Dawn Baldwin Presents: THE ART OF BENDING GENDER Every hour every day we encounter something new Electric this, Atomic that – a modern point of view Now anything can happen and we shouldn’t think it strange, If oysters smoke cigars Or lobsters drive imported cars, For we live in a time of change… When the First Lady is a he – and the President is me It’s a switch – it’s a twist – it’s a change. Still these things would shock most people But I really don’t know why, For the world is full of changes – who knows this more than I! --from the stage act of Christine Jorgensen, 1954, Christine Jorgensen: A Personal Autobiography, with introduction by Susan Stryker, Cleis Books, 2000, original, 1967.13

ACT I: SEX Terms and Definitions IT’S WHAT’S BETWEEN YOUR LEGS THAT MATTERS! Terms and Definitions SEX: The state of being either female or male, as determined by biological characteristics such as anatomical, reproductive and chromosomal attributes.8 Sex operates in a binary world of male or female. MALE CHARACTERISTICS Penis Testicles XY chromosomes FEMALE CHARACTERISTICS Clitoris/Labia Uterus/Ovaries XX chromosomes INTERSEXED: These individuals are typically born with varying degrees of both male and female characteristics. These characteristics can be either fully or only partially developed. This condition is not always discovered at birth, rather it is uncovered as the individual develops through their adolescence.5,6

SCENE I BOY OR GIRL? Originally referred to as “hermaphrodites,” although it is now deemed socially unacceptable, intersexed individuals are compared to the Greek god Hermaphroditos, a mythological winged god whose body was joined with that of a water nymph. Hermaphroditos was the son of Hermes and Aphrodite, the gods of both male and female sexuality.5,7 There are varying biological, neurological and chromosomal conditions that can cause ambiguous genitalia in infants, thereby making them intersexed.5,6,15 It is estimated that anywhere from 1% to upwards of 4% of recorded births are considered instersex.5,6,7,14 Approximately one in every 1,500 to 2,000 additional births are estimated to require a consultation by a specialist in sex differentiation due to the ambiguous nature of the child’s genitals.7

SCENE II BOY OR GIRL? Although classification of infants with ambiguous genitalia as intersexed began in the late 1800s, it wasn’t until the now infamous Dr. John Money and his team at John Hopkins University in Baltimore, MD in the 1950s developed a system for assigning a sex to infants with ambiguous genitalia and subjecting them to multiple surgeries and hormonal treatments to make them appear more “normal”.7,11,15 Anywhere from 30% to 80% of children who receive genital surgery are committed to undergo more than one operation.5 In non-Western culture, intersex births are treated with a more positive outlook, while Western culture views these births as abnormal, problematic and worthy of a “solution”.4,5,6 It is now more widely believed that the parents and doctors should step aside and allow the infant to develop so that they may make the determination themselves at a more appropriate age.6,7,11,15

ACT II: GENDER Terms and Definitions IT’S WHAT’S BETWEEN YOUR EARS THAT COUNTS! Terms and Definitions GENDER: The culturally determined behavioral, social, and psychological traits that are typically associated with being male or female/masculine or feminine.3 Also recognized as a personal internal feeling of being male or female. MASCULINE CHARACTERISTICS Powerful and assertive Ambitious Insensitive Independent Competitive Rational Plays sports Analytical Sexually aggressive FEMININE CHARACTERISTICS Delicate and submissive Content Nurturing Dependent Cooperative Emotional Cooks and cleans Intuitive Sexually passive

SCENE I: THIS IS NOT A CHOICE! ACT II: GENDER SCENE I: THIS IS NOT A CHOICE! GENDER IDENTITY: The internal mental image of who an individual feels they are as a person. Gender identity is typically based on the male/female dichotomy, however, many people have been documented as stating that they feel both male and female as well as neither male nor female.1 Gender identity has been found to be fully established by the time an individual is five years old.3 The only way to know a person’s gender identity is to ask! GENDER EXPRESSION: This term refers to how a person externalizes or portrays their gender identity. This includes manner of dress, hairstyles, mannerisms along with how a person speaks and interacts with others.2 GENDERQUEER/ANDROGYNOUS: Refers to a person who has neither entirely masculine nor entirely feminine features or mannerisms but instead has a balance of both masculine and feminine qualities.8

SCENE II: A DISORDER, YOU SAY? ACT II: GENDER SCENE II: A DISORDER, YOU SAY? GENDER IDENTITY DISORDER (GID): Classified as a strong and persistent cross-gender identification, which is the desire to be, or the insistence that one is, of another (not necessarily “opposite”) sex.1 Data on the prevalence of GID is nearly impossible to gather based on the number of people who do not or cannot seek treatment for the disorder. These treatments include counseling, hormone therapy and surgical intervention to assist in full transition from one sex to another. Trans-activist groups are currently fighting to have GID removed from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders because it furthers the belief that these individuals are “crazy” or “sick.” HIJRAS: A religious community of men in India who dress and act like women. The hijras undergo an operation in which their genitals are removed. Hijras, as neither men nor women, function as an institutionalized third gender role in India.12 Although not accepted by everyone, hijras are often revered for their connection to the Gods.

ACT III: The Trans Umbrella TRANSGENDER and TRANSSEXUAL INDIVIDUALS Generally diagnosed with Gender Identity Disorder, their individual gender identity does not match their assigned birth sex. They strongly feel that they are or ought to be, the opposite sex (based on the male/female dichotomy).2,3 Often these individuals describe themselves as being “trapped” in the wrong body. These individuals typically attempt to rectify this mistake in their bodies by undergoing hormone therapy and sex reassignment surgery.3 Transgender individuals may or may not transition into the sex they feel they are. Transsexual, however, is a term used to describe those who intend to fully transition from one sex to another, regardless of what stage they are at in the process.

The Trans Umbrella (con’t) MALE-TO-FEMALE (MTF) TRANSSEXUAL: Anatomically, biologically or chromosomally classified at birth as male, these individuals have a feminine gender identity. They are working to transition their outer sex from that of a male to female in order to match their internal gender. Born George William Jorgensen in 1926, in 1952, Christine Jorgensen, an ex-GI became known as the first MTF in the U.S. She became an instant celebrity and used her newfound status to raise awareness for transsexuals everywhere.9 FEMALE-TO-MALE (FTM) TRANSSEXUAL: Anatomically, biologically or chromosomally classified at birth as female, these individuals have a masculine gender identity. They are working to transition their outer sex from that of a female to male in order to match their internal gender. Based only upon reported cases of individuals undergoing sex reassignment surgery, it is believed that approximately .01% of the human population describes themselves as transgendered or transsexual.3 This means that at least one out of every 10,000 people identifies as transgender. If more accurate records were available, this number may be much higher.

The Trans Umbrella (con’t) TERMS OFTEN INCORRECTLY USED INTERCHANGABLY WITH TRANSSEXUAL TRANSVESTITE: Also known as cross-dressers, these are individuals who wear clothing of the opposite gender primarily for erotic arousal or sexual gratification.3 INTERSEXED: Although these individuals may have been born with ambiguous genitalia, or undergone corrective surgery shortly after birth, they are not necessarily transgendered or transsexual. However, if their assigned sex does not match their gender identity as they grow older, they may identify as transgendered or transsexual. MALE/FEMALE IMPERSONATOR and DRAG KING/QUEEN: These are individuals who wear apparel of the opposite gender in order to entertain an audience.3 HOMOSEXUAL: Individuals who are sexually and emotionally attracted to members of their own gender. Although some trans individuals consider themselves to be homosexual, SEXUAL ORIENTATION should not be confused with GENDER IDENTITY.3

SEX REASSIGNMENT SURGERY ACT IV: SEX REASSIGNMENT SURGERY Formerly known as a “Sex Change Operation,” for MTF transsexuals, this process entails Breast Augmentation Surgery and Vaginoplasty (construction of the vulva and vagina).3 In addition to this genital surgery, MTFs may choose to undergo more elective cosmetic procedures in order to feminize their masculine features. Among many procedures, these may include: Tracheal shave to reduce or eliminate the Adam’s apple Voice surgery to elevate the voice Rhinoplasty, cheek implants and other facial modifications. OUT OF POCKET EXPENSE: $10,000 - $45,000

SEX REASSIGNMENT SURGERY ACT IV: SEX REASSIGNMENT SURGERY For FTM transsexuals, this process entails Mastectomy (removal of breast tissue), Vaginectomy (removal of the vagina), Hysterectomy (removal of the uterus, ovaries and fallopian tubes), both Penis and Scrotum Construction, and Urethroplasty (extension of the urethra through the newly created penis).3 Typically FTM transsexuals do not require additional elective surgeries as the testosterone they receive for hormone therapy is strong enough to produce most desired masculine features. OUT OF POCKET EXPENSE: $25,000 - $100,000 Due to the high costs of having surgery in the U.S. and the fact that nearly all insurance companies consider sex reassignment surgery an “elective” surgery and do not cover the procedures, many transsexuals are forced to look for surgeons outside of the country where the cost can be less than one half the cost in the U.S.3

BORN AGAIN A pooling of data from 28 different studies on individuals with Gender Identity Disorder (GID) regarding SRS10 concluded that: 80% reported significant improvement in their quality of life after surgery. At least two-thirds reported more stable relationships, better adjustment, satisfaction with sex reassignment and overall happiness. Financial and professional status as well as employment situations were improved when compared with their status pre-SRS. 72% reported significant improvement in sexual function. In cases where the individual’s GID was diagnosed along with additional disorders (mood disorders, anxiety disorders, somatoform disorders, schizophrenia, substance abuse and eating disorders) 78% of individuals reported significant improvement in their psychiatric symptoms. Many people mistake Sex Reassignment Surgery (SRS) for someone “becoming” a man or woman, however, these individuals have ALWAYS BEEN men and women. Just because the world couldn’t see them, doesn’t mean they weren’t there.

RECOMMENDED READING LIST BOOKS As Nature Made Him By: David Reimer Gender Outlaw: On Men, Women, and the Rest of Us By: Kate Bornstein How Sex Changed: A History of Transsexuality in the United States By: Joanne Meyerowitz Middlesex By: Jeffrey Eugenides The Last Time I Wore a Dress: A Memoir By: Daphne (Dylan) Scholinski Transition: The Story of How I Became a Man By: Chaz Bono MAGAZINES A Boy’s Life --Hanna Rosin, Atlantic Magazine, November 2008. View the full article online here. Transitions: What will it take for America to accept transgender people for who they really are? --Eliza Gray, The New Republic, July 14, 2011 print issue. View the full article online here.

RECOMMENDED VIEWING LIST VIDEOS AND MOVIES Sex, Lies, and Gender (SPECIAL, National Geographic, 2009) Part I (Intersex) Part II (Intersex) Part III (Transgender) Part IV (Transgender) Part V (Third Gender/Hijra) My Secret Self: A Story of Transgender Children* (SPECIAL, 20/20, 2007) Part I Part II Part III *NOTE: Use of the term “Gender Identity” by Barbara Walters in the beginning of this special is incorrect. Gender Identity is the internal feeling of being male or female/masculine or feminine. What Ms. Walters refers to as “Gender Identity” in this case is actually “Sex Identity”. Transamerica (Movie, 2005) Hedwig and the Angry Inch (Movie, 2001) Boys Don’t Cry (Movie, 1999)

REFERENCES American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author. Brill, S., & Pepper, R. (2008). The transgender child: A handbook for families and professionals. San Francisco, California: Cleis Press Inc. Brown, M. L., & Rounsley, C. A. (1996). True selves: Understanding Transsexualism – For families, friends, coworkers, and helping professionals. San Francisco, California: Jossey-Bass. Elfer, J. & Lee, A. (2009). To make a male: What does it take? Journal of Child Psychotherapy, 35(1), 49-61. Fausto-Sterling, A. (2000). Sexing the body: Gender politics and the construction of sexuality. New York, New York: Basic Books. Gough, B., Weyman, N., Alderson, J., Butler, G., & Stoner, M. (2008). ‘They did not have a word’: The parental quest to locate a ‘true sex’ for their intersex children. Psychology and Health, 23(4), 493-507. Hotchkiss, R. (2010-2011). Crossing the line. Canada’s History, 90(6), 40-45. Marchbank, J., & Letherby, G. (2007). Introduction to gender: Social science perspectives. Essex, England: Pearson Education Limited. Meyerowitz, J. (2002). How sex changed: A history of transsexuality in the United States. Cambridge, Massachusetts: Harvard University Press.

REFERENCES (con’t) Murad, M. H., Elamin, M. B., Garcia, M. Z., Mullan, R. J., Murad, A., Erwin, P. J., & Montori, V. M. (2010). Hormonal therapy and sex reassignment: a systematic review and meta-analysis of quality of life and psychosocial outcomes. Clinical Endocrinology, 72, 214-231. Murray, S. (2009). Within or beyond the binary/boundary? Intersex infants and parental decisions. Australian Feminist Studies, 24(60), 265-274. Nanda, S. (1999). The hijras of India: Neither man nor woman. Belmont, California: Wadsworth Publishing Company. Nestle, J., Howell, C., & Wilchins, R. (2002). Genderqueer: voices from beyond the sexual binary. New York, New York: Alyson Books. Parsi, J. (2010). The (mis)categorization of sex in Anglo-American cases of transsexual marriage, Michigan Law Review, 108(8), 1497-1525. Reis, E. (2005). Impossible hermaphrodites: Intersex in America, 1620-1960. Journal of American History, 92(2), 411-441. **Please feel free to utilize this presentation as a private teaching tool, however, this presentation may not be copied in whole or in part without the written consent of the author. Contact Dawn Baldwin for use of presentation or photo materials at dawn_baldwin@hotmail.com. Thank you for your consideration.