Transsexualism

1
Transsexualism

• Kari Whitaker
• Human Sexuality
• Dr. Paul Young
• 4-16-98

2
Definitions of Transsexualism

• There is general agreement that transsexualism
  occurs when a person strongly believes that they
  belong to the opposite sex.
• This is typically a lifelong feeling and results
  in varied degrees of physical/external changes
• There is also some debate around what
  transsexualism should be named.

3
Different Names for Transsexualism

• just a condition
• a phenomenon
• a mental disorder
• a neuroendocrine disorder
• gender identity disorder
• a pathological disorder

4
Transsexual vs. Transgendered

• Transsexuals
• people who have had partial or total sex-change
  surgery or who take hormones in order to change
  their physical appearance
• Transgendered
• people who live as the opposite sex without any
  alterations of their physical appearance through
  hormones or sex-change surgery

5
Historical Background

• Transsexualism was not recognized in the medical
  field until 1853.
• 1949 - termed psychopathia transsexualis by
  Cauldwell
• 1966 - Benjamin published The Transsexual
  Phenomenon
• deemed it incurable
• only treatment - sex reassignment surgery
• his patients were among the his most miserable

6
More Historical Background

• 1980 - DSM first defined transsexualism as an
  illness

7
Diagnosis (DSM-IV diagnostic criteria)

• A strong and persistent cross-gender
  identification
• Persistent discomfort with their assigned natal
  sex and its associated gender role
• Absence of any physical intersex condition
• Clinically significant distress or impairment of
  social or occupational functioning.

8
Prevalence

• not common and exact prevalence is unclear
• Estimations
• one in 700 people affected
• 10 times more common in men
• .025 of American population call themselves
  transsexual
• vast majority are in the West
• occurs in both heterosexual and homosexual
  individuals

9
Etiology

• There has been much debate as to the cause of
  transsexualism
• Ellis - sex assignment and rearing responsible
• Money, Hampson and Hampson - socialization rather
  than birth is responsible
• Stoller - found little evidence of genetic causes

10
More Etiology

• Kallman et.al. - found strong genetic and
  biological components to be involved
• Environment Theory
• Transsexualism is developed through four stages
  throughout life
• 1. Same - different comparing
• 2. Self testing and niche searching
• 3. Decision making and mental switching
• 4. Decision actuating and physical switching

11
Treatment

• Purpose to help patients achieve their goal
  rather than attempt to change their identity
• A common treatment is called Sex Reassignment
  Surgery (SRS) however, there are guidelines that
  are to be followed if this is the route taken.

12
Guidelines for SRS

• The patient must first undergo the Real Life Test
  (RLT)
• The patient lives and works as the new sex for
  a year in order to learn how to survive
• The patient also begins to take hormones to alter
  body chemistry

13
Sex Reassignment Surgery

• The procedure itself takes between four and five
  hours
• The health, fitness, hygiene and age of the
  patient are key factors in the success of the
  surgery
• There are different procedures involved in the
  surgery depending on whether a male is
  reassigning to female or a female is reassigning
  to male.

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For Male to Female Transsexuals

• vaginoplasty (construction of a vagina)
• penectomy (removal of the penis)
• orchidectomy (removal of the testes)
• clitoroplasty (construction of a clitoris)
• breast augmentation (breast enlargement)
• rhinoplasty (reshaping the nose)
• hair transplants and face remodeling

15
For Female to Male Transsexuals

• hysterectomy (removal of the uterus)
• oophorectomy (removal of the ovaries)
• bilateral mastectomy (removal of the breasts)
• phalloplasty (construction of a penis)

16
Hormone Treatment Method

• Hormones are manufactured and controlled by the
  endocrine system
• They are chemical messengers to the body
• Artificial hormones may be given to patients to
  produce desired effects
• Sometime there are also a few undesired effects.
• The hormones have different effects for different
  patients

17
Male to Female Hormone Effects

• Fertility decreases
• Male sex drive decreases
• Breast size increases
• Fat is redistributed
• Body hair growth decreases
• Muscle tone may decrease
• Oil and sweat glands become less active
• Metabolism decreases

18
More M2F Hormone Effects

• Fingernails become brittle
• Body odors change
• Female sex drive increases

19
Female to Male Hormone Effects

• Vocal cords thicken
• Fertility decreases
• Clitoris elongates
• Body and facial hair increase
• Male pattern baldness may set in
• Oil and sweat glands may set in

20
More on Hormones

• Hormones have never been proven to alter any of
  the following
• strength
• size
• fat
• heart
• blood
• body frame

21
Social Issues

• With any change in physical appearance, whether
  by SRS or hormones, there are bound to be social
  issues that arise.
• For example
• the need for a support group
• facing employment discrimination
• facing rejection from family and friends
• beginning new relationships in the community
• attempting to live a fulfilling life

22
Ethical Issues

• With any medical proceedings, there are ethical
  considerations
• There are three main duties of the psychologist
  that they are required to fulfill
• identify clearly the client and their rights
• never cause any harm to the client whether
  actively or passively
• show sensible regard for moral and legal standards

23
Myths about Transsexualism

• A transsexual is a male homosexual
• Transsexualism is not a matter of homosexuality
  but rather one of gender identification
• A transsexual is a transvestite
• A transvestite typically only dresses similar to
  the opposite sex to fulfill a fetish but still
  remains true to their original gender identity

24
More Myths

• A transsexual is created by cutting of the
  penis and replacing it with a constructed vagina
• Typically, the only parts that are removed are
  the testes and the inner tissue of the penis.
  ALL of the other tissue is used to construct
  female genitalia.

25
Final Words

• There is much debate over what a transsexual
  really is and what different treatments there
  are.
• It is important to remember that before making
  any hasty decisions about transsexuals, one needs
  to do extensive research into the subject