Whipping Girl

Gatekeepers also practiced traditional sexism, as evident in the way their research and writings focused almost exclusively on MTF spectrum trans people. This occurred even though their own estimates typically showed MTF transsexuality to be merely three-times more prevalent than in the FTM direction.²⁴ Of course, as previously discussed, gatekeeper statistics were often just a reflection of their own biases (i.e., if they chose not to examine or treat you, you would not be counted as a transsexual). Today (now that information and access to transitioning is more widely available), trans people seem to be transitioning in both directions at roughly equal rates. This strongly suggests that the higher rates of MTF transsexuality cited in the past were simply an artifact of the gatekeepers’ preferences for studying and “treating” it.

Many attempts to explain the gatekeepers’ focus on trans women over trans men have centered on the assumption that traditional sexism was occurring based on the trans person’s assigned sex. For example, many have pointed out that trans women, having been raised male, tended to have more financial resources to afford the extremely costly therapies and procedures associated with transitioning. Others have argued that a female-bodied person who wanted to transition to male would be taken far less seriously than a male-bodied person who expressed a desire to transition to female.²⁵ While the idea that a gatekeeper would take a “man” more seriously than a “woman” probably played some role in fostering this discrepancy, I would argue that, more often than not, traditional sexism tended to work in the other direction. In other words, the gatekeepers focused on MTF spectrum individuals not because of that group’s male privilege per se, but because they considered male expressions of femininity to be more disturbing and potentially threatening to society than female expressions of masculinity.

The idea that “male femininity” is more psychopathological than “female masculinity” can be found throughout the transgender-specific diagnoses in the most recent edition of the DSM (DSM-IV-TR) . For example, the entry for transvestic fetishism (which exempts FTM spectrum trans people) is listed in the DSM as a paraphilia, a psychiatric category for sexual behaviors described as involving “(1) nonhuman objects, (2) the suffering or humiliation of oneself or one’s partner, or (3) children or other nonconsenting persons.” The transvestic fetishism diagnosis is written in such a vague way as to include most, if not all, heterosexual men who routinely crossdress.²⁶ Katherine Wilson, who writes for GID Reform Advocates (an organization that works to reform the psychiatric classification of gender diversity as mental disorder), has pointed out how this diagnosis, while targeting male-bodied people, is mired in traditional sexism:

Curiously, women and gay men are free to wear whatever clothing they choose without a label of mental illness. This criterion serves to enforce a stricter standard of conformity for straight males than women or gay men. Its dual standard not only reflects the social privilege of heterosexual males in American culture, but promotes it. One implication is that biological males who emulate women, with their lower social status, are presumed irrational and mentally disordered, while biological females who emulate males are not. A second implication stereotypically associates femininity and cross dressing with male homosexuality and serves to punish straight males who transgress this stereotype.²⁷

A similar tactic of punishing femininity in boys more vigorously than masculinity in girls can be found in the DSM’s gender identity disorder (GID) in children diagnosis. As Wilson points out, “Boys are inexplicably held to a much stricter standard of conformity than girls in their choice of clothing and activities. A simple preference for crossdressing or simulating female attire meets the diagnostic criterion for boys but not for girls, who must insist on wearing only male clothing to merit diagnosis.”²⁸

The GID in children diagnosis has come under a lot of scrutiny since it was instituted in 1980, as it is often used as the justification for carrying out behavioral modification (including aversion and electroshock therapies) on children in an attempt to eliminate their exceptional gender expression and prevent them from growing up to be queer.²⁹ While children of both sexes have been subjected to these procedures, the lion’s share of the research and funding for such projects has targeted femininity in boys rather than masculinity in girls. In fact, the largest grant awarded to this sort of research has gone to the “Feminine Boy Project,” which was conducted by Richard Green and summarized in his 1987 book The “Sissy Boy Syndrome” and the Development of Homosexuality.³⁰ Green (who is also a former HBIGDA president and coeditor of the book Transsexualism and Sex Reassignment) is just one of many researchers whose work seems to be primarily focused on studying all varieties of feminine or female-associated behaviors and inclinations in male-bodied people. I would describe much of this research as stemming from effemimania—an obsession with “male femininity.”

One of the characteristic traits of effemimanic research is that it tends to conflate feminine gender expression, male homosexuality, and MTF transsexuality with one another, often treating them as though they were different symptoms of the same “disease.” This is evident in the theories psychiatrists and sexologists have offered to explain the etiology of these phenomena. The most common of these theories is that the combination of a dominant or smothering mother and a passive or distant father leads young boys to identify with their mothers and emulate their mothers’ behaviors.³¹ (This theory, which was fiercely forwarded by effemimanic psychiatrist Robert Stoller, has been regularly applied to both male homosexuality and MTF transsexuality.) Variations on this theory remained popular in the psychiatric community for many decades, despite psychiatrists’ inability to explain all, or even most, instances of “male femininity.” Another common theory is that a male child’s developing brain may be inappropriately influenced by the mother’s female hormones in utero. Others have suggested that both male homosexuality and MTF transsexuality may arise from X chromosome-specific mutations or genomic imprinting events that a mother passes on to her son (who is susceptible due to the fact that he has a single X chromosome). ³² Of course, the one thing that these theories all have in common—besides the fact that they all blame the mother for her son’s feminine inclinations—is that they cannot be applied to (nor do they even attempt to account for) the existence of exceptional gender inclinations in those born and raised female.

Effemimania in sexology has led to the creation of additional labels and subcategories for MTF spectrum trans people that are rarely, if ever, applied to FTM spectrum individuals. The most common of these is the distinction between transvestites and transsexuals. According to gatekeeper lore, transvestites are male-identified, are attracted to women, and show no interest in transitioning, while MTF transsexuals are female-identified, attracted to men, and wish to fully transition. Some gatekeepers continue to rely on such stereotypes despite the overwhelming evidence that such cut-and-dried categories do not exist: Some male transvestites are bisexual or gay, and many who seem heterosexual often fantasize about having sex with men; many MTF transsexuals are bisexual or lesbian; some MTF trans people choose to live full-time as women without undergoing sex reassignment; and a significant percentage of transvestites eventually come to identify as transsexual and seek out sex reassignment.

Another common classification system specifically designed to describe variations among MTF spectrum individuals is the distinction between primary and secondary transsexuals.³³ According to this model, primary transsexuals fit the classic archetype of “true” transsexuals: They tend to become aware of their female gender identity very early in childhood, they are often very feminine throughout their lives, and they are generally attracted to men. Secondary transsexuals tend to discover their female gender identity much later in life (usually during puberty), they are typically less feminine than primary transsexuals, and they are usually attracted to women. A hypersexualized version of this model recently garnered attention with the publication of J. Michael Bailey’s 2003 book The Man Who Would Be Queen.³⁴ Bailey refers to primary-type MTF transsexuals as being “homosexual” and claims that they are merely feminine men whose decision to transition to female arises from their desire to be intimate with men. Bailey further claims that secondary-type transsexuals are “autogynephilic”—essentially men who are attracted to women and who seek sex reassignment because they are turned on by the idea of having female bodies themselves. Despite the fact that the concept of autogynephilia (which was originally coined by fellow gatekeeper Ray Blanchard in the late 1980s) is based on dubious evidence and has never been scientifically substantiated, it also appears in the DSM.³⁵

Of course, anyone who has spent any significant time in the transgender community—beyond interviewing folks at a nearby gender identity clinic, a local crossdressing support group, or the tranny bar scene (where Bailey apparently conducted much of his research)—realizes that there are countless exceptions to all of these models.³⁶ Rather than trying to shove all trans people into some rigid, dichotomous model, one could instead easily explain the vast diversity that exists in the transgender population by assuming that gender expression, subconscious sex, and sexual orientation are determined largely independently of one another (as I did in chapter 6, “Intrinsic Inclinations”). This would not only account for the variation seen among transgender people, but can also explain why some trans people consciously identify as the other sex from their earliest memories, while others come to this realization later in life. After all, prior to puberty, social distinctions between girls and boys are almost solely based on gender expression and gender roles. Thus, a physically male child who has both a feminine gender expression and a female subconscious sex is likely to come to the conclusion that they are (or should be) a girl rather than a boy. On the other hand, if that same child were masculine in gender expression, they might initially identify as a boy—both because of their physical sex and their tendency to exhibit stereotypically masculine behaviors—and might not become consciously aware of their female subconscious sex until puberty, when physical sex becomes the predominant distinguishing characteristic between females and males. This model can also explain why many cross-gender-identified boys grow up to be gay or bisexual rather than transsexual: Their early cross-gender identification arises from their feminine gender expression rather than from a female subconscious sex.

So if a relatively straightforward intrinsic inclination model can explain all of the variation among trans people on both the MTF and FTM spectrums, then why have so many gatekeepers continued to put forward effemimanic, MTF-specific models to describe transgenderism? Because effemimania is first and foremost an expression of traditional sexism. And because the gatekeepers often work from the implicit assumption that femininity is inferior to masculinity, it should be no surprise that they view “male femininity” to be a greater concern than “female masculinity.” Such assumptions are illuminated in Phyllis Burke’s 1996 book Gender Shock, which focuses heavily on Richard Green’s Feminine Boy Project. Burke describes Green’s line of reasoning as involving “a devaluation of all that is traditionally feminine when it appears strongly in a boy. Girls are not chosen [as playmates] by boys because they like them; they are chosen because they can be dominated, or are not a threat. Activities are chosen not because they are enjoyed, but because boys fail at masculine activities, because if the boys could succeed at masculine activities, why would they bother with feminine activities?”³⁷

Some might be inclined to view effemimania as simply a manifestation of homophobia or transphobia, but this would be inaccurate. Effemimania specifically targets femininity rather than homosexuality or transsexuality as a whole. For example, in her 1991 essay “How to Bring Your Kids Up Gay: The War on Effeminate Boys,” Eve Kosofsky Sedgwick discusses how Richard C. Friedman, a psychoanalyst and the author of Male Homosexuality: A Contemporary Psychoanalytic Perspective, speaks rather admirably about gay men who exhibit masculine traits, while correlating “adult gay male effeminacy with ‘global character psychopathology’ and what he calls ‘the lower part of the psychostructural spectrum.’”³⁸ And while all forms of transsexuality are still formally pathologized, it has been quite common for gatekeepers to claim that trans men are more psychologically “stable” than trans women.³⁹ Often, such comments are made without any further explanation, leading one to suspect that these characterizations stem from the gatekeepers’ unspoken assumption that masculinity and the desire to be male are, in and of themselves, more rational and healthy tendencies than femininity and the desire to be female.

Another issue that seems to fuel effemimania is our cultural tendency to sexualize femininity and femaleness in all its forms. While countless feminist writers and theorists have analyzed the ways in which the sexualization of femaleness and femininity permeates virtually every aspect of our culture and has a negative impact on most women’s lives, they have typically ignored the way this tendency creates an environment in which “male femininity” is almost always considered in purely sexual terms. For example, most popular images and impressions of trans women revolve around sexuality: from “she-male” and “chicks with dicks” pornography to media portrayals of us as sexual deceivers, prostitutes, and sex workers. And of course, there are the recurring themes of trans women who transition in order either to gain the sexual attention of men or to fulfill some kind of bizarre sex fantasy (both of which appear regularly in the media, and also in Bailey and Blanchard’s model of MTF transgenderism).

In this context, it’s easy to understand why Bailey and Blanchard were able to get away with proposing a homosexual/autogynephilic model for MTF spectrum trans people without ever being challenged by their professional peers to apply their theories to FTM spectrum trans people. To do so would require these predominantly straight- and male-identified gatekeepers to view masculinity and maleness in purely erotic terms—in other words, to reduce maleness to the status of mere sexual object (something that they would be loath to do in the unlikely event that this line of reasoning ever crossed their minds). This unwillingness to sexualize masculinity to the extent that femininity is sexualized explains why the gatekeepers endlessly dwelled on every perceived nuance and variation that occurred in the sexual practices and fantasies of the MTF spectrum population while simultaneously adamantly claiming that there was no such thing as female transvestism, no erotic component to FTM crossdressing, and no such thing as a gay-identified trans man.⁴⁰ Of course, such identities and experiences have always existed, and have been documented by members of the transgender community and by researchers outside the field of sexology.

The sexualization of trans women has also had a profound effect on the criteria used to determine which transsexuals have been allowed to transition. While both trans men and trans women were historically required to meet the gatekeepers’ oppositional sexist ideals, trans women often faced an additional standard: They had to be sexually desirable in their identified sex as well. In the 1970s, Suzanne J. Kessler and Wendy McKenna came across several instances in which gatekeepers were rather blatant about this practice: “A clinician during a panel session on transsexualism at the 1974 meeting of the American Psychological Association said that he was more convinced of the femaleness of a male-to-female transsexual if she was particularly beautiful and was capable of evoking in him those feelings that beautiful women generally do. Another clinician told us that he uses his own sexual interest as a criterion for deciding whether a transsexual is really the gender she/he claims.”⁴¹

While not all gatekeepers relied on their own sexual attraction to assess whether trans women would gain their approval for sex reassignment, it is clear that most took the issue of sexual desirability into consideration. For example, in 1969, gatekeeper John Randell stated, “In both sexes, the individuals chosen for operation were selected because they were credible in their impersonation or, in the case of some males, had won sexual acceptance in the female role despite minor incongruous features.”⁴² Thus, being sexually desirable often superseded other transitioning criteria. Further, as one reads through MTF transsexual case studies, it becomes readily apparent that the word “attractive” is regularly used in conjunction with trans women whom the gatekeepers consider to be successful in their transitions. Those who would argue that this emphasis on the sexual desirability of trans women is a thing of the past might want to take a look at J. Michael Bailey’s book, which I mentioned previously (published in 2003), in which he comments, “There is no way to say this as sensitively as I would prefer, so I will just go ahead. Most homosexual transsexuals are much better looking than most autogynephilic transsexuals.”⁴³

While not all gatekeepers are guilty of sexualizing their trans female clients to this extent, it is clear that many, if not most, expect trans women to make themselves as conventionally pretty as possible. In Anne Bolin’s 1988 book In Search of Eve, a trans woman she interviewed put it this way: “Shrinks have the idea that to be a transsexual you must be a traditionally feminine woman: skirts, stockings, the whole nine yards.”⁴⁴ Another trans woman sums up the problem this way: “You must conform to a doctor’s idea of a woman, not necessarily yours.”⁴⁵

Viviane Namaste’s 2000 book Invisible Lives includes an interview with a trans woman who was initially denied hormones by a gatekeeper because she showed up for her therapy appointment wearing “male” clothes. She recounts: “I just went back, and this time I did all my kohl [makeup], inside and outside my eyes, [wore] my little fake fur jacket and my tight black pants. And she said, ‘You’ve come a long way since I saw you first. And now I am convinced that you’re transsexual.’ It was like three weeks later!”⁴⁶

In my own conversations with trans women, I’ve found that such expectations are still quite prevalent. On a trans-woman-focused email list that I was a member of in the early 2000s, a new member posted that she had just scheduled her first therapy appointment and she asked if anyone had any advice for her. Sadly, there were about twenty responses, mostly from trans women who’d had the experience of being turned down because they had worn “male” or unisex clothing to their visits, and then later being approved after showing up to their appointments wearing dresses and makeup. While such standards are clearly traditionally sexist, it should once again be pointed out that they are also cissexist, as they require transsexual women to meet a more rigid standard of femininity than cissexual women in order to be considered female.

In chapter 2, “Skirt Chasers,” I discussed the ways in which trans women are often required to prove their femaleness through superficial means—particularly by wearing dresses, heels, makeup, etc.—and then are dismissed as being “fake” women or “female impersonators” because of the perceived artifice involved. The same criticism can be applied to the gatekeepers who complained or commented on trans women’s “exaggeration” of their femininity without ever considering that their own criteria virtually required trans women to maintain a hyperfeminine appearance in order to gain access to the means of transitioning. In 1969, Money (and coauthors) discussed the results of tests they had administered to transsexuals to measure their feminine and masculine tendencies.⁴⁷ The authors praised trans men for giving answers that were “masculine,” but not any more “masculine” than those of the average cissexual man. At no time did the authors consider the possibility that the trans men’s unexaggerated masculine responses were made possible by the fact that most gatekeepers, being male themselves, understood that there was more than one way to be a man. In contrast, trans women were derided for having scores that were higher on the feminine range than that of the average woman. Yet trans women were required to act more feminine than the average woman in order to be taken seriously as transsexuals. Evidence to support the idea that trans women’s hyperfeminine test scores were merely an attempt to appease the traditionally sexist biases of the gatekeepers can be found in Anne Bolin’s 1988 work In Search of Eve. When Bolin—who is not a gatekeeper and whose interactions with trans women occurred entirely outside of a clinical setting—administered a similar test, she found that trans women’s scores were a lot more varied and closer to the norm of cissexual women. She commented, “The importance of fulfilling caretaker expectations ... may be the single most important factor responsible for the prevalent medicalmental health conceptions of transsexualism.”⁴⁸

This, of course, is the major problem with most medical, psychiatric, and sexological research into transgenderism. While generally presented under the guise of objective science, the body of research compiled by the gatekeepers has been so undermined by their own biases that their results are nothing more than a research artifact. The gatekeepers consistently claimed that transsexuality was a “rare” phenomenon without acknowledging that they themselves played an active role in restricting the number of trans people who would be allowed to transition; they believed that crossdressing and transsexuality primarily “afflicted” those assigned a male sex at birth without realizing that their own effemimania rendered FTM spectrum individuals invisible. Indeed, the majority of research on transgenderism and transsexuality they produced clearly fit the criteria for “pathological science,” a term used to describe work that initially conforms to the scientific method, but then unconsciously veers from that method and begins a pathological process of wishful data interpretation.⁴⁹

Traditional Sexism and Effemimania