Chapter 3

Deconstructing Sex and Gender:
Thinking Outside the BOK
[N|oparticularunderstanding of sexual difference historically follows
from undisputed facts about the body The dominant, though by no
means universal, view since the eighteenth centur> has been thai Ihere
are two stable, incommensurable, opposite sexes and that the poliiicai.
economic, and cultural lives of men and women, their gender roles,
are somehow based on the "facts."
Thomas Laqueur
Making Se.K, 1990
It is obvious to any student of history, anthropology, or medical science
that gender and its expression have been experienced, Jescribed, defined,
and treated differently in difierent epochs. As the inherit irs ol this legacy of
confusing and contradictory language it is necessary lo develop a conlem-
ptirary and comprehensive modern terminology that respects the complex-
ity of gender identity and the different ways that it manifests and is experi-
enced. Gender is a biopsychosocial phenomenon wher:by the component
parts of self—biological, psychological, and ihe social ronstruction of cul-
lure—intersect and interact in complex ways to create ai integrated whole.
Many people would also .suggest that there is a transpersonal, or spiritual,
element to the process of gender identity integration.
FOUR COMPONENTS OF IDENTITY
Gender dichotomies were not only restrietive, they were also constitu-
tive. . . . the gendering of social spheres not only constrained personal
freedom, but gender categories also determined w hat it was possible
to know.
Virginia Goldner, 1988
79
80 TRANSGENDER EMERGENCE
Gender and sex are often used interchangeably and, indeed, we tend to
think of them as the same thing. People are as likely to say, "There is a /H«/Í,"
as they are to say, "There is a male," not identifying any salient differences
in the terminology used. The word man actually refers to the person's gen-
der, whereas the term male refers to his sex—the first being a sociological
construct and the second being a biophysiological phenomenon. In comnwn
discourse we eonflate the words gender and sex and assume them to be
equivalent. However, gender is. as Green (1999) said, "a form of communi-
cation, a language we use to express and interpret each other socially"
(p. 125).
Se.xual identity is being used here to describe the complex relationship of
biological sex. gender identity, gender-role expression, and sexual orienta-
tion. These components of human identity develop and are integrated within
a biopsychosocial matrix. Sexual identity- is not being used in its narrower
definition to refer to sexual orientation or preference. These component
parts of .sexual identity will be outlined in the following sections. The termi-
nology used here borrows from, but is not identical to. other theorists
(Coleman, 1987; Diamond, 2002; Money and Erhardt, 1972; Money and
Tucker, 1975; Paul, 1993; Shively and De Ceceo, 1993). (See Glossary for
definitions.)
Biological Sex or Natal Sex
Sex is the physiological makeup of a human being, referred to as ihe hiologlcal or
nafül sex. Sex is a complex relationship of frenetic, hormonal, morphological. chn>-
mosomal, gonadai. biochemical, and anatomical determinants ihat impact the
physiology of the body and the sexual differentiation of the brain. Although every-
one is assigned a sex at birth, approximately 2 percent of the population are
intersexed and do not easily fit into a dimorphic division of two sexes that are "op-
po.iite."
The first component of human identity is biological sex. Everyone is as-
signed a biological sex at birth based on an examination of the visible geni-
talia. The differenee between males and females is initially determined
rather simplistically by whether one has an "innie" or "outie." The presence
or absence of the phallus is the first, most salient, and often the only variable
that determines whether one is a boy or a giri. Biological sex is actually a
complex relationship of genetic, hormonal, morphological, chromosomal,
gonadai, biochemical, and anatomical determinants that impact the physiol-
ogy of the body and the sexual differentiation of the brain (Money, 1995;
Wilson and Reiner, 1999).
Deconstructing Sex and Gender: Thinking Outside ihe Box SI
The biologieal differences between males and femal<;s develop at aboul
six weeks into gestation. Before this stage male and female (XY and XX)
appear the same, although genetic or chromosomal se>ual diflerenees are
established at conception. The primitive duct systems ar^ identical until the
presence of male hormones triggers the development cf male gonuds, the
dilierentialion of the duct systems, und the formation o external genitalia.
Without the presence of male hormones, the fetus devel )ps female gonads,
which has led scientists to label the female development process a "default"
syslem. This means that if the XY felus does not trigger the correet mascu-
linizing process, it will appear to be female. The gonaJs produce various
hormones that further differentiate male from female an J eventually stimu-
late the development of internal and external genitalia (Money. 1993;
Migeon, Wisniewski, and Gearhart, 2001; Carroll and Wolpe, 1996) (see
Figure 3.1). Sex, simply, is defined as the bipolar categories of male and fe-
male. Intersexuality is a combination, or mixture, of these two poles.
When sex is not easily assigned, the person is refern d to as itUersexed.
Gender Identity
Gender is a social construct that divides people into "natural" categories of men
and women that are aasumed to derive from their physiological male and female
bodies. Most people's gender identity M congruent with their a ¿signed sex. bul nnrnv
people experience fheir gender iilentity to he discordant with tl eir natal sex. Gender
identity is considered a core identity. A person's self-concepi of his or her gender
I regardless oftheir biological sex) is called his or her gender identity.
Gender identity is defined as the internal experience )f gender, how one
experiences his or her own sense of self as a gendered being. Gender identity
is experienced as a core identity, a fundamental sense of belonging to one sex
or the other (Stoller, 1968b). The sense of being a man or l>eing a woman is an
essential attribute of self Many people would have trouiOe identifying their
sense of "self" outside of ihe parameters of gender. Neaiiy everyone has an
understanding of themselves as a man or a woman, a bo} or a girl.
Gender is a social construct that divides people inlo "natural" categories
of men and women that are thought to derive from their physiological male
and female bodies. Gender attributes vary from culture to culture and are ar-
bitrarily imposed. Gender identity is established early ir life and is thought
to be relatively impervious lo change. Children begin to iilentify their gender
82
TRANSGENDER EMERGENCE
Ct^iiital
tubercle
Clans
I'reiliral fo!d^
l.'ríihr.il groove
I .;ibî(wcroml
swelling
Peiineiim
Mate development
Female developnieiit
FIGURE 3.1. Development of the male and female external genitalia from the
undifferentiated genital tubercle. {Source: From Carroll, Janell L. and Wolpe,
Paul Root, SEXUALITY AND GENDER IN SOCIETY. Copyright © 1996, by Allyn
& Bacon. Reprinted by permission.)
Deconstrucling Sex and Gender: Tliinking Outside i he Box 83
as young as two years old and the sense of gender identity generally stabilizes
within the first few years of life. Kohlberg (1966) said thai when a child ean
accurately discriminate males from females and identify his or her own gen-
der siaius correctly they have reached the stage of "geniler constancy"—an
essential stage in normative gender development.
For most people their gender identity is congruent »vith their assigned
sex. This means that ifthey are "male" they experience themselves as "men"
and if they are "female" ihey experience themselves as "women." Bolin
( 1988 ) refers to this as the "cultural requirement that women are people with
vaginas" (p. 7) and, of course, the opposite is also true—hat men arc people
with penises. People may feel confined by some of the societal assumptions
about proper male ov female behavior or they may resist certain role restrie-
lions associated with preseribed genders (e.g., men doi' t cry; women are
jiassive), but most people experience eongruence with the label they have
been given. They may believe the eategories themselves are restrictive but
not that they have been wrongly elassified.
For other people, however, their gender identity—how they experience
themselves in their bodies—is discordant with their natal sex and is in direct
conflict with the biological facts of their bodies. Theirgi-nder identity is ex-
perienced as dysphoric, or dystonic, to their physicaliW- Transsexuals are
people who cross over and are legally reassigned as the "other" sex. and
transgendered people live somewhere in the middle of the eontinuum, either
as bi-gender, cross-dressers, or people who move back and Ibrth from one
gender expression to the other. Cross-gender behavior i^ often present from
a very young age. This is not to be confused with a psychotic process in
which people deny that they have the physiology which they actually have.
Transgendered people arc aware of the reality of their physical bodies bui do
not feel that it describes who they really are inside. It h interesting to note
that many intersexed people also have stable male or female gender identi-
ties, even though their sex classification may be more dif Icult to ascertain.
A person's self-concept of his or her gender (regardiez s of biological sex)
is called gender identity. Gender and gender identity are "learned and
achieved at the inleraetional level, reified at the cultural level, and institu-
tionally enforeed via the family, law, religion, politics, economy, medicine,
and Ihe media" (Gagné, Tewksbury, and McGaughey, 1997, p. 478). Kessler
and McKenna (1978) said, "The only way to ascertain someone's gender
identity is to ask her/him" (p. 9).
When gender identity differs from natal sex, the perwn is identified as
transgendered, often as transsexual.
84 TRANSGENDER EMERGENCE
Gender-Role Expression
Gender role is the expression of masculinity and femininity and has ofien heen re-
ferred to as ".sex role." Gender raies are thought in he reflections of one's gender
identity and are socially dictated and reinfotved. It is thnmgh gender toles that gen-
der is enacted or "performed" (consciously or unconsciously) and may or may not
he related to gender identity or natal .se.x.
Gender role has commonly been referred to as "sex role." and it is the ex-
pression of masculinity or femininity. Gender role is the socialized aspect of
gender that is "tied to appearance, behavior, and personality" (Shively and
De Ceceo, 1993, p. 82). The term .sex role was originally used by Margaret
Mead to describe culturally determined behaviors expected of men and
women (Meyerowitz, 2002). Socially dictated and reinforced, gender roles
are thought to be a reflection of one's gender identity (which is assumed to
describe one's biological sex) but may or may not be related to gender iden-
tity or natal sex. Gender roles are how gender is enacted or "performed"
(consciously or unconsciously) and are the "public expression of one's gen-
der identity" (Money and Ehrhardt, 1972, p. 4). Money, who first developed
Ihe terms gender role and gender identity, says that they are "two sides of the
same coin" (Money and Lehne. 1999, p. 214). He described this as "gender-
identity/role" (Money and Ehrhardt. 1972, p. 146).
The acquisition of gender roles is a social process. It is achieved rather
than ascribed (Kessler and McKenna. 1978; Lewins, 1995). Gender role is
expressed in a variety of ways, including through clothing, mannerisms,
grooming or adornment habits, voice inflection, and social interests. It in-
cludes:
public presentations of self in dress and verbal and nonverbal commu-
nication; the economic and family roles one pl ays; . . . the sexual roles
one plays and emotions one experiences and displays; and the experi-
encing of one's body, as it is defined as masculine or feminine in any
particular society. (Nanda. 1994, p. 396)
It is undeniable that women and men are, as Blackwood and Wieringa
(1999b) said, "situated differently in all cultures" (p. 51) and thai social di-
visions between the sexes exist almost universally. "Gender roles can be de-
fined as the sum of socially designated behavior that differentiates between
men and women" (Hamilton and Jensvold, 1992, p. 118). For example, in
Western cultures males are expected to be independent, logical, objective.
Deconstructing Sex and Gender: Thinking Oulside ilw Box 85
active, competent, and instrumental, while females are assumed to be pas-
sive, dependent, emmional, warm, expressive, and nurt.irant. Studies have
shown that when ranked hierarchically gender roles asstclated with women
are considered less mentally healthy and are less valued by both men and
women (Broverman et al., 1970; Gilligan, 1982; Hare-Mustin, 1983).
Despite the restrictions on extreme cross-gender expiession, gender-role
behavior is probably the most flexible of all these variables of identity.
Many people express their sense of masculinity or f( mininity in cross-
gcndcr expression without experiencing any discord with their biological
sex. For many people there is a range of feminine and maseuline behavior
that they are comfortable expressing in terms of clothing or mannerisms.
One may dress and behave differently playing softball, attending a profes-
sional conference, fighting for a seat on the subway, anO preparing lor a ro-
mantic date. Young people are especially flexible about lender-role expres-
sion and enjoy stretching approved gender behavior past its approved edges.
Bem ( 1974, 1993) developed a research tool—the Bem Sex Role Inventory
(BSRI)—todemonstrate that both men and women have a wide range of traits
in both categories. It is possible to view maseuline and f ;minine traits inde-
pendently, instead of on a continuum of opposites (Constantinople, 1973).
Western stK'iety has experienced huge upheavals in thj rules determining
proper male and female gender-role expression in the p.ist forty years. The
ciiriy women's liberation movement bravely fought against the idea that
gendered expectations for men and women are biological givens, arguing
instead that they are socially constructed. Issues have ranged from equal pay
and access to abortion and birth control to women's right to wear pants in
public. This false division of the sexes that emanated from the arbitrary
rules of gender was the rallying ery for feminists who have waged a war—a
rather successful war—on patriarchal standards. As Newton (2000) said,
"Gender categories are learned by all, but "natural'to none" (p. 170).
When gender role is divergent from social e.xpectation s. the person is per-
ceived as a cross-dresser or gender bender, "effeminate^' {if male), or hutch
{if female).
Sexual Orientation
Sexual orientation is the selj perception of one's .sexual preft mue and emotional
attraction. Sexual orientation can be directed toward member, of the same sex (ho-
mosexual), the opposite sex (heterosexual), both .sexes (bise mal), or neither sex
(nonsexual). Sexuality is experienced thwugh the person '.v gerder identity {regard-
less of his or her biology).
86 TRANSGENDER EMERGENCE
Sexual orientation is the self-perception of the direction of u person's
sexual und/or emotional desire. It describes both sexuu! preference and
emotional attraction. Sexual orientation is less of an internal sense of self
and more of an extemal desire for another person, although certainly sexual
orientation becomes integrated as an identity construct. Some people expe-
rience their sexual orientution as an unchanging essential purt of ihcir na-
ture. Others experience it in u more lluid wuy. Sexual orientation can be di-
rected toward members of the same sex (homosexual), ihe opposite sex
(heterosexual), both sexes (bisexual), or neither sex (asexual).
Homosexual and heterosexual identity is a modern eonstmction (Chaun-
cey, 1982; D'Emilio, 1983; Freedman, 1995; Foucault, 1978; Halperin,
2000; Plummer, 1981; Weeks, 1981). Although homosexual behavior has
always existed, it is only in the modem era that it has been used to define a
person's nature or assumed lo be an innate part of personhood. Individuals
can engage in same-sex behavior and not identify as homtisexuul. Inversely,
individuals can "be" homosexual (i.e., prefer or desire partners of the same
sex) and noi engage in homosexual behavior. Padgug (1989) said, " 'Homo-
sexual' and 'heterosexual" behavior muy be universal; homosexual and het-
erosexual identity and consciousness are modem realities" (p. 60). His-
torically, dislinctions between people who violated accepted gender roles
and people who were sexual wilh members of their own sex were not clearly
delineated (Chauncey, 1982; Greenberg, 1988; Hekma, 1994) and gender-
transgressive people were mostly assumed to be homosexual.
Sexual orientation has many component parts, including physical prefer-
ence, affectional preference, fantasy, and social relationships. It is more
than iust sexual expression (Klein, 1993). Sexual orientation can refer to
sexual behavior, sexual attraction (regardless of behavior), or sense of iden-
tity, which may or may noi be rellective of behavior or ultruction. Sexual
orientation is particularly complex in a world where certain sexual expres-
sions (e.g., homosexuality and bisexuality) have been despised and crimi-
nally punished. Sexual orientation—the desire for particular categories o


sexed or gendered people—may not be ihe only or best way lo describe our
sexual desires. Bem (1993) said, that her sexuality "does not mesh with
available cultural categories" (p. vii), and Litwoman ( 1990) discussed feel-
ing forced into a '"bisexual" identity since she is attracted to bolh men and
women. Litwoman believed that gender is not the salient aspect of how her
desires function.
Due to the societal stigma surrounding homosexual behavior, lesbian,
gay, and bisexual people have to "come out" of the assumption that they are
heterosexual, not only to others but also to themselves. Although sometimes
the terms sexual orientation and se.xualpreference are used interchangeably
with the term sexual identity, they are actually subsets of the broader cate-
Deconstructing Sex and Gender: Thinking OuLúde ¡he Box 87
gory of sexual identity. Sometimes the term sexual identity is used with
pride by people wilh a homosexual or bisexual orientât on to give voice to
the idea that their sexuality is not merely a desire but an integrated part of
iheir identity.
When sexual orientation is not heterosexual, it is stigmatized, for homo-
sexuals and bisexuals.
DECONSTRUCTING THE ASSUMPTIONS
OF SEXUAL IDENTITY
[Tlhe category of sex and the naturalized institution of heterosexuality
are constructs, socially instituted and socially retaliated fantasies or
"fetishes," not natural categories, but political oni:s.
Judith Butler
Ge.ider Trouble, 1990
The four components of sexual identity interact wilh one another in com-
plex ways and develop and integrate in various patterns. Despite the bipolar
divisions of male/female, man/woman, masculine/feminine, and gay/straight,
all aspects of human sexuality—physiology, gender identity, gender-role
behavior, and sexual identity—have multiple variables and expressions.
As discussed previously, people are assigned to theii natal sex category
based on visible genitalia. Genitalia are rarely visible publicly so assump-
tions about male or female sex are actually hased on gender-role expression
of masculine or feminine features. Gender identity and biological sex is at-
tributed lo people based on perceived traits, which are enacted or performed
through gender-role expression. Kessler and McKenna 1978) suggest ihal
gender attribution is the foundation for understanding all other components
of sexual idenlily. People use cues to discern whether otiers are male or fe-
male and, in cases of ambiguity, people more easily assume that .someone is
male, even when the person has visible female getiitalia, as long as there are
enough other tnasculine cues.
None of these categories offer much information about sexuality itself.
Sexual orientation, especially if it is nonnormative heterisexuality, must be
achieved through a proeess of self-discovery and cominj; out. Sexual orien-
tation may reveal the "love-object choice" of a person, but not whether he or
she acts on those desires. The tour components do not ex ^lore sexual desire,
erotic identity, erotic role, or erotic acts (Newton |with vV'alton|, 2ü(K)).
The way that societies transform biological attributes into socialized
identities—affecting not only reproduction but social po A^er. role character-
88 TRANSGENDER EMERGENCE
isties, and the very nature of identity—has been called the sex/gender sys-
tem (Rubin, 1975). The entire sex/gender system is built on a series of as-
sumptions that are so much a part of our way of thinking we do not realize
they are assumptions. The first and most salient of these is the premise ol'
duality.
The Assumption of Duality
It is an assumed trulh that humans are divided into two groups, one called
male and the other called female. The two groups are considered bipolar op-
posites, matched parts that fit together as puzzle pieces (see Figure 3.2).
This binary division is based on an either/or dichotomy; one is either male
or female. Males and females are perceived to be different from each other
in seienlifically observable ways and aeross all academic disciples, from ihe
hard sciences such as biology to the soft sciences such as sociology, and
even the political seienees such as women's studies. Stone (1991) said.
Male •
Man
Masculine
Heterosexual
SEX
GEXDER
Wt'MflY
GENDER
ROLU
< J ^
SEXUAL
ORIENTATION
Female
Woman
Feminine
Ilomosexna!
FIGURE 3.2. Sex, gender identity, gender role, and sexual orientation are
assumed to be bipolar opposites. This bipolar system renders invisible those who
are intersexed, gender variant, androgynous, eross-gendered, and/or bisexual.
Deconstructing Sex and Gender: Thinking Outside ¡he Box 89
"Under the binary phallocratie found myth by which Westem bodies and
subjects are authorized, only one body per gendered subject is 'right'. All
other bodies are wrong" (p. 297).
It is further assumed that men and women are different in personality, de-
sires, behaviors, and interests and ihal these difference:, are based on their
physiological differences. Masculine and feminine sex-iole expressions are
assumed to be dichotomous, and people are socialized to be "opposites" thai
are different and complementary. This duality is then piesumed to result in
an attraction—as in opposites attract—and places sex and gender identity
into a heterosexual male/female structure that is deemed "normal": every-
thing else is presumed lo deviate from this norm. Gayle Rubin (1975) re-
fered to gender as the "socially imposed division of the si;xes... [thai] trans-
form|s| males and females into 'men' and 'women,' each an Incomplete half
which can only find wholeness when united with the oticr" (p. 40).
Many difficullies emerge from this paradigm, whiih will be outlined
here and described later. The first problem is thai the assumption humans
are divided into male and female subspecies determimd by genitalia ren-
ders people with ambiguous genitalia invisible from the social discourse.
Intersexed people, by some estimates to be about 2 percent of the popula-
tion, arc "disappeared" when the only available filing categories are male
and female.
Second, this bipolar paradigm socializes men and women to think of
themselves as living on different and warring planets—Mars and Venus—
and lo believe that they are more difterent from each otht r ihan they are sim-
ilar. Even the nature of research itself, including feminist research, rests in
assumptions aboul male/female diflerences. Whatever particular differ-
ences are being studied, "the range of variation is ÍÜT greller among males or
among females than between the two sexes" (Bleier, 1984, p. 109). Caplan
and Caplan (1994) suggested that students of research ask melaqueslions
about the process of doing research, e.g., "What might he researchers' mo-
tives for doing this research?" and "Are certain kinds of bias reflected in the
way the research question was asked?" They raised the concern that re-
searchers are "ignoring or downplaying overlap in fema es' and males'per-
formance or behavior," reminding academics that femalt s and males are far
more alike on all variables than they are différent (199*-, pp. I lO-111). As
Rothblalt ( 1995) said, "All of the alleged proofs of sexuil dimorphism have
suffered from a glaring . . . Achilles' heel—absolute differences in men's
and women's minds, mental abilities, and psychological natures have never
been found" (p. 107). The differences between males and females always
privilege males and create an androcentrism that assumes women to be "the
other" (Bem. 1993).
90 TRANSGENDER EMERGENCE
Third, the entire system of sexual expression (i.e., sexual orientation or
preference) is built on the premise of a bipolar gender system. Assumptions
about sexual orientation, even liberal assumptions, are based on the pre-
sumption of there being two opposite sexes. A worid that is neatly divided
into male/female designations also very neatly splits into heterosexual and
homosexual people. The possibility of same-sex intimacy exists only as a
category when it is compared to opposite-sex intimacy. Sedgwick (1990)
said that "without a concept of gender there could be . . . no concept of
homo- or heterosexuality" (p. 31). Bisexuality as a paradigm is defined by
its middle position between the two available poles. Pharr ( 1988) said that
"homophobia [or, more accurately, heterosexism | . . . is a weapon of sex-
ism." describing the process in which homophobic violence is used to rein-
force traditional gender roles (p. 16).
Einally, behaviors that deviate from expected gender requirements are
considered clinically diagnosable, rendering cross-gender behavior not just
unusual but pathological. Binary sex and gender systems force all people
who do not easily fit either polar field—including intersexed, gender-
variant, homosexual, bisexual, and transsexual peopl e^nt o a category of
"other" that ultimately stigmatizes them for being different and then path-
oiogizes their uniqueness.
Intersexuality ,
For most people there is a consistency between their external genitalia,
their internal genitalia, their hormones, and their chromosomes and they are
easily plaeed into the available categories of male or female. However, due
to the numerous biological variables intervening in the fetal development
process it is possible for sexual differentiation to take place atypically. For
instance, an irregularity in hormone production, such as an over- or under-
exposure to particular hormones or certain genetic conditions, can cause in-
ternal or external genitalia to develop outside expected parameters. When
external genitals are ambiguous at birth, medical professionals step in to
further examine the chromosomes, hormones, and internal genitalia to see if
an intersexed condition is present. Of course, no further examination is nec-
essary if the genitals are "normal" looking. Most people have not had their
sex scientifically examined, and if they do not have an obvious physiologi-
cal difference, more subtle intersexed conditions may never be identified.
Intersexed people may have the internal reproductive system of one or
both sexes as well as ambiguous or incompletely differentiated external
genitalia. People who have the physiological external genitalia of both
males and females have been traditionally referred to as hermaphrodites.
The Intersex Society of North America (ISNA) said that the word hermaph-
Deconstructing Sex and Gemler: Thinking Outside the Box 91
rodite is stigmatizing and misleading and a result of scienlific theories de-
veloped in the Vicioriun uge. They recommended the use of the word
interse.x, a practice ihat will be followed here.
Intersexuulity is found among all populations throughout the world, al-
thtmgh with variable frequency. Fausto-Sterling (2(X)0) Í stimaled thut when
all causes of intersex are considered, approximately 1.7 :)erccnt of all births
are affected. This is certainly not a small number of people and raises the
question of why more people are not aware of the existence of intersexed
pet)ple. The answer to this question is steeped in biomédical and surgical
ethics. I
Most intersexed children born in (he United Slates have been surgically
altered at birlh and assigned lo fit into the approved dimorphic sex eatego-
ries. "People of mixed sex all but disappeared, not because they had become
rarer, but because scientific methods classified them out of existence"
(Fausto-Sterling, 2000, p. 39). Based on the theories of gender identity de-
velopmenl initialed and instituted by John Money (1961; Money and Ehr-
hardt, 1972; Money. Hampson, and Hampson, 1955a; Money and Tucker.
1975), pédiatrie endocrinologists and urologists, wilh the support of the
American Academy of Pediatrics (AAP), have routinely recommenited sur-
gical ""conection" of ambiguous genitalia of intersexed inünt.s (AAP, I996a,b;
Migeon, Berkovitz, and Brown, 1994: Donahoe and Schnitzer, 1996: Feder-
man and Donahoe, 1995; Grumbrach and Conte, 1998)
These surgeries have been justified because of physicians' fears that
Ihese babies will develop confused gender identities due to their physical
differences. The medical, surgical, and sexological experts have assumed
Ihal gender identity emanates as the logical outcome ol physiological sex,
and ihal the creation of a morphologically correct bodj can determine the
inlernal experience of gender. The relationship between natal sex. physiol-
ogy, and the development of gender identity is far more c omplex than surgi-
cally altering the genilulia of intersexed babies. Crouch < 1999)said, "In the
West, if one is neither a man nor a woman, ihen one ha; no social place or
state to occupy" (p. 36).
Despiic the lack of follow-up studies on surgically allered intersexed ba-
bies, when the AAP released its new guidelines in the summer of 2000,
there were no discernible changes in the treatment strat^igies that had been
historically employed. This is despite the tireless efforts of the ISNA under
the guidance of Cheryl Chase, despite the publication of lumerous accounts
by survivors of genital surgeries (Alexander, 1999; Cameron, 1999; Cola-
pinto, 2(M)0; Coventry, 1999; Devore. 1999; Groveman. 1999; Laurent,
1995), and despile the proliferation of clinical research questioning the con-
tinuation of "'business as usual" (Chase, 1999; Diamond and Sigmundson,
I997u,b; Lewis, 2000). Al least the AAP has recognized the movement to
92 TRANSGENDER EMERCENCE
reexamine intersex surgical guidelines from an ethical perspective, even if it
was only to mention it by discounting it (AAP, 2000).
However, the existence of intersexed people stands as the most direct evi-
dence that biological sex is not simply dimorphic and that calling a baby a
"boy" or a "girl" is more of a social decision than a biological one. Simply
put, "To be gendered, one must llrst be sexed, not intersexed" (Crouch,
1999, p. 36).
Sexism and Socialized Differences
Another difficulty with the premise of duality is that it presumes tbat
males and females have different, diametrically opposed psychologies, be-
haviors, and experiences. The traits of one group are the antithesis of the
otber, e.g., males are stronger than females and females are more emotion-
ally sensitive than males. However, if we list all gender markers there are
none that are, in Kessler and McKenna's ( 1978) words, "always and with-
out exception " true of only one gender (p. 1, italics in original). Many deter-
minants of personality derive from these perceived differences, including
career options and clothing choices. In reality, men and women are more
like each other than they are different.
Although the feminist movement has taken us far since the 1960s, and no
one could deny that the lives of women, individually as well as collectively,
have changed in bold and blatant ways, gender-role expectations are still
prescribed and restrictive. Although some of the more extreme and rigid
boundaries of gendered social expectations have broken down in the past
few decades due to the strides of the women's liberation movement, the ba-
sic bipolar assumption of male and female differences—based on genitalia
and affecting all societal arenasei s mostly intact. Bem (1993) referred to
this proeess of how socialization impacts and reinforces the development of
gender appropriate behaviors in children as gender schema theory.
The social rules of gender are based on assumptions about the differences
between males and females that are expressed in Stereotypie masculine and
feminine ways. Most gendered behavior is arbitrary. Although we have
grown accustomed to blue for boys and pink for girls, it was only a few gen-
erations back that most babies wore white dresses. It is thought that the cus-
tom of blue for boys and pink for girls originated in 1929, when a midwife
from Bologna, Italy, hung blue and pink ribbons to announce the birth of a
child (Giuseppe Vidossi as cited by Belotti, 1975). An early feminist note-
card outlined the arbitrary quality of gender polarization by showing two
toddlers looking down into their diapers and one saying, "Oh, so that is what
determines the différence in our paychecks." Boys are still expected to play
with cars and action toys and girls are still expected to play with dolls. A
Deconstructing Sex and Gender: Thinking Outsitle ¡ he Box 93
brief viewing of the commercials during Saturday morning cartot^ns will
easily prove this point.
Maintaining distinctions between men and women is.ifundamenlal prin-
ciple of the sex/gender system, and although it onee organized society, it has
outlived its functionality. Wittig (1982) felt that feminis n itself bought into
the "myth of woman," and reified theelass of people called women, despite
acknowledging that gender attributions were socially en:ated (p. 106). But-
ler ( 1990) went so far as to suggest that "there is no gender identity behind
the expressions of gender; that identity is performatively constituted by the
very 'expressions' that are said lo be its result" (p. 33). Transgenderism is so
threatening to the status quo preeisely because the existen;e of gender-variant
people shows that the boundaries separating men froni women are false.
In an interesting historical twist of fate women now have much greater
freedom of dress than men do. The social costs are higher for men with only
small clothing transgressions. Although men can wear their hair longer or
even wear an earring (or two!), it is not unusual for men to be arrested for
wearing women's clothing in public. However, female transvestism is no
longer a diagnostic concept. Only men can be transvesti es beeause women
can wear almost anything they want without social disgrace.
Bisexuality and Homosexuality
Although a dimorphic gender system allows for both same- and oppo-
site-sex relationships, it is inherently a heterosexist one. Homosexuality is
allowed as the binary opposite of heterosexuality only lo serve as a foil of
"otherness," as a way to support the naturalness of hi'terosexual pairing
(Katz, 1995). Rich (1980) analyzed this heterosexual imperative regarding
Ihe particulars of women's oppression and referred to it as "compulsory het-
erosexuality." This is the culturally mandated assumption that women are
and will be heterosexual, and despite the rhetoric of si;xual "preference,"
women are socialized into aeeepting heterosexuality as the only ehoice.
As stated earlier, the world is presumed to be engineered as a bipi>lar jig-
saw puzzle, with sexually matehing parts, which Butler ( 1990) referred to as
"the heterosexualization of desire" (p. 23) (see Figure 3.3). Much of the re-
sistance to the depathologizing of homosexual relationships, clinically and
politically, has stemmed from the assumption that gay and lesbian relation-
ships are against this "natural order." If male and female parts are naturally
paired then it is reasonable to deduee that any male/male or female/female
bonding is unnatural. This renders bisexual people—who probably repre-
sent a larger population than either heterosexuals or homosexuals—into a
nonexistent category labeled "fence-sitters." Klein (1999) said that bisexu-
94 TRANSGENDER EMERGENCE
Male
SEX
Female
Man
GENDER
IDENTITY
Woman
Masculine
Heterosexual
GENDER
ROLE
SEXVAl
ORIENTATION
Feminine
Heterosexual
FIGURE 3.3. It is assumed that each of these components lines up and ensures
the next.
-> if a person is a mate, he is a man;
-> if a person is a man, he is masculine;
-> if a person is a masculine male man, be will be attracted to a feminine female
woman;
->^ if a person is a female, she is a woman;
-> if a person is a woman, she is feminine;
-> if a person is a feminine female woman, she will be attracted to a masculine
male man.
ais often have to contend with the myth that "they did not exist, i.e., that they
were really gay or straight" (p. 132). Furthermore, since "male" and "fe-
male" arc a dualislic binary, it creates a false assumption that female homo-
sexuality and male homosexuality are also mirrored opposites (Blackwood
and Wieringa. 1999a). a paradigm that not only fails to accurately reflect the
gay and lesbian communities in the modem era, it reinforces the invisibility
of bisexuals.
Deconstructing Sex and Gender: Thinking Outside ilie Box 95
It is important to note that historically it was commo l for gender clinics
to insist on a heterosexual postsurgical identity in order to apprtwe a trans-
sexual for surgery. Heterosexism was embedded into the very fabric of gen-
der clinics and even "sex change" theorists could not conceive of "creating"
homosexual persons. However, they could justify sex re issignment surgery
to a skeptical public if it "fixed" previously homosexual people and made
them heterosexual. Devor (1998) said, "Present elassif cation systems are
unable to capture adequately the subjecfive experience of posttransition
transsexuals who identify and live as gay men and lesbi ins" (p. 253). A bi-
polar sexual system infers and reinforces a heterosexual world.
The Disappearance of Diversity
Another consequence of a dual gender assumption is hat it makes invisi-
ble much of the diversity of humanity and creates the possibility of certain
pathological, deviant, and diagnostic categories. In a di alistic system, cer-
tain groups of people simply cannot exist since their ex stence places them
outside of the available categories of definition. Intersexed people, bisexual
and homosexual people, and, of course, transgendered aid transsexual peo-
ple have all been rendered invisible or pathologi/ed pre:isely because they
cull into question this bipolar system of sex and gender. Butler ( 1990) said.
"Those bodily figures who do not fit into either gender fall outside the hu-
man, indeed, eonstitute the domain of the dehumanized and the abject
against which the human itself is constituted" (p. 142).
The Assumption of Immutability
Onee upon a time, westem European culture thought there was one sex.
which of course was male, and females were considered an incomplete and
imperfect facsimile (Laqueur, 1990). However, the seien ific study of the bi-
polar nature of human biology fashioned the sex/gendei system as we now
know it. It is viewed not only as a system of duality but also as an immutable
and unchanging facet of human identity. The particulars may vary from era
to era or eulture to culture, but the basie yin/yang perspec tive invariably cre-
ates an immutable paradigm. Even the concept of the oiiposite or other sex
describes our sense of diametrical distinction, the inability to exist as
"both/and." Sex is not something that is considered chjngeable but is or-
dained at birth and permanently unalterable. Without tbis black-and-white
division of male and female, our universe would not be divided into oppo-
sites that therefore become diametrically opposed (e.g., if men are strong
then women are weak). It must also be noted that the ver/ use of the exprès-
96 TRANSGENDER EMERGENCE
sion "black-and-white" comes from a bipolar and racist paradigm that as-
sumes black and white to be opposites, not variations. Il assumes no gray ar-
eas at the same time that it assumes no biracial or mixed race people.
The last half of the twentieth century has seen great changes in the social
fabric of society as women, and to a lesser extent men, have broken free of
many previously prescribed roles. Although men and women have more
freedom to move within these role categories, great prohibitions against
stepping outside of them or erossing over to the other side of the binary still
exist.
Much of the shoek exhibited by the birth of an inlersexed child, the news
of a colleague's transsexua! surgery, or the announcement of a heterosexual
married friend's lesbianism is related to the belief that sex, gender, and sex-
ual orientution are unchangeable, immutable facets of human nature. Even
the gay liberation movement has fostered this belief system by building a
civil rights movement based on the idea that homosexuality is innate and un-
ehungeuble and therefore naiurul. Homosexuality becomes socially accept-
able when it is defined as inborn and intrinsic. The gay liberation movement,
which began as a movement to liberate the homosexual within everyone
(Altmun, 1971), became politicized as a civil rights struggle for un op-
pressed minority, a people defined by their inability to change. People are as
uncomfortable when a known homosexual has a relationship with someone
of the opposite sex as they are when a heterosexual person comes out, in part
because it reveals the fluidity and potentiality of sexual desire as natural to
all humans.
Assigning a sex to an intersexed infant evokes anxiety preeisely because
it highlights the arbitrary nature of sex/gender assignment und provokes the
fear that the assignment may be incorrect. Transsexuality further highlights
the arbitrary eategories of sex and gender when a "normally" sexed person
reveals ihat his or her sex/gender assignment is incorrect; the individual is
then cast in the role of an outlaw by transgressing these boundaries. Burch
(1995) suid, "Assignment of gender brings a profound sense of limitation"
(p. 292) and stepping outside of the margins that have been assigned high-
lights the limits of those boundaries.
In reality, all of the categories of sexual identity deseribed earlier have a
flexible quality (see Figure 3.4). Each exists on a continuum, which allows
for the existence of intersexed, bisexual, and transgendered/transsexual
people and a diversity of sexual and gender styles of presentation. "Gender
identity," as Bolin (1992) said, "is . . . socially mediated and dynamic rulher
than fixated und statie" (p. 13). In any eategory people can change their be-
havior, presentation, or identity and none of these categories represents an
immutable entity.
Deconstructing Sex and Gender: Thinking Outside > he Box
97
Mile SEX Fftihile
Man GEMiER U'om.vi
MiiscuUne SEX ROLE Fanimm
Heterosexual SEXUAL ORIENTATION Home
FIGURE 3.4. All components of identity are actually on a continuum. Sex, gen-
der identity, gender-role expression, and sexual orientation are not mutually
exclusive (i.e., moving in one direction does not necessarily mean that one can-
not also move in the other direction).
If these components are not a binary, then people h;ive flexibility as to
where they fit on the continuum and can exist in more tl an one place at the
same time. Intersexed people can, therefore, exist as bo h male and female
simultaneously. This means that men and women do not have to choose be-
tween traditional and stereotypically gendered traits but can be androgy-
nous, exhibiting traits of both masculinity and feminin ty simultaneously.
This means options for gender variation exist beyond tr lnssexualism as an
act of crossing over from one sex to the other, allowing ft r a variety of trans-
gendering presentations, including being bi-gendered. Soxual orientation is
therefore not "either/or," but allows for bisexual identity as well as Hexible
sexual expression throughout the life span.
98 TRANSGENDER EMERGENCE
Fluidity of sex and gender does not mean thai any of these components of
identity ean (or should) be altered from the outside—e.g., gay people should
not be "made" into heterosexuals, transsexuals should not be "made" into
nontranssexuals, men should not be encouraged to be more virile, nor
should women be encouraged to be more ladylike. Nor does it mean that one
ean simply change by an act of will. However, it does appear that these com-
ponents can, and do. change for many people. Heterosexuals come-out gay
and bisexual, lesbians and gay men ean fall in love with someone of the op-
posite sex, and men and women can, and have, ehanged their sex assignment
to one more congruent for them. Clearly there is fluidity in sexual and gen-
der identity. This fluidity should not be interpreted, however, to infer that
outside social forces should attempt to manipulate the sexual or gender
identities of people or to minimize the oppression faced by people within
certain social categories. The mutability of the component parts of sexual
identity can, however, eneourage society to broaden its acceptance of di-
verse experiences of gender and sexual expression.
The Assumption of Biological Determinism
The sex/gender system outlined earlier is presumed to develop naturally,
one component part from the other, as if one was a natural outgrowth of the
other. Like ihe Russian folk art of mairushka (nesting dolls), each compo-
nent of identity is assumed to be seeured within the one before it, creating a
structure that is both developmental and sequential, determined by natal
sex. It is not simply that mule and female is a binary system but that "man-
hood" is an assumed subset of maleness, a natural outgrowth of maleness as
it were. Masculinity is then an assumed eomponent of manhood and how
manhood is expressed. Each matrushka doll when opened has within it a
masculine male man, who is of course heterosexual and attraeted to his
complementary opposite—^a female who expresses womanhood through
her femininity. This creates a perfect heterosexual matched unit (see Fig-
ure 3.3).
The entire discussion regarding sex and gender is, as Butler (1990) sug-
gested, "always set within the terms of a hégémonie cultural diseourse pred-
ieated on binary structures that appear as the language of universal rational-
ity" (p. 13). To even begin to question the validity and universality of these
eoncepts makes one appear irrational. To think outside ol' the box is to step
outside of the agreed-upon and known universe. Whittig ( 1982), plaeed the
known universe into a political perspective when she said, "Masculine/
feminine, male/female are the categories whieh serve to coneeal the faet that
Deconstructing Sex and Gender: Thinking Outside. he Box 99
differences always belong to an économie, politieal, ideological or-
der" (p. 64).
Nowhere is this clearer than examming the discomfoi most people have
regiu^ding intersexual i ly, which blurs ihe distinction betwten male and female
and consequently heter(V and homosexuality. As Fausto-Steriing ( 1993) said.
Hermaphrodites have unruly bodies. They do net fall into a binary
classificafion system . . . inasmuch as hermaphrodites literally em-
body boih sexes, they challenge traditional beliefs about sexual differ-
ence: they possess the irritating ability to sometimes live as one sex
and sometimes the other, and they raise the specter of homosexuality,
(p. 24)
The current social discourse regarding intersexed pecple challenges our
very notions of a binary system of sexual orientation and desire.
Transgenderism also forces people to step outside of ihe bipolar division
of male and female and potentially allows not just another option, i.e.,
transitioning from the sex of birth to the gender of experience, but innumer-
able options for how one defines, experiences, and expn sses his or lier own
gender. In this sense, tratisgenderism is a radical term that tears down one of
the great sacred cows of our time; The division of the species into male and
female. Cromwell (1999) said thai "transpeople . . . mix liodies and genders,
have intermediate genders and obfuscate the Westem view ol two and only
two genders" (p. 99). Transsexualily specifically challenges our way of
thinking because "transsexuals make explicit for us th; usually tacit pro-
cesses of gender attribution" (Shapiro, 1991. p. 257) and shows us not just
how transsexuals acquire a new gender, but how we all create the genders
we express.
TTic assumption of a binary, immutable developments 1 sequencing of sex
and gender not only restricts what we know but. to paraphrase Goldner
(1988). actually constrains what is possible to know, in Devor's (1997a)
words, "The dominant gender schema is a matrix of rules which govern the
organization of sex, gender, and sexuality." If the linkages between male/
man/masculinity/heterosexuality are broken, ihen nume 'ous configurations
of identity, partnership, and expression are potentially birlhed.
Gendered Sexuality: The Example of Transgendered ßutches
The example of transgender butch identity will be u ,ed to illustrate the
complexity, conflation, and deconstruction of various co nponents of sexual
and gender identity. The place where transgender idenUly meets sexual ori-
entation creates a fascinating quagmire of definitions and identities within a
100 TRANSGENDER EMERGENCE
spectrum of maseuline embodiment in females. Corbett (1998) suggested
that "there may be forms of gender within homosexuality that contradict
and move beyond the conventional categories of masculinity and feminin-
ity" (p. 353). The focus here on female masculinities is to counterbalance
the historical attention on MTE literature in most major writing on trans-
genderism.
The relationship between sexual identity and gender identity is compli-
cated, partially because it has been historically linked, for example, in the
assumption that inverts were somehow both homosexual and transsexual. It
is also complex because it has been conflated within the popular di.scourse;
for example, many people believe that all effeminate males are homosexual.
Researchers argue about the development of sexual orientation and gender
identities. like the proverbial chicken-and-egg question, searching for which
"came first" (Bailey and Zucker, 1995). Eor instance. Green (1987) pro-
posed that gender identity develops first, influencing gender role and then
sexual orientation, and Isay (1987, 1989) suggested the exact opposite de-
velopmental sequence^—^that early sexual preferences affect the develop-
ment of gender role and idenUty. Nicolosi (1991) hypothesized that faulty
gender identity development in males is caused by pot)r fathering and impacts
the progression of male homosexuality. Freund and Blanehard ( 1983) ques-
tioned whether paternal distance was ihc cause or effect oi' ihc ch'úú'í^ atypi-
cal gender expression or it was the early manifestations of the child's sexual
orientation. It is possible that cross-gender identity and homoeroticism are
both manifestations of the same underlying phenomenon (perhaps prenatal
hormones or genetic underpinnings?) or that both are casually unique with
neither one impacting the other. Bailey (2003) assumes a biological origin
for femininity in males that can manifest as homosexuality or. in the ex-
treme, transsexuality. Although Bailey denies that the search for etiological
roots implies a search for a "cure." his descriptive language is seeped in sex-
ist and homophobic commentary. Seeking scientific "truths" for human sex-
ual and gender diversity often ends up emphasizing those that are more un-
usual, instead of focusing on the unique qualities of all sexual and gender
expression. The relationship between sexual orientation and gender iden-
tity, whatever its cause, remains a complex one.
Although it may be easy to mark the difference between sexual orienta-
tion and gender identity on a chart or grid—clearly "love-object choice,"
e.g.. sexual orientation, is different from internal gender identity^these
components of identity are often more difficult to separate in the lives of
people. These two separate components of human identity describe differ-
ent phenomena; however, they often overlap and their relationship can be
extremely complex. Social assumptions arc often made that gay and lesbian
people have cross-gendered identities and that people who are transgen-
Deconstructing Sex and Gender: Thinking Ouiside he Box W¡
dered or transsexuals are gay. This is intemalized by people stmggling with
sexual and/or gender identity issues. It is also true thut many people who are
gay, lesbian, or bisexual experienee confusion about their gender and many
people who are gender variant express confusion about iheir sexual orienta-
tion, In reality, gender-variant people can be homosexual, heterosexual, or
bisexual and ¡leople of all sexual orientations can be transgendered.
It is by examining the gender perlormativity and expression within the
lesbian and gay communities thut ihe mullilude of sexu; I and gender possi-
bilities become highlighted. It is iniporlant lo note that most gay men and
lesbians, despite the stereotypes, present in the expected gender role oftheir
sexed bodies. In other words, their identities as male/man/masculine (or
female/womun/feminine) follow through us sociully expected. It is their
sexual orientution that "switches" categories. When peojile say that they can
always reeognize a gay person—referred to within the I.GB community as
"gaydar"—it is commonly gender variance that they are noting. The major-
ity of LGB people are unrecognizable preeisely because their gender is pro-
foundly unremarkable.
It is also true, however, that some gay men and lesbians have always been
"gender benders." Within the gay community, feminine nales have been re-
ferred toas nellies or queens, and within the lesbian community, masculine
females have been referred to as butches or dykes. Wiihin certain subt:ul-
tures of Ihe gay and lesbian community, most notably lh)se that identify as
bulch/lemme, these identities have been an essential ard core part of self-
ideniiiy—not simply a gender-role expression but an expression of aciual
gender identity (Buranu, Roxxie, and Due, 1994; Halberstam, 1998a; Ken-
nedy and Davis, 1993; Munt, 1998; Nestle, 1992). N.;wton (2000) said,
""This masculinity, my masculinity, is not extemal; it ¡permeates and ani-
mates me. Nor is it a masquerade. In my home, when no one is present, I still
sit with my legs carelessly Hung apart" (p. 199). Furthermore she suid.
"This gay gender, butch, makes my body recognizable and it alone makes
sexual love possible" (p. 197).
The early sexologists were correct in identifying "inverts" as both trans-
vestites and homosexuals, although they were wrong to assume that this was
the only form in which homosexuality, or transvestism fur that matter, could
express itself Halberstum (1998a) said.
Inversion as a theory of homosexuality folded gimder variance and
sexual preference into one eeonomical package and attempted to ex-
plain all deviant behavior in lerms of a firm and air lost intuitive belief
in a binary syslem of sexual stratification in which the stability of the
terms "male" and "female" depended on the stability of the homosex-
ual-heterosexual binary, (p. 82)
102
TRANSGENDER EMERGENCE
Cross-gendered identity—masculinity in females or femininity in males—
can have many different meanings and experiences and cannot easily be
judged on the outside without understanding phenomenologically the expe-
riences of the person. Halberstam ( 1998a) said.
There are many histories of bodies that escape and elude medical tax-
onomies, or bodies that never present themselves to the physician's
gaze, or subjects who identify within categories that emerge as a con-
sequence of sexual communities and not in relation to medical or
psychosexual research, (p. 161)
Homosexual relationships are often referred to as same sex, signifying
the importance of the genitalia of the partners, as well as the similarity of so-
cial roles for women-loving women (see Figure 3.5). However, same sex is
not the same as same gender. Lesbian couples who identify as butch/femme
are often experiencing a same-sex relationship (i.e., they are both females).
Lesbian
Female
Female
Woman
¡Ionian
Feminine
Feminine
Lesbian
Lesbiati
FIGURE 3.5. Attracted to same sex and same gender.
Deconstructing Sex and Gender: Thinking Outside i he Bo.x
103
and yet an opposite gender relationship (i.e., they relate in a more man/
woman, or masculine/feminine paradigm within female bodies) (see Fig-
ure 3.6). Inness and Lloyd (1996) identified four salient aspects of butch
identity; she is a masculine woman (though "female" mi ihl be a better word
here); she is like a man (but she is not one); she adopts an active sexual role;
and/or desires femmes. Inness and Lloyd try to uncouple the association of
biilch with attraction to femmes, describing other partner choices and erotic
attractions open to butches. It is also true that not all butihes adopt an active
sexual role. "Butch" is, to use Rubin's (1992) words, "a category of lesbian
gender. . . lesbian vernacular... for women who are mo'-e comfortable with
masculine gender eodes. styles, or identities" (p. 467).
Halberstam ( 1998a) said, "Female maseulinity is not iimply the opposite
of female femininity, nor is it a female version of male maseulinity" (p. 29),
and attempts to define "what" it is are just beginning. "Butch lesbians." said
Cromwell (1999), "have masculine gender identities, but unlike FTMs and
transmen, they do not identify as men" (p. 27).
Lesbian—Butch/Femme
Female
r
etnale
•9
Wotr.an
MascuHrtf
Butch
FIGURE 3.6. Attracted to same sex and opposite (lender role.
/ ()4 TRANSGENDER EMERCENCE
Rather than a binary of butch lesbians on one side and FTM/transmen on
the other, it is best to see masculine expression as spectrum of behavior and
expression involving gender and sexual orientation. Some female-bodied
masculine people do not identify as either transsexual or butch lesbians but
see themselves as transgendered butches—a category that links the gender
identity descriptions of the transsexual paradigm with the historical con-
sciousness of lesbian-butch/femme role dynamics. They express their gen-
der role in typically masculine ways and (to borrow from the masthead of
the American Boyz [n.d.] organization) "were labeled female at birth but
. . . feel that is not an accurate or complete description of who they are."
Transgendered butches may experience their bodies, sexuality, desires,
and identity in many different ways. Some transgendered butches modify
their bodies with hormones and/or surgeries and appear as males in public.
Others use clothing, hairstyles, and how they move their bodies to connote
masculinity. For some, their gender identity is congruent wilh a female
body. Others experience dysphoria in their gender identity. Some trans-
gendered butches identify as lesbian, since they prefer female partners, and
others do not see themselves as lesbian because lesbian implies a "woman-
to-woman" sexuality, and they do not see themselves as women. Since many
have previously identified as lesbians, and are often partnered with women
who still do identify as lesbians, they may have strong links to the lesbian
community although they do not currently identify as either women or les-
bians. Devor ( 1997a,b) noted that FTMs have often tried to fit themselves
inlo the available social roles, and therefore many identified as lesbians
since they were female-bodied and lovers wilh women, even though the fit
was always awkward. Still other iransgendered butches do not see them-
selves as lesbians because they are not sexually interested in olher females.
They may identify as gay men, although they are technically female bodied.
Eyler and Wright ( 1997) developed a nine-point gender scale ihat identi-
fies a continuum of gender identiflcation for genetic female.s with gender-
blended self-perception. Although it is tempting to describe this as a contin-
uum with butch lesbian on one end and female-to-male transsexual on the
other (Halberstam, 1998a,b). there are butch lesbians with a strong male
identification and transmen who still maintain a sense of themselves as
female/woman or lesbian. As Halberstam ( 1998b) said, "There are many
butches. . . [who] pass as men and many transsexuals who present as gender
ambiguous, and many bodies that cannot be classified by the options of
transsexual and bulch" (p. 153). Halberstam wamed the reader to avoid cre-
ating a "masculine continuum" that assumes butch to be less masculine—or
less dysphoric—than transsexual. She said that "gender dysphoria |is not
thel exclusive property of transsexual bodies" (Halberstam, 1998a. p. 151)
and that more gender dysphoria does not necessarily create a more transsex-
Deconstructing Sex and Gender: Thinking Ouulde 'lie Bo.x ¡05
uai identification. Hale (1998) suggested that some butehes "might have
richer, more solid male or masculine self-identilications than do some
ll-TMs]" (p. 322) and Bolus (n.d.) said, "FTM identity is not simply the
endpoint on the continuum of butch masculinity."
The line where butch/woman identity ends and trans/ nan identity begins
is a territory still being mapped and the heated debate over identity bound-
aries has been called the "butch/FTM border war." Both FTMs and butches
deploy "male signifiers, clothes, hair, mannerisms, and body movements"
hut they do so with "different motives" within "two différent interpretative
frames" (Rubin, 1996, p. 194). Rubin explained that "FTMs are men and
lesbians are not. no matter how butch they are" (p. 98). He further said that
because these borders are "still under construction," whi:n "lesbians and fe-
maie-to-male transsexuals confront one another they distinguish them-
selves from the other through a process of disidentifica ion" (p. 981. Some
FTMs have rejected their lesbian pasts, which they have come to see as a
"mistaken identity" (Halherstam, 1998a, p. 150). For th ise who clearly ex-
perience themselves as transsexual, or as lesbian butches. this process of
disidentification is paramount. However, for many transçendered butches it
is not so easy to separate these parts of self within their own bodies.
A female couple—one partner appearing masculiw (butch) identified
and the other appearing more traditionally female—may identify as a les-
bian couple, a butch/femme couple, ora heterosextial ccuple, depending on
how gender and sexuality are defmed hy the couple themselves (see Fig-
ure 3.7). Living as a transgendered butch may involve a fluidity of shifting
identities in which one passes in the world as a man. bui identifies as trans-
gendered among close friends, and yet still sees a gyne^jologist for routine
checkups for his female anatomy. Devor referred to this as "gendered sexu-
ality" ( I997h) and explained how one can talk "with ac:uracy and without
contradiction" about a relationship that is homosexual fiom the perspective
of biology yet straight from the perspective of lived identities and social/
sexual relationships (pp. xxv-xxvi). Pauly (1998) referrtd to this as the dif-
ference between those who are "homogenderal" and tho;e who are "hetero-
genderal"—which privileges the importance of gender identity over the
genitalia. Pauly (1992) also said that "the important variable is not the ge-
netics of the relationship, but the gender status of two p micipants" (p. 7).
Of course, gender transitions do not take place in isolation but often im-
pact significant others and their relalionship to their ovn sexual identity.
This is illustrated by a conversation that took place betwt en a transgendered
butch-identified "guy" who worked and passed in a traditional male job. He
was in a long-term partnership that had been lesbian identified before he de-
eided to transition, had chest surgery, and began hormone treatment. One
day a co-worker asked him a question about his "wifi:." He told his co-
706 TRANSGENDER EMERGENCE
Tran s gendered Butch and Femme
Female —>
Male
Female
Butch
Woman
Masculine Feminine
Transman
Heterosexual
Queer
Femme
FIGURE 3.7. Attracted to opposite sex and opposite gender role.
worker that he was not legally married and was then asked, "Why not"? Af-
ter stammering for u minute, struggling lo explain his unique situation with-
out revealing himself, he said, "Well, because she's a lesbian." Of course,
the co-worker had no idea that the guy had lived most of his life as a "lesbian
woman" and still had female genitalia underneath his male appearance. The
co-worker was justifiably confused about why a man would partner with a
lesbian, although the truth might have confused him even more. The
transgendered butch had not changed his sexual orientation (i.e.. his sexual
desire for women remained const ant ) ^t was his "wife's" sexual identity
thut was chullenged by his transition. How could his wife retain her identity
as u '"lesbian" when she was partnered with a person who looked like and
passed as a "man" in the outside world? .
Deconstructing Sex and Gender: Thinking Outside ¡he Box ¡07
The subject of female masculinity—from butch iesbians and female
cross-dressers to fully transitioned female transsexuals or transmen)—has
been historically invisible. Jamison Green (1998) wrote an overview of the
history and current experience of female-to-male transsexuals and other
female-bodied men and examined the segment of the FTM world that has
historical roots in the lesbian-butchpuradigm, as well as many other "types"
of transmen and masculine females. He is committed to .-reating a space for
"men with female histories" (Green, 2001, p. 62). Gary Bowen (2001, per-
sonal communication) said, "When I invented the term ' ransman' I deliber-
ately did it to provide a new transsexual term and identity. It was my first at-
tempt to find a word for myself without the buggagt of pathology and
racism."
Gayle Rubin (1992) said, "Although important discontinuities sepaiate
lesbian butch experience and female-to-male experienct, there are also sig-
niiicant points of connection . . . the boundaries bet wet n the categories of
butch and transsexual are permeable" (p. 473). Some transgendered butches
enjoy the fluidity of shifting gender identities, and others Imd this shifting
deeply problematic. Each transgendered butch identifies somewhat differ-
ently. Many do not see themselves as women, most do not see themselves as
men, and others see themselves as both men and women preferring to iden-
tify as bi-gendered or "other" gendered—essentially, a third sex. Triinsgen-
dered butch, butch lesbian, stone butch, transman (IVniale transsexual),
female man, atid mandyke are words that attempt to define different experi-
ences for masculinity in females.
Coming to gender congruence in the botdertands can be a complicated
process. Dealing with ihis overlap of sexual and gender identities makes it
difficult for clinicians, as well as the people embodying these complex iden-
tities, to sort out the meanings and develop a sense of congruenee of iden-
tity. For those on the outside—e.g., psychotherapists—i[ may be especially
difficult to sort out the gender expressions and meaning for masculine fe-
males presenting with gender dysphoria. Is a client with a lesbian past who
is struggling with issues related to gender eoming ojt as butch, trans-
gendered, or transsexual? How does she or he redéfinit intimate relation-
ships, comprehend heror/i/i history, or define identity. Halberstam ( 1998a)
said the issue of border wars assumes that "masculinity is a limited re-
source" (p. 144). Perhaps for those born female it has bien.
It is not difficult to understand how sexual and gendei identity can easily
become conflated within the public's eye. Indeed much of the gay rights
movement's fœus of the past few decades has been to dispel mistoncep-
tions that gay people have cross-gender behavior. By and large, ihis has
been successful. When professionals are queried during raining sessions as
to whether gay men are more "effeminate" than straight men, they immedi-
70S TRANSGENDER EMERGENCE
ately denounce that as a stereotype. However, when challenged about this
position, and having determined that it is safe to ask difficult questions, pro-
fessionals will often admit, "Yes, it diws seem that many gay men are more
effeminate that most heterosexual men. Why is that?"
Obviously, the answer to that question is not simple, but it is trtte that
gender inversion has always been one aspect of the gay community. Al-
though most gay men express and present their gender in a normative
male/man/masculine manner and are therefore invisible as gay men. many
gay men have gender role expressions that are feminine, and perhaps some
have cross-gendered identities. Some cross-gender behavior has served as
an entertainment element of the gay community (e.g., drag queens, female
impersonators) and other cross-gender presentations have served as a way
for cross-gendered individuals to recognize one another in what has been a
hostile world. Wearing more feminine colors, wearing an earring, or ex-
pressing traditionally feminine mannerisms has served as "in-group" recog-
nition. Gay men jokingly refer to one another as "Mary" or "Blanehe," and
idolize and imitate glamorous female movie stars such as Bette Davis.
Green's (1987) longitudinal study of young "'sissy" boys showed that many
of these boys grow up to be gay, raising questions about the relationship of
sexual and gender identities in early childhood development, including bio-
logical underpinnings.
Just as the gay community has denied cross-gender behavior in trying to
gain soeial respect, many transgendered and transsexual people have iried to
distanee themselves from any association with the gay eommunity. Some of
this is, of course, simply homophobia, but it is also an attempt to separate
whal is actually an issue related to gender rather than sexual desire. In olher
words, a transsexual may appear to be homosexual, beeause they are in a
same-sex relationship (pretransifion). but they experienee themselves in an
opposite-sex relationship and are therefore heterosexual. The clinical com-
munity has continued to eonfuse this already-complex issue by insisting on
ufilizing nomenclature that refers to transsexuals as "homosexual" and "het-
erosexual," basing people's sexual identity on their natal sex, not their cho-
sen gender.
Boekting and Coleman (1992) suggest that eaeh component of sex identity
should be assessed separately. The difficulty in this is that each component of
identity interacts with other components of identity, creating endless possibil-
ities for expression, and has been limited only by historical social and politi-
cal parameters. "Gender," as Mitchell (2(X)0) suggested, "is constnicted
within a relational context" (p. 233). Every descriptor and experience of gen-
der or sexuality is seen through the lens of what is thought possible. Butler
(1990) said, "If sexuality is eulturally constructed within existing power rela-
tions, then the postulation of a normative sexuality that is 'before,' or "out-
Deconstructing Sex and Gender: Thinking Outside he ßo.v 109
side,' or 'beyond' power is a eultural impossibility" (p. 4(1). It is very diflleult
to be something that has no name: naming calls identity into being. When the
only names available that describe one's experience are ;iss(x:iated wilh per-
version, it can create a dissonance with one's own emboiliment.
At the beginning of the twenty-first century, multipU expressions of sex
and gender are better understood and the possibility exists for creating a so-
ciety Ihat accurately reflects the diversity of humankind. The understanding
of Ihese four separate components of identity that overlap and impact one
another highlights the need to "dismantle not only andrecentricism and bio-
logical essentialism, but also gender polarization and i ompulsory hetero-
sexuality" (Bem, 1993). Rubin (1984) critiqued her cwn analysis of the
sex/gender system and noted that it is nol enough to see sex and gender op-
pression ihough a lens of feminist thought, but to understand that the sexual
system takes place in the eontext of gender expectations and assumptions of
sexual normativily. For example, she said thai lesbians are nol merely op-
pressed as women, but also "as queers and perverts" (p. 308). It is not only
Iheir biological sex status, or their social gender that is ceemcd inferior, but
also their sexual desire.
When sex is nol assumed to be dimorphic, it allows for the existence ol'
intersexed people. When gender is not an assumed matter of binary opposites,
it allows for transsexual, androgynous, bi-gendered, hutch, nelly, cross-
dressing, and transgender identities. When sexual orienta ion is not limited to
two choices, bisexuals are given social freedom and homosexuals and hetero-
sexuals are allowed Huidity throughout their lifetimes. Some people fear ihal
if society allows diverse gender expression and variant seuialilies to prolifer-
ate then people will easily discard genders at will, freely engage in sex-
change surgeries, and the institution of marriage will lost its scared and eco-
nomic value. Halberstam (1998a) disagreed with those concems. She said
transgender discourse "asks only thai we recognize the nonmale and non-
lcmale genders already in circulation and presently under construction"
(p. 162). Bem (1995) took this one step further and sujigested that instead
oi eliminating the gender-polari/ing lens of Western sj stems, perhaps we
should "begin madly and exuberantly to proliferate ourselves inlo as many
categories of sex/gender/dcsire as we seem to need" (p. r-33).
Mental health providers—social workers, psycholoiiists, and counsel-
o r s ^ have a powerful role to play in reexamining what has been considered
normative regarding sex and gender identities. Fausto-Sterling (1993) re-
minded us thai, "Scientific and medical understandings of multiple human
sexes bring with them both the means to disrupt and ih: tools to reinforce
dominant beliefs aboul sex and gender" (p. 77). It is a ¡livotal lime for to-
day's clinicians to decide whether to be social control agents or harbingers
of socia! change and social justice.

Related Interests


sexed or gendered people—may not be ihe only or best way lo describe our
sexual desires. Bem (1993) said, that her sexuality "does not mesh with
available cultural categories" (p. vii), and Litwoman ( 1990) discussed feel-
ing forced into a '"bisexual" identity since she is attracted to bolh men and
women. Litwoman believed that gender is not the salient aspect of how her
desires function.
Due to the societal stigma surrounding homosexual behavior, lesbian,
gay, and bisexual people have to "come out" of the assumption that they are
heterosexual, not only to others but also to themselves. Although sometimes
the terms sexual orientation and se.xualpreference are used interchangeably
with the term sexual identity, they are actually subsets of the broader cate-
Deconstructing Sex and Gender: Thinking OuLúde ¡he Box 87
gory of sexual identity. Sometimes the term sexual identity is used with
pride by people wilh a homosexual or bisexual orientât on to give voice to
the idea that their sexuality is not merely a desire but an integrated part of
iheir identity.
When sexual orientation is not heterosexual, it is stigmatized, for homo-
sexuals and bisexuals.
DECONSTRUCTING THE ASSUMPTIONS
OF SEXUAL IDENTITY
[Tlhe category of sex and the naturalized institution of heterosexuality
are constructs, socially instituted and socially retaliated fantasies or
"fetishes," not natural categories, but political oni:s.
Judith Butler
Ge.ider Trouble, 1990
The four components of sexual identity interact wilh one another in com-
plex ways and develop and integrate in various patterns. Despite the bipolar
divisions of male/female, man/woman, masculine/feminine, and gay/straight,
all aspects of human sexuality—physiology, gender identity, gender-role
behavior, and sexual identity—have multiple variables and expressions.
As discussed previously, people are assigned to theii natal sex category
based on visible genitalia. Genitalia are rarely visible publicly so assump-
tions about male or female sex are actually hased on gender-role expression
of masculine or feminine features. Gender identity and biological sex is at-
tributed lo people based on perceived traits, which are enacted or performed
through gender-role expression. Kessler and McKenna 1978) suggest ihal
gender attribution is the foundation for understanding all other components
of sexual idenlily. People use cues to discern whether otiers are male or fe-
male and, in cases of ambiguity, people more easily assume that .someone is
male, even when the person has visible female getiitalia, as long as there are
enough other tnasculine cues.
None of these categories offer much information about sexuality itself.
Sexual orientation, especially if it is nonnormative heterisexuality, must be
achieved through a proeess of self-discovery and cominj; out. Sexual orien-
tation may reveal the "love-object choice" of a person, but not whether he or
she acts on those desires. The tour components do not ex ^lore sexual desire,
erotic identity, erotic role, or erotic acts (Newton |with vV'alton|, 2ü(K)).
The way that societies transform biological attributes into socialized
identities—affecting not only reproduction but social po A^er. role character-
88 TRANSGENDER EMERGENCE
isties, and the very nature of identity—has been called the sex/gender sys-
tem (Rubin, 1975). The entire sex/gender system is built on a series of as-
sumptions that are so much a part of our way of thinking we do not realize
they are assumptions. The first and most salient of these is the premise ol'
duality.
The Assumption of Duality
It is an assumed trulh that humans are divided into two groups, one called
male and the other called female. The two groups are considered bipolar op-
posites, matched parts that fit together as puzzle pieces (see Figure 3.2).
This binary division is based on an either/or dichotomy; one is either male
or female. Males and females are perceived to be different from each other
in seienlifically observable ways and aeross all academic disciples, from ihe
hard sciences such as biology to the soft sciences such as sociology, and
even the political seienees such as women's studies. Stone (1991) said.
Male •
Man
Masculine
Heterosexual
SEX
GEXDER
Wt'MflY
GENDER
ROLU
< J ^
SEXUAL
ORIENTATION
Female
Woman
Feminine
Ilomosexna!
FIGURE 3.2. Sex, gender identity, gender role, and sexual orientation are
assumed to be bipolar opposites. This bipolar system renders invisible those who
are intersexed, gender variant, androgynous, eross-gendered, and/or bisexual.
Deconstructing Sex and Gender: Thinking Outside ¡he Box 89
"Under the binary phallocratie found myth by which Westem bodies and
subjects are authorized, only one body per gendered subject is 'right'. All
other bodies are wrong" (p. 297).
It is further assumed that men and women are different in personality, de-
sires, behaviors, and interests and ihal these difference:, are based on their
physiological differences. Masculine and feminine sex-iole expressions are
assumed to be dichotomous, and people are socialized to be "opposites" thai
are different and complementary. This duality is then piesumed to result in
an attraction—as in opposites attract—and places sex and gender identity
into a heterosexual male/female structure that is deemed "normal": every-
thing else is presumed lo deviate from this norm. Gayle Rubin (1975) re-
fered to gender as the "socially imposed division of the si;xes... [thai] trans-
form|s| males and females into 'men' and 'women,' each an Incomplete half
which can only find wholeness when united with the oticr" (p. 40).
Many difficullies emerge from this paradigm, whiih will be outlined
here and described later. The first problem is thai the assumption humans
are divided into male and female subspecies determimd by genitalia ren-
ders people with ambiguous genitalia invisible from the social discourse.
Intersexed people, by some estimates to be about 2 percent of the popula-
tion, arc "disappeared" when the only available filing categories are male
and female.
Second, this bipolar paradigm socializes men and women to think of
themselves as living on different and warring planets—Mars and Venus—
and lo believe that they are more difterent from each otht r ihan they are sim-
ilar. Even the nature of research itself, including feminist research, rests in
assumptions aboul male/female diflerences. Whatever particular differ-
ences are being studied, "the range of variation is ÍÜT greller among males or
among females than between the two sexes" (Bleier, 1984, p. 109). Caplan
and Caplan (1994) suggested that students of research ask melaqueslions
about the process of doing research, e.g., "What might he researchers' mo-
tives for doing this research?" and "Are certain kinds of bias reflected in the
way the research question was asked?" They raised the concern that re-
searchers are "ignoring or downplaying overlap in fema es' and males'per-
formance or behavior," reminding academics that femalt s and males are far
more alike on all variables than they are différent (199*-, pp. I lO-111). As
Rothblalt ( 1995) said, "All of the alleged proofs of sexuil dimorphism have
suffered from a glaring . . . Achilles' heel—absolute differences in men's
and women's minds, mental abilities, and psychological natures have never
been found" (p. 107). The differences between males and females always
privilege males and create an androcentrism that assumes women to be "the
other" (Bem. 1993).
90 TRANSGENDER EMERGENCE
Third, the entire system of sexual expression (i.e., sexual orientation or
preference) is built on the premise of a bipolar gender system. Assumptions
about sexual orientation, even liberal assumptions, are based on the pre-
sumption of there being two opposite sexes. A worid that is neatly divided
into male/female designations also very neatly splits into heterosexual and
homosexual people. The possibility of same-sex intimacy exists only as a
category when it is compared to opposite-sex intimacy. Sedgwick (1990)
said that "without a concept of gender there could be . . . no concept of
homo- or heterosexuality" (p. 31). Bisexuality as a paradigm is defined by
its middle position between the two available poles. Pharr ( 1988) said that
"homophobia [or, more accurately, heterosexism | . . . is a weapon of sex-
ism." describing the process in which homophobic violence is used to rein-
force traditional gender roles (p. 16).
Einally, behaviors that deviate from expected gender requirements are
considered clinically diagnosable, rendering cross-gender behavior not just
unusual but pathological. Binary sex and gender systems force all people
who do not easily fit either polar field—including intersexed, gender-
variant, homosexual, bisexual, and transsexual peopl e^nt o a category of
"other" that ultimately stigmatizes them for being different and then path-
oiogizes their uniqueness.
Intersexuality ,
For most people there is a consistency between their external genitalia,
their internal genitalia, their hormones, and their chromosomes and they are
easily plaeed into the available categories of male or female. However, due
to the numerous biological variables intervening in the fetal development
process it is possible for sexual differentiation to take place atypically. For
instance, an irregularity in hormone production, such as an over- or under-
exposure to particular hormones or certain genetic conditions, can cause in-
ternal or external genitalia to develop outside expected parameters. When
external genitals are ambiguous at birth, medical professionals step in to
further examine the chromosomes, hormones, and internal genitalia to see if
an intersexed condition is present. Of course, no further examination is nec-
essary if the genitals are "normal" looking. Most people have not had their
sex scientifically examined, and if they do not have an obvious physiologi-
cal difference, more subtle intersexed conditions may never be identified.
Intersexed people may have the internal reproductive system of one or
both sexes as well as ambiguous or incompletely differentiated external
genitalia. People who have the physiological external genitalia of both
males and females have been traditionally referred to as hermaphrodites.
The Intersex Society of North America (ISNA) said that the word hermaph-
Deconstructing Sex and Gemler: Thinking Outside the Box 91
rodite is stigmatizing and misleading and a result of scienlific theories de-
veloped in the Vicioriun uge. They recommended the use of the word
interse.x, a practice ihat will be followed here.
Intersexuulity is found among all populations throughout the world, al-
thtmgh with variable frequency. Fausto-Sterling (2(X)0) Í stimaled thut when
all causes of intersex are considered, approximately 1.7 :)erccnt of all births
are affected. This is certainly not a small number of people and raises the
question of why more people are not aware of the existence of intersexed
pet)ple. The answer to this question is steeped in biomédical and surgical
ethics. I
Most intersexed children born in (he United Slates have been surgically
altered at birlh and assigned lo fit into the approved dimorphic sex eatego-
ries. "People of mixed sex all but disappeared, not because they had become
rarer, but because scientific methods classified them out of existence"
(Fausto-Sterling, 2000, p. 39). Based on the theories of gender identity de-
velopmenl initialed and instituted by John Money (1961; Money and Ehr-
hardt, 1972; Money. Hampson, and Hampson, 1955a; Money and Tucker.
1975), pédiatrie endocrinologists and urologists, wilh the support of the
American Academy of Pediatrics (AAP), have routinely recommenited sur-
gical ""conection" of ambiguous genitalia of intersexed inünt.s (AAP, I996a,b;
Migeon, Berkovitz, and Brown, 1994: Donahoe and Schnitzer, 1996: Feder-
man and Donahoe, 1995; Grumbrach and Conte, 1998)
These surgeries have been justified because of physicians' fears that
Ihese babies will develop confused gender identities due to their physical
differences. The medical, surgical, and sexological experts have assumed
Ihal gender identity emanates as the logical outcome ol physiological sex,
and ihal the creation of a morphologically correct bodj can determine the
inlernal experience of gender. The relationship between natal sex. physiol-
ogy, and the development of gender identity is far more c omplex than surgi-
cally altering the genilulia of intersexed babies. Crouch < 1999)said, "In the
West, if one is neither a man nor a woman, ihen one ha; no social place or
state to occupy" (p. 36).
Despiic the lack of follow-up studies on surgically allered intersexed ba-
bies, when the AAP released its new guidelines in the summer of 2000,
there were no discernible changes in the treatment strat^igies that had been
historically employed. This is despite the tireless efforts of the ISNA under
the guidance of Cheryl Chase, despite the publication of lumerous accounts
by survivors of genital surgeries (Alexander, 1999; Cameron, 1999; Cola-
pinto, 2(M)0; Coventry, 1999; Devore. 1999; Groveman. 1999; Laurent,
1995), and despile the proliferation of clinical research questioning the con-
tinuation of "'business as usual" (Chase, 1999; Diamond and Sigmundson,
I997u,b; Lewis, 2000). Al least the AAP has recognized the movement to
92 TRANSGENDER EMERCENCE
reexamine intersex surgical guidelines from an ethical perspective, even if it
was only to mention it by discounting it (AAP, 2000).
However, the existence of intersexed people stands as the most direct evi-
dence that biological sex is not simply dimorphic and that calling a baby a
"boy" or a "girl" is more of a social decision than a biological one. Simply
put, "To be gendered, one must llrst be sexed, not intersexed" (Crouch,
1999, p. 36).
Sexism and Socialized Differences
Another difficulty with the premise of duality is that it presumes tbat
males and females have different, diametrically opposed psychologies, be-
haviors, and experiences. The traits of one group are the antithesis of the
otber, e.g., males are stronger than females and females are more emotion-
ally sensitive than males. However, if we list all gender markers there are
none that are, in Kessler and McKenna's ( 1978) words, "always and with-
out exception " true of only one gender (p. 1, italics in original). Many deter-
minants of personality derive from these perceived differences, including
career options and clothing choices. In reality, men and women are more
like each other than they are different.
Although the feminist movement has taken us far since the 1960s, and no
one could deny that the lives of women, individually as well as collectively,
have changed in bold and blatant ways, gender-role expectations are still
prescribed and restrictive. Although some of the more extreme and rigid
boundaries of gendered social expectations have broken down in the past
few decades due to the strides of the women's liberation movement, the ba-
sic bipolar assumption of male and female differences—based on genitalia
and affecting all societal arenasei s mostly intact. Bem (1993) referred to
this proeess of how socialization impacts and reinforces the development of
gender appropriate behaviors in children as gender schema theory.
The social rules of gender are based on assumptions about the differences
between males and females that are expressed in Stereotypie masculine and
feminine ways. Most gendered behavior is arbitrary. Although we have
grown accustomed to blue for boys and pink for girls, it was only a few gen-
erations back that most babies wore white dresses. It is thought that the cus-
tom of blue for boys and pink for girls originated in 1929, when a midwife
from Bologna, Italy, hung blue and pink ribbons to announce the birth of a
child (Giuseppe Vidossi as cited by Belotti, 1975). An early feminist note-
card outlined the arbitrary quality of gender polarization by showing two
toddlers looking down into their diapers and one saying, "Oh, so that is what
determines the différence in our paychecks." Boys are still expected to play
with cars and action toys and girls are still expected to play with dolls. A
Deconstructing Sex and Gender: Thinking Outsitle ¡ he Box 93
brief viewing of the commercials during Saturday morning cartot^ns will
easily prove this point.
Maintaining distinctions between men and women is.ifundamenlal prin-
ciple of the sex/gender system, and although it onee organized society, it has
outlived its functionality. Wittig (1982) felt that feminis n itself bought into
the "myth of woman," and reified theelass of people called women, despite
acknowledging that gender attributions were socially en:ated (p. 106). But-
ler ( 1990) went so far as to suggest that "there is no gender identity behind
the expressions of gender; that identity is performatively constituted by the
very 'expressions' that are said lo be its result" (p. 33). Transgenderism is so
threatening to the status quo preeisely because the existen;e of gender-variant
people shows that the boundaries separating men froni women are false.
In an interesting historical twist of fate women now have much greater
freedom of dress than men do. The social costs are higher for men with only
small clothing transgressions. Although men can wear their hair longer or
even wear an earring (or two!), it is not unusual for men to be arrested for
wearing women's clothing in public. However, female transvestism is no
longer a diagnostic concept. Only men can be transvesti es beeause women
can wear almost anything they want without social disgrace.
Bisexuality and Homosexuality
Although a dimorphic gender system allows for both same- and oppo-
site-sex relationships, it is inherently a heterosexist one. Homosexuality is
allowed as the binary opposite of heterosexuality only lo serve as a foil of
"otherness," as a way to support the naturalness of hi'terosexual pairing
(Katz, 1995). Rich (1980) analyzed this heterosexual imperative regarding
Ihe particulars of women's oppression and referred to it as "compulsory het-
erosexuality." This is the culturally mandated assumption that women are
and will be heterosexual, and despite the rhetoric of si;xual "preference,"
women are socialized into aeeepting heterosexuality as the only ehoice.
As stated earlier, the world is presumed to be engineered as a bipi>lar jig-
saw puzzle, with sexually matehing parts, which Butler ( 1990) referred to as
"the heterosexualization of desire" (p. 23) (see Figure 3.3). Much of the re-
sistance to the depathologizing of homosexual relationships, clinically and
politically, has stemmed from the assumption that gay and lesbian relation-
ships are against this "natural order." If male and female parts are naturally
paired then it is reasonable to deduee that any male/male or female/female
bonding is unnatural. This renders bisexual people—who probably repre-
sent a larger population than either heterosexuals or homosexuals—into a
nonexistent category labeled "fence-sitters." Klein (1999) said that bisexu-
94 TRANSGENDER EMERGENCE
Male
SEX
Female
Man
GENDER
IDENTITY
Woman
Masculine
Heterosexual
GENDER
ROLE
SEXVAl
ORIENTATION
Feminine
Heterosexual
FIGURE 3.3. It is assumed that each of these components lines up and ensures
the next.
-> if a person is a mate, he is a man;
-> if a person is a man, he is masculine;
-> if a person is a masculine male man, be will be attracted to a feminine female
woman;
->^ if a person is a female, she is a woman;
-> if a person is a woman, she is feminine;
-> if a person is a feminine female woman, she will be attracted to a masculine
male man.
ais often have to contend with the myth that "they did not exist, i.e., that they
were really gay or straight" (p. 132). Furthermore, since "male" and "fe-
male" arc a dualislic binary, it creates a false assumption that female homo-
sexuality and male homosexuality are also mirrored opposites (Blackwood
and Wieringa. 1999a). a paradigm that not only fails to accurately reflect the
gay and lesbian communities in the modem era, it reinforces the invisibility
of bisexuals.
Deconstructing Sex and Gender: Thinking Outside ilie Box 95
It is important to note that historically it was commo l for gender clinics
to insist on a heterosexual postsurgical identity in order to apprtwe a trans-
sexual for surgery. Heterosexism was embedded into the very fabric of gen-
der clinics and even "sex change" theorists could not conceive of "creating"
homosexual persons. However, they could justify sex re issignment surgery
to a skeptical public if it "fixed" previously homosexual people and made
them heterosexual. Devor (1998) said, "Present elassif cation systems are
unable to capture adequately the subjecfive experience of posttransition
transsexuals who identify and live as gay men and lesbi ins" (p. 253). A bi-
polar sexual system infers and reinforces a heterosexual world.
The Disappearance of Diversity
Another consequence of a dual gender assumption is hat it makes invisi-
ble much of the diversity of humanity and creates the possibility of certain
pathological, deviant, and diagnostic categories. In a di alistic system, cer-
tain groups of people simply cannot exist since their ex stence places them
outside of the available categories of definition. Intersexed people, bisexual
and homosexual people, and, of course, transgendered aid transsexual peo-
ple have all been rendered invisible or pathologi/ed pre:isely because they
cull into question this bipolar system of sex and gender. Butler ( 1990) said.
"Those bodily figures who do not fit into either gender fall outside the hu-
man, indeed, eonstitute the domain of the dehumanized and the abject
against which the human itself is constituted" (p. 142).
The Assumption of Immutability
Onee upon a time, westem European culture thought there was one sex.
which of course was male, and females were considered an incomplete and
imperfect facsimile (Laqueur, 1990). However, the seien ific study of the bi-
polar nature of human biology fashioned the sex/gendei system as we now
know it. It is viewed not only as a system of duality but also as an immutable
and unchanging facet of human identity. The particulars may vary from era
to era or eulture to culture, but the basie yin/yang perspec tive invariably cre-
ates an immutable paradigm. Even the concept of the oiiposite or other sex
describes our sense of diametrical distinction, the inability to exist as
"both/and." Sex is not something that is considered chjngeable but is or-
dained at birth and permanently unalterable. Without tbis black-and-white
division of male and female, our universe would not be divided into oppo-
sites that therefore become diametrically opposed (e.g., if men are strong
then women are weak). It must also be noted that the ver/ use of the exprès-
96 TRANSGENDER EMERGENCE
sion "black-and-white" comes from a bipolar and racist paradigm that as-
sumes black and white to be opposites, not variations. Il assumes no gray ar-
eas at the same time that it assumes no biracial or mixed race people.
The last half of the twentieth century has seen great changes in the social
fabric of society as women, and to a lesser extent men, have broken free of
many previously prescribed roles. Although men and women have more
freedom to move within these role categories, great prohibitions against
stepping outside of them or erossing over to the other side of the binary still
exist.
Much of the shoek exhibited by the birth of an inlersexed child, the news
of a colleague's transsexua! surgery, or the announcement of a heterosexual
married friend's lesbianism is related to the belief that sex, gender, and sex-
ual orientution are unchangeable, immutable facets of human nature. Even
the gay liberation movement has fostered this belief system by building a
civil rights movement based on the idea that homosexuality is innate and un-
ehungeuble and therefore naiurul. Homosexuality becomes socially accept-
able when it is defined as inborn and intrinsic. The gay liberation movement,
which began as a movement to liberate the homosexual within everyone
(Altmun, 1971), became politicized as a civil rights struggle for un op-
pressed minority, a people defined by their inability to change. People are as
uncomfortable when a known homosexual has a relationship with someone
of the opposite sex as they are when a heterosexual person comes out, in part
because it reveals the fluidity and potentiality of sexual desire as natural to
all humans.
Assigning a sex to an intersexed infant evokes anxiety preeisely because
it highlights the arbitrary nature of sex/gender assignment und provokes the
fear that the assignment may be incorrect. Transsexuality further highlights
the arbitrary eategories of sex and gender when a "normally" sexed person
reveals ihat his or her sex/gender assignment is incorrect; the individual is
then cast in the role of an outlaw by transgressing these boundaries. Burch
(1995) suid, "Assignment of gender brings a profound sense of limitation"
(p. 292) and stepping outside of the margins that have been assigned high-
lights the limits of those boundaries.
In reality, all of the categories of sexual identity deseribed earlier have a
flexible quality (see Figure 3.4). Each exists on a continuum, which allows
for the existence of intersexed, bisexual, and transgendered/transsexual
people and a diversity of sexual and gender styles of presentation. "Gender
identity," as Bolin (1992) said, "is . . . socially mediated and dynamic rulher
than fixated und statie" (p. 13). In any eategory people can change their be-
havior, presentation, or identity and none of these categories represents an
immutable entity.
Deconstructing Sex and Gender: Thinking Outside > he Box
97
Mile SEX Fftihile
Man GEMiER U'om.vi
MiiscuUne SEX ROLE Fanimm
Heterosexual SEXUAL ORIENTATION Home
FIGURE 3.4. All components of identity are actually on a continuum. Sex, gen-
der identity, gender-role expression, and sexual orientation are not mutually
exclusive (i.e., moving in one direction does not necessarily mean that one can-
not also move in the other direction).
If these components are not a binary, then people h;ive flexibility as to
where they fit on the continuum and can exist in more tl an one place at the
same time. Intersexed people can, therefore, exist as bo h male and female
simultaneously. This means that men and women do not have to choose be-
tween traditional and stereotypically gendered traits but can be androgy-
nous, exhibiting traits of both masculinity and feminin ty simultaneously.
This means options for gender variation exist beyond tr lnssexualism as an
act of crossing over from one sex to the other, allowing ft r a variety of trans-
gendering presentations, including being bi-gendered. Soxual orientation is
therefore not "either/or," but allows for bisexual identity as well as Hexible
sexual expression throughout the life span.
98 TRANSGENDER EMERGENCE
Fluidity of sex and gender does not mean thai any of these components of
identity ean (or should) be altered from the outside—e.g., gay people should
not be "made" into heterosexuals, transsexuals should not be "made" into
nontranssexuals, men should not be encouraged to be more virile, nor
should women be encouraged to be more ladylike. Nor does it mean that one
ean simply change by an act of will. However, it does appear that these com-
ponents can, and do. change for many people. Heterosexuals come-out gay
and bisexual, lesbians and gay men ean fall in love with someone of the op-
posite sex, and men and women can, and have, ehanged their sex assignment
to one more congruent for them. Clearly there is fluidity in sexual and gen-
der identity. This fluidity should not be interpreted, however, to infer that
outside social forces should attempt to manipulate the sexual or gender
identities of people or to minimize the oppression faced by people within
certain social categories. The mutability of the component parts of sexual
identity can, however, eneourage society to broaden its acceptance of di-
verse experiences of gender and sexual expression.
The Assumption of Biological Determinism
The sex/gender system outlined earlier is presumed to develop naturally,
one component part from the other, as if one was a natural outgrowth of the
other. Like ihe Russian folk art of mairushka (nesting dolls), each compo-
nent of identity is assumed to be seeured within the one before it, creating a
structure that is both developmental and sequential, determined by natal
sex. It is not simply that mule and female is a binary system but that "man-
hood" is an assumed subset of maleness, a natural outgrowth of maleness as
it were. Masculinity is then an assumed eomponent of manhood and how
manhood is expressed. Each matrushka doll when opened has within it a
masculine male man, who is of course heterosexual and attraeted to his
complementary opposite—^a female who expresses womanhood through
her femininity. This creates a perfect heterosexual matched unit (see Fig-
ure 3.3).
The entire discussion regarding sex and gender is, as Butler (1990) sug-
gested, "always set within the terms of a hégémonie cultural diseourse pred-
ieated on binary structures that appear as the language of universal rational-
ity" (p. 13). To even begin to question the validity and universality of these
eoncepts makes one appear irrational. To think outside ol' the box is to step
outside of the agreed-upon and known universe. Whittig ( 1982), plaeed the
known universe into a political perspective when she said, "Masculine/
feminine, male/female are the categories whieh serve to coneeal the faet that
Deconstructing Sex and Gender: Thinking Outside. he Box 99
differences always belong to an économie, politieal, ideological or-
der" (p. 64).
Nowhere is this clearer than examming the discomfoi most people have
regiu^ding intersexual i ly, which blurs ihe distinction betwten male and female
and consequently heter(V and homosexuality. As Fausto-Steriing ( 1993) said.
Hermaphrodites have unruly bodies. They do net fall into a binary
classificafion system . . . inasmuch as hermaphrodites literally em-
body boih sexes, they challenge traditional beliefs about sexual differ-
ence: they possess the irritating ability to sometimes live as one sex
and sometimes the other, and they raise the specter of homosexuality,
(p. 24)
The current social discourse regarding intersexed pecple challenges our
very notions of a binary system of sexual orientation and desire.
Transgenderism also forces people to step outside of ihe bipolar division
of male and female and potentially allows not just another option, i.e.,
transitioning from the sex of birth to the gender of experience, but innumer-
able options for how one defines, experiences, and expn sses his or lier own
gender. In this sense, tratisgenderism is a radical term that tears down one of
the great sacred cows of our time; The division of the species into male and
female. Cromwell (1999) said thai "transpeople . . . mix liodies and genders,
have intermediate genders and obfuscate the Westem view ol two and only
two genders" (p. 99). Transsexualily specifically challenges our way of
thinking because "transsexuals make explicit for us th; usually tacit pro-
cesses of gender attribution" (Shapiro, 1991. p. 257) and shows us not just
how transsexuals acquire a new gender, but how we all create the genders
we express.
TTic assumption of a binary, immutable developments 1 sequencing of sex
and gender not only restricts what we know but. to paraphrase Goldner
(1988). actually constrains what is possible to know, in Devor's (1997a)
words, "The dominant gender schema is a matrix of rules which govern the
organization of sex, gender, and sexuality." If the linkages between male/
man/masculinity/heterosexuality are broken, ihen nume 'ous configurations
of identity, partnership, and expression are potentially birlhed.
Gendered Sexuality: The Example of Transgendered ßutches
The example of transgender butch identity will be u ,ed to illustrate the
complexity, conflation, and deconstruction of various co nponents of sexual
and gender identity. The place where transgender idenUly meets sexual ori-
entation creates a fascinating quagmire of definitions and identities within a
100 TRANSGENDER EMERGENCE
spectrum of maseuline embodiment in females. Corbett (1998) suggested
that "there may be forms of gender within homosexuality that contradict
and move beyond the conventional categories of masculinity and feminin-
ity" (p. 353). The focus here on female masculinities is to counterbalance
the historical attention on MTE literature in most major writing on trans-
genderism.
The relationship between sexual identity and gender identity is compli-
cated, partially because it has been historically linked, for example, in the
assumption that inverts were somehow both homosexual and transsexual. It
is also complex because it has been conflated within the popular di.scourse;
for example, many people believe that all effeminate males are homosexual.
Researchers argue about the development of sexual orientation and gender
identities. like the proverbial chicken-and-egg question, searching for which
"came first" (Bailey and Zucker, 1995). Eor instance. Green (1987) pro-
posed that gender identity develops first, influencing gender role and then
sexual orientation, and Isay (1987, 1989) suggested the exact opposite de-
velopmental sequence^—^that early sexual preferences affect the develop-
ment of gender role and idenUty. Nicolosi (1991) hypothesized that faulty
gender identity development in males is caused by pot)r fathering and impacts
the progression of male homosexuality. Freund and Blanehard ( 1983) ques-
tioned whether paternal distance was ihc cause or effect oi' ihc ch'úú'í^ atypi-
cal gender expression or it was the early manifestations of the child's sexual
orientation. It is possible that cross-gender identity and homoeroticism are
both manifestations of the same underlying phenomenon (perhaps prenatal
hormones or genetic underpinnings?) or that both are casually unique with
neither one impacting the other. Bailey (2003) assumes a biological origin
for femininity in males that can manifest as homosexuality or. in the ex-
treme, transsexuality. Although Bailey denies that the search for etiological
roots implies a search for a "cure." his descriptive language is seeped in sex-
ist and homophobic commentary. Seeking scientific "truths" for human sex-
ual and gender diversity often ends up emphasizing those that are more un-
usual, instead of focusing on the unique qualities of all sexual and gender
expression. The relationship between sexual orientation and gender iden-
tity, whatever its cause, remains a complex one.
Although it may be easy to mark the difference between sexual orienta-
tion and gender identity on a chart or grid—clearly "love-object choice,"
e.g.. sexual orientation, is different from internal gender identity^these
components of identity are often more difficult to separate in the lives of
people. These two separate components of human identity describe differ-
ent phenomena; however, they often overlap and their relationship can be
extremely complex. Social assumptions arc often made that gay and lesbian
people have cross-gendered identities and that people who are transgen-
Deconstructing Sex and Gender: Thinking Ouiside he Box W¡
dered or transsexuals are gay. This is intemalized by people stmggling with
sexual and/or gender identity issues. It is also true thut many people who are
gay, lesbian, or bisexual experienee confusion about their gender and many
people who are gender variant express confusion about iheir sexual orienta-
tion, In reality, gender-variant people can be homosexual, heterosexual, or
bisexual and ¡leople of all sexual orientations can be transgendered.
It is by examining the gender perlormativity and expression within the
lesbian and gay communities thut ihe mullilude of sexu; I and gender possi-
bilities become highlighted. It is iniporlant lo note that most gay men and
lesbians, despite the stereotypes, present in the expected gender role oftheir
sexed bodies. In other words, their identities as male/man/masculine (or
female/womun/feminine) follow through us sociully expected. It is their
sexual orientution that "switches" categories. When peojile say that they can
always reeognize a gay person—referred to within the I.GB community as
"gaydar"—it is commonly gender variance that they are noting. The major-
ity of LGB people are unrecognizable preeisely because their gender is pro-
foundly unremarkable.
It is also true, however, that some gay men and lesbians have always been
"gender benders." Within the gay community, feminine nales have been re-
ferred toas nellies or queens, and within the lesbian community, masculine
females have been referred to as butches or dykes. Wiihin certain subt:ul-
tures of Ihe gay and lesbian community, most notably lh)se that identify as
bulch/lemme, these identities have been an essential ard core part of self-
ideniiiy—not simply a gender-role expression but an expression of aciual
gender identity (Buranu, Roxxie, and Due, 1994; Halberstam, 1998a; Ken-
nedy and Davis, 1993; Munt, 1998; Nestle, 1992). N.;wton (2000) said,
""This masculinity, my masculinity, is not extemal; it ¡permeates and ani-
mates me. Nor is it a masquerade. In my home, when no one is present, I still
sit with my legs carelessly Hung apart" (p. 199). Furthermore she suid.
"This gay gender, butch, makes my body recognizable and it alone makes
sexual love possible" (p. 197).
The early sexologists were correct in identifying "inverts" as both trans-
vestites and homosexuals, although they were wrong to assume that this was
the only form in which homosexuality, or transvestism fur that matter, could
express itself Halberstum (1998a) said.
Inversion as a theory of homosexuality folded gimder variance and
sexual preference into one eeonomical package and attempted to ex-
plain all deviant behavior in lerms of a firm and air lost intuitive belief
in a binary syslem of sexual stratification in which the stability of the
terms "male" and "female" depended on the stability of the homosex-
ual-heterosexual binary, (p. 82)
102
TRANSGENDER EMERGENCE
Cross-gendered identity—masculinity in females or femininity in males—
can have many different meanings and experiences and cannot easily be
judged on the outside without understanding phenomenologically the expe-
riences of the person. Halberstam ( 1998a) said.
There are many histories of bodies that escape and elude medical tax-
onomies, or bodies that never present themselves to the physician's
gaze, or subjects who identify within categories that emerge as a con-
sequence of sexual communities and not in relation to medical or
psychosexual research, (p. 161)
Homosexual relationships are often referred to as same sex, signifying
the importance of the genitalia of the partners, as well as the similarity of so-
cial roles for women-loving women (see Figure 3.5). However, same sex is
not the same as same gender. Lesbian couples who identify as butch/femme
are often experiencing a same-sex relationship (i.e., they are both females).
Lesbian
Female
Female
Woman
¡Ionian
Feminine
Feminine
Lesbian
Lesbiati
FIGURE 3.5. Attracted to same sex and same gender.
Deconstructing Sex and Gender: Thinking Outside i he Bo.x
103
and yet an opposite gender relationship (i.e., they relate in a more man/
woman, or masculine/feminine paradigm within female bodies) (see Fig-
ure 3.6). Inness and Lloyd (1996) identified four salient aspects of butch
identity; she is a masculine woman (though "female" mi ihl be a better word
here); she is like a man (but she is not one); she adopts an active sexual role;
and/or desires femmes. Inness and Lloyd try to uncouple the association of
biilch with attraction to femmes, describing other partner choices and erotic
attractions open to butches. It is also true that not all butihes adopt an active
sexual role. "Butch" is, to use Rubin's (1992) words, "a category of lesbian
gender. . . lesbian vernacular... for women who are mo'-e comfortable with
masculine gender eodes. styles, or identities" (p. 467).
Halberstam ( 1998a) said, "Female maseulinity is not iimply the opposite
of female femininity, nor is it a female version of male maseulinity" (p. 29),
and attempts to define "what" it is are just beginning. "Butch lesbians." said
Cromwell (1999), "have masculine gender identities, but unlike FTMs and
transmen, they do not identify as men" (p. 27).
Lesbian—Butch/Femme
Female
r
etnale
•9
Wotr.an
MascuHrtf
Butch
FIGURE 3.6. Attracted to same sex and opposite (lender role.
/ ()4 TRANSGENDER EMERCENCE
Rather than a binary of butch lesbians on one side and FTM/transmen on
the other, it is best to see masculine expression as spectrum of behavior and
expression involving gender and sexual orientation. Some female-bodied
masculine people do not identify as either transsexual or butch lesbians but
see themselves as transgendered butches—a category that links the gender
identity descriptions of the transsexual paradigm with the historical con-
sciousness of lesbian-butch/femme role dynamics. They express their gen-
der role in typically masculine ways and (to borrow from the masthead of
the American Boyz [n.d.] organization) "were labeled female at birth but
. . . feel that is not an accurate or complete description of who they are."
Transgendered butches may experience their bodies, sexuality, desires,
and identity in many different ways. Some transgendered butches modify
their bodies with hormones and/or surgeries and appear as males in public.
Others use clothing, hairstyles, and how they move their bodies to connote
masculinity. For some, their gender identity is congruent wilh a female
body. Others experience dysphoria in their gender identity. Some trans-
gendered butches identify as lesbian, since they prefer female partners, and
others do not see themselves as lesbian because lesbian implies a "woman-
to-woman" sexuality, and they do not see themselves as women. Since many
have previously identified as lesbians, and are often partnered with women
who still do identify as lesbians, they may have strong links to the lesbian
community although they do not currently identify as either women or les-
bians. Devor ( 1997a,b) noted that FTMs have often tried to fit themselves
inlo the available social roles, and therefore many identified as lesbians
since they were female-bodied and lovers wilh women, even though the fit
was always awkward. Still other iransgendered butches do not see them-
selves as lesbians because they are not sexually interested in olher females.
They may identify as gay men, although they are technically female bodied.
Eyler and Wright ( 1997) developed a nine-point gender scale ihat identi-
fies a continuum of gender identiflcation for genetic female.s with gender-
blended self-perception. Although it is tempting to describe this as a contin-
uum with butch lesbian on one end and female-to-male transsexual on the
other (Halberstam, 1998a,b). there are butch lesbians with a strong male
identification and transmen who still maintain a sense of themselves as
female/woman or lesbian. As Halberstam ( 1998b) said, "There are many
butches. . . [who] pass as men and many transsexuals who present as gender
ambiguous, and many bodies that cannot be classified by the options of
transsexual and bulch" (p. 153). Halberstam wamed the reader to avoid cre-
ating a "masculine continuum" that assumes butch to be less masculine—or
less dysphoric—than transsexual. She said that "gender dysphoria |is not
thel exclusive property of transsexual bodies" (Halberstam, 1998a. p. 151)
and that more gender dysphoria does not necessarily create a more transsex-
Deconstructing Sex and Gender: Thinking Ouulde 'lie Bo.x ¡05
uai identification. Hale (1998) suggested that some butehes "might have
richer, more solid male or masculine self-identilications than do some
ll-TMs]" (p. 322) and Bolus (n.d.) said, "FTM identity is not simply the
endpoint on the continuum of butch masculinity."
The line where butch/woman identity ends and trans/ nan identity begins
is a territory still being mapped and the heated debate over identity bound-
aries has been called the "butch/FTM border war." Both FTMs and butches
deploy "male signifiers, clothes, hair, mannerisms, and body movements"
hut they do so with "different motives" within "two différent interpretative
frames" (Rubin, 1996, p. 194). Rubin explained that "FTMs are men and
lesbians are not. no matter how butch they are" (p. 98). He further said that
because these borders are "still under construction," whi:n "lesbians and fe-
maie-to-male transsexuals confront one another they distinguish them-
selves from the other through a process of disidentifica ion" (p. 981. Some
FTMs have rejected their lesbian pasts, which they have come to see as a
"mistaken identity" (Halherstam, 1998a, p. 150). For th ise who clearly ex-
perience themselves as transsexual, or as lesbian butches. this process of
disidentification is paramount. However, for many transçendered butches it
is not so easy to separate these parts of self within their own bodies.
A female couple—one partner appearing masculiw (butch) identified
and the other appearing more traditionally female—may identify as a les-
bian couple, a butch/femme couple, ora heterosextial ccuple, depending on
how gender and sexuality are defmed hy the couple themselves (see Fig-
ure 3.7). Living as a transgendered butch may involve a fluidity of shifting
identities in which one passes in the world as a man. bui identifies as trans-
gendered among close friends, and yet still sees a gyne^jologist for routine
checkups for his female anatomy. Devor referred to this as "gendered sexu-
ality" ( I997h) and explained how one can talk "with ac:uracy and without
contradiction" about a relationship that is homosexual fiom the perspective
of biology yet straight from the perspective of lived identities and social/
sexual relationships (pp. xxv-xxvi). Pauly (1998) referrtd to this as the dif-
ference between those who are "homogenderal" and tho;e who are "hetero-
genderal"—which privileges the importance of gender identity over the
genitalia. Pauly (1992) also said that "the important variable is not the ge-
netics of the relationship, but the gender status of two p micipants" (p. 7).
Of course, gender transitions do not take place in isolation but often im-
pact significant others and their relalionship to their ovn sexual identity.
This is illustrated by a conversation that took place betwt en a transgendered
butch-identified "guy" who worked and passed in a traditional male job. He
was in a long-term partnership that had been lesbian identified before he de-
eided to transition, had chest surgery, and began hormone treatment. One
day a co-worker asked him a question about his "wifi:." He told his co-
706 TRANSGENDER EMERGENCE
Tran s gendered Butch and Femme
Female —>
Male
Female
Butch
Woman
Masculine Feminine
Transman
Heterosexual
Queer
Femme
FIGURE 3.7. Attracted to opposite sex and opposite gender role.
worker that he was not legally married and was then asked, "Why not"? Af-
ter stammering for u minute, struggling lo explain his unique situation with-
out revealing himself, he said, "Well, because she's a lesbian." Of course,
the co-worker had no idea that the guy had lived most of his life as a "lesbian
woman" and still had female genitalia underneath his male appearance. The
co-worker was justifiably confused about why a man would partner with a
lesbian, although the truth might have confused him even more. The
transgendered butch had not changed his sexual orientation (i.e.. his sexual
desire for women remained const ant ) ^t was his "wife's" sexual identity
thut was chullenged by his transition. How could his wife retain her identity
as u '"lesbian" when she was partnered with a person who looked like and
passed as a "man" in the outside world? .
Deconstructing Sex and Gender: Thinking Outside ¡he Box ¡07
The subject of female masculinity—from butch iesbians and female
cross-dressers to fully transitioned female transsexuals or transmen)—has
been historically invisible. Jamison Green (1998) wrote an overview of the
history and current experience of female-to-male transsexuals and other
female-bodied men and examined the segment of the FTM world that has
historical roots in the lesbian-butchpuradigm, as well as many other "types"
of transmen and masculine females. He is committed to .-reating a space for
"men with female histories" (Green, 2001, p. 62). Gary Bowen (2001, per-
sonal communication) said, "When I invented the term ' ransman' I deliber-
ately did it to provide a new transsexual term and identity. It was my first at-
tempt to find a word for myself without the buggagt of pathology and
racism."
Gayle Rubin (1992) said, "Although important discontinuities sepaiate
lesbian butch experience and female-to-male experienct, there are also sig-
niiicant points of connection . . . the boundaries bet wet n the categories of
butch and transsexual are permeable" (p. 473). Some transgendered butches
enjoy the fluidity of shifting gender identities, and others Imd this shifting
deeply problematic. Each transgendered butch identifies somewhat differ-
ently. Many do not see themselves as women, most do not see themselves as
men, and others see themselves as both men and women preferring to iden-
tify as bi-gendered or "other" gendered—essentially, a third sex. Triinsgen-
dered butch, butch lesbian, stone butch, transman (IVniale transsexual),
female man, atid mandyke are words that attempt to define different experi-
ences for masculinity in females.
Coming to gender congruence in the botdertands can be a complicated
process. Dealing with ihis overlap of sexual and gender identities makes it
difficult for clinicians, as well as the people embodying these complex iden-
tities, to sort out the meanings and develop a sense of congruenee of iden-
tity. For those on the outside—e.g., psychotherapists—i[ may be especially
difficult to sort out the gender expressions and meaning for masculine fe-
males presenting with gender dysphoria. Is a client with a lesbian past who
is struggling with issues related to gender eoming ojt as butch, trans-
gendered, or transsexual? How does she or he redéfinit intimate relation-
ships, comprehend heror/i/i history, or define identity. Halberstam ( 1998a)
said the issue of border wars assumes that "masculinity is a limited re-
source" (p. 144). Perhaps for those born female it has bien.
It is not difficult to understand how sexual and gendei identity can easily
become conflated within the public's eye. Indeed much of the gay rights
movement's fœus of the past few decades has been to dispel mistoncep-
tions that gay people have cross-gender behavior. By and large, ihis has
been successful. When professionals are queried during raining sessions as
to whether gay men are more "effeminate" than straight men, they immedi-
70S TRANSGENDER EMERGENCE
ately denounce that as a stereotype. However, when challenged about this
position, and having determined that it is safe to ask difficult questions, pro-
fessionals will often admit, "Yes, it diws seem that many gay men are more
effeminate that most heterosexual men. Why is that?"
Obviously, the answer to that question is not simple, but it is trtte that
gender inversion has always been one aspect of the gay community. Al-
though most gay men express and present their gender in a normative
male/man/masculine manner and are therefore invisible as gay men. many
gay men have gender role expressions that are feminine, and perhaps some
have cross-gendered identities. Some cross-gender behavior has served as
an entertainment element of the gay community (e.g., drag queens, female
impersonators) and other cross-gender presentations have served as a way
for cross-gendered individuals to recognize one another in what has been a
hostile world. Wearing more feminine colors, wearing an earring, or ex-
pressing traditionally feminine mannerisms has served as "in-group" recog-
nition. Gay men jokingly refer to one another as "Mary" or "Blanehe," and
idolize and imitate glamorous female movie stars such as Bette Davis.
Green's (1987) longitudinal study of young "'sissy" boys showed that many
of these boys grow up to be gay, raising questions about the relationship of
sexual and gender identities in early childhood development, including bio-
logical underpinnings.
Just as the gay community has denied cross-gender behavior in trying to
gain soeial respect, many transgendered and transsexual people have iried to
distanee themselves from any association with the gay eommunity. Some of
this is, of course, simply homophobia, but it is also an attempt to separate
whal is actually an issue related to gender rather than sexual desire. In olher
words, a transsexual may appear to be homosexual, beeause they are in a
same-sex relationship (pretransifion). but they experienee themselves in an
opposite-sex relationship and are therefore heterosexual. The clinical com-
munity has continued to eonfuse this already-complex issue by insisting on
ufilizing nomenclature that refers to transsexuals as "homosexual" and "het-
erosexual," basing people's sexual identity on their natal sex, not their cho-
sen gender.
Boekting and Coleman (1992) suggest that eaeh component of sex identity
should be assessed separately. The difficulty in this is that each component of
identity interacts with other components of identity, creating endless possibil-
ities for expression, and has been limited only by historical social and politi-
cal parameters. "Gender," as Mitchell (2(X)0) suggested, "is constnicted
within a relational context" (p. 233). Every descriptor and experience of gen-
der or sexuality is seen through the lens of what is thought possible. Butler
(1990) said, "If sexuality is eulturally constructed within existing power rela-
tions, then the postulation of a normative sexuality that is 'before,' or "out-
Deconstructing Sex and Gender: Thinking Outside he ßo.v 109
side,' or 'beyond' power is a eultural impossibility" (p. 4(1). It is very diflleult
to be something that has no name: naming calls identity into being. When the
only names available that describe one's experience are ;iss(x:iated wilh per-
version, it can create a dissonance with one's own emboiliment.
At the beginning of the twenty-first century, multipU expressions of sex
and gender are better understood and the possibility exists for creating a so-
ciety Ihat accurately reflects the diversity of humankind. The understanding
of Ihese four separate components of identity that overlap and impact one
another highlights the need to "dismantle not only andrecentricism and bio-
logical essentialism, but also gender polarization and i ompulsory hetero-
sexuality" (Bem, 1993). Rubin (1984) critiqued her cwn analysis of the
sex/gender system and noted that it is nol enough to see sex and gender op-
pression ihough a lens of feminist thought, but to understand that the sexual
system takes place in the eontext of gender expectations and assumptions of
sexual normativily. For example, she said thai lesbians are nol merely op-
pressed as women, but also "as queers and perverts" (p. 308). It is not only
Iheir biological sex status, or their social gender that is ceemcd inferior, but
also their sexual desire.
When sex is nol assumed to be dimorphic, it allows for the existence ol'
intersexed people. When gender is not an assumed matter of binary opposites,
it allows for transsexual, androgynous, bi-gendered, hutch, nelly, cross-
dressing, and transgender identities. When sexual orienta ion is not limited to
two choices, bisexuals are given social freedom and homosexuals and hetero-
sexuals are allowed Huidity throughout their lifetimes. Some people fear ihal
if society allows diverse gender expression and variant seuialilies to prolifer-
ate then people will easily discard genders at will, freely engage in sex-
change surgeries, and the institution of marriage will lost its scared and eco-
nomic value. Halberstam (1998a) disagreed with those concems. She said
transgender discourse "asks only thai we recognize the nonmale and non-
lcmale genders already in circulation and presently under construction"
(p. 162). Bem (1995) took this one step further and sujigested that instead
oi eliminating the gender-polari/ing lens of Western sj stems, perhaps we
should "begin madly and exuberantly to proliferate ourselves inlo as many
categories of sex/gender/dcsire as we seem to need" (p. r-33).
Mental health providers—social workers, psycholoiiists, and counsel-
o r s ^ have a powerful role to play in reexamining what has been considered
normative regarding sex and gender identities. Fausto-Sterling (1993) re-
minded us thai, "Scientific and medical understandings of multiple human
sexes bring with them both the means to disrupt and ih: tools to reinforce
dominant beliefs aboul sex and gender" (p. 77). It is a ¡livotal lime for to-
day's clinicians to decide whether to be social control agents or harbingers
of socia! change and social justice.

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