Normal

1. "Normal" is a Societal Fantasy, Not a Biological Fact.

Why is it so hard for us to face that our truths are often fantasies?

Societal blind spots. The book explores individuals widely considered "not normal" – transsexuals, crossdressers, and the intersexed – revealing that societal definitions of gender and sexuality are often rigid, arbitrary, and based on fantasy rather than biological reality. Encountering these individuals forces a confrontation with our own presumptions and the narrowness of cultural norms. The author's initial ignorance and assumptions about these groups were challenged and dismantled through personal interviews and research.

Challenging assumptions. The author initially presumed transsexuals were delusional or victims, crossdressers were closeted gay men, and intersexed people were crazy for questioning early surgery. These presumptions were consistently proven wrong. The book argues that pathology can teach us about health, and difference can illuminate commonality, suggesting that the real strangeness lies in society's inability to accept variation.

Bentham's timeless critique. Jeremy Bentham's 18th-century observation that people label things "unnatural" simply because they don't like or practice them remains relevant. This highlights how definitions of "normal" are often subjective sentiments disguised as objective truths or "Laws of Nature." The book demonstrates this through the experiences of people whose very existence challenges these comfortable, but often baseless, societal constructs.

2. Female-to-Male Transsexuals Are Men Born in Female Bodies.

I didn’t meet those people. I met men.

Innate male identity. The author's journey interviewing female-to-male (FTM) transsexuals revealed they were not psychologically disturbed women or butch lesbians, but men who had known themselves to be male since early childhood. Their stories consistently described deep distress over being perceived and treated as girls, a feeling of being in "drag," and an early, unwavering sense of male identity despite their anatomy.

Diverse individuals. The FTM men interviewed were diverse in personality, background, and sexual orientation. They included cowboys, engineers, artists, and businessmen, some straight, some gay, some bisexual. This diversity underscored that their core identity as men was distinct from their sexual preferences or personality traits, challenging the simplistic societal notion that gender identity is solely determined by birth anatomy or aligns neatly with sexual orientation.

Beyond stereotypes. Unlike the often-visible male-to-female transsexuals portrayed in media, FTM transsexuals have historically been less visible. The author initially wondered if this was due to unsuccessful physical transformations or greater psychological disturbance. Instead, she found men whose physical transitions, while complex, allowed them to align their bodies with their innate sense of self, enabling them to live authentically as the men they always were.

3. Surgery is a Necessary Solution, Not Pathology, for Transsexuals.

Because that’s what the patients need, and that’s what we strive for: the best anatomical solution to the problem, since the problem has no other solution.

Aligning body and self. For high-intensity transsexuals, surgery is presented not as self-mutilation or a sign of mental illness, but as a necessary medical intervention to bring their physical bodies into alignment with their deeply felt gender identity. This perspective is shared by many patients and experienced surgeons like Don Laub, who see it as the only effective solution for profound gender dysphoria.

Complex procedures. The transition involves multiple steps, including hormone therapy and surgeries. FTM surgeries can include:

• Double mastectomy (top surgery)
• Hysterectomy
• Genital surgeries (phalloplasty or metoidioplasty)
  These procedures are expensive and physically demanding, highlighting the depth of the need driving individuals to pursue them.

Improved psychological well-being. Research cited by experts like Dr. Friedemann Pfafflin suggests that post-operative transsexuals show psychological profiles within the normal range for their affirmed gender. This supports the view that surgery, as part of a comprehensive transition process including therapy and real-life experience, leads to improved mental health and a sense of wholeness, allowing individuals to live fully as themselves.

4. Heterosexual Crossdressers Are Straight Men with a Complex Compulsion.

Heterosexual crossdressers bother almost everyone.

Marginalized identity. Heterosexual crossdressers occupy a unique and often misunderstood space, feeling marginal among straight men, gay men, and transsexuals. They are straight men who experience a need or compulsion to wear women's clothing, distinct from gay drag queens or transsexuals seeking to live as women full-time. Their identity challenges conventional boxes and often elicits discomfort or disdain from various groups.

Not closeted gay men. A common misconception is that heterosexual crossdressers are simply closeted gay men. The book strongly refutes this, emphasizing that these men are genuinely attracted to women. Their desire to wear women's clothes is separate from their sexual orientation, although it may have an erotic component.

Traditional and conservative. Many heterosexual crossdressers, particularly those in groups like Tri-Ess, are traditional, often conservative men, including military veterans, engineers, and ministers. This contrasts sharply with the "gender outlaw" stereotype and highlights the internal conflict between their conventional lives and their crossdressing need. Their wives are often traditional women navigating the unexpected challenge this presents to their marriage.

5. Crossdressing is More Than a Hobby; It's Often Erotic and Anxious.

Crossdressing is a compulsion, but somehow not a sickness.

Compulsion vs. hobby. While some crossdressers describe their practice as relaxing or a form of self-expression, the book suggests it is often a compulsion or fetishistic behavior. The anxiety surrounding secrecy, the effort involved in presentation (makeup, padding, corsets), and the risk-taking associated with public appearances indicate it's far more intense than a simple hobby like fly-fishing.

Erotic dimension. Experts like Ray Blanchard suggest that crossdressing often originates as an erotic response, potentially involving a confusion between desiring a sexual object and wanting to be the object. While the erotic intensity may diminish over time, the need to crossdress often persists, becoming deeply ingrained in the individual's identity and behavior.

Performance and illusion. Crossdressers often strive for a convincing female appearance, which requires significant effort and can be a source of anxiety. The focus on external presentation, makeup, and clothing suggests a performance aimed at being perceived as female, even if they identify as men. This performance aspect, coupled with the underlying compulsion, distinguishes it from simple relaxation or non-erotic self-expression.

6. Intersexuality is a Natural Variation, Not a Medical Emergency.

Far from being an exceptionally rare problem, babies born with 'genitals that are pretty confusing to all the adults in the room,' as medical historian and ethicist Alice Dreger puts it, are more common than babies born with cystic fibrosis.

Prevalence and diversity. Intersex conditions, involving variations in reproductive or sexual anatomy, are not rare. They encompass a range of conditions, from ambiguous genitalia visible at birth to conditions that only become apparent at puberty or later, or are never externally visible. Examples include:

• Hypospadias (urethral opening variation)
• Klinefelter's syndrome (XXY chromosomes)
• Androgen Insensitivity Syndrome (AIS)
• Congenital Adrenal Hyperplasia (CAH)
  These variations highlight that biological sex is not always a simple binary.

Historical context. Historically, intersex individuals ("hermaphrodites") were viewed differently across cultures and time periods, sometimes as monsters, sometimes as simply variations. Medical science in the late 19th century began categorizing based on gonadal tissue, leading to the "disappearance" of "true hermaphrodites" from records, often based on limited understanding and technology.

Challenging the "emergency" narrative. The medical view of ambiguous genitalia as a "medical and social emergency" requiring immediate intervention is challenged. The book argues that this urgency stems more from societal discomfort with ambiguity than from a true medical necessity in many cases. Many intersex variations are compatible with health and do not require immediate surgical alteration.

7. Early, Unnecessary Surgery Harms Intersexed Infants.

In modern America, we have done our own disappearing act on hermaphrodites: we have turned a lot of baby boys into baby girls, and a lot of healthy baby girls into traumatized ones.

Focus on cosmetic conformity. For decades, the standard medical approach to intersex infants has been early, often irreversible surgery aimed at making the genitals conform to typical male or female appearance, regardless of the underlying condition or potential future identity. This was driven by the belief that ambiguous genitalia would cause unbearable shame and psychological harm if left unaltered.

Damaging consequences. These surgeries, particularly clitoral reduction and vaginoplasty performed on infants, often result in:

• Loss of sensation
• Scarring
• Need for repeated procedures (e.g., vaginal dilation)
• Psychological trauma later in life when individuals discover their history
  The case of John/Joan, where a boy raised as a girl after a botched circumcision ultimately rejected the assigned gender, is a stark example of the potential harm of overriding biological factors through surgery and nurture alone.

Advocacy for change. Organizations like the Intersex Society of North America (ISNA), founded by activist Cheryl Chase (herself intersexed), advocate against non-medically necessary surgery on infants. They promote informed consent, delaying irreversible procedures until the individual can participate in the decision, and providing psychological support to families to accept their child's natural variation.

8. Societal Discomfort Drives the Urgency to "Fix" Gender Variance.

Nature loves variety. Unfortunately, society hates it.

Intolerance of ambiguity. The intense pressure to assign a clear male or female sex to intersex infants immediately after birth stems primarily from societal discomfort with ambiguity. Parents and medical professionals alike struggle with the idea of a baby who doesn't fit neatly into the binary, fearing social ostracism and psychological harm for the child if their genitals are not "normalized."

Questioning medical motives. While physicians often act with the best intentions, the book suggests that the historical emphasis on early surgical "correction" of intersexuality was heavily influenced by cultural norms and the desire to alleviate adult anxiety, rather than solely by the medical needs of the infant. The focus was on creating genitals that would be deemed "adequate" for future sexual function within a heterosexual framework.

Beyond the binary. The existence of intersex individuals, transsexuals, and crossdressers challenges the deeply ingrained societal belief in a simple, fixed gender binary. Society's resistance to accepting this natural variation leads to attempts to force individuals into conventional boxes, often through medical or social pressure, rather than adapting norms to accommodate human diversity.

9. Encountering Difference Challenges Our Own Assumptions About Gender.

The danger of questioning everything we take for granted. The danger of questioning yourself.

Personal transformation. The author's experience interviewing individuals across the gender spectrum led to a profound shift in her own understanding. She moved from viewing these groups through lenses of pathology or bizarreness to seeing them as people with complex lives, motivations, and needs. This process required her to question her own deeply held assumptions about what constitutes "male," "female," and "normal."

Beyond stereotypes. Meeting diverse individuals – FTM men who were straight, gay, or bisexual; crossdressers who were conservative family men; intersex activists advocating for bodily autonomy – dismantled simplistic stereotypes. It highlighted that gender identity, expression, and sexual orientation are distinct and can combine in ways that defy conventional expectations, forcing a re-evaluation of rigid categories.

Universal human experience. Despite the unique challenges faced by transsexuals, crossdressers, and intersexed people, their stories reveal universal human desires: the need for identity, acceptance, love, and the pursuit of happiness. Their struggles to live authentically in a world that often rejects their difference resonate with broader human experiences of marginalization and the quest for self-acceptance.

10. Despite Differences, These Individuals Share Universal Human Needs.

All these obstacles, and I am who I dreamed I’d be, who I wanted to be.

Quest for authenticity. Regardless of their specific journey – transitioning gender, expressing a crossdressing need, or advocating for bodily integrity – the individuals in the book share a fundamental drive to live authentically and align their inner sense of self with their outward presentation or circumstances. This pursuit often involves overcoming significant external obstacles and internal conflicts.

Desire for acceptance. A recurring theme is the deep human need for acceptance, both from loved ones and society. FTM men seek to be recognized as men, crossdressers navigate the complexities of revealing their need to partners, and intersex activists fight for the right of individuals to be accepted as they are, without unnecessary medical intervention driven by societal discomfort.

Finding happiness. Despite the challenges, many individuals find happiness and fulfillment once they are able to live more fully in accordance with their true selves. Whether it's an FTM man building a family, a crossdresser finding a partner who accepts him, or an intersex person reclaiming their history and advocating for others, the stories ultimately speak to resilience and the capacity for joy in the face of adversity.

11. Partners of Crossdressers and Transsexuals Face Unique Challenges.

It just about kills her that this should be their life, and although she absolutely believes that Jesus will guide them, Felicity’s crossdressing is a cross to bear.

Navigating unexpected realities. Wives and partners of crossdressers and transsexuals often face unexpected and significant challenges in their relationships. For wives of crossdressers, this can involve grappling with a partner's compulsion they did not anticipate, managing secrecy, and reconciling their desire for a conventional marriage with their husband's need to crossdress.

Accommodation and pain. Many wives, particularly of crossdressers, make immense accommodations, sometimes out of love, sometimes out of a sense of duty or fear of losing the relationship. The book highlights the emotional toll this can take, with some wives expressing deep sadness, resentment, or a feeling that their own needs and identity are secondary to their husband's compulsion. The support groups for wives underscore the unique burden they carry.

Shifting dynamics. Partners of transsexuals navigate the transition process, which fundamentally changes the nature of the relationship. While some relationships thrive, others struggle with the shift in gender roles, sexual dynamics, and societal perception. The experiences of partners reveal that while the individual's transition may bring them peace, it requires significant adaptation and emotional work from those closest to them.

Last updated: May 11, 2025