Gender variant? Gender non-conforming? Gender minority? Gender creative?
In the book, Gender Born, Gender Made by Diane Ehrensaft, Ph.D she recommends the term “gender web” – intricate pathways in 3 dimensions. She also suggests using “gender creative” because it does not have any negative connotation. This takes into account a child’s gender (what appears on the birth certificate), gender identity (how you feel; the inner sense of self as male, female or other), gender expression (how you look and act). Sexual orientation (who you love) is totally separate.
In the late 1980’s, the term “transgender” was coined as an umbrella term to refer to all gender non-conforming people. This includes transsexuals who have transitioned genders, heterosexual cross-dressers who have an opposite gender presentation only part of the time, and genderqueer people who have a unique gender presentation all of the time. An estimate of the incidence of transgender people is 1.5 % of the population or 15 people per thousand in the population. That is one person for every 3 gay/lesbian people. Many transgender people are either unable to afford hormones or surgery, fear medical procedures or shun them on principle but are increasingly referred to as transsexuals, even though they have not transitioned medically.
Transsexual/transgender people can be lesbian, gay, bisexual or straight. Their issue is their right to BOTH gender expression AND gender identity.
A transsexual person who has had surgery has a mental disorder, or so says the current Diagnostic and Statistics Manual of Mental Disorders, Fourth Edition (DSM IV) of the American Psychiatric Association. Their diagnosis code is 302.85 – Gender Identity Disorder of Adolescence of Adulthood (GID). Gay men and lesbians used to have a mental disorder as well. This was true until 1973 when homosexuality was removed from the DSM.
It is a very complicated matter, due in part to the existence of “The Standards of Care for Gender Identity Disorders“ (SOC). The SOC require that a person have a diagnosis of Gender Identity Disorder as defined in the DSM IV in order to access treatment. Specifically, the SOC recommend a minimum of 3 months of psychotherapy before the therapist will write a letter permitting access to hormones. During that time, the therapist confirms that the patient has GID and not something else. Once passing that hurdle, the SOC recommend that the patient live in the perceived gender for at least a year before the therapist writes a letter granting access to sex reassignment surgery. That letter must be countersigned by a psychiatrist or PhD psychologist.
The catch-22 is this: The SOC essentially represent a medicalized approach to treatment, involving hormone therapy or surgery. And yet, because the DSM IV labels a person as mentally ill, most health insurance plans will NOT pay for any treatment for a GID diagnosis code. There is another problem with the GID diagnosis: it assumes the gender binary as a foundation. What if you define or express your gender in a way that doesn’t quite fit the binary? Or what if you don’t desire hormone therapy or surgery to feel comfortable expressing your gender identity? You likely will not be diagnosed as having GID, meaning you too will be denied treatment.
When speaking of transgender/transsexual people: use trans or transgender as an adjective, as you do the word “gay”. It’s o.k. to say “transgender woman” or even “trans woman” but not simply “Joanne is a trans”. The label “tranny” is also a derogatory term. Just as you would not say “gayed”, don’t use the term “transgendered”.
Tips for talking with a transgender person or their family member:
Today, gender can no longer really be considered a 2-option category. That form of thinking is outdated. It can be compared to trying to view the world in distinct racial categories without an understanding that an ever-growing percentage of the population is beautifully multi-ethnic. Gender is very similar.
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