Psycho-Social
Factors on People's Tendency to Sexual Change
in the City of Tehran
.........................................................................................................................
1. Professor Ali
Reza Kaldi, University of Social Welfare
and Rehabilitation, Tehran, IRAN.
2. Dr Afsaneh Tavassoli
3. M.A. Maryam Hosseinian
Correspondence:
arkaldi@yahoo.com
|
ABSTRACT
Objective:
This research aims at identifying the
differences between the roles of men and
women (the expected role) and what they
actually do (the adopted role). The Process
of trans-sexuality as a topic in the domain
of sex study is not well-considered so
far in different cultures. This research
mainly seeks to study the psycho-social
reasons of the youth's tendency to trans-sexuality
in the city of Tehran.
Materials and Method: This is a
descriptive study and survey research.
Data was collected by administering a
researcher-made questionnaire. Cultural
factors, socio-economic factors, religious
values, legal and civil domains, psycho-social
factors are considered to be the independent
variables, and trans-sexuality (from male
to female and from female to male) was
considered as a dependent variable. The
population included 312 transsexual people
who had come to Tehran's Rehabilitation
Centre. Among them 150 trans-sexual persons
were selected randomly. They were divided
into two groups of 75 subjects (one group
with a tendency from male to female and
the other group from female to male).
Data were analyzed and it is defined that
reliability of questionnaire (Cronbach's
alpha) is 87%.
Results: The findings of the study
indicate that there is a significant relationship
between trans-sexuality and the variables
such as life expectancy, the absence of
parents, family support, job status, income,
charges from society, respecting tradition,
family satisfaction, education, respecting
religious beliefs, lack of any kind of
legal rule, and the functions of governmental
institutions. In the first five components,
the relationship is more significant in
the group with tendency "from male
to female", but the other factors
are significant among the group with tendency
"from female to male". Moreover,
there is a significant relationship between
trans-sexuality and four components of
syntonia, asthenia, schizothymia, and
hysteroidia. In the first three components,
these were more significant among females
with a desire to the male, and the fourth
component is more significant among the
opposite group.
Conclusion: Trans-sexuals suffer
from gender identity disorders, and some
psycho-social factors influence their
private lives and also social environment.
Further research about trans-sexuality
would be beneficial for their adjustment
in society.
Keywords: Trans-sexuality, Sexual
Change, Youth, Psycho-Social Factors,
Tendency.
|
Routine pre-operative investigations
are used in most patients admitted for elective
minor surgery in order to identify those at
high risk of complications. Despite the fact
that routine screening tests has no major influence
in the management of the elective surgical patients,
these tests continue to be performed in some
hospitals. It is generally accepted that clinical
history and physical examination represent the
best method of screening the presence of a disease.
Performing routine laboratory tests in patients
who appear healthy after such screening is invariably
of little use and a waste of resources. Several
pre-operative screening investigations in the
general surgical population have been evaluated
and their benefit questioned. Routine laboratory
screening does not remove the possibility of
peri-operative complications. In this study,
we examined the value of widely accepted pre-operative
investigation in otherwise healthy children
scheduled for elective minor surgery.
In every society, people
are categorized based on social factors like
their role, situation, religion, race, ethnicity,
etc. One of the most important social and cultural
factors which distinguish people is gender.
Many scholars believe that gender is likely
to be the only substantial characteristic that
determines perception, viewpoint, behaviour
and attitude of people in society and this characteristic
is formed and highly influenced by social and
cultural learning. It is believed that gender
has at least three distinct levels, which are
related to each other: Personal level (which
consists of roles and personality), Inter-personal
level and interaction (which consists of behavioural
practices with others) and the social level
(which consists of cultural beliefs and resource
distribution)(1).
Gender identity is formed by social interaction
and transmitted from social agents (family,
school, friends and public media). In other
words, "a child adopts a specific gender
identity by the socialization process and personality
growth and using this personality he or she
starts to reproduce behaviours, standpoints
and values which the social environment dictates
to boy or girl"(2).
Based on this fact, gender identity means adopting
self-physiological gender from the mental system
of the individual and therefore conformity with
his or her same sex throughout life in order
to gain ordinary gender behaviour in personal
and social life(3).
There are individuals who feel deep and continuous
dissatisfaction with their biological gender
for several reasons and are inclined to the
other gender. They feel dependency to the opposite
gender, dissatisfied with their own gender and
body and try to approach the opposite gender
using hormones and surgery. These individuals
are stricken by Gender Identity Disorder (GID)
or trans-sexualism(4,5).
Sex Reversal Surgery (SRS) is surgery which
alters corporal characteristics of an individual
to the opposite sex. In other words, sex reversal
happens when external sexual organs of one's
body change. In cases of male to female, the
surgery may consists of mammoplasty, testicle
and phallus removal, and creating organs from
phallus skin or the colon(6).
Transsexuals have existed throughout history.
In primitive societies, people believed that
trans-sexuals were charmed and had magic powers
or had a relationship with though Gods having
a nice spirit and sacred attitude.
Today however, sex reversal surgery is done
in many countries without considering whether
these transsexuals are psychotic or they suffer
harmonic-biologic or social disorders.
A survey conducted in 1994 in Tehran called
"A survey on gender identity disorder of
girls in Tehran province" on 168 children
between 4 and 11 years in kindergartens, primary
and guidance schools of Tehran, randomly. The
results showed that the girls insisted on their
female identity in all ages, as age influences
the forming and evolution of gender identity(7).
Another survey was conducted in 1997 called
"The influence of environment on gender
identity formation". This survey tries
to clarify the effect of the environment and
family on preventing gender identity disorders
and the importance of the behaviour of parents
of the children by studying current results
and without overlooking biological differences.
Finally, the survey prescribes some recommendations
of which their effects are proven(8).
Another survey was conducted in 1997 called
"Surveying family characteristics of some
trans-sexuals in Iran". The results of
this survey showed that identifying family characteristics
on formation of the mentioned disorder, especially
in Iran's social and cultural situations, plays
a significant role in prevention and treatment
of the disorder(9).
From another survey called "Gender Identity
disorders during childhood and adolescence"
the following results were obtained: Gender
identity means personal feeling of being male
or female which starts from 3 and 4 years of
age. To identify gender identity disorder, there
are two primary criteria: a) Intense and continuous
assimilation to the opposite sex; b) Continuous
suffering from his or her own sex or non-conformity
with his or her own gender role(10).
The other survey called "Recognition and
treatment of trans-sexual disorder by emphasizing
spiritual treatment" was conducted. The
results are as follows:
Using hormones and surgery for sex reversal
are the only available means of psychiatric
treatments for this disorder which don't lead
to a desirable outcome. It is observed that
psychoanalytical methods, family treatment,
psychological treatments and individual behavioral
reformation in combination, have positive effects
on the disorder(11).
Another survey called "The relationship
between the perceptions of gender roles and
gender satisfaction" was conducted and
led to the following results: The psychological
differences of girls and boys are of significant
importance because of their effect on sociability
of adolescents and their perceptions of gender
roles. The most considerable consequence of
the survey explains that sexual beliefs of boys
are less stereotypical in comparison with girls.
Girls are more likely to desire to have the
opposite sex in case of rebirth. This issue
confirms that girls are more dissatisfied with
their gender than boys. The fact that girls
are more open to criticism because of their
sentimental attitudes, leads to applying gender
stereotypes in society and any avoidance of
these stereotypes is considered a kind of disorder(12).
Other research entitled "Comparative study
on sex-reversal in the scope of Iran - US laws
based on the standpoint of legal medicine"
was conducted in 2005. The following results
were obtained from a total of 57 cases on transsexuals
of which 37 were male and another 20 were female
cases: 17% of transsexual families ignored and
disregarded the patient when he/she was upset(3).
Other research entitled "Identifying personality
disorders and personal characteristics of men
suffering from gender identity disorder"
was done in 2006. The results are as follows:
Personality disorders were surveyed among two
groups using multi-criteria clinical questionnaire
of Milon (MCMI-II). The results showed that
GID patients got high grades in 6 criteria of
the Milon questionnaire (dependent, histrionic,
anti-social, passive, aggressive, borderline,
paranoia) that had distinctive difference in
comparison to the evidence group in terms of
statistics. In general, we can deduce that people
suffering from gender identity disorders are
more prone to personality disorders than ordinary
people(13).
Research entitled "The role of family to
gender identity disorder patients" was
conducted in 2007. Based on the results, the
existence of gender identity disorder in people
encountering sensational, sentimental and emotional
issues in family are more probable and helping
these people by family intermediation is likely
to be effective. In addition, informing families
about emotional and training needs of their
children reduces the likelihood of the disorder(14).
The bulk of gender identity - either normal
or trans-sexual identity - arises from an unknown
hormonic process during the second to fourth
months of pregnancy(15,16).
From the viewpoint of cause and effect, gender
identity is categorized as follows: Genetic,
Prenatal hormonal, Postnatal social, and Post
pubertal hormonal.
When we see a woman working outside and in a
career like truck driving or watchdogging and
her husband does housekeeping, we immediately
come to deduce that the couple must have a deficiency(7).
Gender identity disorder includes transsexual,
transvestite, drug king, drug queen, lady boy
and shemale.
In the US, the number of men dissatisfied with
their sex is about 1.3 million and the number
of women dissatisfied in term of their sex is
about 1.4. In the US, the number of men has
been operated to reverse their gender in 1960
was 1,000 and in 2000 was 20,000.
In Iran though, 470 persons have been referred
to legal medicine from 1987 to 2004 of whom
270 were men and 70 were women and during 1987
to 2001, surgery on 214 were accepted, 11 cases
were refused and the others never referred again.
In the capital of the provinces, a total number
of 57 were referred of who 35 wanted to reverse
from male to female and 22 wanted the opposite.
In general, the prevalence of this disorder
is 1 in 30 thousand among men and 1 in 100 thousand
among women.
Another survey called "Gender identity
disorder and its social consequences" has
resulted from the fact that gender and sex identity
can have several socio-cultural implications(17).
Since this phenomenon isn't limited to one element,
so the factors which effect the phenomenon are
as follows:
a) Physical Factors:
1)Endocrine disorder (sexual hormone management
method);
2) Brain disorder (abnormal EEG);
3) Several unnatural factors during pregnancy;
4) Brain damage (scarlet fever, mental retardation,
epilepsy);
5) Inherited factors;
6) Disorder in chromosomal or genetic factors;
7) Appearance tendency (picking up eyebrow,
surgery, injection of paraffin into the breast
and vice versa).
Based on the standpoint of Harry Benjamin -founder
of the international institute of trans-sexuals
of the US- this disorder takes place because
of the combination of hormonic, psychological
and other similar causes.
In general, the characteristics of trans-sexuals
are divided into four categories: 1) Those related
to trans-sexualism;
2) Those resulting from trans-sexualism;
3) Those independent from trans-sexualism;
4) Those that could be found in any group of
people with mental troubles.
Psychological factors:
1)Personality factors;
2) Psychological problems during childhood;
3) Sexual eagerness;
4) Mother's psychological problems during labor;
5) Gender role or recognition of sexual differentiation;
6) Psychotic problem;
7) Sexual hallucination;
8) Gender reversal delirium;
9) Paranoia;
10) Schizophrenia;
11) Stabilization;
12) Fixation in childhood;
13) Depression.
b) Environmental Factors:
It is obvious from the latest scientific research
that formation and evolution of one's personality
starts in utero\ It is obvious that parents
and mostly acquaintances play a significant
role to help normal sexual and mental growth
of the baby during this time.
Improper environmental factors (social factors)
speed up the process of transsexualism of which
some of them are as follows:
1) The growth of child in an unsafe and improper
environment;
2) The method of bringing up;
3) The poverty of parents;
4) Deprivation of parents, especially in the
first years of youthfulness and the beginning
of gender identification of the child;
5) Non-legitimacy of the child;
6) Leaving home;
7) Excommunication;
8) Social obliquity of the parents(18).
Materials and Method
This research was done by survey. The questionnaire
is the tool of data gathering. The amount of
Cronbakh's alpha for considered identifications
has been 0.89, and that shows the perpetuity
of the research measurement tool.
The statistical universe consists of all the
people on survey who researchers distributed
sampling units amongst. So, the population of
the current survey is 312 transsexuals referred
to state welfare center in Tehran.
Among them, the available sample under survey,
is transsexuals referred to the above organization
and 75 men and 75 women, totalling 150, were
selected. The transsexuals of Tehran have been
selected by the method of simple random sampling.
The survey was conducted in 2007-2008 and the
location was Shahid Navvab state welfare center
in Tehran. Since the transsexuals mostly refer
to state welfare organization, psychiatric institutes,
legal medicine organizations and some offices
for their sex reversal, then the researchers
were obliged to refer to these centers in order
to fill out their questionnaire.Finally, the
data were gathered in Tehran Shahid Navvab state
welfare center.
The lowest age of male respondents was 20 and
the highest was 49, the lowest age of female
respondents was 16 and the highest was 38.
5.3 percent of male respondents were illiterate,
13.3 percent were under diploma, 53.3 percent
had a diploma, 6.7 percent had an upper diploma
and 21.3 percent were B.S.
1.3 percent of female respondents were illiterate,
13.3 percent were under diploma, 36 percent
had a diploma, 20 percent were upper diploma
and 22.7 percent were B.S and 6.7 percent were
M.S.
32 percent of male respondents were employed
and 66.7 percent were unemployed. 29.3 percent
of female respondents were employed and 65.3
percent were unemployed.
In social aspects, some social factors are effective
on tendency to sex reversal.
|
Table
1 Social factors effective on tendency
to sex reversal |
|
Hypothesis |
Test Type
|
Meaningfulness
level |
Degree of freedom |
Cramer |
Test Result |
|
It
seems that some social factors are effective
on sex reversal |
Male
to Female |
|
Chi-Square |
0.021 |
2 |
0.69 |
A
meaningful relation exists |
| Female
to Male |
|
Chi-Square |
0.004 |
2 |
0.76 |
A
meaningful relation exists |
|
Table
2 Correlation of Spearman between the
variables and tendency of transsexuals to
sex reversal |
|
Variable |
Statistical
Indicator |
Tendency of transsexuals to sex reversal |
|
Male to Female |
Female to Male |
|
Hope to Live |
Spearman Correlation coefficient |
0.64 |
0.53 |
|
Meaningfulness Level of a Domain |
0.000 |
0.000 |
|
Sum
|
75 |
75 |
|
Family Support |
Spearman Correlation |
0.53 |
0.43 |
|
Meaningfulness Level of a Domain |
0.000 |
0.000 |
|
Sum |
75 |
75 |
|
Labeling Value |
Spearman Correlation |
0.69 |
0.73 |
|
Meaningfulness Level of a Domain |
0.000 |
0.000 |
|
Sum |
75 |
75 |
|
Occupation Situation |
Spearman Correlation |
0.63 |
0.59 |
|
Meaningfulness Level of a Domain |
0.000 |
0.000 |
|
Sum |
75 |
75 |
|
Income |
Spearman Correlation |
0.91 |
0.89 |
|
Meaningfulness Level of a Domain |
0.000 |
0.000 |
|
Sum |
75 |
75 |
|
Education Level |
Spearman Correlation |
0.55 |
0.67 |
|
Meaningfulness Level of a Domain |
0.000 |
0.000 |
|
Sum |
75 |
75 |
|
Religious Beliefs |
Spearman Correlation |
0.66 |
0.73 |
|
Meaningfulness Level of a Domain |
0.000 |
0.000 |
|
Sum |
75 |
75 |
|
Lack of Legal Bills and Regulations |
Spearman Correlation |
0.26 |
0.39 |
|
Meaningfulness Level of a Domain |
0.000 |
0.000 |
|
Sum |
75 |
75 |
About sex reversal (male to female): it seems
that some social factors are effective on sex
reversal. Chi-Square test was used. Considering
the value of chi-square on the freedom factor
of two and meaningfulness level below 0.05,
it can be deducted that the relationship between
two variables is not by chance and a meaningful,
direct relationship exists between these variables.
The Cramer coefficient also expresses the meaningfulness
of the relationship between these two variables
and its intensity.
It seems that there are relationships between
the following variables and tendency of transsexuals
to sex reversal.
Considering the above table, there exists a
meaningful relationship between hope to live,
family support, labeling value, occupation situation,
income, education level, religious beliefs and
lack of legal bills and regulations factor and
tendency of transsexuals to sex reversal.
In psychological context, it seems that transsexual
youth have a psychological dissociation (psychological
childhood characteristic or stabilization in
childhood feedback).
|
Table
3 social factors effective on tendency
to sex reversal |
|
Hypothesis |
Test
Type |
Meaningfulness
level |
Degree
of freedom |
Cramer |
Test
Result |
|
It
seems that most of the transsexual youth
have a psychological dissociation |
Male
to Female |
| Chi-square |
0.008 |
2 |
0.52 |
A
meaningful relation exists |
| Female
to Male |
| Chi-square |
0.032 |
2 |
0.63 |
A
meaningful relation exists |
From female to male tendency, it seems that
most of the transsexual youth have a psychological
dissociation (psychological childhood characteristic
or stabilization in childhood feedback). Chi-square
test was used. Considering the value of chi-square
test and meaningfulness level below 0.05, it
can be deducted that the relationship between
two variables is not by chance and a meaningful,
direct relationship exists between these variables.
The Cramer coefficient also expresses the meaningfulness
of the relationship between these two variables
and its intensity.
From male to female tendency, chi-square test
was used. Considering the value of chi-square
test on the freedom factor of two and meaningfulness
level below 0.05, it can be deduced that the
relationship between two variables is not by
chance and a meaningful, direct relationship
exists between these variables. The Cramer coefficient
also expresses the meaningfulness of the relationship
between these two variables and its intensity.
Therefore, both tests are meaningful for both
variables.
It seems that there is a relationship between
the tendency to sex reversal of transsexuals
and environmental effect, inability, excitement,
and dissociation of personality.
Correlation coefficient of Spearmen was used
to study the intensity of linear relationship
of these variables.
|
Table
4 Correlation of Spearman between environmental
effect, inability, excitement, and dissociation
of personality and the tendency of transsexuals
to sex reversal |
|
Variable |
Statistical
Indicators |
Tendency
of transsexuals to sex reversal |
|
Male
to Female |
Female
to Male |
|
Environmental
effect |
Correlation
of Spearman |
0.43 |
0.45 |
|
Meaningfulness
Level of a Domain |
0.000 |
0.000 |
|
Sum |
75 |
75 |
|
Inability |
Correlation
of Spearman |
0.53 |
0.66 |
|
Meaningfulness
Level of a Domain |
0.000 |
0.000 |
|
Sum |
75 |
75 |
|
Excitement |
Correlation
of Spearman |
0.69 |
0.58 |
|
Meaningfulness
Level of a Domain |
0.000 |
0.000 |
|
Sum |
75 |
75 |
|
Dissociation
of personality |
Correlation
of Spearman |
0.58 |
0.63 |
|
Meaningfulness
Level of a Domain |
0.000 |
0.000 |
|
Sum |
75 |
75 |
Considering the above table, there exists a
meaningful relationship between environmental
effect, inability, excitement, and dissociation
of personality and tendency of transsexuals
to sex reversal.
It seems that tendency
to sex reversal is increasing quantitatively.
However, it is worth considering that the percentage
of boys tendency to reverse their sex to females
is lesser.
The higher the wish to live as transsexuals,
the higher the tendency of sex reversal. The
more there is labeling, the more is the tendency
of transsexuals to sex reversal. Also, the more
family support, equaotes to higher transsexuals'
tendency to sex reversal. Meanwhile, the better
the occupation situation, the more transsexuals'
tendency to sex reversal. This fact is true
when more income is considered. The higher theeducation
level, the highertranssexuals' tendency to sex
reversal.
Most of transsexual youth suffer from psychological
dissociation. The more environmental effect,
the more tendency of transsexuals to sex reversal.
The more excitement, the more tendency of transsexuals
to sex reversal. And finally, the more dissociation
of personality, the more tendency to sex reversal.
Recommendations
- Authorities should prepare an appropriate
and safe environment for these people, so
they can express their problems and possibly
undergo treatment to find their real gender
and be relieved from their sufferings.
- Lawyers should investigate the incentives
to sex reversal and its consequences and also
they should analyze related regulations, so
they can apply laws related to sex reversal
forthose requiring it.
- The parents and families of transsexuals
should understand their pains. On the other
side, ordinary people should be introduced
to the transsexualism phenomenon in order
to help these patients.
- NGOs should be supported in order to organize
and provide support for these kinds of patients.
- These patients are vulnerable to AIDS, so
they should be introduced to its means of
transmission. Therefore, this disease should
be considered important.
- Transsexualism is not considered a criminal
or insolvable problem in its essence. The
problem is lack of social awareness and homophobia
(panic, avoiding transsexuals due to fear
and disregarding their personal and social
rights or worse, disrespecting them). Therefore,
by giving respect and support to these patients,
not only will social unawareness be removed,
but also opinion independence and moral sense
will be experienced.
- It is better for families to refer to psychologists
in case they are uncertain or doubtful about
their child's sex prior to his or her maturity
and follow up the issue. There is a possibility
that doing that after maturity will be too
late.
- Developing public and complementary insurances
and unemployment insurance and devising proper
economical, social, cultural and educational
facilities for these people by government
authorities, and leading facilities and resources
based on equality and non-discrimination approach
throughout society for these transsexuals.
- Passing some rules in parliament to mandate
genetic tests and consultation.
- Foundation of medical centers and professional
practitioners proficient in sex reversal surgery,
and equal job opportunities and maintaining
their rights, should be considered.
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