Reasserting the Medical Model of Transsexualism
Debunking Transgenderism and its Ideological Distortions
The world of trans discourse is at a crossroads. Between a mélange of ideological, sociopolitical, and medical definitions, the experiences and struggles of transsexuals have been diluted, obscured, and redefined.
It's a world where terms such as 'gender fluidity', 'gender spectrum', and 'non-binary' have taken precedence over all other discussion, steering the conversation away from medical reality into the subjective territories of personal feelings and constructed identities. But this isn't the battleground for transsexuals. Theirs is of an altogether different nature: It's a battle against an agonising incongruence between mind and body—a battle founded in neurobiology, not ideology.
Debunking Transgenderism
Modern transvestism, with its contemporary veneer of 'transgender', cloaks itself in the guise of gender dysphoria, diverting the focus from the sexed body to the societal roles of 'man' and 'woman'. It's a farce, a deliberate detachment from material reality, and a caricature of the profound dissonance experienced by transsexuals. It perpetuates the ludicrous notion that permissive attitudes towards gender-nonconformity, or 'inclusive language', can somehow mitigate the profound torment of true transsexuals. When society declares, 'some women have penises', it makes a mockery of post-operative transsexuals and does nothing but ignite the internal conflict of the pre-operative transsexual, which screams that female penises are an oxymoron.
Transsexualism is entirely about self-concept. Being distressed about one's own biology and finding ways to mitigate the distress. Whereas modern transvestism—or transgenderism—is about controlling others. Forcing everyone else to think of them as something they are not. These pathologies—transsexualism versus transgenderism—could not be more different from each other.
The litmus test is simple. When humans claiming to be trans do something, view it through the lens of, 'would a human who hated every natal sex characteristic they have behave this way?' If not, they are, by definition, not transsexual. That’s not to say these other humans do not deserve recognition on their own terms; they should just not be conflated with transsexuals.
Historical Foundations: Lest We Forget
The concept of transsexualism, grounded in a clinical and historical framework, has faced relentless assault from these newer, ideologically-driven interpretations. Once upon a time, pioneers of sexology painstakingly documented the phenomenon, delving into the deep discomfort that certain individuals felt towards their biological sex. They worked from observations and methodical documentation, not from the whims of societal fads or fleeting ideologies.
Early pioneers like Karl Heinrich Ulrichs in the 19th century observed cases of profound discomfort with one's biological sex, far before the modern ideological muddling of the diagnostic codes. It was not about 'gender' as a sociocultural construct but 'sex' as a tangible, biological reality.
Magnus Hirschfeld, another monumental figure in the field, delved deeper into the distinctions in 1910, differentiating those who cross-dressed from a place of genuine discomfort rather than mere fantasy, and who desired as much physical change as possible. It was a nuanced exploration that later informed the works of others like David Oliver Cauldwell, who wrote of psychopathia transexualis in 1949, and Harry Benjamin, who introduced the term 'transsexualism' in a 1953 symposium, in which he drew a clear line between it and transvestism, with which it was often confused:
The transvestite wants to be accepted in society as a member of the opposite sex; he or she wants to play the role as completely and as successfully as possible. The male transvestite admires the female form and manners and tries to imitate both with an intensity that varies greatly from case to case…
…Transsexualism is a different problem and a much greater one. It indicates more than just playing a role. It denotes the intense and often obsessive desire to change the entire sexual status including the anatomical structure. While the male transvestite, enacts the role of a woman, the transsexualist [sic] wants to be one and function as one, wishing to assume as many of her characteristics as possible, physical, mental and sexual.
— Harry Benjamin, “Transsexualism and Transvestism as Psychosomatic and Somato-psychic Syndromes”, 1953
According to Benjamin, the cardinal distinction and the principal differential diagnostic sign between the transvestite and the transsexual lay in their attitude towards their sex organs — "otherwise there is no sharp separation between the two, one merging into the other."
Benjamin’s differentiation between transvestism and transsexualism was not merely a product of his times. He was addressing deeply-seated differences in experience and need. To equate the two phenomena under the guise of 'inclusivity' is not just academically inept; it's a travesty to intellectual integrity and medical ethics.
Material Reality vs. Ideological Rhetoric
Let's slice through the rhetoric and get to the heart of the matter. At its core, transsexualism isn't about societal roles or performative gender expressions. It's about a relentless, gnawing, unyielding urge to align one's physical body with one's innate sense of their 'true' sex. It's not about playing a role; it's about being in the most genuine sense of the word.
Today’s ideologues who peddle the narrative of gender fluidity and attempt to retrofit this onto the transsexual experience are not just off the mark — they're on a different target altogether. This isn't a game. This isn't a debate club topic. For transsexuals, this is life, in all its raw, visceral reality.
And for those who trumpet the AGP/HSTS typology as the exhaustive classification, consider this: it discards Benjamin’s warning by merging transvestism with transsexualism, caters more to perception of gender role congruence, and leaves little room for the neuronal disconnection related to own-body sex perception that research groups, such as Ivanka Savic’s, have documented.
Linguistic Theft
Those who endeavour to co-opt, distort, or obliterate the historical essence and ongoing struggles of transsexualism with vague terminologies and ideological maelstroms are not simply mistaken—they are active agents in the cultural genocide of transsexual specificity. This calculated theft of language and meaning has left transsexuals trying to express a reality that’s been painted over, as if trying to describe the colour blue in a world where everything related to it now means orange. We have been robbed of the ability to communicate, to dissent, and even the means to describe our dissent, as the relevant vocabulary has been stolen without replacement. This is a grievous wrong that demands immediate redress.
A Clarion Call for the Medical Model
We cannot continue to let the reality of transsexualism be drowned out by a carnival of whimsical identities and expressions. We are at a precipice, and transsexuals are lost in the noise. We need to strip away the ideological veneer, the farcical "transgender" facade of modern transvestism, and re-anchor the conversation in the medical model of transsexualism.
This isn't about exclusion; it's about rigorous diagnostics. It's not bigotry; it's a call for precision and clarity. We're not swapping one ideology for another; but rather upholding the clinical and historical foundations of transsexualism, buttressed by an emerging neurobiological understanding of sex dysphoria.
To cloak the profound, real torment of transsexualism in the flimsy fabric of modern transvestism and its ideological "transgender" concoction is a disservice to the legacy, struggle, and essence of what it truly means to be a transsexual. It’s time for society to extend to transsexuals the recognition, distinction, and the serious, empathetic understanding we deserve but rarely receive. It's time for the medical model of transsexualism to be revived and reasserted.
Tired Transsexual is the pen name of a male-to-female transsexual who lives in the U.K. Her Twitter account is @tiredtransmed