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1.4 The concept of transgender
In more recent literature the concept of transgender has started to be
used as an umbrella term to refer to a diverse group of individuals who
cross or transcend culturally defined categories of gender. Whilst there
is no generally accepted and unambiguous definition of the concept of
a transgender individual, there is a consensus that it should include all
those who practise cross-dressing. This means that it embraces individuals
who identify themselves as transvestites and cross-dressers, transsexuals
and all the intermediate groups between transvestism and transsexualism
(Bockting & Cesaretti 2001; Bolin 1994; Zander 2003).
The spectrum of cross-dressing
The literature contains extensive discussions on cross-dressing. There
are various forms of cross-dressing (the spectrum of cross-dressing)
identified, such as (Docter 1988):
1. Transvestism, i.e., individuals who periodically dress in the clothes
of the opposite sex.
2. Marginal transvestism, in which identification with the opposite
sex role is more intensive and where the individual often seeks hormone
therapy but periodically lives in the opposite sex role.
3. Transgenderism, in which the individual lives full-time in the role of
the opposite sex without undergoing sex reassignment treatment.
4. Primary transsexualism, which describes a situation where the individual
since early childhood identified with the opposite sex.
5. Secondary transsexualism, which describes a developmental process
in which the individual could, for example, have been a transvestite
in an earlier phase but where a later developmental pattern has led
to a need for sex reassignment surgery.
There are male-to-female (MtF) transsexuals and female-to-male
transsexuals (FtM). The literature also describes other variations such
as drag queens/kings or she-males, referring to groups in which many
use hormones and have undergone cosmetic surgery to varying degrees
but where only a few have undergone complete sex reassignment surgery.
Another group is female role impersonators working as artistes
imitating women or appearing in female roles. There are heterosexual,
bisexual and homosexual variations of cross-dressing (Bockting &
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