Gendercraft Helping clients to align their gender expressions with their gender identities - Equitas Health Institute
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Gendercraft
Helping clients to align their gender expressions
with their gender identities
Gary Cordingley, MD, PhD
Disclosures • The speaker and members of the planning committee do not have a conflict of interest in this topic. • There is no commercial support for this program. • The speaker will discuss uses of hormonal medications that are well studied, but off-label.
Many thanks for contributions and advice from:
Carrie Chandler
Jody Davis, RN, MSW, LISW
Theodore Hutchinson, PhD
Dionysus Mondlich
Jacob Nash, MA, CDP
Gabriel Pellikka
Kaye Plumley, CT
Brenda Robson
Sarah Taylor, MA, CCC, SLP
L. Justin Wheeler, LISW-S
Ginger Williams
Participants in an earlier version of this seminar
Learning Objectives • Define “passing” and provide reasons why gender-diverse people often have conflicted relationships with the concept. • Describe tools available to gender-diverse people who wish to feminize or masculinize their presentations, including by managing hairstyle, facial hair, facial appearance, skin care, shoulders, chests, waists, hips, genitalia, clothing, accessories, posture, movement and communication. • List methods that gender-diverse people can employ to minimize awkwardness and embarrassment while obtaining clothing and other materials associated with a gender different from the sex assigned at birth.
What gendercraft is: • A toolkit of devices, methods and skills available to people who seek gender expressions more consistent with their gender identities • Analogous to “tradecraft” or “stagecraft” • A body of knowledge for people raised in genders incongruent with their identities and who did not receive training and socialization consistent with their identities • A means to compensate for pubescent physical changes of a sex incongruent with gender identity • Helpful for both binary and non-binary trans people to individualize their gender expressions • A menu from which people can choose, whether or not there is concurrent use of hormone or surgical treatments (though hormones and operations can affect the need for or the methods of gendercraft)
What gendercraft is not:
• A set of procedures that anyone is required to use
• An implication that people who don’t use it are any less valid than people
who do
• An endorsement of the binary model or a criticism of non-binary identities
• Easily found or assimilated even among those who immerse themselves in the
trans community
Disclaimer and Request Let me be clear: I am not telling anyone what to do or how they should live their life. If someone doesn’t like a presented idea, then they shouldn’t use it! What I am doing is providing options. Without knowing one’s options, one might not make the choice that’s best for them. This list of possibilities is not all-inclusive. Please let me know if there are other tools of gendercraft I might capture for future revisions.
Gendercraft: Why of interest to healthcare professionals? • It is no less important in our patients’/clients’ affirmations of their authentic selves than use of hormones or surgeries, which sometimes attract more attention. • To become aware of the issues being debated inside our patients’/clients’ heads, as well as the awkward and difficult choices that trans people are up against in living their identities • To understand that these are not automatic or effortless decisions • To be able to offer guidance and affirmation to our patients/clients in their efforts to make their outsides resemble their insides • To provide balanced advice concerning the risks and benefits of using a tool versus the risks and benefits of not using a tool
Passing
“Passing” = being perceived as a cis-gender person in one’s identified gender.
(Historically, this term has also been used in a racial context.)
Passing is not all-or-nothing. Environment affects one’s ability to pass. Crowded
spaces contain distractions that make passing easier. Also, success is affected by
whether other people are preoccupied with their own activities, such as in gambling
casinos, department stores or busy restaurants. In any event, few trans people pass
100% of the time, and even some cis-gender people exhibit confusing gender
signals.
Among many gender-diverse people the concept of passing stirs up conflicting emotions.
(As we will see, even the term itself is problematic.)
Trans people often feel conflicted about the concept of passing.
Here are arguments on either side of using gendercraft tools:
Against: For:
Passing seems like a form of deception. It’s just the opposite: it’s living one’s truth. One dresses
for self, not others. “Blending in” is a less loaded term.
It shouldn’t matter how one presents to the world. The reality is that it often does.
The only gender police are the self-appointed ones. The self-appointed ones can be vicious. Someone who
blends in is more safe from harassment and assault.
It can be inconvenient and expensive. It can be worth it. Less costly approaches are available
for most options.
It can be frustrating when efforts fall short. Even then, efforts can be rewarding – glass half-full.
Forgoing use of gendercraft tools may be more Using the tools can be gender-affirming and self-
acceptable to others in one’s family and social circle. validating. Gender dysphoria can improve.
Internalized transphobia can be a barrier. Living one’s truth fosters emotional growth.
Ultimately, it’s up to the individual to make their own choices according to their own needs.
There is no “one size fits all” model.Gendercraft Methods: Outline Appearance • Managing hairstyle: taking account of the shape of the face; flattering and unflattering styles for MTF and FTM; hairstyles and treatment for FTM with male pattern baldness from testosterone • Managing unwanted hair: color blocking and covering of beard; electrolysis, laser, and comparisons • Facial appearance: skincare, makeup and eyeglasses • Managing the silhouette of the torso: shoulders, chest, waist, hips and legs for MTF and FTM • Managing genitalia: gaffs, tucking, packing and standing to pee Behavior • Posture: gender differences in standing and sitting • Walking Communication • Pitch, resonance, intonation, word choice and gestures • Active vs. passive listening Shopping for Clothes • Things to know before you go • Three approaches to getting what you need
MTF Hairstyles: Optimized according to shape of the face
• Compared to cis women, trans women are more likely to have squared and long faces.
• Curly or wavy hair can compensate for angularity. Volume on the sides rounds out the
head’s silhouette and keeps the components in proportion.
Images from: thehairstyler.comMTF Hairstyles: Optimized according to Shape of the Face
These styles provide both curves and side-volume.
Images from: amazon.com, thehairstyler.com, thehairstyler.comMTF Hairstyles: Optimized according to shape of the face
Wispy bangs can compensate for high foreheads.
Image sources: allthingshair.com, elipsosalon.com, liebeleben.me, therighthairstyles.comMTF Hairstyles: Choose colors harmonious with skin tone
For many skin colors there is a discernible warm or cool tone.
Use this table to categorize your own:
Warm tones Cool tones
Blood vessels on inner surface of Blood vessels on inner surface of
forearms are green. forearms are blue.
A white sheet of paper next to A white sheet of paper next to
the face makes it look great. the face makes it look terrible.
Gold jewelry is more flattering. Silver jewelry is more flattering.
• Example: Honey blonde goes better with warm tones; straw blonde goes with cool tones.
• Sometimes hair colorants or wigs are described as such, but not always.
• Knowing your skin tone also helps in choosing flattering colors of clothes.MTF Hairstyles
Don’t forget the eyebrows!
• Eyebrows “frame” the face and their appearance is a key component of gender expression.
• Photos of Michael Jackson illustrate common differences between masculine and feminine eyebrows
-- masculine eyebrows are lower, flatter and bushier.
• Ideally, obtain professional help to trim and shape the eyebrows, and then maintain them at home.
• If circumstances don’t permit more extensive changes, a certain amount of grooming may still be
possible, such as to trim the lengths of the hairs and to pluck the outliers. Comb the hairs upward
and then downward, snipping hairs that protrude through the comb’s teeth by a chosen distance.
Images: bookwormroom.com, Sam Villa Hair Tutorials on youtube.comMTF Hairstyles
Don’t forget the eyebrows!
• The diagram shows classic locations for the eyebrow to start, peak and end.
• After completion of trimming and plucking, comb the brow from its inside end to its
outside end with a wand of clear or tinted eyebrow gel.
• While the gel is still wet, pinch the eyebrow from above and below between forefinger
and thumb to decrease the brow’s perceived thickness.
Images: virtualffs.co.uk, amazon.comFTM Hairstyles
To compensate for soft, round faces, go for angles, sharp lines and edges.
Plucking or electrolysis can square up rounded hairlines.
High and Tight Medium/Longer Length The Undercut Modern Pompadour
http://point5cc.com/four-great-haircuts-for-trans-mascftms/FTM Hairstyles
“This is the picture that I've consistently
had the best luck with at hair salons. I
bring it in and say, `Give me this,’ and even
if it doesn't come out the same … the
result is usually something I can live with.”
-- Gabriel, in his FTM Guide
Gabriel, The FTM’s Complete Illustrated Guide to
Looking Like a Hot Dude, ftmguide.rassaku.netHairstyles for Male Pattern Baldness (MPB) in FTM Users of Testosterone
Trans men under treatment with testosterone can develop gradual MPB, as seen in cis men.
Some people are more susceptible to this adverse effect than others.
Clean Shave Buzz Cut Short Caesar Shaggy Layers
From: Brett & Kate McKay, Balding Gracefully: Tips and Hairstyles for Balding Men
See: artofmanliness.com/2010/07/14/balding-gracefully-tips-and-hairstyles-for-balding-men/Medical Treatment of MPB in FTM Users of Testosterone • Finasteride (originally marketed in the U.S. under the brand name Propecia®) can be used by prescription at 1 milligram per day to counteract MPB. It is a pill, so the drug goes everywhere in the body, not just to the scalp. Because it blocks conversion of testosterone to its more potent form, dihydro-testosterone, it might reduce effectiveness of concurrent testosterone treatment. Trans men who might become pregnant should not use finasteride. (Trans men who are no longer menstruating can still become pregnant.) • Minoxidil (originally marketed in the U.S. under the brand name Rogaine®) is available without prescription for topical use on the scalp. There is minimal spread of drug effects to other parts of the body. It is more effective for hair loss at the crown of the head than at the front and temple areas. • Finasteride and minoxidil can be used in combination. • Hair restoration surgery can also be effective.
Managing Unwanted Hair (in Any Gender)
Color-Blocking
• In people with dark hair and light skin,
shaving does not eliminate a blue-tinted
shadow created by the hair remaining
beneath the skin’s surface.
• Because orange is opposite blue in the color
wheel, use of a light coat of orange pigment
(e.g. from lipstick) as the first layer of make-
up blocks out the blue color.
• Another approach is to use an opaque
concealer such as Dermablend®, but this
can create a thicker and less natural
appearance.
Images from: transoutloud.com, HGTV.comManaging Unwanted Hair (in Any Gender)
Essential Facts about Electrolysis
• An electrologist inserts a very fine needle
into the natural opening of the hair
follicle alongside the hair shaft. A tiny
amount of electrical current is then
applied to destroy the hair growth cells.
• Electrolysis can destroy the hair growth
cells with chemical energy (galvanic
current), heat energy (thermolysis), or
both (blend method).
• FDA categorizes electrolysis as effective
for “permanent hair removal.”
Sources: American Electrology Association at electrology.com, silkhairremoval.comManaging Unwanted Hair (in Any Gender)
Essential Facts about Laser
FDA categorizes laser as effective
for “permanent hair reduction.”
Images from: healthandmedspa.comManaging Unwanted Hair (in Any Gender)
Growth Cycles Affect Both Treatments
• Hairs are constantly growing and shedding on independent schedules. After the active growth phase
(anagen), the follicle goes through a resting phase (catagen) and then a shedding phase (telogen) during
which the old hair falls out in preparation for growth of a new hair.
• Both electrolysis and laser work best on hairs in the growth (anagen) phase.
• Repeated treatments are needed to disable all the hair follicles as they re-enter their growth phases.
Images from: maximedicare.comLet’s Compare Them
Image from: laserhairclinic.comElectrolysis Laser
Effectiveness Destroys individual follicles of all hairs Effective only on pigmented hairs. Hairs must contain
regardless of color melanin in order to absorb the laser’s energy
Pain More discomfort, especially in the Less discomfort
area between the upper lip and nose
Preparation Must grow hairs at least 1 mm long Must shave prior to each session
prior to each session
Process Electric current applied by a needle Flashes of laser light applied to zones of skin, one
within follicle, one follicle at a time zone at a time (size of zone depends on laser source)
Session Length Multiple hours One hour or less
# of Sessions Depends greatly on length of sessions At least seven. Sessions for faces are spaced about
and extent of clearing; produces four weeks apart. Produces less permanent outcome;
more permanent outcome. may need re-treatment.
Cost Billed by the hour. Billed by the session or by package deal. Prices vary
widely. Shop around!
For people who are candidates for either method and at median prices, laser is usually less costly and goes faster.FTM Creation of Facial Hair – Hormonal
A beard may be the most persuasive male gender marker. For trans men, use of testosterone
is clearly effective, though the amount of growth depends on genetics, just as in cis men.
Images from: betamaxipad-tumblr.com, reddit.comFTM Creation of Facial Hair – Non-Hormonal
Some people are successful with cosmetics or theatric tools, but using these techniques can
be risky. If you goof, you are suddenly more obvious than if you didn’t use them at all.
1. Dark brown eyeshadow Brushing brown mascara onto Attaching short Using fiber mascara to
brushed onto face; 2. peach fuzz. Note: People who pieces of real create stubble.
eyeliner to thicken the don’t use this technique are or fake hair by
eyebrows; 3. black pigment better off shaving their peach means of spirit
applied to face with a fuzz because adult males don’t gum.
stipple sponge. have peach fuzz.
Sources: Sailor Cruz on youtube.com, TheSLOfox on youtube.com, Dyson Fraser on youtube.com, Riley JustRiley on youtube.comSkincare – it should be of interest to all genders!
(But children raised as boys might be less aware of its importance.)
• Facial cleansers are less harsh and irritating than soaps.
• Moisturizers promote softness and prevent chapping.
• Sunscreens block the damaging and aging effects of UV light.
• Skin that is well cared for provides a better canvas for applying makeup.
All images from target.comMTF: Makeup
Common recommendations
• Ideally, purchase a makeover by a cosmetologist who has experience with trans
people. Ask the cosmetologist to write down the names of the products that were
used along with reminders of how they were applied.
• There are many youtube.com videos you can study involving both cisgender and
transgender women.
• Take into consideration your age and the situation for which you are applying the
makeup. Explore the space between social expectation and unrestrained individual
expression. Experiment (and even go “over the top” on purpose). Gather feedback
from trusted sources. Have fun!
• Practice!!!MTF and FTM: Eyeglasses
• Eyeglass (or sunglass) frames are another vehicle for
masculinizing or feminizing faces.
• Angular faces can be balanced out by rounded frames
and round faces can be balanced out by angular frames.
• Although many frames are unisex, some styles are more
distinctly feminine – e.g. red, blue or multi-colored
frames or those with cat-eye shapes.
• Eyeglasses (and especially sunglasses) obscure or de-
emphasize eyebrows or brow ridges that are less than
ideal.
• Note that men’s eyeglasses are usually bigger than
women’s eyeglasses because of men’s larger head sizes,
as well as greater distances between eyes and ears. Many
frames are available in more than one size.
Sources: fostergrant.com, globaleyeglasses.comMTF: Smiling
Smiling is the greatest and most effective beauty accessory of them all.
Notice the extent to which smiling warms the faces of these trans women.
Sources: allure.com, endhepcsf.org, hornet.com, eurweb.com, dissolve.com, google.comMasculine and Feminine Silhouettes
Key points in going from one silhouette to the other
• One of the most recognizable differences is the waist-to-hip ratio.
• A healthy masculine waist-to-hip ratio is 0.9, while a healthy feminine ratio is 0.7.
• From shoulders to hips, the silhouettes can be likened to rectangles and hourglasses.
• We will direct our attention to management of the silhouette at shoulders, chest, waist, hips and
their extensions down through the legs.
• (These are idealized silhouettes. Hormone treatment, surgery and weight gain can modify the
silhouettes and application of gendercraft techniques.)
Images: ftmguide.rassaku.net, Kościński in openi.nlm.nig.govMale to Female (MTF) Torso Management
From Rectangle to Hourglass
Unfortunately, the shoulders are not compressible.Male to Female (MTF) Torso Management
Minimizing Broad Shoulders with Necklines, Draping and Accessories
These styles all emphasize vertical lines, elongate the torso and
draw attention away from the shoulders. Cap-sleeved tops do
just the opposite and emphasize the shoulders. Good posture
can help: hold the head up and the shoulders down and back.
Images from: jjill.com, northstyle.com, northstyle.com, twighair.com, northstyle.com, dailyconnoisseur.blogspot.com and dailymail.co.ukMale to Female (MTF) Torso Management
Minimizing Broad Shoulders with Necklines, Draping and Accessories
Janet Christine Carmen Caitlyn
The principle of emphasizing vertical lines to minimize
broad shoulders plays out with varying degrees of
success in these famous transgender women.
Images by: 2paragraphs.com, drchristinemcginn.com, out.com, variety.com,
Candis Laverne worldlifestyle.com, vh1.comMale to Female (MTF) Torso Management
Padding the Chest by Filling Bra Cups
Silicone Breast Forms Foam Breast Forms Birdseed in Pantyhose
From most expensive to least expensive
Images from: truekare.com, Walmart.com and sophielynn1.blogspot.comMale to Female (MTF) Torso Management
First method for creating cleavage
• Place bra inserts at the bottoms of a push-up bra.
• Gather loose skin upward and inward.
• Obtain additional lifting and squeezing from an elevatrix underbra.
Images from: fashionfirstaid.com, leonisa.com, ebay.com, dersertcart.aeMale to Female (MTF) Torso Management
First method for creating cleavage
• A transgender woman demonstrates the steps of this procedure.
• Cleavage effectively draws the eye away from less feminine features.
Images from: unordinarystyle.comMale to Female (MTF) Torso Management
Second method for creating cleavage
• A similar strategy is employed with commercial cleavage makers. Over top of them, one
wears a typical bra filled with breast forms.
• “IT STAYS®” is a roll-on body adhesive that helps maintain traction between loose skin and
cloth garments, such as bras, and keeps the gathered skin in place.
Images from: glamourboutique.com, discountsurgical.comMale to Female (MTF) Torso Management
Third method for creating cleavage
• NuBra® consists of two silicone pads with re-
usable adhesive surfaces. (Generic silicone pads
are also available.)
• One pad is attached to each breast; then the
pads are pulled together and linked by their tabs.
• Over top of the NuBra®, transgender women
often wear regular bras filled with breast forms.
Image from: nubra.comMale to Female (MTF) Torso Management
Fourth method for creating cleavage
• Taping the chest can create cleavage by forcing loose skin upward and inward. The tape
does not go all the way around the chest, so restriction of breathing is lessened.
• Although duct tape is often used for this technique, surgical tape is likely to be safer.
• Tape should be removed carefully in order to avoid ripping or blistering the skin.
Images from: glamourboutique.com, patientsleepsupplies.comMale to Female (MTF) Torso Management
Fifth method for creating cleavage
Before After Method
• Cleavage can be enhanced by means of contouring make-up.
• Light colors visually move forward and dark colors recede.
• The photo on the right illustrates the starting point, after which the make-up is blended
to look more natural.
• This method can be combined with any of the others.
Images from: look.co.ukMale to Female (MTF) Torso Management
Decreasing the Waist with Cinchers, Diet, Exercise and (Questionably) Corset-Training
• Just like high heels, waist cinchers might be reserved for
special occasions.
• Ideally, exercise programs target all the muscles of the
abdomen and not just the “sit-up muscles” (rectus abdominis).
• Corset-training, aka waist-training, involves prolonged use of
progressively tightening corsets in order to re-shape the
abdomen semi-permanently. There are no modern studies
concerning its safety. Its use might be risky.
Images by: ardyssbodymagicshop.com, catofashions.comMale to Female (MTF) Torso Management
Creating a Higher Waist
A belted or structured waist raises it visually to a more usual female height.
(“Structured” means that the curves are built into the clothes themselves.)
Images by: nyandcompany.com, northstyle.com, xeuee.com, chadwicks.com (last 3)Male to Female (MTF) Torso Management
Padding the Bottom and Expanding the Hips
The waist-to-hip ratio is the most recognizable feature of the female torso.
One can purchase ready-made garments or save money with DIY approaches on youtube.com.
Images from: ebay.com and joyobsession.comMale to Female (MTF) Torso Management
Using Style to Widen the Hips
Flared (A-line) skirts make the hips appear broader.
Images by: adriannapapel.com, chadwicks.com, dillards.com, modcloth.com, dillards.com, modcloth.comMale to Female (MTF) Torso Management
Extending the silhouette down through the legs with tapering slacks
• Cis women often wear slacks, especially as day-wear. To blend in with cis women, one needs an
effective strategy for wearing them.
• Skinny-leg designs are very gendered garments, particularly when paired with feminine shoes.
• By narrowing the silhouette at the ankles, they effectively broaden the silhouette of the hips.
• High-waisted (“high rise”) pants are preferable to those which are just hip-high, because they
are less likely to creep downward as you walk. Images: express.com, polyvore.com, denimology.comFemale to Male (FTM) Torso Management
From Hourglass to Rectangle
Unfortunately, the hips are not compressible.Female to Male (FTM) Torso Management
Dealing with Narrow Shoulders
• Slightly oversized shirts can disguise bulk at the chest, but excessively oversized shirts can
make the shoulders look even smaller.
• It can be difficult to find a shirt that fits your proportions, but it is worth the hunt.
• This diagonal pattern flatters by drawing the eyes upward and outward.
See: Gabriel, The FTM’s Complete Illustrated Guide to Looking Like a Hot Dude, ftmguide.rassaku.netFemale to Male (FTM) Torso Management
Dealing with Narrow Shoulders
• Shoulder pads don’t work well because they look fake and are more frequently used in
women’s clothing. However, epaulets can flatter.
• Notice how well the suit jackets square up the shoulders of these trans men.
Images from: ftmguide.rassuku.net, dapperq.com (second and third images)Female to Male (FTM) Torso Management
Weaves vs. Knits
• In shirts, wear weaves instead of knits.
Weaves (such as in buttoned dress shirts)
are stiffer and don’t stretch, while knits cling
to the curves.
• Vests (waistcoats) are great. They are a
weave, provide structure, and flatten the
chest. They are cut for men’s bodies so they
extend directly from underarms to hips,
disguising curves. A tie provides plausible
deniability for bulk on the chest.
Gabriel, The FTM’s Complete Illustrated Guide to Looking Like a Hot Dude, ftmguide.rassaku.netFemale to Male (FTM) Torso Management
Binders, sports bras and athletic wear compress the breasts.
Image by: gc2b.coFemale to Male (FTM) Torso Management
Binders, sports bras and athletic wear compress the breasts.
Images by: amazon.com, bluestockingsboutique.com, underworks.com (last 2)Female to Male (FTM) Torso Management
Common Advice on Binding Safety from Websites by or for Trans Men
Do not use Ace bandages or duct tape for binding -- these can restrict breathing and cause
tissue damage. Do not bind for longer than 8-12 hours. Tissues need time to recover.
Images by: point5cc.com, aminoapps.comSafety of binding: what do published studies say about it? There is only one such study. Online survey of 1,800 adults assigned female at birth with current or past history of binding. Data included demographics, binding practices, mood changes, and presence of any of 28 adverse health outcomes.
Binding Survey: Sample Characteristics
Geographical location: Gender Identity (marking all that apply):
USA 68% Transgender 80%
Canada 13% Male or masculine 68%
Genderqueer/bigender 34%
38 countries represented Agender 34%
Feminine 12%
Age: Masculine female 7%
18-24 58% Cisgender 2%
25-34 33% Intersex 1%
Range 18-66 y
Median 23 y
Peitzmeier et al. (2017) Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study. Culture, Health
& Sexuality, 19:1, 64-75.Binding Survey: Binding Practices
Hours per day spent binding (median) 10 hours
Days per week spent binding (median) 7 days
Duration of binding (median) 2 years
Binding methods used (mark all that apply)
Commercial binders 87%
Sports bras 33%
Shirt layering 24%
Multiple sports bras 19%
Elastic or other bandages 16%
Athletic compression wear 15%
Neoprene compression wear 7%
Duct tape or plastic wrap 4%
Homemade 3%
Peitzmeier et al. (2017) Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study. Culture, Health
& Sexuality, 19:1, 64-75.Binding Survey: Negative Health Outcomes
Adverse health outcomes by symptom: Surprising findings:
Back pain 54% Days per week spent binding was the factor most
Overheating 54% correlated with negative health outcomes
Chest pain 49% Hours per day binding was relatively uncorrelated with
Shortness of breath 47% negative health outcomes
Itching 45%
Bad posture 40% Commercial binders were most correlated with negative
Shoulder pain 39% health outcomes
Elastic or other bandages, duct tape and plastic wrap
Any of 28 symptoms 97% showed intermediate correlation with negative
health outcomes
Sports bras, layering sports bras, and neoprene or athletic
compression wear showed the least correlation
with negative health outcomes
Peitzmeier et al. (2017) Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study. Culture, Health
& Sexuality, 19:1, 64-75.Binding Survey: Mood Effects
Q: So with all these negative health outcomes, why would trans masculine
individuals subject their bodies to such abuse?
A: Mood rated on a 1-5 scale with 1 as very negative and 5 as very positive:
Mood before binding 2.1
Mood after binding 3.8
Therefore think in terms of harm reduction, i.e. breast symptoms vs worsened
gender dysphoria and suicide risk.
Peitzmeier et al. (2017) Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study. Culture, Health
& Sexuality, 19:1, 64-75.Female to Male (FTM) Torso Management
Style Straightens Out the Lines
Layering can be effective. Excessively oversized clothes are needless and unfashionable.
Side note: Don’t you just love the individual on the right? Don’t they look perfectly comfortable in their own
skin? Self-confidence is the secret sauce that affects how others treat you.
Images by: autostraddle.com, rebloggy.comFemale to Male (FTM) Torso Management
Style Straightens Out the Lines
Images by: dailymail.co.uk, dailymail.co.uk, theguardian.comFemale to Male (FTM) Torso Management
Style Straightens Out the Lines
Fashion can even
hide pregnancy!
Images by: dailymail.co.ukFemale to Male (FTM) Torso Management
Extending the silhouette down through the legs
• Men’s and women’s slacks are constructed differently.
Men’s slacks (expressed in waist circumference and
inseam length, e.g. 32 x30) drop straight from waist to
ankles. Women’s slacks are narrower at the waist and
wider at the hips. So if you have a woman’s body, your
waist size in men’s clothing needs to be individualized.
• Wearing suspenders instead of a belt reduces bulk
(bunching) at the waist.
• Cargo pants work well because they add bulk at the
knees thereby balancing the width at the hips to
create a very masculine rectangle.
Gabriel, The FTM’s Complete Illustrated Guide to Looking Like a Hot Dude, ftmguide.rassaku.netMale to Female (MTF) Genitalia Management
Using a Dancer’s Belt, Also Known as a Gaff
• Can be purchased at dance or crossdresser stores
• Can be worn in conjunction with “tucking”
Images from: dancebelt.info, amazon.com, amazon.co.ukMale to Female (MTF) Genitalia Management
Tucking Procedure
• Tucking is a method to minimize the contour of the penis and scrotum.
• It involves pushing the testicles up toward the inguinal canals (through which the testicles
originally descended) so they are positioned at the entrance of the canals or within them.
• Then the penis is pushed downward and back between the legs.
• This configuration is held in place with medical tape, a gaff, one or more pairs of undersized
underwear, a bikini bottom, shapewear or Spanx®.
• Tucking permits the individual to wear tight pants or swimwear without a bulge.Male to Female (MTF) Genitalia Management
Tucking Safety
• There are no published studies on the safety of tucking. As a result, all we have are expert opinions
and anecdotes.
• “A common cause of scrotal contents pain in transgender women is`tucking.’ … Resulting pain may be
traumatic, mechanical or neuropathic. Prolonged tucking may also result in urinary reflux and
symptoms of prostatism or even infection such as epididymo-orchitis, prostatitis, or cystitis.
Prolonged positioning of a compressed urethral meatus in close approximation to the anus may also
serve as a portal of infection.” -- Barry Zevin, MD, Center of Excellence for Transgender Health,
University of California at San Francisco
• “Anecdotally, some people have reported pulling or tearing sensitive tissues in their genital region
during tucking. This confirms the importance of going slow and listening to your body. Medical
supply stores carry medical remover which may be helpful for removing build-up from tape. If you
have concerns about the safety of tucking for you, talk to a health care professional.” – Transgender
Health Information Program, Provincial (B.C.) Health Services Authority
Sources: transhealth.ucsf.edu, transhealth.phsa.caFemale to Male (FTM) Genitalia Management
Packing
• Packing means creating a contour consistent
with male genitalia.
• The simulated genitalia can be put together
from available materials or purchased
commercially.
• The genitalia can be inserted or pinned into
ordinary underwear, or held within a jockstrap
or a pocket of commercially obtainable
underwear, or slung from straps.
Images from: tumblr.com, etsy.com, susans.org and amazon.com (clockwise from upper left)Female to Male (FTM) Genitalia Management
Standing to Pee (STP) Devices
• Some trans masculine people find that standing to pee is validating.
• Others are content to pee while sitting.
Images from: transguys.com, transitionmtfuk.uk.comCommon Gender Differences in Stance, Sitting and Walking • “You can observe a lot by just watching.” – Yogi Berra • For trans people who wish to feminize or masculinize their stance, gait or sitting posture, a great place to start is by watching how cis-gender members of their identified gender do these things. • Let’s see how well we can observe these differences ourselves…
Stance
Common Gender Differences in Stance
• Curved vs. straight lines
• Narrow vs. wide base
• Small vs. large amount of occupied space
• Equal vs. unequal weight on feet, e.g. more on rear foot
• Arms folded or hands near face vs. arms down or hands
Image sources: feminizationsecrets.com,
in pockets recruitingtimes.org, tutorialspoint.comWalking
Common Gender Differences in Walking
What did we notice?
• Wide vs. narrow base (width)
• Length of stride
• Speed
• Fluid vs. solid
• Heavy vs. light foot-fall
• Leading with chest vs. leading with hips
• Noticing the scenery vs. ploughing straight ahead
• Posture (imaginary string through top of head pulls upward, elongating the
neck, rolling the shoulders back and straightening the spine)
• Open spaces vs. closed spaces
• Elbows in vs. elbows out
• Arms swing from elbows vs shouldersSitting
Common Gender Differences in Sitting Postures
What did we notice?
• Knees together vs. knees apart
• Occupying smaller vs. larger amounts of space
• Sitting upright vs. slouching
• Hands together on lap vs. hands on kneesGender Differences in Communication • Voice: pitch, resonance and intonation patterns • Content: word choice and use of descriptors can vary • Body Language: gestural systems; active and passive listening styles
Vocal Pitch
• Vocal ranges are usually broader than shown on the keyboard above, but most people have
“comfort” ranges that are narrower.
• Testosterone thickens the vocal cords and lowers the pitch of the voice.
• Estrogen does not raise the pitch.
• To feminize their voices, MTF people can benefit from vocal coaching.
• For FTM people who don’t use testosterone and even for some who do, vocal coaching can
masculinize their voices and reduce mis-gendering on the phone.
Image from: professionalvoice.orgVocal Resonance
• Resonance refers to how the sound output from the vocal cords (phonation) is modified
by vibrating within different air cavities, such as in the chest, throat, mouth, nasal
passages and sinuses.
• Chest vibration adds deeper, darker and richer qualities.
• MTF speakers can achieve a more feminine vocal quality by decreasing chest vibration
and increasing vibration in the head’s cavities, especially in the front of the head.
• By contrast, FTM speakers can obtain a more masculine vocal quality by increasing
chest vibration and decreasing head vibration.
• With hand on chest, a speaker can feel the amount of chest vibration.
See: “Vocal resonation” in WikipediaIntonation means variation of pitch during conversation. Masculine intonation is flatter
in pitch and ends on a lower note, while feminine intonation varies more in pitch and
sometimes ends on a higher note.
Source: jamiefaye.comGendered word choices The upper cluster shows words and phrases on Facebook particularly distinctive of females, while the lower cluster shows words and phrases particularly distinctive of males. Applying these results to spoken conversation is tricky because comments written in social media may not be the same as those used in face-to-face conversation. Use of these words also needs to be appropriate to context, and not just randomly sprinkled in. Schwartz HA, Eichstaedt JC, Kern ML, Dziurzynski L, Ramones SM, Agrawal M, et al. (2013) Personality, Gender, and Age in the Language of Social Media: The Open-Vocabulary Approach. PLoS ONE 8(9): e73791. https://doi.org/10.1371/journal.pone.0073791
Gesturing While Talking
• In ordinary conversation, women use more hand gestures.
• Though fewer in number, male gestures can be larger, while female gestures are more
contained and in front of the body.
Gifs from: singleguysays.wordpress.com, tenor.comActive listening is good for all genders, but children
raised as boys might be less socialized to its use.
Image: slideshare.netRecommendations for MTF speakers
• Ideally, obtain guidance from a speech and language pathologist to feminize pitch,
resonance and intonation without damaging your vocal cords.
• If obtaining professional help is not feasible: (1) raise your pitch by a few notes; (2) make
your voice soft and light; (3) decrease chest vibration; (4) vary the pitch; (5) avoid
profanity; and (6) own some feminine words, e.g. cute, adorable, excited, love and
yummy -- but be sure their use is appropriate to context!
• Practice laughing, coughing and sneezing more softly and in a higher register.
• Gesture more but keep the movements contained and in front of your body.
• Listen actively.
See: transhealth.ucsf.edu/trans?page=guidelines-vocal-healthRecommendations for FTM speakers
• Ideally, obtain guidance from a speech and language pathologist to masculinize
your pitch, resonance and intonation without damaging your vocal cords.
• If obtaining professional help is not feasible: (1) lower your pitch by a few notes;
(2) increase chest resonance; (3) keep the pitch flatter during conversation; and
(4) especially avoid “up-talk” (rising pitch) at the ends of sentences.
• Practice laughing, coughing and sneezing in a lower register.
• Avoid excessive gesturing.
See: transhealth.ucsf.edu/trans?page=guidelines-vocal-healthShopping: Things to know before you go • Shoulder seams and waist seams are good to know. Find a shirt and a pair of pants that fit you comfortably. Measure their seams in inches, and also measure them against your arm by holding one end with a bent finger and seeing how far up your arm it goes. Later, when you are in a store, you can measure the seams of clothes you like without holding them up against your body. • Size systems are complicated. You can get a very rough idea of what your sizes will be by checking your measurements against a sizing chart in a catalog or on the internet. Shoes in the U.S. are about 1 ½ sizes different. (A size 9 in men’s shoes is about 10 ½ in women’s shoes.) • Vendors are there to sell you clothing and help you make the best decision for you. Pretending that the clothes are a gifts or using fake or androgynous names may not be worth the trouble and may not afford you the best shopping experience. Assess your own ability to navigate the difficult terrain between risk and self-liberation. Consult others about who your trusted local retailers are. • Shopping can be more comfortable and fun when a cisgender ally of your identified gender goes with you and helps you navigate your fashion options!
Shopping: The totally avoidant approach • Buy online, e.g. at amazon.com or payless.com. Try the clothes on at home and send back what you don’t like or that doesn’t fit. • Shop online at specialty shops that cater to trans people. Expect to pay more than at regular stores. Also, be aware that clothes marketed for crossdressing men tend to be more immodest and revealing than many trans women might care to wear. • Shop at Walmart dressed in your assigned gender. Don’t try anything on. Use the self- checkout lane. Try the clothes on at home and bring back what you don’t like. • Keep repeating the process until you get what you want. Don’t feel bad – when you’re ready to take a bolder step, you will!
Shopping: The semi-adventurous approach • Go to a big-box store on a weekday morning in your assigned gender. Look through clothes carefully, knowing that you have every right to be there. If a clerk asks if they can help you, consider saying yes. Sales people often provide great advice! Get a good idea of what will fit by measuring the seams with a tape or against your arm. Put the ones you like in your cart along with another one in the next size up or down. • Screw up the courage to actually try them on in the store. Throw the clothes over your arm. If it helps your confidence, put a garment of your assigned gender on top of the stack. Enter a changing room of your assigned gender. Try on your clothes. Remember to enjoy the experience! • Check out in a cashier lane, knowing that the clothes you bought fit you, look good and won’t have to be returned. If the cashier asks if you found everything you were looking for, say yes. And smile!
Shopping: The go-for-it approach • Get dressed at home in your identified gender. Go shopping with one or more friends – the more the merrier! • Head for the stores. Be mindful that Walmart and Target have friendly bathroom policies in every state of the U.S. – even the red ones. Enjoy trying things on and experimenting with your look. You can even try on undergarments and shoes. • If you are a trans man who doesn’t find well-fitting clothes or shoes in the men’s section, try the boys’ section. That’s perfectly fine and you are likely to save money! • You can pay for your clothes with a Visa® or American Express® card showing your preferred name, whether you had an official name-change or not. It is easy to get an add-on card if you already have a card in your assigned name at the same bank. It’s prudent to use the same last name in case you are asked for an ID. • Go to lunch with your friends and have a great time! Today’s experience is exactly what you have always wanted to do!
Feel free to share this presentation with
• health and social service professionals
• trans and gender non-conforming people
• allies
• anyone else who can use it to help trans people!
cordingl@ohio.eduYou can also read
