Transgender sexuality

From Wikipedia, the free encyclopedia
Jump to navigation Jump to search

Sexuality in transgender individuals encompasses all the issues of sexuality of other groups, including establishing a sexual identity, learning to deal with one's sexual needs, and finding a partner, but may be complicated by issues of gender dysphoria, side effects of surgery, physiological and emotional effects of hormone replacement therapy, psychological aspects of expressing sexuality after medical transition, or social aspects of expressing their gender.

Sexual orientation[edit]

Historically, clinicians labelled trans people as heterosexual or homosexual relative to their sex assigned at birth.[1] As of 2020, terminology based on birth sex is generally considered to be affiliated with gender critical movements.[2][failed verification][3][verification needed] Within the transgender community sexual orientation terms based on gender identity are the most common, and these terms include lesbian, gay, bisexual, asexual, queer, and others.[4] In literature the terms gynephilia and androphilia are sometimes used to describe attraction to women and men, respectively.[citation needed]

Sexual orientation distribution[edit]

In the United States, transgender respondents to one 2015 survey self-identified as queer (21%), pansexual (18%), gay, lesbian, or same-gender-loving (16%), straight (15%), bisexual (14%), and asexual (10%).[5] A second study found 23% reported being gay, lesbian, or same-gender-loving, 25% bisexual, 4% asexual, 23% queer, 23% straight and 2% something else.[6]

Transgender women[edit]

A 2015 survey of roughly 3000 American trans women showed that at least 60% were attracted to women.[7] Of the trans women respondents 27% answered gay, lesbian, or same-gender-loving, 20% answered bisexual, 19% heterosexual, 16% pansexual, 6% answered asexual, 6% queer, and 6% did not answer.[5]

Transgender men[edit]

Foerster reported a 15-year successful relationship between a woman and a trans man who transitioned in the late 1960s.[8][9]

In the 20th century, trans men attracted to women struggled to demonstrate the existence and legitimacy of their identity.[10] Many trans men attracted to women, such as jazz musician Billy Tipton, kept their trans status private until their deaths.

Although the literature indicates that most trans men identify as heterosexual,[11][12] their attraction can vary. Author Henry Rubin wrote that "[i]t took the substantial efforts of Lou Sullivan, a gay FTM activist who insisted that female-to-male transgender people could be attracted to men."[10] Matt Kailey, author of Just Add Hormones: An Insider’s Guide to the Transsexual Experience,[13] recounts his transition "from 40-something straight woman to the gay man he’d always known himself to be."[14] Researchers eventually acknowledged the existence of this phenomenon, and by the end of the 20th century, psychiatrist Ira Pauly wrote, "The statement that all female-to-male transgender are homosexual [Pauly means attracted to women] in their sexual preference can no longer be made."[15]

A 2015 survey of roughly 2000 American trans men showed more variation in sexual orientation or sexual identity among trans men. 23% identified as heterosexual or straight. The vast majority (65%) identified their sexual orientation or sexual identity as queer (24%), pansexual (17%), bisexual (12%), gay/same-gender loving (12%), asexual (7%), and 5% did not answer.[16]

Gay trans men have varying levels of acceptance within other communities.[17] Upon beginning testosterone treatments, some trans men report an increase in both their libido and their desire for sex with non-trans men.[18]

Trans-feminine third genders[edit]

Psychiatrist Richard Green, in an appendix to Harry Benjamin's 1966 The Transsexual Phenomenon, considers people assigned male at birth who have adopted a more feminine gender role.[19] In this broad overview, entitled "Transsexualism: Mythological, Historical, and Cross-Cultural Aspects", Green argues that the members of these groups are mentally indistinguishable from modern western transsexual women.[19] They have in common early effeminacy, adulthood femininity, and attraction to masculine males.[20]

The Hijra of the Indian Subcontinent are people who were assigned male at birth but occupy a female sexual and/or gender role, sometimes undergoing castration.[21] As adults, they occupy a female role, but traditionally Hijra describe themselves as neither male nor female, preferring Hijra as their gender.[21] They often express their femininity in youth; as adults, they are usually sexually-oriented towards masculine men.[21]

Mukhannathun were transgender individuals of the Muslim faith and Arab extraction who were present in Medina and Mecca during and after the time of Muhammad.[22] Ibn Abd Al-Barh Al-Tabaeen, a companion of Aisha Umm ul-Mu'min'in who knew the same mukhannath as Mohammed, stated that "If he is like this, he would have no desire for women and he would not notice anything about them. This is one of those who have no interest in women who were permitted to enter upon women."[23] That said, one of the Mukhannath of Medina during Muhammad's time had married a woman.[22]

Travesti are Brazilian male assigned people who are attracted to men.[24] Travestis' feminine identity includes hormones and/or silicone body alterations, feminine dress, language, and social and sexual roles, but rarely genital surgery.[24] However, in contrast to North American transgender women, they often don't see themselves as real women, and many describe themselves as gay or homosexual.[24] According to Don Kulick, they will describe themselves instead as "feeling like a woman".[24] In his book Travesti: Sex, Gender and Culture among Brazilian Transgendered Prostitutes, he writes that no travesti in Salvador ever claims to be mulher (a woman) except as a joke, and travestis reading or hearing about transgender people who say they feel like women regard them as disturbed.[25]

Cultural status[edit]

Beyond western cultures, sexual behavior and gender roles vary, which affects the place of gender variant people in that culture.[26] Nadleehe of the North American Navajo hold a respected ceremonial position, where as the Kathoey of Thailand experience more stigma comparatively.[26]

Sexual practices[edit]

Tobi Hill-Meyer, self-described 'Queer Trans Multiracial Sex-Positive Activist Writer and Porn Maker', is making a documentary called Doing it Again: In Depth about transgender people's sexualities. As of December 17, Volume 1: Playful Awakenings has been released.[27] This volume interviews couples where both people are transgender. Cultural studies scholar J.R. Latham wrote the first definitive analysis of trans men's sexual practices in the journal Sexualities.[28]

Naming the body[edit]

Many transgender individuals choose to not use the language that is typically used to refer to sexual body parts, instead using less gendered words. The reason for this practice, is that hearing the typical names for genitalia and other sexual body parts can cause severe gender dysphoria for some trans people.[29]

Not all transgender people choose to rename their bodies. Those that choose not to rename their body, are often less uncomfortable with their body and/or don't associate their sexual body parts with a gender that differs from the one that they identify with.[29]

Ultimately, the decision of what language a trans person chooses to use for their body, and wants others to use, is up to the individual whose body is being named.[29]

Transgender women[edit]

Some trans women choose to call their anus their vagina because they can use their anus in many of the same ways that cisgender women can use their vagina. Furthermore, some transgender women choose to refer to other, non-sexual, parts of their body as sexual body parts that belong to cis women, such as the vulva and the clitoris.[29]

Transgender men[edit]

Some trans men choose to call their vagina euphemistically as their "front hole" because they feel that it is less gendered. Furthermore, some transgender men choose to refer to other parts of their bodies using male terminology. For example, some transgender men choose to refer to their clitoris as their penis, because, like the penis, the clitoris often increases in size, when an individual is aroused.[29]

Effects of transitioning[edit]

Effects of feminizing hormone therapy[edit]

For transgender women, taking estrogen stimulates the development of breast tissue, causing them to increase in both size and sensitivity. For some, this increased sensitivity can be pleasurable, while for others it can be uncomfortable or painful. Furthermore, for those taking estrogen and who have male genitalia, estrogen can (and often does) shrink the external male genitalia and decrease the production of semen (at times bringing the sperm count to zero), and can decrease the ability for the male genitalia to become erect. In addition to these changes, some transgender women going through hormone therapy (HRT) can experience changes in the way their orgasms feel. For example, some people report the ability to experience multiple orgasms.[29]

HR can cause decrease in sex drive or a change in the way arousal is experienced by trans women.[29] A study published in 2014 found that 62.4% of trans women surveyed reported a decrease in sexual desire after hormone therapy and/or vaginoplasty.[30] A 2008 study reported hypoactive sexual desire disorder (HSDD) in as many as one in three post-operative trans women on HRT.[31]

A 2009 pilot study tested the effectiveness of two treatments for HSDD in trans women: transdermal testosterone and oral dydrogesterone (a progestin).[32] After six weeks of treatment, the group treated with testosterone reported improved sexual desire, while the group treated with the progestin reported no change.[32]

Effects of masculinizing hormone therapy[edit]

For transgender men, one of the most notable physical changes that many taking testosterone experience, in terms of sexuality and the sexual body, is the stimulation of clitoral tissue and the enlargement of the clitoris.[33] This increase in size can range anywhere from just a slight increase to quadrupling in size.[3] Other effects can include vaginal atrophy, where the tissues of the vagina thin and may produce less lubrication. This can make sex with the female genitalia more painful and can, at times, result in bleeding.[3] Transgender men taking testosterone are likely at increased risk of developing urinary tract infections, especially if they have receptive vaginal intercourse.[34]

Other effects that testosterone can have on transgender men can include an increase in their sex drive/libido. At times, this increase can be very sudden and dramatic. Like transgender women, some transgender men also experience changes in the way they experience arousal.[33][3]

Effects of sex reassignment surgery[edit]

Trans women who have undergone vaginoplasty must dilate in order to properly shape and form the neovagina. After several months, sexual intercourse can replace dilation, but if not sexually active, dilation is required again, for the rest of the patient's life.[35]

Sexual orientation and transitioning[edit]

Some trans people maintain a consistent orientation throughout their lives,[36][37] in some cases remaining with the same partner through transition.[38]

Some gynephilic trans women self-report that after transitioning, they became sexually oriented towards males, and explain this as part of their emerging female identity.[39] Kurt Freund hypothesized that such reports might reflect the desire of some trans women to portray themselves as "typically feminine" or, alternatively, might reflect their erotic interest in the validation provided by male partners, rather than representing a genuine change in preference.[40] A 2005 study which relied upon vaginal photoplethysmographies to measure blood-flow in the genitalia of postoperative trans women found they had arousal patterns which were category specific (i.e. androphilic trans women were aroused by males, gynephilic trans women were aroused by females) in a similar fashion to natal males, and argue that vaginal photoplethysmographies are a useful technology for measuring the validity of such reports. The one trans woman in the study who reported a change in sexual orientation had arousal responses consistent with her pre-reassignment sexual orientation.[40]

While undergoing hormone therapy, some trans men report experiencing increased sexual attraction to cisgender men.[33] This change can be confusing for those who experience it because it is often not a change that they expect to happen.[33]

Transvestic fetishism[edit]

The DSM once had a diagnosis of "transvestic fetishism".[41] Some therapists and activists sought to de-pathologize this category in future revisions.[42] DSM 5, which was released in 2013, replaced the transvestic fetishism category with "transvestic disorder".[43]

Following the example of the Benjamin Scale, in 1979 Buhrich and McConaghy proposed three clinically discrete categories of fetishistic transvestism: "nuclear" transvestites who were satisfied with cross-dressing, "marginal" transvestites who also desired feminization by hormones or surgical intervention, and "fetishistic transsexuals", who had shown fetishistic arousal but who identified as transsexuals and sought sex reassignment surgery.[44]

Sex work[edit]

In many cultures, transgender people (especially trans women) are frequently involved in sex work such as transgender pornography.[citation needed] This is correlated with employment discrimination.[citation needed] In the National Trans Discrimination Survey, 11% of respondents reported having done sex work for income, compared to 1% of cisgender women in the US.[45] According to the same survey, 13% of transgender Americans are unemployed, almost double the national average.[46] 26% had lost their jobs due to their gender identity/expression. Transgender sex workers have high rates of HIV. In a review of studies on HIV prevalence in trans women working in the sex industry, over 27% were HIV positive. However, the review found that trans women engaged in sex work were not more likely than trans women not engaged in sex work to be HIV positive.[47] Studies have found that in the United States HIV is especially prevalent amongst transgender sex workers of color, particularly black trans women, a problem that has been identified by academics[48] and members of the transgender community.

The subject of transgender sex workers has attracted attention in the media. Paris Lees, a British trans woman and journalist, wrote an article in June 2012 for the Independent defending criticism of Ria, star of Channel 4 documentary Ria: Teen Transsexual, who was seventeen at the time and depicted as working as a prostitute at a massage parlor, saying that the choice to engage in sex work is a matter of bodily autonomy and pointing out reasons that young trans women often turn to sex work such as low self-esteem and severe employment discrimination.[49] A review by GLAAD of its archives of transgender-inclusive television episodes from 2002 to 2012 found that 20% of transgender characters were depicted as sex workers.[50] A 2020 Netflix documentary, Disclosure, explores this in more depth.[51]

History[edit]

Classifying transgender people by sexual orientation[edit]

Historically, transgender people were unable to access gender affirming care unless they would be considered heterosexual post surgery.[52][53] For much of the early 1900's, transgender persons were conflated with being either an invert or homosexual; as such, non-heterosexual sexual orientation data for transgender people is limited.[52][53][54] In the 1980's, Lou Sullivan was instrumental in allowing non-heterosexual transgender people access to surgical care and hormones.[52]

Sexologist Magnus Hirschfeld first suggested a distinction based on sexual orientation in 1923.[55] A number of two-type taxonomies based on sexuality have subsequently been proposed by clinicians, though some clinicians believe that other factors are more clinically useful categories, or that two types are insufficient.[56] Some researchers have distinguished trans men attracted to women and trans men attracted to men.[57][58]

The Benjamin Scale proposed by endocrinologist Harry Benjamin in 1966 used sexual orientation as one of several factors to distinguish between "transvestites", "non-surgical" transsexuals, and "true transsexuals".[59]

In 1974, Person and Ovesey proposed dividing transsexual women into "primary" and "secondary" transsexuals. They defined "primary transsexuals" as asexual persons with little or no interest in partnered sexual activity and with no history of sexual arousal to cross-dressing or "cross-gender fantasy".[60] They defined both homosexual and "transvestic" trans people to be "secondary transsexuals".[61]

Dr Norman Fisk noted those entering his clinic seeking reassignment surgery comprised a larger group than fit into the classical transsexual diagnosis. The article notes that effeminate gay men and heterosexual fetishistic transvestites desire surgery and could be considered good candidates for it.[62]

In the DSM-II, released in 1968, "transsexualism" was within the "paraphilias" category, and no other information was provided.[63]

In the DSM-III-R, released in 1987, the category of "gender identity disorder" was created, and "transsexualism" was divided into "asexual", "homosexual", "heterosexual" and "unspecified" sub-types.[64]

In the DSM-IV-TR, released in 2000, "transsexualism" was renamed "gender identity disorder". Attraction specifications were to male, female, both, or neither, with specific variations dependent on birth sex.[65]

In the DSM-V, released in 2013 and currently used in the United States and Canada, "gender identity disorder" is now "gender dysphoria", and attraction specifications are either gynephillic or androphillic.[66]

See also[edit]

References[edit]

  1. ^ Chivers, Meredith L.; Bailey, J. Michael. Sexual Orientation of Female-to-Male Transsexuals: A Comparison of Homosexual and Nonhomosexual Types. Archives of Sexual Behavior
  2. ^ Zanghellini, Aleardo (April 2020). "Philosophical Problems With the Gender-Critical Feminist Argument Against Trans Inclusion". SAGE Open. 10 (2): 215824402092702. doi:10.1177/2158244020927029. ISSN 2158-2440.
  3. ^ a b c d Stryker, Susan (2017-11-07). Transgender history : the roots of today's revolution (Second ed.). New York, NY. ISBN 9781580056892. OCLC 990183211.
  4. ^ "Wonky Wednesday: Trans people & sexual orientation". National LGBTQ Task Force. 2013-06-05. Retrieved 2021-02-03.
  5. ^ a b James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016). "The Report of the 2015 U.S. Transgender Survey" (PDF). National Center for Transgender Equality.CS1 maint: multiple names: authors list (link)
  6. ^ Harrison,Jack. "WONKY WEDNESDAY: TRANS PEOPLE & SEXUAL ORIENTATION". Task Force and the National Center for Transgender Equality.
  7. ^ "Injustice at Every Turn: A Report of the National Transgender Discrimination Survey" (PDF). National Center for Transgender Equality & National Gay and Lesbian Task Force. 2015-01-21. p. 29.
  8. ^ Foerster, DW (1983). "Female to Male Transsexual Conversion: A 15-Year Follow-Up". Plastic and Reconstructive Surgery. 72 (2): 237–40. doi:10.1097/00006534-198308000-00024. PMID 6683850.
  9. ^ G. Kockott, E. -M. Fahrner (1988). Male-to-female and Female-to-male transsexuals: A comparison. Archives of Sexual Behavior, Volume 17, Number 6 / December, 1988
  10. ^ a b Henry Rubin (2003). Self-made Men: Identity and Embodiment Among Transsexual Men. Vanderbilt University Press, ISBN 978-0-8265-1435-6
  11. ^ Michael Shankle (2013). The Handbook of Lesbian, Gay, Bisexual, and Transgender Public Health: A Practitioner's Guide to Service. Routledge. p. 175. ISBN 978-1-136-57355-2. Retrieved January 10, 2016.
  12. ^ Yitzchak M. Binik, Kathryn S. K. Hall (2014). Principles and Practice of Sex Therapy, Fifth Edition. Guilford Publications. p. 252. ISBN 978-1-4625-1389-5. Retrieved January 10, 2016.CS1 maint: uses authors parameter (link)
  13. ^ Kailey, Matt (2006). Just Add Hormones: An Insider’s Guide to the Transsexual Experience, Beacon Press, ISBN 978-0-8070-7959-1
  14. ^ Jacob Anderson-Minshall (January 19, 2006) Invisible Man. San Francisco Bay Times
  15. ^ Ira B. Pauly (1998). Gender Identity and Sexual Orientation. In Dallas Denny, ed. Current Concepts in Transgender Identity. Routledge, ISBN 978-0-8153-1793-7
  16. ^ James, S.E.; Herman, J.L.; Rankin, S.; Keisling, M.; Mottet, L.; Anafi, M. "The Report of the 2015 U.S. Transgender Survey" (PDF). 2015 US Transgender Survey. National Center for Transgender Equality. Retrieved 1 June 2018.
  17. ^ Szymanski, Zak (January 19, 2006). Leather community debates trans exclusion at upcoming contest. Bay Area Reporter
  18. ^ "What are transgender men's HIV prevention needs?". Center for AIDS Prevention Studies. Retrieved 2012-10-02.
  19. ^ a b Green R (1966) Transsexualism: Mythological, Historical, and Cross-Cultural Aspects. Archived 2012-10-23 at the Wayback Machine in Benjamin H, The Transsexual Phenomenon. Julian Press ASIN B0007HXA76
  20. ^ Barrett, Jackson (2007). Transsexual and Other Disorders of Gender Identity: A Practical Guide to Management. Google books: Radcliffe Publishing. p. 298. ISBN 978-1-85775-719-4.CS1 maint: location (link)
  21. ^ a b c See, for example, In Their Own Words: The Formulation of Sexual and Reproductive Health Behaviour Among Young Men in Bangladesh Archived 2012-02-22 at the Wayback Machine, Shivananda Khan, Sharful Islam Khan and Paula E. Hollerbach, for the Catalyst Consortium.
  22. ^ a b Rowson, Everett K. (October 1991). "The Effeminates of Early Medina" (PDF). Journal of the American Oriental Society. 111 (4): 671–693. CiteSeerX 10.1.1.693.1504. doi:10.2307/603399. JSTOR 603399.
  23. ^ Al Muqni, Matan. al Sharh al Kabeer (in Arabic). 7. pp. 347–348.
  24. ^ a b c d Kulick, Don (1998). Travesti: Sex, Gender, and Culture Among Brazilian Transgendered Prostitutes. Chicago: University of Chicago Press. p. 269. ISBN 978-0-226-46100-7.
  25. ^ Kulick, Don (1998). Travesti: Sex, Gender, and Culture among Brazilian Transgendered Prostitutes (PDF). University of Chicago Press. p. 248.
  26. ^ a b Bosson, Jennifer K. (27 February 2018). The psychology of sex and gender. Vendello, Joseph A.,, Buckner, Camille E. Thousand Oaks, California. pp. 89–90. ISBN 978-1-5063-3132-4. OCLC 1004248895.
  27. ^ "Download - Doing it Again, Vol 1: Playful Awakenings". handbasketproductions.com.
  28. ^ Latham, JR (March 2016). "Trans men's sexual narrative-practices: Introducing STS to trans and sexuality studies". Sexualities. 19 (3): 347–368. doi:10.1177/1363460715583609. S2CID 147597591.
  29. ^ a b c d e f g Erickson-Schroth, Laura, ed. (2014). Trans bodies, trans selves a resource for the transgender community. ISBN 978-0199325351. OCLC 944726648.
  30. ^ Wierckx, Katrien; Elaut, Els; Van Hoorde, Birgit; Heylens, Gunter; De Cuypere, Griet; Monstrey, Stan; Weyers, Steven; Hoebeke, Piet; t'Sjoen, Guy (2014). "Sexual Desire in Trans Persons: Associations with Sex Reassignment Treatment". The Journal of Sexual Medicine. 11 (1): 107–118. doi:10.1111/jsm.12365. PMID 24165564.
  31. ^ Elaut, Els; De Cuypere, Griet; De Sutter, Petra; Gijs, Luk; Van Trotsenburg, Michael; Heylens, Gunter; Kaufman, Jean-Marc; Rubens, Robert; t'Sjoen, Guy (2008). "Hypoactive sexual desire in transsexual women: Prevalence and association with testosterone levels". European Journal of Endocrinology. 158 (3): 393–399. doi:10.1530/eje-07-0511. PMID 18299474.
  32. ^ a b Kronawitter D, Gooren LJ, Zollver H, Oppelt PG, Beckmann MW, Dittrich R, Mueller A (August 2009). "Effects of transdermal testosterone or oral dydrogesterone on hypoactive sexual desire disorder in transsexual women: results of a pilot study". European Journal of Endocrinology. 161 (2): 363–8. doi:10.1530/EJE-09-0265. PMID 19497984.
  33. ^ a b c d Davis, Samuel A.; Colton Meier, S. (2014-04-03). "Effects of Testosterone Treatment and Chest Reconstruction Surgery on Mental Health and Sexuality in Female-To-Male Transgender People". International Journal of Sexual Health. 26 (2): 113–128. doi:10.1080/19317611.2013.833152. ISSN 1931-7611. S2CID 144469446.
  34. ^ Land, Emily (July 23, 2019). "Q&A: Gynecologic and vaginal care for trans men". San Francisco AIDS Foundation. Retrieved April 5, 2020.
  35. ^ https://www.vogue.com/article/breathless-karley-sciortino-trans-sex. Missing or empty |title= (help)
  36. ^ Ashley A, Thompson D (1986). The First Lady. John Blake Publishing, ISBN 1-84454-231-9
  37. ^ Cossey C (1992). My Story. Faber & Faber, ISBN 0-571-16251-7
  38. ^ Boylan JF (2003). She's Not There: A Life in Two Genders. Broadway ISBN 0-7679-1404-X
  39. ^ Daskalos, CD (1998). "Changes in the Sexual Orientation of Six Heterosexual Male-to-Female Transsexuals". Archives of Sexual Behavior. 27 (6): 605–614. doi:10.1023/A:1018725201811. PMID 9883308. S2CID 476834.
  40. ^ a b Lawrence, Anne A.; Latty, Elizabeth M.; Chivers, Meredith L.; Bailey, J. Michael (2005-04-01). "Measurement of Sexual Arousal in Postoperative Male-to-Female Transsexuals Using Vaginal Photoplethysmography". Archives of Sexual Behavior. 34 (2): 135–145. doi:10.1007/s10508-005-1792-z. ISSN 1573-2800. PMID 15803248. S2CID 8356885.
  41. ^ American Psychological Association (APA)(2000) Gender Identity Disorder in DSM IV TR.
  42. ^ "Ten Reasons Why the Transvestic Disorder Diagnosis in the DSM-5 Has Got to Go". 16 October 2010.
  43. ^ http://www.dsm5.org/Documents/Paraphilic%2520Disorders%2520Fact%2520Sheet.pdf Archived 2016-07-24 at the Wayback Machine
  44. ^ Buhrish N, McConaghy N (1979). Three clinically discrete categories of fetishistic transvestism..Archives of Sexual Behavior Volume 8, Number 2 / March, 1979.
  45. ^ "National Transgender Discrimination Survey: Full Report" (PDF). 2015-01-21.
  46. ^ "National Transgender Discrimination Survey" (PDF). Archived from the original (PDF) on 2011-07-28.
  47. ^ Operario, Don; Soma, Toho; Underhill, Kristen (2008). "Sex Work and HIV Status Among Transgender Women: Systematic Review and Meta-Analysis". Journal of Acquired Immune Deficiency Syndromes. 48 (1): 97–103. doi:10.1097/QAI.0b013e31816e3971. PMID 18344875. S2CID 20298656.
  48. ^ Clements-Nolle, K; Marx, R; Guzman, R; Katz, M (2001). "HIV Prevalence, Risk Behaviors, Health Care Use, and Mental Health Status of Transgender Persons: Implications for Public Health Intervention". Am J Public Health. 91 (6): 915–21. doi:10.2105/ajph.91.6.915. PMC 1446468. PMID 11392934.
  49. ^ Lees, Paris. "Paris Lees: Bodily autonomy- confessions of a transsexual sex worker". The Independent. Archived from the original on 2013-03-12.
  50. ^ Kane, Matt (2012-11-19). "GLAAD EXAMINES TEN YEARS OF TRANSGENDER IMAGES ON TELEVISION; MORE THAN HALF WERE NEGATIVE OR DEFAMATORY".
  51. ^ "DISCLOSURE | Netflix Original Documentary | June 19 Release". DISCLOSURE: Documentary by Sam Feder and Amy Scholder. Retrieved 2021-02-03.
  52. ^ a b c Haefele-Thomas, Ardel (5 February 2019). Introduction to transgender studies. Combs, Thatcher,, Rains, Cameron,, Stryker, Susan,, Clifford, Jo, 1950-. New York, NY, USA. pp. 107–110. ISBN 978-1-939594-28-0. OCLC 1048658263.
  53. ^ a b Gill-Peterson, Julian (23 October 2018). Histories of the transgender child. Minneapolis. pp. 80–90. ISBN 978-1-4529-5815-6. OCLC 1027732161.
  54. ^ Skidmore, Emily (19 September 2017). True sex : the lives of trans men at the turn of the twentieth century. New York. ISBN 978-1-4798-7063-9. OCLC 982435476.
  55. ^ Hirschfeld, M (1923). "Die intersexuelle Konstitution". Jarhbuch für Sexuelle Zwischenstufen. 1923: 3–27.
  56. ^ Doctor RF, Fleming JS (2001). Measures of Transgender Behavior. Archives of Sexual Behavior Volume 30, Number 3 / June, 2001
  57. ^ Rachlin, Katherine (1999) Factors Which Influence Individual’s Decisions When Considering Female-To-Male Genital Reconstructive Surgery. IJT 3,3, "Archived copy". Archived from the original on 2009-03-18. Retrieved 2009-05-01.CS1 maint: archived copy as title (link)
  58. ^ Deana F. Morrow, Lori Messinger (2006). Sexual Orientation and Gender Expression in Social Work Practice, p. 265. Columbia University Press, ISBN 978-0-231-12728-8
  59. ^ Benjamin (1966). " Benjamin Scale Archived 2008-09-13 at the Wayback Machine
  60. ^ Person, E; Ovesey, L (1974). "The transsexual syndrome in males. I. Primary transsexualism". American Journal of Psychotherapy. 28 (1): 4–20. doi:10.1176/appi.psychotherapy.1974.28.1.4. PMID 4812111.
  61. ^ Person, E; Ovesey, L (1974b). "The transsexual syndrome in males. II. Secondary transsexualism". American Journal of Psychotherapy. 28 (2): 174–193. doi:10.1176/appi.psychotherapy.1974.28.2.174. PMID 4829699. S2CID 5866529.
  62. ^ Fisk, N M (1974-05-01). "Editorial: Gender dysphoria syndrome--the conceptualization that liberalizes indications for total gender reorientation and implies a broadly based multi-dimensional rehabilitative regimen". Western Journal of Medicine. 120 (5): 386–391. ISSN 0093-0415. PMC 1130142. PMID 4839483.
  63. ^ DSM II. Washington, D.C.: American Psychological Association. 1968. p. 44.
  64. ^ Diagnostic and statistical manual of mental disorders : DSM-III-R. American Psychiatric Association., American Psychiatric Association. Work Group to Revise DSM-III. (3rd edition, revised ed.). Washington, DC. pp. 71–78. ISBN 0-89042-018-1. OCLC 16395933.CS1 maint: others (link)
  65. ^ Diagnostic and statistical manual of mental disorders : DSM-IV-TR. American Psychiatric Association., American Psychiatric Association. Task Force on DSM-IV. (4th ed., text revision ed.). Washington, DC: American Psychiatric Association. 2000. pp. 576–582. ISBN 0-89042-024-6. OCLC 43483668.CS1 maint: others (link)
  66. ^ Diagnostic and statistical manual of mental disorders : DSM-5. American Psychiatric Association., American Psychiatric Association. DSM-5 Task Force. (5th ed.). Arlington, VA: American Psychiatric Association. 2013. pp. 452–459. ISBN 978-0-89042-554-1. OCLC 830807378.CS1 maint: others (link)