Homosexuality

Gender Dysphoria Diagnosis (Part 3): Childhood Gender Non-Conformity

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————
Part 1: GIDYQ-AA Personal Reflection
Part 2: Psychological Benefits of Diagnostic Confirmation 
~ Part 3 in the Gender Dysphoria Diagnosis series ~
Part 4: DSM and ICD Diagnostic Criteria 
Part 5: GIDYQ-AA Full Text
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Jantina Cow

That’s me. A child dressed in baggy boy’s clothes, peeking out from underneath shaggy bangs – hair longer than she wanted but parentally forbidden from getting it cut – playing with her heifer calf named John. A child who knew she was a girl but desperately wanted to be a boy instead.

In a previous post, I discussed my overwhelming doubts about whether or not I truly have gender dysphoria given how atypical my experience seems to be in comparison to the more commonly portrayed trans narratives and the established diagnostic criteria. My experience since puberty has been predominantly characterized by intense physical dysphoria regarding female body characteristics, in the absence of any cognitive gender identity. So I didn’t consider myself “transgender” and I didn’t even know that gender dysphoria (formerly called gender identity disorder) was an established phenomenon or that transition options existed until two years ago – I just thought I had a very unusual and very severe body image disturbance. I have also previously described the powerful relief and peace I felt after having the gender dysphoria diagnosis confirmed by a specialist.

But despite the relief, acceptance, and confidence that followed after receiving expert confirmation of gender dysphoria, I found that after a couple of months those familiar doubts started creeping back in. Contributing to this resurgence of doubt was my ongoing difficulty understanding the significance of my childhood gender experience with respect to my current adult gender experience. Throughout my exploration of the trans community and investigation of transition options over the past two years, I have never been sure to what extent my obvious childhood gender non-conformity (obvious in memory and in family photos) and my distinct childhood desire to be a boy would necessarily add support to an adulthood diagnosis of gender dysphoria. I kept asking myself: how relevant is my childhood gender non-conformity?

Jantina Dress

That’s me too. A child posing awkwardly in a dress, a child forced into that dress by her rigidly insistent mother, a child hating that dress with a feisty little rage because dresses are impractical and frivolous garments, a girl who wanted to be a boy and resented being forced into a conventional girl’s uniform, but pulling off an admirably convincing smile to please her father holding the camera.

Typical trans narratives on personal blogs and from high-profile trans advocates usually emphasize that they “knew” they were the “opposite” gender since they were extremely young.

“As a child I knew everyone was telling me that I was a boy but I felt like a girl.” – Laverne Cox 

“Ever since I could form coherent thoughts, I knew I was a girl trapped inside a boy’s body. There was never any confusion in my mind.” – Jazz Jennings

“For me, I tend to refer to my childhood as one of a transgender child. When I was four and began asserting myself as the girl I knew myself to be… all I knew was that my internal sense of gender, what spoke to my soul, did not align with my body. But my prepubescent body had not grown into this battle I had to fight against.” – Janet Mock

“As far back as four or five I felt like a boy and wished I was a boy.” – Chaz Bono

“My earliest memories were that of wanting to be a girl even before I learned to spell.” – Jade Starr

Most trans people seem to interpret early childhood behaviors and preferences that align with opposite-sex stereotypes as incontrovertible evidence of their gender dysphoria. But research suggests that childhood gender non-conformity is relatively common. “Surveys report that 2-5% of children aged up to seven, as reported by their parents, ‘behaves like opposite sex’ and 1-2% ‘wishes to be of opposite sex.'” (Kaltiala-Heino 2015) And among these gender non-conforming children, only a small minority (ranging from 2-37% in various studies) will retain gender dysphoric feelings into adolescence (Kaltiala-Heino 2015, Smith 2014, Steensma 2013, Wallien 2008). “The evolution of a gender nonconforming child is unpredictable, and it is therefore impossible to determine whether the condition will persist into adolescence or adulthood.” (Meriggiola 2015)

And of course, assessment of whether a child’s behavior is “gender non-conforming” is based on a troubling frame of reference: cultural gender stereotypes and the sexist attitudes associated with deviation from those stereotypes. “Cultural issues likely play a major role in whether a child’s behavior is perceived as gender atypical. Consultations due to gender identity are generally more often sought for boys than girls, which may suggest greater gender variation in boys, but also that effeminate behaviors in boys are perceived as more of a problem than tom-boyishness in girls… that natal boys were more commonly bullied because of gender presentation suggests that effeminate characteristics in boys are less tolerated than masculine self-presentation in girls.” (Kaltiala-Heino 2015)

Research also shows that childhood gender non-conformity is more often associated with adolescent and adult non-heterosexual sexual orientations than with gender dysphoria and transgender identity. “Another issue regarding the psychosexual outcome of children with gender identity disorder is the relation between the child’s gender atypicality and sexual orientation in adulthood. Early prospective follow-up studies indicated that a high rate (60-100%) of children (mostly boys) with gender dysphoria had a homosexual or bisexual sexual orientation in adolescence or adulthood and no longer experienced gender-dysphoric feelings… in accordance with retrospective studies among adult homosexuals, who recalled more childhood cross-gender behavior than heterosexuals. Adult individuals with childhood gender dysphoria are thus much more likely to have a nonheterosexual sexual orientation than a heterosexual sexual orientation.” (Wallien 2008)

In light of that information, I have always been uncomfortable with the strong emphasis that many trans people place on their childhood gender non-conformity. It left me feeling very unsure about how to integrate my own childhood experience into my current perspective regarding a diagnosis of gender dysphoria. And their emphasis also makes me deeply uncomfortable because it perpetuates the idea to the general public (who likely don’t know the statistics regarding low rates of persistence of childhood gender dysphoria into adolescence but who seem to have an exaggerated perception of the association between childhood gender non-conformity and future homosexuality) that childhood cross-sex behavior means their kid is trans or gay. These ideas potentially lead to inappropriate suppression of that behavior by the parents (if parents are homophobic or transphobic and believe they can prevent their kid “becoming” trans or gay). “There is evidence that some clinicians and parents have offered or requested treatment for children with gender identity disorder, in part, to prevent the development of homosexuality.” (Davy 2015) Or these ideas may lead to premature medical or psychological intervention (if parents are supportive of their child’s cross-gender interests but perhaps somewhat misguided and overenthusiastic in pursuing early transition). And clinical experience suggests that it is often the parents’ concern about their child’s gender non-conformity that leads to psychological assessment, rather than the child’s own distress about their gender non-conformity. “Parents of children with gender identity disorder are often ‘unable to cope’ with gender uncertainty… parents most often bring their children to clinical attention… in these cases, it is the parents whose children do not adhere to normative expectations of gender performance who experience ‘distress’.” (Hird 2003) I felt so confused and conflicted about all of this, and I have therefore intentionally avoided discussing my childhood gender experience in any great detail on my blog until now.

Laverne Cox has spoken out about the psychological advantages of puberty suppression in adolescents with gender dysphoria, a procedure which scientific evidence strongly supports as having substantial therapeutic benefit and which allows for more satisfying physical transition outcomes (Smith 2014, Kaltiala-Heino 2015, Meriggiola 2015). But Laverne Cox also promotes transitioning in early childhood, “With transition, the earlier the better. I think if your child knows that they are transgender – and we usually know – then it is life-saving.” I think that is an extremely irresponsible statement for an influential transgender advocate to make, given the existing evidence about the unpredictable psychosexual outcomes in gender non-conforming children.“Medical interventions are not warranted in pre-pubertal children.” (Kaltiala-Heino 2015) Research about the management of gender dysphoria in children recommends a supportive but cautious monitoring approach, with further assessment and consideration of puberty suppression if gender dysphoria does in fact persist past the onset of puberty. “The percentage of transitioned children is increasing and seems to exceed the percentages known from prior literature for the persistence of gender dysphoria, which could result in a larger proportion of children who have to change back to their original gender role, because of desisting gender dysphoria, accompanied with a possible struggle… the clinical management of children with gender dysphoria in general should not be aimed to block gender-variant behaviors.” (Steensma 2013)

To summarize the results of numerous studies: childhood gender dysphoria seems to be associated with an increased likelihood of future homosexual or bisexual orientation, and childhood gender dysphoria may or may not (and usually does not) persist into adolescence. “In clinical practice, gender-dysphoric children and their parents should be made aware of [these outcomes] and, if this would create problems, be adequately counseled.” (Wallien 2008) But of course, childhood “gender non-conformity” may simply represent the beautiful freedom and remarkable creativity inherent in children’s innocent pastimes viewed through an adult lens of social gender stereotypes. Childhood “gender non-conforming” behavior may also be a vital process in the development of their individual identity, not something that requires any parental intervention whatsoever. Let them be kids. Let them figure out for themselves who they are. “It is with seasoned modesty that we emphasize, to different degrees, the changeability of children during growth and development… what children desire of themselves as children is rarely what satisfies them as adults.” (Reiner 2011)

Revisiting the scientific literature on these topics has also had substantial personal relevance, allowing me to reframe my own childhood and adolescent experiences in a way that gives me more confidence in a current diagnosis of gender dysphoria and gives me a deeper understanding of assorted fragments of my increasingly coalescent story.

Knowledge of the factors associated with persistence versus desistance of childhood gender dysphoria into adolescence is limited (Steensma 2013). However, from this limited research, it has been demonstrated repeatedly that one of the most important factors associated with higher rates of persistence of gender dysphoria from childhood into adolescence is the intensity of childhood gender non-conformity or cross-sex identification. “Presentation [of gender dysphoria] is heterogeneous in childhood, with some children exhibiting extreme gender non-conforming behaviors accompanied by severe discomfort and other children showing less intense characteristics. Not all adolescents with gender dysphoria experience symptoms in early childhood, but those who do often present with more extreme gender non-conformity.” (Smith 2014) “Taken together, the prior research suggests that persistence of childhood gender dysphoria is most closely linked to the intensity of the gender dysphoria in childhood and the amount of gender-variant behavior.” (Steensma 2013) My childhood gender non-conformity WAS extremely intense, with a very strong and persistent desire to “be a boy” (in the context of a childish understanding of gender and a naive perception of masculine and feminine stereotypes) and drastic efforts (within a child’s limited scope of control) to create a boyish physical appearance through choice of clothing and hairstyle. The above research lends major relevance to the intensity of my childhood gender dysphoria, rather than the mere presence of it. Which adds diagnostic value to that aspect of my own story, and also allows me to understand the significance of my childhood experience without perpetuating the troublesome misconceptions about childhood gender non-conformity that I described above.

In terms of persistence of childhood gender dysphoria into adolescence, I now understand the significance of my own response to the physical changes accompanying puberty. “Gender dysphoria which intensifies with the onset of puberty usually persists… At puberty, the development of secondary sexual characteristics can lead to increased distress, sometimes leading to severe extremes such as depression, anxiety, self-harm, suicidal tendencies, substance abuse, and high-risk sexual behaviour. Reactions to early pubertal changes have a high diagnostic value.” (Meriggiola 2015) Several other studies also reinforce the “high diagnostic value” of teenagers’ response to development of secondary sexual characteristics in early puberty (Smith 2014, Steensma 2013, Wallien 2008). In contrast to cognitive gender identity (which I suppose I would have described as “wishing to be a boy” when I was a child, but which seemed to fade away at the onset of puberty), my physical dysphoria increased dramatically in response to early pubertal changes. I was so intensely distressed by my budding breasts and broadening hips and my first few periods, that I immediately initiated a regime of strict dietary restriction and excessive exercise to starve away all traces of physical femaleness. These behaviors quickly progressed to full-blown anorexia nervosa, which persisted for the next six years. In retrospect, this experience now has high diagnostic value and is strongly consistent with gender dysphoria.

Not only do reactions to early pubertal changes have “high diagnostic value”, there is also diagnostic value associated with the response to puberty suppression. “Treatment with a GnRH analog [puberty suppression] is thought to be a diagnostic aid as well as a therapeutic intervention for this age group because stopping the progression of the physical changes of puberty would be expected to partially alleviate gender dysphoria symptoms in true gender dysphoria. The first prospective study of psychological outcomes in adolescents… showed a statistically significant improvement in behavior, emotional problems, and general functioning after puberty suppression.” (Smith 2014) I experienced intensified body aversion at the onset of puberty, but through extreme and prolonged starvation I basically created my own puberty suppression protocol (which ideally should have been achieved with appropriate drugs under medical supervision but I wasn’t aware of those options at the time so I did what I could on my own to suppress my confusing physical dysphoria). Anorexia virtually halted further pubertal development: the drastic weight loss induced amenorrhea which lasted from age 13 to 19 and prevented any further increase in chest and hip size, so that I floated through my teenage years in a rail-thin, nearly pre-pubescent, and highly androgynous body. During those years, my eating disorder was its own source of distress (food-related thoughts were incessant and abnormal eating behaviors were pronounced). But that all seemed such a small price to pay to achieve a tenuous and provisional satisfaction and comfort with a less feminine body, a “partial alleviation of gender dysphoria” secondary to “stopping the progression of the physical changes of puberty”. Which aligns precisely with the description in the above study. Once again, this evidence provides very definitive support for a true diagnosis of gender dysphoria in my case.

When I was 19, I experienced my first episode of major depression and I gained nearly 100lbs over a nine-month span. Menstruation resumed, acne worsened, my chest and hips increased in size, and my body basically went through normal puberty after a six-year starvation-induced delay. Following the weight gain and further pubertal development at 19 years old, my body became more feminine and my physical dysphoria escalated to a previously unprecedented intensity, to the point that I could no longer tolerate the sight of myself and began avoiding mirrors and showering in the dark. Moving uncomfortably through the next five years in a much heavier and more feminized body, I would often reflect on my androgynous teenage thinness with an excruciating sense of loss tainting all of those fond memories, a desperate feeling of hopelessness of ever regaining such a genderless and comfortable body. Only in the past year, after having lost some of the weight that I gained six years ago and developing a much more rigorous weightlifting routine to increase my upper body muscle mass, have I been able to create a more satisfying and comfortably androgynous appearance without depending on a dangerously low body weight. So now, when I reflect on my teenage body, those memories are no longer pained by desperation and loss. Instead, those memories have become just one more part of my story that now makes sense. I have finally let go of those last remnants of doubt: I DO have gender dysphoria. Atypical gender dysphoria, sure. But “atypical” tends to be my typical way of life.

Jantina Rope Ladder

That’s me. A skinny teenager sweating in the heat of August summer, her smile genuine this time from the satisfaction of building a rope ladder from sawed-off poplar branches to scale the walls of a hay bale fortress. I can still feel the comforting looseness of those tattered jeans around my narrow hips. I can feel the freedom and lightness and vitality in that slender androgynous body. It is only the slightest rise of my pectoral topography through the kid-sized purple T-shirt that hints at the biological truth I tried to deny.

Jantina Dirtbike

That’s me. A scrawny kid taking her first solo ride on her brother’s dirtbike, a little wobbly and a little cautious and a lot exhilarated. I can still feel the weight of my brother’s heavy boots on my feet, still feel the wind snatching my breath away as I tossed caution aside and revved up into top speed, still remember how alive I felt in that slim boyish body.

Jantina Peter Pan

And that’s me too. A lean little nymph leaping so lightly across the scattered hay bales, her favorite green Peter Pan sweater billowing around her weightless self. In the moment before the jump, I felt like I could fly, I felt alive inside my body, and I trusted my body to do what I wanted it to do. So all the muscles in my legs contracted, my feet pushed down hard against the hay, and then, recklessly, I tossed my stick-thin Peter Pan body up… and up… and up… towards a genderless Neverland in the dusky evening sky.

“Lastly, she pictured to herself… how she would keep, through all her riper years, the simple and loving heart of her childhood; and how she would gather about her other little children, and make their eyes bright and eager with many a Wonderland of long ago; and how she would feel with all their simple sorrows, and find a pleasure in all their simple joys, remembering her own child-life, and the happy summer days.”
– Lewis Carroll (Alice’s Adventures in Wonderland, 1865)

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References

Davy Z. The DSM-5 and the politics of diagnosing transpeople. 2015. Archives of Sexual Behavior 44(5): 1165-76. 

Hird MJ. A typical gender identity conference? Some disturbing reports from the therapeutic front lines. 2003. Feminism and Psychology, 13: 181–199. 

Kaltiala-Heino R, Sumia M, Työläjärvi M, et al. Two years of gender identity service for minors: overrepresentation of natal girls with severe problems in adolescent development. 2015. Child Adolescent Psychiatry and Mental Health 9: 1-9. 

Meriggiola MC, Gava G. Endocrine care of transpeople part I. A review of cross-sex hormonal treatments, outcomes and adverse effects in transmen. 2015. Clinical Endocrinology 83(5): 597-606.

Reiner WG, Townsend Reiner D. Thoughts on the nature of identity: disorders of sex development and gender identity. 2011. Child and Adolescent Psychiatric Clinics of North America 20(4): 627-38. 

Smith KP, Madison CM, Milne NM. Gonadal suppressive and cross-sex hormone therapy for gender dysphoria in adolescents and adults. 2014. Pharmacotherapy 34(12): 1282-97. 

Steensma TD, McGuire JK, Kreukels BP, et al. Factors associated with desistence and persistence of childhood gender dysphoria: a quantitative follow-up study. 2013. Journal of the American Academy of Child and Adolescent Psychiatry 52(6): 582-90. 

Wallien MS, Cohen-Kettenis PT. Psychosexual outcome of gender-dysphoric children. 2008. Journal of the American Academy of Child and Adolescent Psychiatry 47(12): 1413-23. 

Not Applicable

/ TomCat / Leave a comment

Not Applicable

A friend sent me that photo of an intake form for a youth program. The list of check-box options in the gender section is highlighted, and the form also provides space for chosen name and preferred pronouns. Compared to so many of the forms and surveys that I fill out on a regular basis, the form in that photo shows an impressive list of gender options – far more inclusive than the standard “M” or “F”, and much more specific in the options offered than even the more ambitious forms that provide “other” in addition to the lonely M and and rigid F.

Some online arenas offer even more inclusive gender options, Facebook for example. Users were originally offered four gender options: male, female, private, or < no answer >. In February 2014, Facebook added a “custom” gender option for users in the United States, which included at least 58 different pre-populated gender options. This update also allowed users to choose their preferred pronouns. Facebook’s decision to expand their list of gender options was highly praised by the trans and genderqueer communities as a milestone of recognition and a beacon of hope. When this change was implemented for users in the United Kingdom in June 2014, the list of gender options had grown to more than 70. In August 2014, Facebook added gender-neutral options to describe family members. In February 2015, Facebook broadened their gender horizons once more, allowing an essentially infinite number of gender identity descriptors by providing a free-form field for users to fill in the blank.

Well done, Facebook. Here’s a round of virtual applause. Compared to paper forms, online forms have more versatility because they are not restricted by physical space. Given the physical restrictions that apply to paper documents, I very much respect the inclusive efforts made by the authors of the form pictured above. They also deserve a round of virtual applause.

Gender: check all that apply. Okay. Reading all the options listed on the intake form, I tried to imagine which ones I would check if I were filling out the form myself. I quickly became confused and frustrated. Every single one of those check-boxes could, perhaps – if stretched a little here and shrunk a little there – apply to me. And yet every single box feels as awkward and ill-fitting as an outgrown T-shirt. Nor was there any combination of boxes that could approximate a more accurate answer. After much fuming and deliberation, I eventually decided that I would check only one box: “other”. And then, on that inviting blank line, I would write “not applicable”.

Not applicable. These words are a defiant slogan for so much of the uncertainty in my life. Not applicable. These words are my defensive withdrawal from the identities it seems that other people understand and claim so easily. Not applicable. These words are a burden of crushing doubt and a window to a world of limitless possibility.

Gender: check all that apply. Gender: fill in the blank. Gender: why is it even included on so many forms? Asking for a person’s gender on a form, seems, in many ways, as irrelevant as asking for their favorite color. Color and gender are both vast supersets that include an infinite number of items, making it impossible – even ridiculous! – to attempt to define the answer within a finite series of boxes or on a single blank line.  Like favorite color, gender is constant and permanent in some people and fluid and changeable in others. Like favorite color, gender means quite a lot to some people and very little to others. And, like knowing someone’s favorite color, knowing someone’s gender tells you nothing about who they really are and merely conjures up in your own mind your perception of the label they chose. Some might argue that gender is directly relevant on forms related to medical or reproductive issues. I argue that even in a medical context, gender isn’t relevant – what IS relevant is the presence or absence of certain organs and the concentration of certain hormones in the bloodstream – haven’t feminists and LGBT advocates been fighting so hard for so long to challenge rigid binary assumptions that tie gender to biology? I would like to see Facebook’s increasingly inclusive effort taken one step further to remove gender entirely from the available fields on a user profile.

It has taken me a long time to develop this provisional (dis?)comfort with the words “not applicable”. And here’s a difficult confession: I don’t understand what gender identity is, I don’t know what it’s supposed to feel like, and I’m beginning to suspect that I don’t even have a gender identity. The chronic physical distress associated with the female features of my body remains the only indicator of gender dysphoria. When I first started exploring gender and considering transition to a more masculine body, I felt so confused and alienated by statements that surfaced so incessantly from famous trans people:

“My brain is much more female than I am male. That’s what my soul is.” – Caitlyn Jenner

“I didn’t have to learn how to act like a man because in my head I’d always been one.” – Chaz Bono

“I knew in my heart and my soul and my spirit that I was a girl.” – Laverne Cox

“When I was four and began asserting myself as the girl I knew myself to be…” – Janet Mock

Similar sentiments echoed from many FTM and MTF blogs. So often it seemed that even in trans discourse, the definitions of “man” and “woman” and “male” and “female” hinged on outdated stereotypes regarding socialized preferences and behaviors. I was left more bewildered than ever, wondering if I even deserved shelter under the trans umbrella given my lack of gender identity. This statement finally resonated with my own aching and unlabeled nonidentity:

“That really begs the question: what is a man? And what is a woman? And how much of that is societal bullshit anyway? None of the labels fit me. None.” – iO Tillet Wright

Then I thought that reading about the experiences of people who identify as agender, bigender, genderfluid, genderqueer, and various other non-binary terms might feel more comfortable. But still I felt so estranged from those perspectives. I could not understand what often seemed like such an aggressive gender neutrality:

“I tend to paint my nails if I feel like I am going to be particularly expected to behave like a man. It creates a dissonance with expectations that I enjoy… I shop in the men’s and women’s sections, cobbling together a look that could confound the most attuned gender-assignment identifier from a few feet away.” – Rae Spoon

It has never been my intent or my desire to deceive anyone with my androgyny. I also could not relate to the conviction that seemed to characterize many non-binary genders:

“My gender is not all that unique or special. My gender is not all that queer or all that different. My gender is not rebellious. My gender is not something you should be jealous of… My gender is not about hating binaries. Really, the binaries are hating my gender. My gender is not about how limiting the binary is, and it’s not about liberating myself or anyone else from any binary… My identity is not about men or women. It’s about me, about how I understand myself, how I live my life, how others understand me, and what makes sense.” – Kae

That statement sounds so enviously confident. But I don’t know what any of it means. It became more and more apparent for me that existing labels were, as ever, not applicable.

The comments about gender that have most accurately captured my own confusing experience come not from the trans or genderqueer community, but from insightful people on the autism spectrum. (Jack 2012)

“I was sailing blind through a world full of gender signals.” – Jane Meyerding

“I’ve never seen any purpose for genders. They don’t reflect anything real, since they take “this sex is likely to do this” and turn it into a set of rules, making “likely” into “has to”… and I don’t identify as either because of that. It’s arbitrary and doesn’t fit anything about me.” – BlackjackGabbiani

“i don’t consider myself to have any sort of “internal” gender identity whatsoever – it always feels like “gender” is simply not a valid category in which to place myself. When i see “gender” as a tick-box category on a form, i feel similarly to if, on a form asking for details of a vehicle, it asked for “miles per gallon” when my vehicle was powered by something completely different (and that can’t be measured in gallons), like say solar electricity – i just don’t really consider myself to belong to the category of beings that have gender.” – Shiva

The absence of gender identity, the utter inapplicability of gender as a concept for me, is so eloquently described in those comments. The article also describes how disorienting and painful this experience can be.

“For some autistic people, gender does not easily serve as an available resource for identity… for some individuals, gender disorientation can be emotionally painful and having a term to describe oneself can be tremendously important… the malign persuasion in question here might be the fact that lacking a term or word with which to identify might persuade people that they do not fit, that they are anomalous.” (Jack 2012)

“I’m upset because I feel like there’s no word to describe my gender expression. It’s probably silly to be upset about not having a word for something, but because I don’t feel represented in either straight or queer communities, I do have a desire to articulate what it is that I am.” – Amanda Forrest Vivian

However, even those statements do not incorporate the intense and distressing incongruence between my female body and my brain’s resistance to that body. This physical discomfort combined with the absence of any cognitive gender identity feels impossibly bewildering.

For me, “not applicable” extends even beyond gender to other areas that serve as important aspects of identity for most people. Most standard forms don’t ask respondents to classify their sexual orientation, but those that do almost universally fail to include “asexual” as an option. For example, one study described the survey used to gather data on a large population: “Sexual orientation was assessed with the question: “Which of the following best describes your feelings? (1) completely heterosexual (attracted to persons of the opposite sex), (2) mostly heterosexual, (3) bisexual (equally attracted to men and women), (4) mostly homosexual, (5) completely homosexual (gay/lesbian, attracted to persons of the same sex), or (6) unsure. Respondents were categorized according to their orientation identity as reported in that question.” (Roberts 2012) Had I filled out that questionnaire, I suppose I could have chosen “unsure”, but, in this context, unsure implies not an absence of sexual attraction but simply indecision regarding the other available options. In fact, only 3 out of 8968 respondents chose “unsure”, a mere 0.03%.

A different study specifically investigating the prevalence of various sexual orientations in the British population did include a category to represent asexuality. “The measure of sexual attraction was introduced as follows: “I have felt sexually attracted to…” Six options followed: (a) only females, never to males; (b) more often to females, and at least once to a male; (c) about equally often to males and females; (d) more often to males, and at least once to a female; (e) only males, never to females; and (f) I have never felt sexually attracted to anyone at all.” (Bogaert 2004) The results of the study showed that 1.05% of 18 876 respondents reported being asexual (“I have never felt sexually attracted to anyone at all”). The authors explain, “This rate [of asexuality] is very similar to the rate of same-sex attraction (both exclusive same-sex and bisexuality combined: 1.11%). However, binomial tests indicated that there were more gay and bisexual men than asexual men, and more asexual women than lesbian and bisexual women.” (Bogaert 2004)

Despite this data suggesting that asexuality is not only relatively common (1%) but actually more common than homosexuality and bisexuality among women, asexuality remains largely ignored as a legitimate sexual orientation. I am still hesitant and uncertain about claiming an asexual and aromantic identity, but these words seem like the best available descriptors for my experience. A big part of my difficulty in accepting an asexual or aromantic orientation with any confidence is that there is so much lingering uncertainty: how do you definitively confirm the absence of sexual and romantic attraction without really knowing what those things feel like? An asexual blogger eloquently described this distressing uncertainty:

“Perhaps the most insidious part of this is that, to some degree, asexuality is a provisional identity. Unlike other sexual orientations, which at least have a frame of reference for what sexual attraction feels like, asexual people must rely on guesswork. When other people figure out their orientations, they can look at specific incidents of attraction and behavior. But asexual people have to look for a void – how do you find a void? How can you know sexual attraction isn’t present, if you have no frame of reference for distinguishing it? You have to compare yourself to other people and make your best guess.”  – Anagnori

The authors of the first study that did not include asexuality in the survey (Roberts 2012) note that in their study, “People “unsure” of their feelings were excluded.” Somehow I feel like that exclusion of people who are uncertain about their sexual identity extends beyond the parameters of that particular study and applies broadly to the world at large. Sexual orientation: check all that apply. Sexual orientation: fill in the blank. Sexual orientation: not applicable.

Our culture emphasizes romantic love as a central pillar of happiness and the foundation of family structure. Our culture considers sexual attraction one of the most fundamental traits of being human – indeed, of being animal. Our culture pathologizes the absence of sexual attraction as a medical or psychological disorder. Our culture, while it has become somewhat more inclusive and more accepting of gender diversity, remains doggedly adherent to indefinable and irrelevant distinctions between “men” and “women”. Our culture insists that, while gender can sometimes bend the rules, it can never disappear. When these core beliefs and assumptions comprise the infrastructure of our society, being agender, asexual, and aromantic – imperfect descriptors for me but no better words exist – is an experience of profound invisibility. In most of the categories that my world deems important, I remain: not applicable.

“It’s exactly like a riddle with no answer!”
– Alice (Through the Looking-Glass and What Alice Found There, 1871)

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References

Bogaert AF. Asexuality: prevalence and associated factors in a national probability sample. 2004. The Journal of Sex Research 41(3):279-287.

Jack J. Gender copia: feminist rhetorical perspectives on an autistic concept of sex/gender. 2012. Women’s Studies in Communication 35:1-17.

Roberts AL, Rosario M, Corliss HL, et al. Childhood gender nonconformity: a risk indicator for childhood abuse and posttraumatic stress in youth. 2012. Paediatrics 129(3):410-41

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This post was awarded Tiffany’s Gender-Bender Award for May 2016.

Gender Bender Award Graphic

Not A Simple Question

/ TomCat / Leave a comment

Ashes

There are numerous articles and blog posts discussing the many ignorant, intrusive, and inappropriate questions that are all too often aimed at transgender people. These articles are on popular websites (Everyday Feminism, BuzzFeed, Astroglide, Huffington Post, Cosmopolitan, Autostraddle), as well as on personal blogs written by trans people (janitorqueer, American Trans Man, Matt Kailey’s Tranifesto). There are even artistic projects devoted to this issue (A Series of Questions). There are differences within the trans community regarding willingness or unwillingness to answer these types of questions, depending on their relationship with the asker, the context in which the questions are asked, their desire for privacy, and the extent to which they want to educate others. I will not rehash what has already been discussed so extensively on other sites.

But, from here in my small corner of the internet, I would like to add something to this ongoing conversation. This is a question that I have not seen mentioned in any of the existing articles, but one which I have heard multiple times and have always found difficult to deal with:

“Which is harder, coming out as gay or coming out as transgender and going through transition?”

In my more generous moments, I want to believe that people who ask this question are making an honest attempt to use an experience they think they understand (coming out as gay) to provide a frame of reference to help them understand an experience that seems more foreign (coming out as trans and going through transition). In a neutral frame of mind, I might view this question as the idle curiosity of an interested audience. But I cannot ignore the dismissive presumption inherent in that question, the way those words reflect a simplistic desire to neatly rank and categorize unfamiliar experiences along a linear scale of difficulty, the way those words erase the incredible diversity of individual experiences with the assumption that one person can speak for everyone who is gay and everyone who is trans.

So whenever someone asks me that question, I feel an odd mixture of anger and resentment conflicting with my effort to be tolerant and give them the benefit of the doubt regarding their intentions. I could choose not to answer the question. But so far I have always chosen to answer, because my desire to be understood exceeds my desire to disengage.

“Which is harder, coming out as gay or coming out as transgender and going through transition?”

This is what I say to people who ask me this question: I think the question is irrelevant and impossible to answer. Each person’s situation is so different. The challenges each individual faces and the distress they experience are dependent on so many complicated factors: their social support system, their home and work environments, their personality, concurrent physical or mental illnesses, economic status, race, perceived gender, the list is long. And I think perhaps one of the most powerful factors influencing LGBT experiences is a person’s own acknowledgement and acceptance of their sexuality or gender identity. The internalized homophobia and transphobia generated by a lifetime of societal conditioning can create such deeply entrenched and overwhelming shame – shame like a slow-burning bonfire that eats away at the edges of your soul until you are entirely consumed by the raging heat.

Speaking only for myself: the constant physical dysphoria that comes from living in a female body with a brain that resists this body so intensely – this incongruence made so glaringly evident in every mirror, every motion, every moment – and the physical effects of the hormonal and surgical aspects of transition are a notable difference between my experience and the experiences I’ve heard gay friends describe. The physical aspects of gender dysphoria and my fears and uncertainties about the medical aspects of transition are more disturbing to me (though no less important) than my fears about the social repercussions of transitioning.

Speaking once more for myself: despite the physical distress that is so painful, my journey so far has allowed me to accept gender dysphoria, authentically and shamelessly, as part of who I am. My shame has stopped burning and now I sift through the ashes to reassemble the charred pieces of myself. And though my landscape still looks bleak and scorched, I get to decide where I go from here. This acceptance has given me an extraordinary freedom that many trans people and gay people have not yet achieved if they remain burdened with shame or denial. For this part of my experience, I have the utmost gratitude.

“You ought to be ashamed of yourself for asking such a simple question.”
– The Gryphon (Alice’s Adventures in Wonderland, 1865)