Alexander John Goodrum (2000) wrote an informative article on transsexualism and transgenderism in which he discussed how people should communicate or interact with individuals with variant gender identities and/or behaviors. We summarize his suggestions as follows:
■ It is important to refer to transsexual or transgendered individuals appropriately. If someone identifies himself as male, refer to him as he; if she identifies herself as female, refer to her as she. If you are not sure, it is all right to ask what this person prefers or expects. Once you know, try to be consistent. If you occasionally forget and use the wrong pronoun, make the correction. Most transsexual or transgendered people will understand slipups and appreciate your efforts.
■ Never "out" someone by telling others, without permission, that he or she is transsexual or transgendered. Furthermore, do not assume that other people
know about a person’s variant gender identity. Many transgendered and transsexual individuals pass very well, and the only way others would know about their variant gender status would be by being told. Clearly, the decision whether to communicate gender status should be made only by the individual, and failure to honor this right would be highly disrespectful.
■ Common sense and good taste mandate that we never ask transsexual or transgendered people what their genital anatomy looks like or how they relate sexually to others.
■ Finally, make no assumptions about whether a person has a homosexual, bisexual, or heterosexual orientation. A person who believes that it is appropriate to reveal information about sexual orientation may elect to communicate this to you.
this condition. Keeping this debate in mind, we will summarize the tenuous state of knowledge about this highly unusual variant gender identity.
Etiology
Many theories have tried to explain transsexualism, but the evidence is inconclusive (Cole et al., 2000; Money, 1994a). Some writers maintain that biological factors play a decisive role. One theory suggests that prenatal exposure to inappropriate amounts of hormones of the other sex causes improper brain differentiation (Dessens et al., 1999; Zhou et al., 1995). Some evidence indicates that in transsexuals, sexual differentiation of the brain and the genitals occurs discordantly (Krujiver et al., 2000; Meyer-Bahlburg, 2005). Support for this interpretation was recently provided by an Australian study that reported evidence of a possible genetic link with transsexualism (Hare et al., 2009). The investigators conducted a DNA analysis of 112 male-to-female transsexuals with a longer-than-normal version of the androgen receptor gene. Longer versions of this gene are associated with less efficient prenatal production of testosterone. Reduction in the action of this hormone may have an effect on gender development in the womb by under-masculinizing the brain during prenatal development, thereby contributing to the female gender identity of male-to-female transsexuals. Other research has found evidence of genetic factors in transsexuals (Bentz et al., 2008; Hare et al., 2009).
It has also been suggested that transsexualism can be induced by abnormal levels of adult sex hormones. However, this explanation is contradicted by numerous indications that sex hormone levels are normal in adult transsexuals (Zhou et al., 1995).
Another theory, which has some supporting evidence, holds that social-learning experiences contribute significantly to the development of transsexualism. A child may be exposed to a variety of conditioning experiences that support behaving in a manner traditionally attributed to the other sex (Bradley & Zucker, 1997; Cohen-Kettenis & Gooren, 1999). Such cross-gender behaviors may be so exclusively rewarded that it may be difficult or impossible for the individual to develop the appropriate gender identity.
Gender Issues