This message (material) was created and (or) distributed by a foreign media outlet performing the functions of a foreign agent, and (or) a Russian legal entity performing the functions of a foreign agent.
We need your help. Please support Meduza.
The first Transgender Pride March. London, September 2019
Wiktor Szymanowicz / Shutterstock / Vida Press
Recently, writer JK Rowling made fun of the expression “people who menstruate” on Twitter and immediately received accusations of transphobia. At the same time, many did not understand why this joke was offensive - and again began to argue about how to talk about transgenderism so as not to offend anyone. In 2016, Meduza already answered embarrassing questions about this topic - we re-read them carefully and realized that a lot has changed since then, and above all, ideas about correct vocabulary. A completely new version of the material was prepared specifically for Meduza by Maria Bobyleva, a correspondent for the publication Takie Dela.
Top 10 things you need to know about being transgender
- Transgender is not a mental disorder.
- Not all transgender people change what is considered their biological sex. Moreover, it cannot be changed completely.
- Therefore, when talking about transgender people, try to use the word “gender” (the term refers to a person’s identity) rather than “sex” or “sex” (the same as “sex” in English).
- “Trans”, “transvestites”, “transgenders” - you shouldn’t say that. It’s better like this: “transgender people”, “transpeople”, “transpersons”.
- A person who sometimes crossdresses into women's clothing but does not feel like a woman should be called a crossdresser, not a transvestite.
- Transgender people who have undergone hormone therapy do not live shorter lives or have terrible health problems than other people.
- If a transgender man does not have his uterus and ovaries removed, he will be able to have a child (this will require stopping hormone therapy).
- Scientists do not know the cause of transgenderism.
- Transgender is not related to a person's sexual orientation.
- Some feminists do not accept transgender women as "real women."
Part one
Correct words
Are transgender people those who have changed their gender?
No. Instead of the word “sex,” it is generally better to use “gender,” a concept that primarily refers to social expectations of men and women, rather than biological characteristics. These expectations include appearance, behavior, role models, etc. A person's assigned gender at birth and their gender identity may not be the same.
The common expression “change gender” usually implies that a person has changed his biological sex characteristics. But in fact, there is no one magical operation that “changes gender”: every transperson (he can be considered as such even before any interventions) can do one or more manipulations to bring the internal feeling into line with external data - depending on his desires and opportunities. This could be hormonal therapy, one or more body surgeries, cosmetic changes in appearance (for example, a new wardrobe or hairstyle), a change of name, documents and gender marker in the passport - everyone chooses for themselves. And instead of “sex change” you should say “transgender transition” or “trans transition”. Or even just “transition”.
What words should we use when we talk about transgender people? Is transgender ok?
It is correct to say about people “transgender person”, “transgender man”, “transgender woman”. You can also use the prefix “trans”: “transperson”, “transman”, “transwoman”, “transperson”.
The word “transgender” (a copy of the English adjective transgender, which came into Russian as a noun) is also incorrect, since it reduces transgender people only to their gender identity (for the same reason, it is better to say not “disabled”, but “person with disabilities”). The word "trans" is also bad. Nobody says “cisgender” - much less “cis”.
Sorry, but I don’t understand - when are we talking about transmen and when are we talking about transwomen?
Transgender people are called "man" or "woman" based on the direction in which they transition. That is, a transgender man or transmasculine person is a person assigned female at birth who is transitioning or has already transitioned. And not vice versa.
By the way, about the direction of the transition. The abbreviations MtF (male to female) and FtM (female to male) mean the direction of the transition, and not the person himself. You can’t say “he’s an FtM person” - it’s correct to say “he’s in the stage of FtM transition.” You can also talk about transition as “transfeminine” or “transmasculine” - with this, we think, everything is clear.
Writer and actor Chaz Bono at the premiere of The Danish Girl in Los Angeles, November 2015
Kevork Djansezian / Reuters / Scanpix / LETA
Are transsexuals and transgender people the same thing?
“Transsexualism” is an outdated medical diagnosis that is offensive to the trans community, so using this word and its derivatives should not be used at all. There is also confusion here because of the word “sex”: in English, where these words come from, sex means “sex”, and not just having sex.
Who are the transvestites then? Or is it no longer possible to say that?
Not worth it. Transgender people should not be confused with crossdressers - they used to be called transvestites, but this term is outdated and today is considered incorrect, because it was also once used as a diagnosis.
Crossdressers dress as the opposite gender, usually temporarily, but do not transition and experience little or no dissatisfaction with their assigned gender at birth. Although for some people, crossdressing may be part of the transgender transition.
There are also hermaphrodites. Are they transgender too?
The correct term in this case is intersex people, and does not refer to trans people. Intersex people can have any sexual orientation and gender identity.
Intersex are people born with genitalia that do not look typically male or female or simply do not match the person's chromosomal sex. In total, there are about 60 intersex variations. For example, a person may have an all-female body, but with a large clitoris (which can be confused with a penis), or, for example, an all-male body, but with an extra X chromosome. In short, it can be any anatomy that differs from the typically female or male one.
How to address transgender people?
A person should be called in the same genus in which he calls himself. A transgender man is a “he”, a transgender woman is a “she”. Most trans people change their name and do not want their previous name (“deadname”) to be used. Calling a person by their old name is called deadnaming.
However, some non-binary people prefer to be addressed as “they” or “it”, since they do not identify themselves with any gender. Some transpeople have a feminine name but call themselves masculine (and vice versa). In general, regarding gender and pronouns, in order not to get confused, it is always better to ask the person himself.
The same applies to talking about a person’s past. From the point of view of the outside world, a transgender man “was a woman” and spoke of himself in the feminine gender. But do not forget that he himself felt discomfort from this (at least for some time), even if he did not show it. He could wear skirts and put on makeup, he could say “I’m off” and so on, but if, having made the transition, he talks about himself in the masculine gender and associates himself with the masculine gender, you should believe him and accept it - even if before that the person positioned himself like a woman.
But why is everyone so angry at JK Rowling? “People who menstruate” does sound weird
Not only can cisgender women menstruate, but transmen and non-binary people can too. However, trans women do not have periods. The phrase “people who menstruate” is accurate because it acknowledges that trans and non-binary people also have the experience of menstruation.
What did Rowling say?
- They say that writer JK Rowling is intolerant of transgender people. This is true? What did she say?
Natalia Maksimova on the cover of the Tatler issue in April 2022. In an interview with the magazine, she spoke about her transgender transition
Part two
Photos before and after gender reassignment of famous personalities
Chastity Bono, the only daughter of singer Cher, has turned into Chaz Bon, which shows how a woman can be turned into a full-fledged man
European pole vault medalist Yvonne Buschbaum had sex reassignment surgery and is now called Balian
Heidi Krieger, European champion in shot put, underwent gender reassignment surgery - this is how Andreas Krieger was born
Transgender transition
Why don't all transgender people have surgery? How do they feel in a body that doesn't match their self-image?
Most trans people experience dysphoria, a feeling of discomfort that their gender identity does not match their sex assigned at birth. Often such dysphoria gives rise to a desire to reconcile internal feelings with appearance and documents. For some, it is enough to change their clothing style and name, for others, it is enough to change their documents and gender marker in their passport, for others, they start hormone therapy, for others, they undergo one or more operations, and for others, all or part of the above.
Transmen can have a mastectomy (removal of the breasts), hysterectomy (removal of the uterus), metoidioplasty, and phalloplasty (clitoris lengthening and penile shaping).
Trans women can have orchiectomies (removal of testicles), vaginoplasty (shaping a vagina), and breast augmentation surgery.
All this costs money, and not every person is ready to undergo surgery—that’s why not all transpeople undergo surgery. Metoidioplasty and phalloplasty are considered particularly difficult and traumatic, which is why most transmen do not undergo genital surgery.
How much does it cost to do all the operations and manipulations to make a trans transition?
As we have already said, there is no single complete set of manipulations. Depending on the country and type of operation, prices can range from one thousand dollars (for a mastectomy in Russia) to 10 thousand dollars (for vaginoplasty in Thailand). Metoidioplasty and phalloplasty are even more expensive and are often done in several stages. In addition to operations on the genitals and breasts, transpeople can undergo plastic surgery on the face and other parts of the body. The number of such surgical interventions can be any - accordingly, the price tag can be infinitely high.
Many transpeople prefer to have operations in Thailand because of the price-quality ratio, and Thai doctors have quite a lot of experience. Operations in Europe and the USA are predictably more expensive. In Russia, on the contrary, it is cheaper, but we also have many times fewer experienced surgeons specializing, for example, in vaginoplasty or phalloplasty.
Is it true that people who want to transition are first admitted to a mental hospital? What are they doing with them there?
No. But in order to change your documents and start hormone replacement therapy, in Russia you will have to register with a psychiatrist - this can be done on an outpatient basis - and no operations need to be done first. Unfortunately, the diagnosis of “transsexualism” (F 64.0) in our country refers to mental illness, although in Western countries “transsexualism” has long not actually been considered as a disease. In 2022, the International Classification of Diseases, 11th Revision (ICD-11), removed transgenderism from the group of mental illnesses. Everywhere in the world, including in Russia, ICD-11 should begin to operate in 2022.
After diagnosis, a person receives a certificate of indications for hormonal therapy and/or surgery and undergoes a medical examination consisting of a psychiatrist, medical psychologist and sexologist. As a rule, such commissions are paid and cost about 30 thousand rubles. The commission, if everything goes according to plan, issues certificate No. 087/u “On gender change”, with which you can already go to the registry office and change the name and gender marker in your passport.
Often registry offices refuse the first time - then the person goes to court, which, as a rule, wins. The second time the registry office changes the documents. In Russia, this is a fairly well-established practice, and support groups for transpeople suggest an algorithm of actions to those interested.
Does hormone therapy make women grow beards and men grow breasts?
And not only. Testosterone causes transmen to develop body and facial hair, lose their periods, and grow muscles. Fat on the body and face is redistributed, the complexion becomes redder. The pressure rises, the veins in the arms become bulging. Body odor changes. Many people lose hair on their heads. The clitoris begins to grow and can reach a length of three to five centimeters. He gets an erection.
When transwomen take estrogen, the opposite happens. Muscle definition disappears, the body becomes more streamlined. The complexion turns pale, the veins on the arms cease to be bulging, the mammary glands swell.
How LGBT people live in Russia
- “People like that” don’t approach us. Domestic violence also happens in LGBT couples. It's even harder to defend against
- “United Russia knew that I was gay, but they turned a blind eye” How LGBT people live in Russian villages and towns
- “There was life. And now there is no life” Ivan Golunov interviewed a gay couple who fled Russia with two adopted sons due to criminal prosecution
They say that in Western countries, teenagers are allowed to transition until they reach adulthood. This is true? After all, they are children and can change their minds
Yes, in many Western countries you can start hormone therapy before adulthood - but under different conditions. So, in the USA this is possible with the consent of the parents, while surgical operations are performed only from the age of 18. It’s the same in many European countries, for example in France, Greece, Hungary. In Spain, Poland and the Netherlands, parental consent is only required up to 16 years of age, and in Latvia - up to 14 years.
Hormone therapy can be started at 12 years of age with parental consent in the Netherlands, and in some countries there is no minimum age for starting hormone therapy with parental consent.
Discussions about at what age a child has the right to begin a transgender transition are still going on in the West. On the one hand, there is indeed a risk that after the end of adolescence, dysphoria will pass - and with it the need for transition. On the other hand, many psychologists write that the later the transition begins, the longer the feeling of dissatisfaction lasts, which means stress, discomfort and anxiety, and this is harmful to the psyche. In general, hormonal therapy is recommended not to be prescribed until puberty.
In any case, psychologists and psychiatrists work with the child before prescribing hormone replacement therapy. Many experts recommend first making a social transition - that is, calling yourself by a different name and in the desired gender, changing your clothing style and gender representation, without resorting to medical changes. This way you can try on life in your desired gender, but without medical interventions, so that if something happens you can turn everything back.
In Western countries, an increase in the number of transgender transitions among teenage girls is recorded. JK Rowling, who has been criticized for being transphobic, claimed that in the UK the number of such transitions has increased by 4,400%. In absolute numbers, we are talking about 40 approved transitions in 2009 - and 1806 in 2017. Many believe the reason for the increase is due to improved access to healthcare.
Caitlyn Jenner at the presentation of her book “The Secrets of My Life.” New York, April 2022
Taylor Jewell / Invision / AP / Scanpix / LETA
Part three
How much does gender reassignment surgery cost - cost, price
As you know, plastic surgery costs a lot of money. The transition from woman to man is one of the most expensive. The high cost is due to:
- a small number of specialists capable of performing high-quality sex reassignment,
- complex of operations carried out,
- complex rehabilitation aimed at minimizing complications.
The total cost of gender reassignment surgery depends on the complex of measures that the woman does. Approximate prices of the main ones:
- Ovariectomy – about $1000;
- Mastectomy – $1500-2500;
- Vaginectomy – about $3000;
- Phalloplasty – $6000;
- Endoprosthetics of erectile penile prosthesis – from $1000 to $4000 (depending on the type of prosthesis)
Since some amputations and transformations can be performed in one surgical procedure, the final cost of gender reassignment may be less - up to approximately $7,000.
Don’t miss the most popular article in the section: Vera Alentova after plastic surgery - the latest photos, what operations were performed, how the star has changed.
What happens after transgender transition
Is it true that transgender people have a shorter life expectancy and a lower quality of life (tendency to mood swings, unstable psyche) due to the hormonal medications they take?
There is no such data. Taking hormone replacement therapy does not affect life expectancy and mental stability - on the contrary, many transmasculine people and transmen note that under the influence of testosterone they become calmer and more self-confident. But, of course, the life of trans people, especially in Russia, is associated with additional stress: transphobia, changing documents, problems with going to doctors, rejection from family and friends, surgical operations, problems with getting a job. Often all this leads people to anxiety disorders, depression and suicide, not to mention violence and physical risks during operations. There is even a Day of Remembrance for Transpeople (victims of transphobia and suicide) in the world - it is celebrated on November 20.
How does transition affect the psyche of a transgender person?
Everything is individual. But, as a rule, the transition brings the desired relief from dysphoria and the acquisition of harmony between internal sensations and external signs. However, the changes that occur to the body after starting hormone therapy and surgery are certainly stressful for the body. Not to mention the reaction of others to the transition, problems with work and socialization. After transition, many transwomen are surprised to discover all the disadvantages of female gender socialization - they face harassment, discrimination and violence from men.
If a trans man does not have his uterus and ovaries removed, will he be able to give birth? What about a trans woman?
Sometimes yes. Some transmen do this: if they do not start testosterone hormone therapy or stop it for a while, fertility can be restored and it is possible to become pregnant. But a trans woman cannot get pregnant and give birth.
So if I say “all pregnant women should get screened,” I’m not talking about all pregnant people?
Yes exactly. This is not very correct.
If a person has made a trans transition, can he then return everything back? Is it possible to restore the body's previous functions?
A small number of people who have made the transition do detransition (from the English detransition, that is, “transition back”). Research shows that the number of those who were disappointed in the transition ranges from approximately 2 to (while out of 8%, more than half interrupted the transition only temporarily). However, critics rightly note that the topic has been little studied and in fact we do not have accurate data.
Detransition occurs for various reasons. A person may realize that dissatisfaction with himself has not gone away after the transgender transition, may experience problems in the new gender role, or something else. Often, during or after transition, a trans person comes to the point that they do not want to fit into the binary gender system - in other words, they do not consider themselves to be either a man or a woman. Some people then stop taking hormone therapy or reduce it in order to look androgynous. There are cases when a person makes several transitions “back and forth.” However, he does not necessarily consider this a mistake - rather, it is his experience and his search.
If a person does not remove their reproductive organs during transition, their function may be restored after cessation of hormonal therapy.
How do transgender people (especially those who have not undergone surgery) go to the pool, fitness club, beach, or toilet?
If possible, the same as cisgender people. Transmen go to the men's restroom, transwomen go to the women's restroom. Everyone decides for themselves where and how much to expose themselves in locker rooms and on the beaches. Transmen often wear a packer, a special silicone imitation penis that is inserted into their briefs or swimming trunks. They come in varying degrees of realism, some can even be used to pee while standing - they are used by those who want to use urinals in toilets. Of course, some trans people continue to experience dysphoria and embarrassment and avoid places where they would be forced to undress in public.
Actresses Indya Moore and MJ Rodriguez in the TV series Pose
Michael Parmalee / FX / Everett Collection / Vida Press
Part four
Stages of preparation for gender reassignment in women
Preparing a woman for the operation of transformation from female to male occurs both from the physical and moral sides.
The physical side includes:
- Observation by a psychiatrist and sex therapist for 18 months. This is necessary to ensure complete confidence in the need for intervention.
- Collecting a complete medical history with all kinds of tests and tests. The absence of any neoplasms in the reproductive system is especially important.
- Hormone therapy for 12 months. Necessary for primary masculinization.
- The moral side includes being comfortable in the role of a man. To do this, experts advise a woman to live like a man for 6-10 months. This will help you finally decide on your gender.
Other important issues
How many transgender people are there in the world now? Can they be counted?
There is no exact answer. The United Nations HIV/AIDS program UNAIDS estimates that transgender people may make up 0.1–1.1% of the adult population. To better understand the scale: in 2022, according to the research company Gallup, 4.5% of Americans considered themselves to be part of the LGBT community. In 2018, in the UK, according to the Annual Population Survey, 2.2% of the country's residents considered themselves lesbian, gay or bisexual.
What is the cause of transgenderism? Maybe scientists are working on learning how to prevent it?
Medicine and biology do not yet know the exact answer, although scattered studies offer possible explanations for transgenderism. On the one hand, the formation of gender in the womb occurs in several stages: sex hormones affect the brain and genitals at different times, and these processes can fail. On the other hand, there are a number of twin studies showing that identical twins are more likely to be transgender. But so far not a single “transgender gene” has been found.
Modern scientists are inclined to believe that even if a person may have some biological predisposition to transgenderism, its appearance is influenced by a lot of complex factors, including social ones. Neither brain research nor the study of genes and hormones has yet given a clear answer. Therefore, there can be no talk of any “prevention”, much less “treatment” (as in the case of homosexuality, which is not a disease).
Is transgenderism somehow related to sexual orientation?
No, transgender people can be of any orientation. Another thing is that after the transition the very name of the orientation changes. For example, if a trans woman has always liked women, then before the transition she was perceived by society as a heterosexual man, and after that she will be considered a lesbian. At the same time, often during and after the transition, transpeople begin to move away from the binary gender system and are no longer ready to call themselves by any clear definitions. Of course, sexual orientation can change, but this happens to cisgender people too.
Why are transgender people so socially hostile? Why are they criticized even by feminists?
For the same reason as other people who are different in some way. The degree to which a society accepts transpeople directly depends on the degree of development and tolerance of that society as a whole.
As for “even feminists,” this has its own specifics. There is an offshoot of second wave feminism called trans-exclusionary radical feminism (TERF). In short, its supporters believe that trans women violate women's bodies and invade typically female spaces without the right to do so, because they do not have real “female” experiences.
At the same time, third wave feminism mainly includes new oppressed groups - in particular, there is a separate direction of transfeminism, which fights for the rights of trans women.
Is it true that in some cultures transgender people are not considered unusual or wrong? Is that why there are so many transgender women in Thailand?
Not all cultures have a strict division between men and women. In Thailand, in addition to male and female, a third gender was traditionally distinguished - kathoey. As Peter Jackson, a researcher on gender and sexual identities in Thailand, notes, the word “katoi” originally applied to intersex people, but over time it also came to be used to refer to transgender women and gay men (sometimes in an offensive manner). In Buddhism, unlike Christianity, there is no consensus on transgenderism and homosexuality. Although in the 1980s, as Jackson writes, voices against homosexual people were increasingly heard due to the outbreak of the HIV epidemic.
Also widely known are “people with two souls” - Indians who could look, behave and have sex in a completely different way than the European colonialists expected from men and women. Now the concept of “two souls” is popular among LGBT people from indigenous peoples in the United States.
In the future, because of transgender people, all the usual ideas about sex and gender will be mixed up?
To some extent, the process is already underway - and not necessarily because of trans people. Feminism, with its postulate that gender is a social construct, is gradually changing society’s ideas about what female and male gender socialization is (in other words, how women and men should look and behave). The diversity of sexual orientations and gender identities is growing and contributing as well. There are no longer only gays, lesbians and bisexuals, but, for example, pansexuals. There are also more and more gender identities: in addition to transgenderism, there are non-binary, bigender and others.
Get to know LGBT culture
- Riga in the 1920s - the most important center of LGBT and travesty culture "Medusa" talks about Riga gay culture, and also publishes the first story about homosexual love in the history of the Baltic press
- Queer fiction How space sagas and dystopias become political statements by LGBT activists
- “People feel uncomfortable when my black ass goes out on the red carpet in a dress” Who is Billy Porter - actor, openly gay and the most prominent guest of Hollywood ceremonies
- “I heard them calling me this word, and I felt funny.” Beauty blogger Andrei Petrov became the first Russian gay rapper - he recorded the video “Pidor” and immediately gained a million views. We talked to him
What organs look like and how they work after gender reassignment
Modern surgery in the field of sex reassignment has reached certain heights. When the operation is performed by an experienced and highly qualified surgeon, the penis will look completely natural, with a visually distinguishable head and shaft.
The sensitivity of the penis will be low. However, everything depends on the individual characteristics of the body and the location of the implanted tissue. The penis formed from a thoracodorsal flap is considered the most sensitive.
Because the nerve is also transplanted along with the skin. The penis reconstructed using the radiation method also has sensitivity. There have been no studies on this issue due to the small number of people who have undergone this operation.
Erection of the neophallus is possible only if a separate operation is performed to install an erection prosthesis. The operation is possible only after the body has fully recovered after phalloplasty. Is very expensive.
Physiological risks
The risks associated with transgender transition can be divided into psychological and physiological.
Physiological includes any complications that may arise after surgery. Namely:
- blood poisoning;
- hematomas;
- tissue infection;
- scars;
- loss of tissue sensitivity;
- swelling;
- bleeding.
Almost all of these complications are reversible. That is, for some time a person will have to face physical discomfort and postoperative difficulties, but after a period of rehabilitation the person’s well-being will be completely normalized.
As a rule, the surgeon gives the patient recommendations, following which, all undesirable consequences of the operation can be minimized. If complications do occur, you should report them to your doctor or medical staff as soon as possible.
Gender reassignment in children
Changing gender in childhood is possible only in a few cases: in case of injury to the genital organs and the impossibility of restoring its function, as well as in congenital pathologies of the reproductive system.
Doctors turned 11-year-old Savarnni from Australia into a boy because they diagnosed him with “gender identity disorder”
In some countries, teenagers who want to change gender are prescribed hormones. They are taken during puberty to prevent the development of secondary sexual characteristics and reduce the development of primary ones. After 18 years of age, such people can undergo sex reassignment surgery.
Writer Janet Mock
Today, the transgender activist, TV presenter and writer, who was once born in a male body and lived under the name Charles, leads a completely female life.
In 2014, she received a marriage proposal from her boyfriend Aaron Treadwell, which she happily accepted. To support this, Janet posted on Twitter, highlighting other significant events that year - the publication of the book Redefining Reality: My Journey to Femininity, Identity, Love and More, becoming the editor of Marie Claire and the launch of her television show So Popular. In a man's body
Possible complications in women after gender reassignment
The risk of complications after a woman is made into a man is very significant. This is due to the high complexity of ectomies. Common complications are:
- Inflammation of the seams.
- Infectious infection of tissues.
- Rejection of the neophallus.
- Loss of sensation.
- Slow healing and bleeding.
- Tissue necrosis.
Psychological complications may occur. This occurs due to a discrepancy between the expected and received results. There may be a feeling of general discomfort from the new appearance. The desire to return to your original appearance.
This complication is extremely rare, since before undergoing a sex change, a woman strives for several years to achieve a male appearance through hormones, undergoes psychological preparation, living a male life.
