Faq

Is transsexuality possible for a person whose sexual organs appear to be 'normal' from the biological point of view? If yes, how and why?

It is very common for transsexuals to have normal appearing genitalia. The problem for transsexuals is that despite their normal appearing genitalia, they have a strong internal sense of being a different gender than their genitalia show them to be. How that can happen is still being looked into. It probably has something to do with the fact that gender identity forms in the brain at a different time than the genitalia do in the body. Hormonal surges at the wrong time could very easily disrupt the normal progression of sex/gender identity development.

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I have viewed your website and I have mixed feelings about what I should believe. I read your essay in which it talked about the mother's tumors causing this disease, my mother suffered from cancer during pregnancy. I'm 16 and I'm not sure about my sex. I have always been happy being male during childhood and I want to sincerely remain male but I am just very worried that my sex is messed up due to the fact that I constantly have scary thoughts that I might become female.

First of all I never said that gender identity issues are a result of a mother having a tumor while she is pregnant. I did say that it is beginning to look like gender issues begin in utero and one possible cause may be stress to the mother at a critical time of the child's gestation. Your fears are unfounded. If you are happy being male than that is the way it will always be. There are many men who exhibit feminine mannerisms and behaviors but have no interest in being female. It is just the way some men are. Males who transition to the female gender role do so only after great consideration and great difficulty. It will not happen to you if you do not actively take part in the process. However, if you continue to obsess over this issue, I suggest that you get your parents to take you to a gender specialist. If you give me the name of your city and the names of several others you are willing to travel to, I will try to find a therapist near by.

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Is Male-To-Female gender identity mostly about appearance (if the person already identifies as female)?

This is an interesting question and the ansewer is, No. The administration of cross-sex hormones has a profound effect on the indifidual's brain. As you must be aware, there is more to being female than appearance and identifying as one. There is also gender expression. Gender expression includes important areas such as how one feels inside (Is it a feminine feeling or a masculine one?). Gender expression dictates how one dresses, moves and talks. And probably most importantly, gender expression has a big influence on how we are perceived in the world and how we relate to others in turn.

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What factors do you think are responsible for more young Americans coming out as transgender? Is it due to the availability of more resources?

First of all there is more information regarding gender issues out there. The internet has made it possible for young people to not only do research on their condition, they can contact others like themselves and compare notes. Twenty years ago a young person would have found it almost impossible to get any information. It would have required a trip to a medical school library to get far less information than they can now get in their own bedroom. The internet has also made it possible to easily ask someone like me for a referral for medical care in their community. I give out at least three referrals a week to people all over the country. The names come from the Harry Benjamin International Gender Dysphoria Association's (HBIGDA) directory.

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Is there a median age when certain individuals realize they identify with the opposite or both genders?

Most people who go on to transition become aware there is a problem somewhere between the ages of 4 and 7. When they decide to ask for help with their problem is another issue entirely. In the past there has been a strong tendency for people with gender issues, especially males, to chose to hold off to the last minute to seek help. By holding off, these individuals go to great lengths to try and override their gender dysphoria by investing more and more energy and time into activities that they hope will make their need to be female 'go away.' This often includes dangerous military duty, getting married and having children and macho jobs. When none of that works, and there is no clinical evidence that it ever will, they are commonly now in their forties or early fifties. More recently, with the advent of the internet, more and more gender dysphoric individuals are aware of the fact that gender identity issues are not socially based and nothing they will ever do short of treatment will resolve the issue.

Gender dysphoric females are much more direct on how they face their issues. They often voluntarily start living their lives in the male gender role in childhood. The advent of the internet has also affected their age of presentation. They are coming in younger and younger now. The current median age of my FTM clients is about 35.

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