Gender Identification and Sex Reassignment Surgery in the Trans Population: A Survey Study in France

Abstract

Drawing from controversies between medical, legal, and associative actors about the obligation of sex reassignment surgeries (SRS) for people who intend to change their civil status, this article discusses the role that medical procedures, and particularly SRS, play in contemporary gender identifications and transition pathways in France. In 2010, the French National Institute of Health and Medical Research conducted a national survey in order to study the sociodemographic characteristics, access to medical, and psychological care, and state of health among trans individuals. After a long period of ethnographic work during which a partnership was established with trans actors to map the social, medical, and political landscape of trans communities, a questionnaire was developed and distributed between July and October 2010 in collaboration with most of the trans organizations and public and private health professionals operating in France. Overall, 381 self-identified trans individuals returned the anonymous self-administered questionnaire. The results highlighted the heterogeneity of the trans population, whose definition cannot be reduced to a group of individuals undergoing standardized hormonal treatments and SRS. Two central indicators, sex assigned at birth and gender self-identification, enabled us to describe and analyze different medical and legal pathways with a particular focus on SRS, which is often compulsory for a change of civil status in France. Although SRS remains an important factor in an individual's subjective evaluation of the success of the transition pathway, its practice varies depending on one's sex assigned at birth and gender identification.

Cancer in Transgender People: Evidence and Methodological Considerations

“…Biological sex is determined on the basis of the appearance of genitals, chromosomal and hormonal makeup, and secondary sex characteristics, whereas gender refers to an individual's sense of maleness, femaleness, neither, or both (1,2). Although transgender people may not self-identify on the basis of binary definitions (3), a person whose gender identity differs from a male sex assignment at birth is often referred to as male-to-female, transfeminine, or transwoman, and a person whose gender identity differs from a female sex assignment at birth is often referred to as a female-to-male, transmasculine, or transman (4,5).…”

Cohort profile: Study of Transition, Outcomes and Gender (STRONG) to assess health status of transgender people

“… 2 3 Many transgender people may not self-identify based on binary definitions; 4 however, a person whose gender identity differs from a male natal sex assignment is often referred to as male-to-female or trans woman, and a person whose gender identity differs from a female natal sex is often referred to as a female-to-male or trans man. 5 6 More recently, the terms transfeminine (TF) and transmasculine (TM) have become preferred as they also apply to individuals who do not identify with binary gender categories. 7 …”

A novel method for estimating transgender status using electronic medical records

“…Transgender people are those whose gender identity or expression differs from the sex originally assigned to them at birth [3]. While self-identification of transgender people may not fit binary definitions [4], a person whose gender identity differs from a male sex assignment at birth is often referred to as male-to-female (MTF) and a person whose gender identity differs from a female sex assignment at birth is often referred to as a female-to-male (FTM) [5]. Transgender people may experience gender dysphoria, which is a diagnostic term that describes “a discomfort or distress that is caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth” [6].…”