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My doctor's other patient

Late transitioners are overwhelmingly heterosexual and most have at some point been married to a woman.

However, no woman wants a man who himself desires to be a woman.

My doctor, who sees over 1500 patients a year, has three among that group who are dysphoric. Besides me, the two others are a woman who transitioned 20 years ago and is married to a man, while the other is a 60 year old man who has known, apparently since the age of 5, that he should have been born a girl. He has recently decided that he can wait no longer and will seek out the surgery to repair this error of nature.

My doctor disclosed this in confidence when we were discussing my own situation during which time I offered to speak to him if he thought it would help.

I know substantially more about this subject than my doctor does and I advised him that he might want to read “The Transsexual Phenomenon” by Harry Benjamin.

This patient of his loves his wife and she loves him but she does not want to be married to a woman. It’s a difficult dilemma to be certain and there are no simple solutions.

In an ideal world this man would never had married and faced his dysphoria head on but being born in the 1950’s North America was not a good place or period in which to be gender confused. In fact no time or place ever is.

You do your best to conform but it catches up with you eventually.

I have educated my doctor quite a bit since I have divulged my struggle with dysphoria to him. He has noticed the improvement in my demeanour and in my level of happiness and it is tied to my having found some sort of equilibrium in handling my own particular situation.

I would not want to be in the shoes of this other person and having to make this sort of heavy choice. Personal peace versus pleasing and honouring a commitment you made to a person you still love and have been married to for over a quarter century.

I am not sure I will ever get to meet this person, but I want to wish her my best for the future on her difficult road and my heart goes out the wife who has been by her side all of these years and who grapples with the implications of what this change means for her.

Here is an excerpt from Anne Vitale's essay "The Gender Variant Phenomenon - A Developmental review" where she deals with the progress of untreated gender dysphoria from adolescence into later life:

"For those who continue to struggle inwardly with their gender issues into mid-life, new issues come to the fore. As a time when most people realize that about half of life has been lived and feel the need to make an accounting of who they are and what they have done with their lives, this period can be especially anxiety provoking for the gender-dysphoric individual. Decades of trying to overcome an increasing gender expression deprivation anxiety begin to weigh heavily on the individual. Family and career are now as deeply rooted as they will ever be. The idea of starting over as a member of a different sex has become seemingly impossible. The fact that the need to change sex has increased rather than diminished, despite Herculean efforts, is now undeniable.

These individuals often show up in therapy offices with symptoms mimicking Depression or Generalized Anxiety Disorder. They complain of panic attacks, irritability, sleeping disorder, inability to concentrate, and recent weight loss. If they are married, there is often serious martial discord due to self-imposed disassociation from the family unit. Job performance may also be affected, it is not uncommon the hear reports of individuals experiencing negative performance revues or outright threats of being fired unless they seek help for whatever is bothering them. Pressed ever deeper into despair, suicidal thoughts begin to intrude into daily life. Even at this point the individual may be reluctant to discuss their gender issues lest the door be opened to a fear-laden real-world exploration of gender transition. They are consumed by feelings of being inexorably trapped.

John, a 50 year-old genetic male, medical research scientist, married (23 years), father of three children aged 20, 17 and 7, phoned me after experiencing a panic attack severe enough to require emergency attention from paramedics at the airport on his way to give a presentation at a conference. John gave me only his first name and informed me that I was the first to be told what he was about to tell me. He said he was "gender dysphoric" and that he was "desperate." Feelings that were once "controllable through sheer force of will," had increased to where he now was having protracted periods where he would close his office door, lie on the floor and weep quietly while curled up in the fetal position, holding his genitals in pain. Other than intrusive and repeated fantasies of being female, he had refused to allow himself any overt form of female gender expression. He reported feeling that if he was to cross-dress and be caught, he would dishonor his wife and family. Having attained international recognition for his work, he was also concerned about his professional reputation. The only other form of temporary relief came through masturbating, often up to five times a day.

Our work together over the last three years has been slow. However, with the help of extensive individual, group, and family psychotherapy, augmented by estrogen replacement therapy, with the full permission of his family, John has recently taken on a female name and is living full time in the female gender role. She is in the process of renewing and redefining her relationship with her family, and has successfully returned to work after an extended leave of absence"


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