Transsexualism

Transsexual specifically refers to individuals who desire to change their physical sex through medical means, such as hormone therapy or surgery, to align their bodies with their gender identity. It is often used in a more clinical context. Transsexual individuals typically have a strong and persistent desire to live and be recognized as a gender different from their assigned sex. Transitioning is an important part towards aligning their physical appearance and social presentation with their gender identity. Transitioning can involve various aspects, including social transition (changing names, pronouns, and presentation), hormone therapy, and gender-affirming surgeries. These steps are not universally pursued by all transsexual individuals and are highly individual choices made in consultation with healthcare professionals. The term transsexual places greater emphasis on the physical and medical aspects of transitioning, and is less commonly used in contemporary discussions about gender identity.

The history of transsexualism is intertwined with the broader understanding of transgender experiences. While the understanding and recognition of transsexualism have evolved over time, transgender identities have existed throughout history, even if the language and concepts used to describe them have varied. Below is a brief and general outline.

Early Medical Approaches –  (1) The concept of transsexualism emerged in the mid-20th century, primarily through the work of medical professionals and psychiatrists. They began to explore the experiences of individuals who expressed a strong and persistent desire to live as the gender different from their assigned sex; (2) In the 1950s and 1960s, various medical professionals, such as Harry Benjamin, introduced diagnostic criteria and treatment guidelines for transsexual individuals. Benjamin's book "The Transsexual Phenomenon" (1966) played a significant role in defining the medical understanding of transsexualism.

Diagnostic Changes –  In 1980, the American Psychiatric Association (APA) included transsexualism as a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III). It was later reclassified as "gender identity disorder" in the DSM-IV (1994) and then as "gender dysphoria" in the DSM-5 (2013).

Debates and Critiques – (1) The medicalization of transsexualism and the pathologization of transgender identities have been subjects of debate and criticism. Some argue that diagnosing transsexualism as a mental disorder reinforces stigmatization and fails to acknowledge the diversity of gender identities and expressions; (2) The move towards depathologization gained traction, leading to changes in diagnostic classifications. The World Health Organization removed "gender identity disorder" from its International Classification of Diseases (ICD-11) and replaced it with "gender incongruence" in 2018.

The history of transsexualism is not a linear progression, and it varies across different cultures and regions. The experiences of transsexual individuals have been shaped by social, cultural, and political contexts.

Transsexualism, a subset of transgender identity, has profound implications for social acceptance and healthcare access. Globally, an estimated 0.3% to 0.5% of the population identifies as transsexual, equating to approximately 25 million individuals. Despite this, many face severe discrimination and violence. In 2021, the Trans Murder Monitoring Project reported that 375 trans and gender-diverse individuals were murdered worldwide, with a staggering 71% of these victims being trans women, predominantly from marginalized racial backgrounds. The situation is dire, as trans individuals experience disproportionately high rates of mental health issues; a survey by the National Center for Transgender Equality revealed that 40% of trans people have considered suicide, with 92% having experienced severe anxiety and depression. Access to appropriate healthcare is another pressing concern; the same survey found that 33% of transgender individuals reported being denied healthcare due to their gender identity. This trend is reflected globally; a study by ILGA-Europe indicated that 63% of trans respondents in Europe had encountered barriers to accessing gender-affirming treatments. Economically, trans individuals often face unemployment at alarming rates; in the U.S., 27% of transgender individuals are unemployed, compared to a national average of 4%.