Margaret Lamacz, a sex researcher at Johns Hopkins University in Baltimore, remembers her confusion when she began working with transsexuals at the Medical Academy in Krakow, Poland. For every male desiring to be a Christine Jorgenson, she found five females who wanted to become men.
"We were always puzzled," Lamacz said. "That did not agree with the literature," which held that transsexualism was primarily a male phenomenon.
Now, in a distant echo of what Lamacz encountered nearly a decade ago in Poland, clinics and therapists from California to Virginia are finding that increasing numbers of women are stepping forward to join hundreds of Americans who change their sex each year.
25% Are Biological Women
Biological women, thought to account for only 6% of the nation's transsexual population in the early 1950s, now make up around 25% of the 10,000 to 25,000 trans-gender people in the United States, according to a survey of those in the field. Even more striking, some leading gender clinics today have as many female as male clients "in transition."
"Until the last couple of years, we didn't think there were as many genetic females" interested in sex reassignment, said Dr. Stanley Biber, whose clinic in Trinidad, Colo., has been nicknamed the sex change capital of the world. "From our communications, that type is increasing tremendously."
The shift is partly a result of recent medical advances, which are enabling surgically created males not only to pass as men on the street and on the job but in the locker room and in the bedroom. Improved surgical techniques are allowing these new males to cast aside below-the-waist padding and lead more normal lives as men.
Adam, 34, a Minneapolis waiter whose surgery was completed in January, said he can now "go around without clothes" in a locker room filled with other men without being stared at. "It feels really good. Things are so far advanced now. I know people who just had the operation a few years back. They wish they had waited."
The growth in numbers of female-to-males is also being attributed to increasing media attention on transsexuals, especially on television shows in which Geraldo Rivera, Oprah Winfrey and Phil Donahue bring sexual minorities into middle-class living rooms.
Men who became women, in the style of World War II ex-G.I. Christine Jorgenson and male-eye-surgeon-turned-woman-tennis-player Renee Richards, have been common fare on such programs. But genetic females who felt uncomfortable with their gender "never knew anybody like themselves," said Paul Walker, a San Francisco psychologist.
Now that's changing. Walker recently appeared on one show with twin sisters who became twin brothers.
Female-to-males have not been as flamboyant as Richards, who conducted a public battle to play women's tennis in the 1970s, or Sister Mary Elizabeth, a San Juan Capistrano transsexual who took vows of chastity earlier this year to inaugurate her own order of nuns only to be repudiated by the Episcopal Church. But inside, their feelings are remarkably the same.
"They all give a similar story," said Leslee Schraeder, head of the mental health clinical program with the Hollywood Mental Health Service. "They wish they were the opposite sex way before puberty."
Often their earliest memories are of feeling that they were issued the wrong kind of body and of fighting with their parents over clothing. As a girl, Luke, 34, a Camarillo female-to-male recovering from breast-removal surgery, would wear walking shorts under a skirt.
"I don't really understand the female mind," he said without a trace of irony.
More Expensive, Difficult
The increasing number of people such as Luke who are stepping forward for surgery is especially arresting, since changing genders for women is much more expensive and difficult than sex reassignment for a man. A biological woman who opts for the latest in plastic surgery may spend more than $50,000, endure weeks of painful recuperation in the hospital and cope with unattractive scarring and the need for periodic repairs of their newly masculinized bodies.
Insurance can cover much of the cost of the surgery.
Transsexualism is a condition in which one's private gender identity differs from one's sex. A person with a male body can be convinced that, deep down, he really is a female. His preference in a sexual partner may be either male or female, though the majority of post-operative transsexuals prefer males, believing themselves to be heterosexual women.
Some medical policy-makers in effect deny the existence of transsexualism, believing transsexuals are trying to escape their gender responsibilities or are afraid of admitting homosexuality. But sympathetic therapists and physicians regard transsexuals as the victims of a sort of birth defect.
"If you think getting married and having kids will suppress the problem--you can not suppress it," said Leah Schaeffer, a New York psychotherapist. "You came into the world with it, and you'll die with it."