Transsexualism

Transsexuals generally also suffer from a moderate to severe personality disturbance. They frequently report anxiety or depression, which they may attribute to inability to live in the role of the desired sex. Any associated personality or adjustment problems would be a security concern. Transsexuals sometimes take strong doses of hormones, and this entails some risk; testosterone, for example, can cause people to become aggressive.

Prevalence of transsexualism is estimated at one per 30,000 for males and one per 100,000 for females. The wish to be a member of the opposite sex commonly dates back to one's earliest childhood memory. The young child may make very emotional assertions that he or she is the other sex. Cross-dressing normally begins early in life, as do play which is more typical of the opposite gender and choice of playmates exclusively of the opposite gender. Although transsexuals almost invariably report having these gender identity problems in childhood, most children who report these problems do not grow up to be transsexuals. The transsexual tends to be asexual and may be so aversive to the genitals that there is a reluctance to touch them to masturbate. Attempted self-mutilation is not uncommon. Transsexuals are usually attracted sexually to members of the same biological gender, but they perceive themselves as heterosexual as they are themselves in the wrong body.

One would assume, intuitively, that the U.S. military is the last place one would find transsexuals. Actually, there are grounds for speculating that transsexuals may be more common than expected in the military. An Air Force psychiatrist assigned to Wright-Patterson Air Force Base reported evaluating 11 male transsexuals during his 3-year tour there. Eight were current or former active duty military personnel, while three were civilians. Of the eight who had extensive military service, seven had joined the service voluntarily at a time when no draft existed or other options were readily available. All were requesting either female hormones or sex reassignment surgery.

Young male transsexuals in the throes of adjusting to their situation appear to go through a hypermasculine phase in which they try to purge the feminine side of their personality and prove their masculinity both to themselves and others. Transsexuals pass through this hypermasculine stage during late adolescence and early adult years, which coincides with the time when men consider military service. Quotes from taped interviews with military transsexuals are typical: "I tried to do things to make me feel more masculine, like joining the Navy and getting married." "I thought it would make a man out of me." "I joined the Navy hoping maybe the problem would go away." "I joined the Air Force as a cover. In uniform, my masculinity would not he questioned." Also typical is the civilian doctor who advised one young man who had come to him for treatment of feminine feelings to "join the Army, go to boot camp, and learn how to run over trees with a tank." These military transsexuals tend to seek out the more macho military specialties. One who had been assigned as a lab technician volunteered for combat-helicopter training during the peak of the Vietnam war; his hobbies were mountain climbing and race car driving. Another became a Green Beret. These are natural choices for the young transsexual in the hypermasculine phase making a last ditch effort to adjust to what society expects from a male. This effort eventually fails in many cases, however, and transsexual urges return, although transsexuals have had successful military careers of 20 years or more.

The transvestite should be distinguished from the drag queen and the female impersonator. A drag queen is a male homosexual who dresses as a woman, often for the purpose of sexually stimulating other males. Although he may be a transvestite, in many cases he is not. The female impersonator is an entertainer. He, too, may also be a transvestite, although in many cases he is not. The drag queen and female impersonator may have no psychological dependence on wearing feminine clothing as a form of tension release, nor do they necessarily gain sexual stimulation from the clothing.

The transvestite should also he differentiated from the male transsexual who seeks to change his gender identity. As discussed above, the transsexual male feels like a woman trapped in a man's body, wishes to live as a woman, and experiences an insistent urge to change his anatomical sex. Although some cross-dressers evolve into transsexuals as young adults or in early middle age, most are quite happy with their gender and feel no urge to change it. There is also an intermediate condition called gynemimesis in males and andromimesis in females, where the person dresses and lives continuously as a person of the opposite sex but does not wish for any change in the anatomy.

Gynemirnesis might be more common in the United States if there were not such strong societal constraints against its expression. Males who live as women are accepted and have well-defined and in some cases highly respected roles in a variety of cultures, including India, Burma, Oman, Polynesia, and among North American Indian tribes. In one small town in Oman where they were studied, the Xanith, as they are known there, comprised 2% of the 3,000 adult males.

Many transvestites are married and masculine in appearance. Most assume a female name and personality while they are cross-dressed. Crossdressing often starts in childhood or early adolescence. The causes are not known, but some prenatal biological influence may be involved as well as later experiences during early childhood.

No valid statistics are available on the prevalence of transvestism. The Society for the Second Self is a support and social organization for heterosexual cross-dressers. The group reports about 1,100 members organized into 27 chapters nationwide, with another 23 chapters in the process of formation. Other similar organizations also exist The "second self' is the woman that the society believes "is buried within every man." The group's purpose is to create a safe environment for the heterosexual male membership "to express without fear, to speak without shame, and to act out without guilt the femininity that is within them." Members generally limit their cross-dressing to the privacy of their homes or cover of night and socialize en femme only at chapter meetings with their close confidants.

The largest survey of transvestites was conducted in the late 1960s by V. Prince and P.M. Bentler. They received survey responses from 504 subscribers to a magazine for heterosexual cross-dressers. Prince, who was one of the founders of the Society for the Second Self has almost 1,200 more responses from recirculating the same survey questionnaire during the past 3 or 4 years. Prince reports that the responses "come out pretty much the same as the original survey, which indicates that the phenomenon is pretty much the same over a 25-year period.'

The findings reported here are from the original Prince and Bentler survey. In response to a question about how they see themselves, 12% said they felt like a woman trapped in a male body; in other words, they may be transsexuals rather than transvestites. Another 12% reported they were a man with just a sexual fetish for feminine attire, which suggests they should be classified as transvestic fetishists. The classical transvestite response, that they feel themselves to he a man who has a feminine side seeking expression, was given by 69%. Only 28% reported ever having any homosexual experience, which is less than the 37% reported by Kinsey for the male population as a whole.

Most (64%) respondents were currently married, with another 14% either separated, divorced, or widowed. About one third of the married members described their wives as either cooperative or understanding, while 20% of the wives were completely unaware of their husbands' interests.

About one quarter had a college degree, while another 13% had earned an advanced degree. A remarkable 17% were either presidents or owners of a company or business, while 19% had played football in high school or college.

To some extent, these figures reflect the fact that people who join any type of support group tend to be well educated. The figures may also say something about transvestites, however. A separate study of 51 members of the Society for the Second Self found that many were high achievers, driven to seek personal success in order to gain a sense of self-worth and positive recognition. Many sought out particularly masculine occupations as a means of compensation, that is, to prove their masculinity both to themselves and to others despite their enjoyment of feminine things.

Cross-dressers are not dangerous. That is, they generally are not child molesters, voyeurs, exhibitionists or rapists. The practice does not generally interfere with work performance. If cross-dressers have difficulties with the law, it is generally because of society's inability to accept persons who do not behave in the "normal" way. A book to be published later this year by one of the principal scholars in this field will argue that gender impersonation (including cross-dressing) should not be classified as a mental illness or a pathology unless it becomes a compulsive behavior. Under those circumstances, it should be considered the same as any other compulsive behavior.

Prince and Bentler report that 76% of their respondents had never had a psychiatric consultation for any reason. This is significant, as it indicates that many transvestites do not experience other emotional problems of sufficient gravity to require treatment. Some scientific literature on transvestism is written by psychiatrists based on their clinical experience, and they tend to see cross-dressing as the tip of the iceberg of other emotional problems. If the psychiatrists see only those transvestites who are seriously disturbed by their problems, their impression of the phenomenon as a whole may be less accurate than the broad survey research.

Because of lack of public acceptance, crossdressers normally conceal their feelings and their secret life, and this creates a potential for extortion in exchange for keeping their secret. On the other hand, secret cross-dressing tends to be a solitary activity. Unlike homosexuality or adultery, it does not require a partner, so the risk of discovery and blackmail may be considerably less. According to the Prince and Bentler study, almost 50% of transvestites had told either no one or only one other person (often the wife). Most others were very limited in their disclosure; only 9% had told anyone who was "antagonistic," showing that transvestites "were quite adept in selecting individuals to talk with who would not respond negatively to the information."

Transvestism is similar to homosexuality in that it is not illegal, and there is no empirical evidence that transvestites are, by nature, less trustworthy or loyal than other persons. Cross-dressing, by itself and in all circumstances, does not necessarily indicate poor judgment, unreliability, irresponsibility or emotional instability, although these disqualifying characteristics will he present in some cases. There is strong evidence that many cross-dressers lead successful lives with a high degree of personal and professional achievement. Each individual should be considered on a case-by-case basis. Appropriate medical authorities should determine whether there are other associated emotional problems or evidence of a progression toward other sexual disorders such as fetishism or transsexualism.

The DCID 1/14 criteria that may apply to some cases of transvestism are the public nature of the behavior and susceptibility to blackmail or coercion. Going out in public dressed as a woman may indicate lack of discretion and would be an aggravating circumstance that may justify disqualification. Concealment of current cross-dressing behavior may indicate susceptibility to pressure. Admission of cross-dressing during a security interview may eliminate some of this susceptibility but is discouraged by the sanctions associated with current personnel security policies.