You will need Adobe Acrobat Reader or similar to view and print files in
P.D.F. format. If you don't have Acrobat Reader you can download it for free at
About this document
This was written for people who have recently learned that someone in their life identifies as a transsexual or has decided to undergo
gender transition. Since many people have not previously had the opportunity to learn about transsexualism and other gender issues, they
frequently have a lot of questions, and may or may not feel comfortable directly asking the transsexual person these questions.
A few notes about terminology
The community of people dealing with gender issues is large and diverse, and terminology about these issues is continuing to evolve. We
will try to follow usages commonly accepted by many people in these communities, but apologize in advance if we unwittingly offend anyone
who uses different words for their experiences.
About the terms "transsexual" and "transgendered"
We are using the term "transsexual" to refer to people who are undergoing or have undergone gender transition
("sex-change"). "Transgendered" is a broader term, generally used to include any person who feels their assigned gender
does not completely or adequately reflect their internal gender. Transgendered people may or may not take steps to live as a different
About the term "opposite sex"
Modern Western culture is very invested in a strict two-sex / two-gender system, where the two categories are constructed as opposites.
Many transsexual and transgendered people (and lots of other folks, too!) feel that this model is too restrictive to accurately describe
their own sense of their gender. Since the phrase "opposite sex" is based on this restrictive concept, we will avoid that term in
this document, in favor of such descriptions as "another sex" or "the target gender expression." (We will occasionally
use the phrase, in quotes, if we are specifically referring to the restrictive two-gender system.)
About "sex" v "gender"
Social scientists make careful distinctions between these two terms. "Sex" generally refers to biology, to the actual form of
the human body, including such factors as chromosomes, genital configuration, and secondary sex characteristics, while "gender"
refers to the social meanings and characteristics associated with certain types of people.
In this document, we will attempt to adhere to this usage, but not too strictly. Because transsexuals combine sex and gender in various
ways, sorting out exactly what is about "sex" v what is about "gender" can get
a little tricky.
- Section I: General information about transsexualism and gender transition;
- Section II: Responses to common reactions and feelings about transition; and
- Section III: Other resources, Web links, Books
Section I: Overview
What is transsexualism?
Transsexualism is a condition in which a person experiences a discontinuity between their assigned sex and what they feel their core
gender is. For example, a person who was identified as "female" at birth, raised as a girl, and has lived being perceived by
others as a woman, may feel that their core sense of who they are is a closer fit with "male" or "man." If this sense
is strong and persistent, this person may decide to take steps to ensure that others perceive them as a man. In other words, they may
decide to transition to living as the sex that more closely matches their internal gender.
What is involved in the transition process?
The answer to this question varies depending on the needs and desires of the individual choosing the transition process. An individual
may choose any combination of social, medical and legal steps that will help that person achieve the greatest level of comfort with their
body and social roles.
Social steps might include asking to be referred to by a different name (perhaps one generally given to people of the "opposite
sex") and different pronouns ("she" instead of "he" or vice versa), dressing in clothing traditionally worn by
people of the sex they wish to be perceived as, and taking on mannerisms frequently associated with that sex / gender.
Medical steps might include hormonal treatment to achieve an appearance more consistent with the target gender expression, and / or
surgery to further modify the appearance. There are a variety of surgical options to alter the transsexual person's body to help them
achieve the greatest comfort with their gender expression. The transsexual person may choose some, all, or none of these surgical
Many transsexual people also work with the courts in their area to achieve legal recognition of their new name and gender. Steps taken
vary depending on the location.
What causes transsexualism?
No one knows the answer to this question, although there is much research currently in progress investigating it. Among the theories
being investigated are genetic influences, in utero hormonal influences, and other brain structure / brain chemical influences.
Human sex and gender are very complex, and it is unlikely that any simplistic analysis will definitively answer this question.
What is the treatment for transsexualism? Is there a "cure?"
Treatments for transsexualism based on attempting to change the individual's sense of their own true gender have proven ineffective.
Accepted treatments are based on helping the transsexual person's body and presentation match their inner sense of their gender, usually
through hormone treatment and surgery.
How common is transsexualism?
The Diagnostic and Statistical Manual of Mental Disorders (D.S.M.-IV), fourth edition, says the
following (© 1994, American Psychiatric Association):
Prevalence: There are no recent epidemiological studies to provide data on prevalence of Gender Identity
Disorder. Data from smaller countries in Europe with access to total population statistics and referrals suggest that roughly 1 per
30,000 adult males and 1 per 100,000 adult females seek sex-reassignment surgery.
Because these numbers reflect only people who have sought traditional medical treatment, they do not reflect
the total numbers of people who have some experience of gender discontinuity.
Is transsexualism a modern phenomenon?
While advances in medical science have only in the last few decades made it possible for individuals to transition with the aid of
hormones and surgery, transgendered people have existed throughout history in many societies.
Jennifer Reitz's "Natural History of Transsexuality" provides a brief historical overview.
Is transsexualism the same as homosexuality?
No. Transsexualism is about a person's core sense of their gender. This is a separate issue from the gender of the people they are
Just like any other individual, a transsexual person may identify as heterosexual, gay, lesbian, or bisexual. For example, a person
raised as a man who transitions to living as a woman may identify as heterosexual, in which case she would seek relationships with men, or
lesbian, in which case she would seek relationships with other women.
Section II: Responses to common reactions and feelings about transition
The person I thought I knew is becoming a stranger.
A person we know who undergoes gender transition will very likely look and sound quite different after their transition. A person we've
known as a woman, for instance, may change his hairstyle, grow facial hair, speak with a lower voice, and adopt an entirely new wardrobe.
But he's not likely to adopt an entirely new personality or set of values, and our history with this person is unchanged. Think of any
person you care about, and ask yourself what qualities you value most about her or him. You are likely to think of qualities which are not
gender-specific, such as sense of humor, intelligence, and loyalty. These qualities are not likely to change as a person undergoes gender
transition. In fact, a person who undergoes gender transition is in a process of becoming more comfortable with himself or herself, and so
their positive qualities are likely to be enhanced.
It can be scary when someone in your life tells you they need to make such a major change, and it's understandable that you may feel you
don't know this person as well as you thought. But if you continue to spend time together, you will likely be comforted to find that they
are in many ways the same person you have always known.
Altering the body through surgery seems like mutilation.
This is also an understandable response. To those of us who are comfortable with our assigned gender, the idea of altering those parts
of our bodies that are most associated with our gender can feel alien, frightening, and disturbing.
Another person's decision to alter parts of their body can feel threatening. It may help to remember that a person undergoing transition
from, for instance, a male to female gender expression, is not making a blanket statement about the value of malehood or the validity of
your gender expression. She is simply seeking to become more comfortable in her body.
Sex reassignment surgery is the aspect of gender transition that is most difficult for some people to understand, and you may never feel
comfortable with it. That's okay. But that discomfort doesn't preclude honoring another person's choice, treating them with respect, and
even supporting them through their gender transition.
I can't imagine the person ever seeming to me like the sex they want to be.
It's hard to let go of our perceptions of someone we've known for a long time. Changes in a person's appearance and behavior can occur
gradually, and may be difficult to perceive if you are in regular contact. But if you pay attention to how strangers react to the person,
it may help you to see these changes. On the other hand, the gradualness of the change may help you to adapt to the new gender identity
step-by-step. You may be surprised, in time, at how completely you accept the person's new chosen gender.
It is true, however, that some people who undergo gender transition will continue to have significant characteristics of their previous
gender identity. Some male-to-female transsexuals, for instance, may be unusually tall for women, while a female-to-male transsexual may
have small features. It may help if you avoid focusing on these specific things, but rather honor the person's chosen gender, and try to
see them as they see themselves.
How can I support this person in their transition?
There are many ways you can be helpful. Perhaps the most important is to convey your intention to be supportive to the person in
transition. Let them know you want to be an ally, and ask them what they need from you. Then, to the extent you are able, offer them the
support they've asked for.
We can offer a couple of specific ideas as well. First, you can adopt the use of the person's new name (if they've chosen one) and
appropriate gender pronouns. This change can be uncomfortable at first, and you may slip up once in a while, but eventually this change
becomes habitual and comfortable. This small but very important step will demonstrate that you take the person's decision seriously.
You can also try to maintain your previous relationship with the person, whether that's the intimate relationship of close friends or
once-a-month bowling buddies. Gender transition is new territory for many people, and hence can be scary. "Hanging in" with the
person in transition despite feelings of discomfort with the process can be a very supportive act.
Also, you may ask the person in transition how you can help in letting others know about their transition. They may want to tell people
themselves, or they may be grateful for help "spreading the word." There may be certain contexts - the softball team, a church
you both attend, or the workplace - where your assistance in telling others and expressing your support will be appreciated. Let them be
your guide in this.
Section III: Other Resources
Internet Resources on Gender Issues: General Resources
The International Foundation for Gender Education (I.F.G.E.)
"A leading advocate and educational organization for promoting the self-definition and free expression of individual gender
identity. I.F.G.E. is not a support group, it is an
information provider and clearinghouse. I.F.G.E. maintains
the most complete bookstore on the subject of transgenderism available anywhere."
Gender Education & Advocacy (G.E.A.)
"Gender Education & Advocacy is a national organization focused on the needs, issues and concerns of gender variant people in
human society. We seek to educate and advocate, not only for ourselves and others like us, but for all human beings who suffer from
gender-based oppression in all of its many forms "
Jennifer Reitz' Transsexuality Page
A lot of good information for trans folks, as well as some interesting general info about gender issues. Sections include: "What
exactly is Transsexuality?; The reasons to cherish being transsexual; Why you don't want to be a woman or a man; What can I expect long
term?; What is it like to be transsexual?."
Paper Cuts on My Soul
Some great educational handouts and pointers to other resources. A wonderful archive of trans folks' letters announcing their
Transsexualism And Gender Identity Disorder
Dr. Anne Vitale's site. "The intent of this web site is to educate the reader to the psychotherapeutic issues of gender
Standards Of Care For Gender Identity Disorders
Issued by the World Professional Association for Transgender Health Inc.. This outlines
suggested protocols transsexuals must conform to receive treatment from participating medical professionals.
"F.T.M. International is the internet contact point for the largest,
longest-running educational organization serving F.T.M. transgendered people and
Resources specifically for male-to-female transgendered / transsexual people
Transsexual Womens Resources
Dr. Anne Lawrence's page contents includes a lot of good information about hormones and surgery, plus pointers to other resources,
including resources specifically for young transsexuals.
Renaissance: Transgender Information & Support
A "transgender education organization and the largest open membership support group in the world." Primarily for
male-to-female trans folks, including cross-dressers and others.
Information for family, friends, employers and others
P.F.L.A.G. Frequently Asked Questions
Webpage associated with the T.G.S. -
P.F.L.A.G. mailing list, a list "for support of
parents, family, spouses and friends of transgendered people and transgenders who wish to discuss family or other personal
"TransFamily is a support group for transgendered and transsexual people, their parents, partners, children, other family members,
friends, and supportive others. We provide referrals, literature, and over-the-phone information on all transgender issues "
A Parent's Dilemma, the Transgender Child
Well-written article by counselor and gender specialist Gianna E. Israel.
A Lover's Leap of Faith
A Speech Given at the Friends (Quakers) for Lesbian and Gay Concerns Midwinter Gathering, February, 1999. The lesbian lover of an
F.T.M. writes from a faith-based perspective about her partner's gender transition and its
effects on her.
Human Rights Campaign's Transgenderism and Transition in the Workplace
"A guide that examines transgender workplace issues, including a discussion of the law and strategies for dealing with
transitioning on the job." For both workers and employers.
Transsexualism: Notes for Employers
"This document is intended to provide guidance to Managers and Employers of persons diagnosed with Transsexualism. It details the
current legal position [in the U.K.] regarding such persons' employment rights, and makes
recommendations for "best practice" ways of dealing with transsexualism in the workplace."
Most of these books can be ordered from the I.F.G.E.
Boenke, Mary (ed.) Trans Forming Families: Real Stories About Transgendered Loved Ones. Waterford Press, 1999.
Brown, Mildred L. True Selves: Understanding Transsexualism-For Families, Friends, Coworkers, and Helping Professionals. San Francisco:
Jossey-Bass Publishers, 1996.
Burke, Phyllis. Gender Shock: Exploding the Myths of Male and Female. Anchor Books, 1996.
Cameron, Loren. Body Alchemy: Transsexual Portraits. Pittsburgh, Pa
U.S.A.: Cleis Press, 1996.
Cole, Dana. The Employer's Guide to Gender Transition. Waltham, Ma
Devor, Holly. F.T.M.: Female to Male Transsexuals in Society. Bloomington: Indiana
University Press, 1997.
Israel, Gianna E., et al. Transgender Care: Recommended Guidelines, Practical
Information, and Personal Accounts. Philadelphia: Temple University Press, 1997.
Kirk, Sheila M.D. Feminizing Hormonal Therapy for the Transgendered. Blawnox,
Pa U.S.A.: Together Lifeworks,
Kirk, Sheila M.D.Masculinizing Hormonal Therapy for the Transgendered. Blawnox,
Pa U.S.A.: Together Lifeworks,
Kirk, Sheila Pa U.S.A. and
Martine Rothblatt, J.D. Medical, Legal & Workplace Issues for the Transsexual.
Blawnox, Pa U.S.A.: Together
Bornstein, Kate. Gender Outlaw: On Men, Women and the Rest of Us. New York: Routledge, 1994.
Califia, Pat. Sex-Changes: The Politics of Transgenderism. San Francisco, California: Cleis Press, 1997.
Feinberg, Leslie. Transgender Warriors: Making History from Joan of Arc to Rupaul. Boston: Beacon Press, 1996. Also see Leslie's
Wilchins, Riki Anne. Read My Lips: Sexual Subversion and the End of Gender. Ithaca, N.Y.
U.S.A.: Firebrand, 1997.
Send us your feedback.
Last modified: 20 July 2003
This document may be copied and distributed in print as long as the entire document is included and the
copyright notice is not removed. Please also include the
U.R.L. for this webpage
. Please do not copy the web pages for posting elsewhere
on the web; link to this site instead.
© Copyright 1998-2003 Su Penn. All rights reserved.
The Gender Centre is listing these links for information regarding specific areas of transgender life and
transition, and other resources where appropriate. Please note, while information on these websites have been found useful to some,
the Gender Centre takes no responsibility for information appearing in these websites.
Many of the websites are American and British owned and operated. While general support information may be
similar to here in Australia, web surfers are encouraged to contact the Gender Centre for information regarding most medical and
The Gender Centre also possesses an extensive referral manual in the areas of legal, medical, accommodation,
employment, H.I.V. /
AIDS, Psychiatric, Youth, Aboriginal and Corrective Services.
some of this information cannot appear on our webpage for legal reasons, and again, interested parties are encouraged to
contact the Gender Centre directly.
Gender Centre publications provide neither medical nor legal advice. The content of Gender
Centre publications, including text, graphics, images, information obtained from other sources, and any material
("Content") contained are intended for informational and educational purposes only. The Content is not intended to
be a substitute for professional medical nor legal advice, diagnosis, or treatment. Always seek the advice of your physician
or other qualified health care provider with any questions you may have regarding your medical condition. Never disregard
professional medical advice or delay seeking it because of something you've read. Always seek professional legal advice on
matters concerning the law. Do not rely on unqualified advice nor informational literature.