeable and supportive help in developing and experiencing their "female persona". To get an idea of the possibilities of makeovers, see the amazing "before/after" photo page in the FemmeFever site, showing some really nice-looking guys and their photos as pretty gals after their makeovers. In addition to these services, FemmeFever is also a focal point for a large CD/TG/TS community in that area, holding many social events that can help newcomers come out and enjoy themselves.
See the wonderful Guy/Gal - Before/After photos
at the Femme Fever website:
Hopefully more and more CD clubs and activities will also become inclusive and welcome TG/TS women, especially those who are first coming out and so very vulnerable at that time. Those clubs could help beginning TG/TS women get off to a better start on their presentation and manners than they might on their own.
In addition to local TV/CD clubs and various chapters of national organizations, the CD community is also a major factor in the staging of several national-level "gender conferences" each year. These major events attract large numbers of attendees, and provide the community with wonderful places to safely congregate and enjoy many social activities staged in wonderful hotels. Three especially large events are the Colorado Gold Rush held late each winter in Denver, Colorado, Chicago's Be-All held each June in Chicago, Illinois, and Southern Comfort held early each fall in Atlanta, Georgia. Participation at these events includes people from all across the gender spectrum, and the conferences are increasingly billed as TG conferences. However, crossdressers are the largest group among attendees and CD'ing is a major focus of these events.
The Colorado Gold Rush, Southern Comfort and the Chicago Be-All:
National-level transgender conferences and crossdressing events.


Attending one of these conferences is an excellent way for someone who newly recognizes that they are TV/CD/TG/TS to come out to themselves, mix and mingle among many diverse and interesting people, quickly learn about the overall community, and begin to find themselves. The conferences provide crossdressers with a great way to enjoy CD'ing openly yet anonymously within the large hotel environment for many days. These conferences also include all sorts of practical seminars and self-help sessions for TV/CD/TG/TS people on everything from the basics of feminine grooming and presentation all the way to seminars for TS women by TS care providers and surgeons. These conferences represent a more future-oriented, fun-loving, less fearful way of enjoying being CD and at the same time are helping the broader TV/CD/TG/TS community get to know one another and better understand one another.
Terminology can once again become a confusing issue when trying to talk about crossdressing within the larger context of gender conditions. Some "gender theorists" consider crossdressers (CD's) and transvestites (TV's) to fall under the so-called "transgender umbrella", even when they identify as having a male gender identity.  Since there are many, many more of these male-gendered heterosexual male crossdressers than there are transgendered people, gender activist organizations usually include them (and also drag queens) in their definition of the "transgender umbrella", in order to draw on their larger numbers for financial support.  Furthermore, although one’s wardrobe does not determine one’s gender identity, crossdressing inherently IS a form of transgender behavior - and the people who engage in it do sometimes wind up the subject of the same hateful, antiquated and discriminatory attitudes of society and the legal system that afflict other gender variant groups.
The traditional TV/CD community is witnessing an ever increasing flow of TG/TS girls through the CD scene. Some of these kids are questioning and are unsure of whether their ultimate gender trajectory will be CD or TG or TS. Meantime, everyone involved is becoming better educated about the differences in the inner feelings and identities of TG/TS girls from those of the more widespread heterosexual male crossdressers and transvestites. Static labeling just doesn't seem to work anymore in such fluid communities.
Since there is no sharp dividing line between those crossdressers who have transgender feelings and those who do not, it seems best to leave the labeling up to the individuals themselves. Many crossdressers dislike being labeled transgender, while others may prefer to be labeled that way, because they do feel some degree of female gender identification. In those cases people should honor the transgender identification.
Unfortunately, the overall crossdressing scene is still dominated by a pervasive cloud of shame, embarrassment and fear because of the long history of social stigmatization of transvestism. The vast majority of crossdressers are still extremely fearful about being outed to their spouses, families, friends and co-workers. This fear is based in the reality that if discovered or outed, crossdressers can become the targets of harassment, hate crimes and very intense employment discrimination, as in the recent "Winn-Dixie" case.
Worse yet, the mental health establishment still classifies male "transvestic fetishism" as a "mental illness" (just as they used to classify homosexuality, until they learned better). Although this classification, in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), 2000, has recently come under attack from many directions, it nevertheless casts a further pall over the CD scene, reinforcing the fear and shame so common among crossdressers.
Sadly, it is likely that any actual "diagnosed mental illnesses" associated with crossdressing are simply "iatrogenic artifacts" of the stigmatization by the medical community and society at large. In other words, the mental problems aren't due to the crossdressing, but are actually depressions or anxieties CAUSED by psychiatrists' and others' efforts to "stop transvestic behaviors" even in cases where crossdressing is clearly beneficial to the person's well being. For a recent paper on this topic, see this link. For an extensive critique of psychiatric stereotypes of gender diversity, see the Gender Identity Center of Colorado's webpage on GID reform.
The non-scientific classification of harmless, pleasurable crossdressing as a mental illness has long been a source of fear and discrimination against not just crossdressers, but against all transgendered people. Hopefully, gender activists will be able to educate and raise people's awareness that the old-time psychiatric establishment's view about crossdressing just don't make sense, and that they unfairly stigmatize people who are just enjoying themselves, exploring their inner gender feelings, finding some peace, and doing no harm to anyone.
Fortunately times are changing. Many modern crossdressers and their SO's are breaking out of old-time paradigms of thought, and simply going on to enjoy who they are and what they do. Although many still feel the need to completely hide their crossdressing from their wives or girlfriends, many others are coming out to their partners. As a result, many wives and girlfriends are finding that they can fully accept and support a partner's crossdressing, especially if this helps him become a much happier, more sensual, more passionate and more loving person. For example, see Alison's website, which describes Alison's relationship with partner Sue, and also Kathy and Amanda Bower's Home Page, describing Kathy's wonderful relationship with a partner who is not only understanding but also accepting and indeed enthusiastic. For more about the trend towards a new paradigm of family openness and comfort about crossdressing, see the newly published book by Helen Boyd:

My Husband Betty is a book by Helen Boyd, the wife of a crossdresser. She has writen this book in an attempt to help both wives and crossdressers see past the 'shame and secrecy' paradigm that currently permeates the crossdressing community. The general attitude - that crossdressing is a problem that must be "coped with" in a relationship - prevents more positive attitudes about crossdressing from flowering. Additionally, Helen has found that the crossdressers themselves are beginning to acknowledge their place in the TG spectrum, and is hoping that the new generation of crossdressers can and will begin to understand that transgender rights are their problem, too. She is a feminist writer, and hopes to see the wives of crossdressers empowered by their partners' love of the feminine, and encourages the entire community to realize, in her words, that "we - so-called genetic women, transitioned women, and 'temporary women' - are engaged in a shared goal: to acknowledge and celebrate our womanness".
Helen's book can now be ordered at
For a further introduction to crossdressing, see the "Why be a TV website". The section entitled "What I believe" is by all accounts a really open, honest, authentic description of what it's like to be a transvestite, and there are other excellent links to follow in that website too. For more insight into CD'ing, there are many personal websites you can explore. Some more good examples of personal sites are Yvonne's Place for Crossdressers, and Tammie's home page. For even more books and references about crossdressing, see Kathryn's list of CD books.
(v) Travestis (“She-males”) and Similar Composite Gender Identities

In most large cities in the Americas and in many seaport cities around the world, there exists a large but more or less underground community of transgender women who work predominantly in the so-called sex industry, i.e. prostitution, strip clubs, pornography, etc.

This has long been an option for a “landing zone” for gender-variant youngsters who have been thrown away or run out by their families. Lacking education, identification papers and any other form of social support – this at least provides them with a means of economic survival.
In a few cases, these kids may become well-paid as call girls, and talented and pretty ones may go on to earn good money for a while as entertainers. However, many live very marginalized lives in the ghettoes of the big cities.

In the English-speaking world there is no consensus about a name for these girls and women. They may be called, or may call themselves, “she-males” or “street trannies”, while others call themselves transgender or transsexual women and may identify as such (even though some follow different life-trajectories than most trans women).
Although "she-male" is considered a derogatory term in some circles (and sometimes used to insult preop trans women), the word is being reclaimed as a good way for some gender-variant people to describe their identities. Internet she-male pornography has also made many people aware of the beauty and sensuality of these women, thus helping the word seem less defamatory and more exotic instead.

In countries where Romance languages are spoken, the universal term for such a person is “travesti.”  This term should NOT be confused with the English word “transvestite” (which instead means a heterosexual male crossdresser). Given the recent surge in immigration from Latin America to the U.S., the term “travesti” is sometimes heard even here, as a substitute for “she-male”.

In common with TG and TS women, travestis and she-males generally undertake a full-time transition away from a male gender identity, but under the traditions of their communities (and often lacking funds for more aggressive transformations) many usually do not go as far as to adopt a fully female identity and physicality.

To outside appearances these women often look very feminine and behave accordingly, but many may not actually claim to be women or claim a feminine gender identity. Not fitting cleanly in their own minds into either of the two main gender boxes, they may sometimes refer to themselves as a “third sex (or gender)” or as “other.”

Such intermediate gender identities develop in parallel with the modifications that the travestis (she-males) make to their physicality. They often go to great lengths to attain the most female body possible, with the critical exception of retaining functional male genitalia. Indeed, while many do use female hormones, others limit or avoid hormone use in order to maintain standard male sexual function, and thus are dependent on cosmetic surgery and/or silicone injections in order to feminize their bodies. Ordinarily the sexual partners of these women are male, but it may be unclear whether the partners’ sexuality should be characterized as gay, straight, or something else (or whether it should be "labeled" at all).

It remains to be seen whether this general group represents a stable gender identity in the long run. Some of the young ones no longer limit themselves to a lifetime of work in the sex industry, and some are avoiding it altogether – especially as advocacy groups and enlightened health services reach out to them in some cities (notably in San Francisco, CA). Some also shift onto other transgender trajectories - including more fully transitioning as trans women and then assimilating into society.

However, in Latin America (and especially in Brazil, where this group has been much more highly-visible and well-established for a much longer time), there is evidence that they do form a coherent group of people with an adopted identity that is neither strictly masculine nor feminine, but rather is a composite of the two. In many cases this composite gender—as opposed merely to an occupational choice—is at the heart of the travestis’ identity, and is a source of fulfillment and great pride to them.
(vi) Transvestic fetishism,"autogynephilia" and other psychiatric classifications of CD/TG/TS people:  Are these labels or stigmata?
Some intensely transvestic males become troubled by feelings of addiction to cross-dressing and masturbation and seek help from counselors to contain this addiction. This group has long been labeled by psychiatrists (in their DSM manual) as suffering from a "mental illness" called "transvestic fetishism". There is no known cause for this condition - nor any cure either, other than helping the person stop worrying so darn much about it and just accept it and have fun doing it.
Sadly, this psychiatric label has a very negative image and has the iatrogenic effect of intensifying guilt and shame in the very people who go to psychiatrists for help. The practice of defamatory labeling by psychiatrists thus causes much of the unnecessary pain felt by crossdressers and other transgender people about their condition (and also insures a steady income stream for those psychiatrists).
The situation got even worse for a few years (from about 2000-2004), during which a clique of sexologists (Ray Blanchard, J. Michael Bailey and Anne Lawrence) tried to pin a variant of that old stigmatizing label onto almost all transsexual women too, coining a new word for it - "autogynephilia". This led to a major investigation into the research methods and ethics of those people, and to the subsequent collapse of their effort.


Transvestic fetishism, also called "autogynephilia"

for a while by Blanchard, Bailey and Lawrence:

Are these labels or stigmata?  (es)

For more about the Blanchard's theory, and the subsequent decline and fall of Bailey, Blanchard and Lawrence - see Andrea James' BBL Clearinghouse, Lynn Conway's Investigative report on Bailey's book and Joan Roughgarden's essay "Psychology Perverted".  Scholars, ethicists and historians of science will find further detailed documentation of this scientific fiasco in the online timeline of events and links to evidence.

Unfortunately, this was only the latest in a long series of rogue theories of transsexualism by psychiatrists, academics and sexologists.  In the future, instead of inventing highly stigmatizing labels for transsexual women and incessantly arguing amongst themselves about the meanings of those labels, sexologists should do something more productive:  They should conduct real-world follow-ups of actual gender transitions, and help us learn which factors lead to positive transition outcomes and which do not.

Meantime when you hear the word "autogynephilia", translate it back into "transvestic fetishism".  Then ask yourself:  Did that term have any real meaning either?  Or was it also merely a stigma masquerading as a scientific label?   For more enlightenment about invented words that define non-existing phenomena to be "mental illnesses", you might also read about the non-existence of "nymphomania" and its parallels with the non-existence of "autogynephilia":


Nymphomania and Autogynephilia:

The Invention of Mental Illnesses by Psychiatrists


For a further critique of the whole issue of "labelling", see the section "Getting beyond labels", below.
(vii) Others:
Another group of people often mis-identified as being either transgender or homosexual are men who are inherently feminine-looking and women who are inherently masculine-looking. Many normally-gendered people have a somewhat cross-gendered physical appearance, sometimes without even realizing the mixed signals their bodies send about their gender. This is a result of their genetic make-up, and is not a deliberate display and does not at all mean that they are transgender. Unfortunately, such people are often the subject of ridicule and prejudice simply because of their cross-gendered physical appearance.
Very recently, quite a few young people have begun calling themselves "trans" or "transgender" as a way of rebelling against rigid gender stereotypes. Some teenage boys, while watching a sensual young woman like Britney Spears perform when she was young and hot, may not only be attracted sexually to someone like her but also wish they could be a little like her physically, aesthetically and sensually. Then they'll start getting that reaction to other pretty girls too. Feeling a bit of gender-stress and gender-envy under current paradigms, they'll demand the right to dress in whatever way they choose, independent of their gender. They may use some make-up, and partially crossdress in explorations of their own gender feelings, and for gender-bending fun and gender-political purposes.
Many of these "trans" kids are not strongly transgendered, and will grow out of this phase after high-school or college. This "movement" is reminiscent of the time in the 60's when some men began to grow long hair as a rebellion against the straightjacket conformity of the 50's. This trend may ultimately be helpful to truly transgender people and to gay people, by loosening up society's attitudes and making people more tolerant of variances in gender presentation.
Other young people have begun to embrace an identity they call “genderqueer,” which involves expression of fluid and individualistic gender identities, sexual orientations and body modifications – and allowing themselves the freedom to vary these expressions as inner feelings dictate.  Many also advocate "queer self-determination", in which the individual resists outside pressure to permanently fit into some existing LGBT "category". For genderqueers a “composite” gender identity is a natural thing, and not merely a rebellion against existing social constraints. Nevertheless, such expressions of gender have the potential to further displace antiquated social notions of “correct gender behavior.”

Yet another gender-variant group, not always easy to differentiate from the genderqueers, are the androgynes, who generally conceive of themselves as having a gender identity lying somewhere near the middle of the male-female spectrum. As with any other group, their gender identity is foremost a matter of their individual internal spirits, and may or may not be reflected in their external appearances.
Finally, there are lots of folks who mingle in among the transgender community but who aren't easily "classified" as, or recognized as, being transgender. One large diffuse grouping consists of people who have done poorly in life, who can't hold their own among other men, who feel like "failures as men", and who then somehow get into their heads that "maybe they should have been women instead". Perhaps they did a little crossdressing in the past, and then hear about transgenderism and think "Aha! That's the explanation for all my problems!" Or perhaps they envy the dependent "kept status" that some young pretty women achieve, and wish they could find a sugar daddy to take care of them too. In a state of confusion about such things, these people sometimes join TG support groups, or come into TG shelters and clinics in the large cities, and seek help for a "sex change" by claiming that they are "transgender".
These "underachievers" are a very difficult group to sort out and to help. Many suffer from mental illness, others are substance abusers, many are in poor health, and most have other complex psychosocial adjustment problems. Many of these people think that they can be turned into pretty women if only the "doctors would give them hormones and perform surgery on them", thinking that they themselves don't have to do anything but undergo the treatments. Presenting as "victims", they often throw themselves onto the clinics and welfare systems pleading for help.
Unfortunately, such dependent people make very poor candidates for gender transition, since they lack the problem-solving abilities and personal development skills to handle such a complex project, independent of whether such a project makes any sense for them. Lacking clear-cut female gender identities, their transition attempts usually fail disastrously, resulting in further social marginalization. These "underachievers" often haunt the edges of many TG/TS support groups, where they may remain for years (and their visible presence in support groups often frightens young transitioners from approaching such groups). These are sad cases for which there are now no ready solutions.
Why do some react to transgender people with such hostility?
Why are transgender and transsexual people blamed for their afflictions?
Being gay doesn't affect one's gender, name, body or appearance in any way. Being gay only means that you are innately drawn towards an intimate love partner of the same gender as yourself. Most gays easily "pass" as normally gendered, thus avoiding constant detection and persecution.
Passing can be vastly more difficult for the transgender people, especially when as adults they seek a partial or complete transition into the correct social gender to match their given brain-sex and inner gender identity. Transition means changing body morphology, changing clothing and outward appearance, changing name, changing legal records, and changing all family and social relationships; in short, changing almost everything one does to one degree or another.
People in the midst of transition who don't pass are often treated as if they were unusually exhibitionist "drag queens" or "out of control transvestites" flaunting themselves in public. Many people react with hostility towards such transitioners, because they confuse them with prurient media stereotypes of "sexual deviants". Even gay people often find themselves feeling uncomfortable around visibly transgender people, and may feel that TG/TS people project a weirdly incorrect image of "gay people" into the larger community. Similarly, men who are themselves closeted transvestites, and who may feel intense guilt and embarrassment about their own crossdressing habits, often feel intense discomfort and fear when they encounter visibly transgender people.

The same feelings of shame and embarrassment can sometimes be evoked in closeted gay men upon seeing visibly transgender women, because they often confuse transgenderism with homosexuality.  Then too, any sensation of sexual attraction toward a visibly transgender person can be the source of profound discomfort for many people who have insecurities about their own gender or sexuality.  

There are also many people who view all transgender expression—as well as any non-normative sexual orientation—as a deliberate choice signifying nothing more than an individual’s desire to “have a good time,” “shake up the legitimate and long-established social order,” or “act out a mental illness.”  People having this viewpoint often apply the term “lifestyle” to GLBT people, implying that non-normative gender and sexual identities are capricious, insubstantial and ultimately invalid. Sadly, such ill-informed, incorrect and stigmatizing thinking is often transmitted from generation to generation in the home and among peer groups in our schools and other institutions.
Also, as we'll see in Part II, many in the psychiatric profession still consider transgenderism and transsexualism to be "mental illnesses" (just as many psychiatrists consider crossdressing to be a mental illness, and call it "transvestic fetishism"), and they are still listed as such in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), 2000. These outdated listings are the source of additional intense stigmatization of TG/TS people by much of the medical community and society at large, because supposedly "mentally ill" people are usually blamed for their causing their own conditions and are stereotyped in ways that frighten others.
Furthermore, many established religions have strict taboos against any form of gender-variant behavior, and in their official doctrines, teachings and practices they often demonize, ridicule and persecute gender-variant people.
For these and many other reasons, transgenderism and transsexualism (especially MtF transsexualism) have historically been "socially unpopular conditions" in western society. Unfortunately, the ongoing hostile reactions of others can complicate and even ruin someone's transition, especially if problems in employment cost the person their livelihood. One should not underestimate the personal agony suffered by someone whose transition stalls or fails (see the story of Rexanne in A Tragedy's Tragic End).
Hopefully the general public will someday come to understand that TG and TS people who are visibly in transition are following deep biological imperatives and desperately trying to resolve their profoundly felt gender incongruity. Such people should neither be feared nor stigmatized for their efforts to resolve a condition that isn't of their own making.
Shades of gray: Combinations and intergradations of gender and partner-preference:
Of course things are not as simple as they might have appeared in our discussion so far. Things are not just black and white. Instead, there are many shades of gray across a continuum of gender conditions.
Some gay people may also have gender identity conflicts. For example, someone who initially finds a place in the gay community as a rather feminine boy, and then takes on a label as a drag queen, may actually be transgender or even intensely transsexual instead. Some strongly transgendered people have same-gender partner preferences. Some people, including transgender people, may be bisexual and be attracted to love partners of either gender. Questions then arise such as whether the pre-operative TS woman who loves a woman is a heterosexual or a lesbian. In all these cases, we see how our tendency to quickly "label" people gets us into semantic difficulties, mislabeling and confusions.
For example, if we learn that two love partners are "genetic males", there are many different possible scenarios for what is actually going on. They could simply be two gay men, both self-gendering as males, and this relationship would seem to both partners as being one between two men. However, one partner could be a straight male who has fallen in love with someone who is a strongly transgendered or pre-operative transsexual woman. Both partners in such a relationship usually feel that they are in love as a man and a woman (Lynn had several such love affairs when she was a young pre-op TS girl). On the other hand, both people might mis-identify themselves as "gay" and think of the relationship as gay, even though in almost all respects it really is a man-woman relationship.
The same kind of complexities can arise in relationships between two genetic females, depending upon the self- and other-gendering of the two lovers. And things can become further blurred as if one or both lovers are just moderately transgendered, and/or if one or both do not disclose their transgender identity to the other lover. Then too, consider what happens if one of the lovers in a gay or lesbian relationship is transgender and finally transitions. For example, a recent story by Sara Corbett in the New York Times Magazine raises the question "Does a Sex Change Mean the End of the Relationship?" The story is of about two women, Chris and Debbie, who were lesbian lovers and who had a little girl, Hannah (Debbie was fertilized with sperm from an anonymous donor). However, Chris was intensely transgendered and later transitioned (FtM), undergoing surgeries and testosterone hormone therapy to become a man. His transition initially raised many questions and difficulties in this relationship, which has since endured and deepened. Debbie is pregnant again, and they are now expecting a little boy. This is a beautiful story about two people in love, and about the family they have created.
Chris and Debbie, with daughter Hannah

[ from the New York Times Magazine, 10-14-01 ]

Another common situation is for late-transitioning pre-operative transsexual women to be married to women and to have had children with them. This is not surprising, because of the long-term social pressures on closeted MtF transsexuals to "go out with women" when they are young, and because of the longings by closeted transsexuals for some form of intimacy and close human companionship. In many of these cases, the transsexual's wife may have no idea that her "husband" thinks of herself as a woman, wants to physically be a woman, and feels that the marriage is actually somewhat like a lesbian relationship. Only if the closeted transsexual finally confronts the condition and seeks help will the wife learn the truth. In most cases, such relationships will gradually end if the husband transitions MtF. However, in some cases (as in the case of Chris and Debbie) these relationships may continue intact if the two partners love each other deeply and can adjust to the physical changes as the transition unfolds.

Both straight and GLBT communities are increasingly recognizing that human variations and combinations of this type are not so uncommon, and are honoring them without any need to assign narrow sexuality or gender labels. The reality is that people's preferences in love partners--whether they are attracted to "the same" and/or "the opposite"--can be focused on either sexual and/or gender characteristics, or on some combination of these factors.


Getting beyond "labels", and thinking of gender feelings, gendered behaviors and gender trajectories instead
We've seen that there are many variations and combinations of gender conditions, across a wide continuum of possibilities. These are major realities that deeply affect the lives of large numbers of people in close human love relationships. Unfortunately, we don't yet have a truly adequate vocabulary for talking about this wide range of phenomena, and most people are left to their own devices when struggling to cope with gender confusions or transgender identities in their love relationships.
The tendency of psychiatrists, psychologists, physicians and gender counselors to "label" us as "transvestites", "crossdressers", "transgender", "transsexual", etc., can greatly obscure what is going on in any given case. Gender-variant people themselves often get trapped into confusions and arguments about these labels. Counselors and their clients often dwell endlessly on questions such as "is this person (or am I) a transvestite, or really a transsexual?"  Or, "is this person a DQ or a TG or a TS?" And on and on it goes, often with an overlay of judgementalism, paternalism and condescension, with some conditions being "more acceptable" than others, or vice-versa, depending who you talk to!
These difficulties with "labels" remind Lynn of an insightful observation made by Edwin Armstrong, a great early 20th century research engineer who made many major inventions underlying modern communications technology:

“Men substitute words for realities, and then talk about the words.” -

- Edwin Armstrong

Wouldn't it be better to ask questions, rather than try to answer meaningless questions with and about ill-defined labels? Someone may be crossdressing, but that may or may not mean that they are a "transvestite". They could be TG or TS or DQ instead. Someone may be taking hormones and enjoy their breast development, but that doesn't necessarily mean that they are TS or even TG for that matter! Can you see how labels get in the way?
Labels give the illusion of standing for something real, but when you probe deeper, they sort of evaporate! We are what we do, what we feel, how we behave, and what trajectory we follow. We are always a "work in progress", just as all other human beings are. We cannot be defined once and for all by simply having a label pinned on us.
What really counts is what you are feeling inside. What is your body and heart telling you that you need to do? What behaviors have you actually been engaging in? What experiences have you actually had? What gender trajectory seems to make sense for you? What physical and social changes can you, and should you make in order to find a more natural and comfortable physical/social place in life. Can you make those changes and follow that trajectory without sacrificing too much, in employment, family relations, and expectations for finding a love partner in your later life?
Now those are real questions that need real answers. Someone cannot simply diagnose you and tell you: "You are TS, and thus you should do X, Y and Z". It just doesn't work that way. It is far more complex than that.
There are so many variables that it doesn't make sense to attempt "in advance" to try to figure out who is CD vs TG vs TS. You find out by watching what they actually do over time. Some people crossdress and that is enough to make them happy. You could call them "CD's", but how do you know what they might do in ten years? Some people go on to transition socially (usually with the aid of hormones). You could call them "TG's", but what does that really mean? After all, they might go further and get SRS someday, or they might even de-transition someday. Some people go on to social transition and also undergo sex reassignment surgery. You might call them "TS's", but as we'll see in Section II, this too has proven to be a mistake in some cases.
The only thing that you CAN be sure of, when it comes to others, is their real observed behaviors and trajectories: If someone crossdresses, that is a REAL behavior and you can say "that person crossdresses". If someone undergoes social transition, that is a REAL behavior and change-point in their gender trajectory. You can say "so and so underwent TG transition". If someone transitions socially and undergoes SRS, that too is a REAL behavior and change-point in their gender trajectory. You can say, "so and so underwent a TS transition". But there is no meaning to labeling these people as CD, TG and TS - except as a sort of "shorthand notation" for very informally referring to those people.
Please note: That is the way Lynn intends labels to be interpreted here in this website, i.e., as a sort of "shorthand", while always recognizing the great complexity of individual situations and their variability over time . We must also be open to changing, extending and evolving this "shorthand language" as our understandings and empirical models of transgender lives evolve.
Gender-minority labels don't work any better for pinning down "gender minority roles" than "role-playing" used to work to define meaningful real roles in the gay community. Labels, and the presumed roles that go along with them, are just too static. Labels are too confining and too limiting in their effect on people. They are useless as predictors of what someone should do and actually will do as they discover how they really need to live and present themselves to society.
Only you can decide what your heart and body are telling you to do, what behaviors you should explore, and what detailed gender trajectory you should follow. In doing so, you should consider the widest range of options and possibilities. Do not jump to the conclusion that you are a "CD", or are a "TS", and then mimic stereotypes of "what a CD should do or not do", or what "a TS should or should not do". As you go along, be sure to allow your gender trajectory to veer off in possibly unexpected directions from your originally predicted path, as your body and heart learn to feel new things along the way.
In a similar way, many young people nowadays are also moving beyond the labels "straight" vs "gay" or "lesbian" when thinking of love-partnering options, because those labels are also too confining and limit one's options for finding real love in life. For many older people in the gay community those labels have great personal meaning and play an important role in self-defining who they are. The labels thus become tightly coupled with their identity as people, and there is considerable "gay political-correctness" pressure to stick with those labels and to apply them to everyone. However, such labels simply do not work for the many people who are bisexual, and whose love-life trajectories depend upon who they happen to fall in love with.
For an excellent introduction to the complex issues surrounding identity labeling,
see the new book discussed at the following Bay Windows Online link:
New book puts gender and trans identity on the table: "Called "Pinned Down by Pronouns" (Conviction Books), the anthology marks an ambitious assembly of 75 local writers - most who identify as transgender, genderqueer, and queer. At first glance, the more than 200-page collection marks a literary achievement for Boston's transgender community. Not to mention a tangible tool to change public attitudes around gender stereotypes. But the book also underscores the city's swelling community solidarity. A community united in the goals to challenge language, its engineering of a gender binary, and subsequent assumptions about what makes a man, what makes a woman, and what makes us human. "Under the terms transgender and genderqueer, some of us want to stretch the binary, some want to smash it, and some want to save it," explained Lee Thornhill, publisher of Conviction Books. "[But] all of us want to be seen for who we are.""
Taryn Levitt
Within these pages we are talking back. Talking back to the theories that erase us...
to the books written about us but never for us, to the doctors who see us only as disorders,
to our given families who disown us, to our chosen families who take us in, to those who love us, to those who want us dead, to those who say "our lives are not possible" (Abe Rybeck). Our lives are not only possible. Our lives are revolutionary.
- from Pinned Down by Pronouns

In the next section we will compare the range of transgender (TG) and transsexual (TS) transitions in more detail. As we will see, the wide range of current-day gender transitions are pushing out the envelope of the known "gender-space" in which people can live fulfilling lives. These explorations are providing scripts for how to follow many new "gender trajectories" (i.e., sequences of "gender states") through life. In the process, we are becoming much better informed on how someone can successfully transition from any particular initial gender state, on through various intermediate states, to finally settle into a state that is comfortable and authentic for that person.
Continue to next section:
Part Ia: TRANSGENDERISM (cont.) 
Reset on 5-26-00


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