Transgenderism has been a frequently discussed topic over the past few weeks. On May 30, the U.S. Department of Health and Human Services review board ruled that Medicare can pay for the “reassignment” surgery sought by the transgendered. A few days later Time magazine’s cover story on the “transgender tipping point” declared the social movement is “poised to challenge deeply held cultural beliefs.” And last week the Southern Baptist Convention, America’s largest Protestant denomination, overwhelmingly passed a resolution titled “On Transgender Identity.” Since the topic will be coming up for some time to come, here are nine things you should know about transgenderism.
1. Transgenderism is an umbrella term for the state or condition of identifying or expressing a gender identity that does not match a person’s physical/genetic sex. Transgender is independent of sexual orientation, and those who self-identify as transgender may consider themselves to be heterosexual, homosexual, bisexual, pansexual, polysexual, or asexual. Approximately 700,000 individuals in the U.S. identify as transgender.
2. Transgenderism differs from intersex, a variation in sex characteristics including chromosomes, gonads, or genitals that do not allow an individual to be distinctly identified as male or female. Intersex is a physical condition while transgender is a psychological condition. The vast majority of people with intersex conditions identify as male or female rather than transgender or transsexual. (The term “hermaphrodite” is now considered outdated, inaccurate, and offensive as a reference to people who are intersex.)
3. The terms transgender, transsexual, and transvestite are not synonymous. Transsexual is a narrower term used to refer to people who identify as the opposite of their birth gender designation, regardless of whether they have undergone or intend to undergo hormone replacement therapy and/or sex reassignment surgery. A transvestite is a person who cross-dresses, or dresses in clothes of the opposite sex, though they may not identify with, or want to be the opposite gender. All transexuals are transgender, but transvestites do not necessarily fall into either of the other categories.
4. The LGBTQIA community considers gender to be a trait that exists along a continuum. Transgenders can thus be bigender (move between feminine and masculine gender-typed behavior depending on context), trigender (shifting between male, female, and a third gender), pangender (all genders at once), genderqueer (a catchall for people who consider themselves any of the subsets of transgender, such as genderless, pangender, etc.).
5. The term cisgender is used to refer to individuals who have a match between the gender they were assigned at birth, their bodies, and their personal identity. Cisgender is often used within the LGBTQIA community to refer to people who are not transgender.
6. In the 1960s Johns Hopkins University became the first American medical center to offer “sex-reassignment surgery.” But they later stopped performing the procedure after a study on transgendered people in the 1970s. The study compared the outcomes of transgendered people who had the surgery with the outcomes of those who did not. Most of the surgically treated patients described themselves as “satisfied” by the results, but their subsequent psycho-social adjustments were no better than those who didn’t have the surgery. As Dr. McHugh, former psychiatrist in chief at Johns Hopkins Hospital, explains, “at Hopkins we stopped doing sex-reassignment surgery, since producing a “satisfied” but still troubled patient seemed an inadequate reason for surgically amputating normal organs.”
7. When children who reported transgender feelings were tracked without medical or surgical treatment at both Vanderbilt University and London’s Portman Clinic, 70-80 percent of them spontaneously lost those feelings. Some 25 percent did have persisting feelings, notes Dr. McHugh, but what differentiates those individuals remains to be discerned. Despite such studies several states—including California, New Jersey and Massachusetts—have passed laws barring psychiatrists, even with parental permission, from striving to restore natural gender feelings to a transgender minor.
8. A 2011 study at the Karolinska Institute in Sweden followed 324 people who had sex-reassignment surgery (191 male-to-females, 133 female-to-males) from 1973 to 2003. The overall rate of death was higher than expected, with suicide being the leading cause. Those who had the sex-change surgery were almost 20 times more likely to take their own lives than the non-transgender population. They were also more likely to seek in-house treatment for psychiatric conditions.
9. At the heart of the problem is confusion over the nature of the transgendered, says McHugh. “’Sex change’ is biologically impossible,” he adds. “People who undergo sex-reassignment surgery do not change from men to women or vice versa. Rather, they become feminized men or masculinized women. Claiming that this is civil-rights matter and encouraging surgical intervention is in reality to collaborate with and promote a mental disorder.”