Sexuality, gender and identity have a relationship that isn’t cut and dried. This article will examine some important concepts related to transsexuals - defined as persons who have a strong desire to assume the physical characteristics and gender role of the opposite sex, and who also may have undergone hormone treatment and surgery to attain the physical characteristics of the opposite sex.

We will also investigate gender reassignment as an option for those struggling with gender anxiety and look at issues that transsexuals face when they cross traditional gender boundaries.

What is the difference between sex and gender?

Sex refers to the biological attributes that assign someone to be male or female. The term includes factors such as reproductive organs, hormones, chromosomes and genitalia. On the other hand, gender represents psycho-social or psycho-cultural behaviours and beliefs, such as the way people feel about themselves, the way they interact, and what their beliefs are regarding male and female categorizations.

Gender Dysphoria

Trying to fit into a traditional gender role creates disorder and confusion when a person isn’t convinced that they represent psychologically that which they are biologically. The condition of gender dysphoria is categorized by the pain that an individual struggles with when they cannot identify with the gender they were born with, or were assigned due to being born intersex (displaying physical sexual characteristics of both male and female).

The causes of gender dysphoria are unclear but researchers recognize biological and environmental factors: genetic and hormonal profile, reproductive organs, genitalia, parental structure and upbringing. Issues can arise as a result of gender dysphoria and can result in: depression, substance abuse, social stigma, desire for surgery, higher incidence of suicide, and difficulties maintaining romantic relationships. Those struggling with gender dysphoria can often be victims of gender-based discrimination such as violence, forced sex, and job loss.

Gender Identity Disorder

Gender identity disorder identifies persons whose intense desire it is to express their gender differently from that which is usual to their biological sex. Moreover, distress felt by this condition is severe and persistent. This classification is a formal diagnosis used by psychologists to describe those who experience gender dysphoria and it applies to a range of matters related to gender identity, including transsexualism. The intensity of the disorder is heightened in societies that do not approve of cross-gender behaviour.

Controversy exists vis-à-vis the classification of gender identity disorder: transgender persons do not regard their feelings as a mental ‘disorder’ or ‘condition’. The psychological models that have been developed to classify transsexual persons seeking gender reassignment have evolved over the last 100 years.

At the beginning of the century, transsexualism was characterized as a type of mental illness. In the last 20 years a newer model regards it as an innate variability that occurs in human beings. Moreover, it recognizes gender reassignment as a human right of choice. Perhaps in the future the formal classification of transsexualism will be removed from diagnostic manuals, just as homosexuality was in the early 1980’s.


One of the most common associations with transsexualism is that a person feels ‘trapped’ in the wrong biological body. A transsexual person deeply connects with the opposite gender and will most often physically assume that gender identity through hormone therapy or surgery. Transvestitism, on the other hand, involves changing appearance with clothing and makeup but doesn’t necessitate a permanent physical change.

Non-op transsexual persons fit in between these two designations because they do not seek out gender reassignment surgery, but do present themselves as the opposite gender to society.

Transgenderism is a term that encompasses a broad range of tendencies that are not traditionally specific to one gender or orientation; however, transsexualism is considered to fall into a separate classification.

The jury is still out when it comes to defining the nature of transsexualism. There are a number of factors that contribute to the existence of transsexuals ranging from biological, cultural and environmental; additionally, there are different causes that affect those who are intersex versus non-intersex.


Individuals who are intersex add a multifaceted dimension to gender identity discussion. The term hermaphrodite describes the condition where a person is born with both sets of male and female genitalia.

In contrast, intersexuality is an all-encompassing term that acknowledges that a person is born neither exclusively male nor female; it includes numerous conditions such as chromosome mutation and ambiguous genitalia. The lines become blurred when a person is born intersex: how does one appropriately choose an identity when the genetic makeup is obscured? The appropriate approach is still being researched by the medical community in order to minimize the gender dysphoria.

Gender Reassignment

Sex Reassignment Therapy (SRT) accomplishes the physical alterations that a transsexual person seeks to align their gender identity with their biological sex. Early gender surgeries date back to the early 1900’s; they entailed the removal of the external genitalia, but didn’t actually reconstruct new genitals as this technology did not evolve until several decades later.

Ex-GI George Jorgensen who later became Christine was the first widely known figure in the United States to undertake a male-to-female gender reassignment surgery. After undergoing the transition, Christine became well known in the media and used the attention to share her experiences; her coming-out represented a historical change.

Before one can undergo sex reassignment therapy, the surgeon and patient have to adhere to the Standards of Care developed by the Harry Benjamin International Gender Dysphoria Association. According to the Standards of Care, patients ought to undergo a Real-Life Experience prior to surgery, a waiting period where the transsexual person lives life as the target gender; this may be required for up to 2 years, particularly for trans-men, females transitioning to male (trans-women are thus males transitioning to females).

Studies show that female to male transition is less common and creates a tougher set of challenges, because phalloplasty is more difficult and more costly than vaginoplasty. Originally the reason behind the tradition of a Real-Life Experience is to minimize regret after surgery and to determine one’s satisfaction living as the opposite gender. As an alternative, the patient undergoes a set period of therapy. There is research currently being done to determine the efficacy in these standards as there was little documented research done when they were initially instituted. Despite the preparatory requirements, by and large, the goal of this surgery is to achieve an integrated sense of self, one that is now united psychologically and physically. Once this is achieved, the existence of gender dysphoria can recede and the patient can live as they have always desired.

Social Acceptance

Gender issues, with reference to transsexualism, are gaining more positive attention in our culture, but the public’s understanding of the nature of transsexualism is slower going. Part of the reason is due to our society’s deficient acceptance of cross-gender behaviour. Even in infancy, the outcome of whether a person is born male or female elicits a strong set of gender-based expectations and stereotypes. When one acts outside of those defined gender roles, their behaviour may be discouraged or rejected by family and peers because of fear that the child may become ostracized in schoolyards and society if they behave outside of traditional roles.

Alternative and independent media is moving toward the depiction of non-traditional gender roles on screen, but Hollywood tends to prefer safer sexual topics. Successful movie production depends greatly on box offices sales surpassing production costs; therefore, theme selection that appeals to as large an audience as possible limits a director from exploring lifestyles that stray from the norm. In spite of this, large-scale movies like Transamerica or Boys Don’t Cry have been created in an effort for the general public to accept the humanity in the sexual identity struggle and to show the many sides to gender identification and sexual reassignment.

Common Misconceptions

Some people mistakably believe transsexualism is purely about sexual orientation, but in practice it is more often about finding love from a partner who accepts you the way you are and doesn’t judge you for it. It doesn’t necessarily mean that a transsexual is a gay person with the objective to change genders in order to seem heterosexual; rather that transsexualism means that you have a set of personal qualities that traditionally are espoused by the opposite gender. In fact, to be considered by others to belong to the other gender would harmonize inner feelings with outer identity.

The way a transsexual person feels treated by others matters to them, because the way they express themselves to the world is impacted by the way that they are acknowledged and accepted. Labels and stereotypes can lead to expectation; the degree to which they are strictly held will depend on culture, level of education and the generation to which an individual belongs. We should all ask ourselves to what degree do we make assumptions about others according to our preconceived notions about gender?

Transsexualism represents a deconstruction of gender; it gives all people, regardless of gender, the opportunity to question stereotypes. One of the reasons that transsexualism is so difficult for people to understand and ultimately accept is that it challenges their underlying beliefs about identity. Those who are challenging boundaries set by biological sex are pioneers for uncharted gender territory … as medical and psychological sciences advance we are sure there will be much further discussion on this topic…

You can get more information on alternative sexual orientations by reading our articles on Heterosexuality, Homosexuality and Bisexuality.

Coach Lilian
Transexual Life

So, let us talk about a women who thinks is a man and feels as such for over 40 yeras..and walks, dresses extremely what? She says she is from within a man..she looks very Butch. Her behaviours are extremely irrational to a point of agression. Her life is intemacy disfunctional. So, here she live her life around Lesbian to be accepted.even so she get hurt in long she wants a REAL WOMEN who likes a man. But problems is the birth certificate sais she *WOMEN* and so the best she thinks she can do is finding lesbians. It is sad in many ways. My client is very sad..because she had met a women ( not lesbian) and she could not handle her because she does not know how to be with women.
The women tried to have them go to counselling! Me-the counsellor. The Transgender refused..WHY ? is my question from any of you..

interesting topic.

Hmmm ok well how about this.

Hmmm ok well how about this. I'm a 14yr old, 100% straight female in a very deep relationship with a 15yr old, 100% straight male. We're both perfectly content with our sex and genders and are 100% heterosexual. Yet I wear guys pants and shirts that go for either gender, but I wear perfume, lip balm, have long hair. My boyfriend thinks I'm beautiful eventhough I wear clothes that hide my figure (I still look UNMISTAKEABLY like a girl. He's not gay and I'm not a transsexual and I'm very contented to my gender and sex. Explanation for all of this: I simply find baggy clothes to be more comfortable and guys clothes are less slutty and restricting, I'm also a tomboy, but again I still look, sound and act clearly like a girl. Didn't think of that now didjya?

Another important thing to

Another important thing to note is that dressing in the clothes of the other sex (Transvestism) or gaining pleasure from imaging oneself as the opposite sex (Autogynophilia) are often just kinks, and not necessarily indications of being a Transsexual (although many transsexuals do exhibit them as well).

Also, transsexualism or a transvestitism of whatever kind does not necessarily make a person homosexual or bi-sexual. Although possibly male transgenders and transvestites are more ready to admit to being bi-curious than other groups of men!

Transsexuality, like homosexuality is today generally becoming attributed at least in part to genetics, with people knowing there is something 'wrong' with themselves from a very young age. The horrible tragedy is that many transsexuals remain 'in the closet' until after puberty and thus, with the limits of current technology cannot change their body to be as it should.

I say this with the knowledge of a fetishist whom for a long time was led to believe that my kinks were an indication of being a transsexual (both by transsexuals and 'normals'), which never felt right.

Thankfully it seems that the kinks are now slowly becoming acknowledged as separate to Transexuality, and I can happily continue being a (mostly) straight man whom occasionally gets a thrill out of dabbing on some makeup and donning frilly undergarments.

It is a complex world out there.