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Gay and Bisexual Identity Development Among Female-to-Male Transsexuals in North America: Emergence of a Transgender Sexuality

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We studied a North American sample of female-to-male (FtM) transsexuals sexually attracted to men, aiming to understand their identity and sexuality in the context of a culture of transgender empowerment. Sex-reassigned FtM transsexuals, 18 years or older and attracted to men, were recruited via an FtM community conference and listserv. Participants (N = 25) responded to open-ended questions about identity development, sexual behavior, and social support. Data were analyzed by content analysis. Scores for sexual identity, self esteem, sexual functioning, and psychological adjustment were compared to those of a comparison group (N = 76 nontransgender gay and bisexual men). Of the 25 FtMs, 15 (60%) identified as gay, 8 (32%) as bisexual, and 2 (8%) as queer. All were comfortable with their gender identity and sexual orientation. The FtM group was more bisexual than the nontransgender gay and bisexual controls. No significant group differences were found in self esteem, sexual satisfaction, or psychological adjustment. For some FtMs, sexual attractions and experiences with men affirmed their gender identity; for others, self-acceptance of a transgender identity facilitated actualization of their attractions toward men. Most were “out” as transgender among friends and family, but not on the job or within the gay community. Disclosure and acceptance of their homosexuality was limited. The sexual identity of gay and bisexual FtMs appears to mirror the developmental process for nontransgender homosexual men and women in several ways; however, participants also had experiences unique to being both transgender and gay/bisexual. This signals the emergence of a transgender sexuality.

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The authors acknowledge Anne Marie Weber-Main, Ph.D., for her critical review and editorial suggestions of earlier manuscripts drafts. The authors also would like to acknowledge the female-to-male participants for their willingness and openness in sharing their life stories with us during the interviews.

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Correspondence to Walter Bockting.

Appendix 1: Semi-Structured Interview Guide

Appendix 1: Semi-Structured Interview Guide

Identity Development

  1. 1.

    How would you describe yourself when it comes to your sexual identity? (Gay men, bisexual, transsexual, other)

    How do you feel about this?

    How comfortable are you with this?

  2. 2.

    When do you recall feeling different for the first time, that is, feeling like a member of the other sex?

  3. 3.

    What came first? The feeling of being a boy or the awareness of attractions to other men?

    Were your attractions to other men of influence to your decision to pursue sex-reassignment surgery?

    Do you think your homosexual feelings have anything to do with your transsexual background? Is there a connection?

  4. 4.

    At what age did you start hormones?

    What kinds of surgeries have you had and in what order?

    How long ago?

  5. 5.

    To whom and to what type did you feel sexually attracted before sex-reassignment surgery?

    Has this changed after sex-reassignment surgery?

    Did you expect any change?

    What is your favorite type?

  6. 6.

    At what age did you feel attracted to men for the first time?

    When did you start talking to other people about your attractions to men?

    When did you start identifying as gay or bisexual?

    Did you ever identify as lesbian?

Social Support

  1. 7.

    Is your social support system aware of your transsexual background?

    Is your social support system aware of your attractions to men?

    Do they accept your transsexuality?

    Do they accept your attractions toward men?

    Does being aware of both your transsexuality and your homosexuality influence the level of acceptance?

    Specification of social support system:

    1. a.


    2. b.


    3. c.


    4. d.


    5. e.


    6. f.


  2. 8.

    How many friends do you have?

    What is their sexual orientation?

    What percentage is homosexual? Bisexual? Heterosexual? Transsexual? Crossdresser? Drag king/queen? Transgender?

    Do they know about your transsexuality?

    Do they know about your homosexual feelings?

    How many gay, male friends are aware of your transsexuality?

    How do they respond to this?

  3. 9.

    Do you feel accepted in the gay community?

    Are people aware of your transsexuality in the gay community?

    Does knowing about your transsexuality make any difference in the way people approach you?

Sexual Behavior

  1. 10.

    At what age did you have your first sexual experience/encounter?

    With what partner (male/female/transgender, homosexual/bisexual, heterosexual)?

    What are your feelings about your first sexual experience)?

  2. 11.

    When did you have your first gay sexual experience? (notice the difference between a sexual experience with a man perceived as a heterosexual/homosexual experience)

    How did you feel about this experience?

    How do you feel about this experience now?

  3. 12.

    Were you involved in sexual contact with somebody who was much older than you (indicator of possible sexual abuse)?

  4. 13.

    When you compare pre- with post-sex-reassignment, has the level of your sexual interest changed? If yes, how? (Significance of hormone therapy)

  5. 14.

    Before sex-reassignment, were your sexual fantasies homosexual, bisexual, or heterosexual?

    Did you fantasize about yourself as male, female, or transgender?

    Has this changed after sex-reassignment? If yes, how?

  6. 15.

    Did you engage in masturbation before sex-reassignment? If so, how frequently?

    In what way did you achieve orgasm?

    Were you able to have multiple orgasms?

    Did this change after sex-reassignment?

  7. 16.

    Before surgery, how comfortable were you with sexual arousal?

    Has this changed after sex-reassignment?

  8. 17.

    With how many partners do you engage in sex?

    How frequently are you having sex with one partner?

    Do you have a lover?

  9. 18.

    Do you have a phalloplasty? If not, are you interested in pursuing a phalloplasty?

    What are your feelings about having/not having a phalloplasty?

    How do your partners respond to this?

  10. 19.

    When you are engaging in sex with a partner, what do you do?

    What is your favorite sexual act?

    What is your favorite sexual fantasy?

    Do you engage in oral sex? As an inserter (receiving) or insertee (giving), or both ways?

    Do you engage in anal sex?

    Do you use toys, like dildos?

    Who takes the initiative?

    Do you prefer foreplay, petting, touching, or oral/anal/vaginal sex?

    How do you feel about nipple stimulation?

  11. 20.

    When you are engaging in sex, do you reach orgasm?

    What percentage of times having sex do you experience orgasm?

    Do you have the ability to experience multiple orgasms?


  1. 21.

    What problems have you encountered concerning the combination of transsexuality and homosexuality (being a transsexual gay/bisexual man)?

  2. 22.

    Do you have any regrets about surgery?


  1. 23.

    Would you like to add something?

    Is there anything of importance we did not cover?

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Bockting, W., Benner, A. & Coleman, E. Gay and Bisexual Identity Development Among Female-to-Male Transsexuals in North America: Emergence of a Transgender Sexuality. Arch Sex Behav 38, 688–701 (2009).

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