Sexuality in Transsexual and Transgender Individuals

Harper Tobin Honors Thesis in Sociology April 2003

Part I: A Review of the Literature

Introduction

Michel Foucault may have been the first to argue that social and in particular sexual identities are historically specific, and are shaped by discourse. Since then it has become a widely accepted tenet in social science and cultural studies that our conceptions of ourselves and our lives are informed by the discourses current in our society -- that discourses have the power to shape us inasmuch as they give us a vocabulary with which to speak about ourselves.

This is as true of transgender and transsexual individuals as it is of anyone else. What's more, due to the relative isolation of trans individuals, the social stigma of gender variance, and the invisibility of gender variance in everyday life, printed literature has been a primary source of information for understanding oneself for a great many trans individuals. Many of us first encountered others somewhat like ourselves in books painstakingly located in libraries, publications ordered through the mail, or more recently, online publications. Christine Jorgensen was the first transsexual of many to relate in her autobiography that she pored over a great body of medical texts, hidden away in corners of university libraries, trying to puzzle out her cross-sex feelings and what to do about them. For thousands of transsexuals in the in the 1930s through the 1970s, media reports about sex changes -- especially Jorgensen's -- were, in the words of one MFT, "like a revelation.... Talk about your shock of recognition. Man, this was it!" (Masters 1966, quoted in Meyerowitz 2002:95-6). "For some," comments historian Joanne Meyerowitz, "the growing coverage in the popular press shaped their inchoate desires to transform their bodies. For others, the news stories renewed their hopes that doctors might actually respond to their already formulated requests. In the 1950s and afterwards they used the press and the medical literature to label their longings, to place themselves in a recognizable category, and to find the names of doctors who might help them" (130). In subsequent decades tabloid television and transsexual autobiographies played similar roles. By the 1980s and '90s, many had some awareness of transsexualism but could not understand their own gender-variant feelings, which did not seem to fit with descriptions of transsexualism. For me, it took reading Kate Bornstein's My Gender Workbook (1998) to realize that yes, I was transgendered. (Subsequently I came to understand that the term transsexual had become somewhat more variously applied and broadly defined by many trans individuals than in previous decades, and when I decided to pursue hormone replacement therapy I decided to apply the term to myself. It's another example of how current discourses shape our conceptions of self, but it's also another story.)

Within this context, a long look at the available literature -- not simply the kind of review of the sociological literature necessary to any research inquiry -- is especially critical to understanding the ways that trans individuals articulate and perform sexuality. While there are large and rapidly growing academic and popular literatures on the lives and experiences of transgender and transsexual people, until very recently relatively little attention has been addressed specifically to issues of sexuality. Early sexologists conceptualized gender variance as a form of sexual pathology, and ever since Christine Jorgensen's sex change became news, popular media have displayed a prurient, exotic interest in trans people's sex lives; despite the protestations of transpeople and of more recent sexological and psychological "experts," trans identity is still tied up with sexuality in the popular imagination -- to be expected, perhaps, given the intricate connections between gender and sexuality. (See Footnote 1)

Transsexual autobiographers appear to have had relatively little interest in sex, little sexual activity during or after transition, or at least little to say on the matter (Jorgensen 2000, Morris 1974, McCloskey 1999); Mark Rees's virtually only reference to sexuality in his autobiography is that he wished he had been asexual and was "troubled" by a sex drive he could not satisfy in a female body (Rees 1996:40). Mario Martino (1977) and Renee Richards (1983), however, describe sexual fantasies, masturbation, and sexual relationships in detail, and more recent narratives by transpeople give much more voice to sexual desire. Sex radicals like Kate Bornstein, David Harrison, Patrick Califia and Christopher Lee have much to say about sexuality; along with co-directing a documentary on FTMs that focuses heavily and exuberantly on sexual matters (Trappings of Transhood), Lee created the first porn films starring transmen (see below). Transsexual activist and filmmaker Mirha-Soleil Ross makes transsexual sexuality a central theme in her works, as well.

More open discussion of sexuality may be seen as part of a kind of generational shift in trans experience more generally. Anne Bolin (1988) adapted the "breastplate of righteousness" theory -- proposed by Laud Humphreys in discussing male homosexuals -- to explain the remarkable conservatism regarding gender roles and sexual matters she observed among MTF transsexuals as a kind of compensation for being part of an ostracized social group. More recently, Bolin (1998) and other authors such as Bornstein (1994), Hubbard (1998), and Boswell (1998) have described a paradigm shift among at least some transpeople away from traditional understandings of sex and gender identity and towards fluidity and free expression. This can be seen in the increasing visibility of non-operative transsexuals, the claiming of gender identities outside the male/female binary, and the emergent notion of a broad "trans" community incorporating disparate groups of gender-variant people -- and, as will be shown here, it may also be seen in the area of sexuality.

Scope

The scope of this literature review is limited in several respects. First of all, it does not address the experiences of intersexuals, crossdressers, and many other people who could be included under the umbrella-term usage of "transgender." Rather, I have concentrated exclusively on the experiences of those who have altered their physical sex characteristics through hormonal and/or surgical intervention. Secondly, this review focuses on the experiences of individuals who are living with genitals that do not "match" their gender identity -- that is, those who are either "non-op" or "pre-op." I do not discuss the medical or sociological aspects of sexual life following sex reassignment surgery (SRS), a subject that merits a lengthy literature review in itself. Thirdly, I have focused on discussions of sexuality in relation to the physical transitioning process -- before, during, after -- and thus have not paid a great deal of attention to discussions of the childhood and adolescent sexual experiences of trans people, though I have mentioned them occasionally. Finally, even within these above-mentioned limits my review of the literature has not been exhaustive -- I have stopped short of finding every back issue of every trans-oriented magazine, every follow-up study on adjustment to gender transition -- but rather is intended to convey general themes in the literature. Given these limits, however, my review is very broad, including works from anthropology, sociology, clinical psychology and sexology, autobiographical narratives, popular periodicals, video documentaries and popular media from the 1960s to the present. (Holly Devor, Frank Lewins, Vivian Namaste and Richard Ekins are the only authors I discuss whose work is really within the realm of sociology.)

Methodological Issues

Literature to date on sexuality among transgenders and transsexuals includes clinical, epidemiological, anthropological and sociological studies, as well as many autobiographical and anecdotal texts. The study of trans sexuality has been fraught with methodological problems, the most important of which I will detail here.

The first problem has to do with scope. Until perhaps a decade ago, most researchers accepted Harry Benjamin's (1966) typology of transsexualism and transvestism, which held that gender dysphoric individuals a) were almost exclusively genetic males, and b) could be separated neatly into the categories of transvestite and transsexual. Transvestites cross-dressed for sexual thrills, whereas transsexuals desired a total change of sex and a life lived as female. As documented extensively by Jason Cromwell (1999), gender diversity among genetic females was virtually invisible in the literature until the late 1990s. Furthermore, for those who sought to change their physical sex characteristics and not live in their assigned gender, "transsexual" was the only identity category open to them, and a fairly narrow one at that. The emergence of a multiplicity of trans identities, and the greater visibility of FTMs and transmen is only beginning to be reflected in the research literature (and the popular literature).

Another clear problem with sociological and anthropological as well as clinical and non-clinical psychological studies addressing trans people's sexual lives has been the small sizes of their samples. The majority of studies I encountered in all fields had sample sizes of less than fifty, and several had sample sizes of fewer than thirty; Anne Bolin's oft-quoted book In Search of Eve is based on interviews with fewer than twenty transsexuals (Bolin 1998, Rehman et al 1998, Daskalos 1999, Devor 1997, Fleming, MacGowan, & Salt 1984, Fleming, MacGowan, & Costos 1985, Griggs 1998, Lawrence 1997).

The first to write about trans people in this century, of course, were those doctors who saw to their hormonal and surgical treatment (e.g. Cauldwell 1949, Benjamin 1966, Walinder 1967), and to date the bulk of published studies on transgender and transsexual people have been clinical psychology studies, which has a number of consequences for the pictures of trans experience available to us. As Jason Cromwell points out, "these studies have been limited by the clinical environment and a focus on individuals who see their identity as problematic" (Cromwell 1999:15). Clinical subjects are likely to see their gender variance as problematic and be less emotionally and psychologically stable in general than the average person, and the approaches of clinical studies are primarily concerned with (what researchers construe as) pathology. Brian Tully's 1992 study, conducted at Britain's leading gender clinic, spends many pages on the prevalence of psychosis, dissociative experiences, alcohol and drug problems and criminal activity among 204 transsexuals -- findings which are not corroborated by any nonclinical research to date. Likewise, one could expect clinical studies to exaggerate the prevalence of sexual dysfunction, dissatisfaction and anxiety among trans people.

The clinical environment itself affects the reliability of data collected about sexual behavior. Many trans people distrust those who treat them, and with good reason; at least one study reports sexual harassment, attempts to impose rigid gender stereotypes in matters ranging from sexual behavior to choosing a new name, discrimination against sex workers and the unemployed, and failure to provide adequate information about treatment options and impacts among transpeople's common complaints (Namaste 2000). Perhaps more significantly, individuals seeking to obtain hormone treatments and/or surgery may have a vested instrumental interest in appearing to conform to antiquated clinical stereotypes about transsexuals, most specifically that "true transsexuals" only want to lead "normal" heterosexual lives. Anne Bolin noted this in her anthropological study of MTF transsexuals:

The preoperative individual recognizes the importance of fulfilling caretaker expectations in order to achieve a favorable recommendation for surgery, and this may be the single most important factor responsible for the prevalent medical-mental health conceptions of transsexualism. Transsexuals feel that they cannot reveal information at odds with caretaker impressions without suffering adverse consequences. They freely admit to lying to their caretakers about sexual orientation and other issues. (Bolin 1998:62-3)

Frank Lewins, studying MTFs at a Sydney gender clinic, found that "in response to a question [on a clinic questionnaire] about their fantasized sexual goal, almost all responded that they fantasized being a woman with a vagina and having sex with a heterosexual man." From his own, private conversations with them, however, he classified 47% as heterosexual, 31% as "clearly lesbian" and 22% as "asexual, although admittedly, [this] designation is difficult to apply" (Lewins 1995:95).

Similar behavior was apparent in Devor's study of FTMs:

When we went to the clinic, they found out [that another FTM and I] were lovers, together, so they asked us about it. So, I knew I couldn't lie, 'cause they...must have heard it from somebody. So, I said, 'We were for a while but we're no longer now.' Of course, we were.... I don't like lying, but if you gotta lie, you gotta lie. You just have to know how to do it right. Tell them what they want to hear. There's no way they would accept that [we were lovers]. (Devor 1997:404)

Though it is impossible to say for sure whether the following passage is truly an example of client deception, the possibility certainly leaps to mind:

In his marriage as with all other girlfriends he has had inadequate capabilities to have erections and has never had intercourse. Although his marriage was not consummated, he masturbated on occasions, and on one of those times, semen ran into the vagina of his wife and consequently his daughter was conceived. (Medical report on a male-to-female transsexual, cited in Tully 1995:93)

It is not only self-reports about sexual orientation or sexual behaviors that may be unreliable in the clinical setting, but also satisfaction with hormonal and surgical results. Since the goal of surgery is to markedly improve quality of life, and since some medical professionals and cultural critics still believe transpeople should be given psychotherapy rather than allowed to "mutilate" their bodies, the continuing availability of surgeries depends on positive results in follow-up studies. "Transsexuals who have survived the medical and psychiatric system's sex-changing authorization process," argues Pat Califia, "are quite sophisticated about how that system works. They know that negative answers to surveys about their postsurgical quality of life will hurt the transsexuals who come after them. Until there are excellent alternatives to the current treatment modality, among which transsexuals are truly free to pick and choose, follow-up studies will be hopelessly skewed" (Califia 1996:270). It was precisely this kind of skewing that motivated Anne Lawrence to conduct her own unscientific survey of transsexual women about their experiences at the 1996 New Woman Conference (Lawrence 1997). She found that "nearly half the women said their transitions had involved some deception of their therapists or healthcare providers."

A recent study concerning HIV prevalence and risk behaviors deserves special attention for its methodological thoroughness. Clements-Nolle et al (2001) recruited an impressive 392 MTF and 123 FTM participants in the San Francisco area from street settings, bars, social gatherings and agencies and respondent-driven sampling. Three MTF and three FTM staff of diverse ethnic backgrounds were hired and trained to conduct interviews. Respondents were given HIV antibody tests and surveyed about their sexual orientation and a range of unprotected and unprotected sexual behaviors. I know of no other study to date with so large a non-clinical sample of trans-people, nor of any other study conducted by non-trans researchers who went to the trouble of hiring trans interviewers.

Devor's book FTM: Female-to-Male Transsexuals in Society (1997) also deserves special attention for the breadth and depth of its inquiry. (See Footenote 2) If you're going to study a group of less than fifty people, particularly members of an understudied group such as FTMs, you ought to do it right; Devor managed to explore nearly every relevant area of participants' lives from childhood to the present, including copious attention to masturbation, intimate relationships, specific sexual practices, and experiences of sexual violence. Unfortunately, Devor's work is so thorough (and at times repetitive) that, at well over 600 pages, it tends to intimidate would-be readers.

Autogynephilia?

Much has been made, both among the experts in clinical psychology and sexology and within trans communities, of the theory of autogynephilia -- first proposed by Ray Blanchard (1989) -- and this theory is perhaps emblematic of the short-sightedness that has until recently pervaded the professional literature on trans experience. In short, Blanchard observed that non-androphilic male-to-female transsexuals were more likely than androphilic MTFs to report sexual arousal related to cross-dressing, feminization of the body, and imagining oneself as a woman. He coined the term "autogynephilia" to describe the phenomenon of being sexually aroused by the thought or sight of oneself as a woman -- in his view a kind of sexual paraphilia -- and argued that, for nonandrophilic MTFs, autogynephilia may be a motivating factor in transitioning. Blanchard was further convinced of his androphilic-versus-autogynephilic typology by the finding that nonandrophilic MTFs reported less femininity both in childhood and as transitioned adult. Androphilic transsexuals, then, were motivated by a genuine core gender identity, whereas others were motivated by this newly discovered sexual fetish (Blanchard 1989).

Departing from the usual position of contemporary gender experts and trans advocates who have worked hard to root out the popular conception that transsexualism is a form of sexual deviance, Blanchard thus linked transsexualism directly to sexuality. Blanchard's theory was criticized by some for repathologizing transsexuals -- would autogynephilia be viewed by clinicians as an "unacceptable" motive for transition and used to block access to hormones and surgery? Blanchard's theory has been praised, however, by a few transwomen, most prominently clinical sexologist Anne Lawrence, as a welcome explanation of heretofore unspoken aspects of some transpeople's experience (Lawrence 1998). Certainly, sexuality has been inadequately addressed in research and theory on gender variance, but I tend to concur with FTM activist Jamison Green (2001) that autogynephilia may be much ado about nothing.

When asked if he thought that autoandrophilia was a factor in FTM transsexualism, he replied that it might be for some, observing that many transmen certainly envisioned themselves as men when making love even pre-transition, and derived erotic satisfaction from seeing their bodies in transition. But, asserted Jamison, these erotic experiences did not constitute the main drive to transition so much as they were characteristic of an overall sense of gender identity. He continued:

I think there are also nontrans men who also get turned on by appreciating their own masculine bodies.... Nontrans women appreciate themselves, too, and can spend plenty of time in front of the mirror doing so, and who's to say some of them don't get turned on by the idea of their own bodies? I would venture to say no one's ever studied this in nontrans women. I would also postulate that this desire could be seen as healthy. ... Those of us who have worked hard to remove the stigma from transsexualism must not deny either the power of erotic desire or the fear of it that craves it obliteration. ... If we isolate autogynephilia or autoandrophilia as occurring only in the trans world, we revictimize ourselves, perpetuating the invalidation most of us experienced for much of our lives. If we're going to talk about the combustible mixture of gender and desire, we have to recognize that it is not the exclusive province of transsexuals. (Green 2001:1-2)

While it might be expected that such theories would wane in popularity as more trans voices emerged in the literature, and as many researchers and clinicians began to discard antiquated classifications of transsexuals, Blanchard's theory has recently received a boost from the work of fellow sexologist J. Michael Bailey, whose forthcoming book, The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism, calls Blanchard's theory a "revolutionary contribution" to sex research. (See Footnote 3) In his book, Bailey sets forth a rigid typology of MTF transsexualism.

The two types of transsexuals who begin life as males are called homosexual and autogynephilic. Once understood, these names are appropriate. Succinctly put, homosexual male-to-female transsexuals are extremely feminine gay men, and autogynephilic transsexuals are men erotically obsessed with the image of themselves as women. (Bailey forthcoming: 146)

When contacted by a transsexual woman who suggested he might be missing a type of transsexual woman whose transitions were actually motivated not by sexual drives but by a core female gender identity, he is reported to have replied that

autogynephilia is a comprehensible motivation, and so is homosexual transsexualism (out of natural femininity and the cost-benefit analysis that some men will do better on the mating market after SRS), but the other alleged category (neither homosexual nor autogynephilic) has never seemed very compelling clinically to me. (Quoted in Conway 2003)

Bailey has made even more explicit his position that the claims of some transsexual women who have read his work and believe they do not fit into his typology are either mistaken or lying. "I am not rejecting the claims (of transsexuals) for no reason," he told one reporter. "There is good scientific research that says you should believe me and not them" (Dreier & Anderson 2003). And with the imprimatur of the National Academies Press, and positive reviews from such reputable publications as Kirkus Reviews and OUT Magazine, it would seem that many people are doing just that.

Sexual Orientation

Despite the assertions of Blanchard and Bailey, it is nowadays widely agreed that gender identity and sexual orientation are related but independent constructs. The typology forged by Harry Benjamin in his seminal The Transsexual Phenomenon, and long thought true by many researchers and caregivers, had it that transsexuals and transvestites could be distinguished in part by sexual orientation: transvestites were men who were attracted to women, whereas transsexuals were men who wanted to be women and were attracted to men -- or occasionally the other way around. Those who did not fit this typology must not be "true transsexuals" -- or as Lawrence put it, "sexual interest in women has been seen as a contraindication to surgery, or at least as a poor prognostic factor" (1997). After all, society's definition of a real woman includes compulsory heterosexuality, and doctors definitely did not want to be in the business of creating homosexuals. As we have seen, sexual orientation is one of, if not the most frequent thing about which transsexuals and transgenders have lied to caregivers.

It has become more and more clear that trans people come in more or less the same variety of sexual orientations as non-trans people. As early as 1976 sociologist Deborah Feinbloom noted that

the majority of male-to-female transsexuals consider themselves heterosexual, but some ... wish to be homosexual females or lesbians postoperatively. Others wish to maintain options for bisexuality. Essentially this group is small, but given the greater freedom in sexuality, it is likely that these resolutions may become more common. I am unaware of any female to male transsexuals who consider the possibility of male homosexuality. (1976:31)

Other early researchers focusing on FTMs (or "female transsexuals" as they were called) such as Stoller (1972) and Pauly (1972; both cited in Cromwell 1999 and Devor 1998) thought that FTMs were exclusively attracted to females who were nonhomosexual. Stoller also commented "female transsexualism strikes me as a form of homosexuality more than a distinct condition" (Stoller 1973:387, cited in Cromwell 111). Mark Rees reinforces this stereotype in his autobiography, writing that his "first and last affair with a male" was a kiss behind the cloakroom door at age six (1996:4). Nevertheless, many researchers showed that a substantial number of FTMs had had some sexual attraction to and/or experience with men before transition -- including half of Pauly's participants! (Pauly has since changed his position that FTMs are "by definition" homosexual/heterogenderal; see Pauly 1998.) As late as 1985, Betty Steiner insisted in her handbook Gender dysphoria: development, research, management that "all transsexual biological females [that is, FTMs] are homosexual in erotic object choice [that is, attracted to women], and all of them wish to have a penis, though most are aware of the difficulties involved in such a procedure" (Steiner 1985:353).

Rejected by clinics that saw sexual interest in women as a necessary indicator of female-to-male transsexualism, Lou Sullivan obtained them from a doctor in private practice (Califia 1996:186). "What I really want," wrote Sullivan, "is a sexual relationship with a gay man, as a gay man. One clinic told me that I could not possibly live as a gay man since gay men were primarily interested in large penises and were not sexually aroused when shown photos of female-to-male surgeries" (Sullivan 1989:69-70, cited in Cromwell 1999:110). Sullivan went on to found the organization FTM International and was the first widely visible gay-identified FTM. Sullivan's struggles to increase the visibility of gay and bisexual FTMs seem to have paid off: by the time he died of AIDS in 1991, there were two clinical articles and one book-length study which discussed gay FTMs (Califia 1996:187; Devor 1998:255). Clements-Nolle et al (2001) reported that 65% of FTM participants identified as either lesbian/gay, homosexual/gay or bisexual, compared with 30% of MTF respondents.

In general, bisexual and lesbian orientation among MTFs has been much more visible in the literature. Some clinical studies have shown a fifth to a third of MTFs reporting bisexual or lesbian orientation (Blanchard 1989, Tully 1994, Rehman et al 1999). Non-clinical research suggests this is even more common. Sociologist Frank Lewins gave a composite case history of a lesbian transsexual that he called "reasonably typical" of MTFs (1995:67). Bolin reported that "of the seventeen [MTF transsexuals providing sexual orientation information] only one was exclusively heterosexual. Three of the six exclusive lesbians were living with women (genetic), one bisexual was living with a lesbian female, and two transsexuals were living with each other in a lesbian relationship." Lawrence reported that "six of the thirteen NWC participants identified as lesbian, and four of the thirteen as bisexual" (1997).

Lewins uses transsexuals' sexual orientations as a grounds for arguing that gender is not continuous but a series of fixed categories, and that transsexuals are gender defenders and not a third gender. "Whether they are now homosexual or heterosexual, transsexuals' histories reveal both constancy of the object of desire and, in a weak sense, their own psychological identities" (1995:134). He is onto something when he argues that "reciprocated desire helps to confirm one's own psychosexual identity" (135). But he generalizes too much. For relationships to endure "there must be a correspondence or self-identity and how one is seen by a partner." But then he says that

The pattern was universal among transsexuals in the study. There were no sexual revolutionaries Whether heterosexual or lesbian, they saw themselves as women; they stressed the importance of having a woman's body and looking like women, and of being regarded as women by their partners and the wider society.... where a sexual relationship exists, it is viewed by self and partner to be one of four dominant types [that is, gay male, lesbian, heterosexual man-woman and heterosexual woman-man] Regardless of whether they were heterosexual or homosexual, transsexuals involved in a relationship saw it as one of those dominant types. No transsexual saw herself or was seen by her partner as a 'transsexual.'

He even quotes the famed sexologist John Money: "There are some partners of pre-operative male-to-female transsexuals who are strongly attracted to a lady with a penis as a sexuoerotic partner. Postsurgically, their attraction wanes, and the partnership dissolves" (Money 1988:92, cited in Lewins 1995:137). But what if, as with more and more MTFs, there is no surgery? His citation seems to work against rather than for him.

Contrary to Lewins's claims, it is clear that for some transpeople -- as for many other people -- sexual orientation is not constant over the lifespan. According to Tully, most MTFs who have experienced attraction to women find that

once movement along the transsexual career commitment had gone far enough, things began to change. 'My attraction to females has been changing, i.e. reducing. I know many other transsexuals who were heterosexual before the change of role, and following the change would never think of that. (Tully 1994:124)

Daskalos (1998) surveyed twenty MTF transsexuals, half of them postoperative, about their sexual orientations before and after transitioning. Six of his participants reported that their sexual orientation had changed from female to male. All six reported that their relationships with women were largely motivated by wanting to fit the masculine gender role -- or, in one case, an outgrowth of an emerging feminine identity. As women, however, they reported being attracted to men. Two had previously experienced such attractions but not acted on them as men; none reported homosexual experiences as men. Attraction to men seemed to be part of their new gender roles. Whether acknowledged or not, homophobia appears to have played a strong role in participants' shifts in orientation; heterosexuality was seen by them as being a part of normal gender roles. Three participants thought that hormones had been involved in their sexual orientation shift. While clinical research shows no such psychosexual changes related to female hormone therapy, it does show that increased relaxation, and reduced tension were effected. These participants believed that hormone use allowed their (feminine) attraction to males to "come out."

Deirdre McCloskey reports in her autobiography being surprised at her own sexual shift:

These past months [leading up to SRS] I've begun to look on men as consumption items rather than as competitive suppliers. I certainly have not had sexual desires directed toward women since the epiphany, and even some months before. One thinks of sexual desire as unalterable. In this case perhaps not. (1999:196)

Renee Richards's autobiography also reports a shift from straight male to straight female, and one of the more popular books on transsexuality for lay audiences (Brown & Rounsley 1996) says that such changes are neither to be expected nor uncommon.

It is probably comforting to many caregivers to find transpeople transitioning from heterosexual to heterosexual -- some however, do just the opposite. David Harrison, for example, reports that his relationship with trans writer/actress/advocate Kate Bornstein broke up because when he transitioned from female to male, he found his sexual desires shift towards men; he had to learn to date all over again as a gay man (Harrison 1997).

Lewins's theory falls flat also on the assertion that sexual attractions and relationship must always fall into his four dominant categories. Many objections could be leveled at this -- take for example the assertion by Califia (1994:183-89) among others that sex between gay men and lesbians is not necessarily heterosexual sex -- but the relevant one here is that just as some transpeople do indeed articulate gender identities outside of male and female, many people report being attracted to transpeople as other than simply male or female. While I am unaware of any scientific research on the subject, there is plenty of anecdotal evidence. Clinical studies have much to say about the salutary abilities of transpeople's partners to overlook their gender-incongruent anatomies -- but what of one who declares, "I love breasts and a dick on the same body" (Newman 1999:171)? In S/HE, her collection of poetic writings inspired by her relationship with trans activist Leslie Feinberg, Minnie Bruce Pratt describes "how I love the maleness in your femaleness, how you are poised where the oppositions meet" (Pratt 1995:103). While Lewins's argument implies that even bisexuals would be attracted to trans partners as man or woman, Andrea Michaela-Gonzalez, in an issue of the bisexual magazine Anything That Moves dedicated to "Forging a Bi-Trans Alliance," describes her attraction to a trans person encountered at a club:

Whether she identifies as male, female, both, neither, or something else entirely, I have no way of guessing, nor do I know what her actual anatomy is -- nor do I care. It doesn't matter, and I don't even think about it as I plunge into her mouth and trace the outline of her teeth with my tongue, while the heavy-set German tourist snaps Polaroids of the two tall, smooching femmes to take home as a souvenir from San Francisco. (Michaela Gonzalez, n.d.)

"Some femmes may even prefer FTMs as partners," reports the Whole Lesbian Sex Book, "appreciating such a high degree of masculinity in someone who wasn't born and raised male" (1999:176). Cromwell (1999) and Nataf (1996) report similarly, and I myself have known many women, and not a few men, who find themselves attracted especially to transpeople.

Between Us

Clinical studies, unsurprisingly, are silent on a topic that comes up in much of the rest of literature on trans people's intimate lives: sexual relations with other transgender and transsexual persons.

In my experience, such partnerships are extremely common -- I've encountered at least half a dozen just in Seattle, and many more elsewhere. But such relationships have scarcely been mentioned, much less documented and studied, in the professional literature. Recall, however, that about 40% of the NWC women report a strong attraction to other transsexual women in general; half had had actual sexual experience with another transsexual; nearly half had had a past abusive relationship with another transsexual; and about 70 percent would have liked to have sex with someone present at the conference. If these women are at all representative of the broader transsexual community, or even of its non-androphilic component, then it is no wonder that partnerships between transsexuals are commonplace. (Lawrence 1997)

Even Benjamin's book mentions one case of "a reversal of roles with the wife becoming the husband and the former husband becoming the wife" (Benjamin 1966:151). Two of Bolin's MTF subjects were in a relationship and were married in a gay church (Bolin 1988:166-7). Two of Daskalos's (1998) MTF subjects dated male transvestites they had met through support groups. The only large studies to bother asking found that eight percent of MTFs had had sex with trans partners, as had fifteen percent of FTMs (Clements-Nolle et al 2001:917-8), and 13% of an undifferentiated sample (mostly MTFs, some FTMs) had had a trans sex partner in the last six months (Sykes 1999).

Frequent trans-trans liaisons are to be expected, if only because transpeople are likely to meet each other through support groups, trans or queer community events, political activity and friendship networks. Furthermore, transpeople, having done the work of recoding their own bodies and sexualities in ways congruent with their gender identity, may be more likely to accept a trans partner's gendered sexual identity. Some may also find that through their process of self-acceptance and socialization within trans social networks that they come to eroticize genderqueerness and be especially attracted to other transpeople.

"What is it when a transfag and a transdyke get together and make magic together with their bodies and hearts?" asks C. Jabob Hale (quoted in Cromwell 1999:133). "It's beauty and delight and peacefulness and excitement and....Whatever else it is, it isn't lesbian or gay or bisexual or heterosexual, because all of those miss the crucial fact that his transsexuality and queerness, her transsexuality and queerness, are a major part of what gets them together in the first place and keeps it fun and exciting and hot and lets it pass into beauty."

Pat Califia describes trans-trans liaisons as a response to the dilemmas of finding full accepting from a non-trans partners, and as a "revolutionary strategy, which opposes the assumption that a transsexual needs to have his or her gender identity bolstered by intimate affirmation from someone whose self-image is consistent with his or her genetic sex" (Califia 1997:217). (See Footnote 4) Cromwell dismisses this characterization and asserts that these relationships are simply "one of the multiple ways in which transpeople have relationships"(1999:134). Indeed, it would be a mistake to read trans-trans liaisons as a utopian alternative, as the mixed experiences of Devor's participants demonstrate.

Devor (1997) observed a number of trans-trans liaisons in a sample of 47 FTMs. Two participants reported serious pre-transition relationships with other transpeople, one with a male cross-dresser and another with a pre-op MTF transsexual. Of the former, Devor reported that "her transgendered lover allowed Alan to further explore her incipient transsexual identity" (280); the latter, on the other hand, reported feeling "'manipulated,' 'taken advantage of,' and 'disgusted' after allowing herself to be sexually stimulated manually by her transsexual friend," and ultimately regretted the entire year-long relationship (279). Devor spoke with another transman in the process of transition "who was still smarting from being rejected ... by a male-to-female transsexual whom he had been dating" because he lacked a penis (1997:476). One transman had a casual sexual relationship after his transition with a pre-op MTF, which "started out being fun, but it turned into counseling, very quickly" (482).

Finally, one participant reported relationships with several other transsexuals; first long-term relationship was with an MTF, with whom he lived for three years and whose surgery he financed.

Their sexual contacts, however, were minimal both before and after the woman's surgery. Before the surgery, both partners felt very ambiguous about using the women's penis, and subsequently, sex reassignment surgery destroyed the woman's erotic sensations. Darren also reported that the woman had never expressed much interest in touching Darren in explicitly sexual ways. In addition, their sexual life was further stymied by the woman's traditional views on how sexuality should transpire. (481)

Darren also reported living with an FTM lover, and it was in this relationship that he first experienced nakedness with a partner, oral sex, and orgasm, and began to enjoy female sexual role-playing and other forms of sexual experimentation (506; interestingly, this relationship ended after his partner cheated on him with their MTF roommate). Darren's most recent partner was an MTF transsexual, and they were happily married at the time of the study. "We're very comfortable with each other, in terms of dressing, undressing, touching, sex, and all that," and "he further explained [writes Devor] that unlike his previous ... partner, this woman did not want him to acquire or simulate a penis for their lovemaking because she saw him entirely as a man without on and she knew the dangers of genital surgery" (482).

BDSM and Trans Sexuality

Several authors have noted BDSM sexual practices among transpeople, and pointed to BDSM communities as sites where transpeople have been more able to sexually express themselves. Bolin was probably the first, noting that out of twelve responding MTF transsexuals (all members of the same support group, and by no means a representative sample), nine had fantasies with BDSM themes, eight had engaged in bondage and discipline, and five "were involved in the subculture of sadomasochism" (Bolin 1988:168-9). Bolin explains this in three ways: first, that transsexuals are forced to the sexual margins of society to find sexual outlets and may find more acceptance in kink culture. Conversely, she also notes "a tendency for the stigmatized to participate in the margins of society regardless of particular subcultural affiliation, due to ease of access" (171). Finally, she argues that these practices may be an extreme way of validating female identity through enacting an exaggerated version of prevalent cultural messages about female vulnerability and submissiveness. Overall, Bolin theorizes that interest in BDSM practices "may be a phase of their own misinterpretation of women's sexuality" (172) and generally declines as they have more conventional sexual experience as women.

Clearly, this theory is at odds with an understanding of BDSM as a natural part of human sexuality, and does not at all explain interest in BDSM among FTMs. A handful of Devor's FTM participants also reported BDSM fantasies, practices and community involvement. Two reported that involvement with S/M lesbians had allowed them to express and explore masculinity prior to coming out as transsexual. One participant, in a gay male-identified sexual relationship with a non-trans biological female, reported that he frequented gay leather bars with his partner as a master/slave couple and that "there was never any problem ... at all. We were accepted" (Devor 1997:507). The authors of Different Loving: The World of Sexual Dominance & Submission (whose perspective is mostly from the world of heterosexual S/M) also assert that transsexuals and transvestites are drawn to kinky communities in part because there tends to be more acceptance of them there (Brame, Brame & Jacobs, 1993). Michael Hernandez (1996) notes that while gender play has become increasingly acceptable in lesbian S/M communities, acceptance of transmen and transwomen in the leatherdyke community -- especially at play parties and as sexual partners -- has continued to be a contentious issue, as it has been in lesbian communities in general. He notes that he has been lucky enough to find acceptance as an FTM lover and S/M player from many queer women, but others have not been so lucky. Writing in the same anthology, MTF transsexual Tala Brandeis similarly feels "extremely lucky" (1996:60) to have a supportive S/M dyke community, unlike many transsexual lesbians.

Trans Asexuality

I'm basically asexual. Sex is not and never has been important. I've never really felt sexually attracted to anyone, male or female. (MTF respondent in Bolin 1994:89-90)

Most patients state they would rather be lonely and frustrated than date during transition. (Brown & Rounsley 1996:140)

Transpeople have long been depicted as more or less asexual. The doctors treating Christine Jorgensen -- America's first famous transsexual -- found "the sexual requirements ... subordinate to the transvestic impulse," and therefore recommended removing her penis and resculpting her genital region for "a completely feminine appearance," without actually creating a clitoris or vagina (Hamburger, Stürup and Dahl-Iverson 1952, quoted in Meyerowitz 2002:61-2). One early clinical study even characterized transsexualism as "an escape from ... sexual impulses" (Worden and Marsh 1955, quoted in Meyerowitz 2002:108; the same conclusion is drawn in Pauly 1965, cited in Meyerowitz 2002:174). No surprise then that, according to historian Joanne Meyerowitz, transsexuals in the 1950s and since have been reticent to express any interest in sex to doctors.

Clinical researchers continued to insist that disinterest in sexuality was common and even characteristic of transsexuals. Harry Benjamin asserted that "Many transsexuals have no overt sex life at all, their sex drive being low to begin with and, in the case of MTFs, diminished sometimes to zero by estrogen" (1966:49). Lewins (1995) noted that "low sex drive" as considered a good "prognostic indicator" by clinicians and categorized over a fifth of his sample as "asexual," a label that, while described by Lewins himself as problematic, is used by at least some transsexuals to describe themselves (e.g. Taft 2001). A contemporary medical expert on transsexualism has this to say:

In fact, a high level of sexual performance, whether with a partner or in masturbation, raises a red flag as to whether the individual is truly a transsexual. While there are no absolutes, gender-dysphoric individuals with extremely high physical sex drives and/or who are extremely active masturbators rarely turn out to be transsexuals. (I have seen a few exceptions.) (Ramsey 1996:49)

Defining transsexuals as having a low sex drive is only logical from the clinical point of view. Before transitioning is complete, sexual engagement may be seen as a sign of accepting one's gendered body. Furthermore, since (clinical optimism notwithstanding) the physical processes of transitioning often have negative impacts on capacity for arousal and orgasm, and transpeople have traditionally had trouble finding accepting partners. Sexuality may be viewed as something that must be sacrificed in order to live in one's chosen gender; in this vein, Califia argues that "Too many transsexuals still feel that if they are 'allowed' to live in their gender of preference, they have won an enormous victory, and ought not to demand or expect anything more," namely sexual pleasure (1996:218). McCloskey puts a more positive spin on this in her autobiography: "losing the ability to have male sex [due to prolonged hormone use] did not seem much of a loss beside the joy of being" (McCloskey 1999:37). One study of personal advertisements showed that MTF transsexuals were more likely than gay men, straight men or straight women to be seeking friendship rather than sexual partners (Child et al 1996).

The transitioning process especially has been seen as an asexual period, a "cocoon" stage where the individual who is neither man nor woman avoids intimacy completely (Brown & Rounsely 1996, Lewins 1995, Bolin 1988, Devor 1997). For many it is as simple as this: "I abhorred the idea of a sexual relationship with a woman unless I was a man," or a woman as the case may be (Rees 1996:40). Even after transition is complete, however, many either do not succeed in finding satisfying relationships or consciously abstain, as in Lawrence's study of post-op women, wherein "only 4 of the 13 women reported having sex regularly, while three had given up on sex," to which she adds that "Neither of these results is particularly remarkable" (Lawrence 1997). It seems that as in Devor's study, there is a substantial group of transpeople who are not interested in or do not pursue sexual relations during transition, and a much smaller but distinct minority who choose long-term celibacy.

Forbidden Pleasures?

In the responses of eleven [MTF] transsexuals, three prevalent attitudes about the penis and its sexual use emerged. One individual did not use her penis at all as a sexual organ. In this regard she stated: "I can't stand to use it any more even for those necessary daily functions." Two masturbated with the penis, but felt guilty afterward, such as one who revealed: "After masturbation I feel extreme distaste and immediately after the waves (of orgasm) I feel dirty and sick." Others (N=8) use the penis in masturbation or in a sexual encounter. They would rather be rid of it but had the perspective that "it's there," "it gives one pleasure, so why not use it?" (Bolin 1988:60)

It is unsurprising that disinterest in or anxiety about sexual relations among many trans individuals is centered on the genitals. Even for some pre-operative or non-operative transpeople who are sexually active, their genital region is a no-go zone, and sexual pleasure must be sought in other places and fashions. Serious discomfort (at best) with the genitals one was born with was originally been thought to be the for most if not all trans individuals -- indeed, it was a central, if not the central, characteristic of transsexualism as defined by traditional medical discourse. Author/photographer Dean Kotula echoes this definition when he insists on a division between transsexuals and the transgendered: transsexuals are people who are deeply uncomfortable with their genitals and desire opposite-sex genitals (though some may not obtain SRS due to financial barriers or dissatisfaction with currently available surgeries) (Kotula 2002:170-1). Transwomen's penises are frequently described as "hated" (Benjamin 1966:49) and "despised" (Feinbloom 1976:163) in the clinical literature. While a far greater number of transmen and FTMs opt not to pursue genital reassignment (Benjamin 1966, Devor 1997, Cromwell 1999; see Griggs 1998:73 for a three-pronged explanation of the disparity in genital surgery), avoidance of genital sexuality is nonetheless prominent among them as well. "I have tried to touch myself there, but I avoid it now," says a typical subject from a clinical study (Tully 1995:132)

Many choose to avoid even revealing their discordant genital status to sexual partners. First mentioned by Benjamin (1966) in relation to MTF prostitutes, the practice of hiding one's genitals from sexual partners is widely reported in clinical and social science literature; Tully (1995) asserts that most preoperative MTFs engage in this practice. While hiding one's gender/sex variance may avoid the difficulty and risks of self-disclosure, it is not generally a tenable strategy in sexual relationships that are more than casual (though jazz musician Billy Tipton's five ex-wives insist they never knew he was born female; see Middlebrook 1999). This manner of avoiding the issue can have disastrous consequences when the individual's genital status is revealed, however, from the end of a relationship to violent rage (e.g. Boys Don't Cry; see below).

While the avoidance of genital stimulation is a very prominent theme, however, what may be an increasing number of transpeople and their partners are able to engage in pleasurable use of the genitals with which they were born with little or no attendant anxiety. This is likely an outgrowth of what trans activist Holly Boswell terms "the transgender paradigm shift towards free expression" (Boswell 1998). Challenges to traditional notions of gender, sex and sexuality presented by feminist and queer movements since the 1960s informed the emergence of the transgender movement in the 1990s, which in addition to pressing for the civil rights of trans people has offered radical redefinitions of these categories. Accordingly, more and more trans individuals feel less and less bound by gender norms; they are less concerned than their predecessors with being "man" or "woman" enough, or with having the "right" body for the gender they identify with.

Trans activist gives a very frank example of such attitudes:

I like vaginal penetration. I like being fucked. I am not going to disown a part of my body which happens to be pleasurable to me. I would love to have a penis, but given the current technology right now that’s not in the near future and what I have feels good and I want to use it. I found out from the person I see for counseling that she has a lot of FTM clients who like vaginal penetration. The thing is that nobody talks about it. (Nataf 1997:25)

Clearly they are beginning to talk about it, and the recent anthology Best Transgender Erotica (Blank and Kaldera, eds. 2002) talks about it quite a lot. This groundbreaking collection of short stories (written both by trans and non-trans individuals) is one of the first productions of trans erotic art or literature outside the exploitative pornographic ghetto of "she-male" porn. In additions to science-fiction visions of futuristic or fantastical genderbending, the entries depict trans people of all sexual orientations who having satisfying sexual experiences: FTMs who like vaginal penetration, MTFs who enjoy penetrating their partners, lovers who appreciate their trans partners' bodies without seeing any contradiction with their gender identities, trans people in sexual relationships with each other -- indeed, there are few characters who are depicted as seeking SRS or are post-op (one pre-op woman is in a relationship with a non-op woman). The pornographic films of Christopher Lee (Alley of the Tranny Boys, Sex Flesh in Blood), also depict pre- or non-op transmen deriving sexual pleasure from their genitals, as well as engaging in strap-on sex, BDSM, and sex with other transmen.

Sexuality and Identity Formation/Affirmation

While the avoidance of sexuality forms one prominent theme in the literature, sexuality emerges elsewhere as a site for identity affirmation, for some an absolutely crucial part of identity formation and self-acceptance. Rees recalls feeling "that until a normal woman had accepted me then it would be very difficult to love, accept and like myself" (Rees 1996:127). As for anyone going through serious life changes, the support of a romantic partner of one's identity, and the difficult processes of coming out, changing one's name and undergoing physical transition are of great importance to those who experience them, and is regarded by Bolin's respondents as "a situation most conducive to" transition (Bolin 1988:164). For those transsexuals who "cocoon" until surgery, engaging in sexual relations with reconfigured genitals may form the crown of what Bolin terms "the rite of reintegration" to society as the opposite sex (Bolin 1988). The need for acceptance via sex is considered so powerful that it has been asserted as a significant causal factor in disproportionate rates of HIV seropositivity and participation in sex work (see below).

Especially for those seeking sexual relationships before or without surgery, attracting sexual partners whose sexual history and/or orientation affirms their own gender identity -- a straight-identified FTM having a straight-identified female partner whose sexual history is only with men, or a dyke-identified MTF having a dyke-identified female partner, for example -- seems to be similarly important. Some however, especially FTMs who have come of age in lesbian communities (see Cohen 2001, Cromwell 1999, Nataf 1996), or married transsexuals who refuse to let transitioning end a good marriage (see Bolin 1998), are able to more or less happily negotiate a relationship with a partner whose orientation is apparently at odds with their own identity. Some transsexuals who transition and remain married, however, report that their relationship to their spouse becomes mostly or entirely platonic (e.g. Morris 1972).

For many, playing out gendered sexual roles is of tremendous importance. Tully again provides the archetypal scenarios: MTFs are preoccupied with passivity in intercourse, whereas "almost all" of the 67 FTMs he interviewed "emphasise the importance of taking active, leading control in lovemaking. It is an issue which is intimately tied up with their sense of gender identity and role" (Tully 1995:131). From this perspective, it should be unsurprising that very few FTMs report receptive vaginal or anal sex behaviors, whereas most MTFs report having receptive anal sex (Clements-Nolle 2001).

Learning Manhood

Several authors mention an interesting twist on identity development and sexual behavior, in which trans individuals gain from genetic male partners both a vicariously exciting experience of the maleness they desire to have, and lessons in male physiology and gender performance.

Mario Martino describes in his autobiography his first and only sexual encounter with a man, a friend who he was not attracted to but sought out as "an experiment":

"God, what I wouldn't give for such a set of organs!" [he recalls thinking upon undressing his friend.] I had no enthusiasm at seeing this set on Bart. I could only envision having my own and displaying it for Louise. With Bart, it was like being back in biology class with someone showing a model and slides of the human male genitalia. I was too absorbed to notice gradual engorgement until suddenly the phallus turned into an erect tool. (Martino 1977:109)

Brian Tully also quotes an FTM subject as saying that while the sexual relationship he had once had with a man had been unsatisfying, "he taught me how to make love to a woman" (1995:135) While these experiences were pre-transition, Devor reported similar motivating factors for post-transition sexual relations with men. At the time of their transition, most of her participants had had only cursory genital sex experience with males, only nonconsensual ones, or none at all. "In order to perform convincingly as straight men," she says, "participants needed to understand how men typically behaved in sexual and romantic encounters." Moreover, they lacked a working knowledge of penises, and thus "were desirous of conducting their own fieldwork." Those who dared to undertake casual sexual relations with men came away with "little useful information," but the experiences appear to have helped them consolidate a male identity, and a few articulated a lasting attraction to men (Devor 1997:508-9).

While Devor's participants overwhelmingly favored women in their sexual preferences, Hein and Kirk observed that

For FTMs who identified as gay or bisexual, sexual encounters with biological males provided opportunities to experience gender equality. Gay sex was described as man to man and reciprocal for both partners regarding power, control and submission. Sex with men also allowed participants to develop affinities with their partners’ genitals. One group member described viewing his partner’s penis as a friend. Other participants experienced vicarious enjoyment of male genitals. Group members also valued sexual energy with other men because it provided access to what one participant called cock energy. Some participants believed that having male energy was as important to their transition as having a male body. (Hein & Kirk 1999:112)

Analogous accounts from genetic male transpeople with genetic female partners were not seen in the literature. A likely explanation for this apparent disparity is that transmen and FTMs as a group are less likely to have intimate experience with members of the "opposite" genetic sense growing up than transwomen and MTFs, and therefore are more likely to seek out such experiences for these particular reasons, or to emphasize these aspects of sexual encounters with men.

The Effects of Hormones

Transsexuals most often report being excited about the secondary sex characteristics that accompany the hormone treatment, which may serve to improve their self-esteem and, consequently, their willingness to consider participating in sexual situations. (Ramsey 1996:49-50).

It is beyond the scope of this paper to summarize thoroughly the physical effects of hormone replacement therapy (HRT) for trans individuals, and their ramifications for sexual life. It must suffice to say that for MTFs, effects generally include breast development, redistribution of body fat to give the hips, face, etc. a more "female" appearance, eventual diminution of body hair; effects on sexual functioning include decrease in fertility, decreased erectile functioning, decreased sex drive (for some) and, especially if sexual activity is sparse or absent, eventual atrophy and shrinking of the genitals. For FTMs, typical effects include facial and body hair development, deepening of the voice, and fat redistribution; effects on sexual functioning include decrease in fertility, elongation of the clitoris, increase in sex drive, and sometimes decrease in vaginal lubrication. The degree or even the presence of all these effects varies significantly among individuals. The implications of these changes for one's sex life also, of course, vary to a considerable degree.

For many individuals, it appears that undergoing HRT may lead to increased comfort with and participation in sexual activities. As the body comes somewhat closer to aligning with the individual's identity, body dysphoria may decrease markedly and with it anxiety about sharing it with partner and experiencing sexual pleasure.

For others, however, the initiation of HRT is precisely the point at which they enter the much less sexual, if not totally asexual "cocoon" stage discussed above. While HRT is a positive and life-enriching choice for practically all of these individuals, hormone-induced changes in their secondary sex characteristics in combination with their unaltered natal genitals may cause them to be more self-conscious and hesitant to risk sharing their increasingly nonstandard body configuration with a partner. Unsurprisingly, this attitude appears to be particularly common among those who intend to eventually undergo SRS.

Remapping the Body

C. Jacob Hale has observed that "many transpeople must remap the sexualized zones of our bodies if we are to be sexually active," meaning that sexed erogenous zoned must be proactively resignified and renamed in ways consistent with an individual's gender identity (Hale 1997:227). Tala Brandeis, for example, describes her body this way:

My body is female. ... It just had inappropriate hormones and aberrant primary and secondary sex characteristics for my gender. I was an intensely androgenized version of female, a metamorph, a changeling. I was born a woman irrespective of my physical traits. (Brandeis 1996:52)

Discussing her lesbian sexual life, she hesitantly refers to lovers wanted to be penetrated "using my ... clit?" (58). Becky Adelman similarly describes, in her analysis of erotic texts by female-born genderqueers and their partners, the "imaginative labor " through which these sexual actors "queer the language of the body," describing testosterone- and (and sometimes surgery-) enlarged clitorises variously as "clit," "dick," and "clit dick" (Adelman 2001:22-29).

Describing the processes of body "transgendering" used in transgender narratives to harmonize physical features with gender identity, sociologists Richard Ekins and Dave King add to "substituting," "concealing" and "implying" the "more subtle and multi-layered" process of "redefining." Along with the broader redefinition of gender categories and personal identity

the nature of the body and its parts may be redefined. The male to female transsexual may redefine her beard growth as facial hair. The penis may be redefined as a "growth between the legs," as in "I was a woman who needed some corrective surgery. The growth was gone and my labia, clitoris and vagina were free" (Ekins and King 1999: 584; quotation from Spry 1997).

Hale describes such practices specifically within the context of "daddy/boy" role-playing scenes among s/m women and genderqueers (aka "leatherdykes"). While not all leatherdykes (or other s/m practitioners who play with gender) are trans or gender-questioning, for those who are an emergent male identity may be explored or consolidated through role-played experiences of masculine endurance or dominance, and within such play it is also possible for, in Hale's terms, "resignify sexed bodily zones."

Thus, if the body part a leatherdyke daddy is fisting is that which a physician would unequivocally deem a 'vagina,' it may be resignified so that its use for erotic pleasure is consistent with male masculinity. It may become a 'hole,' 'fuckhole,' 'manhole,' 'boyhole,' 'asshole,' or 'butthole,' and a leatherdyke boy pleading, 'Please, Daddy, fuck my butt!' may be asking daddy to fuck the same orifice into which a physician would insert a speculum to perform a pap smear.... For some FTMs who used to be leatherdykes, our abilities to rechart our bodies -- I would even say to change our embodiments without changing our bodies, that is, to change the personal and social meanings of our sexualized bodies -- began in the queer resignifying practices available to us in leatherdyke culture. (1997:230)

Thus, while some trans individuals simply deny any contradiction in being a man with a vulva and vagina or a woman with a penis and testes, for others the body is made consistent with gender identity through processes of resignification.

HIV Risk and Safer Sex Practices

A number of recent studies have addressed the HIV prevalence and risk behaviors of trans people in North and South America, Europe and South Asia. While epidemiological studies in this area have been some of the largest studies of sexual behaviors among transpeople outside the field of clinical psychology, they do not provide a representative picture, as most have been limited to MTF sex workers (e.g. Modan et al 1992; Harcourt, van Beek, Heslop, et al 2001; Tsakris, Kyriakis, Chryssou & Papoutsakis 1997; Spizzichino et al 2001) or to the San Francisco area (Nemoto et al 1999; Clements-Nolle et al 2001; Kellogg et al 2001).

These studies have shown high rates of HIV risk behaviors and of HIV seroprevalence among trans people. While it is not known with any certainty what percentage of trans people engage in sex work, a high rate of participation in commercial sex may partially explain these phenomena; certainly the San Francisco studies have shown that a large number of MTFs engage in sex work, and that few practice safer sex consistently. The high medical costs of transitioning, family rejection, job discrimination, difficulty in passing may all contribute to transwomen entering sex work. Nemoto et al cite studies from Italy, Brazil, Israel and the United States showing that trans prostitutes have higher rates than both male and female non-trans prostitutes (298), which may be due to their making less money and being less likely to turn away clients who refuse to practice safer sex or offer more money for unsafe sex.

Not only sex workers but also the community at large may be at risk for a number of reasons. Citing focus groups conducted by the Minnesota Department of Health, Bockting and Kirk (1999) write that

Invisibility, poverty, shame, low self-esteem, loneliness, and sharing needles for hormone or silicone injection [are all risk factors affecting the trans community]. ... The chronic lack of HIV prevention efforts targeting the transgender community was seen as supporting a denial of risk already widespread in the community. Myths about HIV that predominate in society as a whole are reflected in the transgender community in unique ways. For example, some transexuals believe a change from a gay or lesbian to a heterosexual role, or a change from male to female, provides them with protection from HIV, without any concomitant behavior change.

It is not known just how many people have been infected by sharing needles for hormone injections, but use of street hormones is widespread and is suspected to be a significant route of transmission among transgendered people. San Francisco is the first city to respond to this problem with needle-exchange programs directed specifically at trans people injecting hormones.

Relatively little is known about the effects that physical processes of gender transition may have on HIV risk. Some have speculated (e.g. Modan et al 1992) that the inability of post-op transwomen's vaginas to self-lubricate may place these women at greater risk of vaginal transmission through abrasions in the vaginal walls, and HIV educators therefore advise post-op women to use added lubrication for vaginal intercourse.

While research thus far suggests that few (though definitely some) FTMs engage in sex work and that FTMs have much lower rates of HIV infection compared with MTFs, (e.g., 2% compared with 35% in Clements-Nolle et al 2001), they face many of the same risk factors and may be unlikely to see themselves as being at risk and to practice safer sex (Namaste 2001, Hein and Kirk 2001). Kammerer, Mason and Connors (2001) note "Contributing to female-to-male transgenders' risks ... is the sexual drive, sometimes both precipitous and strong, brought on by the use of male hormones to effect bodily transition, perhaps accentuated, as Griggs (1998: 34) notes, by "cultural reinforcement of masculine [sexual] expression."

Emotional and cognitive factors can and do impede the use of safer sex practices in all populations; specific factors may affect both MTFs and FTMs. Because, as discussed above, acceptance by sexual partners seems to be so important for many transpeople's self-esteem, especially during the transitioning process, that they may not insist on safer sex practices, even if they would like to, for fear of rejection. Transsexual activist Riki Anne Wilchins relates that, "You want to be accepted and sex feels like acceptance . . . even for a night, even for fifteen minutes . . . lots of Trans people will have unsafe sex to feel desirable, to feel loved, to be validated as a woman or a man . . ." (quoted in Warren 2001:145). And in Hein and Kirk's FTM workshops,

One participant related that simply being perceived as a man by potential male or female sexual partners predisposed him to emotional and physical risk. He described the profound validation he continues to feel being recognized as male, and the difficulty of asserting his needs when his gender identity is at stake; doing so might jeopardize his acceptability as a sexual partner, complicate the encounter, and end in rejection. (113)

Transmen and their partners may be unsure how to approach safer penetrative or oral sex, as they find that standard male condoms will not fit their genitals. Hein and Kirk (1999) reported of an FTM focus group that they

valued condoms because they provided male-identified options for safer intercourse and oral sex but found them difficult or impossible to use. When one group member related his struggles with safer sex, other participants raised the possibility of adapting dental dams for different sexual acts. He shuddered as he told the group that he associated dental dams with vaginal sex and being female; they were not an option, even if it meant contracting HIV. (113)

Questioned on this subject in her online advice column, Carol Queen (2001) suggested that finger cots and plastic wrap are appropriate alternatives for some.

Sexual Violence Against Transpeople

Experiences of childhood sexual abuse, rape, sexual assault, and domestic violence were not generally addressed in literature discussing sexuality. Unique among researchers I read, Devor (1997) specifically sought data about sexual abuse and assault, and gathered plenty of it. From that sample of FTMs, 20% had been sexually abused as children, and 6% had been sexually assaulted at an older age. Devor did not, however, make any comment on how these experiences might have impact participants' sexual lives.

Sexuality cannot be fully understood, however, without attention to nonconsensual and violent experiences of sexuality and to violence within sexual relationships, which may impact individuals' sexual lives greatly and in myriad ways. Although there is little research on these topics, it is known that transpeople suffer disproportionately high rates of victimization from many forms of violence, and this includes sexual violence and domestic violence; one preliminary study of trans and intersex people found that "50% of respondents had been raped or assaulted by a romantic partner" (Courvant and Cook-Daniels, 1998). Even if this alarmingly high number is not representative, transpeople are certainly sharply aware of the possibility of violence from sexual or romantic partners, and this is often cited as one reason for concealing one's transgender history and genitals in sexual encounters. The American Boyz organization studied sexual violence among female-born transpeople and found that "incidents of sexual assault, rape, and incest, correspond with estimates for the female population at large, which suggests that gender appearance may influence how the sexual abuse manifests, but does not seem to serve as a trigger for provoking sexual abuse" (cited in Courvant 1997). Transwomen probably experience victimization more frequently than transmen, at least once they begin to live in their chosen gender full-time (NCAVP 2001), and considerably more than for biological males in general.

Sexual assault against transpeople, often a hate crime specifically motivated by transgender status and specifically aimed at gender-transgressive sexual anatomy, may heighten survivors' body or body-part dysphoria, especially for FTMs who have a "female" role forced on them through rape (as dramatized in Boys Don't Cry, the harrowing film biography of the late Brandon Teena). Pre- or non-operative transwomen may also experience sexual assault directed at their genitals, as in the case reported by Diana Courvant of a transsexual woman whose female abuser took advantage of the transwoman's involuntary, fear-induced erections to rape her (Courvant 1997), but the exact prevalence of such crimes is not known, and transwomen are probably more likely to be sexually assaulted as women by men (Witten & Eyler 1999, cited in Lev & Lev 1999).

Conclusions

The published literature on sexuality among transitioning trans people has historically been dominated by the works of psychiatrists, psychologists and surgeons. These works have been and continue to be notable for their assumptions of pathology among trans people, their inattention to sexual diversity in this population, and their serious methodological limitations. The few published works by trans people -- autobiographies aimed at winning acceptance from gender-normative audiences -- generally conformed to the stereotypes promulgated in the clinical literature. As recently as the mid-1980s, trans people were depicted as generally asexual or even sex-phobic, heterosexual to the extent that they were sexual, and focusing their sexual practices towards affirming their chosen gender identity.

In recent decades, epidemiologists, sociologists and historians have added to the available professional literature on trans experience, and sexuality in particular. Most notable, however, has been the burgeoning of popular literature addressing trans experience, especially literature produced by and directed towards trans people themselves, including autobiographical writings, newsletters and magazines, and web pages, as well as artistic productions such as novels, erotic stories, and films. Particularly since the early 1990s, this literature has begun to devote significant attention to sexual issues and experiences, and has played the most significant role in articulating a much more complicated picture of trans sexuality.

While there is still no really representative research in this area, sexuality among trans people appears to be in key respects just as diverse as in any other population. Contrary to the assertions of early researchers, there is increasing evidence that there is great variation in sexual orientation among trans people, and some research even points to bi- or homosexual trans people outnumbering heterosexual ones. Trans people engage in the full range of human sexual practices, not necessarily limited by gender identity or surgical status, including celibacy, manual and oral sex, penetrative and receptive anal and vaginal intercourse, the use of sex toys, BDSM and various kinds of sexual role-playing, casual sex, and sex work. The intersection of questions of gender identity and sexual practice, particularly at the site of the genitals, however, does produce some issues and experiences that seem to be either unique to trans experience or more common among trans people.

Most centrally, the gap between self-understanding and physical sex experienced by transitioning trans individuals presents a problem for sexual activity. The literature shows several different strategies employed by trans individuals to deal with this problem:

1) Avoid sexual activity altogether. This strategy sidesteps the problem altogether, and is strongly emphasized in the medical and clinical psychological literature, though it appears throughout the literature.

2) Limit sexual activity in ways that minimize or avoid experiences of discordance. This may involve focusing sexual activity on partners' bodies and avoiding sexual attention to the trans individual's body altogether, or simply eschewing any form of genital stimulation. This strategy appears throughout the literature and is emphasized in the medical and psychological literature.

3) Remap the body in ways that accord with gender identity. In this strategy, bodily features -- especially the genitals -- that do not accord with one's gender identity by traditional standards are redefined. Individuals conceive themselves as having conventional bodily features for their gender, only with more or less unconventional configurations (e.g. a large clitoris or small penis). In this way, individuals may be able to enjoy genital sexuality with little or no anxiety. This strategy is reported in recent social-scientific and autobiographical literature.

4) Reconceive binary gender categories so that no discord is experienced between the sexual body and gender identity. In this strategy, bodily features -- especially the genitals -- conventionally defined as belonging to one gender can be accepted as features of members of the "opposite" gender (e.g. penis in a woman, vulva and vagina in a man). This strategy is mentioned very occasionally in the clinical literature, and appears frequently in recent autobiographical and popular literature.

5) Reject binary gender categories altogether. In this strategy, the individual identifies as being in neither the male nor the female category exclusively, and is thus able to see their non-traditional physical configuration as unproblematic. While this strategy was not specifically reported in the literature on sexuality among transitioning individuals, it has been described with increasing frequency in the broader trans population, and it is expected that it is indeed employed by some individuals who choose physical transition. (If so, these individuals would presumably not conceive of transition as most do, as a transition from living in one gender to living in another, but rather as seeking specific physical changes which may enable greater personal comfort and the articulation of a gender identity that challenges binary categories.)

Potential implications of this problem turn up in almost every area of sexual experience. Supportive and understanding partners may help individuals to become more comfortable with their apparent mind/body incongruity, and trans people's choice of other trans people as romantic and sexual partners may in many cases be related to expectations of greater understanding and comfort. Sexuality can be not only a site of anxiety about identity, but also a site for identity development and affirmation, as reported by BDSM practitioners and some FTMs who had sexual experiences with natal males. Trans populations have been identified as particularly at risk for HIV infection, for reasons related to many trans people's anxieties about their genitals as well as the effects of social marginalization. Experiences of sexual violence, of fears of experiencing sexual violence, may heighten trans individuals' body dysphoria.

The "transgender paradigm shift towards free expression" may be reflected in a kind of generational shift in trans people's feelings about and experiences of sexuality, with more young trans people adopting the third, fourth and fifth strategies described above, though many (perhaps most) may still adopt the first and second strategies. If this is so, it is possible in significant part because in the last generation trans individuals have had access not only to a professional literature that delineates a rather narrow picture of trans people's sexuality, but also an increasingly diverse array of trans voices speaking about their own sexual feelings and experiences (as well as increasingly better published research).

In what follows, I have attempted to explore many of these questions through a unique study of sexual experiences in a trans sample.

Footnotes
1 - For a discussion of popular media treatment of Jorgsensen, see Denny 1998; for a discussion of transgenderism in contemporary talk shows, see Gamson 1998.
2 - Since the publication of the work discussed here, Devor has made a gender transition and now writes under the name Aaron H. Devor (personal communication).
3 - Unfortunately, this forthcoming publication came to my attention only 24 hours before my thesis was due, so I was not able to offer an in-depth analysis of Bailey's theory or his methods.
4 - Not long after that sentence was published, Califia (who, incidentally, also wrote one of the first books on lesbian sex -- see Califia 1980) changed his name to Patrick, started on hormones, and had a child with his FTM lover (see Califia-Rice 2000, Califia 2002).

Part II

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