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Why do some men prefer to live the lives of women and vice versa? A good starting point to understanding the world of transsexuals, is to understand the differences between gender, anatomical sex and sexual orientation.
Gender is composed of both gender identity and gender role. Gender identity refers to an individual’s perception of themselves as male, female or a combination of both and to a lesser extent, society’s perception and reaction to their outward presentation. Gender identity usually manifests itself through the presentation of gender role.
Gender role refers to the behavioural expectations based on anatomical sex that are placed on an individual by society. This would be, to a greater or lesser degree, what we think of a stereotypical male or female behavioural presentation.
A person’s gender is actually independent of their anatomical sex. For most people, their gender matches their anatomical sex and they rarely think about the difference between the two concepts. But when an individual’s gender does not match their anatomical sex and this disparity causes emotional problems, the person is said to be gender conflicted.
When this conflict is extreme and lasts for a significant period of time, the person is considered to be transgendered.
Anatomical sex
Anatomical sex refers to the presence or absence of specific genitalia and internal organs which identifies a human body as being that of either a man or a woman. This is actually an oversimplification as it does not take into consideration such conditions as intersex, but it will serve for the purpose of this introduction.
Sexual orientation
Sexual orientation refers to whether an individual is sexually attracted to persons of the same sex (homosexual), the opposite sex (heterosexual) or both sexes (bisexual). A transgendered person may be of any sexual orientation, or may even be asexual.
The “T” words
Transgender: Originally, this term was used to describe a person who chose to live in the gender role that was opposite of their anatomical sex, but who did not seek genital reassignment surgery. Common usage has diluted this meaning, however, and the term is now often uses to describe any gender presentation that is contrary to their anatomical sex.
Transvestite: The term refers to men, usually heterosexual, who enjoy occasionally adopting the clothing, mannerisms and gender role of women for personal satisfaction. This satisfaction may take the form of sexual arousal and / or gratification but may just as easily be of a non-sexual nature. Transvestites generally self-identify as men and have no interest in having permanent feminisation done to their body.
Transsexual: A transsexual person believes with total conviction that they should have been born in the sex and gender opposite that of their anatomical sex. They are not delusional; they are painfully aware of the reality of their physical characteristics and anatomical sex and it is a source of discomfort to them. That being said, there are three categories of transsexual:
Pre-operative refers to someone who seeks gender reassignment surgery but has not yet had the operation.
Post-operative refers to someone who has completed gender reassignment surgery. Post-operative transsexuals are often referred to as “former transsexuals” or “transsexual women”.
Non-operative refers to someone who, for health and personal reasons, chooses not to have gender reassignment surgery.
The majority of transsexual persons who seek therapy for their gender incongruity are those who identify as preoperative. The other categories of transsexual persons may also seek therapy, but it will most likely be for depression, relationship problems and other conditions / situations that may or may not be related to their transsexual status.
The technical term for transsexualism is Gender Identity Disorder (GID) or Gender Dysphoria and it is listed, defined and subdivided in the DSM-IV (302.85). However, transsexualism is not a mental illness. There is no effective psychotherapeutic treatment for transsexualism; the only effective treatment is to surgically alter the anatomy of the body to coincide with the person’s natural gender identity.
Additional terms
There are some additional terms that have very specific meanings in the context of the transgender community.
Passing: This refers to the person’s ability to successfully cause others to perceive them as being of the gender that is contrary to their anatomical sex. This is often a goal of many transgendered persons.
Clocked: To be “clocked” means to be recognised as a transgendered person when attempting to pass as a member of the gender that is opposite to the person’s anatomical sex. This is also referred to as “being read”.
Real-Life Test: Also known as “living full time” or “twenty-four seven” (24/7), this refers to the transgendered person living in the gender role opposite that of their anatomical sex all day, every day. A real-life test for a period of at least one year is considered a prerequisite for surgery according to the HBIGDA Standards of Care.
MTF: This is an acronym for “male to female” and is used to identify the direction the transgendered person’s transition is moving.
FTM: This is an acronym for “female to male” and is used in the same manner as MTF above.
GRS: Gender Reassignment Surgery (also referred to as SRS or Sex Reassignment Surgery). With MTF transsexuals, this refers to castration and the reformation of the penis and scrotum into a neo-vagina and labia.
Finally, mention should be made of the proper use of pronouns when addressing or referring to a transgendered person. As a general rule, a transgendered person should be addressed and referred to with the pronouns that are appropriate to the person’s gender presentation. – (Dr Elna MacIntosh, sexologist)
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