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TransMed

Sexual Histories Of
Post Op MTF TS's

by Sheila Kirk, M.D.

Preliminary Review Survey Data
Presented at HBIGDA, Vancouver September 12, 1997

This paper is presented to give you a bit of insight into some trends in various aspects of the post-surgical lives of Male to Female Transsexuals. I stress to you that this is very much a preliminary report. I have taken data from surveys returned by 100 M to F Transsexuals. The survey was originated 18 months ago and has been distributed to approximately 400 individuals with 360 completed surveys returned. The goal of the survey is to learn from 1500 participants many things including their experiences in the workplace and in their sexual involvements. In the process, information is gathered also in demographics, in previous marriage and in the nature of medical and surgical services they have experienced. The survey, 23 pages in length contains a total of 216 questions. The material gathered will be the basis for a considerable number of reports to the medical and mental health care communities via various professional journals. I'm only beginning to get our toes wet, yours and mine, in this very early report.

There's no doubt that what I tell you today about sexual practices in these 100 survey participant's may change in lesser or greater extent as the study progresses and the data base becomes larger in amount and scope . With that in mind, I present this to you, to give only indication of trends-nothing in this is "cut in stone." I've taken only a small amount of demographics to give some background to these 100 individuals and I've joined it with some information that could introduce my bias in the conclusions I am led to. One of the notable bias factors in this report is that what one individual may state in their sexual orientation or practice at the time of reporting could very well be entirely the opposite in the year since they completed the survey. Therefore, a follow up survey is one of my considerations.

One of the thoughts that I hold to is that individuals who are post-operative several years or more may now be settled into the routine of life from many standpoints. One among many are their sexual interests and involvements. Hence, in this report, the range of post-operative time elapsed from surgery date to survey response date is 6 months in 10 instances-- to as long as 17 years in the remaining 90, with a mean of 6 years 3 months. The range in age at the time of surgery for these 100 people is 21 years to 63 years with a mean of 44.6 years. Breaking that down somewhat-there were 4 in their 20's, 20 in their 30's, 44 in their 40's and 28 in their 50's with 4 past the age of 60.

In this response group 98 are Caucasians, two are Asians. This emphasizes to me the need to look closely at reasons that may exist for a kind of "exclusion" of other races and ethic groups in medical and surgical transsexual care-- if it exists. However, when one looks at various conventions and conferences in the Transgender community, it's striking how absent these groups are-particularly Afro-Americans. Does this mean that financial restrictions are involved? Is it a matter of education and its greater availability to the Caucasian Transgendered who have increased affluency? Does it have to do with even deeper concerns and divisions primarily along racial lines. We need an in-depth study to look at that circumstance.

When trying to learn about the influence of parents, female siblings and female peers in the younger years of these one hundred post-op individuals -some interesting figures are noted. For example, in an effort to determine which parent was regarded as more loving and attentive in younger years; mother seemed to edge out father almost 2 to 1. But when asked about dominant personalities both mother and father came out even. When asked about the influence that mothers and fathers had over each of the respondents in a variety of categories during their life while living at home, 72 of the 100 picked mother while only 16 choose Dad. Now that might not be terribly important until we look at the influence of other females in the first 16 0r 17 years of life of these respondents. For instance in 44 families there was a preponderance of female siblings. In those particular families the respondents also indicated that in grammar and high school a significant number identified with girls and not with boys. Actually 60 out of the total 100 stated they identified with girls in those years while only 22 identified with boys. Is there any importance to this Perhaps! Other data not looked at for this report to you will need close inspection to seek out any relevance.

For whatever it may matter-22 were raised in the Catholic tradition, 10 in the Jewish religion, 60 were raised in various Protestant faiths and 4 professed no religion. I put that in because I really wanted to tell you something a biblical scholar told me recently-The Bible contains 362 admonishments to heterosexuals and only 6 admonishments to homosexuals. The scholar added in his remarks to me "That doesn't mean that God doesn't love heterosexuals. It's just that they need more supervision."

That's a good "jumping into" place for the more interesting data in this study. If we look at the ages at which each of these respondents had their first sexual experience with a partner we find a spread of 11 years to 33 years. Looking at initial sex experience by decades of life-in the 2nd decade 11-19 years, we note that 54 experienced sex for the first time somewhere in that 10 years. Forty-two however, did not participate until after 20 years of age.

Now that adds up to 96...four did not want to give me an answer. Perhaps it was so unremarkable for them they had no memory for it.

The fifty-four early participants would probably match fairly closely with a group of 50 other young people who are non-transgendered in libido and orgasm except that when we look at the age of sexual involvement in non-transgendered youth today-we know that they begin those experiences usually fairly early in their teens. This group of 54 post-op transsexuals cluster between 19 & 19 years of age.

But, even more important are the 42 who had no sex until they were into their 20's. Of the 42 individuals who began partnered sexual activity at twenty or later, just 10 state they had moderate to high libido in the years before marriage. Every one of the entire group of 42 but one, went into and through marriage with low libido and carried their low interest in sexual activity into transition or real life test period of time-except for one, albeit a different one!

What Happens to Libido

Once post-operative there was a mixture of response in reference to libido -- in these same 42 people only fourteen of them experienced increases in their sexual appetite and while 4 noted no changes, 26 were quite positive that libido was even lower for them, than in their younger years and during their marriages.

In addition, 24 of that 42 were specific in their answer when asked about post-surgery partnered sexual experience. They answered they had no sex and quite a number stated they were not interested in it -- not because of pain or discomfort or fear of disclosure but simply because they had no interest. Four had only occasional sex and fourteen gave no answer to that specific inquiry.

Answers about sexual partners are interesting to review. In premarital sex the experience of all of the same 42, except for one, was to choose a genetic female. Just that one had relations with both males and females. In the transition period before surgery partners varied. Some choosing only females, others genetic males and an increasing number identified themselves as bisexual. Another separate and distinct group of 23 stated they had no sex whatever during transition and even more interesting was the fact that virtually all of the same 23 had no partnered sexual experience once they were post-operative. When looking at the experiences of the entire 100 individuals, one is surprised at the low libido rates in the pre-marital and the marital years. Overall in these 100 respondents once post-operative, libido is even lower and sexual experiences are more infrequent. Actually 46 state they have no sexual experience at all, most of them because they have no interest and only a few because of pain or inability to function adequately with vaginal size and length. The individuals who do have sex disclose a shift in their choices of parters in premarital and transition years. 28 have selected genetic male partners while only 18 still have sex with genetic females exclusively.

There is a great deal more to look at in these 100 respondents-- For instance, the level of satisfaction or orgasmic experience with penetration or with fondling experience and mutual masturbation seems high in those having sex . Of note is the fact that self-masturbation is considerably a frequent practice in the post-operative group. They utilize this approach to sexual satisfaction even more so than partnered sex and to a degree more than in premarital and transition years. Another point -- there is little history of sexual abuse in the past lives of the respondents. Only 8 cases tell of it.

Interestingly quite a few do not reveal that they are new women to their partners, about 70%.

Just what this all means, I can't say at this time. This series is too small. It will be expanded with examination of the data waiting to be reviewed and in time by even more as the study continues. Many factors haven't been presented to you even with this small number. Age certainly has to be a consideration in reference to sexuality. Considerable numbers of respondants are near 50 or in their 50s. Sex at this time in life is not a major consideration for many.

Consider with me the fact that what we have learned in the past about sexuality and sexual orientation in this population is probably in error and that there likely are some surprises and amazements waiting for all of us as we look more into the lives of post-operative male to female individuals.


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