The term, along with tranny, ladyboy and others, is often used in sex industries to refer to a pre-operative transsexual woman who has not had sex reassignment surgery; although the industry is known to advertise catering to customer's interests.
Like many potentially derogatory labels, some have adopted the term as an endearment or as a form of self-empowerment.
According to the Online Etymology Dictionary, by 1970 the term shemale had come to be used disparagingly for "masculine lesbian", although this is no longer common usage. In 1979, Janice Raymond employed the term's modern usage in her controversial book, The Transsexual Empire: The Making of the She-Male in which she argues that from a feminist point of view, transsexuals constitute an attack by males upon femininity. In 1990, Jennifer Anne Stevens defined a she-male as "Usually a gay male who lives full time as a woman; a gay transgenderist" in her book From Masculine To Feminine And All points In Between.