Gianna Israel article about "Transgenderists"

Transgenderists: When Self-Identification Challenges Transgender Stereotypes
By Gianna E. Israel
Copyright 1996, all rights reserved.
There has been an interesting development in the transgender community in recent years, specifically of persons who do not identify with the social and clinical definitions which apply to individuals with gender identity issues. Traditionally, those who comprise what is frequently referred to as the “transgender community” include transsexuals and crossdressers. In part, the definitions on who is a transsexual and who is a crossdresser are defined by social stereotypes and clinical literature; however they are also defined by those unique persons who have transgender experiences.
A transsexual is a person who transitions and permanently lives as a member of the opposite gender. These persons seek out sex hormones and cosmetic surgery. This includes breast augmentation or mastectomy depending on the direction of change. In addition, transsexuals are interested in Genital Reassignment Surgery or what is also known as Sex Reassignment Surgery. It is common knowledge that there is a larger proportion of individuals who self-identify as transsexual, than the actual number of people who have genital reassignment. This in part is due to the high financial, emotional and social costs associated with living as a member of the opposite gender as well as the surgical procedure itself. There also exists a number of individuals who are unable to undergo Genital Reassignment. More information about those persons will be briefly addressed later in this article.
Crossdressers are persons who temporarily wear clothing of the opposite gender to fulfill an inner sense of need or reduce gender related anxiety. Typically crossdressing is done privately, although some persons do so publicly when circumstances appear safe. Some also crossdress for sexual fulfillment, such as in “transvestic fetishism.” While crossdressers do not experience the many difficulties transsexuals face during the pursuit of transition or Genital Reassignment, they do experience emotional turbulence, social isolation, or concerns regarding privacy and whether to tell others about their secret. Like transsexuals, these factors are particularly evident when a crossdresser is unaware of transgender resources or is unable to resolve stereotype induced feelings of guilt, shame or fear. Both transsexuals and crossdressers are at risk of victimization by persons who cannot tolerate differences in others. Although, transsexuals face slightly higher risks because they are more visible than crossdressers who tend to be more hidden.
Transgenderists are persons who consistently live as members of the opposite gender either on a part or full-time basis. Some maintain their original identity in the work place or during formal occasions. Others appear in their new identity during all aspects of daily life. Transgenderists are unique because maintaining both masculine and feminine characteristics is integral to having a sense of balance. However, the outward presentation of these characteristics varies subtly depending on the individual’s needs and sense of connection to each gender. Like transsexuals, many are interested in obtaining electrolysis, hormones and even cosmetic surgery to bring their outward presentation in line with their inner sense of self. However, like crossdressers, transgenderists are not interested in Genital Reassignment Surgery.
To elaborate on this distinction, even if a transgenderists lives “in role” as a member of the opposite gender on a full-time basis, what separates them from transsexuals, is that they derive pleasure from and value their genitals as originally developed. However, in most circumstances, it is unlikely that a transgenderist who lives in role full-time will disclose such private information without good reason. Because transgenderists are not interested in genital reassignment, they should not be confused with “non-operative” transsexuals or persons who are unable to have surgery due to financial or medical hardship. Although the majority of non-operative transsexuals live “in role” permanently, most need to adjust to a period of internalized incongruency during the time they are unable to have genital reassignment, if at all. Transgenderists do not go through this period of adjustment, because they are not interested in altering their genitals.
Like transsexuals who are at the very beginning of transition, transgenderists frequently experience incongruent feelings regarding their gender identity. Unlike crossdressers these feelings persist “after the clothes come off” and the person dresses in their original gender. These incongruent feelings typically can be continuous, lasting for days and even weeks, until the individual recognizes a pattern in his or her needs. Transgenderists stop feeling incongruent when their needs are consistently met by maintaining characteristics from both genders.
Understanding a transgenderist identity becomes particularly interesting when the subject of differentiating these from other transgender persons is looked at in further detail. Upon hearing about transgenderists, many people are inclined to believe that transgenderists are actually undecided about or simply unaware of genital reassignment. Others believe transgenderists are crossdressers, who somehow have managed to arrange unique living situations, so as to live out their fantasy. While the potential for such circumstances exists, a person usually self identifies as a transgenderist because their internal needs do not meet the narrow definitions associated with transsexuals or crossdressers.
As we try understanding the process of differentiating one type of transgender person from another, it is important to recognize where transgender persons get their definitions and role models. In coming to terms with crossdressing or gender identity issues, most people consult clinical as well as community resources, so as to compare their experiences with others. Access to resources can vary immensely depending upon the individual’s location, cultural background, social status, educational and investigative skills.
For example, the standards which validates a person having a transgender identity vary greatly depending on location. In India, many transgender people have a choice between conforming to traditional gender stereotypes or becoming part of the Hijra caste. This is particularly so if they intend to live out their lives as members of the opposite gender. Within the caste, ritual castration without anesthesia is performed on new members by the caste. Also, hand plucking of facial and body hair is widely encouraged over shaving. Subsequently, while crossdressers and transgenderists may participate in Hijra activities to some extent, none are really considered a full member until they have suffered the pain of beautification and ritual castration.
These practices can seem quite removed from the experiences of transgender persons living in the North America or Europe. These individuals find out about electrolysis, coping with crossdressing, or making a gender transition through relatively similar gender clinics or organizations. For the transgenderist, information addressing their needs has come forth slowly as clinicians began documenting gender identity issues only 20 years ago. In fact, the process of disseminating clinical information about gender issues is so slow, most people are not aware that transgender persons may have specialized medical needs. They may also not be aware that having a transgender identity is not in and of itself mentally disordered, medically diseased or pathological.
Because the majority of clinical resources make no reference to transgenderists, it is important to recognize that differentiating this specialized sub-population is not much different than other transgender persons. Whereas most clinical resources use “consistency” in determining who is a crossdresser as well as who is a transsexual (and therefore an appropriate candidate for hormone administration and genital reassignment), this criterion is equally valuable in identifying transgenderists and their needs. Consistency is defined as person having consistent thoughts, actions, requests or demands for a set period of time. Professionals who utilize consistency as a factor for assessing crossdresser and transsexual treatment plans, may also do so for transgenderists. For example, within the Recommended Guidelines for Transgender Care, Dr. Donald Tarver and I recommend (in part) that “transgender individuals appropriate for hormone administration include those who have in the preceding three months consistently expressed interest in the permanent physical changes brought forward by hormones, in order to bring the body in line with an intended masculine, feminine or androgynous appearance.”
On the surface the preceding recommendation may appear vague because it does not distinguish between transgender sub-populations. This lack of distinction, however, reflects an increasing trend among care providers to encourage transgender persons to adopt a gender-identification based on their needs and experiences, rather than force clients to conform to a provider or clinic’s stereotypes. Encouraging self-determination has encouraged a relaxation of gender boundaries, which meets the needs of all transgender persons.
Because there is not an overabundance of clinical literature portraying the specialized needs and issues transgenderists face, frequently these people cannot locate or are turned away from medical, surgical and psychological services. Those given incorrect information suffer needlessly and are often at risk. For example, those believing they are crossdressers and ineligible for professional services frequently end up self-prescribing, or seeking black market hormones and substandard cosmetic surgeries. Others, believing they are transsexuals, mistakenly proceed with a full-time transition or undergo Genital Reassignment Surgery. As a result these persons end up making huge sacrifices in order to validate themselves, and those who go through with genital reassignment may find themselves regretting having done so for the remainder of their lives. Recognition by professionals and the transgender community of transgenderist needs can help reduce these types of incidents.
Frequently I receive requests for information from physicians who are uncertain about how to address hormone administration in transgenderists. Because hormone administration is a routine medical procedure, providing it to transgenderists is for the most part identical to that of pre-operative transsexuals. I always advise physicians to take into account the patient’s general health, blood laboratory testing, prescription side effects and cosmetic predisposition. The only significant differences include the possibility that the transgenderist may ask that the prescription strength does not interfere with sexual performance, or that cosmetic growth be focused on moderate development or androgenization.
One of the most exciting developments in understanding transgenderist issues, is the recognition that these their experiences can sharply differ in regard to pre-existing relationships such as marriages. Unlike transsexuals who are more likely to face divorce as a consequence of transition, and unlike closeted crossdressers who are the least likely to share “their secret” with a spouse, transgender issues become a significant dynamic within relationships. This is particularly true for those who live in role. In most circumstances the person’s spouse or significant other is clearly supportive of the transgenderist’s needs. Frequently many couples find that the relaxation of gender roles allows both persons to get their internal needs met, whereas they might not get through traditional role play.
It may be assumed that the majority of transgenderist persons deny a desire to have Genital Reassignment Surgery in order to save a pre-existing marital relationship. In some circumstances that maybe the case. However, within my counseling practice only 1 out of every 4 transgenderists state that he or she would “possibly be interested” in genital reassignment if not involved in a pre-existing relationship. Frequently, this ambiguity diminishes the more accepted the person is by others, particularly when acceptance comes from their spouse.
Other issues where transgenderists find difficulties include disclosure and isolation. Disclosing one’s transgender status to others is a challenging prospect fraught with risks. However for the transgenderist, in addition to potential rejection from family and friends, they face the possibility of being turned away by professionals and rejected by the transgender community at large. This is particularly so when transgenderists encounter crossdressers who prefer keeping their behavior hidden, and subsequently feel uncomfortable being around someone who is so visible. Likewise, transsexuals may not be interested in socializing with a transgenderist for fear of having a desire or lack of desire in seeking Genital Reassignment Surgery invalidated.
Like other transgender persons who are hidden or who have not found resources, transgenderists tend to live very isolated, painful lives. This can be overcome by organizations and professionals encouraging differences in others, even when a person’s gender identification challenges transgender stereotypes.
GENDER ARTICLES. This educational column authored by Gianna E. Israel is regularly featured on the 3rd Monday of each month in Tg-Forum, the Internet’s most up-to-date, weekly Transgender Magazine . Several weeks later each article is forwarded to Usenet and AOL . Each column has been written to inspire contemplation and dialogue. Columns may be reprinted in any medium insofar as each article, its introduction, and the author’s contact information remains unaltered.
GIANNA E. ISRAEL provides nationwide telephone consultation, individual & relationship counseling, evaluations and referrals. She is principal author of the Transgender Care (Temple University / in press 1997). She also writes Transgender Tapestry’s “Ask Gianna” column; is an AEGIS board member and HBIGDA member.She can be contacted at (415) 558-8058, at P.O. Box 424447 San Francisco, CA 94142, or via e-mail at
Copyright 2001 by Diane Wilson. All rights reserved.