Transgender 101:  Stages of Development

What is common to see from a person with Gender Dysphoria throughout their development?

Childhood

During childhood, it is common for these children assigned male at birth to express interest in traditionally feminine activities. They may prefer dressing in girls’ or women’s clothes. A boy who openly admits wanting to be a girl is likely to be teased, redirected, or told that’s not “right,” and that he “shouldn’t” want to be a girl, though increased awareness may slowly change this common parental response. He is expected to grow out of it quickly. In boys, there is also often an assertion that his penis or testes are disgusting or will disappear or assertion that it would be better not to have a penis, or aversion toward rough-and-tumble play and rejection of male stereotypical toys, games, and activities. In other cases, children assigned male at birth show no particular inclination toward feminine activites or expression, just as some cis-gender female girls don’t. 

Traditionally, a young girl who wants to be a boy and expresses this is less likely to invite such criticism. She may be labeled as a tomboy, but is still expected to grow out of it. In girls, rejection of urinating in a sitting position, assertion that she has or will grow a penis, or assertion that she does not want to grow breasts or menstruate, or marked aversion toward normative feminine clothing.

Many children do grow out of gender dysphoria. Only a small number of children continue to feel the same way in later adolescence. Some families are better than others at accepting their children’s behavior. Some children live openly in their chosen gender role but have to endure the taunts of their peers as well as pressure from their parents. Others cope by hiding their feelings and learning to play the gender role assigned to them, meanwhile going deeper into a private world of cross-gender fantasy and desire.

Adolescence

With puberty, hormones start to trigger body changes which often ignite greater stress for gender incongruent men not wanting to develop a deeper voice and greater muscle mass or incongruent women not wanting to start their menstrual cycle or grow breasts

Adulthood

In adulthood, the disturbance is manifested by symptoms such as preoccupation with getting rid of primary and secondary sex characteristics (e.g., request for hormones, surgery, or other procedures to physically alter sexual characteristics to simulate the other sex) or belief that he or she was born the wrong sex.

Most people who have grown up with GD show less openly cross-gender behavior as time goes on, because of their parent’s interventions or pressure from their peers. By early adulthood, nearly 75 percent boys who had a childhood history of gender dysphoria may think of themselves as homosexual or bisexual. They no longer have feelings of belonging to the wrong gender.

The remaining 25 percent or so, however, continue to experience dysphoria into adulthood. They may try to rid themselves of their ever-increasing gender anxiety in various ways. They may get married and have children, in the hope that this will help, or simply to hide their feelings from others. Some seek professional help, often to ask for gender reassignment.

Later adulthood

Years of trying to overcome a deep-rooted desire and coping with anxiety can lead to depression. For some, the pressure is so great that they attempt suicide. Many re-assess their lifestyle when they come to later life. Some seek professional help; others start cross-dressing more frequently, in private.

 

Transgender 101:  Stages of Development

What is common to see from a person with Gender Dysphoria throughout their development?

Childhood

During childhood, boys will typically show an obvious interest in traditionally feminine activities. They may prefer dressing in girls’ or women’s clothes. A boy who openly admits wanting to be a girl is likely to be teased, redirected, or told that’s not “right,” and that he “shouldn’t” want to be a girl. He is expected to grow out of it quickly. In boys, there is also often an assertion that his penis or testes are disgusting or will disappear or assertion that it would be better not to have a penis, or aversion toward rough-and-tumble play and rejection of male stereotypical toys, games, and activities.

Traditionally, a young girl who wants to be a boy and expresses this is less likely to invite such criticism. She may be labeled as a tomboy, but is still expected to grow out of it. In girls, rejection of urinating in a sitting position, assertion that she has or will grow a penis, or assertion that she does not want to grow breasts or menstruate, or marked aversion toward normative feminine clothing.

Many children do grow out of gender dysphoria. Only a small number of children continue to feel the same way in later adolescence. Some families are better than others at accepting their children’s behavior. Some children live openly in their chosen gender role but have to endure the taunts of their peers as well as pressure from their parents. Others cope by hiding their feelings and learning to play the gender role assigned to them, meanwhile going deeper into a private world of cross-gender fantasy and desire.

Adolescence

With puberty, hormones start to trigger body changes which often ignite greater stress for gender incongruent men not wanting to develop a deeper voice and greater muscle mass or incongruent women not wanting to start their menstrual cycle or grow breasts

Adulthood

In adulthood, the disturbance is manifested by symptoms such as preoccupation with getting rid of primary and secondary sex characteristics (e.g., request for hormones, surgery, or other procedures to physically alter sexual characteristics to simulate the other sex) or belief that he or she was born the wrong sex.

Most people who have grown up with GD show less openly cross-gender behavior as time goes on, because of their parent’s interventions or pressure from their peers. By early adulthood, nearly 75 percent boys who had a childhood history of gender dysphoria may think of themselves as homosexual or bisexual. They no longer have feelings of belonging to the wrong gender.

The remaining 25 percent or so, however, continue to experience dysphoria into adulthood. They may try to rid themselves of their ever-increasing gender anxiety in various ways. They may get married and have children, in the hope that this will help, or simply to hide their feelings from others. Some seek professional help, often to ask for gender reassignment.

Later adulthood

Years of trying to overcome a deep-rooted desire and coping with anxiety can lead to depression. For some, the pressure is so great that they attempt suicide. Many re-assess their lifestyle when they come to later life. Some seek professional help; others start cross-dressing more frequently, in private.

Transgender 101: Gender and Sexual Orientation

How are gender and sexual orientation-related?

Gender identity is the way in which a person defines their sense of self as male or female. Sexual orientation is unrelated, except that it is defined by the gender toward whom we find ourselves attracted both emotionally and physically. People with gender dysphoria can be homosexual, bisexual or heterosexual. Typically the direction of one’s attractions toward males or females remains consistent despite changes in one’s gender role. So if a man is married to a woman (pre-transition), it is likely that after transition she will wish to remain married, or will at least remain attracted to women even if she now lives as one. It does appear common, however, for those who have transitioned to experiment with relationships that serve to affirm their gender.

 

Transgender 101:  Gender Dysphoric vs. Cross Dresser

Transvestite / Cross-dresser

A transvestite, which is now more commonly known as a “cross-dresser,” and when it isTransvesticic for the cross-dresser, it is clinically referred to as a transvestic fetishist, will dress as a member of the opposite sex and will often get sexual excitement from it. Transvestism is quite different from transsexualism and other forms of gender dysphoria. Cross-dressers don’t feel that they belong to the opposite sex or alienated from their own bodies or sexual organs.

 

What do you look for in diagnosing Transvestic Fetishism?

• Over a period of at least 6 months, in a heterosexual male, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving cross-dressing.

• The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Transgender 101:  Gender Transitioning

What is gender reassignment?

Gender reassignment for most people spans several years. The process starts with an inner conflict that is unrelenting. Once the transgender person acknowledges this conflict and makes the decision to deal with it, he or she typically starts counseling. Typically within three months of counseling with a skilled gender therapist, a trans man or woman will initiate HRT (hormone replacement therapy) to begin reshaping their body and initiating a long-overdue ender-appropriate puberty. Eventually, a real life test (RLT) will be initiated and this is an opportunity to live for an entire year in the preferred gender role. For those seeking Sex Reassignment Surgery (SRS), this year is required prior to surgery.

Some people reassign their genders without ever having surgery. It is difficult, however, to transfer your identity on legal documents such as birth certificates, drivers licenses, and social security cards if you do not have a letter from a surgeon stating your gender has been reassigned. Although people’s chromosomes and reproductive identity can’t be altered, long-term hormone treatment and surgery should allow them the physical appearance and some of the sexual functions of the opposite sex. However, after surgery, they will lose the ability to have children.

Gender reassignment is not the best solution for everyone. There are many steps to move a person closer to their authentic gender without requiring surgery. For others, though, it’s essential to live peacefully.

 

What does male to female gender reassignment involve?

For a biological male wanting to affirm his female gender, it is necessary to first start a regimen of estrogen (hormone replacement therapy or HRT). This will move the affirmed female into something akin to puberty, whereby she will experience fat redistribution, softer skin, some mood changes with increased emotional sensitivity, breast development, and it will also cause the penis to atrophy and not perform as well, if at all, as usual.

Following HRT, if surgery is desired, the candidate will have to live for one year in her new gender, prior to receiving a letter of referral from a gender specialist. It is common during this time to initiate hair removal (via laser or electrolysis), undergo facial feminization surgery, practice feminizing voice, experiment with feminine dress and make-up as well as hairstyles and body language.

After carefully selecting a surgeon, receiving a letter of support from her therapist, the affirmed female can have surgery. Though there are different techniques for this surgery, the most common will form of surgery will remove the testicles and erectile tissue of the penis in order to create a vagina lined with the skin of the penis, where the nerves and blood vessels remain largely intact. Tissue from the scrotum is then used to create the labia, and the urethra is shortened and repositioned appropriately.

 

What does female to male gender reassignment involve?

For a biological woman wanting to affirm his male gender, it is necessary to first start a regimen of testosterone (hormone replacement therapy or HRT). This will move the affirmed male into something akin to puberty, whereby he will experience beard growth and muscle development, along with a deeper voice, changes in his body odor, skin (it’s common to get acne), and even personality. Affirmed men often feel more aggressive on testosterone, than prior to taking it. On the whole, these changes can’t be reversed later. It is also common for affirmed men to have a double mastectomy (breast removal) with chest reconstruction. This makes it much easier for the person to appear as a man in public. After at least a year of hormone treatment, the ovaries and uterus are removed (although menstrual cycles tend to cease within the first couple of months on testosterone.

For many females to male transsexuals, this is as far as they will go with surgery. Going further is more complex, very costly and the surgical techniques available are not as effective for affirmed males as they are for affirmed females. For those who do continue, phalloplasty (penis construction) and testicle implants are available. It’s also possible to create a male urethra and to move the clitoris to the head of the penis.

Transgender 101:  Common Terms

Cross-dressing

Cross-dressing is simply the behavior of wearing clothes and styles that have been assigned by a culture or society for a person of the opposite gender. This behavior does not indicate that a person is transsexual or that he desires to live in the role of the other gender. Rather, it is a behavior that may be motivated by various reasons, including, but not limited to, transsexualism.

Cross-dressing behaviors that are not the same as Gender Dysphoria include:

• Drag – is a special form of entertainment based on cross-dressing

• Drag-Queen is a male-bodied person who performs as an exaggeratedly feminine character, in an elaborate costume. A drag queen will often imitate famous female film or pop-music stars.

• Drag king – is the counterpart of the drag queen — a female-bodied person who adopts an exaggerated masculine persona in performance or who imitates a male film or pop-music star.

 

Androgyny

This is a term derived from the combination of Greek words meaning man (andro) and woman (gyny), that can refer to two concepts regarding the mixing of both male and female genders or have a lack of gender identification.

 

Intersexuality

This is a term used to describe a person whose sex chromosomes, genitalia and/or secondary sex characteristics are determined to be neither exclusively male nor female. A person with intersex may have biological characteristics of both the male and female sexes.

 

Genderqueer or (intergender)

This is a gender identity of both, neither or some combination of “man” and/or “woman”. In relation to the gender binary (the view that there are only two genders), genderqueer people generally identify as more “both/and” or “neither/nor,” rather than “either/or.”

Some genderqueer people see their identity as one of many different genders outside of man and woman, some see it as a term encompassing all gender identities outside of the gender binary, some believe it encompasses binary genders among others, some may identify as a-gender and some see it as a third gender in addition to the traditional two. The commonality is that all genderqueer people reject the notion that there are only two genders in the world. The term genderqueer is also occasionally used more broadly as an adjective to refer to people who are in some way gender-transgressive and could have any gender identity.

 

Pansexual

Pansexuality means being attracted to or open to attraction to people of all different gender identities, and reflects a non-binary understanding of gender and its interplay with sexuality. Other associated terms include: Omnisexual Polysexual and Multisexual

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