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For an overview of the many categories and prevalence of intersex conditions, see the Intersex Society of North America's page entitled "How Common Are Intersex Conditions?". For more information, see Wikipedia�s excellent page on intersexuality , which includes links to many websites about specific conditions. The existence of XY (genetic male) intersex infants who have female genitals and who grow up to have female gender identity (the cAIS girls), was one of many early-known facts of intersexuality that led scientists years ago to recognize that gender identity IS NOT determined directly by having XY vs XX genes. Instead, they theorized that gender identity must be neutral at birth, and is determined later in early childhood by one's genitalia and upbringing. The leading proponent of this theory was John Money of Johns Hopkins University. According to this theory, a child having a vagina and raised as a girl will grow up to have a female gender identity, independent of her genes. Similarly, it predicted that a child having a penis and raised as a boy would grow up to have a normal male gender identity, independent of his genes. If the child's gender identity didn't turn out according to this scheme, psychologists and psychiatrists assumed that something "went wrong" in the child's upbringing, or that the child was mentally disturbed or delusional in some way (i.e., "mentally ill"). Correction s to any gender identity problems were sought through psychiatry, on the assumption that this "mental disturbance" could be reversed. The practice of "surgically correcting" the genitals of intersex infants to make them "normal": By the 1960's, advances in plastic surgery combined with the "Genitals + Upbringing" theory of gender identity led physicians to recommend "corrective" surgeries on many types of intersexed infants. The idea was to make the genitals look cosmetically correct for a boy or girl, and then raise the child in the corresponding gender, believing that the child would grow up to have a correspondingly normal gender identity. John Money of Johns Hopkins University, who gradually became the medical community's dominant authority-figure in "gender-identity studies", was the leading advocate of such treatments. A believer in behaviorist psychology, in which the mind of the infant is thought to be a blank slate having no inherent personality characteristics, John Money theorized that gender identity was solely the product of upbringing and socialization. The motive for doing "corrective" surgeries on infants was to solve the "social emergency" caused by an intersex birth. The very existence in nature of many intersex babies, with their many variations of genitalia, breaks down the strict male-female gender dichotomy of our culture. Thus the existence of intersex babies brings into question many deep religious and legal strictures. Parents and doctors are under incredible social pressure to eliminate these variations. John Money provided a theoretical rationale which validated intersex infant "corrective" surgeries, and made them appear to be "scientifically sound". Since it was easier to surgically "make a girl" than to "make a boy", it frequently happened that XY intersex boys having small or missing penises were turned into girls. The fact that sensitive genital tissue was lost in the process didn't deter the surgeons, because for many years our society did not openly recognize that most women have strong sexual feelings and a capacity for orgasm. If the infant was turned into a girl, doctors didn't worry about whether she would later have strong erotic genital sexual feelings and enjoy lovemaking; they only worried about whether she would function sexually for her male partner's pleasure. Surgeries on intersex infants have been done for many years now, with a frequency of about 1 in every 2000 births. In most cases the surgeries create girls. Amazingly, there was never any organized scientific follow-up to see how these cases turned out! Even in the early years of these surgeries, there were people urging caution, most notably a young researcher named Milton Diamond, now a Professor at the University of Hawaii. While still a graduate student, Diamond made an audacious challenge to Money's theories in a 1959 paper entitled "A Critical Evaluation of the Ontogeny of Human Sexual Behavior". Diamond's insights were based on his own observations in animal experimentation. He further marshaled "evidence from biology, psychology, psychiatry, anthropology, and endocrinology to argue that gender identity is hardwired into the brain virtually from conception" (see As Nature Made Him, p.44). However, the notions that human beings had "advanced beyond the influences of biological evolution in matters of sexuality", and that one's sexuality and gender were socially constructed, had already been deeply imprinted in the medical community. Under the influence of the " gender prophet" John Money, this view dominated medical and psychological thinking for the remaining decades of the 20th century. Infant intersex surgeries were performed by the thousands during those decades, and again without any follow-ups. Only as the century was closing did awful questions begin to arise, as occasional rare follow-ups revealed things hadn't turned out as Money predicted. How these attempted "corrections" reveal that old theories of gender identify formation were wrong: In recent years, many intersex people have "found each other" via the internet and begun to compare notes about their situations. As a result, it's become clear to intersex people themselves that many of the "corrective" surgeries didn't work out according to their doctors' theories. Instead, many intersex people were left genitally maimed by those infant genital surgeries. Many were also suffering from gender identity crises, because of having undergone arbitrary gender reassignments based on what it was "easiest for the surgeons to do". Under pressure from intersex activists, especially the newly formed ISNA, follow-up studies have finally begun on infants who were "surgically corrected" over the years. The first such study, of 25 genetically XY boys who had missing penises as infants (cloacal exstrophy syndrome) and who had been surgically turned into girls and raised as girls, revealed that all 25 developed MALE gender identities. Those kids, although raised as girls, had all exhibited the rough and tumble play of boys when young. By their teens, each of these kids insisted against all evidence of their female genitalia and upbringing that they were boys, and wanted to be changed into boys. Many of them desperately sought girlfriends, just as might any other teenage boys. Instead of reversing their innate gender identities and turning these intersex boys into girls, the infant surgeries effectively turned them into the equivalent of female to male transsexuals! Many of these boys have since undertaken hormonal and social gender reassignment from female to male. Tragically, the effects of their infant genital surgeries preclude the surgical reconstruction of male genitalia and in many cases even preclude them from experiencing sexual pleasure and orgasm. More lessons from intersex people about gender identity: These recent studies call into question the entire existing practice of genital surgery on intersex infants. The studies then do something even more awesome: They turn on its head the theory that genitals and upbringing determine gender identity, triggering a paradigm shift in the medical community's overall thinking about the underlying nature of gender identity. The personal experiences of intersex people who have traveled different gender trajectories (some "corrected" as infants, and some not) are now becoming more widely known about, and are helping build a deeper understanding of the many variations in gender identity that are independent of one's physicality. For example, in intersex conditions such as XY-Turner mosaic (mixed gonadal dysgenesis) a child may appear to have normal male genitalia at birth and be raised as a boy, but then not masculinize at puberty and instead remain slight and feminine appearing. These teens can face great difficulties if their condition goes undiagnosed and/or if they do not become aware of good options for treatment. If they do not have a well-established male gender identity, they may face a difficult choice of whether to undertake testosterone treatments to masculinize and become men, or undertake estrogen treatments and genital surgeries to become women. In some cases, XY-Turner teens have female gender identities and if given a choice in the matter will chose reassignment as females. The article "What do children know?", by Jane Spalding tells the compelling story of such a child who was raised as a boy, but who had a female gender identity and who sought hormonal and surgical reassignment as a female during her twenties. The existence of such cases further refutes John Money's proclamation that genitalia and upbringing establish gender identity: Jane Spalding

Misguided by Money's theories for many decades, the medical profession has caused the irreversible physical maiming of thousands upon thousands of intersex babies. For compelling insights into the traumatic life experiences of an intersex person who was surgically "corrected" at birth, and who grew up without ever being told what had been done, see the recent interview of Cheryl Chase in Between the Lines: coming to terms with children born " intersexed " , by Victoria Tilney McDonough. Cheryl was the founding Director of the Intersex Society of North America (ISNA), and the early leader of the movement to end shame, secrecy and unwanted genital surgeries for people born with atypical reproductive anatomies. ISNA is working to end the idea that intersexuality is shameful or freakish. In the U.S. alone, five children are subjected to harmful, medically unnecessary sexual surgeries every day. ISNA urges physicians to use a model of care that is patient-centered, rather than concealment-centered. For more insight into these issues, see the Discovery Channel documentary "Is it a Boy or a Girl?", which was produced with ISNA participation. Cheryl Chase, Founding Director of ISNA "When an intersex baby is born, the default is usually to perform surgery," says Cheryl Chase, who was surgically "reassigned" female when she was 18 months old. "Doctors want to 'fix' what is not right, then slap a diaper on the baby, close the file, and send it off into it's life." The theory that gender identity is socially constructed is finally shattered: The breakaway from John Money's paradigm escalated rapidly after the scientific community learned that Money had suppressed for many years clear evidence that his theories were wrong. The final straw was the highly publicized case of "John/Joan", presented in the book As Nature Made Him: The Boy Who Was Raised as a Girl, by John Colapinto. Decades ago, John Money had advised the parents of an infant boy who had lost most of his penis in a medical accident to have the boy surgically changed into a girl - under the theory that "she" would then grow up to be a normal girl instead of an "abnormal boy". This was a very noteworthy case for scientific researchers because the child was born with an identical twin who could serve as a basis of comparison in the study of gender development. As a first step, the child was castrated and the rest of his penis removed. He was then raised as a girl. However, clearly exhibiting an innate gender identity as a little boy, "she" began to declare that "she" was "really a boy" and rebelled against efforts to make "her" behave like a girl. At puberty, still unaware of "her" childhood surgery, she resisted her parent's and physician's efforts to feminize her with estrogen and further surgeries. Eventually, she underwent gender transition to become male, much as would an FtM transsexual. In this case, raising a boy-child with apparently female genitals as a girl clearly did NOT alter the child's inborn sense of his own true gender. Over many decades, John Money continually referred to the John/Joan case as a victory, fabricating facts to indicate that this case had been a "complete success". Money never "allowed" anyone to get close to "Joan" to learn more details about her life, begging off any contact in the name of "privacy". The case gradually became so legendary that it became the cornerstone of support for Money's entire theory of gender. And then the shattering news came down, in the revelations that John Money knew full well that the infant's reassignment had not worked at all. And worse yet, he had deliberately concealed this counter-evidence to his theories for decades - decades during which thousands more infants had been subjected to infant intersex surgical maimings. Fittingly, it was Professor Milton Diamond, the scientist who'd bravely challenged Money as a young graduate students decades earlier, who uncovered the deception. Professor Diamond had always been suspicious of Money's results. Over the years he had tried in numerous research studies and papers to persuade others to at least consider the possibility that gender identity was inborn. However, his efforts were to no avail, given Money's intellectual dominance of the field. Finally, in the early 1990's, Diamond managed to track down the child "Joan", now presumably a grown woman, whose case had been the foundation of Money's entire viewpoint. Wanting to simply confirm what had or had not happened to her, Diamond had stumbled into the incredible fact that "she" had never felt like a girl at all, and was now a married man!*

[ *The story later came to a very tragic end. Although "John" had been able to socially and surgically reverse his childhood reassignment and become a male, "he acknowledged a deep well of wrenching anger that would never go away. "You can never escape the past," he told the Seattle Post-Intelligencer in 2000. "I had parts of my body cut away and thrown in a wastepaper basket. I've had my mind ripped away."" "John" committed suicide on May 4 2004.]

Also note that the emotions and feelings of gender variance are expressed in different ways in different cultures, depending on available social roles in which transgender people can exist in each culture. Different words may be used to describe of gender-variant people in a particular culture. These �types� vary widely from culture to culture, and evolve over time within each culture. See Lynn's page regarding the situations of TG/TS people in different countries and also the TransgenderAsia website , for examples of widely varying transgender typing in many different cultures.

See also the following page concerning the difficulties in cross-cultural communications and language translations regarding gender variance. As one example, that page discusses how the word �travesti� in Romance languages (such as Spanish, Portuguese, Italian, etc.) is very often confused with the word �transvestite� in English (a word that has a very different meaning). As we will learn, gender-variation typing and labeling are highly culture-dependent and language-dependent, and are very inexact practices.

(i) confusion of TG'ism and TS'ism with being Gay: Over 5% of all men and women are gay, and prefer to mate with love-partners of the same sex and/or gender. This innate feeling of same-sex attraction in many people is a part of human nature. It has always been so, in spite of ongoing efforts by various religions and societies to stamp it out. It seems that love always finds a way to thrive, in spite of all obstacles. Because being gay is so common, transgenderism and transsexualism are most often confused with simply being gay, and in fact confused with being "really, really gay". The first thing that pops into the people's heads when they hear that someone is transsexual is, "wow, I didn't know 'he' was gay". It's easy to see how people might jump to this conclusion. Seeing an MtF TS woman with a straight man as her partner, they simply think that she is (or was) a "gay man". They jump to the conclusion that "he" changed sex simply in order to attract men as partners. However, this is a totally mistaken idea rooted in ignorance about gender identity. And as we'll see, this idea totally mixes up and conflates two totally different kinds of people: transsexual women and gay men. How did the confusions get started? One possibility is that years ago many gay people got into "role-playing". For decades and decades there have been gay men who act "effeminate", and who emulate the "woman's" role in a relationship, even though they are strongly male-gendered and don't feel like women at all. Gays and lesbians have also often allowed themselves more freedom than heterosexuals to break the rules of gender behavior as well�especially within closed or �friendly� social environments. Even so, t he majority of gay and lesbian people have gender expressions difficult or impossible to distinguish from that of heterosexuals. However, effeminate gay men as a minority of the gay male community have been far more publicly visible than TG/TS women, because the gay male community is so large to begin with. After all, over 5% of all men and women are gay, and prefer to mate with love-partners of the same sex and/or gender. Meantime, TG/TS women have mostly had to live in stealth in the past, staying as "invisible" as possible just to survive, and they were much smaller in number than gay men to begin with. All this led many straight folks to confuse "role-players" and feminine-acting gays as being gay men who "really wanted to be women." Now, here's the deal: A gay man has a male gender identity. He is attracted to males who also have a male gender identity, and who are attracted to him because he is a male. The last thing on earth that a gay man would want to do is change sex and become a woman. To do so would be a catastrophically self-destructive act, because of his male gender identity and his love of masculinity both in himself and in his partners. In contrast, an MtF TG or TS woman has a female gender identity. She may be either straight or gay after she transitions. She is either attracted to males who have a male gender identity or to females who have a female gender identity, and who are attracted to her because she is a female. She is desperate to change her body so that she can fully feel like and be perceived to be a woman - both by herself and her lovers. If it turns out that she is "gay" after her transition, it is because she is a lesbian in her new role, not because she is a "gay man". (ii) Drag Queens: Some gay men occasionally dress in "drag" for fun and as a kind of caricature of women (DRAG = "DRessed As a Girl"). They'll sometimes they "go in drag" to bars and clubs, and sometimes on special occasions and for various fun events. Gay men who are particularly skillful female impersonators perform in drag in various gay nightclubs (such as the club "Oz" in New Orleans). Some of these gay men, such as Ru Paul, have great skills as "illusionists" and have become famous mainstream drag performers. RuPaul - a famous drag performer The origins of this fairly common practice go way back in gay culture. These men are called "drag-queens" (DQ) and are usually completely male-gendered gay men. Many of them started in drag as gay teenagers when they discovered it was a way to attract lots of attention from men in gay clubs. They make no permanent body modifications by hormones and rely on great performance skills and skill with clothing, prosthetic props and makeup to create their female bodily images. As gay men they tremendously value their masculine genitals. They are totally turned off by the concept of "sex changes", and would never consider such a thing themselves, any more that any other gay man would. There is a rather large gay-male subculture of drag performers and drag contests all across the U.S., and there is always some small fraction of young gay men who are attracted to the "lifestyle" as it is sometimes called. For many of these young men, even those who aren't particularly attractive as boys, performing in drag in a gay club is a sure-fire way to attract gay male lovers and attention, at least while they are still young. However, outside the clubs these gay boys are almost always boys again, and since they do not take hormones or make major body-feminization modifications very few could pass as women in the light of day. Many transgender and transsexual youths, on learning that they could dress and perform as "girls" in local gay clubs, feel a strong tug to join that scene and initially may even self-identify as drag queens. This has always been a common path for TG/TS kids who are beginning to explore their gender issues. After going to these clubs for a while, these TG/TS girls usually realize that they aren't gay male "queens" after all. Many tire of the attention of gay men who want them precisely because they "are boys", instead of wanting them to love them as women. They gradually learn about other girls who've taken hormones and had electrolysis and breast implants, and who can "pass" as women outside the clubs. Better yet, they hear that some of those girls are finding straight boyfriends who love them as girls. As they learn about the possibilities of "going full-time" by undertaking a TG or TS transition, they may begin to plan their own transition too - and work to move on beyond the part-time gay drag scene and out into heterosexual society as a transitioned woman. Thus there has long been a mixture of DQ, TG, and TS girls in the gay drag scene, because so many TG and TS girls continually migrate through that scene and on out into the world beyond it. Although the majority of girls performing at the gay clubs are gay queens, there are always a few TS's in among them. This isn't a bad way for some TS girls to get started, because drag clubs are often a fun-loving, uninhibited, non-judgmental environments where they can feel very liberated and able to explore their gender issues. For an inside look into "the lifestyle" by a transsexual girl who passed through the gay club scene, see Calpernia Addams' wonderful book Mark 947. For more insight into the world of drag queens, drag performances and drag contests, you can explore the links to drag clubs from many gay male community websites. Of special interest are the major beauty and performance contests, such as the famous Miss Continental pageant ( more ), which provide opportunities for the expression of feminine beauty by large numbers of DQ's and TG girls. QUEENMOTHER.TV , the online outpost of New York City's thriving drag performance community, is another good window into the drag community. Drag queens (DQ's) themselves are often confused by the public as being "transsexuals", and vice-versa. The extravagant caricatures of femininity presented by many drag queens tends to propagate a misleading image of transgender people as being male-gendered people who like to caricature women in flamboyant ways. Then too, people familiar only with MtF transsexualism may mistakenly assume that a drag queen has a female gender identity, which he generally does not. Some gender theorists consider drag queens to fall under the "transgender umbrella", a term that lumps all gender-variant people together. Lynn finds this over-inclusive terminology very confusing, since the majority of drag queens unquestionably self-identify as male-gendered, do their crossdressing just for fun, and seldom self-identify as "transgender" since they do not have any issues with gender identity. The best way to learn whether a drag queen considers themself to be "transgender" is to ask them, rather than automatically label them that way just because they do drag.

(iii) Female impersonators (FI's), and the historical role of FI clubs in disseminating knowledge about gender transition:

(iv) Crossdressers (Transvestites): Many heterosexual men occasionally engage in partial or full crossdressing * (CD'ing) as a means of feeling sensual and as a fun sexual turn-on. This has long been called transvestism* (TV'ism), and perhaps as many as 20% to 30% of ALL males do it sometime during their lives. [*See Lynn's page "The Wide Spectrum of Gender-Variant People and the Words Used to Describe Them" for a discussion of such terminology, and how the meanings of such words have shifted over time. For example, the word "transvestism" in English has gradually fallen out of use due its social and psychiatric stigmatization in the past, and the word "crossdressing" has gradually replaced it. Then too, the old word "transvestite"" in English is often confused with the term "travesti" in the Romance languages - which refers to an altogether different form of gender variance ( see below )].

It is important to realize that this is a very, very common practice, and thus we need to put it clearly in perspective in the overall picture of gender issues.

Crossdressing is often simply a regular expression of male sexuality similar to the use of pornography for pleasurable visual arousal and auto-sexual release, and in these cases is not a gender issue at all. Sexually active males who are turned on visually by females may get very excited by seeing part of themselves as female by wearing a bit of women's clothing. Some of these men then gradually get into fully crossdressing as a means of experiencing more sensuality and turn-ons than they otherwise might. However, it is important to note that crossdressers and transvestites generally do NOT modify their bodies through surgical or hormonal means.

(v) Travestis (�She-males�) and Similar Composite Gender Identities



In most large cities in the Americas and in many seaport cities around the world, there exists a large but more or less underground community of transgender women who work predominantly in the so-called sex industry, i.e. prostitution, strip clubs, pornography, etc.



This has long been an option for a �landing zone� for gender-variant youngsters who have been thrown away or run out by their families. Lacking education, identification papers and any other form of social support � this at least provides them with a means of economic survival. In a few cases, these kids may become well-paid as call girls, and talented and pretty ones may go on to earn good money for a while as entertainers. However, many live very marginalized lives in the ghettoes of the big cities.



In the English-speaking world there is no consensus about a name for these girls and women. They may be called, or may call themselves, �she-males� or �street trannies�, while others call themselves transgender or transsexual women and may identify as such (even though some follow different life-trajectories than most trans women). Although "she-male" is considered a derogatory term in some circles (and sometimes used to insult preop trans women), the word is being reclaimed as a good way for some gender-variant people to describe their identities. Internet she-male pornography has also made many people aware of the beauty and sensuality of these women, thus helping the word seem less defamatory and more exotic instead.



In countries where Romance languages are spoken, the universal term for such a person is �travesti.� This term should NOT be confused with the English word �transvestite� (which instead means a heterosexual male crossdresser). Given the recent surge in immigration from Latin America to the U.S., the term �travesti� is sometimes heard even here , as a substitute for �she-male�.



In common with TG and TS women, travestis and she-males generally undertake a full-time transition away from a male gender identity, but under the traditions of their communities (and often lacking funds for more aggressive transformations) many usually do not go as far as to adopt a fully female identity and physicality.



To outside appearances these women often look very feminine and behave accordingly, but many may not actually claim to be women or claim a feminine gender identity. Not fitting cleanly in their own minds into either of the two main gender boxes, they may sometimes refer to themselves as a �third sex (or gender)� or as �other.�



Such intermediate gender identities develop in parallel with the modifications that the travestis (she-males) make to their physicality. They often go to great lengths to attain the most female body possible, with the critical exception of retaining functional male genitalia. Indeed, while many do use female hormones, others limit or avoid hormone use in order to maintain standard male sexual function, and thus are dependent on cosmetic surgery and/or silicone injections in order to feminize their bodies. Ordinarily the sexual partners of these women are male, but it may be unclear whether the partners� sexuality should be characterized as gay, straight, or something else (or whether it should be "labeled" at all).



It remains to be seen whether this general group represents a stable gender identity in the long run. Some of the young ones no longer limit themselves to a lifetime of work in the sex industry, and some are avoiding it altogether � especially as advocacy groups and enlightened health services reach out to them in some cities (notably in San Francisco, CA). Some also shift onto other transgender trajectories - including more fully transitioning as trans women and then assimilating into society.



However, in Latin America ( and especially in Brazil , where this group has been much more highly-visible and well-established for a much longer time), there is evidence that they do form a coherent group of people with an adopted identity that is neither strictly masculine nor feminine, but rather is a composite of the two. In many cases this composite gender�as opposed merely to an occupational choice�is at the heart of the travestis� identity, and is a source of fulfillment and great pride to them. (vi) Transvestic fetishism,"autogynephilia" and other psychiatric classifications of CD/TG/TS people: Are these labels or stigmata? Some intensely transvestic males become troubled by feelings of addiction to cross-dressing and masturbation and seek help from counselors to contain this addiction. This group has long been labeled by psychiatrists (in their DSM manual) as suffering from a "mental illness" called "transvestic fetishism". There is no known cause for this condition - nor any cure either, other than helping the person stop worrying so darn much about it and just accept it and have fun doing it. Sadly, this psychiatric label has a very negative image and has the iatrogenic effect of intensifying guilt and shame in the very people who go to psychiatrists for help. The practice of defamatory labeling by psychiatrists thus causes much of the unnecessary pain felt by crossdressers and other transgender people about their condition (and also insures a steady income stream for those psychiatrists). The situation got even worse for a few years (from about 2000-2004), during which a clique of sexologists (Ray Blanchard, J. Michael Bailey and Anne Lawrence) tried to pin a variant of that old stigmatizing label onto almost all transsexual women too, coining a new word for it - "autogynephilia". This led to a major investigation into the research methods and ethics of those people, and to the subsequent collapse of their effort.

For more about the Blanchard's theory, and the subsequent decline and fall of Bailey, Blanchard and Lawrence - see Andrea James' BBL Clearinghouse, Lynn Conway's Investigative report on Bailey's book and Joan Roughgarden's essay "Psychology Perverted". Scholars, ethicists and historians of science will find further detailed documentation of this scientific fiasco in the online timeline of events and links to evidence. Unfortunately, this was only the latest in a long series of rogue theories of transsexualism by psychiatrists, academics and sexologists. In the future, instead of inventing highly stigmatizing labels for transsexual women and incessantly arguing amongst themselves about the meanings of those labels, sexologists should do something more productive: They should conduct real-world follow-ups of actual gender transitions, and help us learn which factors lead to positive transition outcomes and which do not. Meantime when you hear the word "autogynephilia", translate it back into "transvestic fetishism". Then ask yourself: Did that term have any real meaning either? Or was it also merely a stigma masquerading as a scientific label? For more enlightenment about invented words that define non-existing phenomena to be "mental illnesses", you might also read about the non-existence of "nymphomania" and its parallels with the non-existence of "autogynephilia": Nymphomania and Autogynephilia: The Invention of Mental Illnesses by Psychiatrists For a further critique of the whole issue of "labelling", see the section "Getting beyond labels", below. (vii) Others: Another group of people often mis-identified as being either transgender or homosexual are men who are inherently feminine-looking and women who are inherently masculine-looking. Many normally-gendered people have a somewhat cross-gendered physical appearance, sometimes without even realizing the mixed signals their bodies send about their gender. This is a result of their genetic make-up, and is not a deliberate display and does not at all mean that they are transgender. Unfortunately, such people are often the subject of ridicule and prejudice simply because of their cross-gendered physical appearance. Very recently, quite a few young people have begun calling themselves "trans" or "transgender" as a way of rebelling against rigid gender stereotypes. Some teenage boys, while watching a sensual young woman like Britney Spears perform when she was young and hot, may not only be attracted sexually to someone like her but also wish they could be a little like her physically, aesthetically and sensually. Then they'll start getting that reaction to other pretty girls too. Feeling a bit of gender-stress and gender-envy under current paradigms, they'll demand the right to dress in whatever way they choose, independent of their gender. They may use some make-up, and partially crossdress in explorations of their own gender feelings, and for gender-bending fun and gender-political purposes. Many of these "trans" kids are not strongly transgendered, and will grow out of this phase after high-school or college. This "movement" is reminiscent of the time in the 60's when some men began to grow long hair as a rebellion against the straightjacket conformity of the 50's. This trend may ultimately be helpful to truly transgender people and to gay people, by loosening up society's attitudes and making people more tolerant of variances in gender presentation. Other young people have begun to embrace an identity they call � genderqueer ,� which involves expression of fluid and individualistic gender identities, sexual orientations and body modifications � and allowing themselves the freedom to vary these expressions as inner feelings dictate. Many also advocate "queer self-determination", in which the individual resists outside pressure to permanently fit into some existing LGBT "category". For genderqueers a �composite� gender identity is a natural thing, and not merely a rebellion against existing social constraints. Nevertheless, such expressions of gender have the potential to further displace antiquated social notions of �correct gender behavior.�



Yet another gender-variant group, not always easy to differentiate from the genderqueers, are the androgynes , who generally conceive of themselves as having a gender identity lying somewhere near the middle of the male-female spectrum. As with any other group, their gender identity is foremost a matter of their individual internal spirits, and may or may not be reflected in their external appearances. Finally, there are lots of folks who mingle in among the transgender community but who aren't easily "classified" as, or recognized as, being transgender. One large diffuse grouping consists of people who have done poorly in life, who can't hold their own among other men, who feel like "failures as men", and who then somehow get into their heads that "maybe they should have been women instead". Perhaps they did a little crossdressing in the past, and then hear about transgenderism and think "Aha! That's the explanation for all my problems!" Or perhaps they envy the dependent "kept status" that some young pretty women achieve, and wish they could find a sugar daddy to take care of them too. In a state of confusion about such things, these people sometimes join TG support groups, or come into TG shelters and clinics in the large cities, and seek help for a "sex change" by claiming that they are "transgender". These "underachievers" are a very difficult group to sort out and to help. Many suffer from mental illness, others are substance abusers, many are in poor health, and most have other complex psychosocial adjustment problems. Many of these people think that they can be turned into pretty women if only the "doctors would give them hormones and perform surgery on them", thinking that they themselves don't have to do anything but undergo the treatments. Presenting as "victims", they often throw themselves onto the clinics and welfare systems pleading for help. Unfortunately, such dependent people make very poor candidates for gender transition, since they lack the problem-solving abilities and personal development skills to handle such a complex project, independent of whether such a project makes any sense for them. Lacking clear-cut female gender identities, their transition attempts usually fail disastrously, resulting in further social marginalization. These "underachievers" often haunt the edges of many TG/TS support groups, where they may remain for years (and their visible presence in support groups often frightens young transitioners from approaching such groups). These are sad cases for which there are now no ready solutions. Why do some react to transgender people with such hostility? Why are transgender and transsexual people blamed for their afflictions? Being gay doesn't affect one's gender, name, body or appearance in any way. Being gay only means that you are innately drawn towards an intimate love partner of the same gender as yourself. Most gays easily "pass" as normally gendered, thus avoiding constant detection and persecution. Passing can be vastly more difficult for the transgender people, especially when as adults they seek a partial or complete transition into the correct social gender to match their given brain-sex and inner gender identity. Transition means changing body morphology, changing clothing and outward appearance, changing name, changing legal records, and changing all family and social relationships; in short, changing almost everything one does to one degree or another. People in the midst of transition who don't pass are often treated as if they were unusually exhibitionist "drag queens" or "out of control transvestites" flaunting themselves in public. Many people react with hostility towards such transitioners, because they confuse them with prurient media stereotypes of "sexual deviants". Even gay people often find themselves feeling uncomfortable around visibly transgender people, and may feel that TG/TS people project a weirdly incorrect image of "gay people" into the larger community. Similarly, men who are themselves closeted transvestites, and who may feel intense guilt and embarrassment about their own crossdressing habits, often feel intense discomfort and fear when they encounter visibly transgender people.

The same feelings of shame and embarrassment can sometimes be evoked in closeted gay men upon seeing visibly transgender women, because they often confuse transgenderism with homosexuality. Then too, any sensation of sexual attraction toward a visibly transgender person can be the source of profound discomfort for many people who have insecurities about their own gender or sexuality.

There are also many people who view all transgender expression�as well as any non-normative sexual orientation�as a deliberate choice signifying nothing more than an individual�s desire to �have a good time,� �shake up the legitimate and long-established social order,� or �act out a mental illness.� People having this viewpoint often apply the term �lifestyle� to GLBT people, implying that non-normative gender and sexual identities are capricious, insubstantial and ultimately invalid. Sadly, such ill-informed, incorrect and stigmatizing thinking is often transmitted from generation to generation in the home and among peer groups in our schools and other institutions. Also, as we'll see in Part II, many in the psychiatric profession still consider transgenderism and transsexualism to be "mental illnesses" (just as many psychiatrists consider crossdressing to be a mental illness, and call it "transvestic fetishism"), and they are still listed as such in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), 2000. These outdated listings are the source of additional intense stigmatization of TG/TS people by much of the medical community and society at large, because supposedly "mentally ill" people are usually blamed for their causing their own conditions and are stereotyped in ways that frighten others. Furthermore, many established religions have strict taboos against any form of gender-variant behavior, and in their official doctrines, teachings and practices they often demonize, ridicule and persecute gender-variant people. For these and many other reasons, transgenderism and transsexualism (especially MtF transsexualism) have historically been "socially unpopular conditions" in western society. Unfortunately, the ongoing hostile reactions of others can complicate and even ruin someone's transition, especially if problems in employment cost the person their livelihood. One should not underestimate the personal agony suffered by someone whose transition stalls or fails (see the story of Rexanne in A Tragedy's Tragic End). Hopefully the general public will someday come to understand that TG and TS people who are visibly in transition are following deep biological imperatives and desperately trying to resolve their profoundly felt gender incongruity. Such people should neither be feared nor stigmatized for their efforts to resolve a condition that isn't of their own making. Shades of gray: Combinations and intergradations of gender and partner-preference: Of course things are not as simple as they might have appeared in our discussion so far. Things are not just black and white. Instead, there are many shades of gray across a continuum of gender conditions. Some gay people may also have gender identity conflicts. For example, someone who initially finds a place in the gay community as a rather feminine boy, and then takes on a label as a drag queen, may actually be transgender or even intensely transsexual instead. Some strongly transgendered people have same-gender partner preferences. Some people, including transgender people, may be bisexual and be attracted to love partners of either gender. Questions then arise such as whether the pre-operative TS woman who loves a woman is a heterosexual or a lesbian. In all these cases, we see how our tendency to quickly "label" people gets us into semantic difficulties, mislabeling and confusions. For example, if we learn that two love partners are "genetic males", there are many different possible scenarios for what is actually going on. They could simply be two gay men, both self-gendering as males, and this relationship would seem to both partners as being one between two men. However, one partner could be a straight male who has fallen in love with someone who is a strongly transgendered or pre-operative transsexual woman. Both partners in such a relationship usually feel that they are in love as a man and a woman (Lynn had several such love affairs when she was a young pre-op TS girl). On the other hand, both people might mis-identify themselves as "gay" and think of the relationship as gay, even though in almost all respects it really is a man-woman relationship. The same kind of complexities can arise in relationships between two genetic females, depending upon the self- and other-gendering of the two lovers. And things can become further blurred as if one or both lovers are just moderately transgendered, and/or if one or both do not disclose their transgender identity to the other lover. Then too, consider what happens if one of the lovers in a gay or lesbian relationship is transgender and finally transitions. For example, a recent story by Sara Corbett in the New York Times Magazine raises the question "Does a Sex Change Mean the End of the Relationship?" The story is of about two women, Chris and Debbie, who were lesbian lovers and who had a little girl, Hannah (Debbie was fertilized with sperm from an anonymous donor). However, Chris was intensely transgendered and later transitioned (FtM), undergoing surgeries and testosterone hormone therapy to become a man. His transition initially raised many questions and difficulties in this relationship, which has since endured and deepened. Debbie is pregnant again, and they are now expecting a little boy. This is a beautiful story about two people in love, and about the family they have created. Chris and Debbie, with daughter Hannah

Another common situation is for late-transitioning pre-operative transsexual women to be married to women and to have had children with them. This is not surprising, because of the long-term social pressures on closeted MtF transsexuals to "go out with women" when they are young, and because of the longings by closeted transsexuals for some form of intimacy and close human companionship. In many of these cases, the transsexual's wife may have no idea that her "husband" thinks of herself as a woman, wants to physically be a woman, and feels that the marriage is actually somewhat like a lesbian relationship. Only if the closeted transsexual finally confronts the condition and seeks help will the wife learn the truth. In most cases, such relationships will gradually end if the husband transitions MtF. However, in some cases (as in the case of Chris and Debbie) these relationships may continue intact if the two partners love each other deeply and can adjust to the physical changes as the transition unfolds.

Both straight and GLBT communities are increasingly recognizing that human variations and combinations of this type are not so uncommon, and are honoring them without any need to assign narrow sexuality or gender labels. The reality is that people's preferences in love partners--whether they are attracted to "the same" and/or "the opposite"--can be focused on either sexual and/or gender characteristics, or on some combination of these factors.