Transgender 101

This speech was given by Anthony Cotton on January 5, 2011. It has been reprinted with his permission.

Before I actually met and spoke with transgender people, my understanding of the phenomenon was very abstract.  I wanted to be supportive, as I knew that transgender people face great social and legal discrimination, but I had to educate myself first.  It is a fascinating topic, and I am going to share the definitions, data, and facts that I learned, mostly from the National Center for Transgender Equality.

Let’s start with definitions.  Transgender is an umbrella term that refers to transsexuals (people who alter or wish to alter their bodies through hormones or surgery in order to make it match their gender identity), cross-dressers (people who sometimes dress in clothing traditionally or stereotypically worn by the other sex, but who generally have no intent to live full-time as the other gender), and other gender non-conforming people.  Gender identity is an individual’s internal sense of being male or female – it is completely distinct from sexual orientation, which means that transgender people can be straight, bisexual, or gay. Transwomen are genetically male yet present to society as female, while transmen are genetically female yet present to society as male.  Finally, the term cisgender refers to those whose gender identity is aligned with their assigned sex at birth – this is the opposite of transgender and represents the vast majority of society.

Society is only slowly beginning to understand the transgender phenomenon, and there is very limited data available on the subject.  For example, there is no consensus regarding how many people in the world are transgender.  Estimates range from 1 in 400 to 1 in 30,000 – clearly this is a major discrepancy.  Similarly, it is unclear what causes a person to be transgender.  Biologists believe there may be differences in the chromosomal structure between transgender and cisgender people.  There is also a theory that hormonal imbalances in utero impact the brain structure of transgender people.  The medical field does not consider being transgender to be a mental illness that can be cured with treatment.  Instead, mental health professionals consider it to be a psychological condition called “Gender Identity Disorder,” which can be resolved through aligning one’s gender identity and gender expression, in some cases through altering one’s physical body.

Not all transgender people want to, or have the resources to, alter their bodies.  Those that do go through a long and expensive process that is not covered by health insurance.  The current accepted standards of care for a person who seeks to transition genders includes counseling, having a trial “real life” experience where the person lives as the target gender for a period of time, learning about the various medical options and impacts, undergoing hormone therapy (in which typically transwomen take estrogen, and transmen take testosterone), and finally having various surgeries to alter the face, chest, and genitals.  According to a transgender friend I interviewed, a full transition takes many years and can easily cost over $50,000 for transwomen, and over $80,000 for transmen, not including ongoing maintenance, therapy, and hormone costs.

In addition to the physical transition, there is also a social transition, which involves changing one’s name and gender marker on official documents such as one’s driver’s license.  This takes a lot of time and effort, and yet represents just a small part of the ongoing difficulties faced by transgender people.  It is very common for transgender people to be ostracized by their family, friends, and communities.  In a 2009 survey of 6,450 transgender Americans, 97% reported experiencing harassment or mistreatment at work (with 26% being fired).  Linked to this, respondents experience unemployment at twice the national rate, 15% live on less than $10,000 per year, and 19% have been or are homeless.  There are similarly stark statistics on discrimination in education, health care, and immigration.

This all paints a very grim picture of the difficulties faced by transgender people.  However, there is some good news.  Not only is there a thriving online transgender community that is better positioned than ever before to advocate for itself, but civil society, the medical profession, and the Obama administration are more supportive of the transgender community than ever before.  For example, there are currently four openly transgender political appointees in the Federal government.  Also, approximately 78% of the U.S. population supports the passage of the Employment Non-Discrimination Act, which would protect the transgender community from workplace discrimination in hiring and harassment.  There will be a long road to social and legal equality for the transgender community, but there is some inertia in the right direction.

There are a few simple things you can do to support the transgender community.  First, don’t tell or laugh at jokes that denigrate transgender people, and actively interrupt people who make disparaging comments.  Next, when speaking of, about, or to a transgender person, use the pronouns referring to the gender he or she identifies as.  For example, use he, him, and his when referring to a transman.  Another way to support the community is by contacting your state representative to encourage the passage of the Employment Non Discrimination Act.  Finally, review the National Center for Transgender Equality’s website, where you can learn more and find a list of 52 ways to support the transgender community.

In sum, there is a lot that we do not know about the transgender phenomenon, but we do know that transgender people need and appreciate the support of cisgender people.  That is the reason I felt compelled to research the topic, and I hope you will do the same.


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