Our Bodies, Ourselves (18 page)
Read Our Bodies, Ourselves Online
Authors: Boston Women's Health Book Collective
For transsexuals, the process of changing gender presentation may range from modifying names and/or use of pronouns to undergoing hormone therapy and possibly surgery to bring one's body more in line with one's gender identity/affirmed gender. Owing to prejudice in some parts of the medical community, high medical costs, and lack of insurance coverage, many transsexuals are unable to afford surgery and instead use clothing, makeup, and mannerisms to live as the preferred gender.
trans.
This shortened form could mean trans-gender or transsexual, and many people use it to mean both.
trans man.
A person who was born biologically female and identifies and portrays his gender as male. Sometimes called affirmed male or, simply, male. Also known, especially in medical literature, as female-to-male (FTM) transsexual.
trans woman.
A person who was born biologically male and identifies and portrays her gender as female. Sometimes called affirmed female or, simply, female. Also known, especially in medical literature, as male-to-female (MTF) transsexual.
Some people question the use of MTF and FTM:
A lot of trans people have moved away from MTF and FTM, feeling that the terms tend to involve too much emphasis on the “change” part of our identity formation and too little on the “existence” part. That is, once one is defined as MTF or FTM one is left feeling that the transition is what defines our identity, rather than the existence of characteristics or traits of the internal gender, the trans person's so-called true identity.
In other words, how can one be “in transition” from the gender one has always been?
cisgender.
Refers to people whose gender identity and presentation fit traditional norms for the sex they were assigned at birth.
cissexual.
A person who lives and identifies with the sex assigned at birth. Those who are cisgender/cissexual tend to experience an inner
harmony between who they feel they are and how the world sees them. They also enjoy the privilege of having their legal sex and gender identities taken for granted and considered valid in a way that those who are transsexual do not.
THE ABCs OF COMMUNITY
As queer communities have become more inclusive, the language of the early gay liberation movement has expanded. The acronym LGBTQ, preferred by many, incorporates those who identify as lesbian, gay, bisexual, transgender, transsexual, questioning, and queer. The inclusions are more than semantic; they are political. They acknowledge the variety of identities and experiences within queer and trans communities.
Whipping Girl author Julia Serano
explains the history and use of cisgender and cissexualâterms that are fairly new and have not been embraced by all gender activists
*
âon her website, juliaserano.livejournal.com:
As a scientist (where the prefixes “trans” and “cis” are routinely used), this terminology seems fairly obvious in retrospect. “Trans” means “across” or “on the opposite side of,” whereas “cis” means “on the same side of.” So if someone who was assigned one sex at birth, but comes to identify and live as a member of the other sex, is called a “transsexual” (because they have crossed from one sex to the other), then the someone who lives and identifies as the sex they were assigned at birth is called a “cissexual.”
Cisgender and cissexual are neutral terms. Using them avoids singling out those who are transgender as being different or abnormal, and affirms that the spectrum from cis to trans expression is all part of natural variation.
Other gender identity labels.
Within queer communities, terms such as butch, femme, and androgynous are used to describe points on a spectrum of masculinity and femininity. Other terms include tranny boys, femme queen, and more. Within straight communities, terms such as girly-girl and tomboy are used to label gender characteristics or expressions. While some people who fit the criteria of these definitions use these terms, others do not.
Regardless of gender identity or sexual orientation, all people have the right to use the term with which they feel most comfortableâand to ask others to respect that choice. It can be painful and awkward when assumptions are made about gender identity based on appearances alone. If you're not sure how a person identifies or what pronoun to use, ask politely. Joanne Herman, author of
Transgender Explained for Those Who Are Not
, explains, “We like your asking much better than if you guess and get it wrong, and we get especially unhappy if you use the pronoun âit.'”
In addition to he, she, her, and him, some in the transgender community use alternative pronouns such as ze and hir as descriptors. Herman notes that she finds “ze” and “hir” “a bit awkward,” but adds that she “felt the same about âMs.' at the beginning. Now I'm glad it's the default.”
2
There is no doubt that from very early on I knew something was wrong. I was a girl, yet my parents named me John Joseph and insisted that I was a boy.
According to the American Psychiatric Association's
Diagnostic and Statistical Manual of Mental Disorders
(DSM), the resource that mental health providers use to diagnose mental illness, transsexuals have a gender identity disorder (GID). Some prefer the term gender dysphoria because it better describes the feeling of being born in a body that doesn't match who you are inside. Others find both terms stigmatizing. In order to have access to the surgeries and/or hormones that some use in order to live successfully in their preferred gender, current medical practice requires a psychiatric diagnosis of GID or gender dysphoria. Insurance coverage, however, is often less available for psychiatric diagnosis.
A revision of the DSM is expected in 2013. Many activists are hard at work seeking to influence the authors to remove the designation of GID as a psychiatric condition.
Many transsexuals who can afford medical care take cross-sex hormonesâeither estrogen or testosterone, as appropriate to the desired female or male physical expression of gender. Some pursue one or more gender affirmation surgeries (often known by the less-favored older name, sex reassignment surgery). For trans women, surgeries can include feminizing genitoplasty: creation of a neovagina, usually from scrotal tissue (some surgeons use colon tissue); relocation of glans penis to a neoclitoris; and gonadectomy (removal of testes). Surgeries can also include breast augmentation, Adam's apple reduction, and facial feminization surgery. Surgery to alter voice pitch is available, but the results are often disappointing and can result in permanent hoarseness.
For trans men, surgeries can include breast reduction or mastectomy; removal of uterus and ovaries; and phalloplasty, or the technically simpler and therefore less expensive metoidioplasty, both of which involve creating a penis out of the testosterone-augmented clitoris and a scrotum out of labia majora using skin grafts and testicular prostheses. So far, genital surgery for trans women has been more satisfactory in terms of physical and sexual functioning than that for trans men.
Jack B.Pierson
Sasha Alexander and Ana Gordon-Loebl from Pioneering Voices, a Family Diversity Projects exhibit
With or without surgery, many transsexuals go through intensive retraining on how to walk and talk and present as their preferred gender.
While cross-sex hormones and surgery can help trans people achieve a better fit between body and identity, these medical interventions are expensive and are not often covered by health insurance (see
“Insurance Exclusions,”
). Surgery and hormones also carry health risks, require ongoing medical surveillance, and may impair sexual functioning. (See
“Side Effects and Risks of Hormone Treatments,”
)
For these and other reasons, many transsexuals manage to live as their preferred gender without pursuing surgery, and some without hormones. Yet in most states, government agencies will not change identifying papers such as a driver's license or birth certificate for someone who has not transitioned medically by means of hormones and surgery. This means that the privileges of full legal transition are frequently out of financial reach. As one trans woman says:
© R.A.McBride
“I CLAIM THE RIGHT TO CHOOSE MY ULTIMATE GENDER”
SUNEEL(A) MUBAYI
I identify as a male-to-female (or male-to-feminine androgynous) transgender or genderqueer person in a male body. I was born and raised as a straight male but started questioning both my gender and sexuality around the age of sixteen for many complex reasonsâ¦. When I was little, kids in school would make fun of me by calling me “Suneela” to characterize a perceived weak and effeminate nature. I decided to reclaim this, but in a way that would make people think and not assume my gender when they look at my name (Suneel is a boy's name in Hindi). It gives me an androgynous quality, which I like.
Often I'm plagued by self-doubtâam I doing this just to attract attention? I answered it myself when I expressed these doubts to my friend Erica (thank god for her) and she asked me the most fundamental question of all: What does being a woman mean to you? To me, being a woman means having an identity that is feminine but without any preconceived notions, ideas, or mind-sets about what a woman is or what a woman should beâin any sense, be it in terms of looks, actions, habits, social roles, or anything else. Everybody feels like there is some kind of “ideal” man and “ideal” woman. Well, I reject that. I am a woman with no conditions and no strings attached. And no presumptions, either. You may find me rather androgynous, deviant, and gender-bending. I like to dress up, be pierced, and be effeminate or girly.
Yes, I am all those things, or rather, I possess all those qualities. But I claim the right to choose my ultimate gender beyond my traits, looks, qualities, and features, even if it is different from the sexual organs I possess. And whether that's feminine or hermaphrodite or my desired blend of masculine and feminine is my choice. You can love it, be okay with it, be uncomfortable with it, be revolted by it, or leave it. But it's my choice. Being a woman means being a woman.
TRANS BODIES, TRANS SELVES
The upcoming book
Trans Bodies, Trans Selves
promises to be a comprehensive resource for transgender and other gender-variant people. Editor Laura Erickson-Schroth says:
As a medical student I realized that my gender-variant patients and their families were having a hard time finding reliable and comprehensive information about their health and their communities. Inspired by my second-wave feminist mother's battered copy of
Our Bodies, Ourselves
,
I set out to gather a group of authors and volunteers who could create the same kind of comprehensive community resource, by and for transgender people, that had been created by the Boston Women's Health Book Collective.
Trans Bodies, Trans Selves
will cover health, legal issues, cultural and social questions, history, theory, and more. It will promote trans-positive, feminist, and genderqueer advocacy and be a place for transgender people, partners and families, students, professors, guidance counselors, and others to look for up-to-date information on transgender life. For more information, see transbodies.com.
Given that the legal determination of gender rides almost solely on a medical chassis, the uneven access to medical help experienced by trans people living with poverty and frequently by trans people of color means that many less-privileged trans folk have a very difficult time attaining legal recognition of our target gender.
Given the extremely high level of antitrans violence, the lack of a legally acceptable ID in one's chosen gender can be a critical missing safety factor.
With or without medical assistance, being able to live as our true selves can mark the end of years of dissonance and inner anguish. Joanne Herman writes about having felt “the wrong primary sex hormone coursing through my body.”