Further Along...Thanksgiving 2012

Well, the holiday season begins and I find myself with so many things rapidly changing, some happy, some not so happy at the moment, but I'm feeling and though life is changing rapidly, far more rapidly than I'm used to, I also have a sense of peace that everything is going to be alright.

Since last Friday, so many things have been happening. My supervisor is now aware of my gender identity, though we have not had a chance to talk about my transitioning yet. That will happen next week, unless the events that have followed since interrupt that time line.

My father became gravely ill Friday night/ Saturday morning and my mother is having a difficult time, so I have had to become the primary contact and take the initiative in making some important decisions about his care and honoring his wishes about how he wants to live out the end of his life. I asked for the hospice team to come to assess him for end of life care and with their input we will make some decisions as a family to respect what my father wants and make him comfortable.

Yesterday, my Patty became ill and needed to be hospitalized. The saving grace is they are both in the same hospital where I work and this makes it much easier for me to take care of everyone involved in my family.

I thought I would never be able to handle any of this, yet I have had several talks with my father about his life ending in the future that he initiated and have been able to do this with a calming grace that I would have never expected to possess at this time.

My mother brought up my gender identity for the first time since finding out about me by accident in June. She was quite upset at the time, as was I and it has been something that she has not spoken of since finding out until now. My father’s illness has created a place where she is able to start to talk to me about this, something I have longed for since she found out. No child wants to think their mother or father is ashamed of them.

I heard that the word “Crisis” in Chinese also means “opportunity”. I believe strongly in God and believe that He is putting all kinds of opportunities in my life right now and giving me a strength I didn’t know I had to cope with all these changes that are happening right now.

Yesterday, I sent in the form to Virginia Division of Motor Vehicles to change the gender marker on my driver’s license to Female, and will get that changed next week.  So I was very happy about that. Soon I will have a new picture and the right gender marker on my license!! YAY!!!!!!

This morning another friend who didn’t know about me was told and she was very supportive. I had accidentally outed myself to her and didn’t realize who I was emailing because I was half asleep. I didn’t panic though. I called her up and talked with her. She’s very happy for me and it worked out just as God intended.

Thanksgiving is my favorite holiday of the year, because it draws me in to a reflective place to remember that I have so much when I know so many who are struggling in many many ways and don’t have the blessings that have been freely granted to me.

I’m thankful for the strength to deal with the illnesses in my family. I’m thankful that I have friends and coworkers who are supportive and I have a therapist who is also supportive of me.

I’m thankful for my church family who love me and care about me and all the other friends over the years who have been my family as much or more than my birth family.

I’m thankful for my good health and that the few health problems I have are relatively small.

I’m especially thankful for a career that has allowed me to help others as I get ready to complete my 40^th year in health and human services. I have had the opportunity to help children, adolescents, adults and the elderly in a wide variety of settings both in hospitals and in the community. I’ve always felt that service to others was my purpose for being here in this life.

I’m thankful for the opportunity to have given homes to so many different kinds of pets who have given me so much love, especially during the times when I felt like no one loved me or cared about me and I was lonely.

I’m very thankful to have had the opportunity to speak to a wide variety of audiences on transsexual issues and have found my talks to always have been well received by the people I’ve talked to and found acceptance where I didn’t expect to find any, and that has always been a joyful experience.

I’m thankful to live in a very beautiful place in the country where I can look up at the mountains that have brought me comfort most of my life.

I’m thankful for having been able to receive an excellent education, something that not everyone has access to, and that I was able to use that education to help others.

 I’m also thankful that I have this forum to reach other people to share my life, to let them know that even though I am a therapist, when it comes to dealing with my own gender issues, the stresses, losses and joys are the same for me just as everyone else and I hope that this blog helps others to navigate their own unique path on finding a place in their own gender identity that brings them peace and happiness.

Further Along.... When Black Friday Comes....

Today turned out a bit better in some respects than what I had anticipated. My boss lady and I have the opportunity to lay it out on the line only two or three times a year. Most of our session was devoted to things previously scheduled to discuss. Some areas of contention that could be resolved that were clinical in nature.

At the end of these lengthy discussions I ventured forward that there was another issue that I wished to discuss. Boss lady indicated she had to be somewhere very shortly and being a Friday evening, I could appreciate that: I wanted to leave work more than anything that day.

I did tell her that I had one thing else that I wanted to discuss but it wasn't something bad. She responded by asking what it was, and I told her that it couldn't be discussed in five minutes. She said that I had her wondering and she would be thinking about it while we were gone over the next week and wondering about what it was. I told her that it wasn't anything bad and she replied now that she would be wondering even more until she returned.

I took that opportunity to tell her it was about a gender issue. She asked me if it was about her gender in a friendly manner and I replied that it was my gender issue. She cheerfully said "Oh ok" and I told her I woud explain when she got back.

My intuition is telling me that she knows and she is trying to make it ok for me.

Interestingly, just before I went in to the meeting, ready to disclose all, one of the front office girls was looking at an Avon catalogue and asked the other girl if she wanted to order some makeup remover. That girl said no and then the girl with the catelogue asked me if I wanted to order some. I a;lso said no. The girl with the catelogue said, I just use soap and water. I said I do too but I used Purity by Philosophy and then used Clinique Even Better Moisturizer with SPF 20. She said, "Yeah thats really good moisturizer. Then I went into my meeting.

I became so much more calm before the meeting until I got in there, but I was able to remain centered. Although I didn't get the whole disclosure done, Boss Lady let me know that what I will be telling her would be ok, by her casual dismissal of what I was about to tell her.

I feel so much more confident and ready to finish what needs to be told and I have a feeling of peace that it will be ok.

Further Along..... Tomorrow is my meeting.

As the time is closer, I am becoming more calm about what will happen tomorrow. This meeting is about more than my informing my boss that I wish to transition at work, but the topics to be discussed lead into this discussion nicely.

I'm reminded of a song that I heard from the soundtrack of Norma Rae and it has stuck with me..... I'd like to share part of it as it is reflective of my state of mind this evening.

I'm quite touched and overwhelmed with all the love and support I have gotten in sharing my preparation for this meeting and I am so very thankful!

Here are part of the lyrics from the song It Goes Like it Goes written by David Shire and Norman Gimble:

Ain't no miracle being born
People doin' it everyday
It ain't no miracle growing up, ah
People just grow that way

So it goes like it goes
Like the river flows
And time it rolls right on
And maybe what's good gets a little bit better
And maybe what's bad gets gone

Love to all of you, Sherri Lynne Tancyus

Further Along....... Standing At the Crossroads

It’s the perfect storm. I couldn't have seen it all playing out like this. Perhaps that is the way that all transitions happen. One can plan it all one wants. Then come events that remove all of your carefully made plans. The situation becomes fluid. Having spent a lot of time planning (or ruminating??) how this was going to be done on my terms have gone out the window. I am left with the bare bones of  what I am going to say. It just wasn’t under the circumstances of my choice and my alternative plan isn’t firmed up. I’ve been working out the details of that.

In one confluence of family, work, marriage and friends, the time to come out has become now. I had planned it for after the first of the year when I got my performance evaluation. That has gone out the window because of a potential reassignment in job duties that I don't wish to do and impacts my practice with individuals and long standing groups, particularly my ability to provide services to transsexual and transgender patients. I have built my trans practice to being one of the largest in Virginia and I have developed more health care services under one “roof” than any other health care system. This allows us to improve the quality of care for all my patients because of the ease of communication and coordination of services. Presently we offer mental health counseling, substance abuse treatment, psychiatric services, aesthetic dermatology, primary care, gynecology, endocrinology and voice therapy.

So it appears Friday will be the day when I sit down with my bosslady and inform her that I am transitioning and wish to do so at work. This will probably take her off guard, but because I am  being forced to perform clinical services in that I have no interest in nor desire to provide, it appears that this would be the time to inform her where things stand with me. I would prefer not to leave where I work because I have a lot of time and effort involved in creating the program we have there, but if not, then I do have a couple of options that appear to be a better alternative than not transitioning.

The other factor that has moved things forward so rapidly have to do with conflict within my wife’s family. Because of that, she and I no longer see a reason to be who I am not in front of them. These events have been very painful and have nothing to do with who I am as they have not become aware. This is also about to change. I have drafted and am polishing a letter to them informing them of what I am doing. Either they accept me for who I am, or I really won’t be bothered too much by not sharing a life with them on any level, as I’ve always felt like an outsider and not especially welcome by a number of them. That isn’t true of all of them though. I think that most of the ones who have made me feel like family will be ok with this, though I can’t be sure.

Having helped people transition over the last 19 years has helped me prepare for this day. It does nothing to help me with the experience of fear and anxiety, whether it is well founded or overly magnified in my mind.

The reason I share this with you at this time is because I am a genuine person and I want you to know that the fear I am experiencing is a normal part of the transitioning process. There comes a time when one has to face their fears over transitioning. Even if you have completed most aspects of the transition, when it comes down to your livelihood and how it affects the ones you live and their financial security, it is going to be terribly anxiety provoking. However, I do know that as in all the other scary things I have faced and losses I have weathered and survived, this too will pass. On the other side, no matter what happens Friday awaits freedom and serenity.

I will be sure to let you know the outcome of Friday’s meeting, though it may take a few days before I will be able to put what happens into words.

I want to thank all of you for the support I have gotten over the years from so many. I am grateful for the love, caring and support I have gotten and I am thankful so many have found what I write to be interesting enough to spend some of your time reading.

Alcoholism and Addiction

It's the same thing, alcoholism and addiction, really. Same illness, just a different substance. Then add on to this category the process addictions: gambling, spending, sex, porn, eating disorders like bulimia and anorexia. Let’s also recognize the binge- purge cycle associated with gender dysphoria where one acquires a wardrobe appropriate to our true gender identity and then in a fit of guilt and shame throws it all away, only to repeat the cycle by acquiring another wardrobe.

“The National Institutes of Health (NIH) estimate that 7.3% of the general public abuses or is dependent on alcohol, while 1.7% abusesor is dependent on non-prescription drugs. Eight percent (8%) of study participants reported currently using alcohol or drugs specifically to cope with the mistreatment that they received as a result of being transgender or gender non-conforming, while 18% said they had done so in the past...” (transequality.org :2011).

How is addiction defined? Essentially, an addict continues in the behavior  involving  a substance or process  even when it creates painful consequences for an individual and the individual continues to engage in the use of the substance or behavior despite those consequences. What are the life domains involved where one experiences negative consequences that indicate an abuse or addiction?

1.     Legal: This could be a result of illegal behavior such as driving under the influence, possession of a substance, or other illegal acts that bring law enforcement attention.

2.     Emotional: Depression, anxiety, obsessive compulsive disorders, and Post Traumatic Stress Disorder. Many of these are a result not just because a person’s physical body does not match the person’s gender identity, but because of emotional, physical and sexual abuse the individual may experience simply because they are transgendered.

3.     Financial: Money spent on substances or process addictions, divorce, custody battles, clothes that can’t be afforded, or to replace what was purged, as well as so many other issues.

4.     Spiritual: the sense that we are alone, isolated and having no connection to others. It may be a result of being rejected by our faith if we are raised in the church.

5.     Health: These are consequences of illness or accidents that are a direct result of abusing substances or engaging in compulsive actions without regard for their consequences.

6.     Social: Broken relationships with friends and loved ones as a consequence of behavior under the influence that is painful or otherwise hurtful to others. 

In the past 11 years, working with substance abuse patients, I have known well over 100 people who have died due to overdose, accidents, illnesses contracted as a result of drug use, and suicide. Most of them were very nice people and their loss of life is tragic. The collateral emotional damage to their loved ones cannot be underestimated. 

Our community has a suicide attempt rate of 41%. Those who abuse substances have higher suicide rates than the general population. It isn’t a surprise that substance abuse plays a large role in depression and suicide. Those of us who are of transgender experience most often are no strangers to depression, myself included, though my depression stems from other issues in addition to having lived years in varying degrees of denial about my own identity. I thank my God and my wife and friends who love me that I have never been to the point where I considered suicide, but I, like many have had bleak dark days when I wished I had never been born or were dead. Now that I have accepted myself and am transitioning those dark days are fewer and fewer. 

When I worked at Bryce Hospital in Tuscaloosa, Alabama (my spiritual home!) I worked with the forensic unit that housed people found Not Guilty by Reason of  Insanity by the courts for varying offenses, some serious, some not of such consequence, but all the crimes were felonious. When I got there and was assigned to the unit, I was told essentially “Here is your unit. Do what you want with the programming”. It had the longest length of stay of the chronic units for several reasons. Some of them were because of the heinousness of the offense, other reasons included they had not had a unit director to provide structured therapeutic treatment for that patient population. Other patients’ offenses were not that severe and were candidates to be returned to the community.

To cut to the chase, I developed programming that allowed many of these patients to progress to the point that they could be placed back in the community and I did indeed start placing them back in to structured living placements or returned to live with their families. Unfortunately, they would stop taking their prescribed medications and abuse drugs and alcohol. Then they would be recommitted to the hospital, most often in a psychotic state or severely depressed, or manic. Typically, they were only out of the hospital for 30 to 90 days before they were returned. 

My graduate program did not include any classes on substance abuse treatment. That was not unusual for that time. So I had to educate myself about substance abuse treatment. In the course of this self-education process, I learned for the first time about 12 step programs. Alcoholics Anonymous was the original 12 step self-help program and was founded by Bill Wilson and Dr. Bob Silkworth. I also studied materials from the Hazelden Foundation, our nation’s premier institute of treating addiction and educating professionals such as myself on how to treat alcoholism and addictions. I also attended 4 days of training at the Alabama School of Alcohol and Drug Studies. I developed the first dual diagnosis (mental illness and chemical dependency) in a state hospital in Alabama and was also the first to bring AA and NA into a state hospital in Alabama.  

People on my unit began to recover from alcoholism and addiction and began to successfully be placed back into the community without returning to life in an institution. It is one of the accomplishments in my life that I am most proud of. 

What I have taken from this is the importance of 12 step programs. The 12 step self-help program has saved the lives of more people and can be applied not only to alcohol and drug dependencies, but to the process addictions. In fact, it is my belief that anyone can benefit from practicing principles of the 12 step program whether you have an addiction or not. They teach you to rely on a higher power; however you may define that to be. They teach you to take stock of yourself, recognize the problem areas of your life and how to address them. They teach you to make a list of those you have hurt in one way or another and to make amends to them when it does not hurt the person you make amends to further. They teach you how to not harbor anger and resentment and how to resolve these issues. They teach you how to improve your relationship with others and your higher power and how to learn to become serene by accepting things you can’t change, changing what you can and recognizing what can be accomplished and what cannot. 

Are the 12 step programs for everyone? No. There is no one size fits all solution to our problems. Not everyone can benefit from the 12 steps, but by and large, the 12 steps help more people than anything else in overcoming addictions and compulsions. 

I have said this for years: Psychotherapy and medications treat depression and anxiety more effectively than either alone, borne out by study after study to the point it is irrefutable.  If someone came to me and said “Sherri, I can either pay you $100.00 (USD) for each hour of therapy or I can go to AA, (NA, or whatever 12 step program addresses the issue at hand) which is free, but I can’t do both, I would send them to the 12 step program to try first. That means its money out of my own pocket, which is a very high endorsement. It’s not about my self-interest, it’s about getting people help so they can be who they are authentically and be happy and healthy. 

I personally estimate that12 step recovery programs can be of benefit to 85 to 90% of people who participate in them. There are 10 to 15% of people who for whatever reason do not find them helpful. Whatever you decide to do if you have an addiction or a dependency of some sort, never give up in your struggle to overcome it. You deserve so much more than having to live with the despair of chemical dependency or with a process addiction.  

To find a local meeting here are some links:

Alcoholics Anonymous:  www.aa.org

Narcotics Anonymous: na.org

Sexaholics Anonymous: http://sa.org/

Gambler's Anonymous: http://www.gamblersanonymous.org/ga/

Sex and Love Addicts Anonymous: http://www.slaafws.org/

Al Anon: http://al-anon.alateen.org/home

Overeaters Anonymous: http://www.overeatersanonymous.org/

or: www.OA.org

Codependens Anonymous: http://www.coda.org/


 A Christian oriented 12 step program: http://overcomersoutreach.org/