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.

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.

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!

No Depression

If anyone suggested that I experience Christmas, my father's death, my birthday and informing my coworkers that I was transitioning at work in 11 days, I would have told them, "Honey child, there just ain't no way! That idea is a non starter." But, that is exactly what happened. I have drawn a lot of lessons from the experience as well having had other prior positive experiences repeated. Hopefully, sharing this will be helpful to others.

I think that in life we need to use what we experience to make better decisions for ourselves that lead us to find peace within ourselves. Some of us are very stubborn and even though we understand what has happened and the positive lesson we were given, we still resist (for whatever reason) to use it for improving our lives. At times, I have been stubborn about a few lessons along the way, but I have been in a place of total serenity and peace, knowing that things happening would be hard and painful, but also recognizing the stressful positive things that were happening to me as well. Since late fall I have felt this place of acceptance and strength that I never thought I had to draw from. Dana was right; I am a lot stronger than I thought.

What is the difference in 11 days? The passing of my father, whose death I once thought would be so intolerable that I could not imagine how I would be able to function, proved to be a time of strength which I was able to lend to my Mother. There certainly were times that I was overcome with grief, but they were manageable. The gift in the release from his long term suffering was the release from a grieving process that has gone on for 10 years and had become more intense as his condition deteriorated.

Then there were the usual stresses of the holiday season which includes my birthday. I am, however, someone who welcomes my birthday. By all rights, I should not be here as my younger life was led in a careless manner because of the pain of living with the secret that I was not a man. While I was not actively suicidal, I neither cared whether I lived or died and my life was conducted in a careless, reckless way, that should have killed me at least 6 times over. I survived; I have a purpose. I'm glad I figured that out in my 30's and am here to carry out that purpose.

This past year, I dealt with my mother finding out quite by accident my closely held secret. While it was devastating to her, being relieved of that burden became quite liberating after the initial trauma of her finding out was resolved. That was a terribly difficult week.

Deciding that I needed to transition at work was my choice and it has become the most freeing decision that I have ever made. I was afraid when I went to tell my supervisor, but I already knew what she would say and while I was less sure about the hospital administration's response, I was very sure that my coworkers would embrace my decision and I was proven to be right about that surety. The outpouring of love and support through all of these events from the people I work with has been phenomenal and really has changed the way I view myself, as much as my own responsibility for  self acceptance and actions towards self actualizing myself during this short period of time have come to fruition.

To what do I attribute the sense of peace and resolution that I have come to know over this short period of time? I attribute it to my faith and the spiritual crisis last year in the spring that brought me to a deeper examination of an already strong faith coupled with my active determination to find a place to explore my spiritual foundation in a church that loves me as I am without judgment.

Will the way I feel right now last? Mostly. I have no "terrible" secret anymore. Everyone of importance in my life now knows who I am, with the exception of a few people important to me who are not physically close. They will be told very soon when I can arrange the proper  opportunity. for one of these people, I feel a need to tell in person. The others live at a distance too far for me to tell in person and I will soon decide whether to write them individually or to tell them over the phone.

In many ways, our lives can be very painful simply because we live with this fundamental conflict between body, mind and spirit. It is up to us to find  ways to minimize the painfulness of this experience.

The primary truth I have learned is that I have to be who I am, be transparent about who I am to the degree that allows me to live as who I really am, and not be ashamed of who I am. That is not a new discovery, nor is it original. It is one though, I suspect we each have to figure out how to go about for ourselves with the proper support of course, where ever we may find that support. That is part of the uniqueness of our personal journey. The way I have done this may not be the right way for you to go about this, but it is essential that you find a way to find a place where you can live an authentic existence that allows you not to be ashamed of who you are and honors your spirit.

The Decision Not To Decide

I have debated for quite awhile whether to share this very personal and painful essay with you my readers on this blog. I wrote this to submit to a national magazine for an essay contest. This particular piece is one of the most revealing and difficult things I have ever put word on paper about. I've debated seriously about publishing it here, and weighed if I thought it would help younger people not make some of the very painful mistakes I made, which is why I am posting this. I came to the conclusion it was more important to post this than the importance of my own comfort.

The style in which I chose to write this article does not mention that what I am speaking of is being a woman of transsexual experience. I did not want to be so public about myself. Some may criticize that decision, but I do want a modicum of anonymity, though it isn't exactly a State Secret about this aspect of myself to a moderate segment of the professional community and in the gender community itself as I have so many friends all over the country who I have met giving workshops, through Pink Essence, Facebook and Google+. That's fine, but I'm a private person and don't feel the need to make this a central aspect of my public identity. It serves a purpose for those who know because I want to be of help, but I don't feel that is a carte blanche to open myself up to the world in general. Some people may think I'm copping out by not being out to everyone I meet, but it really isn't anyone's business what my medical issues are or what my genitalia are and how they got there. No one would ever enquire of a woman of non transsexual experience what their genitalia are or how they came to be and I wish to be afforded the same dignity and privacy as they have. So without further delay I give you the story about myself.


"Some of us turn off the lights and we live
In the moonlight shooting by
Some of us scare ourselves to death in the dark
To be where the angels fly" The Girl From the Red River Shore   Bob Dylan

 The decision that I most regret in my life was the day I first made the decision to not decide. Because of this decision to not decide, my life became a war of attrition within myself. I find that my life has consisted of a slow drift in which I would strike a bargain with myself over and over again. Each time I would concede a bit more and have faith that this would be the end point, only to find myself drift some more.  No one knew anything about what I failed to decide for the first 37 years of my life. When someone did learn of it, it was a very disturbing and painful event. However, it allowed me to come to the conclusion that I needed to accept this and continue to become more comfortable with myself. The consequences of not coming to terms with me would be serious.

Even with this, I continued in the same way, deciding not to decide, but allowing the concessions to continue as they became manifest in my life. Somewhere the tipping point was reached. It happened three years ago when I made a decision that I should have made when I was 22, or 27 or even at 37. I was 51.

Though I finally made the decision to decide, I’m sure you must be wondering what is it that I regret by not making a decision. After all, yesterday is gone. Tomorrow is not promised to us. We only have today.

 I regret living with fear.  I regret that so many people I have known, some loved, many wonderful people, have missed out in knowing me as equally well as I have known them. I may owe some of them an apology for not trusting when they have proven themselves again and again. I regret that because of my decision not to decide for so long that I limited my own ability to reach my full potential in many domains of my life.

When T.S. Eliot wrote in his poem The Love Song of J. Alfred Prufrock, “I have heard the mermaids singing each to each. I do not think they will sing to me.” It held a lot of significance about my decision not to decide. It left me with being incomplete and life would not offer the same opportunities others have had.

What I have been so indecisive about is about my identity. I have known this about myself since I was able to acquire the language to name it. I was very young then. Then when I was about 10, I began to go to the library and read about others who shared similar struggles. I was a very advanced reader for my age. That was when I became unhappy about who I was, as opposed to being confused about who I was. The battle of attrition began. I figured out all kinds of ways to be ok with myself without having to deal with reality, but they either only worked temporarily, or not at all. I did things that not many people did. Sometimes they were things that were dangerous with potential for serious injury. I should have been killed six times over because of serious accidents I was involved in. They might not have been my fault, but I was responsible indirectly (which means I was responsible) for making choices that put me in those situations. I had no wish to die, but I wasn’t very happy with my life. I was careless about myself.

Through all these years since I first read about myself, I continued to follow new publications and articles and learned quite a bit about myself that made me unhappier for a variety of reasons. I always wanted to understand and know my own truth. I continued to read and be current. Most of what I read seemed to be right; some of it was way off base.

I avoided serious relationships for many years so as not to have to be open to people or hurt them in some way. I’m sure I puzzled some people who would try to get close and were pushed away. I was very lonely for a number of years. There were some very fine people I decided to protect from me that under different circumstances I could have been very happy with.

Finally, I met someone and decided that I was wrong about myself. I could have this side of my to remain only with me. Eventually this person became the first person to know me completely. I’m very sorry that I must have inflicted a great deal of emotional pain on this person due to my unwillingness to make a decision with personal integrity, though that person also inflicted a great deal of emotional pain upon me as well. Nevertheless that does not justify my lack of sharing myself openly for me. I was at fault for a lot of our conflicts as well.

Even with the person to who I am spiritually bonded now, who I told at the time when our relationship became serious, it has been a painful burden to bear over the course of our relationship. It makes me extremely sad that even though I had progressed to the point to be able to be transparent about myself, it has been a painful experience for us as a couple. There have been very few who have traveled this path together. We define ourselves in relation to each other as well as we define ourselves.  It is not clear that we will be able to travel together forever, though we hope and pray so. We stay in the moment, or at least the day. We remember we each have a process we are going through, more or less of our own design. We feel it out as we go. Sometimes we are afraid. Sometimes we are just sad. But then there are other times that are happy. They renew us and remind us why we are in this process together, and that is a good thing.

Even now with the decision made, the battle of attrition has become a different battle. The battle has become about how long I will wait to allow myself to finish this process, if at all, so the next part of life can begin. There is a need for immediacy that must be as carefully approached as I approached my own truth. While before I had dug my heels in, I am now accelerating towards something I did not ever wish for and I attempt to exercise restraint as a matter of judgment. I now grow impatient, yet the need for patience is even greater than before.

 I have also been mindful that there is very little left to do, just two important things and when I complete that that aspect of my life. I’ll be there.

T.S. Eliot wrote in The Love Song of J. Alfred Prufrock, “I have measured out my life in coffee spoons.” I don’t want to do that anymore. I have learned that you have to live in the moment and it will pass, whether it was good or bad. We aren’t guaranteed a tomorrow. That’s enough to live with myself today and be at peace.

 

In Praise of Pink Essence and Social Networking

To rip off old Willie Shakespeare and misquote him, I would like to say that I come here to praise Pink Essence, not to bury it (and other similar transgender social networking websites).

If you are not familiar with Pink Essence or other social networking websites such as URNotAlone, perhaps you might visit one of them and see if you enjoy being a part of an online community specifically for those who are transgendered and those who support them.

I speak specifically of Pink Essence in this article because that is the social networking website that I have been most familiar and I have participated to varying degrees of activity for almost 4 years. UrNotAlone is notable in that it was the first of it's kind and was begun in 1995. There are some others too that I have heard of in passing but I am not really knowledgeable about them.

There are a lot of people who love Pink Essence and those who don't care for it at all. There are members who have been active on the site and remain very involved to this day, those who briefly become members, find it is not their cup of tea and close their membership without ever having much involvement in the activities available and those who were once very active on the site who remain members, though participate almost in a nominal manner. This latter type of member would probably describe me best. Then there are the members who remain very active since they joined to this day.

There are people who vehemently loathe Pink Essence and denegrate it and its creator for various reasons. There are ardent members of the site who seem to devote much or all of their online life to it like some people on Face Book do.

The detractors complain about all sorts of things they don't like and some of them demonize the creator and owner of Pink Essence. Personally, I admire her. She has created something that has been a source of support during a terrifying time for a transgendered person when she comes to terms with who she is after years of either being in denial of herself, or being aware of who she is but living in terror others learn about her. Typically, she has never known anyone like herself or has no where to turn to gain access to support groups or knowlegable allied health care professionals who could be of help to her. Sometimes even when these resources are locally available she may almost be petrified with fear and a site like Pink Essence is her first foray into coping with herself in a healthier manner. This is one of the most important reasons that these sites exist.

In addition to that, Pink Essence also offers ways to express one's opinion on things Trans, non trans, and trans related including chat rooms and blogging. There is a forum on book reviews, on spirituality, on people who have the same career, information on how to contact professionals who help transgender people. There are political discussions and information on real world support groups, social gatherings and transgender conferences where one may meet others on a similiar journey and have the opportunity to speak with many professionals face to face. Most important of all is the opportunity to forge life long friendships like I have with some of the members of Pink Essence. They don't live very close, but they have become some of my dearest friends and I never would have gotten to know them without the presence of Pink Essence on the internet.

Is Pink Essence perfect? Of course not, silly! It has its strengths and its challenges. Some people call them faults, but I think a challenge is something that can be overcome. A fault is something there is no hope to ever change.

Pink Essence is really a big extended family. As in all families, there are squabbles; people get mad at each other and cut each other off emotionally. Sometimes they "kiss and make up" and sometimes they never have anything to do with each other ever again. They become estranged. They adore their "mother" (the website owner and creator) and sometimes they get angry at "mother" because something occurs they don't like.

Personally, while I have had some disagreements with the creator of Pink Essence, just as anyone does in any type of relationship. Most importantly though, I really admire and respect the creator of Pink Essence for what she has created. She has something she created that hasn't just helped people in the U.S., but it has helped people all over the world. I think that is pretty special, don't you?

For a later article I wrote on the potential downside of membership in Pink Essence and other social media websites please follow this link:
http://twoworldstranstherapist.blogspot.com/2014/05/pink-essence-why-i-chose-to-discontinue.html

I would like to again restate, I believe that Chloe Prince created something very positive for transgendered people, but nothing is seldom all good or all bad; it is up to the user of social media to be responsible in educating themselves about the benefits and risks of belonging so social support websites.

Are You a Sissy?

Are you a sissy? That is a very loaded question and an emotionally charged topic as well in the world of transgender identies and trans politics. It is an issue that sharply divides those who identify as transsexuals from the rest of the gender community and also can divide the rest of the transgender community from those who identify as sissies. I hope that this article will shed some light on this gender identity in a respectful manner. I believe that while I can't relate to these individuals from my own experience, there are people who identify as sissies and have the right to do so.

So what am I talking about here when I speak of sissies? I'm speaking of those people who usually identify as male, but enjoy dressing and appearing as little girls or in a hyperfeminine way that a woman would not appear. There is no way these individuals are going to pass in public, which is part of the piquancy. A google image search of "Sissy" turns up a lot of pictures of Sissy Spacek. She is an awesome actress.

 But pertaining to the topic at hand, the images retrieved are all closely related to female domination, humiliation and other D&S themes. Again, that's fine. I think however they express their sexuality and identity is not my business and everyone has the right to be who they are.

Two years ago, I met a pair of sissies at a transgender conference. They stood out in a convention of people whose identity is that of women with no qualifiers attached to that identity and who are doing everything they can do to blend in with society. In talking with them, I found them to be very nice people.  They told me they weren't really enjoying the conference because no one was being especially friendly or attempting to be inclusive in the activities that were going on in the hotel. I doubt that I will see them again at the conference I was attending.

But I couldn't relate to the experience of a sissy identity in the everyday world. I worry about how the public percieves the woman of transsexual experience and if the public sees me and those who identify as sissies as being one and the same. While there is an intersection on the axis of gender identity, just as there is an intersection in the mathmatical model of the X and Y axis, for me, sexuality is not an issue. For the sissy, sexuality is up front and integral to the sissy experience. It includes strong elements of being shamed and being degraded by others. It is an identity that is less than the genetic woman and definately less than a man.

I wonder if this is for most who identify as a sissy a developmental stage in forming a transsexual identity or is it a stable identity of its own? Some women of transsexual experience at some point experience some attraction to the fantasy of forced feminization, usually early on in their life when they are coming to terms with who they are. For them, this is about not being able to take responsibility for who they are and at a point when they feel ashamed of who they are. If it does occur, it is a transient event that fades to black and disappears. It goes away when the woman of transsexual experience knows that there is nothing wrong with her identity as a woman. As a result, feelings of shame and guilt have no place in her identity. Simply put, for the woman of transsexual experience who is comfortable with her identity, the old addage "You can't rape the willing" is true. She sees herself as no different than the woman who was assigned at birth as a female and is comfortable living her life in mainstream society. This is the basis for women (and men) of transsexual experience not viewing themselves as part of the transgender spectrum, but understanding themselves to be very different and not part of a spectrum of gender identities.

Just as sissies have the right to claim their identity, so do women of transsexual experience. We also have the right to claim our own identity as unique and not part of a spectrum. We have the right to our own uniqueness.

I'd be very interested in hearing the views of readers of this blog. I think this is a topic worthy of discussion and reading your comments.

Meditations While Mowing- On Low Self Esteem

Today, once again, I contemplated playing golf. I have taken it up again a year and a few months since my cervical spinal fusion. I feel so much better and hadn't been able to do outside yard work for the last three years either. My friend "Janet" from college is an excellent golfer and on the state ladies' golf association board. She plays in tournaments around the state and I admire that she has continued to play at a competitive level after having become a recent survivor from breast cancer.



Girls, get your mammogram. Do it for the people you love even if you don't want to do it for yourself. It might be embarrasing the first time, but you will be treated respectfully and while it is uncomfortable, I can think of other medical tests that are less pleasant. If you are without insurance or have low income, your local health department and community hospital can help! For many, there are no costs involved.



One of the benefits of feeling better is being able to mow again. Mowing is something I have enjoyed in my adult life. Plenty of sunshine makes me feel wonderful! I also have time to think about a lot of things and it is a wonderful time to nourish my spiritual condition. This is a very important thing to do at this time in my life with many major changes in process. Being able to mow gives me time to be reflective and mindful of what needs to be done, not only for myself, but for others as well.


I am trying to be a good daughter as we go through my father's final illness. I'm learning many lessons about myself and about taking care of myself. One of the things I have been learning is to take much better care of myself. Today I was sore, decided I shouldn't play golf because of being sore, and I still had a lot of mowing to do. I have a lot to mow to begin with, and I have begun doing Mother and Dad's home so there is one less thing my mama has to worry about.

While I was out there mowing my Mother's huge yard, once again I had my "fingers forcibly pressed upon that firey braile alphabet (Tennessee Williams, Glass Menagarie)" and experienced a uniquely female experience that is uncomfortable. Too much bounce to the ounce.  I wasn't wearing a bra and I need to when I mow. I had my diamond ring on as I usually do but neglected to put it away because of being in a hurry to get their place done and finish up mine. It takes almost five and half hours to do it all.
As I mentioned this gives me plenty of time to meditate and contemplate things that I often don't have the time to think about otherwise. I'm soaking up the sunshine and thinking about things personal and things impersonal.  Sometimes it is a spiritual discipline and I think of the matters that are greater than myself. I spent some time on this today. I thought about those who need help and asked for help for them. I think about the many things I'm grateful for. I think about what I need to do and take responsibility for in order to improve my overall wellbeing.

I spent some time thinking about why so many of us in our community experience low self esteem. I think it develops as a result of our realization that we are different from others, even before we know what that difference is. So we are speaking of people at a very young age when this begins. We know we are different from other boys and girls and we intuitively recognize that most often being different equals bad, especially when the differences are pointed out frequently in something said by the ones important in our lives such as "Why can't you be more like.....??" If you hear that a lot, especially the younger you are, it's going to create feelings that you aren't ok to begin with and then soon after you discover what that difference is. You aren't like the other boys who you are supposed to be like, and you aren't like the other girls who you feel you are like. Quite the internal conflict for a very young person, isn't it?
After a while, it becomes more and more apparent to others and is pointed out to the young person. "You need to act like this because boys...... or don't do that, you are acting like a girl...." Generally, people in this situation are often physically and emotionally abused and sometimes even sexually abused. It creates very low self esteem if it is allowed to go on. It will have life long consequences for that person if it is not prevented from happening or stopped as soon  as it becomes known.

We know that people with low self esteem are much more likely to suffer from depression and anxiety, substance abuse, poor academic and career performance, problems with forming positive and healthy relationships with others, poor self care and increased mortality rates due to suicide and accidents (because people who don't care about themselves aren't careful about their activities). Even when these people are relatively successful in various areas of their life such as career or a sport or with a good relationship, they often have difficulty in seeing themselves as being successful in these endeavors.

Low self esteem is often difficult to treat because it presents in so many different ways as I have pointed out. We professionals tend to treat the symptoms and often don't address the low self esteem that creates the problems. That happens because individuals with low self esteem frequently are unable to identify why they have low self esteem. They know they have it, they need help identifying the lies that were told to them about themselves as well as the ones they told themselves and bought in to so much  that it has become their reality and their "truth" about themselves.



The hard part is being vigilent in identifying these negative beliefs and especially being comitted to replace the self deception with more objective and healthy beliefs about oneself. Yes, we all have things we do poorly, never did well at, and most likely never will. And, that's ok. We have to be objective enough to be ok with that. For example, I will never get to be a medical doctor because of my inability to be able to perform math well enough to have that career, but I have a wonderful career as a therapist, I have been able to help untold numbers of people directly and indirectly. I know I have saved peoples' lives. It's been a very satisfying career for me. I don't dwell on the failure of not becoming a doctor. I am also a very caring person and I go out of my way to help others if at all possible.

The failure is in not also recognizing that we are amazing women in other ways than what we are not good at and being able to celebrate ourselves for those wonderful things that make us good people. Its our responsibility to recognize these wonderful things and to take joy in these qualities. We need to recognize there is nothing wrong with being a transsexual. That took me awhile until I took the responsibility to change how I felt about myself. How about you?