Transsexual

Transsexual is an older word for a person whose gender differs from the sex recorded at birth, historically carrying an implication the broader transgender umbrella does not: that the person has sought, or wants, medical transition. Its history runs in an unusual direction. It began as a diagnosis, became for a few decades the ordinary English word for the population, and has since been displaced by transgender — while staying in deliberate use by a minority who reject the displacement.

Definition & scope

The distinction the word once carried was between changing a social role and changing a body. In the mid-century framework a transvestite cross-dressed and a transsexual sought hormones and surgery, and the two were treated as different kinds of person rather than as points on a range. That taxonomy has not survived, largely because it described access to medicine at least as much as it described people — whether someone counted as transsexual often turned on whether a clinic agreed.

What remains is a subset marker rather than an umbrella. Someone who calls herself transsexual is usually saying she is a trans woman who has medically transitioned or intends to; a trans man using it says the same thing in the other direction. As with every term in this vertical it says nothing about who a person is attracted to — that axis is catalogued separately in the orientations vertical.

Usage is genuinely contested, and the two positions are worth stating apart. Style guidance now treats the word as outdated, following GLAAD's position that the transgender community largely replaced it with transgender. Against that, a minority — disproportionately people who transitioned before the 1990s — go on using it of themselves, on the grounds that it names something specific which the umbrella term deliberately does not.

History & origins

The word is older in German than in English, and the gap explains a persistent misattribution.

• 1910: Magnus Hirschfeld publishes Die Transvestiten, establishing the clinical vocabulary from which this term later split.
• 1923: Hirschfeld uses seelischer Transsexualismus in a lecture titled Die intersexuelle Konstitution. Because his institute was destroyed and he died in exile in 1935, English-language scholarship long credited the coinage to others.
• 1949: David Oliver Cauldwell publishes "Psychopathia Transexualis" in Sexology, introducing the word to English under a title modelled on Krafft-Ebing's Psychopathia Sexualis.
• 1966: Harry Benjamin's The Transsexual Phenomenon gives the category clinical standing and argues the appropriate treatment is transition rather than psychotherapy.
• 1980: the DSM-III adds transsexualism as a formal diagnosis.
• 1994: the DSM-IV replaces it with gender identity disorder.
• 2013–2019: the DSM-5 replaces that in turn with gender dysphoria, and the ICD-11 drops the category from its mental-disorders chapter altogether, re-siting gender incongruence under conditions related to sexual health.

In practice

Because the word entered English as a diagnosis, its practical history is a history of gatekeeping. Benjamin's intensity scale, and the clinic protocols built on it, sorted applicants into those who qualified for treatment and everyone else; applicants learned which biography to present in order to be believed. The retirement of the term is bound up with the retirement of that model.

Where the word survives in current documents it is more often legal than clinical: older statutes still carry it, so people meet it on forms long after their clinicians stopped saying it.

Psychology

No current diagnostic manual contains the word. The DSM-5 diagnoses gender dysphoria, which is distress rather than identity, and the ICD-11 removed the category from its mental-disorders chapter in 2019. Anyone describing themselves as transsexual today is therefore offering a self-description and not reporting a diagnosis; the two have been separate things for over a decade.

The research literature has followed the vocabulary. Studies published before roughly 2000 use transsexual as the population term, which makes older findings easy to misread as being about a narrower group than they were.

Prevalence & culture

How common is transsexual identity?

No population survey asks about the term, so the figure here is derived rather than measured.

The best available evidence is a check-all question in the 2015 U.S. Transgender Survey, which offered its 27,715 respondents a list of identity terms: 65% checked transgender, 56% trans, and 18% transsexual, putting it level with androgynous and well below the umbrella words. Applying that share to the Williams Institute's estimate of 2.1 million transgender US adults — 0.8% of the adult population — gives roughly 0.14% of adults, the figure recorded on this entry.

Two things pull that estimate in opposite directions and neither can be quantified: the survey's sample skews young while the term skews old, which understates it, and checking a term from a list is a weaker claim than choosing it, which overstates it. Confidence is accordingly low.

The direction of travel is legible in the surveys themselves. The 2022 successor to the USTS sorts its respondents into transgender women, transgender men, non-binary people and crossdressers; transsexual is not among the categories, and the term's slow retreat from instruments of that kind is why no current figure for it exists.