Transsexuality

A transsexual (sometimes transexual) person establishes a permanent identity with the opposite gender to their assigned (usually at birth) sex. Transsexual men and women make or desire to make a transition from their birth sex to that of the opposite sex, with some type of medical alteration (gender reassignment therapy) to their body. The stereotypical explanation is of a "woman trapped in a man's body" or vice versa, although many in the transsexual community reject this formulation.

Causes of transsexualism

There is no scientifically proven cause of transsexualism. However, many theories have been proposed which suggest that the cause of transsexualism has its roots in biology.

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Proposed psychological causes

In the past, many psychological causes for transsexualism have been proposed; including "overbearing mothers and absent fathers", "parents who wanted a child of the other sex", "repressed homosexuality", "sexual abuse" or a variety of sexual "perversions". (Compare autogynephilia.)

Related Topics:
Psychological - Sexual abuse - Perversion - Autogynephilia

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None of these theories however was able to be applied successfully to a majority of transsexual people, usually not even to a significant minority. Many theories also were developed in order to describe transsexual women, and when applied to transmen, they usually work even less. Many of these theories had also previously been applied to homosexuals, where they did not work out, either. This led to theories which consider physical reasons for transsexualism.

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Experience with individuals who were surgically reassigned at birth (in order to correct deformities such as those caused by accidental castration) suggests strongly that the mental gender identification is determined at birth - individuals born male but raised as female show the same symptoms of gender dysphoria as transsexuals. (Compare intersex)

Related Topics:
Castration - Intersex

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"Curing" transsexualism

Psychological treatments aimed at curing transsexuality are historically known to be unsuccessful. As early as 1972, the American Medical Association Committee on Human Sexuality published the prevailing medical belief that psychotherapy was generally ineffectual for adult transsexuals and that sexual reassignment therapy was more useful. (Human Sexuality. The American Medical Association Committee on Human Sexuality. Chicago. 1972.) A number of other treatments have been used in the past that are now considered ineffective for people with significant and persistent cross gender identity, including aversion therapy, psychoactive medications, electroconvulsive therapy, hormone treatments consistent with the birth gender, and psychotherapy alone.

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Reparative therapy aimed at gay or lesbian people has also been applied to transsexual and transgender people, since gender variant behaviour is seen by proponents of reparative therapy as an extreme form of homosexuality (a view that has long since disappeared from almost all scientific discourses). While the Kinsey scale expressed a similar view, the scientific community today rejects this part of Kinsey's theory, making reparative therapy as useless to transsexual people as it is for gay and lesbian people. Unfortunately, even though many of the major medical professional associations have repeatedly condemned reparative therapy as not only ineffective, but actually harmful, it continues to be advocated as a treatment for both homosexuals and transsexuals by several organizations with ties to the conservative Christian movement. However, reparative therapy is not considered either standard of care or good medical/psychological care currently in modern western medicine.

Related Topics:
Reparative therapy - Kinsey scale

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However, it should be remembered that all therapy aimed at resolving gender conflicts, which is exclusive of somatic treatments to reassign physical sex, is not entirely negative. Some people may have milder conflicts between gender identity and their physical sexual characteristics. These individuals may not actually wish to pursue sexual reassignment therapy, but may seek care to help deal with the conflicts they face. If individuals express this desire for psychological care without SRS, supportive and psychoeducational counseling may be helpful. Additionally some transsexuals, who may have a significant lifelong conflict between gender identity and their sexed-body may present for care without requesting SRS. Their reasons for forgoing transition may include family or professional concerns, perceptions of difficulty of transition, worry about perceived losses of social standing or role, and sometimes even advanced age or chronic medical problems. Regardless of their reasoning, if their decision is consistent, it should be respected. These individuals can often be helped by alternative methods to improve current functional status, promote acceptance of their gender identity as valid, and ameliorate mood symptoms caused by gender conflict through psychotherapy and sometimes medications. Additionally, these individuals sometimes benefit from partial somatic treatment. Low dose hormonal therapy only, validating patients desire to dress and live partially in the gender role appropriate to their gender, and even simply allowing the person a safe outlet to express themselves as a male or female can provide a great deal of comfort to patients who for one reason or another chose not to transition.

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Physical causes

Many transsexual (and also many other transgendered) people have assumed that there is a physical cause of their transsexualism, because they claim to have had the feeling of being a girl or a boy for as long as they can remember. However, research into brain gender identity has been sparse.

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While the article by Zhou, et al: http://www.symposion.com/ijt/ijtc0106.htm, has been touted as strong evidence that transsexuality is based in structural and neurochemical similarities between the brain of transsexuals and brains typical of their gender identity, this article has numerous flaws.

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More interesting evidence comes from numerous animal studies demonstrating that exposure to cross-sex hormones during development can reliably produce cross-sex behaviors in animals. In addition twin studies have demonstrated a strong heritability for transsexuality. (Concordance for Gender Identity Among Monozygotic and Dizygotic Twin Pairs. Diamond, M and Hawk, S. American Psychological Association 2004 Annual Meeting. July 28 - August 1, 2004, Honolulu, Hawaii.) This research provides more suggestive evidence that transsexuality may be determined in part by genetics and in utero hormonal environment.

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Objections against research of causes

Scholars of gender theory, gender professionals and transsexual and transgender rights activists contest the very rationale of looking for a "cause" to transsexualism. The basic assumption behind this quest for "causes" is that gender dimorphism (the idea that there are only two discrete, well defined and dichotomous genders) is an established fact. The critics cite, among other things, historiographic and anthropological findings pointing to the fact that different cultures had diverse concepts of gender, some of them including three or more genders.

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The main argument against the search for a "cause" to transsexualism is that it assumes a priori the legitimacy of normative gender identity, i.e. gender identity congruent with the external genitalia. This, affirm the critics, is an unproved contention. Historical research shows that the relation of genitals and gender identity changes across cultures. Assuming a priori that variant gender identity is anomalous (and therefore its "causes" should be investigated) distorts science's view of gender and contributes to the stigmatization of gender non-conformists.

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