Transgenderism defined, in words and by the numbers

Transgenderism can be a tricky and sometimes confusing topic. Here are a few things to keep in mind:

Transgender versus transsexual: The word “transgender” is an umbrella term. For example, a man cross-dressing as a woman (who has not had surgery to switch gender) can be identified as transgender. By contrast, “transsexual” refers to someone who identifies as the opposite of the sex which he or she was born. So all transsexual people are transgender, but the reverse is not necessarily true. The word “transgender” is, by the way, considered sufficient as an adjective.

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By the numbers: Recent estimates peg the percentage of the transsexual population in the United States (and presumably Canada) as being between 0.25 and one per cent. The transgender population, being more broadly defined, is higher.

Victoria psychiatrist Gail Knudson — a former president of the Canadian Professional Association of Transgender Health — says female-to-male surgeries are less common than male-to-female. Studies suggest the ratio is about 45 per cent for female-to-male, compared to 55 per cent for male-to-female.

Gender-affirming surgery: The phrase “sex-change surgery” is considered outdated. Gender-affirming surgery refers to a number of surgeries to enable a trans person to become a different sex. These can include genital and facial reconstruction, chest and other procedures.

Gender dysphoria: The feeling that one’s true gender does not match one’s sex at birth.

Vaginoplasty: A vagina is created out of the penile skin. Usually, the penile skin is turned inside-out to create the new vagina.

Phalloplasty: A penis is constructed using skin from another part of the body, such as the forearm or abdomen. This can include the creation of a scrotum with testicular implants.

Metoidioplasty: The clitoris (enlarged through testosterone hormone therapy) is separated from the labia minora, with the surgeon severing its suspensory ligament. This lowers the clitoris to the approximate the position of a penis.

The price tags: The provincial Medical Services Plan covers gender reassignment for both male-to-female and female-to-male transitions. Here are the approximate costs, as provided by the Ministry of Health.

Phalloplasty: $41,500 (includes anesthesiology cost)

Metoidioplasty: $20,000 (includes anesthesiology cost)

Testicular implant: $6,000

Penile implant: $16,000 (includes anesthesiology cost)

Vaginoplasty: $16,000 (includes anesthesiology cost)

Bilateral mastectomy (includes mastectomy, nipple areolar reconstruction and chest wall reconstruction): $2,000 (includes anesthesiology cost)

Transgenderism and children: Transgender expert Nicholas M. Teich writes: “The vast majority of adults would be hesitant to believe that a child can make such a serious decision as gender transition. But it is possible.” Gender identity, he added, is believed to be “solidified by the age of six.”

In her recent New Yorker article on transgenderism and young people, Margaret Talbot observed: “In recent years, the most striking change for trans people is the possibility of switching at younger and younger ages.” The article suggests thousands of American adolescents are now taking hormones to slow the onset of puberty. This buys them more time to decide whether they want to proceed with physical procedures to change their sex.

The World Professional Association for Transgender Health suggests it’s best to wait until the age of 18 for genital surgery.

Famous transgender folk: George Jorgensen, who became Christine Jorgensen after serving as a soldier in the Second World War, was America’s most famous trans person of the time. Her genital surgery was performed in Denmark in 1952. Headlines read: “Ex-GI Becomes Blonde Beauty” and “Bronx ‘Boy’ is Now a Girl.” More recently, Chaz (formerly Chastity) Bono, the only child of Cher and Sonny Bono, went public following a female-to-male transition. He legally changed his name and gender in 2010.

Primary sources: Transgender 101: A Simple Guide to a Complex Issue (2012) by Nicholas M. Teich; British Columbia Ministry of Health.

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