A transsexual is someone who feels that their true gender identity is not the same as their physical sex.
The old medical definitions
The term transsexual was coined by Dr. Harry Benjamin in the 1950s and used in his book The Transsexual Phenomenon.
The DSM-IV prefers the term Gender Identity Disorder or GID, insinuating that there is something "wrong" with anyone who feels their body's sex doesn't match their mind's gender identity. The people who contributed this definition also seem to have a bit of trouble differentiating between gender identity and sexuality. Similarly, many surgeons who mutilate intersexed babies believe they are successful only if the child grows up into a healthy, straight adult of a binary sex and gender identity.
Transsexuals used to be given electric shock "therapy" to try and convince them they were really deluded about their gender identity. Needless to say, this method yielded no positive results.
The current scientific understanding
There seems to be an ever increasing amount of evidence1 showing that transsexual women (those that identify as women despite being biologically male) have the same sized hypothalamus (and other sexually dimorphic attributes of the brain) as cissexual women (that is, non-transsexual women, who are biologically female), which is drastically different to that of men. This means there may well be some truth to the notion that transsexuals really are the neurological sex we believe ourselves to be.
The life of a hypothetical transsexual
The basic life of a transsexual is currently something like this: You're born, and someone says "It's a boy!" or "It's a girl!", only it isn't. Either you get into trouble for doing inappropriate things and wearing inappropriate clothes for your sex, or you live happily for a while, blissfully unaware that anything's askew.
Then puberty hits. You may be depressed, even suicidal (there's a reported suicide attempt rate of 41%2 amongst the transsexuals that lived long enough to fill in a survey, so I dread to speculate how many transsexuals successfully killed themselves, forever remaining unknown), and might self harm every now and then.
Eventually you'll discover that what you've been feeling is a known condition, and find a psychiatrist who can help you and give you the right hormones. Then you transition, finally living and presenting as your real self, and hopefully eventually look like you should too. This can take a while and/or cost a lot. At this point your family may disown you and your friends may ostracise you, but don't worry. If they do, you'll get better ones who like you for who you are, not who you pretend to be. After a year of living as your true self, AKA the "real life test," you can have sex reassignment surgery (if you want to; many transsexuals now opt to be non-op for various reasons) for a mere ten thousand pounds or so. If you're lucky you might even fall in love with someone, and if they don't run away screaming or hurt you when you tell them your medical history, you can now even marry them, thanks to the Gender Recognition Act 2004. (At least, in the UK. In many countries, you still can't marry someone.)
What a transsexual isn't
- Gay Some people believe that transsexuals are simply gay and either can't come to terms with it, or want to experience straight privilege. This is patently absurd. For one thing, it ignores that transsexuals really have the gender identity that they claim. Secondly, it ignores that cis privilege can be much more important than straight privilege. Thirdly, it ignores that there's a pretty even split between straight, gay and bisexual transsexuals.2 That's a lot of ignorance!
- A transvestite Transvestism and transsexualism are completely different. The former involves wearing clothes of the opposite gender for sexual arousal. The latter involves wearing clothes of what you believe is your actual gender identity because it feels right. While it's possible that a transsexual may occasionally wear sexy clothes and enjoy it, the same is true of cissexuals3, so again, it's not the people who are different, it's the view outsiders currently have of them.
- Mad Despite what doctors used to think.
- A pervert Again, some are, like with any cross section of humanity, but transsexualism itself doesn't make you perverted. In fact, it's not even a sexuality despite the confusing name. (See "What the word means" below.)
What a transsexual is
- Male or female Transsexuals aren't always women with male bodies. Some are men with female bodies. The latter just don't get as much media attention, but they do exist.
- Shy They are most likely shy and low on self esteem, and might be low on social skills too. If you hated your body for a substantial part of your life, and had trouble differentiating between that and hating yourself, wouldn't you be?
How to tell if you're a transsexual
Unsurprisingly, a persistent desire to be the other sex is the main clue. Pretty much by definition, cissexual people don't have such a desire. While that probably goes without saying for such people, it can actually come as a surprise if you assume everyone else has harboured the same feelings and needs as yourself, which is a surprisingly common fallacy.
The main thing to make sure of is that your desire to change sex is for the sake of being the right sex. Some people get it into their heads that they want to change sex either because they've been abused as children, or because they're delusional, or to fulfil a fetish. Such people are in a minority even compared to actual transsexuals, but they do exist. They generally regret changing sex, if they actually go ahead with it.
In stark contrast, transsexuals are under no illusion that the other sex has an easier life in general, only believing that they themselves as individuals would be happier as the opposite sex. Having a body that's the wrong sex for your mind can be utterly depressing, and fixing that can indeed relieve depression caused by transsexualism.
The most obvious way to tell if you are a transsexual is to suppress your natural hormones and take the hormones of the opposite sex. Within less than a few weeks, you should either feel much, much worse... or finally feel good for the first time since puberty. You should be able to tell if you should remain on the opposite sex's hormones or not, long before irreversible secondary sexual characteristics start to set in. Alas, we're not yet at the stage where many psychiatrists take such a liberal approach.
What the word means
There seems to be a bit of confusion over the meaning of the word "transsexual."
For subjects people don't really feel comfortable talking about, they seem to pick Latin words to describe them. So you get phrases like trans (crossed) sexual (something to do with sex). Both of these words are a bit ambiguous. "Crossed" doesn't mean you cross from male to female, or from female to male; it means your gender identity is one thing and your physical sex is another, hence they are crossed. "Sexual" causes even more confusion. It means something to do with sex, but in English sex can mean several things. In this context, it doesn't mean the action of sex, it means your gender identity or your body's physical sex. So while it might sound like the word could mean "someone who gets aroused by changing from male to female," it actually means "someone whose gender identity and sex are different from each other." Hence it has nothing to do with sexuality in the sense of what turns you on, even though it has the phrase "sexual" in it.
- A. E. Brain: Transsexual and Intersex Gender Identity
- Injustice at Every Turn: a Report of the National Transgender Discrimination Survey
- Charles Moser, PhD, MD: Autogynephilia in Women