Trans* is short for “transgender” and “transsexual”, however the terms are not interchangeable and mean different things to different people. Given that trans* has less political baggage I tend to use it in place of the other 2 terms. If you are are mentally the same gender as your birth sex then you are CIS-gender (CIS comes from organic chemistry and refers to the fact that both birth sex and gender identity are on the “same” side). If your gender identity is distinct from your birth sex then you are TRANS-gender (sex and gender are on “opposite” sides). Like sexuality, gender identity does not neatly fit into 2 separate boxes. Some people may feel that they are the opposite gender, between genders, both genders or neither. Posts in this category relate to these individuals.
To this day I do not know a single LGBTQ* person from my youth. I was not privileged to have understanding parents nor to have role models with whom I could connect. Many youth today find themselves in a similar position.
Growing up as an LGBTQ* person is rarely easy. Rejection, isolation, discrimination, harassment and physical violence are all too common. Understandably this results in low self-esteem, risky self-destructive behaviors, homelessness and suicide. Hope for a better future is often an essential lifeline to those of us who are hurting. We need to know that suffering will end and that we can be happy.
I choose to be visible for this reason. As many others have said, I want you to know that life does get better. So much better!
If you are struggling please know that you are not alone. You are precious and you are loved. There are many resources available to you. All you need to do is reach out.
The Trevor Project (http://www.thetrevorproject.org) is a 24 hour help line that is available to anyone who needs a listening ear.
866-4-U-TREVOR (866-488-7386)
Parents, Families and Friends of Lesbians and Gays (http://www.pflag.org) provides support and resources for families and friends of LGBT people.
Information from the American Psychological Association (APA)
Dr Costello writes in his blog entry, Intersex Fertility, that “My daughter was not of woman born. That is a concept that has fascinated people through the ages. My daughter’s gestation was perfectly ‘natural,’ I should point out–but I carried her, and I was never of the female sex; I am a so-called ‘true hermaphrodite.’ I was assigned female at birth, and was living as such when I gave birth to her, but I never identified as a woman, and am now legally male.”
He continues, “I’m glad that I was able to become a parent, but believing that this should have ‘cured’ me of my distress with my assignment is magical thinking along the lines of believing that procreating will ‘cure’ a lesbian or gay man and make them heterosexual. Gender identity, sexual orientation, and procreative status are independent characteristics. Lesbians and trans men and intersex individuals aren’t mystically “converted” by pregnancies. Gay men and trans women and intersex individuals who inseminate someone aren’t thereby made straight or cis or dyadically-male-sexed.”
He concludes: “Most of us who do reap the rewards of fertility do this in private, with no medical journal articles trumpeting a star in the east. In fact, some medical ‘corrections’ of our physical differences render us infertile, and I don’t see why that’s treated as unimportant when doctors are so very willing to write articles about their ‘cases’ who do prove fertile. And the magical thinking behind the idea that doctors can validate a sex assignment through the intersex person contributing the ‘correct’ component, egg or sperm, to a conception just boggles my mind. It’s time for some more sophisticated thinking about intersex fertility.”
I couldn’t agree more. Ready more about Dr Costello, his experiences and his scholarly opinions regarding intersex and trans issues on his blogs:
Ob-Gyns: Prepare to Treat Transgender Patients
November 21, 2011
From: The American College of Obstetricians and Gynecologists
Washington, DC — To address the significant health care disparities of transgender individuals and to improve their access to care, ob-gyns should prepare to provide routine treatment and screening or refer them to other physicians, according to The American College of Obstetricians and Gynecologists (The College). In a Committee Opinion published today, The College also states its opposition to gender identity discrimination and supports both public and private health insurance coverage for gender identity disorder treatment.
Although the total number of transgender people in the US is unknown, studies suggest they make up a small, though substantial, population. Transgender is a broad umbrella term that includes people whose gender identity and/or gender expression differs from their assigned sex at birth. Female-to-male, male-to-female, crossdressers, bi-gendered, and intersex are the major groups that fall under the term transgender.
“Transgender patients have many of the same health care needs as the rest of our patients,” said Eliza Buyers, MD, former member of The College’s Committee on Health Care for Underserved Women who helped develop the new recommendations. Health outcomes for the transgender community are very poor due to their lack of access to health care, noted Dr. Buyers. “It would be wonderful if all transgender patients had the resources to be seen in a specialized clinic, but the reality is that many forgo care because they don’t. By increasing the number of ob-gyns providing care to transgender patients we can help improve the overall health of the transgender community.”
Transgender individuals who were assigned female sex at birth but are now living as a male will continue needing breast and reproductive organ screening, unless they’ve had mastectomy or had their ovaries, uterus, and/or cervix removed. Male-to-female individuals who have had genital reconstruction may need cancer screening of the neovagina and breast cancer screening if taking estrogen hormones.
“Services that ob-gyns should be able to offer transgender patients include preventive care, Pap tests, sexually transmitted infection (STI) screenings, and hysterectomy for standard indications like heavy bleeding or pain,” said Dr. Buyers. The College recommends ob-gyns first consult with transgender experts before performing hysterectomies as part of gender affirmation surgery. “Hormone replacement can be managed in consultation with experts in transgender care, as many patients will seek hormones on the black market if unable to obtain them from their providers.”
Many, if not most, transgender people face social harassment, discrimination, and rejection from family and society in general. Many of them are homeless, particularly youth who identify as transgender. Transgender individuals are at an increased risk for sexually transmitted infections (STIs), including HIV, and physical abuse.
“We need to make our offices settings that treat all patients with respect,” said Dr. Buyers. The College offers ob-gyns suggestions on how to create an office environment that is welcoming to transgender patients. For instance, asking patients their preferred name and pronoun, posting non-discrimination policies, ensuring confidentiality, and offering sensitivity training for staff are all steps that signal acceptance and let patients know that they will be treated with dignity. “We want the transgender community to know that we, as ob-gyns, care about their health.”
Committee Opinion #512 “Health Care for Transgendered Individuals” is published in the December 2011 issue of Obstetrics & Gynecology.
During National Suicide Prevention Week (9/4/11 – 9/10/11), join Kevin McHale and The Trevor Project for “Talk To Me,” a campaign for conversation. Visit our website to learn how you can participate.
And remember: If you or someone you know ever needs help, please call The Trevor Lifeline at 866-488-7386. It’s free, confidential and available 24/7. Or visit http://www.TheTrevorProject.org.
James Connell, Worcester News, reports that adults — not children — are the biggest tormentors of a 10-year-old MTF child in the UK. According to her mother:
“She is within her mind a girl but she has a boy’s body. She is the same as everybody else apart from the fact she doesn’t feel right in her own body. It’s not a phase. It’s not a choice. What child would choose to be completely miserable? I don’t expect people to understand. I just don’t want people abusing my child. I don’t want her to be called a freak. I want her to be left alone.”
Sounds like a reasonable request to me. As is common for other trans kids with supportive parents, she will most likely be protected from puberty and the undesired physical changes that accompany it with the use of hormone blockers. Only after she is old enough to understand the implications of gender reassignment will she be permitted to consent to cross hormone therapy.
Neal Broverman, Advocate.com, reports that the National Collegiate Athletic Association (NCAA) has updated their policy regarding transgender student athletes:
The new policy states that a transgender male athlete “who has a medical exception for testosterone hormone therapy may compete on a men’s team, but is no longer eligible to compete on a women’s team without changing the team status to a mixed team,” according to a press release from the National Center for Lesbian Rights, which worked with the NCAA to develop the new standards. For transgender female athletes, those who have “taken medication to suppress testosterone for a year may compete on a women’s team. Under the new policy, transgender student athletes who are not undergoing hormone therapy remain eligible to play on teams based on the gender of their birth sex and may socially transition by dressing and using the appropriate pronouns that match their gender identity.”
Girls can wear jeans
And cut their hair short
Wear shirts and boots
‘Cause it’s OK to be a boy
But for a boy to look like a girl is degrading
‘Cause you think that being a girl is degrading – Madonna, “What It feels Like For A Girl”
I am a bit of a news junkie and because of my habit I am repeatedly angered by the ongoing abuse of women around the world: rape for “correction” or as a “weapon of war”, mutilation and honor killings are but a few examples. However a couple of topics in recent weeks have actually made my jaw drop, not because the harm sustained by the affected women was any greater but because of the misuse of medicine and surgical skill to further misogynistic schemes. In India, the selective abortion of female fetuses is nothing new but in select locations and for the right price parents can find physicians who will surgically change their little girls into boys. In the US, the rights of the fetus seem to be surpassing women’s rights given that women have become prisoners within hospitals, undergone surgery without their consent and have even been charged with murder over fetal well-being. These cases demonstrate the pervasiveness of misogyny and the degradation of medicine by its collaborators.
Girls to men
Baby boys naturally outnumber baby girls by around 6%; in other words, for every 100 girls born there are 106 boys that accompany them. Perhaps this is a good thing given that nearly everywhere people seem to prefer boys over girls. Clara Kim, Time NewsFeed, reports “Contrary to the stereotypical notion, girl bias or boy obsession isn’t limited just to Asia. A Gallup poll shows that such a mindset is prevalent in the U.S., too and has been for at least 70 years. The poll asked 1,020 American adults, if they could have only one child, which gender they would prefer. Forty percent of the participants said a boy, while 28% answered a girl. This is not much different from the first poll results in 1941, which were 38% and 24%.” But while Americans are for the most part content to raise whichever gender comes their way, other cultures take a more active role in increasing the rate of male births.
S V Subramanian, a Professor at Harvard School of Public Heath, published in 2009 that “according to the most recent census, for every 1000 males, there were only 933 females, and the corresponding ratio for ages 0–6 years was 927 girls for every 1000 boys. The disproportionate distribution of sexes, at least in more recent years, has been surmised to be driven largely through the use of medical technologies by physicians and prospective parents to determine the sex of fetuses followed by selective abortion of female fetuses. This explanation was initially suggested in the 1980s, and has gained considerable acceptance since then. Some 10 million female fetuses are estimated to have been aborted over the last two decades in India.” By these numbers it appears that there are around 8% more boys than girls among the youngest generation of India and that 2 of every 100 pregnant women with female fetuses choose to abort based on fetal sex alone.
And now there is another way to ensure male offspring. Amrita Kadam of Hindustan Times, India reports that “Girls are being ‘converted’ into boys in Indore – by the hundreds every year – at ages where they cannot give their consent for this life-changing operation. This shocking, unprecedented trend, catering to the fetish for a son, is unfolding at conservative Indore’s well-known clinics and hospitals on children who are 1-5 years old. The process being used to ‘produce’ a male child from a female is known as genitoplasty. Each surgery costs Rs 1.5 lakh [~$3400 US dollars]. Moreover, these children are pumped with hormonal treatment as part of the sex change procedure that may be irreversible. The low cost of surgery and the relatively easy and unobtrusive way of getting it done in this city attracts parents from Delhi and Mumbai to get their child surgically ‘corrected’.”
Dean Nelson of The Telegraph, UK reports that “Indian doctors have been accused of conducting sex change operations on young girls whose parents want sons to improve the family’s income prospects.” It’s not just a preference for boys that is driving the femicide, it is also money. “People don’t want to share their property or invest in girls’ education or pay dowries.” Regardless of parental motivation there remains the doctors’ compliance and lives destroyed by it.
Contrary to Dr John Money’s debunked theory that gender identity is flexible to the whims of social upbringing, medical observation as well as experimentation have proven that gender identity is not malleable. David Reimer was one of Dr Money’s greatest success stories until the truth about his life became known. David’s story began with a botched circumcision that destroyed his infant penis followed by his parents decision to follow Dr Money’s advice to surgically reassign his sex and to raise him as a girl. Unfortunately, David never accepted his forced female gender role and began living as a male at the age of 15. He continued to suffer years of severe depression, financial instability, a dissolving marriage and eventually committed suicide in 2005. His tragic story is catalogued in the bestseller biography: “As Nature Made Him: The Boy Who Was Raised as a Girl” by John Colapinto.
Modification of body parts by physicians without medical indication and without the consent of the person receiving it is tragic and should be criminalized. This is especially true of the sex organs given that at best, surgery permanently alters cosmetic appearance, sensitivity and sexual function. At worst, surgery can result in horrific disfiguration and/or death. Given these risks I strongly believe that non-medically indicated genital surgeries, including circumcision, should be banned for all minors.
Fetal incubator
As if unemployment, home foreclosures and ongoing wars in Iraq and Afghanistan weren’t enough to keep our legislators occupied, the Republican War on Women continues to escalate. According to the Associated Press as reported by MSNBC:
“In 1987, a Washington, D.C., judge ordered a woman who was dying of cancer to have a C-section, which she had refused, to save her fetus. The baby died within two hours of delivery and the mother died two days later. An appeals court later ruled the judge should not have ordered the C-section.
“In 2003, prosecutors in Salt Lake City charged an acknowledged cocaine addict who had a history of mental health problems with murder when she refused to have a C-section for two weeks before finally agreeing to the procedure. One of her twins died in the womb during the delay. Through a plea deal, the charge was later reduced to child endangerment.
“In 2004, a hospital in Wilkes-Barre, Pennsylvania, obtained a court order to force a woman to have a C-section because her seventh baby was oversized, but the order was too late. The mother, whose first six children each weighed nearly 12 pounds (5 1/2 kilograms) at birth, went to another hospital and delivered a nearly 12-pound girl naturally.
“Also in 2004, a judge in Rochester, New York, ordered a homeless woman not to get pregnant again without court approval after she lost custody of several neglected children.”
In 2009, Wikipedia records that “Samantha Burton, a mother of two, was twenty-five weeks pregnant in March of 2009 when she experienced a premature rupture of membranes and displayed signs of premature labor. At the urging of her obstetrician, she sought care at Tallahassee Memorial Hospital. She found not to be in labor, but ordered to remain on bed rest. Her obstetrician, Dr. Jana Bures-Forsthoefel, refused to allow her to leave the hospital to garner a second opinion and then obtained a court order from the Circuit Court of Leon County which required Burton to undergo “any and all medical treatments” that her physician, acting in the interests of the fetus, deemed necessary. The Court held the hearing by telephone with Burton being required to argue her case from her hospital bed without the assistance of an attorney or independent medical opinion. Three days into her court-ordered confinement, Burton underwent an emergency C-section, at which time the fetus was found to be dead.”
Republicans not only want to reduce women’s access to abortion care, they’re actually trying to redefine rape. After a major backlash, they promised to stop. But they haven’t yet. Shocker.
A state legislator in Georgia wants to change the legal term for victims of rape, stalking, and domestic violence to “accuser.” But victims of other less gendered crimes, like burglary, would remain “victims.”
In South Dakota, Republicans proposed a bill that could make it legal to murder a doctor who provides abortion care. (Yep, for real.)
Republicans want to cut nearly a billion dollars of food and other aid to low-income pregnant women, mothers, babies, and kids.
In Congress, Republicans have a bill that would let hospitals allow a woman to die rather than perform an abortion necessary to save her life.
Maryland Republicans ended all county money for a low-income kids’ preschool program. Why? No need, they said. Women should really be home with the kids, not out working.
And at the federal level, Republicans want to cut that same program, Head Start, by $1 billion. That means over 200,000 kids could lose their spots in preschool.
Two-thirds of the elderly poor are women, and Republicans are taking aim at them too. A spending bill would cut funding for employment services, meals, and housing for senior citizens.
Congress just voted for a Republican amendment to cut all federal funding from Planned Parenthood health centers, one of the most trusted providers of basic health care and family planning in our country.
And if that wasn’t enough, Republicans are pushing to eliminate all funds for the only federal family planning program. (For humans. But Republican Dan Burton has a bill to provide contraception for wild horses. You can’t make this stuff up).
Summary
The abuse of women is atrocious in any form but utterly unacceptable within the medical community. It is incomprehensible that physicians would tinker with the genitalia and sex of rearing of innocent little girls given the scientific evidence we already have regarding gender identity formation and durability. It is also unacceptable for physicians to debase women to the level of fetal incubators. End genital mutilation and no wire hangers, ever!
James Pate, MD 