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Transgenders, Vestidas, Hijra, Kathoey

Responding to Cultural Expressions of Gender Identity

Stacee L. Reicherzer, Jason L. Patton and Megan Steves

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A presentation of the Texas Association of Gay, Lesbian, and Bisexual Issues in Counseling (TAGLBIC)

It is important to note…that sexual and gender identities that are not accepted by Western civilization are not necessarily unnatural….human societies exhibit a wide range of norms and beliefs about what natural sexual or gender identities may be and be about. Forms of sexuality considered to be perverse by one social or cultural group are considered to be right, good, useful and natural by others and can indeed serve useful purposes (i.e., enhance survival and well-being.)

Stephanie Wickstrom (2005): The Politics of Forbidden Liasons

Overview

• A Western Postmodern model of sex and gender

• The historical development toward standardized care for transgenders by the Western medical community

• The Gender Identity Disorder Diagnosis and World Professional Association of Transgender Health(WPATH) Standards of Care (SOC)

• Non-Western paradigms of gender diversity

• The impact of Western colonialism on global cultures

• Vestidas of Mexico and the United States border region

• Hijra of India

• Kathoey of Thailand

• Using cultural distinctions in counseling gender diversity

• About the authors

A Western Postmodern model of sex and gender

• Birth Assigned Gender- a person’s apparent biological sex as assigned at birth. In the U.S., birth-assignment is traditionally made by the doctor or midwife who performs delivery.

  Male___ Female___

• Sex- The genitalia a person has. This may be male, female, or a blending of the two. It is demonstrated as a continuum of bodily possibilities.

  Male I--------------------------------------I Female

Adapted from Whalley (2005)

A Western Postmodern Model of Sex and Gender

• Gender Identity- A person’s core sense of being male, female, or a gender that is in-between or both. This is treated as a continuum of identity possibilities, which may either fluid or fixed.

  Male I--------------------------------------I Female

• Gender Expression- External characteristics and behaviors that are socially constructed as either male or female: clothing style, demeanor, speech patterns, etc. These are treated as historically-based, and mobile over time based on cultural considerations of masculinity or femininity. This also is represented as a continuum of possibilities.

  Masculine I--------------------------------------I Feminine

Adapted from Whalley (2005)

A Western Postmodern Model of Sex and Gender

• An alternate way of understanding gender identity and expression: Non-Mutually Exclusive Gender, expressed as a Dual Continuum. Maleness and masculinity is not treated as opposite from femaleness or femininity. Rather these appear as equal possibilities that can be experienced in a fuller range of gender possibilities, in which an individual identifies multiple characteristics of each gender; or alternatively, few characteristics.

A Western Postmodern Model of Sex and Gender

• Sexual orientation- The sex or sexes to whom a person tends to be sexually and otherwise relationally attracted. Sexual orientation maintains a variety of experiences related to body-type attraction, relational dynamics in which romantic feelings occur, and other forms of experience that bring people into relational-sexual connection. It is treated as a separate but parallel continuum from the gender continua.

Transgender Issues: Contemporary US Culture

• The medical model of Gender Identity Disorder (APA, 2001), and transsexualism (Benjamin, 1966) have been the dominant models used for describing experiences about transpeople by the medical community

• Beginning in the 1990s, the term “transgender” (Feinberg, 1996, 1998) came to be used as a self-description by transgenders who used a postmodern reframe of the medical model

The historical development toward standardized care for transgenders (Reicherzer, 2006)

• 1920s: first sexual reassignment surgeries (SRS) performed in London on two “transvestite homosexuals.”

• 1920s to 30s: Magnus Hirschfield’s Institute of Sexual Science in Berlin

• 1947: David Cauldwell coins term “transsexual”

• 1952: George Jorgensen becomes Christine

The historical development toward standardized care for transgenders (Reicherzer, 2006)

• 1962- UCLA opens the Gender Identity Research Clinic- endeavored to teach gender conformity to children

• 1966- Harry Benjamin published The Transsexual Phenomenon

• 1966- Johns Hopkins University began providing SRS, first of many gender clinics to do so (each with its own standards)

The historical development toward standardized care for transgenders (Reicherzer, 2006)

• 1968- The DSM II is published to include “Transvestism” and “Sexual Orientation Disturbance [Homosexuality]”

• 1979- Harry Benjamin organized first Harry Benjamin International Gender Dysphoria Association (HBIGDA)

• 1980- DSM III includes in “Psychosexual Disorders” a section of “Gender Identity Disorders,” uses psychodynamic language in describing how the experience ‘seems always to develop in the context of a disturbed parent- child relationship ...” (p. 263).

The historical development toward standardized care for transgenders (Reicherzer, 2006)

• 1987- DSM III-R, Gender Identity Disorders are now in a category called “Disorders Usually First Evident in Infancy, Childhood, or Adolescence”- “weak reinforcement behavior” (p. 73) by parents is seen as a predisposing factor

• 1970s to 80s- many private surgeons begin providing SRS.

• 1994- DSM IV removes predisposing factors, several differential diagnoses

• 2000- DSM-IV-TR modifies language once more, terms “autogynephilia” in describing MTF sexual preoccupation

• 2006- HBIGDA changes its name to the World Professional Association of Transgender Health (WPATH)

The Diagnosis: Gender Identity Disorder (APA, 2000)

• “Strong and persistent cross-gender identification”

• “Persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex”

• Does not include physical intersex condition

• “The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning”

World Professional Association of Transgender Health (WPATH) Standards of Care (SOC)

• Standards of Care provide recommended transgender medical and mental health care

• Epidemiological Considerations

• Diagnostic nomenclature, which now uses DSM-IV-TR language

• The role of mental health professional

• Work with transgender children and adolescents

• Work with transgender adults

Understanding WPATH Standards of Care

• Mental health guidelines for medical recommendations for hormone replacement therapy

• Medical effects of hormones

• Require a real-life experience of one year prior to surgery

• Guidelines to determine readiness for genital Surgery, breast surgery

• Post- Transition Follow-up

Important Considerations

• Both the medical model of Gender Identity Disorder and the Postmodern model of Gender and Sexuality represent Western paradigms

• A number of expressions of gender identity have existed in other cultures, throughout human history

• Global expressions of gender identity have been impacted, at varying degrees, by Western colonizing of aboriginal culture and thought

European and United States World Conquest

• Colonization

• Forced adherence of aboriginal cultures to dominant European ideologies, including system of gender binarism

• Eradication of native cultures, religions, systems of beliefs

• This has led, in many instances, to the domination of White-oriented capitalist culture over indigenous cultures

Consideration of Colonization

• What is colonization?

  • The imposition of one culture’s worldview on another

  • The imposition of one system of language as a means of organizing the universe

  • Erasure of other cultures’ traditions, speech communities

Three Global Expressions of Male-Female Identities

• Vestidas of Mexico and the U.S. Border Region

• Hijra of India

• Kathoey of Thailand

• Important research limitations:

  • These groups’ experiences have been only minimally explored by anthropologists, even less by mental health professionals- limited data for each group

  • Most of the previous research and historical accounts have been collected by researchers from outside the group, and reflects the researchers’ biases about sex and gender

  • The three researchers of this work are White counselors, Queer- identified, who live in south central Texas- outside of these three cultures

Vestidasof Mexico and the U.S. Border Region

• Who are vestidas?

• Gender and Sexuality in Pre-Hispanic Mexico and today

• Influential factors

• How vestidas view gender and sexuality

• Living as a vestida

Who are vestidas?

• Male born

• Live as women, or simply identify as vestida (the Spanish word for “dressed”)

• Very sexualized gender roles that are considered effeminate: high heels, short skirts, heavy make-up (Prieur, 1996).

• Vestidas gender identities are closely linked to sex roles: they tend to be exclusively male-attracted, and generally prefer to be penetrated in anal sex (vestidas do not generally prefer to penetrate). This is thought to be consistent with a female role (Thing, 2004).

• While difficult to trace precisely, the history of vestidas may be rooted in pre-Colonial Mexico (Carillo, 1999)

Fluid Gender and Sexuality in Pre-Colonial Mexico

• Difficult to trace due to author bias- many historical documents were written by Spanish conquistadores and missionaries, who used derogatory language to describe Native traditions

• Ritualized and Institutionalized sexual practices, gender blending were practiced by Mayans and some native cultures in Central Mexico (Carrillo, 1999; Castaneda, Brindis, & Castaneda-Camey, 2001).

• Many practices were linked to healing and deities

• Xochihua- Nahuatl word of reverence for people of blended genders (Sigals, 2005)

Current Mexican Attitudes about Gender and Sexual Blending

• Machismo (Carrillo, 1999; Castaneda, 2001) reflects a male attitude of demonstrable masculinity, according to Mexican social norms. Traditionally, machismo is not compromised in sex with another male, so long as the macho male does not play a feminine sex role (is not penetrated anally by another male.) So long as a male is penetrating, he retains machismo.

Outside Influences

• U.S. culture, English language has significant influence on Mexico

• More affluent Mexicans, Mexican-Americans who have access to higher education resources have adapted U.S.-English-based understandings of gender and sexuality

• Traditional understandings of sex and gender are more common for people who have had less exposure to the U.S. culture (Prieur, 1996; Thing, 2004)

Cultural Considerations of Mexican-American Gender/Sexual Diversity

• Degree of saturation in English-based linguistic understandings of gender and sex

• Degree of colonization, exposure to Eurocentric values (oftentimes driven by higher SES)

• Linguistic differences, terminology varying by region of Mexican or Mexican-American origin

• Cultural differences varying by region (Mayan regions, for example, continue to recognize third gender.)

• Age

How vestidas view gender and sexuality

• Homosexual/Pasivo- A natal male, whose male attraction forms a gender identity marker; primarily (or exclusively) performing oral sex, or receiving anal sex from a male Activo. Is understood as female-gendered sexual orientation.

• Vestida- A natal male, Pasivo, who dresses in femme attire some or all of the time, and often has bodily augmentation (black market silicone, peanut oil, mineral oil).

• Joto, Maricon, Puto- Generally, derogatory slurs for Pasivos, Vestidas; a slightly different connotation than the English word “fag.”

How vestidas view gender and sexuality

• Activo, Mayate, Chichifo, Picador- A natal male, whose gender identity is seen as macho male, who exclusively performs penetration on a pasivo. In this model, because he is never penetrated, he is not considered homosexual (and is not generally referred to as joto, maricon, etc.) Activos often maintain their primary romantic relationships with natal females.

• Bisexual- Generally, a male who performs both penetrates, and is penetrated by another male.

Living as a Vestida (Prieur, 1999)

• Few economic opportunities- many work as hairdressers or prostitutes

• Emphasis in cultural norms of beauty, grace

• Emphasis in sexual desirability to mayates

• La familia, reverence to one’s mothers remains an important part of the person’s life

• Vestidas often live in close communities, share living space with other

  vestidas

• Vestidas in their societies may be called names or slurs, but overall, there is a degree of cultural acceptance (vestidas who were interviewed consistently stated that they had never been the victims of physical violence because of their gender)

The Lives of Hijras of India

• Historical Perspective

• Effects of Colonization

• Roles in Society

• Media Representations

• Author Bias

• Looking Towards Tomorrow

Historical Perspective

• Born male sex-type (with male genitalia)

• Defined as “neither man nor woman”

  • Many experience gender identity as “like women”

• “Origin myth” explains caste’s origin by linking caste to Hindu deities

  • Deity Ram blessed those “who were not men and not women”

  • Alternative gender roles of deities and mythic figures create positive identity for hijras

• Member of traditional social organization who worship goddess Bahuchara Mata

• Population in north approx. 50,000 (Nanda, 1990)

Historical Perspective (Nanda, 1990)

• Born “Besarm” or without shame

  • Intimidation arises from fear of conveyance of shame on non-hijras

• Emasculation Ritual

  • Secret ritual removal of genitals

  • Sanctions role as performers; links to Shiva and Mother Goddess

Effects of Colonization

• British believed that homology between sexual and political dominance fundamental

  • Redefined construction of power and subjectivity

  • Virile (British) masculinity legitimized colonization over (Indian) femininity (Reddy, 2003)

Effects of Colonization (Reddy, 2003)

• At turn of the century Indian nationalists construct a new masculinity

  • Based on spiritual not bodily, physical strength

  • Ghandi calls for “dissident androgyny”

    • Ability to transcend male/female dichotomy

      • “God’s Eunuch” both feminine and masculine

      • Sexual renunciation central to transformation into powerful figure

Roles in Society (Nanda, 1990)

• Roles in Society

  • Embrace the Mother Goddess identity; fertility

    • Traditional occupation as performer on auspicious occasions

      • Perform as dancers at weddings and births

        • Can give power to create new life to male child

        • After marriage ceremony blesses husband’s fertility

        • Ritual reinforced by fear of shaming or curse of infertility to those that do not allow performance/offer money

  • Sex trade has become practical occupation

    • Prostitution

    • May also take “husbands”

Media Representations: Cinema (Chawda, 1997)

• India represents the most liberal South Asian cinema

  • Concept of defending a “lifestyle” in cinema non-existent

  • Pre-90’s depictions:

    • Homophobic, drag roles, background entertainers

    • Seen as comic relief or self-loathing presence

    • At best supporting actors

• Mid to Late 90s

  • Emergence as integral characters

  • Challenge conventional roles using characters in ordinary, human settings

    • Mani Rathnam’s Bombay, Mahesh Bhatt’s Tamanna

    • Gang leaders, Heros, Pimps

Media Representations: Literature (Vanita, 1997)

• Traditional non-victim narratives and “opting out” of heterosexual structures

  • Bhakati Movement in India's medieval era (eleventh–eighteenth centuries)

    • Populist literary form composed by poet-saints of all castes and both genders

    • Criticized caste, class, religious differences

    • Men and women refused to be good spouses and parents

    • Altered gender categories by stripping them of meaning “Suppose you cut a a tall bamboo in two; make the bottom piece a woman, the head-piece a man; rub them together until they

      kindle: tell me now the fire that’s born, is it male or female, O Ramahatha?” (Twelfth century Kannada Virashiva poet Dasimayya)

Media Representations: Literature (Vanita, 1997)

• Contemporary Authors

  • Narrative of power and creativity

  • Use of animals blurs boundaries of race, gender, culture

    • Suniti Namojoshi chooses beastly persona not inherently inferior to human; same spirit reincarnated as human and non-human bodies

    • Vikram Seth draws on old tradition of friendship between human and non-human animals

      • Question of “she” or “he” meaningless by way of species sameness and difference to mask (i.e. are two mice both female? are the elephant and mouse both male? )

Author Bias

• Serena Nanda Neither Man nor Woman

  • Cited as prominent study of hijras

    • Indian author’s claims of openness to gender expression questionable

      • Use of pejorative or shaming language

        • Described as, “ [individuals who seem] bizarre”

        • In describing performance: “twirled in a grotesque, sexually suggestive parody”

Author Bias

• Anne Ogborn’s Saheli!

  • American transgender woman adopted hijra identity through cultural immersion

    • Attempts to equate hijras with U.S. expression of transgender identity

    • Ignores different context, cultural meanings

      • India’s “third gender” society seen as primordial; foundation of Western gender formulation (Towle & Morgan, 2002)

Looking Towards Tomorrow

• Political gains

  • New emerging force in Indian politics in 90’s

    • Elected at local, state and national levels

  • Revolt against upper-caste politicians

    • Seen as “Neutralists” who rise above nepotism & fighting typical of men & women

    • More sensitive to issues of poverty and social stigma

    • Popular campaign slogan “You don't need genitals for politics; you need brains and integrity.” (Reddy, 2003)

Kathoeyof Thailand

• Traditionally male born

• Portray themselves as women and live, in many ways, like them. Here, Kathoey’s views on gender and what it means to be a woman are much like they are in the West (Winter & Udomsak, 2002).

• They do not hold status as women, however, they are seen as phet thi-sam: the third sex (Totman, 2003).

• Some Kathoey prefer to be called sao praphet song or phuying prahphet sam: a second kind of woman (Winter, 2006).

The Place of Kathoey in Thai Society

• There are somewhat conflicting ideas on the history of Kathoey

  • Some believe Kathoey was originally used to describe hermaphrodites [sic] (Jackson, 1998)

  • Others believe Kathoey has described transgender males for centuries (Totman, 2003)

• In Thai Buddhist belief systems, Kathoey are reincarnated people who, in previous lives performed some acts of sexual perversity [sic]. Through kamma or karmic consequences, a soul is born to the life of a Kathoey. Thai people are tolerant and/or kind to Kathoey because there is a widespread belief that all souls will be Kathoey at some point (Totman, 2003).

The Place of Kathoey in Thai Society

• Kathoey believe society and their family members hold favorable attitudes towards them (Winter, 2006).

• In contrast to this, many in Thai society see the role of a Kathoey as one of suffering: where they are pitied because it is believed they will not find true love and will be tormented by wanting and not being able to have children (Totman, 2003).

• There is some social opprobrium based on their femininity and sexual passivity, rather than perceived homosexuality, though (CPAmedia, 2002).

The Place of Kathoey in Thai Society

• Kathoey can be found in many levels of society and the roles they fill vary accordingly (CPAmedia, 2002).

• For centuries, Kathoey lived primarily in rural areas, but have more recently moved to find work in the more populous cities of Phuket, Bangkok, Chiang Mai, and others (Totman, 2003).

• Still many live in smaller villages where they are visible performers as female impersonators in likay folk operas or in “transvetite beauty contests” (CPAmedia, 2002).

The Place of Kathoey in Thai Society

• Kathoeys exist in upper echelon roles as businesspersons, actresses, etc (CPA media, 2002). However, the changing face of Thai society is becoming less tolerant of Kathoey visibility to the outside world (Totman, 2003).

• Kathoeys are often performers in larger cities where they do performances which can be likened to drag in the west. They often are hired as greeters and serve fixed roles in bars and clubs (Totman, 2003).

Kathoeys Working in the Entertainment Industry

• Bars pay greeters, wait staff, and performers very little. As a result, small communities of Kathoey will support each other while trying to earn money for themselves and to send home to their families.

• There may often be a natural progression from being hired as a greeter in a bar to personal entertainment, which often includes some form of prostitution. Such personal endeavors are often encouraged by employers.

• Tips received make up the bulk of the income of a Kathoey entertainer. Most Kathoey in the entertainment industry believe tips are directly related to beauty and femininity.

• Kathoey who make the most tips experience a mixed reaction from their peers. These reactions run the gamut from envy to sabotage.

  (Totman, 2003)

The Life of a Kathoey

• Kathoeys often come to a realization that they want to live life as a phuying prahphet sam, second kind of woman, very early in life. Many tell their families as preteens that they wish to become Kathoey (Totman, 2003).

• Nun Udomsak, a Thai transgender researcher, relays her personal experience as beginning hormones, which are available over-the-counter in Thailand, at 13 (Udomsak, 2002).

• Often, it is the goal of a Kathoey to earn enough money to complete Sexual Reassignment Surgery (Totman, 2003).

The Struggle of Kathoey for Rights and Recognition/

• Totman (2003) describes the government of Thailand as trying to downplay the role of Kathoey in Thai life. In a sense, this is to promote a more “cosmopolitan,” and essentially westernized image.

• Udomsak (2002) believes the Thai people as a whole do not want Kathoey in jobs, like tour guides, visible to the outside because “they give an unfavorable image of Thailand.” Because of this, people like Udomsak with university degrees are having increasingly more trouble obtaining a “respectable occupation.”

The Struggle of Kathoey for Rights and Recognition

• However, gender cannot be changed on any Thai legal documents even Sexual Reassignment Surgery

• There is no enumerated legal protection from discrimination for Kathoey

• Organizations for the promotion of Kathoey rights, like Si Chompoo, are working towards legal and social change

• Thailand is reported as having a RED (Respect, Equality, and Dignity) score for transgender people of 6/20.

  (Transgender rights: Thailand and the rest of the world compared)

Global Gender Diversity Redefines Care Guidelines

• Reconceptualizing:

  • Rethinking gender, movement from a disease model

  • Not to be seen as “sick,” “crazy, ” or “aberrant”

  • Moving beyond gender as a binary experience of male or female

  • Understanding that high functioning gender blended people have existed throughout history

Global Gender Diversity Redefines Care Guidelines

• Understanding social pain:

  • Consider that pathologizing gender diversity as a disease creates stigmatization and marginalization

  • Consider the contextual features of what is considered mental illness

  • Understand the role of social reaction to gender diversity in a gender binary culture

Global Gender Diversity Redefines Care Guidelines

• Owning the profession’s role in stigmatization

  • Understand the bias that informs the system of diagnosis for GID

  • Understand that the APA, in developing the diagnosis of GID, functions to reinforce societal biases

  • This reinforcement feeds mistrust that many gender blended people feel about the mental health profession

Global Gender Diversity Redefines Care Guidelines

• The helping relationship

  • Gender blended peoples’ expectations of mental health are informed by prior experiences, as well as relational images of professionals as representative of a White, biased culture

  • Differences exist in the reasons gender-blended people seek therapy, which inform expectations

  • Therapists function to support client’s naming of their gender experiences, we do not do it for them

Global Gender Diversity Redefines Care Guidelines

• Therapists as resources:

  • Therapists should not expect clients to teach them everything about gender

  • Therapists educate other therapists, teachers, law enforcement, and doctors

  • Therapists know community resources that are helpful to gender-blended persons, including familiarity with ethnic community resources

Global Gender Diversity Redefines Care Guidelines

• Therapists as resources:

  • Therapists know WPATH SOC

  • Therapists assure that doctor referrals are credible

  • Therapists advocate for equality in all expressions of gender

Global Gender Diversity Redefines Care Guidelines

• The person of the therapist:

  • The therapist is honest about personal values, own biases without “playing headgames”

  • The therapist sees the gender client’s humanness, not just the person’s gender

  • The therapist shares with the client the therapist’s model of gender, how the therapist conceptualizes it

Global Gender Diversity Redefines Care Guidelines

• The person of the therapist:

  • The therapist is active in learning about gender issues, and demonstrates care through actions

  • The therapist and the client talk frankly about their relationship in a power structure that is established by WPATH SOC, and the need for therapist as diagnostician of GID, for clients who seek SRS

About the Authors:

Dr. Stacee L. Reicherzer, LPC, NCC is a gender specialist at Waterloo Counseling Center in Austin, TX; an adjunct faculty for Our Lady of the Lake University; and a part-time faculty of Walden University. Dr. Reicherzer has produced numerous publications and workshops on transgender issues, and is the President of the Texas Association of Gay, Lesbian, and Bisexual Issues in Counseling (TAGLBIC). She can be reached at: 512-444-9922 ext. 307; drstacee@mac.com

Megan Steves, MA is a feminist therapist at the YWCA of Austin. Ms. Steves has been active in organizing GLBT social justice efforts on two college campuses, and having completed her MA in Professional Counseling in December 2006, has recently become active in professional workshops that advance rights for all persons of gender and sexual diversity. She can be reached at: mksteves@gmail.com

Jason Patton, MA, LPC-Intern is a gender specialist at Waterloo Counseling Center in Austin, TX. Mr. Patton has published research of GLBT issues, with emphasis in higher education settings. As Community Education Coordinator for TAGLBIC, Mr. Patton routinely gives lectures and workshop about gender and sexual diversity, throughout south central Texas. He can be reache at 512-444-9922 ext. 324; jason-patton@austin.rr.com