Transvestic disorder occurs when an individual experiences recurrent, intense sexual arousal from cross-dressing, or dressing as the opposite gender, and in which that person's urge to do so causes significant distress or impairment to their daily life. Transvestic disorder is a rare diagnosis and is classified as a paraphilia, or atypical sexual behavior.
An individual with transvestic disorder may experience depression, guilt, or shame because of their urge to cross-dress. These feelings are often a result of disapproval from their partner or their own concern about negative social or professional ramifications.
Most people who cross-dress do not fit into the diagnostic standards of transvestic disorder. Cross-dressing is done for many reasons, including a desire to subvert gender norms. It can be seen as an act of sexual liberation or an exploration of one’s gender identity. Most people who experience transvestic disorder are heterosexual men.
One of the most common reasons people seek treatment for transvestic disorder is because it interferes with their romantic relationships or marriages with women.
The symptoms of transvestic disorder are shame, guilt, and anxiety associated with cross-dressing. Cross-dressing may include wearing only a single article of clothing typically associated with the opposite gender or a complete outfit, along with hair and makeup. To be diagnosed with transvestic disorder, according to the DSM-5, a person must experience persistent and intense sexual arousal from fantasizing about, or acting upon, urges to wear one or more pieces of clothing normally worn by the opposite gender. These fantasies or behaviors must endure for at least six months and cause severe distress to the individual, or dysfunction in social, professional, or other significant areas of day-to-day life.
A person with transvestic disorder may experience continuous urges to cross-dress, or their desire may fluctuate or occur in a series of episodes. They may become stuck in a negative behavioral pattern of purchasing clothing with the intent of cross-dressing, wearing it during a cross-dressing session, and throwing it away in hopes of quitting. They may also be co-diagnosed with other conditions, including fetishism, in which one is sexually aroused by fabrics, materials, or garments; or masochism, in which one experiences sexual gratification at his or her own pain or humiliation.
What is the difference between transvestism and transvestic disorder?
Transvestism is simply a clinical term for cross-dressing. Most people who cross-dress do not have transvestic disorder. Only if a person’s urges are experienced with a sense of intense anxiety and shame, emotional pressure, sometimes to the point of compulsion, and are accompanied by sexual satisfaction can transvestic disorder be diagnosed. The phenomenon of the drag queen, in contrast, often comes out of a desire to subvert or critique traditional gender norms, rather than to derive sexual satisfaction from cross-dressing.
What’s the difference between the terms “transvestism,” “transsexual,” and “transgender?”
Transvestism is the act of dressing in the clothes associated with the opposite sex. The word itself is culturally dated, with many preferring the term “cross-dressing.” A transsexual individual is a person who has undergone medical procedures to change their biological sex. The term “transsexual” can also be seen as dated. The most contemporary of these terms is “transgender.” Someone who is transgender identifies as the opposite gender from their natal sex. A transgender person may cross-dress and may have surgery or take hormones to change their outward appearance, but they also may not. The term encompasses all individuals who don’t feel they conform to the gender roles assigned to their natal sex.
How common is transvestic disorder?
The prevalence of transvestic disorder is unknown but believed to be rare. According to the DSM-5, fewer than 3 percent of males have reported being sexually aroused by dressing in women’s clothes. One study found that 6 percent of men have had fantasies about cross-dressing. Neither of these conditions, on their own, would constitute a diagnosis of transvestic disorder.
No specific cause has been determined for transvestic disorder. It has been observed that in childhood, cross-dressing sometimes causes excitement which may, after puberty, become sexual excitement. As the person ages through adulthood and the behavior is repeated and reinforced, the desire to cross-dress may become stronger, even if sexual gratification diminishes
Why might a man cross-dress?
There are many reasons why a man might wear women’s clothes, most of them unrelated to transvestic disorder, such as exploring their sexual identity or escaping from masculine gender norms. In the case of transvestic disorder, men receive sexual excitement from the act of dressing in women’s clothes, and also feel intense guilt or shame as a result.
Is transvestic disorder correlated with homosexuality?
No. Transvestic disorder primarily presents in heterosexual men, and experts say it is distinct from homosexuality. Individuals with transvestic disorder do not experience a desire to be of the other gender or generally feel an incongruence between their experienced gender and their natal gender.
Is transvestic disorder a fetish?
Transvestic disorder is distinct from fetishistic disorder in that transvestic disorder pertains only to articles of clothing worn during cross-dressing, while fetishistic disorder could pertain to many other objects. The two disorders do share commonalities, and fetishistic disorder is one of the major disorders co-diagnosed with transvestic disorder. Previous volumes of the DSM included a diagnosis of “transvestic fetishism,” but the two conditions have since been diagnostically separated.
Cross-dressing in and of itself is not a disorder, so it does not require treatment. Those with transvestic disorder typically work with a therapist to understand their urges, the pressures society places on them, and work to lessen the symptoms of shame and guilt. A person with a history of transvestic disorder is considered to be in remission when their desire to cross-dress has not caused them distress or impaired their daily life in at least five years
Is cross-dressing a mental health disorder?
No. Cross-dressing on its own is not a psychiatric condition. Happy and healthy sexual behavior can include many behaviors considered to be outside the conventions of society. There is plenty of discussion about how to define what is sexually “normal.”
Further, there is debate over whether transvestic disorder and other non-violent paraphilias should be considered disorders at all. The debate remains ongoing.