Further Reflections on the Nature of Post Traumatic Stress Disorder in Transgender Individuals and Implications for Its Treatment

In October of this year, I completed 12 face to face educational hours and 16.5 hours online learning in depth about the nature and treatment of Post Traumatic Stress Disorder. I became a certified trauma counselor through the International Association of Trauma Professionals. I have had an intensive exposure to learning about the nature of Post Traumatic Stress Disorder as a dis-regulation of the Sympathetic Nervous System resulting in a person on a  frequent to continuous basis experiences being in the state of "flight or fight"response.

 The Sympathetic Nervous System is a subdivision of the Autonomic Nervous System. The other half of the Autonomic Nervous System is called the Parasympathetic Nervous System and it's job is to promote a physical sense of calm and well being, and allowing us to be present in the moment when there is no existing threat to us.

Normally, the Parasympathetic is the dominant or default condition of the autonomic nervous system, In those who experience dis-regulation of the Sympathetic Nervous System, it becomes the dominant system. The individual will experience symptoms of anxiety, excessive perspiration or dry mouth, muscular tension, sleep disturbances, feelings of panic and other symptoms of this nature when in reality, no threat exists for the individual.Experiencing these type of symptoms can range from frequently feeling dysphoria of a mild to a severely incapacitating degree.

It is not known at this time the number of transgender people who suffer from the symptoms of P.T.S.D, In my opinion, to the degree that a transsexual has developed a sense of self awareness, the discovery of one's physical body is not of the gender that matches one's gender identity, the greater the degree of traumatization the individual will experience. Similarly, the longer the individual lives with the inability to live authentically and denies one's true identity, the greater the risk for increasing levels of traumatization over the life span.

It is important to be able to identify the type of trauma experience of the transgender person as a complex trauma or as a developmental trauma, so that the type of treatment selection is important.
Developmental traumas do not respond well to psychotropic medications. That does not mean they have no role in the treatment of developmental or complex trauma, it does imply that medications will not be the solution alone in successfully treating this type of PTSD. Medications will be relatively less effective in this type of PTSD over the long term in resolving symptoms.

What is necessary is a retraining of the Autonomic Nervous System to give people more control in activating and learning to stay in states when the Parasympathetic  system is restored to being the dominant division over the Sympathetic system.

When a person is able to exercise more emotional regulation, it is then the therapy can move forward to process and resolve the significance of the past trauma. In part, this is accomplished by the individual recognizing that the past trauma is not occurring in the here and now. As one is able to leave the past behind, the trauma loses its powerful hold on the individual and she is able to continue through the healing process using the techniques learned to manage her levels of reactivity. She is able to be more present in day to day life as opposed to experiencing symptoms of rumination of negative thoughts of the past or future that remove one from what is going on in the here and now. She becomes free to build a brighter future.

An area that I think deserves further consideration and study is whether  the presence of lingering low self esteem or a sense of stigmatization in individuals who have successfully transitioned represents some type or residual state of PTSD that will be extremely treatment resistant.. Is it possible, as Bob Dylan wrote, "You can always come back, but you can't come back all the way..."?

If it can be addressed, it will likely come through cognitive restructuring requiring long term psychotherapy.  The longevity of the treatment will be as important as the frequency of appointments. In psychotherapy that lasts over several years, appointments are held once a week for a long period of time leading to appointments a few times a year over several years after the most intensive part of the therapy is completed. I believe this type of therapy offers the best chance of resolving residual issues of PTSD such as I described above.

I did a literature search on the National Medical Library of the National Institutes of Health and did several fetches using keywords such as PTSD, Transgender and Trauma and found no articles after an advanced search that directly address the concepts I am writing of here. The closest article was an article in a psychoanalytic journal. It is called Mourning the Body as Bedrock;  Developmental Considerations in Treating the Transsexual Patient Analytically. (www.NCBI.NLM.NIH.gov/pubmed/25277869). It suggests that psychoanalytic treatment can be helpful in resolving developmental or complex traumas experienced by transgender people. Research into the treatment of PTSD reveals that many different therapies can be effective in treating PTSD. What is most important is that the therapist be fluent in the modality of of treatment she employs over any particular school of therapy.

In any event, much more research is obviously indicated to help transgender people effectively resolve past trauma and build a future based on mastery over self and the social environment.

Hello Russia!

Russia is the nation with the second most views of my blog for all time after my own country, the USA. For the past month, I've had 600 views from Russia, not many less than my own country's views.

As an amateur student of Russian History and Russian Literature, I am curious about what it means to be a transsexual or transgender person in Russia or in Eastern Europe and in the former member states of the former Soviet Union.

My interest in Russia goes back to my adolescent years when I first saw the movie Nicholas and Alexandra. In my undergraduate studies.  I took a course in Russian History. I began to read literature by Dostoevsky, Chekov, and Solzhenitsyn. I found Ayn Rand on my own and have embraced many) of her philosophical ideas in my own personal philosophy (along with much of the philosophy of B.F. Skinner and Behaviorism). I was also fascinated by the influence of Grigory Rasputin (referred to as the "Mad Monk" over the Czarina Alexandra as well as his own story.

I grew up in the 1960's and 1970's in the era of what we call in America "The Cold War". One of my earliest memories was of the Cuban Missile Crisis. Here in the USA, my early childhood memory was of the adults fearing we were going to die at what seemed to be the beginning of World War III. Thankfully, that event would not become the catalyst of the destruction of two great countries and perhaps the entirety of Western Civilization.

I was a young adult when Ronald Reagan implored Gorbachev to tear down the wall separating East Berlin and West Berlin and saw that wall fall on television along with the disintegration of the United Soviet Socialist Republic, or as we called it, the Soviet Union.

 As an American transsexual who is a mental health professional, my practice is partly devoted to working with transgender people. I am quite interested in how people such as myself fare in other countries. My audience for this blog is truly international. I have readers in every continent, even from Middle Eastern countries and African countries where people such as myself suffer unspeakable persecution, to the point of torture and loss of life because of who they are. There are things worse than dying for who one is or one's religious belief, though, such as being tortured or living under extreme oppression.

I seldom get comments from people from foreign countries who read my blog. My guess is that in some of the countries my readers come from that they dare not leave a trace that they have read what I have written.

As I mentioned, I am quite interested in the lives of transgender people in other countries and other cultures. I would like to invite my Russian readers to participate in commenting on your lives, your struggles and your triumphs to live an authentic life.

Thank you my Russian friends!

So Now We Learn the Vatican Has Objected to the White House Guest List

As our French friends would say, "Quelle Surprise!" (What a surprise!) Not really. Of course the Vatican would object to a White House reception that Obama planned in order to attempt to humiliate the Pope, Catholicism and Christendom at large. To participate in that planned circus would be a humiliation of the greatest degree. Perhaps Obama expected the Pope to bow to him and his controversial guests as Obama has made a show of bowing to other leaders of State who he thinks America owes apologies to for our history.

Pope Francis is a very liberal Pope and endorses views that I personally oppose, such as open borders and a belief that global warming is the result of human activity ( more on that perhaps another time, some scientists are lobbying to have Obama legally prosecute other scientists who dissent from the opinion that global warming is the result of human activity). He holds other views that I do not agree with or support, but I respect Pope Francis and believe that he has done things that have been good for the Catholic church and for the progress of Christendom at large. He has granted audiences to people who are transsexual and not rejected them, though the teachings of the church is at odds with the belief that transsexuals and transgender people have a place at the table in the world of Christendom. He has met with gay people as well and seems to say they should not be excluded from being offered the sacraments, though he believes having a transsexual or transgender identity or gay sexual orientation is a sin. Christian theologians recognize that there is no sin greater than another and while I disagree that I am sinning because of my identity as a woman, I know that I can be forgiven for that if it is a sin as it is no worse than any other sin.

In principle, Obama and Pope Francis share much on an ideological basis. It puzzles me why Obama would attempt to set up such a situation. Is it mere arrogance? Obama seems to be able to act outside of the United States Constitution with impunity. However, Pope Francis and the Catholic church are much bigger than the United States and in this instance, it might behoove Mr. President to remember his place in the grand scheme of the world and seek to build bridges instead of continuing to burn them to the ground.

Mateo Williamson, Barak Obama and Pope Francis

Barak Obama has decided to welcome Pope Francis to America and to the White House by inviting some guests to help him greet the Pope. He has invited Gene Robinson, a retired Episcopal Bishop who is a gay man, Sister Simone Campbell, who is a pro abortion nun and is the Executive Director of the social justice lobby group Network, and Mateo Williamson who is supposed to be representing "transgender" people to the Catholic church.

First, I must question why Barak Obama is insisting on sticking his thumb in the eye of Pope Francis and by extension Catholics in America and the rest of the world? How will this possibly move the dialogue forward between Christians who are Catholic, and by extension all Christians who are not accepting of abortion, particularly unfettered access to abortion which includes partial birth abortion and the harvesting and sale for profit of the organs of unborn children? How does having a gay man who likes to wear women's clothes advance the acceptance of people who are transsexual with the Catholic Church and the broader body of Christ when he has nothing in common with transsexuals and confuses the public about who transsexuals are?

While the Episcopal church has recognized that gay people have a rightful place as members of Christendom and are just as much children of God as straight people, presenting Bishop Robinson along with Sister Campbell and Mateo Williams discredits the message that Bishop Robinson could bring to meeting with the Pope and diminishes the opportunity and hope for reconciliation between the Catholic Church and the Episcopal and Anglican churches, which is a much desired outcome between these denominations. It certainly isn't going to help me find acceptance in the broader sense of Christendom. Presently, I worship with the Episcopal church, but I long for the day when I can find acceptance as a woman of Christ in the Southern Baptist Convention where I spent my formative years.

It utterly confuses me why Mateo Williams would be included in this meeting. I quote Mateo Williamson from his own words published in Breitbart News: "Today I identify as a gay man and before that was difficult to understand because I thought that in order to be transgender, in order to be a transgender male that I had to be attracted to females but I never have throughout my entire life.”

How he came to the conclusion that he "had to be attracted to women to be transgender" escapes me. I can only conclude he has never been familiar with the professional literature (of which I am very well acquainted dating back to the mid 1960's). In actuality, in the earliest days, professionals believed transsexuals must be attracted to men and there has been considerable debate on whether people who are attracted to women or can only imagine themselves as being women having intimate relationships with men were fetishists. I'm sure Barak Obama could have found someone more grounded and more knowledgeable about transsexualism to greet the Pope if only the President cared about substance over symbolism.

http://www.breitbart.com/big-government/2015/09/16/white-house-invites-trio-catholic-dissenters-greet-pope-francis/

Mateo Williamson is not a woman of transsexual experience. He's a gay man who likes to wear women's clothes for whatever reason. He has had a clear confusion about his identity over the course of his life and that is what the problem with the umbrella term "transgender". His life and his experiences which make him sound by his own words to be a drag queen at best, or just another gay man, have nothing to do with people like me and others I know and have worked with. Presenting him in the context of representing people like me to the Pope devalues my unique identity and experience. People like him and people like me have nothing in common with the exception that we are all human and have the right to be respected for who we are, but other than that, we have nothing in common.

The fallacy of likening people like him with people like me is that his issues, plainly spoken in his own words, have to do with his sexual orientation. My issues are based on my gender identity. To have him publicly be the face of some conglomeration of people in which I am lumped in only makes it harder for the public to understand and become more tolerant of people like me.  

I do understand that what I rail against here means very little, but I do have a voice and a separate identity that should not be subsumed under some term like transgender or like LGBTQI (Et Cetera Ad Nauseam) that blurs my unique experience for some larger political lobby that does not represent me or care about my rights or needs. Because under that paradigm, any hope for advancement or gaining access to health care, or other basic human rights are slowed to a snail's pace.

The 2015 National Center For Transgender Equality Trans Survey

I'm sorry to have overlooked posting this sooner, but an important opportunity is at hand. The National Center For Trans Equality is seeking respondents for its second survey that is the most important study to identify transgender issues about access to health care, employment discrimination, mental health, substance abuse, public access to activities and education, to name some of the very important things that we as members under the umbrella "transgender" face.

The first survey revealed important information that was brought to public attention and made a tremendous contribution to the expansion of our freedoms and access to healthcare. It is important that no matter how you identify under the umbrella of "transgender" that you participate in the survey, even if you responded to the survey the last time it was offered. Don't believe your voice makes a difference? Maybe not in a lot of circumstances, but here it really does and it is worth the 20 to 30 minutes to take your time and respond to the survey!

A big and heartfelt THANK YOU to Mara Keisling and all the folks at the National Center For Transgender Equality.....

Here is the Link to the survey:  http://www.ustranssurvey.org/

An Essay on the Transgender Healthcare Experience

Today I would like to share an essay that I wrote for a contest for the University of Virginia health care system. Unfortunately, I missed the deadline to submit my essay, but I think that my readers would like to read about my experience interacting with health care in the United States during and after my transition. Here is what I wrote about my experiences:


 Identity seems like such a simple thing, but it can be anything but that. Identity can be as simple as seeing a beautiful bird and thinking, “Oh! There is an indigo bunting!” or seeing a piece of crystallized rock and saying to a friend, “That’s quartz.” Sometimes identity is not so simple; does this fish have 17 dorsal spines in its fin or are there only 16? It can make a difference in what species of fish you are identifying.

Identity in the health care system is something that we hold to be so important that a whole canon of law on how to go about correctly identifying a person, about protecting that person’s identity as well as her identifying health care information has emerged.

What happens when someone whose true identity has been hidden for many years, perhaps almost all of one’s life suddenly becomes known to the health care system? This is the situation a transsexual finds herself in when she makes the decision to live an outwardly authentic life that reflects her true identity. It is also the situation health care systems find themselves in when the patient who has always been identified as male becomes a woman outwardly and legally, matching her experience of her internal identity with her outward appearance and her day to day social life.

When a person such as myself transitions and begins to live authentically in public after many years of maintaining a false pretense, it is not necessarily easy, especially at first. However it becomes natural after a relatively short period of time. I have always known who I was, the difficulty was in shedding the layers of armor built to protect anyone else from knowing who I was. It didn't take very long at all though to feel as natural and comfortable as any other woman in my daily life.

Fortunately, I was able to recognize that while my very public transition was voluntary for me, it was not voluntary for my coworkers and patients as well as my loved ones. Those who have remained in my life, thankfully almost everyone who involuntarily transitioned with me did so with fairly little difficulty and successfully made the transition with me.

Yes, mistakes were made along the way. What I found to be most helpful in facilitating my transition for these people was to grant them grace and not get upset when mistakes were made by using my old name or using the wrong pronoun in referring to me. Being mindful of the involuntary nature of their position was a way for me to extend good will and gratitude for finding acceptance and understanding with my transition.  They were getting a more open and authentic person to work with. Who wants to work with someone who has to live a lie? I wouldn't and I would feel sad for that person and would want them to be who they are and be all they can be. It’s why I do what I do for a living.

Working in health care as well as being a recipient of health care has been an interesting experience in becoming public with my identity. For most of my life a change of public gender identity, was just not done. Health Care, just as the rest of society, is slow to react to the truth that not as rarely as we once thought, poorly understood biopsychosocial factors create a split between gender identity and a  body habitus that does not match one's gender identity. My experiences have ranged from inconvenient to mildly embarrassing to being subjected to flat out discrimination by Health Care. Mostly my experiences were those of being inconvenienced and on one occasion it was rather embarrassing. On that occasion I was pretty sick with the flu which only added to my misery at the the moment.

Because I work in healthcare, I also transitioned on the business side of the organization and I can only say wonderful things about my supervisor and Human Resources. The transition happened with very little fanfare which is how I hoped it would be. I am very thankful to my employer.

Getting the health care system to identify me correctly was not as easy as managing the rest of my legal identity. It was a pretty simple process to get the world to legally say that Lauren Tancyus is a female. Legal name change: file the court form that I filled out myself and pay a fee. Driver’s license: one form to be signed by a health care professional to change my gender to female on my license and one form to get my legal name on my license along with a small fee. The court notified vital statistics in the state I was born and my new birth certificate (unfortunately with the WRONG gender due to that state’s laws) was sent to me with my new legal name. I went to Social Security and filled out the form to have my name changed. I notified the Board of Social Work and they changed my name and gender on my Social Work license for free. All in all it was fairly simple with no frustrations along the way to become legally identified as who I am.

Now getting the health care system to recognize me as female and my legal name change was not as smooth and seamless as getting my legal identity changed. I knew that my medical information needed to reflect who I am. I coordinated with my wonderful office manager Carmen to change my identity in the system with permission from our Health Information Management department. I provided the needed legal documentation which was entered into the system. All seemed right with the world!

About 5 months later, I went to one of my health care system’s prompt care outpatient offices on a weekend. Imagine my surprise when I registered with my legal female identification and my health insurance card reflecting my correct identity, only to be called back by my male name by the health care professional who would treat me. It was extremely embarrassing to me. Much worse was when I got to the pharmacy and found the prescriptions in my male name even after I explained to the treating physician that my legal identity was now female. I did not have any old identification with me and felt too sick to go home and come back. My only option was to out myself to the pharmacy staff, personal and private information they did not need to know to perform filling these prescriptions, if only Health Information Management had performed this task correctly when I gave them my new legal identity information.

  Fortunately, they were wonderfully kind and under the circumstances quite merciful to me in not insisting I go home to get the old identification in order to fill my prescriptions. They also made no issue of my gender transition. That at least, was a very positive experience during that unhappy episode of my health care.

I contacted Health Information Management about this experience and told them how embarrassed I was on top of being pretty sick at the time. They investigated the complaint and found that while some things had been changed to reflect my gender and name change, others had not which resulted in my unpleasant experience. I was assured that policy and procedure would be updated so that this did not happen again to someone else. I was also given a very sincere apology from the director of medical records. As far as I’m concerned, in correcting this problem, health care worked well and I consider my grievance with the health care system resolved. I think that this reflects my attitude in that for Health Care, my transition was involuntary for them while it was voluntary for me. Health Care can be behind the curve in this area, but I do see an effort being made to change these problems and get up to speed.I'm glad that my experience will pave the way to make life easier for someone else in the future.

In all of Health Care, there is only one area that the transsexual interacts with that fails most of us catastrophically. It is within the domain of Health Care Insurance, or for me at least with my health insurance to be subject to bigotry and discrimination and that is the failure to cover my health care expenses related to the treatment of my gender dysphoria. Not a dime of my treatment was or is eligible to be covered by the insurance coverage I have through my employment in Health Care. Even though my condition is medically recognized and the treatments I have had are considered medically necessary, I am left with no avenue to become whole. I am blessed however that I was able to personally pay for most of the medical care that I need. There are so many more like me without the resources even to do that. Imagine how they must suffer! I can certainly say that my quality of life would be so much better even as improved as it has become. To deny my healthcare insurance coverage for transgender health care is unconscionable. It puts medical care out of reach for some of my most important health care needs.

The message received is that as far as my healthcare insurance company is concerned, my identity is not a valid identity. It is a very stigmatizing message from my insurance company, in my opinion.

In terms of providing quality health care for transgender people, I would give my health care organization pretty high marks. I have one of the largest mental health practices in Virginia serving transgender patients and generally see 5 or 6 individuals a week. I have been able to successfully coordinate other health care services for transgender people to be provided by our organization. We offer speech therapy, endocrinology, aesthetic dermatology, psychiatry and gynecologic services all leading to referral for gender reassignment surgery and we provide the necessary services for after care post gender reassignment surgery. We offer every needed service except for gender reassignment surgery itself all in one system. I see this as tremendous progress for people whose identity changes in the health care system and I am very proud of that accomplishment for Health Care.

What I Did For Football, What Football Did to Me

I want to be absolutely clear that the intent of this article is NOT to malign the sport of football, which one might infer from the title. To the contrary, I continue to enjoy watching football to this day and I believe that my prior participation in the game helped me to build the internal strength and courage to successfully face my gender identity issues and finally be able to live an authentic life, despite the consequences I endured from playing the game.

I was 12 years old when I stepped onto the field to play real football with the big boys. I would be entering the 7^th grade that fall, but the rest of the boys who came out for summer practice were mostly 16 and older and no one else was younger than 15. They were for the most part four to six years older than me. We called summer practice “Captain’s Practice” and it began the last week of June for four weeks. We were to get into shape to begin organized practice that began in the last week of July and went on until school started the first week of September and the season began the first Saturday in September.

The Junior Varsity team would not form up until the school started and played their first game in late September. I couldn’t afford to wait that long to begin playing football because I had something to prove. I had to prove it to everyone else but more importantly I had to try to prove a lie to myself about who I really was. In all truth, back then, I secretly wanted to one of the cheerleaders rather than be a football player, but I knew that could never be.

Why else would someone who was outweighed by anywhere from 40 to well over 100 pounds subject themselves to full contact football? The other question that came much later in life, was what kind of judgment were the adults who ran this particular program exercising to allow someone so much younger and so much smaller to engage at this level of competition with the high probability of injuries which were inevitable in this situation?

However, ultimately, the person who decided to do this was me. The more important question is why would I engage in such a foolish and dangerous activity? That is a question that can only to be answered by me. Simply put, it was because I had something to try to convince myself of that was not true. It was something that was not true to convince everyone else who had no idea what it was I was trying to prove, because I was unwilling to face my own truth.

As I’ve written about earlier, I knew I was not a boy and was really a girl, no matter what my biological reality was when I had the language to identify it. That was around age 6. I also knew the word for people like me at that time, but this, the summer of my twelfth year, was also the summer that I began to read the professional books about transsexuals and learn more specific information about myself. What I read terrified me because I was reading about my truth and my reality. These learned professionals were describing me in detail and they had no way of knowing me. Yet they were writing about me in such accurate detail that it was truly terrifying.  I in no way wanted to be one of those people who I was reading about. Yet I could not keep from going back over and over again to read everything there was about people like me. I had to know the truth even if I was a long way from being able to accept that truth and was very desperate to prove to myself and to those that I imagined could see who I truly was, that I was not like those people I read about.

Really, it was far easier to go out every day and endure the extreme physical punishment I experienced every time I played with the others than to face up to and accept the reality of who I was. The older boys seemed to relish every opportunity to hit me as hard as they could since they couldn’t deliver the same degree of physical punishment to boys their own age and size. The coaches seemed to also relish matching me up against the oldest and biggest team members as well. After all, isn’t that what someone like me deserved for being such an abomination? Perhaps I was hoping they would literally beat the transsexualism out of me. Looking back, I realize what a sad mindset that was for a young child.

It’s really no surprise that the first year playing with them that I broke my nose, had a very painful tailbone injury and in hindsight I recognize that I suffered at least three concussions of one degree or another. Eventually, I had to have cervical spinal surgery due to injuries sustained from helmet to helmet hits which were legal at the time. These are particularly dangerous on kickoffs and kickoff returns.

A culture of hazing existed as well, fostered by tradition and encouraged by the adults who ran our program. Instead of garnering respect for what I did, something that I had desperately hoped for, something that no one my age did until we were all 15 and then only two other classmates (in my third year of playing), participated in, I was the subject of physical, emotional and eventually on one isolated occasion the victim of sexual abuse. Because of the emotional abuse and that one incident of sexual abuse I became convinced that they knew my secret, but in hindsight, I know this not to be true. They were simply abusive and probably were acting out many things that had been perpetrated upon them coming up through the same system. The difference between me and them were that some of them were gifted athletes and I was not. They did not , however, to my present degree of knowledge, harbor a secret that caused them tremendous guilt and shame. I did.

What I was able to accomplish was accomplished through my sheer willpower and determination. I was the only one in my class to play football 6 seasons at my school. I was the only one to earn 4 varsity letters in football and three Junior Varsity letters. I was the only one to start offense and defense during my Sophomore, Junior and Senior seasons and I set two school records at the time in my Senior year for fumble recoveries in a game and in a season. Not being a skill player, I accomplished these things as an undersized offensive and defensive lineman. I accomplished this through having learned to take heavy physical punishment and doling out my own when the opportunity presented itself.  I earned my accomplishments through willpower and desire, not through any athletic talent because I am not talented athletically.

Over the years between that first year and my last season, I had probably suffered 4 or 5 more concussions. Nobody paid attention to that back then and hitting each other helmet to helmet was expected. I injured a shoulder, a knee, broke a finger, and one year experienced such severe staph infections all over my body that they nearly resulted in my hospitalization because I hid the extent of them until the season ended and I missed the next two weeks of school because I was too sick to attend after the season was over. Years later I required surgery to fuse my cervical spine as a consequence of way too many helmet to helmet hits, particularly on kickoffs and kickoff returns. That sort of dangerous contact was legal back then.

Really, it was far easier to go out every day and endure the extreme physical punishment I experienced every time I played with the others than to face up to and accept the reality of who I was. The older boys seemed to relish every opportunity to hit me as hard as they could since they couldn’t deliver the same degree of physical punishment to boys their own age and size. The coaches seemed to also relish matching me up against the oldest and biggest team members as well. After all, isn’t that what someone like me deserved for being such an abomination? Perhaps I was hoping they would literally beat the transsexualism out of me. Looking back, I realize what a sad mindset that was for a young child.

It’s really no surprise that the first year playing with them that I broke my nose, had a very painful tailbone injury and in hindsight I recognize that I suffered at least three concussions of one degree or another.

A culture of hazing existed as well, fostered by tradition and encouraged by the adults who ran our program. Instead of garnering respect for what I did, something that I had desperately hoped for, something that no one my age did until we were all 15 and then only two other classmates (in my third year of playing), participated in, I was the subject of physical, emotional and eventually on one isolated occasion the victim of sexual abuse. Because of the emotional abuse and that one incident of sexual abuse I became convinced that they knew my secret, but in hindsight, I know this not to be true. They were simply abusive and probably were acting out many things that had been perpetrated upon them coming up through the same system. The difference between me and them were that some of them were gifted athletes and I was not. They did not harbor a secret that caused them tremendous guilt and shame. I did.

What I was able to accomplish was accomplished through my sheer willpower and determination. I was the only one in my class to play football 6 seasons at my school. I was the only one to earn 4 varsity letters in football and three Junior Varsity letters. I was the only one to start offense and defense during my Sophomore, Junior and Senior seasons and I set two school records at the time in my Senior year for fumble recoveries in a game and in a season. Not being a skill player, I accomplished these things as an undersized offensive and defensive lineman. I accomplished this through having learned to take heavy physical punishment and doling out my own when the opportunity presented itself.  

Over the years between that first year and my last season, I had probably suffered 4 or 5 more concussions. Nobody paid attention to that back then and hitting each other helmet to helmet was expected. I injured a shoulder, a knee, broke a finger, and one year experienced such severe staph infections all over my body that they nearly resulted in my hospitalization because I hid the extent of them until the season ended and I missed the next two weeks of school because I was too sick to attend after the season was over.

Over these six years, I continued to read every professional book that came out on transsexualism. By the time I was in my last season of playing I had lost the enthusiasm for trying to hide by playing football. I didn’t show up for summer practice, preferring to work at my job at the hospital as a nursing aide. I questioned why I bothered playing at all at that point. I simply didn’t care. It was clear to me that I was not like the others

either at the most fundamental level. Football is a game for men and I was never a man. I was a woman. I just couldn’t accept that fact at that time, though I knew it to be true. The only reason I continued to play was to finish what I started. I knew I didn’t have the talent or physical size to play at the collegiate level, though I tried to convince myself otherwise and spoke with several Division III coaches of schools I was considering attending. None of them encouraged me.

Looking back, I am glad that I had the experience of playing football and enduring what I did. I learned to take beating after beating. Sometimes I wonder how I got back up each time after each one, but I know that learning to endure and survive that experience year after year gave me the internal strength and fortitude to be able to finally come to terms with myself and go through a gender transition. Not many people who grew up in the times that I did have been able to do that. Gender transition is probably one of the hardest human experiences one can undergo. Many of the things I learned about myself back then and the willingness to endure what I willingly endured gave me the strength to do what I had to do to live my life authentically. The tolerance to pain, both physical and emotional in nature gave me the courage and emotional resiliency to undergo my gender transition. I paid it forward. It was worth the price.

on my team. I could never be. It wasn’t my fault, and it wasn’t really their fault

either at the most fundamental level. Football is a game for men and I was never a man. I was a woman. I just couldn’t accept that fact at that time, though I knew it to be true. The only reason I continued to play was to finish what I started. I knew I didn’t have the talent or physical size to play at the collegiate level, though I tried to convince myself otherwise and spoke with several Division III coaches of schools I was considering attending. None of them encouraged me. This time I decided to listen.

Looking back, I am glad that I had the experience of playing football and enduring what I did. I learned to take beating after beating. Sometimes I wonder how I got back up each time after each one, but I know that learning to endure and survive that experience year after year gave me the internal strength and fortitude to be able to finally come to terms with myself and go through a gender transition. Not many people who grew up in the times that I did have been able to do that. Gender transition is probably one of the hardest human experiences one can undergo. Many of the things I learned about myself back then and the willingness to endure what I willingly endured gave me the strength to do what I had to do to live my life authentically. The tolerance to pain, both physical and emotional in nature gave me the courage and emotional resiliency to undergo my gender transition. I paid it forward. It was worth the price.

Quack! Quack! The Ducks Attack! (Or Were They Attacked??)

Here in the United States, the end of the year "Great Controversy" has been the remarks of the head of a family featured on a popular American "reality show". Reality Show, what a concept! I mean, REALLY??! I've never seen one yet that had anything to do with reality.

The most popular show of this genre in the U.S. is called Duck Dynasty. It is run on a network known as A&E. Its about a family in Louisiana who is passionate about duck hunting and they make their living through a family owned business that makes high quality duck calls.

The present crisis du jour began when the patriarch of the family, Phil Robertson, was interviewed by a widely followed men's magazine here in the U.S. called GQ (Gentleman's Quarterly as it was formerly known). Mr. Robertson is a fundamentalist Christian and he voiced the opinion that homosexual behavior is sinful. He did not state in anyway that gay people should be persecuted, victimized or harmed in any way. The worst that could be said, in my opinion was that he might have been less graphic about sexual acts that homosexual men engage in, but he never advocated any mistreatment or abuse of homosexuals because of their sexual orientation.

His understanding of Christianity is quite literal. He publically endorses a literal interpretation of the Bible and it's proclamation of law. In my opinion, it is the interpretation of an immature Christian. Here is why I believe this: Jesus came to bring us the New Law and the covenant that he brought is a new covenant, much different from the one brought to us in the Old Testament. Mr. Robertson's comments give no indication to any appreciation of the history of the tribe of Israel and the cultural context in which Old Testament scripture was written. Some of what was written had to do with preserving and strengthening the tribe of Israel. Some of what was written had to do with health and hygiene in a time with little understanding of what caused disease. People of that time often thought of states of illness as being the result of sin and Devine retribution.

Some of my comments will address in a cursory manner some of the insights that Mr. Robertson does not seem to understand.

Jesus never made a comment about homosexuals that was recorded in the Bible. (Paul did). However we are told in the New Testament by Paul that eunuchs (the term used for transsexual people, among others who castrated themselves either voluntarily or involuntarily, had a place in Heaven.

In the Old Testament in the same book of law (Deuteronomy), besides a proscription against homosexual relationships and wearing the clothing of the other gender, one must not eat shellfish (Sorry Phil, there go your crawdads (crayfish)!! You must have a rail around your roof (Don't think I saw one on yours, Phil). One must not wear garments of two different fabrics combined among others that I don't think he follows, nor do I. I'm pretty certain that Phil enjoys a good pulled pork bar b que, as well do I. Strictly forbidden in the Old Testament.

Mr. Robertson's shortcoming, in my opinion is this literal interpretation of the Bible. There is no insight into why these scriptures were written. In those days, homosexual sex was frequently associated with sexually transmitted diseases. Today we have more hygienic conditions that allow us to prevent those diseases if people are responsible enough to take the precautions to do so.

The same was true of the proscriptions of certain kinds of foods. Pork carried trichinosis and can anybody really believe that eating shellfish in the middle of the desert after having no source of refrigeration to be anything but a prescription for disaster?

Why did you need to have a rail around your roof? Because it was common for visitors or itinerant people to have been offered a place to sleep on the roof of the house, particularly during the hot summers.

The proscription of wearing garments of the other gender had to do with the customs of worship of the tribes that worshipped Baal. In their fertility rites, priests and priestesses exchanged garments as a part of their religious services in the spring.

The tribe of Israel was small and surrounded by enemies. They did not want people of their tribe wandering over to become worshippers of Baal and they needed their members to have many children to build the numbers and the strength of the tribe of Israel. Gay couples were not going to be able to contribute to that effort. These legalisms have nothing to do with our world today.

Recently GLAAD labeled what Mr. Robertson said about homosexual behavior as hate speech and demanded that he be censored for his remarks. The network A&E made a predictable knee jerk response making a gesture of "suspending" Phil Robertson from the show while recording was on hiatus for the holidays. Then they chose to run a marathon of episodes that included him over the holidays and when filming begins again in January, he will continue to be featured on the show.

I find fault with GLAAD for trying to label what I consider free speech to be hate speech. If what he said was to be considered hate speech, I believe he would have had to advocated violence or advocated some form of violence or deprivation of individual civil rights because of someone's sexual orientation and in fact this was not the case.

One could make the argument that GLAAD engaged in hate speech against Phil Robertson if one wanted to use the same logic that GLAAD did in their attack on Mr. Robertson. In truth, I believe neither case to be true. Mr. Robertson has his opinion (I think he is wrong) and GLAAD has their opinion ( I think they are wrong, too).

If we continue in this climate, I think each side will continue to further alienate the other. Responding to people we don't agree with by inflammatory attacks will do nothing to improve acceptance between people who have differences. It would have been much more helpful for GLAAD to say that they disagreed with Mr. Robertson and lay out a factual argument based on their disagreement, rather than lay out an attack on him as a person. It is always better to win with a persuasive argument than by attacking your opponent. All GLAAD managed to do was to emotionally entrench Evangelical Christians in their beliefs due to an ill advised strategy to respond to Mr. Robertson's personal beliefs.

Now I have no illusions that Mr. Robertson would be accepting of me as a transsexual from his religious views. I'm sure that he would believe that I am living a sinful life for simply being who I am. That is no consequence to me for two reasons. I don't believe that Mr. Robertson means me any personal harm, wants to deprive me of my civil liberties or would in any other way wish to see anything bad happen to me. He espouses the doctrine of "hate the sin, but love the sinner".

Secondly, In my own Christian walk, I don't believe that I am sinning. He and I both believe that salvation rests between each person and God. It is not for someone else to judge. While I am sure Mr. Robertson thinks my life is sinful, I have not heard him presume to judge the status of my salvation.

A&E, however, is the real villain in this whole sad and sorry episode. They initially pandered to the militant gay community. Then they sold them out for the almighty dollar. They have no courage of their conviction. They only want to make money. I doubt they ever had any intention rather than to placate the militant gay community and ensure they didn't lose their #1 money making show. How sad is that? Rather pathetic, I think.

Judge Not, Lest Ye Be Judged: Is it Possible You Might be Cisphobic?

I had an experience this past week that I would like to share with you. It does not reflect the best of me, though it turned out well. I think the lesson I took from this is one I would like to share because we can all benefit from it. It is a lesson that has been profoundly repeated at least weekly, if not almost daily since I made the decision to complete my transition over the past 6 years or so. It occurs so frequently now that in many ways I have begun to take it for granted. It is the more poignant examples that I now find to be emotionally moving.

There is another type of bias and prejudice that I have described in vague ways. It is something that we must search within ourselves and sit in judgment of ourselves. It is a form of oppression of the worst kind. It is oppression of the self and it is called CISPHOBIA. It occurs when we expect cisgendered people to discriminate against us, hate us, or perpetrate violence against us with no basis for that expectation. It is rarely discussed and even more rarely described.

Do cisgendered people at times discriminate and publically express hatred towards us, even to the point of having perpetrated violence against us solely for the reason we are transgendered? That is an unequivocal YES. It is the legacy that I grew up with, the same type of virulent hatred also characterized by racism and homophobia, however we must also recognize the tremendous advances our society has made in accepting us and recognizing our right to participate openly in a free and just society with respect to our Constitutional rights. There is, however much that remains to be done to further the progress we all have made. That progress benefits cisgendered people as well as transgendered people.

Incumbent upon us is that we also reflect and identify those areas of potential and/ or unrecognized cisphobia that impair our ability to experience a fully free and self actualized life. It is also incumbent to make necessary changes in our own personal attitudes when necessary to eliminate cisphobia in our lives.

The example I would like to share with you involves a former patient of mine who I had not worked with for about two years. Quite frankly, the experience of informing all of my current patients that I was transitioning, while very successful (I retained over 97% of my patients), was also very stressful, at times exhausting, and it was an experience that I am glad is over. On occasion, I still have to disclose to a former patient who is insistent about wanting to work with me. I don't look forward to the times I have to do this. I just want to live my life without having to review the past, but in my choice of work, that is not always possible. Here is where the problem arises and it is where I have personally struggled with an area of cisphobia.

This patient came to the office two weeks ago, unaware that I had transitioned. He had asked to see me for a few minutes, but because of the unanticipated nature of the visit and that I had already seen 9 patients with a serious crisis patient in the afternoon I was not prepared to deal with the situation.

My thoughts were that due factors of his cultural background, his religious background and his personality that there was no way that he would be accepting. In other words, I made a cisphobic judgement about him. It turns out that I was grossly unfair to this gentleman.

The front office staff did an admirable job handling the situation. They began to try to explain without discussing my transition that I (my former male self) was no longer there. Out of genuine concern and care, he pressed them to tell himwhat happened to me as he was clearly worried that something tragic had befallen me. So they explained in simple terms that I had undergone a gender transition. His response to them was that it did not matter a bit to him and that he felt that because of the work I had done with him that I had saved his life. (No I didn't save his life, I was simply the tool he chose to use to save his own life).

The front desk staff relayed this information back to me and I asked that he come by on another occasion. It had indeed been a very long day and I was tired.

Yesterday my patient had an appointment with me and saw me for the first time. The first order of business was to apologize to him for my misjudgment. He graciously told me that no apology was necessary, but I insisted that I had been wrong, apologized to him again and thanked him for his acceptance of me.

In the past, I have seen opinions expressed that people who are oppressed cannot be oppressors themselves because of their oppressed status. I have always sharply disagreed with that opinion. By the act of being bigoted, prejudiced or biased against people, whether they are members of an oppressed class of people, or by the act of being bigoted, prejudiced or biased against people who are members of a class of people who have been oppressive towards another class, we perpetrate the impedance of societal progress. We injure those we have unfairly judged. We injure ourselves by depriving ourselves of the opportunity to take advantage of the progress we have made as a society. We slow the process and the progress of our own full integration into society.

Now I am someone who believes I am fully assimilated in daily life; I do not fear going to the ladies room, using the ladies dressing room in stores, nor do I fear an encounter with the police, going through TSA when I travel or interact in any way with the predominant culture. I generally don't see myself as a person who is cisphobic, but there are these areas of cisphobia that apparently do exist in my life.

It is my hope, through my own personal growth in this area and by bringing this potential problem to the attention of other transgendered people that we can do our part to make our society a more free and open society.

Ain't That America?

Today was a day that made me proud to be an American! We hear so many stories about how awful our country is and how we as people of trans experience are hated and driven to despair. That isn't always the case and we need to focus on positive things. We can overcome adversity and we can have happy, fulfilling lives!

Today, I had a very positive experience interviewing with the Veteran's Administration for a job that has a lot of opportunity for advancement. The five people who interviewed me were all very positive and seemed interested in my experience and skills as a Social Worker. They informed me that I was a finalist for the position and they indicated that they would be in touch no later than the first of next week about the position.

Then I went to vote. It was the first time I ever voted as Lauren, here where I have lived a male life out in rural Virginia since 1992. I grew up here before leaving for college and grad school.

It was a very comfortable experience. There were no challenges to my right to vote and the election officials were very polite and professional.

The world is a much better place for us, even as recently as twenty years ago. I live in one of the most conservative (both politically and religiously) areas in the U.S. here in the Shenandoah Valley.

If I can do it, so can you! Yes, there have been obstacles along the way. My biggest obstacle was my own fear.

I hope that you will follow your dreams and become the best you that you can be!

Sage Smith is Still Missing!

Sage Smith continues to remain missing since December of 2012. Two other young women who have gone missing since then may be vindicated by a recent arrest of a man from this area (Charlottesville, Virginia) but Sage's suspected assailant who was identified, Erik McFadden who is from Minnesota and met her on Facebook, remains at large. He came to Charlottesville to meet her and was seen with her at the local Amtrak station, and has not been seen since an initial interview by police who named him as a "person of interest", but was allowed to leave and has not been heard of since.

My belief is that if she were a cis gendered woman and not a transsexual woman, and if she were not a woman of color, more effort would have been brought to bear in apprehending her perpetrator. Much unlike the effort focused on recent cases of missing women who were murdered or not found to date.

If anyone has heard of Erik McFadden, come across him on social media as someone who is attracted to transsexual women, please contact the Charlottesville, Virginia Police.

Please join me in prayers for Sage and if, by a miracle, you read this and happen to have even the tiniest shred of information that might be helpful in solving this missing person case, please call the Charlottesville, Virginia Police at 434-977-4000

Gender Dysphoria, Transphobia and Post Traumatic Stress Disorder

Having written on the topics of gender dysphoria, transphobia and posttraumatic stress disorder, I would like to explore how they all interact with each other to negatively impact the lives of transgender people.

 I have experienced my life as a transsexual woman, observed and facilitated the process of well over 450 trans people's experience as a therapist. I have worked with individuals across the developmental life span over quite a dynamic time in the lives of trans people from the late 1950's to this time in history. I have been afforded the opportunity to experience both my private experience, echoed in my clinical work with people who have sought me out to help them find their unique path in expressing their gender identity with a sense of congruence.

Most have transitioned socially; some have completed their goal of gender reassignment surgery, while others have found a middle ground that they can be comfortable with and a few chose not to transition at all, usually because of relationships that they cherish and are not willing to lose. Despite the pain of living in a compromised manner, they have found a place where they can be their true selves to a degree that is manageable.

There have been a few who could not transition at all, instead choosing to suffer secretly or they were not candidates to transition due to medical reasons. There are also a very few who have experienced gender identity conflicts that are not clearly transsexual and come to find that hormonal reassignment is not right for them nor would transitioning to a different gender social role bring them a sense of comfort and peace or be a solution for their lives.

In almost all cases of these individuals, myself included, the forces of institutionalized transphobia, internalized transphobia and social stigmatization have played a role in the marked emotional distress they have experienced. In most cases, these social and emotional forces have resulted in various degrees of Post Traumatic Stress Disorder. Some people's experiences of being traumatized have been mild and easily resolved through treatment with the use of medications and with psychotherapy, or by simply transitioning and  there are others  who were severely traumatized and have been left with life long significant impairment and disability in their social functioning despite their decision to transition.

I spent some time working with Viet Nam Veterans (God Bless you and thank you for serving our country at such great personal sacrifice in so many ways), learning from more experienced therapists in that field that one common predictor of how a combat veteran would fare psychologically had a great deal to do with their pre combat adjustment.

Soldiers who grew up in stable family environments with two parent households where the children were well cared for and free of physical, emotional, and sexual abuse and did not have addictions to alcohol or drugs fared much better than those where were victimized as children, had unstable households and came from broken homes. Now this is not true of any given individual situation. Some combat veterans were also biologically more resilient to extreme distress, but these factors have had a great deal of prognostic value in predicting outcomes. I believe that the same parameters operate in the lives of people with a cross gender identity as well.  These same parameters seem to have a great deal of value in determining who will experience greater trauma as a result of having a transsexual identity as opposed to those who will be able to manage the experience and have happier, better outcomes.

In Western cultures, we have seen a profound sea change in the degree that institutionalized and internalized transphobia has decreased over the past 50 years and particularly since the mid to late 1990s . In turn, I have seen better emotional and functional outcomes in young adults as opposed to people of my generation.

Indeed, the cultural changes we have experienced since then were instrumental in my own ability to come to terms with my own identity and complete my transition over the past 5 and a half years. I simply wasn't able to see a way through prior to the mid 1990's to become socially the girl and then the woman I have always experienced myself to be.

In the context of my culture's views of people like myself, which were internalized from the time of my recognition of my identity as a small child, this was simply unacceptable to myself and the culture I grew up in. Yes, there were a few people who were emotionally strong enough to do what I yearned to do from such a young age, but they were thought to be so rare that there was no way the majority of people like me could even comprehend becoming who we truly were, so I and most of my transsexual peers lived silent, tortured and desperate lives.

It is because of the process of stigmatization; the process of internalizing institutional (or cultural) transphobia that we have such high rates of suicide, addiction and alcoholism, as well as being victims of crime that we do in our community. The reason people resort to cope with drugs and alcohol place themselves in situations in which there is an increased risk of victimization and destroy themselves rather than continue to suffer in misery is because they have been traumatized and lack the coping skills to overcome their traumatization.

It is the result of internalizing societal messages that we are unacceptable as members of our society, as well as to ourselves and that we will never be able to participate in life as equals with others who have value and worth.

We come to internalize the idea that we are deviants and do not have the right to participate in life to become the best we can be and we are not worthy of loving others or being loved. As a result we become unable to love and accept ourselves and fall into a state of helplessness and hopelessness. It is a state of despair.  It can become a terminal condition when a person does not see a way to integrate her cross gender identity and see herself as a whole and healthy person worthy of loving and being loved, with value as a member of our culture. It is the result of having a guilt and shame based identity, so common in people with post traumatic stress disorder.

In the taxonomy of human problems that my chosen profession addresses, we have refined the definition of the problem at hand, not as a problem with having an identity that does not match the physical body, but it is that of the distress of the recognition that the physical body habitus is not congruent with our gender identity. (Keep in mind that the diagnostic categories we have created are partly reflections of cultural norms and values.) The problem is two fold. One is the biological conflict we experience psychologically from having a gendered body that is not congruent with our gender identity. The other problem is that we recognize that this is not a state of existence that our society considers within the norm and that we have internalized that value that as a result we are not "normal" and as a result, this recognition is traumatizing.

Therefore, in reality, gender dysphoria is a symptom of having been traumatized. Gender dysphoria is not a disorder; it is a symptom of post traumatic stress disorder. In our next iteration of categorizing and diagnosing mental disorders, we need to find a way of capturing gender dysphoria as a symptom of post traumatic stress disorder and not keep it as a stand alone diagnosis, though we must preserve a way of keeping it as a legitimately recognized source of distress that is a focus of treatment and also a treatment that is reimbursed by health care insurance.

There may be those who object to this being categorized as a symptom of post traumatic stress disorder, but the only other alternative diagnostic category would be under the classification of adjustment disorders.

The migration of these diagnostic categories from a stand alone gender disorder to recognizing it as a trauma disorder or adjustment disorder will be predicated on mitigating institutionalized transphobia and the process of stigmatization that results in internalized transphobia. This will result as our evolving society becomes more and more accepting of transsexuals and other transgendered people.

We have seen this happen with increasing speed in society and as these changes in accepting trans people have come about we have witnessed the changing conceptualizations of how to identify and help people with gender dysphoria in the iterations of the DSM over the years. As society changes, we will continue to see this reflected in future DSM volumes. We will see people markedly less distressed about having a cross gender identity and they will be able to participate fully in the dominant culture without being stigmatized or internalizing a stigmatized identity in our society's future.

Do Transsexuals Discriminate Against Each Other?

I was exchanging emails with my friend Amanda who is a relatively new friend I met on Pink Essence. Amanda is a very sweet lady who is coming to terms with her gender identity later in life. This is not unusual for people in their 40's, 50's, 60's and even 70's or older. There just weren't any resources readily available to people of our age.

The few sources of medical research and psychological research suggested in the 1960's and 1970's that people such as me were extremely rare, so rare that the estimate of our population was around one in 33,000 (1:33000). In 1970, when I was 12 and went to the public library in Charlottesville, Virginia to read about people like me in books by Harry Benjamin, Robert Stoller and Richard Green, the principle authors of the time, Charlottesville, in 1970,  had a population of about 30,000. I knew this because on the Interstate signs for the exits for Charlottesville, they posted the population at that time.

 Can you imagine how alone I felt as a 12 year old? It was a terrible feeling and I continued to feel that sense of terminal uniqueness until about 1990 when I got a subscription to Compuserve and found live time chat called "CB channels". Compuserve was very expensive at the time. It cost over $6.00 USD an hour over the basic plan. It didn't take too long for someone who was dire in need to talk to people who were like me to run up a huge bill and this limited how often I could talk to another transsexual after weeding out the fetishists and people with various interests other than realizing their internal gender identity.

Just before that, I had taken a "mental health" day off from work and watched Geraldo Rivera's daytime talk show that afternoon. Marsha Botzner was on his show. She was (and is) the director of the Ingersoll Center and the next day, I called her in Seattle where she is located. She was the very first person like myself I had ever spoken to and that gave me a tiny glimmer of hope. She was extremely encouraging with me, but it wasn't until 1997 that I made the decision to begin taking baby steps to actively seek my own transition and stop living with the misery of living with my secret.

My dearest friend Christina and my wonderful beautiful wife Patty were my rock in beginning the painful process of coming to terms with myself and the world I live in. Although I had been helping other transgendered people, it wasn't until 5 years ago that I found the strength to seek therapy for my own gender dysphoria. I deeply appreciate what my therapist Dana has done to help me find my way on a difficult life journey. She had no experience with people such as me. I'm the only therapist around for about a 3 and a half hour drive who works with adult transgender people. She is a highly skilled therapist and had the courage and compassion to stretch herself in her own growth as a professional to help me. I could have easily skirted the standards of care in obtaining my hormones, but I followed the process that I ask others to follow. I believe in the WPATH Standards of Care and cannot exclude myself from following them.

Along the way, from time to time, I would run into someone who would tell me that because I hadn't already transitioned, gone on hormones and had my genital reassignment surgery, that I wasn't a transsexual and that I was something else, less than the person who made these observations and not worthy of being friends with this person. I was "otherized". I found this reaction to be very painful and it would often increase my sense of emotional isolation and being unacceptable. I know my sister Christina experienced a lot of the same treatment by some of the other transsexuals with who were we were acquainted online.

It saddened me greatly to learn that Amanda had formed a close friendship on a transgender social website with another person who identified herself as a transsexual. After being friends and with someone who Amanda considered a close friend for a while, the friend learned that Amanda has chosen to honor her spouse's wishes that she not begin hormonal reassignment therapy and to not appear publically in her authentic gender identity. Her friend was not supportive of her, instead she was quite incensed that Amanda has chosen to make a compromise to preserve the relationship of many, many years with her spouse. In fact, she was so upset with Amanda's decision that she decided to "unfriend" Amanda. Amanda, understandably, was quite hurt by her friend's shallow an insensitive attitude towards her.

Now I do not know who Amanda was referring to and I do not care to know her identity. I think that this person must be very insecure with her own identity to insist that every transsexual follow in lockstep and begin HRT and eventually (the sooner, the better?) have genital reassignment surgery. it really matters not a whit, in my opinion whether someone begins HRT or has the surgery to confirm they are, indeed, a transsexual. There are many among us, particularly those who are older and in committed relationships who choose to not make our gender identity not "all about me". We love our spouses and want to remain with them for the rest of our lives. So, we make compromises that we are able to live with.  We try to find a middle road that our spouses can support as well as what brings us a level of congruency that allows us to live as comfortably as we can. It isn't the best of all possible worlds, but it is what works for us as individuals.  Gladys Knight and the Pips got it right in their song, Leaving on That Midnight Train To Georgia- " I'd rather live with him in his world than without him in mine".

Relationship is about compromise. To be in an intimate relationships, we have to find a middle ground with our partner. It doesn't matter what that compromise is, as long as we can live with it. Having a transsexual identity has nothing to do with what we do about it. It's simply about the identity.

We transsexuals frequently resent being lumped into the "transgender" umbrella. To me this is understandable because we don't care for the thought that we are identified by the public as being many things we are not. However, that has never influenced my choice of my friends. They are my friends because of their character and not because of their identity. It is particularly distressing to me that some of us who identify as transsexual will choose to denigrate others who identify as transsexual because of the compromises they choose to make to preserve the most important relationships in our lives.

I'm so glad you are my friend Amanda!

The Face of Trans Today

Over the past few months, I've begun to think about the question, "In the predominant culture (the United States, my culture) today, what is the image of being transgendered today?" I'm not sure that this is as easy a question to answer as it would appear on the surface.

This is something I've been thinking about since my adoptive niece Erica, made a comment about the featured speakers and content of the conference workshops at Trans Philadelphia Health Conference. Over the past few years, the content of workshops and speakers reflect a trend towards those who identify as "gender queers", particularly in the Northeast and West Coast.

According to the National Transgender Discrimination survey approximately 13% of people who were included in the survey identified as gender queer. Those who identify as gender queer are much younger than the general population obtained in the survey. 67% identified within the gender binary of male or female. Another 20% identified themselves as sometimes living as male and sometimes female, but still clearly identified with the gender binary concept to a large degree. 71% were under the age of 44 years, so the study does not accurately reflect the age distribution of transgendered people. 20% were in school at the time of this survey. It was also limited to those with internet access, so there are some confounding variables to this survey. In other words, the results cannot be considered statistically valid or reliable.

However, it remains the most important study on discrimination transgendered people face in the United States conducted to date. In my opinion, despite the limitations of the survey, it is the most accurate reflection of the life experiences of transgendered people in the US today.

 Individuals who identify as gender queer appear to be heavily influenced by an extreme left feminist ideology that is fashionable in academia at colleges and universities. It is known as third wave feminism. They advocate the ideological belief that individuals who identify with the gender binary schema are hurt by it as their lives are limited and scripted by having to conform to either a male or female identity. Instead, they argue, we must create a genderless society.

In October 2012, a Gallup Poll reported that a survey conducted from June 1, 2012 through September 30, 2012 found that approximately 3.4% of Americans identified as being transgendered. These are very similar results as reported in several other surveys since 2006 and can be considered a good estimate of the general population of the U.S. These surveys have a much higher degree of internal validity and reliability of the findings.

It is a more difficult task to ascertain how the culture perceives transgendered people. There are several ways of coming up with a general idea. One can look at how transgendered people are portrayed in the media such as in movies and television. Another way is to look at how transgendered people are portrayed in news sources. A third is to look at the programming presented at transgender conferences.

Curious to me, is the image that Jerry Springer provides on his television show. I'm also surprised that someone as strongly identified with liberal politics gets away with the way transgendered people are portrayed on his show and that he is so revered by the left. He regularly brings on the worst examples of transgendered people in our society. If one watches his show, one would draw the conclusion that transgendered people are promiscuous, adulterous, drug addicted and essentially shiftless people who engage in outrageous low life behavior. I do not dismiss the thought that at least some of what he portrays is staged, but I also think that some of the people he has on the show are real people. How Springer gets a pass on this from the transgender community is beyond me, but I see more far more attacks on conservatives who make negative comments about transgendered people and I can't ever recall anyone complaining about Springer. Yet he damages the image of transgendered people tremendously. Why is that? I wonder...

Another problem I see is very complicated and is a conundrum with no easy solution. We have a very high rate of suicide attempts, unemployment, addiction and alcoholism. Those of us who have been disenfranchised by lacking an education because of dropping out of school are also often marginalized and often end up working in the sex trades. I was very fortunate that despite being physically and emotionally abused in school for a significant portion of my high school years that I was able to endure that and later a brief period of homelessness (directly related to being who I am) and manage to overcome those experiences. I was fortunate to have overcome these experiences and I know that it was only by the grace of God that this happened. The majority of transgendered people are also people of color and in addition to the burden of institutionalized racism, bear the stigma of being transgendered.

Having said this, I clearly want to say this is not an attempt to "blame the victim". People do what they do to cope with being stigmatized. Transgendered people don’t have the same access to the opportunities that people who are not transgendered have and they experience a much higher rate of being victimized physically, emotionally and sexually.

 Remember, when you were in grade school on "career day" and the teacher asked the classroom "What do you want to be when you grow up? No one is raising their hands and waving them wildly exclaiming" I want to be an alcoholic and addict when I grow up!!" or "I want to prostitute myself when I grow up!!!!!"

But we do have a responsibility to overcome the illness of addiction with treatment and 12 step programs, seek help for mental health disorders such as anxiety, depression and post-traumatic stress disorder. We do not have the luxury of just rolling over and giving up, as tempting as that may seem at times.

I looked at the content of workshops offered in recent years at transgender conferences as a way to understand how we are portraying ourselves to the public. I'm not sure that this is a way of discovering what the public's perceptions are, but based on the percentage of workshop programming devoted to gender queers. I do know that they are a very vocal and public image of the "transgender community", much as drag queens and kings" draw a lot of attention and possibly could be a strong influence on the perceived image we have by the predominant culture.

 Another element that influences the public image of transgendered people is something that I have seen decried frequently in our community. That is the tendency for transsexuals who have successfully transitioned to end their involvement in the transgendered community. Their attachment to the broader transgender community is often more tenuous than other transgendered people. They are often criticized harshly for not "giving back" to other transgendered people who are coming along and finding their own way on the long and winding road of successfully transitioning. Because they "disappear" into the predominant culture, the public has little context for these individuals in our society and this further skews the public perception of transsexuals (as opposed to transgendered individuals not including transsexuals). While this is ultimately the goal of most transsexuals, it is not necessarily what is desired by other transgendered people who have a strong attachment to the transgender culture.

My interpretation of what this represents is that the majority of transsexuals do not identify with other people considered to be transgendered and they do not share the same sense of community with drag kings and queens, cross dressers, gender queers, and other diverse identities that consider themselves members of the transgendered community.

In my opinion, a transsexual who has managed to transition and does not wish to continue being involved in the community has every right to do so. She does not owe the community or others coming behind her anything. Her sole responsibility is to herself. In the words of Oprah Winfrey “… to live your best life...”

Because of my profession and my experiences as a transsexual, I will remain active in the transgendered community to a large degree to help individuals with their transition and in overcoming addictions and mental health issues that we all too frequently have. This is a choice I make voluntarily as a professional, not a personal responsibility. This necessarily means that I will have less privacy about my identity than I desire, but because of my special set of skills I will continue to make my skills available to the transgender community.

These are just my observations. What do you think is the image of the transgendered community and what are the reasons for this? I'm very interested in your opinions and I hope you will share them!

 

 

 

The Commonwealth of Massachusetts, Transgendered Minors and Bill O'Reilly

A friend had sent me a message that Bill O'Reilly had a segment on his Fox News opinion show about something to do with transgender. She didn't mention what it was but wanted to let me know. I think she watched it, but I was engaged in something REALLY important at the time, watching my beloved Crimson Tide whip the stuffing out of Auburn in basketball. There are few things in the sporting world that give me such pleasure as Alabama whuppin' up on Auburn in any athletic endeavor, so I taped it and put it on the back burner. The airing date was on 2/26/2013.

I usually find a lot of common ground with Mr. O'Reilly. I did have some serious problems with what I initially interpreted to be a condescending tone in his voice towards people who are transgendered, but later changed my mind and decided his tone was directed towards the Department of Education in the Commonwealth of Massachusetts or whatever the governing agency that oversees education there is called. I think he is actually sympathetic towards adults who are transsexuals, but not necessarily "transgendered" which tends to be a catch all phrase for people with various gender identities that may or may not be congruent with their somatic sex.

His guests who were debating the Commonwealth's policy with the broad category of students were Alan Colmes, a frequent Fox News contributor who represents liberal points of view and Monica Crowley, who is also a frequent Fox News political commentator and represents conservative points of view. In my opinion, Mr. O'Reilly could have found much better people who were imminently more qualified to comment on this topic who might share different points of view. Ummm, perhaps my good friend Mara Keisling, the Executive Director of National Center for Transgender Equality (who I respect and admire and who is doing extremely important work, though we are on opposite ends of the political spectrum) and myself, for instance.

The following topics were introduced; cross gender competition in sports;
the ever controversial bathroom and locker room issue; and parental rights to notification that the school system is assisting students not of the age of majority to pursue living a cross gender life that is congruent with their identity without the knowledge of the parents.

It seems to me that these students, most likely have not had the benefit of being hormonally reassigned. It is by simple declaration of an adolescent or child, for that matter, that the government of  Massachusetts' educational system, will allow students to compete in sports that are designated men's or women's sports, as well as allow them to use restrooms and locker rooms designated for cisgendered individuals.

There are several problems that I see with this policy. First, if male bodied athletes are allowed to compete in cis women's sports, and have not been hormonally reassigned, they have a significant advantage over ciswomen physically in most cases and this has a negative impact on women's ability to have opportunities to compete in sports that schools offers given the limited number of roster spots on scholastic teams. There exists a possible conflict with Title IX which was enacted to give women equal access to sports in schools, as men traditionally have had. That would result in uncounted rounds of legal battles to resolve these issues, likely to ultimately be decided by the United States Supreme Court.

If a male bodied student has been hormonally reassigned, this levels the playing field and I believe they should be allowed to compete in their identified gender identity because generally they are at a physical disadvantage compared to cis males and if they can make the team it would clearly be by their athletic talents and skills. For the female to male identified student, competing in men's sports is not such a disadvantage to cis males

The bathroom and locker room issue has always been controversial. My opinion is that there should be separate facilities available for rest room and locker room needs for students who have not been hormonally and surgically reassigned. I think this is just a matter of respect towards cisgender people, just as they should respect us. I think the IN-Your- Face attitude of people whose somatic gender is not congruent with their gender identity creates more ill will towards us than helps us advance our rights as members of a democratic society. What good comes of making the vast majority of people uncomfortable in the name of insisting we be treated the same, though in fact when we have not had surgical reassignment we are not the same? To me it is a simple matter of courtesy and respect, just as I expect to be treated with respect.

For those who are undergoing hormonal reassignment and live full time in our true gender identity, the restroom issue is moot. We should and do use the appropriate gendered restroom. More and more states are issuing legal identification with the proper gender marker to our identity and in those situations, there is no question about which restroom is appropriate to use.

To me, though, the most important problem is the systematic violation of parental rights by the Commonwealth of Massachusetts. The Commonwealth's position is that simply by the student declaring he or she is transgendered and does not wish his or her parents to know, will facilitate the student's gender transition at school. While if there is a real threat of physical, emotional or sexual abuse, or neglect, a child should be removed from the parent's home. To simply bypass the parents and facilitate this cross gender life at school only without any proof of abuse or neglect, in my opinion, is extremely harmful to the family unit and is a prescription to ensure long term alienation of family relationships.

Mr. Colmes argued that extensive evaluations and documentation must be conducted or provided for the school to be allowed to intervene this way, but Dr. Crowly argued, and I believed correctly, how will these extensive evaluations be conducted without the parent's knowledge? It seems to me that it is highly unlikely that that could occur and I think this governmental interference in family life in both the short run and long run, does much to hurt the individual and the individual's family, and is a set back in normalizing acceptance of transsexual people in our culture. I think that this removes the opportunity to provide services to the family to help the entire family unit to adjust and make positive changes so that the transsexual individual may preserve family relationships, not permanently alienate them from their families. The role of the government should be to strengthen families, not to destroy them.