Toward an Understanding of Transsexuality

I was probably only about 6 or 7 when my older sister told me about Christine Jorgensen, a nightclub performer who was a man before going to Denmark to become a woman. The idea was a bit inconceivable to me, but, at that time, so were the ideas of sexual intercourse and menstruation. Over the years, several other cases captured my interest. Most notably, there was Jan Morris, formerly James Morris, a correspondent for the London Times who reached the peak of masculinity with the Mt. Everest climbing team before his conversion to a feminine persona. In .the field of athletics, Renee Richards was causing a stir. For me, they were a fascinating departure from the ordinary and little more.

It was not until more recently, when transsexuality became a controversial topic within the women's movement, that I took a closer look. It began when Olivia Records, a feminist recording company in California, acknowledged that their sound engineer was a transsexual. Many feminists raised cries of outrage that a person who had reaped the benefits of male privilege for so many years could gain a promi-. nent position within the feminist community. Others, like myself, took the position that anyone who would go to such personal pain to deny their biological sex did not need the pain of exclusion. The most immediate effect of the controversy here in Cleveland was that the local Olivia distributor quit her job in protest. The furor eventually died down, and the transsexual quietly left the Olivia collective.

The issue, however, did not remain dormant but has surfaced again--and on a much more personal level. In the Cleveland women's community, as in other communities, it has raised charges of exclusiveness and lack of compassion. It has also prompted-many of us to attempt to redefine our boundaries and challenged our basic notions of female and male.

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However, like so many issues. that we do not analyze until they directly affect us, it is fraught with ⚫ strong emotions and a great potential for divisiveness. It seems so much easier to deal with issues on a strictly theoretical level as if, in some way,

our convictions are weakened when personal feelings and real personalities become involved. But it is only by confronting controversies based on both our emotions and our intellects that we can begin to see a solution.

The Medical Definition of Transsexualism

Since, in many respects, transsexualism is a medically-defined concept, it is only appropriate to look at within the medical context. Scientifically, a transsexual is defined as a person who believes they belong to the opposite sex and attempts to live in that role. In lay language, this translates to the description commonly heard from transsexuals of "feeling like a woman trapped in a man's body" and vice ver-

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Within the current medical establishment, a -transsexual is said to be suffering from "gender dysphoria', in other words, gender discomfort. Ex-

actly what qualifies a person for the label of "transsexual" is unclear, even among the doctors who perform transsexual surgery. It is generally agreed, however, that "transsexualism is not a distinct entity but rather falls at the end of a con-

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tinuum of gender identity deviation" (Barlow, Abel, and Blanchard, Archives of General Psychiatry, Aug., 1979).

The term "gender" is crucial to an understanding of transsexualism within the medical context. Gender is considered only one of several components that make up a person's sex.

Chronologically, the first component is one's chromosomes: an XX chromosomal pattern equals female and XY `equals male. Chromosomal abnormalities, such as an XXY, are a rare occurrence and do not appear to have any bearing on transsexualism.

A second important component is a hormonal sex. Generally, females produce more estrogens and males more androgens, but estrogens and androgens are present in both sexes. It is generally accepted that mammals become females unless they receive a high dose of androgens during specific phases of fetal development. Like chromosomes, hormones are not believed to be related to transsexualism.

A third component is a person's anatomical sex. This refers to a person's primary and secondary sex characteristics-the reproductive organs, body structure, hair distribution, voice characteristics, etc. A person's anatomical sex usually falls into line with their chromosomal and hormonal sex.

A fourth component is a person's psychological sex, or gender. This element of sex encompasses the attitudes and behavioral characteristics and traits of being male or female. As one might expect, it is this aspect of sex that is most open to interpretation.

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For many purposes, sex is conclusively determined by a person's chromosomes, which can be, and occasionally are, verified by taking a sample of skin cells (e.g., Renee Richards flunked the chromosome test, thereby disqualifying him from women's professional tennis). However, some individuals, due to chromosomal anomalies and/or hormonal imbalances, are of ambiguous sex. This condition, known as interssexuality, or hermaphroditism, usually is evident and corrected medically at any early age. When the condition is discovered at a later age, for example, if a child raised as a male begins to develop breasts and menstruate as a teenager, the child is usually, at least in our culture, altered surgically to conform to the sex of their upbringing. (It is interesting to note here that in a culture in New Guinea, reported by Gajdosek in 1977, a group of children raised as females were reinitiated into the tribe as males when they developed male sex characteristics at puberty.)

For most people, these four components of sex are consistent. A child with an XX or XY chromosomal pattern produces more of the appropriate hormone, develops "normal" primary and secondary sex characteristics, and establishes both the attitudes and behavior appropriate to his or her gender. Certain physiological anomalies aside, however, this formula