TRANSSEXUALISM AND TRANSVESTITISM
Within psychological or psychosocial-behavioral sex, two aspects can be distinguished: that of sexual identity, which translates into convincing the individual that he belongs to one of the sexes that is normally consistent with other levels of sexualization and the second aspect is that of the sexual role that is expressed through the attitude, the way of behavior, according to his sexual identity, in a certain social and cultural context.
Sexual identity is formed early, during the first years and after Stoller (quoted by Haynal A. – Med. Et. Hyg., 990, 1971) is influenced by three factors: the morphology of the external genitalia, the behavior of parents over the child (considered a boy or a girl) and of the biological factor. Sexual identity is certainly influenced by body image, that of owning or not having a penis. The biological factor, gonadal sex plays a role especially in males. Male castration causes a change in sexual behavior, whether before or after puberty, while female castration does not cause changes in sexual behavior (A. Haynal). The educational factors, the learning of an attitude, habits or games of masculine or feminine type, within the parent-child relations, are the ones that determine to the greatest degree the psychological or psychosocial behavioral sex.
Transsexualism is a sexual identity disorder, with a discrepancy between psychological sex and other levels of sexualization (genetic sex, gonadal, gonophoric, external genitalia, pubertal hormones). The transsexual has an irresistible sense of belonging to the other sex, without presenting sexual ambiguity at any level, in transsexualism, a compulsive tendency prevails, an assiduous desire to change his anatomical sex in the sense of the opposite sex with which he identifies psychologically, for which the individual addresses the surgeon. Transsexualism is found in both sexes. While the man with transsexualism is convinced that he belongs to the female sex, the woman with transsexualism is not satisfied with his anatomical sex and is convinced that he belongs to the male sex.
Transvestism, or heterosexual disguise, is characterized only by a long-standing or episodic erotic desire to dress and play the role of a subject of the opposite sex. While the individual with transsexualism is convinced that she is a woman, the one with transvestism has no doubt about his masculine sexual identity, but has only an intrinsic desire to feel like a woman and play a feminine role. The heterosexual transvestite individual would like to be both a woman and a man, or to consider herself a superior woman, possessor of male sex. Along with the complete disguise in women, there is also a form of partial disguise, in which the individual is content to wear only some women’s clothing, such as waste, panties.
The term eonism refers to an episodic heterosexual disguise as practiced by the knight of the Aeon in the twelfth century.
Subjects with transsexualism want at all costs to change the anatomical sex with the opposite and, because this is impossible to achieve they (they) get nervous, have depressive psychoses and can even lead to self-harm and suicide. A case cited by Binder found its peace only at the age of 42 after he was castrated and his civil sex changed. The incidence of suicides and suicide attempts among transsexuals and transvestites exceeds the average number of suicides among declared homosexuals (Oliven F.G., Sexual Hygiene and Pathology, Philadelphia-Montreal).
Regarding the explanation of transsexualism, Stoller, who made important contributions to this psychic deviation, claims that the basis of this sexual identity disorder is a wrong early mental conditioning of an educational nature, in the conditions offered by excessive intimacy between mother or entourage and child. The genetic sex of these individuals was not found to be altered, being normal (Barr, Holb, Lucien, d’Gennes, Kallman). Some authors such as F. Neumann and H. Steinbeck who have dealt with the influence of hormones on sexual behavior attribute a role to hormonal disturbances in the phase of hypothalamic sexual differentiation of the fetus in subjects with transsexualism and transvestism.
In rats and guinea pigs, early impregnation of the hypothalamus with opposite sex hormones indicates a reversal of sexual identity; but to extrapolate this data to man would be a gratuitous hypothesis, as H. P. Klotz asserts.
Erhardth and Money in 1967 showed that androgen hormones influence the „pattern” of the psyche. They report that in girls born to mothers treated with gestagenic substances with androgenic effects during pregnancy and who were followed between 3 and 14 years, they presented boy psychic models (tom boys) externalized by the way they dress, the preferred type of games and so on. The same pattern of male behavior is presented by girls with congenital androgenital syndrome (by congenital adrenal hyperplasia), in which there is a hypersecretion of androgens since intrauterine life as shown by Hinmann (1951).
Given these findings and Stoller’s studies, transsexualism can be defined as a psychic intersexuality in which there is a discrepancy between the perinatal neurobehavioral sexualization and the other levels of sexualization that precede and succeed it. To this component of deficient and innate neurobehavioral sexualization is added a disorder of sexual identity acquired through a wrong and early conditioning of an early, educational nature.
The therapy of transsexualism poses multiple and difficult problems for the practitioner, sometimes difficult or impossible to solve. Through surgical treatment and psychotherapy performed by a specialist some results can be hoped for, especially for the transgender man.
T. Stoica (Sexologie, Editura Medicala., Buc., 1975, ROMANIA)