A Selective Bibliography of Transsexualism

ABSTRACT Transsexualism, codified in DSM-IV-TR as Gender Identity Disorder, first appeared in DSM-III in 1980 with the name Gender Dysphoria, but its history in the psychiatric profession dates back more than 100 years. During the first half of the twentieth century, little was published on gender identity variability, but the high-profile sex reassignment of Christine Jorgensen resulted in immediate negative reaction from elements of the psychiatric community. Inquiry began into the nature of the newly discovered and not-yet-named syndrome of people who wanted to change their sex, and accelerated after the publication in 1966 of Harry Benjamin's magnum opus, The Transsexual Phenomenon. The entry of the prestigious Johns Hopkins University into the arena of transsexualism led to the formation of other university-affiliated gender clinics, of which there were soon more than 40 in the U.S. The late 1960s and the 1970s saw the publication of hundreds of journal articles, varying from reports of surgical technique, outcome studies, descriptions of clinical populations, and tips for treatment. In 1979, Meyer and Reter published a study that purported to show “no objective improvement” in male-to-female transsexuals who had undergone sex reassignment surgery. The effect of this publication was immediate and far-reaching. The Hopkins gender clinic closed in the furor which followed, and other clinics folded in its wake. Of the more than 40 university-affiliated gender programs in the U.S., only three survived. The closing of the U.S. gender clinics created a treatment vacuum which resulted in the slow development of a market economy for the treatment of transsexualism. Long kept out of communication with one another by privacy requirements of gender clinics and by the insistence of the clinics that to be “proper” transsexuals, they must blend into society and disappear, transsexuals began communicating with one another, seeking and providing information and comparing notes. By 1985, there were a number of support groups and regional conferences which welcomed both crossdressers and transsexuals. Around 1990, transsexuals, who had been conspicuously absent from the literature, began to publish, adding their voices to those of feminist scholars. In 1991, Boswell suggested that many trans-gendered people are neither transvestite nor transsexual, but have an essential transgender nature. Transgendered individuals need not take hormones or have genital surgery in order to express their gendered selves; sex reassignment was not necessarily a requirement, but an option. The collision of the psychomedical and postmodern models of transsexualism provided fertile ground for a paradigm shift. An alternative model had been proposed which changed the locus of pathology: transsexuals were not mentally ill men and women whose misery could be alleviated only by sex reassignment, but rather emotionally healthy individuals whose expression of gender was not constrained by societal expectations. Research on transsexualism proceeds apace, with advances being made in surgical and hormonal treatments, and new treatment models are being developed. Transgendered people have become politically active and have been successful in gaining some legal protections. This century promises a continued and growing understanding of gender identity variability, one in which transgendered people will themselves contribute significantly. Toward that end, this annotated bibliography is provided by a transgendered author, mental health professional, and activitist.