Transsexualism, also known as gender dysphoria or gender identity disorder, refers to a condition in which individuals experience a profound and persistent incongruence between their assigned sex at birth and their deeply-felt gender identity. The term "transsexualism" is an older term that has been largely replaced by "gender dysphoria" in contemporary medical and psychological discourse. Transsexual individuals typically have a strong and persistent desire to live and be recognized as a gender different from their assigned sex. They often experience distress, discomfort, and a sense of incongruity with their physical appearance, social roles, and the expectations associated with their assigned sex. For many transsexual individuals, transitioning is an important part of their journey towards aligning their physical appearance and social presentation with their gender identity. Transitioning can involve various aspects, including social transition (changing names, pronouns, and presentation), hormone therapy, and gender-affirming surgeries. These steps are not universally pursued by all transsexual individuals and are highly individual choices made in consultation with healthcare professionals.
The history of transsexualism is intertwined with the broader understanding of transgender experiences. While the understanding and recognition of transsexualism have evolved over time, transgender identities have existed throughout history, even if the language and concepts used to describe them have varied. Below is a brief and general outline.
Early Medical Approaches – (1) The concept of transsexualism emerged in the mid-20th century, primarily through the work of medical professionals and psychiatrists. They began to explore the experiences of individuals who expressed a strong and persistent desire to live as the gender different from their assigned sex; (2) In the 1950s and 1960s, various medical professionals, such as Harry Benjamin, introduced diagnostic criteria and treatment guidelines for transsexual individuals. Benjamin's book "The Transsexual Phenomenon" (1966) played a significant role in defining the medical understanding of transsexualism.
Diagnostic Changes – In 1980, the American Psychiatric Association (APA) included transsexualism as a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III). It was later reclassified as "gender identity disorder" in the DSM-IV (1994) and then as "gender dysphoria" in the DSM-5 (2013).
Debates and Critiques – (1) The medicalization of transsexualism and the pathologization of transgender identities have been subjects of debate and criticism. Some argue that diagnosing transsexualism as a mental disorder reinforces stigmatization and fails to acknowledge the diversity of gender identities and expressions; (2) The move towards depathologization gained traction, leading to changes in diagnostic classifications. The World Health Organization removed "gender identity disorder" from its International Classification of Diseases (ICD-11) and replaced it with "gender incongruence" in 2018.
The history of transsexualism is not a linear progression, and it varies across different cultures and regions. The experiences of transsexual individuals have been shaped by social, cultural, and political contexts.
Gathering comprehensive and up-to-date global statistics specifically focused on transsexualism or gender dysphoria can be challenging due to a variety of factors, including social stigma, legal barriers, and difficulties in data collection. Below is some general information based on available studies and estimates:
The exact prevalence of transsexual individuals worldwide is difficult to determine due to underreporting, varying definitions, and cultural differences in understanding and recognition of transgender identities. Estimates suggest that the prevalence of gender dysphoria or transgender individuals is relatively low, typically ranging from 0.1% to 1% of the population.
The prevalence and visibility of transsexual individuals can vary across different regions and countries. Factors such as cultural attitudes, legal protections, and access to healthcare play a role in shaping the experiences of transsexual individuals.
Some countries have established specialized clinics or centers that provide assessments, diagnoses, and medical interventions for transsexual individuals. The number of individuals seeking assistance from such clinics can provide some indication of demand for gender-affirming healthcare services.
The legal recognition of gender identity and access to legal gender changes vary worldwide. Some countries have implemented self-determination models that allow individuals to change their legal gender marker without requiring invasive medical procedures or extensive legal processes.
Access to gender-affirming healthcare, including hormone therapy and gender-affirming surgeries, varies globally. While some countries have comprehensive healthcare coverage for transsexual individuals, others may have limited resources and restrictions, leading to disparities in access and care.
Gender is strictly determined by biological sex. One's assigned sex at birth should dictate their gender identity and expression.
Transsexualism is a mental disorder and a form of psychological distress.
Transsexuals reject the gender assigned to them, of which they have the complete morphology and even the genetic structure. They have a strong feeling and deeply rooted belief that they belong to the opposite sex. Psychologically, they find their situation incongruous and feel only alienation vis-a-vis their body and revulsion for their genital organs. They desire to live as a member of the opposite sex and they seek to change their sexual appearance through hormones and surgery and subsequently have their civil status amended.
Being transgender or experiencing gender dysphoria is not considered a mental illness or disorder. Major medical and psychological professional organizations, such as the World Professional Association for Transgender Health and the American Psychological Association, affirm that being transgender is a valid aspect of human diversity. They advocate for access to gender-affirming healthcare, support, and social acceptance to improve the well-being and quality of life for transsexual individuals.