A Comparative Study of Male Transvestites
Male to Female Transsexuals
and Male Homosexuals
   
VERN BULLOUGH, BONNIE BULLOUGH, AND RICHARD SMITH 
   


   One of the problems in the field of sex research has been a lack of 
empirical testing of definitions. In the past, the term homosexual, for 
example, has been used for individuals who are totally oriented towards the 
same sex, as well as bisexual persons (a 6, a 5, or even a 3 on the Kinsey 
scale, Kinsey, Pomeroy, & Martin, 1948). What is true for defining 
homosexuality is even more true for the phenomena of transsexualism and 
transvestism. The current definitions of who belongs to which group were 
constructed by an accretion of clinical wisdom, based mostly upon observations 
made by therapists who used the case study mode as their approach to a search 
for understanding. Usually, the individuals who were observed were being 
treated, so the treatment process may have entered into and even contaminated 
the data gathering process. The purpose of this research was to test some of 
the current assumptions about the characteristics of transvestites and male to 
female transsexuals by divorcing the research from the treatment process. 
Instead, the data were gathered from the points of view of the members of 
these groups themselves. It was hypothesized that this subjective viewpoint 
might reveal some commonalities which would distinguish transsexuals from 
transvestites and both groups from homosexuals or heterosexuals. These two 
groups were selected because the categories have been established 
comparatively recently, and there is not always agreement about who belongs to 
which group; there is still also considerable confusion of those two 
categories with homosexuality. If they arc to be separate categories,there 
ought to be a clear distinction among the three groups. 
   Transvestism (TV), as a phenomenon, has a long history, ranging from 
mythical figures to medieval saints who cross dressed; from the many instances 
of berdache in anthropological literature to historical figures such as the 
Chevalier d'Eon (Bullough, 1974; Bullough, 1976). Still, the diagnostic 
category was so uncertain that Kinsey did not include it in his examples of 
sexual behavior (Kinsey et al., 1948), in spite of the fact that the term 
transvestism appeared in the writings of Hirschfeld in two different books 
entitled Die Tranvestiten (1925). Hirschfeld's term emphasizes the cross 
dressing aspect of transvestism. Later writers, mostly post-Kinsey, have added 
other characteristics, particularly after organized transvestite groups 
appeared in this country and in Europe. Stoller (1871), for example, held that 
transvestites have a fetish for the clothing of the opposite sex. Prince has 
attempted to refine the definition further by arguing that "true" 
transvestites are heterosexuals (Prince, 1978; Prince & Bentler, 1972), and, 
by implication, she indicates that homosexuals who cross dress are not 
transvestites. Prince, who classifies herself as a transvestite, has, at 
times, used other terms such as femmephile to distinguish her definitions from 
the more ambiguous term transvestism. 
   The transsexual phenomenon (TS), historically, is more difficult to 
document (Bullough, 1976 Hoyer, 1933) since the surgical technology required 
to meet the current usage of the term was not possible until well into the 
20th century. The term was introduced in the literature in the article 
"Psychopathia Transsexualism," by Cauldwell (1950). Benjamin popularized the 
term transsexualism in a lecture at the New York Academy of Medicine in 195 3 
(Benjamin, 1954). In that same year, the term reached public attention when 
Christine Jorgensen, who had undergone sex change surgery, was featured in the 
public press (Bullough & Bullough, 1977). Interestingly, the first scientific 
description of the case labeled her a transvestite (Hamburger, Sturup, & Dahl-
Iversen, 1953). Obviously, as in the case of transvestism, the term 
"transsexualism" is loaded with implications that go beyond the literal 
meaning of a desire to change sex. Benjamin, for example, felt that 
transsexuals considered their sex organs sources of disgust (Benjamin, 1954; 
Buhrich & McConaghy, 1977). On the basis of our extensive personal contact 
with transsexuals it is known that some who call themselves transsexuals and 
have had considerable surgery to achieve that end, however, stop short at 
their genitalia. This has been true of many female to male transsexuals. In 
our experience a genitalia change does not necessarily change sex preference, 
and there are numerous individuals who have completed surgery only to find out 
that their sex preference was the same as before they began surgery. There is, 
for example, a growing community of male to female transsexuals who are 
lesbians. Others change both their sex and their sex preference. The issue of 
just who is a transsexual has been complicated by the need, if only to protect 
the surgeon from charges of mutilation or malpractice, for some kind of 
counseling for those seeking surgery. Whether the gender dysphoria clinics 
accept multiple definitions of what constitutes the condition of 
transsexualism is undoubtedly debatable; among transsexuals and would-be 
transsexuals, however, there is a widespread belief that only certain 
responses are acceptable. The key element seems to be a statement by the 
patient that he (in the case of males) feels like a woman trapped in a man's 
body or vice versa (MacKenzie, 1978; Prince, 1978; Prince & Bentler, 1972). Is 
there any agreement among the groups themselves as to who belongs to which 
group? 
   Though numerous descriptive studies have been conducted of various sexual 
groups, very few have been done of transvestites or transsexuals, perhaps 
because they are not so numerous and are not as well organized. The earliest 
large sample study of transvestite males was that by Prince and Bentler 
(1972). Over 500 subscribers to the magazine Transvestia were studied by means 
of a questionnaire focusing on their social and demographic characteristics. 
The readership and the responses, in retrospect, seem to have been deeply 
influenced by Prince 's own definition of the phenomenon. As editor of the 
journal Transvestia and as a missionary for transvestism, Prince had 
continually emphasized that transvestism was a heterosexual phenomenon which 
differed radically from transsexualism (Prince, 1978). Consequently, the 
magazine and the organized groups which grew out of it at first insisted on 
the Prince definition, and, in the groups at least, those who did not conform 
were re moved from membership. Still, in spite of this limitation, 11% of the 
sample members in the Prince and Bentler survey did not classify themselves as 
heterosexual. Overall, the subjects in this pioneering study tended to be well 
educated with substantial incomes and responsible jobs. 
   Since the Prince and Bentler study, others have entered the field, but the 
number of studies re mains limited. Buhrich and McConaghy (1977, 1978, 1979) 
studied 34 transvestite and 29 transsexual men, along with 29 male homosexuals 
gathered together from three different sources. The transsexual group members 
had presented them selves to the Prince Henry Hospital Transsexual Clinic 
seeking sex change surgery; the transvestites were club members, and the gay 
males had sought psychiatric help because of their homosexuality. In a series 
of articles, they reported demographic and behavioral differences among their 
sample. The transsexuals were younger than the transvestites and they (the 
TS's) were more likely to dress fully and to report homosexual interests than 
the TV's. The TV's were older, and more likely to be heterosexual and to cross 
dress only partially. They con cluded that these were two clinical entities. 
   MCauley and Ehrhardt (1977) studied 15 females requesting TS surgery who 
ware presented for treatment at the psychoendrocrinology clinic, and 15 
lesbian volunteers from local gay groups. Tests of cognitive function did not 
discriminate between the two groups, but on the personality scales the 
transsexual women were more stereotypically male, whereas the lesbians were 
more androgynous. More female transsexuals held jobs that were within the male 
dominated domain, whereas lesbians filled more neutral work roles. The authors 
speculated that the more stereotypic responses may reflect a desire to be 
convincing as males. 
   
   Studies Related to Childhood 
   A part of the scenarios often used to describe individuals from one of the 
sexual minority groups has been to indicate that it was their childhood 
experiences which formed them. This has been particularly true of the 
psychoanalytic approach. Though only a few such studies have paid any detailed 
attention to transvestites and transsexuals, those dealing with homosexuality 
have sometimes made passing references to the topic. The so-called "Bieber 
Mom," the dominant, overprotective, and closebinding woman who superintended a 
family situation sufficiently pathological to induce sexual variation in her 
child, has been utilized to explain transvestism and transsexualism (Bieber, 
1962, 1968). Socarides' (1968, 1978) belief, that a key element in sexual 
variation was a fixated wish for mother-child unity which resulted in behavior 
designed to forestall such a powerful affective state threatening to destroy 
the individual, has been used similarly. Although almost all recent studies 
have challenged the picture for homosexuals (Bell, Weinberg, & Hammersmith, 
1982; Whitam, 1980), no such challenge has been made for transvestism and 
transsexualism. Stoller (1978) differentiated between two types of feminine 
boys. The first type resulted from a mother-infant symbiosis in which the 
father was totally absent. He saw this pattern as predisposing to child hood 
transsexualism. The second and more common picture in his conceptual scheme 
involved some separation from the mother and a situation of conflict marked by 
hatred and blackmail of the boy by the mother so that his sense of self as a 
male was threatened. Stoller visualized this as the precursor to castration 
anxiety which, in turn, led to transvestism, effeminate homosexuality, and 
transsexual patterns that are more conflict ridden than he first described. 
Stoller held that in the case of the transsexual in particular, the father 
would be physically absent but psychologically present in that he, the father, 
is constantly cited by the mother as a model of failure. The totally absent 
father is seen by Stoller as a less consistent but common feature of the 
childhood of both homosexual and transvestite males. Stoller (1976, 1978), 
however, questions whether the analysis of adults is a sufficient source of 
information about what went on in infancy. 
   The psychoanalytic case study method has come under attack on the grounds 
that it favors the sought for diagnosis, making it possible to construct a 
pathological case for anyone, regardless of that individual's well-being 
(Karlen, 1971; Mavahedi, 1975; Weinberg & Williams, 1974). To avoid this 
charge Green (1974) approached the problem longitudinally in his study of 
feminine boys. Although his review of the literature indicated that there were 
a number of sociological and psychological variables for adult sexual 
behavior, he believed that child hood socialization was a key process. In his 
study, he identified such elements as a close relationship with the mother and 
conscious or unconscious encouragement of feminine behavior patterns as 
present in his case histories. In his study of 50 feminine boys, he reported 
that 75% cross dressed before their 4th birthday and only 3% after their 6th 
birthday, and that 93% of his boys began doll playing, which all children 
probably exhibit and emphasized that he was describing marked and persistent 
cross gender behavior. Green had originally studied five feminine boys; a 
follow-up study of these was reported by Money and Russo (1979), who found all 
five to be homosexual. In a follow-up on his own study, Green (1979) reported 
that in the nine cases where genital contact had occurred there was a high 
incidence of homo sexual and bisexual experience. Since most of the boys in 
his sample were still in their early or middle adolescence, it is probably too 
early to fully assess their adult sexual identity. One of the difficulties 
with a study such as Green's is that we are not yet certain what childhood 
factors to look for in any longitudinal study of transvestites and 
transsexuals. It might be that feminine behavior is only one factor or might 
not exist at all. Buhrich and McConaghy (1977, 1978, 1979) found the only 
statistically significant family-related variable was that more of the 
transvestite and transsexual subjects reported, that their mothers hoped for a 
girl prior to their birth.  No such report was made by the control groups. 
   In a Swedish study of 12 male and 12 female transsexuals, which compared 
their subject with male army conscripts and female nulliparous pregnant women, 
Uddenberg, Walinder, and Hojerback (1979) found significant differences 
between transsexuals and other young adults. The transsexuals were much more 
likely to report unsatisfactory relationships with parents than other young 
adults. The pattern described by Stoller (1978) of intense relationship with 
the opposite parent was found in only half of the male transsexuals and none 
of the females. They concluded that probably both parents were important in 
defining gender and sexual identity. 
   The implications of these studies seem rather limited. They support the 
early genesis of these problems, as outlined by Money and Ehrhardt (1972), and 
suggest that this period is not touched by their type of retrospective 
studies. They suggest that gender misidentification may impair the parents' 
efforts to establish satisfactory relationships with the child. If this is the 
case, it would challenge some of the psychoanalytic concepts which put the 
burden on the parents. Perhaps even the psychoanalytic explanation is the 
result of, rather than a cause of, the behavior being described. 
   The major recent study of homosexuality is that of Bell, Weinberg, and 
Hammersmith (1982). Their report also does much to dispel myths related to 
some of the early psychoanalytic assumptions relative to homosexuals. 
   
   Focus of This Study 
   From this literature review, there are some assumptions and finding which 
emerge that can be subjected to further testing. The first is the theme, 
pervasive throughout the psychoanalytic literature, of the absent father, as a 
basis not only for homosexuality, but also for transvestism and 
transsexualism. Other assumptions focus on feminine behavior of boys and 
childhood adjustment. These assumptions can be converted to the following 
hypotheses: 
   a. Transvestites and transsexuals will be more likely to have grown up in a 
family headed by a female than will members of the sexually unidentifies 
comparison group but will be very similar to the homosexual comparison group. 
   b. Transvestites and transsexuals will be less likely to have engaged in 
typical boy activities than will the sexually unidentified comparison group 
and will have a pattern very similar to that of the homosexual group. 
   c. Transsexuals, because they are most rejecting of their childhood sex, 
will report a less happy childhood than any of the other groups.   
   d. Transsexuals will report more academic difficulties as children than 
members of other groups. 
   Several other foci, which also emerge from the literature review, were 
examined but not as major hypotheses: demographic and social variable, life 
histories, and current sex patterns of male to female transsexuals and 
transvestites as compared to comparison groups of gay males and the group of 
men whose sexual orientation was not identified. This article concentrates on 
sex patterns and childhood differences. 
   
   Method 
   Subjects 
   Subjects were 65 transvestites (TV's), 33 male to female transsexuals 
(TS's), 57 gay males, and an undifferentiated control group of 61 men. 
Subjects, except for the undifferentiated control group, were identified by 
their membership in organized groups. These sexual subcultures have been 
described in several studies (Sagarin, 1969;Siegel & Zitrin, 1978; Warren, 
1974). They are a well-known phenomenon in large cities and have been studied 
at least since the time of Hirschfeld (1910) in Berlin. In Los Angeles, a few 
of the more scholarly members of these groups are also members of, or friends 
of, the local chapter of the Society for the Scientific Study of Sex. These 
ties were used for locating members. The cooperating organizations included 
three transvestite sororities (including two groups whose members had split 
from the original Prince-sponsored TV group over definitional matters). The 
TS's were members of a Southern California transsexual support group which 
included both preoperative and post-operative persons who met for purposes of 
mutual support and socializing. The gay comparison group came from a random 
sample of an established city-wide gay organization and a nearby campus gay 
group. The second comparison group included men from occupations represented 
in the two samples, as well as a group of randomly selected college students 
whose age was in the range of the transsexual sample. The occupational 
population was obtained by searching through the library for local membership 
lists of professional groups or trade unions similar to the groups to which 
many of our transvestite and transsexual members belonged. This group was then 
randomly sampled to obtain a mailing list. This group did not receive the 
sexually oriented questions. They were used only for some baseline data 
comparisons on the non-sexually oriented questions. 
   
   Questionnaire 
   The questionnaire was a nine-page instrument in four parts. The first part 
dealt with background information about age, height, weight, occupation, 
living arrangements, marital status, education, in come, parents, political 
views, sports, etc. There were 28 items in this part. The second part was a 
standardized Spence-Helmreich Scale (1978) and consisted of 24 questions. The 
third part was the Texas Social Behavior Inventory (Helmreich, Stapp, & Ervin, 
1974), a 16-question instrument. The fourth part consisted of a series of 
questions about sex, cross dressing, and related matters. These questions were 
pretested and revised, as necessary, prior to their use in this investigation. 
   
   Procedure 
   Each person was mailed a questionnaire. Mailing was done by the 
organizations, except in the case of the unidentified comparison group. The 
researchers furnished the postage. This procedure was followed to protect the 
identity of the person who did not wish to respond. 
   The questionnaire was accompanied by a cover letter from us and the 
organization of which they were a member. It indicated that the respondent had 
been selected for participation in this research be cause of his membership in 
that organization. It explained that the purpose of the research was to 
clarify misconceptions concerning various erotic minority groups. All our 
credentials were described and our telephone numbers indicated for those who 
wanted further information. 
   The overall response rate was 60%. The response rate for the three erotic 
groups was roughly comparable, but the response rate for the undifferentiated 
group was somewhat lower. A follow-up letter to the latter group produced 
additional responses, making the total percentage almost comparable to the 
other three groups. 
   One obvious defect in this method of sample selection is that we reached no 
truly isolated or nongroup members. A second limitation in the study related 
to the sampling technique is the fact that studies have indicated that members 
of organized groups tend to be better integrated into society, are more 
affluent, and are better educated than the non-organized (Durkheim, 1951; 
Nisbet, 1953). In defense, however, the sample is more representative of the 
universe of transsexuals and transvestites than previous ones drawn from 
patients who have presented themselves for psychotherapy. Interestingly, how 
ever, 50% of the total sexually differentiated sample (including homosexuals) 
reported that they had sought some type of counseling or psychotherapy, with 
transsexuals being the most overrepresented in patient populations 
(transsexuals, 93%; transvestites, 54%; homosexuals, 29%), perhaps because of 
the requirements of reputable medical centers that there be psychiatric 
evaluation before hormone therapy or surgery. 
   
   Results 
   The first hypothesis, which dealt with family patterns, was tested in 
several ways. A summary of the responses to the question about who raised the 
subjects is shown in Table 1. No statistically significant relationship 
between group membership and parenting figures was found, x2 (6) = 8.56, p > 
.05. In fact, comparisons of national data for female heads of household 
(Table 2) suggest that absent fathers are no more common among the sexual 
minority groups than they are in the general population. 
   
           Table 1 
           Summary of Responses to the Question: "By Whom Were You Raised?" 
                                           Both Parents    Mother  Othera 
   Transvestite            (n = 65)                85%             8%      8% 
   Transsexual             (n = 33)                79%             6%      15% 
   Homosexual              (n = 57)                81%             16%     4% 
   Undifferentiated        (n = 61)                89%             7%      2% 
   Note. X2(6) = 8.56. p > .05. 
   aIncluded father, grandparents, other relatives, and adoptive parents. 
   
   Table 2 
   National Statistics on the Percentage of Female Heads of Households 
   
   1978    25% 
   1970    21% 
   1960    18% 
   1950    15% 
   1940    15% 
   1930    19% 
   1890    14% 
   
   Note. From Historical Statistics of the United States: Colonial Times to 
1970, United States Bureau of the Census. Washington, D.C.: U.S. Government 
Printing Office 1975; Statistical Abstract of the U.S., 1979, United States 
Bureau of the Census. Washington, D.C.: U.S. Government Printing Office, 1979 
p. 47. 
   
   A summary of the data pertaining to mother's work status is contained in 
Table 3. Whether the subjects' mothers worked when they were children emerged 
as a statistically significant relationship. The transvestite group presented 
the most extreme pattern: Members of this group were much more likely to have 
had mothers whose occupation was listed as "housewife." Whether this is an 
important finding or simply a function of the age and economic standing of the 
TV group as compared to the others is not clear.  
   Other data, not shown in tabular form, were also sought to determine 
whether family constellation and placement were important. Data relating 
subjects' birth order (older, middle, younger, or only children) to the four 
groups did not result in a statistically significant association. So, if the 
mother tended to smother or favor a child, she apparently did so in a way that 
was not related to birth order. Number of male and female siblings also proved 
to be nonproductive. Thus, the psychoanalytic picture of the overwhelming 
mother and absent father was not supported by the data.  
   The second cluster of hypotheses dealt with the masculine vs. feminine 
behavior because of the emphasis on this behavior as a marker for later gender 
and erotic development. The question was asked if sports were an important 
part of the subject's adolescent life, and whether their involvement in sports 
was a participant or an observer. Here, the TV's and the sexually unidentified 
group stand out as most interested in sports, both as participants and as 
observers. These data are summarized in Table 4. 
   
   Table 3 
   Subjects' Mothers' Work Status 
   
                           Transvestites  Transsexual   Homosexuals  Undifferentiated 
                           (n = 58)       (n = 30)      (n = 52)     (n = 60) 
   Housewife                81%             63%          56%          53% 
   Occupation indicated     19%             37%          44%          47% 
   Note.: x2(3) = 11.71, p < .01. 
   
   Table 4 
   Summary of Responses to the Question: "Were Sports an Important Part of 
Your Adolescent Life?" 
   
   Responses                
                              Transvestites  Transexuals  Homosexuals  Undifferentiated 
                              (n = 65)       (n = 33)     (n = 57)     (n = 61) 
   No                          23%            64%          51%          26% 
   Somewhat, as an observer     6%             6%          11%           3% 
   Somewhat, as a participant  26%            12%          26%          26% 
   Yes, as an observer         14%             6%                       3% 
   Yes, as a participant       31%            12%          12%          41% 
   Note.: x2(12) = 31.90, p < .0001. 
   
   Table 5 
   Age First Cross Dressed 
   
   Age                        Transvestites  Transsexals  Homosexuals 
                              (n = 63        (n = 33)     (n = 51) 
   Up to age 10               73%             21%          7% 
   11-15                      19%              -           -
   16-20                       2%              3%          2% 
   20-29                       5%              3%          -
   50-59                       2%              -           -
   Never cross dressed         -               73%         91% 
   x2(10) = 105.56, p < .001. 
   
   
   Table 6 
   Responses to an Open Ended Question Which Asked How Happy the Respondents 
Were as Children. 
   
    Responses                  
              Undifferentiated   Transvestites   Transsexuals   Homosexuals
              (n = 64)           (n = 32)        (n = 55)       {n = 61) 
   Happy      38%                16%             64%            60% 
   Mixed      39%                34%             16%            21% 
   Unhappy    23%                50%             20%            19% 
   Note. x2(6) = 29.75, p < .0001. 
   
   One of the marks of feminine boys is youthful cross dressing and female 
role modeling. Table 5 shows patterns of cross dressing. Here, the major 
difference appeared between the transvestites and the other groups. (The 
unidentified group was not asked this question.) Cross dressing, where it 
existed started at an early age in all three groups, but as an index of later 
behavior it would seem to be more predictive of transvestism than either 
transsexualism or homosexuality. The transsexuals seem to be less focused on 
clothing than the transvestites, and comparatively few of the homosexuals 
crossdressed as children. This seems to be contrary to the Green (1979) 
findings, but it could be that the TV's learned early to compensate for their 
cross dressing by playing the masculine role fully enough to avoid questions 
in the minds of their parents. 
   There was a cluster of variables related to child hood adjustment which 
emerged as significant and tended to differentiate the groups from each other. 
Respondents were asked how they would describe their childhood. In order to 
get the subjects' impressions, each was asked to indicate whether they were 
happy, lonely, full of guilt, etc. Responses were categorized as happy; as 
mixed or neutral, which included both negative and positive responses; and as 
unhappy, with only negative adjectives. These retrospective views of childhood 
appear in Table 6. The transsexual group stands out as the most unhappy, with 
the TV's intermediate, and the gay group the most happy. 
   Although not at such an extreme level, the transsexual group also perceived 
themselves as poorer students. Table 7 shows responses to the question. "How 
strong were you academically in high school?' Three choices were supplied: (l) 
Excellent (A to B), (2) Fair (B to C), 
   
   Table 7 
   Summary of Responses to the Question: "How Strong Were You Academically in 
High School?" 
   
Academic Strength               Transvestites   Transsexual     Homosexuals  Undifferentiated                (n = 65)        (n = 33)        (n = 57)  (n = 61) 
Excellent student (A to B)      35%             30%             47%          59% 
Fair student (B to C)           54%             49%             53%          36% 
Poor Student                    11%             21%             -             5% 
   Note. x2(6) = 21.57, p < .001. 
   
   Table 8 
   Sexual Orientation: Responses to the Question: "Are You More Sexually 
Attracted to Males, Females, Both, or Neither?" 
   
   Attraction to   Transvestites   Transexuals     Homosexuals 
                   (n = 65)        (n = 33)        (n = 55) 
   Females         82%             24%              2% 
   Males            6%             52%             80% 
   Botha           12%             17%             17% 
   Neither          2%              6%              2% 
   Note. x2(6) = 98.65, p < .0001. 
   a"Both" included people who were attracted to males at one time in their 
life and females at another time as well as currently active bisexuals. 
   
   Sexual Orientation 
   Since the inclusion of the subjects in the study was determined by their 
ties to a subcultural grouping and these cultures carried a sexual identity 
with them, we anticipated that there would be considerable uniformity within 
the sample groups. This did not turn out to be the case. Table 8 indicates the 
responses to the question, "Are you more sexually attracted to males, females, 
both, or neither?" This question was not asked of the sexually unidentified 
control group. Most noteworthy is the degree of blurring of the lines between 
the groups. Although the majority of the homosexual sample was, in fact, 
homosexual, and the majority of transvestites was heterosexual, an ambisexual 
minority was evident in all the groups. This suggests that a definition of 
transvestism limiting the phenomenon to heterosexual males is much too 
confining. Even among groups who proclaim their heterosexuality there is 
considerable ambivalence. Some of the transsexuals had serial orientations: 
having been attracted to females at one point in their lives and then, having 
decided they were transsexuals, they switched over. Not all changed their 
preference in sexual partners, and one of the post-operative transsexuals 
included in the sample is a leader in the lesbian movement. Though such a 
situation is decried by Raymond in The Transsexual Empire (1979), it should be 
emphasized that a desire to change one's sexual identity may or may not 
involve a change in sexual orientation. 
   
   
   Table 9 
   Gender Identity & Self-descriptions 
   
   Descriptions                            Transvestite   Transsexuals  Homosexuals 
                                           (n = 65)       (n = 33)      (n = 57) 
   Woman trapped in male body               11%            64%           4% 
   Man trapped in female body                2%             -            -
   Man with feminine side                   46%             6%          14% 
   Woman with masculine side                 3%             3%           4% 
   Person who enjoys opposite clothing      37%             -            4% 
   Other: 
   a. Gay                                    -              -           75% 
   b. Woman                                  -             27%           -
   c. Chromosomal Disorder                   2%             -            -
   Note. x2(14) = 135, p = .0001. 
   
   Sexual Identity 
   In an effort to see how some of the phrases from the sex and gender 
identity literature matched with the self-perception of the subjects, a 
question was posed asking respondents to describe gender identity and interest 
in cross dressing in some of the terms used by the various sexual subcultures. 
Those terms and the responses are shown in Table 9. As can be noted, 75% of 
the members of the gay sample rejected these alternative. Their self-
perception was in terms of their homosexual sex preference. Only a few 
endorsed statements suggesting any blurring of gender identity. Members of the 
transvestite sample chose all possible gender identities, although the two 
most popular phrases were that of a man with a feminine side and a person who 
enjoys wearing the clothing of the opposite sex. Eleven per cent, however, 
chose the statement that they were women trapped in a man's body, and one 
person explained that he was born with a chromosomal disorder. The majority of 
the transsexual sample accepted the traditional view of themselves as having 
been born women but trapped in male bodies. Unfortunately, however, this term 
is known to have evaluation which clears the way for surgery (MacKenzie, 
1978). The sample members were part of the transsexual subculture, and one of 
the important functions of that subculture is to orient its members to the 
appropriate answers which one gives to the psychiatric or psychological 
evaluator. 
   
   Table 10 
   Responses to the Question: "To What Extent Are You Interested In Sex 
Change?" 
   
   Interest                       Transvestites  Transsexuals Homosexuals 
                                  (n = 65)       (n = 33)     (n = 51) 
   Not at all                     54%            3%           96% 
   Looked into the possibility 
     and rejected it              20%             -            -
   Am favorably inclined           2%            15%           2% 
   Have taken or am now taking 
     sex hormones                 25%            49%           2% 
   Have had surgery                -             33%           -
   Note. x2(8) = 126, p < .0001.   
   
   Though transsexuals are obviously the groups who have dealt with the sex 
change surgery in the most direct way, consideration of the possibility of sex 
change or actual sex change was also found in all the groups, as noted in 
Table 10. Clearly the emphasis is different in the three groups but the 
blurring of lines is also seen. One "transsexual" indicated he was not at all 
interested in the complete sex change, although he considered himself a 
transsexual. Nearly half of the transvestites have either considered sex 
change or taken sex hormones, and two members of the gay sample had seriously 
thought of sex change. Note, also, that only 33% of the TS sample members are 
completely post-operative. This suggests that the transsexual subculture may 
be most important pre-operatively. Young men who feel that they somehow do not 
fit into established traditional gender identities apparently seek out the 
group for support and advice during the decision making process. Only a small 
minority of the post operative TS's known to the authors actually participate 
in the TS groups after surgery. 
   
   
   Table 11 
   Detailed List of Occupations 
   
   Occupations                Rating  Transvestites  Transsexuals  Homosexuals Undifferentiated    
   Waiter/waitress                49                                   1           1 
   Refinery worker                50                                               1 
   Security guard                 50                                               1 
   Dance instructor               53                                               1 
   Cook                           55                                               1 
   Warehouseman                   55                                               1 
   Salesperson/clerk              56        6              1            4          7 
   Medical assistant              57                                    1 
   Truck driver                   59                                               1 
   Mechanic                       62        3                           1 
   Foreman-laborer                62                       1 
   Piano repairman                63        1 
   Beauty operator/hairdresser    63        2              5            1 
   Machine operator               63                                               2 
   Fireman                        63        1 
   Recreation assistant           63 
   Student                        64        1              3            13        10 
   Electrician                    65        1                            1 
   Carpenter                      65                                     1 
   Small businessman (manager)    67                                     3          2 
   Telephone operator             67                       1 
   Housewife                      68                                     1 
   Real estate agent              69                                     2 
   Insurance agent                69                       1 
   Office clerical,data processing, 
   teller                         70        1              6              5         1 
   Dispatcher                     71        1 
   Survey researcher              71                                      1         1 
   Retired                        71        1              1              1         2 
   Child care (handicapped)       71                                      1 
   Technician                     75        4              1              3 
   Small businessman (owner)      76                                                1 
   Music engraver                 78                                                1 
   Artist                         78        4               1             1 
   Advertising                    78        1                                       1 
   Writer/author                  78        5               1                       1 
   Actor/musician                 78        2               2                       2 
   Owner/manager                  80        1                                       1 
   Contractor                     80        1                                       2 
   Safety director                80                                      1 
   Librarian                      81        1                             1 
   Teacher                        81        1                             1 
   Stockbroker/investor           81        3               1                       3 
   Accountant                     81                                                3 
   Administrator                  81        5               1             3 
   Counselor                      81                        3             1 
   Health professional            83                                                1 
   Banker                         85        1 
   Engineer                       86       10              1              1        13 
   Pilot                          86        1 
   Lawyer                         89        1                             2         3 
   College professor              90        1                             1         1 
   Physician                      93        1 
   
   In sociological terms, one of the most important factors relating to an 
individual's self-identification as a TV, as distinguished from a TS, was 
income and occupation. A standard scale of occupational prestige developed by 
Hodge, Siegel, and Rossi (1964) was used to rank the subjects. This scale 
utilizes a range between 94 for Supreme Court justices and 34 for workers at 
the lowest level of occupational prestige (shoe-shining). An average 
occupation ranks at 71. A detailed list of the jobs held by members of the 
four groups is shown in Table 11 and the summarization is shown in Table 12. 
   
   Table 12 
   Occupation Level of the Four Subsamples Split at the Median of the Total 
Sample 
   
                          Transvetites   Transsexuals   Homosexuals   Undifferentiated 
   Occupational Level     (n = 63)       (n = 32)      (n = 53)      (n = 60) 
   Above median            64%            31%           30%           48% 
   Below median            37%            69%           70%           52% 
   Note x2(3) = 16.03, p < .001. 
   
   Though the median of the total sample was 75, which places it somewhat 
above the national aver age, the transvestite sample was heavily represented 
in the mainstream white collar world, including engineering, accounting, 
teaching, sales, and clerical work. These men clearly are high prestige 
workers, and, except for the two hairdressers and the per forming artists, 
they were not represented in stereotypically feminine jobs. On the other hand, 
the transsexuals were much more likely to choose the feminine image jobs, with 
five hairdressers among their ranks. The gay group showed greater occupational 
variation, although again transvestites as a group had the highest median. 
   
   Discussion 
   Although the data suggest that there is considerable blurring of 
categories, certain things, not always anticipated by the TS's in their 
preparation to pass the psychiatric examination for surgery, appear important. 
TS's are more likely to be unhappy in their childhood and to seek employment 
in low status occupations, many of which are usually held by women. One of the 
differences between the transsexuals and transvestites has been the 
willingness of the transsexual to assume publicly the role of the opposite sex 
to which they were born. The transvestites, with Prince as a major exception, 
have carefully protected their male identities. They presented a feminine 
persona only on occasions when they cross dressed in seclusion. To do more was 
to risk exposure, and with this, a significant status loss. 
   The history of an unhappy childhood and poor academic performance found in 
the transsexual sample has implications in light of the differences both with 
gays and transvestites, as well as with the sexually undifferentiated samples. 
It might well be that the existence of a category of transsexual has allowed 
many of the people with the most troubled childhoods and most marginal adult 
occupations and happiness to classify themselves as transsexuals rather than 
homosexuals. This suggests that many of the early case studies on 
homosexuality are no longer valid, since those so classified might today have 
been classified as transsexual. 
   The absent father as a variable simply did not hold up in this study. If 
sports and cross dressing can be thought of as clues as to what is regarded as 
feminine behavior in young boys, the evidence is contradictory. TV's were most 
interested in sports, and they also participated most actively in cross 
dressing. Gays and TS's were not so sports-minded, and although some TS 
subjects also cross dressed, hardly any of the gays did. From what the 
individuals can reconstruct of their childhood on a questionnaire, few would 
have acted in an overly feminine manner. The family constellation of the 
groups also lacked significance, although the transsexuals again seem to have 
been the most marginal. The sample is still too small to make any firm 
generalizations, but it would seem that there might well be an overemphasis on 
childhood in the psychoanalytic literature, at least as it relates to 
relationships with parents. It might well be that, ultimately, whether a 
person classifies himself as a transvestite or as a transsexual relates to his 
success in the world at large. Transvestites were eminently successful, were 
heavily into male identified occupations, and, outwardly, seemed secure in 
their role as males. Perhaps the very security of success in the male world 
carries a burden which the adoption of a feminine persona allows them to 
escape. If this speculation is correct, transvestites might well be 
distinguished from transsexuals in their life goal orientation and their 
motivation towards material satisfaction and occupational prestige. Success in 
these lines makes them unwilling to risk more than periodic cross dressing. 
Failure to be successful in these areas might well encourage them to adopt 
more radical solutions such as surgery. This, however, is only a speculation.  
   There are obvious differences between the various groups, but there is also 
a considerable overlap among them. Perhaps, as the definitions become further 
refined and the self-selection process develops, there will be less overlap.  

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