Sexual Orientation: The direction of one's sexual interest towards persons of the same sex, the opposite sex, or both sexes.

Females can be those who define themselves as female by sex and by gender, female by sex but not by gender, and female by gender but not by sex. Sounds a bit confusing? It can be at first but that's no reason to give up.

• Medically, a transgender is someone who identifies with the opposite gender more than the one they were assigned at birth. A transsexual is a transgender who chooses sex reassignment surgery on top of changing their gender identity. Transgender people have Gender Identity Disorder which is a clinical term used to describe the feelings above.

• There is a simple answer to this: YOU CAN'T, unless they've told you. Someone's self identity isn't written on them. A person can have a feminine name, with long hair, be biologically female, but identify as male gender. A biological male doesn't have to have breast implants to consider herself female by gender. The safest (and most respectful) thing to do is ask.

• Kate's story brings up an interesting point. Just as biological females can be butch and still identify as female, a transgender female does not have to wear the short skirts and high heels in order to identify as female. There is still a lot of discrimination within the transgender communities about how "much" a person must transition in order to call themselves transgender. While it can be frustrating not knowing the gender of another person, it is important to recognize that the gender continuum applies to everyone.

• Again, YOU DON'T, unless they've told you. People have their own preferences, especially transgender's who are at different stages of transitioning from one sex to the other. To repeat, the safest (and most respectful) thing to do is ask.

• MTF stands for Male-to-Female transgender and FTM stands for Female to Male transgender. Depending upon what the person was originally labeled, MTF and FTM are used to classify transgender individuals at any state of gender identity or transexualism.

Yes, but they are all solvable. Much is related to discrimination due to ignorance. Much of the difficulties would go away if people took the time to understand that gender is not binary and that there are many different types of people out there. But some specific problems are listed below:

• Using incorrect and disrespectful names and pronouns: Many transgender youth face the uphill battle of getting others to call them by their preferred names and pronouns. Teenagers love to make assumptions and one that is most always done is whether someone is female or male. Asking a person which pronoun and/or which name they want to use is the most polite and respectful thing a person can do to make a transgender person's life that much better
  
  
• Lack of gender neutral bathrooms and harassment in restrooms: The Gay Straight Alliance Network did a focus group and found that one of the largest issues that transgender youth face in schools is the bathrooms.
  

Brandon is a junior in high school who was born biologically female by the name of Brenda. He began dressing and acting like a male his junior year but many kids still remembered Brenda. When he would use the male bathrooms the boys would harass him and beat him up because he still had female genitalia. The females were uncomfortable having him in their bathroom because they didn't want to be in a bathroom with a male. Brandon also felt uncomfortable in the female bathroom because he did not identify as a female. After constant harassment in the boys bathrooms Brandon went to use the girls' bathroom. A girl saw him and called security saying there was a male in the girls' bathroom. Brandon was dragged out and sent to the principal's office.

Sadly, this dilemma is very common. What Brandon needed was a third option. Some schools have begun giving one: a gender neutral bathroom. This bathroom could be a single room bathroom so that a student does not have to choose between male and female. Many FTM's do not want to cause girls discomfort by using the female bathrooms but in some cases they feel they are more safe there than in the men's.

• Sex based P.E. classes and locker rooms: Most P.E. classes are still segregated into male and female. This creates a dilemma for the transgender students who do not feel comfortable in a P.E. class that does not correspond with the student's gender identity. The same goes for locker rooms. Transgender students are constantly forced into humiliation by having to undress with those of a gender with which the student does not identify. Allowing for stalls and safe spaces where students can change in private especially helps a transgender student feel more at ease with their gender because "you don't have to be transgender to want to change in private."
  
  
• Gender segregated dress codes: Many schools have dress codes or uniforms that specifically state what females are to wear and what males are to wear. Many transgender students are forced to wear clothes that are not congruent with their gender identity. For instance many schools do not allow MTF's to wear dresses and skirts. De-genderizing the dress codes would allow for transgenders to wear what they feel is in line with their gender identity.
  
  
• Inside and out of school there are general problems of discrimination because transgender youth are considered different. It is understandable that people can be uncomfortable about things they don't understand. Teaching about transgender youth can alleviate some of this discomfort. Transgenders are just like everyone else: trying to fit in and retain their self identity at the same time. It's a hard balancing act. Adding harassment to that can be difficult. Especially when that harassment is to the point of death
  

The Brendan-Teena story is one of the most famous transgender stories to date. Brendan was born Teena in a small town. When he moved he began his transition--starting off a new life as a male in another town. He fell in love with a girl and her family accepted him. Yet when her brother and his friends discovered Brendan was not a biological male they raped him to "teach her a lesson." Eventually they ended up killing him for "hiding his true identity."

This brings up the debate that many are having: is a transgender required to tell others of their past? Some feel that they have a right to know if they are dealing with a person who has female or male genitalia. Schools have said that girls have a right to know if the girl in the stall next to her in the bathroom is biologically male. It can be discomforting not to know if the person truly feels female or if they just want to peek at other girls. On the other hand, the transgender feels that their past is exactly that: their past. It's hard to have to feel like you need to carry your old identity with you...like a burden. The female transgender in the next stall is just as scared that the biological female may discover her old identity, and may not accept her in the female world. Trying to make a clean cut from the old you is hard, and it can be even harder when you know its never going to be a clean cut. Some people say that person's genitalia is their own business, and they have the right to keep it private. The privacy amendment in the bill of rights supports this argument. It's based on trust. If you do not invade another person's privacy, they won't invade yours.

• There are lots of reasons why transgenders choose not to seek out health care or medical attention. Thus they aren't thought about as often as groups that do. Their biggest fear is discovery. The idea of being "outed" in a waiting room or being treated like a freak in the hospital is just not appealing. There are also huge fears of being discovered after an accident when the transgender is unconscious and unable to respond to the jokes and curses. Surgeries have been stopped when the patient has been found to be transgender. There are also transgenders who do not want to bother with the insurance system because many insurers will claim they do not cover certain procedures because the condition would not have been present had the person not been transitioning. For FTMs, many do not want to go to gynecologists to get pap smears because they are thought to be invasive. Also, it's hard to find a gynecologist who is sympathetic to an FTM. Many are more concerned about the genitalia rather than the gender, so when a FTM says he wants his ovaries removed due to pain and infection the gynecologist may refuse to remove them seeing a chance at saving reproductive organs rather than a FTM life.
  
  
• Transgenders are also left out of many mental health discussions because they fear being called mad. They tend to isolate themselves because of the constant threat of being outed, harassed, beaten, and worse killed. There is also the threat of being locked up for "treatment." The best thing for the world to do is to speak out for the transgender community. Give them a voice that is safe and firm.

• On their own is the first way. They may choose to dress and act in mannerisms coherent with the opposite gender. The second way is medical intervention. Before any sort of physical treatment is started, therapy should be pursued to ensure that the youth makes the right decision. With that said, there are three types of medical intervention.

1. Fully Reversible Interventions: hormone treatment to block puberty from progressing. This is usually done in youth who have been through therapy at an early age and who's doctor feels it is a good idea to delay puberty so the child can explore feelings of the opposite gender more fully, with out then having to go back later on and have surgery to reverse the puberty (ie: a potential FTM youth would take puberty delaying hormones so he would not have to worry about breasts if he decided to become a FTM transsexual.
2. Partially Reversible Interventions: the administration of hormones of the opposite sex (ie: testosterone for FTMs and estrogen for MTFs)
3. Irreversible Interventions: surgery
   NOTE: It is important to understand that Sex Reassignment Surgery is irreversible and thus youth who feel they are the opposite sex may want to start with hormone therapy before jumping into surgery

There are two types as stated above: Puberty Delaying Hormones and Hormone Therapy.

• A youth may be ready to receive Puberty Delaying Hormones as soon as puberty has begun. In order for an informed decision to be made by both the youth and his/her parents it is important to wait until the youth has experienced the onset of his/her biological sex's puberty¹.
  
• In order for a youth to begin real life experience (living as the opposite sex) and hormone therapy (receiving hormones associated with the opposite sex) s/he should be involved with a mental health professional for at least six months to ensure the mental well being of the youth. It is important to realize that the maximum hormone effects may not be visible until after two years of continuous treatment. Heredity plays a major role in how quickly a person's tissue will react to the new hormones.
  
• The intensity of the effects of hormones varies from person to person.
  
• For MTF's on estrogen they will have larger breasts, redistribution of fat to female places, decreased upper body strength, halting of the loss of hair, decreased sperm production, and smaller and scarcer erections.
  
• For FTM's on testosterone they will have a deeper voice, a larger clitoris, a stalling of the increasing in breast size, increased body and facial hair, balding, increased upper body strength, weight gain, and increased sexual arousal. There are two types of testosterone that can be prescribed: Testosterone Cypionate, a cottonseed oil suspension, and Testosterone Enanthate, a sesame seed oil suspension. Both are shots. Sometimes people use oral testosterone but it is strongly discouraged because it can cause high blood pressure and damage to the liver.
  

NOTE: there are many negative side effects that could happen to someone who is not clinically tested and monitored before and during hormone therapy. Smoking and obesity are just two of many reasons a person could have problems such as blood clotting and liver disease while on hormones. But above all please see a doctor before starting hormones!

*For the purpose of this website I am going to focus on FTM surgery since they start out as females and will probably be looking to the female community for support and understanding. Do not underestimate how hard MTF surgery is, though. Giving everyone your support when they are transitioning is important.*

• Chest: There is the double mastectomy which is the full removal of the breasts, and the double mastopexy which is the fixation of the breasts flat against the chest.
  
  
• Hysterectomy: removal of all parts of the uterus. In addition to having the surgery, a FTM will usually start estrogen pills to make up for the estrogen he has lost by removal of the ovaries. A common myth is that estrogen is associated with being a female and that a FTM would fall out of transition when taking these pills. The truth is estrogen is important for the body to function and is also present in the male body.
  
  
• Metaoidioplasty: the detaching of the enlarged clitoris and creation of a scrotal sack with testicular implants.
  
  
• Phalloplasty: these are the most difficult of all the FTM surgeries. It is taking tissue from either the inside of one forearm, the lower side of the torso, or the side of one thigh, and constructing a penis-like graft in the vaginal area. It is a very risky surgery due to the high rate of rejections of the graft from the body and the emotional toll of loss of tissue from other parts of the body. Very few FTM's get this surgery and when they do it's usually not until later in life. Many FTM's who transition in their early twenties would not think of getting the phalloplasty until at least ten years later because of its risks.
  

• Most are around legal recognition of sex changes and name changes. Changing one's name and sex marker on legal documents ranges from fairly easy to fairly complicated, depending on the type of document. The process differs from state to state. In general, a person must fill out paperwork to request the name change, and then they must take out an ad in a local paper advertising the name change, then around six weeks later the person must appear before a judge with proof of the ad and the paperwork. The judge will ask a few questions about the name change and then, if no one objects, the judge will order the change and the new name is now your LEGAL name.

• There is a simpler way that sometimes works called the Common Law Name Change where people adopt a name and use it over time on formal documents even though it never gets legal recognition.
  NOTE: if you are under the age of 18 you will need a parent or guardian to apply for the name change with you.
  

Resources:

Female to Male International

www.ftmi.org

Transfeminism--A website dedicated to raising awareness about abuse of trans and intersex females and promoting trans feminist power!

www.transfeminism.org

American Boyz--A website for females who do not feel they fit into the feminine female category.

www.amboyz.org

GSA Network--Has basic trans information as well as games and fun activities to engage people in to raise awareness about trans issues.

http://www.gsanetwork.org/resources/trans.html

Transgender Law Center

www.transgenderlawcenter.org

¹ Information upheld by the Harry Benjamin International Gender Dysphoria Institute Standards of Care