577
Sociology
Copyright  2002
BSA Publications Ltd
Volume 36(3): 577­595
[0038-0385(200208)36:3;577­595;025047]
SAGE Publications
London,Thousand Oaks,
New Delhi
For a Sociology of Transsexualism
s Myra J. Hird
School of Sociology and Social Policy, Queen's University, Belfast, Northern Ireland
ABSTRACT
The aim of this article is to explore the development of theories on transsexualism
with a view to advancing a typology of theories of transsexualism.This
typology exposes a general shift from concerns with `authenticity' (the transsexual
as a `real' woman or man) to issues of `performativity' (the transsexual as hyperbolic
enactment of gender). I will argue it is through a displacement of psychology
with sociology as the major lens through which transsexualism is theorized that
such a shift from authenticity to performativity is effected.The final typology considers
the notion of transgression (rendering the modern two-gender system
obsolete). The article argues that whilst transgression may be possible, it is not
guaranteed by all forms of transsexualism.
KEY WORDS
authenticity / ethnomethodology / performativity / symbolic interactionism / transgression
/ transsexualism
We find the epistemologies of white male medical practice, the rage of
radical feminist theories and the chaos of lived gendered experience
meeting on the battlefield of the transsexual body.
(Stone, 1998: 10)
uch sociological theory has been occupied with the vicissitudes of identity,
prompted recently by postmodern and new materialist inter-
ventions.1
Whereas sociology has always emphasized the social
construction of identity, after postmodernism, the limits of social constructionism
have taken on a much sharper hue. Reflecting this theoretical turn, socialization
theory have been largely displaced by deeper explorations of the
ontological status of key concepts such as gender, race, ethnicity, age and
M
disability. Within gender and sexuality studies, sociologists seek to challenge the
`naturalness' of sex, gender and sexuality. For instance, Weeks (1996) provides
an account of the construction of homosexuality, Esterberg (1996) the
construction of lesbianism, and Ingraham (1996) and Jackson (1999) the construction
of heterosexuality.
The aim of this article is to explore the development of theories on transsexualism
with a view to advancing the need for a distinctly sociological
approach to this particular identity. The history of development exposes a
general shift from concerns with `authenticity' (the transsexual as a `real'
woman or man) to issues of `performativity' (the transsexual as hyperbolic
enactment of gender). I will argue that it is through a displacement of psychology
with sociology as the major lens through which transsexualism is theorized
that such a shift from authenticity to performativity is effected.
My argument is, briefly, that psychological analyses of transsexualism
focus on the issue of authenticity because the discipline remains wedded to sex
and gender as coherent, stable and `real' concepts. I argue that a particularly
sociological imagination supplants the notion of authenticity with performativity
because sociology explicitly questions the relationship between sex and
gender. Given sociology's understanding of both sex and gender as the outcome
of social interaction rather than human `nature', its agenda is not to police the
boundaries of the modern two-gender system, but rather to understand why
such vociferous debates concerning these boundaries take place (Hird, 2000). I
will argue, finally, that a recent return to symbolic interactionism (particularly
Mead and Goffman) and ethnomethodology (particularly Garfinkel, and
Kessler and McKenna) are reframing debates within transsexual studies around
the notion of transgression (rendering the modern two-gender system obsolete).
I will conclude by contemplating the possibilities for considering transsexualism
as transgressive, from a sociological perspective.
Although analyses of transsexualism usually appear within other disciplines
such as sexuality studies, the questions which transsexualism raises
regarding the materiality of the body, the construction of identity and the interaction
between self and society are definitively sociological concerns
(Featherstone and Turner, 1995; Turner, 1992). As such, current developments
in transsexual studies will be of interest to sociologists generally. Given also
that studies on transsexualism are increasing, it is both relevant and timely that
sociology now reflect upon its approach to this social phenomenon.
Transsexualism in Society
Transsexualism currently defines an individual's relation to gender reassignment
­ pre-transition/operative, transitioning/in the process of hormonal and surgical
sex-reassignment, and post-transition/operative (Bolin, 1994; Prosser,
1998). There are approximately 5000 post-operative transsexual people in the
UK. Several NHS hospitals provide ongoing surgical, hormonal and psychiatric
578 Sociology Volume 36 s Number 3 s August 2002
care for transsexuals in Bristol, Leeds, Leicester, London and Newcastle
(Department of Economic Development, 1999; Press for Change, 2000).
My hypothesization of a typology consisting of authenticity, performativity
and transgression emerged from an analysis of the history of transsexualism.
This is a history of pathology ­ the very term `transsexual' is a psychological
and medical classification. It is helpful to signpost this historical context
through which transsexualism emerges as a social phenomenon in order to
situate the typology to be hypothesized.
Psychology and medicine remain central in transsexual studies, and both
disciplines steadfastly adhere to a two-gender (female and male) paradigm.
Medical inquiry into transsexualism advances two theories of aetiology: psychiatric
and somatic. I review the development of attempts within the field of
psychiatry to account for transsexualism, and then attend to arguments supporting
a somatic causation.
Psychiatric Arguments
Sexology emerged toward the end of the 19th century as a distinct subdiscipline
of psychology, on the heels of medicine and psychiatry which were
rapidly expanding fields. The `innocent pleasures' of cross-dressing described by
men during the 18th century were gradually usurped by a hegemonic psychomedical
discourse, the major `cultural lens' through which sexuality is now
understood (Ekins and King, 1997; Farrer, 1987, 1994). In the first instance,
sexology focused on homosexuality. Von Krafft-Ebing considered `contrary
inverted sexual feelings' and `gynandry' in the seminal The Psychopathia
Sexualis (1894). This work was followed closely by more favourable considerations
of `congenital inverts' in Havelock Ellis's Studies in the Psychology of Sex
(1936) and philanthropists such as Edward Carpenter's `intermediate sex' in
Love's Coming of Age (1896). Challenging the hitherto hegemonic notion of
homosexuals as `criminal', these early sexologists determined homosexuality to
be a biological ailment, a sickness rather than a crime. The approach was distinctly
positivist ­ von Krafft-Ebing measured the hips, ears, faces, pelvises and
skulls of living `inverts' and performed autopsies on the dead, in order to discover
a congenital cause (MacKenzie, 1994: 35). `Insane' relatives were considered
for a possible hereditary effect. Demonstrating a surprising consistency
with pre-modern theories, von Krafft-Ebing considered male-to-female (MTF)
`inverts' to be `failed men' in contrast to female-to-male (FTM) `inverts' who
were apparently intelligent, accomplished and independent women.
Stoller (1968, 1975) first distinguished transsexualism from those psychopathia
sexualis already under scrutiny, homosexuality and transvestism.
Stoller proposed transsexualism to be the product of `unconscious' rearing of
the child in the opposite sex. Stoller focused on a three-generation formula that
he summarized as: `too much mother made possible by too little father' (1969:
166). Heavily influenced by psychology and medicine, a large number of
researchers subsequently took as given the aetiology of transsexualism to
579For a sociology of transsexualism Hird
consist of parental `deviations' from `normal' femininity and masculinity. These
included `effeminate' fathers, domineering mothers, birth order, divorce
(Pomeroy, 1969); IQ (Doorbar, 1969); temporal lobe disorder (Blumer, 1969);
parental age (Wlinder, 1969); introversion, depression and non-adjustment to
work (Johnson and Hunt, 1990); a precursor of transvestism and homosexuality
(Limentani, 1979); and narcissism, profound dependency conflicts, immature,
potentially explosive, demanding, manipulative, controlling, coercive and
paranoid personalities (Lothstein, 1988).
At the same time that homosexuality liberated itself through political rights
claims from psycho-medical classification, transsexualism became an official
psychological `disorder' in the 1980 edition of the American Psychiatric
Association's Diagnostic and Statistical Manual (DSM-III). According to the
more recent DSM-IV, adult `gender dysphoria' (formerly `transsexualism') is
defined as:
A strong and persistent cross-gender identification (not merely a desire for any perceived
cultural advantages of being the other sex).
Persistent discomfort with his or her sex or sense of inappropriateness in the gender
role of that sex.
The disturbance is not concurrent with a physical intersex condition.
The disturbance causes clinically significant distress or impairment in social, occupational,
or other important areas of functioning.
(Wilson 1997: 1­11)
Currently, psychoanalysis and behaviour modification represent the major
psycho-medical responses to transsexualism. Both treatment approaches `seek
to ensure that identity, social status and biology "match". The end result is that
the binary structure of gender is maintained' (Ekins and King, 1997: 9). The
`success' criteria for these three psycho-medical treatment responses is the same
­ at all costs, the result must be an individual who is unambiguously either
female or male.
Somatic Arguments
Despite many years of attempts, arguments that transsexualism is somatic in
origin have taken a backseat to psychiatric arguments (Playdon, 2000). Those
supporting somatic arguments cite long-term evidence suggesting that transsexual
women and men are not mentally ill, and that, in tandem with homosexuality,
much of the distress, anger and depression evidenced in transsexual
people is a result of societal discrimination and not the transsexual condition
itself. And as in the case of homosexuality, no reliable evidence suggests transsexualism
can be `cured'. Thus Playdon argues that transsexualism be considered
an intersexed condition (2000). This theory is supported by recent
evidence by Zhou et al. (in Gooren, 2000) who found that six transsexual
women revealed female patterns in a normally sexually dimorphic part of the
580 Sociology Volume 36 s Number 3 s August 2002
brain. Despite continued research into somatic causation, these types of studies,
like `gay gene' theories of homosexuality, remain less popular than psychiatric
theories of transsexualism.
A Typology of Transsexualism
As I have outlined, transsexualism has been most widely theorized from medical
and psychiatric perspectives. However, a number of other theoretical perspectives,
including feminist, queer and transgender studies, have offered
analyses of transsexualism since the 1970s. Each of these theoretical perspectives
is undergirded by particular assumptions about sex and gender. Following
Brunsdon's (1997) analysis of the development of identity in feminist television
criticism, I want to construct a similar typology to hypothesize the relationship
between these theories and transsexualism. This typology would consist of the
following:
(1) authenticity ­ transsexualism and `real' sex and gender;
(2) performativity ­ transsexualism and fictive sex and gender; and
(3) transgression ­ transsexualism and the disruption of sex and gender.
Each category is defined through the relationship between transsexualism
and the concepts of sex and gender. Focus on authenticity assumes a relationship
between sex, gender and `reality', usually defined through morphology.
Here, transsexualism is assessed against criteria of stable, fixed and immutable
sex. Performativity, in contrast, suggests the discursive production of any
notion of reality based upon sex. As such, transsexualism offers key insights
into the mechanisms and techniques through which sex and gender are
naturalized and essentialized. Closely linked with performativity, transgression
argues that transsexualism purposefully violates society's naturalization of
sexual difference.
Authenticity
Concern with the authenticity of transsexualism reflects upon the possibility
of changing sex. Society relies on sex as a stable and unchangeable indicator of
sexual difference, upon which hierarchies of power then produce divisions
of labour. As such, society is most familiar with arguments relating to transsexual
people's supposed declarations of `being' the `opposite' sex to their
bodies. The notion of authenticity rests upon three inter-related assumptions:
that sex and gender exist; that sex and gender constitute measurable traits;
and that the `normal' population adheres to the first two assumptions.
In terms of the first assumption, the entire psychological approach to transsexualism
depends upon stable notions of `sex' as the biological, anatomical
makeup of individuals; and `gender' as the identity which individuals derive
581For a sociology of transsexualism Hird
from their anatomical `sex'. Adult maturity is determined by the extent to
which the individual is able to adhere to society's two-gender system. Thus, the
medical community does not view the post-operative individual as changing
their sex or gender: `it is difficult to persuade transsexuals who have had their
genitals removed that they are in fact nothing more than castrated males'
(Randell, 1969: 375). It is anathema to some psychoanalysis to accept the individual's
stated sex identity and much therapeutic energy is devoted to convincing
the transsexual of the immutability of `sex'. Hence, individuals are referred
to as `transsexuals', men `living as' women or women `living as' men.
The second assumption made within psychology is that sex and gender are
measurable traits. To assess the supposed effects on gender identity of children
raised by transsexual people, Green (1978) assesses children's gender identity
by toy, game and clothing preference, peer group composition, roles played in
fantasy games and vocational aspiration. Highly stereotyped behavioural cues,
long criticized by sociologists as providing social rather than individual expectations
of gender, remain central in the diagnosis of children suspected of
`potential' transsexualism. At the recent Atypical Gender Identity Conference
(2000), clinicians reviewed cases in which transsexualism was diagnosed as
early as three years of age, based on a male child's interest in wearing nail
polish, dressing in `flowery' clothing, and preference for urinating in a sitting
position (see Hird, forthcoming).
The final assumption undergirding authenticity debates is that, as a
`dysphoria', transsexualism effects a minority of `deviants' in an otherwise `normally'
sexed and gendered population. So although Oppenheimer (1991)
admits that `so many people wish to undergo a sex change', psychology remains
committed to a view of transsexualism as an individual `pathology'. Indeed,
transsexualism has been described as a `disturbance' (Walters and Ross, 1986:
22); `the most extreme degree of disorder' (Lancet, in Lewins, 1995: 26); `psychosis'
(Socarides, 1970); and a `narcissistic disorder' (Lothstein, 1988).
Doorbar notes that transsexuals exhibit some `suspiciousness of authority
figures [and] quite frank delusions of persecution' (1969: 192). Knorr et al.
(1969) report the medical fraternity's belief that anyone wanting surgery that
involves penile castration must be, by definition, psychotic, regardless of how
`normal' his other personality and behavioural attributes. Stoller (1968, 1975)
describes transsexuals as distrustful and ready liars who trivialize their problems.
With obvious reluctance, Money and Brennan report that the FTM transsexuals
they studied `would otherwise be classed as normal females', although
the researchers wistfully offer the hope that `negative findings today do not rule
out the possibility of positive findings tomorrow' (1969: 149).
Authenticity to Performativity
The shift from concerns around authenticity to debate about transsexualism as
performative may be largely attributed to the influence of feminist theory. When
582 Sociology Volume 36 s Number 3 s August 2002
sex reassignment surgery was propelled onto the public stage by Christine
Jorgenson's case in 1953, feminism was one of the first disciplines beyond psychology
to analyse transsexuality. Feminist analyses responded to the autobiographical
narrations of transsexuals that began to proliferate in the 1960s and
1970s. At this time, feminism largely rejected transsexualism as a legitimate
identity, arguing that transsexuality conformed to gender stereotypes rather
than challenged hegemonic gender in any way. This critique was directed
towards the popular `woman trapped in man's body' trope and the subsequent
emphasis on sex-reassignment surgery to `fix' this psycho-medical problem.
Medical practitioners, psychologists and transsexuals crafted a `transsexual
identity' based on the sustained desire for sex-reassignment surgery (Bolin,
1994; Prosser, 1998). Individuals quickly keyed into the necessary life-history
required for successful `passing', although it took some years before clinicians
realised that both they and their `patients' were referring to the same
behavioural profiles provided in The Standards of Care for Gender Identity
Disorders (Harry Benjamin International Gender Dysphoria Association,
1998).2
Highly stereotyped, traditional markers of gender continue to establish
the success of reassignment, from dress, makeup and even fainting at the sight
of blood. For example, when Lili Elbe awoke from the first stage of her MTF
surgery, she wrote a note that she then showed to her doctor (Stone, 1991).
Both `patient' and doctor agreed that `no man' could have written the script.
Here even orthography apparently reflects innate sex rather than acquired
skill.
Given feminists' commitment to illuminating these supposedly innate
`feminine' behaviours as socially constructed requirements of patriarchal
society, transsexual narratives unsurprisingly raised suspicion and rancour. So
much so that the issue of `passing' commanded feminist theories of transsexualism.
Janice Raymond's Transsexual Empire (1979) remains the `definitive
statement on transsexualism by a genetic female academic' opposed to sex reassignment
surgery (Stone, 1991: 3). In order to differentiate between `authentic'
and `inauthentic' women, Raymond employed the distinctly modern recipe of
biology and socialization:
We know who we are. We know that we are women who are born with female
chromosomes and anatomy, and that whether or not we were socialised to be socalled
normal women, patriarchy has treated and will treat us like women.
Transsexuals have not had this same history.
(1979: 114)
This double-cocktail criteria of biology and socialization resonated with
those of psychology outlined above. A similar argument was espoused by
Jeffreys (1990), who provided a critical review of early autobiographies by
Roberta Cowell and Jan Morris, whom Jeffreys claimed are `typical' transsexual
stories. Jeffreys argued that transsexuals choose to `imitate the most
extreme examples of feminine behaviour and dress in grossly stereotypical
feminine clothing' in preference to feminists who dress `in jeans and t-shirts'
583For a sociology of transsexualism Hird
(1990: 177, 178).3
Jeffreys criticized MTF transsexuals for, what she argued, is
an inability to understand supposedly `feminine' behaviours and characteristics
as those which women must adopt in order to avoid patriarchal censure. What
transsexuals consider individual attributes, Jeffreys maintained are political signifiers
of women's oppression. By donning stereotyped clothing and behaviours,
transsexuals, for Jeffreys, collude with patriarchy and further contribute to
women's oppression.4
Jeffreys' suspicion towards gender reassignment was argued from a feminist
perspective, but social theorists have more generally shared this scepticism.
Those opposed to gender reassignment surgery argue that the medical fraternity
colludes with society to silence the cultural imperative of the two-gender system.
For example, MacKenzie (1994) argues that surgery maintains the current
artificial distinctions based on gender, rather than challenging it in any way. In
Sex by Prescription, Szasz suggests transsexualism is a `condition tailor-made
for our surgical-technological age' ­ the desire to experiment with new
technology ensures that critical reflection on the efficacy of gender reassignment
is minimized (1990: 86). In Changing Sex (1995), Hausman argues similarly
that transsexualism is a product of a modern belief in technology as societal
saviour. Millott argues `there is no transsexuality without the surgeon and
endocrinologist' (1983: 17).
Performativity
The opposition that Raymond, Szasz, Hausman and others express towards
gender reassignment has been challenged within the last ten years by emerging
transsexual narratives, suggesting that many transsexuals choose sex and
gender identification by default. As argued previously, modern psycho-medical
discourses compel individuals to identify themselves as only one of two genders.
Until recently, transsexual narratives have been scarce because transsexual survival
has largely depended upon the ability to disappear (Green, 1999). In the
1990s, a distinct set of transsexual narratives began to argue that if gender can
be learned, then `womanhood' is available to anyone with the capacity to learn
(Denny, 1996; Feinberg, 1996; Lewins, 1995; More and Whittle, 1999; Prosser,
1998; Rothblatt, 1995; Stone, 1991; Stryker, 1994, 1995).
Thus we find a shift from an analytic emphasis on the authenticity of
gendered identity to a more malleable notion of identity as performance. This
shift is propelled by a combination of transsexual rights claims (see Feinberg,
1996; More and Whittle, 1999), poststructural and postmodern feminist
theory's critique of essentialism (see Alcoff, 1988; Butler and Scott, 1992; Flax,
1988; Fraser and Nicholson, 1988; Spelman, 1988), and an increasing focus
within sociology on identity (see Featherstone and Turner, 1995; Rose, 1996;
Shilling, 1993). In recent years the most prominent and commonly-cited text
referring to performativity is Judith Butler's Gender Trouble (1990). Butler
argues that `we never experience or know ourselves as a body pure and simple,
584 Sociology Volume 36 s Number 3 s August 2002
i.e. as our "sex", because we never know our sex outside of its expression of
gender' (1986: 39). Butler reverses the naturalized understanding of sex existing
prior to gender and argues that gender produces the effect of sex:
Acts, gestures, and desire produce the effect of an internal core or substance, but
produces this on the surface of the body, through the play of signifying absences
that suggest, but never reveal, the organising principle of identity as a cause. Such
acts, gestures, enactments, generally construed, are performative in the sense that
the essence or identity that they otherwise purport to express are fabrications manufactured
and sustained through corporeal signs and other discursive means. That
the gendered body is performative suggests that it has no ontological status apart
from the various acts which constitute its reality.
(1990: 136, original emphasis)
Drawing upon Foucault's (1984) insight that dominant discourses reinforce
the idea that nature has already determined the `truth' of our bodies, and that
our bodies define our gender for us, Butler argues that gender does not alter from
some locatable starting point, but is much more an activity, enactment or performance
in constant movement. Butler and Delphy (1984, 1993) concur that
rather than ontology, sex is no more than an `effect'.5
In Gender Trouble, Butler
uses drag to illustrate the techniques of performative gender, and later in Bodies
That Matter (1993), transsexualism provides the example of gender's production
of sex. Thus, transsexualism is a hyperbolic performance of sex and gender.6
Butler's account of gender producing sex through performative enactment
is a contemporary development of distinguished and distinctly sociological
theories of symbolic interactionism and ethnomethodology. In one of the founding
texts of sociology, The Rules of Sociological Method, Durkheim remarked
`every time a social phenomenon is directly explained by a psychological phenomenon,
we may be sure that the explanation is false' (1938: 104). Durkheim
was not arguing that social phenomena are produced without individual consciousness,
but that the general characteristics of `human nature' are not the
cause of collective representations. Thus, sociological analyses that transpose
psychological states onto social phenomena, take effect as cause. Put another
way, by resisting psychology's epistemology of diagnosing the `cause' of transsexualism
by means of a priori natural, universal human laws, sociology is
better able to analyse transsexualism as a specifically social production of society
(Durkheim, in Giddens, 1972). From this starting point, symbolic interactionist
and ethnomethodological approaches have focused on the relationship
between sex and gender in society.
Symbolic Interactionism
Defining one of the fundamental precepts of symbolic interactionism, Mead
(1934) forcefully argued that the self cannot exist without society ­ the continuous
interactive process between individuals establishes and maintains
conceptions of self by reflecting back images of the self as object. What is now
585For a sociology of transsexualism Hird
discussed in terms of performativity, symbolic interactionism emphasized
decades ago the continually renegotiated character of social action, which produces
malleable identities, both allowing and compelling the possibility of contradiction
and conflict (Goffman, 1971, 1976; Mead, 1934). This is the `genius
of our individuality, for we are not born with individuality ­ we create it'
(Hansen, 1976: 21).
Erving Goffman developed many of Mead's ideas to argue that human
interaction is fragile and maintained through social performances. In The
Presentation of Self in Everyday Life (1971) Goffman theorizes the self as a
process and effect rather than an `object' with prior ontological status.
However, he notes that social interaction is largely governed by a deep belief
that objects produce signs that are self-informing. In Gender Advertisements
(1976), Goffman explores gender as a particularly powerful object which does
not exist in any essential way, but whose `schedule' for portrayal does, and this
portrayal is often mistaken as `essentially real'. As Goffman argues:
[O]ur concern . . . ought not to be in uncovering real, natural expressions, whatever
they might be. One should not appeal to the doctrine of natural expression in an
attempt to account for natural expression, for that . . . would conclude the analysis
before it had begun.
(1976: 7)
For Goffman, the incisive sociological consideration is that the impressions
received from everyday performances are subject to disruption. For symbolic
interactionists, the question is not how to discern `real' from `false' impressions,
but to discern those impressionistic mechanisms that claim people's sense of
reality. In other words, Goffman notes that people assume their own, and
others' gender from a bare minimum of cues, but that we nevertheless `do'
gender. Thus, `in short, we all act better than we know' (1976: 80).
Sexuality studies use many of the insights developed within symbolic interactionist
approaches. For example, in classic symbolic interactionist style,
Kenneth Plummer (1995, 1996) analyses homosexuality as a `process' and
`ongoing accomplishment' rather than a stable identity (1996: 66). Plummer
considers the ongoing social interactions, in terms of both the individual's interactions
with others and with her/himself, as the guiding force through which
`life is constantly built, altered, but never completed' (1996: 68).
Symbolic interactionism challenges authenticity arguments because it does
not understand identity as a stable, coherent and morphologically-based object.
Nor does symbolic interactionism adhere to sex and gender as `real'. Thus, from
this sociological perspective, the problem with the `authenticity' argument is
twofold. First, to the extent that transsexual individuals are able to `pass' as
`real' women or men, they reveal that sex and gender do not adhere to particular
bodies naturally. In effect, transsexuals render visible the invisible signs on
which society relies to produce sex and gender. Indeed, one transsexual wryly
notes that `however strange a cross-dresser looks, a genetic woman can always
be found who looks even stranger' (Taylor, 1995: 6). Sex and gender are
586 Sociology Volume 36 s Number 3 s August 2002
pre-established performances which transsexuals, like all other individuals, are
confronted with:
The more closely the impostor's performance approximates to the real thing, the
more intensely we may be threatened, for a competent performance by someone
who proves to be an impostor may weaken in our minds the moral connection
between legitimate authorisation to play a part and the capacity to play it.
(Goffman, 1971: 66)
The second, related, problem with authenticity arguments is that they do
not take sufficient account of gender as an ongoing product of interaction. For
example, because psychology adheres to the `materiality' of the flesh, transsexuals
are not understood to be able to `know' the genitals of the gender to
which they `feel' they belong. In one of the most recent and intriguing challenges
to this claim, Prosser (1998) argues that transsexuals phantasmatically
feel surgically constructed genitals as `real' ­ in the same way that people who
have lost limbs maintain the `feeling' of those limbs phantasmatically. In
another effort, Stoltenberg reverses the claim that bodies produce gender to
argue that ideas about gender produce feelings attached to particular body
parts:
Most people born with a penis between their legs grow up aspiring to feel and act
unambiguously male, longing to belong to the sex that is male and not to belong to
the sex that is not, and feeling this urgency for a visceral and constant verification
of their male sexual identity ­ for a fleshy connection to manhood ­ as the driving
force of their life. The drive does not originate in the anatomy. The sensations derive
from the idea. The idea gives the feelings social meaning; the idea determines which
sensations shall be sought.
(1989: 112, emphasis added)
The process of `feeling' gender is enabled via narrative restructuring, a
mechanism very familiar to sociology. For example, Shilling points out that
modern subjectivity is increasingly situated within embodied biography, `a project
which should be worked at and accomplished as part of an individual's selfidentity'
(1993: 5). Thus, narration is an inherently interactive process. As
Gagné and Tewksbury (1998) found from their interviews, transsexuals make
sense of their gendered and sexed selves as an interactive process. While
Hausman (1995) claims that this interactive narration of the self is the means
through which transsexuals `create' their subjectivity, she fails to recognize this
as a process common to all individuals. How else does a girl learn her vagina
places her within a particular structural relationship to patriarchy, if not
through social interaction? As Mead recognized over 60 years ago, every individual
necessarily composes the self through narration, told as an ongoing
`story' between self and others. Or, as Prosser notes:
Heterosexuals who believe that their penises and vaginas are the `cause' of their
pleasure or desire literalise them and `forget' an/other body: both the (once loved)
homosexual body, the body of the other, and their own imaginary or phantasmatic
body. (1998: 39)
587For a sociology of transsexualism Hird
Ethnomethodology
For ethnomethodologists, like symbolic interactionists, social facts are the
accomplishment of members of any group. As such, ethnomethodology is most
interested in the accounting practices that people use to establish and maintain
social facts. Two texts, Harold Garfinkel's Studies in Ethnomethodology (1967)
and Suzanne Kessler and Wendy McKenna's Gender: An Ethnomethodological
Approach (1978), remain definitive ethnomethodological analyses of accounting
practices of gender.
Garfinkel presents one of the most widely-cited examples of the ways in
which sex and gender are situationally-specific, managed accomplishments.
Garfinkel and Stoller's work with Agnes, who presented as a `normal young
woman' with a penis, details the techniques of `femaling' through which Agnes
learned to be a woman.7
Indeed, it was only in particular circumstances (such
as having sex with her boyfriend) that her penis and lack of vagina presented
problems. Their work with Agnes and her negotiation of gender led Garfinkel
and Stoller (1967: 122­ 8) to observe eight everyday accounting practices that
establish gender as a social fact. These include the following beliefs:
(1) there are two genders, and only two genders;
(2) gender is invariant;
(3) genitals are the essential sign of gender;
(4) exceptions to two genders should not be taken seriously, but only considered
jokes or examples of pathology;
(5) there are no transfers from one gender to another;
(6) everyone must be classified as either one gender or another;
(7) the `female'/`male' dichotomy is natural; and
(8) gender membership is natural.
Applying these accounting practices to transsexualism, Kessler and
McKenna reverse the relationship between sex and gender to argue that `biological,
psychological and social differences do not lead to our seeing two
genders. Our seeing two genders leads to the "discovery" of biological, psychological,
and social differences' (1978: 163). Interested in how gender attribution
works, Kessler and McKenna note the insistence with which people need
to know whether they are interacting with a woman or a man, and the acute
uneasiness people feel when gender attribution cannot be made instantaneously.
Gender attribution is ostensibly based upon genitals, but since we do not see
most people's genitals when making gender attributions, other visual cues are
substituted. In other words, the imperative to maintain the natural attitude
towards gender compels individuals to rely upon cultural genitals to make
gender attributions. As Kessler and McKenna write `the reality of "gender" is
proved by the genital which is attributed and at the same time the attributed
genital only has meaning through the socially shared construction of gender
attribution' (1978: 155).
588 Sociology Volume 36 s Number 3 s August 2002
In sum, performative, symbolic interactionist and ethnomethodological
theories argue that the focus on authenticity reveals the salience of gender and
sex in modern society. As Prosser notes, transsexual narratives `produce the
sobering realisation of [gender's] ongoing foundational power' (1998: 11).
Within our current discursive field, to exist at all means being a woman or a
man; `sex is the norm by which the "one" becomes viable at all' (Butler, 1993:
2). This explains, in part, why individuals continue to demand sex-reassignment
surgery, despite the fact that sex and gender are primarily observed and judged
by `various visual and vocal signals such as hair, clothes, body shape, and movement,
gestures and facial expressions, voice and speech' rather than by the
appearance of genitals (Woodhouse, in MacKenzie, 1994).8
Performativity to Transgression?
The final typology concerns the extent to which transsexualism renders obsolete
the modern relationship between sex and gender. Recent transgender and
queer studies, drawing heavily on the sociological foundations outlined here,
employ transsexualism as a key queer trope in challenging claims concerning
the immutability of sex and gender. As such, transgender studies invest heavily
in transsexualism's `transgressive' potential. For example, Feinberg (1996)
refuses to legally conform hir sex to hir expression of gender, instead directing
hir efforts towards questioning society's need to categorize by sex at all ­ the
requirement to `pass' for Feinberg is itself a product of oppression. Kris asks
`does the fact that everywhere I go everyone calls me "sir" make me a man?
Does the fact that I have breasts and a cunt make me a woman?' (in Feinberg,
1996: 158). Bornstein (1994: 8) remarks:
I know I'm not a man ­ about that much I'm very clear, and I've come to the conclusion
that I'm probably not a woman either, at least not according to a lot of
people's rules on this sort of thing.
Bornstein argues that transsexuals are not men or women, not because they
are `inauthentic', but because transsexuals, by their very existence, radically
deconstruct sex and gender. Emerging narratives, and recent conferences
devoted to transgenderism increasingly focus on deconstructing the modern
two-gender system.9
As Zita writes: `queer scramble[s] the categories of heterosexual
sex/gender ontology and open[s] up the possibility of playing against the
edge of meaning with the body' (1998: 55).
Although transgender and queer studies offer very interesting analyses of
the gender system, sociological analyses remain ambivalent about the potential
of transsexualism to render sex and gender obsolete. The principle problem for
sociology is that although queer theory contests the attribution of any character
to masculinity and femininity, performing or `doing' gender seems to principally
consist in combining or parodying existing gender practices, for example,
in assertions of a `third sex' (Taylor, 1995). After the meteoric rise of Gender
589For a sociology of transsexualism Hird
Trouble as the definitive work on gender transgression through drag, Butler
spent some time in clarifying her position. In Bodies That Matter (1993)
Butler asks whether `parodying the dominant norms is enough to displace them;
indeed, whether the denaturalization of gender cannot be the very vehicle for a
reconsolidation of hegemonic norms'. Butler goes to some length to clarify that
`there is no necessary relation between drag and subversion': this relationship is
more accurately ambivalent in the sense that the parodic imitation is always
implicated in the power that it opposes (1993: 125). The extent to which
this imitation is subversive depends upon the degree to which it reflects the imitative
structure of all gender. Thus Butler argues that when Venus Xtravaganza
performed hyper-heterosexual femininity in the film Paris is Burning (1991),
she was subverting hegemonic gender. However, this subversion breaks down
the moment that Venus reconsolidates hegemonic norms by speaking of her
desire to become a whole woman by undergoing genital surgery, finding a husband
and living in the suburbs. It is difficult for transgender studies to avoid,
for example, concerns that hormonal and surgical intervention serves only to
confirm and reify hegemonic gender rather than subvert it in any way. Put
another way, sociologists may well argue that those forms of transsexualism
which continue to prioritize genital surgery remain dependent upon sex and
gender as `real' objects, defeating the entire aim of transgression.
The overarching concern is that all modern expressions of sex and gender
identity depend upon the current two-gender system, and subversion is not
guaranteed through imitation, particularly if that imitation remains focused on
femininity and masculinity. At her plenary address to the BSA conference in
1999, Liz Stanley argued that sociologists must question the `perceived radicalism'
of transgenderism. She went on to ask:
[I]f you don't want to be a woman then why want to be a man, and if you don't
want to be a man then why want to be a woman, rather than, for example, a zebra
or a cherub?
(2000: 3)
This is not to dispute the very positive impact of transgender theory indeed
transgender theory has done much to raise important questions about
the relationship between bodies, sex and gender. Moreover, it is vital to present
challenges to psycho-medical treatment models that pathologize transsexuals
while reifying the two-gender system. However, the question of transgression is
a complex one, and it is difficult to argue that all forms of transsexualism are
subversive.
Conclusions
In summary, I have offered a typology of theories of transsexualism that pivots
on the understanding of sex and gender as either objects of `reality' or performative
effects of social interaction. I have suggested that the shift in concerns
590 Sociology Volume 36 s Number 3 s August 2002
about the `realness' of sex and gender reflects a basic divergence in the fundamental
philosophical foundations of psychology and sociology.
As Brunsdon (1997) notes, most typologies end with a particular preferred
approach. However, like Brunsdon, such a `theoretical clean getaway' is both
impractical and undesirable. I have certainly argued that sociology offers greater
purchase on analyses of the social organization of sexual difference. But the malleability
of both sex and gender does not in itself guarantee the subversion of
sexual difference. Transsexualism is a complex social phenomenon, and involves
many issues, not least of which are the contradictions and divisions within transsexual
narratives. Further sociological analysis might fruitfully be applied to
analysing these contradictions and divisions in terms of their transgressive
potential. Indeed, it is the possibility of transcending sex and gender altogether
that offers, from a sociological perspective, the most interesting possibilities.
Notes
1 The author wishes to gratefully acknowledge the helpful comments received
from Professor John Brewer and the anonymous reviewers and editors on an
earlier version of this article.
2 The International Classification of Diseases­10 (ICD­10) also provides criteria
for acceptance for sex-reassignment surgery.
3 It is interesting that both psychoanalysts and feminists employ the same
discursive mechanisms to exclude transsexuals from their identified sex. In
reporting an interview with FTM Lou Stothard, Jeffreys (1990) consistently
refers to him as `she'/`her'.
4 Whittle (1998) points out that MTF transsexuals seek inclusion within the
group (i.e. women) that patriarchy oppresses, leaving behind whatever benefits
they derived from their male status.
5 For more on sociological critiques of the modern division between sex and
gender see Delphy, 1984, 1993; Hird, 2000; Laqueur, 1990.
6 The permanence of transsexual cross-identification makes its performance
much more enduring than the occasioned performance of drag.
7 Garfinkel and Stoller `diagnosed' Agnes as intersexual with testicular feminization
syndrome. It later transpired that Agnes had been taking her mother's birth
control pills for years in order to appear feminine.
8 Given the social stigma, intimidation and violence that transsexuals face, it is
unsurprising that so many attempt to `pass' without recognition.
9 The Renaissance Transgender Association hosted the 4th International
Congress on Crossdressing, Sex and Gender in October 2000. GENDYS 6th
Gender Dysphoria Conference was held in Manchester in September 2000.
References
Alcoff, L. (1988) `Cultural Feminism vs. Post-structuralism: The Identity Crisis in
Feminist Theory', Signs 13: 405­36.
591For a sociology of transsexualism Hird
Atypical Gender Identity Development: Therapeutic Models, Philosophical and
Ethical Issues Conference (2000) Tavistock/Portman Clinics, London, 17­18
November.
Blumer, D. (1969) `Transsexualism, Sexual Dysfunction, and Temporal Lobe
Disorder', pp. 213­20 in R. Green and J. Money (eds) Transsexualism and Sex
Reassignment Baltimore, MD: Johns Hopkins Press.
Bolin, A. (1994) `Transcending and Transgendering' pp. 447­86 in G. Herdt (ed.)
Third Sex, Third Gender. New York: Zone Books.
Bornstein, K. (1994) Gender Outlaw. New York: Routledge.
Brunsdon, C. (1997) `Identity in Feminist Television Criticism', pp. 114­25 in
C. Brunsdon, J. D'Acci and L. Spigel (eds) Feminist Television Criticism: A
Reader. Oxford: Clarendon.
Butler, J. (1986) `Variations on Sex and Gender: Beauvoir, Wittig, and Foucault',
Praxis International 5(4): 505­16.
Butler, J. (1990) Gender Trouble. New York and London: Routledge.
Butler, J. (1993) Bodies That Matter. New York and London: Routledge.
Butler, J. and J. Scott (eds) (1992) Feminists Theorise the Political. London:
Routledge.
Carpenter, E. (1896) Love's Coming of Age. London: Methuen.
Delphy, C. (1984) Close to Home. London: Hutchinson.
Delphy, C. (1993) `Rethinking Sex and Gender', Women's Studies International
Forum 16(1): 1­9.
Denny, D. (1996) Current Concepts in Transgender Identity: Towards a New
Synthesis. New York: Garland Publishers.
Department of Economic Development (1999) Guide to the Sex Discrimination
(Gender Reassignment) Regulations (NI). Belfast: Northern Ireland Equality
Commission.
Doorbar, R. (1969) `Psychological Testing of Male Transsexuals: A Brief Report of
Results from the Wechsler Adult Intelligence Scale, The Thematic Apperception
Test, and the House-Tree-Person Test', pp. 189­200 in R. Green and J. Money
(eds) Transsexualism and Sex Reassignment. Baltimore, MD: Johns Hopkins
Press.
Durkheim, E. (1938) The Rules of Sociological Method (8th edn). Chicago, IL:
University of Chicago Press.
Ekins, R. and D. King (1997) `Blending Genders: Contributions to the Emerging
Field of Transgender Studies', The International Journal of Transgendering:
http: //www.symposion.com/ijt/ijtc0101.htm
Ellis, H. (1936) Studies in the Psychology of Sex. Philadelphia, PA: Davis.
Esterberg, K. (1996) `"A Certain Swagger When I Walk": Performing Lesbian
Identity', pp. 259­79 in S. Seidman (ed.) Queer Theory/Sociology. London:
Routledge.
Farrer, P. (1987) Men in Petticoats. Liverpool: Karn Publications.
Farrer, P. (1994) Borrowed Plumes: Letters from Edwardian Newspapers on Male
Cross-Dressing. Liverpool: Karn Publications.
Featherstone, M. and B. Turner (1995) `Body and Society: An Introduction', Body
and Society 1(1): 1­12.
Feinberg, L. (1996) Transgender Warriors. Making History from Joan of Arc to
Rupaul. Boston, MA: Beacon Press.
592 Sociology Volume 36 s Number 3 s August 2002
Flax, J. (1988) `Postmodernism and Gender Relations in Feminist Theory', pp.
39­62 in L. Nicholson (ed.) Feminism/Postmodernism: New York: Routledge.
Foucault, M. (1984) The History of Sexuality, Vol. I. London: Penguin.
Fraser, N. and L. Nicholson (1988) `Social Criticism without Philosophy: An
Encounter Between Feminism and Postmodernism', pp. 19­38 in L. Nicholson
(ed.) Feminism/Postmodernism: New York: Routledge.
Gagne, P. and R. Tewksbury (1998) `Conformity Pressures and Gender Resistance
Among Transgendered Individuals', Social Problems 45(1): 81­101.
Garfinkel, H. (1967) Studies in Ethnomethodology. Englewood Cliffs, NJ: Prentice
Hall.
Giddens, A. (ed.) (1972) Emile Durkheim: Selected Writings. Cambridge:
Cambridge University Press.
Goffman, E. (1971) The Presentation of Self in Everyday Life. Harmondsworth:
Penguin.
Goffman, E. (1976) Gender Advertisements. London: Macmillan.
Gooren, L. (2000) `Expert Witness Statement', report of the Interdepartmental
Working Group on Transsexual People, Home Office. London: HMSO.
Green, J. (1999) `Look! Don't!: The Visibility Dilemma for Transsexual Men',
pp. 117­31 in K. More and S. Whittle (eds) Reclaiming Genders. London:
Cassell.
Green, R. (1978) `Sexual Identity of 37 Children Raised by Homosexual or
Transsexual Patients', American Journal of Psychiatry 135(6): 692­7.
Hansen, D. (1976) An Invitation to Critical Sociology. New York and London: Free
Press.
Harry Benjamin's International Gender Dysphoria Association (1998) The
Standards of Care for Gender Identity Disorders (http://www.symposium.con/
ijt/soc_2001/index.htm).
Hausman, B. (1995) Changing Sex: Transsexualism,Technology and the Idea of
Gender. Durham, NC: Duke University Press.
Hird, M. (2000) `Gender's Nature: Intersexuals, Transsexuals and the
"Sex"/"Gender" Binary', Feminist Theory 1(3): 347­64.
Hird, M. (forthcoming) A Typical Gender Identity Conference? Some Disturbing
Reports from the Therapeutic Frontlines. Feminism and Psychology.
Ingraham, C. (1996) `The Heterosexual Imaginary: Feminist Sociology and Theories
of Gender', pp. 168­93 in S. Seidman (ed.) Queery Theory/Sociology. Oxford:
Blackwell.
Jackson, S. (1999) Heterosexuality in ?uestion. London: Sage.
Jeffreys, S. (1990) Anticlimax: A Feminist Perspective on the Sexual Revolution.
London: Women's Press.
Johnson, S. and D. Hunt (1990) `The Relationship of Male Transsexual Typology
to Psychosocial Adjustment', Archives of Sexual Behavior 19(4): 349­60.
Kessler, S. and W. McKenna (1978) Gender: An Ethnomethodological Approach.
Chicago, IL: University of Chicago Press.
Knorr, N., S. Wolf and E. Meyer (1969) `Psychiatric Evaluation of Male
Transsexuals for Surgery', pp. 271­80 in R. Green and J. Money (eds)
Transsexualism and Sex Reassignment. Baltimore, MD: Johns Hopkins Press.
Laqueur, T. (1990) Making Sex. London: Harvard University Press.
Lewins, F. (1995) Transsexualism in Society. Melbourne: Macmillan.
593For a sociology of transsexualism Hird
Limentani, A. (1979) `The Significance of Transsexualism in Relation to Some Basic
Psychoanalytic Concepts', International Review of Psychoanalysis 6: 139­53.
Lothstein, L. (1988) `Self-object Failure and Gender Identity', in Progress in Self
Psychology, Vol.III: Frontiers in Self Psychology. Hillsdale, NJ: Analytic Press.
MacKenzie, G. (1994) Transgender Nation. Bowling Green, OH: State University
Popular Press.
Mead, G. (1934) Mind, Self and Society. Chicago, IL: University of Chicago Press.
Millott, C. (1983) Horsexe: Essays on Transsexuality. New York: Autono Media.
Money, J. and J. Brennan (1969) `Sexual Dimorphism in the Psychology of Female
Transsexuals', pp. 137­52 in R. Green and J. Money (eds) Transsexualism and
Sex Reassignment. Baltimore, MD: Johns Hopkins Press.
More, K. and S. Whittle (1999) Reclaiming Genders. Transsexual Grammars at the
Fin de Sicle. London: Cassell.
Oppenheimer, A. (1991) `The Wish for a Sex Change: A Challenge to
Psychoanalysis?', International Journal of Psycho-analysis 72: 221­31.
Playdon, Z. (2000) `Transsexualism as an Intersex Condition', report of the
Interdepartmental Working Group on Transsexual People, Home Office.
London: HMSO.
Plummer, K. (1995) Telling Sexual Stories. London: Routledge.
Plummer, K. (1996) `Symbolic Interactionism and the Forms of Homosexuality',
pp. 64­82 in S. Seidman (ed.) Queer Theory/Sociology. Oxford: Blackwell.
Pomeroy, W. (1969) `Transsexualism and Sexuality: Sexual Behavior of Pre- and
Postoperative Male Transsexuals' pp. 183­8 in R. Green and J. Money (eds)
Transsexualism and Sex Reassignment. Baltimore, MD: Johns Hopkins Press.
Press For Change (URL consulted 10/4/2000) http://www.pfc.org.uk
Prosser, J. (1998) Second Skins. New York: Columbia University Press.
Randell, J. (1969) `Preoperative and Postoperative Status of Male and Female
Transsexuals', pp. 355­82 in R. Green and J. Money (eds) Transsexualism and
Sex Reassignment. Baltimore, MD: Johns Hopkins University Press.
Raymond, J. (1979) The Transsexual Empire: The Making of the She-Male. New
York: Teachers College Press.
Rose, N. (1996) Inventing Our Selves. Cambridge: Cambridge University Press.
Rothblatt, M. (1995) The Apartheid of Sex: A Manifesto on the Freedom of
Gender. New York: Crown Publishers.
Shilling, C. (1993) The Body and Social Theory. London: Sage.
Socarides, C. (1970) `A Psychoanalytic Study of the Desire for Sexual
Transformation: The Plaster-of-Paris Man', International Journal of
Psychoanalysis 51: 341­ 9.
Spelman, E. (1988) Inessential Woman. London: Women's Press.
Stanley, L. (2000) `Interview: Liz Stanley', Network Newsletter of the British
Sociological Association 75: 1­4.
Stoller, R. (1968) Sex and Gender. Vol. I: The Development of Masculinity and
Femininity. London: Maresfield Reprints.
Stoller, R. (1969) `Parental Influences in Male Transsexualism', pp. 153­70 in
R. Green and J. Money (eds) Transsexualism and Sex Reassignment. Baltimore,
MD: Johns Hopkins University Press.
Stoller, R. (1975) Sex and Gender. Vol. II: The Transsexual Experiment. New York:
Science House.
Stoltenberg, J. (1989) Refusing to Be a Man. Portland, OR: Breitenbursh.
594 Sociology Volume 36 s Number 3 s August 2002
Stone, S. (URL consulted on 30/1/98) http://www.qrd.org/qrd/trans/empire-strikes-
back.
Stryker, S. (1994) `My Words to Victor Frankenstein Above the Village of
Chamounix: Performing Transgender Rage', GLQ: A Journal of Lesbian and
Gay Studies 1(3): 237­54.
Stryker, S. (1995) `Transsexuality: The Postmodern Body and/as Technology',
Exposure 30(1­2): 38­50.
Szasz, T. (1990) Sex by Prescription. Syracuse, NY: Syracuse University Press.
Taylor, J. (1995) `The Third Sex', Esquire 123(4): 102­12.
Turner, B. (1992) Regulating Bodies. London: Routledge.
von Krafft-Ebing, R. (1894) Psychopathia Sexualis. London: Panther.
Wlinder, J. (1969) `Transsexuals: Physical Characteristics, Parental Age, and Birth
Order', pp. 221­31 in R. Green and J. Money (eds) Transsexualism and Sex
Reassignment. Baltimore, MD: Johns Hopkins Press.
Walters, A. and M. Ross (eds) (1986) Transsexualism and Sex Reassignment.
Oxford: Oxford University Press.
Weeks, J. (1996) `The Construction of Homosexuality', pp. 41­63 in S. Seidman
(ed.) Queer Theory/Sociology. Oxford: Blackwell.
Whittle, S. (1998) `The Trans-Cyberian Mail Way', Social and Legal Studies 7(3):
389­408.
Wilson, K. (1997) `Gender as Illness: Issues of Psychiatric Classification', 6th
Annual ICTLEP Transgender Law and Employment Policy Conference,
Houston, Texas, July.
Zita, J. (1998) Body Talk. Philosophical Reflections on Sex and Gender. New York:
Columbia University Press.
Myra J. Hird
Is a lecturer in sociology at Queen's University, Belfast. She is the author of several articles
on materiality, sexual difference, intersex and transgender, including `Intersex:ATestcase
for Psycho-analytic Theory?' in Signs: Journal of Women in Culture and Society;
`Gender's Nature: Intersexuality, Transsexualism and the "Sex"/ "Gender" Binary' in
Feminist Theory; `Unidentified Pleasures: Gender Identity and its Failure' in Body and
Society and `Out/perfoming Our Selves ­ Invitation for Dialogue' in Sexualities; and is
completing a sole-authored book on the relation of intersex and transsex with theories
of sexual difference.
Address: School of Sociology and Social Policy, Queen's University, Belfast, BT7 1NN,
Northern Ireland, UK.
E-mail: M.Hird@qub.ac.uk
595For a sociology of transsexualism Hird