Transvestism is the practice of cross-dressing, which is wearing clothing of the opposite sex.

The relationship between transvestism and transsexualism has been debated over the decades and its position within the different diagnostic categories has changed several times during this time. The International Classification of Diseases, 10th Edition (ICD-10) divides transvestism into two main types: fetishistic transvestism and dual-role transvestism. They have some fundamental differences, which are described in more detail below, but significantly it is dual-role transvestism that is included as a gender identity disorder, whereas fetishistic transvestism is not.

Fetishistic transvestism

Fetishistic transvestism, as the name suggests, refers to cross-dressing associated with sexual excitement. It tends to involve clothing of a particularly sexual or erotic nature, often inappropriate to the person's age or social setting and is usually accompanied with masturbation. After sexual climax, the urge to cross-dress usually stops and, for some people, can involve feelings of embarassment or even revulsion. The behaviour usually remains relatively stable over time and is often kept hidden, rarely presenting to specialist services. It is therefore very difficult to measure, in terms of how common it is, but studies have suggested that as many as 50% of men have cross-dressed, with between 5-10% doing it on a regular basis.

Dual-role transvestism

Dual-role transvestism is different in that it is a disorder of gender identity. Unlike fetishistic transvestism, men displaying this condition spend significantly more time in the female role. It is not usually sexually driven but may have originally started in a fetishistic way. It is much more likely to be associated with enjoyment of female feelings and individuals tend to dress in more age-appropriate clothing with a much less erotic component. Some dual-role transvestites may even live full-time in female clothes but an important distinction from transsexualism is that the men concerned do not feel that they are truly female. They always retain their core gender identity as being male, have an emotional investment in keeping their original male persona and body, and do not wish to seek specialist help to change gender. Dual-role transvestites are almost always men, usually heterosexual and see themselves as cross-dressers and not transsexuals.

Relationship with transsexualism

Dual-role transvestism may orginate from fetishistic transvestism and, in a small number of cases, can precede transsexualism. The change to transsexualism is usually gradual over a long period of time with increasing feelings of being identifed as the opposite gender with associated gender dysphoria. At this point, dual-role transvestites may seek help to permanently change gender. For these individuals, with support and time, they come to realize that they are actually transsexuals, but they represent a very small proportion of the transvestite population.

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