Forty-five female-to-male transsexuals from diverse backgrounds and at different stages of transition were interviewed in depth about their sexual attractions, sexual practices, and sexual orientation identities prior to their transitions into men. Forty-three participants had been sexually attracted to women at some time prior to their transitions. Thirty-five participants engaged in homosexual activity, 25 of whom adopted lesbian identities before coming to recognize themselves as female-to-male transsexuals. The information provided by participants suggested that they were initially attracted to lesbian identities on the basis of popular images of lesbians as mannish women. However, they later rejected lesbian identities at least partially in response to politicized lesbian-feminist definitions of lesbians as women-loving-women who emphasize womanhood and eschew manliness. Participants adopted identities as female-to-male transsexuals because they believed that such identities more accurately captured the natures of their sex, gender, and sexual orientation identities.
Coming to recognize oneself as transsexual involves a number of stages of exploration and
analysis on both an interpersonal and intrapersonal level over the course of many years. A
model encompassing fourteen possible stages is proposed: (1) Abiding Anxiety, (2) Identity
Confusion About Originally Assigned Gender and Sex, (3) Identity Comparisons About
Originally Assigned Gender and Sex, (4) Discovery of Transsexualism, (5) Identity Confusion
about Transsexualism, (6) Identity Comparisons about Transsexualism, (7) Tolerance of
Transsexual Identity, (8) Delay Before Acceptance of Transsexual Identity, (9) Acceptance of
Transsexualism Identity, (10) Delay Before Transition, (11) Transition, (12) Acceptance of Posttransition
Gender and Sex Identities, (13) Integration, and (14) Pride.