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Exploring TranssexualismReview - Exploring Transsexualism
by Colette Chiland
Karnac Books, 2005
Review by Aagie Ieven, M.A.
Aug 27th 2005 (Volume 9, Issue 34)

Exploring Transsexualism is a title well-chosen for Colette Chiland's most recent book on the subject of gender identity disorder. The author, a psychoanalyst who has worked with transsexuals prior to and following their hormonal and surgical sex reassignment, aims to familiarize psychotherapists with various aspects of transsexualism, should they be confronted with it. Therefore, her work contains neither thorough insights nor lengthy arguments on causes, symptoms and treatments. Instead it offers a glance at the different problems related to transsexualism and an account of the author's personal experiences with them.

For Chiland, the main question of concern is whether psychotherapy can be fulfill a purpose in the 'treatment' of transsexuals in times where sex reassignment operations have become the norm. Eventually, her answer will be a positive one. Despite the many difficulties that will have to be overcome, Chiland believes psychotherapy can be a place where transsexuals can speak freely about themselves and their condition without having to live up to certain patterns of behavior and thought.

This feeling of having to live up to a certain pattern is a major complicating factor in therapist's conversations with transsexual 'patients', though. Chiland explains that prior to any sex reassignment operation the transsexual's desire to obtain such an operation at all costs will induce the transsexual to lie about his or her past and true feelings. She claims that clients will obscure their feelings of ambiguity, their doubt and conflicting fantasies in order to produce a personal history consistent with the pattern of a primary transsexual (i.e. a transsexual 'from birth') and to obtain surgery. This hinders the therapeutic process that depends upon the ability to speak truthfully and on the ability to question oneself.

Moreover, the many problems transsexuals are confronted with after a sex reassignment operation (such as the inability to change their civil status, to marry a person of the now opposite sex or to adopt a child) are all consequent to the decision to operate. On the one hand, the author sharply (and, in my opinion, rightly) condemns the prevailing ambiguous societal attitude that approves and promotes surgical treatment for transsexuals but subsequently leaves them in a no mans land between male and female. She does not hesitate to call this a violation of transsexuals' right to life. On the other hand, Chiland argues that this complex problematic sharpens the need for alternative forms of treatment, for example psychotherapy.

While remaining at the surface on the best option to take in this therapeutic dilemma, Chiland embarks on the quest of defining the causes of transsexuality. She contends that a certain group or transsexuals might like to hear that transsexuality, like intersexuality, is attributable to biological factors (genetic or other). Chiland explains that this desire is caused by the belief that transsexuals would no longer be blamed for their condition if biological causation could be proved. According to the author there is no conclusive evidence for this position. Moreover, she criticizes the societal attitude that casts a slur on people for their psychologically caused condition. If transsexuality, like homosexuality, has psychological causes tracing back to the child's interaction with its parents in very early childhood, should it be blamed for this -- Chiland asks -- when it is no more responsible for these early interactions than it is for its biological heritage? In any case, the author claims that the causes for transsexualism are not social ones. Unlike feminism, transsexualism is not caused by a discomfort with the social roles attributed to the sexes. To the contrary, transsexuals will try to conform to the social roles attributed to their desired sex, exactly because they long for social recognition of this sexual identity.

Chiland therefore emphasizes the importance of distinguishing between one's biological sex (male/female), one's core gender identity (which is formed in the early years of childhood) and one's social gender (masculine/feminine). As she thinks the biological argument is debatable, it seems that 'core gender identity' is where the (primary) transsexual differs from 'normal' people, whose core gender identity coincides with their biological sex and social gender. Despite all this, the author recognizes that an operation is often the only viable solution for transsexuals, but emphasizes that it is not a cure, but merely 'care': an operation cannot change males into females, but only bring relief to males who feel they are and want to live as females. The argument for sex reassignment operations as a treatment for transsexualism, in Chiland's view, is one of compassion.

†Throughout the book, the author stresses the importance of the 'compass of sex', her term for the biological fact of sex difference. Even though she seems to plead for a third social gender in some places -- which would certainly accommodate intersexuals and possibly some transsexuals- her general message seems to be to confront transsexuals with the biological reality that their sex can never be changed completely. Chiland's main advice to psychotherapists dealing with transsexuals is to be aware of the many complexities it involves, to avoid judgment, not to take sex change operations for granted as the best treatment and to keep confronting clients with 'the compass of sex' -- whether before or after an operation. She is realistic about the effects of psychotherapy -- which her experience proves to be limited -- but maintains that psychotherapy can be useful before as well as after a sex reassignment operation, as long as it is a place where transsexuals can speak truthfully. Exactly how that truthfulness can be secured, she does not clarify.

Exploring Transsexualism takes a look at gender identity disorder from a variety of perspectives and with sufficient complexity; although in its complexity the discussion is not very profound. Readers expecting the experimental method and an inductive argumentative structure will be disappointed by this book and should resort to one of the many works of reference or one of Chiland's earlier books. Nevertheless, this book provides a highly informative and balanced overview of the issues raised by this controversial disorder, accessible to anyone interested in transsexualism. Moreover, the text is indeed as 'challenging' as was promised by the jacket blurb: Chiland's questions are highly relevant and call for deep reflection about the way health care workers and society handle transsexualism and about how transsexuals think of themselves.


© 2005 Aagie Ieven


Aagje Ieven received a BA in Medical Science and an MA in Philosophy from the University of Leuven, Belgium. She is currently working there as a teaching assistant in the field of legal and political philosophy and is in the process of obtaining a PhD.:


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