XVI Harry Benjamin International Gender Dysphoria Association Symposium
17 - 21 August 1999, London

Reflections on "Transsexualism and Sex Reassignment" 1969 -1999

Belief in Having Been Born Intersexed as a Psychological Defense among "Transphobic" Transsexuals: Report of Three Cases

Preves, Sharon, E., Ph.D.(cand.), Department of Sociology, University of Minnesota; Eyler, Evan A., M.D., M.P.H., Department of Family Medicine, University of Michigan Medical School

Despite the increased public visibility of persons who identify as transsexual, transgendered, or intersex, many people remain ignorant regarding the differences between these psychological and physical states of being, and the stigmatization of individuals who self-identify outside the male-female dichotomy remains commonplace. For some, persons who are intersex-identified are considered more socially acceptable, since their variance appears to be the result of a medically documentable physical difference, rather than an invisible, psychological difference. Persons who present for gender transition medical services have sometimes internalized substantial transphobia prior to accepting their own transsexual or transgendered identity. In these cases, one possible psychological defense is the belief that one was born intersexed and incorrectly sex-assigned in infancy; therefore, the decision to pursue sex reassignment or gender transition in adulthood represents a logical undoing of previous medical mismanagement. This belief may persist despite a lack of objective support and may take on a fixed, delusional quality. This session will present three cases in which an incorrect but persistent belief in an intersex birth history served as a rationalization for gender transition in adulthood, and will briefly discuss the clinical implications of providing medical services to transgendered and transsexual persons who hold these beliefs.