Implications of the Transsexual Identity

            The Bryn Mawr community proudly and vocally offers an open and accepting space for all walks of gender and sexuality, offering its students an opportunity for personal exploration and growth, both as participants in and/or supporters of the queer community.  Simply living on this campus is an experiment in the complexity of gender and sexual identities, and the variation from individual to individual.  Even general terms defined today, such as lesbian, gay, bi, or heterosexual are not inclusive enough to adequately “label” all forms of sexual orientation (not surprisingly many people would prefer not to be labeled), and gender identities serve as an even greater example of complexity.  One identity in particular, that of transgendered individuals, specifically transsexuals, poses a particularly intricate mix of gender and sex “norms,” prompting questions about both the mental and physical aspects of the self in creating identity.

Although the exact science behind transgender identity is still undetermined, it is generally agreed upon in the scientific (and cultural) community that there are direct biological causes for transsexuality.  A transsexual individual, born one sex but associating their gender identity with the opposite sex, is born with this identity: it is derived from something pre-existent in their physical make up.  For many years, it was thought exposure to different hormone levels during development was the driving force behind gender identity, but new evidence by a study conducted at UCLA suggests that there are certain genes acting separately in males and females that actually lead to structural and functional differences in the male and female brain (1).  Another study looked at the differences between the volume of the central part of the BST (bed nucleus of the stria terminalis) based on its vasoactive intestinal polypeptide (VIP) innervation (2).  The bed nucleus of the stria terminalis is part of the “extended amygdala,” and is implicated in complex motivational responses and dopamine responses in diverse brain regions (3).  VIP is a biologically active neuropeptide found in both the peripheral and the central nervous systems (4), and is present in the BST and thus can be used as a marker.  Although only correlative evidence, when comparing the BST regions of a heterosexual and homosexual male alongside a transgendered female (biologically male, identifying as a female) and a heterosexual female, the results support the idea that certain physical brain structures are gender-biased and dependent.  Both of the male brains resembled each other (suggesting the results are gendered-based, not sexuality-based), having a greater volume in the BST region, while both of the female BST regions had a much smaller volume and resembled each other closely, despite the differences in genitalia. 

Despite compelling scientific evidence, evidence that at this point should not be proving gender and sexuality are biological traits and not choices but rather exploring the how and whys of such identity formation, there are still many people who lack understanding about the queer community and any “unconventional” identities.  One site I came across, while looking for examples of specific anatomical differences between genders, is bent on perpetuating gender and sexuality myths, such as the link between handedness and homosexuality, and its catch phrase is “My Genes Made Me Do It!” (5)  As it becomes increasingly impossible to deny that sexuality and gender are just as valid and equal identity traits as hair color (albeit much more complex), understanding of variations becomes essential in recognizing this biologically-derived status.

Biologically-driven variations also create a new window through which to examine our own sexual and gender identities.  It is difficult to imagine the sensation that you are one person trapped in what feels like another’s body.  Most of us are so accustomed to feeling as one with our bodies, harking back to the mind-body connection, and the debate over which really controls the other.  For the most part, however, our physical selves reflect our mental selves and even if our bodies are simply a perceived construct of our minds, at least the two match up.  In the case of a transgendered individual, the mind is displaced within the body, and the mental identity does not correlate with the physical one.  The confusion and extreme sense of disembodiment is unimaginable.

Unfortunately, most transgendered individuals not only feel like a stranger in their own body, but within their entire lives as well.  They face many of the same challenges as gays, lesbians and bisexuals (even though their identity differences are gender-based, not necessarily sexuality-based), but transsexuals are also “a minority within a minority group” (6).  Although they are typically linked with homosexuals and bisexuals, this is more because of the similar discrimination they are exposed to and the alternative nature of their identities as compared with the decided cultural norms, and not because of a similar identity situation.  In reality, there is little similarity between transsexuals and homosexuals: homosexuals have a sexual preference for the same sex, and that’s the end of the story.  Transsexuals are actually strangers in their own bodies, and have an actual identity issue, called gender identity disorder.  Some (although not all) transsexuals feel they need to physically alter or fix themselves before they can truly embody the person they mentally are.  This distinction is an important one to make: a person can be a heterosexual transsexual, identify as a woman and be attracted to men, but born, genitalia-wise, a male. 

There are a variety of medical options for transsexuals, although none unfortunately inexpensive or near-perfect.  In most cases, a transsexual will begin hormone therapy, either taking estrogen or testosterone to alter their outward appearance and acquire general sex-specific characteristics.  A MtF (male to female) transsexual, for example, will tend to grow less body hair, grow feminine curves, have a change in voice, and develop a more outwardly female appearace, whereas a FtM may begin to grow body hair, gain a deeper voice, and perhaps develop a more masculine face.  Results vary from individual to individual, however, and some hormone therapies are more successful than others.  Additionally, there are a number of SRS (sexual reassignment surgeries) that can be performed.  A FtM patient can get a mastectomy and a hysterectomy, and there are also some  surgeries that form a rudimentary penis.  The result of this SRS is not highly functional, and although the nerves are generally in tact enough to allow for arousal and orgasm, the phallace remains substantially reduced in size and does not produce a true erection.  The MtF SRS, a vaginoplasty, leaves the patient with a greater amount of options, and something appearing much more like the true anatomy of a female, although not without its own level of life-long care and maintenance required.  Regardless, it does seem much more possible for a MtF to lead a near-“normal” life than a FtM.  (referenced 7 - graphic material)

These surgeries are not for everyone, though.  In order to qualify for sexual reassignment requires rigorous psychological screening.  Additionally, the surgeries are very expensive, and many patients will have one surgery completed, only to save up for a few more years before having the next one performed.  The surgeries are very complex (understandably), and require experienced medical professionals to avoid both serious health risks and ensure aesthetically pleasing results.  Finally, especially with the vaginoplasty, if the surgery is not performed well, or if the patient does not follow proper care and dilation instructions, the skin grafts may not take or the entire vagina may collapse and seal up.  Patients do not all experience the same level of satisfaction or success after these surgeries, either.  Some experience significantly decreased sexual interest or arousal, and others lose feeling all together.  In an operation involving such delicate procedures and essential nerves for arousal and sensation, positive outcomes are never guaranteed.

Transsexuals are perhaps the most misunderstood members of the queer community.  Most people, hearing the word, immediately think of cross dressers or drag queens.  While some of these people may be transsexuals, they hardly represent the gamut of individuals within the community.  Transsexuality, far from being an identity related to sexuality, is an issue of gender alone, and this distinction is another important facet to understand concerning transsexuals.  Transgendered individuals offer everyone insight into their own gender and sex identities, and what the biological bases for these aspects of self is.  We are forced to step back and ask again what it is that makes us who were are as an individual, and how we each define our sense of self.  It is difficult to imagine what it must feel like to have the physical manifestation of your self be so drastically different from the self you feel when you close your eyes.  Examining the lengths transsexuals will go to in order to correct their physical image speaks to the importance and necessity of harmony and accordance between the brain and body, something most of us take for granted on a daily basis.

Sources

1.  “Sexual Identity Hard-Wired by Genetics, Study Says.”  Avail 14 April 2007.  <http://www.tgcrossroads.org/news/archive.asp?aid=770>.

An article originally published in Molecular Brain Research, it describes recent findings of a UCLA experiment concerning genetics and their impact on gender and sexuality

2.  “A Sex Difference in the Human Brain and its Relations to Transsexuality.”  Avail 14 April 2007.”  <http://www.symposion.com/ijt/ijtc0106.htm>.

Rather self-explanatory, this is from an article originally published in Nature, and it deals with a distinct anatomical difference in the brain between people identifying as the female versus the male gender

3.  Fudge, JL, Haber SN.  “Bed nucleus of the stria terminalis and extended amygdala inputs to dopamine subpopulations in primates.”  Neuroscience: 2001;104(3):807-27.  <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd= Retrieve&db=PubMed&list_uids=11440812&dopt=Abstract>.

Article more clearly defining the bed nucleus of the stria terminalis

4.  Sibony PA, Walcott B, McKeon C and FA Jakobiec.  “Vasoactive intestinal polypeptide and the innervation of the human lacrimal gland.”  Opthomology:1988;106(8).  Avail 14 April 2007.  <http://archopht.ama-assn.org/cgi/content/abstract/106/8/1085>.

Article more clearly defining the vasoactive intestinal polypeptide

5.  “A mainstream scientific look at sexual orientation.”  Avail 14 April 2007.  <http://www.mygenes.co.nz/index.htm>.

Not directly cited in my text, but referenced as an example of continued discrimination and misunderstanding of transgendered individuals, and others with “unconventional” sexualities or genders.  Presented as a site of scientific fact and accuracy.

6.  Lee, R.  “Health care problems of lesbian, gay, bisexual , and transgendered patients.”  West J Med. 2000 June; 172(6): 403–408.  Avail 14 April 2007.  <http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=10854396>.

Self-explanatory: presented me with an even broader idea of the difficulties specific to a transgendered lifestyle.

7.  Conway, Lynn.  “Vaginoplasty: Male to Female Sex Reassignment Surgery.”  Avail 14 April 2007.  <http://ai.eecs.umich.edu/people/conway/TS/SRS.html>.

GRAPHIC MATERIAL ON FRONT PAGE.  Images of surgery, so be forewarned.  This site explores in depth the surgical and medical options transsexuals have, as well as a history of sexual reassignment surgeries and a plethora of historical and background information on transsexuals.