Transsexuals' Experiences

I am a member of a very complicated and elite group of people, I am transsexual.

Our history goes back in time, which could be said of it, that we have always been there. In many cultures we were revered as special people, The Shaman, or The People of Two-Spirits, and still are in some cultures. This usually meant that we held a position as either the Leader of the Clan, or as the Religious leader, or as the Medicine Person.

We have also been persecuted throughout modern history for being ourselves, for being what we are. As people gained knowledge, of our existence, but not understanding nor acceptance of us, they turned away from us, and we became a target for religious persecution that is still on going to this day. We were burnt at the stake for being witches. Now we are isolated, bashed, abused and very often murdered, but to the consternation of many of these abusers, we are flourishing!–(Possibly due in part to ubiquitous chemical pollution-EDCs-see “Transsexualism”)

Lack of up-to-date knowledge and understanding of our condition throughout society in general leads to many closing their minds, and whatever is not understood has to be destroyed, as perverse &/or evil!

We in the Transsexual community are alienated to a far greater extent than the communities (Gay, Lesbian and Bi-sexual), which are discriminated against because of their sexuality not fitting neatly into the bi-polar model of sexuality and gender, which has been promoted for centuries through lack of knowledge and the lack of willingness to learn!

This is largely due to ignorance of our condition and what we have to endure and come to terms with over a period of time, in order to become our true selves! We are across all areas of business and professions, and if given the opportunity to, we make a very significant input to the community.

Almodovar: "There are transsexuals and transvestites in my day-to-day life, so I treat them as a fact of life. On the other hand, the transsexual stands as a symbol of what it means to represent oneself. And if you stick one of these characters in the middle of a narrative, it magically energises the situation and all the characters around them. I especially value the sheer force of these characters who take on nature and reorganise it to express something."

In an effort to produce a readable and accessible rendition of the complex situation that we call GID (Gender Identity Disorder) or GD (Gender Dysphoria), we’ve sat down together and gone through the stages and thoughts that we encounter during our transition from Male to Female (MtF) or Female to Male (FtM). They are not intended to be a total coverage of the problem nor an excuse that is not tangible, just an account of how we feel and what we’ve found to be true. This small booklet is aimed at professionals as well as lay people and significant others as well as those afflicted.

These are the collective experiences and problems encountered by members of Changeling Aspects. We have tried to tell how these experiences and problems have affected us. Our intention is to state them from our perspective and not include the medical professionals that we have come into contact with. There will be reference through out this booklet as to where to find these medical people in parts of the Changeling Aspects web site. (Practitioners)

Because of the age variations, we have tried to convey ideas that cover from ‘crib to grave’. This is to hopefully give ideas of what can be both entailed and encountered on this awesome journey of self discovery and vast change. In doing so, we have tried to encompass the range of transsexualism and also include those who are very important to us, who we affectionately call ‘significant others’ (Links and Transsexualism, in the Changeling Aspects web site).

Any questions or omissions can be directed to any one of us and we will be only too happy to discuss the situation with anyone that feels we’ve erred or gone off track. We wish anyone with a need to read this booklet luck and the fortitude to keep going without hurting those around us more than need be. The courage to take each step as it comes and the hope that the light at the end of the tunnel reaches you and gives you guidance.

This usually occurs sometime between 3 and 8 years of age, when a boy (might) pronounce (s)he is really a girl, or a girl that (s)he is a boy. (Of course this is by no means certain, I never told my folks I was a girl, though I did ask ‘when’ I would be a girl, I got the answer that it would of course be never) . We are in a highly complex confused muddle as our brain is telling us that we have the wrong body, that it is the wrong sex for our gender. There are several reasons why these situations manifest and certainly the most difficult to prove but the most obvious to us is the brain. Simplistically put, if, during the first trimester, we do not receive the correct (either male or female) ‘wash’ of hormones to both the gonads and the brain, then we have a brain that tells us our gender is different to our apparent sex. This wash is affected by the endocrine system in the mother and can be affected by drugs, physical wellbeing and other influences like a twin sister in the womb. Genetically, most of us have the genes that are accorded to a male or female body and not the brain, which is XY for male and XX for female. There are exceptions to this and they are usually confirmed by a Klinefelters test for males, or a Turners test for females. These are usually presented with a different physicality that is more obvious to a doctor and is a more cut and dried situation. (Links and other support groups C A web site)

After realisation, we may begin to adopt a part of the role of the opposite sex (usually one that we think we can get away with) and this leads to confusion and angst for parents, siblings and friends (it also affects the sufferer, but that is more than obvious). The young boy who feels he is really a girl is attracted to girls to play with and do girly activities, as he really feels that (though he doesn’t look like one naked), he is more comfortable in the mental role. At this point in time many will not know the difference in genitalia, unless they have female siblings and have seen them naked. This will cause anxiety if there is knowledge of the difference and boys will hope and pray that their penis will disappear, drop off, or that they will be magically transformed overnight to wake with female genitalia. The opposite is true for the female who knows she is really male. This is a trait common to every TS – magic, prayer and unfounded belief that we can change ourselves. This leads to a disappointment that is increased daily to the point of puberty when everything we’ve tried to do becomes futile as we begin to mature as the WRONG sex.

Our genetic structure will not and cannot alter, so we have years to contend with the wrong genitalia, when the brain is telling us it is wrong. There is one situation that sometimes presents at puberty and that is the Androgen Insensitivity Syndrome (AIS or *PAIS , *P for partial) where the boy really does in most ways grow into a girl. More on that later (Links and AIS in CA web site)

Due to continual assertion that we are opposite to what people suppose us to be, we are also destined to experience years of misunderstanding, abuse of one type or another, because of our insistence that we are in the wrong body and should be a girl, not a boy, or a boy, not a girl. We very soon learn that we have to try to hide these feelings, or else we will be abused, beaten and socially outcast.

This can, and usually does, lead to denial of what we truly are (the pressure to conform is enormous). It can also lead to self harm, such as trying to remove the offending parts, cutting or attempts to terminate one’s self. Normal presentation of the genitalia is often so mentally disgusting, that boys often hide the unwanted parts by tucking them between the legs so as to present a flat crotch. This can be damaging to the parts (not that the child is concerned). Girls who wish to be boys tend to cut their hair and wear daggy ‘boy’ clothes – and may even resort to ‘packing’ the crotch of their pants to simulate male parts and as their breasts grow, binding them with elastic bandages. Often this will lead to frustration and depression due to lack of understanding by people in general and also the medical fraternity. We wish to adopt girly things, mannerisms and even dress as a girl. This can cause many problems for parents with and by the medical fraternity, as we are usually subjected to medical people treating the symptoms and not the cause. “It’s just a phase they’ll grow out of,” is commonly used to defer any decision by the doctor. Often it is the fervent wish of the young transsexual too – most of us would dearly love to forego the honour of being TS. Though if asked, they would opt to have been born the opposite sex.

Unfortunately, many will lose this battle because of the constraints put on us by society at large and the medical fraternity in particular. So, do we just self harm or do we go the whole hog and end up taking our life? The thought and fact of suicide is often a lot less painful than what we are otherwise called on to endure.

If however the parents are supportive and willing to learn more about our condition (if you are a parent reading this, please have a hug), it is a wonderful thing. At some stage the child will determine their true self and blossom into the boy or girl they know they should be.

This is when things really become involved and steeped in red tape, bureaucratic and medical voodoo, as we now move to Assessments, Laws, Age of Consent, Clothing, Schooling, Family, Friends, Neighbours and hopefully acceptance by all around you. This is a vast step for all to come to terms with. Oddly enough it shouldn’t be, but our ‘civilisation’ is built around the male of the species and anything that changes that status quo is so far beyond the understanding of the general and even the specific parts of the culture as to be unfathomable.

This is most probably the hardest thing you will ever undertake in your life. It makes no difference if you are 5 or 60; the ramifications are much the same. The only good thing about coming out earlier in life is that you will not compound events by getting married and having children. This is what most of us older ones do in life. We now do not only have to explain to parents, but to loved ones, who can go either way. If you are lucky you will retain the love of your family and friends and workmates. If not, then you are out on your own in a hostile environment. Yes, you now have no support from family, friends, job, income and home. You must start from scratch and that can be very disheartening, not to mention extremely hard!

We have found that the use of photos of the new you, seem an acceptable way of introducing the new you. This is so that people can determine if they wish to see the new you, as seeing you for the first time“In the flesh” can be a daunting situation for many, as well as making some feel embarrassed and uncomfortable. If they wish to meet you“In the flesh” they then have the opportunity to say so. I and many others have used this approach to good effect.

Coming out at school for a child is not recommended. There are too many shades of grey that appear to a child that only understands black and white. Children are mostly the result of their parent’s attitudes, education, and upbringing. To expect any child to understand why a boy plays with dolls and doesn’t want to climb trees is hard. For them to accept it needs the infrastructure of a highly developed family group system, where questions may be answered by adults without laying down learnt bigotry, bias and attitudes from previous generations. Men are, in the main, responsible for making thugs out of their male children. Teasing, bullying and peer pressure to conform to ‘normal’ are rife in any school up to the student age of about 15. It is what drives a society to remain static in its attitudes and mores. If we ever manage to control those factors of school life, society can undergo change in every generation. Presently, any real change takes three generations.

Since we are actually fairly androgynous up to the age of about 10, most of us do not need any medical intervention until that time. We would love to be treated as our mental gender, but we have pretty much come to terms with the wait, even if we know that sex change is possible by medical intervention later on. Doctors favour ‘the wait’ since there is no determinable physical symptom that can give them the indication of true mental gender. I would suggest that some tempering might be possible if doctors were allowed to help to balance the endocrine system of a child that feels gender alienated. At present, no doctor will put themselves out on a limb that far. Legally we are not allowed to alter our systems till way past the point that we have been damaged irreparably by virilisation (the masculinisation of the skeleton, face, voice and hair growth). After the case of Alex and under strict supervision, it is now possible that some chemical intervention maybe given to help cease this virilisation.

So, you are alone! Where do you go from here? Who will support you? Where do I find support? These are the big questions!

Your internal demons are now working overtime. The peer pressure, guilt and parental forming are telling you that you are a boy, so act like one. We become more macho than most males would ever be! We go into sport, the real rough stuff, the armed services, marriage and children, mortgage and all that is expected of a male. You are now husband and father, and perhaps grandfather too. We have been forced into a cultural belief system that as we are equipped with male genitals – we are men.

Wrong. At some stage those cultural demons will drop out and your mind will force you to become the woman you are supposed to be. You tell your partner, children, family, friends and workmates and if lucky you will remain part of their lives. If you do secure that position, it now means that you are living in an entirely new relationship with your partner. Most cannot adjust to this aspect of marriage, they married a man, not another woman (this is also a cultural bind since you are supposed to marry the PERSON that you fall in love with). This may cause them to feel lesbian and therefore can no longer go on in the marriage. Those partners that do accept the change or the ones that did fall for a person and not a label may last the whole distance, but many even after supporting a transsexual partner for a while find that it is just too much to fly in the face of our cultural and social barriers and eventually go their own way.

If the marriage is to continue, do we now live as sisters, friends or lesbians? Most partners are not lesbian and need/require the company of a male. You have now left that area, as you are becoming, or have become female. Over time many will opt for another relationship with a new male partner and who can blame them? On the other hand you may well meet a male partner, have you thought of that?

The reality of where you fit in socially will have a lot of influence on your future – open Western culture is often closed once you transgress the sex/gender/sexuality divide.

The term ‘significant other’ is one of those modernistic catch phrases that is used in parts of the politically correct world where lines are blurred due to gender or sexuality situations that are considered outside the norm. I hate the fact that we have to use terms like that since it only serves to push us further from the standard that we have been part of. We become less by making the phraseology less defining

Wives and girlfriends become ‘significant others’. Partners are partners, whichever way you want to play the scene. I believe that the more changes we make to accommodate our situation the more we change the society that we are part of and personally I find that a shame. My partner has no bearing on the situation of my change except in that he or she can help or hinder the time frame or the manner of that change. If the partner demands such drastic things as divorce – removal of child visitation rights and other significant social outrages, then we have failed to create a frame within which we can transition. The changes can and will create a drain of very large dimension on resources. If you own a home or business and you are forced to leave it for your spouse or de facto since they’ve been able to throw you out, you are not going to be able to transition at all.

One set of reasoning could be that half of what you put into the marriage or partnership is yours. Contractually you stated in most cases that you would, for richer for poorer in sickness and in health, stay together. So did your partner. Since DSMV IV states that at present transsexualism is a disease, the contract is still in force.

This may be a bit trite, but I am trying to show that it is not your fault that you have this problem and you should not bear the full weight of it if your partner decides they cannot bear the outcome. Negotiate and make sure you have the wherewithal to continue to live and (eventually maybe) enjoy your life. If you have a partner, keep them in the loop of understanding and talking about yours and their problems, as you face this dilemma together. It is the most important factor that you can affect. Having that person there to support you is better than the most able doctor or counsellor – they are already a part of you – they know you well and can help more than you can believe.

OK, so we have the term defined and we need to think about our significant others.

· Psychiatrists/Psychologists ignoring the partner, instead of counselling both

· Advice on what lies ahead for both the TS person and the partner legally, financially, medically and employment wise.

To a great degree they are excluded from learning and understanding what affects and makes a Transsexual (TS) person tick. They bear the brunt of what inevitably befalls the family, which is usually, a complete break down of communications and being allowed to understand via information from both their partner (Now TS) and support groups, preferably mixed to include them.

For them to really understand their plight, and in most instances the final outcome of the family breakdown, they are denied the right to be part of this vast change that is over taking the family as a whole!

Because of the way we TSs are driven in our quest for change to what we consider, or know to be our true selves, we totally overlook and discredit what harm and hurt we are causing our oft quoted, by us, loved ones!

If we really loved them, then surely we would not treat them in such an off handed way. Supposedly, we loved them and the children of this partnership. So how come they are kept so totally in the dark?

So few actually finish up staying together and many of those finally part as they see just how different life now really is and finally go their own ways.

Partners are just as important, if not more so than the TS person. They now have the very real total responsibility of caring for, and keeping the family together as a unit. The family situation can deteriorate if the TS person is forced to leave employment. This causes great hardship on the family, as lost income comes into play.

So far we have talked of the adult partner affected, but what about the children? They appear to have been forgotten in this head long rush to achieve change! They are affected, not just at home, but at their school, in their friendships and the loss of a loved parent, who they now no longer recognise.

We, the TS people involved do not appear to give a second’s thought to any one else’s problems, as we are so single minded and selfish in our quest, so that we shut out all others. Only when it is too late do we try to make amends, and if we are unable to, we then blame all around us for not understanding us. HAVE WE GIVEN THEM A CHANCE TO DO SO? Did we explain to them at any time what we really were?

We now have what was a loving family torn apart through lack of knowledge and understanding. SOs deserve better than this. They are people who have hopes and aspirations too! They thought they had a life time relationship, which has now been drastically altered, so that only a very few actually stay together. Could this figure improve if support was given to the SO and the children? At present, it is weighted all in the TS person’s favour, through support and education, not so the SOs.

Much, much more must be done to include all partners in this equation. At present it is pathetically little and needs to be amended, so that they are involved from day one to the extent that they feel capable of making an educated and rational decision on this very subject, and how it will affect their futures, and those of their children!

If we look at the legal issues, they are many, and must also be taken into account. Divorce, cost, children, home, superannuation and many other items. This would, one hopes very definitely include the SO, as it maybe that she/he is now the sole provider for the family. Think of what this incurs.

A happy new year to all partners, friends and families; we hope you are all in good spirits after the Christmas/New year break, and are feeling refreshed and ready to start a new year.

The following article was written in August 2004 and received by the Persepctive's editor in September 2004, from Kathy Noble in Australia. As you may gather she found it frustrating that there was no one for the partner of a person with gender issues and, as is Kathy's style, she took control of the situation, as you will read in her article.

At first when I read this article. I was upset that we, the partners group of Agender, had not been contacted. After all we make sure the contact information is in the 'Persepctive' and it is also on the Agender website. After all, Australia is not far away with email.

I then realised that we assume that people who need us have also some access to emails and the internet, but they may not. There is still, postal mail but the main thing is "to have someone to talk to".

I forwarded Cathy's article to Caroline and Michelle for comment - both of who shared it with other people.

"I love the article from Kathy. And she is right she would have a lot of knowledge to give us in a workshop. There are so many SO's that are too scared to step out and ask for help and/or don't know where to go for help. I know of a couple. We're wanting to help them,as we have been there we know what it is like, but they won't make the first step (or accept help). If the SO does not have a high confidence level then it is less likely that they are going to ask for help. Most likely they go into denial, "if I ignore it, it will go away!""

"The article has caused some uproar in this house. I showed it to a few friends to get their feedback and it definitely ruffled some feathers."

So with mixed feelings we publish this article - and would like to know what you think.

Due to certain circumstances that I have recently witnessed, I am forced to ask, "Where is the support for Partners?

We are currently talking about Transsexual Support and building a Group to cover this, but to my certain knowledge there is nothing for Partners. Don't forget Partners are suddenly confronted by our Transsexualism, they are literally thrown in at the deep end. We expect them to grasp in a few days or hours what has taken us many years to acknowledge. What's more, we expect, no demand support from them. This surely is wrong!

The pain and anguish for Partners is lost on the Transsexual, who in their exuberance to reach their goal forget about those around them. To further add to the grief, in most instances the relationship ends. Then what happens? The Transsexual starts bemoaning their fate because they have lost their Partner, maybe their job and home. They then have the temerity to say "No one understands me" Have they taken the time to think about helping their Partner understand and not just pushing it in their face in the rush to transition! Do they understand, or are they willing to understand just what their Partner is going through?

I have made contact with a Women's Health Clinic, but they know very little if anything about this situation. There is no one to counsel the Partner if female in an emergency, so they have to join a queue, which could mean 2 weeks or more before an appointment. Because of this situation at the clinic, I have been invited to talk to them as they say, "We need to learn about these problems"

As this is a concern for Women, I will approach the Minister for Women's Affairs in QLD. I met her at the Women's Forum that I attended. I feel a great need to have something put in place for these ladies, and most probably something similar is needed for Male Partners, where they find their partner is Transsexual.

Since my transition I feel empathy for Partners in this position. I have a tendency to lean towards the female as I am now one and accepted and integrated into the community. I will still stand up and be counted for Transsexual matters, but I feel we are deluding ourselves if we think we can get away with expecting our Partners to accept our change with open arms!

To Transsexuals I would say "Slow down and remember it is all new to your Partner. You have had years to come to terms with the situation, they also need time" I am disappointed and in some cases disgusted at the way we treat our Partners. We keep saying we are human beings like the rest of society, as are our Partners. So give them some thought, because they too need to be loved and understood as much, if not more so than we Transsexuals. We demand respect! I would say we have to earn it by respecting our Partners needs and fears. - Kathy Anne Noble 28/08/2004

For three years now I have tried unsuccessfully to set up a group for significant others. To date, it has not got off the ground. It appears that like the medical fraternity, the partners, in the main, place it in the too hard basket. Many just walk away without even trying to understand. Many partners will support cross dressers, but if that person progresses to becoming Transsexual and living as a woman, they will walk away.

It is understood that partners will feel ill at ease because of the circumstances that now confront them. They married a man, not another woman and this can lead to them feeling that a lesbian relationship has now been created. Many will stay together as soul mates and friends without the feeling of being lesbian. If a relationship has lasted for 20 or 30 years what is the difference? Do you suddenly stop loving and liking the person who is changing, as they are no different inside, and could be a lot more understanding and helpful than they were before. Or, do you now look on this person who you lived with for so long and loved and cherished, as some form of monster!

Think of all that will be entailed legally in order to split the family, home, income and savings. The cost could be horrendous, not just monetarily, but in pain and heart ache. Many will opt to go down this road and will finish by feeling hate and loathing for each other. There is too much at stake for both to not consider the after effects of this, in many cases, inevitable outcome. If you cannot resolve your differences then at least do so amicably, calmly and cost effectively.

Many who are older will have substantial estates that will have to be split, and that can be very costly and time consuming. The legal costs can mount until you are losing vast amounts of money that you both will need in the years ahead. I know, you say that a clean break now is the best thing to do, but, really is it?

At least try to communicate with each other and understand each others feelings. We transsexuals are not known for approaching our problems in a slow, calm and considered manner, we need to do everything at the speed of light and in doing so tend to cut out our partner and forget their feelings. We become engrossed in our self to the detriment of those around us. Is it any wonder that our partner continually tells us we are shutting them out!

Now perhaps we should stop and see things from their point of view. We have declared what we are going to do, but have forgotten what effect this will have on them. We need to sit and talk and inform all members of the family, so that they can make a judgement based on fact and not fear. I hear what you say, the outcome will be no different, we will still split, but have you tried this approach instead of the approach of crashing through? Give your partner the chance to decide after talking calmly and putting your case, but do listen and try to understand theirs as well. This is the person that you married and had kids with, when if you had done the right thing none of this would have happened. Did you explain to her that you were Transsexual when you first met, or before you waltzed her down the aisle? We tend to go over the top in our quest to lose that feeling of transsexualism, but when we do this we are starting a course of action that will have very severe repercussions in the future. If you have not explained to your partner these innate feelings, then don’t blame her when it all goes wrong. She will need to be able to feel secure in your relationship, but at present will feel anything but. You have apparently misled her, badly! No wonder everything hits the fan when you tell her, what you are about to do. She may never forgive you for not taking her into your confidence at the start of the relationship, and who can really blame her. She thought that you were set for the final years together, and now you have blown that clean out of the water. No wonder she feels hard done by. She is thinking about looking for another partner and how difficult that can be at her age. If the kids are young, then who is willing to take them on as well?

You have taken her secure world and made it into a very insecure one, with no idea of what is in store for the present, let alone the future. She now thinks in terms of being alone, not out of choice or bereavement, but having something foisted upon her that is not of her making, or her wish. Can you blame her for being so self centred as to even contemplate thinking of a divorce under these circumstances. You have given her no real time or thought as you go on your merry way to achieving your goal.

I ask, would it be different if you had considered telling her as soon as possible and explaining what is happening to you, in a way that she can understand and perhaps come to terms with. We do not know, as the shock some times is enough to end the relationship, as in many cases it has deteriorated over the years in many cases due to our inability to have intercourse, not just sexually, but verbally!

Try to understand how they feel. How would you feel if it was you that was being told that the Mother of your children, now wants to be a MAN?

This anecdotal letter was devised by a group of Significant Others to show how they felt.

DEVASTATION

Today I woke to the realisation that today and every day from here on will be hugely different.

My Husband, a Cross dresser for years with my support, informed me yesterday that he now wants to become a Woman full time. This means a complete change to our way of living, and for him to live as a woman before having an operation to change his sex!

To say I am hurt is an understatement. I am angry, I am tearful, I am absolutely devastated to think that the Man I married and whose children I had, and was looking forward to spending the rest of my life with, will no longer be there. At present this is all new, the cross dresser I have come to accept because of the in built need to do so, will no longer exist.

I feel like the proverbial chook, running around headless! I can’t get my head around this. I feel totally let down, and very alone. I am ashamed that I have lost the Man I love, just what have I done wrong? Should I have made him cease his cross-dressing, or would that have meant I would lose him a lot earlier? At present I feel so totally mixed up at the thought of living with another WOMAN that it appals me and makes me feel like a Lesbian. I am a heterosexual WOMAN with needs that only my Male partner can satisfy. My mind is in a whirl, or total free fall as I consider the future, or more to the point a total lack of the future as I saw it! What is to happen to the kids and me? Where is all the cash coming from to achieve this huge change? The cost of Cross-dressing was heavy and sometimes came before other needs.

This is only DAY 1----How do I tell the kids and the rest of the family? Do I have to tell them, or will SHE volunteer to do it?

Please excuse me while I have a good cry, as I am so mixed up. The mere thought of seeing HER all the time makes my senses reel. Surely this is a dream, no a nightmare and I will wake to find it all gone. However reality tells me that this is no nightmare, it is DAY1 and HE/SHE has gone to work leaving me with all these horrible thoughts, a seeming lack of future, Oh God, who do I turn to for help and guidance, or am I at last really mad?

Tonight we are to sit and discuss what is to happen. HE/SHE has it all planned I have been informed. What about me, where do I fit, in the scheme of things?

The longer I am alone, the worse it seems to be. SHE has it all mapped out, but I have to start to try to come to terms with what will become reality in the near future!

I am hurting, I am very mad and upset, I am very angry----Whom to tell? What to tell? How do you explain it all? My mind is in turmoil, is it my fault? I feel I need to hit out at HER, but will it alter HER plan?

About eighteen months ago my Father in Canberra rang with the disturbing news that my younger brother Peter wanted to undergo a sex change operation. This was devastating for my father as Peter was his only son. He was very sullen and found it difficult to speak about anything at all for about six, maybe even twelve months. I am glad to say that he is coping better with it now.

As for me, I was shocked at this news. I did not suspect for one minute that he may have had thoughts this way. By the way, Peter was 46 years old at the time. As I was living in Brisbane it was difficult to get a grasp of this by mere telephone conversation. I knew that both Mum and Dad (also in Canberra) were struggling with it and I was unable to believe it without seeing for myself. So I flew to Canberra to see what I could do.

As anyone who has been down this track knows, there was very little I could do for either Peter or my parents except to listen and offer comfort and reassure all of them that everything would be OK.

Peter, now Peta, had the operation last September on the Gold Coast. It was a complete success and she has had no second thoughts about ‘Have I made the right decision?’ Peta has blossomed and appears to be enjoying a new vigour for life. She has not looked back since.

I endeavoured to offer support and encouragement throughout these traumatic times. Although at times it was difficult to do this, I went with her to Kathy’s meetings where we met several others in similar situations. I was rather nervous and felt somewhat out of place the first couple of times we went. However I have found that they are just regular people who face incredible problems in coping with their identity and with what they want to be. It may seem very simple but for many the chance of the operation may never happen either because of the expense or because their physical state of health prevents it.

Since Peta’s return to Canberra I have continued to go to meetings at Kathy’s home in the hope that I may be of some support to them and for their families.

A few weeks ago I was called upon to support a wife with a teenage family whose husband had just told her of his true feelings (re himself) the night before. She was devastated, imagining the worst and wondering how she would cope. I felt for her and imagine I would feel much the same if it were me. I wanted to help but didn’t have a clue what to say or what to do. All I could do was to hold her and encourage her to let all her feelings out. Afterwards we discussed what some of her real fears were and ways of coping with them whilst having a cup of coffee.

I feel it was relatively easy for me to adapt to my brother becoming my sister. However, for a husband to change is quite devastating for the wife. It changes the dynamics of a marriage totally. Many wives and parents blame themselves and ask: “what have I done wrong?” It is important to reassure them that this is not the case and that there is no blame there.

After feeling so inadequate at offering support I decided it would be a good idea if I could do a counselling course to enable me to be more effective. After making several enquiries I was almost about to give up when I spoke to a friend who has recently completed a Diploma in Psychology. She advised me to do two modules from this course which will give me basic guidelines in questioning and offering support. Although these subjects are expensive I hope to start in the New Year.

To me it seems to be a grief process as we more or less have to say ‘good-bye’ to the old person we used to know and then welcome the new person into our lives. Albeit they are essentially the same in character, personality and humour---now just the body is different.

The spouses and family seem to me to be the forgotten casualties of the trans-gender people. Most are expected to just accept it and get on with life as if nothing has changed. But we know that everything changes. If this weren’t so, then there would be no point in making such a dramatic decision to go ahead and have the operation

We now have to expose our innermost feelings to the “Gate Keepers” This is our term for the medical fraternity that will decide if we are mad, have GID (Gender Identity Disorder), are gender dysphoric or transsexual. Don’t forget, we know what we really are and feel abused again at having to prove this to someone who has had no formal training in the fields of gender dysphoria or transsexualism (there is no qualification in Gender studies). In the main they will learn from the presenting patient (when one of us walks into their practice - yes we are that rare). They then use it as an adjunct to that practice. However, many Doctors, over time become well informed and we seek these people out by experience and word of mouth. The down side of this is that many of those who are able to assess us are coming up to retirement and there are few if any young psychiatrists or psychologists taking up the gaps (not sufficient incentive to interest new doctors).

If we are accepted as transsexual, then after (possibly) many months of assessment, we are referred to an endocrinologist for a drug and hormone regime. Again we have to ‘out’ ourselves and this is only the beginning of a long journey.

We become frustrated at the lack of expertise, time taken to arrive at a decision and the ever increasing cost. Most (of us) are on a pension of some sort, (depression and unemployment) (caused by the pressure of society to conform to the stereotypical norm), so cannot afford these high costs.

Bearing in mind that the assessments are based (sometimes loosely) on the Harry Benjamin Standard of Care (HBSOC), which was formulated as a guide for transsexuals, it makes one wonder how we survive! The Benjamin standard of care details paths to be followed in determining what condition we suffer. It states that the GP should refer you to a psychiatrist/psychologist who over a period of months will assess your mental state. If OK, then an endocrinologist will give a drug and hormones regime after 5 blood tests in order to ascertain what current levels are in your body and to make sure that your renal system can cope. The tests are:- Liver, Kidneys, Testosterone, Oestrogen and Prolactin. Prolactin for the first 2 years of hormone therapy due to the interaction between it and Oestrogen.

If the assessments by these people are OK, you can then move on to finding a surgeon in order to have SRS (sex re-assignment surgery) You will need 2 reports from Psychiatrists/psychologists and 1 from your endocrinologist in order to be able to undergo SRS, the operation that will make you complete, the person you should have always been.

This is a document sent to us by Simon De Voil an FtM who works in the Mental Health area. It is reproduced with his kind permission

In this article I hope to illustrate some of the background information and issues relevant to psychiatrists working with FTM transsexuals. I believe that quality training and resources need to be available for psychiatrists as they have been given the duty of ‘gate keeper’ for transsexuals. This is a very unusual and specialist area of medicine that has few experienced psychiatrists and gender identity doctors.

The latter points in this article are based on my own experience and observation of the 50 or more FTMs that I have known personally & professionally. It is not intended to be a complete guide or an authoritative text but rather a starting point to stimulate thinking and be a rough guide.

Currently transsexual groups support psychiatrists taking this role despite the fact very few transsexuals see themselves as having a psychiatric condition. Psychiatrists being responsible for deciding whether or not someone is a legitimate case for medically altering their body is of importance to transsexuals and transgender people for various reasons:

It helps protects the doctors/surgeons who perform irreversible surgery from mistaken individuals who sue.

It will stop some individuals with gender dysphoria but who are not transsexual from transitioning only to regret their decision.

Living with Gender Dysphoria and transitioning genders does impact on our mental health.

I believe that the duty of ‘gate keeper’ means that psychiatry has a duty to support and understand the phenomenon of gender dysphoria and transsexuality in it’s diversity. On the whole, most of the reports I have heard on the appropriateness and support of transsexuals have been positive, but this is not always the case, particularly for individuals who do not live in Brisbane or Sydney.

I would also like to draw attention to the fact that Female To Male and Male To Female identities and experiences are different and a few FTMs have found their condition to be incorrectly viewed by psychiatrists who are informing their practice based on issues more relevant to MTFs.

Transsexuality is a topic loaded with misunderstanding and stigma, so therefore measures need to be taken to ensure that treatment is appropriate and sensitive. Fortunately, there are currently a few very sensitive and specialised medical professionals working in this field; these specialists are a ‘God send and life-raft’ to transsexual people, but they are too few and often they are not officially recognised for their role and thus do not get replaced when they retire. Where I live in Queensland, excellent, sensitive and appropriate treatment is available but the doctors/psychiatrists are already over-loaded and are only available if you know where to look and if you live in certain areas.

I am a 29 year old transsexual who transitioned from female to male in 2000. For two years I worked professionally as a support worker with transgender young people and I am currently involved with the FTMQld support group on a voluntary capacity. I have a background in psychology (BA hons) and have worked as a counsellor for many years. Much of the work I have done involved working in mental health and thus I have a basic working knowledge of various mental health conditions and personality disorders.

Although the information below is focused on FTMs, many of the points will also be relevant to all transsexuals.

FTMs usually know they identify either more with, or as, a boy and should really be male by the age of 4.

Following this, usually FTMs are tomboys and unlike “sissy” boys, they are generally more accepted. Perhaps this is linked to the fact that FTMs do not tend to repress their identity in the same way that MTFs do (pre-identifying FTMs are quite obviously masculine and un-feminine)

Being a tomboy is no longer tolerated by others; the Calamity Jane idea tends to prevail - saying that it’s ok to be a tomboy as long as you grow into a feminine young woman.

Your peers change - boys and girls separate and there is more distinction between them out of childhood

Cognitive changes mean that we are more aware of other people’s perceptions and thinking and I suspect this makes the experience of gender dysphoria worse.

Very many FTMs live as lesbians first, as our masculinity is often assumed to mean that we are lesbian. Also this identity allows for some level of masculinity and fits better than being a woman.

We are not linked with the sex industry and are not sexually validated or exploited in the way MTF are.

Most FTM transsexuals take testosterone and 12 months or so afterwards have chest surgery that removes their breasts and reconstructs a masculine chest. Many FTMs also have hysterectomies. Fewer FTMs have the penis construction operations (perhaps a quarter) and this surgery tends to happen quite a few years after testosterone and chest surgery; this is partially to do with enormous costs, mixed quality of results and the level of scarring/pain.

We do not see ourselves as having a psychiatric condition – most transsexuals see themselves as having a medical or intersex condition. Some FTMs (particularly Transgender FTMs, who often do choose the medical path to live more masculine lives) may not identify as having a medical condition but rather see themselves as being a diversity in the human form (probably similar to the way gay people just see themselves as different).

FTMs tend to make a slow and gradual shift from female to male (perhaps over years). Where as MTFs often think about it for a long time and cross dress in private and then jump from male to female (perhaps because society is less accepting and reacts more violently to them). This results in a different experience; an example of this can be seen in MTFs who often embrace their femininity, which sometimes appears almost larger than life, whereas FTMs instead tend to reject their femininity and find harder to embrace their masculinity.

We tend to have an under developed masculinity that is slowly teased out rather than an identity that explodes out. We sometimes aren’t sure we are really FTM and our FTM identity often is severely lacking in confidence

Traditionally, transsexuals say they would have committed suicide if they had not been able to transition. More recently, I have heard quite a few FTMs share my sentiment that they would have been able to keep on living but their quality of life and mental health would have been poorer. This could indicate that a greater variety of people with gender dsyphoria are transitioning or it could simply be that Transsexuals are transitioning at an earlier stage and before they have got to the end of the line.

Typically, we have can have some male and some female patterns of psychiatry, behaviour, cognition and personality depending on individual factors, confidence in the new male identity and whether we have started testosterone.

There is a variety of different intensities of body dysmorphia that FTMs experience. In addition, the fact that our surgery results are less than perfect means that different FTMs choose different operational procedures. It is worth remembering that body dysmorphia can come and go and factors like having no penis can create more distress or dissonance for a FTM man who has already had surgery and lived in role for a number of years than for a pre-operational FTM. I believe that body dysmorphia is relative and is influenced by how you see yourself. So, the more confidence you have in your new identity, the harder it may be to deal with a feminine body.

Gender dysphoria and/or body dysmorphia don’t necessarily mean the individual should transition.

FTMs, or possible FTMs, do not tend to have any psychosexual issues or identity confusion around the area of cross dressing and transvestism (in writing this I would like to qualify the above statement by acknowledging that many cross dressers and MTFs also do not psychosexual issues).

Transsexuals have an under-developed or immature chosen identity that needs to mature and integrate with who they are and how they live their lives. The process of identity exploration and maturation is probably different for MTFs and FTMs. I personally see that my masculinity did not get to grow past the age of 9 and that I was not able to catch up with my peers until I had taken enough testosterone and lived as Simon for a year or two. In the early stages of transition, FTMs usually look and sound like 14 year old teenage boys.

MTF tend to have full surgical body reconstruction where as FTMs tend to only have partial reconstruction.

Self harm in the form of cutting is a very common issue for pre-transition FTMs. I am not aware if this is the case for MTFs.

Few psychiatrists are trained up in gender issues– many take our cases on and are very slow and cautious; meanwhile the FTM is paying.

Some psychiatrists hold expectations of transsexuals which are stereotypically male or female and as such, gay and less typically masculine FTMs can struggle to ‘pass the test’.

There are also young masculine females, usually 16-21 years old (sometime lesbians) who strongly identify as FTMs and then revert back to living as female. Of the 3 individuals I personally know who were like this, all reverted before hormones or after a few injections and managed to transition back easily. I suspect that the gradual “masculinisation” of the body that testosterone produces is an effective process for self selection of masculine women who are not in fact FTMs. Having supported and met many young FTMs I suspect that the percentage of young people starting the transition and then stopping is around 5%. I must also add that I have also met 2 FTMs who started the process and then stopped because they found it too difficult, who then, years later went on to transition successfully.

Like all people, Transsexuals often have separate compacting issues which impact on their mental health such as trauma. It is my observation and hypothesis that people with poor mental health are less able to repress or ‘work around’ identity issues such as gender dysphoria and are therefore over represented amongst transsexual people who present to medical services. I believe that there are many more people experiencing long term gender dysphoria and that transsexuals who seek medical treatment are only a percentage of that population. Therefore I suspect that as the world becomes more transsexual aware the number of individual seeking treatment will rise (as has happened in the last 5 years, especially with young FTMs).

A problem that quite a few FTMs have had with their psychiatrist, is that the psychiatrist focuses on and finds it dubious that the FTMs plans to have chest surgery but not penis construction. Friends of mine have been told “but you won’t be a real man then” by their psychiatrist. I believe the above shows a very narrow view of gender but it also ignores how the typical FTM experiences gender dysphoria (it is harder to live with unwanted protruding body parts than it is with absent body parts – it’s about getting rid of the female first and upmost). The reality for many FTMs also includes the fact that penis construction surgery is long, expensive, painful and not satisfactory in its results.

We make light of the hormone regime, we often fail to convey how important this is to us and how we change under its manipulating fingers. Secondary sex characteristics are important in making us who we long to be – defining things such as breasts and hips and making the waistline shrink. Other less noticeable effects are on the emotional responses and the other physical things like hair reduction on the body and the important skin changes (softening and lining it with a layer of subcutaneous fat.) Also the dissolving of the short muscles – giving us the longer and smoother feminine muscles – this makes us weaker – a small price to pay.

Currently we are told all of the good things that the drug and hormone regime will do, but very few occasions as to the adverse reactions that can occur.

OESTROGEN

OESTRONE, OESTRADIOL, ETHINYLOESTRADIOL, OESTRIOL, DIENOESTROL, CONJUGATED EQUINE OESTROGENS AND FOSFESTEROL.

These are all forms of oestrogen that we may take. There are 5 ways to administer oestrogen, they are, by mouth, by patches, by injection, by implants and by Creams. It is considered that oestrogen taken by mouth can have a greater effect on the liver. The other 4 are absorbed straight into the blood stream.

Many on the way to changing to female are placed on low dose contraceptive pills, such as Diane 35 or 50, Microgygon 30 and 50. The Diane 35 and 50 contains small amounts of Androcur, which helps with curtailing the testosterone levels.

Many are perturbed at what could manifest if younger Transsexuals are on this hormone for 20, 30 or 40 years. We know of transwomen who have developed DVT, Clots, Embolisms and Bi-lateral femoral arterial deterioration, which needs an angioplasty in each leg. Also some are suffering from Heart and Stroke conditions. These are all no longer allowed to take oestrogen because of these situations. Some have only been on the contraceptive pill and have developed these problems. One is on warfarin for the rest of her life. Because of this, we have sent details of these cases to the “Adverse reaction clinic” at the Mater Hospital in Brisbane. In the hope that they will follow through and hopefully come up with answers.

We have also considered alternative Oestrogen from plants, but have been told by a laboratory in Melbourne that transwomen do not have the oestrogen receptors that genetic women have, so it may not be as effective (this is at present not proven).

To our knowledge, there is no research carried out in any of these areas that concern us. Most of the cases that we have been told of and have been referred to the “Adverse reaction clinic” are also suffering from hypertension and fluid retention. We are aware that these are listed as “possible side effects” and may diminish over time, but these have not and have become worse.

The most important of the oestrogen hormones (female sex hormones), essential for the healthy functioning of the reproductive system and for breast development. In its synthetic form, oestradiol is prescribed as a tablet to treat symptoms and complications of the menopause and to stimulate sexual development in females with underdeveloped ovaries. It can be taken orally, by injection, by implants or via patches.

A group of hormones (chemical messengers released by glands) essential for normal female sexual development. In women they are produced mainly in the ovaries and also in small amounts in the adrenal glands in both men and women. In men, oestrogens have no known specific function.

We as trans women need to take female hormones to promote the secondary sex characteristics that we require. They are, breasts and movement of body fat to align with how a female’s fat is distributed, on the hips and buttocks. Extensive counselling is often required. The outlook on how well or otherwise a transsexual adjusts to their new gender varies.. Some make a complete adjustment, but others are left with serious psychological problems. Hormone therapy may need to be continued for life to maintain the secondary sex characteristics, such as body shape and hair distribution. Female transsexuals can have intercourse but cannot conceive. More on this in the section on SRS and Life after SRS.

The inner feeling of maleness or femaleness. Gender identity is not necessarily the same as biological sex. Gender identity is fixed within the first two or three years of life and is reinforced during puberty; once established, it usually cannot be changed. Gender role is the public declaration of gender identity--- that is, the image people present outwardly that confirms their inner feelings about their gender.

Gender identity problems occur when a person has persistent feelings of discomfort about his or her sexual identity. Transsexualism is the most common example of this problem.

PROLACTIN

A hormone produced by the pituitary gland. Prolactin, acting with certain other hormones, stimulates the growth and development of the mammary glands (breasts). Secretion of prolactin is increased during pregnancy, and helps to initiate and maintain milk production for breast feeding. We cannot become pregnant, but we can lactate! This can occur in varying degrees and sometimes it can be heavy and go on for a considerable amount of time.

As mentioned earlier there can be an adverse reaction when high prolactin and high oestrogen work together. Over dosing on oestrogen with high prolactin present can cause an adenoma, if present, to transmute to a prolactinoma. This all takes place in the pituitary cavity, which is not very large, so pressure builds on the optic nerves which can cause the gradual loss of the outer field of vision. The condition is diagnosed from blood tests to measure prolactin levels, and from CT scanning or MRI of the brain. Treatment may consist of removal of the tumour, radiotherapy, or the drug bromocriptine, which inhibits prolactin secretion. This tumour is benign. It can also mean the removal of the pituitary gland which means more medication to make up for hormones not produced, that the body needs.

A Canadian survey found that up to 30% of the population carry a benign adenoma. Also John Delahunt, a New Zealand Endocrinologist based in Wellington said about 15% carried an Adenoma, but his figures were based on deceased people. The Canadian one was based on 10,000 people’s scans. The one thing about this adenoma, or prolactinoma, is that it is benign. This does however still give cause for concern when some people double or treble their oestrogen intake, in order to arrive sooner at the secondary sex characteristics they want!

TESTOSTERONE

The most important of the androgen hormones (male sex hormones) and the one that we wish to lose! This hormone is produced in the testes and in very small amounts in the ovaries. To get rid of the testosterone we usually are given t-blockers, such as Aldactone or Androcur. Also an orchidectomy can be performed this is the removal of the testes in order to stop the production of testosterone. Adrenalin converts to testosterone as it dissipates.

It is recognised that andropause (the male menopause equivalent) can be a contributing factor with regard to secondary transsexuals. This is not a derogatory term, it is applied to those that have fought their transsexualism all their life, they, are late comers to full transsexualism and their ultimate change.

During andropause, the testosterone levels usually drop, just as oestrogen levels drop in women when they experience menopause. This of course will lead to loss, or lower libido and sex drive, but also that if the latent transsexual has been giving way to cross-dressing, he may now want to go further! At this point in time he is in a relationship that maybe suffering because of his cross-dressing, lack of sex drive and his partner not at all sure what is happening. It maybe suggested that a course of testosterone be under gone in order to rebuild their levels, but if you are truly transsexual, this will have no effect and will only cause you great upset. I know. I have been there!

Finacially, the transsexual can be in a good position, with mortgage paid off, kids away from home and a good income, plus savings and superannuation. If he goes down this road then it is imperative that the partner and family are informed, so that they are aware of what the real problem is. Hopefully it can be handled with love and care for all concerned, so that it is a good an outcome as can be expected for all concerned. Again it all comes down to how this very difficult situation is approached. There will unfortunately be losers, but many will retain their loved ones.

Please, don’t run away with the idea that all men suffering andropause are transsexual. It is a very small proportion who are transsexual, even those who have been cross-dressing and have been hiding the fact of their transsexualism from all around them for many years. For those few, the sudden advent of andropause may trigger their innate desire to finally live in their preferred and to some their correct gender. It can be scary after all of those years in hiding, denial, depression and frustration, to find that they can consider their true self. But please, remember those around you who have only known you as Husband or Father, they deserve respect and to be told how you really feel. Give them time to come to terms with this news in order to reach an understanding. Love can help. As it is basically the same person but the outer shell has altered.

A potassium sparing diuretic drug. Combined with thiazide or loop diuretics, it is given to treat hypertension (high blood pressure) and oedema (accumulation of fluid in tissues)Spironolactone may cause numbness, nausea and vomiting. Less common adverse effects include diarrhoea, lethargy, impotence and rashes. High doses of spironolactone may cause abnormal breast enlargement in men. Just what we as trans women need! I have found it to compensate with regards to Oestrogen, in as much as it cancels out hypertension and retention of fluid. Plus keeping potassium in the body means that you do not have to eat a lot of items high in potassium, such as bananas.

This drug also helps in regard to body hair, which in conjunction with oestrogen helps to soften body hair, but unfortunately does nothing for the beard!

A synthetic hormone that blocks the action of androgen hormones (male sex hormones) and has the effects similar to those of progesterone hormone (a female sex hormone)

Cyproterone acetate is used in the treatment of cancer of the prostate. It is also occasionally used to reduce male sex drive. Cyproterone acetate may be prescribed in combination with an oestrogen drug to treat women with severe acne or excessive hair growth.

Possible adverse effects, which usually diminish as treatment continues, include breast tenderness and weight gain.

It opposes the effects of testosterone, the male sex hormone. It also reduces the sex drive of men with sexual deviations such as pederasty (sexual abuse of children) or convictions for rape.

It can be used to clear severe acne and hirsutism in women. However, the print out from SCHERING who make it is very