Transsexual F to M

Female-to-male (F2M, F-M, or FTM) transsexuals (sometimes called "female-toward-male" or "male-to-male") are female-born persons who suffer from intense, often painful feelings that their assigned sex does not match their actual gender (a condition called gender dysphoria and clinically diagnosed as gender identity disorder). As opposed to transvestites who habitually cross-dress, transsexuals live fulltime as men or women and may undergo sex-reassignment surgery (SRS) in order to transition from one sex to another. Transsexuals may also identify as transgender (an umbrella term coined in the 1970s to refer to multiple gender-bending identities). Some reserve the term transsexual for those who have had hormone therapy or some form of SRS.

FTM is an expansive category that encompasses a range of experiences, identities, and gender expressions. FTMs identify along a spectrum of masculinity and may describe themselves as men, transmen, butch transmasculine, genderqueer, or transgender. Some FTMs may self-consciously differentiate themselves from non-transsexual members of the male sex, or "biomen" (biological men). Once their transition is complete, other FTMs discard their trans status and are "stealth"—living as men without reference to their former identity. The acronym MTM (male-to-male) is used by those who have always identified as males and who disagree with the "sex change" implied by FTM.

Because of the social and economic marginalization of transsexual people, the instability of trans support services, and discrepancies in research, the prevalence as well as the origin of transsexuality are unknown. There are likely as many FTM transsexuals as there are male-to-female (MTF), although in the past it was generally assumed that there were fewer FTMs than MTFs. With data that spans four decades in a country accepting of trans people, a 1997 study from the Amsterdam Gender Dysphoria Clinic puts the prevalence of MTFs at 1 in 10,000 and FTMs at 1 in 30,000. Available reports, however, do not account for the political and cultural biases that taint these numbers, or for the dramatic rise in FTMs at the start of the twenty-first century.

As assigned women, FTMs may have less recourse or resources to seek help for their problem. As many scholars have noted, assigned men who identify as women are immediately viewed as deviant and ill in patriarchal cultures that privilege maleness and manliness above all else. In stark contrast, the motivations of assigned women who identify as men have been explained away as feminist strategies against female oppression. Assigned women who identify as men, rather than being recognized as trans, may be wrongly classified as failed heterosexual women or as butch lesbians who are uncomfortable with their homosexuality.

HISTORY OF MALE IDENTIFICATION IN "WOMEN"

The history of female-to-male transsexuals overlaps with histories of lesbianism, the pathologizing classification of early sexology, and the mapping of deviant female genders across place and time. Some of these overlaps are produced through similarities in terminology, mirroring physical presentations, and aesthetics and affects culled from a shared masculine/butch cultural iconography (Rubin 2006). On the other hand, these overlaps may also be blamed on cultural assumptions and oversights.

For example, in his Dialogue of the Courtesans, the Greek satirist and rhetorician Lucian (c. 120–after 180 ce) describes a woman named Megilla who renames herself Megillus, seduces women, uses dildos, and has a "face like a man." Megilla has traditionally been claimed in lesbian histories, although arguments can be made for her as an early FTM figure. The seventeenth-century case of Catalina de Erauso (c. 1592–c. 1650), a Basque sailor who escaped from a convent at a young age and sailed for the Americas dressed as a man, has likewise confounded scholars.

Similar cases abound in ages that predate the current terms used to describe sexuality and gender and appear to increase in the West after 1850. The historian Jason Cromwell (1999) has written of three major motivations for "women" who lived their lives as men: (1) economic necessity or for adventure; (2) to explore their desire for and love of women; and (3) to live as the men they felt themselves to be. A list of these early figures includes the Civil War soldier Loreta Janeta Velazquez (1842–1897), the New York City politician Murray Hall (c. 1831–1901), and the San Francisco writer and curiosity Babe Bean (1869–1936). Many of these women who lived as men (sometimes referred to as "passing women") were not discovered to have female anatomy until they died.

Instances such as these reveal the extent to which lesbian history has appropriated trans figures of the past. As soldiers, pirates, doctors, authors, musicians, and laborers, these figures have provided examples of support and pride to more contemporary FTMs. Yet, there are significant factors that differentiate contemporary FTMs from these ancestors—namely, that of technology. The lack of the very technologies that currently define FTM experience—testosterone hormones and surgical operations—make women who had gender dysphoria or strong "male identifications" in the past clash with their current cultural manifestation. Nevertheless, many FTMs of the past devised tools to accent their manhoods. In fact, as Cromwell notes, the Irish sailor Christian Davies (1667–1739) inherited a urinary device from an older female-bodied soldier who was a friend of his father. Erauso was said to have found a remedy that reduced the size of the breasts. The first FTM transition was completed sometime around 1917 on Dr. Alan Hart.

More modern FTMs include the American jazz pianist and saxophonist Billy Tipton (1914–1989); the millionaire entrepreneur and philanthropist Reed Erickson (1917–1992); the author and activist Leslie Feinberg (b. 1949); the author, activist, and FTM International founding president Lou Sullivan (1951–1991); and the author Patrick Califia (b. 1954). Erickson's philanthropy offers an inspiring case of gay/trans activism. In the 1960s and 1970s, through his Erickson Educational Foundation, Erickson donated millions of dollars to homophile and trans organizations, including ONE, Inc., the Johns Hopkins Gender Identity Clinic, and the Harry Benjamin Foundation.

In 1977 an FTM teacher in northern California named Steve Dain received national media attention when he lost his job as a result of his outing. This blip of media exposure and visibility for FTMs is remembered as instrumental to many FTMs coming-of-age in the era—especially because of Bain's composure and strength and his successful fight to retain his teaching credentials. Nearly twenty years later, a young Nebraskan named Brandon Teena (1971–1993) was raped and murdered by two friends who had discovered his trans status. Widespread media reports, the documentary The Brandon Teena Story (1998), and the award-winning film Boys Don't Cry (1999), starring Hilary Swank, brought FTM trans issues to greater visibility.

The feminist movement of the 1970s was a galvanizing force in the formation of contemporary FTM identity. As women discussed their identities and realities in gendered terms and lesbians critiqued butch and femme genders, fierce arguments about masculinity and male identification in women erupted, resulting in the margin-alization of butches, FTMs, and their lovers within the feminist movement. Despite transsexuality's evidence for feminism's thesis about the social construction of gender, FTMs have been ruthlessly stereotyped and degraded within women's communities. Understood as "not lesbians" and "not women," FTMs and trans butches continue to endure a queer backlash that claims FTMs "steal their women" and encroach on lesbian butch territory. Nevertheless, lesbians, tomboys, and FTMs share similar histories in terms of childhood play, resenting the limitations put on girls in a male-dominated world, or fantasizing about escaping the femininity one was born into, even if these similarities have yet to serve as platforms for solidarity. Henry Rubin (2003) posits the invert as the original deviant identity that developed—through sexological, feminist, and other twentieth-century discourses—into multiple deviant identities, including the lesbian, the butch, the tomboy, the FTM transsexual, and the gay male FTM—as FTM identity evolves, no doubt the boundaries of "appropriate" FTM transgenderism will continue to shift.

FTMs across the globe face varying, and in some case more critical, circumstances. Nevertheless, many countries have made surgeries more accessible to FTMs. For instance, despite the stigma attached to homosexuality and transsexuality (which are conflated in this case), in Iran fatwas have been issued by clerics of multiple levels (including Ayatollah Ruhollah Khomeini) that insist on the rights of transsexuals—both male and female—to access sex-reassignment surgery. Although a strident homophobia seems to be the motivation for this type of national recognition, the state actually helps to finance these surgeries.

FTM TRANSITIONS

Most FTMs report experiencing gender dysphoria from a young age, or at the onset of puberty when bodily changes make the dissonance between their felt gender (male) and their assigned sex (female) all the more apparent. Transitions for FTMs begin with the individual coming out to herself, and later to others, about her status. Upon recognizing this imperative for transsexual self-realization, FTMs will begin to alter their physical presentations as they begin to live as men. Strategies include binding the breasts, packing a dildo, using the men's restroom, and adopting a new name. A critical step for many FTMs is hormone replacement therapy—taking injections of testosterone (known as "T") to produce "male" secondary sex characteristics (such as body hair and a deeper voice). FTMs experience side effects with the administration of testosterone, including the cessation of menstruation, increased libido, acne, mood swings, and increased aggressiveness.

From here, many FTMs seek further medical attention, but the next phase of transition varies depending on the individual's financial situation. If an FTM is affluent enough, he will progress through the accepted medical route for the "correction" of his problem (i.e., be diagnosed with gender identity disorder and be treated accordingly). Although many transsexuals do not think they need psychological counseling and therapy, they must submit to this treatment in order to have their FTM status authenticated by a medical authority for legal recognition, name changes on government identification, and access to the next steps of transition (including hormones as well as surgery). This system of "certification" has been heavily criticized for requiring trans people to enact and confess their "abnormality," self-loathing, and pathology to a paternalistic medical power. Other scholars, such as Judith Butler (2004), argue that this process is not necessarily an obstruction to transsexual and transgender self-determination and agency.

Whereas some FTMs will not take hormones or desire any physical changes, others will proceed with sex-reassignment surgery. For FTMs, this may include "top" or chest surgery (removal of the breasts and reconstruction of the chest) and/or "bottom" surgery, which may consist of a hysterectomy and/or any number of genital-focused surgeries (including phalloplasty, metoidioplasty, genitoplasty, and scrotoplasty).

Many men in the trans community consider genital surgeries rudimentary and unsatisfactory and are waiting for technological advances in these surgeries before they will have them. Genital surgeries are also very expensive, ranging from $15,000 to $85,000 depending on their complexity, as opposed to the cost of chest surgery, which may cost up to $9,000. Because insurance companies, as yet, do not typically cover sex-reassignment surgery, FTMs, especially those in urban communities who are connected to supportive queer networks, may host benefit events to raise money for their surgeries.

Other transsexuals do not identify with the queer community. Some FTMs transition outside of the queer community or, upon transitioning, leave the queer community and are not "out" about their trans status. A report on FTMs of color (FTMOCs) commissioned by FTM International suggests that this is more common in communities of color—in part because FTMOCs feel alienated from the mostly white organized FTM communities (such as FTM International).

SEXUAL ORIENTATION AND GENDERED MEMORY

The category FTM represents a diversity of experience. In terms of race, class, ethnicity, and genders, FTMs come in every shape and size. Like people of any gender, FTMs may be heterosexual, homosexual, bisexual, queer, or pansexual, or may express their sexualities in shifting terms.

Years of suffering from body dysporia may have damaged if not demolished the sex lives of FTMs prior to their transition. Many FTMs may not have had satisfactory or comfortable sex prior to their coming out and/or transitioning. New bodies and identifications, sometimes coupled with an increased sex drive triggered by testosterone injections, may liberate FTMs to explore new sexualities. In fact, studies have shown that some FTMs change their sexual orientation or develop new sexual interests (such as sadomasochism) as they transition. Many FTMs identify as gay men and sleep with non-transsexual as well as transsexual men.

Most FTMs were socialized as females (even if this socialization was rejected or undesired), but FTMs relate to their gendered pasts with a range of styles. Although FTMs may not have ever identified as girls or women, they likely have intimate knowledge of the struggles, values, and pressures specific to women in their cultures. FTMs may believe that this prior knowledge differentiates them from sexist men in a patriarchal culture, whereas others view such notions as pretentious or irrelevant and focus instead on being "normal" guys. Within such debates, the academic Jean Bobby Noble (2006) has argued adamantly against FTMs adopting hegemonic masculinities, while the activist and educator Jamison Green (1999) has written on the politics of outing and FTM/trans visibility.

CLASS, RACE, AND EXCLUSION

Class distinctions within the FTM community often spark conflict in a world in which gendered authenticity relies on an expensive transition. Aggressive territorial disputes and cliquish behavior occur within communities where a hierarchy of maleness often determines which transmen are accepted as "real men" (hormones and top surgery represent the standard). The meaning of "gendered passing" differs across class backgrounds as do the strategies of passing within different class contexts. There have been contentious rifts between FTM/butch transgenders and FTM transsexuals largely because of class conflict that is euphemized, for instance, in stereotypes that FTM transsexuals are "old-fashioned" and FTM butch-trans are overprivileged and self-absorbed. There are many more intersectional axes that have yet to be analyzed alongside FTM identity, including disability, fatness, and age.

Arguments about male privilege between FTMs hinge on race, class, and sexual orientation and further reveal how transitioning or passing as a man can have an array of cultural meanings. For example, many white FTMs are self-conscious about transitioning into their new life as white men. For an FTMOC, however, settling into life as a black or brown man represents a completely different association to male privilege. The white transitioning FTM may be seen as a "gender traitor" who will benefit from male privilege, whereas the FTMOC will actually experience a decline in social status, as he becomes more suspect and more dangerous in the eyes of white, Western culture. Unfortunately, discourse around FTM issues such as these is dominated by the white perspective, resulting in FTMOCs feeling that their voices and struggles are not heard or attended to in FTM groups or beyond. Narrow definitions of FTM (especially those that fetishize expensive surgeries and trajectories of self-realization that value sameness over difference) exclude transmen of color and working-class transmen and deny the huge range of powerful differences that actually define and shape FTM experience.

see also Transgender; Transsexual M to F.

BIBLIOGRAPHY

Butler, Judith. 2004. Undoing Gender. New York: Routledge.

Cromwell, Jason. 1999. Transmen and FTMs: Identities, Bodies, Genders, and Sexualities. Urbana: University of Illinois Press.

Currah, Paisley; Richard M. Juang; and Shannon Price Minter, eds. 2006. Transgender Rights. Minneapolis: University of Minnesota Press.

Devor, Aaron H., and Nicholas Matte. 2006. "ONE Inc. and Reed Erickson: The Uneasy Collaboration of Gay and Trans Activism, 1964–2003." In The Transgender Studies Reader, ed. Susan Stryker and Stephen Whittle. New York: Routledge.

Erauso, Catalina de. 1996. Lieutenant Nun: Memoir of a Basque Transvestite in the New World, trans. Michele Stepto and Gabriel Stepto. Boston: Beacon Press.

Green, Jamison. 1999. "Look! No, Don't! The Visibility Dilemma for Transsexual Men." In Reclaiming Genders: Transsexual Grammars at the Fin de Siècle, ed. Kate More and Stephen Whittle. London: Cassell.

Noble, Jean Bobby. 2006. Sons of the Movement: FtMs Risking Incoherence on a Post-Queer Cultural Landscape. Toronto: Women's Press.

Rubin, Gayle. 2006. "Of Catamites and Kings: Reflections on Butch, Gender, and Boundaries." In The Transgender Studies Reader, ed. Susan Stryker and Stephen Whittle. New York: Routledge.

Rubin, Henry. 2003. Self-Made Men: Identity and Embodiment among Transsexual Men. Nashville, TN: Vanderbilt University Press.

Stryker, Susan, and Stephen Whittle, eds. 2006. The Transgender Studies Reader. New York: Routledge.

van Kesteren, Paul J. M.; Henk Asscheman; Jos A. J. Megens; and Louis J. G. Gooren. 1997. "Mortality and Morbidity in Transsexual Subjects Treated with Cross-Sex Hormones." Clinical Endocrinology 47(3): 337-342.

                                             Emma Crandall