Transgender in America

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Transgender in America

In 2011 a survey conducted by famed demographer Gary Gates, for the Williams Institute under the U.C.L.A. School of Law, he found that more than 700,000 American adults identified as transgender.  His follow-up survey published in June, 2016, by the same institute, found that the number had risen to 1.4 million.

That means the known population of transgender adults doubled in a five year period.  This huge leap is mostly attributed to the fact that younger generations, those who were under the age of 18 at the time of the original study, are less fearful of public stigma and more open about topics such as human sexuality and gender identity.

In the same study in 2011, Gary concluded that 9 million Americans exclusively identified as lesbian, gay, bisexual, or transgender.  This number was supported by a 2015 Gallup study which found that nearly 10 million Americans exclusively identified as either lesbian, gay, bisexual, or transgender.

The part that interested me the most about Gary’s 2011 study, is a group of 25 million Americans who admitted to being attracted to the same gender, and the 76% of them who admitted to engaging in same-gender sexual experiences.  Why would this be interesting?  Because these Americans didn’t identify as gay, lesbian, bisexual, or transgender, they identified as straight.  Yes, these 25 million Americans who admitted to be attracted to members of the same gender, 76% of which had homosexual experiences, still claimed to be straight.

Why are so many Americans engaging in homosexual experiences and yet identifying as straight?  There are a few reasons for this phenomenon, but it is mostly due to social stigma.  Only about 77% of gay men ever come out of the closet and publicly admit to being gay.  Similarly, only 71% of lesbians publicly admit to it.  The most important numbers here are that only 28% of bisexuals ever come out of the closet, or in other words publicly admit to having same-gender attraction.

According to the Federal government, as of 2017, the total U.S. population is somewhere around 325 million people, meaning members of the LGBT make up anywhere between 3 – 8% of the total U.S. population, depending on weather or not you count the people who claim to have same-gender attraction but don’t accept any LGBT label.

The smallest sector of the LGBT are those Americans who are transgender.  Though a minority within a minority, they have found themselves the topic of social and political debate over the past ten years.  Nearly five years ago, I started a journey to understand more about people who identified as transgender.  At the time, I was completely ignorant on the topic, which is exactly why I felt the need to learn about who these people were, what they felt, how they navigated through this world, how they knew they were transgender, and what it really meant to be transgender in America.

I spent the years following that decision talking to people who actually identified as transgender.  Despite my ignorance and consequential inability to use the right adjectives and pronouns, I initially found two guys willing to give me the audience I needed to take the first steps in becoming knowledgeable on the topic.  One of these guys would one day amass a large social media following and even end up as a guest on the Ellen DeGeneres Show.  His name was Aydian Dowling and he would be the first of many trans men I would learn so much from.  Below is a photo of Aydian.

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At the time, Aydian was developing a strong YouTube presence, currently he has over 45,000 subscribers, he also has over 12,000 followers on Twitter, 60,000 on Facebook, and 139,000 on Instagram.  Like a lot of other transgender men and women, he found a base for not only connecting to other transgender youths and sharing their collective experiences on social media, but he also uses it to enlighten those of us who are cisgender on what it really means to be transgender in America.  You may be wondering what the term “cisgender” means, I also had never heard the term prior to talking to Aydian.  Cisgender is a term almost exclusively used by trans men and women to refer to people who are not transgender.

Before I go any further I should go into more detail about the language used in the trans community.  The very terms trans male and trans female, sometimes typed as transman and transwoman, are shrouded in confusion for people on the outside looking in.  Furthermore, many people literally don’t understand what a trans man or woman actually is.

Trans men are individuals born with female bodies and male personalities.  In the trans community these people are referred to as FTMs, which stands for female-to-male transgender.  Aydian Dowling is a female-to-male transgender man, or transman.  Aydian began his transition in 2009, when he began taking prescription testosterone injections under the supervision of his physician, intentionally to change his body physically from a female appearance into a male appearance.

Trans women are individuals born with male bodies and female personalities, referred to in the trans community as MTF’s, which stands for male-to-female transgender.  For the sake of convenience, I will use these shortened terms throughout this essay.  I must admit that I do not know a lot about transwomen, nor a lot about the effects of estrogen when taken long term.  In terms of the information presented in this article, most of it will be centered around female-to-male transgender.

The second trans person I had the opportunity to talk with was another FTM named Anthony, he chose not to disclose his last name.  He and I spoke over Skype and he was gracious enough to enlighten me to many of the facts that I had been too embarrassed to ask Aydian about.  This included questions about sex reassignment surgery, romantic and sexual experiences, the effects of testosterone therapy on his entire body, and questions about terminology used to describe his genitalia.

This is when I learned that FTMs who have not had sex reassignment surgery (which is the majority that I’ve encountered) never refer to their genitalia as a vagina, and for someone else to do so it is perceived as an insult.  This is because psychologically FTMs are men and the point of transitioning is to further remove the parts of them that appear physically female.  The last thing they want is for any part of them to still be referred to in female terms.  Depending on who you’re talking to, FTMs have various names for what they have between their legs.

Anthony went on to tell me that he was sexually only interested in women, and that he had a girlfriend at the time and showed me a photo of her.  She was tall, slim and had long blonde hair that framed her beautiful face.  When I asked about how they engaged in intimacy he candidly explained the use of hands, mouths, dildos, including those that strap-on.  I’ll save you the more graphic details.

As the years continued in my research, the presence of transgender adults and teens on YouTube continued to grow.  As of today, anyone can log on and hear the countless stories of young trans men and women recounting their childhood, how they knew they were trans before they had ever heard of the word, how their friends and family reacted, the struggles they faced back then and the struggles they faced in their current lives.  Trans men talk about how they want to have breast reduction surgery, trans women talk about how they want breast implants, and those who’ve had their respective surgeries talk about how it’s changed their lives for the better.

Even though the prevalence of transgender discussions have increased massively over the last ten years, transgender is not a new occurrence, it’s not something that just suddenly started happening to American youths, it’s not a trend in social rebellion.  There is decades worth of medical research and study into being transgender.  In fact, the first gender identity clinic opened at Johns Hopkins University in 1965 and the very first transgender surgery to transition from one gender to another occurred in 1966.

In 2014, the Williams Institute published another study that found that 15,000 transgender people were actively serving in the United States military.  They also found that nearly 135,000 American veterans are transgender.  According to the data, 32% were MTF, 5.5% were FTM, and 62.5% declined to answer which gender they were born as.

Click below to hear a story about one transgender couple serving in the U.S. military.

Transgender Americans have been living among us openly for decades, but pinpointing the cause of it could lead us to proving that transgender has been a part of the human species since our origins.

The Human Rights Campaign, a long time champion organization for the LGBT, found that in 2009 only 49 analyzed corporations provided healthcare coverage to transgender employees.  In 2012, that number rose to 207 companies out of 636 that were analyzed.  This data is important because the transgender community has a particularly high discrimination rate.  According to the 2011 National Transgender Discrimination Survey, 41% of transgender respondents (2,644 of the 6,450) stated they had attempted suicide.  When asked why they attempted suicide, the majority cited they had been sexually assaulted, followed by other reasons such as physical assault, harassment at school, and termination from employment.

A similar study in 2011, jointly launched by the National Center for Transgender Equality and the National Gay and Lesbian Task Force, showed that 19% of those surveyed said they had suffered domestic abuse because of gender non-conformity.  When comparing whether MTFs or FTMs suffered more abuse, the data showed that MTFs experienced the highest amount.  This trend matches data from a 2013 study by the National Coalition of Anti-Violence Programs which found that 72% of all violent crimes committed against the LGBT were crimes committed against transgender women (MTFs).

According to the National Transgender Discrimination Survey Report, 26% of transgender people were terminated from employment due to being transgender.  Another 50% stated they were harassed at work for being trans.  So what’s being done?  By 2015, there were 18 states that enacted laws that clearly protected transgender people from discrimination.  These states include California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, and Washington.

For transgender people, the focus of transitioning into an appearance that correlates with their gender identity is essential for their ability to live out their daily lives.  In the same study mentioned above, 78% of respondents who had transitioned into their identified gender stated that they felt more comfortable at the workplace.  This same trend of being at ease, comfortable, accepted, has been echoed continuously to me by trans men and women I’ve met over the past few years.  These data points prove that transition is necessary for transgender Americans to lead healthy, successful lives.

This same conclusion has been drawn by American psychological associations, including the American Psychiatric Association, which diagnoses transgender people with a condition called gender dysphoria.  This condition is defined by the American Psychiatric Association as an individual’s discontent with the assigned gender. It is more specifically defined when used in a more personal diagnosis.  In order for a physician to perform surgeries that alter the gender appearance of transgender youth, they typically must undergo a monitored six months evaluation.  This evaluation period looks at several key factors of the young person’s life, including their psychological well-being and physical well-being.  Upon completion of this evaluation period and provided they meet all necessary criteria, trans youth are permitted to schedule operations that further their transition into their identified gender.

So what kind of operations are there and who receives them?  FTMs, female-to-male transgender men, like their counterparts male-to-female (MTF) transgender women, begin their transition with hormone therapy.  For FTMs this involves testosterone injections.  These injections continue throughout life as their bodies do not naturally produce enough testosterone to maintain a more masculine physical and psychological state.  Likewise, MTFs begin their transition with estrogen hormone injections to make themselves appear more female and to suppress the effects of naturally occurring testosterone.

Later in transition, FTM’s can opt to have breast reduction surgery, what’s referred to as top surgery in the trans community.  The majority of FTM’s I’ve talked to have chosen (or intended to choose) this option.  Some insurance companies cover this operation under special circumstances, while most others do not and the patient must pay for it out of pocket.  Most of these transmen have chosen not to undergo what’s referred to as bottom surgery, an operation that involves surgically creating a penis from the patients own body tissue.  The common reason I’ve been given is that the penis is not sexually functional.

An interesting point to mention about FTMs is the immense change their minds and bodies go through during hormone therapy.  It is one of the most fascinating aspects of the entire transgender discussion.  To understand why this change is so remarkable, you must first understand just how powerful testosterone, or any hormone, is on the human mind and body.  To tell that story we must go back way before young adulthood, before puberty, before childhood, and into prenatal development.

If you’re a biological male, then the only reason you look and act male is because during prenatal development when your Y chromosome activated, your testes released enough testosterone that your brain’s hypothalamus formed in accordance with your DNA.  This gave you the appearance and personality of a male, rather than a female.  When the level of testosterone is below where it needs to be, the hypothalamus doesn’t form the way it is intended to for a male and the outcome is a more effeminate (female like) male baby.  Science doesn’t know what causes these fluctuations in hormone levels during prenatal development, it could be genetic, it could be due to the mother’s own hormone levels, it could be mere chance, or it could be from some environmental influence such as pollution, contaminated food or drink, medications, or something else inducing a chemical imbalance.

What we do know is that the hypothalamus plays a significant role in how a human behaves and to whom they are sexually attracted.  Science has determined that fluctuations in the levels of testosterone exposed to the hypothalamus can cause changes in not only how the brain forms, but also in how masculine or feminine a baby eventually grows into through childhood, adolescents, and young adulthood.  These fluctuations not only effect how a person will eventually behave, but also who they will eventually be sexually attracted to.

An interesting discovery from evaluating FTMs while they were initially undergoing testosterone therapy, found that a small number of them experienced a change in their sexual orientation.  The majority of transmen (FTMs) are sexually attracted to women (their birth gender).  However, a small percentage of FTMs are sexually attracted to men.  Transwomen (MTFs) on the other hand typically have a sexual attraction to men (their birth gender), while a smaller fraction are sexually attracted to women.

This is a common point of confusion for outsiders, so let me reiterate this point.  The majority of transmen, those who are born physically female and transition into male, are sexually attracted to women.  The majority of transwomen, those born physically male and transition into female, are sexually attracted to men.  Because transgender people identify their sexual orientation with their gender identity and not their gender at birth, most trans men and women are considered straight or heterosexual.

What if I told you that there are people out there who believe that the man shown below should not be allowed to use the men’s bathroom and that the woman shown below should not be allowed to use the women’s bathroom?  What if I told you that you might be one of those people who have this opinion?  Why would people or possibly even you, not want them to use their respective bathrooms?  Because these two people are transgender.  This man’s name is Balian Buschbaum, a former German pole vaulter, he was born physically female and this woman is Andreja Pejic, a model, and she was born physically male, both have undergone hormone therapy and other medical procedures to align some parts of their bodies with their personalities.

Over the past ten years, the most heated debate involving transgender Americans, also involves the bathroom of all things.  This debate has created a firestorm in congress, on television, and on social media.  The most consistent argument behind banning transgender men and women from using restrooms that align with their gender identity is that they will in some way abuse other people in the bathroom.

These allegations seem to have been completely fabricated out of fear and misunderstanding.  Nowhere have I found any data showing some sort of mass epidemic of transgender men and women sexually abusing people in bathrooms.  In fact, what I did find was data from police reports showing sexual assaults and physical abuse on transgender women by non-transgender attackers in both private and public settings.

According to the Public Religion Research Institute (PRRI), a “nonprofit, nonpartisan organization dedicated to conducting independent research at the intersection of religion, culture, and public policy,” in a study published February 2017 by Daniel Cox Ph.D. and Robert P. Jones Ph.D., they found that 64% of Americans believe that transgender citizens receive discrimination in the United States.  According to the Federal Bureau of Investigation’s 2014 report on hate crimes in America, crimes against persons of the LGBT was the second highest group of victims making up for more than 20% of all reported hate crimes.  Only crimes committed against racial minorities (47%) exceeded them.

It’s not just the statistics that prove the allegations of abuse caused by transgender people to be utterly false, it’s the sheer facts alone that prove it absurd.  The reality is that men and women like Balian and Andreja are attracted to the gender opposite of their gender identity.  Meaning, most transmen like Balian are attracted to women and most transwomen like Andreja are interested in men.  Crimes of sexual assault are almost always committed by someone who is sexually attracted to the victim.  Transmen like Balian have no reason to sexually assault other men in the men’s bathroom, and transwomen like Andreja have no reason to sexually assault other women in the women’s bathroom.  The real concern for abuse, would be directed at transwomen like Andreja if she were forced to use the men’s bathroom simply because she was born male.

Other people claim that if transgender people are allowed to use the restrooms of their gender identity and not their birth gender, then cisgender men (men who are not transgender) will dress up as women and try to use the women’s bathroom so that they can sexually assault women.  This is also a claim based solely on fear mongering.  Trans people have already been using bathrooms that correspond to their gender identity for decades, without anyone noticing apparently.  And yet despite this, there has been no epidemic of non-transgender men pretending to be transgender women and dressing up as women and trying to use the women’s bathroom to assault women.

So why are people making all of this stuff up?  The only viable possibility is because they are insecure and this uncertainty and misunderstanding feeds their fear, causing them to make ill-judgments and misconceptions about subjects and people they know nothing about.  Socialization, education, information based on facts and evidence, these are the keys to understanding the issues, not hearsay and rumors.

Through my journey I’ve come to realize that transgender men and women are no different than the rest of us.  They simply want to live out their lives as true to themselves as any of the rest of us.  Whether they are learning in schools, working at their place of employment, socializing in bars, serving in the military, going to church, attending concerts, visiting new restaurants, these are all normal things to do and at any one of these places you can come across someone who is transgender and never even know it.  This is all it should mean to be transgender in America, just people living out their lives.

At the end of this article are photos of men.  As you scroll through them you won’t be able to tell how many of them are transgender and how many are not just by looking at them.  You may be convinced that you could figure it out, that you can somehow just tell.  I could challenge you to this very task, to pick out which ones are trans and which ones are not, but the truth is each and every one of them are transmen.  Not a single person shown at the end of this article was born physically male, but every single one of them was born psychologically male.  At its core that’s exactly what it means to be a transman: to be a man born in the wrong body.  Transitioning for any transgender person is not about changing who they are, it’s about becoming who they’ve always known themselves to be.

As you will see, many, if not all, have had top surgery, meaning they had their breast tissue removed.  Most, if not all, of these transmen began taking testosterone injections during their teen years.  Which is the average physical starting point or process for transitioning.  Long before they knew what being transgender meant, long before they ever heard of the word transgender, they knew they were born into and trapped in the wrong body.  According to the American Psychiatric Association, most trans youth begin showing signs of being transgender by the time they are 3 years old.

Most were probably considered “tomboys” as kids because they preferred to do boy things rather than girl stuff.  However, it goes so much deeper than sports, mechanics, and other stereotypical male interests.  Most, if not all, of these transmen are sexually attracted to women.  Studies on transmen’s brains show they are similar to the brains of heterosexual men.  Even before beginning testosterone injections.  And once that process begins, they undergo physical and further psychological changes.  Their bone structure changes, body hair growth intensifies, their voices deepen, muscle growth increases, they begin to have an increase in thoughts and feelings typically associated with men.

Regardless of whether or not they have sex reassignment surgery, which consists of changing their genitalia from female to male, their bodies begin to change on their own due to hormone therapy, to the extent that their clitoris grows outward like an erect penis when they are sexually aroused, in some instances it can extend up to three inches.  This effect is interesting because during the first phases of development in the uterus, all embryos are physically female.  It is only after the Y Chromosome’s activation does the fetus become physically male.  This behavior of the clitoris is why it is used for the construction of a penis in FTMs who choose to have sex-reassignment surgery.  Since most FTMs do not choose to have this surgery, most do choose to have their uterus, ovaries and cervix removed due to the risk of cancer after starting testosterone.

Too many people seem clueless as to what all happens during transition for transmen and they convince themselves that transmen are somehow still women, refusing to acknowledge them as men, refusing to use male pronouns like he, him, and his.  However, the only thing still female about an FTM (female-to-male person) is the fact that they have the XX Chromosomes.  It’s true that will never change, but these men are far from being females.  After the below photos, I have included an addendum to this article.  It is a separate article specifically about concerns over transgender athletes in competitive sports.

In Addendum:  Transgender and Competitive Sports

Mack Beggs, a high school female-to-male transgender wrestler from Texas, wanted to wrestle with the boys in his weight class, but because he was born physically female he was not permitted to do so due to league restrictions recognizing him by his birth gender rather than his gender identity.  Mack’s desire to be treated like a male and not a female is nothing new.  I haven’t spoken with a single female-to-male (FTM) who didn’t want to be acknowledged as male.  Mack, who had been on testosterone therapy for 2 years, went on to win the Texas state title in his weight class in the female division, which caused an uproar from angry parents, both those with kids in the bracket and those without.

The effects of testosterone therapy are astonishing on FTMs both physically and mentally. His chromosomes may say female and he may have female genitalia, but the testosterone surging through his body and brain causes it to chemically react as male, as I explained in my previous article. One of the side effects is that it does increase muscle density, which means he’s competing at a level beyond the girls in his weight class. But the University Interscholastic League in Texas forced him against his will to compete with girls, and that’s not his fault.  The League does have a stipulation about hormone levels, but Mack’s testosterone level was never high enough to permit him to compete against boys.

Those who oppose transgender athletes from competing in high school, collegiate, and professional sports argue that testosterone is a performance enhancing drug and the use of this drug should make the athlete ineligible to compete.  The real question is whether or not testosterone enhances a female-to-male athlete in a way that is unfair to other cisgender/biological (non-transgender) athletes who do not take testosterone injections.  According to USA Wrestling in a new policy just implemented March 2017, it doesn’t give them an unfair advantage as long as the levels of testosterone in someone like Mack Beggs, is equivalent to the testosterone levels in biological boys his own age.  As USA Wrestling holds tournaments outside of school brackets, Mack Beggs will now have the opportunity to be competing against boys under the organization’s new policy.

This new policy is based on the one implemented by the International Olympic Committee in 2015.  Their policy only requires pubescent FTM athletes to undergo blood tests to find out where their hormone levels are at.  FTM athletes who are transitioning after puberty do not have to comply with this requirement, however, male-to-female (MTF) athletes must identify as female for four years consecutively and undergo blood tests to make sure their testosterone is low enough for one year prior to competition and during competition.  This is because male-to-female transgender athletes pose the greatest opportunity to have an advantage over biological female athletes, due to their body’s natural ability to create higher levels of testosterone.

For MTFs who are transitioning, they must take estrogen and testosterone blockers to keep their testosterone levels low.  This process of hormone therapy causes muscle tissue to dissipate, bone density to weaken, and a drop in red blood cells.  Dr. Eric Vilain, M.D., Ph.D., Professor of Human Genetics, Pediatrics and Urology, Director of the Center for Gender-Based Biology and Chief of Medical Genetics in the UCLA Department of Pediatrics, and member of the International Olympic Committee’s Medical Advisory Board, and one of the architects behind the IOC’s 2015 policy change, has spent years on the topic of transgender athletes in competitive sports.  Many collegiate and professional sports organizations, including the NCAA, have used him as a reference for understanding the effects of hormone therapy on transgender athletes and the implementation of policies and rules for regulation in competitive sports.

He and his colleagues have become the primary voice on just how to determine whether a transgender athlete has any unfair advantage in competitive sports.  The bottom line in traversing this incredibly difficult debate are the questions of what are the hormone levels in cisgender/biological athletes in any particular sport and what are the transgender athlete’s hormone levels who wants to compete with them.  That’s pretty much the guiding principle in all of this, making sure there is no unfair advantage from too much testosterone.

In the case of Mack Beggs, his body creates high levels of estrogen which works against the effects of testosterone.  We know that estrogen causes muscle loss and a weakening of bone density.  Testosterone does the exact opposite.  Which is why he has to continuously take injections to sustain the level of testosterone his physician has determined is right for him to continue to transition into male. The effects of that amount of testosterone on his body is not the same as the effects caused on a biological teen male taking the same amount of testosterone to boost his performance (who’s body produces low levels of estrogen, and naturally occurring high levels of testosterone).  In other words the effect of 0.5 CC’s of testosterone for Mack is not the same as 0.5 CC’s of testosterone on a biological teen male who’s body is already raging with the hormone.

Depending on the case, some transmen inject their own testosterone based on the dosage prescribed by their physician, others go to weekly visits to have the testosterone injected for them by a nurse or physician. In either case the dosage and testosterone levels have to be monitored due to the risks associated with taking testosterone. The biggest risk is cancer.  Because testosterone injections increase this risk of cancer many FTM transmen have their breast tissue removed, along with their ovaries, uterus, and cervix.

Despite no legitimate evidence to suggest that transgender athletes have an unfair advantage when they are under the supervision of a physician and abiding the requirements by a committee or league for drug testing of hormone levels, some people continue to assert that they do have an advantage and should be banned completely from competitive sports and often compare it to the problem of juicing.  While I agree that in professional, collegiate, and high school level sports, juicing is a problem, in cases like Mack’s, he absolutely is not juicing and he shouldn’t be ostracized from a sport just because he has a medical condition known as dysphoria, which clinically requires testosterone.  This condition which all trans people have is recognized by all American psychological associations as a treatable condition via hormone therapy and optional surgery.

It is clear to me and without question that transmen should not compete in women’s divisions of their respective sport, and transwomen should not compete in men’s divisions of their respective sports due to the effects of hormone therapy on their bodies.  However, these athletes should be allowed to compete in the gender division that correlates with their gender identity (the gender they are transitioning into).

Some people have a misconception about how much muscle mass testosterone injections induce on a FTM’s body when used at dosages prescribed for transgender patients.  While it does increase their muscle mass, the FTM does not become a hulking body builder like someone who abuses anabolic-androgenic steroids.  Steroids used for juicing are actually synthetic compounds that act similarly to testosterone, but are taken by athletes in extreme dosages, anywhere from 10 to 100 times the amount that any physician would prescribe.  The desire by some to compare these two circumstances as being the same is the result of an obvious lack in information and understanding.

Additional videos of interest…


Articles of note:

Public Opinion of Transgender Rights in the United States (2017) | UCLA School of Law – Williams Institute

LGBT Data and Demographics (2019) | UCLA School of Law – Williams Institute