Transgender
Encyclopedia
Transgender is a general term applied to a variety of individuals, behaviors, and groups involving tendencies to vary from culturally conventional gender role
Gender role
Gender roles refer to the set of social and behavioral norms that are considered to be socially appropriate for individuals of a specific sex in the context of a specific culture, which differ widely between cultures and over time...

s.

Transgender is the state of one's "gender identity
Gender identity
A gender identity is the way in which an individual self-identifies with a gender category, for example, as being either a man or a woman, or in some cases being neither, which can be distinct from biological sex. Basic gender identity is usually formed by age three and is extremely difficult to...

" (self-identification as woman, man, neither or both) not matching one's "assigned sex" (identification by others as male, female or intersex
Intersex
Intersex, in humans and other animals, is the presence of intermediate or atypical combinations of physical features that usually distinguish female from male...

 based on physical/genetic sex
SRY
SRY is a sex-determining gene on the Y chromosome in the therians .This intronless gene encodes a transcription factor that is a member of the SOX gene family of DNA-binding proteins...

). "Transgender" does not imply any specific form 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,...

; transgender people may identify as heterosexual, homosexual
Homosexuality
Homosexuality is romantic or sexual attraction or behavior between members of the same sex or gender. As a sexual orientation, homosexuality refers to "an enduring pattern of or disposition to experience sexual, affectional, or romantic attractions" primarily or exclusively to people of the same...

, bisexual, pansexual
Pansexuality
Pansexuality refers to the potential for sexual attractions, sexual desire, romantic love, or emotional attraction, towards people of all gender identities and biological sexes...

, polysexual
Polysexuality
Polysexuality is the attraction to more than one gender or sex. It should not be confused with polyamory, the ability to be romantically involved with more than one person at once.-Gender definition:...

, or asexual
Asexuality
Asexuality , in its broadest sense, is the lack of sexual attraction and, in some cases, the lack of interest in sex. Sometimes, it is considered a lack of a sexual orientation...

; some may consider conventional sexual orientation labels inadequate or inapplicable to them. The precise definition for transgender remains in flux, but includes:
  • "Of, relating to, or designating a person whose identity does not conform unambiguously to conventional notions of male or female gender
    Gender
    Gender is a range of characteristics used to distinguish between males and females, particularly in the cases of men and women and the masculine and feminine attributes assigned to them. Depending on the context, the discriminating characteristics vary from sex to social role to gender identity...

     roles, but combines or moves between these."
  • "People who were assigned a sex, usually at birth and based on their genitals, but who feel that this is a false or incomplete description of themselves."
  • "Non-identification with, or non-presentation as, the sex (and assumed gender) one was assigned at birth."


A transgender individual may have characteristics that are normally associated with a particular gender, identify elsewhere on the traditional gender continuum, or exist outside of it as "other", "agender", "Genderqueer
Genderqueer
Genderqueer is a catch-all term for gender identities other than man and woman, thus outside of the gender binary and heteronormativity...

", or "third gender
Third gender
The terms third gender and third sex describe individuals who are categorized as neither man nor woman, as well as the social category present in those societies who recognize three or more genders...

". Transgender people may also identify as bigender
Bigender
Bigender, bi-gender or bi+gender describes a tendency to move between feminine and masculine gender-typed behaviour depending on context. Some bigendered individuals express a distinctly "en femme" persona and a distinctly "en homme" persona, feminine and masculine respectively; others have shades...

, or along several places on either the traditional transgender continuum, or the more encompassing continuums which have been developed in response to the significantly more detailed studies done in recent years.

Evolution of the term transgender

The term transgender (TG) was popularised in the 1970s (but implied in the 1960s) describing people who wanted to live cross-gender without 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...

. In the 1980s the term was expanded to an umbrella term, and became popular as a means of uniting all those whose gender identity did not mesh with their gender assigned at birth.

In the 1990s, the term took on a political dimension as an alliance covering all who have at some point not conformed to gender norms, and the term became used to question the validity of those norms or pursue equal rights and anti-discrimination legislation, leading to its widespread usage in the media, academic world and law. The term continues to evolve.

Transgender vs. transsexual

The word transsexual, unlike the word transgender, originated in the medical and psychological communities. It was defined by Harry Benjamin
Harry 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 :...

 in his seminal book The Transsexual Phenomenon. In particular he defined transsexuals on a scale called the "Benjamin Scale
Benjamin scale
Harry Benjamin's Sex Orientation Scale was an attempt to classify and understand various forms and subtypes of transvestism and transsexualism in biological males...

", which defines a few different levels of intensity of transsexualism; these are listed as "Transsexual (nonsurgical)", "True Transsexual (moderate intensity)", and "True Transsexual (high intensity)". Many transsexuals believe that to be a true transsexual, a person needs to have a desire for surgery.
However, it is notable that Benjamin's moderate intensity "true transsexual" needs either estrogen or testosterone medication as a "substitute for or preliminary to operation." There also exist people who have had sexual reassignment surgery (SRS), but do not meet the definition of a transsexual, such as Gregory Hemingway, while other people do not desire SRS, yet clearly meet Dr. Benjamin's definition of a "true transsexual", such as Miriam Rivera
Miriam (entertainer)
Miriam Rivera is a Mexican transsexual woman who appeared on the reality television shows There's Something About Miriam and Big Brother Australia 2004...

.

In addition to the larger categories of transgender and transsexual, there is a wide range of gender expressions and identities which are contrary to the mainstream male-female binary. These include Cross dressers, drag queen
Drag queen
A drag queen is a man who dresses, and usually acts, like a caricature woman often for the purpose of entertaining. There are many kinds of drag artists and they vary greatly, from professionals who have starred in films to people who just try it once. Drag queens also vary by class and culture and...

s, drag king
Drag king
Drag kings are mostly female performance artists who dress in masculine drag and personify male gender stereotypes as part of their performance. A typical drag king routine may incorporate dancing and singing, live as in the Momma's Boyz of San Francisco's performances or lip-synching...

s, transvestites, genderqueer
Genderqueer
Genderqueer is a catch-all term for gender identities other than man and woman, thus outside of the gender binary and heteronormativity...

, etc.

Some transsexuals also take issue with the term because Charles "Virginia" Prince
Virginia Prince
Virginia Prince was an American transgender activist, who published Transvestia magazine and started Society for the Second Self for male heterosexual cross-dressers...

, the founder of the cross-dressing organization Tri-Ess
Tri-Ess
Tri-Ess is an international educational, social and support group for heterosexual crossdressers, their partners, the spouses of married crossdressers and their families....

 and coiner of the term "transgender", took those actions because she wished to distinguish herself from transsexual people. In "Men Who Choose to Be Women," Prince wrote "I, at least, know the difference between sex and gender and have simply elected to change the latter and not the former". There is a substantial academic literature on the difference between sex and gender, but in pragmatic
Descriptive linguistics
In the study of language, description, or descriptive linguistics, is the work of objectively analyzing and describing how language is spoken by a group of people in a speech community...

 English, this distinction is often ignored, so that "gender" is used to describe the categorical male/female difference and "sex" is used to describe the physical act of sexual intercourse
Sexual intercourse
Sexual intercourse, also known as copulation or coitus, commonly refers to the act in which a male's penis enters a female's vagina for the purposes of sexual pleasure or reproduction. The entities may be of opposite sexes, or they may be hermaphroditic, as is the case with snails...

.

There is political tension between the identities that fall under the "transgender umbrella". For example, transsexual men and women who can pay for medical treatments (or who have institutional coverage for their treatment) are likely to be concerned with medical privacy and establishing a durable legal status as men and women later in life. Extending insurance coverage for medical care is a coherent issue in the intersection
Intersectionality
Intersectionality is a feminist sociological theory first highlighted by Kimberlé Crenshaw . Intersectionality is a methodology of studying "the relationships among multiple dimensions and modalities of social relationships and subject formations"...

 of transsexuality and economic class. Most of these issues can appeal even to conservatives, if framed in terms of an unusual sort of "maintenance" of traditional notions of gender for rare people who feel the need for medical treatments. Some trans people might express this by saying, "I don't challenge the gender binary. I just started out on the wrong side of it."

Transgender identities

While people self-identify as transgender, transgender identity includes many overlapping categories. These include cross-dresser (CD); transvestite
Transvestism
Transvestism is the practice of cross-dressing, which is wearing clothing traditionally associated with the opposite sex. Transvestite refers to a person who cross-dresses; however, the word often has additional connotations. -History:Although the word transvestism was coined as late as the 1910s,...

 (TV); androgynes
Androgyny
Androgyny is a term derived from the Greek words ανήρ, stem ανδρ- and γυνή , referring to the combination of masculine and feminine characteristics...

; genderqueer
Genderqueer
Genderqueer is a catch-all term for gender identities other than man and woman, thus outside of the gender binary and heteronormativity...

; people who live cross-gender; drag king
Drag king
Drag kings are mostly female performance artists who dress in masculine drag and personify male gender stereotypes as part of their performance. A typical drag king routine may incorporate dancing and singing, live as in the Momma's Boyz of San Francisco's performances or lip-synching...

s; and drag queen
Drag queen
A drag queen is a man who dresses, and usually acts, like a caricature woman often for the purpose of entertaining. There are many kinds of drag artists and they vary greatly, from professionals who have starred in films to people who just try it once. Drag queens also vary by class and culture and...

s; and, frequently, transsexual (TS). Usually not included are transvestic fetishists (because it is considered to be a paraphilia
Paraphilia
Paraphilia is a biomedical term used to describe sexual arousal to objects, situations, or individuals that are not part of normative stimulation and that may cause distress or serious problems for the paraphiliac or persons associated with him or her...

 rather than gender identification). In an interview, artist RuPaul
RuPaul
RuPaul Andre Charles , best known as simply RuPaul, is an American actor, drag queen, model, author, and singer-songwriter, who first became widely known in the 1990s when he appeared in a wide variety of television programs, films, and musical albums. Previously, he was a fixture on the Atlanta...

 talked about society's ambivalence to the differences in the people who embody these terms. "A friend of mine recently did the Oprah
The Oprah Winfrey Show
The Oprah Winfrey Show is an American syndicated talk show hosted and produced by its namesake Oprah Winfrey. It ran nationally for 25 seasons beginning in 1986, before concluding in 2011. It is the highest-rated talk show in American television history....

 show about transgender youth," said RuPaul. "It was obvious that we, as a culture, have a hard time trying to understand the difference between a drag queen, transsexual, and a transgender [person], yet we find it very easy to know the difference between the American baseball league
American League
The American League of Professional Baseball Clubs, or simply the American League , is one of two leagues that make up Major League Baseball in the United States and Canada. It developed from the Western League, a minor league based in the Great Lakes states, which eventually aspired to major...

 and the National baseball league
National League
The National League of Professional Baseball Clubs, known simply as the National League , is the older of two leagues constituting Major League Baseball, and the world's oldest extant professional team sports league. Founded on February 2, 1876, to replace the National Association of Professional...

, when they are both so similar." These terms are explained below.

The current definitions of transgender include all transsexual people, although this has been criticized. (See below.) Intersex
Intersex
Intersex, in humans and other animals, is the presence of intermediate or atypical combinations of physical features that usually distinguish female from male...

 people have genitalia or other physical sexual characteristics
Sex
In biology, sex is a process of combining and mixing genetic traits, often resulting in the specialization of organisms into a male or female variety . Sexual reproduction involves combining specialized cells to form offspring that inherit traits from both parents...

 that do not conform to strict definitions of male and/or female, but intersex people are not necessarily transgender, since they do not all disagree with their assigned sex at birth. Transgender and intersex issues often overlap, however, because they both challenge the notion of rigid definitions of sex and gender.

The term trans man
Trans man
A trans man, transman, trans guy, or FTM is a transgender or transsexual man: a person who was assigned female at birth, but who identifies as male....

 refers to female-to-male (FtM or F2M) transgender people, and trans woman
Trans woman
A trans woman is a male-to-female transsexual or transgender person and the term trans woman is preferred by some individuals over various medical terms. Other non-medical terms include t-girl, tg-girl and ts-girl...

 refers to male-to-female (MtF or M2F) transgender people. In the past, it was assumed that there were more trans women than trans men, but a Swedish study estimated a ratio of 1.4:1 in favour of trans women for those requesting sex reassignment surgery and a ratio of 1:1 for those who proceeded.

The term cisgender
Cisgender
Cisgender is an adjective used in the context of gender issues and counselling to refer to a class of gender identities formed by a match between an individual's gender identity and the behavior or role considered appropriate for one's sex.Kristen Schilt and Laurel Westbrook defined "cisgender"...

 has been coined as an antonym referring to non-transgender people; i.e. those who identify with their gender assigned at birth.

When referring to a transgender person, it is respectful to always use that person's preferred name and pronoun regardless of their legal gender status (as not all transgender people can afford surgery or other body modifications). The word "transgender" should be used as an adjective rather than a noun — for example, "Max is transgender" or "Max is a transgender man" rather than "Max is a transgender."

Transsexual

Transsexual
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...

 people identify as, or desire to live and be accepted as, a member of the sex opposite to that assigned at birth.

Many trans people desire to undergo gender transition. People who have transitioned may or may not necessarily identify as transgender or transsexual any longer, but simply as a man or a woman. Those who continue identifying as transsexual men or women may not want to ignore their pre-transition life, and may continue strong ties with other trans people and raising social consciousness. Transgender and transsexual people may be either open or closeted about their trans status prior to, in the process of, or after fully transitioning.

Many transsexual people have a wish to alter their bodies. These physical changes are collectively known as gender reassignment therapy and often (but not always) include hormone replacement therapy
Hormone replacement therapy (male-to-female)
Hormone replacement therapy for transgender and transsexual people changes the balance of sex hormones in their bodies. Some intersex people also receive HRT, either starting in childhood to confirm the sex to which they were assigned, or later, if this assignment has proven to be incorrect...

 and 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...

. References to "pre-operative", "post-operative" and "non-operative" transsexual people indicate whether they have had, or are planning to have sex reassignment surgery, although some trans people reject these terms as objectifying trans people based on their surgical status and not their mental gender identity.

Cross-dresser

The term 'cross-dresser' is not exactly defined in the relevant literature. Michael A. Gilbert, professor at the Department of Philosophy, York University
York University
York University is a public research university in Toronto, Ontario, Canada. It is Canada's third-largest university, Ontario's second-largest graduate school, and Canada's leading interdisciplinary university....

, Toronto
Toronto
Toronto is the provincial capital of Ontario and the largest city in Canada. It is located in Southern Ontario on the northwestern shore of Lake Ontario. A relatively modern city, Toronto's history dates back to the late-18th century, when its land was first purchased by the British monarchy from...

, offers this definition: "[A cross-dresser] is a person who has an apparent gender identification with one sex, and who has and certainly has been birth-designated as belonging to one sex, but who wears the clothing of the opposite sex because it is the clothing of the opposite sex." This excludes people "who wear opposite sex clothing for other reasons". Also, the group does not include "those female impersonators who look upon dressing as solely connected to their livelihood, actors undertaking roles, individual males and females enjoying a masquerade, and so on. These individuals are cross dressing but are not cross dressers."
Cross-dressers may not identify with, or want to be the opposite gender, nor adopt the behaviors or practices of the opposite gender, and generally do not want to change their bodies medically. The majority of cross-dressers identify as heterosexual.

Transvestite

A transvestite
Transvestism
Transvestism is the practice of cross-dressing, which is wearing clothing traditionally associated with the opposite sex. Transvestite refers to a person who cross-dresses; however, the word often has additional connotations. -History:Although the word transvestism was coined as late as the 1910s,...

 is somebody who cross-dresses. The term "transvestite" is used as a synonym for the term "cross-dresser", although "cross-dresser" is generally considered the preferred term. The term "transvestite" and the associated outdated term "transvestism" are conceptually different from the term "fetishistic transvestism" (a.k.a. "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...

"), as "transvestic fetishist" describes those who intermittently use clothing of the opposite gender for fetishistic purposes. In medical terms, transvestic fetishism is differentiated from cross-dressing by use of the separate codes 302.3 in the DSM
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...

 and F65.1 in the ICD
ICD
The International Statistical Classification of Diseases and Related Health Problems is a medical classification that provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease...

.

Drag kings and queens

Drag
Drag (clothing)
Drag is used for any clothing carrying symbolic significance but usually referring to the clothing associated with one gender role when worn by a person of another gender. The origin of the term "drag" is unknown, but it may have originated in Polari, a gay street argot in England in the early...

 is a term applied to clothing and make-up worn on special occasions for performing
Performing arts
The performing arts are those forms art which differ from the plastic arts insofar as the former uses the artist's own body, face, and presence as a medium, and the latter uses materials such as clay, metal or paint which can be molded or transformed to create some physical art object...

 or entertaining as a hostess, stage artist or at an event (e.g. Lypsinka). This is in contrast to those who cross-dress for other reasons or who are transgender. Drag performance also includes overall presentation and behavior in addition to clothing and makeup. Drag can be theatrical, comedic, or grotesque, and female-identified drag has been considered a caricature of women by second-wave feminism
Second-wave feminism
The Feminist Movement, or the Women's Liberation Movement in the United States refers to a period of feminist activity which began during the early 1960s and lasted through the early 1990s....

. Within the genre of drag are gender illusionists
Passing (gender)
Passing refers to a person's ability to be regarded as a member of the sex or gender with which they physically present. Typically, passing involves a mixture of physical gender cues as well as certain behavioral attributes that tend to be culturally associated with a particular gender...

 who do try to pass as another gender. Drag artists explore gender issues and have a long tradition in LGBT culture
LGBT culture
LGBT culture, is the common culture shared by lesbian, gay, bisexual, transgender, and queer people. It is sometimes also referred to as Queer culture. The term gay culture, though not synonymous, is sometimes also used though this may also apply specifically to the culture of homosexual men.LGBT...

. Generally the terms drag queen
Drag queen
A drag queen is a man who dresses, and usually acts, like a caricature woman often for the purpose of entertaining. There are many kinds of drag artists and they vary greatly, from professionals who have starred in films to people who just try it once. Drag queens also vary by class and culture and...

 covers men doing female drag, drag king
Drag king
Drag kings are mostly female performance artists who dress in masculine drag and personify male gender stereotypes as part of their performance. A typical drag king routine may incorporate dancing and singing, live as in the Momma's Boyz of San Francisco's performances or lip-synching...

 covers women doing male drag, and faux queen covers women doing female drag. Nevertheless, there are drag artists of all genders and sexualities who perform for various reasons.

Genderqueer

Genderqueer
Genderqueer
Genderqueer is a catch-all term for gender identities other than man and woman, thus outside of the gender binary and heteronormativity...

 is a recent attempt to signify gender experiences that do not fit into binary concepts, and refers to a combination of gender identities and sexual orientations. One example could be a person whose gender presentation is sometimes perceived as male, sometimes female, but whose gender identity is female, gender expression is butch, and sexual orientation is lesbian. It suggests nonconformity or mixing of gender stereotypes, conjoining both gender and sexuality, and challenges existing constructions and identities. In the binary sex/gender system, genderqueerness is unintelligible and abjected.

People who live cross-gender

People who live cross-gender live always or mostly as the gender other than that assigned at birth. If they want to be or identify as their gender assigned at birth, then the term "crossdresser" may be used. If they want to be or identify as the gender they always or mostly live in, then the term "transsexual" may be used. The term "transgender" or "transgenderist" has been applied to people who live cross-gender without sex reassignment surgery.

Androgyne

An androgyne
Androgyny
Androgyny is a term derived from the Greek words ανήρ, stem ανδρ- and γυνή , referring to the combination of masculine and feminine characteristics...

 is a person who does not fit cleanly into the typical gender roles of their society. It does not imply any specific form of sexual orientation. Androgynes may identify as beyond gender, between genders, moving across genders, entirely genderless, or any or all of these, exhbiting a variety of male, female, and other characteristics. Androgyne identities include pangender
Pangender
Pangender is a term used to describe people who feel that they cannot be labeled as male or female in gender. As such it has a great deal of overlap with genderqueer. Pangender people feel that they do not fit into binary genders, instead identifying as mixed gender or as a third gendered...

, ambigender, non-gendered, agender, Gender fluid or intergender. Androgyny can be either physical or psychological, and it does not depend on birth sex. Occasionally, people who do not define themselves as androgynes adapt their physical appearance to look androgynous. This outward androgyny has been used in fashion, and the milder forms of it (women wearing men's pants or men wearing two earrings, for example) are not seen as transgender behavior.

The term androgyne is also sometimes used as a medical synonym for an intersex
Intersex
Intersex, in humans and other animals, is the presence of intermediate or atypical combinations of physical features that usually distinguish female from male...

 individual.

Bigender

A bigender
Bigender
Bigender, bi-gender or bi+gender describes a tendency to move between feminine and masculine gender-typed behaviour depending on context. Some bigendered individuals express a distinctly "en femme" persona and a distinctly "en homme" persona, feminine and masculine respectively; others have shades...

 (sometimes rendered as bi-gender or bi+gender) individual is one who moves between masculine
Masculine
Masculine or masculinity, normally refer to qualities positively associated with men.Masculine may also refer to:*Masculine , a grammatical gender*Masculine cadence, a final chord occurring on a strong beat in music...

 and feminine
Feminine
Feminine, or femininity, normally refers to qualities positively associated with women.Feminine may also refer to:*Feminine , a grammatical gender*Feminine cadence, a final chord falling in a metrically weak position...

 gender roles. Such individuals move between two distinct personalities fluidly depending on context. While an androgynous person retains the same gender-typed behaviour across situations, the bigendered person consciously or unconsciously changes their gender-role behaviour from primarily masculine to primarily feminine, or vice versa.

Transgender people and the LGBT community

The concepts of gender identity and transgender identity differ from that 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,...

. Sexual orientation describes an individual's enduring physical, romantic, emotional, and/or spiritual attraction to another person, while gender identity is one's personal sense of being a man or a woman. Transgender people have more or less the same variety of sexual orientations as cisgender people. In the past, the terms homosexual and heterosexual were incorrectly used to label transgender individuals' sexual orientation based on their birth sex. Professional literature now uses terms such as attracted to men (androphilic), attracted to women (gynephilic), attracted to both or attracted to neither to describe a person's sexual orientation without reference to their gender identity. Therapists are coming to understand the necessity of using terms with respect to their clients' gender identities and preferences. For example, a person who is assigned male at birth, transitions to female, and is attracted to men would be identified as heterosexual.

Despite the distinction between sexual orientation and gender, throughout history the gay, lesbian, and bisexual
LGBT
LGBT is an initialism that collectively refers to "lesbian, gay, bisexual, and transgender" people. In use since the 1990s, the term "LGBT" is an adaptation of the initialism "LGB", which itself started replacing the phrase "gay community" beginning in the mid-to-late 1980s, which many within the...

 subculture was often the only place where gender-variant people were socially accepted in the gender role
Gender role
Gender roles refer to the set of social and behavioral norms that are considered to be socially appropriate for individuals of a specific sex in the context of a specific culture, which differ widely between cultures and over time...

 they felt they belonged to; especially during the time when legal or medical transitioning
Transitioning (transgender)
Transitioning is the process of changing one's gender presentation to accord with one's internal sense of one's gender - the idea of what it means to be a man or woman...

 was almost impossible. This acceptance has had a complex history. Like the wider world, the gay community in Western societies did not generally distinguish between sex and gender identity
Gender identity
A gender identity is the way in which an individual self-identifies with a gender category, for example, as being either a man or a woman, or in some cases being neither, which can be distinct from biological sex. Basic gender identity is usually formed by age three and is extremely difficult to...

 until the 1970s, and often perceived gender variant people more as homosexuals who behaved in a gender-variant way than as gender-variant people in their own right. Today, members of the transgender community often continue to struggle to remain part of the same movement as lesbian, gay and bisexual citizens, and to be included in rights protections.

Pride symbols


A common symbol for the transgender community is the transgender pride flag
Transgender Pride flag
Transgender flags the Transgender Pride flag is a symbol of transgender pride and diversity, and transgender rights.The Transgender Pride flag was created by Monica Helms in 1999, and was first shown at a pride parade in Phoenix, Arizona, United States in 2000.The flag represents the transgender...

, which was designed by Monica Helms, and was first shown at a pride parade in Phoenix, Arizona
Phoenix, Arizona
Phoenix is the capital, and largest city, of the U.S. state of Arizona, as well as the sixth most populated city in the United States. Phoenix is home to 1,445,632 people according to the official 2010 U.S. Census Bureau data...

, United States in 2000.

The flag consists of five horizontal stripes, two light blue
Blue
Blue is a colour, the perception of which is evoked by light having a spectrum dominated by energy with a wavelength of roughly 440–490 nm. It is considered one of the additive primary colours. On the HSV Colour Wheel, the complement of blue is yellow; that is, a colour corresponding to an equal...

, two pink
Pink
Pink is a mixture of red and white. Commonly used for Valentine's Day and Easter, pink is sometimes referred to as "the color of love." The use of the word for the color known today as pink was first recorded in the late 17th century....

, with a white
White
White is a color, the perception of which is evoked by light that stimulates all three types of color sensitive cone cells in the human eye in nearly equal amounts and with high brightness compared to the surroundings. A white visual stimulation will be void of hue and grayness.White light can be...

 stripe in the center.

Monica describes the meaning of the flag as follows:

The light blue is the traditional color for baby boys, pink is for girl
Girl
A girl is any female human from birth through childhood and adolescence to attainment of adulthood. The term may also be used to mean a young woman.-Etymology:...

s, and the white in the middle is for those who are transitioning, those who feel they have a neutral gender or no gender, and those who are intersexed. The pattern is such that no matter which way you fly it, it will always be correct. This symbolizes us trying to find correctness in our own lives.


Other transgender symbols include the butterfly
Butterfly
A butterfly is a mainly day-flying insect of the order Lepidoptera, which includes the butterflies and moths. Like other holometabolous insects, the butterfly's life cycle consists of four parts: egg, larva, pupa and adult. Most species are diurnal. Butterflies have large, often brightly coloured...

 (symbolizing transformation or metamorphosis), and a pink/light blue yin and yang
Yin and yang
In Asian philosophy, the concept of yin yang , which is often referred to in the West as "yin and yang", is used to describe how polar opposites or seemingly contrary forces are interconnected and interdependent in the natural world, and how they give rise to each other in turn. Opposites thus only...

 symbol.

Transgender people and feminism

Some feminists and feminist groups are supportive of transgender people. Others are not.

Though second-wave feminism
Second-wave feminism
The Feminist Movement, or the Women's Liberation Movement in the United States refers to a period of feminist activity which began during the early 1960s and lasted through the early 1990s....

 argued for the sex and gender distinction, some feminists believed there was a conflict between transgender identity and the feminist cause. These feminists believed, for example, that male-to-female transition abandoned or devalued female identity, and that trangender people embraced traditional gender roles and stereotypes. Many transgender feminists, however, viewed themselves as contributing positively to feminism by questioning and subverting gender norms. Third wave and contemporary feminism have tended to be more accepting of transgender people.

Feminist writer Janice Raymond
Janice Raymond
Janice G. Raymond is a longtime feminist activist against violence, sexual exploitation and the "medical abuse" of cissexual women, as well as for her writings and activism against transsexualism...

 asserts that sex determines gender, and that there is no practical difference between the two. In her view, genitalia or "birth sex" or chromosomes deeply and permanently determine one's essential identity as a woman or man; trying to violate this divide is impossible, unnatural, and unhealthy. She argues that while transpeople may claim to feel like a certain gender, only a biological female can genuinely feel what it is to occupy a woman's body, including having experiences such as childbirth.

Transgender healthcare

Mental healthcare

Therapy is recommended by most mental health professionals for those who suffer from internal conflicts regarding their gender identity or those who feel discomfort in their assigned gender role, especially if they desire to transition
Transitioning (transgender)
Transitioning is the process of changing one's gender presentation to accord with one's internal sense of one's gender - the idea of what it means to be a man or woman...

. People who experience discord between their gender and the expectations of others or whose gender identity conflicts with their body may benefit by talking through their feelings in depth with someone who will listen attentively. However, research on gender identity is relatively new to psychology and scientific understanding of it and related issues is still in its infancy.

Transgender people may be eligible for diagnosis of gender identity disorder (GID) "only if [being transgender] causes distress or disability." This distress is referred to as gender dysphoria and may manifest as depression or inability to work and form healthy relationships with others. This diagnosis is often misinterpreted as implying that simply being transgender means a person suffers from GID, which is not the case. This has caused much confusion to transgender people and those who seek to either criticize or affirm them. Transgender people who are comfortable with their gender, whose gender does not directly cause inner frustration or impair their functioning, do not suffer from GID. Moreover, GID is not necessarily permanent, and is often resolved through therapy and/or transitioning. GID does not refer to people who feel oppressed by the negative attitudes and behaviors or others including legal entities in the same way that racist institutions do not create a "race disorder." Neither does GID imply an opinion of immorality; the psychological establishment holds the position that people with any kind of mental or emotional problem should not receive stigma. The solution for GID is whatever will alleviate suffering and restore functionality; this often, but not always, consists of undergoing a gender transition
Transitioning (transgender)
Transitioning is the process of changing one's gender presentation to accord with one's internal sense of one's gender - the idea of what it means to be a man or woman...

.

The terms "transsexualism", "dual-role transvestism", "gender identity disorder in adolescents or adults" and "gender identity disorder not otherwise specified" are listed as such in the International Statistical Classification of Diseases (ICD) or the American Diagnostic and Statistical Manual of Mental Disorders (DSM)
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...

 under codes F64.0, F64.1, 302.85 and 302.6 respectively.

In February 2010, France became the first country in the world to remove transgender identity from the list of mental diseases.

The issues around psychological classifications and associated stigma (whether based in paraphilia or not) of cross dressers, transsexual men and women (and for that matter lesbian and gay children who may be difficult to tell apart from trans children early in life) have recently become more complex since it was announced that CAMH
Centre for Addiction and Mental Health
The Centre for Addiction and Mental Health is a consortium of mental health clinics at several sites in Toronto, Ontario, Canada. Its name in French is Centre de toxicomanie et de santé mentale...

 colleagues Kenneth Zucker
Kenneth Zucker
Kenneth J. Zucker is a Jewish American-Canadian psychologist and sexologist, and head of the child and adolescent gender identity clinic at Toronto's Centre for Addiction and Mental Health. Based on his collaboration with Susan Bradley, Zucker is considered an international authority in the field...

 and Ray Blanchard
Ray 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...

 would serve on the DSM-V's Sexual and Gender Identity Disorders Work Group
. CAMH aims to 'cure' transgender people of their 'disorder', especially in children. Within the trans community, this has mostly produced shock and outrage with attempts to organize other responses.

One of the reasons there is so much controversy about Kenneth Zucker and Ray Blanchard's work group is that many people believe that gender identity disorders/homosexuality are incurable as they are genetic and/or occur as a result of events occurring before birth (therefore already "solidified" by the time of birth). If this is the case, then trying to 'cure' said condition(s) could lead (and in some individuals already has led) to increased confusion, more intense dysphoria later in life, and perhaps even suicide (likely due to the fact that the younger the transgender individual, the greater the effect of hormones). While some cases of individuals partaking in these sessions seem to show success, the long term repercussions (if any) of some of these individuals being 'cured' have not yet been observed, due to an indefinite amount of time before negative reactions could possibly occur.

Transgender issues are both new in the scientific field and affect relatively few people, so many mental healthcare providers know little about transgender issues. People seeking help from these professionals often end up educating the professional rather than receiving help. Among those therapists who profess to know about transgender issues, many believe that transitioning from one sex to another the standard transsexual model is the best or only solution. This usually works well for those who are transsexual, but is not the solution for other transgender people, particularly genderqueer
Genderqueer
Genderqueer is a catch-all term for gender identities other than man and woman, thus outside of the gender binary and heteronormativity...

 people who do not identify as exclusively male
Male
Male refers to the biological sex of an organism, or part of an organism, which produces small mobile gametes, called spermatozoa. Each spermatozoon can fuse with a larger female gamete or ovum, in the process of fertilization...

 or female
Female
Female is the sex of an organism, or a part of an organism, which produces non-mobile ova .- Defining characteristics :The ova are defined as the larger gametes in a heterogamous reproduction system, while the smaller, usually motile gamete, the spermatozoon, is produced by the male...

.

Physical healthcare

Medical and surgical procedures exist for transsexual and some transgender people. (Most categories of transgender people as described above are not known for seeking the following treatments.) Hormone replacement therapy for trans men
Hormone replacement therapy (female-to-male)
Hormone replacement therapy for transgender gender variant and transsexual introduces hormones associate with the gender that the patient identifies with...

 induces beard growth and masculinises skin, hair, voice and fat distribution. Hormone replacement therapy for trans women
Hormone replacement therapy (male-to-female)
Hormone replacement therapy for transgender and transsexual people changes the balance of sex hormones in their bodies. Some intersex people also receive HRT, either starting in childhood to confirm the sex to which they were assigned, or later, if this assignment has proven to be incorrect...

 feminises fat distribution and breasts. Laser hair removal
Laser hair removal
Laser hair removal was performed experimentally for about 20 years before it became commercially available in the mid 1990s. One of the first published articles describing laser hair removal was authored by the group at Massachusetts General Hospital in 1998...

 or electrolysis
Electrology
Electrology is the practice of electrical epilation to permanently remove human hair. The actual process of removing the hair is referred to as electrolysis.-Overview:...

 removes excess hair for trans women. Surgical procedures for trans women feminise the voice, skin
Dermabrasion
Dermabrasion is a surgical procedure that involves the controlled abrasion of the upper layers of the skin with sandpaper or other mechanical means. Nowadays it has become common to use CO2 or Erbium:YAG laser as well. The procedure requires a local anaesthetic...

, face
Facial feminization surgery
Facial feminization surgery is a set of reconstructive surgical procedures that alter typically male facial features to bring them closer in shape and size to typical female facial features...

, adam's apple
Chondrolaryngoplasty
Chondrolaryngoplasty is a surgical procedure in which the thyroid cartilage is reduced in size by shaving down the cartilage through an incision in the throat, generally to aid trans women in achieving a passable female appearance, and occasionally on cisgender men and women who are uncomfortable...

, breasts, waist
Liposuction
Liposuction, also known as lipoplasty , liposculpture suction lipectomy or simply lipo is a cosmetic surgery operation that removes fat from many different sites on the human body...

, buttocks
Buttock augmentation
thumb|right|250px|Gluteoplasty: the pre-operative, back and oblique-right aspects , and the like post-operative aspects , of a combined procedure of buttocks augmentation and thigh contouring.Gluteoplasty thumb|right|250px|Gluteoplasty: the pre-operative, back and oblique-right aspects (left), and...

 and genitals
Sex reassignment surgery male-to-female
Sex reassignment surgery from male to female involves reshaping the male genitals into a form with the appearance of and, as far as possible, the function of female genitalia. Prior to any surgeries, trans women usually undergo hormone replacement therapy and facial hair removal...

. Surgical procedures for trans men masculinise the chest
Male Chest Reconstruction
In men with female breast growth, caused either by gynecomastia or by status as a trans man, a male chest reconstruction is often done to give the chest a more masculine appearance...

 and genitals and remove the womb
Hysterectomy
A hysterectomy is the surgical removal of the uterus, usually performed by a gynecologist. Hysterectomy may be total or partial...

 and ovaries and fallopian tubes
Oophorectomy
Oophorectomy is the surgical removal of an ovary or ovaries. The surgery is also called ovariectomy, but this term has been traditionally used in basic science research describing the surgical removal of ovaries in laboratory animals...

. The acronyms "GRS" and "SRS
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...

" refer to genital surgery. The term "sex reassignment therapy
Sex reassignment therapy
Sex reassignment therapy is an umbrella term for all medical procedures regarding sex reassignment of both transgender and intersexual people...

" (SRT) is used as an umbrella term for physical procedures required for transition. Use of the term "sex change
Sex change
Sex change is a term often used for gender reassignment therapy, that is, all medical procedures transgendered people can have, or specifically to sexual reassignment surgery, which usually refers to genitalia surgery only...

" has been criticized for its emphasis on surgery, and the term "transition" is preferred. Availability of these procedures depends on degree of gender dysphoria, presence or absence of gender identity disorder
Gender 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...

, and standards of care
Standards of care for gender identity disorders
The Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People are non-binding protocols outlining the usual treatment for individuals who wish to undergo hormonal or surgical transition to the other sex...

 in the relevant jurisdiction.

Transgender people and the law


Legal procedures exist in some jurisdiction
Jurisdiction
Jurisdiction is the practical authority granted to a formally constituted legal body or to a political leader to deal with and make pronouncements on legal matters and, by implication, to administer justice within a defined area of responsibility...

s allowing individuals to change their legal gender, or their name, to reflect their gender identity
Gender identity
A gender identity is the way in which an individual self-identifies with a gender category, for example, as being either a man or a woman, or in some cases being neither, which can be distinct from biological sex. Basic gender identity is usually formed by age three and is extremely difficult to...

. Requirements for these procedures vary from an explicit formal diagnosis 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...

, to a diagnosis of gender identity disorder
Gender 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...

, to a letter from a physician attesting to the individual's gender transition, or the fact that one has established a different gender role
Gender role
Gender roles refer to the set of social and behavioral norms that are considered to be socially appropriate for individuals of a specific sex in the context of a specific culture, which differ widely between cultures and over time...

. In 1994, the DSM IV entry was changed from "Transsexual" to "Gender Identity Disorder." In many places, transgender people are not legally protected from discrimination in the workplace or in public accommodations. A report released in February 2011 found that 90% of transgender people faced discrimination at work, and were unemployed at double the rate of the general population. Over half had been harassed or turned away when attempting to access public services. Members of the transgender community also encounter high levels of discrimination in health care on an everyday basis.

In Canada, a private members bill protecting the rights of freedom of gender expression and gender identity passed in the House of Commons on February 9, 2011. It amends the Canada Human Rights code to help protect gender-variant people from discrimination by including gender identity and expression in the list of prohibited grounds for discrimination, as well as including gender identity and expression in the description of identifiable group, so that offences deliberately against gender-variant people can be punished to a similar extent as a racial-based crime. It is uncertain whether the bill will be passed by the Senate.

In the U.S., a federal bill to protect workers from discrimination based on sexual orientation and gender identity – called the Employment Non-Discrimination Act – has stalled and failed several times over the past two decades. Still, individual states and cities have begun passing their own non-discrimination ordinances. In New York, for example, Governor David Paterson passed the first legislation to include transgender protections in September 2010.

Transgender people and religion

The world's religions display great diversity and their interpretations of and reactions to transgender people demonstrate equal diversity. Even within one specific religion, Christianity, different groups have very different interpretations of gender identity and socio-cultural gender roles as well as very different attitudes toward and reactions to transgender people (see the main article on this topic). More generally the scriptures of Abrahamic religions
Abrahamic religions
Abrahamic religions are the monotheistic faiths emphasizing and tracing their common origin to Abraham or recognizing a spiritual tradition identified with him...

 include both texts sometimes interpreted as condemning transgender persons as well as texts sometimes interpreted as challenging conservative views of gender and of the possibilities open to transgender people, as well as offering them encouragement, support and hope.

Brain-based studies

Several studies have concentrated on whether sexually dimorphic brain structures in transsexuals are more similar to their preferred sex or to their birth sex. Researchers caution that there are known brain differences between homosexual and heterosexual persons and that the brain changes in response to hormone-treatment, which many transsexuals use. In order to know what in the brain is related to what feature of the person, studies of more uniform groups give clearer results than do studies of more mixed groups.

Androphilic MtF transsexuals

Studies have consistently shown that specifically androphilic male-to-female transsexuals (sometimes confusingly called homosexual MtF transsexuals in studies) show a shift towards the female direction in brain anatomy. In 2009, a German team of radiologists led by Gizewski compared 12 androphilic transsexuals with 12 biological males and 12 biological females. Using functional magnetic resonance imaging
Functional magnetic resonance imaging
Functional magnetic resonance imaging or functional MRI is a type of specialized MRI scan used to measure the hemodynamic response related to neural activity in the brain or spinal cord of humans or other animals. It is one of the most recently developed forms of neuroimaging...

 (fMRI), they found that when shown erotica, the biological men responded in several brain regions that the biological women did not, and that the sample of androphilic transsexuals was shifted towards the female direction in brain responses.

Rametti and colleagues used diffusion tensor imaging (DTI) to compare 18 androphilic male-to-female transsexuals with 19 gynephilic males and 19 typical (heterosexual) females. The androphilic transsexuals differed from both control groups in multiple brain areas, including the superior longitudinal fasciculus, the right anterior cingulum, the right forceps minor, and the right corticospinal tract. The study authors concluded that androphilic transsexuals are halfway between the patterns exhibited by male and female controls.

Gynephilic MtF transsexuals

Conversely, gynephilic male-to-female transsexuals also show differences in the brain from non-transsexual males, but in a unique pattern different from being shifted in a female direction. Researchers of the Karolinska Institute of Stockholm
Stockholm
Stockholm is the capital and the largest city of Sweden and constitutes the most populated urban area in Scandinavia. Stockholm is the most populous city in Sweden, with a population of 851,155 in the municipality , 1.37 million in the urban area , and around 2.1 million in the metropolitan area...

 used MRI to compare 24 gynephilic male-to-female transsexuals with 24 non-transsexual male and 24 non-transsexual female controls. None of the study participants were on hormone treatment. The researchers found sex-typical differentiation between the MtF transsexuals and non-transsexual males, and the non-transsexual females; but the gynephilic transsexuals "displayed also singular features and differed from both control groups by having reduced thalamus and putamen volumes and elevated GM volumes in the right insular and inferior frontal cortex and an area covering the right angular gyrus."

These researchers concluded that "Contrary to the primary hypothesis, no sex-atypical features with signs of 'feminization' were detected in the transsexual group....The present study does not support the dogma that [male-to-female transsexuals] have atypical sex dimorphism in the brain but confirms the previously reported sex differences. The observed differences between MtF-TR and controls raise the question as to whether gender dysphoria may be associated with changes in multiple structures and involve a network (rather than a single nodal area)."

In Sweden, non-androphilic transsexual women were tested when they were smelling odorous steroids. The results showed that the transsexual women demonstrated "a pattern of activation away from the biological sex, occupying an intermediate position with predominantly female-like features."

Anne Lawrence, a sexologist, physician, and self-identified autogynephilic transsexual, has hypothesized that the desire by persons with autogynephilia, including some cross dressers and some transsexuals, to alter their body can be compared with apotemnophilia
Apotemnophilia
Apotemnophilia is a neurological disorder in which otherwise sane and rational individuals express a strong and specific desire for the amputation of a healthy limb or limbs. It is due to hypothesized damage to the right parietal lobe, as the disorder has features in common with somatoparaphrenia...

 (alternately body integrity identity disorder
Body integrity identity disorder
Body Integrity Identity Disorder , formerly known as Amputee Identity Disorder, is a psychological disorder wherein sufferers feel they would be happier living as an amputee...

 if framed as an identity issue rather than a fetish). Explanations of the desire to transition based on libido
Libido
Libido refers to a person's sex drive or desire for sexual activity. The desire for sex is an aspect of a person's sexuality, but varies enormously from one person to another, and it also varies depending on circumstances at a particular time. A person who has extremely frequent or a suddenly...

, such as this, have been criticized by some transsexuals who argue that they are unscientific or transphobic.

Mixed samples of MtF transsexuals

Several teams of researchers have examined the brains or brain functioning of MtF transsexuals, but without breaking down the samples into androphilic (or homosexual) and gynephilic (or autogynephilic or heterosexual) types. Such studies have yielded contradictory results, with some studies reporting differences between the (mixed groups of) MtF transsexuals and the non-transsexual controls but with other studies finding no differences.

One brain structure that was examined in MtF transsexuals because of having known sex difference is the corpus callosum
Corpus callosum
The corpus callosum , also known as the colossal commissure, is a wide, flat bundle of neural fibers beneath the cortex in the eutherian brain at the longitudinal fissure. It connects the left and right cerebral hemispheres and facilitates interhemispheric communication...

, which is larger and of a different shape in men than in women. In 1991, a University of Texas team reported comparing the corpus callosa of 10 MtF transsexuals, 10 FtM transsexuals, 20 control males, and 20 control females. No significant differences were found.

In a pair of reports, a Dutch team led by Swaab, examined the volume and neuron count in the bed nucleus of the stria terminalis in six estrogen-treated transsexuals and one pre-treatment transsexual. They found the BSTc to be female-shifted (smaller) among the transsexuals than among the male control subjects. A subsequent study by Swaab found that the BSTc becomes sexually dimorphic only in adulthood, suggesting that differentiation of the BSTc does not cause transsexualism. Rather, the difference in the BSTc might instead be the result of a "failure to develop a male-like gender identity" (p. 1032). The BSTc has also been reported to be smaller in other sexually atypical populations unrelated to transsexualism.

Another team of Dutch researchers examined the effects of cross-gender hormone treatment on the brain in 8 male-to-female transsexuals and in 6 female-to-male transsexuals, finding that the hormones changed the sizes of the hypothalamus in a gender consistent manner. Treatment with male hormones shifted the hypothalamus towards the male direction in the same way as in male controls, and treatment with female hormones shifted the hypothalamus towards the female direction in the same way as female controls.

A 2003 study by Haraldsen and colleagues compared the performance of 52 persons with Gender Identity Disorder (33 from Norway and 19 from the U.S.) with that of 29 control subjects on a series of tests that tap into the functioning of different parts of the brain and on which men and women perform differently. The people in the GID sample "were either homosexually attracted by males or females (n=38), by both (n=3) or by neither (n=9)." No effects of transsexual status were detected.

Johns Hopkins researchers in 2005 reported on another test of brain functioning using test performance. The study subjects included 27 MtF transsexuals and 16 control men, and the authors reported that no female-typical patterns in cerebral lateralization or cognitive performance were found within the transsexual sample.

In 2009, UCLA researchers used MRIs to examine a mixed sample of 24 non-hormone-treated male-to-female transsexuals (6 were androphilic, and 18 were gynephilic), comparing them with 30 non-transsexual males and 30 non-transsexual females. The results "revealed that regional gray matter variation in MTF transsexuals is more similar to the pattern found in men than in women," except for the "right putamen.". They concluded that "These findings provide new evidence that transsexualism is associated with distinct cerebral pattern, which supports the assumption that brain anatomy plays a role in gender identity."

Gynephilic FtM transsexuals

Brain-based research has repeatedly shown that female-to-male transsexuals have several male-like characteristics in neuroanatomy. In 2010, a team of neuroscientists compared 18 female-to-male transsexuals with 24 male and 19 female gynephilic controls, using an MRI technique called diffusion tensor imaging or DTI. DTI is a specialized technique for visualizing white matter
White matter
White matter is one of the two components of the central nervous system and consists mostly of myelinated axons. White matter tissue of the freshly cut brain appears pinkish white to the naked eye because myelin is composed largely of lipid tissue veined with capillaries. Its white color is due to...

 of the brain, and white matter structure is one of the differences in neuroanatomy between men and women. The study found that the white matter pattern in female-to-male transsexuals was shifted in the direction of biological males, even before the female-to-male transsexuals started taking male hormones (which can also modify brain structure).

Another team of neuroscientists, led by Nawata in Japan, used a technique called single-photon emission computed tomography (SPECT) compare the regional cerebral blood flow
Cerebral blood flow
Cerebral blood flow, or CBF, is the blood supply to the brain in a given time. In an adult, CBF is typically 750 millitres per minute or 15% of the cardiac output. This equates to 50 to 54 millilitres of blood per 100 grams of brain tissue per minute. CBF is tightly regulated to meet the brain's...

 (rCBF) of 11 female-to-male transsexuals (attracted to women) with that of 9 biological females (attracted to men). Although the study did not include a sample of biological males so that a conclusion of "male shift" could be made, the study did reveal that the female-to-male transsexuals showed significant decrease in blood flow in the left anterior cingulate cortex and a significant increase in the right insula
Insular cortex
In each hemisphere of the mammalian brain the insular cortex is a portion of the cerebral cortex folded deep within the lateral sulcus between the temporal lobe and the frontal lobe. The cortical area overlying it towards the lateral surface of the brain is the operculum...

, two brain regions known to respond during sexual arousal.

Genetic studies

In 2008, a study was performed to attempt to find a link between genes and transsexuality. The researchers compared 112 male-to-female transsexuals (both androphilic and gynephilic), mostly already undergoing hormone treatment, with 258 cis-gendered male controls. The male-to-female transsexuals were more likely than non-transsexual males to have a longer version of a receptor gene for the sex hormone androgen or testosterone. The research suggests reduced androgen and androgen signaling contributes to the female gender identity of male to female transsexuals. The authors say that it is possible that a decrease in testosterone levels in the brain during development might result in incomplete masculinization of the brain in male to female transsexuals, resulting in a more feminized brain and a female gender identity.

Terms and Typology

The use of homosexual transsexual and related terms have been applied to transgender people since the middle of the 20th century, though concerns about the terms have been voiced since then. Harry Benjamin
Harry 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 :...

 said in 1966:
....it seems evident that the question "Is the transsexual homosexual?" must be answered "yes" and " no." "Yes," if his anatomy is considered; "no" if his psyche is given preference.

What would be the situation after corrective surgery has been performed and the sex anatomy now resembles that of a woman? Is the "new woman" still a homosexual man? "Yes," if pedantry and technicalities prevail. "No" if reason and common sense are applied and if the respective patient is treated as an individual and not as a rubber stamp.


Many sources, including some supporters of the typology, criticize this choice of wording as confusing and degrading. Biologist Bruce Bagemihl
Bruce Bagemihl
Bruce Bagemihl is a Canadian biologist, linguist, and author of the book Biological Exuberance: Animal Homosexuality and Natural Diversity.-Life and career:He served on the faculty of University of British Columbia, and he earned a Ph.D...

 writes "..the point of reference for "heterosexual" or "homosexual" orientation in this nomenclature is solely the individual's genetic sex prior to reassignment (see for example, Blanchard et al. 1987[24], Coleman and Bockting, 1988[25], Blanchard, 1989[26]). These labels thereby ignore the individual’s personal sense of gender identity taking precedence over biological sex, rather than the other way around." Bagemihl goes on to take issue with the way this terminology makes it easy to claim transsexuals are really homosexual males seeking to escape from stigma. Leavitt and Berger stated in 1990 that "The homosexual transsexual label is both confusing and controversial among males seeking sex reassignment. Critics argue that the term "homosexual transsexual" is "heterosexist
Heterosexism
Heterosexism is a system of attitudes, bias, and discrimination in favor of opposite-sex sexuality and relationships. It can include the presumption that everyone is heterosexual or that opposite-sex attractions and relationships are the only norm and therefore superior...

", "archaic", and demeaning because it labels people by sex assigned at birth instead of their gender identity
Gender identity
A gender identity is the way in which an individual self-identifies with a gender category, for example, as being either a man or a woman, or in some cases being neither, which can be distinct from biological sex. Basic gender identity is usually formed by age three and is extremely difficult to...

. Benjamin, Leavitt, and Berger have all used the term in their own work. Sexologist John Bancroft
John Bancroft
Dr John H.J. Bancroft is a physician who was Director of The Kinsey Institute for Research in Sex, Gender, and Reproduction at Indiana University from 1995 to 2004. He is a Clinical Professor of Psychiatry at Indiana University School of Medicine....

 also recently expressed regret for having used this terminology, which was standard when he used it, to refer to transsexual women. He says that he now tries to choose his words more sensitively. Sexologist Charles Allen Moser
Charles Allen Moser
Charles Allen Moser is an American physician specializing in internal medicine and focusing on sexual medicine. Moser is based in San Francisco and focuses his research and practice on individuals in the LGBT, kink, and fetish communities...

 is likewise critical of the terminology.

Use of androphilia and gynephilia was proposed and popularized by psychologist Ron Langevin in the 1980s. Psychologist Stephen T. Wegener
Stephen T. Wegener
Stephen Thomas Wegener is an American rehabilitation psychologist specializing in the psychology of pain management. His work seeks to improve function and reduce disability for persons with chronic illness and impairments, including occupational injuries, rheumatic disease, spinal cord injury or...

 writes, "Langevin makes several concrete suggestions regarding the language used to describe sexual anomalies. For example, he proposes the terms gynephilic and androphilic to indicate the type of partner preferred regardless of an individual's gender identity
Gender identity
A gender identity is the way in which an individual self-identifies with a gender category, for example, as being either a man or a woman, or in some cases being neither, which can be distinct from biological sex. Basic gender identity is usually formed by age three and is extremely difficult to...

 or dress. Those who are writing and researching in this area would do well to adopt his clear and concise vocabulary."

Psychiatrist Anil Aggrawal
Anil Aggrawal
Anil Aggrawal M.D. is a professor of forensic medicine at the Maulana Azad Medical College, New Delhi, India. He is known chiefly as the Editor-in-Chief of the Internet Journal of Forensic Medicine and Toxicology.-Early life:Dr...

 explains why the terms are useful in a glossary:
Androphilia – The romantic and/or sexual attraction to adult males. The term, along with gynephilia, is needed to overcome immense difficulties in characterizing the sexual orientation of transmen and transwomen. For instance, it is difficult to decide whether a transman erotically attracted to males is a heterosexual female or a homosexual male; or a transwoman erotically attracted to females is a heterosexual male or a lesbian female. Any attempt to classify them may not only cause confusion but arouse offense among the affected subjects. In such cases, while defining sexual attraction, it is best to focus on the object of their attraction rather than on the sex or gender of the subject.


Sexologist Milton Diamond
Milton Diamond
Milton Diamond is a retired professor of anatomy and reproductive biology at the University of Hawai'i at Mānoa. He has had a very long and productive career in the study of human sexuality...

, who prefers the correctly-formed term gynecophilia, writes, "The terms heterosexual, homosexual, and bisexual are better used as adjectives, not nouns, and are better applied to behaviors, not people. Diamond has encouraged using the terms androphilic, gynecophilic, and ambiphilic to describe the sexual-erotic partners on prefers (andro = male, gyneco – female, ambi = both, philic = to love). Such terms obviate the need to specify the subject and focus instead on the desired partner. This usage is particularly advantageous when discussing the partners of transsexual or intersexed individuals. These newer terms also do not carry the social weight of the former ones."

Psychologist Rachel Ann Heath writes, "The terms homosexual and heterosexual are awkward, especially when the former is used with, or instead of, gay and lesbian. Alternatively, I use gynephilic and androphilic to refer to sexual preference for women and men, respectively. Gynephilic and androphilic derive from the Greek meaning love of a woman and love of a man respectively. So a gynephilic man is a man who likes women, that is, a heterosexual man, whereas an androphilic man is a man who likes men, that is, a gay man. For completeness, a lesbian is a gynephilic woman, a woman who likes other women. Gynephilic transsexed woman refers to a woman of transsexual background whose sexual preference is for women. Unless homosexual and heterosexual are more readily understood terms in a given context, this more precise terminology will be used throughout the book. Since homosexual, gay, and lesbian are often associated with bigotry and exclusion in many societies, the emphasis on sexual affiliation is both appropriate and socially just." Author Helen Boyd
Helen Boyd
Helen Boyd is the pen name of Gail Kramer, the American author of two books about her relationship with her transgender partner. Her partner is referred to in both books as "Betty Crow", though this is also a pseudonym.-Biography:...

 agrees, writing, "It would be much more accurate to define sexual orientation as either “androphilic” (loving men) and “gynephilic” (loving women) instead." Sociomedical scientist Rebecca Jordan-Young challenges researchers like Simon LeVay
Simon LeVay
Simon LeVay is a British-American neuroscientist. He is known for his studies about brain structures and sexual orientation.-Personal life:LeVay was born on August 28, 1943 in Oxford, England...

, J. Michael Bailey
J. Michael Bailey
John Michael Bailey is an American psychologist and professor at Northwestern University. He is best known among scientists for his work on the etiology of sexual orientation, from which he concluded that homosexuality is substantially inherited...

, and Martin Lalumiere, who she says "have completely failed to appreciate the implications of alternative ways of framing sexual orientation."

Blanchard's typology

Blanchard's transsexualism typology
Blanchard's transsexualism typology
Blanchard's transsexualism typology is a psychological typology of male-to-female transsexualism created by Ray Blanchard through the 1980s and 1990s, building on the work of his colleague, Kurt Freund...

 characterizes trans women as having one of two motivations for transition. Whereas previous descriptions of transgenderism included very many combinations of sexual orientation, gender identity, and the desire to cross-dress, Blanchard interprets his evidence as suggesting that there were only two basic phenomena. One phenomenon was androphilia (male homosexuality), which ranged from typical gay men to, when extreme, androphilic or homosexual transsexualism. The other phenomenon was autogynephilia, which ranged from typical cross-dressers to, when extreme, autogynephilic transsexualism (or non-homosexual transsexualism). Androphilic male-to-female transsexuals are characterized by sexual attraction to males and by overt and obvious femininity since childhood, whereas autogynephilic transsexuals are characterized by sexual attraction to females (or sometimes to females and males, or by asexuality) and whose presentations are internal and typically unremarkable until they choose to disclose them, typically later in life. There are community activists who dislike the theory.

Scientific criticism of the theory includes papers from Veale, Nuttbrock, Moser, and others who argue that the theory is poorly representative of MTF transsexuals, non-instructive, the experiments poorly controlled, or contradicted by other data. Many sources, including some supporters of the theory, criticize Blanchard's choice of wording as confusing or degrading.

Also the DSM V workgroup has been quoted as saying:
"In contemporary clinical practice, sexual orientation per se plays only a minor role in treatment protocols or decisions. Also, changes as to the preferred gender of sex partner occur during or after treatment (DeCuypere, Janes, & Rubens, 2005; Lawrence, 2005; Schroder & Carroll, 1999). It can be difficult to assess sexual orientation in individuals with a GI diagnosis, as they preoperatively might give incorrect information in order to be approved for hormonal and surgical treatment (Lawrence, 1999). Because sexual orientation subtyping is of interest to researchers in the field, it is recommended that reference to it be addressed in the text, but not as a specifier. It should also be assessed as a dimensional construct."

Blanchard is a member of the DSM V Sexual and Gender Identity Disorders Work Group chaired by Kenneth J. Zucker. Though it has supporters, the transsexual community has for the most part vehemently rejected Blanchards typology theory.

Transgender people in non-Western cultures

Asia

In Thailand
Thailand
Thailand , officially the Kingdom of Thailand , formerly known as Siam , is a country located at the centre of the Indochina peninsula and Southeast Asia. It is bordered to the north by Burma and Laos, to the east by Laos and Cambodia, to the south by the Gulf of Thailand and Malaysia, and to the...

 and Laos
Laos
Laos Lao: ສາທາລະນະລັດ ປະຊາທິປະໄຕ ປະຊາຊົນລາວ Sathalanalat Paxathipatai Paxaxon Lao, officially the Lao People's Democratic Republic, is a landlocked country in Southeast Asia, bordered by Burma and China to the northwest, Vietnam to the east, Cambodia to the south and Thailand to the west...

, the term kathoey
Kathoey
Kathoey or katoey is a male-to-female transgender person or an effeminate gay male in Thailand. Related phrases include sao praphet song , or phet thi sam . The word kathoey is thought to be of Khmer origin...

 is used to refer to male-to-female transgender people and effeminate gay men. The cultures of the Indian subcontinent
Indian subcontinent
The Indian subcontinent, also Indian Subcontinent, Indo-Pak Subcontinent or South Asian Subcontinent is a region of the Asian continent on the Indian tectonic plate from the Hindu Kush or Hindu Koh, Himalayas and including the Kuen Lun and Karakoram ranges, forming a land mass which extends...

 include a third gender
Third gender
The terms third gender and third sex describe individuals who are categorized as neither man nor woman, as well as the social category present in those societies who recognize three or more genders...

, referred to as hijra
Hijra (South Asia)
In the culture of South Asia, hijras or chakka in Kannada, khusra in Punjabi and kojja in Telugu are physiological males who have feminine gender identity, women's clothing and other feminine gender roles. Hijras have a long recorded history in the Indian subcontinent, from the antiquity, as...

 in Hindi
Hindi
Standard Hindi, or more precisely Modern Standard Hindi, also known as Manak Hindi , High Hindi, Nagari Hindi, and Literary Hindi, is a standardized and sanskritized register of the Hindustani language derived from the Khariboli dialect of Delhi...

.
Transgender people also have been documented in Iran
Transsexuality in Iran
Before the Islamic Revolution in 1979, the issue of transsexuality in Iran had never been officially addressed by the government. Beginning in the mid-1980s, however, transsexual individuals were officially recognized by the government and allowed to undergo sex reassignment surgery...

, Japan, Nepal
Nepal
Nepal , officially the Federal Democratic Republic of Nepal, is a landlocked sovereign state located in South Asia. It is located in the Himalayas and bordered to the north by the People's Republic of China, and to the south, east, and west by the Republic of India...

, Indonesia
Indonesia
Indonesia , officially the Republic of Indonesia , is a country in Southeast Asia and Oceania. Indonesia is an archipelago comprising approximately 13,000 islands. It has 33 provinces with over 238 million people, and is the world's fourth most populous country. Indonesia is a republic, with an...

, Vietnam
Vietnam
Vietnam – sometimes spelled Viet Nam , officially the Socialist Republic of Vietnam – is the easternmost country on the Indochina Peninsula in Southeast Asia. It is bordered by China to the north, Laos to the northwest, Cambodia to the southwest, and the South China Sea –...

, South Korea, Singapore
Transgender people in Singapore
The history and subculture surrounding Transgender people in Singapore is substantial. Not immediately apparent to Singapore's mainstream society is the fact that the gay community sees itself as a totally separate entity from the transgender communities...

, and the greater Chinese region
Transgender in China
China and greater China have a long history of transgenderism.-Terminology:...

, including Hong Kong, Taiwan
Taiwan
Taiwan , also known, especially in the past, as Formosa , is the largest island of the same-named island group of East Asia in the western Pacific Ocean and located off the southeastern coast of mainland China. The island forms over 99% of the current territory of the Republic of China following...

, and the People's Republic of China.

North America

In what is now the United States and Canada, many Native American and First Nations peoples recognised the existence of more than two genders, such as the Zuñi male-bodied Ła'mana, the Lakota male-bodied winkte and the Mohave
Mohave
Mohave or Mojave are a Native American people indigenous to the Colorado River in the Mojave Desert. The Fort Mojave Indian Reservation includes parts of California, Arizona, and Nevada...

 male-bodied alyhaa and female-bodied hwamee. Such people were previously referred to as berdache but are now referred to as Two-Spirit
Two-Spirit
Two-Spirit People , is an English term that emerged in 1990 out of the third annual inter-tribal Native American/First Nations gay/lesbian American conference in Winnipeg. It describes Indigenous North Americans who fulfill one of many mixed gender roles found traditionally among many Native...

, and their spouses would not necessarily have been regarded as gender-different. In Mexico, the Zapotec culture includes a third gender
Third gender
The terms third gender and third sex describe individuals who are categorized as neither man nor woman, as well as the social category present in those societies who recognize three or more genders...

 in the form of the Muxe
Muxe
In Zapotec cultures of Oaxaca , a muxe is a physically male individual who dresses and behaves in a feminine manner; they may be seen as a third gender. Some marry women and have children while others choose men as sexual or romantic partners...

.

Other

In early Medina
Medina
Medina , or ; also transliterated as Madinah, or madinat al-nabi "the city of the prophet") is a city in the Hejaz region of western Saudi Arabia, and serves as the capital of the Al Madinah Province. It is the second holiest city in Islam, and the burial place of the Islamic Prophet Muhammad, and...

, gender-variant male-to-female Islam
Islam
Islam . The most common are and .   : Arabic pronunciation varies regionally. The first vowel ranges from ~~. The second vowel ranges from ~~~...

ic people were acknowledged in the form of the Mukhannathun
Mukhannathun
Mukhannathun is classical Arabic for people who would now be called transgender women, perhaps poorly distinguished from eunuchs. Various "mukhannathun" appear in several hadith. In one hadith the prophet Muhammad banishes a mukhannath to a region near Medina, but prohibits people from killing...

. In Ancient Rome
Ancient Rome
Ancient Rome was a thriving civilization that grew on the Italian Peninsula as early as the 8th century BC. Located along the Mediterranean Sea and centered on the city of Rome, it expanded to one of the largest empires in the ancient world....

, the Gallae
Galli
A Gallus was a eunuch priest of the Phrygian goddess Cybele, whose worship was incorporated into the state religious practices of ancient Rome.-About the Galli:...

 were castrated
Castration
Castration is any action, surgical, chemical, or otherwise, by which a male loses the functions of the testicles or a female loses the functions of the ovaries.-Humans:...

 followers of the Phrygia
Phrygia
In antiquity, Phrygia was a kingdom in the west central part of Anatolia, in what is now modern-day Turkey. The Phrygians initially lived in the southern Balkans; according to Herodotus, under the name of Bryges , changing it to Phruges after their final migration to Anatolia, via the...

n goddess Cybele
Cybele
Cybele , was a Phrygian form of the Earth Mother or Great Mother. As with Greek Gaia , her Minoan equivalent Rhea and some aspects of Demeter, Cybele embodies the fertile Earth...

 and can be regarded as transgender in today's terms.

Among the ancient Middle Eastern Akkadian people, a salzikrum was a person who appeared biologically female but had distinct male traits. Salzikrum is a compound word meaning male daughter. According to the Code of Hammurabi
Code of Hammurabi
The Code of Hammurabi is a well-preserved Babylonian law code, dating to ca. 1780 BC . It is one of the oldest deciphered writings of significant length in the world. The sixth Babylonian king, Hammurabi, enacted the code, and partial copies exist on a human-sized stone stele and various clay...

, salzikrūm had inheritance rights like that of priestesses; they inherited from their fathers, unlike regular daughters. A salzikrum's father could also stipulate that she inherit a certain amount.

Mahu is a traditional status in Polynesian cultures. Also, in Fa'asamoa
Fa'asamoa
Fa'asamoa literally means the ways of Samoa. Fa'a is a Samoan prefix that can be translated to English as 'the ways of'. Fa'a could also mean 'to do' or 'to implement' as in the word Fa'atonu .-Concept:...

 traditions, the Samoan culture allows a specific role for male to female transgender individuals as Fa'afafine
Fa'afafine
Fa'afafine may be viewed as a third gender specific to Samoan culture.Fa'afafine are biological males who have a strong feminine gender orientation, which the Samoan parents recognize quite early in childhood. Not always are they raised as female children or rather 'third gender' children...

.

Coming Out

Transgender people vary greatly in choosing when, if, and how to disclose their transgender status to family, close friends, and others. The prevalence of discrimination and violence against the transgender community can make coming out a risky decision. Fear of retaliatory behavior, such as being removed from the parental home while underage, is a cause for transgender people to not come out to their families until they have reached adulthood. Parental confusion and lack of acceptance of the child's transgenderism may be met with an effort to change their children back to "normal" by utilizing mental health services to alter the child's sexual orientation and what is seen as a "phase".

See also

  • Cisgender
    Cisgender
    Cisgender is an adjective used in the context of gender issues and counselling to refer to a class of gender identities formed by a match between an individual's gender identity and the behavior or role considered appropriate for one's sex.Kristen Schilt and Laurel Westbrook defined "cisgender"...

  • Gender identity disorder
    Gender 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...

  • Genderqueer
    Genderqueer
    Genderqueer is a catch-all term for gender identities other than man and woman, thus outside of the gender binary and heteronormativity...

  • List of transgender people
  • List of transgender-related topics
  • List of transgender-rights organizations
  • List of transgender, transsexual and intersex fictional characters
  • List of unlawfully killed transgender people
  • Queer
    Queer
    Queer is an umbrella term for sexual minorities that are not heterosexual, heteronormative, or gender-binary. In the context of Western identity politics the term also acts as a label setting queer-identifying people apart from discourse, ideologies, and lifestyles that typify mainstream LGBT ...

  • Transgender Day of Remembrance
    Transgender Day of Remembrance
    Transgender Day of Remembrance is a day to memorialize those who have been killed as a result of transphobia, or the hatred or fear of transgender and gender non-conforming people, and acts to bring attention to the continued violence endured by the transgender community.The Transgender Day of...

  • Transgender musicians
  • Transgender publications
    Transgender publications
    -Books:There are now many books available covering transgender, including cross-dressing and transsexualism.The Lazy Crossdresser is a carefree and useful guide by Charles Anders , who crossdressed publicly for several years...

  • Transgenderism
    Transgenderism
    Transgenderism is a social movement seeking transgender rights and affirming transgender pride.-History:In her 1995 book Apartheid of Sex, biopolitical lawyer and writer Martine Rothblatt describes "transgenderism" as a grassroots social movement seeking transgender rights and affirming transgender...

  • Transphobia
    Transphobia
    Transphobia is a range of negative attitudes and feelings towards transsexualism and transsexual or transgender people, based on the expression of their internal gender...

  • LGBT
    LGBT
    LGBT is an initialism that collectively refers to "lesbian, gay, bisexual, and transgender" people. In use since the 1990s, the term "LGBT" is an adaptation of the initialism "LGB", which itself started replacing the phrase "gay community" beginning in the mid-to-late 1980s, which many within the...


External links

  • "Lesbian, Gay, Bisexual, and Transgender/Transsexual Individuals" - Chapter on LGBT issues and public health (co-authored with Emilia Lombardi). Social Injustice and Public Health (eds. Barry Levy and Victor Sidel), Dr. Talia Mae Bettcher, Dr. Emilia Lombardi, Oxford University Press, 2005.
  • Sellers, Mitchell D. 2011. "Discrimination and the Transgender Population: A Description of Local Government Policies that Protect Gender Identity or Expression". Applied Research Projects, Texas State University-San Marcos. Paper 360. http://ecommons.txstate.edu/arp/360
The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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