So ..uh, what's a transgender?

So ..uh, what's a transgender?
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Hi there!

I’m a transwoman, grew up in a small town in Kansas, lived life as a male for twenty-five years, and only just recently jumped into my own transition head-first.

I’m lucky enough to say that we live in exciting times for the transgender community; we finally have some visibility, we’re discovering new allies, the Obama administration is fighting for us, and more people are informing themselves of our issues. However, I’m finding that many statements and arguments surrounding trans people are often preconceived and based on incorrect assumptions.

The terminology in the transgender community can be a bit overwhelming, so I’d like to offer clarity there. I want to expose some of the culture and history of transgender people, address some concerns people have with the state of current events and offer some insight into the transition process. Above all, I just want to try and offer my perspective.

Transgender is an umbrella term.

People often use the terms “transgender” and “transsexual” interchangeably. This isn’t quite right. “Transgender” is really just an umbrella term for all people who have some sort of variance in gender.

This umbrella includes folks who are transsexual, gender fluid, agender, demigender, or a number of other identifications. There is a shitload of terminology, I know, but luckily this infographic from the The Trevor Projectis particularly helpful.

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Image from The Trevor Project.

Gender identity and sexual orientation are commonly coupled together, but as the infographic shows, they actually lie on separate spectrums. This is an important distinction because they doesn’t necessarily affect another.

I included the disambiguation here because when we discuss transgender issues, the depth of discussion usually falls short. We often incorrectly frame these issues solely from a transsexual lens and the focus is more commonly placed on trans women (male to female, or MTF) over trans men (female to male, or FTM).

We can do better. We need a broader scope when we address these issues and we need to include all people within the transgender bubble.

tl;dr Transgender doesn’t necessarily mean transsexual and visibility should be extended to all within the umbrella.

Edit: It came to my attention after publishing this article that some terms I used are a little dated, specifically MTF, FTM, and transsexual. I tried to use MTF and FTM to describe trans people in early transition; however, do note that the terms “trans man” and “trans woman” are generally preferred over FTM and MTF respectively.

As for the term transsexual, it varies on the individual, but it’s generally safer to use “transgender.” This is contrary to what I just said, but as far as I know, there really isn’t a good, single term to describe someone who is medically transitioning but not presenting. As the time, “transsexual” felt more appropriate for me, but I now prefer trans woman as a label for my gender identity. You can find more details on terminology here.

Also note that the Trevor Project infographic can give the impression that femininity implies the absence of masculinity or vice versa. Since that’s not really the case, two-dimensional graphs are preferred by some to illustrate the spectrum, such as this example that was provided to me.

Alright, back to the fun!

We’re not new.

Despite the illusion provided by the current hype and commotion around our culture, transgender history actually goes pretty far back. I’m certainly not an expert in the subject, but it’s interesting to see how transgender folks lived and existed across different cultures and eras.

Gender variance is well documented in many Native American tribes, ranging back as early as the seventeenth century. Originally known under the term Berdache, transgender people in these tribes were known and highly regarded for their skills as shaman, fortune tellers, or as assets on the battlefield. But also dude, Berdache is not the preferred nomenclature. Two-Spirted, please. Unfortunately, unhealthy amounts of this culture was crushed during the reservation era from westernization. However, I believe the culture is coming back. From documentaries and social movements, Two-Spirited people are finally reclaiming their heritage.

In India and other South Asian countries, trans women are often referred to as “Hijra.” Droves of terminology accompany the term “Hijra,” used to describe transness across various countries and cultures. Once revered for their culture significance, Hijras have more recently experienced an uphill battle with society. Section 377, an archaic law from 1860, was upheld by the Supreme Court of India in 2013 despite its use to attack and oppress the rights of the LGBT community. It’s not all bad though. The Indian government officially recognized a third gender in 2014, providing rights to voting, education and work for third gendered people. And thanks to the hard work from the Naz Foundation and LGBT activists, a curative petition was pushed against Section 377. With any luck, this petition will trash Section 377 in the India Penal Code.

And beyond culture specifics, many notable transgender people have made their mark in American history. Albert Cashier served in the American Civil War. Billy Tipton was a jazz musician in the early twentieth century. Wendy Carlos performed a collection of Bach pieces on Moog synthesizers for the album, Switched-On Bach. She also composed the music for Stanley’s Kubrick’s A Clockwork Orange and The ShiningMurray Hill was a politician in the late nineteenth century.

Marsha Johnson and Sylvia Rivera, along with many other LGBT folks, helped stir the fire at Stonewall, one of the most infamous riots for LGBT rightsChristine Jorgensen, one of the first heavily publicized transgender people in the United States, used her notoriety to give transgender people a voice in times where transgender culture was largely unknown. Leslie Feinberg also helped bringing attention to transgender issues with her writing, most notably the book, Stone Butch Blues.

tl;dr I can’t speak for all specifics, but the transgender community has a deep and rich history across all cultures.

We’re not perverts.

I sympathize with those who are afraid of trans people using the restroom that aligns with their identity; I really do. No doubt you’re worried about the safety your kids, your spouse, or your friends. I get the apprehension. However, these concerns are a little misguided.

In my experience, one of the most common arguments I see against trans people using the bathroom they feel comfortable with almost always boils down to predatory concerns. The public right now is so shocked by the notion that a trans man may use the men’s restroom or vice-versa. Forget about the fact that the estrogen flowing through my veins has totally killed my sex drive (true story) or that trans people just want to shit, we’re in the bathroom to prey and pillage people. Of course this is ridiculous, but why is this perspective so pervasive?

I suspect people are sexualizing the bathroom, which is bizarre. I don’t know what you do when you go to the bathroom, but it’s a pretty good guess you’re not in there for sex. Moreover, given that media portrayal of the trans community has been less than favorable in the past, I believe many of these arguments are predicated on this false representation.

We are not perverts. We are not in the bathroom to prey on your kids or people you care about. We simply want to go to the bathroom, you know? I think there are real sexual assault issues that are more deserving of this attention.

tl;dr Being transgender and sexual perversion are not the same thing. This brings me to my next point…

Transitioning sucks.

Another argument against transgender bathroom use goes like this:

Oh, so I can put on a dress, call myself transgender, and use the women’s bathroom? Perfect!
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Come on…

I’m certainly not here to complain, but for transsexuals, the choice to transition isn’t taken lightly and it sure as hell ain’t easy. The process for transitioning is a web of confusing rules, harsh realities, and tough choices. Besides all the internal turmoil and self-realizations you have to go through to even begin considerations, transitioning is an exhaustive list of to-dos.

There is transgender therapy, because your gender feels like a confusing mess. And in many states, you need a letter of recommendation from a qualified gender therapist to begin hormone replacement therapy. I did. Therapy isn’t typically covered by health insurance either.

Hormone replacement therapy, or HRT, is a core part of the transition for many transsexuals. Doctors prescribe FTMs with testosterone, most commonly administered via injection or creams. This is used to spur muscle growth, hair growth, deepening of the voice, and more. Trans men on HRT also experience many lesser known side-effects such as increases in hunger, energy, or sex drive.

This process varies a bit for trans women. While injections are also available for MTFs, endocrinologists tend to prescribe Estradiol (estrogen) and Spironolactone. Estradiol contributes to breast development, softer skin, redistributed fat stores, and a whole lot more. Spironolactone is used as an antiandrogen, which helps maintain the effects of estrogen and reduce things like hair growth. It also makes you pee a lot.

HRT is thrilling and confusing; scary, and reaffirming. It’s cool to wake up and say, “Oh shit! Something is happening!,” but the process is pretty grueling too. The experience varies quite a bit by person, but in my case, I take five pills a day. If I poorly manage my schedule and slip up on taking medication, sometimes it can throw my emotions out of whack or lead to mental confusion. And while it is unsurprising, as MTFs, we lose our fertility during HRT. You can get some troops frozen away with cryopreservation, but this is generally not covered by health insurance.

HRT isn’t a catch-all solution either. For example, estrogen doesn’t affect your vocal pitch at all, nor does it remove your beard. Established bone changes from puberty are unaffected by hormones, so it won’t make a trans man’s hands bigger or a trans woman’s rib cage smaller. Testosterone doesn’t really shrink or remove breasts. Despite the shortcomings of HRT though, various forms of mitigation are available.

If you’re trying to pass, i.e. live without people knowing you’re trans, and you want to maintain a convincing voice as a trans woman, it requires diligence and practice. This is often supplemented with voice therapy too, but only if you’re fortunate enough to find or get therapy. Because Speech-Language Pathologists are licensed by state, this generally means they can’t provide sessions to anyone outside their state as well. This puts inconveniently located trans-people at a disadvantage since it rules out Skype or other telecommunication methods across state lines.

If you want to remove your beard, multiple laser hair removal and/or electrolysis appointments are required and the appointments aren’t particularly pleasant. I don’t know about electrolysis, but laser hair removal is an acute, scalding rite of passage that you have to schedule every four to six weeks. You usually have to do several sessions before you’re really done too. I’ve only had six sessions of laser hair removal, but I’m definitely ready for the finish line.

Surgery is usually the next step beyond HRT to fill in the gaps. Admittedly, I’m unfamiliar with this area personally but I do know that the list of surgeries is pretty exhausting. Trans women may opt for a trachea shaving, i.e. adam’s apple reduction surgery, facial feminization surgery, or bottom surgery, a euphemism for gender reassignment surgery. Trans men can undergo top surgery to remove their breasts or undergo one of many bottom surgeries, e.g. an oophorectomy or a metoidioplasty. There are more surgeries on both sides too.

Surgery eligibility is complicated and tedious though. The WPATH Standards of Care, or SOC, is commonly used to define surgery requirements. Bottom surgery generally requires several recommendation letters and you generally have to live in the desired identity for a sufficient amount of time. Finding specifics on these requirements is pretty difficult however, as these requirements tend to vary quite a bit based on state laws.

The unseen dilemma here too is that many laws regarding name changes, legal recognition, and more are contingent on this surgery and this is the case in about half of the states. This means that even if you choose to transition, you may have to live in the role for a year or longer without proper state identification or the legal ability to use a bathroom that matches your identity. This is obviously tougher for trans-people who choose not to get bottom surgery at all.

Let’s talk about the money too. Since health insurance doesn’t cover a lot of these corrective procedures, a lot of the costs have to come out of pocket. I’m privileged enough to have a moderate income that allows me to facilitate my transition, but not everyone is that fortunate.

You gotta pay the pharmacy every month for HRT. My laser hair removal appointments ranged anywhere from $150 to $300 a session. My initial consultation for voice coaching was $295 with subsequent appointments running at $140 a piece.

According to the Surgery Encyclopedia, MTF bottom surgery can cost anywhere between $7,000 to $24,000 while FTMs get shit on more with surgery costs surging up to $50,000 and beyond. This is one of the more common surgeries covered by insurance, but the trick is finding insurance that’s trans-inclusive. Other aforementioned surgeries generally cost thousands as well.

Lastly, one of the suckiest parts about transitioning is made up of learning to navigate society, the gender dysphoria, and the social stigma. The rock in your throat every time you tell a friend or family member the first time, binding your chest as a trans man to curb gender dysphoria and pass in public, or sneaking around department stores trying to find clothes you like. There are kids who have asked to mutilate themselves to reconcile their gender.
It’s a rotten feeling to look down at yourself and not feel at home.

I have serious doubts about my transition sometimes too. I think the trans community has a hard time ever admitting any sense of apprehension because we’re always put on trial to defend our identity, but it’s hard not to have doubts. I tend to ask myself the same questions every morning when I shower or every night when I go to bed; is this transition worth it? Is it worth exposing myself to be happy only to be at the mercy of unbridled criticism? There are days when I feel hopeless and aimless with the transition, but there’s nothing you can do but keep moving.

tl;dr The transition process is more involved than what may meet the eye.

What do you think?

We are not here to assault people in bathrooms.
We are not creeps.
We are not pedophiles.
We are not perverts.

I think I can speak for the entire community when I say we just want to be happy.

And please, if you have any questions, feel free to comment or reach out on social media. I‘m happy to expand and I would love to hear from others in the LGBT community who can help plug holes in my knowledge.

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To read morek from Emma Bukacek, click here: Medium - Emma Bukacek