Transgenderism and the Concept of Gender

Vern L. Bullough
SUNY Distinguished Professor Emeritus ( history and sociology,)
Outstanding Professor Emeritus, California State University at Northridge
  

Abstract

Transgender was first researched by Magnus Hirschfeld and Havelock Ellis although they did not call it that. Few immediately followed up on their pioneering work and most of those who did were psychiatrists. Freudian theories remained dominant in U.S. It was the Christine Jorgensen case, which gave renewed impetus to the study of transgendered individuals, and Harry Benjamin was particularly influential. The concept of gender as distinct from sex was developed by John Money and popularized by the second wave of feminists. The growth of organized transvestitism provided a natural research group that went beyond the clinical case study and led to new explanations and theories about gender.
  

Historical Background

The modern study of what might be called transgenderism began with Magnus Hirschfeld (1868-1935) and the 1910 publication of his book, The Transvestites: An Investigation of the Erotic Desire to Cross Dress (Hirschfeld, 1991).Hirschfeld reviewed the cases of 16 men and one woman cross dresser, most of whom were his patients. He also drew on other sources of information, including interviews with female impersonators and an examination of the psychiatric literature of his time. He was struck by the predominance of "heterosexuals" in his sample, although he also believed that some were "monosexual" or "auto-erotic" and some were homosexual. To try to explain the phenomenon, Hirschfeld developed a theory of intermediaries. He argued that although the two sexes had usually been regarded as dimorphic, this was much too simplistic since there were many varieties of intermediates. One group who did not fit this description were those individuals who thought, felt, or acted like the opposite sex in many aspects of their life, a group which he designated as transvestites (literally cross dressers).

Another pioneer in investigating the topic was Havelock Ellis, who in his first paper on the subject published in 1913, used the term 'sexo-aesthetic inversion' instead of Hirschfeld's word 'transvestism' (Ellis, 1913). As Ellis later talked with colleagues about the paper, he concluded that the word inversion was misleading, since it suggested homosexuality, and most of the cases he had studied were either heterosexual or not particularly interested in sex. He therefore decided that the best term would be 'eonism,' using the name of the eighteenth century cross dresser, the Chevalier d'Eon. He argued that the term avoided the problems inherent in terms such as cross dressing, and that he was simply following the example of Kraft-Ebbing who invoked the names of well known models of behavior to describe a complex of behaviors under the terms sadism and masochism (Ellis, 1936). Ellis did not consider Eonism a particularly troublesome problem since most of the people he studied were able to lead lives they found satisfactory and did not harm others. His term, however, was not often used by later investigators who preferred the term 'transvestism.' Ellis' dissatisfaction with Hirschfeld's term has renewed in recent years as gender research has grown, and the currently favored term is 'transgender,' which is a much broader category than simply cross dressing and allows a greater variety of behavior to be grouped together.

Though both Hirschfeld and Ellis were physicians, they were primarily interested in compiling information about transgenderism, not to bring about cures. Those who wrote about the phenomenon after them were for many years dominated by psychotherapists of one kind or another whose mission was to find "cures" or "treatment" for those with gender dysphoria. Most were heavily influenced by the writings of Sigmund Freud whose general theory of sex (Freud, 1910 & 1962) was regarded by his disciples as the key to understanding any kind of sexual dysphoria whether or not Freud had himself written on the topic. Some of his followers relied also on his explanations of fetishism as a possible explanation (Freud, 1928) while others supplemented this with other Freudian papers (Freud, 1959) Generally the Freudian explanations of transgender behavior assumed that the male cross dresser as a boy or young man somehow had seen his mother's genitals and realized she lacked a penis. The realization created horrible anxiety for him because he feared losing his own penis, and could result in not only transvestism but other sexual pathologies.

Probably the most influential of the psychoanalytic writers to develop a theory of transgenderism was Wilhelm Stekel (1930). He invented the term 'paraphilia' to describe what others had simply regarded as a perversion. The section of his book dealing with transvestism was written by Emil Gutheil (1930) who differentiated between fetishism and transvestism. In his mind transvestism was a special form of a compulsion in which the patient's desire for the genitals of the other sex is displaced to the clothing, creating in a sense a phallic female.

As the psychoanalytic influence grew in the first half of the twentieth century, the focus on psychological factors (instead of inherited, constitutional factors) became more accepted. Analysts tended to explain transgender behavior either as a type of homosexuality, or a flight from homosexuality caused by some event in childhood that created castration anxiety. Cross dressing also continued following Gutheil to be looked upon as an attempt to overcome the fear of castration by creating an imaginary phallic woman and identifying with her (Lukianowicz, 1959).

Despite the dominant psychological focus, vestiges of a concern for hereditary factors also appeared in some of the psychiatric literature, which led therapists to scrutinize the relatives of clients. Even those "authorities" who explained cross dressing as castration anxiety also searched for other influences such as parental rejection of the child, the parent dressing the child in the garb of the opposite sex, the parents favoring a child of the opposite sex in the family, or reversal of parenting roles in the family.

There were even some challenges to the psychiatric view, probably the most notable of which was Harry Benjamin (1964) who developed a continuum of transgender behavior of which transvestism (depending on level) was at one end and transsexualism at the other. Even within the psychiatric community there was a questioning of the illness pathology by writers such as Ethel Person and Lionel Ovesey (1978) who while following a psychoanalytic model, challenged it on several points. They classified sexual neuroses into two types: (1) those that inhibit pleasure such as premature ejaculation, and (2) those that facilitate pleasure such as transgenderism. They also argued that male transvestites were never overtly effeminate in boyhood even though cross dressing usually began in childhood or adolescence. They also developed different categories or stages of transvestism.

For the most part, however, the standard Freudian terminology dominated the literature although there were only a comparatively small number of studies dealing with the phenomenon (Bullough and Bullough, 1993). Even after homosexuality was omitted from the list of mental disorders in the Diagnostic and Statistical Manual (APA,1987), transvestism remained, in part because transgender people as a group had been little studied, and in part because they lacked the political clout of the gay and lesbian communities.
  

The Recognition of Gender

The major challenge to the psychiatric domination came from a new generation of social and behavioral scientists who challenged the dominance of the medical community as experts in sexology, and in the process, challenged the medicalization of much of sexual behavior. The key to the challenge was the development of the concept of gender. Gender is an old term that has been widely used in linguistic discourse to designate whether nouns are masculine, feminine, or neuter. It was, however, not normally used either in the language of social sciences or sexology until John Money adopted the term in 1955 to serve as an umbrella concept to distinguish femininity, or womanliness, and masculinity, or manliness, from biological sex (male or female).

Money started his research by examining hermaphrodites, and recognized that the existing terminology of sexual discourse was not sufficient to describe what he was observing. By using the term gender, he believed he could avoid being bogged down by the necessity of having continually to make qualifying statements such as "John has a male sex role except that his sex organs are not male and his genetic sex is female." (Money, 1955A, 1955B). The term sex, he felt, should be used with a qualifying criterion, as in genetic sex, hormonal sex, or external genitalia sex, whereas the word gender was more inclusive since it involved somatic and behavioral criteria, for example, whether one is masculine or feminine, how one conducts oneself personally and socially, or how one is regarded legally. Sex belongs more to reproductive biology than to social science, romance, and nurture, whereas gender belongs to both (Money and Ehrhardt, 1972)

As Money realized the value of his original insight, he continued to expand on it, developing such terms as gender identity, by which he meant the total perception of the individual about his or her own gender, including a basic personal identity as a man or woman, boy or girl. He also held that the term could be used to make personal judgments about the individual's level of conformity to the social norms of masculinity and femininity. Gender, as it is perceived by others, he called gender role. The two concepts are tied together, because most people show their perceptions of themselves in their dress, manners, and activities. Clothing and body decoration are the major symbols of gender and they allow people immediately to identify the gender role of others. There are, however, other symbols, including mannerism, gait, occupational choice, and sexual orientation.Most people are gender congruent, that is, their gender identity, gender role, and all the symbolic manifestations of gender are harmonious and they will not have a cross-gender sexual orientation. There is, however, a minority who fail to conform in some way, perhaps somewhere between ten and fifteen percent of the population, depending on how one defines gender non conformity. Because the definitions vary so much, the diagnostic categories long favored by the medical community simply should no longer be used. Moreover, to paraphrase Donald Mosher (1991), another explorer in the gender field, such definitions were made when both the medical community and society in general tended to believe in a dimorphic sexual essentialism. That is, males and females must and should display congruent erotic sex and congruent gender characteristics of their sex because their biological or God-given nature made it so.This assumption, however, was, if one dug beneath the surface, not valid either in the past or in the present.To simply call those people who do not fit neatly into the gender boxes of male and female non conformists implies that they deliberately violated the norms of society. Because this may not be the case, most sexual scientists now use the term 'cross gender' or increasingly 'transgender' to avoid this judgment. 'Cross gender' seems to imply a significant change while 'transgender' gives room for more subtle variations and yet still allows for radical change. Whichever term is used, the individuals involved do not fit neatly into either the male or female category, or their behavior is not totally congruent with the rules and expectation for their sex in the society in which they live.

Transgender behavior covers a wide spectrum of individuals.It includes males and females who engage in same sex relationships to those who prefer relationships to the opposite sex and those who have sex with both. It includes those content with the traditional clothing assigned to their biological sex to those who are in full scale rebellion, such as the gay queen and ultra butch lesbian. Also belonging to the group are the heterosexuals who gain some feeling of a new gender identity through clothing (including jewelry, tattoos, and other adornments usually associated with the opposite gender,) either secretly or openly, either completely or partially. The most radical members are the transsexuals who through surgery have sought a new identity as a member of the biologically opposite sex. Such changes might or might not involve a change in sexual orientation, defined as the personal view of sexual attractiveness of other persons whether that be to the same sex or opposite sex (or both) as well as the details of an individual's sexual turn on. In sum, transgenderism has many facets.

So far, there is no final agreement as to what factors are involved in transgender behavior. There are two major conflicting schools, one emphasizing nature, the other nurture, and many who find the answer in a various combinations of the two. Those who emphasize nature look not only to chromosomal variations such as XXY or single X or others but the influence of hormones and other factors on the embryo. One of the richest sources of study have been children with ambiguous sexuality . This could be due to various factors including adrenogenital syndrome which produces varying degrees of pseudo hermaphroditism and virilization in girls (Ehrhardt, Epstein and Money, 1968A; Ehrhardt, Evers, and Money, 1968B).Another factor involved is androgen insensitivity syndrome which results in testicular feminization. It occurs as a result of a deficiency of androgen receptors, a condition that makes the subject insensitive to androgens in the genital area. It only occurs in genetic males and results in sexual differentiation along female lines, but because of the crucial effects of the Muellerian inhibiting factor, not quite into a normal female. Thus even though they have the normal female external genitalia, internally there are intra-abdominal testes, a lack of a uterus, and a short and blind vagina. The child usually is reared as a girl and develops breasts, but she never begins to menstruate. In spite of their lack of ovaries and uteri, these XY women develop as normal females in their capacity for sexual response and sexual desire.

If testosterone is added to the bloodstream of a genetically female fetus during a critical period in development, a girl will be born with either a grossly enlarged clitoris, or in rare instances, a normal looking penis with an empty scrotum. Such a development can take place through an abnormal function of the adrenal cortex, or might result from a tumor (Money, 1965, Money,1968). The list of various anomalies can be extended, but the point I want to emphasize is that though biology has an important role in how we develop as boys and girls, men and women, other factors are also present.This was emphasized by the famous case of the Canadian male twins, one of whom had his penis burned off by a cauterizing gun during a circumcision procedure which took place when they were seven months old. The parents over the course of the next year sought help on what to do about their boy without a penis, but everyone agreed it was impossible to make an artificial penis until the child was in his teens. The parents felt that a penis-less boy would forever be taunted by his playmates and, after seeking advice from a wide variety of specialists, decided to rear the child as a girl. To this end they had the scrotum and testes removed at 17 months. John Money supported the parents' decision and seized on the opportunity to study the pair, using them as an example of the influence of nurture on development of sexual identity. There were early reports from Money that the new girl was developing feminine characteristics, but then the case disappeared from the literature (Money and Ehrhardt, 1972). Unfortunately, developments did not proceed according to what Money predicted, and the child in her teens rejected the female persona and began to live as a man, though one without a penis or testicles. With the benefit of injections of male hormones, he now functions and lives as a man. This only emphasizes that coding of gender is multivariate, sequential, and developmental, reflecting a complex interaction across the boundaries of disciplines and across biological and social variables. There probably are critical periods during which socio-psychological factors have greater influence than the others, but it is not always clear what agents are at work.In fact, the concept that masculinity is the opposite of femininity, has itself been challenged. Instead of an either/or identity, it seems there is a both/and concept. In 1973, Ann Constantinople was a pioneer in questioning the assumption that masculinity was the opposite of femininity and suggested that the identification of masculine traits might be independent from rather than opposite of the identification of feminine traits (Constantinople, 1973). Sandra Bem successfully tested such a hypothesis with her Bem Sex Role Inventory, that treated identification with masculine traits independently of identification with feminine traits (Bem, 1974), and found that men had a wide range of feminine traits, some far more than others, and that women had a wide range of masculine traits and in greater or lesser amounts. Using a variety of scales, including their own, J. T. Spence and R. L. Helmreich found wide variation in gender traits, although they also found that stereotypically masculine personality traits in males were correlated with self-esteem (Spence and Helmreich, 1978). This only serves to emphasize just how much influence society and culture have on self-esteem.

Unfortunately, for any definitive answers, the scales, like the ones which preceded them, are based on observable patterns without any real attempt to think through whether there are behaviors that must be distinctly limited to females or to males. Still they emphasize that there is a tremendous variation in gender orientation, but there is also compulsive pressure to conform. But in recent years those who have different gender patterns can get support from groups who have the same or similar patterns and this is why groups of transgender people have assumed such extremely important functions.

Taking all the factors into account, Bonnie Bullough developed a theory for the formation of gender identities and sexual preferences. She held that several factors were involved from genetic to socialization. A genetic predisposition is stimulated by prenatal hormonal developments which perhaps indelibly mark the neural pathways so the pattern that produces the cross-gender identity is continued after birth. The socialization patterns shapes the specific manifestation of the predisposition, at certain critical phases of development(Bullough and Bullough, 1993,ch. 13). Even if there is not a genetic predisposition, the prenatal hormones, as indicated above, can mark variant neural pathways.This theory posits that certain children are born with a gender identity that leans to the other side of the gender continuum to varying degrees. These children are not born with a specific identity as a homosexual, cross dresser, or transsexual, but these patterns are shaped by the socialization process as they grow.. The socialization process, however, has a different impact on children who have a cross-gender tendency than it does on children who cluster elsewhere on the gender continuum.. This explanation recognizes a biological factor, but it also recognizes the importance of psychological, sociological, and cultural variables, and these are not always easy to predict..

For example, folk wisdom has long linked feminine behavior among boys with latent homosexuality. Irving Bieber and his colleagues were the first researchers to give some hard data. Bieber studied 106 male homosexual patients who were being treated by him or other psychiatrists and found that cross-gender behavior as children was the most common element in their background. This led him to postulate that homosexuality among adults actually started very early, long before the hormonal surge at puberty. While few today accept Bieber's theoretical explanations of a dominant mother and weak father for why this behavior occurred, his data stands independently of his psychoanalytic assumptions. (Bieber et al., 1962).Bell, Weinberg, and Hammersmith (1981), in fact, offered a quite different interpretation for the existence of childhood feminine behavior among certain boys based on their detailed path analysis of the lives of a sizable sample of homosexual and heterosexual men and women from the San Francisco Bay Area. They found that homosexual men and women were more likely to report poor relationships with their father than heterosexual members of the study group. It was not clear, however, whether the poor relationship was because mainly of the child's non conforming gender behavior or whether it was part of a casual sequence. The most common element in the childhoods of both lesbians and homosexual men was gender nonconformity, not alienation from one or the other parent.Other studies have also emphasized this including the longitudinal one of Richard Green (1987).Green studied fifty feminine boys over a fifteen year time span. The boys were decidedly feminine as toddlers, so much so that their parents sought professional help at the UCLA Center for Gender studies. The boy children consistently cross dressed very early (94 percent by age six), played with dolls, preferred girl playmates, and indicated they wished they have been born girls. Approximately 75 per cent of the feminine boys became homosexual as adults compared with only one homosexual man in the fifty member control group. Note, however, that not all the effeminate boys became homosexual, which again indicates there are many variables involved. None of them were transvestites or transsexuals although one had flirted with the idea of surgical change. Many more studies could be cited, but this paper is intended not to be exhaustive but indicative of the kind of information available, and the number of gender studies increases exponentially every year, some by people on this panel.
  

Where are we now

What does all this have to do with transgender ranging from cross dressers to transsexuals? Unfortunately these sub groups of the transgender community still have not been studied as much as same sex preference and the sources are somewhat contaminated. Until recently there were only two major sources of data: (1) individuals who showed up in clinics for help either for permission to get a sex change or because of personal problems in their life in which their transgender activities might have played a part; or (2) individuals who had joined various kind of transgender clubs. Until 1960, the second group did not exist, and even for those in the first group few professionals had a sufficiently large number of clients to do more than lump them together with homosexuals as did Henry (1941).

Making the second group possible was Virginia Prince, who beginning in 1960, devoted her life to bringing the transgender group at least partially out of their hiding place. Her efforts led to the appearance of a vast number of transgender clubs not only in the United States but throughout the world. The initial studies were based on her groups, and Prince had requirements for membership: Anyone who did not identify as a heterosexual transvestite was not allowed in. Also excluded were gays and any who regarded themselves as transsexuals. Still, a surprising number of individuals who did not meet her criteria engaged in creative enough stories to slip through. As a growing number of individuals surfaced to join groups, many broke with Prince's organization, and founded new organizations seeking members from a wider spectrum of transgender individuals.What Prince had done, however, was to establish a socialization process for transgender people, and her organization and its rivals gave the previously stigmatized transgender people a culture in which they could feel comfortable and, in part, where they also parroted the words of the leader as to why they became involved in the transgender community. A social constructionist would call this 'the process by which people come to describe, explain, or otherwise account for the world (including themselves) in which they live."

What they did is establish, in John Gagnon's and William Simon's terms, a sexual and gender script (Gagnon and Simon, 1985). Gagnon and Simon believed that sexual activities were social activities guided by what they called scripts.They emphasized that though there was a public discourse about sex, not all individuals opted for the same sexual categories, since there were a variety of alternatives. Using the term, we can see that what Prince's transvestite script did was give cross dressers a group identity that shaped their own self concepts. As new groups came into being, they sometimes challenged the Prince interpretation, and what had been seen as a fairly unitary kind of behavior has become ever more complicated, with a variety of scripts. By implication transgender people now see themselves somewhat differently than they did twenty years ago, and there is a growing network which accepts gay and straight cross dressers, transsexuals, and simply transgendered..

It would seem to me that this trend will continue, as we recognize that all gender variant people have a lot in common, but also a wide variety of differences. As they grow in number, there will be wider public acceptance of them, and the groups themselves will become more political. This is already happening. To many of the laws prohibiting discrimination based on the grounds of race or ethnic origin, the rising feminist movement has added sex, and the rising gay and lesbian movement have added sexual preference. Now the transgender people will campaign, and in fact have done so in some places successfully, to add transgender to the list of categories.Transgenderism as it is now defined includes a significant part of the population, including many who can also be classed as gay or lesbian, as well as transsexuals, individuals who have gone public in their transgender persona, others who belong to the various clubs and organizations, and thousands who have not yet admitted to anyone other than their spouse or significant other that they have some transgender characteristics. This last group is still impossible to research extensively, but as more individuals in the groups go public, the stigma associated with being transgender lessens.

What we still need to know, however, is much more about what is involved in transgenderism and this can only be done by researchers, both in and outside the community, and by members of the community writing up their own lives and stories. I should add that the more we learn about the transgender community, the more we will understand gender differences and similarities, and what makes us human. This conference, hopefully, will throw more light on what is to come, and the new understanding of gender that is developing.
  

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