Intra-psychic disarray of gender identity and sexual orientation: in the process of coming out as transsexual

Budhiswatya Shankar Das1, Soumitra Ghosh2

1Psychiatric Social Worker, Assam Medical College and Hospital, Dibrugarh, Assam, India, 2Professor and Head of Department, Department of Psychiatry, Tezpur Medical College and Hospital, Tezpur, Assam, India


The present paper takes a step towards understanding the confusion that a transgender individual undergoes, while coming in terms with one’s gender identity. Here, we will be presenting a case study with few anecdotes to put forward concepts of negotiation, self-understanding, and disclosure. We will refer to the individual as ‘him’ as the person identifies himself as a male and is in the process of transition. Here, we have introduced the coming out process as a one-way and two-way process.

Keywords: Understanding. Confusion. Transgender. Disclosure.

Correspondence: Budhiswatya Shankar Das, Psychiatric Social Worker, Assam Medical College and Hospital, Barbari, Dibrugarh-786002, Assam, India. budhiswatya@gmail.com

Received: 2 January 2019

Revised: 10 July 2019

Accepted: 11 July 2019

Epub: 22 July 2019


Gender identity is an innate sense of being a man, woman, or any other gender.[1] It is completely internal in nature, and is private and invisible. On the other hand, how gender is manifested to others and communicated is what is termed as gender expression. Individuals are mostly considered gender congruent if their gender identity, gender expression, and role are in alignment. If gender identity seems incongruent with gender expression then it is usually considered gender variant.[1]

For quiet sometime, the demarcation between the terms ‘gender’ and ‘sex’ did comply with a binary model of namely two dimensions- male and female. While discussing about trans-identities, or transgenderism and transsexuality, it depicts an incongruence between one’s biological sex, and one’s own gender identity. Trans-identities do not challenge the binary model consisting of only two sexes, neither on social nor on biological level. Rather they seem to be individuals with mostly gender identity confusion in the other sex respectively, who would like to align their bodies into this direction. In a way where they are perceived as having a sexed body that totally corresponds with their own gender identity.[2] Not always does trans-identities abide by the binary concept of male-female, there are individuals who does oppose the societal pressure the assignment of labels of clear delineation. In fact, they do lie somewhere in between the continuum of gender queer, multigendered, or gender fluid.[1]

While in theory the concept of gender beyond binary is considered but in everyday life within mainstream society living beyond this concept is still not a socially feasible alternative.[3] The following case of a transsexual reflects the transgressing of the binary of sex and gender boundaries.


Twenty-two years old, hailing from Assam, India, identifying oneself as male, had completed his graduation and was preparing himself for the upcoming police examination. During his early school days, he went to a co-educational school and had more of friends who were boys than girls. He preferred being dressed as a boy and preferred games like football, kabaddi, and marbles; in fact, he was not interested in playing with girls. His family never objected or questioned his choices and he was quite contended.

“I liked playing with boys and they were happy to include me in their games.”

He recalled his first experience of menstrual cycle, where he did not feel comfortable about it as he became aware of the fact that boys did not go through this. He wore clothes preferred by boys and revealed that his parents never scolded or restricted him on doing so. Yet, his mother at times persuaded him to wear female outfits, to which he refused and continued wearing in what he found ease.

“I did not like the skirts brought for me and asked my mother to give it to my cousin who enjoys wearing it.”

In class eighth, he was sent to a residential girls’ school and over there, the confusion regarding his identity and sexual orientation crept in. He remembered being attracted to girls, which was quite confusing for him. He often pondered over the thought if it was healthy to feel that way. It was there that he had his first relationship with a girl of his own class. The relation continued for two years and ended as he himself was not clear about his own self.

“I questioned myself - Am, I a lesbian or what?”

He enrolled himself in a co-educational institution for his class XI. He started to live as he used to do previously. He roamed around with boys, stood in queues for men, and started experimenting with alcohol and nicotine. He came to terms with the fact that he did not like his female identity and that he was a male trapped in a female body and thus, wanted to change physically. On joining a girls’ college for further studies, he recollected the mental turmoil and stigma he underwent for his gender identity for the first time in his entire life. For three years in the hostel he was ostracised and was a centre of discussion about his appearance and behaviour for almost every meal they took.

“I was considered a sinner, you know?”

As he was not economically independent; so, he felt that it was not an appropriate time to reveal about his gender identity to his parents. He was quiet apprehensive about the disclosure process and was open about his status to only handful of his friends. He had been very specific about the fact that the real coming out was that to his own self. He has had a lot of confusion and as clarity dawned he became affirm about himself. Presently, he was in a relationship with a girl who has accepted his identity. She was supportive about his sex re-assignment surgery.

“I feel awkward to hug my girlfriend. I will go for my upper body surgery, which is safer as compared to the lower one.”



To exactly pin point when an individual realise the disarray is difficult to mention. Few realise it while they are children not knowing exactly what it is but realising a difference. There are individuals who understand it during their adolescence and few maybe later in life. Few try to fit into the gender roles expected of them and thus, end up being in a state of discomfort and turmoil. As the understanding of self proceeds as similar as peeling an onion layer by layer, individuals get introduced to newer selves of themselves.

Coming out

On realising that one is being placed on the wrong side[4] of the continuum, the next phase that is of revelation crops up. Coming out is an ongoing process, and the first and foremost person an individual comes out is to himself or herself. After oneself when it is time to reveal others then it must be understood that it is not a one-time act and is quiet a continuous process. Coming out is a process of acknowledging to oneself or disclosing to others something that is not readily apparent or understood about who we are.[5] Coming out may contribute in knowing oneself, in how one is presented in front of others, in a modified body of oneself. Yet, these aspects solely depend on an individual’s choice of when and how an individual wants to accept the new self and proceed about the coming out process of oneself.

Every individual has a different life circumstance to consider while preparing oneself to come out to others. Initially coming out to others is a one-way process; one allows the other person to get to know the individual better. Thus, for few it may be loss of family security, friends’ support, loss of job or bullying or ostracism in school or college. For others it might be their own fear, internal stigma of shame or guilt. On the other hand, it might be a matter of complete acceptance. It is to be understood that it is a complicated process and encountering resistance from the other party or parties is the part of the whole process. Coming out becomes a two-way process when there is either an acceptance, rejection or partial acceptance or partial rejection. Either individual will retreat or they might approach with an openness which depends upon many factors such as knowledge about the concepts, the kind of relationship one shares, socio-cultural background.

Creating a coming out plan is always a welcome thing to do. To figure out if it needs to be known to the whole family or group of friends’ altogether or whether to one individual at a time is a challenging thing to sort out. A list may be made according to the level of intimacy, emotional bonding shared. Then a disclosure plan might be made on the factors such as family/friends who know each other, anyone who is likely to pass on the news without consent or gossip about it, whether to do it in person or through a letter or email, at a public place or at home.

Transition negotiated

There are times when after realising one’s gender identity or after the disclosure of one’s identity to family or close friends, contemplation on change begins. That is, if the time is appropriate to go on with the change or to withhold it for some time. The negotiation to postpone may be for various situations one is going through in life- economic crisis, ailing parents, ageing grandparents, partner’s disapproval, and children’s dependency. The negotiation usually occurs within oneself to delay the process of change to either ease relationships or to avoid confrontation with others.


An individual may go through various encounters of experimentation and self-identification while exploring and coming in conclusion of one’s gender identity. The whole process of discovering oneself and coming out cannot be measured and restricted within a stipulated time period. Though difficult and complicated, yet understanding one’s self and disclosing to others can also be exciting and self-affirming journey as a whole.


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  2. Kollen T. Sexual orientation and transgender issues in organizations: global perspectives on LGBT workforce diversity. Springer International Publishing; 2016.
  3. Hines S, Sanger T, editors. Transgender identities: towards a social analysis of gender diversity. New York, NY: Taylor & Francis; 2010.
  4. Beemyn G, Rankin S. The lives of transgender people. Columbia University Press; 2011.
  5. Erickson-Schroth L. Trans bodies, trans selves: a resource for the transgender community. Oxford University Press; 2014.

Das BS, Ghosh S. Intra-psychic disarray of gender identity and sexual orientation: in the process of coming out as transsexual. Open J Psychiatry Allied Sci. 2019 Jul 22. [Epub ahead of print]

Source of support: Nil. Declaration of interest: None.

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