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Wednesday, October 26, 2011

Is Gender always fixed at birth?

Transgender rights are a component of the advocacy efforts for groups supporting gay rights.  Discrimination against transgender people can be more blatant and aggressive. The recent incident here in Maryland where a trans woman was attacked at a McDonald's shows that violence against this population is happening right in our back yard.

It is important to realize that gender identity and sexual identity are not the same thing.  Gender identity is an internal sense of who we are. Sexual identity is about who we are attracted to. Interestingly a person’s gender identity is often understood by that person at a very early age, even if that identity conflicts with the child’s assigned sex at birth.  It is not uncommon to have a 3- or 4-year old try to tell a parent that they feel they were born with the wrong body. As one parent told me her, 4-year old child (who was assigned male at birth) said that there was mix-up in the mommy’s tummy and that he was supposed to be a girl.  Whereas sexual identity is something that develops at a later age, much closer to puberty.

When it comes to being transgender or gender variant, we give girls a lot more room than we do boys. Girls in our society are permitted to be “tomboys” and athletic, whereas boys are labeled “sissies” if they show signs of not being masculine enough. Women can show affection to each other in ways that men are not allowed.  Men are more likely to be homophobic than women.

The concept of transgender first came to widespread public attention with Christine Jorgensen back in the 1950’s, when she was the first publicly known American recipient of a “sex change.”  In the late 1970’s Rene Richards, a transgender woman, caused controversy in the tennis circuit when she was interested in playing in women’s tennis tournaments. Today a great deal of attention has been given to Chaz Bono, the transgender son of Sonny and Cher, and a recent participant on Dancing with the Stars.

Coming to terms with your true gender identity, when it differs from your birth gender, comes in stages.  The first stage is a social transition. They will begin to dress differently and change appearance to fit their internal  image of their correct gender. Second stage is to use hormone therapy to change their physical appearance. First, they block the hormones of their birth gender; then take the hormones (either estrogen or testosterone) that align with their identified gender. The third stage and is to have surgery to change their body. This is the most dramatic change and one that not all transgender individuals can access.  Insurance coverage for this expensive surgery can be problematic. And some trans people chose not to have surgery.

Sadly and tragically, transgender people suffer from a very high rate of suicide. Some studies indicate that up to 50% of transgender teens have attempted suicide. The rejection of family and society is a major psychological hurdle for many transgender individuals. As happened in the past with homosexuality, the mental health community is slowly coming to the realization that gender identity is not a mental disorder.  As usual the professionals coming to this realization are the social workers and pediatricians.  The psychiatrists and psychologists are slower to make this adjustment.

In Howard County, the school system has been very open and supportive of transgender children and has partnered with PFLAG to train school psychologists.  The Howard County Council is aiming to make gender identity a protected class from discrimination. PFLAG sponsors a support group for parents of trans and gender variant children. For more information, go to

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