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Saturday, November 26, 2011

I've Added Some Useful Information!

For those of you who want to learn more about the history of Transgender Care, I have added a bibliography at the bottom of the blog. Some of these books are well worth the trouble to seek out even though they are out of print and may be difficult to find, particularly the "foundation" books from the late 1960's through the mid 1980's. This list is not complete and will be updated periodically, so please check back if you are interested for your own edification or you are a serious scholar of the subject. I really hope that you will find this useful!

You will also find a list of blogs that I am following and I encourage you to visit them often as they are updated.

Either by the end of today or tomorrow, I will add some links to some resources that I think you will find informative and helpful.

As always, I am very thankful that you take the time to read my blog!

Monday, November 21, 2011

Choosing the Right Therapist For You (It's Not As Hard As You Might Think)

Finding the right therapist for someone who is transgendered is not an easy task, as most of you know already. Many trans people would prefer that their therapist not only be well versed in providing transgender care, but also be transgender themselves. As difficult as it is to find a therapist who is well experienced in this area to begin with, the therapist who is transsexual, such as myself, is an even more rare thing to find. As many of you know, my practice is in a rural health care system in the heart of the Shenandoah Valley. I am the only therapist for over a three hour's drive radius who practices transgender care and there are no other therapists who do practice in this area who are transgendered themselves to the best of my knowledge. I do know most of the therapists in Virginia who provide this type of therapy. So when I went searching for my own therapist, I had to find someone who although had no experience specifically in transgender care and wasn't transgendered, yet would be able to provide me with competent care to the best of her abilities.

I did a quick survey of the top 40 graduate programs in my own discipline of Social Work. Of the handful I surveyed, only two had practice course work that had the keyword transgender in the course title. The program I attended at the School of Social Work at the University of Alabama had no courses in this area when I attended (NO! I will NOT tell you the year I graduated!! A lady NEVER reveals her age!!!!).

A therapist who has herself as a patient is a fool. Someone asked me me why I don't do my own therapy in all seriousness and it was a fair question to ask. It's because I lack the objectivity that one would get from a therapist when it comes to myself. The decision to transition is one of the most important ones of my life and I have only one chance to do it right). This might seem like it would be impossible to find someone who could get the job done, but that isn't true. My own therapist has never worked with a transgendered person before me and she has done an excellent job. At this point I would recommend her to anyone seeking transgender care. She has some characteristics that ensured that she would be competent to do the job, and I knew this when I selected her to be my therapist at the beginning of my own care. I want to share with you how I was able to find someone to help me. It isn't that hard when you know how to go about it.

The secret in finding the right therapist for you is really simple: You are hiring someone to do a job for you and you need to do your homework up front, just as you would if you were hiring an electrician or a plumber. There are things you can do to make sure the person you hire is competent to do the job, just as hiring anyone else. Remember, the therapist works for you and you are interviewing candidates to fill the position, just like any other job. This can be an intimidating prospect for most people because they don't have the same knowlege base as the therapist and they don't feel like they can pick someone who will be competent, so they make appointments with someone and see if it works. That can get expensive, especially if you see two or three before finding THE ONE. Plan on interviewing three or four, if at all possible. It's nice to have a number of options.
If a therapist isn't willing to spend 15 to 30 minutes speaking with you on the phone about what your needs are, then he or she will not be a good candidate for you to contract with. When you are interviewing, it isn't so important that you completely understand the answers to some of the questions you ask, just write them down. You can look up some things afterward on the internet which will help you make an informed decision on who to pick for your therapist.

The first thing you will want to do is look in the yellow pages and see if anyone uses the term "gender and sexuality" in their advertisement. That one key phrase brought me tremendous numbers of trans patients when I had my private practice. The other resource was people who found information about me on the internet. A number of websites provide lists of therapists who are competent in gender therapy.

More and more insurance companies are paying for transgender therapy. The easiest way to find out if you will be covered is to call your insurance company or the mental health managed care entity who handles this for your insurance and ask them if the the  DSM IV- TR diagnostic code 302.85 is covered under you insurance policy. Almost every insurance company I am a provider for, with the notable exception of Coventry administered by Southern Health and their mental health managed care company MhNet cover this therapy and that includes Virginia Medicaid and Medicare.

When you are speaking on the phone interview you will want to ask the following questions:

1. Do you accept my insurance plan and what are your rates? If my plan doesn't cover this service, what is your fee for service? (If there are valid reasons that you can't pay the full rate) Do you have a sliding scale?

2. What is your theoretical orientation? There are many theoretical schools of psychotherapy. Some of the major ones are:  Behaviorism and it's derivitives, Cognitive Behavioral Therapy and Rational Emotive Therapy; Humanism; Gestalt; Transactional Analysis; Psychoanalysis and it's derivitive, Object Relations and Feminist Therapy.

My undergraduate education was strongly rooted in Behaviorism and I practice mostly Cognitive Behavioral therapy and Rational Emotive Therapy. I am well versed Humanistic therapy, Gestalt and Transactional Analysis and have a working knowlege of Psychoanalysis and Object Relations, though I only use them to conceptualize therapeutic issues when I find it useful and do not practice their techniques as I have not been supervised to practice in that area.

Over the years I have been concerned when I hear that a therapist describes their therapy as "eclectic". Too often that means that a therapist has not mastered any particular school of psychotherapy and just draws techniques to use in their practice because they feel right to them for the situation. They often can't articulate why the selected a particular intervention and the theory base behind it. Not all therapists who say they are "eclectic" though don't operate without a philosophical underpinning it is just important to know they understand why they select their interventions.

After you have interviewed the therapists you have selected, it's time to hit the internet and look up the information they provided you. You can then decide which therapists' theoretical orientation seem to be in tune with your own belief system and make a wiser choice in your decision.

3. If they have no transgender treatment experience, then enquire if they have worked to any extent with gay and lesbian individuals. If they have experience with them, they are more likely able to be helpful to you. While our issues are not identical to their's, they do overlap to some degree. This was the deciding factor in my choice for my own therapist.

If they do have transgender experience, ask them if they are a member of the World Professional Association of Transgender Health. If they are a member of WPATH, that is the gold standard for transgender care. If they are not, ask them if they are familiar with the new seventh version of the WPATH standards of care. If they are knowlegable of them or the prior version, then you know they are at least well enough acquainted with transgender care that they are likely to be able to provide you with quality treatment.

If they don't, but have other experiences that place them into serious consideration to become your therapist, then ask them to what degree they are willing to educate themselves to be able to help you. Are they willing to dig up resources and learn on their own? If so, you will most likely find a good therapist to help you, though they might be inclined to follow the standards of care more to the letter of the law. That can be frustrating. We all want what we want when we want it in terms of our gender issues and transition and I am no different in that respect, but someone who is going to be careful before signing off on your hormones and surgery rather than just going along with what you want may just be what is best. At least you will be sure they erred on the side of caution, if they erred at all.

Too many of us have rushed into decisions they knew were right for them without consideration how they will support themselves, who will be supportive of them and who will abandon them merely because they are differently gendered. Too many times thre have been disasterous outcomes. Our community has about an 800% higher rate of attempted suicide than the general population and an astronomically higher rate of substance abuse and addiction as well.

I hope that these thoughts and strategies will help those of you who are looking for a therapist. If anyone has any other ideas that will help my viewers, please do contribute your thoughts to the discussion.

Saturday, November 12, 2011

Transphobia: How do you victimize yourself?

When most of us think about transphobia we generally think of the most obvious form such as when we are physically assaulted, denied access to services, harassed, denied employment or educational opportunities. Almost of all of us have experienced this to some degree, myself included.

Then there is the more insidious form, institutionalized transphobia. Institutionalized transphobia happens when you are denied access to a public restroom for example. When you go to the ladies room, you go into a stall with the door closed and sit down. Nobody knows whether you are pre op, post op, non op or intersexed. When confronted, the person who accuses you makes a judgement on your physical appearance on whether you are male or female without regard to your physical sex and your expression of gender identity. This is based on the institution that men use one rest room and women another. I've heard some activists refer to this as "gender apartheid" I for one, don't want to share a restroom with a man, I'm not in favor of unisex bathrooms unless they are SRO's (single room only).
I experienced this one personally once in a major department store and it was very humiliating.

Another example of institutionalized transphobia that I experienced as a result of this episode happened when I was sharing the example with a female friend who is very supportive. She said, "Well what if a mother with her 7 year old daughter had been going in while you were in there? "She might be afraid for the safety of her daughter." My friend didn't recognize that she had internalized a fear based on fear and bigotry; much of society fears us because if we are transgendered, then we must pose a threat as a potential sex offender. Ouch. That really hurt and when I pointed this out to her, she was immediately apologetic. She recognized that her statement was based on a bigoted stereotype that is in fact not true, but that is how deeply ingrained institutional transphobia can be. It was stated without any real thoughtfulness involved.

Overt and institutionalized transphobia can be confronted, but because internalized transphobia has become rooted in our subconscious, it is much more difficult to overcome.

Consider the following statement:

             "If there is no shame in being a woman, why should I be ashamed of wanting to become a woman?"

I think this captures the deepest most damaging aspect of internalized transphobia. It is the guilt and shame we experience for merely being transgendered that is the worst. Of course, this wouldn't have happened without the presence of transphobia or institutionalized transphobia, but the reality for people of a (ahem) a certain age, things were so much worse that we can easily see the changes for the positive and how rapidly things are beginning to get better. Make no mistake, we are still seriously discriminated against and we are not able to go about our lives without being vigilant for our safety in certain places. We do not enjoy the same access to health care as other people do. That has been getting better. Every insurance company I work with as a mental health professional (with exception of my own (COVENTRY, ADMINISTERED BY SOUTHERN HEALTH AND THE MENTAL HEALTH MANAGEMENT GROUP MHNET), cover mental health services and most of them to the best of my knowledge are paying for hormones, blood work, physician visits, and preventive care such as mammography based on what my patients report to me.

I do not fear every moment I am out living my life publicly. I fly, get passed through TSA, rent cars, get hotel rooms, shop, use dressing rooms and have only had one negative restroom experience. I have a church that not only is welcoming but wants me as an active member of their community to meet my spiritual needs. I am able to go to the grocery store, do my banking, get my oil changed and all those little mundane things that make a normal life normal, the things cisgendered people don't think twice about. These are all good things, but the National Center for Transgender Equality and their executive director, Mara Keisling, work tirelessly to advance our civil rights and we owe a lot of gratitude to  NCTE and Mara, as I do, that things are improving. We have a long way to go. The results of their recent survey documenting how far we have to go show how hard life is for many of us and even more so if we are a person of color.

One of the most important things we must do, is examine the ways we handicap ourselves. Do we allow ourselves to live with guilt and shame? Do we tell ourselves that no one will treat us with dignity and respect, so we avoid living our lives publicly and hide away living a lonely life? Do we get involved in service work to the larger community we live in and make a difference, for the good it does us spiritually and to be an example to the community that we are regular people going about our daily business leading normal lives? Do we take risks in going after opportunities presented to us or do we avoid them because we "know" it won't turn out well. We have to challenge all those self defeating thoughts and actions that are based on transphobia. Even when you think you have rid yourself of all of these negative thoughts and actions that are self nullifying, you might just still be hanging on to something that is holding you back.

Just for today, I'd like to challenge you to take some time and look at what transphobic thoughts and beliefs that you have about yourself and remove those obstacles from becoming the best you that you can be!

Sunday, November 6, 2011

She Gave Me Hope a Long Time Ago

As I had mentioned previously, When I was 12, I went to the library and started reading about people like me. That started a life long search in the literature to learn more about myself. I'd go to the library quite often and read the books about Transsexualism. I'd re-read the books that I had read before and read the new ones when they came in. I was too afraid to check them out so I could only read them for an hour or so at a time. This went on all through junior high and then high school. I was very fortunate that the Charlottesville Public Library had these books. In high school, I worked at U.Va. Hospital and then had access to the medical school library. Jackpot!! That gave me access to medical and other allied health care journals as well. The thing that struck me most (aside from THIS IS WHO I AM!!) was that there were so few of us that I felt so alone and so different in the world. I also thought that this is such a shameful thing that no matter what, I must let NO ONE know the truth about who I was. It continued into college, after college and then through grad school at the University of Alabama. Every time I went to the library, I'd almost inevitably get side tracked and go read the books about people like me. Even today, if I go to Barnes & Noble or online to look at books I still get sidetracked by looking for books on transgender themes and I have quite an extensive library that even includes all those old books long out of print that I read at the beginning when I was 12 and up.

A year after I graduated from the School of Social Work, I got married for the first time. The only thing I will always hold myself accountable for in the failure of my marriage was I didn't tell her the truth about myself before we married. No matter what her transgressions were, that is something that I was totally responsible for. She didn't deserve that. In my defense, I, like many of us who marry, thought it would go away. It didn't take long, maybe 6 months or so, to figure out that being transsexual wasn't nor will it ever go away. It wasn't until after my ex left that I came to the conclusion that I better make friends with this or it was going to kill me. Literally.

About a year after I was married, I made a decision that seemed inconsequential, but really gave me that first hope, just a glimmer of hope, that maybe there was a way for me to become the person I truly as I continue in the process of self-actualization today.

I had been working at the state hospital as director of the forensic unit, a unit whose mission is to care for those who were adjudicated Not Guilty By Reason of Insanity, or had not been able to be restored to competency to stand trial. This is a particularly political position for a mental health professional, and my assessments potentially had a controversial impact on communities and courts across the state of Alabama, as well as United States Federal Court in some instances as Bryce Hospital was still under Federal receivership due to the Wyatt vs Stickney landmark legal decision. That case resulted in nationally set standards for the care of institutionalized mentally ill people and is considered the "Bill of Rights" for institutionalized mentally ill people. While it was a very good job with the potential for rapid professional growth, it was also very stressful, and here is where I made a decision that changed the course of my life a bit. I decided that I needed to have a mental health day ( I called in sick). I really didn't do much of anything, I just really wanted to have a day to myself alone.

Early in the afternoon, after playing Ms Pacman for the 100th time or some of the other computer game I had (we're talking 1989 and the IBM XT. I was 32 years old), and talking to people on Compuserve, I decided to watch some TV. During those years, Geraldo Rivera had a day time talk show. That particular day, Geraldo has a guest whose name was Marsha Botzer. I didn't know who she was, but it turned out that she was a transsexual woman who had founded the Ingersoll Center in Seattle, Washington in 1977 (To put it into historical perspective, in 1977 I was finishing up my Freshman year at Bridgewater College).

I was rivited; never before had I ever seen or heard another person who was like me. I remember how nice and respectful he was in that interview towards her. I wanted to talk to her badly, but I knew I couldn't call her from home because my wife would question the phone call. I had no idea how to tell her about my most carefully guarded secret. Until this television show, I never talked to or heard another person like myself. I had thought that people like me were so rare that it would be nearly impossible to find or even to talk to someone like myself who could understand the depth of the emotional pain with that I lived.

The next day, back at work, I knew I had to take a risk. I used the work phone to call directory assistance in Seattle, got the number for the Ingersoll Center and after a few minutes of anxiety, called the Ingersoll Center and asked to speak to Marsha. I remember being really shy and telling her how I had seen her on TV the day before the day before. I told her about myself and that I had never known anyone else like me and it meant a lot to me that she would take a few minutes to spend on the phone talking with me. I told her that I was a clinical social worker and about my life growing up. She asked me if I would like some information about the Ingersoll Center and sent me a couple of brochures that I still have to this day. I've always remembered this experience and from time to time have shared that story with others.

As some of you know, this past September, I attended the Southern Comfort Conference where for the past three years I have presented my workshop and The World Professional Association of Transgender Health International Symposium. What a once in a lifetime experience that was for me! I met so many wonderful people, many I have only read about and never dreamed I would have the opportunity to meet.

After the morning workshop on Saturday, I was walking around feeling a bit alone and shy as I often do in new situations and found myself within speaking distance with Marsha. She now sits on the WPATH Board of Directors. Now, this was one of this OMG!! experiences for me! I just had to meet her and tell her what that experience so many years ago meant to me and thank her for that!

In talking to her, I became emotional and I could see that what I had said had touched her as well, just as I had been touched by her generosity with a few minutes of her time so long time ago. Then, the highlight of the conference for me and one of the highlights of my life was that she invited me to have lunch with her! WOW! That was such a wonderful experience. I'll never forget that.

You know, life is pretty short. We never know what little act of kindness, something we wouldn't think twice about doing, will have a profound impact on someone else's life. I think it's really important to let those people who touched your life in a meaningful way know what they have meant to you when that opportunity comes. You never know if you might ever have that opportunity again. It's always gratifying to be able to make someone else aware that they are appreciated for the things they do that makes things just a little bit better for others when the opportunity presents itself.

Friday, November 4, 2011

Practicing What I Preach: My Life With the WPATH SOC

I'm sure that some people must imagine that because I am a therapist that I can scoot around the Standards of Care and get what I want using my professional connections with other professionals who work with trans people, but I don't believe that would be in my best interest for my own health care. So I abide with the Standards of Care in my own life. Would you want to have open heart surgery by a doctor who didn't have a standard of care for that procedure?

I have been an advocate for the Standards of Care long before I became a member of WPATH. I know that some people deeply resent the existence of a standard of care and being required to follow a process. Consider this though; The National Center For Transgender Equality (  and The National Gay and Lesbian Task Force commissioned a survey that reported a number of terribly sad statistics of what many of us have experienced, some things I have personally experienced over the years. 41% of trans people who were surveyed had attempted suicide at least once as opposed to the general public whose rate of attempted suicide is only 1.6%. For those of us who are unemployed, lost a job due to discrimination, or have been forced into sex work, the rates are much higher and for people of color the attempted suicide is 49%. I find these rates appalling and unacceptable.

Addiction and substance abuse are also terrible problems for us. 70% of the survey reported current problems with substances overall. 3% have been denied access to substance abuse treatment programs and 4% have experienced mistreatment while participating in substance abuse treatment programs. As a professional who also has spent a significant part of my practice in substance abuse treatment, I recognize that it can be absolutely crucial to catch a person at the moment they are willing to get into treatment or that moment will be lost and not come around for quite a long time, if ever. If you miss that opportunity, it could literally be fatal. 25% experienced either denial of care or being treated poorly by doctors' offices or hospitals and 16% were denied help or were mistreated in emergency rooms. 12% reported denial of help or were mistreated in mental health clinics. Simply unacceptable.

Another reason to seek out healthcare professionals who use the framework of the Standards of Care is because of the discrimination we face from healthcare professionals which bothers me quite a bit both personally and especially as a health care professional.  Professionals who use the standards to guide practice will likely have a network of local health care providers who can be sure that you have equal access and are treated with the dignity any person is due.

Half of us report we have had to educate health care professionals on our needs and how to treat us. Fortunately, there is a national effort directed by the National Institutes of care to educate the health care community to provide us with competent care. Having WPATH's Standard of Care, provides health care professionals a quick way to get up to speed on how to work with trans people.

One of the pitfalls that some health care professionals fall into is solely relying on the standards and not tailoring them to the needs of the individual. The SOC clearly state that they are not to be rigidly used and state they are a guide to practice. They were not meant to be followed by rote with each patient. Often in the beginning of the learning curve, a professional will tend to rely on them more often ver batim, but as experience is gained the professional often feels more comfortable in relying on their own clinical judgement. I think that I would prefer a practioner who followed them as written rather than practicing in ignorance and possibly making a serious mistake in my own care.

SO all in all, I think having the WPATH SOC benefits us and that is why I use them personally and professionally.

Thursday, November 3, 2011

Little Things Make a Difference in My Life

In daily life, I, like most women like me, sometimes wonder in the back of my head if I'm really being accepted in public as any other woman, or are people reading me as a transwoman and being polite. At this point, I'm very comfortable with daily activities. I go shopping for clothes, go to the grocery store, now have a church I feel comfortable attending and am welcome to be there by congregation. That was a huge milestone for me in my comfort in public as well as in feeling accepted by others.

Over the last three weeks, I have had a couple of experiences that tell me that I am making progress in being seen as just another woman, which is what I see as my goal in the transition process. What has happened is that twice now I have been asked by another woman for assistance. The first time I was on my way into the grocery store and a woman stopped me and asked me if I could look at her receipt from the grocery store. She was concerned that she had paid too much for an item that was on a buy one get one free special. I explained that usually you only get charged half price for one item, but she had been charged a little over half, maybe three quarters. She was asking if I thought she should ask the managers about it, as if she was going to have to pay that much, she would go back and get the second item in that case.

Now being a Social Worker by profession, I just have that natural urge to help people. I guess it's like a pointer who hunts birds (No smart remarks PLEASE!!!! LOL!) So, naturally it gives me a good feeling to be able to do something, even if it is a little thing like that for someone else. But being able to do that little helpful thing gave me so much more. I felt accepted as just another woman!

The day before yesterday, I went to see my doctor for a horrible case of bronchitis I'm dealing with and then had to drop off a prescription. Now Walmart is always a mixed bag for me. On the one hand, I get all my HRT prescriptions there and they cost me a lot less because my insurance doesn't cover it. Two out of three of my prescriptions are on the $4.00 list. Ironically, because my insurance won't cover me for those, I save a dollar on two of them because it's a dollar less than my normal copay! What a little twist that turned out to be, in my favor for once!!

Otherwise, Walmart pharmacy has been a pain to deal with for some other reasons. I really don't like the long lines and the waiting. I also had one of the very few unpleasant experiences there during my transition interacting with their staff at the beginning of my relationship with that pharmacy. But, we got that straightened out and things have been ok with them since then. I can forgive and move on. Still, it's not the most convenient place to get my presciptions.

Dr. Laura Jean had called in my antibiotic to Walmart since it was closest. I was feeling very poorly and knew it would be a little while, so I went grocery shopping. That took about 45 minutes and then I went to Walmart (Here in the sunny south we call it "Walmarts" or if we go to Kmart it's pronounced "Kmarts". I don't know why, it just is!). After the perfunctory long wait, I learned it would be another 45 minutes, so I left and went to Books a Million to hang out.

When I got back, on my way in I noticed a woman in a handicapped parking spot and she was on oxygen. She called out to me and I went over. She was struggling to change out an oxygen bottle. She was literally crammed in her car with all her groceries and I wondered how she would ever get all those groceries into her home without a lot of physically agony from oxygen starvation. She asked me to change out her bottle for her. I told her that I worked in the medical field and knew how to do this. It's pretty easy actually and I've done hundreds of them over the years. So I was able to help her out and she was very grateful for my help.

But it was really me who got the help! I got another affirmation that people look at me as just another woman out there taking care of her daily business. To me, these two women gave me something more than I gave them. They gave me confidence that I can lead a regular life and be seen as who I see myself; another woman leading her life in an ordinary everyday way.

Wednesday, November 2, 2011

Were you exposed to D.E.S?

Were you born between between 1938 and 1971? I was. Chances are good that your mother was administered a powerful synthetic estrogen either by prescription to prevent miscarriage or in prenatal vitamins that were not sold only by prescription. As a result, an estimated 5-10 million pregnant women and the children born of these pregnancies were exposed to DES. Physicians prescribed DES to pregnant women on the theory that miscarriages and premature births occurred because some pregnant women did not produce enough estrogen naturally. At the time, physicians thought DES was safe and would prevent miscarriages and pre-term (early) births. In 1953, published research showed that DES did not prevent miscarriages or premature births. However, DES continued to be prescribed until 1971. In that year, the Food and Drug Administration (FDA) issued a Drug Bulletin advising physicians to stop prescribing DES to pregnant women. The FDA warning was based on a study published in 1971 that identified DES as a cause of a rare vaginal cancer (clear cell adenoma) in girls and young women who had been exposed to DES before birth (in the womb).

In 1985, the Center for Disease Control turned it's attention to DES sons and the problems they are experiencing as a result of in utero exposure. Frequently observed consequences include testicular hydroceles ( fluid filled cysts in the testicles), Vericoceles (abnormally formed blood vessels that supply the testicles) and epididymal cysts ( cysts on the cords that conduct sperm from the testicles), infertility, poor semen qualtity, undescended testicles, micropenis and higher rates of transsexualism than would be expected for the general public. It should be stated though that there are no accurate statistics on the true numbers of transsexuals. Figures such as 5: 30k have been bantered about, but in my own anecdotal clinical experience, my guess is probably as high as 10% of the population. I base that on the fact that I practice in a very rural environment and my patients come to see me in about a 4 hour driving radius that includes most of Virginia, and a large portion of West Virginia. I've seen about 250 individuals over the last 15 years. That's quite a few folks! Consider the stigma, guilt and shame that transsexual people experience who may have lived with a dark and shameful secret (their perception) and never breathed a work to anyone about it. My opinion is that there are as many of us as there are gay folks.

So with all that said, there is a good chance that you may have been exposed and not know it. Many women were prescribed this drug or took it in their prenatal vitamins. How many women took DES and the over the counter prenatal vitamins that contained DES? Many women do not recall if they took it or not and if it was included in the formulary of their prenatal vitamins, they would most likely be clueless about that.

So with that in mind, our friendly friends at the CDC have come up with a screening test that you can take at This self assessment can tell you whether you are at high risk to having been exposed. Turns out that I am one of the high risk folks. Of course, I am always trying to figure out the "whys" about myself. It's just an academic pursuit to understand myself and how I came to be a transsexual. In the long run, "I am what I am and that's all that I am", as Popeye the Sailor Man used to say. Reductionism seems futile.

You can find more information about DES sons and support groups at and, plus a whole lot more if you do a seach under DES SONS.

I'm curious about how many of us are DES sons. Take the assesssment and let me know, I'd be interested!

Harry Benjamin, Robert Stoller, Richard Green and John Money

I started reading these books back in 1968 or 69. I already knew who I was; a transsexual. Benjamin's book came out in 1966, Then Robert Stoller was next in 1968 and Green and Money in 1969. Those were the first "BIG FOUR" in the field; I think after Benjamin, who advocated biological determinants, is where the wheels started coming off the bus, slowly at first and then it took a radical wrong turn with Money, which is a very strange story.

With Stoller, the etiology of transsexual being due to a psychoanalytic disturbance began to creep into the discussion. Psychoanalytic theory or Object Relations as it is more often practiced today, views us as deeply disturbed, severely personality disordered and deviant. You do not see that kind of language with Benjamin, except in the sense that it is an anomalous, statistically significant rarity. Psychoanalytic theory blames the maternal relationship for just about every problem under the sun from schizophrenia to transsexualism and all sorts of other mental maladies. Psychoanalytic theory is based on mythology and that the powers of myths describe human conflicts which are why Psychoanalysis is such an arcane practice. We do have to note that the Greek and Roman mythology was created as an explanation of human behavior which makes psychoanalysis of value.

Things get worse with John Money, a Feminist. He fully ascribed to Social Learning theory of personality development and this is where feminism chimes in. They believed in John Locke's idea of Tabula Rasa: the mind is a blank slate and you can take a baby regardless of biological potential and raise it to be anything, doctor, banker, lawyer, male, female, whatever; all by environmental determinations. Biology plays no role in this and there is Money's infamous destruction of one child's life that he had recommended to reassigned female after a terribly tragic circumcision accident that destroyed his penis. That was passed off as a great success for so many years until the truth came out after that poor person suicided. Money advocated the promotion of pornography and suggested that pedophilia was not necessarily an unhealthy practice.

 Feminists believe the same thing about social learning as did Money. They believe that much of feminine behavior is societally enforced through a coercive patriarchy. They believe that women who are traditionally feminine and take more traditional roles are sell outs to the patriarchy.

There is a hierarchy of science: Physics, Chemistry, biology, Psychology and Sociology, Economics and Political science. You can see where things stand from that hierarchy. Psychoanalysis tends to be a blend of psychology and sociological theory.

BTW, 1:500 males have Klinefelter's mosaic which a portion of cells are XY and a portion of cells are XXY in various proportions. This is usually discovered in men who are infertile and they have a higher rate of transsexualism than XY males. Of course there are the more severe cases of Andorgen Insensitivity Disorder, Congenital Adrenal Hyperplasia and questions about other more subtle brain changes due to hormonal washing at different times in life.

As we become more sophisticated in neurophysiology, I think more will be learned that Transsexualism is by and large a biological condition and not as a result of any social learning theory.


Hello, I'm Sherri Lynne

Hi! I'm Sherri Lynne. I'm a psychotherapist and I am a transsexual. I am a Clinical Social Worker and hold the Diplomate, the highest credential in my field. Although I do many other kinds of therapy, I am a gender specialist, scholar and educator. I am engaged in one of the largest gender programs in Virginia which I created. I've developed a comprehensive program that includes my services as a psychotherapist, a psychiatrist who writes my second opinion letters, aesthetic dermatology, primary care, hormonal reassignment specialists and in January we will be offering voice therapy. All but the services I have offered and HRT (Hormonal Reassignment Therapy) have been initiated in the last two years, so my program is extremely dynamic and represents the state of the art of transgender care. I maintain relationships with a number of surgeons who perform surgical gender reassignment around the country and in Canada.

Over the past three years I have been giving workshops all over the eastern U.S. at transgender conferences and at Universities, some for continuing education credits for mental health professionals. Recently I founded a consulting business, E.I.T.C. (Excellence in Transgender Care), whose mission is to help build comprehensive health care systems that will provide competent and compassionate care. E.I.T.C. also is involved in providing professional education opportunities. I am a member of the World Professional Association of Transgender Health.

I do stay busy! I am also writing a professional text from the perspective of a transgender person who is also a psychotherapist. My goal is to write a book that is accessible to the general public but is informative for mental health professionals as well as practical. I hope it will also lend insights to professionals on what it is like to live at odds in the mind-body continuum and how to apply the WPATH standards of care in the spirit to which they are intended, not as a rigid set of rules that must be followed by rote, as explicitly stated in the SOC.

So, I hope that you will find my blog interesting, informative and thought provoking. I look forward to getting to know my readers and learn from you all as well!

Sherri Lynne