Outcomes of Sex Reassignment Surgery

My recent consideration of the book Galileo's Middle Finger and my previous interview with Helen Boyd have prompted me to think again about the science of sex and gender. As I have mentioned many times before, there isn't a lot of hard, reliable science out there.

You might consider that science isn't the best tool with which to view transgenderism. To me, that's a little like saying that counting isn't the best tool with which to view how much money you have.

Opposed: Prof Paul McHugh

Since the study of transgenderism is such a huge field, let's narrow it down to one, relatively well-delineated question: should genetic males be offered sex reassignment surgery? You might already have an answer to this question, one way or the other, but let's look a bit more closely.

Detransitioning is the process whereby someone post sex reassignment surgery, living as the opposite sex, regrets their decision, and returns to their original sex. We know it happens, and that means that sex reassignment surgery isn't for everyone.

Paul McHugh, an eminent psychiatrist, and University Distinguished Professor of Psychiatry at Johns Hopkins in Baltimore, went so far as to discontinue sex reassignment surgery at Johns Hopkins in 1979, after studying the outcomes. He wrote:

McHugh: We saw the results as demonstrating that just as these men enjoyed cross-dressing as women before the operation so they enjoyed cross-living after it. But they were no better in their psychological integration or any easier to live with. With these facts in hand I concluded that Hopkins was fundamentally cooperating with a mental illness. We psychiatrists, I thought, would do better to concentrate on trying to fix their minds and not their genitalia.

You can read his whole 2004 article here. I can see how some of his terminology could be inflammatory, but he comes across as someone who believes what he is doing is right. Before you dismiss him completely, read the whole article. In particular, his review (in the same article) of the previously-misguided surgical treatment of intersex children is very balanced and enlightened, and I find it very difficult to disagree with any of it.

Benefits and harms

Suppose you have heart disease. Your doctor suggests you take aspirin, because there is good evidence that aspirin prevents heart attacks. You take aspirin, confident that you will not have a heart attack, because you are doing the right thing.

But it isn't as simple as that. Not everyone with heart disease will suffer a heart attack, so not everybody needs to take aspirin. And some people who take aspirin will still suffer a heart attack, meaning that aspirin is incompletely successful at preventing heart attacks.

Balanced; benefits and harms

All we can say is that aspirin reduces the risk of heart attack. The actual reduction of risk per person is unexpectedly low. It's only when this small benefit is multiplied by thousands of people across a population that it becomes demonstrable. Multiplied across tens, or hundreds of thousands, aspirin can be shown to prevent hundreds of heart attacks.

But aspirin isn't harmless. As well as its benefits, aspirin causes harms. Again, per individual, these harms are tiny, but multiplied across a population, aspirin can be shown to cause an increased risk of bleeding events. We tend to think of these as risks, but to me (and others) this is an unhelpful word, as it implies that risks are avoidable, where in this case they are not: they are inevitable. It creates the irony that some people will take aspirin and experience only the harms (even though most people expect only the benefits!).

There is therefore a bargain to be struck, between the benefits and the harms of any treatment. In the case of aspirin, we can see that the benefits strongly outweigh the harms, and therefore it makes rational sense to take aspirin. For some treatments, the balance of benefit versus harm is not so clear-cut.

There are also people who are already at risk of having a bleeding event. Those people have a different balance of harm versus benefit. For some of them, it may still make sense to take aspirin; for others, it may make sense not to.

So aspirin is a simple example (there is an excellent discussion of aspirin in this context here on Alvin Lin's blog). This article is about the benefits and harms of sex reassignment surgery.

More complicated than aspirin

Once again, we are faced with a population: people born male who request sex reassignment surgery. It's clear that, if we provide that for all of our population, some will receive benefits, and some will receive harms. Some will receive a mixture of both benefits and harms.

Confusing: statistics

As ethical, and rational people, what we want to do is to maximise the benefits and minimise the harms. Our best efforts may mean that more people have benefit than harm, or more correctly that the total sum of benefit outweighs the total sum of harm. (But it may be hard to judge between a hundred people feeling better, but one person losing their life: which is the greater sum?) If we decide that the balance favours performing the surgery, that's an argument for offering the surgery. If, however, we decide that that the balance favours not performing the surgery, then that's an argument for not performing it.

This is the argument put forward by Paul McHugh, but he is missing one important point: that even if the balance of harm and benefit favours not performing the surgery, this applies to a population, and not individuals, and there may therefore be individuals for whom the benefit is greater. In other words, even if, on the whole, surgery is more harmful than beneficial, there will still be some individuals for whom surgery would be the right thing.

The corollary of all this is that, even if surgery is shown to be more beneficial than harmful, there will still be some people for whom surgery would not be the right thing; in other words, surgery still wouldn't be for everyone!

I'm sorry if I am making your head spin. What's the answer to this conundrum? Science, and plenty of it.

Counting your blessings: estimating benefits and harms

The first question is this: taken as a population seeking sex reassignment surgery, how does the sum of benefit compare to the sum of harm?

You might think that's easy: just find a load of post-op transsexuals and ask them if they are happier since they transitioned. Most of them will say yes. So there's your answer, surely? But a sceptic like me would say: hang on. You might not be counting everyone. Some people might have detransitioned. Some people might have taken their own lives (this number is non-trivial where gender dysphoria is concerned, as this study reminds us). Some people might be so miserable that they declined to answer the survey. This is sampling bias, just one of the many biases potentially associated with research.

I came across this useful paper here at the Bournemouth and Poole Joint Strategic Needs Assessment (JSNA) page. It seems to cover the whole UK, and it has a lot to recommend it: it's short; it contains excellent information including great statistics, and it seems to have a very good idea about the priorities in the care of transgender people. On the other hand, it doesn't say who its authors are; it gives no date, and no sources for its figures. I would really like to know if this is some sort of annual report, and if so, where it comes from.

What it says (in brief) is that sex-reassignment surgery is becoming a lot commoner in the UK, but that trans people face a lot of difficulties in schools, in the workplace, and in their personal and emotional lives. So does sex reassignment surgery result in a greater quality of life?

It's difficult to estimate quality of life. You can't measure it directly; you can only ask people to report it. As a result, it is very prone to error and bias, and people telling the researchers what they think they want to hear, or telling them what they wish were true.

Thankfully for us, Una over at Transas City has done the homework for us, and presents a magnificent, detailed meta-analysis of 34 studies from the literature, together with a very detailed discussion of the strengths and limitations of each study. To save you going through it, the bottom line is this: transsexual treatment (not just surgery) is usually (but not always) associated with a better quality of life afterward, though some problems (such as social integration, difficulties finding employment, and so on) persist. I can't praise Una's article highly enough; she has really put in a lot of hard work to bring this data together.

Meanwhile, Elizabeth Hungerford over at Sex Matters presents four different studies, which suggest increased risk of mortality (including suicide) in transsexuals, increased criminal behaviour, and a disconnect between the subjective reporting of outcomes (most people reported improvement) and the objective reporting of outcomes (a lot of complications were reported). She writes:

Hungerford: As this brief review of long term studies illustrates, positive patient satisfaction should be separated from objectively measurably negative outcomes in order to fully understand the efficacy and “success” of “sex reassignment” procedures. We must be skeptical and refuse to accept emotionally motivated claims of “necessity” that are not supported by long term evidence. We must subject these studies to rigorous, unflinching analysis.

And I really think she has a point. Sometimes, giving people what they want isn't the same as giving them what they need. What should a good doctor, using the principles of medical ethics to guide them, offer the person who asks for sex reassignment treatment?

So where does that leave us?

Cumbersome: scientific research

The ideal scientific study will never happen. In it, a large cohort of gender-dysphoric individuals will present for treatment. They will be subjected to an intense battery of psychological testing, designed to demonstrate every facet of psychological function, and every hint of psychiatric illness. They will then be randomised into at least two arms (preferably three). In one arm, they get full treatment: hormones, surgery, the works. In the second arm, they get the next best treatment: counselling, cognitive-behavioural therapy, maybe antidepressants. In the third arm, they get no treatment at all, but get observed to see what happens if you have no treatment at all. The three groups get followed up for a long period (e.g. a decade) to see what the outcomes are. We decide, based on the result, what the best possible treatment for gender dysphoria is.

The reason this study will never happen falls into several areas. First, to enrol patients in a study, you need to fully inform them of what might happen. Tell someone seeking sex reassignment surgery that they may be randomised to a group which doesn't receive it, and they will instantly withdraw from your study. Second, you need a large cohort of people to get robust results, and it's very difficult and expensive to conduct large studies on large groups of people. Third, the longitudinal followup required means that many researchers cannot devote the time required. A PhD, for example, would normally require all the research to be done in a few years. But unless we wait for a lot longer, we might only observe a "honeymoon period" where everything seems rosy (or potentially the opposite: a period of turmoil and unhappiness while settling into a new life which is ultimately more satisfying). Finally, as described here, nobody really wants to touch this sort of research any more.

One solution: real informed consent

By what means can we identify people, in advance, who will ultimately benefit from sex reassignment surgery? Or who won't? The answer is: we cannot. Nobody can tell the future. Doctors are no more able to tell the future than anyone else. And there are a lot of surgical procedures where the outcome is far from certain in advance. Coronary artery bypass grafting, for example, improves lives for many thousands, but opening someone's chest with a saw and plumbing their major blood vessels into a pump (in order to carry out the surgery) is risky, difficult, and expensive.

Informed: consent

Nonetheless, there is a solution, and it is the same as for any type of surgery. We fully inform the individual of the very best information we have, and let them make the choice. We make the assumption that the adult acting with capacity is the best judge of their own best interests. Note that Paul McHugh has already made up his mind--doctor knows best--and he is happy to make the decision that he knows better than his patients what is best for them. Having decided that transgenderism is a mental illness, he may possibly be more comfortable with the notion that transgender people lack capacity to judge their own best interests. This sort of medical paternalism is (thankfully) well on the wane.

Informed consent for surgery might look something like this:

Sex reassignment surgery is likely to be painful and leave you subject to several complications, including incontinence, scarring, bleeding, infection, wound breakdown, blood clots, and even your own death, though this is very rare. The surgery will be permanent and cannot be reversed. You may not have full sexual function afterward, and you may never be able to experience orgasm. Afterward, you are likely to feel better in yourself, but your risk of suicide will remain high, and you may still experience difficulty integrating into society. If you still want the surgery, sign here.

In my experience, most surgical consent forms tend to stress the negative. They need to be seen to make it clear to the patient that while everyone hopes the surgery will go well, and tries to bring about a great result, that might not actually happen.

But making people clearly aware that surgery might go wrong, and even if it goes right, it won't solve all their problems, is a big step forward from saying "no, you can't have surgery". People should be given this information early and often during the consent process for sex reassignment surgery, so that they can really weigh the decision.

I haven't had sex reassignment surgery, so I don't know what the consent process is like. Those of you who have, please post your experiences and comments below.

Meanwhile, we can only hope that particles of good science continue to be done, and that meta-analysis of those particles can clarify the picture for everyone.

Homosexuality and Crossdressing

During the Second World War, Benito Mussolini's fascist government rounded up "degenerate" people, particularly homosexuals, and confined them in a series of camps around the country. One of the largest was on the island of San Domino, in the Tremiti chain, in the Mediterranean Sea northeast of Italy.

Mussolini was attempting to weed out these undesirable people, to keep the society pure and virile. And conditions for the prisoners were intentionally harsh. However, Mussolini unwittingly created a homosexual paradise, doing the prisoners the favour of confining a large group of them to a beautiful island together for the duration of the war.

Hello, sailor!

This episode is not widely known. I had never heard of it until I read about it on the BBC, and you can read the article here written by Alan Johnson. In turn, the article comes from a book, The Island and the City, by Gianfranco Goretti and Tomasso Giartosi. I have searched for the book and it doesn't seem to exist in English. I assume this is a translation of the Italian title. In any case, what follows is all quoted from Johnson's BBC article:

"We were curious because they were called 'the girls'," says Carmela Santoro, an islander who was just a child when the gay exiles began to arrive. "We would go and watch them get off the boat... all dressed up in the summer with white pants - with hats. And we would watch in awe - 'Look at that one, how she moves!' But we had no contact with them."

What this meant to the exiles was explained in a rare interview with a San Domino veteran, named only as Giuseppe B - published many years ago in the gay magazine, Babilonia - who said that in a way the men were better off on the island.

"In those days if you were a femminella [a slang Italian word for a gay man] you couldn't even leave your home, or make yourself noticed - the police would arrest you," he said of his home town near Naples. "On the island, on the other hand, we would celebrate our Saint's days or the arrival of someone new... We did theatre, and we could dress as women there and no-one would say anything."

And he said that of course, there was romance, and even fights over lovers. Some prisoners wept, Giuseppe said, when the outbreak of World War II in 1939 led to the end of the internal exile regime on San Domino, and the men were returned to a kind of house arrest in the places where they came from.

What struck me about this article is how miserable and difficult it must have been for anyone, during the War, who found themselves considered "degenerate" by society. The Brits were no better or more enlightened in their treatment of gay people. As long as he was cracking the Enigma cypher (and keeping his mouth shut), Alan Turing (one of my heroes) was allowed to work for the British intelligence services, and a blind eye was turned. However, after the War, Turing was persecuted for his homosexuality, forced to take huge doses of female hormones (as if that would cure him!) and eventually he took his own life, depriving us of his gargantuan intellect.

Vaudeville drag

But this article throws up some other interesting points. First, the Italians used the word femminella ("little girl") to describe gay men. Carmela Santoro uses female pronouns when describing the men ("How she moves!"). That's all very well. Our society uses the word sissy (a diminutive of "sister") and also uses feminine pronouns in a scornful, offensive manner when a man's masculinity seemingly fails to measure up. So we can tell little about the San Domino internees from what other people thought or said about them.

So what did they say about themselves? None of the San Domino internees are believed to still be alive, and the interview with Giuseppe B is very old. Giuseppe B says "We did theatre, and we could dress as women there and no-one would say anything". Gay men loving the theatre? What are the chances? (And Italians fighting over love? Who would have thought?)

The reason for this post is that I have been puzzling over the relationship between homosexuality and crossdressing for a few weeks now. I have lurked for some years on an academic LGBT forum. What I find surprising is how few T people there are. When I post comments about crossdressing (as I did this week, attempting to stimulate a debate on this subject) I am treated with polite tolerance, but no real engagement. On most of the topics (relationships, coming out at work, discrimination) I seem to have very little in common with the things which trouble or preoccupy them. On the other hand, I feel sure if I sat down among them with a glass of wine we would soon all be laughing and finding all sorts of common ground.

My question to them (and also to you) is this: what is the relationship between homosexuality and crossdressing? Is there one? Are they completely separate, or is there some sort of correlation?

Sister Act

I believe that, in past times, gay and lesbian people might have crossdressed as a means of making it more "acceptable" to have a same-sex partner. I could see how a gay man, brought up to believe that homosexuality was an abomination, might not be comfortable being affectionate towards another man, but might find it a lot easier if that man were fabulously dressed as a woman. In other words, for some of those people (as was the case for Billy Tipton and others), the crossdressing may have been the means to an end, rather than an end in itself.

As just one example,  Molly houses were establishments in 18th-century Britain where gay and crossdressing men would meet up for sex. Wikipedia writes:

Patrons of Molly houses formed a distinct subculture in Georgian England. They would take on a female persona, have a female name, and affect feminine mannerisms and speech. Marriage ceremonies between a Molly and his male lover were enacted to symbolise their partnership and commitment.

As a second example, let's return to Giuseppe B. In his words, the internees of San Domino sometimes expressed themselves by "dressing as women". Is that because some of them were not "ordinary" gays, but what we might recognise as transvestites, who were all lumped in together by the authorities? Or is it because the connection between gay men and crossdressing is closer than we think?


John Leguizamo as Chi Chi Rodriguez

It certainly seems to be true that the popular media lump crossdressing and homosexuality together. To take some examples, the Sean Bean drama Tracie's Story features a gay crossdresser who falls in love with a man; the romantic film Sweet November features two gay transvestites living together, who are the supportive best friends of the quirky female lead, Charlize Theron; the iconic road movie The Adventures of Priscilla, Queen of the Desert, features gay men in drag virtually all the way through, as does its remarkably similar counterpart To Wong Foo, Thanks for Everything! Julie Newmar. All these works feature gay men who are portrayed as powerful, subtle, interesting characters (not simply shrieking and pouting and prancing about), but crossdressing, or drag, is a central theme in each.

In modern Western society, surrounded as we are by openly homosexual politicians and clerics and academics and entertainers (even sportspeople), surely it is no longer necessary to crossdress to attract a same-sex partner? Therefore if gay and lesbian people want to crossdress, surely now they are doing it because they like it? This may be for the performance (as in gay drag), or it may be because they enjoy it for other reasons; perhaps the same reasons that I enjoy it.

In his documentary, Grayson Perry insists in front of the schoolboys that most transvestites are straight men. In this interview on the Huffington Post, journalist and academic Marcie Bianco states the same thing:

Bianco: The largest population of crossdressers that we see in the United States is that of the heterosexual male. Drag is almost a protic performance. They are very different, and to then map on lesbian and gay onto drag, that takes it elsewhere entirely. I don't view crossdressing as a kind of protic performance. I view it as a personal aesthetic that people do to please themselves, to please the person that they are with, I mean it could be a fetish, right? Those are different concepts, different ways of being, that I think need to be distinct.

Gay comedian Julian Clary

So what, if anything, has changed in the last couple of centuries? What does everyone else think? Here are a few perspectives from people who have been kind enough to put up with my pestering questions on the subject. Let's start with Helen Boyd, taken from my interview with her:

Boyd: There have always been gay men who have crossdressed, and it’s not always drag when they do. I assume it’s for similar reasons crossdressers do – some combination of scratching an itch, connecting to a feminine self, fabulousness, and sexuality.

Another one of my correspondents, a gay doctor, writes:

Having thought about it I think the question why do men (or men and women rather) cross-dress is almost as useful as asking why are some people gay? I'm sure there are multiple reasons, different reasons for different people, and it's all a spectrum anyway.

There are serious cross-dressers and occasional or faddy "passing phase" cross-dressers. There are gay cross-dressers and straight cross-dressers. There are those certain of their sexuality and those thrown into doubt by a passing experience of it. I'm not convinced by the autogynephilia theory. It may explain some guys I've no doubt, but it doesn't explain why a gay house music club in London I went to a couple of years ago had some sensational looking cross-dressed dancers gyrating on a podium in the middle of the dance floor full of sweaty gay men. I don't think many of those men were there to get turned on by someone in women's underwear, but they were there to be entertained and have fun.

I think the answer lies in a sense of otherness - of the exotic, outre and titillating. It's different - the opposite of straight and conservative and an expression of the ultra different and liberal. I'm reminded of Cabaret and inter-war Berlin. And it's fabric on the skin that to a man is unusual, strange and soft feeling. And a bit of a laugh. It's naughty. And not to be over-analysed.

I'm sorry if I sound like I'm belittling the topic. I'm not meaning to, but all I'm trying to say is that I don't think it's easily analysable. I think it's often just done for a bit of fun, to prove you're not mainstream, to mess around. But I'm sure different people do it for different reasons, and I'm sure there's a transsexual overlap. But it seems a bit like trying to analyse why gay people are gay!!

Molly, a transgendered woman, writes:

I don't know any gay men who used cross dressing as an entry path to being gay.  I do know a few gay men who have cross dressed from time to time, usually on Hallowe'en or a special event, more for a lark, usually more drag than realistically, and in any event not as part of the social life or their primary relationships.  Doesn't rule it out, just not something I have heard of. It just isn't what it means to be gay.  Gay is about sexual attraction and most gay men are very secure in their gender.  I do know at least one gay man who discovered over time he was trans but it was a very slow, evolutionary process and he was ostracized by his gay friends for a time because of it.  Gay men can be as gender binary as female spouses.

And Janice, another transgendered woman, writes:

About a year ago I was testing the waters, so to speak, and was talking to a gay friend of mine at work about cross-dressing. He got very angry and told me he just couldn't understand why any man would want to put on a dress. I thought, mistakenly, that since he was gay that he would be more understanding and since we are good friends that he would be someone I could come out to.  I was wrong and I dropped it right there.

I must say that I am not really much further forward. I have asked a lot of people what they think, and they seem to think it's not really important. Perhaps it isn't! Perhaps I am just over-thinking it. Comments and perspectives are welcome!

===

My thanks to Tasi Zuriack of Sister House for drawing my attention to the Huffington Post interview.
My further thanks to Janice for reminding me about The Birdcage, another wonderful movie which reinforces the stereotype of the crossdressing gay man.

Helen Boyd Interview

Regular readers of this blog will know of the esteem in which I hold Helen Boyd, author of two forthright and powerful books about life with a crossdressing husband. The first, My Husband Betty (2003), describes Boyd’s relationship with her husband, from his first admission of crossdressing, and her exploration of the consequences of this on their relationship. Just about every aspect of crossdressing comes under Boyd’s insightful and sympathetic, yet ruthless, eye.

This book was followed by She’s Not the Man I Married: My life with a transgender husband (2007). In this book, she describes Betty’s further exploration of her identity, and the consideration of transition.

Excuse me, is this seat taken?

Boyd is a fellow academic. She is a lecturer in Gender and Freshman Studies at Lawrence University, Wisconsin, USA. In my (limited) experience, partners of crossdressers tend to either loathe it openly or tolerate it silently. Boyd is a rare animal: someone who did neither, but was prepared to inquire, to appraise, to judge the good and the bad of crossdressing. Best of all, she is well-placed to tell us her thoughts: crossdressers, our partners, and those around us who want to know more. For people who ask me about crossdressing, I tell them there is no better place to start than My Husband Betty.

After some effort and persistence, Boyd agreed to an email interview with me. I was delighted, but suddenly (and this is unusual for me) lost for questions. I struggled to think of questions which wouldn’t make her roll her eyes (“Like I haven’t been asked this a million times before?”) So I tried to compose questions which were a little probing, a little challenging, just to see what the results would be.

It's been several years since She's Not the Man I Married was published. For those of us who don't know the latest, could you give us a brief update on where things are with Betty's transgender journey?

She transitioned and has been living in the world as a woman for a few years now.

Does this mean hormones and surgery, or something short of that? Legal gender change?

I mean she lives as a woman now. I’m not being coy, but how she transitioned doesn’t make much of a difference for me. My husband is now my wife.

I completely understand your desire to write My Husband Betty, but did you realise or suspect at the time the impact it would have on you? Did you foresee that it would become part of your identity, at least your public one? And is that OK?

I had no idea what was about to happen! None. When you’re an aspiring writer your whole life you have no idea what it will mean – and I’d worked as an assistant to a writer for many years before I wrote it, too, so you think I might have. I wouldn’t have it any other way, and actually like having a public persona, although I’ve had to fine tune how to have a private one, too.

What are your plans for your next book?

I’m writing about masculinity. Something like my other books, but more – this sounds pretentious – literary. It’s an evocative, emotional book right now, brought about by my realization that when my father died, and my husband transitioned, I felt really adrift with no men in my life. It’s hard to explain, but that was the starting point. The first sentence I wrote was “At the age of 43 I’ve found myself bereft of men.” Because I was.

What else do you write about which isn't to do with gender? From my point of view, you seem like someone with a point to make, and I suspect you would have made it in a different area if the cards had fallen a little differently. I just wonder what that area might have been.

A point to make, ha. It’s never occurred to me. I think often the point I’m trying to make more than any other is that people need to let go of shame. Half of the misery in the world is worrying about what other people think even if we think we don’t. I write about music on my blog a lot. The one thing I don’t write about is my family, really, and sometimes I wonder why not.

I admit to feelings of envy when I read your books and realise how open you are to the idea of Betty's transgender status. I suspect that a question you get asked frequently by crossdressers is: "How can I get my wife to be more like you?"

But my question to you is this: has your acceptance of Betty ever led to problems? Have you been the subject of hostility for your views?

Helen and Betty

Of course! Plenty of wives of crossdressers think I’m a pain in the ass. Which, yeah, I am. But I do like to explain that as much as I was an accepting, even enthusiastic, spouse, I had a very hard time with Betty’s transition. Still do. I think the second book hinted at exactly what kinds of issues I would have, but you have to read between the lines to find them.

Why do you consider yourself a pain in the ass?

Because I like crossdressers and would be happy to have one as a husband. They aren’t. For a lot of wives, the crossdressing is a deal-breaker, or keeps them from seeing the masculine husband they know and love. I genuinely enjoyed having a husband who crossdressed. I wish I still had a crossdressing husband, to be honest. Betty knows that, too, but it wasn’t in the cards for us.

What's the most difficult thing for you about having a trans husband?

That she’s my wife now. :-)

What's the best thing for you about having a trans husband?

I think my very favorite thing is having to confront my own issues about gender, although that’s often the most difficult thing, too. (Difficult and amazing do seem to go together a lot.) Because of the work I do, people often assume I’m trans, so I get to experience that thing that trans people do, when others look for the “signs” of whatever gender they think I was declared at birth, which in turns makes me think about what parts of me are masculine, or might be read as masculine if someone thought I was trans. That is, the best thing is being in a space and a community where I get to hear people talk about gender and learn about mine.

What advice would you give to a woman (perhaps a wife) whose partner has just told her about his crossdressing for the first time?

Fasten your seat belt.

A theme of my blog has become my (qualified) acceptance of the Freund-Blanchard autogynephilia model. I wondered what your current view about this hypothesis is (you touch on it in My Husband Betty, but I wondered if your views have evolved).

A couple of things:
(1) I don’t think it’s causal. That is, that there is sometimes a correlation of transness + sexuality, yes. But I don’t think one causes the other.
(2) I’m tired of old men telling everyone else they’re perverts. Honestly.
(3) I have a hard time believing that autogynephilia is a thing at all these days. I think Blanchard has taken autosexuality – which is practically a requirement for men who crossdress – and has turned it into something else. That is, I think there’s a desire to feel pretty, or powerful, or sexy – whichever version of femininity excites you, combined with an acceptance that others aren’t going to be into it so it becomes an autosexual fantasy. There’s nothing wrong with that. Sometimes that person will need to transition and sometimes they won’t. That is, I think they’re turning it into a thing where it’s really just a perfect storm that looks like a thing.

Old men? You mean scientists? Or perhaps priests?

Ha, I mean the whole of the patriarchy, sure.

Most crossdressers insist they are straight men attracted to women. Yet some gay men crossdress. What's your take on that?

There have always been gay men who have crossdressed, and it’s not always drag when they do. I assume it’s for similar reasons crossdressers do – some combination of scratching an itch, connecting to a feminine self, fabulousness, and sexuality.

What famous person would you most like to meet and why?


Adam Ant, c.1982

Honestly? I think my answer is still Adam Ant. He pretty much kept me alive with his music as a teenager and young adult, and I read an awful lot of books he mentioned in songs and interviews, and he’s recently come back after being diagnosed as bipolar, and is as thoughtful and interesting on that topic as he’s always been about art. And he’s still crazy hot at 58. :-)

==

This wouldn’t be much of an interview if all I did was to gush about Helen and how great her books are. Putting my own academic hat on, a little analysis and discussion are in order. All I know of Boyd is what I have read in her books, and a little on her blog, and these answers above. That may not be all that much to go on.

Boyd is about the same age as me, and I find her attractive. This is not merely about looks, but a combination of intelligence, self-confidence, and acceptance of trans people; a heady mixture indeed. She ranks very highly on my list of people I would like to have dinner with.

One of the reasons I feel uncomfortable when I read her books is that I think: why can’t my wife see that crossdressing isn’t all bad? I am sure that Boyd has often been asked questions like this; how do I make my wife understand? I believe she has, perhaps unwittingly, become a poster child for the (hypothetical) Supportive Wives of Crossdressers Movement.

I find it extraordinary that people might consider Boyd herself to be transgendered. However, I suppose this situation allows (as she says) her to experience some interactions exactly as a trans-person would.

I deliberately posed the autogynephilia question because it was raised by a previous commentator to this blog. I am not wholly satisfied with this answer. I see autogynephilia as a theory which fits some of the observable facts quite well. Like all good models, it is testable, and makes predictions which can also be tested. (As I have written elsewhere, the fact that it is a reasonable model does not make it the truth; nor does the fact that it makes some people uncomfortable make it false; nor does it hold a monopoly on ways to conceptualise men who enjoy wearing women's clothing). I don't see it as "old men telling everyone they are perverts", and my first take on this phrase was to assume that Boyd was talking about clergymen, rather than scientists.

From my perspective, with limited information, it looks as if the autogynephilia theory applies quite well to Betty.

For someone who has written so openly, Boyd seems (in my opinion) slightly elusive. She deflected two of my questions above with amusing or pithy retorts, rather than a seemingly honest or analytical response, and disregarded a couple of others completely. In addition, she mentions her family without really being drawn into why she doesn’t write about them.

Wow! Those eyes! What's going on behind them?

I am left with the impression that Boyd is being guarded. She hints at keeping her public persona and private life separate. I understand this completely; she has no reason to take me into her confidence, nor the anonymous readers of this blog. In her books, she has explicitly held up the “Do Not Disturb” sign: there are some places she will not go. And I understand (from Wikipedia) that “Helen Boyd” is itself a pseudonym, albeit one which seems to be quite official.

What would have happened, I ask myself, if Helen Boyd and Betty had never met? Who would Boyd have chosen as a partner? Another trans person? An “ordinary” guy (perhaps a fellow scholar)? And what then? It seems to me that Boyd’s name and (public) identity are inextricable from her association with transgenderism. Would her life have unfolded differently?

I wonder what would she have had to sink her academic teeth into, if not gender issues? And what would that look like to us? Would she be as well known? (“And tonight, my guest is Helen Boyd, author of My Husband the Trainspotter. Helen, a lot of wives will be wanting to know: how do I get him to stop this weird behaviour?”)

And I can’t help wondering, what is the real Helen Boyd like? Perhaps we get a clue from her answer to my “famous person” question. Adam Ant, a singer best-known in the 1980’s for his outrageous and flamboyant style, produced hits like Prince Charming and Stand and Deliver. His videos were colourful, energetic and Bohemian, and regularly featured glorious costumes and cosmetics for both men and women. His music was edgy punk, mixed with energetic rhythms and tribal-influenced vocals.

With lyrics like “Ridicule is nothing to be scared of” and “Although we know it’s wrong, we must do it every day”, Ant was making powerful statements about clothing, identity and behaviour. In the video for Prince Charming, Ant is featured as a Cinderella-like character, with his two ugly brothers going to the ball. Fairy godmother Diana Dors appears to wave her wand. The significance of all this wasn’t lost on me, as a young crossdresser: boys can be Cinderella too. And Ant spends plenty of time pouting and preening for the camera with liberal quantities of mascara and lip gloss on.

Boyd’s affinity for Adam Ant confirms she has an innate liking for boys in costumes and makeup. I didn’t follow Ant’s career past about 1985, and I had no idea he was still touring. But he is, and still, apparently, pressing Boyd’s buttons. Perhaps even without Betty, we can infer that Boyd’s life would have followed a similar groove.

But as a further thought experiment, I wonder what would have happened to me if I had married Helen? Or perhaps Betty, if she had married someone less tolerant? In my case, would I now be transitioning, supported by a loving partner, instead of being a closeted, occasional crossdresser? In Betty's case, would she now still be transitioning, or would she have suppressed her feminine inclinations more? To borrow a very old metaphor, when you look at a tree, how much of its character and appearance is determined by the seed, and how much by the soil?

My thanks to Helen for her time and patience with my questions, and for linking to this blog from hers, which you can find here.

Androgyny

You free your mind in your androgyny. -Garbage, Androgyny.

Androgyny seems to be everywhere these days. My hairdresser was talking about it only the other day. Admittedly, it's not new (look at David Bowie in the 1970's), but it seems to be becoming commoner and more popular.

Wikipedia says androgyny refers to the combination of masculine and feminine characteristics. Well, I think that's technically true, although perhaps the current interpretation of it is someplace in between male and female. One could technically approach androgyny from the male side (by making oneself more feminine) or the female side (by making oneself more masculine).

Andrej Pejic, Covergirl

Nowhere is the current trend of androgyny more apparent than in the fashion world. BBC journalist Maya Sayer has been surveying the Spring 2014 collections of the fashion world and writes: Last week, as the Spring ’14 menswear shows kicked off in London, one trend sounded with all the subtlety of an air horn: androgyny is the new black.

She points out that several fashion houses are putting men wearing skirts, lace, halter tops, and other feminine clothing on their catwalks, "testing the boundaries" between men's and women's clothing.

I know that fashionistas have been talking about men wearing skirts as normal attire for decades, but it hasn't happened yet. I know that some cultures have skirt-like garments which men wear on a daily basis, but you and I know that isn't the same thing. I know there are some men in our culture who wear skirts regardless-- and good luck to them.

How can we mention the fashion world without discussing Andrej Pejic? As I have mentioned before, Pejic, a naturalised Australian citizen of Bosnian descent, is a man who is so beautiful that he is in demand to model both male and female clothing lines. He was voted the 98th Sexiest Woman in the World by FHM magazine in 2011, and was featured as a covergirl on Elle magazine. Wikipedia claims Elle is the world's best-selling fashion magazine.

Lucia Ianelli

Sayer continues: Confidence. If there’s one thing these new androgynous looks demand of men, it’s that. Which raises the question: have the über-masculine looks dominating menswear up to now been signalling a crisis of male confidence?

I agree that for a man to wear a skirt in public (or another seemingly feminine garment) requires an extra helping of self-confidence. Even someone with the credentials of David Beckham, adored for his masculinity by millions of women (and gay men) worldwide, came in for some flak when he wore a sarong. As I have mentioned elsewhere, we are not at all comfortable when our football heroes show any cracks whatever in their masculinity.

Sayer continues: But I’m willing to bet that, given some time, the public will come around to some version of this new unisex aesthetic.

Well, they might be helped by video games, as well as fashion. One of my longstanding favourite video game franchises is the Tekken series, which I have been playing since you could measure the size of the pixels with a ruler. Tekken and its sequels are beat-'em-up games, in which players control highly skilled martial artists and cause them to kick the stuffing out of one another. With each successive sequel, the characters have become more detailed.

Leo from Tekken 6

Tekken games are basically like comics. They are marketed at adolescent boys (of all ages) and therefore contain what that demographic wants to look at: big, muscly men, and beautiful, scantily-clad women in revealing costumes (OK, so there are a few animals, robots, and demons in there too). From its first outing, Tekken featured characters like Nina, who fights wearing ridiculously impractical, skimpy outfits, stockings, and combat stilettos.

Enter the character Leo, introduced in Tekken 6. At first glance, with the jeans, the boots, the gloves and the stance (and the name!), we kind of assume that Leo is a boy, albeit a somewhat slight one. In the game, Leo is given no gender-specific pronouns, and none of the costumes reveal any part of Leo's body, so no clues there. We can't tell from Leo's fighting style; one of the aspects of Tekken is that diminutive teenage girls (such as Xiaoyu) can defeat hulking, Terminator-like robots (such as Jack), using only kung-fu. Yeah, good luck with that.

In fact, Leo is a girl, whose real name is Eleonore, though this fact only became official when her creator, Katushiro Harada, announced it publicly. Until then, fans of the game around the world were tossing coins to decide her official gender.

Most of the female characters in Tekken are exaggeratedly feminine; not just in their costumes, but in the little intro and outro animations played for each character. They wiggle their hips, shake their boobies, beckon in a sexual manner, or (in the case of the younger characters) adopt Lolita-like, little-girl mannerisms. Actually it's quite refreshing to find a female character who can wear something more practical to fight in than a bikini, and who doesn't flaunt their booty in front of the player.


Androgyne celebrity B. Scott

Tekken is of course Japanese, and I suspect that many of the teenage girl characters are there to pay fan-service to the Japanese fondness for schoolgirls and Lolitas; nothing to do with setting positive role models for women, or even giving female players something to empathise with. I wonder whether Leo is there, not to transcend gender stereotypes, but to pander to some Japanese attraction to androgyny.

And what is it with our current fascination with androgyny? You can even find instructions on how to achieve it. Why do we (as a society) find androgyny so attractive? (And why do we find crossdressing so disturbing?). Just type the word into Google (or Google images) and be drenched in pictures of people blending the gender categories (with greater or lesser degrees of success).

In My Husband Betty, Helen Boyd writes (p.186) of how she and husband Betty attended a Hallowe'en party, with Betty dressed as Desire, an androgyne character from Neil Gaiman's Sandman: My husband is beautiful as a man or a woman, but unbelievably beautiful when he's something in-between.

So there is definitely something in it, something intangible. I must say, when I look at the pictures of female bodybuilders, although some of them look really quite masculine, as well as feminine, I don't find it attractive at all. On the other hand, when I look at pictures such as that of Lucia Ianelli, above, I think: wow! How can I explain that? Is it because the bodybuilders look like lots of masculine plus lots of feminine, and the androgynes look like not much masculine plus not much feminine?

As for myself, is androgyny something I aim for? Not in the least. When I am male, I want to be completely male. When I am trying to be female, I want completely female. Somewhere in between doesn't really do it for me. But for those who can carry it off, I wish them nothing but the best.

What about the mainstream? Are men really going to go into stores and buy skirts?

Charlie Casely-Hayford (clothes designer): We want to challenge our customer, but we don’t want to freak him out. So every season, I’m asking myself – can we do a skirt? Will he understand? We’re almost there... But, you know, not quite yet.

Leah True

In the last day or so, my blog counter has passed the 10,000 mark. That's a thousand times more successful than I ever thought this blog would be, so many thanks to all of you who have dropped by, and I hope you will keep on visiting!

Time to post about another transgendered "celebrity", Leah True.

Leah first came to my attention in 2007, on a documentary in the UK (also screened in other countries) entitled Mr Miss Pageant. The whole documentary is available on YouTube, and you can find Part 1 here.

It was originally entitled Mr Miss World, but apparently the real Miss World people objected (and I guess I can see why). In any case, the competition Leah actually entered is called Miss International Queen, an annual beauty contest in Thailand for transgendered male-to-female people (pre-op and post-op), and is still going. Apparently about 10 million people in Thailand watch it every year, making it approximately one million times more popular than the Eurovision Song Contest. You can see the website here. Leah was Britain's first entrant to the competition, but since then there have been two more (but none for the last two competitions! Come on, you chaps! Where's your sense of British spirit?)

Leah True

The documentary follows Leah (real name Gavin), a then 41-yr old man who runs his own company designing power tools.

Gavin: I've never liked this ambiguity thing. If I'm dressed like a guy, I like to look like a guy. If I'm dressed like a woman then I like to look like a woman.

At the time of the documentary, neither his family nor his workmates knew anything about his double life. He lived in the North East of England, but travelled to London at weekends to keep his dressing a secret, where at one point he won the crown of Miss Alternative London. The reviewer of the documentary in the Sydney Morning Herald wrote: "Gavin likes dressing as a woman. No surprise there - he's English."

Gavin: I look at the results as a work of art. Basically, Gavin is the canvas, and Leah is painted on top, and that's what I'm looking at. When I'm all made up, the hair and all the rest of it, what I create, I find very erotic.

Early in the documentary, we meet Sue, a cardiac nurse from London. At the time of filming, Gavin and Sue had been together for six years. Sue describes how they met in a nightclub:

Sue: It was my first experience of a tranny club. Leah was wearing a fantastic black rubber outfit and I had just been out to a gig with my friends, and they said: What do you think of this person, do you think they're a real girl or a boy? And I said wow! Who cares? They look so fantastic.

What struck me about Leah while watching the documentary (a bit like Sue) was how fantastically beautiful she looked. I found myself riveted to the screen. As a trained observer, I look closely at crossdressers, and just about everybody has some "tells" (or in my own case, "screams"). Leah seemed to have nothing: the hair was convincing, the face was convincing, the figure and the cleavage were convincing; and not just convincing but fabulous. I was deeply envious, especially (and I couldn't quite believe it) when there was a short segment showing Sue and Leah, dressed more or less identically, sitting close in bed. In case you haven't watched it, Sue is blonde and slim and extremely attractive.

Interviewer: So who are you most turned on by? Yourself, or Sue?
Leah: If I was really honest... myself. (Sue nods).
Interviewer: Do you masturbate dressed as Leah?
Leah: Yes, I do.

In the next scene we see them shopping together. "We are the same size," Gavin explains, and this makes it easy for Sue to try on clothing or shoes which are actually for Leah.

The documentary also introduces Darlene, who lives in Sydney, Australia, but represents Egypt in the competition. Darlene was banished from her family when she came out to them at the age of 18, but was aware she was differently gendered from the age of 6. She hadn't seen her family for 4 years.

Darlene: You have to understand. Just because I have a penis, doesn't make me any less of a woman than any other woman.

Darlene in a different competition

Darlene has a website here, and you can see a lot more of her here on her YouTube channel.

Darlene: I'm not here to promote Thailand tourism. I'm here to join Miss International Queen. To compete. To see where I stand.

Darlene's brother was getting married at the time, and Darlene was invited to attend, but only if she attended as a boy. This was clearly very painful for her. She has had some surgery to appear more feminine, but hadn't had sex-reassignment surgery at the time of filming; this may have changed.

At the time Leah entered the competition, there were 26 competitors in the competition. Most of the competitors were transsexuals, and professional performers to boot, used to working a crowd. Leah is described as the only "full-time man" in the competition. Gavin has to work "twice as hard" as the other competitors. He takes deportment lessons, complete with the classical walking with a book balanced on his head.

As the competition progresses, the relationship with Sue becomes visibly strained. Like a prima donna, Leah becomes irritable, petulant, snappy and demanding. Sue weeps, and Leah admits she wishes it was over because it was so stressful. After the first round, a 4-minute "talent act", where he misreads his audience completely, Gavin's confidence droops even lower.

Gavin: If you want to be put off a dress for the rest of your life, this is the way to do it. I'm not really getting a huge amount of enjoyment about dressing up every morning, for a purpose. At home, I feel quite special. In the tranny world I usually stand head and shoulders, you know, near the top of the tree. I don't feel like that here.

Gavin uses his engineering skills to design a national costume for Leah, one which is "feminine and visually exciting", and "a bit more technical round the back". In a moment of national pride, his costume extends two Union Jack flags, but at the last minute he is told that he cannot extend it on stage because it takes up too much room. He defies the instructions and extends the costume anyway, but fails to win. Darlene's costume is a Nefertiti-Queen of the Nile thing, with swooping wings.

Neither Leah nor Darlene do well in the competition, and the eventual winner is Miss Mexico.

Darlene: I'll do whatever it takes to find love. Even if it's coming from a different avenue, a different type of love. I found a few friends that love me, that care about me. Now that I found that, you know, I want to find someone that can love me, and be with me. And that is so hard to find.

Why did Leah enter that competition? Without doubt, Leah looks fantastic. But she was competing against competitors who had had hormones, surgery, practice, and (in most cases) were a lot younger than her. What made Gavin think that he could pull it off? Was it confidence? Arrogance even? Afterwards Gavin is seen reviewing the tapes of the competition and expressing some bitterness about being treated unfairly. But, objectively, I think Leah True's talent act was lifeless, and I think winning that competition is not just about looking fantastic in a frock, but about personality and sparkle. I don't think Leah was ever in with a chance of winning.

Of the two competitors, Leah gets (I estimate) 75% of the camera's time (it was a British production, after all), and yet Darlene is the more entertaining. Darlene said she was entering the competition to win, but I really think she was looking to prove something: perhaps prove to her family, perhaps prove to herself, perhaps prove to a future husband, that she is accepted for who she is. Not just accepted, but adored, desired, worshipped. Loved?

Darlene: If suddenly you see I'm not there? That means I've stolen the crown and the chair, and run for Bangkok.

Given the choice of which of them to take out to dinner, I would take Darlene any day of the week. She just comes across as being more fun. The decision is (for me) nothing to do with who seems the more beautiful to look at.

On a completely different note, a point which is made is that, when you crossdress for pleasure, it's wonderful; but when you crossdress for a purpose, it becomes hard work. I suppose lots of crossdressers would quite value a valid excuse to dress more frequently, but when it becomes a chore, it loses a lot of its shine. Here's Helen Boyd from My Husband Betty:

Helen Boyd: Ali says he knew he was "just a crossdresser" when he agreed to be in a documentary film about tranvestism in his native England. After three days of putting on nylons it was no fun any more, and he knew he didn't want to crossdress every day.

Photo credit: Sally Payne / Foter.com / CC BY-NC-ND

And yet, compared to what most crossdressers have got, what does Gavin have to complain about? He has a gorgeous partner who loves him (and deserves a gold medal for putting up with some of his selfish antics); he can dress freely in front of her (and she even admits she quite fancies Leah- phew!) He looks absolutely dazzling when he puts the gear on. It must be pretty close to crossdressing Nirvana.

Gavin: I'm very very good at what I do. I'm probably one of the best in the world at what I do.

But the documentary doesn't end with the end of the competition. It follows Gavin's journey back to Britain, and where he finally "with [his] new-found confidence" comes out to his astonished parents, showing them large glossy prints of Leah. And it seems that the competition was, for Gavin, about validation too.

Gavin's Mum: I always wanted a daughter. They're [the photographs] absolutely incredible. That's wonderful, that one.

Gavin's mum seems unexpectedly unfazed, indeed somewhat impressed, by Leah. There follows a tearful hug between Gavin and his mum. It would be a nice moment to end on, but instead we end with a weeping Darlene, expressing a wish to be hugged and accepted by her own mother.

Leah and Sue were interviewed a few years later on the popular This Morning show in the UK. Unfortunately the website won't give me access from outside the UK, so I can't tell you what was said. Answers on a postcard please. If you want to see more photos of Leah, you can check out her Facebook profile photos. Leah doesn't have a website; at least not one that I have come across, so there is no way to know what she is currently doing.

I didn't figure this out when I first watched this documentary, but it seems abundantly clear that Gavin has autogynephilia: show me a box he doesn't tick! And in turn, I think that Darlene is probably an early-transitioning transsexual; what Cloudy would call an HSTS. But you might disagree! Please post your comments below.

I consider several of the people I have blogged about to be heroes: people whose achievements or behaviour are inspirational to me in one form or another. Though I think Leah looks fantastic and I wish her nothing but the best, I haven't accorded her this accolade: I don't consider her to be an example I seek to follow.

My final point is this one. This blog, for me, is at least partly about my own validation. It's about trying to make something positive out of crossdressing. About me trying to point out to the world that I am not a pervert or a freak, but a nice sensitive guy who happens to like wearing a dress. And 10,000 hits is a pretty resounding validation. When you look at either Leah or Darlene they each seem so successful, so beautiful, that you would think that they wouldn't need validation (surely a case of res ipsa loquitur!). But it's really interesting that they both do; as I suspect quite a few of us do, and I don't know whether to be pleased I am in that company, or disheartened that no level of beauty will make my deep inner insecurities go away.

The Story So Far...

A couple of things prompted this blog post. First, it's the end of the year, which always makes me want to take stock of things which have happened over the last 12 months. Secondly, I came across another blog, Stop Crossdressing, quite recently, and having read quite a few of the more recent posts and discussion, I found myself wanting to repeat on there a lot of things which I've posted on other people's blogs. (Stop Crossdressing has been taken down since I wrote this post).


Vivienne



So I decided that a bit of summing up is in order. I've learned a tremendous amount about myself over the last 12 months, and I've profoundly re-evaluated my views about crossdressing. My plan is that, by putting this all together in the one place, I can crystallise my thoughts (always helpful, I have discovered), and also refer other people to here if they want to know my point of view. Regular readers won't find much that is new, but new visitors will hopefully find all my points here in one place.

For ease of reference, I have grouped everything into headings. Some of this stuff is overlapping, so please read to the bottom before you write in to complain about something!

We are all the same

First, we are all the same (provided we are talking here about men who wear women's clothing). Regardless of whether you call our behaviour crossdressing, transvestic fetishism, crossplaying, or whatever, just about everyone who comes to this site (and just about everyone mentioned on here) has the same inner motivations, which arose, at least in the first instance, for sexual arousal. (I am a "lumper", not a "splitter").

For some of us, those motivations are so strong that they overthrow us; for others, they are less strong and can be managed more easily. But all of us, all the time, feel the same desires and tendencies. For some of us, the fiery sexual component has mellowed into a gentler gratification which may not even involve arousal, but for some of us, it's still all about the sexual arousal.

For all of us, I feel sure, there is no other activity which provides the same relief and pleasure.

Alongside the assertion that we are all the same, but independent from it, is my deeply-held belief that no group is somehow more proper, more meritorious, more deserving of sympathy or recognition, than any other. I believe (and have repeatedly stated) that we have more that unites us than divides us, and that we ought to be generally respectful and courteous to one another at all times.

Crossdressing as an addiction

The concept of addiction is an attractive one for some commentators. Certainly crossdressing behaviour can have features resembling addiction, in that crossdressing desires are sometimes unrelenting and all-consuming. The person would rather be free of those desires, and they cause tremendous self-loathing. And the framework of addiction offers the prospect of rehabilitation, and eventually cure.

But for many common addictions (tobacco, alcohol, drugs, gambling) the initial activity is unpleasant. I still think smoking is loathsome, and I remember drinking my first beer, and hating it. I had to work at it to tolerate it, then enjoy it (which I now do). I have no desire whatever to take drugs, or to gamble (I don't even play the Lottery). On the other hand, I was drawn to crossdressing from my earliest memories, certainly before starting primary school, and the very first activities were pleasurable from the very outset. So I don't consider crossdressing to be an addiction in the same mould as those other things. However, it can certainly become one, if allowed to get out of control.

The morality of cross-dressing

The act of a man wearing women's clothing or cosmetics is morally neutral. I don't consider it intrinsically harmful in any way. In particular, I reject claims that there is somehow a biblical or Christian prohibition against crossdressing.

But crossdressing can be tremendously damaging and harmful. The reason is that many crossdressers seem to pursue crossdressing excessively, and it takes away time and money and other resources which could be better spent looking after a family, or a spouse, or a job. When crossdressing reaches the stage where it prevents someone being able to live a normal life, it's too much.

I frequently use the analogy of golf. Like crossdressing, golf is morally neutral. A couple of rounds a week is fine, but there are some guys who want to play golf all the time; they spend excessively on memberships and green fees, and on the latest clubs and equipment, and their wife might be called a  "golf widow". For those guys, golf is interfering with their ability to lead a normal life and has become excessive. But that doesn't make golf itself intrinsically immoral.

Who is in charge

Amour de moi en femme?

Without doubt, I wish I could be free of my crossdressing desires. They have caused me a considerable amount of personal unhappiness, self-loathing, and marital strife. I am not a "happy crossdresser". It seems I have two choices: either crossdressing is in charge of me, or I am in charge of crossdressing. It's clear for me which of us needs to be in charge.

Deciding that involves making an active choice about the priorities in my life. My marriage is more important to me than my crossdressing. My children are more important to me than my crossdressing. My career is more important to me than my crossdressing. On the other hand, setting aside crossdressing permanently costs too much in terms of mental and emotional effort: I become moody and tense all the time, and am no fun at all to be around. I know that my crossdressing feelings won't go away, no matter how long I desist.

So what I am seeking is a middle ground: to permit just enough crossdressing to assuage my yearnings, but not to pursue it to such an extent that it interferes with my normal life. You might well point out (and I would agree with you) that I am seeking to have my cake and eat it too; that such a balance won't be easily struck. But that's what I am aiming for.

Nobody can sum up my feelings better than old Polonius: This above all: to thine ownself be true.

Autogynephilia

Autogynephilia (or autogynaephilia if you speak British) is the word coined by the sexologist Ray Blanchard to describe "a man's paraphilic tendency to be sexually aroused by the thought or image of himself as a woman". Initially I resisted this description of myself, but after coming across Cloudy's blog On the Science of Changing Sex, I accept it as the only theory which fits all the facts and behaviour as I observe them, in myself and others.

The reason this troubles me is that I had considered that crossdressing was not a sexual thing for me; instead, it seems mostly to be about emotional expression and sensual pleasure these days. However, Blanchard's theory is that it has its roots in sexual arousal, and, though it makes me very uncomfortable to admit it, this is absolutely true for me. On the other hand, although the root of autogynephilia is sexual, sexual gratification isn't (by any means) the only reward which it provides, and emotional and sensual pleasures are comfortably within its purview.

Autogynephilia is also (I believe) the reason that late-transitioning transsexuals (like Caitlyn Jenner for example) desire to change sex, although in most cases by the time transitioning occurs the sexual aspect to it has mellowed into a sensation of comfort or belonging in the female role.

Addendum 22nd September 2015: I am extremely indebted to Alice Dreger's wonderful book, Galileo's Middle Finger, for providing the French translation of autogynephilia. In contrast to what I think is a very clunky and uncomfortable term, in French it is amour de soi en femme, (love of oneself as a woman) which sounds positively lovely.

Crossdressing is common

If you look at my post here, you can see fairly reliable figures from the UK's Office for National Statistics about the prevalence of homosexuality in the population. I had previously read a figure of about 1% of males being crossdressers. A more recent figure from Anne Lawrence says that "up to 3% of men in Western countries may experience autogynephilia". I suspect this might be a bit of an overestimate; one swallow does not a summer make, and I suspect that regular, frequent crossdressers are fewer. We are probably on a continuum of frequency or intensity of crossdressing expression, which makes drawing any line pretty arbitrary. (Are you autogynephilic if you dress once a week? Once a month? Once a year? Or are you autogynephilic if you don't dress at all, but are troubled by daily thoughts about it? How do you decide? I touch on these difficulties in my linked blog post).

What Anne Lawrence also says (and I am sure she is right) is that the number of people who change sex from male to female is rising sharply. Lawrence suggests that this increase is largely accounted for by late-onset transitioners, who previously would have been denied sex-reassignment surgery.

In any case, there are a lot of us out there.

Crossdressing is lifelong and incurable

I believe crossdressing is innate to me. Crossdressing desires have been present from my very earliest memories. Though they have faded from time to time, they have never completely gone away. I do not believe that they ever will. I do not believe that someone can be "cured" of crossdressing in any meaningful way; not any more than one can be "cured" of homosexuality.

One one occasion I met an older crossdresser, who told me that in his youth he had been subjected to electric aversion therapy as a means of attempting to cure his crossdressing. He pretended he was cured just long enough to escape the treatment, before returning to crossdressing, which he had pursued for the rest of his life. It had cost him his marriage, and he seemed deeply unhappy, even though he was dressed at a social gathering. And no amount of military discipline could permanently make a man out of Jan Hamilton.

There is a small amount of evidence that anti-androgens (such as spironolactone) can have some effect at suppressing crossdressing tendencies. However, since the hormonal balance of the human body is akin to an orchestra, to meddle with it carelessly is likely to cause far-reaching and potentially permanent side-effects. I therefore don't recommend anyone to take any hormonal medication without thorough discussion with their doctor first.

Crossdressing tends to be progressive as one gets older; a clear and detailed description of how crossdressing manifests in each decade of life is given in Helen Boyd's wonderful book (which I wholly recommend to everyone) My Husband Betty.

Putting crossdressing aside

Many of my correspondents, and some of the other bloggers I link to, are people who have chosen to set crossdressing aside from their lives. Their motivations vary, from religious or spiritual reasons, through to repugnance at crossdressing, through to a desire to retake control of their lives.

I want to be clear that I wish these individuals nothing but success. I think I have quite a lot in common with many of them (and you know who you are!), and the reason for this is that I share with them a determination that crossdressing will not overwhelm me, and a strong moral sense which keeps me away from the less savoury behaviour of some of my fellow crossdressers.

I don't think that crossdressing can be put aside permanently without considerable effort. It’s sort of like being on a diet. At first, it’s OK to go without chocolate and pizza and the other things you enjoy, but after a while you come to miss them more and more. No matter which way you dress your salad or your rice crackers, you can’t make them delicious or satisfying. And then you find that you are using up all your patience and your energy resisting the urge to have a slice of pizza, and you are moody and tense all the time. You may even accept that chocolate and pizza make you overweight, and all those vegetables are highly nutritious and doing wonders for your digestion (and all that is indisputably true). But still, nothing hits the spot like a fresh hot pizza dripping with melted cheese.

It can be done; some people can manage it for ever, but it costs. I believe people who say they have successfully given up crossdressing and no longer feel the urge to do it are lying to themselves and everyone else; just as I believe people who say they prefer salad instead of pizza are lying to themselves (and everyone else too). You can deliberately choose the salad for all sorts of reasons, and I wish you nothing but the very best of luck, but to insist you don’t like pizza any more makes me highly doubtful.

Intersex and transgender

Intersex isn’t the same as transgender because sex isn’t the same as gender. Sex is a biological distinction (chromosomes, hormones and physical characteristics). Gender is a social distinction (roles and behaviour). And to add a third term, sexuality is about who you want to go to bed with. Usually they coincide pretty neatly, but not always.

It’s absolutely true that sex is not black and white, and neither is gender nor sexuality. Intersex people cannot reliably be assigned to either female or male; some of them have unusual chromosome patterns (karyotypes, such as XXY), and some of them have other syndromes which cause them to develop features of both male and female anatomy. Almost all of them are assigned at birth in to one or other sex, and raised accordingly. I believe that's because parents want their kids to be spared the agony of growing up different. On the other hand, some intersex people, when they become adults, are very uncomfortable with the sex they were assigned to.

I think some transgendered people do probably identify with intersex people (without knowing the science well enough) and use the existence of intersex people to justify their views, beliefs, behaviour, whatever. I can also understand how transgendered people might be slightly envious of intersex people (you might wish you were a man with breasts or a woman with a penis) and why intersex people might be uncomfortable with that.

I think what makes some intersex people uncomfortable about themselves is not the same as what makes transgendered people uncomfortable about themselves. I think most members of both groups are uncomfortable about themselves; I know I am. However, I flatter myself that I do understand the science as well as just about anyone.

I imagine a transgendered person saying to an intersex person: “See, I am just like you: neither male nor female.” I imagine the intersex person replying “You’re nothing like me. You started off as one, and now you want to be the other. Whereas I started off somewhere in the middle.”

As a lumper, I say to both: I understand that you both have different feelings and different biology. But, seen from the outside, you are both people who don’t neatly fit into the categories of male and female. Therefore, perhaps you have quite a lot in common after all (rejection, loneliness, doubt), even if you got there by different routes.

Crossdressing and LGBT

And that brings me on to LGBT. The whole notion of LGBT is exactly this: an attempt to lump together people whose behaviour and predilections don’t quite fit with the "mainstream". Before I started this blog, I had joined a closed internet forum for LGBT academics. I had thought that I would have something in common with them. I was, at the time, desperate to open a dialogue with like-minded individuals, but found (almost) nobody like me there. Though I posted about my own thoughts and fears and concerns, all I seemed to get was a polite concern; nobody (and we are talking about gay and lesbian academics) seemed to feel I had much in common with them. I had hoped to strike a chord, but failed.

As it happens, this blog has done quite well, and I have all but given up visiting that forum. But in the months when I lurked, I realised indeed that I had little in common with the regular posters. I dutifully tried to pitch into some of the conversations, and was treated politely and with tolerance, but without ever developing a sensation of feeling I belonged. And I never felt like attending any of the social gatherings which were held quite regularly. It seemed to me that all I had in common with them was my sense of isolation and self-loathing.

I think, though, for the "general public" (if indeed there are any left when you subtract all the trannies and queers and gays and whatnot), crossdressers are considered to be lumped in with homosexuals. How often have you heard an accusation that because a man wants to wear a frock, he must be gay? And how often have you heard crossdressers insist and demand that they are not gay? Where men are concerned, I think most gay men are attracted to masculine men, not feminine men. So crossdressing isn't an especially effective way to find oneself a gay male partner; Jaye Davidson said something of this kind, and I guess he would know better than most.

Crossdressing isn't an expression of inner femininity

I've left this until the end because I think it is one of the most controversial, and counter-intuitive things which I have discovered. It bears repeating. Men don't crossdress because they are innately feminine. Crossdressers don't want to be like women; they want to be like men think women are. It's true that many crossdressers (and here I include myself) didn't behave like typical boys when younger, and were aware something about them made them different from others, but they didn't actually consider themselves to be girls.

Instead, crossdressers are attracted to women (remember: crossdressers are not gay). It's just, for crossdressers, the attraction to women extends to themselves as a woman (the technical term for this is an erotic target location error). In other words, crossdressing is an expression of heterosexual desire, turned inwards. Anne Lawrence puts it more prosaically, and I refer you to her whole article here:

Thinking about autogynephilic MtF... as men who “love women and want to become what they love” offers a more accurate and more richly informative model for clinicians.

In other words, autogynephilia isn't just a sexual fetish, and to dismiss it as such angers nearly everyone, who insist there is a lot more to it (I know I think so). But it can be conceptualised as a whole suite of romantic or attractive feelings, directed towards oneself as a woman, even though most of us are also capable of directing these feelings outward to a female partner. I suppose that makes me feel a little better about the label of autogynephilia applied to me: it isn't just about the sex thing.

I personally believe that the reason some male crossdressers seek out sex with other male crossdressers, is that the sex partner each is attracted to is not the other one, but themselves in the female role, doing things which they consider it erotic for women to do. Add to that the sexual overlay that many men consider it erotic for two "women" to have sex together, and you have a powerful mix indeed. And indeed, each participant will tell you he is quite sure he isn't doing it because he is gay. See here for Helen Boyd's comment.

I also believe that many crossdressers are more sexually attracted to the woman they see in the mirror than with the woman they may be married to, and Helen Boyd offers plenty in support of this assertion too.

My final piece of evidence in support of this assertion is mentioned above: if you want to suppress crossdressing desires, you don't take more androgens (which, you might think, would make you more "manly"). Instead you take anti-androgens, which suppress male sexual appetite and behaviour. Why does that work? Because crossdressing isn't driven by femininity, but by masculinity.

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Anyway, that's been a lot of useful discovery for just a little over a year. For regular visitors, please do keep coming, and posting your comments; I find them extremely stimulating and valuable. For new visitors, do please browse through; one of my personal favourite, but least-visited posts, is this one.

All the best for 2013,

Vivienne.