What does it mean to be transgender?
According to the Transgender Law and Policy Institute, up to 5% of the United States population identifies as transgender. For many, this term and identity represents a new facet of the LGBT community in the mainstream as trans people have only recently publicly gained the attention of the masses. The truth is that trans people have long been an important and integral part of the social and political movements to garner support for LGBT people.
And with Caitlyn Jenner most recently and courageously sharing her authentic self with the world through her Diane Sawyer interview, the mainstream media and many American households are buzzing with the question, what does it mean to be transgender? And if you're reading this, you might even be asking yourself, "Am I transgender?" As someone who has worked with and came to care for many trans or gender non-confirming folks, my hope is that this brief post will help provide you with some insight and answers along on your journey.
First, a little context. Up until 1973, the psychological community still sanctioned homosexuality as a mental disorder. While it was removed from the Diagnostic and Statistical Manual (the DSM) that year, the psychological community is still conflicted about how to best support people who self-identify as gay. Thankfully, there are many professionals (gay and heterosexual) who acknowledge and promote the mental and emotional health of gay folks by adopting supportive and gay affirmative practices. Sadly, however, there is still a large segment of the population who advocates for the use of conversion therapy, which aims to rid gay people of their same-sex desires in order to make them "straight". Too often the practice of conversion therapy is both emotionally and physically damaging and inappropriate, leaving the clients more emotionally damaged, confused and isolated from their families and loved ones. Now that transgender people are being more widely recognized in the public sphere, our culture is faced with the same questions and barriers as a society on how to best support trans folks.
For better or for worse, gender dysphoria is still listed in the DSM as a mental disorder. Many counselors like myself, don't consider identifying as trans as a mental health disorder, however, this often presents a conundrum for trans advocates as many states require a person to carry a diagnosis of gender dysphoria in order to begin gender affirmative treatment such as hormone replacement therapy and what has previously been known as sexual reassignment surgery, which is more colloquially referred to as "top" and "bottom" surgeries in the community. Given the restrictions on treatment, you can see how in order to live in accordance with your gender identity, some have to be stigmatized in order to receive the appropriate, supportive, and necessary medical interventions that are gender affirming. More plainly put, trans people must admit to being "sick" before receiving what is often life saving treatment.
Despite trans visibility increasing in the past few years, many folks still have questions and concerns about what it means to be trans. There are a lot of online resources that often feature the voices of trans people themselves such as Laura's Playground, TransAdvocate and PFLAG National. These are all great resources if you yourself think you may be trans or need insight about a friend or loved one. As a mental health professional, I will share with you the criteria of gender dysphoria which might help you gain some insight and clarity into what trans people might be experiencing. Here is an abbreviated list of that criteria:
Feelings that your internal gender identity does not match your physical characteristics
A desire for the sex characteristics of another gender (ex. sex organs such as penis, vagina, testicles or things like amount of body hair, tone of voice, waist to hip ratio, etc.)
Feeling that you should be treated as a different gender (than what you were assigned at birth)
Strong and persistent internal feelings that you are of a different gender or sex that you were assigned at birth
Again, this is a list based on heteronormative ideals and standards which see a trans identity as being "disordered".
There are histories of cultures with two-spirited, or third genders which haven't described or treated trans folks in the same way. I hope that this can serve as a starting point to form questions, invite discussion and ultimately garner understanding and compassion for people who all identify as trans like Caitlyn Jenner, Leelah Alcorn, Chaz Bono or Laverne Cox. All too often the health and livelihood of trans folks depends on our willingness to develop empathy and compassion, irrespective of our cultural or religious backgrounds. The truth of the matter is, lives are at stake.
And if you think that you might be trans, I invite you to seek out support in a trusted friend, loved one or affirmative counselor who can help guide you and support you on your journey of being your most authentic self.
You deserve that ability to do so. We all do.