We have learned that gender-identity formation is a complex process influenced by many factors, with congruity between biological sex and gender identity by no means guaranteed. We have become increasingly aware of the rich diversity in gender identities and roles. Many people fall somewhere within a range of variant gender identities. The community of gender-variant people, composed of transsexual and transgendered individuals, has acquired considerable voice in both the professional literature and the popular media.
A transsexual is a person whose gender identity is opposite to his or her biological sex. Such people feel trapped in a body of the "wrong" sex, a condition known as gender dysphoria. Thus an anatomically male transsexual feels that she is a woman who, by some quirk of fate, has been provided with male genitals but who wishes to be socially identified as female. Some theorists, based largely on their clinical experiences treating transsexuals, maintain that the "trapped in the body of the wrong sex" conceptualization
of transsexualism is incomplete or inaccurate, especially as applied to some male-to — female transsexuals (Bailey & Triea, 2007; Lawrence, 2007). Prominent among them is psychologist Roy Blanchard (1991, 1995), who maintains that there are two distinct subtypes of male-to-female transsexuals: (1) those with a homosexual orientation, who are exclusively attracted to men, and (2) individuals with a paraphilia labeled autogynephilia, which is a propensity to be sexually aroused by the thought or image of oneself as female. (See Chapter 16 for a discussion of paraphilias.) This interpretation, while controversial within the transsexual community, continues to generate research and discussion among professionals who study and treat transsexualism. For example, physician and researcher Anne Lawrence (2007), who herself is a male-to-female transsexual, has recently argued that it is a misconception to view autogynephilia as a purely erotic phenomenon. She suggests that autogynephilia can be more accurately conceptualized as a variety of romantic love embraced by men who "love women and want to become what they love" (p. 516).
Many transsexuals undergo sex-reassignment procedures involving extensive screening, hormone therapy, and genital-altering surgery. However, not all gender-dysphoric people want complete sex reassignment. Instead, they may want only the physical body, gender role, or sexuality of the other sex. Many gender-dysphoric individuals, including most transsexuals, want all three of these aspects of the other sex, but some are content to take on only one or two (Carroll, 1999). Furthermore, some transgendered people who manifest variant gender-role behaviors experience little or no gender dysphoria.
The term transgendered is generally applied to individuals whose appearance and/or behaviors do not conform to traditional gender roles (Dragowski et al., 2011; Olson et al., 2011). In other words, transgendered people, "to varying degrees, ‘transgress’ cultural norms as to what a man or woman ‘should be’" (Goodrum, 2000, p. 1). These "transgressions" often involve cross-dressing, either occasionally or full time. Variations of transgendered behaviors include:
■ androphilic (attracted to males) men who cross-dress and assume a female role either to attract men (often heterosexual men) or, less commonly, to entertain (i. e., female impersonators).
■ gynephilic (attracted to females) men who may have urges to become female but are reasonably content to live in a male role that may include being married to a woman and frequently cross-dressing and/or socializing as a woman.
■ gynephilic (attracted to females) women who manifest masculine qualities (sometimes a complete male identity) but never seek sex reassignment (Carroll, 1999).
Nontranssexual cross-dressers used to be labeled transvestites. This term is now generally applied only to people who cross-dress to achieve sexual arousal (see the discussion of transvestic fetishism in Chapter 16). Transgendered people who cross-dress typically do so to obtain psychosocial rather than sexual gratification.
Some intersexed people, who were born exhibiting a mixture of male and female external genitals, also consider themselves members of the transgendered community. This group can include intersexed individuals who have undergone surgical and/or hormonal treatments to establish congruence between their anatomical sex structures and their gender identity (Goodrum, 2000).
The primary difference between a transsexual and a transgenderist is that the trans — genderist does not want to change his or her physical body to create a better fit with personal or societal role expectations. Transsexuals often undergo major surgeries to make their physical bodies congruent with their gender identity. In contrast, most trans — gendered people have no wish to undergo anatomical alterations but do occasionally or frequently dress like and take on the mannerisms of the other sex. Some transgenderists live full time manifesting gender-role behaviors opposite to those ascribed by society to someone of their biological sex (Bolin, 1997).
Variant Gender Identity and Sexual Orientation
Many people are confused about the difference between gender identity (especially variant gender identity) and sexual orientation. Simply stated, gender identity is who we are—our own subjective sense of being male, female, or some combination of the two. Sexual orientation refers to which of the sexes we are emotionally and sexually attracted to (see Chapter 9).
Before sex reassignment, most transsexuals are attracted to people who match them anatomically but not in gender identity. Thus a transsexual with a female gender identity who feels trapped in a man’s body (and is probably identified as a male by society) is likely to be attracted to men. In other words, she has a heterosexual orientation based on her own self-identification as female. If she acts on her sexual desires before undergoing sex reassignment, she may be falsely labeled as homosexual. In terms of postsurgical sexual orientation, almost all female-to-male transsexuals desire female sexual partners, whereas male-to-female transsexuals can be sexually oriented to either sex, with most preferring male sex partners (Zhou et al., 1995). It is important to note that most transsexuals who pursue sex reassignment are motivated primarily by a desire to alleviate a gender-identity conflict rather than to increase their sexual attractiveness to desired partners (Bockting, 2005).
Although transsexuals are predominantly heterosexual, the transgendered community is more eclectic, consisting of gay men, lesbians, bisexuals, and heterosexuals (Burdge, 2007; Goodrum, 2000).