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What does 'Transgendered' Mean?

Transgendered people are those whose gender identity or gender expression differ from conventional expectations for their physical sex. Gender Identity is one's internal sense of being male or female, which is commonly communicated to others by one's Gender Expression (clothes, hair style, mannerisms, etc.) Although transgendered people have been part of every culture and society in recorded human history, they have only recently become the focus of medical science. Many medical researchers now believe that transgenderism is rooted in complex biological factors that are fixed at birth, and thus it is not a choice but a personal dilemma.

Who are Trans People?

Trans people include pre?operative, post-operative and non-operative transsexuals, who generally feel that they were born into the wrong physical sex; crossdressers (formerly called transvestites), who wear the clothing of the opposite sex in order to fully express an inner, cross-gender identity; intersexed persons, (formerly called hermaphrodites); and many other identities too numerous to list here.

It's important to note that the term 'transgendered' describes several distinct but related groups of people who use a variety of other terms to self-identify. For example, many transsexuals see themselves as a separate group, and do not want to be included under the umbrella term 'transgendered'. Many post-operative transsexuals no longer consider themselves to be transsexual. Some non-operative transsexuals identify themselves as transgenderists. Despite this variation in terminology, most trans people will agree that their self-identification is an important personal right, which we strongly support.

Who are Crossdressers?

Crossdressers are the largest group of transgendered persons.  Although most crossdressers are heterosexual men, there are also gay and bisexual men, as well as lesbians, bisexual and straight women, who crossdress. Most male crossdressers are married and many have children. The vast majority live in secrecy about their transgendered status. Unlike transsexuals, they do not wish to change their physical sex.

Who are Intersexed People ?
Intersex people are born with chromosomal anomalies or ambiguous genitalia. Those with unusual genitalia are often subjected to surgical "normalization" procedures from infancy to adolescence, which usually results in loss of sexual response in adulthood. The Intersexed Society of North America has labeled this practice Infant Genital Mutilation. Some intersexed infants have even been sexually reassigned – without their consent – and later in life develop gender identity issues strikingly similar to those of transsexual people.

What causes transsexualism?

No one really knows, but there are many theories. It may be caused by the bathing of a fetus by opposite birth sex hormones while in utero, or perhaps by some spontaneous genetic mutation, which is also one of the theories of the origin of homosexuality.  Transsexual persons include female-to-male (FTM) transmen as well as the more familiar male-to female (MTF) transwomen.  Due to the intensity of their gender dysphoria, they come to feel they can no longer continue living in the gender associated with their physical (birth) sex.

What is gender dysphoria?
Gender dysphoria is the overall psychological term used to describe the feelings of pain, anguish, and anxiety that arise from the mismatch between a trans person's physical sex and gender identity, and from parental and societal pressure to conform to gender norms. Almost all transgendered people suffer from gender dysphoria in varying degrees. Some transsexual persons discover at an early age that they are unable to live in the gender of their birth sex, but the majority struggle to conform, in spite of intense suffering, until their adult years. To seek relief, transsexual persons enter gender transition.

What is gender transition?
Gender transition is the period during which transsexual persons begin changing their appearances and bodies to match their internal gender identity. Because gender is so visible, transsexuals in transition MUST "out" themselves to their employers, their families, and their friends – literally everyone in their lives. While in transition, they are very vulnerable to discrimination and in dire need of support from family and friends. Hormonal therapy can take several months to many years to effect the physical changes in secondary sexual characteristics that will produce a passable appearance, and some may never pass completely.

What is the Real Life Test?

For transsexual persons seeking Sex Reassignment Surgery (SRS), the Real Life Test (also called the Real-Life Experience) is a one?year minimum period during which they must be able to demonstrate to their psychotherapists their ability to live and work full?time successfully in their congruent gender. The Real Life Test is a prerequisite for sex reassignment surgery under the Standards of Care.

What are the Standards of Care?

The Standards of Care are a set of guidelines formulated and recently revised by the Harry Benjamin International Gender Dysphoria Association (HBIGDA) under which many transsexual persons obtain hormonal and surgical sex reassignment. While the Standards of Care minimize the chance of someone making a mistake, they have been criticized as a “gatekeeper” system. In general, a complete gender transition includes a period of psychotherapy to confirm one’s true gender, the beginning of lifelong hormonal therapy, the Real Life Test, and finally, if desired, sex reassignment surgery.

What is Sex Reassignment Surgery (SRS) ?

SRS is the permanent surgical refashioning of sexual anatomy to resemble that of the appropriate sex. For MTF transsexuals, SRS involves the conversion of penile and scrotal tissue into female genitalia. For FTM transsexuals, it may be limited to just top surgery (breast removal) and sometimes hysterectomy. While many transmen become satisfied with their new male anatomy, most opt out of genital surgeries for a variety of reasons, including the expense and dissatisfaction with the results. Many MTF trans people also undergo additional cosmetic procedures, including electrolysis to remove facial and body hair, breast augmentation, Adams Apple reduction, hair transplantation, liposuction and many types of facial surgeries.


What is the difference between gender identity and sexual orientation?

Gender identity is a person's internal sense of being a man or a woman, a boy or a girl. Sexual orientation is someone's sexual attraction to others who may be of the opposite sex, the same sex, or either sex. Like other people, transgendered people can be straight, gay, lesbian or bisexual. Generally speaking, their gender identity – not their physical sex status – determines their sexual orientation.

What is Gender Identity Disorder (GID) ?
GID is a psychological classification found in the Diagnostic and Statistical Manual (DSM) published by the American Psychiatric Association. Although GID is the only diagnosis under which trans people may receive treatment, and therefore necessary, it also is controversial. GID has been used inappropriately and harmfully by some psychotherapists to treat gender variant youth. Moreover, many if not most trans people also believe they do not have a mental disorder.

Is Gender Identity Disorder related to sexual orientation?
Not necessarily. Many gender variant children and teens who exhibit gender non?conforming behaviors are diagnosed with GID, and later in life identify as gay, lesbian or straight.  Other gay men and lesbians conform to most traditional gender behaviors, with the exception of their same gender sexual relationships.

Yet there does seem to be some overlap between gender expression and sexual orientation. For example, some lesbians express their gender in a masculine fashion, by wearing men's clothes and their hair short. This is the area where sexual orientation and gender identity issues overlap and become blurred.


Do trans people exhibit gender variant behaviors in childhood?
Just as all children experience social pressures to conform, most youth who later become transgendered adults learn to bury their true gender preferences about dress, play and names. Many families may never recognize that their child is having severe difficulties, while others report children as young as age 3 clearly preferring the other gender.

Do gender variant children benefit from psychotherapy?
Gender variant children suffering from gender dysphoria may benefit from supportive therapy, by learning to accept themselves and to cope better with social pressures. However, since the GID diagnosis has been used to manipulate these children to become more gender conforming, in efforts to prevent the development of homosexuality or transsexualism, parents are urged to screen prospective psychotherapists carefully regarding their therapeutic goals and techniques. Major medical professional organizations have declared that homosexuality is not an illness, and that so-called conversion or reparative therapies generally do more harm than good. This same concern now applies to gender variant children, adolescents and adults.

What common experiences do trans people share with other sexual minorities?
They are all subject to the same social pressures to conform, which can include harassment and even violence. Later in life, many transgendered people, like openly gay men, lesbians and bisexuals, must also deal with discrimination in employment, housing, and public accommodations. Many trans people also often confuse their internal feelings of being another gender with feelings of being gay or lesbian. It can take a long time for them to recognize and acknowledge their true identity. And, like gay men and lesbians who do not come out, many trans people must cope with a profound loneliness as members of a relatively small sexual minority.

What common experiences do the families of transgendered people share with those of other sexual minorities?
The parents, families and friends of gay, lesbian, bisexual and trans persons all may experience the same stages of denial and grief, along with safety concerns and much confusion when a family member comes out. Since the transgendered experience is less common and more complex, with more profound changes, these parents have an even more difficult time reaching the stages of acceptance and celebration that we have come to know in PFLAG. They, too, are in need of much support and understanding.

How do female hormones affect a male body?
Quite simply, it depends on the particular male body! There are however some general effects that are considered as almost universal result of HRT on the typical male bio-system...
· Loss of male sex drive
· Inability to achieve erection
· Promotion of secondary female sex characteristics
· Increased difficulty in achieving orgasm
· Decrease in semen fluid

Are there organic and natural sources of hormones?

There are a number of plants, herbs and compounds for which hormonal effects are claimed... though I've found them less than effective and a waste of time, effort and money. But each person must find out for themselves

What are the methods of hormone delivery?
As with many drugs, there are basically four methods available. Each method of delivery has its respective advantages and disadvantages in terms of placing increased demands and stress on the body's primary organs of intestine, liver, kidney and heart. Four methods are...
Orally (pills);
Intramuscular (injection);
Time-Release (implant);
Dermal (skin patch/creme)


What are the types, names, of popular drugs employed in M2F transition and available in the U.S.?
Estrogen: One of most widely prescribed estrogen drugs in the world is Premarin (the drug taking its name from its source of origin Pregnant mares urine... which, over recent years, has sparked concern for way in which battery live-stock are frequently treated inhumanely and the questionable wisdom of using medications derived from 'stressed-out' animals to treat humans). Premarin along with other estrogen drugs is available in a wide diversity of forms and strengths, the most popular being daily pill form.Although these estrogen drugs were primarily developed to treat a much wider spectrum of prospective ailments than gender transition... today, estrogen therapy forms the basis for TS-HRT and the promotion and development of female sex characteristics in a male TS.
Progesterones Progestins are essential in physical transition of most M2F TSs. Not only in the promotion of secondary female characteristics and body fat redistribution, but are a pre-requisite for the development of lactating milk sacs within the breasts.

Again, while no FDA approved drug has ever been developed specifically for the treatment of M2F TSs, a number of progesterone drugs have found favor with physicians and the TS community alike. Anti-Androgen This type of drug is frequently used in the treatment of M2F TSs to inhibit the production of male hormones and breakdown testosterone resistance and allow the newly introduced estrogen and progesterone drugs to be more effective. Though many drugs have anti-androgen properties, none were specifically developed for that purpose. However, a number of medications have achieved popularity in this application including Aladactone.

Favored for Anti-Androgen Use in the U.S. --
Aldactazide (Spironolactone (speer-on-oh-LAK-tone


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