What's Gender Got to Do With It?
(A TRANS PSYCHOLOGY BLOG)

I’m a transgender man and psychology researcher looking for trans people to take an online research survey on mental health and adverse experiences

My name is Sebastian Barr – I am a transgender man and a doctoral candidate in Counseling Psychology at the University of Louisville. I used to write the blog xxboy and for Autostraddle, and am now primarily researching and educating on transgender mental health and psychology. I am currently seeking participants for my dissertation research, which I am conducting under the supervision of Drs. Kate Snyder and Mark Leach. 

To qualify for the study, participants must identify as having a gender that is different from the sex they were assigned at birth and must be over the age of 18. Participation involves completing an anonymous online questionnaire that will take approximately 15-20 minutes to complete. After you finish the survey you will have the option of providing your contact information in order to be entered to win a $100 gift card. This study has been approved by University of Louisville’s IRB. 

The information collected will not necessarily benefit you directly but may be helpful to others. As you are likely aware, gender diverse people are at increased risk of having adverse experiences and poor mental health. The information you provide will help us better understand the experiences of transgender and gender non-conforming people and may help us communicate these experiences to the scientific community and the general public. This could lead to important applications in therapy and counseling that might improve access to effective mental health care. 

It is important to us that the research reflects the wide range of identities and experiences of transgender and gender non-conforming people, so we strongly encourage the participation of individuals who are often left out of other trans-focused studies, e.g., those who live stealth and people with nonbinary identities. For this reason, we also encourage individuals with marginalized intersecting identities (e.g., trans people of color, trans people with disabilities) to participate. 

If you are interested in being a part of this study, you can complete the questionnaire here: http://bit.ly/BarrTransSurvey 

If you have any questions, please contact Sebastian Barr at sebastian.barr@louisville.edu. 

Thank you, 

Sebastian Mitchell Barr 
Doctoral Candidate, Counseling Psychology
University of Louisville

Reflections on the murder of yet another trans person

Every trans person murdered is a reminder to me of three things:

1. The unacceptable lack of safety, support, resources, and rights trans people have access to, particularly trans people of color and trans people in poverty (which aforementioned lack of safety, support, resources, and rights makes more likely for trans people in general).
2. The near-constant pain the trans community is in, suffering blow after blow, being dealt a steady mix of personal and political losses and rejection.
3. The strength, power, and beauty of my trans siblings who live their truths (privately and/or publicly) and fight to live authentically in whatever ways are accessible to them; who survive and thrive in the face of obstacles; who find and create beauty in the face of pain.

I have so much love for my community. There is still so much need for change.

A note about correlations, risk factors, and aggregate quantitative research

I recently posted a review of the quantitative research on trans suicide (8 Things the Statistics Actually Say About Trans Suicide), which has gone slightly-viral (at least compared to other nerdy research things I’ve written in the past, haha).

As I’ve been tracking the response to the post, I realize that I failed to clarify some important things about the language I used in the post and about some of the limitations of these types of research, so I’d like to do that now. Note that there is no quick and dirty one-sentence explanation for any of these (people spend entire semesters learning this stuff) and I’m definitely leaving stuff out (again, there are entire textbooks written on statistical analyses for psychology), so bear with me. It’s really important :) [Trigger Warning for discussions of transphobia, violence, and suicide]

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8 Things the Statistics Actually Say About Trans Suicide

Author’s note 1: If you are thinking about hurting yourself or ending your life, please reach out and get help. We want you to stay alive. National Suicide Hotline: 1 (800) 273-8255; National Crisis Textline: Text “GO” to 741-741; Trans Lifeline: 877-565-8860; Trevor Helpline for LGBT Youth: 1-866-7386.

Author’s note 2: As this is getting shared, many people have been asking questions about how to interpret the findings I describe. For example, “Does this mean that this causes that?” I penned a post briefly explaining some concepts*, like correlations and risk, which should help if, like most folks, you’ve never had the pleasure of a course on statistics or research methods.*

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I have seen a growing number of people citing statistics about increased suicide risk as evidence that therapists/psychologists/counselors/society should not support trans people’s identities and transitions. Gina Loudon told Fox News that those who supported trans people’s right to transition were “science deniers,” claiming that research has found that trans people’s suicide risk increases 20-fold when they transition (spoiler: that statistic is inaccurate). Michael Cook recently penned a blog post titled “What do the statistics say about transgender mental health?”, in which he concluded that the idea that trans people’s psychological stress will be relieved through transitioning is pure deception that runs counter to the evidence. Heath Lambert, professor of biblical counseling who counsels trans people to avoid transition, defends his position by stating that trans people who have transitioned still have higher rates than the general population.

I’ll be clear: Trans people do have increased suicide risk. Across all demographics, if a person is transgender they are more likely to seriously consider and attempt suicide.¹ The research, however, just flat out does not support the above views that this increased risk is due to some instability associated with undergoing a gender transition. I propose we take a thorough look at the statistics and the science on trans suicide, so we can get a grasp on what we do know about trans people’s suicide risk. Below are 8 consistent findings from the literature on trans suicide.

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Transgender 101

Sex and Gender

I think the difficulty people have in understanding what it means to be transgender comes from the fact that in our society, we often learn about sex and gender in overly simplistic and conflated ways. The first step to understanding the concept of being transgender is to try to understand what sex and gender mean.

There are four main components to sex and gender: sex assigned at birth, biological sex, gender identity, and gender expression. These are separate components and do not necessarily directly influence each other.

Sex assigned at birth is an assignment made at birth, based on doctors’ interpretation of a person’s biology – typically, via examination of external genitalia. In the United States, birth certificates must bear a “male” or “female” sex assignment. Male is assigned when a baby appears to have a penis; female is assigned when a baby appears to have a clitoris, vulva, and vagina. These assignments are not always straightforward, as it is pretty common to have genitalia that do not clearly fall into one of the above categories.¹

Biological sex can refer to chromosomes, hormone levels, reproductive anatomy, secondary sex characteristics (e.g., facial hair, breasts), or a combination of all of these things. Despite the fact that we are typically taught in science about “male and female” sexes, biological sex does not fit easily into two discrete categories. Our biological sex is actually very complicated, with a great deal of diversity in chromosomal makeup, hormone levels, reproductive anatomy, and secondary sex characteristics across male-assigned and female-assigned folks. There are multitudes of chromosomal combinations; the two most common (though most of us never have our chromosomes tested) are XX and XY. Typically, people with two X chromosomes have vaginas, wombs and ovaries, are given “female” sex assignments, and have higher levels of progesterone and estrogen after puberty, which lead to menstruation and breast development. Typically people with an X chromosome and a Y chromosome have penises and testes, are given a  “male” sex assignment and have higher levels of testosterone after puberty, which leads to increased body hair, lower vocal ranges, and greater muscle mass. It’s important to think about biological sex as a complicated spectrum: “[Typically] male and [typically] female [sexes] form the extremes of a biological continuum that features many types of intersex conditions” -Dr. Anne Fausto-Sterling, biologist and historian.

Gender is a general term referring to social categories based on culturally-specific role expectations that are attached to sex assignments. Gender identity is a person’s internal sense of what gender and/or sex they are and/or how they fit into their society’s gender categories. A person might have an internal sense of being female/woman, male/man, a combination of both, or neither, or may have a fluid internal sense of gender, such that they identify differently at different points in time. There are lots of different possible gender identities and labels outside of man and woman, some of which include genderqueer, non-binary (referring to the fact they do not identify within the binary framework of man vs. woman), genderfluid, and two-spirited (a traditional Native American gender identity).

Gender expression is how a person communicates their gender to the world. Examples of ways we express our gender include the clothing we wear, our hairstyles, and conversation styles. When we use the words masculine and feminine, we tend to be talking about gender expression, for example. Other terms associated with gender expression include femme and butch.

None of these concepts is directly related to sexuality or sexual orientation (e.g., bisexual, lesbian, queer, gay, straight), which involve whom a person is attracted to.

Transgender People, Cisgender People, and Gender Transitions

When we learn about sex and gender, we are usually taught to think about them as a singular concept with two options, when really there are (at least) four components and an infinite possibility of combinations.

People are considered transgender when their particular sex and gender combination includes a gender identity that is different from their sex assigned at birth. For example a person who has a female sex assignment and a genderqueer gender identity is transgender; a person who was female assigned at birth and has a male gender identity is also transgender. People are considered cisgender when their particular sex and gender combination include a gender identity that is the same as their sex assigned at birth (cis is the latin root meaning same). Both cisgender and transgender people have a wide range of biological sex characteristics and gender expressions.

Some transgender people go through gender transitions in order to make their gender identity more visible to the outside world. This can include changes in a person’s gender expression and/or changes in their biological sex to align either or both with their gender identity. For example, a transgender man (a man who was female assigned at birth) may wear more masculine clothes and change his name to a traditionally masculine name in order to communicate his male gender identity; these would be changes in his gender expression. Changes to his biological sex may include hormone replacement or surgeries. Just like there are infinite possible combinations of gender and sex identities, there is not a singular way in which transgender people undergo a gender transition, if they choose to do so.

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So, the cheat sheet version of all of this is: gender identity is an internal, psychological sense of how a person fits into gender categories; sex assigned at birth is the label a person was given at birth typically in response to their external genitalia. When these two things differ, a person is considered transgender.

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How to Refer to Trans²  People

Terminology

Transgender is an adjective that describes a person, identity, experience, issue, etc. Transgendered is an outdated term that highlights medicalized/pathologized view of trans people, so it should not be used; transgender is the appropriate term. Transgender is not a noun, so a person or group of people should never be referred to as a transgender or as transgenders. Finally, transgender isn’t a verb, so it is inaccurate to say a person transgendered - if you are talking about a gender transition, you can say they transitioned or went through a gender transition.

There also appropriate and inappropriate ways to discuss the categories and gender identities of transgender people. Though trans people are routinely categorized and described by the terms FTM (female-to-male), MTF (male-to-female), and non-binary-identfied, FTM and MTF are really not appropriate³, unless you are referring to a specific person who has expressly stated that they use that terminology for themselves. First and foremost, transgender people should be identified using the terminology they use for themselves (for example, a transgender woman should be referred to as a woman if she calls herself that; a genderqueer person should be referred to as genderqueer or using whatever gender label they use for themselves). When using the word transgender as a description for someone,⁴ include it with the person’s gender identity, not their sex assigned at birth. So a transgender woman is a person who identifies as a woman. When a person’s transgender history is important and needs to be referenced, identify them based on their gender identity and their sex assigned at birth. FAAB and MAAB are acronyms for female-assigned-at-birth and male-assigned-at-birth. For example, a transgender woman is a woman (MAAB) or a woman who was male assigned at birth. Intersex may also be appropriate if a person’s assigned sex and/or biological sex at birth were not discretely male or female. In this case, you might describe someone with a female gender identity as an intersex woman.⁵  An intersex person may or may not consider themselves transgender.  

Pronouns

Pronouns are the words we use in place of people’s names when referring to them. In English (and many other languages), third person pronouns are gender-specific. He/him/his are typically used for people with male gender identities and she/her/hers are typically used for people with female gender identities. Because pronouns then inherently announce a person’s gender, it is important that we ask others which pronouns they want us to use for them. Many transgender men prefer he/him/his pronouns and many transgender women prefer she/her/hers pronouns, while genderqueer folks and other people with non-binary gender identities may prefer gender-neutral pronouns (e.g., they/them/theirs, ze/hir/hirs). Because we can’t tell a person’s gender identity or pronouns from looking at them, it’s most affirming to ask and use gender-neutral pronouns (or avoid pronouns) until we know which ones to use.

Further Reading

(Coming soon!)