Archive for the ‘Surgery’ Category

Question MarkI’m catching up, but still behind. Today we have two short letters that I have some thoughts about, but that I am unable to answer with much certainty, so I hope that readers can give these writers some additional information.

A reader writes: “I found your website while googling around on gender-neutral pronouns. My question, in brief, is this: Is it just me, or are gender-neutral pronouns mostly sought by people who were assumed to be cis women at birth?

“I love the idea of genderqueer and have happily appropriated the parts that work for me and read a fair amount of queer theory over the years. It occurred to me today that most of the third-way writing I have read is by people who no longer want to use girl-pronouns after being assigned she/her at birth, where as trans women tend to love getting access to (and perhaps ideally only using) the girl pronouns versus seeking some third way.

“I googled a bit hoping to find some evidence to the contrary, but didn’t find much. Perhaps I’m insufficiently thorough. Thanks in advance for your reply, and also for your patience with my question and any parts I may have phrased inelegantly or insensitively.”

I don’t know whether or not this is true, but it appears to me, as well, that the majority of people who prefer gender-neutral pronouns are those who were assumed to be female at birth. I do know some genderqueer-identified people who were designated male at birth who use “they,” and I know some who use “he” and “she” interchangeably. But again, the majority of people who I have found to use “they” or “ze” were designated female at birth.

I’m not aware of any statistics on this, or whether or not any surveys or studies have been done (if anyone knows, please fill us in), so my answer is coming from personal experience.

If my personal experience transfers to the larger culture (and I don’t know if it does or not), and I had to give my thoughts on why this might be, I would say that I think that the “gendered” life experience is different for those who are designated female at birth and those who are designated male at birth, and this causes potentially different responses to any feelings of gender incongruity. (more…)

Read Full Post »

Question MarkA reader writes: “I’m 17 years old and have been thinking about and researching FTM transitions since I was 13. I did the ‘wait a year to think about it,’ like you would for a permanent tattoo, for the past four years.

“I decided August of last year that I honestly want to go through with the process. I have friends and a girlfriend who will be there for me, even though I know my family might not be.

“I’m asking you about recommendations and for any advice you could spare. I have a few ideas on how to go about it, but I’m not sure what’s proper, or if there is even a proper way. Like, what kind of therapist(s) should I contact to get the ‘green light’ to start the process, and what kind of doctor should I talk to for treatments and surgery and such?

“That, and I’m not sure which surgery I would go with first, top or bottom. I was thinking bottom, because I heard they can do womb transplants, and I want to give a woman in need something that could make her world – I’m just not sure if I should get that surgery before even doing T so that it would be safer for transplantation. But I really do want to know your opinion on that, on everything!”

I’m going to assume that you’re in the United States, but I don’t know this for sure. I’m not that familiar with health care systems in other countries, so if you are not in the U.S., you would need to check with your (probably far superior) health care system to find out what you need to do. Some countries’ health care plans have very specific steps that must be taken in order to receive transition services that are covered by the health plan.

At 17, you might have a difficult time getting a doctor’s approval for hormones without parental consent. But you will soon be 18, so if this is a barrier, it will go away in twelve months or less.

The first thing that I would recommend is that you find a therapist. Depending on where you live, you might have gender specialists already there who are advertising as such. If not, I would look for a therapist who has something in his or her advertisement about self-discovery, moving past obstacles, living an authentic life, or other phrases that might ring true to you. (more…)

Read Full Post »

Question MarkHere are some short questions and short answers. I (and I’m sure the writers) would love to get reader input on any or all:

A reader writes: “When someone says they are a transsexual man, does that mean that they are a woman contemplating their sex identity or a man contemplating their sex identity? Pardon me if this was offensive, it was purely out of curiosity so I don’t mess up in the future.”

No offense taken. It’s a legitimate question. (Here’s a link to some vocabulary terms that might also help: Trans-lations.)

In most cases, when a person says that he is a transsexual man, what he means is that he has transitioned in some way from female to male. In other words, he was assigned female at birth, and now lives as a man. When someone says that she is a transsexual woman, she means that she was assigned male at birth and has transitioned in some way to female.

This is particularly confusing when the press refers to a “transgender man” when they actually mean a “trans woman,” and vice versa. I could go into a long diatribe about the whole “transgender” and language thing, but I won’t (because nobody wants to hear it again).

Suffice it to say that when people refer to themselves as a man or a woman and any form of “trans” is in front of that, they will generally mean that they are living in a sex and gender that were not assigned to them by the outside world at birth.

A reader writes: “I’ve always felt like I was male from being a young child, and now I feel ready to begin my journey. My question is: I understand there is no guarantee with hormones, but do people who are younger when they begin hormones see results sooner?”

Hmm. That depends on the person. I don’t think there is any research behind this. In my experience, it seems to me that people who are younger when they begin often have “better” results. By that, I mean that I have seen young people masculinize relatively quickly when compared to older people (but “quickly” is just a matter of a few months), and it seems to me that they generally get better facial hair and muscle tone. (more…)

Read Full Post »

Question MarkA reader writes: “I turned 33 and for all my life, I’ve always tended to dress and act in a manly way. I don’t like the traces of femininity on my body but I learned to live with it. The last nine years I identified as a lesbian and was quite content, although I always felt something isn’t right.

“Half a year ago I realized that there is something as ‘transgender’ and it felt like the solution to my discomfort. I went to therapists and got my paper to start testosterone. I told few friends. First they were like, ‘No problem, that’s cool,’ but now when it turns serious, they tell me that they don’t see me as a man and that I’m doing a big mistake, I would mutilate a perfect body now and still not be a real man.

“I had myself a breakdown thinking about a new male name – everything felt ‘ridiculous.’ I know I have to know what is right for me, but some of the points my friend told me are torturing me. I am biologically a woman now. I am perhaps the outsider in look and behavior, but completely accepted among my female friends. In fact, I have only female close friends.

“I feel at ease around men, but they look at me as a woman and so I still don’t belong to them, which discomforts me again. I was socialized for 33 years as a woman and was always trying to fit in as best – I can’t cut out this part and I don’t want to lose my female friends.

“How was this transition for you? As I understand you had the bigger change from ‘girly girl’ to man. Did you never doubt you were on the right track? Did you lose your friends? How did you cope emotionally?”

While I think there are many people who have no doubts whatsoever about transition, having doubts is not uncommon. It can be a very scary thing. Many of the changes that come with testosterone are permanent, and changing a body that might not fit you, but that you have lived with for a long time, is a big deal.

But I honestly think that the body can be the least complicated issue for many people (and correcting a body that is absolutely not right is not mutilation, by the way). The social aspects of any transition can sometimes the most difficult. (more…)

Read Full Post »

Question MarkBelow we have three letters with a common theme: a desire to medically transition, the inability to do so, and the problems that can create. Each is a little different, so I’m hoping that readers will have some thoughts about one or more of these situations.

A reader writes: “I’m writing because I went to my Kaiser trans specialist yesterday. She said that they now offer SRS and breast implants to trans women who work for certain companies. I replied that it was fine, and I’d happily take a genital reworking once my company was among the fold.

“However, to meet the requirements of WPATH, I would need (and want!) to live full-time for a year prior. To facilitate that, I asked, could I get electrolysis and/or facial changes that would enable me to live comfortably as a woman. She said that Kaiser won’t cover those procedures. My PCP added that she remembers when they didn’t offer ANY trans surgery.

“So I feel caught in a Catch-22. I can get bigger boobs, but not a chance to live comfortably in my skin, relatively free from harassment. And I should be grateful. Argh! I have a small income and no savings. What do you think? I just feel frustrated.”

It is frustrating, because some of the very basic procedures that trans people need – sometimes more than extensive surgery itself – are not considered medically necessary. Things such as electrolysis and facial surgery are considered “cosmetic,” although they can be the foundation of living socially in the gender that matches a person’s identity.

And social presentation can be just as important – and sometimes more so – than parts of our physical body that are generally private. How we are seen by others, and how others interact with us, can be essential to how we see ourselves.

In my opinion, the things that allow for appropriate and successful social adjustment in transition should be considered just as necessary as any larger medical procedures that trans people might need. However, my opinion has yet to be taken into consideration by the powers who make these decisions. (more…)

Read Full Post »

Question MarkA reader writes: “I am a gay man and have no doubts really about that. I was late in coming out after being married and having children. However, 15 months ago I started a relationship with a guy who I had met several years earlier and who also was previously married with children.

“After we had been dating for six or seven months, he started to talk about how he really liked dressing as a girl and felt he should have been born a girl. I did know he was always quite fem and liked fem things and that was part of my attraction to him.

“Well, now he is well into transition to her, including name change and hormone treatments, and is fully out to family and work. I have supported this transition because I loved/love him/her and know that it was making her happy and it was what she wanted.

“Now, though, I am having a real problem in my head as to how can it be that a gay guy is still fancying a girl. Is it an identity issue? What is going on in my mind? Can this relationship continue?

“We have talked about surgery and I have said I would not like her to have reassignment and she says that she doesn’t want it anyway. However, will that change in a year or two? Just struggling with where I am in this relationship.”

Once again, labels are hanging us up. Remember that “gay” is just a label for your sexual orientation – it is not your sexual orientation. You have the label “gay” because you have a particular type of body and gender identity and you are attracted to people with the same type of body and gender identity.

Your attraction to this person started out in this way. It’s possible that if you had met this person after she had already transitioned, you would not have been attracted to her. But that’s not the case. So you fell in love with a person who a gay man (you) might have fallen in love with, and now she has changed, but you are still in love with her.

In my opinion, that does not mean that you are no longer gay. It just means you are in love with a particular person, and this person no longer meets a specific set of criteria that a gay man might look for when choosing a partner. But you’ve already chosen a partner – this person – and you are in love with her, so those criteria no longer matter. (more…)

Read Full Post »

Question MarkA reader writes: “I am a 45-year-old black woman who is partnered, well, recently married (though not legally; it is important for me to make this distinction) to a 45-year-old white trans man who started the process and completed both surgeries within one year of us knowing one another.

“I have had wonderful relationships with both biologically born men and ‘butch-identified’ lesbian women, but never a trans man, so when I first met my partner, the fact that he self-identified as a ‘stone-cold, dyed-in-the-wool butch lesbian’ was not something I had any ‘issues’ with, though I did realize he was transgender before he did.

“It is not my partner’s gender identity or expression that is currently causing me concern. What I am most concerned about is that my partner’s identity, I mean, who he identifies with as a man, are all fictional characters: Superman, John Wayne and Cary Grant. I don’t even really know who these characters are.

“We are struggling. We love each other deeply and sincerely. We have a wonderful life and share wonderful times together. However, as my partner ‘works all of this gender stuff out,’ we have not had sex since July. There, I said it! Please, please, please, H-E-L-P!!!”

Okay, it seems to me that the main concern here is no sex, but before we get to that, I can tell you that the men who your partner is identifying with are all traditionally masculine men (in Western culture) who each embody certain masculine “ideals” – Superman embodies the strong superhero who takes care of and rescues other people, particularly women. John Wayne was an actor, and the characters that he portrayed were generally Wild-West cowboy types, so we’ve got two very tough, brave guys here. Cary Grant was also an actor, and he tended to portray very suave, sophisticated masculine characters – the kind who lit cigarettes for women, stood up when women entered a room, held the door for them, and wore really nice suits while doing all of that.

This seems typical to me for some guys. These Western masculine archetypes might be what some guys would aspire to, and there’s really nothing wrong with that, other than that they might be slightly old-fashioned. But none of them were really jerks or anything that I’m aware of (John Wayne’s characters probably said “little lady” a few more times than necessary when referring to women, but that was the cowboy aspect of it all). So I wouldn’t stress out over that, unless he starts to become very chauvinistic and you start to have a hard time with it. (more…)

Read Full Post »

Older Posts »