Gender Expressions
By Carl W. Bushong, Ph.D., LMFT, LMHC
During my years of work and study with gender folk, I have consistently been surprised
and amazed at both the depth and breadth of change that has occurred during transition.
And when I say transition, I am not just speaking of individuals described (either by oneself or by others) as "transsexuals," but also "crossdressers," "transvestites,"
"transgendered people," etc.
As I discussed in my article, "The Multi-Dimensionality of Gender," one's Gender Identity
is only one of our five semi-independent aspects of gender (Genetic, Physical, Brain
Sex, Gender Identity and Sexual Orientation). One's Gender Identity is established early in childhood and is our Self Map.
Gender identity is one's subjective sense of one's own sex. Like pain, it is unambiguously
felt but one is unable to prove or display it to others. One's subjective gender
is just as real and more immalleable than one's physical gender but unfortunately
not recognized in our culture. This internal map forms how we see ourselves as a
sexual individual (our affiliation to a gender), just as Sexual Orientation is our
Love Map how we identify our love/sex partner.
When our gender Self Map does not match our Physical Gender (genitals), along with
our society providing no niche or role (although most other societies do) for this
varied gender expression, a conflict usually develops. Although gender folk's combination
of the five gender factors is just as natural as any other, it is not perceived as
"normal" (what you are supposed to be or do) in our society.
Because a child's greatest desire is to be normal (like everybody else), they create
an artificial self which meets this goal. They are often so successful at this that
they not only fool everyone else but themselves as well at least part of the time,
in some way.
I have gradually come to the conclusion that for most physically male gender folk,
the male persona is an artificial construction produced by the early adolescent individual
(ages 12 to 15) in order to fit in and be like everybody else. For the physically female person, there is a separate and different, but still consistent pattern, which
I will address in a separate writing.
Once created, physically male gender folk live in this role a 3-D personality with
its own goals, likes and dislikes, values, hobbies, etc. Although indistinguishable
from the "real thing," it isn't themselves. It is an artificial creation for them
to be able to fit in. But, as the nagging reality of the deception becomes harder and
harder to suppress, one has to express their true self somehow, in some way.
For most, dressing is the obvious compromise. If one cannot be female, one can at
least express femininity. But the more one expresses one's true self, the desire
for more becomes greater. Some individuals continue expressing themselves more and
more, others panic and purge only to start again later.
One's transgender classification) crossdresser, transgenderist, transsexual, etc.)
is due to how each individual adjusts to first, the conflict between their natural
female subjective gender (Self-map) and their need to be "normal," and later to how
and how much they resolve the conflict between their female subjective gender and their
"male persona." There is no objective "best solution," only a subjective, personal
best solution, which may change over time.
After years or decades of living, working and building within their male persona,
it is often too "expensive" to give up the life, perks, family, etc., one has built
up in order to go back to basics and have an emotionally 12 year old girl grow
up and live in a once male 40+ year old body.
Therefore, while all gender folk need to transition, not all need to use hormones,
let alone surgery. The only person who truly knows where and how far to go is the
transgendered person, themselves. But even they cannot do it alone. When one has
spent decades fooling everyone, including oneself, it is difficult to tell what is true and
what is smoke and mirrors. As we need a reflection to see our own face, we need
a knowledgeable, experienced helper to see our true self.
How does one find such a helper? With great difficulty, I'm afraid. In my opinion,
a psychotherapist's role is to be a helper, a teacher, and a guide. To help the
transgendered with those areas and conflicts resulting from a lifetime of living
a double life, one inside or hidden from others, one out in public. The therapist needs
to be a teacher in making available all the accumulated knowledge, skills and choices
one has as well as clearing away the myths, lies and misinformation. And as a guide,
the therapist aids the client through the social, legal, medical and emotional mine
fields toward one's true self. Here are some must haves you will need to find in
your helper.
1. Is your helper knowledgeable and up-to-date about transgender needs and problems?
2. Has your helper previously helped at least two other people transition successfully
before you?
3. Is your helper knowledgeable about electrolysis, hormones, surgery, transgender
law, etc., to guide you through your transition?
4. Does your helper know and understand the difference between transitioning and psychotherapy?
5. Last but not least, does your helper have working relationships with other knowing,
experienced and successful practitioners such as electrologists, endocrinologists,
surgeons, attorneys, etc.?
While gender folk have problems and need psychotherapy, and marriage and family counseling
like any other group, transitioning, itself, is not psychotherapy. Transitioning
is being given the tools and knowledge to ask the questions whose answers set them
free. The old artificial male persona falls away piece by piece, revealing underneath
a brand new self. The new self may be female or just more feminine. Whatever transitioned
people may appear to others, to themselves they are happy, and sometimes for the first time, whole individuals.
I am pleased to say that those who have stayed to complete their transition with me
have all become both happy people and very happy with their decision to transition.
Never have I had so many people use the word "giddy" to describe themselves and
their new life.
However far one is able to go toward dismantling the male persona and allowing their
naturally female subjective gender to develop, one generally seems to have the following
three levels of transition:
1. Recognition that one's Self Map (Subjective Gender) is different from one's Physical
Gender This can take the form of seeing one's self as a "woman trapped in a man's
body," a need to express one's "feminine side," etc. This stage is mainly concerned with physical/surface changes such as crossdressing, passing, makeup, wigs, body
shape, etc. In this first part, many gender folk don't even venture from their own
home and often have a juvenile phase (before age 15) and later, an adult phase.
The so called "Primary Transsexual" is an individual who never constructs a male persona and
therefore never accepts their male genitals or challenges their female Self Map/subjective
gender.
2. Accepting one's Self-Map (Subjective Gender) This stage is more varied than
the first and consists of changing one's life to include one's Self-Map. These changes
may only involve bringing one's significant other and loved ones into their dressing
behavior and expanding their activities ("crossdressers") or continuing to express
their Self Map and dismantle their male persona as well as starting hormones, electrolysis
and public dressing. One develops towards a "comfort level" with one's naturally
female subjective gender and its conflict with their developed male persona.
3. Becoming one's True Self This the last but unfortunately least experienced part
of transitioning. This is the stage when that little girl trapped inside an artificial
male persona in order to fit in, breaks free, grows up and has her own life often with markedly different values, temperament and interests.
It has been my observation that the female subjective self needs little help in growing
up and developing if the overpowering weight of the male persona is removed from
it. The individual has spent years, decades developing, reinforcing and living in
this male role. Dismantling the male persona takes a great deal of time, effort and outside
help. In those individuals identified as "transsexual," their subjective sense of
happiness and success is directly parallel with the degree they have dismantled their male identity, not on their age, physical size, hormones, surgery, etc.
Another interesting aspect of a female subjective gender with a male physical gender
is the concept of Sexual Orientation. To classify a M/F individual as either homosexual
or heterosexual would be equally false. If one views their gender as that established by their subjective gender, then having sex with a physical/subjective female
would make them homosexual (lesbian). But, if one viewed their actions from their
physical gender, they would be committing a heterosexual act. In other words, no
matter which gender they have sexual relations with, they are simultaneously committing both
a homosexual and heterosexual act.
Informed Choice
I term my method for transitioning, "Informed Decision Making." In this, the client makes
their own decision to go down whichever road they choose and how far, upon being
given the information and insight needed to do so. I find most gender folk focus
on their dress and body at first, not realizing that the whole persona changes during successful
transitioning. This is why physical transitioning (clothes, makeup, hormones, surgery)
is only a minor part of the whole transition process. Values, lifelong hobbies,
musical tastes, temperament, and goals, can and often do change. The new self which
emerges from under the male personality often grows into a person no closer to the
male persona than a sister. It is often a rebirth in slow motion (it takes one to
two + years). One becomes their true natural self, which is far greater than just a change
in physical gender.
But, while transitioning offers great promise, there are also great dangers if one
does not use care in choosing who they listen to and ask for help. All too often
individuals in transition, or for that matter, those who feel they have arrived,
become a collection of disparate traits and cosmetic changes instead of a complete package.
Naturally, some individuals are stubborn and refuse to accept any guidance and support.
But the real culprits that hold many from achieving their best are often the treating professionals themselves.
Many times providers remain ill informed about transgender issues or worse, remain
uncaring and expect the transgendered client to fend for oneself. They never aid
or foster an informed consumer's mind-set. Who's best interest is served when a
provider is often unprepared to provide the client with the broad based understanding needed
to make the proper choices?
If an individual happens upon "professionals" who offer no guidance or sense of priority
while making available hormones or surgery with little or no life-style preparation
a disaster may be in store. The individual's future happiness is threatened when the outcome of such "professional" intervention may be a bearded, baritone post-op
lady with large breast implants but little or no training or understanding of how
to walk, talk, or sit, let alone a strong sense of "female-self."
In an area such as gender, where myth and ignorance often exceed knowledge within
the professional community, it is only expected that the lay persons in need should
be confused, frustrated, and uninformed. The transgendered often begin life feeling
as if they are the only person in the world to have such a problem; that something is wrong
with them and not just in society's view. When at last they try to be themselves,
to throw off sometimes decades of deception, frustration and denial, they are often both fearful and resentful. So much of their life is felt to be "lost," and naturally
there is an eagerness to get on with their "new self," right now! Unfortunately,
many gender folk have collected a lot of "excess baggage" in the form of a marriage,
family, children, and educational/professional development that doesn't properly translate
to one's desired gender status. And, just like society as a whole, the transgendered
individual may focus far too much on the physical aspects of gender, down-playing or even missing the mental, behavioral, social and emotional aspects. Their male
persona is not realized or appreciated, let alone its need to be dismantled.
When it comes to gender, our culture is genitally obsessed. What's between your legs
and on your chest determines your gender (sex). Body form and plumbing are all our
society sees and therefore all the transgendered person may be aware of. Actually,
most conventional wisdom regarding sex and gender is incorrect (see Multi-Dimensionality
of Gender).
The most important service a professional can provide for the transgendered individual
is to provide the knowledge, support and resources needed for a series of "informed
choices" as to what, how and where their transformation will take them.
Today quality gender based services are becoming increasingly available, although
they are still geographically spotty. While some regions of the country are very
"gender knowledgeable," others are not so gifted. Even in areas with minimal professional
services available, the dynamism that a conscientious and self-aware gender support
group can provide is tremendous. But sometimes support groups and Internet "chat
rooms" can be counterproductive if the blind are leading the blind. All too often those with the least knowledge
and the most misinformation are the most eager to share their "insights" not as
an opinion, but as "fact." When a transgendered individual who is new to the community
comes across these self-appointed experts, they are often swayed by this mis- and disinformation.
Even with the gender community's growing size, knowledge base and opportunities,
groups of individuals suffering from the consequences of misinformation and the quick-fix mentality are living in a small world of their own still trying to influence
others along the same ill-fated path. Group knowledge, resources, and a desire for
personal growth are essential. While the transgendered now can take a long overdue control of their destiny, one should keep in mind that success is heightened by
"informed choice," not just choice.
Counseling, though, need not be weekly. In fact, very few of my clients receive weekly
sessions after the first few months. Of course, the more intensive the effort, the
quicker one will reach their goal. But counseling more than once a week doesn't
seem to help unless there is more than one problem being worked on, such as transitioning
plus marriage problems.
For example, let's say Mary (who was Bob) has recently come to accept she is transgendered,
and has a wife, Betty, who she cares for, and three children ages seven, nine, and
twelve. Mary is a successful engineer at a large company making a very good wage. Her wife does not work outside the home.
Mary has several problems to solve. One, what does "transgendered" mean to her?
Two how does she now relate to her wife who is fearful and upset? Three how,
when and what to tell the children? Four what should she do about work, friends,
family, etc.?
The first problem is part of transitioning and by far the most important. As Mary
answers, "What does being transgendered mean to me?," the solution to her other questions
will become clearer and clearer. But at some point, as Mary gets to know and accept herself more, she and Betty will probably benefit from couple/marriage counseling
as there are many issues between them they need to resolve.
Because a person's core personality often changes greatly during transition, making
too many decisions too soon is a mistake. At the beginning of transition, Bob's
values, goals and baggage (personal responsibilities, etc.) are still in charge
at this stage Mary is only a gleam in Bob's eye. It takes time to tear down the walls and
fill in the gaps. As Mary is learning and growing, Betty needs to be brought along
too at least as far as she is willing or capable of going. Remember, this is
a very trying time for the spouse as well as the transgendered person. The partner's whole
life is being turned upside down and she has no control over it. The partner often
feels betrayed, angry and frustrated. Betty can even see Mary as her enemy, her
competition. But, the more and the sooner a knowing, experienced professional is brought
into the picture, the easier it is for both parties, and the better the outcome for
everyone. Betty's willing cooperation is needed for best dealing with the children,
family, and future living arrangements.
With Betty brought into the process, as Mary's transformation continues they can decide
as a couple what their relationship and living conditions will be. Not always, happily,
but truthfully with everyone's needs acknowledged and discussed.
If Mary realizes she must transition fully into a female body and role, they are now
positioned to deal with this together including the telling of children, family and
friends. Often a completely new job description is called for upon transition
sometimes because of the difference in Bob's and Mary's personality and values, and other
times because a woman is not as accepted or respected in the old employment. And,
of course, sometimes the prejudice of the employer leads to a loss of job. But,
I have found that prejudice is the least common reason for job change if the transition is
done correctly on all levels emotional and psychological as well as physical.
In fact, over the last few years, I have experienced very few negative reactions
from employers, family and friends toward my transitioning gender clients. So few that I have
began to feel that most negative reactions stem from gender folks not being given
good help during transition rather than the transition itself. The exceptions to
this rule are often spouses and best friends, because in both cases, the very basis of the
relationship are often threatened by transitioning.
There is a global need for all gender folk, whether CD, TV, TS or TG to transition,
although the road taken and the distance traveled may vary greatly from individual
to individual. Transitioning is much more than a physical/superficial journey.
And transitioning in itself is not psychotherapy but a rebirth of an individual long buried
under the layers of society's imposed expectations. Like all births, it can be long,
difficult, very painful and full of doubts at times. But who can deny the joy and
expectation of a new life, a new beginning, even if the death of the old is needed to
give room for the birth of the new?
Dr. Bushong can be contacted at the Tampa Gender Identity Program, PO Box 273107,
Tampa, FL 33688-3107, Telephone: (813) 884-7835, and online.
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