WHAT IS NOT GID?
The terms which
follow on this page are NOT part of the
clinical diagnostic classifications in neither the DSM-IV
nor ICD-10. While GID likely does encompass many, if not all, of the
classifications on this page, they are not widely accepted as clinical
terminology, if at all. To see the exact clinical defintions read the
"WHAT IS GID?" page.
Transgender
This is a colloquial
term that emerged relatively recently. The exact meaning of the word
is a subject of debate. The
coining of the term is usually attributed to Charles "Virginia"
Prince, a "full time" male to female crossdresser (meaning
he wished to present himself dressed as a woman but not become physically
female). However, the specific reference to first usage remains elusive.
If you read Issue 60 of The TV/TS Tapestry, you'll see a
letter from Prince promoting the term "Bigendered". That
was 1991, and the term "transgender" apparently hadn't yet
been proposed.
Prince wrote:
... Now
I think it is time and necessary to generate a new and acceptable
term for us.
I say necessary
because there is an aspect of this terminology problem that has
not been given much consideration, but which is vitally important,
and that is the public perception of whatever term is used. Whether
we like it or not, the public needs to have a descriptive term which
they can easily understand and use, which is also acceptable to
members of our community. We are not like alcoholics, drug abusers,
criminals, voyeurs, pederasts, schizophrenics, epileptics, or a
million other types of people. Therefore, we need a handle by which
others can comfortably refere to us, distinguish us from other types
of people, and which is positive and not condemnatory.
"Bigendered,"
while still in use in some circles, never had the wide acceptance
of "transgendered" but the belief is that Prince's intentions
were the same - to coin a word that would distinguish full-time crossdressers
like himself from transsexuals (and other groups). If true, it is
rather ironic because the term "transgender" is now generally
accepted as an "umbrella term" encompassing ALL contrasexual
presentations, identifications, and behaviors. It is the common-usage
equivelent of the medical classification "Gender Identity Disordered
/ Gender Dysphoric."
That being said,
in some places it remains more associated with transvestiticism while
in others it is now more associated with transsexualism. Some transsexuals
prefer it as a means to "de-sexualize" their condition as
the suffix "-gender" focuses attention on the subject of
GENDER whereas the suffix "-sexual" concentrates on SEX
- often perceived to mean sexual activity or orientation (in the same
vein as "heterosexual," "bisexual," or "homosexual.").
If
your intent is accuracy it may be wise to avoid applying the term
to anyone altogether unless they've already applied it to themselves,
and if you aren't sure what they mean by it, ask them before making
any assumptions.
Autogynephilia
This is a contraversial
THEORY about motivation for some contrasexual behavior. It
is not part of the official medical diagnostic criteria
and is mentioned here for informational purposes only. It is, however,
used for diagnostic purposes at the University of Toronto and the
affiliated Clarke Institute, where the theory was formulated. Other
than the Clarke Institute and a scattered few private therapists,
the theory has not been widely accepted by the Psychology Community.
The term autogynephilia
was coined in 1989 by Ray Blanchard, a clinical psychologist at the
Clarke Institute of Psychiatry in Toronto. Blanchard hypothesized
that there are two fundamentally different types of gender dysphoric
males: those who are exclusively or almost exclusively aroused by
men, i.e., who are androphilic ; and all the rest, who, as
it turns out, are primarily aroused by the idea of being women,
i.e., who are autogynephilic. Note that it says IDEA - which
means that a person could be unconflicted, never actually engaging
in any contrasexual behaviors, but could be aroused by the fantasy
of it.
Perhaps Blanchard
explained this motivation best when he wrote: "Autogynephilia
takes a variety of forms. Some men are most aroused sexually by the
idea of wearing women's clothes, and they are primarily interested
in wearing women's clothes. Some men are most aroused sexually by
the idea of having a woman's body, and they are most interested in
acquiring a woman's body. Viewed in this light, the desire for sex
reassignment surgery of the latter group appears as logical as the
desire of heterosexual men to marry wives, the desire of homosexual
men to establish permanent relationships with male partners, and perhaps
the desire of other paraphilic men to bond with their paraphilic objects
in ways no one has thought to observe."
DSM-IV Sexual
and Gender Identity Disorders: Paraphilias [defined as recurrent,
sexually arousing fantasies, sexual urges or behaviors generally
involving 1) non-human objects, 2) the suffering or humiliation
of oneself or one's partner, or 3) children or other non-consenting
persons.]
- 302.4
Exhibitionism
- 302.81
Fetishism
- 302.89
Frotteurism
- 302.2
Pedophilia
- 302.83
Sexual Masochism
- 302.84
Sexual Sadism
- 302.3
Transvestic Fetishism
- 302.82
Voyeurism
Strictly speaking,
though, if it is recurrent, sexually motivated fantasy, urges, or
behaviors regarding oneself it would be categorized as a "Paraphilia."
Notice that "Transvestic Fetishism" is also lumped into
this category. Please note that the Greek root "philia"
means "love or fondness," NOT "perversion!"
Blanchard's general
criteria to identify the presence of autogynephilia were something
like this: If the person is NOT a homosexual, did NOT have gender
conflicts early in life, and IS aroused by contrasexual fantasy, behavior,
or activities; the condition is found to be present. There
are also sub-classifications by type or arousal:
- from crossdressing
or from clothing of the opposite sex (transvestic)
- from acting
in a contrasexual manner or showing an interest in contrasexual
activities (behavioral)
- from fantasizing
about having physical attributes of the opposite sex (physiologic)
- and/or from
actually altering physical appearance to be more like that of the
opposite sex (anatomic)
Many transsexual
people despise this theory or are even offended by the sexualization
of their problem. Within the Transgender Community there are transsexual
people who assert that anyone who identifies as an autogynephile is
not really transsexual, but has some unrelated form of gender fetish
in the same way that a crossdresser is not the same as a transsexual,
many transsexuals argue an autogynephile is also distinct and different
from a transsexual. Autogynephiles have been described as "Men
trapped in men's bodies," a turn of phrase used to indicate they
are/were never psychologically female, even after they may have undergone
SRS to become phenotypically female. While this may be true for some
autogynephiles, there also appears to be subset of psychologically
female transsexuals (many lesbian in orientation) who, at some point,
acknowledge experiencing sexual attraction to themselves or arousal
from some "feminizing" process they've undergone. Some of
them simply accept this as "normal," while others worry
it somehow invalidates their identity as either a transsexual or a
woman. It should be noted, however, there are natal women who also
experience self-arousal or attraction so it isn't necessarily an experience
exclusive to fetishistic transsexual narcissists, though no studies
have been done to clinically identify the behavior in natal women
(or anyone other than non-adrophilic transsexual women), so there
is simply no way of knowing how "normal" or "unusual"
this sort of auto-erotic reaction may be within the general population.
If you really
want to know more about this theory, you might start by reading self-described
transsexual autogynephile and clinical Sexologist Dr. Anne Lawrence's
article HERE.
"Transgender"
Types
In 1966 Dr. Harry
Benjamin, an Endocrinologist who pioneered the standardized treatment
of transsexuals, published a scale to "type" transgendered
people. This was very similar to the scale developed by Dr. Alfred Kinsey
for categorizing sexual orientations.
The Kinsey
Scale of Sexual Orientations:
Type 0: Exclusively
heterosexual with no homosexual experience
Type 1: Predominantly heterosexual, only incidentally homosexual
Type 2: Predominantly heterosexual, but more than incidentally homosexual
Type 3: Equally heterosexual and homosexual
Type 4: Predominantly homosexual, but more than incidentally heterosexual
Type 5: Predominantly homosexual, but incidentally heterosexual
Type 6: Exclusively homosexual, with no heterosexual experience
The
Benjamin Sex Orientation Scale (S.O.S.) or Gender Identity
Scale
Sex and Gender Role Disorientation and Indecision (Males):
Type 0 - "Normal"
Type 1 - Transvestite - (Pseudo)
Type 2 - Transvestite - (Fetishistic)
Type 3 - Transvestite - (True)
Type 4 - Transsexual - (Non-Surgical)
Type 5 - True Transsexual - (Moderate Intensity)
Type 6 - True Transsexual - (High Intensity)
Please note that
this is Dr. Benjamin's ORIGINAL scale from 1966. The term "True
Transsexual" has since been dropped from the nomenclature. The
criteria for the "Modified Benjamin Scale" are as follows:
TYPE 0
Normal sexual orientation and identification, heterosexual, bisexual
or homosexual. The ideas of "dressing" or "sex change"
are foreign and unpleasant. Includes the vast majority of all people.
TYPE I - Tranvestite (Pseudo)
Gender "feeling" : Masculine
Dressing Habits and Social Life : Normal male life. May get
a "kick" from "dressing". Not truly TV.
Sex Object Choice and Sex Life : Usually heterosexual. Rare
bisexual. Masturbation with fetish. Feels guilt. "Purges"
and relapses.
Conversion Operation (SRS) : Not considered in reality.
Hormone Therapy/Estrogen Therapy : Not considered. / Not
indicated.
Psychotherapy :Not wanted. Unnecessary.
Remarks : Only a sporadic interest in "dressing".
Rarely has a female name when "dressed".
TYPE II - Transvestite (Fetishistic)
Gender "feeling" : Masculine
Dressing Habits and Social Life:
Lives as a man. Dresses periodically or part time. Dresses
under male clothes.
Sex Object Choice and Sex Life :Usually heterosexual. May
be bisexual or homosexual. "Dressing" and "sex change"
in masturbation fantasy mainly.
Conversion Operation (SRS) :May consider in fantasy. Rejected
Hormone Therapy/Estrogen Therapy : Rarely
interested. / May help to reduce libido.
Psychotherapy : May be successful
in favorable environment.
Remarks : May imitate male & female double personality
with male and female names.
TYPE III - Transvestite - True
Gender "feeling" : Masculine (but with less conviction)
Dressing Habits and Social Life : "Dresses"
constantly or as often as possible. May live and be accepted as a
woman. May dress under male clothes.
Sex Object Choice and Sex Life : Heterosexual except when
dressed. Dressing gives sexual satisfaction, relief of gender discomfort.
Common to purge and relapse.
Conversion Operation (SRS) : Rejected but the idea is attractive.
Hormone Therapy/Estrogen Therapy : Attractive
as an experiment. / Can be helpful as a diagnostic.
Psychotherapy : If attempted, almost never successful as
to cure.
Remarks : May assume a double personality.
Trend may be toward Transsexualism
TYPE IV - Transsexual - Non-Surgical
Gender "feeling" : Uncertain Wavering between TV
and TS. May reject "gender".
Dressing Habits and Social Life : "Dresses" often
as possible with insufficient relief of gender discomfort. May live
as man or as a woman.
Sex Object Choice and Sex Life : Libido
low. Genrally asexual or autoerotic.May be bisexual.
Conversion Operation (SRS) : Attractive but not required.
Hormone Therapy/Estrogen Therapy : Needed
for comfort & emotioal balance.
Psychotherapy : Only as guidance, most often refused and
unsuccessful.
Remarks : Social life dependant on circumstances. Often identifies
as "transgenderist".
TYPE V - Transsexual - Moderate Intensity
Gender "feeling" : Feminine "Trapped"
in a male body.
Dressing Habits and Social Life : Lives and works as a woman
if possible. Insufficient relief from "dressing".
Sex Object Choice and Sex Life : Low libido. Asexual, autoerotic,
or passive homosexual activity.May have been married and have children.
Conversion Operation (SRS) : Requested.
Hormone Therapy/Estrogen Therapy : Needed
for a substitute for or preliminary to SRS operation.
Psychotherapy: Rejected. Unless as to cure. Permissive psychological
guidance.
Remarks : Operation hoped for and worked for, often attained.
TYPE VI - Transsexual - High Intensity
Gender "feeling" : Feminine. Total
"psycho-sexual" inversion.
Dressing Habits and Social Life : Usually
lives & works as a woman. No relief from "dressing".
Gender discomfort intense.
Sex Object Choice and Sex Life : Intensly desires relations
with normal male as a "female" if young. Later libido low.
Heterosexual, bisexual or lesbian identification. May have been married
and have children.
Conversion Operation (SRS) : Urgently requested and usually
attained.
Hormone Therapy/Estrogen Therapy : Required for partial relief.
Psychotherapy : Psychological guidance or psychotherapy for
symptomatic relief only.
Remarks : Despises her male sex
organs. Strong danger of genital self-mutilation or even suicide if
too long frustrated before SRS is attained
[Original
version: Harry Benjamin © 1966, Julian press, Modified version:
Anne Curr © 1995, Basic Books]
In the past doctors
believed a person HAD to meet the criteria for a "True Transsexual"
to be diagnosed and treated as one. Surgical reassignment, in most cases,
was only recommended for those who met the criteria for a Type VI
True Transsexual. This meant that the person HAD to intensely desire
surgical reassignment and HAD to homosexual (as determined by birthsex
- in other words, if born male they had to be attracted to men). In
many cases these people also had to be hyper-feminine, self-mutilating,
and suicidal. Studies supported the observation by therapists that these
strict criteria were rarely encountered in a clinical setting, and in
many of the cases where they were it was later discovered the patients
had lied to the doctors to obtain the Type IV diagnosis and a recommendation
for immediate surgical reassignment. Those who still adhere to the original
Benjamin Scale (many of them post-op transsexuals who were diagnosed
under it) claim the studies and observations used to overturn the "true
transsexual" criteria were "tainted" because therapist
had simply misdiagnosed people who where not "truly transsexual"
as being transsexual. The detractors sometimes cite the fact that -
in the past - all post-op transsexuals met the strict criteria, which
is of course circular logic, because if they did't they wouldn't have
got the diagnosis to be cleared for surgery in the first place. Whether
they like it or not, the Benjamin Scale has been modified by modern
medicine to recognize that a person CAN have a female gender identity,
be sexually attracted to women, and be something of a "Tomboy"
while having a desire for sex reassignment surgery. In other words,
a stereotypically feminine, heterosexual outcome is no more a requirement
today than it is for natale females.
It should go without
saying, but unfortunately doesn't, that these types and categories are
not meant to classify one person as being "better" than another
person. Nor do these two highly generalized categories describe the
life experiences of EVERY transsexual person.
For more detailed
information on the role these terms, types, and categories play in the
"Transgender Community" please read the section on the TRANSGENDER
COMMUNITY.
Primary
& Secondary Transsexuals
These terms apply
to both female-to-male (F2M) and male-to-female (M2F) transsexuals.
Primary Transsexuals:
Usually behave like their target sex from childhood. They feel they
are (or should be) members of the 'opposite' sex before puberty. They
rarely doubt their convictions that they are/should be a member of
their target sex. If they do and try to conform to their biological
sex's gender role, they don't do very well at blending into the expected
gender role. Primary transsexuals are often sexually attracted to
their biological sex (i.e., classified as "homosexual" by
most doctors). Primary transsexuals are either living as their target
sex or requesting sex reassignment surgery (SRS) by the time they
are 25 years old. With very supportive parents they sometimes even
have SRS at 18 years old. Primary M2F transsexuals are usually obviously
feminine and primary F2M transsexuals are quite masculine. Many primary
transsexuals are ill received by secondary transsexuals for playing
into gender stereotypes or because primary transsexuals tend to transition
at a younger age with better physical results and socialization in
their target gender role than secondaries usually achieve.
Secondary
Transsexuals: Usually don't 'come out' until almost 40 years
old or later, often in the midst of a mid-life crisis. The most striking
feature of secondary transsexuals is how, despite a deep conviction
of being their target sex, their gender behavior is still quite a
lot like that of their biological sex. They say they went into deep,
long-term denial and they often highly successful in the gender role
of their biological sex. Even after transitioning their gender behavior
still isn't all that much like their target sex. Especially in the
case of M2F secondary transsexuals there are often charges that they
simply aren't "trying hard enough" to fit into a female
gender role, or that they want to "have thier cake and eat it
too" by trying to maintain the patriarchal power they enjoyed
while living as men.
Secondary transsexuals
report higher rates of regret and less social adjustment than primary
transsexuals do. Some researchers and transsexual people alike question
if the distinction into these two categories is really appropriate.
No matter how or if you categorize 'types' of transsexuals, almost all
research on SRS shows very positive outcomes, with the exception of
a major study saying SRS wasn't effective (Meyer and Reter, Arch. Sex.
Behav. 9: 451-456) which ultimately proved so methodologically flawed
the conclusions cannot be trusted. [reference: Fleming M, Steinman C,
Bocknek G (1980), Methodological Problems in Assessing. Sex-Reassignment
Surgery: http://www.symposion.com/ijt/ijtc0401.htm]
"The
Three Dysphorias"
Within some
quarters of the Transgender Community you might hear terms like "The
Three Dysphorias" or references to the individual "Physical
Dysphoria" or "Social Dysphoria." These concepts seem
absent and largely ignored by academic circles, but seem quite obvious
to many transgender people. While everyone seems to have their own ideas
about these, this is what I've gleaned from the Internet as a definition:
Physical
Dysphoria - this refers to the amount of unhappiness an individual
has with their physical form or appearance.
Social
Dysphoria - refers to the amount of unhappiness an individual
has concerning their social interaction (i.e., "gender role").
Identity
Dysphoria - refers to the degree of a person's self-perception
is that of the opposite gender, including emotionally and cognitively,
as well as their beliefs concerning how others perceive them.
A person can have
any combination or intensity of these factors, which will shape the
nature and intensity of that person's overall Gender Dysphoria. It is
believed that these three variables explain the diversity of gender
dysphoria expressed within the Transgender Community - for example,
why some people are comfortable with just crossdressing in private and
have little or no unhappiness with their identity, while others have
great unhappiness about identity and are driven to change their bodies
and social role.
Disclaimer:
Please do not use
this information to "diagnose" yourself. Although GID is a
"condition" that is often described as "self-diagnosed"
you should seek the help of a qualified therapist specializing in gender
psychology. A good list of therapists is available at Dr.
Becky Allison's web site.
For more information
on the diagnosis and treatment of Gender Identity Disorders also see
the Standards of Care section. A fairly comprehensive
"patient information" article is available from eMedicine. |