I can’t imagine the person ever seeming to me like the sex they want to be. It’s hard to let go of our perceptions of someone we’ve known for a long time. Changes in a person’s appearance and behavior can occur gradually, and may be difficult to perceive if you are in regular contact. But if you pay attention to how strangers react to the person, it may help you to see these changes. On the other hand, the gradualness of the change may help you to adapt to the new gender identity step-by-step. You may be surprised, in time, at how completely you accept the person’s new chosen gender.
It is true, however, that some people who undergo gender transition will continue to have significant characteristics of their previous gender identity. Some male-to-female transsexuals, for instance, may be unusually tall for women, while a female-to-male transsexual may have small features. It may help if you avoid focusing on these specific things, but rather honor the person’s chosen gender, and try to see them as they see themselves.
How can I support this person in their transition? There are many ways you can be helpful. Perhaps the most important is to convey your intention to be supportive to the person in transition. Let them know you want to be an ally, and ask them what they need from you. Then, to the extent you are able, offer them the support they’ve asked for.
We can offer a couple of specific ideas as well. First, you can adopt the use of the person’s new name (if they’ve chosen one) and appropriate gender pronouns. This change can be uncomfortable at first, and you may slip up once in a while, but eventually this change becomes habitual and comfortable. This small but very important step will demonstrate that you take the person’s decision seriously.
You can also try to maintain your previous relationship with the person, whether that’s the intimate relationship of close friends or once-a-month bowling buddies. Gender transition is new territory for many people, and hence can be scary. “Hanging in” with the person in transition despite feelings of discomfort with the process can be a very supportive act.
Also, you may ask the person in transition how you can help in letting others know about their transition. They may want to tell people themselves, or they may be grateful for help “spreading the word.” There may be certain contexts–the softball team, a church you both attend, or the workplace–where your assistance in telling others and expressing your support will be appreciated. Let them be your guide in this.
The person I thought I knew is becoming a stranger. A person we know who undergoes gender transition will very likely look and sound quite different after their transition. A person we’ve known as a woman, for instance, may change his hairstyle, grow facial hair, speak with a lower voice, and adopt an entirely new wardrobe. But he’s not likely to adopt an entirely new personality or set of values, and our history with this person is unchanged. Think of any person you care about, and ask yourself what qualities you value most about her or him. You are likely to think of qualities which are not gender-specific, such as sense of humor, intelligence, and loyalty. These qualities are not likely to change as a person undergoes gender transition. In fact, a person who undergoes gender transition is in a process of becoming more comfortable with himself or herself, and so their positive qualities are likely to be enhanced.
It can be scary when someone in your life tells you they need to make such a major change, and it’s understandable that you may feel you don’t know this person as well as you thought. But if you continue to spend time together, you will likely be comforted to find that they are in many ways the same person you have always known.
Altering the body through surgery seems like mutilation. This is also an understandable response. To those of us who are comfortable with our assigned gender, the idea of altering those parts of our bodies that are most associated with our gender can feel alien, frightening, and disturbing.
Another person’s decision to alter parts of their body can feel threatening. It may help to remember that a person undergoing transition from, for instance, a male to female gender expression, is not making a blanket statement about the value of malehood or the validity of your gender expression. She is simply seeking to become more comfortable in her body.
Sex reassignment surgery is the aspect of gender transition that is most difficult for some people to understand, and you may never feel comfortable with it. That’s OK. But that discomfort doesn’t preclude honoring another person’s choice, treating them with respect, and even supporting them through their gender transition.
Transsexualism is a condition in which a person experiences a discontinuity between their assigned sex and what they feel their core gender is. For example, a person who was identified as “female” at birth, raised as a girl, and has lived being perceived by others as a woman, may feel that their core sense of who they are is a closer fit with “male” or “man.” If this sense is strong and persistent, this person may decide to take steps to ensure that others perceive them as a man. In other words, they may decide to transition to living as the sex that more closely matches their internal gender.
What is involved in the transition process? The answer to this question varies depending on the needs and desires of the individual choosing the transition process. An individual may choose any combination of social, medical and legal steps that will help that person achieve the greatest level of comfort with their body and social roles.
Social steps might include asking to be referred to by a different name (perhaps one generally given to people of the “opposite sex”) and different pronouns (“she” instead of “he” or vice versa), dressing in clothing traditionally worn by people of the sex they wish to be perceived as, and taking on mannerisms frequently associated with that sex/gender.
Medical steps might include hormonal treatment to achieve an appearance more consistent with the target gender expression, and/or surgery to further modify the appearance. There are a variety of surgical options to alter the transsexual person’s body to help them achieve the greatest comfort with their gender expression. The transsexual person may choose some, all, or none of these surgical options.
Many transsexual people also work with the courts in their area to achieve legal recognition of their new name and gender. Steps taken vary depending on the location.
What causes transsexualism? No one knows the answer to this question, although there is much research currently in progress investigating it. Among the theories being investigated are genetic influences, in utero hormonal influences, and other brain structure/brain chemical influences.
Human sex and gender are very complex, and it is unlikely that any simplistic analysis will definitively answer this question.
What is the treatment for transsexualism? Is there a “cure?” Treatments for transsexualism based on attempting to change the individual’s sense of their own true gender have proven ineffective. Accepted treatments are based on helping the transsexual person’s body and presentation match their inner sense of their gender, usually through hormone treatment and surgery.
How common is transsexualism? The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), Fourth edition, says the following (© 1994, American Psychiatric Assoc.):
Prevalence: There are no recent epidemiological studies to provide data on prevalence of Gender Identity Disorder. Data from smaller countries in Europe with access to total population statistics and referrals suggest that roughly 1 per 30,000 adult males and 1 per 100,000 adult females seek sex-reassignment surgery. Because these numbers reflect only people who have sought traditional medical treatment, they do not reflect the total numbers of people who have some experience of gender discontinuity.
Is transsexualism a modern phenomenon? While advances in medical science have only in the last few decades made it possible for individuals to transition with the aid of hormones and surgery, transgendered people have existed throughout history in many societies. Jennifer Reitz’s Natural History of Transsexuality provides a brief historical overview.
Is transsexualism the same as homosexuality? No. Transsexualism is about a person’s core sense of their gender. This is a separate issue from the gender of the people they are attracted to.
Just like any other individual, a transsexual person may identify as heterosexual, gay, lesbian, or bisexual. For example, a person raised as a man who transitions to living as a woman may identify as heterosexual, in which case she would seek relationships with men, or lesbian, in which case she would seek relationships with other women.