Classification of transsexuals
Encyclopedia
The classification of transsexuals and people who experience various types of gender dysphoria has been attempted by many researchers and clinicians. A discussion of classifications cannot be cleanly separate from a discussion of the terminology
used because new terms were defined alongside new classifications.
coined the term transvestite in his seminal work on the matter, Die Transvestiten. In that work, he describes what today would be referred to as transvestic fetishism
(or erotic cross-dressing
) and transsexualism. In 1930, he supervised the first known sex reassignment surgery
on Lili Elbe
of Denmark
.
The term "transexual" (with one 's') was first used by D. O. Cauldwell in 1949. Transsexual was also used by Harry Benjamin during his work of the 1950s and 1960s, which culminated in The Transsexual Phenomenon in 1966. This term continues to be used by the public and medical profession today.
The terms "Gender Dysphoria" and "Gender Identity Disorder" were not used until the 1970s when Laub and Fisk published several works on transsexualism using these terms.
's Sex Orientation Scale (S.O.S.) was an attempt to classify and understand various forms and subtypes of transvestism and transsexualism in biological males. It was a seven-point scale (with three types of transvestism, three types of transsexualism, and one category for typical males); it was analogous to the Kinsey scale
of sexual orientation
, which also had seven categories. Much like Kinsey's understanding of sexual orientation, Dr. Benjamin understood the nature of gender identity and gender expression not as a discrete scale, but as a spectrum, a continuum with many variations, much more than those featured in the scale. But the scale he developed seemed to be an easy, rational and clinically useful way to diagnose different forms of transsexualism
and to distinguish between those who needed surgical and/or hormonal treatment and those who didn't. Benjamin noted, "It must be emphasized again that the remaining six types are not and never can be sharply separated."
conducted a series of taxonomic studies of male-to-female transsexuals in the 1980s, concluding that there exist two distinct types. One group are those who are exclusively attracted to men, whom Blanchard called homosexual transsexuals (also sometimes called androphilic transsexuals). The other group include those who are attracted to females (gynephilic), attracted to both males and females (bisexual), and attracted to neither males nor females (asexual); Blanchard referred to this latter set collectively as the non-homosexual transsexuals. Blanchard has also reported that the non-homosexual transsexuals (but not the homosexual transsexuals) exhibit autogynephilia, a paraphilic interest in having a female body.
"Gender Identity Disorder" was a term created in the DSM-III in regard to transsexuals, and the categories were "GID/Children Transsexualism"; "GID/Adolescent and Adult, Non-transsexual type" and "GID/Not Otherwise Specified". Notably, this did not address Late-onset transsexualism, where patients may not have had symptoms as children. Interestingly, in the major revision of the DSM, DSM-III-R, they were placed in the category "Disorders Usually First Evident in Infancy, Childhood or Adolescence". The problem was that it got lost here, as well as the issue of adult onset explained above.
In the DSM-III, the terms "Homosexual", "Heterosexual", and "Asexual" were used - with quite a bit of confusion. (These terms were replaced in the DSM-IV by "Attracted to males", "Attracted to Females", "Attracted to Both" and "Attracted to neither.")
s, F64 in ICD-10 Chapter V: Mental and behavioural disorders
under the heading "Disorders of adult personality and behaviour".
Terminology
Terminology is the study of terms and their use. Terms are words and compound words that in specific contexts are given specific meanings, meanings that may deviate from the meaning the same words have in other contexts and in everyday language. The discipline Terminology studies among other...
used because new terms were defined alongside new classifications.
Terminology overview
Magnus HirschfeldMagnus Hirschfeld
Magnus Hirschfeld was a German physician and sexologist. An outspoken advocate for sexual minorities, Hirschfeld founded the Scientific Humanitarian Committee, which Dustin Goltz called "the first advocacy for homosexual and transgender rights."-Early life:Hirschfeld was born in Kolberg in a...
coined the term transvestite in his seminal work on the matter, Die Transvestiten. In that work, he describes what today would be referred to as transvestic fetishism
Transvestic fetishism
Transvestic fetishism is having a sexual or erotic interest in cross-dressing. It differs from cross-dressing for entertainment or other purposes that do not involve sexual arousal and is categorized as a paraphilia in the Diagnostic and Statistical Manual of the American Psychiatric Association...
(or erotic cross-dressing
Cross-dressing
Cross-dressing is the wearing of clothing and other accoutrement commonly associated with a gender within a particular society that is seen as different than the one usually presented by the dresser...
) and transsexualism. In 1930, he supervised the first known sex reassignment surgery
Sex reassignment surgery
Sex reassignment surgery is a term for the surgical procedures by which a person's physical appearance and function of their existing sexual characteristics are altered to resemble...
on Lili Elbe
Lili Elbe
Lili Elbe was an Intersex person and one of the first identifiable recipients of male to female sex reassignment surgery. Elbe was born as a male in Denmark. Born as Einar Mogens Wegener, she identified as male for most of her life and was a successful artist with that name...
of Denmark
Denmark
Denmark is a Scandinavian country in Northern Europe. The countries of Denmark and Greenland, as well as the Faroe Islands, constitute the Kingdom of Denmark . It is the southernmost of the Nordic countries, southwest of Sweden and south of Norway, and bordered to the south by Germany. Denmark...
.
The term "transexual" (with one 's') was first used by D. O. Cauldwell in 1949. Transsexual was also used by Harry Benjamin during his work of the 1950s and 1960s, which culminated in The Transsexual Phenomenon in 1966. This term continues to be used by the public and medical profession today.
The terms "Gender Dysphoria" and "Gender Identity Disorder" were not used until the 1970s when Laub and Fisk published several works on transsexualism using these terms.
The Harry Benjamin scale
Harry BenjaminHarry Benjamin
Harry Benjamin was a German endocrinologist, widely known for his clinical work with transsexualism. He was raised in an observant Ashkenazy Jewish home.- Early life and career :...
's Sex Orientation Scale (S.O.S.) was an attempt to classify and understand various forms and subtypes of transvestism and transsexualism in biological males. It was a seven-point scale (with three types of transvestism, three types of transsexualism, and one category for typical males); it was analogous to the Kinsey scale
Kinsey scale
The Kinsey scale, also called the Heterosexual-Homosexual Rating Scale, attempts to describe a person's sexual history or episodes of his or her sexual activity at a given time. It uses a scale from 0, meaning exclusively heterosexual, to 6, meaning exclusively homosexual...
of sexual orientation
Sexual orientation
Sexual orientation describes a pattern of emotional, romantic, or sexual attractions to the opposite sex, the same sex, both, or neither, and the genders that accompany them. By the convention of organized researchers, these attractions are subsumed under heterosexuality, homosexuality,...
, which also had seven categories. Much like Kinsey's understanding of sexual orientation, Dr. Benjamin understood the nature of gender identity and gender expression not as a discrete scale, but as a spectrum, a continuum with many variations, much more than those featured in the scale. But the scale he developed seemed to be an easy, rational and clinically useful way to diagnose different forms of transsexualism
Transsexualism
Transsexualism is an individual's identification with a gender inconsistent or not culturally associated with their biological sex. Simply put, it defines a person whose biological birth sex conflicts with their psychological gender...
and to distinguish between those who needed surgical and/or hormonal treatment and those who didn't. Benjamin noted, "It must be emphasized again that the remaining six types are not and never can be sharply separated."
Ray Blanchard
Ray BlanchardRay Blanchard
Ray Milton Blanchard is an American-Canadian sexologist, best known for his research studies on pedophilia, gender dysphoria, and sexual orientation. He has also published research studies on phallometry and several paraphilias, including transvestism and autoerotic asphyxia.-Education and...
conducted a series of taxonomic studies of male-to-female transsexuals in the 1980s, concluding that there exist two distinct types. One group are those who are exclusively attracted to men, whom Blanchard called homosexual transsexuals (also sometimes called androphilic transsexuals). The other group include those who are attracted to females (gynephilic), attracted to both males and females (bisexual), and attracted to neither males nor females (asexual); Blanchard referred to this latter set collectively as the non-homosexual transsexuals. Blanchard has also reported that the non-homosexual transsexuals (but not the homosexual transsexuals) exhibit autogynephilia, a paraphilic interest in having a female body.
Peter Bentler
Bentler divided male-to-female transsexuals into homosexual transsexuals, asexual transsexuals, and heterosexual transsexuals, with the adjectives referring to sexual orientation being based on individuals' sex at birth.DSM-III
Transsexualism was included for the first time in the DSM-III in 1980."Gender Identity Disorder" was a term created in the DSM-III in regard to transsexuals, and the categories were "GID/Children Transsexualism"; "GID/Adolescent and Adult, Non-transsexual type" and "GID/Not Otherwise Specified". Notably, this did not address Late-onset transsexualism, where patients may not have had symptoms as children. Interestingly, in the major revision of the DSM, DSM-III-R, they were placed in the category "Disorders Usually First Evident in Infancy, Childhood or Adolescence". The problem was that it got lost here, as well as the issue of adult onset explained above.
In the DSM-III, the terms "Homosexual", "Heterosexual", and "Asexual" were used - with quite a bit of confusion. (These terms were replaced in the DSM-IV by "Attracted to males", "Attracted to Females", "Attracted to Both" and "Attracted to neither.")
DSM-III-R
The DSM-III-R, published in 1987, retained the term transsexualism. It was located under "Disorders Usually First Evident in Infancy, Childhood or Adolescence".DSM-IV and DSM-IV-TR
Gender Identity Disorder in Adolescents and Adults replaced the term transsexualism. In the DSM-IV-TR, the current version, GID is placed in the category of Sexual Disorders, with the subcategory of Gender Identity Disorders. The names were changed in DSM-IV to "Gender Identity Disorder in Children", "Gender Identity Disorder in Adolescents or Adults", and "Gender Identity Disorder Not Otherwise Specified".ICD-10
In the International Classification of Diseases, ICD-10, transsexualism is classified within Gender identity disorderGender identity disorder
Gender identity disorder is the formal diagnosis used by psychologists and physicians to describe persons who experience significant gender dysphoria . It describes the symptoms related to transsexualism, as well as less severe manifestations of gender dysphoria...
s, F64 in ICD-10 Chapter V: Mental and behavioural disorders
ICD-10 Chapter V: Mental and behavioural disorders
- Organic, including symptomatic, mental disorders :* Dementia in Alzheimer's disease* Vascular dementia** Multi-infarct dementia* Dementia in other diseases classified elsewhere** Dementia in Pick's disease...
under the heading "Disorders of adult personality and behaviour".