A necessary action to improve the dialogue between Medical and Social Science ScholarsErie, PA, USA. In the fall of 2010 I began work on my Masters Thesis (which examined the life experiences of transsexual teenagers and young adults compared to the life experiences of other queer youth).

My research found disconnects between the use of the terms transsexual and transgender in the scholarly and academic literature vs my own understanding of the terms (based on a decade of living with a group that includes transsexual women in upstate New York). [N1]


My observation was that transsexual individuals were a separate group of people who believed that they had been born with the wrong biological sex. These women would undergo hormone replacement therapy, have their Adam’s apple shaved, have facial surgery to give them a more feminine appearance, and finally undergo sex reassignment surgery. After this process was complete the person would often no longer identify as a transsexual; instead they would identify with their new sex or say they were a “person of trans history”. [N2]

Transgender individuals that I had met more often identified as third gender or would say they were men who lived as women; however, they wanted access to women’s restrooms and locker rooms. While some would have breast augmentation or electrolysis to remove facial hair they would never consider becoming anatomic women because they still enjoyed being anatomic men.

My research was looking at specific problems experienced by young people transitioning between sexes: changing one’s name and birth certificate to reflect their new sex, and having their SSI information changed to match the new name and sex.

Frankly, I was shocked to find that in the social science literature transsexual individuals were put under the umbrella term of transgender, a term which also includes: cross dressers, transvestites, androgynous, third gender, and other non-gender conforming individuals. [N3]

When I examined the medical literature, such as the suggested revisions to the DSM-5, I found that the two groups were defined separately.

• Transsexual individuals were identified as having Gender Dysphoria, a mental condition in which the person believes that they were born into the wrong biological sex and that once the person was treated with hormones and reassignment surgery they were no longer classified as suffering from the disorder. [N4]
  
  
• Conversely, transgender individuals who present themselves as the opposite gender without seeking medical augmentation of their sex more closely fit the classification of Transvestic Disorder, a condition that cannot be treated. [N5]

By denying separate identity to transsexual individuals and people of transsexual history, scholars and academics are in essence denying their specific psychopathology, medical and social service needs, ignoring the different types of prejudice and oppression they endure, and how they negotiate the world around them. I suggest in this article that

1. The medical definition and distinctions between transsexual and transgender individuals needs to be accepted and used by the non-medical academic community.
   
   
2. The continued incorporation of transsexual into transgender identity is a societal way of denying the medical reality of these individuals and is profoundly disrespectful to people of transsexual history.

Many transgender activists support the use of transgender as an umbrella term for all gender non-conforming individuals. They claim it is easier for activists to organize around this term for people who do not fit into the categories of Gay, Lesbian, or Bisexual. In this way their concerns and experiences can be recognized as unique in greater the LGB community. [N6] However, umbrella terms which include groups with vastly different needs and identities can be more limiting than separate terms because the larger group identity can mask or destroy the identity of the smaller group; this masking of identity can cause problems with public understanding of the smaller group.

Most transsexual women, and women of history, feel that the use of transgender as an umbrella term is detrimental to their quest for medical and social acknowledgement and equal protection. According to Cathryn Platine (well known activist, writer, and woman of history), in the early 1990’s the general population had accepted and was sympathetic to transsexual individuals who felt they were born in the wrong body. [N7]

• After the revolution in Iran a Fatwa was issued that recognized the corrected sex of post-operative individuals [N8].

Conservative figure Pat Robertson gave his approval of transsexual individuals seeking medical correction, saying on the 700 Club,

• “There are people who are born with various types of hormonal activity in their bodies and they feel more male than female or more female than male … it is not a sin, and so you don't need to feel guilty … not what your external organs are, one way or the other, whether it's male or female. The question is, where are you living? Are you living for God and yes, he forgives you and yes, he loves you and yes, he understands what's going on in your body.” [Pat Robertson; N9]

When transgender activists began claiming that surgical correction was not necessary

• “ … which it isn't for them, and not the life saving medical treatment it actually is for those actually born transsexed” [Pat Robertson; N10]

they moved public understanding out of a medical context to include what they called non-op transsexual(s), those individuals who only needed to change their social presentation and not correct their bodies. According to Platine,

• by equating transsexuality with the "umbrella" term transgender, this (social acceptance) was effectively reversed and the public understanding switched almost overnight from learning someone was transsexed and knowing they were probably post surgically corrected or soon would be to (the person being a) "chick with a dick" or shemale. [cf. Pat Robertson; N11]

So by re-writing — in the public mind — the definition of transsexual to include a range of other sexual and gender identities, transgender activists had actually reversed many of the gains and protections that transsexual activists had achieved. This wrongly moved transsexuality from being a medical condition to being considered part of a broad range of fetishistic behaviors that were typically denigrated in the mainstream.

I believe that to correct this misinformation which has entered into the public discourse, and in light of advances in the medical understanding of both groups, that the academic and scholarly understanding of transsexual and transgender identities needs to be brought in line with the medical definition and criteria outlined in the revised DSM-5.

By bringing the social science literature up to date with current medical knowledge scholars and researchers will be able to study and address each group based on the medical and societal context in which they exist. Only when both medical and social science researchers have the same language to define each group can new and more relevant research be done to address the medical and societal needs of both groups.