Being Trans Without Medical Transition: Exploring Characteristics of Trans Individuals from Germany Not Seeking Gender-A
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ORIGINAL PAPER
Being Trans Without Medical Transition: Exploring Characteristics of Trans Individuals from Germany Not Seeking Gender‑Affirmative Medical Interventions Timo O. Nieder1 · Jana Eyssel1 · Andreas Köhler1 Received: 15 February 2019 / Revised: 5 October 2019 / Accepted: 9 October 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Until recently, trans persons were expected to align their sex characteristics as much as possible with the opposite sex. Today, research and health care, as well as the diagnostic criteria from DSM-5 and ICD-11, reflect a broader understanding of trans individuals. It encompasses diverse identities and treatment requests, including trans individuals not wanting or having decided against genderaffirmative medical interventions (GAMI). The present study explored this insufficiently studied group by (1) reviewing the existing literature regarding trans individuals not seeking GAMI and by (2) exploring their demographic and trans-related characteristics in a non-clinical online convenience sample from Germany. The literature review found one large survey with a single question on trans individuals not seeking GAMI. Beyond that, only community literature addressed the topic. The analyzed sample consisted of 415 trans participants, of whom 220 were assigned female at birth (AFAB) and 195 were assigned male at birth (AMAB). Fourteen (3.4%) reported neither previous nor planned GAMI (AFAB = 9, AMAB = 5). Trans individuals not seeking GAMI were significantly older and more often reported to identify with a non-binary gender. The two interdependent, central reasons for refusing GAMI were the avoidance of transition-related suffering and the lack of necessity for treatment. The diversification of gender, as reflected in the increasing visibility of non-binary or genderqueer gender identities, seems to go hand in hand with a diversification of transition-related treatment, including the option not to seek GAMI. Keywords Transgender · Non-binary · Gender dysphoria · Social transition
Introduction Historically, trans individuals (short, for example, for transgender, transsexual, or genderqueer1) were usually subjected to fixed expectations with respect to their gender identity and treatment requests (Meyerowitz, 2002). Regarding their gender identity, trans persons were assumed to identify with the other gender (Nieder & Richter-Appelt, 2011). In the context of treatment, the common expectation was for trans persons to as closely as possible align their sex characteristics with the opposite sex (CohenKettenis & Pfäfflin, 2010) by accessing all gender-affirmative medical interventions available (referred to as GAMI; e.g., hair removal treatment, hormone therapy, mastectomy and breast * Timo O. Nieder [email protected] 1
Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Interdisciplinary Transgender Health Care Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
augmentation, genital,
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