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Posts tagged ‘gender identity disorder’

What is the Difference between Gay and Transgender?

This may be a very basic post for some and if so I invite you to skip it, but it is one of the most frequent search requests that land people on my blog, so I thought I should write a very clear answer to this query. (I wrote previously about the difference between some experiences of gay and transgender people here.)

OK, to begin with let’s define some terms.

‘Gay’, ’Lesbian’ and ‘Bisexual’ refer to sexual orientation, in other words – who you are attracted to.   A man who is attracted to other men could identify as ‘Gay’ or ‘Homosexual’.

‘Transgender’ is often used to mean ‘Transsexual’(Transgender refers to a larger group of people than that) has to do with one’s gender identity.  Gender Identity is how one identifies in terms of maleness or femaleness.  For a transgender or transsexual person one’s gender identity is different from what one might expect given ones natal or biological sex (‘Sex’ here refers to one’s biological sex – how one was born.)  Gender is not always the same as one’s sex.  ‘Gender Identity’ is how one feels inside, and Sexual Orientation is who one is attracted to vis-à-vis your current gender presentation.

To get back to the question ‘What is the Difference between Gay and Transgender?’ – we see that the difference is one has to do with sexual orientation (who you are attracted to sexually) and the other has to do with gender identity (who you feel yourself to be).

Why then all the confusion?

I think it has to do with the fact that queer folk – (i.e. gay lesbian and bisexual) might have more overlap with gender queerness than other (heteronormative or ‘straight’) folk.  In other words – among gay men – there may be a larger percentage of gender fluidity – or those who identify as somewhat more feminine than among straight men and the same with gay women.  This is their natural ‘Gender Expression’.  Indeed Freud remarked on the biological characteristics of gay men back in the early 1900’s.  Therefore it is possible to confuse or conflate sexual orientation with gender identity.  In addition, much of the stigma and discrimination suffered by gays and lesbians over the years has more to do with their visible gender non-conformity than with their invisible sexual preference.  The world has very little tolerance for gender non-conformity, although the world is changing.

Find out about Psychotherapy when dealing with Gender variance in yourself or someone close to you.

Sexual and Gender Identity Disorders | APA’s proposed changes (part 2) – DSM-5

The previous post with the first version of the proposed changes can be found here.

A few notes before the quoted text.

  • The big changes from the last revision (not from the last DSM) are that

1. they’ve dropped ‘gender incongruence’ and gone with ‘gender dysphoria’

2. they have added a ‘B’ criteria of distress and

3. they have added a ‘post-transition’ specifier.

  • Version 5 of the book is due out May 2013
  • the current commenting period will end on June 15, 2011.
  • This is the APA DSM 5 (American Psychiatric Association) site.  The APA “writes” the DSM (Diagnostic and Statistical Manual)
  • It’s important because this will be one of the key tools for how mental health professions view and define gender issues for the coming decade.

The following (in blue) is quoted from the APA site:

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Updated May 4, 2011

 Gender Dysphoria (in Adolescents or Adults)**

A. 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: [2, 3, 4]**

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) [13, 16]

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) [17]

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)

B. The condition is associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning,  or with a significantly increased risk of suffering, such as distress or disability** 

Subtypes

With a disorder of sex development [14]

Without a disorder of sex development

See also: [15, 16, 19]

Specifier**

Post-transition, i.e., the individual has transitioned to full-time living in the desired gender (with or without legalization of gender change) and has undergone (or is undergoing) at least one cross-sex medical procedure or treatment regimen, namely, regular cross-sex hormone treatment or gender reassignment surgery confirming the desired gender (e.g., penectomy, vaginoplasty in a natal male, mastectomy, phalloplasty in a natal female).

Note: Three changes have been made since the initial website launch in February 2010: the name of the diagnosis, the addition of the B criterion, and the addition of a specifier. Definitions and criterion under A remain unchanged.

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Understanding Gender Dysphoria

While there are many social implications related to gender dysphoria that I’ve written about and will write about in the future this post focuses on the inner experience of gender dysphoria.

Gender Dysphoria is a fundamental unease and dissatisfaction with the biological sex one is born with (one’s body) which results in anxiety, depression, restlessness, and other symptoms.  The dysphoria often acts as a catalyst to change one’s body and gender expression (how one presents to the world) to be more in keeping with what is felt to be one’s gender identity (the gender that one feels oneself to be).

In simpler terms this means that natal (biological) males, who are gender dysphoric have unease, dissatisfaction and even disgust with their male genitals, body hair, angularity, facial hair, musculature and any other attributes that one typically identifies with “maleness”.  Natal females who are gender dysphoric can have similar feelings with developing breasts, fuller hips, long hair, menstruation and other attributes that are associates with femaleness.

The time of adolescence when sex changes become more pronounced is understandably a very difficult time for many transgender individuals.  Puberty blocking interventions are now becoming more common in dealing with this.

It can be difficult for people to express how one feels about one’s body, in part because people with gender dysphoria often wish to avoid of the whole subject.  I’ve heard many variations of “it just feels wrong” or “I don’t like it”.   The following is an excerpt from Dear Sir or Madam: The Autobiography of a Female-to-Male Transsexual (1996) by Mark Rees:

 One of the great battles was of The Bra.  I angrily spurned the bra which my mother bought me when I was fourteen.  To have worn it would be not only accepting my femininity, but accentuating it.  I could do neither.

I’ve seen that transgender individuals vary in the degree to which they are disturbed by their male or female organs.  Some will be extremely avoidant of them; not looking in a mirror, not going to the doctor, not going to the beach or pool so as to avoid putting on a bathing suit and not have sexual partners, etc.  Others can engage in these activities to some extent but may still feel uncomfortable.

For many transgender individuals being transgender is not just about wanting to live in the social role of the other gender (to some degree), but it’s also about a fundamental dissatisfaction with one’s body.

Find out about Psychotherapy when dealing with Gender variance in yourself or someone close to you. email: info@amikaplan.net

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