Conclusions
The published literature on sexuality among transitioning trans people has historically been dominated by the works of psychiatrists, psychologists and surgeons. These works have been and continue to be notable for their assumptions of pathology among trans people, their inattention to sexual diversity in this population, and their serious methodological limitations. The few published works by trans people -- autobiographies aimed at winning acceptance from gender-normative audiences -- generally conformed to the stereotypes promulgated in the clinical literature. As recently as the mid-1980s, trans people were depicted as generally asexual or even sex-phobic, heterosexual to the extent that they were sexual, and focusing their sexual practices narrowly towards affirming their chosen gender identity.
In recent decades, epidemiologists, sociologists and historians have added to the available professional literature on trans experience, and sexuality in particular. Most notable, however, has been the burgeoning of popular literature addressing trans experience, especially literature produced by and directed towards trans people themselves, including autobiographical works, newsletters and magazines, and web pages, as well as artistic productions such as novels, erotic stories, and films. Particularly since the early 1990s, this literature has begun to devote significant attention to sexual issues and experiences, and has played the most significant role in articulating a much more complicated picture of trans sexuality.
While there is still no really representative research in this area, sexuality among trans people appears to be in key respects just as diverse as in any other population. Contrary to the assertions of early researchers, there is increasing evidence that there is great variation in sexual orientation among trans people, and some research even points to bi- or homosexual trans people outnumbering heterosexual ones (though these unexpected findings remain to be confirmed by more and better studies). Trans people engage in the full range of human sexual practices, not necessarily limited by gender identity or surgical status, including celibacy, manual and oral sex, penetrative and receptive anal and vaginal intercourse, the use of sex toys, BDSM and various kinds of sexual role-playing, casual sex, and sex work. The intersection of questions of gender identity and sexual practice, particularly at the site of the genitals, however, does produce some issues and experiences that seem to be either unique to trans experience or more common among trans people.
Most centrally, the gap between self-understanding and physical sex experienced by transitioning trans individuals presents a problem for sexual activity. The literature shows several different strategies employed by trans individuals to deal with this problem:
1) Avoid sexual activity altogether. This strategy sidesteps the problem altogether, and is strongly emphasized in the medical and clinical psychological literature, though it appears throughout the literature.
2) Limit sexual activity in ways that minimize or avoid experiences of discordance. This may involve focusing sexual activity on partners' bodies and avoiding sexual attention to the trans individual's body altogether, or simply eschewing any form of genital stimulation. This strategy appears throughout the literature and is emphasized in the medical and psychological literature.
3) Remap the body in ways that accord with gender identity. In this strategy, bodily features -- especially the genitals -- that do not accord with one's gender identity by traditional standards are cognitively redefined. Individuals conceive themselves as having conventional bodily features for their gender, only with more or less unconventional configurations (e.g. a large clitoris or small penis). In this way, individuals may be able to enjoy genital sexuality with little or no anxiety. This strategy is reported in recent social-scientific and autobiographical literature.
4) Reconceive binary gender categories so that no discord is experienced between the sexual body and gender identity. In this strategy, bodily features -- especially the genitals -- conventionally defined as belonging to one gender can be accepted as features of members of the "opposite" gender (e.g. penis and testes in a woman, vulva and vagina in a man). This strategy is mentioned very occasionally in the clinical literature, and appears frequently in recent autobiographical and popular literature.
5) Reject binary gender categories altogether. In this strategy, the trans individual identifies as being in neither the male nor the female category exclusively, and is thus able to see their non-traditional physical configuration as unproblematic. While this strategy was not specifically reported in the literature on sexuality among transitioning individuals, it has been described with increasing frequency in the broader trans population (as in Feinberg's groundbreaking novel Stone Butch Blues [1993/2003]), and discussions in trans-oriented Internet forums and print periodicals suggest it is an emerging phenomenon among some pursuing physical transition. These individuals may not conceive of transition as most do -- as a transition from living in one gender to living in another -- but rather as seeking specific physical changes which may enable greater personal comfort and the articulation of a gender identity that challenges binary categories. Others (like Feinberg's protagonist and the author hirself) may initially see their transition as conventially FTM or MTF, but subsequently identify as genderqueer or "other."
Potential implications of this problem turn up in almost every area of sexual experience. Supportive and understanding partners may help individuals to become more comfortable with their apparent mind/body incongruity, and trans people's choice of other trans people as romantic and sexual partners may in many cases be related to expectations of greater understanding and comfort. Sexuality can be not only a site of anxiety about identity, but also a site for identity development and affirmation, as reported by BDSM practitioners and some FTMs who had sexual experiences with natal males. Trans populations have been identified as particularly at risk for HIV infection, for reasons related to many trans people's anxieties about their genitals as well as the effects of social marginalization. Trans individuals are considered to be at higher than average risk for sexual violence; experiences of sexual violence, or fears of experiencing sexual violence, may heighten trans individuals' body dysphoria.
The "transgender paradigm shift towards free expression" may be reflected in a kind of generational shift in trans people's feelings about and experiences of sexuality, with more young trans people adopting the third, fourth and fifth strategies described above, though many (perhaps most) may still adopt the first and second strategies. If this is so, it is possible in significant part because in the last generation trans individuals have had access not only to a professional literature that delineates a rather narrow picture of trans people's sexuality, but also an increasingly diverse array of trans voices speaking about their own sexual feelings and experiences (as well as increasingly better published research).
In what follows, I have attempted to explore many of these questions through a unique study of sexual experiences in a trans sample.
Footnotes