Apples and Oranges

It has come to my attention that the world might need a refresher on the notion that there are two distinct sub-groups of male-to-female transsexuals, historically known as 'primary', and 'secondary'.

These labels have been scorned recently because at their root, they simply mean what they say:  a primary transsexual is someone who presents as transsexual with issues, such as anxiety, that stem from a gender identity crisis.  That is, transsexualism is their primary mental issue from which secondary issues have manifested.

Secondary transsexuals are those whose gender identity issues are generally diagnosed after prior therapy for other conditions; usually depression.  These transsexuals generally present for these other conditions, and then through therapy find they have issues with their gender identity; although, some secondary transsexuals do not undergo therapy but do have past psychiatric histories.

These simplistic definitions have led to all sorts of arguments since a large portion of the transsexual population doesn't have the cut-and-dried histories required to fit into either category.  But, over time, there have been established several other characteristics that define these two sub-classes more accurately:

- a primary transsexual is usually driven to transition quickly due to a crisis of anxiety; a secondary transsexual typically has a long history of depression and comes to that decision slowly.

- a primary transsexual will generally accept total loss of family, friends and their career as potential consequences of transition; a secondary transsexual tends not to transition if they will lose immediate family, and will wait for children to grow into adulthood, for example.

- a primary transsexual will risk financial ruin and resort to prostitution or crime if necessary to transition as quickly as possible after 'crisis'; a secondary transsexual will wait, keep their employment as a male and save up, as if purchasing a car or a house, and be content with slower progress.

- a primary transsexual is far more concerned with the way the world sees them, where the secondary transsexual is far more concerned with how they see themselves.

- that said, if given a choice between being 'stealth' and having SRS, a primary transsexual will tend to choose the former; the secondary the latter.

- primary transsexuals tend to have close, even sexual relationships with other males before transition; secondary transsexuals tend to form close relationships with women, have sexual relationships and even children.

- obviously, the majority of primary transsexuals transition in their teens and early twenties; however, some secondary transsexuals, who have had successful heterosexual relationships, and perhaps children, in their teens, also transition in their twenties.

- primary transsexuals generally see SRS as a means to have normal heterosexual relationships with men (as per Blanchard's homosexual transsexual label), where secondary transsexuals see SRS as a means of matching their body with their mental image of themselves, and as a symbol of femininity (as per Blanchard's theory of autogynephelia).  

- to clarify, however, one does not need to be strictly interested in men to be an HSTS -- the choice to have a conventional relationship with a man tends to be more of a social decision than a sexual one.  Also, autogynephelia does not necessarily mean one is obsessed with one's genitals for the genitals sake -- in a broader sense this applies to any individual who transitions with the primary aim of correcting a perceived physical incongruity regarding their genitals.*

(In other words: 'I would be more comfortable if my boyfriend and I could have heterosexual intercourse' vs. 'I hate my penis, and I want to chop that fucker off'.)

*(...in case you'd like to argue my interpretations with me, or with Blanchard's theories in general,  I'd like to first inform you that fifteen years ago, I myself had input into some of the studies from which Blanchard derived his conclusions.

Seriously, people, he didn't just make this shit up.)

As you can see, the two baskets are quite clearly defined if you look at them -- apples and oranges.  Of course, there are many varieties of apples, and many varieties of oranges, just as there are many varieties of primary and secondary transsexuals.

But apples are still apples, and oranges are still oranges.  Not that either is better than the other -- but they are certainly different; arguing otherwise is just plain silly, and detrimental to ensuring that both groups are given access to relevant treatment and resources.