What is the difference between transgender and transsexual?

Transgender models are revolutionizing the catwalks and advertisements. But their popularity does not mean that transgender people will have an easier life.

Caitlyn Jenner on the cover of Vanity Fair

Transgender models are having successful careers: transgender model Valentina Sampaio becomes the face of Victoria’s Secret, Belgian model Maxime Magnus debuts at the Schiaparelli Couture spring-summer 2019 show. Crowe Kian graces the covers of Vogue. Top model, Nicolas Ghesquière’s muse Nathalie Westling becomes Nathan Westling and continues to participate in the shoot. Lea Tee, Hari Nef and Andrea Pezic successfully continue their careers. Izaak Theo is a young man, the son of singer Shade, formerly a daughter. There is a modeling agency, Transmodels, which exclusively represents transmodels in New York City, and National Geographic has produced a documentary series, Gender Revolution, about transgender issues.

Transgender people are people whose gender identity does not match the sex assigned at birth. They may or may not make a surgical and/or hormonal “transition” (then it is more correct to call them “transsexuals”). Thus, the concept of “transgender” is broader than “transsexual. The transition from male to female is called MTF (male-to-female), from female to male is called FTM (female-to-male). When a child is born, its sex is determined by its primary sex characteristics. In questionable cases (such as intersexuality – the presence of organs of both sexes), tests are used to determine which chromosomes are predominant – male or female. Recently, top model Hannah Gabi Odile admitted that she was born “intersex,” and her parents made the decision that she would be a girl. People only learned to separate gender (physical sex characteristics) from gender (social role) in the mid-20th century, thanks in large part to an active movement for the right to self-identity.

Eddie Redmayne, who played the first transgender woman to undergo a surgical sex change (“The Girl from Denmark”), was struck by the statistics: 41 percent of transgender people end up committing suicide. However, there are some optimistic examples. In Ukrainian reality, the stories of trans people are battles with shadows.

Olympic champion, Kim Kardashian’s stepfather Bruce Jenner decided to change his gender at the age of 60. It’s hard to imagine how he lived all those years and the degree of freedom of a man who overcame prejudice and allowed himself to be real – not in secret from everyone, but by declaring it to the world. Caitlyn Jenner’s story is a living example of how hype becomes a gift when contracts are awarded to global brands. This cameo is a good reason to think about the fact that it’s not so scary to come clean: it’s much sadder to remain in the shadow of public condemnation. Another thing is that Caitlin is now questioning whether she made the right decision.

Gender reassignment is a complicated, troublesome, and costly procedure. In addition to realizing gender identity and a new social role, the transition can involve hormone therapy, sex reassignment surgery, and personality changes. This is partly why not everyone decides to undergo surgery. The relief of being able to look the way you want with hormone therapy and not having to hide is often enough. In addition, hormone therapy is also a matter of personal choice.

Soldadou Kovalisidi lives in Kiev and works for the human rights organization Amnesty International Ukraine. At university, he cut his hair short, started tightening his chest and wearing men’s clothes, and at age 24 he became openly transgender. “I asked those around me to address me only in the masculine gender and by my first name – Soldado. From that point on, I really felt like everything fell into place. That’s what freedom is all about.” Every three months Soldado gets testosterone injections, intramuscularly. It’s not cheap (about 5,000 hryvnia), but he believes the expensive drugs have fewer side effects. “In a year of therapy, my voice changed, my shoulders got wider and my hips got narrower, there were hints of a beard.” One of the perks of his new “manly” life, according to Soldado, is being able to go to the barber shop. “This place used to be inaccessible to me, but now I’m genuinely happy about this important little thing.” The pool, sauna and massage remain inaccessible to Soldado because she has yet to have a mastectomy (surgery to remove her breasts).

Nikita Karimov, a gestalt therapist and LGBT activist, says he began his transition in 2015 with hormone injections. By the time this piece was published, he had already had a mastectomy. “Body dissociation (when a person does not associate himself with his own body. – Vogue UA’s comment) before the transition was terrible: I suffered from anorexia and self-loathing throughout my teenage years. But now the lack of menstruation, physical strength, low voice, body hair, redistribution of fat and other things that distinguish the male body from the female, it seems quite natural. Change has its own price: Nikita gained 12 kg and is trying to reach a comfortable weight with diet and exercise, a lot of effort and money invested in skin care. He says that now he is essentially going through his second puberty with all the ensuing consequences in the form of acne and other hormonal restructuring.

“It’s not our genitals that make us men and women, it’s our gut feeling”.

Ukrainian athlete, photographer, and trans activist Tangarr Forgart says he would have decided to transition earlier if not for his confusing sexual preferences. “I’ve always liked guys, but I had no idea that transgender men could be gay, too.” Once Tangarr learned that a transgender man’s orientation could be anything, he began positioning himself as a man. Six months later he started hormone therapy, and after another year he had his breasts removed. “Now I’m on hormone therapy, it’s for life,” he says. – I use testosterone drugs: twice a month, an intramuscular injection.” Feminizing hormone therapy is much more expensive. In developed countries hormones are paid by the state, in full or in part. The government pays for them in full or in part.

Since the reproductive organs are not only sex characteristics, but also produce hormones, these characteristics are corrected in the final stage of transition – the ovaries or testicles are removed. Additionally, more feminine or masculine facial features can be shaped.

Caitlyn Jenner is a living example of how, along with the hype about gender reassignment, the gift of contracts with global brands.

Dr. Kamol, a sex-change surgeon in Bangkok, where more such surgeries are performed than anywhere else in the world, says that he is more often approached for FTM (female-to-male) surgery, although it is significantly more expensive.

Such surgery may include removal of breasts, uterus, vaginal closure, phalloplasty (when the penis is formed from folds of skin) or metoidioplasty (when the clitoris is transformed into a penis to preserve sensitivity), as well as cheekbone and chin plasty to make the face appear more masculine. The number of MTF (male-to-female) surgeries remains stable. At Kamola Clinic, FTM surgery costs from $32,000 to $50,000, and MTF surgery costs up to $16,500. The prices of the surgeries differ in Ukraine, and a careful approach is necessary when looking for a surgeon. This is because such surgeries are not yet “mainstreamed” and there are few good surgeons.

But not everything can be changed by surgery: the length of the hand, the structure of the pelvis, the Adam’s apple, the shape and width of the chest will remain the same, and no operation will save an erection and the ability to conceive, so many transgender people stop at mastectomy and lifelong hormone therapy.

“It’s not our genitals that make us men and women, it’s our gut feeling.”

Even people who have lost weight or changed the shape of their nose sometimes complain that with a new appearance a new sense of self never came, and the old fear of not being accepted remains. Plastic surgeons warn about this: external changes do not get rid of complexes. Therefore, the transition must be accompanied by psychotherapy. Soldadou Kovalissidi says it is important for trans people to work with psychologists to learn to accept their bodies: “It is not genitals that make us men and women but an internal feeling. However, there are very few specialists in Ukraine who work with transgender people. Get moral support and answers to many questions at amnesty.org.ua and in the Facebook group Gay Alliance Ukraine.

“A trans woman can be brave, determined and dream of serving in the military, while a trans man can be timid, vulnerable and love melodramas.”

Tangarr Forgart says a trans man doesn’t have to conform to stereotypes of masculinity-just as a trans girl doesn’t have to look exaggeratedly feminine. “A transwoman can be bold, determined, wear no skirts, and dream of serving in the military, while a trans man can be timid, vulnerable, and love melodrama. This also applies to cisgender people (those whose gender assigned at birth, body and own identity coincide. – Note to Vogue UA). Because things are just things, they have no gender. Jobs don’t have gender. Hobbies have no gender. And feelings don’t have it either.”

Before 2016, any deviation from cisgenderism was considered a mental illness. In order to transition, it was necessary not only to be examined by a special commission, but also to spend up to a month and a half in a psychiatric hospital, and then undergo sterilization and give up rights to their children if they had not turned 18 by that time. Moreover, the legislation was designed in such a way that trans people had to undergo surgery – if you call yourself a coward, you get in the back of the truck. Tangarr says that he had a hard time getting a referral to a psychiatric clinic, but even there no one understood what to do with him and his kind of patients and in which department (male or female) to put them.

“Things are just things, they have no gender. Jobs don’t have gender. Hobbies are not gendered. And feelings don’t have gender either.”

In the fall of 2016, Acting Minister of Health Ulyana Suprun signed an order abolishing the stage of sterilization and deprivation of parental rights, but a new format of interaction between the gender reassignment commission and trans people has not yet been invented. The commission includes a psychiatrist, a plastic surgeon, a urologist and a gynecologist – they give collegial consent for sex change and documents, which can be changed in the bodies of the RACS. The journey from start to finish takes about two years. Transgender people hope that soon, instead of a commission, a family doctor will issue the opinion. The popularity of the transgender topic in the fashion industry can be misleading: it seems that transsexuality and transgenderism are gradually moving from the category of “incredible” to the category of “commonplace”. Unfortunately, this is not the case. The world beyond the walls of show and fashion business is conservative. People think in a formulaic way: a man means strong, in pants and with stubble, a woman means red lipstick and a dress. In the perception of the majority, transgender is still epatage, “depravity,” bad upbringing. But there is hope that society will become more tolerant. The history of the development of fashion (and human rights) confirms this. For example, less than a hundred years ago, a woman could be condemned simply for having the audacity to appear in public in pants. In addition, transgenderism has ceased to be demonized in medical circles. It is no longer a pathology, but a conscious choice.

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