The New Gender Paradigm
A crossdresser is a man. He has a traditional range of male interests, skills and perspectives. Except he occasionally adopts a fully female persona for several hours to days each month. ...Or she may be a woman who occasionally adopts a male persona.
It’s essential to understand that a crossdresser’s alternative persona is an innate need. It’s present at birth and lasts throughout life. If that need isn’t fulfilled from time to time, the individual experiences very real distress that gradually worsens until it becomes extreme anguish – that may even lead to suicide or other forms of self-injury.
It’s a need that doesn’t suddenly disappear during the senior years.
While living as an independent adult, crossdressers work out a system for meeting the crossdressing need. ...Usually that means crossdressing in secret, since general society doesn’t want to see switching between modes of gender expression. Secrecy is possible because the need is only occasional. During the interval, a crossdresser is just like any other man.
And then aging takes a toll. Senior crossdressers find themselves losing independence and privacy. Suddenly there are outside caretakers entering the home – perhaps to clean or do laundry. Embarrassing questions are asked when the visitor stumbles upon a hidden cache of women’s clothes. Or a visitor may appear unexpectedly during a session of alternative dressing....
Once a crossdresser reaches an assisted-living facility, he probably won't be able to put on a dress without someone else’s help. If that help isn't available, then a deep innate need isn't being fulfilled.
The word “crossdresser” doesn’t appear in psychiatry’s DSM or in WPATH’s treatment guidelines. Books on so-called “transgenderism” don’t mention people who have a need to alternate between modes of gender expression. The closest theme that can be found in the gender literature is “transvestic fetishism”, a sexual deviation (a “paraphilia”) supposedly motivated purely by lust.
It's a ridiculous notion, but if that’s what’s taught in nursing school, what’s the likelihood of finding someone on the nursing staff willing to help with a monthly session of crossdressing?
Senior crossdressers are the group most in need of a New Gender Paradigm which recognizes the existence of the crossdressing phenomenon. And crossdressers are extremely common – around 1 in 10 people. Every nursing home has patients who suffer in silence, drifting into increasing depression and despair.
Even if an enlightened facility staff recognize the existence of crossdressing, accommodating the guest’s needs is a complex task that requires careful consideration. Transsexuals fit in more easily (once the staff gets over their biases) because their gender expression is consistent. The transsexual Ms Smith is always a woman with female friends and who always uses the women’s restroom. If allowed, other guests will get used to her as a woman; the issue will fade away.
On the other hand, other guests see a crossdresser in both modes of gender expression. Mr Jones is a man on Monday. He cheers for his football team and uses the men’s room like any other man. But on Friday, Ms Jones is wearing a dress and wants to use the women’s restroom.
Most of the time, he's a "he". On Friday she's a "she". The name switches from "John" to "Joan". She may prefer knitting over football -- but only on Friday.
Few bystanders are able to cope with such changes. As a result, crossdressing policy must be quite different from transsexual policy. For example, male crossdressers shouldn't be housed with transsexual females, even if both happen to have a penis.
Although some facilities may have residents who can understand & offer support to a crossdresser, the best solution may be to arrange for crossdressing to occur away from the facility. The home knows Mr Jones only as a man; they never see Ms Jones. Most cities have crossdressing support groups that meet together regularly and have an active social agenda. ...Such an arrangement would have to be acceptable to Mr & Ms Jones, of course. Other arrangements are also possible.
For the bedridden, the only viable approach would be for the resident to be put into a dress, say, one day every two weeks. How hard is that? People outside the gender community can never appreciate the deep inner fulfillment that can come from those few hours. It's the difference between stress vs comfort; between anger & depression vs inner peace.
One in ten people are crossdressers. Don't be surprised if other residents privately ask to join Joan on her Friday shopping trips. Crossdressing isn't contagious, it's just common.
© Cassandra Branch, MD