The Middle Men: An Introduction to the Transmasculine Identities

Griffin Hansbury. Studies in Gender and Sexuality. Volume 6, Issue 3. Summer 2005.

What can be meant by “identity,” then, and what grounds the presumption that identities are self-identical, persisting through time as the same, unified and internally coherent?
~ Judith Butler, Gender Trouble

In recent years the transmasculine community has become increasingly heterogeneous, including not only subgroups with special needs (youth, seniors, people of color, substance users, etc.), but also those with special identities (Raj, 2002). A multitude of such subgroups, which sprang up in the sex-positive 1990s, continues to evolve today, each with its own therapeutic needs. It is therefore essential for clinicians who work with transmasculine persons to understand more about those subgroups. In this paper, in an effort to simplify a complex web of identity, I attempt to contain and name these subgroups in three broad categories.

One transpositive clinician divides the subgroups broadly into “those who subscribe to a concept of self that is both ‘essentialist’ (biogenic) and binary-gendered (male or female) and those who adopt a ‘constructionist’ (sociogenic) and nonbinary-gendered self-concept (both/neither male and/or female)” (Raj, 2002, p. 5). Here, I focus on these two extreme ends of the transmasculine continuum, as well as on a middle group, one that straddles both the essentialist and the constructionist concept of self. The labels I have chosen for the three subgroups are, from most essentialist to most constructionist, (1) Woodworkers, (2) Transmen, and (3) Genderqueers.

To posit such a taxonomy is dangerous business. It presumes that there are such things as “identities” and that they must be, as Butler says in the foregoing quote, self-identical, persistent, unified, and internally coherent. To argue against these identities, however, to dispel them completely by forever citing the exceptions and many permutations, is to render them-and the people who stand behind them-invisible. Somewhere in all the discussion, the individual is lost. Trans people, and especially transmasculine people, have been lost and invisible for far too long. I am trying, with limited tools, to find them, to make them visible and intelligible to my readers.

The labels I have chosen to represent the three broad subgroups of transmasculine identity are currently part of the trans vocabulary. Given that this vocabulary is forever in flux, however, I do not expect the labels-and the identities they represent-to persist through time. For now, while they hover here in this moment, allow me to shine some light on them.

True Spirit

Every February, over the long Presidents’ Day weekend, several hundred members of the transmasculine community gather in Washington, DC for the True Spirit Conference. It is, in the words of its sponsors, “an annual conference for all gender variant people on the masculine spectrum or the transgender experience and significant others, friends, families and allies (SOFFAs) of all gender variations and sexual orientations.”

The True Spirit Conference is a useful, if limited, tool for talking about the transmasculine community and its many identities. To travel to the conference requires the privilege of time and money, as well as an interest in participating in a trans event, elements not all transmasculine people share. I have attended the conference for the past three years, but it has been going strong since 1997. As I have been told from long-time attendees, it has evolved along with the community to include more and more of the masculine spectrum I have mentioned.

That spectrum is immediately evident when one walks into the hotel lobby where True Spirit is convening. There, in the smoky lounge, is a vast array of transmasculine expressions seated around the bar and on comfortable couches and chairs. They range from the rambunctious, purple-haired squatter punks and leather-clad daddies who, at any Queer Pride event, would blend in seamlessly with the more radical gay men and lesbians; to the mild-mannered young men in J. Crew khakis and the fatherly middle-aged fellows who, in this crowd, look oddly out of place, too straight to fit in with the jubilantly queer atmosphere. But fit in they do, for all the wildly various characters lounging in the hotel lounge are there for the same purpose: to connect with their transmasculine community.

“Community,” according to Merriam Webster, is “a unified body of individuals” with commonality and likeness as their defining traits. The transmasculine community does contain commonality; I would not call it unified, however, not even on the occasion of the True Spirit Conference. Even then, when each facet of the community comes together, there is much division within the spectrum.

The word spectrum has been embraced by many transpeople to describe the profusion of identities that is subsumed under the overarching label of trans. The idea of a spectrum was adopted to replace the linear model, a kind of Kinsey scale with a trans extreme on each end and variations in between. The line is often considered to be too limiting and dangerously hierarchical. But is the spectrum so different from a line? On the rainbow, one color may bleed into its immediate neighbor, but red never touches blue. Perhaps a matrix would be more accurate, an enormous grid of columns and rows. Even better, we might imagine a cluster of bubbles, each trans identity connected to others, touching at multiple vertices, a concept not unlike recent theories of the universe, what physicist Alan Guth imagines as an infinite tree of bubbles. But this kind of thinking requires multidimensional mathematics, and I was never good at math. I like the simple elegance of the line. It is a convenient, if ultimately inefficient, tool for talking about something so complex that it is beyond the reach of clear language.

The line is out of fashion today because it appears to reinforce the concept of the binary, which is, for many trans people, an anathema. This may be the fundamental bone of contention that divides the transmasculine community. On one side, there are those who find comfort in the two-party system of man and woman (a rapidly dwindling, or perhaps simply silent, minority) and, on the other, those who view such a system as too limiting, suffocating, and unbearable. It is this second group that appears to be growing into the majority, or perhaps they are merely more visible, and more vocal. Indeed, on the schedule of workshops for a recent True Spirit Conference, there were 16 offerings listed under the category “Beyond the Binary,” by far the largest category, and only three workshops on the topic of “Transition Process.” True Spirit workshops are peer planned and facilitated. In evidence here, the more active and vocal strata of the trans community may be becoming less and less transition focused-the movement from here to there, A to B, female to male-and more interested in an existence someplace in the middle, or completely outside of binary notions of male-female, man-woman.

The middle is a place inevitably (often unhappily) occupied by every transmasculine person, up and down the line. Though some, on the surface, may be more intelligible as male-gendered persons-a beard and a three-piece suit go a long way to covering up the ambiguities of the trans body-underneath, the transmasculine person, no matter how much surgery and socialization he has undergone, remains “beyond the binary,” surely more so than the average nontranssexual man.

The real differences among the various identities are based less on how many testosterone injections one has had or which surgeries one has opted to undergo, and more on how each person interprets his or her identity-how she or he perceives himself or herself and how he or she wishes to be perceived by others. Someone may identify as a Transsexual Man yet still maintain his breasts and forgo testosterone. Another may choose to undergo a mastectomy, take low-dosage testosterone, and identify as a Passing Woman.

The array of labels used within the transmasculine spectrum are many and attest to the infinitude of the community-think again of Guth’s ever-branching tree of bubbles-as well as its incipience. This is a community in its infancy, still struggling to define and demarcate, an endeavor that has led to a dizzying profusion of labels. Arranged here in an unscientific, somewhat linear fashion, from (perhaps) the more male-identified to the more nonbinary, these labels include, but are not limited to, Man, MTM, FTM, Transsexual Man, Man of Transsexual Experience, New Man, Transman, Transfag, Transqueer, GenderQueer, Guy, Boi, Trans-Butch, Tomboy, Boy-Chick, Gender Outlaw, Drag King, Passing Woman, Bearded Female, Two-Spirit, Ungendered, Gender Trash, Questioning, Just Curious. And these identities are not always “self-identical”; one transmasculine person’s FTM may be another’s Gender Trash.

For the purposes of simplicity, allow me to return to my linear tool, upon which I have boiled down the transmasculine spectrum into three broad groups (again arranged from the more male-identified/essentialist to the more nonbinary/constructionist): (1) Woodworkers, (2) Transmen, and (3) Genderqueers. Aside from the gender differences between these groups, there may also be a corresponding generational difference, with Woodworkers tending to be the eldest (late 30s and up), Transmen in the middle (late 20s to early 30s), and Genderqueers the youngest (mid-20s and teens). The reasons for this demographic appear to be various: from society’s changing views of transsexuality over time, to the Internet’s revolutionary connecting of marginalized groups, to youth’s love of joyful anarchy and maturity’s more conservative desire for stability. There may be educational, racial, and class differences as well. The Woodworkers I have encountered are mostly from working-class backgrounds, and have little or no college education; the majority of Genderqueers I have known were white, college educated, and of middle-class or more affluent backgrounds. Although there are many variations and exceptions to these observations, they may suggest that privilege is necessary before one can choose to step into the margins.


To put what I have been discussing into some perspective, there are thousands of transsexual men who do not attend the True Spirit Conference. They do not read books by Marjorie Garber, Judith Butler, or even Leslie Feinberg. They are your run-of-the-mill, Joe-six-pack, female-to-male transsexuals. They would most likely identify themselves as men, minus any transspecific prefixes, and are sometimes called Woodworkers by other transpeople because of their tendency to blend into the woodwork. They “go stealth,” or (a term more common to African-American FTMs) they are “DL,” keeping it on the “down low.” They live as men, are out only to their families and perhaps to their partners, and treat their female histories as something to keep hidden. While a few use the label MTM, which stands for some combination of Man-to-Male, Man-to-Man, or Masculine-to-Male (a designation used by men of transsexual experience who feel they have never truly lived as female), most just call themselves men and forget the rest as best they can. This “forgetting” is more an act of disavowal. One transsexual man I knew used to speak of his former “female” self as someone who was dead, someone he had had to “murder” in order to live himself. “If I hadn’t buried Rose-Marie,” he would say, “RoseMarie would’ve buried me.”

Sociologist Aaron H. Devor, writing under the name Holly Devor (1997), posits a system of identity-development stages for FTMs. The second-to-last stage on this chart is Integration. And here is where most of the participants stood at the time of Devor’s study (approximately 1987-1991). At this stage, the FTMs

lived their lives as unremarkable men whose transsexuality remained invisible except to specifically chosen other people. They treated the information that they once had been female and had lived as girls and as women as potentially discrediting information which needed to be managed with care [p. 604].

Devor describes very well the group of men known as Woodworkers, or MTMs. However, a quandary arises when we look at Devor’s next, or last, stage: Identity Pride. A smaller number of participants moved from the Integration stage to this phase, one in which “they fully and publicly claimed their bifurcated histories” and “proudly posed themselves and their lives as challenges to the restrictive binarisms of the dominant gender schema.” The quandary is this: by setting up a system in which the final, triumphant goal is public pride and activism, FTMs who remain at the Integration stage-in the woodwork may too easily be seen as developmentally stuck, as poor, misguided victims of the heteropatriarchy, suffering from internalized transphobia.

Many, perhaps most, transsexual men, have dreamed all their lives of becoming, unremarkably, men. To live “normal, average” lives as their own fathers and brothers did. The pursuit of such a life does not necessarily spring from a place of shame, although, to live a “closeted” life (if there even is such a thing as a trans closet) can produce feelings of shame. It is all too easy to see such men as ensnared in the dark, tangled jungle of selfloathing. But we must ask why, to be fully actualized, every transsexual must publicly challenge “the restrictive binarisms of the dominant gender schema.” Many of these men would say that they never were girls or women in the first place and that the invisible boys and men they truly were have now been liberated from the bonds of what was a horrible birth defect. If anything, to these men, making the transition to and maintaining a male identity is the ultimate coming out. For such men, transsexuality is a foreign state. They do not identify with it. They take great pride in the male bodies and identities they have achieved. They are, unashamedly, men. Therefore, to be out as trans would be to deny their hard-won identity, to erase themselves.

In 1995, when I began my own transition from female to male, the only FTMs I met were Woodworkers. My therapist, a gay man and a gender-savvy CSW, referred me to a new therapy group for FTMs that was just getting started in the West Village of New York City. In that room I found a handful of men at various stages of transition. Some had been on testosterone for years and, with deep voices, full beards, and receding hairlines, bore no traces of the female bodies they inhabited. Others, like me, were just beginning. But there was no doubt that all of us felt ourselves to be, in the now-antiquated vernacular of those old fin-de-millennial days, “men trapped in women’s bodies.” We were determined to get to the other side, where we could acquire the physical masculinity we had so dreamed about all our lives. We were, gathered together in that room, “classic” FTMs.

The group of men I met there were, for the most part, heterosexual, working class, and older than I was at the age of 24. They were like big brothers, offering advice and guidance to someone just starting out, and I am indebted to them. But I also remember them as unhappy men, sometimes angry, often lonely in their isolation. The stories they told were about the families they had lost, the women they longed for, the friends from whom they kept their secret. These are stories common to many transmasculine people, all along the line, but they seem to be especially common to Woodworkers. They are the stories of alienation.

Much has changed in the intervening years, but these men, and many others like them, are still out there. Now and then, they will come out of the woodwork to attend the True Spirit Conference or join a support group for a few meetings, then retreat once again. In the groups, they express loneliness and the need to connect with other transsexual men. Once this need is temporarily filled, they often leave the group, taking a few phone numbers with them. It is as if they are getting their batteries recharged.

Although there has been no research to back this up, my educated guess is that, as a group, the Woodworkers are the most likely to go “all the way” with sex reassignment surgery, that is, phalloplasty. Their friends are, by and large, not transsexuals, from whom the FTM keeps the secret of his female history. Many of them have little contact with their parents and birth families, who often rejected them earlier in life. They do not talk “gender-speak” and are likely to adhere closely to our culture’s rules for masculinity. They also tend to be older, late 30s and up; they made the transition and went underground before the so-called transgender revolution got underway.

Until that recent revolution, in order to be given the clinical stamp of approval for sex reassignment, a trans person had to prove himself or herself to be a “true transsexual,” that is, one who fits the typical profile set forth by Harry Benjamin (1966) in his Sex Orientation Scale (S.O.S.). The scale ranges from the Type I Pseudo Transvestite to the Type VI High Intensity True Transsexual. A true transsexual is one who “intensely desires relations with normal male as ‘female’“ (Benjamin’s scale measured only male-to-females); who unequivocally requests, hopes for, and works for sex reassignment surgery; and, in the high intensity case, who “despises his male sex organs” and is in “danger of suicide or self mutilation if too long frustrated” (p. 22).

Transidentified persons seeking psychotherapy and sex reassignment in the 1960s, 70s, and 80s, but who did not fit this narrow definition, often lied to their therapists and doctors, the gatekeepers who held the keys to transition and happiness. An FTM, for instance, who was primarily attracted to males and who did not desire phalloplasty to construct a (nonfunctioning) penis, would have to play it straight in order to get the hormones and surgeries he did desire and need. This necessity for subterfuge, along with the pregender-studies climate that preceded the 1990s, I believe helped to create a whole generation of Woodworkers. Indeed, blending into the woodwork was the number-one goal of sex reassignment specifically encouraged by the health-care providers of the time. A successful transsexual was an invisible transsexual.

This history, coupled with the average Woodworker’s lower economic status and lack of formal education, combines to rob him of the luxury to “fuck with gender” and go beyond the binary. To make such a choice would be to reveal himself as a marginal figure, stepping outside the mainstream where it is more difficult to earn a paycheck, obtain health insurance, and keep oneself physically safe in the small-town hinterlands and aggressive inner-city. Such a choice requires a certain amount of privilege before it can be made; privilege that many Woodworkers simply do not possess.

When a Woodworker does seek gender-related therapy, he may do so out of a profound sense of alienation. He longs to talk to someone about his transsexual life while, at the same time, he wants not to have to live such a life. He doesn’t like to think about it, doesn’t like to talk about it. It is possible that he will describe his transsexuality as a “birth defect,” one that has been corrected through physical transition. “Trans,” therefore, has no place in his self-identification. If he has a wife or girlfriend (or a homosexual, nontranssexual male partner), she is most likely also deeply invested in keeping his transsexuality secret, which is now their secret. She may identify as heterosexual, with no fondness for the “queer” label and does not want her family, friends, or larger community to know that she is romantically involved with a transsexual man. With so much secrecy surrounding him, and with a distinct lack of transmasculine role models, the Woodworker may come to therapy with a great deal of shame and internalized transphobia. And, because he identifies as a man, a public proclamation of his transsexuality is not the answer for him.


I had a difficult time identifying wholeheartedly with the men in that first therapy group. While many of the things we discussed struck a chord with me, and while many details of our trans-stories were startlingly similar, the thought of living my life so invisibly was an uneasy one. But, in 1995, before the Internet revolution, I had access to very little information. My transmasculine role models were Woodworkers.

For the previous 20 years, Robert Stoller’s (1975) definition of the female-to-male transsexual had held water. He said, in summary: Assigned to the female sex at birth, FTMs began to show masculine interests and behaviors at about age four, and their gender identities progressed along a masculine line, so that they invented boys’ names for themselves, played only with boys’ toys, walked and talked like boys, and so on. At puberty, they detested getting their periods, breasts, and all of the female secondary-sex characteristics. They were attracted to feminine females and to masculine pursuits and occupations (pp. 223-225).

Stoller was correct in positing that FTMs deny themselves to be homosexual women. It is also true, however, that, before physical transition, many seek refuge in the lesbian community, where they may be accepted and celebrated as butch. For such FTMs, when “butch” begins to feel just as uncomfortable as “woman,” they may opt out and begin to pursue the possibilities of sex reassignment.

Stoller’s (1975) definition is an old standard and, while much of it remains true, it is far too limited to encompass the vast array of transmasculine folks who now either float within the bubble formation of the trans universe, or who perch, like starlings on a telephone wire, along its continuum.

A little bit further down that line are the FTMs/Transmen. This is (at the present moment) my own comfortable spot along the continuum.

I prefer the label Transman.

I am not comfortable labeling myself as just a man. For me, it’s too limiting. To call myself only a man is to deny my historythe 24 years I spent living in a visibly female body-and my present, in which I continue to live in a body that, after hormones and some surgery, persists in being neither female nor wholly male. And yet I am a man, and I also want to own that label. Still, it needs a modifier. Hence, “trans.” A prefix perpetually in the act of changing, forever crossing from one side to the other, it means “across,” “beyond,” and “through.” It has nothing to do with arrival, or departure. It is forever about the journey. (The label FTM, for Female-to-Male, may be read as asserting that it is possible to move from one sex to another, as if regular doses of testosterone and multiple surgeries are capable of transforming not only sexual organs and hormone levels, but also chromosomes, brain chemistry, and a lifetime of female socialization; as if there were such a thing as male and female. I am most interested in the “to.” Many trans people now read that “to” as “toward,” and many just use the prefix “trans” as their identifying label.)

I met my first Transmen in 2000. I had left my first therapy group a few years before and spent the intervening time working as a man (minus the “trans”) in the conservative office of a multinational corporation. In effect, I slipped into the woodwork. Initially, I embraced my invisibility and my ability to pass completely as male. It was, indeed, liberating to be seen at last as the man I knew myself to be. And aside from my more masculine identity and desire to be perceived as male, I cannot deny that I was (and continue to be) attracted to the comfort and security that comes with being “normal.” I earned a whitecollar salary, complete with 401(k), health insurance, and paid vacations. As the first person in my family to earn a college degree and to leave the small, blue-collar town in which I grew up, I had an awareness of the potential for poverty, an abyss that yawned beneath me, one that could swallow me up at the next wrong move. To come out as transsexual-and risk losing my job and all its attendant perks-I was convinced, would have been that wrong move.

Though I never made that move, eventually the silk tie around my neck began to become tight. I joined the Men’s Support Group offered by the Gender Identity Project in New York City. There I found men more like myself: Transmen.

A sea change had occurred in the years of my absence. These Transmen were younger, first of all, than the Woodworkers I knew from the initial therapy group. All of them were in their mid- to late 20s-I, at 29, was one of the oldest. Most of them were college educated and had lived as butch dykes during the early postfeminist, sex-positive campus days of the 1990s. In college, they read Judith Butler, Camille Paglia, and Madonna’s mylar-wrapped Sex. They were men, but they also embraced their transness, which lent them a blended quality that made them more gender fluid than the Woodworkers and the “just men” I had previously known.

Being more fluid, such a Transman may or may not fit the classic, Stolleresque definition of the female-to-male transsexual. The Transman may or may not have invented a boy’s name for himself in early childhood (I did not). He probably played with boys’ toys; however, a few girlish things may have slipped in there as well (my Victorian dollhouse made a great space-station for my Star Wars action figures). While it is very likely that he detested the physical changes of female puberty, as he made the transition, it is not uncommon for him to go through a brief, and often uneasy, period of mourning for those physical markers of femaleness-menstruation, breasts, and the like. He may or may not be attracted to feminine females and masculine pursuits. Indeed, many Transmen are primarily attracted to males, other Transmen, or masculine females. Many identify as gay men. Many Transmen do not like football, and a few even choose to become pregnant and give birth (after going off testosterone for the time being), although there is great controversy in the FTM community about this practice.

On my transmasculine line, then, the Transmen would sit somewhere in the middle, with essentialist Woodworkers on one side and, on the other, the constructionist Genderqueers. All trans people must get used to occupying middle spaces, and the Transman’s position in the FTM community is just one more. It is a difficult place to stand; for, in the transmasculine communities, as in any society, there are prejudices. And here the linear tool has another use, revealing the left-right politics that often lurk behind the transmasculine identities.

To many Woodworkers, a Transman may be seen as too trans, too far to the left. In earlier days, in support groups populated mostly by Woodworkers, I felt a pressure to hide my trans leanings from the group, to be “one of the guys” and conceal any feminine traits I might have possessed. But the real pressure these days comes not from the Woodworkers (who, for the most part, as the silent and invisible stratum of FTM society, exert little or no influence on its shape), but from the very vocal and influential Genderqueers, for whom the Transman stands too far to the right.

Transmen, like Woodworkers, are hard to find. Difficult to see. We look like men and there is little visible evidence that would convince you otherwise if you saw us walking down the street or into your office. Like Woodworkers, most Transmen have committed to a lifetime of testosterone (injections, patches, or gels) and have reaped the benefits of that hormone: a deepened, masculine voice; facial and body hair; increased musculature and bone density; a heightened libido and energy level; and so on. They may have also undergone, or have plans to undergo, the same surgeries that Woodworkers have: bilateral mastectomy, hysterectomy and oophorectomy, and one of two genital options, phalloplasty or metaoidioplasty.

Both the Woodworker and the Transman present themselves to the world as men, but the Transman may be more likely to allow some segment of that world to know about his transsexuality and his female past-and not only to know about it, but to celebrate it to a certain extent. This segment may include family, friends, romantic partners, and coworkers. It is less likely to include strangers, although many Transmen do take up the mantle of activism, thereby outing themselves as trans in a public way.

Transmen seem to be more comfortable than Woodworkers when talking about their female pasts. In “safe” company, it is not unusual to hear a Transman say, “When I was a dyke “… or “When I was a Girl Scout …” On the other hand, I cannot recall hearing a Transman utter the words, “When I was a woman …” or “When I was a girl …” Language is a touchy thing and, when referring to the female years, it is preferable to say, “Before transition,” “Before testosterone,” or “When I was still presenting as female.” For while the Transman may have less surface anxiety around his female history than the Woodworker does, it still remains an uncomfortable place. A clinician can quickly alienate a trans client by using the wrong language. Just as, too often in the clinical literature today, clinicians offensively (and confusingly) refer to FTMs as “transsexual women,” a designation that is specific to male-to-female transsexuals. They also label gay Transmen as “nonhomosexual female-to-males” (Chivers and Bailey, 2000), belying their loyalty to genetic sex, when the transfags I know are proud to claim the title of “homo.” In general, it is best for a therapist to inquire at the outset what language the client prefers-which words, including pronouns, are off limits and which are acceptable.

The Transman stands in his own kind of limbo, half in and half out of the trans closet. The unique struggle of the Transman is that he often feels pulled between the left (Genderqueers) and the right (Woodworkers), between the two identities of “trans” and “man.” Which takes precedence in his life? Perhaps it changes from day to day, but the perennial question for a Transman is simply this: to be or not to be invisible. Do I allow myself the comfort of anonymity, of being just a man? Or do I out myself in an attempt to be my whole self and to raise the consciousness of the people around me? This is the Transman’s dilemma, but it is also his choice-a choice that I struggle with almost every day.


As in any politically correct caste system, the ones with the privilege to sit at the top of the food chain are those who are most oppressed, and the Genderqueers, in many ways, have the roughest time of it, simply because they defy classification. Indeed, their motto might be “Don’t pin a label on me.” Genderqueer is a catch-all term. It may be, to some, synonymous with Gender Trash and is used to refer to a steamy, ever-changing compost of identities in which the gardens of a new gender paradigm are germinating.

I first became aware of the term Genderqueer, and the population for which it stands, at the 2001 True Spirit Conference, where their ranks vastly outnumbered those of the Transmen and Woodworkers. While this population, of any on the transmasculine spectrum, is the most diverse, fluid, shifting, dynamic, and impossible to describe, allow me to make the attempt just the same.

In the hotel lounge at the True Spirit Conference, the most visible Genderqueers were the youngest of the bunch and the most rambunctious. Many adopted a squatter-punk style, complete with tattoos, facial piercings, and blue mohawks. Doggie-piled on one of the couches, they were smoking cigarettes, laughing, and making out with each other in gleeful adolescent abandon. When the mood struck them, some of them would take testosterone, which they purchased not with a prescription, but on the black market. Some of them were boyish looking, others appeared femme, and most of them might be taken for punk-rock dykes or teenage boys.

This group did not represent all Genderqueers, but only one, albeit vocal, segment of the Genderqueer population, a segment that sometimes takes on the aggressive label “Gender Anarchists” or the scary-sounding “Gender Anarchoterrorists.” These labels are apt, for this group’s defining style comes straight from “punk” and shares many characteristics with that movement, especially the desire and the ability to shock. These kids are making a youthful protest with their bodies, and I wonder if today’s gender anarchists will “grow out of it.” Their population is so new, it is impossible to say what they will grow into: Transmen, butch dykes, or more conservative Genderqueers?

The more conservative Genderqueers could also be found at the True Spirit Conference. They were seated around tables, outside of the rowdier, colorful crowd. They also tended to be younger (teens to 20s) and were probably not taking testosterone. They were dressed in khakis, sweaters, and oxford shirts. And, again, you would most likely perceive them as masculine women or teenage boys. Indeed, those among this group identify not as men, but as “bois” or “guys.” Within this more conservative segment, just as in the “punk” group, there are different types: those who have made the decision not to take hormones (a.k.a. “No-Hos,” for “no hormones”), those who are taking low doses of testosterone (a.k.a. “Lo-Hos”), and those who may still be deciding.

There are many reasons someone may opt not to take testosterone. There are health issues to consider: uterine, ovarian, and cervical cancer (potential problems that can be avoided with a full hysterectomy); polycythemia, the overproduction of red blood cells; liver disease; hypertension; high cholesterol; and cardiovascular disease. Some transmasculine Genderqueers do not like the idea of taking on all the male secondary-sex characteristics-they might like to grow a mustache, but don’t want male-pattern baldness (who does?). For others, their female, feminist, activist, or transgender identity is so crucial, they don’t want it to disappear behind the “straight male” scrim of testosterone. Still, they identify as transmasculine and, for the No-Hos, the dilemma becomes how to achieve a trans visibility when, without the effects of testosterone, they remain invisibly transmasculine. For some, the answer is to take low doses of testosterone (becoming LoHos) to achieve a comparably lower level of masculinization, where they can strike a balance without going over the edge into the controversial province of “straight, white, male”; but this solution does not always resolve the dilemma, as they often remain androgynous-a desired, but problematic state to be in.

For those persons who have made the decision to go No-Ho or Lo-Ho, Genderqueer is a final destination. More transmasculine/male than butch dykes, the middle is exactly where they want to be. But for those who are still deciding, it may be only a stopover on the way to another identity, perhaps Transman, perhaps something else. Even so, it is a mistake to view Genderqueer as a phase within the transsexual transition, though it often may seem to be. Before testosterone, most transsexual men never identified as Genderqueer, but always as FTM (or Man, Transman, etc.). More and more, Genderqueers are seeking a comfortable place in the middle, outside any and all boxes. Many eschew gender-specific pronouns, or, conversely, they embrace ambiguity. Some of the labels this group uses are: androgyne, gendermutt, ungendered, and polygendered.

For those who reside in the un/polygendered space, the middle is a place of both comfort and discord. Because most Genderqueers do not take testosterone, they often do not pass as male. How, then, do Genderqueers maintain a sense of self when the world is constantly perceiving them as female or butch, and not seeing them as they see themselves? This oppressive feeling of invisibility may pressure many Genderqueers to begin transition before they are ready, or when they do not really want to. The pressure comes not only from the general nontrans population, but also from the transmasculine community, from whom the Genderqueer receives the subliminal or overt message, “Without testosterone, you’re not trans enough-not man enough.” How can you be trans, without transition? In response, the Genderqueer may turn to testosterone for a beard to hide behind and wear as a badge of validating masculinity.

In addition, Genderqueers often maintain close social ties to the lesbian community, from whom they also receive a fair amount of grief. Many lesbians, perhaps more than heterosexuals and gay men, have an especially difficult time accepting the transmasculine identity, which may be seen as a betrayal. “Why would you want to be a man?” some lesbians have asked of transmasculine persons (myself included). They utter the word man with the same distaste as they would “cockroach.” This prejudice, coupled with the Genderqueer’s seemingly butch-dyke exterior, leads many lesbians to continue referring to their Genderqueer friends and partners with female pronouns and names, even after the Genderqueer has asked them not to. While the Genderqueers feel pressure from the transmasculine community to begin testosterone and transition, they often receive the opposite pressure from the lesbian community; and, in particular, from their potentially lesbianidentified partners, who may say, “I will leave you if you take testosterone.”

Between the transmasculine and the lesbian communities, Genderqueers often feel caught in a tug-of-war and, simultaneously, exiled from both sides, without a community of their own. And, of course, the nontrans world offers no respite. All this makes it very difficult for the undecided among the Genderqueers to make a decision about transition. They must find a way to turn down the volume on the many voices that exert their desires; they must tune in to their own inner self-perception.

What makes a Genderqueer boi different from a butch dyke? Physically, there is often no difference. Again, it is all about self-interpretation. The boi, or guy, perceives himself, and wishes to be perceived, as a transmasculine boi. That’s a much taller order than that of the Woodworker or Transman who asks to be seen as a man. We all know, or think we know, what a man looks like, and testosterone will do most of our work for us. But what is a transmasculine boi? How can I see him without testosterone to make him visible? This is the challenge of everyone in a relationship with a Genderqueer, including counselors and therapists. The best way to go about it, is to simply ask, and to keep on asking, because a Genderqueer’s identity, name, and pronomial preference is often in flux.

While all on the transmasculine spectrum struggle with self-perception, the Genderqueer (and nonhormonal Transman) probably struggles most with the perceptions of others, simply because the rift between inside and outside is so much greater.

Without full doses of testosterone, few transmasculine persons can pass full-time. This difficulty leads to crises when the time comes to use public restrooms, swim at public pools, or sun on the beach, and when using the locker room at the gym. Nonpassing trans people are the recipients of often-daily harassment. Their ambiguous appearance invites the worst from strangers, acquaintances, coworkers, family, and friends. And, as Genderqueers age, without the virilizing effects of testosterone it becomes more frustrating to be seen as a young boy. One Genderqueer in his mid-20s with whom I recently spoke recounted to me the story of being at a wedding, dressed in a suit and tie: “When I went up to the bar and asked for a gin and tonic, the bartender looked at me like I was crazy. He thought I was a 14-year-old kid. It really ruined my night.”

For the transitioning Transman who, with the help of testosterone, will soon move through this ambiguous, androgynous phase, there is comfort: this too shall pass. But for the Genderqueer who chooses this middle space in which to reside permanently, the privilege of passing is not an option. Nonhormonal transmasculine persons, most of all, need to acquire the skills necessary to cope with everyday life. Simply moving through the public world-going to work, buying groceries, riding the subway-can be a harrowing daily experience. The pressure to take testosterone can be overwhelming, and the risk is that a Genderqueer will be tempted to do so before he or she is ready, or, worse, when testosterone is not at all what he or she wants for life.


Although homosexuality was officially depathologized and removed from the DSM in 1973, transsexuality has yet to earn the same distinction. The presence of “Gender Identity Disorder” in the DSM-IV (American Psychiatric Association, 2000) is a controversial one among trans people-many oppose its inclusion, while others believe that its status as a disorder assists transpeople in receiving the psychotherapeutic and medical help they need. Either way, the existence of a pathologized “Gender Identity Disorder” is problematic. The DSM-IV definition of this “disturbance” is a narrow one, leaving no room for those transidentified persons who do not “desire to be the other sex” and do not “request for hormones, surgery, or other procedures to physically alter sexual characteristics to simulate the other sex.”8 Further, the diagnosis asserts that “the disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning” (p. 260).

I must argue that it is not the person’s trans identity that causes such very real impairments in functioning, but rather the negative and stigmatizing views of the transphobic society in which the person exists. From early life, the masculine female child-whether the child grows up to be lesbian or trans-who expresses gender-variant tastes and behaviors is often “corrected” by parents and peers. In adolescence, the predicament intensifies as the transmasculine teen faces isolation. At a time when peer identifications are so crucial, nongender-normative adolescents may find themselves without the opportunity to develop a group identity, a sense of “we.” Even in their own families, there is no sense of “we”; parents of an African American child can role model what it means to be an African American, but the transsexual child grows up without models and without mirrors; there is little information available to tell the trans adolescent how to be. Martin and Hetrick (1988) found that, for gay and lesbian adolescents, this isolation resolves once “the young person has the example of adult as well as peer role models [and] when the adolescent has someone to talk to openly and has access to accurate information” (p. 172). Even at a time when more and more high schools and colleges are offering gay and lesbian clubs and peer activities, few embrace the trans student.

Such isolation, in adolescence and in adulthood, can impair the transmasculine person’s sense of self and lead to self-destructive behavior. The relationship between suicide risk and sexual orientation is strong; studies have shown that suicide rates for homosexual adolescents are much higher than those for their heterosexual counterparts (e. g., Remafedi et al., 1998). Devor’s (1997) study of FTMs found that 27% of participants (n = 45) had considered suicide during adolescence, compared with 15% of teenagers in general (p. 305).

In adulthood, transmasculine persons may seek counseling on their own for a variety reasons. Some may need help in coping with their personal feelings of isolation and internalized transphobia. Some may not feel the need for psychotherapy at all but will come (often resentfully) because they are required by the Standards of Care to do so before beginning transition. Others will seek mental health services for reasons unrelated to their trans status. Whatever their reasons, many trans people will have fears about sharing their trans identities and stones with someone who is not trans and who may not only misunderstand trans clients, but also mistreat them.

Transphobia has long been a problem in clinician-patient relationships (Raj, 2002). Any clinician, whether hetero-, homo-, bi-, or transsexual, may exhibit transphobia, a fear that most likely springs from society’s negative view of trans people and from the still-dominant theories of transsexuality that pathologize the desire to transition physically from one sex to the other (Stoller, 1975; Lothstein, 1983; Volkan and Masri, 1989). However, as mental health providers educate themselves on trans issues, this paradigm is changing from “transphobia to transpositivity” (Raj, 2002, p. 2). Self-education is the key.

FTM (and MTF) respondents to a survey asking about their experiences in psychotherapy yielded the following valuable information:

When asked what had been most helpful people listed four things: acceptance, respect for the person’s gender identity, flexibility in the treatment approach, and connection to the Transgender community … negative experiences in therapy were more often associated with perceived lack of provider experience with gender issues. Subjects also reported that treatment was compromised when providers who had some expertise in gender were not adequately up-to-date on current queer, transgender, or FTM issues [Rachlin, 2002].

In trans parlance, the clinician is known, not affectionately, as the “gatekeeper,” for it is the clinician who has the power to provide or deny the letter required by the Standards of Care. Without this letter of approval, most endocrinologists and surgeons will not assist a trans person on the desired journey of transition. Trans clients are inclined to approach a new therapeutic relationship with suspicion and, oftentimes, resentment. To establish trust at the outset of treatment, it is essential that mental health providers be able to show not only that they are educated in basic trans issues, but that they are also up to date on the current language and trends in the trans communities. It is my hope that this article will assist my readers in doing just that.

Of course, with a community-and its language-constantly in flux, and with a taxonomic tool hopelessly inefficient at fully expressing every permutation on that infinite tree of bubbles, by the time this article is read, it will undoubtedly be out of date. Like identity itself, it cannot possibly “persist through time.” Still, it is a place to start.