Q:   Are transgender people usually males who feel they are female?
A:   There are both male to female — what we refer to as m to f — and female to male (f to m) transgender individuals. I see a lot of transgender clients in my clinic, both male to female and female to male. It may seem to many people like there are more male to female transgender individuals, but you have to keep in mind that in our society females have the ability to dress with far fewer constraints than males do. So if I'm talking to you as a female and I'm wearing a skirt today and trousers tomorrow, that would not be odd. However, if I'm male and I'm wearing trousers today and a skirt tomorrow, that would be odd. So one of the things that happens is that the stereotypes of these definitions get identified in people's minds based on a lot of things people might not even think about. Historically, in fact, there have been many more female to males. And today a woman dressing as a male is so unremarkable that it isn't the hallmark of anything. So when we think of cross-dressing today, almost exclusively we're thinking about males as opposed to females and that has to do not so much with reality as perception. In reality, when we talk about transgender people living the other gender, there are both males who live as females and females who live as males.

---

Q:   What about sexual orientation? Are transgender people usually homosexual or heterosexual?
A:   There is a lot of controversy about this right now because a new book has just come out that is very controversial. But my answer is that sexual orientation is distinct from gender. So some people who are transgendered identify as heterosexual and some identify as homosexual.

---

Q:   You mentioned that the term "transgender" is in flux. How has the term transgender changed in recent years?
A:   Typically, in the past, people used to think of a transgender individual as someone being trapped in the wrong body. And, indeed, for quite a number of people that is the case. But younger people today are having the opportunity to explore their gender identity and gender experience, and they are more willing to try out other identities and roles. So, for example, I have one client who was born female who uses a male name but says "I am a trans-boy: I will never be a straight guy; people will see me as very feminine because I am, so I'd be seen as a gay guy except that I am attracted to women." So there are further expansions to the term transgender than there used to be. More people are saying "I feel kind of gender different." Another term they often use in this community is "queer." They use it to mean "I don't conform to the gender rules that society wants me to." Young people like the term because it is nice and ambiguous and they don't have to identify exactly how they feel. My view as a sex therapist is that this is a good thing because it is easier for people to explore their gender roles earlier in life. When people with gender dysphoria — or gender discomfort — come in later in life dealing with it, more often they have gone through life trying to conform to their genitals and the expectations that people have regarding their gender. Often they get to the point where they say, "I can't do it anymore — I'm so miserable," and they have to make a change at a point in their lives when their life is already established. That is a tremendous upheaval in their lives; it's much easier if people can explore these things early on. So the good news is that society is opening up a little with these things and younger people are more likely to try out different things earlier in life and figure out where they fit at a time that is more in sync with normal life stages. Then they can go on with the rest of their lives in the same way that people who already have this under their belts do.

---