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An interview with Anne Vitale

The following is an interview conducted by Lin Fraser (herself a trained therapist), with her longtime friend and associate Anne Vitale, PhD. The interview took place by phone on Aug 27, 2010 in San Francisco and Pt. Reyes Station California.

Anne M. Vitale PhD is a senior clinician and charter member of HBIGDA, now WPATH. She is a founding member of BAGA (Bay Area Gender Associates, the longest ongoing peer consultation group devoted to transgender issues started in 1989 in San Francisco) and web visionary of Anne also published the book. (2010), “The Gendered Self: Further Commentary on the Transsexual Phenomenon”, which is a compendium of her 30+ years experience working with the transgender community.

Needless to say I am a huge fan of her work and have quoted her in my blog often:

Lin Fraser (LF)- Tell us a little bit about your background.

Anne Vitale (AV)- I’m a shoe worker’s daughter from back east who ended up with a doctorate in Psychology after art school. I wanted to be a painter and I still enjoy painting, but I needed to earn a living. After so many years of therapy dealing with my gender identity issues, I decided to go back to school in psychology and undergo transition at the same time. This was in 1975, and I was 37. I was 42 when I had my surgery on Jan 10, 1980. I had a long transition--5 years, and during that time, I went to school, worked on my dissertation, moved to the Bay Area and started my psychology assistantship at the same psychotherapy practice in San Rafael where I still work. I even joined HBIGDA, in 1979, during my transition at one of the first symposiums HBIGDA ever held in San Diego. I finished my PhD in 1982.

LF- Tell us a little more about your practice.

AV- I’ve seen approximately 500 people since 1984, people who came to see me to work on their gender issues. As you know, I co-founded BAGA with you and a few other therapists in 1989 and I also started a website in 1995, “Notes on Gender Role Transition“ where I posted information about transgender issues. I also posted my own ideas and writings. The site mushroomed over time, and it’s still going strong. Back in the early days of the web there was not much information available in a central location. Hundreds of people have contacted me over the years asking for referrals in their home area and advice after seeing the website.

LF - How has your experience changed you over time?

AV- Well, I’m a different therapist now than I was when I first started. Experience has mattered. I used to be old school, pretty much a dyed-in-the-wool don’t start something if you can’t complete it person. I was strict: no hormones, if you’re not planning surgery. I believed in the idea of a complete sex change, and if you were going to do it, you needed to do it right. That’s all changed now. I’ve seen people lead good lives without sex reassignment surgery. My job is to help people make their lives work, not to define them according to a particular model.Now I’m just a mellow-old lady who practices in San Rafael California.

And I don’t really believe that there’s such a thing as a sex change. I even stopped using that term in my writings.

LF- Speaking of your writing, tell us about your new book.

AV- Well, by way of background, I mentioned that in 1995 I started a website on transgender issues which got a lot of attention in the community. It was one of the first sites devoted to transgender issues and it gave me a forum to publish my ideas and get feedback. Even now, when I go to conferences, people surprise me by telling me it made a difference in their lives. That makes me feel very good.

In terms of the book, I had written a lot on the website, and I decided I didn’t want to sugarcoat the transgender experience. I even stopped using the term sex change because I learned that transition was only a direction, not an either/or switch that gets turned to one pole or the other. I no longer believe you can turn a woman into a man or vice-versa. I wanted to clarify that only one's gender role changes but it’s hard to write a scientific paper on that. I tried to publish in academic journals, but reviewers kicked my ideas back, saying ‘this is only your opinion.’ So I decided to write a book because that would be a less problematic way to talk about my views based on my years of experiences as both a therapist and a transsexual. Also, and this is quite important, the timing was right because I also had a way to publish a book. I could do it via the web both in paperback and ePub format. That made a huge difference.

LF- How would you describe your book?

AV- It’s kind of a collection of my thoughts and notions, but some is evidence-based, especially the parts about the brain. I hadn’t seen the science about genderizing the brain in one place, how it can go awry. I wanted to write all that down in one place and I wanted to write it in plain English for the non-science person.

LF- Yes, I particularly appreciated that part of your manuscript. I have read and highly recommend your entire book, but for me, the science was particularly enjoyable because it was so clear for the layperson. I think you might be selling yourself short by saying your book is not evidence based. You have many references. But I’m pleased to note that I really can hear your voice throughout the book.

AV- Yes, much is based on my experience. I’ve seen hundreds of people and I try to describe what I’ve learned over the years from them. In some ways my book is my continuation of Harry Benjamin’s book “The Transsexual Phenomenon”. I describe the condition, do a developmental review, describe treatment limits and options and therapeutic interventions, clinical interventions, the reality of the real-life experience without sugarcoating it, because, in my view, transition is extremely hard. I specifically describe early regrets, mid transition land mines and post-transition regrets and conclude with post transition stories and finish with a summary.

LF- I would say that your book, although cautionary, is ultimately optimistic. Would you agree?

AV- Yes. I wrote the book to tell the truth about what it means to be transsexual, so in a way I have blown the cover of the typical upbeat transgender narrative. This is about the reality of T life. I couldn’t say it’s going to be hunky-dory. That’s been written many times, so I’ve written something new. I also came up with what I think is a new term, “transpeak”, which is the language trans people learn to be able to talk about their past lives truthfully without revealing too many specifics or outing themselves. But going back to your question, I would say my book is essentially trans positive, but I try to tell it like it is.

LF- Along the lines of truth telling, I had heard you talk about your sense of feeling more invisible as a transsexual now that we are using transgender as an umbrella term. This shift in language has created some consternation for some, as you may know. Would you care to comment on this issue?

AV- I do recognize that many young people (and some older ones, too) don’t see themselves as transsexual right off the bat, and transgender, as a concept, has worked for many people who do not transition fully, in the “old pattern”. The term transgender doesn’t mean anything to me personally, but it does to many people, so I’m content with its usage even though I identify more with the term transsexual. It’s the medical and psychological aspects of care that require standards, and WPATH provides that for all who need to access care for gender issues, transsexual or not.

LF- Speaking of the Standards, we’re thinking of adding Telehealth, or eTherapy to the next version of the SOC. Since you’ve always been at the forefront of technology, have you tried distance counseling?

AV- Yes, but not a lot yet. What I have done has shown to be very effective. Mostly, I help relatives of children who appear gender dysphoric and the wives of cross dressers who have found my site, or people on Social Security with such modest incomes who live far away and even the cost of travel to the Bay Area is prohibitive. With this latter group, I talk on the phone and get paid by Medicare. I suspect we will be doing more and more work this way as it provides access to qualified clinicians.

LF- Is there anything we missed?

AV- No, I’m just amazed at how much I enjoyed this discussion.

LF-. Thank you Anne for such an interesting interview and for all your good work. Even though I’ve nown you for many years, I feel I learned a lot. I especially enjoyed your book and I’m sure our readers will too.


  1. Anne Vitale has been of great help to many crossdreamers, as she actually discuss this topic in her book.

    I also like her way of discussing those who realize that they are trans late in life, and the special challenges that follows from that.

    I have published a short summary of Anne Vitale on Crossdreaming in Middle Age over at my blog.

    I especially made note of the following paragraph:

    "The irony is that gender dysphoric symptoms appear to worsen in direct proportion to their self-enforced entrenchment in the gendered world they do not identify with. The further an individual gets from believing he or she can ever live as a member of the opposite sex, the more acute and disruptive his or her dysphoria becomes."

    This is still one of the main challenges facing those that do not transition.

    1. Jack I agree that the entrenchment makes things worse. The best thing is to allow yourself to go where your psyche naturally wants to go and find stability there. This was my biggest challenge and lesson I needed to learn. If I accept myself as a dysphoric and embrace that part of myself I can lead as normal and productive life as I desire. Not an easy thing to do especially when you potentially have family members and friends who might want to negate what you are trying to do


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