Myths about Transsexualism
Although transsexualism is becoming increasingly understood, there are still many misconceptions and false assumptions that only serve to create extra stress and confusion for all involved.
The Transgender Explored team have identified the most common myths below with a short explanation for each in an attempt to dispel some of the common misunderstandings.
Feel free to add more to this blog and together we can educate the uneducated!
Transsexualism is very rare.
Transsexualism is much more common than people think. Male to female transsexuals (MTF) generally outnumber female to male transsexuals (FTM) by about three to one, and the statistics vary. Current estimates are about 1 in 10,000 for biological males and 1 in 30,000 for biological females. Worldwide it may be as common as 1 in 5,000 people. In a city of 100,000 inhabitants, this could include as many as 20 transsexuals, if not more!
Transsexualism is a lifestyle choice.
Transsexuals do not choose to be transsexuals, just as noone can decide their own gender. Many believe this is determined at birth and is supported by an increasing body of evidence from research looking at biological causes, such as differences in the human brain and genetic factors. Many psychological causes have also been proposed and it is generally understood as multifactorial, that is, it has many different causes that vary from individual to individual. However these are out of the person's control and are not as simple as a lifestyle choice.
If you get sexually excited when cross-dressing, you can't be a true transsexual.
It is not uncommon for transsexuals to become sexually aroused when cross-dressing, particularly early on in life. It is often associated with strong feelings of things being right and so it is not surprising that, for some, it can be an invigorating experience. The main difference between a transsexual and a transvestite is a distinct one: it is not just about cross-dressing but is instead driven by a feeling that they belong to the opposite gender role.
Transvestites turn into transsexuals later on.
Transvestite people may cross-dress occasionally or may enjoy dressing up more regularly either in privacy or to socialize. Some even live full-time in female clothes, but they always retain their core gender identity as being male (in most cases) and do not wish to seek treatment to change their gender through hormones or surgery. However, for some transsexual individuals, being a transvestite may be the first step in accepting their own gender dysphoria. For these individuals, with support and time, they come to realize that they are actually transsexuals, but they represent a very small proportion of the transvestite population.
People's gender is either masculine or feminine. Transsexuals are confused between the two.
This is simply not true. Even for people who have clear gender identities, they are able to identify both masculine and feminine aspects to their personality. This is both genetically determined and modified by early life experiences, which makes each person unique. Transsexuals are exactly the same and will describe both masculine and feminine features to themselves, even if their true gender identity may not match their biological one.
Transsexuals are only found in the Western World.
Transsexual people exist all over the world with the highest prevalence being in Thailand and Brazil. Their existence dates back to early civilizations, with historical evidence showing that transsexuals in ancient Mediterranean, Indian and African tribes enjoyed high esteem as shamans, priests and sorcerers!
Transsexuals are gay.
Although, to a certain extent, there is some overlap between gender identity and sexual orientation, they are completely different concepts. Sexual orientation refers to a person's sexual attraction to men, women or both (or neither!) whereas gender identity is about an individual's sense of their own gender, whether that is male or female. Transsexuals may be attracted to men, women or both (or neither) and this is their own sexual preference and not related to their gender! Therefore transsexuals share the same feelings and choice with regard to their sexual orientation as the rest of the population.
Transsexualism is a mental illness.
Transsexualism is not a mental illness, although the symptoms related to gender dysphoria can predispose the individual to develop more serious emotional and mental health problems. Transsexualism is a medical condition and the diagnosis is controversial as, for some, it feels like the problem is being pathologized inappropriately. However it is generally accepted that the diagnosis serves the purpose of justifying medical and psychological treatments (and the development of specialist services) so it is essential to retain the diagnosis to ensure access to care.
Psychotherapy can cure transsexualism.
The current accepted and effective treatments for transsexualism include hormone therapy and gender reassignment surgery. Although this will involve counselling and other psychotherapeutic approaches, the treatment of choice includes permanent physical changes, including cosmetic procedures, if appropriate. These treatments are supported by the significant reduction in gender dysphoria following treatment, with a very low rate of regret (less than 1%).
There is no help available in the UK under the NHS.
Transsexualism is recognized as a medical condition in the UK with specific treatments that involve hormone therapy and surgery. These are available for free under the NHS provided you are given the diagnosis and follow the Standards of Care. Similarly, in the United States, there is a similar health care system that, following diagnosis, allows access to the medical and psychological treatments. The rest of Europe shares this approach and has developed specialist services similar to what is available in the UK and the USA.
Transsexuals need to be living as the opposite gender before seeking help.
It is generally accepted that specialist gender services wish to see individuals as early as possible so that they can offer help to support people to make what is the right decision for them. Therefore they would prefer to see people with gender dysphoria before they have made any serious decisions and recommend that people are referred sooner rather than later. There is no expectation for people to have begun the transition before seeking help.
You need to have the right story to get treatment.
There is no such thing as the "right story"! Everyone is different and everyone's gender experience is unique to them. Transsexuals often share common experiences in terms of their own gender development, realizations about their gender issues and how this impacted on their lives. However there is no right or wrong answer to gender development and part of the assessment process is to allow individuals to understand their own experiences, rather than conform to what is the perceived expectation.
All transsexuals need to have gender reassignment surgey.
The specialist gender service has a clear role: to support individuals in finding out about their true gender identity and to help them make the right decision for them. For many, this can involve hormone treatment and surgery. For others, it may involve no change at all. As long as the individual feels comfortable with their decision, then the job is done! There is no expectation for people to accept any treatment that they are not happy with and they can take all the time they need to make up their mind!
Can you think of any more myths? Add more with your comments here!
The Transgender Explored team have identified the most common myths below with a short explanation for each in an attempt to dispel some of the common misunderstandings.
Feel free to add more to this blog and together we can educate the uneducated!
Transsexualism is very rare.
Transsexualism is much more common than people think. Male to female transsexuals (MTF) generally outnumber female to male transsexuals (FTM) by about three to one, and the statistics vary. Current estimates are about 1 in 10,000 for biological males and 1 in 30,000 for biological females. Worldwide it may be as common as 1 in 5,000 people. In a city of 100,000 inhabitants, this could include as many as 20 transsexuals, if not more!
Transsexualism is a lifestyle choice.
Transsexuals do not choose to be transsexuals, just as noone can decide their own gender. Many believe this is determined at birth and is supported by an increasing body of evidence from research looking at biological causes, such as differences in the human brain and genetic factors. Many psychological causes have also been proposed and it is generally understood as multifactorial, that is, it has many different causes that vary from individual to individual. However these are out of the person's control and are not as simple as a lifestyle choice.
If you get sexually excited when cross-dressing, you can't be a true transsexual.
It is not uncommon for transsexuals to become sexually aroused when cross-dressing, particularly early on in life. It is often associated with strong feelings of things being right and so it is not surprising that, for some, it can be an invigorating experience. The main difference between a transsexual and a transvestite is a distinct one: it is not just about cross-dressing but is instead driven by a feeling that they belong to the opposite gender role.
Transvestites turn into transsexuals later on.
Transvestite people may cross-dress occasionally or may enjoy dressing up more regularly either in privacy or to socialize. Some even live full-time in female clothes, but they always retain their core gender identity as being male (in most cases) and do not wish to seek treatment to change their gender through hormones or surgery. However, for some transsexual individuals, being a transvestite may be the first step in accepting their own gender dysphoria. For these individuals, with support and time, they come to realize that they are actually transsexuals, but they represent a very small proportion of the transvestite population.
People's gender is either masculine or feminine. Transsexuals are confused between the two.
This is simply not true. Even for people who have clear gender identities, they are able to identify both masculine and feminine aspects to their personality. This is both genetically determined and modified by early life experiences, which makes each person unique. Transsexuals are exactly the same and will describe both masculine and feminine features to themselves, even if their true gender identity may not match their biological one.
Transsexuals are only found in the Western World.
Transsexual people exist all over the world with the highest prevalence being in Thailand and Brazil. Their existence dates back to early civilizations, with historical evidence showing that transsexuals in ancient Mediterranean, Indian and African tribes enjoyed high esteem as shamans, priests and sorcerers!
Transsexuals are gay.
Although, to a certain extent, there is some overlap between gender identity and sexual orientation, they are completely different concepts. Sexual orientation refers to a person's sexual attraction to men, women or both (or neither!) whereas gender identity is about an individual's sense of their own gender, whether that is male or female. Transsexuals may be attracted to men, women or both (or neither) and this is their own sexual preference and not related to their gender! Therefore transsexuals share the same feelings and choice with regard to their sexual orientation as the rest of the population.
Transsexualism is a mental illness.
Transsexualism is not a mental illness, although the symptoms related to gender dysphoria can predispose the individual to develop more serious emotional and mental health problems. Transsexualism is a medical condition and the diagnosis is controversial as, for some, it feels like the problem is being pathologized inappropriately. However it is generally accepted that the diagnosis serves the purpose of justifying medical and psychological treatments (and the development of specialist services) so it is essential to retain the diagnosis to ensure access to care.
Psychotherapy can cure transsexualism.
The current accepted and effective treatments for transsexualism include hormone therapy and gender reassignment surgery. Although this will involve counselling and other psychotherapeutic approaches, the treatment of choice includes permanent physical changes, including cosmetic procedures, if appropriate. These treatments are supported by the significant reduction in gender dysphoria following treatment, with a very low rate of regret (less than 1%).
There is no help available in the UK under the NHS.
Transsexualism is recognized as a medical condition in the UK with specific treatments that involve hormone therapy and surgery. These are available for free under the NHS provided you are given the diagnosis and follow the Standards of Care. Similarly, in the United States, there is a similar health care system that, following diagnosis, allows access to the medical and psychological treatments. The rest of Europe shares this approach and has developed specialist services similar to what is available in the UK and the USA.
Transsexuals need to be living as the opposite gender before seeking help.
It is generally accepted that specialist gender services wish to see individuals as early as possible so that they can offer help to support people to make what is the right decision for them. Therefore they would prefer to see people with gender dysphoria before they have made any serious decisions and recommend that people are referred sooner rather than later. There is no expectation for people to have begun the transition before seeking help.
You need to have the right story to get treatment.
There is no such thing as the "right story"! Everyone is different and everyone's gender experience is unique to them. Transsexuals often share common experiences in terms of their own gender development, realizations about their gender issues and how this impacted on their lives. However there is no right or wrong answer to gender development and part of the assessment process is to allow individuals to understand their own experiences, rather than conform to what is the perceived expectation.
All transsexuals need to have gender reassignment surgey.
The specialist gender service has a clear role: to support individuals in finding out about their true gender identity and to help them make the right decision for them. For many, this can involve hormone treatment and surgery. For others, it may involve no change at all. As long as the individual feels comfortable with their decision, then the job is done! There is no expectation for people to accept any treatment that they are not happy with and they can take all the time they need to make up their mind!
Can you think of any more myths? Add more with your comments here!
posted by Transgender Explored at
9:11 AM
8 Comments:
Dear Transgender Explored,
As a transwoman, I was really worried about what the gender clinic were going to expect me to do. I was particularly anxious about going to see the psychiatrist as I felt under quite a lot of pressure to go along with what they were expecting of me. When I actually got there, I realized it wasn't like that at all, so this was a myth that I kinda had as a trans person myself!
Jessie, Atlanta, Georgia.
I am 60 and I have had hormones and have no interest in having any surgery. I look and feel feminine and am comfortable as I am. I don't want to have an operation. I was pleased to find out that that was OK and I didn't need to have the full op!
When you say thay it is a myth that trans people are gay, well I am gay! As a trans female with a girlfriend (of 3 years), I am a gay woman, which lots of people did find hard to get their heads around. So I couldn't agree more with your comments on the post!
Alice (Bournemouth, UK).
I wanted to have the full gender change operation and I knew this since I was about 11. I had to wait 3 years for the surgery, which I think is too long.
Lisa, 29, Herts
Thanks for all your comments!
Lisa, we are currently constructing the site to include the Standards Of Care recommendations, which include the Real Life Experience test. This varies from country to country, but in the UK, as you know, it is a minimum of 2 years. We are planning a Blog to create a forum to look at the evidence-base behind this, and we are hoping to hear the views of everyone who is about to start, or has experienced this themselves. It can be found on the Real Life Experience page... coming soon.
Please keep an eye on the site and we hope you will tell us your story soon!
I think the RLE should take into account your age and how long you have accepted things. As a FTM, I think I have always been in the RLE. Think its different for transmen. I look forward to seeing the RLE postings.
Jason,24, NV
I have bipolar disorder, (age 48) and have had it for about 20 years. But some of my symptoms have never fit into bipolar, and maybe they are due to frustration at being female. Does anyone have experience with bipolar disorder and transgender? I do know I have always wanted to be a man and have always felt male. There's also been zero family and peer support - I only really have just begun to realize that I should look into whether I am transgender and should consider starting the process toward surgery. I think the psych evaluators would be a lot happier - I know I would - if I gathered some facts and life experiences of others with bipolar who have done the full transgender.
Also, if I had just the breast removal and hysterectomy, but postponed the penile/scrotum construction as I am not currently sexually interested, would that bring down the cost significantly? Or would I be leaving out a crucial part of the process and perhaps sabotaging my transition?
PS What specific health insurance plans, if any, could I get that would cover the surgery?
Thank you for your comments.
Having a mental health problem, such as Bipolar, does not mean that you can not explore gender transition. They are two, completely separate things, both having very different treatments.
We would always recommend that people seek specialist advice about stabilizing any mental health condition before embarking on gender transition because transition itself can be a stressful experience.
As for gender transition, this is completely up to you. There is no reason why you could not do it in the stages you have suggested, adopting a slow-paced transition with the support of the specialist services. Many individuals choose only "top" surgery and are happy to stay this way, particularly if there is marked gender dysphoria associated with breast development.
Funding is usually available through private health care insurance, provided that you meet the criteria for diagnosis of gender dysphoria. Treatment should not be excluded if you have a coexisting Bipolar disorder, provided that you are currently well and see a psychiatrist for advice regularly.
Please feel free to email us if you wish to discuss things in more detail.
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