Trans 101: Introduction

(reposted from Facebook, originally posted January 4, 2017)

For those of you who aren’t transgender, I’ve noticed that the subject may be somewhat fresh to you, and sometimes people don’t want to ask questions, from a desire not to offend. So for those who are interested, here’s the first installment in a brief Trans 101 primer. As I started writing this, I realized there was no way I could contain it all in a bite-sized post, so I’m splitting it up. Here’s part one.

The Basics:

There are numerous ways that people don’t conform to gender norms. There are crossdressers, who are (typically) men who dress as women at times because they enjoy doing so (these folks used to be called “transvestites”, and some, like Eddie Izzard, still use the term). There are drag queens (and drag kings!) who put on elaborate performances of a different gender that deliberately highlights gendered aspects of culture. There are genderfluid people whose gender identify isn’t stable. There are people who engage in “genderfucking” who are deliberately messing with gender norms in order to express themselves or make a statement. Those are all interesting and valid identities, but they’re not mine, so that’s all I will say about them. I’m transgender.

A transgender person is someone whose gender identity doesn’t match their assigned biological sex. Cisgender people (those who aren’t transgender) often don’t realize that sex and gender are two different things. Broadly, your biological sex is determined by which reproductive apparatus you have. It’s a physical category used to describe bodies. Gender, on the other hand, is a product of culture; “male” and “female” are two sets of images, ideas, and behaviors that are rooted in biological sex, but spill out far past it, spread out, and overlap with each other in various, fascinating ways.

To be transgender is to say that you do not identify with the gender that you have been assigned at birth. Trans people often describe themselves as “Assigned Male At Birth” (AMAB) or “Assigned Female At Birth” (AFAB), for this reason.

That mismatch has two major repercussions, one of which is physical and the other of which is social. The physical one is called Gender Dysphoria. It’s defined in the DSM as “a marked incongruence between one’s experienced/expressed gender and assigned gender.” Dysphoria affects everyone differently. Some trans people don’t experience it at all, and some find it crippling. To me it feels like a pronounced dissonance, a jangling discord between what I feel myself to be and how I find myself to be. To the extent that your body doesn’t match the body image of your preferred gender, it can manifest as feelings of disgust for or distance from your body, especially secondary sex characteristics like body hair, breasts, genitals, face shape, etc. To the extent that your emotional/social life doesn’t match your preferred gender, you can feel deep social anxiety, jealousy of people who express your preferred gender, and despair over feeling forced to conform to a gender that you can’t identify with.

There are two identified treatments for gender dysphoria — psychotherapy and gender transition — and most trans people employ one or both. The big one, obviously, is gender transition. The “transition” is technically from a body shape and lifestyle that conforms to the assigned gender, to a body shape and lifestyle that conforms to the preferred gender (or anywhere in the gender spectrum, a fluid space between, some of each, or no gender at all).

People assigned male at birth who are transitioning to female (often abbreviated as MtF), are referred to as “transgender women” or “trans women.” People assigned female at birth who are going the other way are “transgender men” or “trans men.” I identify as a “trans woman.”

Transition means different things to different people. For some it means no outward change at all. For some it means a total change of body shape, including surgery, hormone therapy and lifestyle, to the point of total immersion in the preferred gender.

Female to male transition has some things in common with male to female, but they are different enough to where I’ll leave it aside for now. So, here are the ways that people transition specifically from male to female:

* Altering your physical appearance. This includes things like laser hair removal or electrolysis, shaving body hair, growing out head hair, doing clever things with cosmetics, dressing as female.

* Hormone therapy, usually referred to as HRT. For trans women, HRT usually consists of estrogen (specifically estradiol) and a drug to block the production of testosterone. Introducing estrogen into a male body has a multitude of fascinating effects. As you can imagine, it affects your mood, and it often does wonders for calming dysphoria. Physically, it makes your hair and skin noticeably softer. It changes the way your sweat smells. It also has the effect of redistributing how fat is stored in your body. This last is a HUGE deal. Women have shapely asses and curvy thighs because of this; women have softer, rounder faces because of this. Often, the redistribution of fat (a bit misleading, because you actually have to LOSE the fat here and then regain it THERE) makes an immense difference on one’s ability to “pass” as their preferred gender. (The importance of “passing” is a huge debate in trans circles, and something I’ll come back to, as I don’t pass and probably never will.)

In the U.S., the main T-blocker (as it’s called) is a drug called Spironolactone, which is a diuretic. Given the bathroom issues that trans people face, Spiro is not a popular drug.

* Surgery. This is the one cisgender people usually think of. Ironically, though, most trans people DON’T get surgery, either because they don’t want to, are afraid to, or can’t afford to. These surgeries are intrusive, often involve lengthy and painful recoveries, and are sometimes extraordinarily expensive. For trans women, they include Facial Feminization Surgery (FFS), which includes rhinoplasty, chin reduction, hairline lowering, and a whole host of other subtle procedures. There’s also breast augmentation, of course. And the big one, which used to be called Sex Reassignment Surgery and is now usually called Gender Confirmation Surgery (GCS). For trans woman, the specific procedure you’re thinking about is called Vaginoplasty, and… well, you can look it up yourself.

I think people know this now, because nobody has asked me about it, but trans people REALLY don’t like being asked about their genitals. Like, REALLY REALLY A LOT.

I think that’s a good place to start for now. Please let me know if this was helpful, and I’ll write more about it. It’s a fascinating subject, and I’m especially interested in the intersection of biological sex and gender, which I will talk about next time…

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