Navigating the uncharted seas of gender identity

First, a disclaimer: I am no trained expert on these topics.  All my information here comes from my personal experience, courses I’ve taken on gender, and my own personal research.  In addition, even though all the information I’m giving here is verified by scholars, there’s still a lot of scientific research to be done on the topic, so ‘facts’ are subject to change as we continue to better understand the complexities of human gender.  What follows is my understanding of these concepts, and I know that the extent of my knowledge is limited.  I will keep this updated to be as accurate as possible.

Gender identity is one of those weird things that doesn’t seem important until it goes awry.  Sort of like power steering on a car, you take it for granted as baseline, not realizing how smooth it makes driving until something starts to not work.  Most people who don’t feel discontent or disconnected with their gender won’t even ‘see’ their gender identity as it coincides very well with their anatomical/biological gender.

Because this is something that hasn’t been talked about much, there isn’t a lot of agreement about the terminology that’s used.  So to start out with I’m going to talk about what exactly these words mean and how I’ll use them in my writings here.

Gender identity is one’s personal sense of their gender.  It is independent of the gender of their body.  In most people, it lines up – an anatomically male individual views himself as male.  In our Western culture, gender identity, like biological gender, is typically viewed as one of two possible categories, male or female.

To further complicate the issue, there’s not a consensus between what ‘gender’ and ‘sex’ mean, even among psychologists and psychiatrists.  Some people say that sex refers to one’s anatomical gender and gender refers to the socially-constructed category.  Unfortunately, that distinction isn’t true of English speakers in general.  For clarity, whenever I am referring to the body’s sex, I will always preface it with one of the following adjectives: physical, anatomical, or biological.  Nor will I make distinctions between the terms ‘gender’ or ‘sex’ when referring to either the physical category, social/cultural category, or personal identity.

Like I talked about above with gender identity, gender is typically viewed as one of two possible options in our culture.  I’m not going to go into too much detail here, but some cultures view gender and gender identity differently, either by providing a ‘third’ gender alternative, or being more aware of intersex individuals.  Intersex is a term used to describe bodies that cannot be classified as male or female in any physical aspect.  Examples of this are people with  chromosomes other than the standard female XX or the male XY or genitalia that are ambiguous.  There are many different conditions and ways that bodies diverge from the standard dichotomy.

I’ve already mentioned that gender dysphoria is also known as gender identity disorder (GID).  From what I understand, the APA is going to change their official listing from Gender Identity Disorder to Gender Dysphoria in the fifth edition of the DSM.  There is no clear distinction between the two terms, and here I’ll mostly call my experience gender dysphoria since it seems a more apt name (dysphoria comes from two Greek words meaning ‘difficult to bear’, and alone refers to a state of being unwell or unhappy).

Now in case you haven’t had your fill of vague terminology yet, let’s talk about the trans- terms.  There are two main labels in this category: transgender and transsexual.  Transsexual usually refers to someone who has done surgical or hormonal procedures to their body.  Transgender is more nebulous – it can refer to someone who is transsexual but also someone who simply experiences gender dysphoria without doing anything to their body.  In popular parlance, it also refers to cross-dressers or other individuals who enjoy crossing gender boundaries but who don’t experience gender dysphoria.

A third term you’ve likely heard is transvestite.  This is equivalent to cross-dresser and refers to people who typically don’t experience gender dysphoria or identify with a gender other than their biological one.  I’ll talk about this in relation to gender dysphoria a little more later.

So there’s a quick summary of some of the terminology found in the thorny field of gender.  It’s important to keep in mind, however, that the word ‘gender’ really incorporates a few distinct aspects: biological sex, the culturally- and socially-defined gender roles and expectations, and one’s gender identity.  Not only that, but these aspects are usually not as dichotomous as we’d like to believe.  Biological sex, while mostly clustering around the two chromosomal patterns of XX females and XY males, exhibits variation with individuals which can’t really categorized in either group (intersex).  Gender as a social category consists of roles and expectations that are set by culture and thus vary significantly.  Traits that one culture views as ‘masculine’ may be considered ‘feminine’ in another culture, or not even be associated with a specific gender.  The social category of gender that one is placed in is often assumed to be directly related to one’s biological gender, but as we rarely inspect each others’ genitals in social situations, it is more a product of one’s gender expression, which in most cases aligns with physical gender.

Now there’s one last thing important thing to discuss here before we’re done – the diagnostic criteria for gender dysphoria.  The APA has come up with four criteria that must be met for someone to be safely diagnosed with gender dysphoria.  They are (from DSM-IV TR):

  1. Long-standing and strong identification with another gender
  2. Long-standing disquiet about the sex assigned or a sense of incongruity in the gender-assigned role of that sex
  3. The diagnosis is not made if the individual also has physical intersex characteristics.
  4. Significant clinical discomfort or impairment at work, social situations, or other important life areas.

The proposed changes for DSM-V that’s supposed to come out this year are:

a marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months duration, as manifested by 2 or more of the following indicators:

  1. a marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (or, in young adolescents, the anticipated secondary sex characteristics)
  2. a strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender (or, in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics)
  3. a strong desire for the primary and/or secondary sex characteristics of the other gender
  4. a strong desire to be of the other gender (or some alternative gender different from one’s assigned gender)
  5. a strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender)
  6. a strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s assigned gender).

Note that there’s no discussion of sexual orientation here, i.e., someone that experiences gender dysphoria may be attracted to either or both genders.*  There’s no data I know of that show that the sexual orientation patterns gender dysphoric individuals has any relation to their identified gender.  In addition, there’s no mention of specific behaviors that ‘all transgender people’ share.  It’s common for people to see a category and immediately attach behaviors which they think are exhibited by all members of the category.  An easy example is gay men – the stereotypical image of a gay man is one that talks with a lisp, loves fashion, and is fairly effeminate.  I’ve known many gay men through my job and I know that’s not at all true.  The opposite is true of lesbian women – while some may exhibit more ‘masculine’ traits, they are, as a whole, no more masculine than straight women.

For transgender individuals, the stereotype is often conflated with cross-dressers or drag queens.  This stereotype is also not true.  In fact, many, if not most, men that cross-dress in public have no desire to lose their ‘man parts,’ do not view themselves as female, and do not fit any of the above criteria for gender dysphoria.

Please just keep that in mind as you continue to read.  Stigmas that we often have about people different than us are rarely accurate, and often harmful.

*This can become confusing when using the labels of homosexual or heterosexual for gender dysphoric individuals since those terms depend on the gender of the subject which generally isn’t in question.  To clarify, one can simply state what one  is attracted to: attracted to women, etc.

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