Rebecca Emberger, LAMFT

Sex & Relationship Therapist
Sex, Gender, & Relationship Diversity Specialist

Discrimination & The Transgender Population


Discrimination & the Transgender Population

Rebecca Emberger

Capella University

December 11, 2008


Transgender people are the subject of intense public stigmatism and face discrimination in almost every sector of society. Even in areas where LGB people have gained rights and seen reduced discrimination, TGs are still subject to dehumanizing stereotypes, misinformation, discrimination, and victimization (including physical violence and murder). This paper will examine the historical and contemporary antecedents of discrimination against TGs; will describe some theories of transgender identity development; and will explore the issues and challenges faced by this population and some of the effects of discrimination. Finally, the paper concludes with an analysis of the author's personal challenges, areas of growth as a result of this research, and goals for the future in order to increase her competency in working with this population in a clinical setting.

Discrimination & the Transgender Population

Transgenderism includes a wide spectrum of gender-variance and includes transsexuals, transvestites, transgenders and intersexed individuals (Britton, 2005). The term transgender refers to anyone who does not fit the societal norm of fitting securely into either male or female. Transvestites, also known as cross-dressers, can be either men or women who enjoy dressing in the cross-gender's (see Notes on Terminology below) clothing. The term transsexual generally refers to someone who chooses to fully transition to the gender expression they feel is consistent with their internal gender identity. They may undergo surgical modification to change their gender, but many do not, for various reasons. Intersex individuals are born with either ambiguous genitalia, or have both masculine and feminine genitalia (Britton, 2005). Transgender also includes those people who are not interested, willing, or able to undergo surgery, but who simply wish to present themselves and live their lives as the other gender (Chambers, 2007). It is important to note, too, that these definitions are simplified, and that there are other varieties of gender variance and a host of other terms are also being introduced into contemporary lexicon (Istar Lev, 2004) to describe these variations. However, for brevity, this discussion will focus primarily on the simplified terms described above.

There is also a difference between gender identity or expression, and sexual orientation – transgenders may identify as heterosexual, homosexual, bisexual, or celibate, and this identification, while entwined with their gender identification, is not indicative of such. Nor is there any causal connection between gender identity and sexual orientation (Istar Lev, 2004). That said, however, there is a lot of commonality between LGB (lesbian, gay, bisexual) peoples and transgender people; thus, the oft-used acronym LGBT. Both homosexual people and transgender people challenge society's notions of gender conformity and are thus united, to some extent, in a common cause to obliterate discrimination based on societally-sanctioned norms of gender conformity (Mottet & Tanis, 2008).

Transgender people are the subject of intense public stigmatism and face discrimination in almost every sector of society. Even in areas where LGB people have gained rights and seen reduced discrimination, TGs are still subject to dehumanizing stereotypes, misinformation, discrimination, and victimization (including physical violence and murder). This paper will examine the historical and contemporary antecedents of discrimination against TGs; will describe some theories of transgender identity development; and will explore the issues and challenges faced by this population and some of the effects of discrimination. Finally, the paper concludes with an analysis of the author's personal challenges, areas of growth as a result of this research, and goals for the future in order to increase her competency in working with this population in a clinical setting.

Notes on Terminology

Since transgender is considered the umbrella term, that is what will primarily be used throughout this paper, and the people to whom this term applies will be referred to with the abbreviation "TG". Occasionally, a particular type of transgenderism will be referenced with the more specific and appropriate term (i.e., transsexual, transvestite, intersex). Today's U.S. society generally sees gender as an "either/or" between only two possibilities, and traditionally refers to men and women as "opposites". Transgenderism turns this perception inside out and introduces the notion that gender is not necessarily dichotomous, with two "opposing" factions - thus, "opposite sex" will not be used in this paper. Instead, the term "cross-gender" has been adopted to refer to the "opposite gender" from one's apparent gender at birth.

Historical Antecedents

Transgender people have existed throughout history and have been variously treated with respect or disrespect, and sex changes have both been signs of favor with god, or as punishments. As far back as ancient Sumeria/Akkadia (circa roughly 6,000 BCE to 2100 BCE), evidence of transgendered people can be found. Often the priests of Inanna/Ishtar either voluntarily castrated themselves or dressed as priestesses in order to worship and perform their religious duties "appropriately" (Stuckey, 2008; Istar Lev, 2004; Kaldera, 2002). Anthropologists and historians have discovered evidence of transgenderism in many cultures, both contemporary and historical, including the Native American "Two Spirit" people (present in some form in many of the various Native American cultures); the Hijra of India (who are men that choose to worship the feminine aspect of the divine through voluntary castration or because they were born intersexed); and the many myths and cultural practices of the Greco-Roman peoples that feature transgender elements (i.e., the god Hermaphroditus, son of Hermes and Aphrodite; and the acceptance of the cross-dressing behavior of Hercules and Achilles) (Tarver, 2002; Istar Lev, 2004). Many deities of older religions sported both masculine and feminine characteristics, or were known to shape-shift from one gender to the other, as well, like Dionysus. Sometimes a sex-change was intended as a punishment, like in the case of Tiresias, who ended up preferring his new female form, and was subsequently changed back into a male, in order to carry out the punishment (Istar Lev, 2004). Even Cro-Magnon cave dwelling paintings often show beings who clearly have both sets of genitalia, which seems to suggest that intersex people were known and acknowledged even in those prehistoric societies (Tarver, 2002).

Often, those who identified as some form of transgender occupied special places in their societies. Many were assumed to be more innately magical or spiritual as a result of their blended gender, while others have been regarded as especially suited to healing or child-rearing (Istar Lev, 2004). Of course, in other societies, even those that had an accepted role for natural transgender people, castration and other forms of sex reassignment were used as punishments (Stuckey, 2008).

They have been both respected and reviled, subject to high social honor as well as ostracism and annihilation. They have served humankind as shamans and warriors, as priests and prostitutes, as healers and artists, as political leaders, and as child-rearers. They have also served as the scapegoats and guinea pigs of religious zeal, political xenophobia, and medical inquisition (Stuckey, 2008, p. 77).

Contemporary Antecedents & Manifestations

Several modern laws and court cases point to the problem our current society has with transgendered peoples. Several vocal anti-transgender activist groups loudly and disrespectfully assert their reasons why TGs should not be treated equally. Because clinicians do not receive training in dealing with gender-variant individuals, and because of the influence of prevailing social norms that can cause clinicians to harbor negative stereotypes and feelings about TGs, this population has repeatedly suffered from ignorant clinicians' mistreatment and pathologization of their condition.
Laws & Court Cases

In June of 2007, New Jersey became the 9th state to enact laws to protect TGs from discrimination in housing and hiring (Associated Press, 2007). The wording of this law explicitly covers many manifestations of transgenderism: "transsexual, cross-dressers, asexual, of ambiguous gender or simply not traditionally feminine or masculine" (¶ 5). In May of this year, although 13 states have passed legislation to prohibit discrimination on the basis of gender identity or expression, many spoke out against the inclusion of transgender rights in a federal bill to ban workplace discrimination against lesbians, gays and bisexuals (Senator Kennedy Excludes Transgenders, 2008). Both Senator Kennedy (D-Mass) and Representative Frank (D-Mass) recommended removing language that specifically covers TGs in this anti-discrimination bill, because they believed that the bill would not pass with this language intact.

August of this year saw advances and resistance to transgender discrimination laws in Colorado and Washington, DC. The Journal of Contemporary Sexuality (2008) reported that although both of these jurisdictions recently passed laws prohibiting transgender discrimination, there has been considerable political backlash from certain anti-transgender groups. James Dodson, of Focus on the Family, protested, saying: "Henceforth, every woman and little girl will have to fear that a predator, bisexual, crossdresser or even a homosexual or heterosexual male might walk in and relieve himself in their presence," (Conservatives Fight, 2008, p. 8).

    The Canadian case of Kimberly Nixon v. Vancouver Rape Relief and Women’s Shelter (Chambers, 2007) demonstrates the controversy regarding the self-identification of gender variant individuals. Kimberly Nixon, a male-to-female transsexual, applied to work at a rape crisis center that employed only women. While she passed the initial screening process and was accepted into the training program, when she showed up, the trainer deduced from her presenting appearance that she wasn’t a biological woman, and told Nixon that she could not be hired on this basis (Chambers, 2007). Nixon took the Vancouver Rape Relief center to court, and the initial court’s decision found in Nixon’s favor, agreeing with her assertion that she had been illegally discriminated against. However, on appeal, this decision was overturned. The appeals court agreed that Nixon had been discriminated against, but not that this particular form of exclusion was actually illegal, since the law does allow for private organizations to determine that a subset of people may be excluded on the basis of particular, work-related issues.

The Library of Congress was charged with discrimination on the basis of sex in the case of Diane J. Shroer v. James H. Billington, Librarian of Congress (Schroer v. Billington, 2008). Shroer had applied for a job with the Library of Congress, for which she was highly qualified, prior to beginning her transition from male to female. After she was offered the position, but before the new-hire paperwork was complete, she informed her supervisors that she would be undergoing the beginning of her transition just prior to starting work, and would be presenting herself as female. The supervisor then reconsidered offering Shroer the position, and ultimately rescinded the offer. In this case, the court decided in favor of Shroer, finding that the Library of Congress had indeed acted in violation of the law protecting individuals from being discriminated against on the basis of their sex.

Both of these cases demonstrate the necessity of further education about transgenderism and the discrimination TGs face in the workplace, among other aspects of their lives. The testimonies of the defendants and the public reactions to these cases also highlight the pervasive attitude of acceptance of discrimination against transgendered people (Chambers, 2007; Schroer v. Billington, 2008)

Social Atmosphere & Workplace Issues

Contrada (2008) is the author of MassResistance, a political blog in Massachusetts, who stated that the transgender activists who seek protections against discrimination in that state “want to offer your children on the bloody altar of transsexuality -- pulling them into sex-change operations involving unimaginable bodily mutilations and hormonal manipulations” (¶ 1). The statements made by Contrada and Dodson (Conservatives Fight, 2008) are not only highly opinionated and prejudicial, but use extremely inflammatory and graphic language to prove their points through emotional reaction.

The media reports on transgenderism contribute to the misinformation and stereotypes that pervade society. Conway (2007) says:

 At present, the media only spotlights transsexual people on two occasions, namely when "someone well-known changes sex" and when someone is a victim of discrimination, harassment or attack. This lack of balance in exposure shapes society's notion that transition leads to social marginalization or worse (¶ 3).  

While transgender people are beginning to appear more frequently in television shows and movies, most are still portrayed in stereotypical ways. Even the recent movie, “Transamerica,” often lauded by the transgender community as pro-transgenderism, perpetrates many stereotypes and misleads the viewer about what it is like to be a transgender person today (Thompson, 2006).

Workplace issues associated with the transgender population have become more visible and the reactions to these issues “range from extreme hostility to full acceptance” (Hunt, 2008).  Weiss (2008), who writes for the LGBT blog, The Bilerico Project, said, “Most employers remain ignorant and/or somewhat hostile to policy changes for transgender workers. I have received hundreds of emails from transgender workers who are having difficulty getting their employers to treat them right” (¶ 3). Two of the most contentious issues have to do with dress code and restroom policies. Kaldera (personal communication, November 4, 2008) related how, during his transition, he was thrown out of both a women’s restroom and a men’s restroom in the same night, because his appearance did not appear to be either fully male or fully female.

However, many progressive companies are making efforts to make the transition period and the general work atmosphere more accepting and accommodating of TGs. Walworth (2003) wrote a guide for Human Resources professionals to use to help them assist TGs in the transition process, and related how one’s genitalia should not be the standard for determining who gets to use which bathroom. The gender one presents should be accepted as that person’s gender, regardless of the state of their genitals. The same goes for dress code – provided the TG dresses appropriately for their current gender expression, this should be acceptable (Walworth, 2003).

Professional Attitudes & Approaches Toward Transgendered Individuals

As many as 1% of all babies born in this country present with ambiguous genitalia, making it difficult to categorize them as either boys or girls (Williams, 2002). The majority of these infants are operated upon, to “repair” the biological anomaly and to assign a clear gender. Neither these individuals, known as intersexed (and previously as hermaphrodites), nor their families are given much support in the way of counseling. Instead, the parents are advised NOT to speak of the condition to their children, and in fact, to treat them only as if they are the gender assigned to them during surgery.  Many of these children grow up to experience severe psychopathology as a result of confusion, silence, secrecy, and dysphoria (Williams, 2002).

Throughout contemporary history, those people who exhibit traits or behavior outside society’s current norms have been considered not just different, but abnormal, and thus pathologizable. The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been the prevailing standard for determining mental health conditions and although supposedly based on scientific and statistical analysis, it has often been used as a political tool for social control (Istar Lev, 2004).  Tarver (2002) supported this assertion when he said, “the persistence of classifying transgender identity or cross-dressing behavior as an aberrant mental disorder may be a result of negative social views rather than empirical justification” (p. 97). Because transgenderism is still classed as a gender identity disorder in the professional literature, many clinicians assume pathology in anyone presenting as transgendered. However, it has also been shown that the presenting symptoms of dysphoria, depression, and suicidality may have less to do with an individual’s gender variance, per se, but instead may be related to the stress of living in a culture that either doesn’t recognize they exist, or when they do, stigmatizes, discriminates against and victimizes them because of their gender variance. Many TGs have suffered further mental distress as a result of ignorant or non-compassionate clinicians who refuse to treat them or who insist on diagnosing them with gender identity disorder and then treating them from that assessment, as opposed to treating them for the concerns they present. [Istar Lev, 2004].

Theories of Identity Formation, Issues, & Challenges

The literature on homosexual identity development has helped inform the current attempts to discern identity development among transgendered peoples. Unfortunately, this population continues to face isolation, rejection, and stigmatism evident in the lack of safe public spaces, the lack of public restrooms, the lack or difficulty of obtaining accurate identification documents, and the lack of career counseling options specific to their unique situations and needs.

Sexual Minority Identity Development & Transgender Emergence

Although the identity developmental process differs for lesbians, gay men, bisexuals, and transgendered people, they all experience “the development of a sexual identity different from most, if not all, of those around them” (Fisher & Ackman, 2002, p. 2). In addition to the typical developmental stages and tasks experienced by most adolescents, sexual minority youth additionally go through a process involving increasing levels of self-awareness and assimilation in the surrounding culture, which leads them to become aware of their difference from their peers. This awareness triggers a series of reactions or stages that include denial and shame, but may ultimately lead to pride, anger, and eventually to a mature integrated sense of identity, wherein their sexual identity is only one part of their overall identity (Fisher & Ackerman, 2002).

Homosexuals and bisexuals experience a “coming-out” process, whereby they come out of the heterosexual assumption about themselves to themselves and others. Istar Lev (2004) has labeled the parallel process for transgendered people as “emergence”. She said that while the processes have similarities and share certain stages (i.e., initial confusion, denial and shame, disclosure to significant others), those who are emerging as transsexual must progress through the additional stage of actually transitioning to a new form (with or without surgery). Many transgender people who progress to this stage do not have the option of “passing” or remaining “in the closet” (Istar Lev, 2004). The stages of transgender emergence, as delineated by Istar Lev, proceed as follows (although not everyone goes through every stage, and some people regress over the course of their identity developmental process): Awareness; seeking information/reaching out; disclosure to significant others; exploration: identity and self-labeling; exploration: transition issues/possible body modification; and integration: acceptance and post-transition issues.

Unfortunately, during and after this transition or emergence process, many TGs have to contend with the fact that although they may have come to a place of acceptance and resolution within themselves, they still live in a society that doesn’t understand or accept them, that often ignores their presence, and does not provide equal rights to those who change their gender identity and expression.

Lack of Safe Public Space

The homosexual community, particularly gay men, have succeeded, in many cities, to create an area that is predominantly homosexual in demographics (Doan, 2007). Within these types of areas are also found a predominance of gay or gay-friendly business owners, and clubs and other spaces that specifically cater to this population. These areas and spaces become places where those who identify as homosexual can congregate in public and feel relatively safe from the victimization and stigmatization often present in places that are predominantly heterosexual, where “we are free to be ourselves and where our identities are never a justification for discrimination and violence” (Mottet & Tanis, 2008). While transgender people often seek out these spaces early in their transition process, these spaces are not always welcoming or comfortable for TGs (Doan, 2007). Due to the prevalence of hostility and violence toward TGs, it is imperative that they find safe public space. “Most transgender people are painfully aware that their visible transgression of gender norms makes them one of the most vulnerable and least protected communities in social space” (Doan, 2007, p. 61). The inclusion of trans people in “queer” space is apparently enough of a challenge and an issue that The National Gay and Lesbian Task Force Policy Institute teamed up with The National Center for Transgender Equality (Mottet & Tanis, 2008) to create a handbook on how to make LGBT organizations more trans-friendly and trans-inclusive.

Issues with Use of Public Restrooms

As noted earlier, many companies are making arrangements and changing policies to alleviate the “restroom issue” associated with transitioning individuals. However, these policies do not apply to other public restrooms, and certainly not all employers are making such accommodations. The issue seems to be a fear that allowing transgendered people access to women’s restrooms will put women at risk of sexual harassment or assault, since any man could put on a dress and walk right in. There is also the implication that transwomen do not have impulse control and will stare at or take advantage of the other women in the bathroom or locker room, which demonstrates the mistaken assumptions that gender identity is equated with sexual orientation, and that transgendered people are somehow different in a more fundamental way (Weiss, 2006).

Not only do transfolk have to deal with the stares and discomfort of people who don’t approve of them using the restroom consistent with their gender identity and expression, but they also sometimes get arrested for doing so, and the cops making the arrests often use slurs and disrespectful comments to the TG person (Weiss, 2006). The bathroom issue is particularly important because of its very “visible and unavoidable occurrence” (Pepper & Lorah, 2008, p. 339). However, it can also be an excellent starting point for counselors working with transitioning individuals to help them deal with the “underlying fear, anxiety, and anger” (p. 339) associated with the difficulty of transitioning.

Multiple Minority Challenges

People who are transgendered as well as having an additional minority status pertaining to their race, ethnicity, age, or some other factor have additional mental health and discrimination challenges. “Many ethnic lesbians and gay men report that adjusting to being a double minority is much more difficult than being either an ethnic minority or a sexual minority” (Kimmel, 2002). Unfortunately, there is very little empirical research regarding multiple minority challenges for sexual minorities, and almost none for those who identify as transgender. Hernandez (2008) pointed out that there has been little attention paid to how transgendered people of color experience their transition, and how the issues of racism impacts their experience. “Trans people of color are finding that they have an extremely different relationship to gender transition than white people” (Hernandez, 2008, ¶ 11). Interestingly, many of the transmen of color that Hernandez interviewed found the gender transition a relatively smooth process because they were prepared for the various problems and challenges associated with transitioning, but they did not anticipate the problems they would encounter as black men.

Problems Resulting from Discrimination

Suicide and hate crimes are two of the worst problems resulting from the discrimination and oppression of the transgender population. Another problem resulting from discriminatory attitudes is the assumption that anytime a transgender person seeks help from a professional, that it must be their gender identity that is the root or cause of their problem.

The suicide rates among lesbian, gay, and bisexual populations is higher than in heterosexual populations (Clements-Noelle, Marx, & Katz, 2006). While some have postulated the increase is evidence of the increased mental instability of homosexuals, another theory asserts that the higher rates of discrimination and victimization are what lead to increased tendencies to commit suicide (Clements-Noelle, Marx, & Katz, 2006). These authors go on to support this assertion by citing research that shows that discrimination leads to anxiety and depression, classic hallmarks of suicidality. Clements-Noelle, Marx, and Katz found in their study that many of the risk factors for suicide among transgender individuals mirror those in the LGB population (including younger age, depression, substance abuse, and a history of forced sex). Additionally, gender-based discrimination and victimization were found to increase the risk for attempted suicide. Unlike studies done of the suicide risk in LGB populations, however, higher levels of self-esteem did not mitigate the risk in transgendered persons, likely because transgendered people are subjected to even more intense discrimination and victimization than their LGB counterparts.

Several suggestions for alleviating this problem were put forth by the authors of this study. Legislation prohibiting discrimination should include specific wording to protect gender identity and expression. Counseling, suicide assessment, and referrals for those exhibiting signs of transgenderism need to become standard procedure for mental health professionals. “In addition, peer-based outreach interventions may be particularly useful for reaching this highly stigmatized and hidden population” (Clements-Noelle, Marx, & Katz, 2006, p. 64).

Doan (2007) described how transgendered people are subject to violence, sometimes known as “gender-bashing”, in addition to the various forms of discriminatory behavior they face. She related several recent surveys and studies that found over half of the transgender population has been the victim of harassment or violent physical assault directly related to their gender identity or expression. Approximately one to two transgendered people have been killed each month since 1990 (Doan, 2007). In 2002, 27 murdered transgendered people were commemorated in a community activist event (Human Rights Campaign, n.d.). Many hate crimes against TGs are not reported, and when they are, law enforcement often does not handle the report adequately (Human Rights Campaign, n.d.).

Again, making sure that anti-discrimination bills contain specific language making transgendered individuals a protected minority would begin to help this problem (Doan, 2007). In addition, more training for law enforcement would help (Human Rights Campaign, n.d.).

A third problem related to discriminatory attitudes is the assumption that when a transgendered person seeks counseling, the cause or root of all their problems is related to their transgendered status. Sometimes, because of the DSM’s description of gender identity disorder, TGs may be misdiagnosed or wrongly pathologized. Hale (2008), in reviewing a book by Viviane Namaste, a Canadian transsexual activist, shared Namaste’s assertion that sometimes the focus on gender identity “obscures other critical issues” (p. 204). TGs may seek counseling for issues directly related to their transition or new identity, but sometimes they seek help for other aspects of their lives, and it is a mistake to assume that their transgenderism is at fault for all their difficulties.

Personal Growth & Challenges

This project has helped to illuminate some assumptions I was harboring about this population, and I learned more about how transgender people view themselves and how they would like to be viewed by others. For instance, I interviewed Raven Kaldera (personal communication, November 4, 2008) for this paper and one of the questions I asked him was whether he was pre- or post-operative. He told me that it is generally considered rude to ask this question, since it is intimate, personal information that I have no need to know. We don’t ask others about the state of their genitals, and so just asking this question is intrusive and can convey the assumption that the questioner is “one of those people who is obsessed with the genital surgery issue” (R. Kaldera, personal communication, November 4, 2008). I also learned from Kaldera and other sources that the appropriate way to refer to a transgendered person is to use the pronoun and name consistent with their gender expression. If someone is presenting themselves as female (even if they don’t look very female to the viewer), it is not appropriate to refer to them using male pronouns. Those who persist and “blatantly use the wrong pronoun in order to rudely state their opinion of the transgendered person’s gender” are acting as “jerks” and should be treated as such, according to Kaldera.

I also learned that although LGB people and TG people are often lumped together into the same community or population, there are differences, and there are also people among both groups who do not wish to be equated with the other (Equality Network, 2007). It is also true that even in organizations that use the LGBT acronym, TGs are often excluded from the discussion and accommodations (Mottet & Tanis, 2008).

Finally, there is a difference between gender identity and sexual orientation. Sexual orientation refers to the sexual attraction to others, while gender identity refers to one’s internal sense of what gender they are. Gender variant people can be homosexual, heterosexual, bisexual, or asexual (Jones & Hill, 2002; Mottet & Tanis, 2008).

I have several personal competencies that suggest that I may be able to work effectively with transgender clients. I have always been open-minded and accepting of diversity, and I am a sexual minority myself, as a bisexual, polyamorous person. I’m already familiar with some of the discrimination and challenges associated with being a sexual minority. I’m not “turned off” by the concept of transgenderism and am willing to learn more. Additionally, my personal spirituality allows me to accept the idea of gender-fluidity. As a Buddhist-influenced Pagan, I worship some of the old gods who sported both sets of genitalia or who engaged in cross-gendered behavior. I also believe that we all have access to both masculine and feminine energies.

Of course, there’s always more to learn, and this research has shown me how much both I and my future profession have yet to learn about this stigmatized and under-served population. I plan on contributing to the academic/professional literature on transgender issues and working with transgendered clients to expand the clinical understanding of the issues unique to this population (Israel, Gorcheva, Walther, Sulzner, & Cohen, 2008). I plan on getting specific training to assess and assist in transgender transitions (Britton, 2005). And I plan on learning how to communicate effectively with transgender clients and teaching other clinicians how to do so, as well (Samuel & Zaritsky, 2008).


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