In the last century, beliefs about sex, gender, and sexuality have changed dramatically. Part of these changes has been the increased knowledge and acceptance of practices and identities that have been termed at various times transsexual, transvestite, transgender, trans, and trans*. The construction of trans categories in the United States has the potential to trouble the assumed link between sex assigned at birth and current gender identity, expand the number of acceptable ways of doing gender, and denaturalize both sex and gender. Due to the intertwined nature of sex, gender, and sexuality, increased acceptance of trans people may also fundamentally alter understandings of sexuality.
Sex, gender, and sexuality are often conceived of as natural and biologically determined, but they are in fact socially constructed systems of classification, changing over time and varying across cultures. In its current conception in the United States, sex is a social system that divides bodies into categories based on genitalia, hormones, and/or chromosomes. Although bodies actually exist on a spectrum, only two categories are usually acknowledged (female and male). Those who are not easily classifiable as female or male are termed intersex, and doctors regularly encourage hormone treatments and surgeries to compel intersex bodies to fit into established binary sex categories (Fausto-Sterling 2000). Gender is a social system that encourages conformity to a set of behaviors and identities often assumed to be caused by, and to reflect, a person’s sex (West and Zimmerman 1987). Females are supposed to be feminine and identify as women, whereas males are expected to be masculine and identify as men. Those who do not follow these norms are frequently met with social sanctions ranging from harassment and employment discrimination to sexual and physical assault (Harrison et al. 2012). Just as sex is believed to produce gender, gender presentation is thought to reflect sex. Those presenting as women are assumed to have vulvas and vaginas and those presenting as men are expected to have penises. Finally, sexuality is a social system that places people into status categories based on sexual desires, behaviors, and identity. This classification schema uses a wide variety of criteria, ranging from the type of sexual acts in which one wants to engage – what Freud (1949) termed sexual aim – to the type of person with whom one wants to engage in them with (a.k.a. sexual object). In the contemporary United States, sexual orientation is defined by sexual object, specifically the sex(es) a person is attracted to.
In current mainstream US culture, sex, gender, and sexuality are mutually reinforcing. Each can be conceptualized as a social structure on its own, but they also work together as a larger system, as understandings of each are dependent on, and naturalized by, beliefs about the other two. This is known as the sex/gender/sexuality system (Seidman 1995). Since “females” and “males” are thought to be biologically “opposite” (although they are actually much more similar than different), they are expected to behave in opposite ways (e.g., doing care work vs. physical labor) and are seen as natural sexual pairs. Similarly, understandings of sexuality are predicated on beliefs about sex and gender. If there were no sex categories, current understandings of sexual orientation would not exist, as the orientations heterosexual, homosexual, and bisexual are defined by one’s own sex and the sex(es) of one’s sexual partner(s). Gendered behaviors also support the existing sexuality system. Although sexual orientation is defined by desire for certain sexed bodies, sex (genitals, hormones, and/or chromosomes) is not visible in everyday interactions. Instead, people signal membership in a sex category by doing gender (West and Zimmerman 1987). These gendered presentations of self thus indicate whom it is acceptable to sexually desire according to the expectations of one’s sexual orientation; for example, a heterosexual man desires people presenting as women, using their gender as a proxy for their femaleness.
The academic conception of sex, gender, and sexuality as separate systems is relatively new; in the past, they were seen as one and the same. Females were thought to be biologically programmed to behave in feminine ways and sexually desire men, whereas males were believed to be biologically programmed to behave in masculine ways and sexually desire women. Deviations from the norms of gender and sexuality were thought to be caused by abnormalities of sex (Meyerowitz 2002). For example, homosexual desires were thought to be caused by a mismatch of sex and gender. In this “inversion” theory of homosexuality, males who desired men were deemed to be gender “inverts” – male bodied people with the minds of women – since women were thought to “naturally” desire men. Similarly, females attracted to women were imagined to have “masculine” brains caused by genetic “irregularities.”
As medical practitioners studied so-called deviants, the belief that gender is determined by sex shifted. Doctors puzzling through how to categorize and “treat” intersex people in the 1950s began to use the term gender to describe a set of masculine and feminine behaviors that were separate from biological sex (Meyerowitz 2002). During this same time period, medical professionals who were working with those who came be to known as transsexuals furthered the analytic distinction between sex and gender. The acknowledgment and acceptance of those assigned male at birth (AMAB) who identified as women and those assigned female at birth (AFAB) who identified as men encouraged a theorization that sex did not determine gender. This acknowledgment came at a price, however, as doctors medicalized this “mismatch” of sex and gender, diagnosing trans people as “sick” and in need of “treatment.”
In their attempts at self-legitimization, those labeled as “deviants” also pushed for distinguishing between sex, gender, and sexuality, often with dire consequences for the more marginalized members of their communities. In an attempt to reduce the stigma around homosexuality, many gay and lesbian organizations and bars became hostile toward gender nonconforming people. As the gay and lesbian rights movement became more mainstream during the 1970s and 1980s, feminine people assigned male at birth and masculine people assigned female at birth were pushed out of gay and lesbian communities (Denny 2006; Valentine 2007). Similarly, activists in transsexual communities worked to distance themselves from the stigma of homosexuality, frequently emphasizing their heterosexual identities (Meyerowitz 2002) and many cross-dressing organizations explicitly banned gay men from participating (Denny 2006). Combined with shifts in medical understandings, these practices of social distancing have unlinked gender and sexual nonconformity; constructed sex, gender, and sexuality as separate; and parsed out identities and practices that would all have previously been seen as forms of “gender inversion.” The result has been a slow increase in the acceptance of gender conforming lesbian, gay, bisexual, and transgender people, paired with the continued stigmatization of people who are gender nonconforming.
The understanding of sex, gender, and sexuality as three distinct systems is not universal within the United States, however, and many Americans still assume a biological and causal relationship between them. Although it was once thought that biology made all people assigned female at birth behave in feminine ways and desire men, many now believe, for example, that biology causes some people assigned female at birth to identify as men and/or to desire women. This has become known as the “born that way” approach to gender and sexuality. Moreover, though there has been increased acceptance of trans people and of gay men and lesbians, most males are still assumed to be masculine and desire females and most females are still expected to be feminine and partner with males. Vestiges of gender inversion theory remain, as people imagine that masculine women are lesbians and feminine men are gay. Thus, the academic distinctions detailed here have not been fully incorporated into the larger culture, and sex, gender, and sexuality are still inextricably intertwined.
Mainstream culture in the United States has become gradually more supportive of trans people. In 2009 “actual or perceived gender identity” was added as a protected category in federal hate crime legislation, and in 2014 the Justice Department announced that trans people would be protected from workplace discrimination under Title VII of the federal Civil Rights Act. The 2010s also saw a significant rise in trans characters on television and movies, as well as increased coverage of trans people in the news, including a TIME Magazine cover article in 2014 featuring an interview with trans actress and activist Laverne Cox and headlined “The Transgender Tipping Point” and the 2015 Vanity Fair cover shoot, interview, and photo spread of Olympic gold medalist Caitlyn Jenner. As trans people publicly challenge some of the dominant understandings of sex and gender, this increased social acceptance is likely to alter the sex and gender systems.
Although people have always done gender in nonnormative ways, trans categories have not always existed. Like all categories of thought, trans categories arose at particular cultural moments. The term transsexual did not come into use as meaning someone who identified as a sex other than that they were assigned at birth until 1949 and it did not widely enter the popular imagination until Christine Jorgensen’s “sex change operation” in 1952 (a practice now known as gender affirmation surgery). Although Jorgensen was not the first person to undergo such surgeries, she was the first to become widely known in the United States. Meyerowitz (2002) attributes Jorgensen’s fame to a number of factors, including being white, normatively attractive, and feminine, and the fact that, at the time, the United States was particularly obsessed with the power of science and World War II–induced questions about the proper roles of women and men. This allowed for transsexuality to emerge in the larger cultural consciousness in a way that was not as possible earlier in the century. Jorgensen’s fame then informed others of the existence of the social category and the possibility of body modifications, and led to discussions about the relationship between sex, gender, and sexuality. Her case was contentious, as some celebrated, and others condemned, her. Much of the anxiety around her centered on sexuality, as she called into question the previously easy division of people in the category of heterosexual or homosexual.
Although media coverage of Jorgensen made the general public aware of the possibility of being transsexual, access to body modification was tightly regulated by doctors. Hormone treatments and surgeries were usually only accessible through university clinics, and to qualify for surgery patients had to conform to dominant norms around gender and sexuality (Denny 2006). For example, after surgery, transsexual people were expected to be highly gender conforming and heterosexual; due to stigma around homosexual desires, transsexual patients were supposed to be nonsexual before surgery. Many clinics also required that transsexual patients not socialize with other transsexual men or women, hold a transsexual identity, or tell people about their transition. Doctors defined transsexual as a “liminal state” rather than an identity; it was what you were as you moved from one clear sex category to “the other.”
Thus, although medical understandings of transsexuality shifted beliefs about sex and gender in some ways, others remained firmly in place. Doctors introduced the idea that people can, with the help of medical technology, change sex, and questioned the necessity that all people assigned male at birth identify as men and all people assigned female at birth identify as women. However, this change in understandings around the mutability of sex was still accompanied by a belief that there were only two genders and only two sexes and that those who identified with a gender that did not “match” their sex should alter their bodies to conform to the expectation that gender reflects genitals. In subsequent years, some activists have rejected this medical model, and the term “transsexual,” as pathologizing.
Early genital surgeries were often extraordinarily painful and damaged or destroyed sexual response. In the early 1980s, following academic publications arguing that “sex reassignment operations” were ineffective, university-funded clinics closed and for-profit facilities quickly took their place (Denny 2006). With the demise of the university-run gender clinics, denial of a trans identity and disassociation from other trans people, commonly known as “going stealth,” were no longer prerequisites for access to medical technologies. Thus, trans community organizing became easier. Starting in the early 1990s, members of these communities coined a new term for themselves – and all others who did gender differently from the norm – the term transgender (Meyerowitz 2002).
The most accepted history of the term transgender is that Virginia Prince invented it as an alternative to the then-dominant terms transsexual and transvestite. It is said that she wanted transgenderist to describe someone who wanted to change gender but not have “sex reassignment surgery.” However, transgender was quickly adopted as an umbrella category that included transsexual, transvestite, transgenderist, and other nonnormative gender practices, after Leslie Feinberg used it that way in the book Transgender Liberation (1992). This history is contested, however. Williams (2014) critiques what she terms the “Virginia Prince Fountainhead Narrative” and argues that many people before Prince used transgenderism, transgendered, and transgender to describe trans practices.
Regardless of who first used it, in the early 1990s in the United States trans people began using transgender as a way to unify a diverse population of people engaged in nonnormative gender practices. Public knowledge of this new category transgender began to grow exponentially, aided by activist groups and the growing popularity of the internet (Whittle 1998). Part of this growth was trans people speaking publicly about themselves, including an increasingly vocal group of trans activists naming themselves, describing how they have been oppressed, and arguing for the value of trans people (Stryker 2008). Another part of this growth came from increased media attention to trans people, both in the news media and in fictional representations. By 1995, the use of transgender as an umbrella category for those who identified as a sex and/or gender other than the one they were assigned at birth was widespread.
Transgender as an umbrella category encompasses a wide variety of ways of doing gender. Unlike transsexual, a desire for body modification is not a prerequisite for category membership. Instead, transgender has been defined as “all persons who cross traditional gender boundaries” (e.g., Green 1994: 9). Since it is said to include all nonnormative gender practices, transgender as a category is “almost infinitely elastic” ( Valentine 2007: 39). Thus, the category includes a number of previously unnamed gender practices, making these ways of doing gender knowable and those who do them recognizable within the gender system (Westbrook 2010). This recognition moves them from what Judith Butler (1993) terms abject (i.e., not seen as human) into a realm of subjects (i.e., humans with agency) eligible for social acknowledgment and rights.
As with all identity categories, trans categories have been intensely debated by those under their purview. Valentine (2007) has detailed how, in the struggle for the right to identify as transgender, many other identities are denied or ignored. Not everyone who identifies as a sex and/or gender other than what they were assigned at birth uses the term transgender or trans. In the 1990s, Valentine interviewed “male-bodied feminine people” who identified simultaneously as “gay,” “women,” and “femme queens.” These people were often young, poor, urban, and of color (mainly Black and/or Latinx). For these individuals, gender and sexuality were not as separate as academics and transgender activists have posited. However, Valentine found that, although they did not identify as transgender, they were nevertheless named as such by leaders in the LGBT community and service providers. When they argue that people are transgender even when they do not identify as such, activists and academics treat transgender as a natural category, and they ignore individuals’ self-conceptions (Westbrook 2010).
The usage of trans terms is constantly changing. Previous terms such as “transvestite,” “transgenderist,” “transgendered,” and “tranny,” which were used by academics and community members alike well into the 2000s have fallen out of favor (GLAAD 2014); their use is now considered by some to be a sign of transphobia (i.e., disdain for trans people). Similarly, due to controversies over whether transgender, with its terminological focus on “gender,” was inclusive enough, many people began to instead use trans. Some have taken this a step further, using trans* as the umbrella term, the asterisk a reference to a wildcard when searching digital archives. These attempts at expanding the umbrella may actually reduce the legibility of trans ways of being gendered or sexed, as the terms themselves are difficult to search on the internet. Whereas a search for “transgender” will immediately produce results on those whose sex and/or gender does not align with that assigned to them at birth, an internet search for “trans” or “trans*” will generate a much more diverse set of results, including translation websites, the homepage of Trans-Siberian Orchestra, and information on trans fats. As evidenced by the history detailed here, trans terms have changed over time and are likely to continue to change in the future.
The rise of the term transgender has spawned a new term: cisgender. “Cis” is the antonym of the Latin prefix “trans,” and cisgender refers to people who identify as the same sex and gender that they were assigned a birth. Before the advent of cisgender, the state of being not transgender was often left linguistically unmarked. Things that are unmarked are generally considered “normal,” whereas those that are marked are seen as unusual. Having both trans and cis be marked with their own term challenges the assumed normalcy of one (cisgender) over the other (transgender).
Many activists and academics once thought that trans categories and practices would undo gender – dismantle or do away with the sex/gender/sexuality system – by highlighting the social, rather than biological, origins of gender norms and categories. However, rather than “undoing” gender, trans categories have, instead, redone gender (West and Zimmerman 2009). This is not to argue that conceptions of trans or transgender do not challenge aspects of the current sex and gender systems. Trans categories have altered the sex and gender systems by introducing the ideas that sex and gender are changeable, gender identities and practices can be diverse and nonbinary, and gender presentation and sexed embodiment do not have to “match.” However, although they do challenge current ways of doing gender, they do not challenge the idea of gender – the belief that all people fit into a gender category and that behaviors reflect gender identity ( Westbrook 2010). With transgender, gender is still posited as central to a person’s identity and a vital part of social interactions. Indeed, with the promotion of preferred pronouns and diverse gender options on forms, gender may have become even more central to people’s understandings of themselves and others.
Although trans people are increasingly acknowledged socially and legally, they still experience high levels of discrimination and violence. Much of this is linked to fears around sexuality. As Westbrook and Schilt (2014) demonstrate, at the national, state, and local levels, governments have been hesitant to extend antidiscrimination protections to trans people for fear that such legislation will allow trans women (whom legislators often conceive of as “really” men) access to “women only” spaces such as restrooms and locker rooms. This fear comes from a belief that all male bodies are potentially inclined toward, and capable of, sexual assault of females and that all female bodies are vulnerable to such assaults when there are no males around to protect them. Although rooted in false assumptions that perpetuate gender inequality, such fears have been effective in preventing inclusion of trans people in antidiscrimination legislation. Similarly, as Schilt and Westbrook (2009) show, much of the fatal violence experienced by trans people is also related to fears around sexuality. Most of the trans people killed in the United States are trans women and a majority of those are killed by cisgender men with whom they have had sexual relations (see also Westbrook 2021). In these sexual interactions, it seems that the cisgender men either become aware of, or become uncomfortable with, the trans women being trans and move from seeing the trans women as women to seeing them as “really” men. Thus, in their minds, the relationship moves from heterosexual to homosexual. Some of these men react with violence, as they fear being stigmatized as homosexual. Hence, the intertwined nature of sex, gender, and sexuality has resulted in discrimination and violence against trans people.
Rising acceptance of trans people and categories and the related significant shifts in understandings of sex and gender may also produce changes in beliefs about sexuality. This has the potential to reduce discrimination and violence in the future. Thus far, the idea of trans people being sexually involved with anyone has not been accepted in mainstream culture and transgender people are compelled to do an enormous amount of trans-situated gender labor to explain and protect themselves in sexual relationships (see zamantakis and Sidibe, Chapter 28 in this volume). Like previous decades where gay or lesbian television and movie characters were not shown in sexual relationships, mainstream media has shied away from depicting trans people in romantic situations (Abbott 2013). This lack of cultural depiction is likely to perpetuate fears around what is now termed trans sexualities, meaning trans peoples’ and their partners’ sexual desires, behaviors, and identities (see Tompkins, Chapter 32 in this volume). For a long time, academics did not focus on trans sexualities, with the exception of studying sexually “risky” behavior (Pfeffer 2014a), such as sex work and sex with/by drug users. Doctors who worked with trans people assumed that they hated the body they were born with and, thus, were asexual unless they had surgically altered their genitals (Cromwell 2006). This silence around trans sexualities is slowly changing, as evidenced by the Journal of Homosexuality’s 2014 special issue “Making Space for Trans Sexualities.” In previous eras, shifting academic understandings, such as a move from seeing trans people as “sick deviants” to seeing trans as a legitimate gender identity, have resulted in changes in the larger culture. Extrapolating from this, there is potential for a number of future changes in cultural understandings of sexuality.
As the number of acceptable ways of being sexed and gendered expand, so may the number of sexual orientation categories. Currently, there are no widely used terms for those who are attracted to trans people, except for the derogatory “tranny chaser,” which stigmatizes such desire as a fetish (Tompkins 2014 and Chapter 32 in this volume). Some have suggested transamorous or transsensual as terms that would legitimate and make legible such desires. We might also conceive of a system where people identify as trans-sexual (desiring trans people), cis-sexual (desiring cis people), or pansexual (desiring all genders). If such sexual orientation categories became more widespread, it would fundamentally alter dominant beliefs about sexuality.
In the current sexuality system, both trans people and their partners have often turned to queer as the label that best encapsulates their desires. In her interviews with cis women partners of trans men, Pfeffer (2014b) finds that, though these relationships are regularly perceived as straight, many identify as queer, in part because there is no other language to describe their identities and desires. Similarly, Kuper et al. (2012) find that, in their sample of trans people, the most common gender identity was genderqueer and the two most common sexual orientations were pansexual and queer. This shift away from heterosexuality and homosexuality is the logical outcome of a genderqueer identity, since heterosexuality and homosexuality are dependent on “man” and “woman” as gender identities and cannot articulate desires by or for a genderqueer person. As the growing acceptance of trans categories and practices expands the possible ways of doing gender to include nonbinary identities such as genderqueer, queer as a sexual identity category – meaning attraction to multiple genders – may become more widespread.
In addition to expanding the number of acceptable ways of doing gender and sexuality, trans categories also have the potential to unlink the assumed causal relationship between sex and gender. In everyday interactions, one’s gender presentation is imagined to reflect one’s genitals. The category transsexual calls into question the idea that sex assigned at birth determines one’s gender identity. However, the reverse relationship has remained unquestioned through the belief that all trans people desire surgeries to make their sex and gender “match.” Currently, a fixed and knowable identity as either a man or a woman is needed for access to body modification. Those identified as cisgender women can access breast implants, vaginal tightening, and labia reductions with relative ease (Davis 2002), just as cisgender men can have surgery to reduce the size of their chests and increase the size of their testicles, as those surgeries assist in sex and gender conformity. Similarly, a clear identity as a trans man or trans woman facilitates access to body modification, as long as those modifications will increase their conformity to expectations of sex and gender. The shift toward embracing trans categories and identities may loosen the restrictions on access to body modifications for trans people, thus allowing for more “mixed” embodiments. As more and more trans people decide whether to pursue hormonal and surgical body modification at all or to engage in some available modifications but not others, the assumed link between sex and gender may change and a separate sex identity and gender identity may become acceptable, such that one could identify as both male and a woman. This would set the stage for a reconceptualization of attraction, distinguishing between attraction to gender presentation (desiring masculine people and/or feminine people and/or androgynous people, etc.), sex (desiring male bodies and/or female bodies and/or intersex bodies), and gender identity (being attracted to those who identify as men and/or women and/or genderqueer or nonbinary). The unlinking of sex and gender would also fundamentally shift one of the premises on which the current sexuality system rests – that one can use gender presentation as a proxy for sexed embodiment. Coming full circle, this may alter the current imperative within the gender system that one signal sex with gender, such that people may feel free to wear dresses because they enjoy them, rather than to indicate the presence of a vulva and vagina.
In Western thought, we tend to construct our classification systems as a set of binaries – you are either gay or straight, a man or a woman, and cisgender or transgender – rather than as spectrum that, for example, acknowledges a diversity of sexed, gendered, and sexual practices that may also change over the life course. As trans categories allow for more varied presentations of gendered and sexed selves, the assumption that sexuality is binary and fixed over the life course may change. The existence of trans people might problematize the belief that sexual orientation is stable over the life course, as a trans person’s sexual orientation may change as their gender identity does. Similarly, the sex and/or gender transition of a romantic partner can significantly disrupt the understanding of sexual orientation as innate and fixed, as, if the relationship continues after the transition, the label put on the relationship would change from, for example, heterosexual to homosexual or queer (Sanger 2007).
Due to the intertwined nature of sex, gender, and sexuality, the transformation of one results in changes in the others. Just as trans categories have caused a redoing of understandings of sex and gender, over time they are likely to redo sexuality. As long as US culture tends to emphasize sex, gender, and sexuality as central to the understanding of the self and vital to interactions with others, none of these systems will be “undone.” But, as they move to accept those previously understood as “deviant,” these systems will be transformed, possibly expanding sex categories beyond male and female, increasing gender identities beyond man and woman, and embracing sexual orientations beyond heterosexual and homosexual.
Laurel Westbrook is Professor of Sociology at Grand Valley State University in Grand Rapids, Michigan, USA. Dr. Westbrook is the author of Unlivable Lives: Violence and Identity in Transgender Activism (University of California Press, 2021). Their scholarship has also been published in Sexualities, Gender & Society, and the Journal of Health and Social Behavior, among others, and has been recognized with multiple awards from the American Sociological Association.