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Understanding Transsexuality

Perspectives on Transgendered Identity

The story of transsexuality is a long history of changing societies and perspectives measured against the “trans person’s” individual position within those societies. But it is only in recent decades that the term “transsexual” has even come into being, and only even more recently that transsexualism has emerged as a field of scholarly inquiry. Since about the middle of the twentieth century, transsexualism has achieved a unique status as a result of the official “medical response” to the transsexual identity (Chiland 2003). However, the general contemporary concept of trans individuals has unique cross-cultural applications as well as evidence through history of gender play that, while not necessarily transsexualism, nevertheless traces a clear thread of gender “otherness” throughout time. Such gender otherness feeds into the total modern transgendered identity, which ultimately encapsulates transsexualism, the philosophy of which is important to have in mind prior to considering the distinct but related definitions of both identities.

Transgender vs. Transsexual

Leslie Feinberg cites the coining of the term “transgender” by an individual who needed a “name for people…who trans the gender barrier—meaning somebody who lives full time in the gender opposite to their anatomy,” but not necessarily someone who has “transed the sex barrier” (1996). It is useful to consider existing definitions to better understand current differences between transgenderism and transsexuality. Feinberg identifies two colloquial meanings of transgender. On the one hand, it is used as “an umbrella term to include everyone who challenges the boundaries of sex and gender,” while on the other, it is used to describe “those who reassign the sex they were labeled at birth”—and often with the contempt of the dominant society (1996). The University of California at Santa Barbara (UCSB) Department of Sociology “SexInfo” Web site further clarifies the two meanings: transgender is the broader term of the two and it “describes all people who feel that their anatomical sex does not match their gender identity, and/or [those] whose appearance and behaviors do not conform to the societal roles expected of their sex.”

The UCSB definition includes among transgendered individuals not only transsexuals, but anyone adopting an “androgynous behavioral style [including]…cross dressers, drag kings, and drag queens.” According to the site, transsexual is the narrower of the two definitions and, since most transgendered individuals are not transsexual, transsexuals are a small minority within the larger category. Precisely speaking, transsexuals “are people who intend to live as a gender other than that assigned to them at birth, based on the appearance of their sex organs at birth. Many transsexuals alter their primary or secondary sex characteristics with hormone treatments, surgery, or both” (www.soc.ucsb.edu). The two definitions closely correspond with Feinberg’s colloquial definitions of transgenderism. The overlap allows the two terms in some cases to be used interchangeably, where a transsexual is often transgendered in identity but the transgendered, being the larger term, is not necessarily transsexual.

Society and the Philosophy of Transsexualism

It is against the narrow-minded construct of a strictly two-gendered society that transgender identities battle in order to lay claim to a distinct place both in history and in the present. And it is the smaller group, transsexuals, who, having crossed sexual barriers, may face the greatest challenge in a society where a twofold division of the sexes is the only understood division. The male/female division is, for most, the only possible division. At the biological level, however, “nature goes beyond [this] dimorphism” in that some individuals, sometimes called “intersexed,” fall somewhere between the two sexes,—most notably, individuals called hermaphrodites. But transsexuals are not intersexed in that transsexuality cannot be reduced to a strictly biological disorder (Chiland 2003).

The challenge of transsexuality then, is that it appears as an affront to what can be seen as “traditionally accepted definitions,” in that both gender identity and sexual orientation have been called into question by physical difference. Whether or not that difference is to be acknowledged socially as a third or fourth or even fifth sex is a difficult question, for social acceptance only helps put “an end to discrimination and persecution.” Colette Chiland suggests many wish to be “come out” and be recognized as “normal,” while others prefer to go unnoticed. Ultimately, it is a question complicated by personal belief in an ongoing debate against contrasting belief. And the whole debate takes place within the added burden of the standard male/female division , and whether the intersexed person wishes to fit into it or be defined as an “other” (2003).

In Queer America: A GLBT History of the 20th Century, a debate over the attempt to establish the modern homosexual identity historically further illuminates the question of transsexual identity. Defining one’s place within a society is understood by social constructionists to be strictly relative to the time and, as such, a history of transsexualism cannot necessarily be so neatly packaged based on “the idea that sexuality, like gender, race, and other factors, is something devised by human beings in various ways.” On the subject of homosexuality, the debate suggests that capitalism is a necessary condition to understand the term in its present sense, particularly with respect to class consciousness. While this side of the debate recognizes long-standing patterns of specific sexual behavior, to include same-sex behavior from other times and societies within the modern developed country’s construct of homosexuality is problematic because it forcibly maps aspects of the modern perception onto other societies that may not have been relevant to those past societies (Eaklor 2008).

Still, the term “transsexualism” and its related words have specific origins that reach as far back as 1910, when German physician Magnus Hirschfeld published his Transvestites: The erotic drive to crossdress.  Not only did Hirschfeld coin the term “transvestite” and delineate some ten types of transvestites, he was also the first to use the term “transsexual.” Moreover, he later “revealed that the first genital reconstruction surgery (GRS) occurred in Berlin as early as 1912” (Heath 2006). But many of Hirschfeld’s ideas, ahead of their time and controversial, were obliterated by the Nazi regime only to be later taken up and popularized by endocrinologist and sexologist Harry Benjamin, who subsequently took partial credit for coining the term in a 1953 lecture series in which he presented the first medical articles on the topic of transsexualism. Benjamin merely offered one definition among many, though most definitions still tended to focus only on the idea of reassignment based on hormonal or surgical work while ignoring psychological aspects of transsexuality. What Colette Chiland makes clear is that many transsexuals approach a doctor “to have their true body restored to them, [or] to correct a mistake of nature” returning to the point that “transsexuals are by definition biologically normal” (2003).

Trans Being through Time and Place

Cross-dressing holds a relatively prominent place in the theater, from ancient Greece to the Elizabethan stage to Peter Pan—but transsexuality in Western society prior to its mid-century blossoming is quite anecdotal. In her Handbook on Transsexuality, Rachel Ann Heath neatly summarizes Richard Green’s 1966 treatise on the history of transsexualism in culture entitled, “Mythological, Historical, and Cross-Cultural Aspects of Transsexualism.” Greek mythology suggests the goddess Venus Castina was sympathetic “to feminine souls locked up in male bodies” while an ancient Assyrian king purportedly dressed in women’s clothes in order to sew among his wives (Heath 2006). Green suggested that there is evidence of gender role discontent among both the ancient societies of Greece and Rome that even reached as high as the Emperor Nero, who may have forced a sex change onto a slave. Cross-gendered behavior in recent centuries include a male French diplomat becoming a mistress of King Louis XV to a colonial governor of New York dressing as a woman even during his tenure in office (Green 1998).

Women dressing as men, still more palatable in today’s Western society, also have precedent in history. Heath calls attention to a thirteenth-century woman who dressed as a monk to escape her previous life as a prostitute, and another who dressed as a man to escape an unhappy marriage. The most famous example is Joan of Arc and, though a proliferation of theories surrounding her cross-dressing complicates the story, modern transgender identity perhaps only uses her as a model of personal conviction. In many cases, women choose to dress in men’s clothing in order to be allowed to participate in society as men, and the examples are not limited to individual cases. It is now believed that about 400 women participated as male soldiers in the United States Civil War (Feinberg 1996).

Green’s references to legend and mythology recognize the long-standing existence of transgendered themes, but transsexuality is an anthropological reality in other well-known societies, wherein transgendered individuals often occupy marginal positions, often as shaman. Within Inuit mythology, for example, gender is unstable, and in practice it is believed that a child’s sex can be changed at birth. The Inuit standard social unit (what is called the family atom) is made up of a man, woman, son, and daughter—so one of the most common reasons for gender reassignment is to complete this unit. Having been reassigned gender (based on any of numerous, complex reasons), a child is raised as that reassigned gender until puberty, when it is allowed to live its original, actual gender (Chiland 2003).

A third sex or gender community has existed for over a thousand years in India. The “Hijra” are, ostensibly, eunuch-transvestites, and are identified by their “impotence with women…[or] incomplete men in that they do not have desires for women that other men do.” In some stories they appear like “passive homosexual male cross-dressers,” but most Hijra self-attribute their “lack of desire to a defective male sexual organ” and refer to themselves as “in-between,” whether they are born that way, with existing defects, or made that way. Either way, they are totally (and illegally) emasculated and become part of their own social caste. Hijra, however, do not ask to become women. Their community is somewhere between the genders (Chiland 2003).

Other indigenous transgendered identities exist among the Polynesians and the Indian tribes of North America. The former concerns a kind of “gender liminality” without much societal acceptance while the latter, called “berdaches” are members of third and fourth genders with economic and religious stature within their communities. The practice, held in common among most of the 150 North American tribes and elsewhere, including Siberia, are not examples of transsexualism, since it is not a matter of expressed desire to cross boundaries to fit a mindset. Rather, berdaches, whatever their particular gender difference, assumed almost automatically certain specialties and were regarded as possessing supernatural powers. Sometimes they were identifiable by clothes common to their gender opposite; sometimes they were assigned their own set of clothes. But like much of indigenous culture, berdaches are in a state of decline. While it is not expected that transgendered individuals are to be perceived as possessive of special powers, Western society could certain learn something from the more general social acceptance of these “in-between” genders (Chiland 2003).

The Turning Point for Transsexualism

A year before Benjamin introduced the term, media attention surrounding a case of “genuine transvestism” spurred one of the most important turning points in the history of transsexualism. While by no means the first to undergo a change in sexual identity, Christine Jorgensen received the most publicity, largely through her own efforts. “[C]omplaining of severe depression brought on by what might now be called gender dysphoria,” American George Jorgensen, already administering himself estrogen, traveled to Denmark, where his research had informed him doctors were experimenting with sex hormones. Jorgensen approached a Copenhagen-based surgeon about his depression.

After extensive evaluation, the surgeon and his team decided to take Jorgensen’s case, and not only increased his estrogen hormone treatment but proceeded with the surgical removal of his genitalia. Even before Benjamin adopted the term transsexualism, the phrase “Psychopathia transsexualis” had been circulating. But Benjamin’s work to formally distinguish between transvestites who physically altered their bodies and those who changed their gendered clothes helped standardize the word, particularly once the Jorgensen story spread. Meanwhile, the attention that Jorgensen got from her surgery opened the door for other individuals, at the time “primarily men who felt themselves to be similarly afflicted, to consider surgery.” The doctor who performed Jorgensen’s surgery immediately received interest from over 450 people (Bullough and Bullough 1998).

More importantly, because of the publicity, new hormonal and synthetic hormonal research was conducted in addition to the development of gender-identity programs in America, beginning with the Johns Hopkins Gender Identity Clinic in 1965. Even as late as 1980, however, transsexualism “was recognized as an illness in the Diagnostic and Statistical Manual of Mental Disorders” before being omitted in 1994. During the same period, a document was prepared outlining standards and principles of hormonal therapy and sex-reassignment surgery (SRS, or the previously cited GRS). The document outlined a series of recommendations, evaluations, and trial periods with the patient under hormonal therapy, and even longer living the social role of the other sex. The purpose was to help everyone involved ensure psychological preparedness for the SRS procedure to limit cases of physician misconduct and patient dissatisfaction (Bullough and Bullough 1998).

Transgenderism in Popular Culture

While there have been instances of cross-dressing and transgender themes in film and television—demonized in films such as The Silence of the Lambs, more playfully depicted in Some Like it Hot, or centrally figured as in Hedwig and the Angry Inch and Priscilla Queen of the Desert—it is when transgender-themed productions gain positive extra media attention that the trans community can find hope for the future. Recent examples including Hillary Swank’s Academy Award for her transgendered character in Boys Don’t Cry and the 2006 film Transamerica, that not only won two Golden Globes but garnered attention from critics, audiences and a nomination for an Academy Award. The movie is especially indicative of the elevated consciousness in America about transsexualism. Such awareness, however, comes after only a few decades of improvement that slowly saw an increase in research and assistance for transsexual and transgender individuals.

Transgenderism and Transsexualism Today

Like many confluent histories, the history of transgenderism flows into the all-encompassing idea of globalization, which brings together the world perspectives and cultures, including those “who have different experiences of gender and sexuality.” But Susan Stryker’s Transgender History points to a number of other factors surrounding the “current fascination with transgenderism” (2008). On the one hand, she posits the theoretical idea about the new digital age of representation and its potential for a distancing of ideas from concrete, corresponding objects in reality. The result is a breakdown of conventional understanding that allows room for abstraction in lieu of traditional binaries and, consequently, transgenderism is simply “not as big a deal as it used to be, especially in the big coastal cities.” Ultimately, she cites biomedical developments, particularly reproductive technology, to suggest “that we are on the verge of completely separating biological reproduction from the status of one’s social and psychological gender.” It points to the more established distinction between sex and gender, the former being biological and the latter cultural (ibid).

Finally, on the other side of the coin, true or “normal gender variant,” transsexuals are relatively rare, so there is controversy surrounding the “condition’s” actual prevalence (Heath 2006). But transsexualism, as a psychologically legitimate identity separate from biology, wants to “assert the primacy of symbolic recognition.” After recognition, bodily change justifies the assertion, whether or not one accepts at face value the symbol of such a change (Chiland 2003). The difference between sex-reassignment surgery and genital reconstruction surgery is roughly that: a kind of subtle rejection of the symbol, since technically sex cannot be reassigned but genitalia can, more or less, be reconstructed. But medical or biological rejection of the symbolism notwithstanding, transsexualism, like transgenderism, is a mindset that, at its heart, strives to break down gender barriers and find its own place within society.

-- Posted August 26, 2008


Bullough, Bonnie and Vern L. Bullough. 1998. “Transsexualism: Historical Perspectives, 1952 to Present.” Current Concepts in Transgender Identity. Dallas Denny, ed. New York, NY: Garland Publishing, Inc.

Chiland, Colette. 2003. Transsexualism: Illusion and Reality. Translated by Philip Slotkin. Middletown, CT: Wesleyan University Press.

Eaklor, Vicki L. 2008. Queer America: A GLBT History of the 20th Century. Westport, CT: Greenwood Press.

Feinberg, Leslie. 1996. Transgender Warriors: Making History from Joan of Arc to Dennis Rodman. Boston, MA: Beacon Press.

Heath, Rachel Ann. 2006. The Praeger Handbook of Transsexuality: Changing Gender to Match Mindset. Westport, CT: Praeger.

Stryker, Susan. 2008. Transgender History. Berkeley, CA: Seal Press.