A transvestite is a man who wears women’s clothes. The term was coined by Magnus Hirschfeld, a German sex researcher in the early twentieth century.
The word is now outdated, replaced by transgender and cross-dresser. However, it is still used to describe a hermaphrodite or a cisgender gay man who dresses as a woman for performance (drag queen). It is also a derogatory term for some transgender people.
Definition
The term transvestite is used to describe a person who enjoys wearing clothes that are traditionally associated with the opposite gender. This activity is also called cross-dressing and was practiced in ancient cultures, including those of Egypt (where castrated priestesses and Hatshepsut ruled) and Asia.
Transvestism is not a mental illness, but it may be a fetish that can cause significant distress. It falls under the category of paraphilia, which also includes atypical sexual thoughts and behaviors.
A transvestite is different from a transgender person, who was assigned one sex at birth but identifies with a gender that differs from the biological sex. However, many people confuse the two terms, because a transgender person is someone who dresses as the opposite sex. Saying “a transgender” is like saying “a rich,” and has the same grammatical implications as the phrase, “a guy who loves to dress up.” Drag queens and kings are also examples of transvestites, but they have a special culture and art form behind them.
Symptoms
Most people know what cross-dressing is, although it may be stigmatized in our culture. Dressing in clothes of the opposite sex isn’t always a problem and doesn’t necessarily require treatment. However, when a person experiences severe shame or anxiety around cross-dressing, they should consider talking to a therapist. Therapists offer a judgment-free space to talk about sex, including sexual experiences, and can help people better manage their impulsive urges.
To be diagnosed with transvestite disorder, a person must experience chronic (for at least six months) and intense sexual arousal from thoughts or urges to wear clothing traditionally associated with the opposite gender. These feelings must cause significant distress or impairment in important aspects of life.
Although a small number of men with transvestic disorder seek medical care, those who do typically do so at the urging of loved ones or co-workers. They may also be referred to a psychiatrist by their physician. Psychiatrists can use behavioral therapy and other non-invasive techniques to help decrease the intensity of a person’s impulsive cross-dressing urges.
Treatment
Many people don’t like the term transvestite because it’s an outdated slur for transgender people. But a drag queen is just one example of someone who crosses dress boundaries and shows gender expressions in a way that’s different from the gender they were assigned at birth. A man who dresses like a stereotypical woman while still identifying as a man is another example.
Most cross-dressers do not have a psychiatric disorder, and doctors usually only diagnose transvestic disorder when the desire to dress in clothing of the opposite sex causes distress or interferes with their normal life functioning. Fetishistic transvestism involves recurrent fantasies or compulsive acts of dressing in the clothing of the opposite sex for sexual arousal.
The other category is non-fetishistic transvestism, in which there’s no sexual motive for the cross-dressing. This category is similar to obsessive-compulsive disorder and has been shown to respond well to selective serotonin reuptake inhibitor (SSRI) medications. In our three cases, the patients also had other paraphilias.
Prevention
Efforts to prevent HIV among transvestites must take into account their diverse sexualities, gender identities and relationships as well as the wider context of dyadic and commercial sex work. Routine transphobia, homophobia, racism, poverty, housing instability, substance use, intimate partner violence and lack of health insurance exacerbate risks for STIs and HIV infection and hinder access to care. Further research using rigorously applied probability sampling methods is needed to accurately define local HIV epidemiology and inform prevention strategies that integrate gender and sexual diversity. Structural interventions are also needed to transform the sex worker context and integrate HIV/STI prevention into daily life.