This document discusses transgender issues and gender identity disorder. It provides background on the experiences of transgender individuals from childhood through adulthood. It also describes the two main treatment options for gender identity disorder - psychotherapy or sex reassignment surgery. The document includes details on the surgical procedures for sex reassignment.

1. DeJuan Burnell
Transgender research paper
CWP: 102
11/17/12
Mr. Short
The Art of Transgender
In boys, the cross gender identification is determined by a marked preoccupation with
prevalent feminine activities. They may have a preference for dressing in girls' or women's
apparel or have a vigorous attraction for the stereotypical games and pastimes of girls. They
particularly enjoy playing house, drawing pictures of beautiful females and princesses. Girls with
Gender Identity Disorder tend to display negative reactions to parental expectations or endeavors
to have them wear dresses. Some may refuse to attend school or social events where such apparel
are required. Their fantasy heroes are most often powerful male figures, such as superheros.
These girls prefer boys as playmates, with whom they share fascinates in contact sports and
traditional boy games. They may occasionally refuse to urinate in a sitting position, claiming she
has or will grow a penis and may not want to grow breasts or menstruate. She may even verbally
express she will grow up to be a man. Such girls typically reveal marked cross-gender
identification in role-play, dreams and fantasies.
Gender Identity Disorder is defined as a mental disorder characterized by a long-
standing, sedulously assiduous feeling that one's biological sex is incongruent with one's gender
identity. Individuals who possess this trait have an excruciating desire to be the opposite sex.
Dressing and identifying as the opposite sex causes feelings of pleasure for these individuals. At

2. times they may even express an extreme dislike for their own genitalia. (Haraldsen, Dahl 2000)
This is often referred to as gender dysphoria.
As being an active member in the GLBT community, I often seen many people that I
came into contact with, both male and females who have consider transition, and later live as a
male or female. Many people undergo transitioning due to the ballroom scene, because their gay
parents encourage them to walk balls and have them to transition, because their outer body
features may have, feminine or masculine characteristics.
Transgenderists live as members of the other sex, but without the extreme need or desire
to modify their bodies shown by transsexuals. Some live as members of the other sex, while
others stake out "third gender" status. Transgenderists may take hormones, but do not have
genital sex reassignment surgery.
Cross dressers wear the clothing of the other sex on occasion, but do not desire to change
their sex. They dress for personal reasons, which can range from a need to express their feminine
or masculine side to a way to express themselves erotically.
Drag Kings and Drag Queens present larger than life images of men and women,
exaggerating sexual stereotypes for entertainment or self-gratification.
Androgynes, Gender Blenders, and Gender Benders merge the characteristics of both
sexes in ways subtle or shocking. Gender Fuck is the deliberate flaunting of gender norms with a
goal of shocking others.
Intersexed (hermaphroditic) persons are born with genitals which show the
characteristics of both sexes. Many have surgery in infancy, and many of those who do grow up
feeling they have been robbed of an essential part of themselves. (Transgendered, 2)

3. The human body is their medium, the operating room their studio. The tools of their craft
include multifarious cutting, clamping, probing and sewing devices, as well as digital and laser
technologies. Most of the work that results is a living art, but this art then turns into science,
which makes them work well together. What is the “art” of surgery? The term intimates there is a
creative and constructive spirit to the practice. Obviously, an artist is one who is talented and
skilled in the practice, and has some natural aptitude as well. True, both of these descriptions can
apply to surgery as well so perhaps it is an art.( When The Science Of Surgery Becomes An Art)
Gender Identity Disorder is listed in the DMV-IV as a mental disorder/illness. Individuals
who experience symptoms of GID are often termed transgendered. In former years, they were
more commonly referred to as transsexuals. Either label is felicitous for individuals who are not
mentally accepting of their biological sexual anatomy. These individuals have vigorous desire to
wear clothing of the opposite gender and to present themselves as the opposite gender while in
public. Some psychologists verbally express that parental influences, such as extreme proximity
to the mother, the absence of the father, or parental dynamics such as a maternal wish for a
daughter have been held responsible for the development of GID. It was thought that such
parental characteristics would give the children insufficient possibilities to identify with the same
sex parent and/or expose them to cross-gender reinforcement patterns. (Cohen-Kettenis and
Gooren 1999) In recorded accounts of gender dysphoria in women, females experience
discomfort with actual female anatomic characteristics like breasts. They also resent their
menstrual cycle and express a desire for a penis and other masculine traits. Often described as
"tomboyish" by their parents, these transgendered women are generally attracted to adult
females. It is not uncommon for these women to have had sexual interaction with adult males;
however they refer to these experiences as unsatisfying. (Mental Health eJournal 1997) Parents

4. of boys with GID often report that, from the moment their sons could talk, they insisted on
wearing their mother's apparel and shoes, were exclusively fascinated with girl's toys and played
mainly with girls. Such individuals often show distress about being a boy or having male
genitals. (Cohen-Kettenis and Gooren 1999) I had a chance to speak with a friend, and asked her
about how her life style growing up as transgender women Velasquez express her personal
experience as a transgendered child who upon adulthood, opted for sex reassignment surgery.
She expressed: When I was a kid, everyone else seemed to know they were boys or girls or men
or women. That's something I’ve never known; not then, not today. I never got to verbally
express to the grownups, "Hold on there- just what is it about me that makes you think I'm a little
boy?" As a kid I just figured I was the crazy one; I was the one who had a serious defect.
(Personal interview Velasquez) These discombobulated children do grow up and during early
adulthood many realize that there are options in managing their gender dysphoria. There are
generally two options for treatment when faced with this disorder. GID patients will either
undergo psychotherapy or opt for sex reassignment surgery. Both treatment plans require a
staunch commitment and a clear fixate on the desired goal.
The most controversial among these treatments is the life altering sex reassignment
surgery where the patient’s body is altered to reflect the intended gender. The first sex change
operations were performed in the 1930's. Many psychotherapists during the1930's viewed
transsexualism as a delusion. They felt that no other method besides psychotherapy could help
these individuals deal with the emotional conflicts that arose from their inner turmoil.
Excruciating therapy and evaluation must be undergone before a successful sex reassignment
surgery can be approved. Clinicians evaluate the mental health of the potential patient and then
assign a life test where the potential patient has to live everyday as the intended gender to

5. determine whether or not they can function socially in that gender. (Mental Health eJournal
1997) According to a report published in 1997 by the Mental Health eJournal, A 2 year period of
the Real-Life Experience sanctions for transitionary practices such as changes in jobs, educating
family members or employers and it also sanctions time for the individual who may not be ready
for surgery to become mentally ready.
Female to Male- In one technique they take a skin graft, either from the inner
thigh or the belly, literally rolls it up, and annexes it at the top of the thigh and the bottom of the
belly. Then the patient has to lie in bed for four weeks or so while this rejuvenates up, to
ascertain the blood is going fine. So you’ve basically acquired what looks like a suitcase handle.
They then remove one end from the thigh, so the suitcase handle is hanging down from the
bottom of the belly. They don’t have a way to elongate the urethra through this penis, so the man
must pee through the same urethral opening he had when he was a woman. Some men keep their
vaginas; some have their vaginas partially sewn up. Male to Female- the most prevalent
technique is the one I had: it’s called “penile inversion”. They lay the penis out, and make an
incision down the length of it, pull the skin open, scrape out the spongy stuff, being scrupulously
meticulous not to perturb the blood vessels and nerves. The scrotum sac is laid open, the testicles
are removed and become compost, I conjecture. So then they take the tip of the penis and
commence pushing it in. Like turning a sock inside-out. Everyone has this natural cavity, right,
so they push it in. the outside of the penis becomes the walls of the new vagina. The tip of the
penis functions in the position of the cervix. They create a kind of clitoris, utilizing the spongy
material from the perineum. And they hope for the best. (Bornstein, 1994)
In conclusion, symptoms of Gender Identity Disorder are often recognized in early
childhood.Categorized as a mental illness by psychologists, this label is often in direct conflict

6. with the way the symptomatic patients view the situation. Societal pressures often keep these
transgendered individuals in the proverbial “closet” and their life satisfaction level is
weakened because of it. Many opt to align their physical bodies with their internal gender
preference and find happiness. Also in order for surgeons to fulfill ones needs, they must master
the craft, and connect science and art together.

7. Work Cited
R. Haraldsen, A. A. Dahl (2000) Symptom profiles of gender dysphoric patients of transsexual
type compared to patients with personality disorders and healthy adults
"Transgender" StudyMode.com. 04 2011. 04 2011
When The Science Of Surgery Becomes An Art Christopher F. Hyer DPM FACFAS
Acta Psyciatr Scand 2000 276-281.Yolanda L. S. Smith, Stephanie H.M. van Goozen, A.J.
Kulper and Peggy Cohen-Kettenis (2005) Transsexual subtypes: Clinical and theoretical
significance
Meds cape Psychiatry & Mental Health eJournal 2
Psychiatry Research Volume 137, Issue 3, 15 December 2005 151-160.P. T. Cohen-Kettenis and
L. J. G. Gooren (1999) Transsexualism a review of etiology, diagnosis and treatment
Rudolph Magnus Institute of Neuroscience, Department of Child and Adolescent Psychiatry
Diagnosing and Treating Gender Identity Disorder in Women
Person Interview, Kelley Velasquez
Meds cape Psychiatry & Mental Health eJournal 2(5), (1997) Bornstein, Kate (1994)
Gender Outlaw; On Men, Women, and the Rest of Us, New York, Random House