Talk:Transsexual

Kindly remember to put new topics at the end of the page, not the top.

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Psychological treatment

i velive this section rarely contains information about the actuall process. It would be great to have some references from a medical aspect here. besides that, great article! 88.73.249.4 (talk) 23:07, 23 January 2008 (UTC) aep

Diagnosis

This section is unclear. If you use the medical model of diagnosis, as a minimum I would recommend giving some "gold standards" for diagnosis, with statements such as "People with HBS must have..." or "People who ... definitely do not have Harry Benjamin Syndrome" I realize that this is difficult if there is no common anatomic, genetic, or biochemical characteristics, or are there? There is an assertion that the brains of Harry Bejamin Syndrome individuals are different. Can you provide referrences to what these differences are, with PMID numbers?75.5.228.202 22:52, 26 September 2007 (UTC)

SusannaBoudrie: "The psycho-patologization of transsexualism by APA and WHO (ICD10) is unfounded. The condition is somatic, but (still) not diagnosable in live humans. Hence even their own manuals make this an auto-diagnose; not validated in itself, only validated not being another (sic!) mental disorder." SusannaBoudrie (talk) 04:10, 5 February 2008 (UTC) —Preceding unsigned comment added by Voyagerfan5761 (talk • contribs)

SusannaBoudrie: "According to numerous researchers transsexualism is hard-wired in the brain during the development of the hypothalamus. People with Transsexualism men and women desire to become men and women in all respects, by physical alterations of their sexual gonads sexual reassignment surgery and by Hormone replacement therapy. The entire process of switching from one sex to the other is referred to as transition, and usually takes several years. This treatment resolves the transsexualism, and post-treatment we are talking about Men-born with-transsexualism [MBT] and Women-born with-Transsexualism [WBT]" SusannaBoudrie (talk) 04:18, 5 February 2008 (UTC)

Adding Smith vs. City of Salem to Employment issues sections

Recently, the court case of Smith vs. Salem took place in the sixth circuit court. This case used a supreme court ruling to extend the definition of sex into the realm of gender, and with it include transgender as a protected class. I think this has merit for inclusion in the employment issues section. What do you think? Link to the opinion:[1]. This is another useful document: [2] LexieM 01:54, 6 February 2007 (UTC)

it's an interesting read, and is actually already covered by Legal aspects of transsexualism. Reading the brief, it does not actually seem as if they have extended any recognition to transsexuals as their target gender, but rather that discriminating against someone for not following the stereotypes provided for their gender is inappropriate, and the document refers to Smith throughout as a "male", albeit as an identified "transsexual", and "medically diagnosed with Gender Identity Disorder". Now, what this does do is create a rock and a hard place for employers (who are subject to Title VII) regarding dismissing a transsexual. The employer cannot dismiss a transsexual as their original gender for expressing themselves as their gender of identity, but it's pretty certain that they wouldn't be able to dismiss a transsexual as their gender of identity, because if they had the job before, then they were qualified for the job, and the only thing that has changed is their sex. Thus, if a employer were to attempt to dismiss them simply for assuming the new gender, they would be by definition firing someone based on their sex. So, I rather see this decision as a boon to transgendered people who are not intending on altering their legal gender, and as protection for transgendered people who are intending on changing their legal gender, but have yet to do so. In many cases though, the courts rulings on what a person's legal gender is can vary from state to state, from courthouse to courthouse and from judge to judge. --Puellanivis 18:12, 6 February 2007 (UTC)

The Legal aspects of transsexualism article should be liked to in the Employment Issues section as it contains much more information. But do you think we should make specific reference to Smith vs. Salem in this article because of its importance as the only decision on the US federal level that possibly offers protection? LexieM 01:08, 7 February 2007 (UTC)

That sounds certainly reasonable. Please feel free to work up a short mention of the protection that it offers us, and then either post it here, or post it into the article. You can leave it with "for more information see Legal aspects of transsexualism" or something like that. I think it would certainly be helpful information. --Puellanivis 07:21, 7 February 2007 (UTC)

the "Coming Out" Section

A noticable problem with the current page is the "Coming Out" section, which is currently empty. Although there is already a page on coming out it deals only briefly with transsexuals.

I suggest this section include:

• Coming out Process
• Stages of Coming out
  • To Health Care Proffessionals
  • To Family
  • To Friends / Socially
  • To employers / At work
• Legal steps in coming out
  • Changing name
  • Changing identity documents
  • Legal recognition

Although now that i look at my own list, it may require it's own article, with references to transsexualism, Legal_aspects_of_transsexualism, and external references.

Lwollert 11:22, 12 February 2007 (UTC)

History of transsexuality

Is there any interest in making a section on the ancient and recent history of transsexuality? I.E.

• Certain ancient greecian temples where men dressed and acted exclusively as women
• Eunuch culture and transsexuality
• Berdache culture in North america
• Harry Benjamin and his contribution to the modern treatment and diagnosis of transsexuals
• the near-infamous Christine Jorgensen who brought transsexualism to popular cultre in the united states
• Renee Richards' challenge against United States Tennis Association in 1976, which helped bring about anti-discrimination rulings, and introduced transsexual women into sport
• The recent ruling, pre-Athens Olympics, by the IOC that transsexuals could compete in the olympics
• the various other legal milestones in regards to marriage, adoption, and the like.

Cheers, Lwollert 02:01, 15 February 2007 (UTC)

Legal milestones may be more appropriate for the Legal aspects of transsexualism. As far as the Olympics is concerned, the full accurate history should be given that they attempted to identify gender based on genetics, and thus invalidated a number of women who are XY female (not just transsexuals). The recent ruling that changed this was that a woman would be allowed to compete in the women's competitions as long as her hormone levels were feminine, and not masculine, thus determining that "doping" by internal production of steroids in the female competitions is against the rules. This allows transsexuals essentially as a side-effect to allowing intersexed females, but it is not sufficient for a person to simply identify as transexual, they need to be physically appropriate to the competition. --Puellanivis 02:13, 15 February 2007 (UTC)

Fair enough; Any comments on the other suggestions, though?

Link for sport in the UK; Includes IOC regulations [3]. Interestingly, www.olympic.org doesn't have the guidelines set out there, merely an explanatory statement. Apparently it's been called the "Stockholm Consensus". And although the consideration was made in light of the review of Gender testing procedures, the consensus on transsexuals took place four years after the scrapping of the old tests [4] and is specifically in regards to transsexuals.

Cheers, Lwollert 00:14, 21 February 2007 (UTC)

Verification - Terminology

My proposition is that the following section from "Terminology" should be changed.

"Harry Benjamin agreed with German sexologist Magnus Hirschfeld [2]that transsexuals were a form of neurological intersex. [3]Hirschfeld coined the terms the terms "Transvestite" and "Transsexual, and in 1930 supervised the first known sex reassignment surgery on Lili Elbe [4]of Denmark."

Just double-checking my facts, but AFAIK Hirschfield coined did not coin either "transvestite" or "transsexual" - The former Coined the term in German - "Die Transvestitien" (1910) in his seminal work on the issue, and was describing what is now known as Transsexuals. The term was translated into English and used to talk about Gender dysphoria as well as what we now know as Transvestic fetishism.

Harry Benjamin actually coined the term "Transsexual" in his work, (Benjamin, 1953) which culminated with "The Transsexual Phenomenon" in 1966. Gender Dysphoria as a term was not used until about the 1970s, and was used as a term to encompass a wide range of individuals with gender discomfort. (Fisk, 1974, Laub and Fisk, 1974)

"Gender Identity Disorder" Was a term created in the DSM-III in regards to transsexuals, and the categories were "GID/Childrem Transsexualism"; "GID/Adolescent and Adult, Non-transsexual type" and "GID/Not Otherwise Specified". Notably, this did not address Late-onset transsexualism, where patients may not have had symptoms as children. Interestingly, in the major revision of the DSM, DSM-III-R, It was placed in the category "Disorders Usually First Evident in Infancy, Childhood or Adolescence". The problem was that it got lost here, as well as the issue of adult onset explained above

In the DSM-IV-TR, the current version, GID is placed in the category of Sexual Disorders, with the subcategory of Gender Identity Disorders. This is perhaps distasteful to transsexual people, as it is right next to transvestitic fetishism, Pedophilia, Fetishism, Orgasmic, Arousal and Erection disorders, and other similar categories. The disorder names were changed to "Gender Identity Disorder in Children", "Gender Identity Disorder in Adolescents or Adults", and "Gender Identity Disorder NOS".

Additionally, Both the DSM-III and DSM-IV differentiate based on sexual attraction. In the DM-III, the terms "Homosexual", "Heterosexual", and "Asexual" were used - with quite a bit of confusion (Pauly, 1992). Currently the terms "Attracted to males", "Attracted to Females", "Attracted to Both" and "Attracted to neither" are used in the DSM-IV-TR.

References:

• American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders 3rd ed. A.P.A.: Washington D.C.
• American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders 3rd ed., revised A.P.A.: Washington D.C.
• Benjamin, H. (1953). Transvestism and Transsexualism. International Journal of Sexlogy, 7, 12-14
• Benjamin, H. (1966). The Transsexual Phenomenon. Julian Press: New York
• Fisk, N (1974) Gender Dysphoria Syndrome. In D. Laub & P. Gandy (Eds.) Proceedings of the Second Interdisciplinary Symposium on Gender Dysphoria Syndrome. Ann Harbour: Edwards Brothers, 7-14
• Laub, D. and Fisk, N. (1974) A rehabilitation program for gender dysphoria syndrome by surgical sex change. Plastics and reconstructive surgery, 53, 338-403
• Pauly, I. (1992) Terminology and Classification of Gender Identity Disorders. Journal od psychology & human sexuality, volume 5, number 4, 1992

Cheers, Lwollert 21:09, 21 February 2007 (UTC)

An important point...

I would like to see some reference to the viewpoint brought up by, for example, Kate Bornstein in "Gender Outlaw" which is that transsexual people may not always feel the necessity for sex reassignment operations (especially, conscious of their possible complications and general uncertainty of the outcome) or indeed strongly dislike their body/genitals (except perhaps for the reason that society does not accept their body to be of the sex or gender that they feel they represent). She proposes the division to pre- and postoperative transsexuals be given up. English is not my first language and I am not certain I know enough on the topic to do this myself, but I'm hoping perhaps there is someone else interested in this aspect and willing to contribute? Shadowcrow 20:50, 11 March 2007 (UTC)

Hmmm.... Kate bornstein is an interesting writer, and she does have some strong opinions.

Part of her argument is that there should be no male/female gender division, and that transsexuals are giving into medical and social structures when they ascribe to the medical process.

The problem is, to subscribe to the medical process, and be diagnosed as transsexuals, they need to have strong cross-gender identification, not just "agender" identification - and additionally, they have to desire surgery, else they don't fit the medical defenition of transsexualism (as in the DSM-IV-TR or ICD-10, anyway).

I think there should be a small section on this, but it does not represent the majority of transsexuals. A more appropriate place to put it would perhaps be transgender rather than transsexualism.

As a side-note, her (Kate Bornstein's} theory is quite similar (perhaps disturbingly so) to Janice Raymond's hypothesis about transsexualism. Both are strongly criticised by some, including Patrick Califia, who I've referenced on a couple of pages now.

Cheers! Lauren^♫/∆ 04:20, 12 March 2007 (UTC)

I believe there already exists the prefix "non-op" to counter "pre-op" and "post-op". Maybe this is mostly restricted to areas where transsexuality is well accepted, like Seattle. But I've already heard it fairly commonly in use. I personally couldn't imagine being non-op... and all of my non-trans female friends probably would agree with me that I'm not "raping" their bodies as Janice Raymond would put it... to them it's entirely naturally that I'm female. I would however argue that there are transsexuals out there who this would describe, but then there are men out there who physically rape women. As with anything, categorizing any group of people and giving a generic reason for their motives, just isn't appropriate, or justified. Sorry to get on a person-ish rant here. But I really just wanted to point out that there are non-op transsexuals out there. And they receive the same treatment all of the other transsexuals do. --Puellanivis 05:57, 12 March 2007 (UTC)

My apologies if I left out aknowledging the non-op transsexuals - I certainly know they exist. I don't dispute that these people are transsexual, or should be labeled otherwise - instead I hoped to include them (although I seem to have failed :) ). My main point in relation to them is that they don't fit the medical definition if they don't desire surgery - but you can be non-op and still desire surgery, or non-op and not desire surgery.

Absolutely non-op individuals need and hopefully recieve medical support - usually under a slightly different diagnosis. And I support them in their right to decide how they want to live, whether or not I would make that choice in the first place.

Most of my objection was supposed to be aimed at the argument by Bornstein that anyone who wants an operation is giving in to a medical diagnosis, and all transsexuals should instead be "gender outlaws" - that none of us should want bottom surgery, and we should all be non-op. It's that that I object to and believe is a view held by a minority of transsexuals, but perhaps describes more people who are transgendered.

Sorry for any accidental offense. Cheers! Lauren^♫/∆ 05:24, 26 March 2007 (UTC)

Oh, I understand better now. That makes more sense. ... Yeah, I just can't agree with that at all. I'm sorry, but I have more than just "preference" for why I want "bottom surgery". Well, first of all, it would be nice to be able to stop taking anti-androgens. Second of all, it's extremely uncomfortable for me. I know an FTM to was talking to the list about how he was very happy to be getting his top surgery done, because during the summers it caused him a great deal of discomfort to bind himself during the summer. I can typically identify with this issue, but instead of being top issues, it's bottom issues. If I'm uncomfortable with something, I'm going to get it taken care of, and I'm not going to let some ideological reasoning stop me from getting that surgery. My ideological reasons don't confront me in the shower, and on the toilet, and it doesn't rub and chafe me in the summer. I can work with the process and still seek to have issues addressed for a better process for following people. I don't expect the world to be perfect for me, but I do hope that I leave it better for those who follow than I had it. --Puellanivis 06:15, 26 March 2007 (UTC)

Hear, Hear, Easy Access to Surgery To Eventually Reduce Chafing! (Tounge-in cheek, I agree totally.) Cheers! Lauren^♫/∆ 00:05, 2 April 2007 (UTC)

Citation dispute

There is an error in this article. In her latest interview, Renee Richards denies any regret regarding her SRS. From the Reuter's article on Feb 18 2007 (written by Belinda Goldsmith) "Richards, now 72 and without a partner, said she does not regret the sex change operation at the age of 40 -- although she might have liked to have gone through the process a bit earlier -- but she does have misgivings about her notoriety. "I made the fateful decision to go and fight the legal battle to be able to play as a woman and stay in the public eye and become this symbol," Richards, an ophthalmologist, told Reuters in an interview in her Manhattan offices. "I could have gone back to my office and just carried on with my life and the notoriety would have died down. I would have been able to resume the semblance of a normal life. I could have lived a more private life but I chose not to. "I have misgivings about that. I am nostalgic about what would have happened if I had done it the other way," said the 6-foot-2-inch tall Richards with an unmistakable air of sadness as she folds her man-sized hands in her lap." This aspect of the article should be corrected

Certainly Renee Richards is quoted in the lynn connway site as experiencing regret, and cites a newspaper article. If you read her book, Renee certainly had a lot of co-morbidities when she transitioned, including fairly severe depression.

I think if you can cite the newspaper article (a link, perhaps?) we sould definately change the article.

Cheers! Lauren^♫/∆ 07:25, 21 March 2007 (UTC)

I believe that Dr. Richards has published a second book - I'll try and get my hands on it ( Richards, Renee; Ames, John (2007), No Way Renee: The Second Half of My Notorious Life (Hardcover), Simon & Schuster, ISBN 978-0743290135 )

Guardian article

The in-text citations from the guardian article don't reference the study itself, and furthermore some of the quotations are taken out of context. ( The original report's finding is avilable here: http://www.arif.bham.ac.uk/requests/g/genderreass.htm#3 )

Note that the report says that the uncertainties are too large to form a conclusion, it certainly does NOT say that there is no evidence ( in contrast to the guardian article ). It also states:

"The points above, by raising significant problems in the conduct of much of the research claiming to show that gender reassignment surgery is beneficial, suggests that the true conclusion from the available research is that we genuinely cannot be certain about what its effects are. A systematic review could help reduce this uncertainty, but because of the flawed nature of the majority of the research it is likely that the only way to reduce the level of uncertainty is to undertake more research using more rigorous designs with a control group, ideally randomly assigned, and blind independent assessment of outcomes (Abramowitz SI, 1986)."

In other words, the report simply says the research on the matter is insufficient to form a conclusion. It certainly doesn't say that there has been no signs suggesting it is beneficial ( which is what the wiki article currently claims ).

Furthermore, the review itself comes with a disclaimer: " The information is only a very brief summary of that available at the time. It was primarily designed to give readers a starting point to consider research evidence in a particular area. Readers should not use the comments made in isolation and should read the literature suggested. Readers should also be aware that more appropriate evidence may have become available since the request was undertaken. ARIF does not routinely update the advice on these pages."

ALl in all, given the above discrepancies between the guardian article and the disclaimer provided in the review, I really don't think it is a good source and basing almost half the section on it is probably not justified. I would much rather see a reference to a more official statement made by an official organisation. The Guardian is a newspaper, known to be sensationalist, and I think it is fairly obvious that the current bit that is in there is probably not a very good representation of the general opinions of experts in the field. I'd say it should go. J.Ring 11:56, 2 April 2007 (UTC)

Hmm. It does sem a bit misplaced, doesn't it?

I think a more accurate description of effectiveness would be that there is insufficient evidence to state clearly that there is a benefit, however current studies show some positive outcomes and possible reduction in healthcare costs after SRS/SAS/GRS (pick your TLA of choice). Additionally, social indicators showed an increase in social function, and psychoneurotic index scores show lowered levels of anxiety. Methodologicaly, however, the studies thus far are unsuitable to giving precice estimates of benefit. (The Wessex Institute for Health Research and Development. Surgical gender reassignment for male to female transsexual people. 1998:25. Southampton: Wessex Institute for Health Research and Development [5])

Shall we replace it? (the above link is a structured review artice, so level 2 or 3 evidence)

Cheers! Lauren^♫/∆ 23:45, 2 April 2007 (UTC)

Not the same as TG

All true-TSs, by definition want SRS and to correct their social role. Failing that, you are a transgender man who pretends he is a "TS" or a "woman," not an actual TS. TSs get surgery, TGs don't. MtF TSs are women, MtF TGs are MEN. Please do not confuse TSs with TGs nor any other type of LGBT. --75.177.39.22 (talk) 07:20, 31 January 2008 (UTC)

Hi, although what you say is probably true to your experience it's not to all. There is plenty of room in all the definitions for some variations. Many in the trans community also purposefully avoid labels. If you have a verifiable reliable source that asserts your POV perhaps posting it here so others can be swayed would be helpful. Benjiboi 12:01, 31 January 2008 (UTC)

Indeed, it's far from that black-and-white. Being transgendered isn't necessarily a "fetish," nor would most transwomen appreciate being called "men"... they're very much imprecise umbrella terms, that both refer to a spectrum of diverse gender identities with similar though slightly different connotations. krimpet✽ 11:46, 4 February 2008 (UTC)

SusannaBoudrie: Transgenderism differs from transsexualism in that the former is an urge to be "trans" and not to become men and women. For People with Transgenderism, including transvestism and different kinds of queerism, it is sufficient to take on the social role (gender) of the opposite sex." The inclusion of transsexualism under transgenderism is considered abusive and cissexual colonizing by most people with transsexualism or those with a born with transsexualism. SusannaBoudrie (talk) 04:15, 5 February 2008 (UTC)

Because Wiki’s contributors are predominantly Americans this page doesn't reflect the cultural differences between American trans community and the British trans community. For many reasons Transgender is the generally accepted broad brush description used in the United States to be inclusive of everything from GID sufferers to Drag Queens, In Britain it the phrase Transgender is more akin to an insult because it implies rejection of your gender identity being neither one not the other. In Britain the term transsexual is appropriate because it defines who is seeking gender reassignment, common enough due to free health care, and are protected by the law against employment discrimination and hate crimes these are transsexual. And those men who simply cross dress as a hobby and don’t want surgery or change their name or will devoice and apply for a new birth certificate as per the UK’s Gender Recognition Act. These guys are transvestites and in the UK the two are quite distinct groups.

Claire Eastwood: