Transgender sexuality
Historically, studies assumed that transgender sexuality might be distinct from traditional human sexuality. For much of the 20th century, what was described as "transsexualism" was believed to be sexual in nature,[1][2] and so was defined along these terms.[3][4][5]
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Like other people, transgender people exhibit the full range of possible sexual orientations and interests,[6] including the potential for a lack of sexual attraction.[7]
Sexual orientation labels
Historically, clinicians labeled trans people as heterosexual or homosexual relative to their sex assigned at birth.[8] Most transgender people find this offensive, and prefer to define their sexual orientation relative to their gender identity.[9] For example, a transgender lesbian is a woman who is both a trans woman (a woman assigned male at birth) and a lesbian (a woman who is attracted to other women).[10][11]
To avoid confusion, particularly with non-binary gender, the terms "gynesexual" and "androsexual" are sometimes used to describe attraction to women and men, respectively.
Sexual orientation distribution
In the United States, transgender respondents to one 2015 survey self-identified as queer (21%), pansexual (18%), gay, lesbian, or same-gender-loving (16%), straight (15%), bisexual (14%), and asexual (10%).[12] A second study cites 23% said they were attracted to the same sex or gender, 25% bisexual, 4% asexual, 23% queer, 23% straight and 2% something else.[13]
Transgender women
A 2015 survey of roughly 3000 American trans women showed that at least 60% were attracted to women.[14] Of the trans women respondents 27% answered gay, lesbian, or same-gender-loving, 20% answered bisexual, 19% heterosexual, 16% pansexual, 6% answered asexual, 6% queer, and 6% did not answer.[12]
Trans-feminine mixed gender roles
Psychiatrist Richard Green, in an appendix to Harry Benjamin's 1966 The Transsexual Phenomenon, considers people assigned male at birth who have adopted a more feminine gender role.[15] In this broad overview, entitled "Transsexualism: Mythological, Historical, and Cross-Cultural Aspects", Green argues that the members of these groups are mentally indistinguishable from modern western transsexual women.[15] They have in common early effeminacy, adulthood femininity, and attraction to masculine males.[16]
The exact cultural role of two-spirit Native Americans varied from tribe to tribe, but in all cases Green writes about they are oriented towards men.[15]
The Hijra of the Indian Subcontinent are people who were assigned male at birth but occupy a female sexual and/or gender role, sometimes undergoing castration.[17] As adults they occupy a female role, but traditionally Hijra describe themselves as neither male nor female, preferring Hijra as their gender.[17] They often express their femininity in youth; as adults they are usually sexually oriented towards masculine men.[17]
Mukhannathun were transgender individuals of the Muslim faith and Arab extraction who were present in Medina and Mecca during and after the time of Muhammad.[18] Ibn Abd Al-Barh Al-Tabaeen, a companion of Aisha Umm ul-Mu'min'in who knew the same mukhannath as Mohammed, stated that "If he is like this, he would have no desire for women and he would not notice anything about them. This is one of those who have no interest in women who were permitted to enter upon women."[19] That said, one of the Mukhannath of Medina during Muhammad's time had married a woman.[18]
Travesti are Brazilian male assigned people who are attracted to men.[20] Travestis' feminine identity includes hormones and/or silicone body alterations, feminine dress, language, and social and sexual roles, but rarely genital surgery.[20] However, in contrast to North American transgender women, they often don't see themselves as real women, and many describe themselves as gay or homosexual.[20] According to Don Kulick, they will describe themselves instead as "feeling like a woman".[20] In his book Travesti: Sex, Gender and Culture among Brazilian Transgendered Prostitutes, he writes that no travesti in Salvador ever claims to be mulher (a woman) except as a joke, and travestis reading or hearing about transgender people who say they feel like women regard them as disturbed.[21]
Transgender men
Foerster reported a 15-year successful relationship between a woman and a trans man who transitioned in the late 1960s.[22][23]
In the 20th century, trans men attracted to women struggled to demonstrate the existence and legitimacy of their identity.[24] Many trans men attracted to women, such as jazz musician Billy Tipton, kept their trans status private until their deaths.
Although the literature indicates that most trans men identify as heterosexual,[25][26] their attraction can vary. Author Henry Rubin wrote that "[i]t took the substantial efforts of Lou Sullivan, a gay FTM activist who insisted that female-to-male transgender people could be attracted to men."[24] Matt Kailey, author of Just Add Hormones: An Insider’s Guide to the Transsexual Experience,[27] recounts his transition "from 40-something straight woman to the gay man he’d always known himself to be."[28] Researchers eventually acknowledged the existence of this phenomenon, and by the end of the 20th century, psychiatrist Ira Pauly wrote, "The statement that all female-to-male transgender are homosexual [Pauly means attracted to women] in their sexual preference can no longer be made."[29]
A 2015 survey of roughly 2000 American trans men showed more variation in sexual orientation or sexual identity among trans men. 23% identified as heterosexual or straight. The vast majority (65%) identified their sexual orientation or sexual identity as queer (24%), pansexual (17%), bisexual (12%), gay/same-gender loving (12%), asexual (7%), and 5% did not answer.[30]
Gay trans men have varying levels of acceptance within other communities.[31] Upon beginning testosterone treatments, some trans men report an increase in both their libido and their desire for sex with non-trans men.[32]
Sexual practices
Tobi Hill-Meyer, self-described 'Queer Trans Multiracial Sex-Positive Activist Writer and Porn Maker', is making a documentary called Doing it Again: In Depth about transgender people's sexualities. As of December 17, Volume 1: Playful Awakenings has been released.[33] This volume interviews couples where both people are transgender. Cultural studies scholar J.R. Latham wrote the first definitive analysis of trans men's sexual practices in the journal Sexualities.[34]
Naming the body
Many transgender individuals choose to not use the language that is typically used to refer to sexual body parts, instead using words that are less gendered. The reason for this practice, is that hearing the typical names for genitalia and other sexual body parts can cause severe gender dysphoria for some trans people.[35]
Not all transgender people choose to rename their body. Those that choose not to rename their body, are often less uncomfortable with their body and/or don’t associate their sexual body parts with a gender that differs from the one that they identify with.[35]
Ultimately, the decision of what language a trans person chooses to use for their body, and wants others to use, is up to the individual whose body is being named.[35]
Transgender women
Some trans women choose to call their anus their vagina because they can use their anus in many of the same ways that cisgender women can use their vagina. Furthermore, some transgender women choose to refer to other, non sexual, parts of their body as sexual body parts that belong to cis women, such as the vulva and the clitoris.[35]
Transgender men
Some trans men choose to call their vagina euphemistically as their "front hole" because they feel that it is less gendered. Furthermore, some transgender men choose to refer to other parts of their body using male terminology. For example, some transgender men choose to refer to their clitoris as their penis, because, like the penis, the clitoris often increases in size, when an individual is aroused.[35]
Effects of hormone replacement therapy
Effects of estrogen
For transgender women, taking estrogen stimulates the development of breast tissue, causing them to increase in both size and sensitivity. For some, this increased sensitivity can be pleasurable, while for others it can be uncomfortable or painful. Furthermore, for those taking estrogen and who have male genitalia, estrogen can (and often does) shrink the external male genitalia and decrease the production of semen (at times bringing the sperm count to zero), and can decrease the ability for the male genitalia to become erect. In addition to these changes, some transgender woman going through HRT can experience changes in the way their orgasms feel. For example, some people report the ability to experience multiple orgasms.[35]
Other effects of HRT for transgender women can include, a decrease in their sex drive/libido or a change in the way they experience arousal.[35] A study published in 2014 found that 62.4% of trans women surveyed reported a decrease in sexual desire after hormone therapy and/or vaginoplasty.[36]
Effects of testosterone
For transgender men, one of the most notable physical changes that many taking testosterone experience, in terms of sexuality and the sexual body, is the stimulation of clitorial tissue and the enlargement of the clitoris.[37] This increase in size can range anywhere from just a slight increase to quadrupling in size.[38] Other effects can include vaginal atrophy, where the tissues of the vagina thin and may produce less lubrication. This can make sex with the female genitalia more painful and can, at times, result in bleeding.[38] Transgender men taking testosterone are likely at increased risk of developing urinary tract infections, especially if they have receptive vaginal intercourse.[39]
Other effects that testosterone can have on transgender men can include an increase in their sex drive/libido. At times, this increase can be very sudden and dramatic. Like transgender women, some transgender men also experience changes in the way they experience arousal.[37][38]
Effects of sex reassignment surgery
Trans women who have undergone vaginoplasty must dilate in order to properly shape and form the neovagina. After several months, sexual intercourse can replace dilation, but if not sexually active, dilation is required again, for the rest of the patient's life.[40]
Sexual orientation and transitioning
Some trans people maintain a consistent orientation throughout their lives,[41][42] in some cases remaining with the same partner through transition.[43]
Some gynephilic trans women self-report that after transitioning, they became sexually oriented towards males, and explain this as part of their emerging female identity.[44]
While undergoing hormone therapy, some trans men report experiencing increased sexual attraction to cisgender men.[37] This change can be confusing for those who experience it, because it is often not a change that they expect to happen.[37]
Transvestic fetishism
The DSM once had a diagnosis of "transvestic fetishism".[1] Some therapists and activists sought to de-pathologize this category in future revisions.[45] DSM 5, which was released in 2013, replaced the transvestic fetishism category with "transvestic disorder".[46]
Following the example of the Benjamin Scale, in 1979 Buhrich and McConaghy proposed three clinically discrete categories of fetishistic transvestism: "nuclear" transvestites who were satisfied with cross-dressing, "marginal" transvestites who also desired feminization by hormones or surgical intervention, and "fetishistic transsexuals", who had shown fetishistic arousal but who identified as transsexuals and sought sex reassignment surgery.[2]
Cultural status
Sexual behavior and gender roles vary by culture, which has an effect on the place of gender variant people in that culture. In most cultures, trans people are stigmatized, and sexual activity involving transgender people is considered shameful, especially in cultures with rigid sex roles or strictures against non-heterosexual sex.
In Arabic, Mediterranean, African-American, and Latino cultures, a distinction is sometimes made between active and passive sexual activity, where the passive or receiving partner is not considered masculine or straight, but the active partner is.[47]
Some Asian countries, notably Thailand, have a more socially tolerant view of transgender sexuality, but there is still much discrimination. (See Kathoey.)
Sex work
In many cultures, transgender people (especially trans women) are frequently involved in sex work such as transgender pornography. This is correlated with employment discrimination. In the National Trans Discrimination Survey, 11% of respondents reported having done sex work for income, compared to 1% of cisgender women in the US.[48] According to the same survey, 13% of transgender Americans are unemployed, almost double the national average.[49] 26% had lost their jobs due to their gender identity/expression. Transgender sex workers have high rates of HIV. In a review of studies on HIV prevalence in trans women working in the sex industry, over 27% were HIV positive. However, the review found that trans women engaged in sex work were not more likely than trans women not engaged in sex work to be HIV positive.[50] Studies have found that in the United States HIV is especially prevalent amongst transgender sex workers of color, particularly black trans women, a problem that has been identified by academics[51] and members of the transgender community.
The subject of transgender sex workers has attracted attention in the media. Paris Lees, a British trans woman and journalist, wrote an article in June 2012 for the Independent defending criticism of Ria, star of Channel 4 documentary Ria: Teen Transsexual, who was seventeen at the time and depicted as working as a prostitute at a massage parlor, saying that the choice to engage in sex work is a matter of bodily autonomy and pointing out reasons that young trans women often turn to sex work such as low self-esteem and severe employment discrimination.[52] A review by GLAAD of its archives of transgender-inclusive television episodes from 2002 to 2012 found that 20% of transgender characters were depicted as sex workers.[53]
History
Classifying transgender people by sexual orientation
Sexologist Magnus Hirschfeld first suggested a distinction based on sexual orientation in 1923.[54] A number of two-type taxonomies based on sexuality have subsequently been proposed by clinicians, though some clinicians believe that other factors are more clinically useful categories, or that two types are insufficient.[55] Some researchers have distinguished trans men attracted to women and trans men attracted to men.[56][57]
The Benjamin Scale proposed by endocrinologist Harry Benjamin in 1966 used sexual orientation as one of several factors to distinguish between "transvestites", "non-surgical" transsexuals, and "true transsexuals".[58]
In 1974, Person and Ovesey proposed dividing transsexual women into "primary" and "secondary" transsexuals. They defined "primary transsexuals" as asexual persons with little or no interest in partnered sexual activity and with no history of sexual arousal to cross-dressing or "cross-gender fantasy".[3] They defined both homosexual and "transvestic" trans people to be "secondary transsexuals".[4]
In the DSM-III-R, released in 1987, "transsexualism" was divided into "homosexual" and "heterosexual" subtypes.[5]
Dr Norman Fisk noted those entering his clinic seeking reassignment surgery comprised a larger group than fit into the classical transsexual diagnosis. The article notes that effeminate gay men and heterosexual fetishistic transvestites desire surgery and could be considered good candidates for it.[59]
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