Comparison of Sex-Typed Motor Behavior in Male-to-Female 
Transsexuals and Women 
   
   David H. Barlow, Ph.D.,1 Joyce R. Mills,2 
   W. Stewart Agras, M.D.,3 and Debra L. Steinman4 
 

  
   Eight presurgical male-to-female transsexuals emitted significantly more 
feminine behaviors on a validated sex role motor behavior checklist than eight 
feminine women.  Transsexuals also emitted more masculine behaviors than 
feminine women, although the total number of masculine behaviors in each group 
was far less than the total number of feminine behaviors.  Indications for the 
management of transsexuals as well as the functions of sex role motor behavior 
in our society are discussed. 
   
   KEY WORDS: sex-typed motor behavior; transsexualism; masculinity; 
femininity. 
   
   1Department of Psychology, State University of New York at Albany, Albany, 
New York 12222.  
   2Nashville, Tennessee 37211. 
   3Department of Psychiatry, Stanford University, Stanford, California 94305. 
   4Department of Psychology, University of Rhode Island, Kingston, Rhode 
Island 02881. 
   
   INTRODUCTION 
   It is widely reported that transsexuals think, feel, and behave as members 
of the opposite sex (Benjamin, 1966; Green and Money, 1969).  This implies 
that there may be no systematic psychological differences between male 
transsexuals and women on the one hand or female transsexuals and men on the 
other hand.  In a study of effeminate boys, Green (1974) has observed scores 
on psychological tests very similar to those of same-aged girls, lending some 
support to this hypothesis. 
   Similarly, Pauley (1974) has observed that female transsexuals obtain 
scores on attitudinal inventories that are in the normal range for men, 
although Money and Brennan (1968) noted that scores on the M-F scale of the 
Guilford Zimmerman Temperament Survey were slightly more feminine than those 
of "normal" men in a small sample of female transsexuals.  Nevertheless, as 
Pauley (1974) points out, female transsexuals adapt quite readily to masculine 
sex roles. 
   Some clinicians, however, have reported that adult male transsexuals appear 
more feminine than women.  For example, Pauley (1974) notes that female 
transsexuals "accept the masculine role more naturally than their male 
counterparts who frequently exaggerate the feminine role and portray a 
caricature of a woman.  This hyperfeminine portrayal by some male transsexuals 
is immediately recognized by an overwhelming aroma of perfume, seductive 
behavior, attire which is inappropriate to the occasion."  This interesting 
observation of a possible difference in the behavioral expression of mistaken 
gender identity between male and female transsexuals may be observed in their 
responses to attitudinal and interest inventories in which some male 
transsexuals score more "feminine" than the average for "normal" women 
(Walinder, 1967; Money and Primrose, 1968; Pauley, 1974). 
   While these differences are not statistically significant, Money and 
Primrose (1968) suggest that these trends indicate "a high degree of verbal 
adherence to female stereotypes" while cautioning that the effect may be due 
to social desirability.  Thus, while suggestive, the results from attitudinal 
and interest tests do not yet clearly confirm the clinical impressions 
mentioned by Pauley (1974) that male transsexuals exaggerate feminine 
identification. 
   Another way to compare transsexuals and nontranssexuals is to measure sex 
role behavior more directly, in the tradition of Birdwhistell (1970), who 
examined sex role specific motor behavior, or what he termed gender signals.  
Recently a behavioral checklist of sex role motor behavior has been developed 
and validated (Barlow et al., 1979b).  This checklist specifies sex-typed 
behavior occurring while sitting, standing, or walking.  The purpose of this 
experiment was to explore the clinical impression that male transsexuals are 
more "feminine" than women, using the sex role motor behavior checklist. 
   METHOD 
   Subjects 
   Subjects included eight white women, ages 18-35, who were employed at a 
major medical center.  These women were employed as nurses, nurses aides, 
medical students, etc., but the majority were nurses.  Eight presurgical male-
to-female transsexuals who came consecutively to our sexual problems clinic 
were also included.  All were white with an age range of 17-26.  Some were 
employed in diverse settings, others were unemployed or in school.  Three had 
been cross-living at the time of their initial appointment for periods ranging 
from 1 month to 1 year.  The remaining five, while cross-dressing frequently, 
had not been cross-living. 
   Procedure 
   All subjects were rated on the sex role motor behavior checklist (Barlow et 
al., 1973, 1979b) in a manner described below.  This checklist contains a 
number of possible sex-typed motor behaviors that occur while sitting, 
standing, or walking.  Examples from sitting include buttocks away from the 
back of the chair, which is sex-typed masculine, and buttocks close to the 
back of the chair, which is sex-typed feminine.  An example from walking is 
feet placed as if straddling a line, which is sex-typed masculine, and feet 
placed as if stepping on a line, which is sex-typed feminine (see Barlow et 
al., 1979b, for a complete description of this checklist).  During a specific 
observation, either masculine-typed behaviors, feminine-typed behaviors, or in 
some cases both might be endorsed by a rater during a particular occurrence of 
sitting, standing, or walking.  Reliability coefficients among independent 
raters are high, and data on validity, where sex role motor behaviors are 
separated from gender, are presented in Barlow et al. (1979b).  Typically, the 
subject is observed for approximately 10 sec. by a trained rater who then 
checks appropriate behaviors on the checklist. 
   In this study, an observer was asked to seek out women working in the 
Medical Center who appeared to be particularly "feminine."  Two independent 
raters were then directed to the working location of these women, where they 
surreptitiously rated sitting, standing, and walking.  The reliability 
coefficient between these two raters on the overall checklist was 95.5%. 
   Since the sex role motor behavior checklist was a routine part of our 
assessment in the Sexual Problems Clinic, all patients coming through this 
clinic were surreptitiously rated by one of the same raters during the first 
session.  People belonging to a large number of diagnostic categories came 
through this clinic, from rapists and exhibitionists, who typically do not 
emit feminine sex-typed motor behavior, to transvestites and transsexuals, who 
do emit some feminine sex-typed motor behaviors.  At the time of the rating, 
the rater was unaware to which diagnostic category these patients would 
eventually be assigned.  Assessment was completed by the clinic staff, and 
ratings for the first eight consecutive patients who were finally diagnosed 
transsexual were retrieved from their files. 
   RESULTS 
   The total number of masculine sex-typed behaviors on the scale in use at 
the time of this study for sitting, standing, and walking was 6, 4, and 5, 
respectively.  The total number of female sex-typed behaviors for sitting, 
standing, and walking was 6, 4, and 6, respectively (see Barlow et al., 
l979b). 
   Feminine Sex Role Motor Behaviors 
   The female subjects emitted a total of 55 feminine sex role motor 
behaviors.  This total represents 95% of the total number of feminine and 
masculine motor behaviors observed.  The presurgical transsexual subjects 
emitted a total of 80 feminine sex role motor behaviors.  This total 
represents 85% of the total number of masculine and feminine behaviors 
observed. 
   
   Fig. 1.  Feminine sex role motor behaviors.  The figure compares the total 
feminine sex role motor behavior scores of eight females to those of eight 
presurgical transsexuals.  The total scores include the total number of 
feminine sitting, standing, and walking behaviors observed and recorded on the 
Motor Behavior Checklist for each individual subject. 
   
   Fig. 2.  Masculine sex role motor behaviors.  The figure compares the total 
masculine sex role motor behavior scores of eight females to those of eight 
presurgical transsexuals. 
   
   Figure 1 presents the individual subjects' total feminine motor behavior 
scores.  The X feminine sex role motor behavior score for the females was 
6.87.  The X feminine sex role motor behavior score for the transsexuals was 
9.88 (see Fig. 4).  The X difference between groups was 3.01.  A one-tailed 
sign test indicated that transsexuals emitted significantly more feminine 
behaviors than women (p < 0.01). 
   Masculine Sex Role Motor Behaviors 
   The females emitted a total of three masculine sex role motor behaviors.  
This total represents 5% of the total number of feminine and masculine motor 
behaviors observed.  The transsexuals emitted a total of 14 masculine sex role 
motor behaviors.  This total represents 15% of the total number of masculine 
and feminine motor behaviors observed.  This difference was also significant 
by a one-tailed sign test (p < 0.02). 
   Figure 2 presents the individual subjects' total masculine motor behavior 
scores.  The X masculine sex role motor behavior score for the females was 
0.37.  The X masculine sex role motor behavior score for the transsexuals was 
1.75 (see Fig. 4).  The X difference between groups was 1.38. 
   Difference Between Masculine and Feminine Motor Behavior Scores 
   A difference score was computed for each individual subject by subtracting 
the total number of observed masculine sex role motor behaviors from the total 
number of observed feminine sex role motor behaviors (see Fig. 3).  The 
overall X differences score for the females was 6.5.  The overall X difference 
score for the transsexuals was 8.13 (see Fig. 4).  In addition, the total 
number of masculine plus feminine behaviors observed for the females was 58, 
the mean being 7.25.  The total number of masculine plus feminine behaviors 
observed for the transsexuals was 94, with a X of 11.75. 
   
   
   Fig. 3.  Difference scores between feminine and masculine sex role motor 
behavior scores.  Difference scores were computed by subtracting the total 
number of masculine motor behaviors from the total number of feminine motor 
behaviors for each individual subject. 
   
   Fig. 4.  Overall X feminine, masculine, and difference scores.  The figure 
compares the overall X feminine sex role motor behavior score, the overall X 
masculine sex role motor behavior score, and the overall X feminine minus 
masculine difference score of the female group to those of the presurgical 
transsexual group. 
   
   DISCUSSION 
   This study indicates that male transsexuals emit more feminine behaviors 
than feminine women in these particular situations.  It is possible that 
transsexuals were attempting to behave in a particularly feminine manner, but 
observations were surreptitious, so no extrinsic demand, such as impressing a 
therapist, was in effect.  Since motor behavior is one of the more prominent 
factors contributing to our gender impressions during initial interpersonal 
encounters (Weitz, 1976), it is possible that clinical judgments of 
exaggerated femininity are based on these behaviors.  This finding has 
implications for the management of transsexuals.  If the goal of a transsexual 
is to be a normal (albeit feminine) woman, then both pre- and postsurgical 
transsexuals could be taught to lower the number of feminine behaviors emitted 
to more closely match that of feminine women.  Since more dramatic alterations 
in motor behavior have been effected in transsexuals wishing to do so (Barlow 
et al., 1979a), these slight alterations could be accomplished, presumably 
without difficulty. 
   Of particular interest in this study, however, is the observation that, 
despite the emission of excessive numbers of feminine behaviors, male 
transsexuals also continue to emit more masculine behaviors than feminine 
women.  Only one out of eight transsexuals failed to emit some masculine 
behaviors during the observation, while only three out of eight of our 
"feminine" women emitted any masculine behaviors at all.  It is possible that 
emission of occasional masculine behaviors in the context of high-frequency 
feminine behaviors (as well as feminine appearance, clothing, etc.) might be 
as much of a basis for transsexuals being "read" or identified as males as the 
exaggerated number of feminine behaviors.  Given the importance of these 
behaviors to gender impressions (Weitz, 1976; Birdwhistell, 1970), this 
deserves to be tested. 
   It is, of course, possible that raters were influenced by gender in scoring 
the occurrence of masculine behavior, but this is unlikely since the scoring 
of feminine behaviors would contradict this possibility, and since gender does 
not seem to influence rating of sex role behaviors in a study designed to 
answer this question (Barlow et al., 1979a). 
   Finally, it is probably inappropriate to suggest to transsexuals in 
treatment, or anyone, that sex-typed motor behavior should be carried 
inflexibly and stereotypically into all social situations.  For example, one 
who appeared extremely masculine or extremely feminine in all situations might 
not be as socially effective as one with more flexibility.  This "flexibility" 
has been hypothesized to occur with sex-typed interpersonal behavior (e.g., 
Bem, 1974; Kelly and Worrell, 1977) and might be termed "behavioral androgyny" 
(Barlow et al., 1979a).  Heckerman, Schoen, and Barlow (unpublished) have 
found some interesting examples of situationally determined sex role motor 
behavior in college students.  More recently, a transsexual who desired to 
reorientate to his anatomical gender (Barlow et al., 1979a) later reported 
that one of the greatest benefits of treatment was an ability to be more 
"flexible" by behaving in either a masculine or a feminine way as was 
"appropriate" (based on his judgment) to the situation. 
   Since male transsexuals emitted more sex-typed behaviors than women when 
observed in this one situation, it is also possible that male transsexuals are 
more stereotypically rigid across all situations, further accounting for some 
of the clinical impressions of "exaggerated femininity."  This has yet to be 
tested. 
   While continued study of sex role motor behavior should benefit 
transsexuals, whether their goals are surgery or, as occasionally happens, 
reorientation to their own gender, these data have broader implications.  In 
the best traditions of the study of abnormal psychology, close examination of 
sex role behavior in transsexuals should illuminate some of the larger 
questions concerning the development and phenomenology of sex roles and the 
relationship of various aspects of sex roles to interpersonal relations and 
adjustment. 
   
   REFERENCES 
   Barlow, D. H., Reynolds, E. J., and Agras, W S. (1973). Gender identity 
change in a transsexual. Arch. Gen. Psychiat. 28: 569-579. 
   Barlow, D. H., Abel, G. G., and Blanchard, E. B. (1979a). Gender identity 
change in transsexuals: Follow-up and replication. Arch. Gen. Psychiat. 36: 
1001-1010. 
   Barlow, D. H., Hayes, S. C., Nelson, R. O., Steele, D. L., Meeler, M. E., 
and Mills, J. R. (1979b). Sex role motor behavior: A behavioral checklist. 
Behav. Assess. 1: 119-138. 
   Bem, S. L. (1974). The measurement of psychological androgyny. J. Consult. 
Clin: Psychol. 42: 155-162. 
   Benjamin, H. (1966). The Transsexual Phenomenon, Julian Press, New York. 
   Birdwhistell, R. (1970). Kinesics and Context, University of Pennsylvania 
Press, Philadelphia. 
   Green, R. (1974). Sexual Identity Conflict in Children and Adults, Basic 
Books, New York, Penguin, 1975. 
   Green, R., and Money, J. (1969). Transsexualism and Sex Reassignment, Johns 
Hopkins Press, Baltimore. 
   Kelly, J. A., and Worrell, J. (1977). New formulation of sex roles and 
androgyny: A critical review. J. Consult. Clin. Psychol. 45: 1101-1125 
   Money, J., and Brennan, J. J. (1968). Sexual dimorphism in the psychology 
of female transsexuals. J. Nerv. Men. Dis. 147: 487-499. 
   Money, J., and Primrose, C. (1968). Sexual dimorphism and dissociation in 
the psychology of male transsexuals. J. Nerv. Men. Dis. 147: 472-486. 
   Pauley, I. B. (1974). Female transsexualism: Part II. Arch. Sex. Behav. 3: 
509-526. 
   Walinder, J. (1967). Transsexualism: A Study of Forty-three Cases, 
Scandinavian University Books, Goteborg. 
   Weitz, S. (1976). Sex difference in nonverbal communication. Sex Roles 2: 
175-184. 

 


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