- Transsexual sexuality
Characterizing a transsexual person as
heterosexualor homosexualis problematic. Historically, clinicians labeled transsexual people as heterosexual or homosexual relative to their birth sex, but most transsexual people find this offensive and define their sexual orientationrelative to self-defined gender identity. For example, a transwomanattracted to other women would self-identify as a lesbian, not as a heterosexual man. To avoid confusion and offense, the terms gynephilia(attraction to women) and androphilia(attraction to men) have been proposed.
Richard Green notes that though cross-gender identity has existed throughout history, "the term 'transsexual,' being of comparatively recent origin, cannot be found in historical sources."Green R (1966) [http://www.symposion.com/ijt/benjamin/appendix_c.htm Transsexualism: Mythological, Historical, and Cross-Cultiral Aspects.] in Benjamin H, "The Transsexual Phenomenon." Julian Press ASIN B0007HXA76]
Transsexual people exhibit the full range of possible sexual orientations and interests,Tobin HJ (2003). [http://www.geocities.com/harperjeantobin/Thesis1.htm Sexuality in Transsexual and Transgender Individuals Part I: A Review of the Literature.] ] including a lack of interest in sex.Devor H (1997). "FTM: Female-to-Male Transsexuals in Society." Bloomington: Indiana University Press. ISBN 0-253-21259-6] Some maintain a consistent orientation throughout their lives,Ashley A, Thompson D (1986). "The First Lady." John Blake Publishing, ISBN 1-84454-231-9] Cossey C (1992). "My Story". Faber & Faber, ISBN 0-571-16251-7] in some cases even remaining with the same partner through transition.Boylan JF (2003). "She's Not There: A Life in Two Genders." Broadway ISBN 0-7679-1404-X] In other cases, their choices in sexual partners may change after transition.Daskalos CD (1998). Changes in the Sexual Orientation of Six Heterosexual Male-to-Female Transsexuals. "
Archives of Sexual Behavior" 6:605-614.]
Taxonomies based on sexuality
Magnus Hirschfeldfirst suggested a distinction based on sexual orientation.Hirschfeld M (1923). Die intersexuelle Konstitution. "Jarhbuch fuer sexuelle Zwischenstufen". 1923: 3-27] A number of two-type taxonomies based on transsexual sexuality have subsequently been proposed by clinicians, though some clinicians believe that other factors are more clinically useful categories, or that two types are insufficient.Doctor RF, Fleming JS (2001). Measures of Transgender Behavior. " Archives of Sexual Behavior" Volume 30, Number 3 / June, 2001]
Harry Benjaminwas a pioneer in medical services for transsexual people. He proposed the Benjamin Scalein 1966 as an early attempt to categorize transsexuals based on his observations. The scale was based on the Kinsey scalecreated by sexologist Alfred Kinsey. Where Kinsey's scale is a continuum between exclusively heterosexual and exclusively homosexual, Benjamin's scale is a continuum between transvestismand transsexualism. This system has six grades of transsexual from "Pseudo-transvestite" at level 1, to a "True Transsexual (High Intensity)" at level 6.Benjamin (1966). " [http://www.symposion.com/ijt/benjamin/chap_02.htm Benjamin Scale] ]
Following Benjamin, Buhrich and McConaghy proposed three clinically discrete categories of fetishistic transvestism: "nuclear" transvestites who were satisfied with cross-dressing, "marginal" transvestites who also desired feminization by hormones or surgical intervention, and "fetishistic transsexuals," who had shown fetishistic arousal but who identified as transsexuals and sought sex reassignment surgery.Buhrish N, McConaghy N (1979). Three clinically discrete categories of fetishistic transvestism. "Archives of Sexual Behavior" Volume 8, Number 2 / March, 1979.]
Person and Ovesey proposed the terms primary versus secondary transsexualism. They defined primary transsexuals as asexual persons with little or no interest in partnered sexual activity and with no history of sexual arousal to cross-dressing or cross-gender fantasy.Person E, Ovesey L (1974). The transsexual syndrome in males. I. Primary transsexualism. "American Journal of Psychotherapy", 28, 4-20.] They defined both homosexual and transvestic transsexuals to be secondary transsexuals.Person E, Ovesey L (1974b). The transsexual syndrome in males. II. Secondary transsexualism. "American Journal of Psychotherapy", 28, 174-193.] Later uses of this terminology often defined primary transsexualism as attracted to males, and secondary transsexualism as attracted to females.
McConahay and McConahay reported that transsexual people have more heterosexual than homosexual experiences. McConahay SA, McConahay JB (1977). Sexual permissiveness, sexrole rigidity and violence across cultures. ‘’Journal of Social Issues’’ 33: 134-143.] According to two published reports, about half of male-to-female transsexuals had sexual intercourse with females.Randell JB (1959). Transvestism and transsexualism. A study of 50 cases. ‘’British Medical Journal’’ 2:1448.] Roth M, Ball JRB (1964). Psychiatric aspects of intersexuality. ‘’Intersexuality In Vertebrates Including Man’’, Armstrong CN, Marschall AJ (eds.), New York, p. 395. ISBN 0-12-063150-4] Bentler found an almost equal distribution of 42 male-to-female studied transsexuals between three distinct categories: homosexual, asexual, and heterosexual.Bentler PM (1976). A typology of transsexualism: Gender identity theory and data. Arch. Sex. Behav. 5: 567-583.] Leavitt and Berger claim "By far, the majority of males seeking reassignment are attracted to males."Leavitt F, Berger JC (1990). Clinical patterns among male transsexual candidates with erotic interest in males. "
Archives of Sexual Behavior" Volume 19, Number 5 / October, 1990] In the same study, Leavitt and Berger found that "those patients who derived erotic pleasure from their penis were more likely to be emotionally unstable, and less likely to have switched to full-time living as women, suggesting that clinicians may be dealing with different disorders that require separate explanations." Hoenig and Kenna reported that most transsexuals masturbate.Hoenig, J., and Kenna, J. C. (1974). The nosological position of transsexualism. Arch. Sex. Behav. 3: 273-287.] In a study with 44 subjects, Langevin reported 88% allowed a male partner to touch their penis, 29% received fellatio, and 2% performed anal sex.Langevin, R., Paitich, D., and Steiner, B. (1977). The clinical profile of male transsexuals living as females vs. those living as males. "Archives of Sexual Behavior" 6: 143-153.] Stoller claimed that erotic pleasure in the penis does not exist in the true transsexual.Stoller RJ (1973). Male transsexualism: Uneasiness. "American Journal of Psychiatry" 130: 536-539.]
Diagnostic and Statistical Manual of Mental Disorders
In the United States, the "
Diagnostic and Statistical Manual of Mental Disorders" is the primary reference in psychology. The DSM has employed several diagnostic categories since its inception. After the DSM removed homosexuality as a mental illness in 1973, several other diagnoses were used, including ego-dystonic homosexuality.
In DSM-IIIR "Transsexualism" was a disorder classified under "Disorders usually first evident in infancy, childhood, and adolescence." DSM-IIIR also listed "Gender identity disorder, adolescence or adulthood, non-transsexual type" (GIDAANT).]
The 2000 edition reflects current accepted terminology,
gender identity disorder(GID). It also has differential diagnosisfor children and GID "not otherwise specified." The DSM also has a diagnosis of transvestic fetishism.American Psychological Association (APA)(2000)" [http://www.mhsanctuary.com/gender/dsm.htm Gender Identity Disorder in DSM IV TR.] ] Some therapists and activists seek to depathologize some or all of these categories in future revisions.
Cultural differences in transsexual sexuality
Sexual behavior and
gender roles vary by culture, which has an effect on the place of gender variant people in that culture. In most cultures, transsexual people are stigmatized, and sexual activity involving transsexuals is considered shameful, especially in cultures with rigid sex roles or strictures against non-heterosexual sex. In many cultures, transsexual people (especially transwomen) are frequently relegated to sex work.
In the United States,
African American transsexualityand Hispanic Transsexualityoccur in a cultures with significant levels of machismoand homophobia. Spanish languagefurther adds to the stigmatization of gender variant people through the use of grammatical gender. In these cultures, a distinction is sometimes made between active and passive sexual activity, where the passive or receiving partner is not considered masculine or straight, but the active partner is.Southern Arizona Gender Alliance Gender Identity 101: A Transgender Primer. [http://sagatucson.org/saga/index.php?option=com_content&task=view&id=42&Itemid=94] ] Some observers question the racist assumptions behind clinical literature on transsexual sexuality in various ethnic groups.Trans-Health:Trans people: are we nuts? "Schizophrenia and Racist Assumptions". [http://www.trans-health.com/displayarticle.php?aid=38] ]
Asian countries, notably
Thailand, have a more socially tolerant view of transsexual sexuality, but the legal status of transsexual people in many Asian countries does not allow for marriage. The Thai kathoeyand South Asian Hijra (South Asia)often seek feminizing surgical procedures, but these can range from orchiectomyto penectomywithout vaginoplasty.
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