Musings from my everyday life...

Quite a while back I posted about the case of David Reimer who was reassigned as a female after a botched circumcision inadvertently removed most of his penis. Reimer eventually committed suicide at the age of 34. Recently, I found a reference online to a New England Journal of Medicine article dating back to 2004 which dealt with genital reassignment surgeries performed on patients suffering from Cloacal exstrophy which is a severe birth defect that occurs in approximately 1 in 400,000 live births. One of the most pronounced characteristics is severe phallic inadequacy, or the complete absence of a penis in genetic males. Historically, doctors have treated cloacal exstrophy by surgically altering, or "reassigning" these babies as female. John Gearhart, M.D., director of pediatric urology at Johns Hopkins Children's Center and an expert on exstrophy complexes, and colleagues challenged this standard treatment by studying 16 genetic males from 5 to 16 years of age, 1

I posted two distinct sections from the same chapter of Ray Blanchard’s book over the last few posts in which he made the distinction between his heterosexual and homosexual dysphoric patients. In his heterosexual group, he explained the difficulty in predicting the difference between transvestism and transsexualism and showed, like Harry Benjamin, that there was a blurring of the line in some of his patients. He suggested that transvestism could be a stunted form of transsexualism. His homosexual gender dysphoric group were found not to be as variable in adulthood as his non-homosexual patients, but were also found to differ in the degree of cross-gender identity and intensity of gender dysphoria. Mild intensity dysphorics might end up like drag queens in using episodic dressing (minus the erotic component) while high intensity dysphorics would need to have hormone treatments and surgery. These were the same patients that Harry Benjamin would have identified as types V and VI. S

The following is another excerpt from Chapter 3 of the same book I referenced the other day. This time it deals with gender dysphoria in homosexual men: "Homosexual Gender Dysphoria Definition. Homosexual gender dysphorics are those who, from the time of earliest sexual awareness in childhood or puberty, feel attracted only to men. The individual's masturbatory fantasies and romantic daydreams are of males; if he also has sexual encounters or love relationships in real life, these are exclusively or almost exclusively with men. Description. The natural history of homosexual gender dysphoria is strikingly different from any of the syndromes examined so far. This difference, which has led many theorists to conclude that homosexual gender dysphoria must have a separate etiology, is already apparent in the individual's earliest gender role behavior. The childhood behavior of homosexual gender dysphorics, unlike that of heterosexual, analloerotic, or bisexual gender

I remember once meeting a fellow patient while I waited for my gender appointment. He was in the early stages of transition and could barely strike up a conversation with me or even look me in the eye. After I went inside, Helene told me that he rarely spoke to strangers and had some communication issues. That meeting stayed with me. People who follow this blog know that I am on record as not being against transition. However I do propose that one get their house in order before embarking on such a journey. Gender dysphoria is a formidable opponent to be sure and it must be dealt with all of your faculties in good working order. If you have low self esteem, suffer from depression or have family problems then your transition will not repair them and potentially only make them worse. It may be tempting to think that these issues are in part due to our incorrect gender role designation. I found that it was only when my psyche was at peace that I able to properly tackle my dysphoria.

The following is an excerpt of Chapter three of the book entitled “Clinical Management of Gender Identity Disorders in Children and Adults” by Ray Blanchard which was published in 1990. The chapter, called “Gender Identity Disorders in Adult Men”, describes the condition of Gender Dysphoria in heterosexual males. What is particularly interesting to note is how, like Harry Benjamin, Blanchard illustrates how difficult it is to distinguish between pure transvestism and transsexualism in some patients (Benjamin's type IV) and how both conditions may be related or one can progress to the other. While I have always had my reservations about his Autogynephilia theory and still do, this chapter describes very well my own life plus the difficulties inherent in making an accurate diagnosis in this area. I presented for treatment at the age of 44 instead of his average age of 39 years described below: "Heterosexual Gender Dysphoria Definition. Heterosexual gender dysphorics may

Rewind to about 1966. Upon receiving the message from my mother that little boys do not wear dresses my activity went underground. I would role play in my room or wait till no one was home to raid my mother’s closet. It was fun and it was my little secret. As I got older and puberty hit I started realizing that this part of me was going to potentially be in conflict with my normal sexuality and my burgeoning interest in girls. I had begun getting inadvertent and unwelcome erections and orgasms which immediately prompted a promise to never go back to raid the wardrobe closet. I began to learn to suppress in earnest. In my world, Roman Catholics did not ever masturbate or have premarital sex so imagine how I saw myself. What didn’t help was that all of the information available to me about the subject was negative. "Transvestite" was a dirty word and it was associated with perversion. Entries in encyclopaedias were short and misleading and I had never heard of Harry Ben

Rewind about 10 years and my dysphoria was starting to bubble to the surface after decades of denial. I had made some earnest attempts at establishing some online presence and met some kindred spirits but also others whose path would take a different trajectory. One of those people was Sherry. She was a transitioned young woman who was establishing her life in the world as the person she was meant to be. She just needed to make the physical adjustments to have her mind and body match. She is a beautiful and petite woman who you would never guess had been raised for part of her life as an unhappy boy. She was one of the first people to bolster my morale when things were confusing and dire for me. She recognized through our online chats that there was something different about me and more than met the eye to the desire to express myself as a female. I miss chatting with her and we seem to never be online at the same time anymore. This is just my little ode to her and if she reads t

The last number of posts I've been boring you with gender theory and summarizing some of the things I've learnt over the years. It's the work I needed to do to make sure I wasn't crazy, perverted or deranged and that I hadn't created all of this in my mind. Maybe you don't find any of it comforting but I did because as difficult as it is to come to terms with accepting you have gender dysphoria it's made just a little more digestible by knowing that it's not your fault. What I do know is that partial self acceptance does not work. This condition demands full and head on acceptance which restablishes your self esteem and your own sense of normality. No you are not statistically normal but who cares about statistics. The risk of partial self acceptance could have you thinking that only a full transition is the right solution and, while this may very well be the way to go for you, it may just not be. Being in an uncomfortable middle can be disconcerting

I’ve abandoned the “gender dysphoria as illness” model. I used to espouse it but I found that it was getting in my way of treating my gender incongruity so I now just do what feels right without hurting my partner or my children. Whether gender dysphoria is due to a birth anomaly or not the fact of the matter is that we suffer more from the slings and arrows of societal rejection than from anything else. If no one cared how we expressed gender, then transgender people wouldn’t be conflicted. Our parents and our peers would accept us exactly as we are and we would see very little turmoil over this issue. This happens now in certain cultures like Samoa, Thailand or India where third genders are more tolerated than in the west. But even here we are starting to come around slowly. I know some people reject any form of discussion of gender dysphoria being an abnormality and prefer to speak of their inner female. All of that is fine by me since no one understands where all of this comes

Ray Blanchard’s Autogynephelia theory is offered as the explanation for men suffering from transvestic fetishism resorting to surgery to become facsimiles of women. But why would a fetishist wish to take hormones and have surgery and why are they still content years after their procedure? It appears that Autogynephelia does nothing more than point to a reality that everyone as far back as Magnus Hirschfield observed and acknowledged. It is not really an explanation for the origins of gender dysphoria which is why it is best relegated to the category of pseudo-science. It hangs its very premise on the notion that prepubescent children can fall victim to fetishes. Harry Benjamin noted it but did not focus on it in his 1966 publication because he believed it to be a result of gender confusion and not a driving force. He preferred to focus on his disorientation scale. People who go to fetish clubs dressed in body hugging latex and high heels are perfectly happy in their skin as males.

There are many of us out there but we are not always visually distinct. We represent a sliver of the general population but we are even less apparent than that due to our ability to blend in and hide. In 2 weeks I will be 52 years old and I have not felt like hiding for quite some time now. Although I have not come out to absolutely everyone those who need to know about me have been informed. Being out in the open has benefited me much more than it has them. Their lives have not changed for the better or for the worse while mine has decidedly taken a turn for the better. For those of you still struggling with the impacts that your condition has on others I would beseech you to take some initiatives to make your case known. When my pot threatened to boil over, going into a gender clinic offered me an oasis where I could have my thinking questioned by someone else; someone who did not harbour the same prejudices and preconceived notions I held about my situation. The ideas I held wer

The following is an excerpt from the most recent edition of the WPATH Standards of Care for Transsexual, Transgender and Gender Non-Conforming people. Of particular interest to some of you will be the approved methods to treat dysphoric individuals: "Advancements in the Knowledge and Treatment of Gender Dysphoria In the second half of the 20th century, awareness of the phenomenon of gender dysphoria increased when health professionals began to provide assistance to alleviate gender dysphoria by supporting changes in primary and secondary sex characteristics through hormone therapy and surgery, along with a change in gender role. Although Harry Benjamin already acknowledged a spectrum of gender nonconformity (Benjamin, 1966), the initial clinical approach largely focused on identifying who was an appropriate candidate for sex reassignment to facilitate a physical change from male to female or female to male as completely as possible (e.g., Green & Fleming, 1990; Hastings, 1

I never got a call back from Helene Cote. I had left her a message telling her that she could call me back to discuss the possibility that I could come speak to her group but that seems to have fallen by the wayside. Perhaps it’s just as well. Aside from this blog I don’t deal with the transgendered world and it’s not because I don’t want to. I think it’s due to the difficulty inherent in finding someone who shares this condition who you also happen to click with. I have interest in meeting many of the people who read my blog and have commented on it as well as those whose blogs I have read but that is unlikely to happen. Years ago I would try and arrange for meet ups but they would never work out or there was insufficient connection to go beyond an initial meeting. This is why I ended up turning to the cisgendered world and have Joanna establish some presence there. To date, I have not regretted that decision. The other night I was out dressed and ended up in a store I used to f

If Anne Vitale is right and this condition should be termed Gender Expression Deprivation Anxiety Disorder then part of the answer for sufferers is to dole out the right amount of expression to soothe that anxiety. Many of the people whose blogs I read are in a situation where their level of expression or lack thereof is leaving them frustrated and conflicted. They are of course thinking about their families and respecting their rejection of a desire that no one understands and which we have imbedded in us since early childhood. But if the desire to express femininity is rooted in insufficient androgen exposure in eutero then we shouldn't feel conflicted about dealing with this condition in a positive and healthy way. If part of the solution involves regular cross gender expression then we need to try and find an arrangement that our families can accept. This will necessarily involve having them understand that this for us is not a choice but a requirement for mental health and s

In a recent post in his blog Thirdwaytrans states: “Basically everyone agrees that many people who transition MtF have erotic fantasies of being feminized or becoming female. Where there is a difference is in the causal relationship between these fantasies and dysphoria. The trans community believes that these fantasies are a sign of a repressed female identity and a sign that one is “really trans” and must transition. Otherwise, according to the community, these fantasies will persist and get worse and worse until they become overwhelming and the only alternative is transition. Critics of the trans community tend to take the reverse position, that the fantasies are driving the gender transition and therefore dismissing transition as the product of “delusion” or “fetish-driven behavior”. People that are questioning are caught in the middle and I see numerous people questioning “whether they have a transgender identity or a fetish”, attempting to determine which causes which .” Then

I know I don't post photos of myself here very often. The one below was a selfie taken in 1999 when I was 37 years old. It shows me smiling and yet a few years later by age 45 I was in crisis mode and trying to figure out what to do about my dysphoria. The answers have came slowly and painstakingly and I still discover new things about this condition and myself all the time.