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Sizing up Transvestism: Perspectives Regarding Its Practice

Back in July 1984, a recent college graduate had secured a respectable job offer in his area of study. The subject's current employment was directing and playing in a roving band of musicians at the aquatic theme park known as Marineland, near Los Angeles, CA. His fellow musicians challenged him to do something out of the ordinary for his last day. Looking around the costume room, the subject spotted a women's costume dress and realized that wearing it was just the thing. Three different women helped in carefully applying fingernail polish, mascara, lipstick, and other cosmetics. The subject's permed hair was adorned with a bonnet. The subject felt various emotions as he now stared at his new persona in a full-length mirror. He felt the humor, but also sensed the thrill and excitement of seeing a somehow believable opposite-sex version of himself. The subject then proceeded to perform music and dance in front of the large summer crowds, to the shock and horror of the park's management.

Would the above behavior label the subject a transvestite? These and other questions regarding transvestism interest me, especially because I was the above-mentioned subject. As we shall see, this does not automatically prove that I am a transvestite.

What is transvestism? The term was coined by Magnus Hirschfeld in 1910. It originally denoted any instance of psychologically motivated cross-dressing, which applied without regard to an individual's sex or sexual preference. The term eventually was limited to cross-dressing heterosexual males and is associated with sexual arousal (Blanchard, 1990). The word transvestism comes from the Latin trans, "across," and vestis, "dress." Most cross-dressing begins in childhood or early adolescence (Katchadourian, 1989). If one took the sexual arousal aspect out of consideration, transvestism and cross-dressing would be synonymous. Cross-dressing has been associated with religious, occultic, and secular rituals. Male homosexuals have old traditions of cross-dressing at parties and balls (Money, 1988). Current definitions make transvestism a subset of cross-dressing.

Though transvestism is associated with men today, a complete contrast to this was seen before 1800, when men dressing as women was rare, and there was a tradition of cross-dressing among women (Dekker & van de Pol, 1989). This interesting shift will be dealt with in more detail later in the paper.

The DSM-IV's diagnostic criteria for Transvestic Fetishism (American Psychiatric Association, 1994) require that the subject be a heterosexual male who has had, for a period of at least six months, recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving cross-dressing. Also, this activity must cause significant distress or impairment in social, occupational, or other important areas of functioning. Interestingly, one can specify this with Gender Dysphoria, which would place the individual closer to having Gender Identity Disorder, or, put simply, being a transsexual. Since my own cross-dressing experience was not preceded or followed by any recurrent intense feelings of any sort regarding the idea of cross-dressing, I believe that it is safe to say that I am not a transvestite.

Are transvestites people who are unhappy about the sex they were born with, otherwise known as suffering from what is called gender dysphoria? Surprisingly, transvestites usually have a solid gender identity that matches their anatomical gender, with perhaps occasional shifts to the other gender identity. Because many transvestites fear being found out, they consciously try to act as traditionally masculine as possible. The parents of Ernest Hemingway, the notoriously macho writer, used to dress him up as a girl when he was young (Francoeur, 1991). Even though I found no reference stating he was a transvestite, his history, coupled with his own struggles with gender confusion found in his writing, would seem to have made him a strong candidate for being one.

Gender identity has been defined as a psychological construct which connotes a basic sense of maleness or femaleness, or a conviction that one is male or female. This is to be distinguished from gender role, which would be behaviors that are understood to reflect masculinity or femininity in our society (Babinski & Reyes, 1994). It should therefore be clear that transvestites do not suffer from having a problem with their gender identity as much as with their gender role.

In what way does cross-dressing become fetishistic? This occurs when the clothes are thought to be a fetish, that is, the substitute inanimate object for the body of a female person. The transvestite needs the clothing (fetish) and the image of self as female (autogynephilic fantasy) to feel excitement and to form a psychic bridge to heterosexual behavior that will allow him to have intercourse. Many cross-dressers report that without the clothing or the fantasy, they cannot bring themselves to initiate sex or attain erections (Levine, 1993).

As with many other psychological disorders, results of many studies indicate that cross-dressing behavior occurs on a continuum, with the clearly defined fetishistic transvestite at one end and the committed full-time transsexual at the other (Bancroft, 1989). Though it is never mentioned in the references I could track down, it would seem fair enough to also assume that there is a continuum between my own semi-innocent cross-dressing experience and actual fetishistic transvestism. Evidence for this, I believe, would help move us toward getting rid of the idea that transvestites, transsexuals, bisexuals, and homosexuals are some kind of genetically defective third sexual gender that we cannot phenomenologically relate to in the least bit. Also, viewing all these behaviors as part of a continuum would prevent these individuals from simply using the argument that they "were born that way" and therefore could not possibly change. I am not saying this with the intention of attacking these people, but with the intention of trying to give them hope, the hope of change if and when they see change as an important goal for themselves.

At this point, I would like to outline the picture of the somewhat typical transvestite regarding his description and his history of development. Such subjects are not effeminate in childhood and are rarely considered sissies. They are not markedly prone to play with girls or to play girlish games, nor do they become "mother's helpers." Most of them enjoy normal peer relations, engaging in and even excelling in many boyish pursuits, such as team sports. As adults, they are frequently found in traditionally male-dominated occupations, ranging from truck drivers to business executives, and almost never in jobs commonly held by homosexual men. Transvestite boys begin secret cross-dressing in childhood or puberty, rarely later than mid-adolescence. The articles of clothing, which often are underwear, are usually borrowed without permission from a mother, sister, or other female in the household. This does not seem to have any special significance, but rather appears to be a matter of opportunity and circumstance. Before puberty, cross-dressing produces feelings of pleasurable excitement. During puberty, wearing women's clothing begins to elicit penile erections. Adolescents usually terminate their cross-dressing sessions by masturbating to orgasm, after which they immediately remove their female attire. Later in adulthood and middle age, cross-dressing elicits less and less sexual excitement, the excitement becoming replaced with feelings of comfort or well-being (Blanchard, 1990; Stoller, 1985).

The transvestite's overt behavior, having typically been established during adolescence, often largely disappears during the early stages of a heterosexual relationship. When problems arise in the relationship or marriage, particularly sexual difficulties, the urge to cross-dress returns and, over a number of years, may fluctuate as the success of the marital relationship varies (Bancroft, 1989).

What does the transvestite typically think or feel about himself while he is cross-dressed? Most cross-dressers feel different, more feminine, while cross-dressed, and they actually respond differently to questionnaire tests of gender while cross-dressed (Bullough, 1991). They seem to enter a fantasy world where reality sometimes becomes a poor second to wishful thinking. They are people pretending, to themselves and to others, that they are something other than what they really are. Some results of this are that the transvestite refers to their male self in the third person, or he gives out information that will later be discovered to be pure fantasy or a lie. Transvestites typically think of themselves as normal, masculine males. Some describe themselves as the most perfect examples of humankind (Bullough et al., 1983; Woodhouse, 1989).

What are some of the typical personality traits found among transvestites? Many, if not most, studies have utilized large samples of transvestites recruited from transvestite social clubs, many of whom have never been in therapy. Most believe that they can somehow influence others' reactions and minimize any adverse social consequences associated with cross-dressing, and they have a general sense of ease in social situations. Given the often extreme importance transvestites place on passing as women, perceptions of skill indicate a high overall sense of worth, high social confidence, and strong interpersonal control (Persinger & Stettner, 1991). Compared with control groups of males, transvestites have higher fantasy levels, more negative body image, and less sexual satisfaction. They also were high in six facets of neuroticism: anxiety, hostility, depression, self-consciousness, impulsiveness, and vulnerability to stress. Transvestites were found to be low on extraversion and agreeableness, both of which cause a low capacity for emotional attachment in any interpersonal relationship; such individuals are many times seen by others as hostile, abrasive, and somewhat self-centered (Wise et al., 1991).

Is there a biological cause of transvestism? At the present time, there is no evidence of a genetic or any other biological mechanism sufficient to account for transvestism. There has been a search for endocrine abnormalities causing a type of androgen-insensitivity syndrome in both transvestites and transsexuals. No such mechanism has been clearly identified, though there have been some suggestive findings. Regarding brain waves, a high incidence of epilepsy or abnormal electroencephalograms (EEGs) in transsexuals has been found by several studies. Because the majority of transsexuals show no such abnormalities, it would be a long shot to try to extrapolate a connection between this finding and transvestism (Bancroft, 1989). Since the evidence for a biological cause is very noticeably lacking, it seems that we now must turn toward looking for a psychological cause of transvestism.

As we turn our attention toward finding the psychological cause of transvestism, we find numerous theories, some of which even seem to contradict one another at points. Some theorists seem to go a little out of their way to try to fit transvestism into their theories.

Some theorists say that identification mechanisms, organized in a definable pattern, are one type of foundation for transvestism. The self is transformed into a female self that is externalized to the mirror. Within the male self, therefore, must reside a female representation, a female image, derived from a prior assimilative identification. Most likely, mother and associatively linked maternal derivatives have been assimilated. This internalized representation is projected. The man's action-self (ego) admires and wishes to penetrate the projected female component in the mirror. The masturbatory behavior represents this penetration wish by the observing action-self. This aspect of projective identification may be called penetrative identification. The internalization, gained originally through assimilative identification, can be penetrated only if externalized by projection (Epstein, 1993).

Another explanation comes from object-relations theory. The core idea involves a splitting of the developing ego, which may be reinforced by the mother's nonacceptance of the male gender qualities of her child. The split-off ego serves as a compensatory internal structure, and the child becomes, in this symptomatic way, his own selfobject. The amount of difficulty attributable to this split-off ego may be due to several variables, such as the cohesiveness of the entire ego system. This line of theory seems to support those who think of transvestism as an expression of a second self (Docter, 1988).

Learning theorists, who hold to behavioristic theories, suggest their own viewpoint. Their socio-psychological research has focused upon gender role conditioning, the notion that transvestism is a symptom of maladjustment (Woodhouse, 1989). They see it as a learned conditioned response in which dressing in women's clothing is paired with an aversive stimulus. In essence, two things have gone wrong: adaptive behaviors have not been learned, and maladaptive behaviors have been learned (Sarason & Sarason, 1993).

Some theorists suggest that transvestism is essentially an outgrowth of a person's narcissism and egocentrism. Through narcissism, it can occur in two ways: one, as an erotic arousal and admiration of oneself dressed in female attire, involving no other person but oneself (automonosexualism), and two, as interpersonal narcissism, in which the attention of another person is sexually arousing. The clothing itself may be a signal saying "Pay attention to me," so that they may be admired. The other person in the exchange is an audience, much as an actor on a stage relates to his or her audience. They do not participate in the exchange. They watch, and then applaud when the performance is finished. In this sense, the clothing may simply be a vehicle to create that attention. Some transvestites believe that women have a better time than men in their courtship relationships. The women receive all of the attention of the men without having to show as much in return. Many of the stereotyped behaviors appalling to feminists today may be the stereotyped sex-role behaviors that are sought out by transvestites as part of their need for attention (Langevin, 1985).

From more of a systems theory approach, strategic therapists present their explanation of the cause of transvestism. This viewpoint is used to explain how cross-dressing could develop from a simple erotic experience into a difficulty that is pervasive. This evolution can be viewed as a positive feedback loop in a self-referential situation. It is not uncommon for transvestites to fear discovery and to fear that they are abnormal. Fear of discovery is not surprising given the possible repercussions that could occur if others knew of the cross-dressing. These two fears, of abnormality and of being discovered, potentially build upon each other. Not being able to discuss the cross-dressing with others reinforces the idea that it is somehow abnormal, which in turn reinforces the secrecy. Compulsive cross-dressing may increase in an attempt to relieve the anxiety created by these difficulties. This creates a vicious cycle, where the difficulty (cross-dressing) leads to the attempted solution (avoiding cross-dressing), which causes more anxiety, which leads the individual back to cross-dressing to again find relief (Shaffer et al., 1989).

Some theorists suggest transvestism is due to psychosexual maladjustment. This stems from painful childhood experiences which have arrested his development. It is here that we find elements of what may be called the dominant/absent parent syndrome. As a child, the transvestite felt alienated from his father and sought to please his mother by engaging in feminine activities. Consequently, he is unable to accept his masculinity later in life (Woodhouse, 1989). It is my opinion that basically the opposite set of causes just mentioned here would more likely be the real cause of transvestism. A distant/passive father is the one whom I think the child would try to please by trying to be more masculine than he actually feels inside. Thus, the child feels that he is never masculine enough to win his father's approval. The mother sets up a double standard where she claims to be feminine but acts in a very dominant/active role. I believe the child, maybe at a subconscious level, sees that the real power in the family lies in this double-standard role, and thus begins to mimic it in his own anxiety-ridding way. This theory did not just come out of the blue, but is based on observing my family, who happened to fit my description. I truly felt that I was greatly missing the mark regarding masculinity in the sight of my stepfather. Even though I did not choose cross-dressing to identify with my mother, I still identified with her much more than with my father. Most of my personality traits appear to me to mirror my mother's.

One study I found seems to support my theory fairly well. The study found that many of the respondent transvestites were humiliated by their fathers for failure to perform at the preconceived level of masculinity. Emotional neglect by the father or father figure was evident in many of the subjects, where the father figure was emotionally or physically absent from the home environment during much of his formative years. The incidence of alcoholism in the home by one or both parents was more than twice the national mean. In my family, all my parents and stepparents were alcoholics. The mother in the family was perceived as being equally dominant and passive in behavior (note the ambiguity). Mental and physical abuse figured very high in the majority of these families.

For 66.6% of these subjects, initial cross-dressing occurred at age 10 or earlier, and for another 19.6%, it occurred between the ages of 11 and 15. The range of age at initial cross-dressing was 2 to 54 years, with a mean age of 10.8 and a median age of 8 (Goodwin & Peterson, 1990).

Another study found that 86% of the transvestites were white. Regarding their professed religion, 59% were Protestant, 35% were Catholic, and 6% had no affiliation. Of the subjects, 50% were single, 33% were married, and 17% were divorced or separated (Wise et al., 1991).

Many clinical observers have noted the frequent co-occurrence of masochism and transvestism. This also has been confirmed by investigators who studied members of transvestite and sadomasochistic clubs. One common fantasy of transvestite men is that they are forced to cross-dress or to put on makeup by a dominant woman. Other somewhat common fantasies include bondage or whipping at the hands of a dominant woman. It should be noted that strong masochistic tendencies are found only in a minority of subjects. A much rarer anomaly, but one with a very strong association with transvestism, is the dangerous masturbation practice of autoerotic asphyxia. About one quarter of autoerotic asphyxia fatalities are found cross-dressed (Blanchard, 1990).

Various therapists are convinced that modern transvestism only becomes understandable in the light of the changing attitudes toward gender that have been taking place over the past century or so. Perhaps the most fascinating contradiction in gender roles is that male cross-dressing in the past never existed on the same scale as female cross-dressing. For most of human history, being a man gave one much higher status than simply being a woman. Women who went further and managed to pass as men through cross-dressing, and who were never found out until they died or until they themselves later told their story, were much admired. There are more than 30 women saints within the Catholic Church who, while they were alive, were thought to be men (Dekker & van de Pol, 1989). One source I quoted (Dekker & van de Pol, 1989) collected nearly 1000 accounts of women who lived out all or a significant part of their adult lives as men, only to be found to be women on their deathbeds. They felt that male attire gave them more freedom.

Toward the end of the nineteenth century, women's roles began to change. A growing cult of womanhood emphasized the purity and the delicacy of women as contrasted with the coarseness of men. Women were made guardians of public morality and the preservers of society in such things as music and the arts. Men were in a sense animals who had to be civilized by women, a characterization that was very upsetting to very many men. Adding to unrest over the male role was the growth of romanticism. In romanticism, the claims of the intellect gave way to those of passion and emotion. The critical spirit was replaced by an imaginative one. What was taking place was a new appreciation of female qualities, raising women's place to a higher moral and aesthetic level, an image which at least some males wished to adopt for themselves. There was a reaction to this potential growth of effeminacy in the male. One reaction was the implementation of more rigorous athleticism in all schools for male students. Many institutions such as the YMCA and the Boy Scouts were founded to develop and encourage a new masculinity. The number of male cross-dressers reported increased steadily and disproportionately during the twentieth century, and even more rapidly in the post-World War II period (Bullough, 1991).

One author I found claimed that since the "Great Renunciation" of the eighteenth century, when men shed their peacock apparel and took to staid, solemn, dark, proper clothing as a mark of their social seriousness and breeding, men's clothing has permitted few fantasmatic touches in style, color, or fabric. In other words, men's clothes were no longer interesting at all. Another author claims that men are driven to fetishistic madness by women. Nearly every adornment and ornament that women have invented, everything they have imagined as pretty, curious, bizarre, and extravagant to please a man, and vice versa, has been able to become the source of a new fetish. Also, fashion and makeup that exaggerate certain pleasing forms of the body and create "psychic illusions" have an undeniable influence upon the senses of men (Matlock, 1993).

Today, women buy clothes in men's and boys' shops for themselves without psychiatrists, psychologists, or almost anyone else thinking much about it, while their male counterparts would be severely stigmatized if they were caught buying women's clothing for themselves. The whole unisex look is not men buying women's clothing but women buying men's, with the result that we no longer look upon men's clothing as entirely male, although for the most part we still look upon women's clothing as belonging exclusively to females (Bullough, 1991).

One author looked at four famous twentieth-century entertainers who, though they may not have been transvestites, all showed certain transvestic symptoms unique to our modern time. Rudolph Valentino, he-man, heartthrob, and movie idol of the 1920s, is in fact an exemplary figure of transvestism, at once feminized and hypermale. His appearance in Arab robes, eyebrow pencil, and mascara as the title character in The Sheik (1921) set off a frenzy of response among (largely female) filmgoers with its drama of sexual sadism amidst the "Middle East" locale. His clean looks were attributed to an effeminate use of depilatories. Liberace, a name more connected with the thought of cross-dressing, looked up to Valentino as his ideal, the male star who had remained forever young by the unlooked-for expediency of dying early. Liberace's mother, a great fan of Valentino, named her son Wladziu Valentino Liberace. Liberace considered Valentino a major figure in his own personal social history of the crossover style of wearing the outrageously effeminate costumes that he did on stage. Of all the show business copies to which Liberace laid claim, the one he most insisted upon was Elvis Presley. Elvis, like Liberace, was obsessed with Valentino. Many other "copies" are mentioned, including the current superstar, Michael Jackson. The author later goes on to say that in the context of popular culture, these transvestic symptoms appear, so to speak, to gratify a social or cultural scenario of desire. The onstage transvestite is the fetishized part-object for the social or cultural script of the fan (Garber, 1992).

As a Christian working toward my MFCC degree, I stand in awe at what appears to me to be such a powerful social as well as individual symptom of a very confused world. In ancient times, the Jews did not seem to get the chance to see, as we do today, the widespread lack of obedience to God's commandment for a woman not to wear anything that pertains to a man, nor a man to put on a woman's garment, "for all who do so are an abomination to the Lord your God" (Deuteronomy 22:5, New King James Version). It appears that in almost all societies that have existed, there has been a sex differentiation in clothing (Bullough, 1991). I believe that since the human race fell into sin and rebellion against God, we have also lost our bearings on who we are as humans, especially the meaning of both genders. History has recorded at least a few of our unhealthy shifts in society's definition of each gender. Instead of each of us seeing the gender opposite to us as a beautifully designed complement to our own, we have either looked down on it as inferior or, as with the transvestite, exalted and worshiped certain aspects of it. Today, I believe that females in general have moved into a paradoxical double-standard gender role that, by definition, excludes the need for men as a counterpart. I would think that the church would do a great service to begin to recognize this imbalance and to carefully rethink its understanding of male/female differences in the social realm. The love between a husband and his wife is, in theory, the best picture on earth that we have of the relationship Christ has with His followers, where Christ is the man, and the follower is the female in the analogy (Ephesians 5:22-33). The ultimate equalizer is entering the family of God through faith in Christ, because "there is neither Jew nor Greek [non-Jew], there is neither slave nor free, there is neither male nor female; for you are all one in Christ Jesus . . . and heirs according to the promise" (Galatians 3:28-29).

The only biological treatment pertaining to all transvestites that I found is the taking of either buspirone or alprazolam. Both, at a certain dosage level, have allegedly helped in reducing the frequency of cross-dressing and the subjects' anxiety level (Fishbain, 1989). Regarding middle-aged gender-dysphoric transvestites, some have been treated successfully with estrogens (Stermac, 1990).

Regarding behaviorist therapy treatment, there are both good and bad reported results. The disappointing results had to do with electric shock aversion treatment and loud, disturbing bells during the watching of transvestite videos (Shaffer et al., 1989). Covert sensitization allegedly has been quite successful in treating transvestism. Subjects are first asked to imagine as vividly as possible the sexually arousing behavior that they are trying to eradicate, and to follow these thoughts with equally vivid aversion imagery, such as dealing with being discovered and embarrassed (Sarason & Sarason, 1993).

The hard part to me is not as much finding a technique that works, but convincing the transvestite that he has a problem. These subjects have an extreme reluctance to give up their cross-dressing behavior. They rarely seek treatment. When they do come to therapy, it is frequently for reasons other than cross-dressing itself, usually because of the urgings of others who have discovered this behavior and are concerned. Transvestites almost always want only to know how to "keep working without breaking down and getting into trouble." Many times, a transvestite will show up for therapy when he is trying to save his marriage through marriage counseling.

Some success has been noted by strategic therapists. They stop or at least ease the vicious anxiety cycle of cross-dressing and not cross-dressing by interfering with the cycle. Reframing or redefining how the subject views his cross-dressing behavior is the goal, so that he has less reason to hide or avoid cross-dressing. For example, to help normalize the behavior in his own view, let him know that even individuals who are considered "normal" have sexual fantasies that would be considered deviant if they acted upon them. This type of approach should lessen the anxiety surrounding the fantasies and the cross-dressing, and thus decrease the power it seems to have over the subject (Shaffer et al., 1989).

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