Volume 6, Number 1, January - March 2002
Male, Female and Transgender : Stereotypes and Self in Thailand
By Sam Winter and Nuttawut Udomsak
Citation: Winter S , Udomsak N (2002) Male, Female and Transgender : Stereotypes and Self in Thailand. IJT 6,1, http://www.symposion.com/ijt/ijtvo06no01_04.htm
Two hundred and four Thai Male-to-Female (MtF) transgenders (mean age 23.0 years) completed questionnaires designed to examine self-concept (actual and ideal) and gender-trait stereotypes held towards men and women.
Findings indicated that (a) participants' gender-trait stereotypes were similar to those of non-transgenders examined in other studies (both in their own country and internationally), (b) their actual and ideal self-concepts each displayed much more consensus about traits not possessed than about those possessed, (c) their actual and ideal self-concepts were commonly discrepant, and (d) while they commonly held a stereotypically female view of themselves, they often aspired towards a broad range of traits that were less stereotyped. Indeed, (e) they commonly disowned stereotypically female traits.
These last two findings suggest that transgenders have personal growth goals that transcend, or even run counter to, gender-stereotype. They may instead conform to more fundamental ideas about favourable human qualities.
Keywords: transgender, Thailand, self-concept, personality traits, gender-trait stereotypes.
Despite the central place of identity and gender in the life of transgenders, there has been little systematic research into either their sense of self (actual or ideal, and defined broadly as of personhood rather than of a gender group) or their perceptions about qualities of males and females (the gender groups between which they are transitioning). This study, conducted in Thailand, focused on these issues, addressing two questions. Firstly, what beliefs do transgenders have regarding the traits of men and women (i.e. 'maleness' and 'femaleness)? Secondly, how may their actual and ideal self-concepts, as well as discrepancies between the two, be viewed in terms of these beliefs about 'maleness' and 'femaleness'?
The findings for the first question indicate that participants overall believed much the same about the characteristics of men and women as do non-transgenders in their own country and overseas. The findings for the second question indicate that, while participants might hold a female-stereotyped view of themselves, they often aspired towards a more balanced self, even to the extent of abandoning female aspects of their current selves. It appears that they commonly had goals for personal growth that went far beyond the narrow pursuit of, and even ran counter to, gender-stereotype.
Psychological research has touched on many aspects of transgender. Among those areas studied have been (a) personal histories and family characteristics (Newcomb, 1985; Tsoi, 1990; Doorn et al., 1994; Mason-Schrock, 1996; Yuksel et al., 2000), (b) sex typing (Brems et al., 1993), (c) sexual behaviour and orientation (Blanchard, 1985; Blanchard et al., 1987; Dulko, 1988; Lief and Hubschman, 1993; Blanchard, 1993; Nemoto et al., 1999; Chivers and Bailey, 2000), (d) physical attractiveness (Zucker et al., 1993; Fridell et al., 1996), (e) cognitive functioning (Hunt et al., 1981), (f) emotional, sexual and social functioning of those who are planning, have undergone or have declined sex reassignment surgery (Fleming et al., 1981; Blanchard et al., 1983; Fleming et al., 1984a and 1984b; Kockott and Fahrner, 1987; Kuiper and Cohen-Kettenis, 1998; Barrett, 1998) and (g) relationships between gender dysphoria and psychiatric disorders of various types (Dixen et al., 1983; Freund and Watson, 1993; Weinrich et al., 1995; Cole et al., 1997).
Transgender and self
By contrast there appears to have been little research into how transgenders view themselves as people (actual self-concept), or what sort of people they would like to be (ideal self-concept). This is somewhat surprising in view of the central place of identity in transgender. True, there is much research on gender identity (their sense of being either male or female). However, relatively few studies have gone on to examine more broadly their perceptions of and aspirations for self as people. Exceptions to this general tendency can be seen in the work of Fleming et al. (1981), Skrapec and MacKenzie (1981), Fleming et al. (1984b), Kuiper and Cohen-Kettenis (1988) and Cole et al. (1997).
Fleming et al. (1981) used the MMPI to examine the personalities of 20 transgenders, comprising equal numbers of pre-surgical and post-surgical clients (MtF and FtM). They found that both pre-surgical and post-surgical MtFs obtained high femininity scores on the Mf (= masculinity-femininity) scale, scoring well above average for males (their biological sex) but within the normal limits for females (their desired gender). The pre- and post-surgical FtMs scored within the normal range for females, but well above average for males. While the Mf scale does not directly examine identity, it measures interests and traits from which it may be possible to infer aspects of identity. To the extent that the Mf scale might do this, these findings perhaps hint at how fully transgenders can take on the identity of their preferred gender, even without having undergone sex reassignment surgery.
Skrapec and MacKenzie (1981) compared homosexual males, heterosexual males and pre-surgical MtFs (eight participants in each group) on a range of repertory grid and questionnaire measures covering, inter alia, self-concept (actual and ideal), self esteem, sex roles, and gender-linked values. Predictably enough, the researchers found that self-concepts of transgenders, unlike those of the other two groups, tended to resemble their perceptions of females. However, responses on the Bem Sex Role Inventory suggested a fairly strong male element accompanying their female persona, so that most of the transgenders could be viewed as androgynous (the only group for which this was true). Finally, on the Maferr Inventory of Masculine Values the transgenders revealed themselves to be highly family oriented, in terms of their descriptions of themselves (as well as in terms of their perceptions of both the ideal man and a woman's ideal man). In summary, the Skrapec and MacKenzie study portrayed the MtF as highly feminised and nurturant, although retaining a substantial 'male' element to personality.
Confirmation that transgenders may retain traits of the gender they are leaving behind comes from Fleming et al. (1984b). who used the Personal Attributes Questionnaire (PAQ) to examine, inter alia, masculinity and femininity in the actual and ideal self-concepts of 22 (post-surgical) FtMs and a group of control males. When completing the PAQ for actual self-concept, transgenders, despite displaying similar responses to the control males on the masculinity (M) scale, scored markedly higher on the femininity (F) scale than did the control males. They therefore seemed to retain a strong element of femaleness in actual self. As for ideal self, there were no significant differences between the two groups at all, either on the M or F scale. However, this did not seem to be because the transgenders wished for more masculinity and less femininity. Rather, it seemed that both groups aspired to greater masculinity and femininity, washing out any differences between them. In summary, Fleming et al. have demonstrated again the somewhat androgynous nature of the transgender self (both as experienced and idealised).
The above studies share two problems: they are small samples drawn from one culture (North American). In a much larger study in the Netherlands, Kuiper and Cohen-Kettenis (1988) interviewed 36 FtMs and 105 MtFs (post-surgical). They found that the vast majority had a gender identity consistent with their sex reassignment, and that most were confident and happy in their new role. Unfortunately, the authors go into little detail about what their sense of being female (or male) might involve.
Back in North America, a large-scale study by Cole et al. (1997), primarily devoted to identification of psychiatric disorder among transgenders, included a short-form MMPI to a sub-group consisting of 93 MtFs and 44 FtMs (pre- and post-surgical). FtMs displayed Mf (= masculinity-femininity) scores well within the normal range for females, and therefore appeared to retain characteristics consonant with genetic self. However, the MtFs displayed Mf scores that were far more typical of genetic females than males, and so seemed to have embraced a cross-gender personality to a greater degree than had the FtMs, abandoning male traits to a greater extent than FtMs abandon female traits. What this study does not reveal, and did not attempt to examine, is the degree to which transgenders wish to abandon these genetic sex-consistent traits, in other words, what traits their ideal selves would embrace.
Transgender and gender-trait stereotype
In view of the central role played by 'maleness' or 'femaleness' in the life of transgenders, it is surprising that there are so few systematic examinations of their beliefs about men's and women's attributes (i.e. gender-trait stereotypes). An exception is the US study of Brems et al. (1993) who examined stereotypes as evidenced in the drawings of MtFs. They found that, while MtFs' drawings of males differed little from other individual's drawings, their drawings of females appeared "to endorse femininity for women to a much larger degree than other individuals" (Brems et al., 1993: 263). The implication is that MtF individuals may have an exaggeratedly feminine view of females.
Apart from this, there is Skrapec and MacKenzie's study of pre-surgical MtFs, homosexual and heterosexual males (1981), which collected data on, inter alia, participants' perceptions of ideal and non-ideal men and women. However, their account of the research gives little indication of what was found, beyond that the transgenders perceived (on the Maferr Inventory of Masculine Values) an ideal man (as well as a woman's ideal man) to be highly family-oriented, as opposed to self-oriented. This finding suggests that MtFs value nurturance in males. However, it gives little indication of whether they see it as a typical feature of maleness. Further, the study tells us little about transgenders' perceptions of femaleness, beyond that women value family-oriented men.
An examination of self, maleness and femaleness in transgenders could conceivably generate many avenues of research. In this article we suggest two. Firstly, what beliefs do transgenders have regarding the traits of men and women (i.e. 'maleness' and 'femaleness')? Secondly, how may their actual and ideal self-concepts (as well as discrepancies between the two) be viewed in terms of these beliefs about 'maleness' and 'femaleness'? These questions (pertaining to gender-trait stereotypes, actual self and ideal self) may be highly salient for transgenders, since perceptions of and aspirations for self, as well as perceptions of femaleness and maleness, arguably go far beyond dress, movement, mannerism, biochemistry or anatomy, extending into personality itself.
Within mainstream psychology there is a substantial body of research into gender-trait stereotypes, and masculinity and femininity in self. Williams and Best (1990a, 1990b) and Hofstede (1998) each reported large cross-cultural studies in these areas. They address the same two questions listed in the above paragraph, albeit in connection with standard male and female participants.
In their adult studies Williams and Best (1990a, 1990b) made use of the 300-item Adjective Checklist (300-ACL), originally developed by Gough and Heilbrun (1980). This instrument, each of whose 300 items names a personality trait, can be used in a variety of ways. Two ways are for the respondent to tick items that describe him/her now (actual self-concept), or describe him/her as he/she would like to be (ideal self-concept). See Williams and Best (1990b) for more details of the 300-ACL used in those ways to examine the actual and ideal self-concepts of young persons in fourteen countries across five continents.
Respondents can also be asked to indicate which sex, if either, most commonly displays each trait (gender-trait stereotype). Williams and Best (1990a) report on a comparative study covering twenty-seven nations and six continents involving the 300-ACL used in this way. They make extensive use of a statistic called the M% score, indicating the degree to which a trait is stereotypically viewed as a 'male' or 'female'. Within any sample the M% score for a trait is calculated by taking the percentage of responses indicating that the trait is displayed more often by males, and then dividing it by the percentages of those indicating that it is more often displayed by females, added to the percentage indicating that it is more often displayed by males. The higher the value of M%, the more stereotypically male is the trait. The M% score will be used later as a tool for analysing the data collected in the present study.
In addition to the 300-ACL, Williams and Best (1990a, 1990b) report use of a 52-item short-form of the 300-ACL, based on earlier research in America, England and Ireland (hence the name 'Amengire'). This short-form was used instead of the 300-ACL in several countries in their study; one was Thailand.
Transgender in Thailand
The term transgender is seldom used in Thailand. Instead, kathoey, a word originally used to denote hermaphrodites (Jackson, 1998), is nowadays used to describe the transgender male. The label is somewhat nebulous, and is sometimes extended to cover male homosexuals (Jackson, 1998; Taywaditep et al., 1997). Thais (including MtFs themselves) often employ more specific labels exclusive to male transgender. These include 'long-haired kathoey' (kathoey phom yao), 'kathoey dressing as a woman' (kathoey tee sai suer pha phooying), or the informal English language terms 'ladyboy' and 'ladyman', all of which makes a clear reference to a female gender identity.
In Thailand, as in other South-East Asian societies, non-normative gender categories form part of the indigenous cultural tradition (Brummelhuis, 1999). The prevalent belief until the beginning of the last century was that there were three original sexes (Jackson, 1995), the third being male-female. Jackson (1998) reports that the Buddhist Vinaya text (a code of conduct for monks) identified four main sex/gender categories: males, females, ubhatobyanjanaka (hermaphrodites) and pandaka (males displaying a variety of other non-normative anatomies or sexual preference).
Arguably, additional themes of gender blending arise from the teachings on transience and incarnation. Buddhism teaches that all things lack permanence, even to the extent that there is no soul (Rahula, 1967; Neumaier-Dargyay, 1997). What is reborn is not a soul as such, but rather the result of one's lives, current and previous (Neumaier-Dargyay, 1997). From life to life one's elements may be incarnated as male or female (Taywaditep et al. 1997), or indeed kathoey (Bunmi, 1986).
Allyn (1991) suggests that kathoey once held an honoured place in Thai society. At the very least they enjoyed some acceptance, in part based on the belief that they were being punished in this life for a misdemeanour in a previous one (Jackson, 1995; 1998; Bunmi, 1986). However, in contemporary Thai society this acceptance is tempered by a degree of prejudice (Jackson, 1995; Matzner, 1999) and discrimination. MtFs remain legally male, even after sex re-assignment. Their birth certificates, identification cards and passports show them to be male. They cannot marry a male.
Because of prejudice and discrimination kathoey, even university graduates, find it hard to obtain professional jobs, or indeed any jobs at all in public and government service. How, then, do they support themselves, or for that matter their families? A very small number achieve success in fashion, music and the media. Others perform in costume and dance cabarets for tourists. Many others find themselves employed in small businesses (sometimes family-owned), working as sales clerks, waitresses, market stallholders, or beauty/ hairdressing salon workers. Others enter the sex trade for a period of months or years, perhaps until their looks fade. It should be noted that in doing so they are entering a world that does not carry the same social and moral stigma that it does in some other societies (Taywaditep et al., 1997; Peracca et al., 1998). In any case, some kathoey will see little other choice for making a living. Brummelhuis (1999) notes that there is very little information about older Thai MtFs. It is possible that many find the practicalities of transgender life so difficult that they revert back to an outwardly male gender-role.
Despite facing prejudice and discrimination the MtF has attained a prominence in Thai society that is probably unknown elsewhere. MtFs have been a regular feature of TV shows for years, albeit often as comic figures. Each year there are several kathoey beauty contests throughout Thailand, in some cases drawing hundreds of entrants. The two best known (Miss Tiffany and Miss Alcazar) are either televised or recorded for later sale as video in mainstream record and video stores. Indeed, kathoey have become so prominent a part of modern Thai culture that the authorities have recently taken steps to reduce their profile, for example making it more difficult for them to work as teachers or tour guides and advising television stations to curb MtF appearances on shows.
It has been reported that there are now some 10,000 Thai MtFs living in Thailand (Ehrlich, 1996), although this figure may be an underestimate. Turning first to the more extreme end of the gender-transition continuum, there are an indeterminate number of government and private hospitals which offer sex re-assignment surgery. The three most active surgeons in this field have together performed around 2,000 operations (Kim, 2001, personal communication). At the other end of the continuum, Matzner (1999) reports that one provincial Thai university of 15,000 students boasts a 'sorority' for over 100 MtF students (most at an early stage in transition). This represents around one in 150 students of the overall student population, and a rather larger proportion of the male student population!
Even if the estimate of 10,000 MtFs in Thailand is an accurate one, this figure would represent an incidence substantially above that estimated for transgender in many other parts of the world (see, for example, American Psychiatric Association, 1994; Kesteren et al., 1996; Francoeur, 1997). Clearly there is a need now for systematic research aimed at identifying what the actual incidence of transgender in Thailand is and, if the incidence is found to be higher than elsewhere, what the factors underlying it are.
In summary, Thailand presents fertile ground for research into transgenders. The apparently substantial numbers of transgenders, their openness about their status, their presence in a range of visible occupations, and their connections to an informal transgender community all serve to facilitate research in this area in Thailand. For a more detailed treatment of sexuality and gender in Thailand see Taywaditep et al., (1997), Jackson (1995, 1998), Brummelhuis (1999), and Jackson and Cook (2000).
The current study sought to examine the gender-trait stereotypes, actual self-concept and ideal self-concept of MtFs in Thailand. The research questions posed were twofold, and echoed those suggested earlier in this paper. Firstly, what beliefs do these transgenders have regarding the traits of men and women, and how do these gender-trait stereotypes compare with those displayed by non-transgenders in their own country and elsewhere in the world (as revealed by Williams and Best's 1990a data)? Secondly, what actual and ideal self-concepts do they express, and how may each of these (and discrepancies between the two) be viewed in terms of their own stereotypes beliefs about the traits of men and women?
The intention in examining actual-ideal discrepancies was to learn more about participants' aspirations for change (traits they would like to acquire or to lose). While it has long been argued that actual-ideal discrepancies provide a measure of self-esteem (e.g. Bills et al., 1951; Cohen, 1959) the practice has been heavily criticised, on the grounds, inter alia, that what matters more is a person's attitude towards a discrepancy (Wells and Marwell, 1976) or the degree of discrepancy between actual self and an 'anti-ideal' (Higgins, 1987). The current authors therefore stress that they had no interest in using discrepancies to study self-esteem.
Two hundred and six Thai MtFs living in Bangkok and Phuket were approached for participation in the research. Two potential participants refused to participate. The remaining 204 participants were aged 17 to 42 years (mean: 23.0 years), and were at the time of the study living full-time in a cross-gendered role. All described themselves as kathoeys, more specifically 'long-haired kathoeys', (kathoey phom yao) or 'kathoeys dressing as women' (kathoey tee sai suer pha phooying), thereby distinguishing themselves from those we would in the West call gays, and identifying themselves as individuals we would in the West call MtF transgenders. All reported having experienced early feelings of female identity. All presented with a highly feminised demeanour. All had gone to some lengths to feminise their appearance. All habitually wore stereotypically female clothes. The vast majority had taken hormones to modify their development in early puberty or during their teenage years. Many were continuing to take hormones at the time of the study. Many had undergone facial surgery (most commonly: nose, chins, eyes, cheeks, foreheads, reduction of 'Adam's apple') and some had obtained breast implants. Some had undergone silicone injections to change the shape of their thighs or buttocks. A few had undergone sex reassignment surgery. In every case their speech exhibited the pronouns, particles and exclamatory phrases employed by females in the Thai language. All reported a primary sexual preference towards males.
Participants came from rural or urban backgrounds, and had grown up in family circumstances that ranged from very poor to middle class professional. All were at the time of the study living in urban centres of Bangkok and Patong, Phuket. Educational level varied from secondary to university, though some participants, and especially those who had grown up in rural poverty, may not have completed their secondary education.
Participants were asked to identify their place of work: 120 indicated that they cabaret performers, 41 were bar workers, and 36 were university students. Their mean ages were 23.7, 22.8 and 20.4, respectively. Another seven (mean age: 26.5) identified themselves as shop workers, self-employed business persons etc. In fact, these categories may all be somewhat arbitrary, as some participants fell into two or more categories, for example, working in cabarets to support their studies. It was, therefore, not surprising that when group differences in response patterns were examined, it was found that significant differences were relatively few in number, and small in scale.
Three closely corresponding checklists were used. They were designed to examine participants' (a) ideal self-concept, (b) actual self-concept, and (c) male and female gender-trait stereotypes. All contained a shortened list of adjectives from the 300-ACL. The ACL was shortened to reduce the demands placed upon participants, some of whom could be expected to have had limited education and little experience completing questionnaires. At the same time, care was taken to include items that might reveal maleness and femaleness (in gender-trait stereotypes, as well as actual and ideal self-concepts), and in sufficient numbers to allow meaningful comparison with the international and Thai samples of non-transgenders reported in Williams and Best (1990a). The adjectives included on the abbreviated check list were as follows:
(a) Sixty-five adjectives shown in the Williams and Best (1990a) study to be clearly and internationally associated with one or other gender. Adjectives satisfying this criterion showed a mean M% score, pooled across 25 countries, of 25% or less (i.e. 'female' characteristics) or 75% or more (i.e. 'male' characteristics). Of the 65 adjectives satisfying this criterion 37 were stereotypically 'male', 28 were 'female'.
(b) Sixteen other adjectives added to ensure incorporation of the entire 'Amengire' short-form of the 300-ACL into the questionnaire, and enable comparison between the transgenders in this study and the non-transgender men and women in Williams and Best's (1990a) Thai sample.
The resulting 81 adjectives, plus instructions for completing each questionnaire, were translated into Thai by a qualified translator. After completion, the completed questionnaires were translated into English.
Items on the three questionnaires displayed a mean M% of 52.22% (close to the mid-range of 50%), as calculated using Williams and Best's (1990a) international M% values (mean M% scores across 25 nations). The 52 'Amengire' items yielded a mean M% score of 53.31%, as calculated using Williams and Best's Thai data (1990a). The questionnaire therefore seemed to be quite well balanced between male-stereotyped and female-stereotyped items. Its balance, in terms of the transgender sample's own stereotypes, is reported in the findings section.
A Thai research assistant, with or without the first author of this article, approached each prospective subject to enquire whether they would be willing to take part in the research. All research assistants were themselves MtFs. In the majority of cases, the research assistant was the second author of this article.
The research assistant presented the research as an attempt to understand transgenders as people, and to communicate that understanding as widely as possible. Participants were told that there were three questionnaires (each of which would take about ten minutes to complete), that there were no right or wrong answers, and that participants should answer in a way that reflected their feelings. Any questions asked by participants were answered by the research assistant.
As indicated earlier, only two potential participants refused to participate. The high participation rate was perhaps due to the nature of the research (focusing on them as people rather than viewing them, as was usually the experience for the bar workers or cabaret performers, as sex objects or oddities) and the way it was introduced (by a transgender like themselves).
For the first questionnaire (examining ideal self-concept) participants were given the following written instructions (after Williams and Best, 1990b), here translated into English:
The second questionnaire (focusing on actual self-concept) was exactly the same, except that participants were required to place a tick beside any adjective that described them as they were currently. The same written instructions were used as before, except that the italicised words printed above were replaced by the phrase describe you as you really are. In addition, there was a final instruction as follows (after Williams and Best, 1990a), again here in English:
The third questionnaire (focusing on gender-trait stereotypes) differed from the others in that there were three boxes, rather than one, beside each adjective. The written instructions (after Williams and Best, 1990a) were as follows, again in English:
Participants completed all three questionnaires at one sitting. Immediately after completion, questionnaires were checked for thoroughness, and for any responses indicating the need for further instructions or questioning. In this latter regard the items 86 ('feminine') and 147 ('masculine') were particularly important. Any subject indicating a 'masculine' ideal (or indeed an ideal not to be 'feminine') was questioned, since such an ideal seemed, at first glance, to run counter to the subject's professed gender identity. Similarly, any subject indicating 'masculine' as a gender-trait stereotype for women (or 'feminine' for men) was questioned, since this constituted a very atypical response. In the vast majority of cases a subject, when questioned, held to and justified the response, and so the questionnaire was accepted without changes.
Overall, respondents experienced no difficulty in completing the questionnaires on actual and ideal self (204 and 201 usable questionnaires respectively). Some respondents found questionnaire three (gender-trait stereotypes) a little difficult, becoming confused about the arrangement of each of the three response columns or failing to make a response at all to certain items. The mean number of usable responses was 194.7, with a range from 189 to 199 depending on the item.
Analysis of data
As indicated earlier, responses from different occupational groups were broadly similar. Consequently, data was pooled for all participants. Gender-trait stereotypes were examined in their own right, and compared with those reported by Williams and Best (1990a) for international and Thai samples of men and women. Actual and ideal selves, as well as actual-ideal discrepancies, were analysed in terms of the participants' own gender-trait stereotypes. Inferential statistical operations were performed by way of SPSS-PC Plus Version 10.0.
The mean M% for the 81 items was 48.18 (s.d. 30.67), very close to the notional mean of 50%. Williams and Best (1990a) obtained an international mean of 52.22 for the same items (s.d. 32.69). The difference in means, though small, was significant at p=0.037. The mean M% for the 52 'Amengire' items was 51.54 (s.d. 30.60), compared to 53.31 (s.d. 36.5) for the same items in Williams and Best's Thai sample. The difference in means was non-significant. In summary, responses in this study seemed as evenly balanced and dispersed as in these other two (non-transgender) samples. The point about dispersion is particularly important, as any tendency on the part of the current sample towards exaggerated male and female stereotypes would have resulted in more polarised M% scores (approaching either 0% or 100%) and consequently higher standard deviations for the distribution of M% scores.
The means and standard deviations for the three samples might conceivably be similar without there being much association between corresponding M% scores at the level of individual items. A correlational analysis was therefore performed. Pearson correlation coefficients between, on one hand, M% scores for the current sample and, on the other hand, those of the international and Thai samples, were 0.843 and 0.767 respectively; both coefficients being significant at the 0.000 level. Clearly, stereotypes of men and women displayed in this study were, overall, closely related to those displayed by young men and women in Thailand and internationally.
Despite the high correlations described above, it was possible that M% scores for specific items in the transgender sample would differ from those in Williams and Best's samples. Accordingly, an analysis of data was performed at the level of individual items. Table 1 displays the individual item M% scores for this sample, together with those for the international and Thai samples (both non-transgender) in the Williams and Best (1990a) study. Difference scores are also displayed.
|Despite the generally close correspondence between the current and
other samples, there were also some interesting differences. Focusing on
those items that in both comparisons displayed discrepancies of 25% and
more, it can been seen that the traits 'boastful', 'confident', and
'stern' were seen as substantially less stereotypically 'male' than in
either of the two other samples (indeed, not stereotypically 'male' at
all). Conversely, the traits 'flirtatious', 'high-strung' and
'sophisticated' were seen as male-stereotyped in a way quite unlike either
of the other two samples. 'Frivolous' represented an unusual case, in that
the current sample viewed it fairly unstereotypically, while the
international and Thai samples of Williams and Best (1990a) viewed it as
stereotypically female and male respectively.
Beyond those items already discussed, the current sample differed from either the Thai or the international sample on a number of other items. Only those stemming from comparison with the Thai sample are discussed here. The transgender sample regarded 'gentle' and 'nagging' as substantially less female stereotyped than did their compatriots, and 'loud' as more male-stereotyped. Intriguingly, they regarded 'submissive' as a female-stereotyped trait, whereas the Williams and Best Thai sample(1990a) regarded it (somewhat idiosyncratically in world terms) as 'male'.
Table 2 shows the percentage of respondents endorsing each of the adjectives. The mean endorsement rate was 42.6% (range from 6.9 to 84.3), indicating, over the sample, a fairly good balance between items that respondents felt able / unable to endorse as aspects of their current self.
An initial question concerned the extent to which there was homogeneity in the actual self-concepts displayed within this sample. Homogeneity on any trait was indicated wherever there was high consensus in responding (endorsement rates deviating well away from 50% and instead approaching either 0% or 100%). The mean absolute deviation from 50% was calculated for the 81 items, and found to be 18.7%. This figure indicated moderate consensus. In summary, participants appeared to retain a substantial level of individuality, refraining from high levels of uniformity in their patterns of responding.
A search was made for items that showed strong consensus (endorsement rates at a level of 90% or more, or 10% or less), moderate-to-strong consensus (endorsement at 80% or more, or 20% or less), and mild-to-strong (67% or more, 33% or less). Much more consensus was found for traits that were not endorsed than for those that were. By way of example, from four strong-consensus items all were endorsed at low (rather than high) levels. From 19 moderate-to-strong-consensus items, sixteen were endorsed at low levels, only three at high levels. Finally, from 46 mild-to-strong-consensus items the corresponding figures were 32 and 14. In sum, these figures indicate a much higher agreement among respondents about what characteristics they did not have than about those they had.
What, then, were the characteristics that were not reported in the sample? The least frequently reported characteristics (i.e. 10% of respondents or less) were 'coarse', 'cruel', 'egotistical', and 'rude'. Other infrequently reported characteristics, (20% of respondents or less) were 'aggressive', 'autocratic', 'boastful', 'disorderly', 'frivolous', 'nagging', 'robust', 'sentimental', 'severe', 'sophisticated', 'timid' and, unsurprisingly, 'masculine'.
As indicated earlier, there were only three characteristics that were endorsed by 80% or more of respondents. These were 'affectionate', 'appreciative', and 'feminine'. Other frequently reported characteristics (endorsed by 67% or more of the sample) were 'active', 'curious', 'dreamy', 'emotional', 'gentle', 'humorous', 'mild', 'rational', 'self-confident', 'sensitive', and 'sympathetic'.
What overall relationship, if any, was there between participants' actual self-concepts and their stereotypes for male and female traits? High- and low-endorsed items were examined to see whether they differed in terms of M% scores. Table 3 shows the relevant data.
As expected, respondents most frequently endorsed items that were stereotypically feminine (i.e. displayed low M% scores), least frequently endorsing those that were stereotypically masculine (i.e. displayed high M% scores). For moderate-to-strong-consensus items there was a 56.7 point difference between the M% scores of high- and low-endorsed items. For mild-to-strong-consensus items the equivalent difference was 37.5. In summary then, respondents had an overall female stereotypic view of themselves.
This is borne out by correlational analysis. The correlation between endorsement rates and participants' own gender-trait stereotypes was -0.49 (significant at the p=0.000 level). For the record, the corresponding correlations with Williams and Best's (1990a) Thai and international stereotypes were -0.371 (p=0.007) and -0.362 (p=0.001) respectively. Put simply, the higher the M% (masculinity) score for an item, the less often it was endorsed as an aspect of current self-concept.
However, the picture was not altogether simple. It will be clear from earlier paragraphs that several of the lowest-endorsed items were stereotypically female (for example 'timid' and 'sentimental', with M% scores of 23.9 and 18.7 for this sample of respondents). Moreover, though 'masculine' was predictably among the least frequently endorsed items (around 16% of respondents), there were in fact eight items that were even less frequently endorsed.
Table 2 shows the percentage of respondents endorsing each of the adjectives as describing their ideal selves. The mean endorsement rate was 43.2% (range from 6.0 to 86.6), again indicating a good balance, over the sample, between endorsable and unendorsable items.
Endorsement rates were examined for indications of homogeneity. Rates deviated a mean 22.8% from 50%, only slightly higher than the equivalent figure for ideal self. Consequently, as in the case of actual self-concept, there appeared to be moderate consensus in ideal self-concept, suggesting a substantial degree of individuality and a clear absence of high levels of uniformity in patterns of responding.
As for actual self, there was much more agreement within the sample about what could not be endorsed than about what could. Of the ten strong-consensus items all were endorsed at extremely low (rather than high) levels. For moderate-to-strong-consensus items there were 21 low-endorsed as against 3 high-endorsed. The corresponding figures for mild-to-extreme-consensus items were 32 and 20. These figures indicate a much higher agreement among respondents about what characteristics they wished not to have than about those they wanted.
What, then, were the characteristics that, over the sample, did not represent their ideal selves? The least frequently endorsed traits (i.e. 10% of respondents or less) were 'aggressive', 'boastful', 'coarse', 'cruel', 'disorderly', 'egotistical', 'frivolous', 'nagging', 'rude', and 'timid'. Other low-endorsed items (20% or under) were 'autocratic'. 'complaining', 'dependent', 'high-strung', 'lazy', 'reckless', 'sentimental', 'severe', 'weak', 'whiny', and (again expected) 'masculine'.
As for the high-endorsed ideals, there were just three items that achieved an endorsement rate of 80% and more. These were 'charming', 'feminine' and 'self-confident'. Other frequently endorsed characteristics (67% or more of the sample) were 'active', 'affectionate', 'appreciative', 'attractive', 'confident', 'courageous', 'determined', 'energetic', 'gentle', 'humorous', 'independent', 'inventive', 'mild', 'poised', 'rational', 'sexy', and 'wise'.
What overall relationship, if any, was there between participants' ideal self-concepts and their stereotypes for male and female traits? As for actual self-concept, high- and low-endorsed items were examined to see whether they differed in terms of M% scores. Table 3 shows the relevant data. As expected, respondents most frequently endorsed items that were stereotypically feminine (i.e. displayed low M% scores), least frequently endorsing those that were stereotypically masculine (i.e. displayed high M% scores). However, the discrepancy in M% scores between low- and high-endorsed items was much smaller than for actual self. For moderate-to-strong-consensus items the difference between M% scores of high- and low-endorsed items was only 34.3 (as against a corresponding figure of 56.7 in actual self). For mild-to-strong-consensus items the difference between high- and low- endorsed items was 11.4 as against 37.5 for corresponding items in actual self.
The data gives a distinct impression that respondents' ideal selves were somewhat less female-stereotyped than were their actual selves. A correlational analysis confirms this impression. The Pearson's correlation coefficient for endorsement rates against participants' own gender-trait stereotypes was -0.173 (non-significant). For the record, the corresponding correlations with Williams and Best's (1990a) Thai and international stereotypes were respectively -0.07 and -0.03 (also both non-significant). Put simply, participants' ideals for themselves seemed entirely unrelated to their stereotypes for men and women.
Inspection of the data for individual items confirms this impression. As will be evident from earlier paragraphs, some of the lowest-endorsed items were seen by the participants as stereotypically female. For example, 'nagging' had an M% score of 28.4, 'timid' a M% score of 23.9, 'complaining' 10.2, 'dependent' 13.1, 'sentimental' 18.7, 'weak' 8.00, and 'whiny' 20.7. Conversely, some of the highest-endorsed were, according to the participants in this study, male-stereotyped. For example, 'active' had an M% score of 74.7, 'courageous' 87.2, 'energetic' 76.5, and 'independent' 74.0. As if to underline the complexity of the picture, even though 'masculine' was one of the lowest endorsed ideals (13.4%) there were actually 12 items that were endorsed at even lower levels.
Discrepancies between actual and ideal self
Discrepancies between actual self and ideal self were examined as indicators of aspirations for change, either in terms of 'aspirations-to-acquire', (traits currently absent which the respondents wished to possess), or 'aspirations-to-lose', (traits currently possessed which they wished to eschew). Overall, the average absolute discrepancy rate (combined percentages for aspirations-to-acquire and aspirations-to-lose) was 27.9%, indicating that, on any given trait, an average of around three in ten respondents had an ideal that differed from their actual selves.
Taking aspirations-to-acquire first, there were 21 traits yielding discrepancy rates beyond 20% (i.e. at least two out of ten participants aspiring to have these traits, believing themselves not to have them at present). They were 'dominant', 'sexy', 'attractive', 'charming', 'confident', 'courageous', 'determined', ' energetic', 'forceful', 'hard-hearted', 'initiative', ' inventive', 'poised', 'progressive', 'sophisticated', 'stolid', 'strong', 'tough', 'unemotional', 'warm', and 'wise'. These traits represent a broad range, and include female-stereotyped, male-stereotyped and unstereotyped items. The mean M% for these traits, in terms of the participants' own stereotypes, was 61.4.
Turning now to aspirations-to-lose, there were fourteen traits yielding discrepancy rates above 20% (i.e. at least two out of ten aspiring to lose these traits). They were 'sensitive', 'emotional', 'anxious', 'changeable', 'excitable' 'shy', 'worrying', 'complaining', 'curious', 'dreamy', 'fearful', 'fussy', 'reckless', and 'soft-hearted'. Most of these were stereotypically 'female' traits, yielding a mean M% of 19.0.
As might be expected from the above, there was a strong correlation between net actual-ideal discrepancies (percentage expressing aspirations-to-acquire minus percentage expressing aspirations-to-lose) and M% scores (0.429, p = 0.000), reflecting the strong tendency for participants to aspire away from some stereotypically female traits.
In summary then, the data suggested some dissatisfaction with actual self, with respondents aspiring to possess characteristics that they currently did not have, as well as to rid themselves of some that they did. The characteristics they wanted to lose were strongly female stereotyped, with those they wanted to possess representing a broader range.
To summarise the main findings of this study:
(a) Participants overall expressed gender-trait stereotypes very similar to those of non-transgenders (both in their own country and internationally), notwithstanding that differences were found on a small number of traits.
(b) For both actual and ideal self-concept the research sample displayed much more consensus about traits they did not possess / wished not to possess, than about those they possessed / wished to possess
(c) Participants commonly expressed actual self-concepts that were discrepant with their ideal selves.
(d) Apart from a few traits, participants' actual self-concepts tended (in terms of their own gender-trait stereotypes) to be stereotypically female. Their ideal self-concepts were far less so, with several stereotypically male traits being frequently endorsed, and female traits being rejected.
(e) As a corollary, the traits that participants wished to acquire tended to be broad-ranging, while those that they wished to lose were female-stereotyped.
The similarity between gender-trait stereotypes of MtFs in this study and those of non-transgenders (both in Thailand and further afield) suggests that all these groups perceive men and women in a broadly similar fashion. This is perhaps not surprising, since within any one society the forces that shape our beliefs about men and women will be at work upon all of us, often regardless of our gender orientation.
The similarity in standard deviations obtained for the distributions of M% scores in all three samples is important, since it suggests that stereotyped beliefs about men and women expressed by the MtFs are no more exaggerated than those expressed by men and women generally. This finding would appear to run counter to that of Brems et al. (1993) suggesting that MtFs endorse femininity for females much more than is done by other groups. In fact, the divergent findings may arise from the rather different data employed in each study. Brems et al. (1993) examined the degree to which individual MtFs displayed stereotypes. In contrast, the current study examines the degree to which a group of MtFs display consensus about stereotypes. Beyond this difference, the use of drawings in the previous study (Brems et al., 1993) necessarily led to a focus on visual aspects of femaleness, a rather narrower focus than in the present study. Beyond that Brems et al. (1993) involved transgenders from another culture, and growing up an average 12 years earlier than those in this study.
The higher consensus for traits not possessed / not wanted (as compared with traits possessed / wanted) suggests that, while MtFs may share views about what they are not and do not want to be, they are far more individualistic in terms of their views about what they are and want to be. One may conclude that our MtFs were united more by what they were not (or at least their perceptions thereof) than by what they were. The same applied to their ideals ' unity in terms of what they did not want than in terms of what they wanted. It appears that little, if any, research has been done into this 'negative' aspect of group identity. It would be interesting to discover how many groups display this phenomenon. One may speculate that it may be a more common feature of marginal groups rejecting societal norms (e.g., transgenders, gays, revolutionary socialists, etc.) than of others (e.g.men, women, the unemployed, etc.).
The finding that actual self-concepts were female-stereotyped is not surprising. Persons who have moved towards a female gender role would be expected to ascribe 'female' qualities to themselves. The earlier studies of Fleming et al. (1981), Skrapec and MacKenzie (1981), Kuiper and Cohen-Kettenis (1988), Cole et al. (1997) confirm that this is the case. More interesting is the apparent rejection of stereotypically female characteristics such as 'sentimental' and 'timid'. This finding may be viewed in the light of the studies by Skrapec and MacKenzie (1981), Fleming et al. (1984b), and Cole et al. (1997) studies, all reviewed earlier, suggesting that traits consistent with former gender role may survive in the transgender. The findings of this study go further than this, suggesting that the transgender may actively reject some stereotypical aspects of the desired gender.
Turning now to ideal self-concept, perhaps the most surprising finding of this study was that MtFs aspired to a self that was far less stereotypically female than their actual self. At first glance, it appears strange that biological males who had adopted highly female personas would aspire to lose some of their 'female' traits and acquire some that are 'male'. In fact, the finding is not entirely surprising. Consider the case of the genetic female, who may view herself as having many stereotypically female traits, but aspire to acquire some that are stereotypically male (independence, activity, progressiveness, courage, etc.) and lose others that are stereotypically female (timidity, submissiveness, etc.). Similarly, the genetic (and gender consistent) male may aspire towards some 'female' traits, and away from some 'male'. We should not be surprised therefore, if we find that the transgenders aspire towards some characteristics stereotypically associated with the gender they have relinquished. Note in this context the finding of Fleming et al. (1984b), discussed earlier, indicating that FtMs (like control men) may aspire to higher levels of femininity as well as masculinity.
Seen in this light the current findings may be taken as evidence that, like many non-transgender males and females, the transgenders in this study resist being 'slaves to stereotype' and instead have ideals for themselves that are guided by factors other than conformity to gender stereotype. Following this line of thought, the current authors have attempted a re-analysis of the aspirations displayed by participants in this study. Using international data from Williams and Best (1990a) and Williams et al. (1998, 1999), they have examined these aspirations in terms of affective meanings, ego states, five-factor personality theory and psychological importance (Winter and Udomsak, in preparation). Our analysis suggests that respondents aspired towards traits generally considered (across many cultures and both sexes) to be favourable human qualities. Space prevents detailed discussion of the analysis here, except to say that the analysis also reveals tendencies to aspire towards traits representing (among other things) strength, an adult ego state, conscientiousness, emotional stability, and openness to experience (to all of which traits non-transgender men and women also seem to aspire).
In summary, the impression gained of MtFs is of persons unremarkable in respects other than their transgender and, like much of the population at large, concerned with self-improvement on a broad front; unrelated to or inconsistent with gender-stereotype, and instead consistent with fairly universal notions of favourable human qualities.
This study may be criticised on the grounds that, in a culture such as Thailand's, any study of self at all may be inappropriate. In Buddhist philosophy all things are transient. Self, personality, and indeed gender identity are all transient because they can all vary across incarnations. All assume further transience because they are just aspects of consciousness. In practice, however, one finds no difficulty in getting Thai people to share with others their views of themselves. For this reason, the current authors consider the study of self in Thailand to be an appropriate one, as others have found working within cultures whose religious and philosophical heritages hold alternative views of self (e.g. Watkins et al., 1991).
On a more methodological level, the current study suffered from several limitations connected with the choice of sample and instruments. Firstly, the choice of sample was determined by ease of access, was exclusively Thai, and predominantly composed of individuals working in the entertainment sector. Uncertainty remains as to the degree to which MtFs in Thailand are representative of those in other societies, or the participants in this survey are representative of transgenders in their own society. With regard to this latter point, we should note that all participants were (by residing in an urban centre and working in universities, cabarets and bars) living in complex and competitive subcultures. Stereotypically male traits such as 'determined', 'energetic', 'enterprising', 'forceful', 'independent', 'progressive' and 'robust' might have been both modeled and rewarded more than would be the case if they had been living with family in a small village deep in the provinces. For additional evidence that cultures can influence gender-role values see Williams et al. (1998) and Hofstede (1998). A second limitation was the instruments employed. The ACL (Adjective Check List) was originally developed for research with Western populations. It is possible that personality traits most salient for Thai identity (male, female or transgender) are not among the 300-ACL traits, nor the 81 items that were extracted, albeit carefully, from the checklist for this study.
A binary response system was employed for the questionnaires on actual and ideal self-concept, with respondents simply indicating whether or not the characteristics applied to them. The consequence is that the data from these two questionnaires could be summarised only in terms of sample percentages and not in terms of means. Ideally a Likert-type rating scale would have been employed so that one could examine, inter alia, the degree to which each respondent felt traits represented men, women and themselves (actual and ideal). However, it was feared that this would raise the cognitive demands imposed, and lower the quality of responding. The difficulties, albeit minor, experienced by some respondents when completing questionnaire three (which required choosing between three possible responses) indicated that these fears may have been reasonable.
Beyond this, the ACL demands that a respondent provides an overall endorsement of each personality trait. Like most other instruments used to examine identity, it fails to take account of the fact that people see themselves differently in different social situations. For example, one may see oneself as shy when surrounded by extrovertly talkative people, but as outgoing when surrounded by quiet introverts. Research support for a contextual effect upon self-concept comes from, among others, Smith, Noll and Bryant (1999).
Any research study presents a social situation of its own. In the current study respondents' actual and ideal self-concepts may have been influenced by their perceptions regarding the research assistant. This possibility would exist no matter who acted as a research assistant. However, the research assistants' qualities may have been more salient (and the effect all the stronger) for the fact that she too was a MtF.
The present research is the first part of a research programme. An immediate question concerns the degree to which transgenders' stereotypes differ from those of ordinary men and women in Thailand. True, a high correlation was found between the responses of this sample and those from non-transgender Thais in Williams and Best's (1990a) study. However the Williams and Best data is from the 1980s, is drawn from the 'Amengire' items only, was based on a small sample, and did not differentiate between the stereotypes held by males and females. The researchers are currently engaged in a study that should avoid these problems.
Correspondence and requests for materials to Dr. Sam Winter, Department of Education, University of Hong Kong, Pokfulam Road, Hong Kong. (firstname.lastname@example.org) Fax: (852) 28595664
Allyn, E. (1991) Trees in the Same Forest: Thailand's Culture and Gay Subculture (The Men of Thailand Revisited), San Francisco: Bua Luang.
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders. 4th ed., Washington D.C., American Psychiatric Association.
Barrett, J. (1998) Psychological and social function before and after phalloplasty. International Journal of Transgenderism, 2(1): http://www.symposium.com/ijt/ijtc0301.htm
Bills, R.E., Vance, E.L., and McLean, O.S. (1951) An index of adjustment and values. Journal of Consulting and Clinical Psychology, 15:257-261.
Blanchard, R. (1985) Typology of male-to-female transsexualism. Archives of Sexual Behavior, 14: 247-261.
Blanchard, R. (1993) Varieties of autogynephilia and their relationship to gender dysphoria. Archives of Sexual Behavior, 22: 241-251.
Blanchard, R., Clemmensen, L.H., and Steiner, B. (1983) Gender reorientation and psychosocial adjustment in male-to-female transsexuals, Archives of Sexual Behavior, 12: 503-509.
Blanchard, R., Clemmensen, L.H., and Steiner, B. (1987). Heterosexual and homosexual gender dysphoria. Archives of Sexual Behavior, 16: 139-152.
Brems, C., Adams, R.L., and Skillman, G.D. (1993) Person drawings by transsexual clients, psychiatric clients, and nonclients compared: indicators of sex-typing and pathology. Archives of Sexual Behavior, 22: 253-262.
Brummelhuis, H. ten (1999) Transformations of transgender: The case of the Thai kathoey. Journal of Gay and Lesbian Social Services, 9: 121-139. Also in P.A. Jackson and G. Sullivan, (Eds.) (1999) Ladyboys, Tomboys, Rent boys: Male and Female Homosexualities in Contemporary Thailand. Birmingham, NY: Haworth Press.
Bunmi, M. (1986) Khon pen kathoey dai yang-rai? (How can people be kathoeys?) Bangkok: Abhidhamma Foundation.
Chivers, M.L. and Bailey, J.M. (2000) Sexual orientation of female-to-male transsexuals: a comparison of homosexual and non-homosexual types. Archives of Sexual Behavior, 29: 259-277.
Cohen, A.R. (1959) Some implications of self-esteem for social influence. In C. Hovland and L.L. Janis, (Eds.) Personality and Persuasibility, New Haven CT: Yale University Press.
Cole, C.M., O'Boyle, M., Emory, L.E., and Meyer, W.J. (1997) Comorbidity of gender dysphoria and other major psychiatric diagnoses. Archives of Sexual Behavior, 26: 13-26.
Dixen, J.M., Maddever, H., Van Maasdam, J., and Edwards, P.W. (1984). Psychosocial characteristics of applicants evaluated for surgical gender reassignment, Archives of Sexual Behavior 13: 269-276.
Doorn, C.D., Poortinga, J. and Vershoor, A.M. (1994). Cross-gender identity in transvestites and male transsexuals. Archives of Sexual Behavior, 23: 185-201.
Dulko, S. (1988). Sexual activity and temperament in Polish transsexuals. Archives of Sexual Behavior, 17: 163-171.
Ehrlich, R. (1996) Thailand's secret sex. Elle Magazine UK, June: 42-48.
Fleming, M., Cohen, D., Salt, P., Jones, D., and Jenkins, S. (1981) A study of pre- and post-surgical transsexuals' MMPI characteristics. Archives of Sexual Behavior, 10: 161-170.
Fleming, M., Costos, D., and MacGowan, B.R. (1984) Ego development in female-to-male transsexual couples. Archives of Sexual Behavior, 13: 581-594.
Fleming, M.Z., MacGowan, B.R. and Salt, P. (1984) Female-to-male transsexualism and sex roles: self and spouse ratings on the PAQ. Archives of Sexual Behavior, 13: 51-57.
Francoeur, R. (Ed.). (1997) International Encyclopedia of Sexuality. New York, NY: Continuum.
Freund, K. and Watson, R.J. (1993) Gender identity disorder and courtship disorder. Archives of Sexual Behavior, 22: 13-21.
Fridell, S.R., Zucker, K.J., Bradley, S.J. and Maing, D.M. (1996). Physical attractiveness of girls with gender identity disorder. Archives of Sexual Behavior, 25: 17-30
Gough, H.G. and Heilbrun, A.B. (1980) The Adjective Check List Manual. Palo Alto, CA: Consulting Psychologists Press.
Higgins, E.T. (1987). Self-discrepancy: a theory relating self and affect. Psychological Review, 94, 319-340.
Hofstede, G. (Ed.) (1998). Masculinity and Femininity: The Taboo Dimension of National Cultures. Thousand Oaks, CA: Sage.
Hunt, D.D., Carr, J.E., and Hampson, J.L. (1981) Cognitive correlates of biologic sex and gender identity in transsexualism. Archives of Sexual Behavior, 10: 65-77.
Jackson, P.A. (1995) Dear Uncle Go: Male Homosexuality in Thailand. Bangkok: Bua Luang Books.
Jackson, P.A. (1998). Male homosexuality and transgenderism in the Thai buddhist tradition. In Leyland, W. (Ed.), Queer Dharma: Voices of Gay Buddhists. San Francisco CA: Gay Sunshine Press.
P.A. Jackson and N.M. Cook, (Eds.) (2000) Genders and Sexualities in Modern Thailand. Chiang Mai: Silkworm Books.
Kesteren, P.J. Van, Gooren, L.J. and Megens, J.A. (1996) An epidemiological and demographic study of transsexuals in the Netherlands. Archives of Sexual Behavior, 25: 589-600.
Kockott, G. and Fahrner, E.M. (1987) Transsexuals who have not undergone surgery: a follow-up study. Archives of Sexual Behavior, 16: 511-522.
Kuiper, A.J., and Cohen-Kettenis, P.T. (1988) Sex reassignment surgery: a study of 141 Dutch transsexuals. Archives of Sexual Behavior, 17: 439-457.
Kuiper, A.J., and Cohen-Kettenis, P.T. (1998) Gender role reversal among postoperative transsexuals. International Journal of Transgenderism, 2(3): http://www.symposion.com/ijt/ijtc0502.htm
Lief, H.I. and Hunschman, L. (1993) Orgasm in the Postoperative transsexual. Archives of Sexual Behavior, 22: 145-155.
Mason-Schrock, D. (1996) Transsexuals' narrative construction of the "true self". Social Psychology Quarterly 59: 176-192.
Matzner, A. (1999) The politics of re-presentation: An analysis of western academic treatments of Thai transgenderism. (unpublished paper)
Nemoto, T., Luke, D., Mamo, A., Ching, A., and Patria, J. (1999) HIV Risk Behaviors among male-to-female transgenders in comparison with homosexual or bisexual males and heterosexual females. AIDS Care, 11: 297-312.
Neumaier-Dargyay, E. K. (1997) Buddhism. In H. Coward, (Ed.) Life after Death in World Religions. Delhi: Sri Satguru.
Newcomb, M.D. (1985) The role of perceived relative parent personality in the development of heterosexuals, homosexuals and transvestites. Archives of Sexual Behavior, 14: 147-164.
Peracca, S., Knodel, J., and Saengtienchai, C. (1998) Can prostitutes marry? Thai attitudes toward female sex workers. Social Science and Medicine, 47(2): 255-267.
Rahula, W. (1967) What the Buddha Taught. London: Gordon Fraser.
Skrapec, C., and MacKenzie, K.R. (1981) Psychological self-perception in male transsexuals, homosexuals and heterosexuals. Archives of Sexual Behavior, 10: 357-370.
Smith, C.J., Noll, J.A., and Bryant, J.B. (1999) The effect of social context on gender self-concept. Sex Roles, 40: 499-512.
Taywaditep, K.J., Coleman, E., and Dumronggittigule, P. (1997) Thailand. In R. Francoeur, (Ed.). International Encyclopedia of Sexuality, New York: Continuum.
Tsoi, W.F. (1990) Developmental profile of 200 male and 100 female transsexuals in Singapore. Archives of Sexual Behavior, 19: 595-605.
Watkins, D.A., Kai, L.M., and Regmi, M. (1991) Cross-cultural assessment of self-esteem: a Nepalese investigation. Psychologia, 34, 2: 98-108.
Weinrich, J.D., Atkinson, J.H., McCutchan, J.A., Grant, I., and the HNRC Group (1995) Is gender dysphoria dysphoric?: Elevated depression and anxiety in gender dysphoric and nondysphoric homosexual and bisexual males in an HIV sample. Archives of Sexual Behavior, 24: 55-72.
Wells, L.E. and Marwell, G. (1976) Self-esteem: its Conceptualization and Measurement. Beverly Hills CA: Sage.
Williams, J.E. and Best, D.L. (1990a) Measuring Sex Stereotypes: A Multi-Nation Study. Newbury Park, CA: Sage Publications.
Williams, J.E. and Best, D.L. (1990b) Sex and Psyche: Gender and Self-concepts Viewed Cross-culturally. Newbury Park, CA: Sage Publications.
Winter, S. and Udomsak, N. (in preparation). Gender stereotype and self among transgenders: Underlying Features.
Yuksel, S., Kulaksizoglu, I.B., Turksoy, N., and Sahin, D. (2000) Group psychotherapy with female-to-male transsexuals in Turkey. Archives of Sexual Behavior, 29: 279-290.
Zucker,K.J., Wild, J., Bradley, S.J., and Lowry, C.B. (1993). Physical attractiveness of boys with gender identity disorder. Archives of Sexual Behavior, 22: 23-36.
For advice and comments, David Watkins, and Paul and Esther Morris of the University of Hong Kong, Pasu ('Kie') Lertsubin and Fiona Kim of Dr Suporn Clinic, Chonburi, Thailand, John Williams of Georgia State University, USA, Peter Jackson of Australian National University, and Andrew Matzner; for questionnaire translation, Pattaranit 'Bhom' Imampai; and for help in distributing questionnaires, Werachat 'Tor' Suttpan, Paniti 'Diana' Thongtuk and Warachai 'Ton' Kuadkengkrai.