Transsexualism : A Guide for Employers

Transsexualism is the most pronounced form of Gender Dysphoria, in which a person experiences such a deep conflict between their physical sex and their mental gender that they have no choice but to embark upon the process of Gender Reassignment. Persons with this condition are likely to have been under a great deal of stress for many years prior to embarking upon treatment. The treatment has a very high success rate (over 97%) in alleviating the person's suffering and helping them to function better both in society and at work.

The process of Transition (switching into living full-time in the desired gender role) and Gender Reassignment (medical and surgical treatment to alter the body) can be stressful for the person involved, and sympathetic treatment by their employers and colleagues will contribute greatly to successful outcome.

It is common for transsexuals to be diligent and highly motivated employees. Prior to transition, many take refuge from their emotional pain in being 'workaholics'; after transition a good employee is likely to be better: the process of changing gender role alleviates the stress and pain, but the motivation remains. Gender reassignment does n~ change the inner person, and there is no need for it to adversely affect workplace relationships.

The Law

This is an area that is currently in a state of change. Historically, transsexuals have had no employment rights and there have been numerous cases of transsexuals being dismissed merely because of their condition. 'Ibis changed in the spring of 1996 when the European Court of Human Rights ruled, in a test case, that such dismissal constituted a breach of human rights, and thus effectively extended the scope of the Sex Discrimination Act to include discrimination against someone for changing sex within the meaning of discrimination on grounds of sex. The outgoing UK government did n~ actually amend statute law to reflect this ruling, however Industrial Tribunals began enforcing it (such EC rulings automatically supervene over national law). .The Sex Discrimination Ad has now been updated by the present government with effect from 1st May 1999, including employment protection for transsexual people - and the government has made a commitment to examining the whole issue of legal rights for transsexuals.

The Transition Process

Before being officially diagnosed, a transsexual will usually have gone through a period of profound introspection, possibly denial, and certainly much emotional torment. The medical diagnosis confirms what the patient has felt, and treatment then commences. The diagnosis is made by a Consultant Psychiatrist with special knowledge of the subject - this Psychiatrist will also oversee the entire reassignment process. This does not mean that transsexualism is a mental illness or a delusion: in fact, quite the opposite.. The psychiatrist's role is to ensure that the patient is sane and really is transsexual, and that they really will be helped by a change of gender role. Recent research has proved that the 'female brain in a male body' (or vice versa for female-male transsexuals) is a biological reality, not a fanciful metaphor. Some transsexuals will require a period of counseling before, or in parallel with, the medical treatment - in many cases they will have experienced much emotional pain from their years trapped in the wrong gender role and the wrong physical sex.

Given a reasonably certain diagnosis by the psychiatrist, the patient will commence Hormone Replacement .Therapy ~T). This involves the administration of high doses of hormco]es appr~riate to the targ~ gender: female hormones for male-to-female (MtF) and male hormones for ~male-to-male (FtM) transsexuals. .These cause tbe body to start changing:
MtFs develop breasts, lose muscle mass and body hair and startto look feminine ~cially, while FtMs become muscular, hairy and masculine and the voice breaks. As well as startig the process of physical change, HRT has a dia~ostic filnction : a person who is not truly transsexual will feel Strange and unhappy under the effects of HRT, while a true transsexual will show a marked increase in emotional well-being. This confinns the diagnosis oftranssexualism. Once this confinnation takes place, most MtFs commence antiandrogen drugs, which wipe out male hormonal and genital filnction; as an alternative, some undergo orchidectomy (castration) atthis stage or later.
MtF transsexuals also require electrolysis treatment to remove facial hair as ~T does not do this. Neither HRT nor genital surgery will 'un-break' a male voice, so speech therapy is often required. During tbis period the person is likely to start living more and more in their desired gender role, as their appearance changes towards that of their true gender.
Once the transsexual and tbeir psychiatrist feel that they are ready, they will 'transition' - that is to say, legally change their name and official documents to match the target gender, and start to live and work filll-time m that gender role. At this point the person is on 'Real Life Test' (RL.I); this is a period of at least a year in which the person must demonstrate that they can successfillly live in the target gender role before Gender Reassignment Surgery takes place.

Good Practice for Management

There is every reason to believe that a transsexual who has been a good employee before transition will continue to be a good (and usuaUy better) employee afterwards; in many cases the Company will have made a substantial inveshnent in an employee in the form of training and job e~erience, and hence it is desirable to manage the person's transition in such a way as to preserve good working relatimships all round and to continue to reap the benefits oftbe person's work.

The attitudes of the person's colleagues and management is Vitally important. It has been found in many companies that it is worthwhile to convene a meeting to explain to all employees having contact With the transsexual person what is happening and why. Good, accurate information on the condition, presented carefillly, can go a long way towards dispelling prejudice and possible hostility in the workplace. Many companies have benefited from calling in a professional or voluntary counsellor With special training in this area, to give a presentation and answer queStions. It should be emphasised that it is a medical condition that has been pr~erly diagDosed by a specialist doctor and that the person's change ofgender role at work is a recognised and medically necessary part oftheir treatment. Having informed the person's colleagues and chain of management about tbe situation, it should be made clear that the Company recogDises that the transsexual employee has a genuine medical condition and tbat the Company is fillly supporting tbe employee in their transition. ~ should be made clear that harassment or discrimination against the person wiU n~ be tolerated, and colleagues are expected to treat them with the same respect and courtesy as any ~er employee of the Company. Once the person has officially transitioned at work, they should always be referred to by their new name and by pronouns appropriate to their new gender role; to wilfillly use the old name or prmouns (occasional slips are ineVitable at first of course) is very hurtfill to the transsexual and should be treated as harassment.

Sympathetic treatment by management is also Vital. .The person will have to spend much time undergoing various treatments (especially electrolysis for MtFs, which may take hundreds ofhours in t~I), and while an employer cannot realistically be expected to grant paid leave for all of this, a sympath~c approach (such as allowing some degree of flexible-hours working, or perhaps unpaid leave) will be beneficial. Of course for strictIy medical treatments such as checkup visits and surgery, the patient shouId be granted sick leave and sick pay under tbe same rules as ~r any ~er medical condition.

The timing of the transition will be as nominated by the employee in consultation with the medical specialist(s) supervising their treatment. Provided that reasonable n~ice is given, the employer should n~ attempt to block or delay the transition, as that can be positively harmfill to the transsexual. A reasonable period of n~ce will allow the company to change records and inform ~er staffofthe impending change be~re it actuaUy happens.

The Company should provide appr~riate recognition of tbe legal name change, when tbe transition at work occurs, in tbe form of changing payroU records, computer logins, staff lists and so on to reflect the new name..The person should always be referred to by pronouns appr~riate to the new gender (i.e. 'she' for an MtF).

No guide to transsexualism in the workplace would be complete Without a discussion on the issue oftoilets. .There is absolutely no reason why a transsexual employee should n~ use tbe toil~ appropriate to tbeir new gender, once official transition has occurred - in ~er words, prior to surgery. To force a pre-operative MtF to use tbe male toil~ despite living as, and looking like, a woman is cruel and discriminatory. Of course it would be wise to reassure the female employees that the person is, psychologically speaking, a woman, and that as a result of the hormone treatment could n~ possibly pose a hazard of sexual impropriety. .The ~ct that she still has male genitals is n~ relevant as tbey would mly be exposed inside a toilet cubicle.
It goes without saying, of course, that in return for sympathetic treatment of the transsexual employee, the employer has a right to expect the employee to continue to work to the best of their ability and to conduct themselves with appropriate professionalism and dignity, and to dress and present tbemselves in an appropriate manner for their job - and not to wilfillly do anything that might cause unnecessary embarrassment to the Company

It should perhaps be pointed out at this point that MtF transsexuals undergoing electrolysis for the removal of ~cial hair will have to grow some 'stubblet for one to three days prior to each treatment. Ifthe employee is n~ in a public-~cing role, then this should simply be recognised as a necessary part ofthe treatment (and n~ as untidiness or wilfill gendermixing). Ifthe employee is in a public-~cing role then it might be necessary for her to restrict her electrolysis to Monday mornings so that the stubble only appears at the weekend, or maybe to delay transition until the facial hair is less obvious.
In such cases the situation should be discussed With the employeets counsellor or psychiatrist: it is not acceptable for a company to attempt to delay or prevent a medically necessary gender transition, and usuaUy an acceptable compromise can be found. In some cases, transsexual staff have been temporarily transferred to less public-~cing roles (With tbeir consent of course) until their physical presentation is more ~assable'. Counsellors and Psychiatrists treating transsexual patients are generally very willing to provide guidance and advice to employers, as well as specific advice regarding individual situations (subject, ofcourse, to the patient's consent to being discussed).

The following is a suggested draft Company Policy which embodies the recommended 'best practice' set out in this document and may be adopted 'as it stands' or used as a basis for tbe Company's own policy towards transsexualism in the workplace.

Company Policy on Transsexual Employees

The Company recognises that Transsexualism (a form of Gender Dysphoria) is a genuine medical

condition. Staff with this condition will be afforded the same treatment and support by the Company as if they suffered from any other treatable medical condition.

Transsexual staff are entitled to be treated with respect and permitted to perform their ,jobs free from harassment and discrimination. The Company views harassment or discrimination against any employee, on any grounds, as a serious disciplinary offence.

Thc Company recognises the right of the transsexual employee to work, and to present themselves at work, as a member oftheir new gender as soon as the official transition and legal name-change occur.

Once official transition to the new gender role has taken place, the Company expects all its staff to treat the transsexual employee in a manner appropriate to their new gender and to address them, and refer to them, by their new name and appropriate pronouns.

Once official transition has taken place, the transsexual employee will be permitted to use the lavatory facilities appropriate to their new gender. The Company will provide appropriate recognition of the legal name change, when the transition at work occurs, in the form of changing payroll records, computer logins, staff lists and so on to reflect the new name and gender.

This information sheet is based on the paper Transsexualism : Notes for Employerspublished by The Looking Glass Sociely in June 1997 Thefull text ofthis paper is available via their website: httr}:#H~'w.crvstalews.demon.co.uk/work.htm.
IS intended as a basis for This information sheet is distributed by the Gender Trust, with thanks to The Looking Glass Sociely, and .
information only. The Gender Trust does not accept responsibililyfor the accuracy ofany information containedin this sheet The Gender Trustpublishes a book Transsexualiq; in the Woriq,lace -A Guiiiefor Employers byJulie Denning availablepriced œ2 50. For further information on gender dysphoria issues and the work ofThe Gender Trust, contact:
The Gender Trust, PO Box 3192, Brighton BN13~.. Tel: 07000 790347 Or visit our website: httr}:/z~~¾~.l'3.mistral.co.uh~entrust/

The Gender Trust is the only registered charity in tbe UK whicb SpecWICally helps tbose who are
transsexual, gender dysphoric, transgenderist, intersexes, and their pRrtners and families.

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