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Building
Your Own
Prison: The Use of External Structure
to Reinforce Suppression of Transgender Feelings and
Behaviors Sandra L. Samons, Ph.D. (From the journal Gender and
Psychoanalysis, Volume 6
#2 Spring 2001)
Clinical observations suggest that male-to-female (MTF) transgendered
individuals often use contragender-negative reinforcement to conceal
their
transgender feelings from others and to support the rejection of these
transgender feelings within themselves. As a means of controlling,
concealing
or compensating for these feelings, the person may exhibit an
exaggerated
transgender negativity, a general disdain for sexual diversity, and/or
may
exhibit hypermasculine behaviors that serve as a facade to conceal his
internal
feminine feelings. He may make commitments in his male gender role that
are
difficult to alter at a later time in his life, when making changes
toward a
female gender role may appear more desirable. These early decisions
become
obstacles to change and become a significant factor in the timing of
when the
person will address his transgender identity. They also make the
treatment
process more complicated. Sandra
Samons is a 1976 graduate of the University of Michigan School of
Social Work
(MSW) and has a Ph.D. from
When
a MTF
(male-to-female) transgendered person enters psychotherapy to address
his
gender identity issues, a personal history will often reveal that the
person
has made pivotal choices in the past. These life choices may have been
made in
a deliberate effort to eradicate his transgender feelings, or in the
naive hope
that suppressing the transgender feelings will make them disappear in
time, as
the individual matures. There are several commonly observed ways
in
which a transgendered individual can do this. These include pursuit
of a career choice that
is male dominated and characteristically chauvinistic, such as
enlistment in military service, adopting a hypermasculine presentation,
marriage
and choice of marriage
partner, and
involvement in a religion that prohibits as sinful the expression of
sexual
diversity. Such choices create external support for his efforts
to keep
his transgender feelings securely locked in a closet.
Arising from the lexicon of the homosexual community, the terms closeted
or being in/out of the closet refer to the individual being
either open
or secretive about his sexual preferences. Although
it is usually thought of in the social context,
the term closeted can be used to refer to either the
psychological or
the social compartmentalization of awarenesses, feelings, or behaviors,
in this
case those related to being transgendered. It involves a conscious
effort to
suppress these feelings from one's own immediate awareness and to
conceal them
from the attention of others. More rarely, awareness may even be
repressed, that is, unavailable to the individual until something
triggers a
breakthrough into consciousness. When
the compartmentalization is psychological, the individual will
usually have access to these awarenesses and feelings but will
consciously and
deliberately attempt to suppress them by focusing his attention
elsewhere,
ignoring or denying their presence to self.
When the individual is in touch with these feelings but chooses to keep
them
private, he may act on them in selected secretive ways, and may even be
open
about them with certain people or in certain situations. Thus, a person
may be
closeted about being transgendered in all or only in selected parts of
his
life. In situations where personal safety is at risk, the choice to
remain
closeted may imply that the person has good reality testing skills. Being
closeted may also reflect
a decision to live with feelings of shame, fear, and avoidance of
intimacy
rather than risk experiencing other unpleasant emotions associated with
disapproval or rejection. A distinction should be made between
preserving
personal privacy and harboring a shameful secret, but being closeted
may
include elements of both. It should also be noted that this choice is
not
without cost any may become too costly or impossible for the individual
to sustain
over time.
A closet can be a wonderful thing. It can provide a safe haven, a place
that is
yours alone, a place where you can be and do entirely as you please
without any
consideration for others. There is no risk of ridicule or rejection. Some
transgendered people guard
their secret possessively at given periods in their life, literally
holding it
close to the heart and preferring not to share it with anyone else.
Among those
who enter treatment, this is a fairly common part of the individual's
early
history. However, since the person is seeking help for transgender
feelings,
the comfort of the secret closet evidently did not continue beyond a
certain
point in life.
Once
the individual begins
to accept his transgender and wishes to reexamine options for
transgender
expression, the closet becomes a trap. As feelings begin to break free
from the
confinement of suppression-repression, the conflict intensifies between
the
desire for female gender expression and the fear of potential negative
consequences. Clinical levels of depression and anxiety can develop.
Male pronouns are being used in this discussion when referring to the
MTF
transgendered person. While this runs the risk of offending some
transgendered
people, it is not done with that intent. The best policy is to respect
the
wished of the client regarding how the person would like to be
addressed,
including the use of a male or female name. Whatever the choice, the
pronouns
should match. When a client is still very closeted, by choice or
otherwise, it
is frequently the client's preference to be addressed in keeping with
his male
gender presentation. Any other approach by the therapist could be
perceived as
an attempt to move the client along faster than the client is prepared
to go.
If the client is suggestible to any degree, it could cloud the
direction of
therapy. If and when the client begins to break down his
self-constructed
prison and explore the female gender role, therapist and client can
reconsider
the use of name and pronouns. Since the focus of this discussion is the
closeted person, the use of male pronouns seems to be appropriate.
Sexual orientation, gender identity and gender role are
fundamental
aspects of human sexuality. Because they are closely intertwined, the
distinction between them can be a source of confusion for the mental
health
therapist as well as the transgendered person. It may be helpful to
begin by
thinking of them separately.
The term sexual orientation refers to which gender the
individual is
erotically attracted. Traditionally, this has been defined as
heterosexual or
homosexual, and more recently also includes bisexual, but this, too, is
problematic when applied to transgendered or intersexed people (having
gonadal,
hormonal, or chromosomal conditions that result in physical
characteristics
that are neither exclusively male nor female).
The term gender identity is used here to refer to the gender or
sexual
identity with which the person identifies and, as such, is treated as a
mental
construct independent of the physical form of the body, although, for
most
people, gender identity is consistent with the body form and genitals.
Regardless of how we are perceived by others, most of us have an
internal sense
of self that includes whether the self is male of female. It is a core
construct of personality and may be thought of as how the continuum of
masculinity and femininity is perceived and experienced by another
person. It
is not specifically about eroticism, although most people are more
inclined to
feel erotic when they see themselves as appearing attractive in the
gender role
that matches self-perceived gender identity.
The term gender role refers to how one presents one's self to
the world,
usually as either male or as female, functioning in social roles
associated
with a particular gender, and how one's gender is perceived by others.
A gender
role different from one's natal sex can be played in life, as it can be
played
on the stage. For
most of
us, gender role, gender identity, and natal sex are the same. A
transgendered
person appears to lack this congruence, often from earliest memory, and
is
usually taught from birth to play a gender role that is congruent with
their
genitals but incongruent with their core gender identity. An individual
may
find this dysphoric and increasingly difficult to sustain over time,
and may
eventually choose to transition, to change his gender role and perhaps
his
body, sometimes in the face of enormous odds. He may no longer have the
emotional energy required to maintain the closet. He may seek outside
help
either to reinforce the closet or to find a way to break out of it.
It is probable that there are some individuals who remain reasonably
content
with secret feelings of transgender for their entire life. We have no
way of
knowing, because these individuals are not available to be counted.
They do not
attend transgender support groups or conferences. They do not show up
in a
therapist's office, requesting help. They remain hidden in plain sight.
There
is no reason for them to reveal themselves and they may have many
personal
reasons to remain closeted. We can only speculate that such individuals
do
exist. The ones we do know about are the
ones who either have become exhausted from the expenditure of
emotional energy required to maintain the closet, or who have reached a
point
in life where the closet no longer looks as attractive as it once did.
New
information may reveal options of which the person was previously
unaware. The
closet may no longer serve so useful a purpose.
Many
MTF transgendered
people seek professional assistance when they find themselves needing
help in
reinforcing a flagging internal structure for suppressing
identification with
femininity. This approach to treatment can give the appearance
of being
the most helpful measure when the person does not yet accept his own
transgender. However, when
the client is already demonstrating an inability to sustain
suppression,
attempts to reinforce it usually prove to be nothing more than a
Band-Aid. The
therapist must be honest with the client about indications for and
against this
approach and needs to express the concern that it may not be helpful
for any
length of time: the transgender feelings are not going to go away.
A
contract can be developed with criteria for reasonable reality testing
and an
agreement to try a different approach if the client becomes satisfied
that
reinforcing suppression is not effective in this case. This is
respectful of
the client's goals and honest on the part of the therapist at the same
time.
The
typical age range for
MTF transgendered people to seek therapy is between 35 and 50 years.
Recently, however, some therapists have begun to report that clients
are more
often entering treatment at an earlier age (Brown and Rounsley, 1996;
Ettner,
1999). Improved availability of information about transgender and a
decrease in
the social taboo surrounding it may help to account for this. Despite
the sleaziness
that is often associated with television talk shows and despite how
frequently
transgender is misrepresented in that venue, such exposure has weakened
the
taboo against talking about it and increased public awareness of the
presence
of transgender in the general population. While we recognize that
negative
social attitudes toward sexual minorities influence lack of
self-acceptance, it
is impossible to evaluate how far these influences reach until the
absence of
these attitudes makes it clear. At the same time, although the numbers
appear
to be shifting, the above mentioned age range is still the norm. It is
also the
people in this age range or older who have usually made the most
concerted
efforts to avoid dealing with transgender earlier in their lives.
One
possible way for an
individual to reinforce suppression of transgender feelings is through
career
choice. This decision typically takes place during late adolescence and
early
adulthood, a time when the transgendered person may well struggle the
most with
a core transgender identity. Choosing a career to reinforce
suppression
can be an easy decision, as there are numerous possible careers where
being
discovered as a cross dresser would be disastrous, and transitioning
from male
to female out of the question (Brown, 1988). Examples
of careers that can serve this function include
such things as auto mechanic, commercial pilot, or law
enforcement
officer (less so for the latter choice, as there have been a few
notable
examples of individuals who have broken ground in this field).
Individuals have
joined the family business, which has served to keep them under the
influence
of their primary male role model and also creates a higher level of
parental
investment in the son's male identity. This gives the son an increased
sense of
obligation not to disappoint or embarrass the father. Over time, as the
father
ages, he may come to depend more and more on the son, also making it
harder for
the son to disengage. If the parent's health becomes fragile, this
increases
the pressure.
A career such as forensic chemistry offers another example. In such a
situation, the person will have invested greatly in a career that could
be
significantly damaged by the secret being revealed or by coming out in
order to
transition. If the person is required to testify in criminal cases, an
opposing
attorney could attempt to use the issue of transgender to undermine his
credibility. This is only one example among many of a career that
reinforces
the closet to the point where the closet becomes a prison.
This brings up two other important points. First, when an employee
wants to
transition at work, whether or not the
employee has direct contact with customers or the public
often makes a huge difference in how willing the employer is to support
the
employee. It is one thing for the employer to deal with the issue
internally,
among the transgendered person's coworkers. It is quite another thing
if the
employer must be concerned
about the reaction of customers or the public, which is harder
to manage
and could result in complaints or even loss of business. The result is
that
young transgendered people lack positive role models with which to
validate
their transgender identity.
The second point has to so with the common misperception of emotional
or
psychological instability on the part of transgendered people, who are as
stable or unstable as anyone
else. They can be
more susceptible to disorders related to depression or anxiety, these
being a
reaction to membership in a group that historically has been treated
with
revulsion or ridicule in our society. While it is true that
mental
health professionals themselves have no particular immunity to mental
health
problems of their own, their credibility rests on the public perception
that
they are personally stable. Sadly, the mental health field is among the
most
hostile professions for a transgendered person who wished to be open,
and
especially to transition. As if fearful that the distinction between
client and
caregiver will be lost, mental health agencies tend to be very
reluctant to
support transgendered workers. However, agencies in large urban areas
and
especially agencies that serve sexual minorities are less likely to be
vulnerable in this way. In the latter setting, employing members of the
community being served can become an asset to the agency. Through these
employees, acceptance of gender and sexual minorities is demonstrated,
while
positive role models and hope for successful, productive lives is
offered to
clients. Only recently have transgendered people made progress in this
area, as
may be observed by the fact that several transgendered mental health
professionals have become members of The Harry Benjamin International
Gender
Dysphoria Association (HBIGDA) (Meyer et al, 2001), the primary
organization in
the world that deals with these issues on a professional level.
Enlisting in the military is a common way in which a MTF transgendered
person
makes a closet into a prison. The enlistment is designed to "make a man
of
him." This is often the hope of the transgendered individual, and if
his
family members are aware of his transgender issues, they may share this
same
hope. Based on the reports of numerous clients, it simply does not
work. True,
with no opportunity to engage in contragender behavior, it will succeed
in
temporarily suppressing the behavior. It will also reinforce the
perceptions of
others that this is indeed a manly man, providing social validation for
this
method of dealing with transgender feelings. However, the typical
outcome is
that the urges return, perhaps with even greater intensity, once the
opportunity is present again. And sometimes the individual does not
wait for
that to happen, but may take unwise risks or become creative in finding
opportunities to engage in feminine expression.
Hobbies
such as hunting
and fishing, and macho behavior in general are used to hide internal
femininity. To the extent that family members and friends have an image
of the
person as masculine in the extreme, the harder it will be later to give
credibility to the person when he comes out and seeks acceptance of his
transgendered self from these people. The announcement of wishing to
transition
seems contradictory and inconceivable to them, frivolous at best and
insane at
worst.
Marriage and a religion that considers sexual diversity sinful can also
be
means of building a closet that becomes a prison. These are choices
that can
function independently or in concert. Many young MTF transgendered
people get
married in the belief that marriage will make the gender identity
issues go
away. Like many of us, they fail to understand the distinction between
gender
identity, gender role, and sexual orientation. They
enter marriage in good faith and may also have
children while they continue their painful struggle with secret
internal
conflict about gender identity.
In other cases, transgendered people will marry and have children,
knowing the
trans issues will probably not go away, but believing that he can keep
the
expression of the feelings to a minimum and maintain the secret, He
does this
out of the same desire to have a family that motivates others, but with
the
fear that if he told his prospective wife about the transgender in
advance, she
would never marry him and he would never have the opportunity to have a
family
life. Later,
when she does
find out, she will probably not only object to the transgender itself,
but will
feel betrayed and lied to for not being told in advance. The marriage
trust
will be broken as she wonders what else he hasn't told her. She may
resent that
she was robbed of the opportunity to have a more conventional life with
a
different husband (Cole et al, 2000).
It
is not uncommon for a
transgendered person to marry a woman who is extremely unlikely to ever
accept
transgender in any form. This woman may also be committed to a
fundamentalist
religious belief system that would never accept transgender. The
transgendered
husband may even join her in that faith. Imagine a scenario in
which a
MTF transgendered person in mid-suppression marries a woman who belongs
to such
a faith and he converts to be able to worship with her. Imagine she was
brought
up in that faith and that her entire extended family and entire social
circle
and support system is within this faith. We will not even attempt to
make this
closet stronger with a career choice and a highly macho presentation. Imagine
the fear and anxiety
that would be aroused in the transgendered husband by the very thought
of
disclosing his transgender to his wife in this situation. How truly
effective
this would be in reinforcing suppression, how formidable an obstacle to
change!
Consequently, the person may take considerably longer than he would
otherwise
have taken to reach the point where he risks coming out and being more
open
about his transgender, regardless of the consequences. His parents may
now be
elderly, so he must worry about the impact this disclosure would have
on them,
not just the risk of their possible rejection. The children are now old
enough
to be solidly involved in the family faith, so he has to worry not only
about
the harmful effect his disclosure might have on them, but the risk that
they
might reject him. Furthermore, children who are coming to terms with
having a
transgendered parent are directly affected by the reaction of the other
parent,
to such an extent that this can be the decisive factor in their ability
to
adjust. Think about how a
wife in this circumstance would have a strong commitment to marriage,
but even
if she was willing to stay with her husband in the face of social
disapproval,
she too would risk rejection and ostracism by her extended family and
entire
support system. This closet has unquestionably become a prison. It was
a closet
while he wanted to be in it, but it is a prison once he wants to exit
but
cannot. Transgendered people have been known to suicide in such a
situation.
Why does the MTF transgendered person so often wait until well
established in
an adult male role before venturing out of the closet or trying to
break out of
his self-made prison? Is it just a matter of needing less social
acceptance as
he matures? While that is unquestionably a factor, several other
factors are at
work here as well. Information is much more readily available in
today's world,
but it is still more easily accessed by adults than by children, so
obtaining
needed information about transgender may take a few years of adulthood
to accomplish.
Along with information comes misinformation that takes time to sort
through.
This is especially true for information obtained from the internet, but
is also
true for outdated books available in libraries.٭
The need for a few adult years to obtain and sort out information is
especially
important if our concept of information includes finding means of
access to
other transgendered people. Such contact with others who feel the same
way can
prove to be a tremendous confidence builder and support for most
transgendered
people, especially early in the process of self-discovery. However, if
this
person is unprepared and this first experience turns out to be an
encounter
with a segment of the world of transgender with which he cannot
identify, it
may also be a major turn off. There is a tremendous amount of diversity
within
this population and he may be frightened until he learns more about
this
diversity. For example, if he prefers an androgynous appearance or
wishes to
pass easily in public as female, and his first experience with a peer
support
group brings him face to face for the first time with drag queens and
others
who, for whatever reason, simply look to him like "guys
in dresses," he may feel revulsion
and not
identify at all with these people.
He may even be confronted with his own worst fears about
himself....that he too might never look like anything but a guy in a
dress. An
experience like this could result in further delay in facing his
transgender
issues, with possible further reinforcement of his prison/closet. ٭The
International Foundation for Gender Education (IFGE) is a peer resource
and an
excellent source of information. They can be reached at:
Then, there is the matter of each individual's level of emotional
maturity,
including the capacity for introspection and the ability to stand alone
in the
face of opposition, whether from parent, friends, or society in
general. The
gender identity therapist must take personality traits into account
when
helping the client to assess his situation and decide how to proceed.
Does the
person tend to be cautious or does he take risks? Is he comfortable
with a lot
of solitude or is he an extrovert who feels a strong need for human
companionship? Is he a concrete thinker or does he have a high
tolerance for
ambiguity? Is he inclined to be self-reliant or dependent? Is he
trusting or
distrustful? Is he flamboyant or unobtrusive? Is he confident or
fearful and
unsure of himself? These traits will influence how he reacts to initial
information he obtains about transgender, how quickly he considers
coming out,
and how well he copes with the subsequent challenges he encounters.
Confrontation of his own internalized homophobia and transphobia will
also play
a part in the timing of this coming out process. We are all exposed to
these
forces in varying ways throughout our formative years and after. The
degree to
which this poses a problem for the individual depends in part on
geographic and
cultural influences. We know that this kind of learning can happen in a
variety
of ways, overt and subtle. Exposure to negative stereo types in motion
pictures
is an example of how one learns cultural norms. These influences can
shape our
attitudes in positive as well as negative ways.
Clinicians who specialize in transgender identity issues have
speculated about
the seemingly increased need to come out of the closet during the
middle years
as representing a sort of mid-life crisis. Although it does not tend to
have
the character of the "middle-aged crazy" phenomenon, there may be an
element of truth in this assessment. Emotional
exhaustion from the sustained effort at suppression can
gradually undermine the MTF transgendered person's ability to maintain
the
defensive system needed to contain transgender desires. As the years go
by,
there is a growing realization that life is passing by and he has not
explored
his transgendered self. The
person experiences an increasing sense of despair that the
opportunity will fade away altogether. There can be risk of the person
bursting
out of the closet too fast, in a manner that is not well thought out
and is
potentially self-defeating. A transgender therapist must be
prepared for
the possible need to reign in the client until the best approach to
coming out
can be more carefully considered.
In contrast, there are some transgendered people who build up so many
exaggerated fears about what would happen if they came out of the
closet that
what they imagine is far worse than is likely in actual reality They
become
like someone looking in the window of the candy store but never daring
to go in
and sample the fare. Although it is usually not appropriate for a
therapist to
push a client in any particular direction, there are times when a nudge
is
indicated. Just getting this client across the threshold of the closet
door can
result in the client experiencing a tremendous sense of relief. For
some
clients, that is all that is needed, but for others, a cautious nudge
at each
benchmark is required. Being fearful of experimenting with new
behaviors may
represent a personality pattern that is consistently exhibited by the
client,
but the therapist should also examine the possibility that these fears
could be
an indication of underlying ambivalence.
Is it possible that lack of success in the male role can be a factor in
the
desire to change gender roles? This does not usually appear to be the
case. More
typically, MTF
transgendered people have been quite successful in the male role,
sometimes so
much so that it is difficult to convince people who know them that this
is not
a spur of the moment impulse, as was commented upon above. For
those who
have not experienced this success, it then becomes a chicken or egg
question.
Does the person want to change to the female gender role because of
lack of
success in the male role, or has the person been unsuccessful in the
male role
because of the underlying female gender identity? Most men who have
been
unsuccessful in the male role for other reasons just get depressed or
angry
about their failures. They don't appear to see becoming female as a
solution.
However, some MTF transgendered people report that they never felt
motivated to
invest in a gender role with which they could not identify.
The fields of biology and genetics still have a great deal to
contribute to our
understanding of gender. One
theory in current favor suggests that all forms of transgender could be
prenatally determined, perhaps by variations in the delivery of
hormones to the
developing fetus at one or more critical times. If this proves to be
the case,
then we will have to view transgender as a special form of
intersexuality,
located in the brain. Many transgendered people already define
themselves this
way, insisting that this fits better with their internal experience
than any
other explanation.
This discussion has been entirely predicated on the concept that being
transgendered does not preclude the person being a psychologically
stable
individual. Clinically this is true for the majority of transgendered
people.
The caveat mentioned above bears repetition. When
a minority group, especially a sexual minority in
our society, is subjected to social disrespect, rejection, and
discrimination,
this affects the emotional well-being of the individual members of that
minority group. It creates a higher level of stress in life, and
predisposes
the individual to reactive depression and anxiety, and feelings of
being
unworthy. Of course, an unrelated comorbid mental health issue
can be
present. Being transgendered does not afford the individual automatic
immunity
for all the other ills of the general population. When such a condition
does
exist, it must be treated concurrently with the transgender and, while
not
prohibitive of gender transition, it does require extra caution on the
part of
the therapist. It is necessary for the therapist to be certain that the
gender
issues are not symptomatic of the other condition, as is sometimes the
case
with the diagnosis of schizophrenic disorders, and can also be a
feature of
bipolar disorder or of borderline personality disorder on occasion.
However, this
does not appear to be the norm and should not make a therapist
excessively
reluctant to treat transgender issues.
In conclusion, it appears that
the far-reaching effects of negative social attitudes toward sexual
minorities
and lack of understanding of transgender issues are major factors in
the lack
of self-acceptance and fear of ridicule and rejection that prompt many
transgendered individuals to stay in the closet. We recognize that
being
closeted, while offering some short term benefits, is costly to the
individual
and difficult to sustain in the long run. It does offer a degree
of
safety and privacy from which the person can try to gain understanding
of self
and make decisions about what to do with his transgender feelings. At
the same
time, being closeted contributes to the building of a wall of defenses
that
keep him out of touch with his own conflicted feelings, thus delaying
their
resolution. The effort to maintain the closet is a drain on emotional
energy
and limits the capacity of the transgendered person for emotional
intimacy with
others.
Choice
of career, marriage
partner, and religious practice, as well as an exaggerated macho
presentation,
can provide external reinforcement of the closet, but make it harder
for the person
to come out at a later time. By not addressing transgender issues in a
timely
manner, the individual goes about building a life that does not take
these
issues into account. When the issues can no longer be avoided, the
person has a
confining life structure to tear down and rebuild. The lives of other
people
are affected more profoundly than would have been the case if the
person had
faced his transgender earlier.
There is a sense
of loss
for what must be torn down, guilt
about the harm or pain caused to other s, and grief about the
loss of youthful years that could have been spent as female. An
otherwise
emotionally stable individual may experience reactive depression and
anxiety at
being so in conflict with himself and the world around him. As
social
attitudes become more open and accepting of diversity, we should see
positive
change in this area. Frank Zappa is alleged to have said, "Without
deviation from the norm, progress is not possible." That being the
case, we may eventually appreciate the increased capacity for creative
thinking
that we all develop as we become more open to diversity in our fellow
human
beings. References Brown, G.R.
(1988), Transsexuals in the military: Flight into hypermasculinity. Arch.
Sex. Behav., 17:527-537. Brown, M.L.,
&
Families, Friends, Coworkers, and Helping Professionals.
Jossey-Bass. Cole, S.S.,
Denny, D., Eyler, A.E., & Samons, S.L. (2000), Issues on
transgender. In
Psychological Perspectives on Human Sexuality, ed. L.T.
Szuchman
& F.
Muscarella. Ettner, R.
(1999), Gender Loving Care, A Guide to Counseling Gender-Variant
Clients.
Meyer, W.,
Bockting, W., Cohen-Kettenis, P., Coleman, E., DiCeglie, D., Devor, H.,
Gooren, L., Hage, J., Kirk, S., Kuiper, B., Laub, D., Lawrence, A.,
Menard, Y.,
for gender identity disorders-6th ver. Intnat. J.
Transgender 5(1). Retrieved from:
www.symposion.com/ijt/soc_01/index.htm Mailing
address: Sandra L.
Samons, M.S.W., Ph.D. Phone: (734)
663-7871 Fax: (734)
663-7441 e-mail:
slsamons@umich.edu References American
Psychiatric Association.
•Diagnostic and statistical Manual of Mental Disorders, 3rd
Edition (DSM-III) (1980). American Psychiatric Press,
•Diagnostic and statistical Manual of Mental Disorders, 4th
Edition (DSM-IV). (1994). American Psychiatric Press, Brown, G.R.
(1988), Transsexuals in the military: flight into hypermasculinity.
Arch. Sex. Behav. 17:527-537. Brown, M. L.,
& Rounsley, C. A. (1996). True Selves: Understanding
Transsexualism...For Families, Friends, Coworkers, and Helping
Professionals.
Jossey-Bass Publishers, San Francisco. Cole, S. S.,
Denny, D., Eyler, A. E., & Samons, S. L. (2000), Issues of
transgender.
Psychological perspectives on Human Sexuality. Ed.
L. T.
Szuchman & F. Muscarella. John Wiley
&
Sons, Inc., Ettner, R.
(1999). Gender Loving Care, A Guide to Counseling Gender Varient
Clients.
Norton
& Co., Meyer, W.,
Bockting, W., Cohen-Kettenis, P., Coleman, E., DiCiglie, D., Devor, H.,
Gooren, L., Hage, J., Kirk, S., Kuiper, B., Laub, D., Lawrence, A.,
Menard, Y.,
Available online at: www.symposion.com/ijt/soc_01/index.htm. Rottnek,
M., Ed. (1999). Sissies and Tomboys: Gender Nonconformity and
Homosexual Childhood.
Sedgwick,
E., (1993). Tendencies. Duke University Press, Donated By my Good Friend , Nikki
from MI
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