Exposing the Truth About Transexualism: Part Two February 5, 2008
Posted by chloeelise2008 in Education, advocacy, community activism, lgbt, transexual, transgender.trackback
There are some transexuals who feel that the Harry Benjamin SoC isn’t fair. “Why should psychiatrists and physicians hold the keys to HRT and SRS? We’re fully capable of transitioning without the SoC“. To these transfolk, the medical practitioners are seen as “gatekeepers“. In truth, the SoC is there to protect the patient. A lot of psychiatrists treat gender dysphoric patients more like good friends, rather than patients. In fact, gender dysphoric patients are often referred to as clients. A competent psychiatrist will act as a guide to transition. They may seem to “hold the keys“, but it is for safety reasons. After all, the SoC isn’t a law. It’s merely a guideline. More often than not, the client is able to transition at their own pace, not at the will of the psychiatrist.
Upon seeking psychotherapy, there are generally two types of transexuals: Knowing and confused. The knowing transexual knows they are transexual. They are merely seeking treatment. The confused transexual may not know they are transexual. They may consider themselves to be another subset under the transgender umbrella, such as a cross-dresser. They could very well be transexual, and not realize it, if they desire to live as a member of the opposite sex is present, with the desire to seek treatment such as HRT and SRS. Some transexuals never seek treatment and are comfortable “cross-dressing” occasionally. For these transexuals (often called NonOp TSs), dressing as a member of their perceived sex may be sufficient. For the rest of us, dressing as the opposite sex just doesn’t quite cut it.
The term used to describe transexuals who are undergoing HRT and the RLT in preparation for surgery is PreOp TS, or pre-operative transexual. During the RLT, the PreOp TS normally undergoes HRT, but not always. There are several different treatment options for PreOp TS individuals:
Electrolysis or laser hair removal for MtF (estrogen does not stop facial hair growth)
Voice Therapy (mainly for MtF TS, as testosterone usually deepens the FtM voice, but estrogen really doesn’t affect MtF vocal cords) – Voice Therapy
Orchiedectomy - removal of the testes (which enables the MtF TS to stop using a testosterone inhibitor)
Breast Augmentation Surgery for MtF (which requires at least 6 months of psychotherapy in accordance with the SoC)
Mastectomy/Hysterectomy – removal of breast tissue (requires at least 6 months of psychotherapy)/removal of inner sex organ tissue for FtM
Hair plugs/transplants for MtF (for those of us cursed with male pattern baldness)
FFS - Facial Feminization Surgery for MtF which can include various procedures, such as jaw contouring, brow shaping, scalp reduction/advancement, cheek implants, and nose reshaping – Dr. Douglas Ousterhout MD, DDS
And last but not least, HRT.
For the MtF TS, HRT can be administered by pill, skin patch or injection. The most commonly used hormone prescriptions for the MtF are Premarin, or Estradiol. Normally, these estrogens are used in conjunction with a testosterone inhibitor, such as Spironolactone (Aldactone).
The effects of estrogen HRT:
- Breast growth
- Skin becomes softer
- Body fat redistribution (waistline becomes smaller, and hips and buttocks become rounder)
- Thinning of body hair
- Reduced muscle mass (reduced physical strength)
- Cessation of scalp hair loss (sometimes hair can become thicker and slight regrowth may occur)
- The ability to achieve erections and to ejaculate diminishes
- Testicular atrophy
- Decreased risk of prostate cancer/Increased risk of breast cancer
For the FtM TS, testosterone HRT is administered by injection every 2 to 4 weeks.
The effects of testosterone HRT:
- Facial and body hair growth
- Vocal cords thicken/Vocal pitch becomes lower
- Increased libido
- Clitoris enlargement
- Menstruation and reproductive functioning cessation
- Skin becomes coarse and oiler (possibly resulting in acne)
- Muscle mass increases (increased physical strength)
- Body fat redistribution (loss of waistline and slimming of hips, although breast size does not decrease)
- Thinning of hair on head and possible hair loss (if male pattern baldness is hereditary)
Like many prescribed medications however, there are risks to undergoing HRT. Sometimes, the risks outweigh the benefits, and transexuals decide not to go through HRT for health reasons. It is very important that a TS seek a therapist who will refer to a doctor of internal medicine or an endocrinologist to assist with HRT. Hormones can be bought on the black market, and I can’t emphasize this enough: They are extremely dangerous. Medical supervision is strongly advised.
We’ve seen the difference between a NonOp TS and a PreOp TS, but what is a PostOp TS? A PostOp TS (Post-operative transexual) is a TS who has completed SRS. Most PostOps do not like to be referred to as PostOp. They are either women or men just as their genetic counterparts. Some PostOp transexuals will say they are post-operative, but some would rather not mention anything about their past… and besides why should transexuals have to disclose medical information to other people? For everyone else, it’s not a necessity to let everyone know their medical history. Why should transexuals be any different?
For the most part, PostOp transexuals experience much pleasure and a healthier well-being after they have been surgically transformed because they finally have the body to match the mind. They are happier, and have a lot more self-confidence. For some transexuals though, these happy emotions may not be as immediate as some could suffer from a period of depression. This is possibly due to unrealistic expectations about life post-SRS, which is the precise reason for the entire RLT to first be completed. Very few transexuals have regrets about transitioning, and the ones that do, normally de-transition… but the ones that de-transition often re-transition. In fact, fewer than 1% of FtMs and 1.5% of MtFs regret having had SRS. Usually the regret stems from transitioning for the wrong reason, proper care was not administered, or because of religious beliefs.
This is a great example of transitioning for the wrong reason, and supposed improper care.
This is an example of a transexual who just couldn’t live in their perceived gender role, and can’t take responsibility for their own decisions. So, they’re suing the surgeon… nice… wonderful anti-transgender propaganda here.
To be continued…
XOXO
Chloe Elise
Imo, the best therapists will refer to the themselves as guides. Certainly meeting the “client” exactly where they are at” is critical.
.BE IT, the person who walks in and says” I think I may transexual and need to come to terms with it ” to the person who walks right in requesting a referral to an endocrinologist” Never should a therapist LEAD a client, but they know the right questions to ask..( the good ones do) Some may notice in their gut, as true advocates that indeed their client IS VERY MUCH TRANSEXUAL – But a GOOD therapist goes at the Cleint’s pace , and knows the SoC guidelines and can explain them to the client and why they are there.etc Helping the client feel ok about them. Its important to try and not be defensive , ideally the relationship is a “partnership”.
..They may SEE their clents TSism BEFORE THE CLIENT does. Many people of course Marry and father/mother Children and do not COME OUT until later in life..(much to the amazement and disbelief of their famiilies) A GOOD therapist will have referrals for the family too. FOR FAMILIES in can be quite a surprise due to yrs of TS folks overcompensating..for some families or spouses its like waking up and finding out your “dog” is telling you its a “cat” –
they HUMANS cannot see past the “outer” shells, and they cannot believe the visiable male/female is saying Ze is not male/female inside. Its a shock, to deny that is to deny their reality and the Gender assumption of the outer shells we all live in. So family counseling, books should be at the ready. Expect shock, and the family to try and do a lot of “bargaining with you” ie..can’t you be satisfied just Cross Dressing etc. It is a death for them. They are losing what they have grown to know and love. Or there may IN FACT will be ANGER at the client, from the family, in many cases. Blaming the client for LYING..its wasn’t lying on purpose, it may have been honest confusion..(just like we hear of homosexuals trying to “fuck themselves straight” it doesn’t work of course)
Some families , have many signs MANY , lifelong signs of feminity or masculinity in their family members .and try to beat it out of the person,..with a bible or worse. There is DENIAL. Many TS are thought to be homosexual – BUT GENDER ID has nothing to DO ALL with Sexuality. In fact once a transition is complete, sexuality comes into play in a big way as the spouse or the opposite gender may NOT BE bisexual or homosexual.
A good therapist WILL be able to help the patient with their own understanding too WE ARE ALL LEARNING.
Thus preventing a confused homosexual or cross dresser, from mistaking that orientation for a TS orientatiion.
Above all , its very important to interview YOUR THERAPIST , if you’re the consumer. Make sure the referral comes from a reputable advocay group…and have a meeting , ask the therapist questions. , How many TS /TG have they treated? ASK them their treatment philosophy. Who did they learn from , what models of care do they follow. Where did they get their education from, who are the clinical heros..etc. Do your research too !
YOU ARE THE CUSTOMER, they are service provider. IF YOU GET A BAD VIBE , talk about it with them. This could be the most important clinician in your journey, utilitize them for all your concerns about transition, sexuality , family issues, and the stress or depression you may be experiencing…A good therapist will fully understand a depression or anxiety secondary to TSism or even someone reporting a lifetime OF DEPRESSION or ANXIETY due to lifelong depression – That will not prevent your Transition. The more honest you can be, the better your chances of recieving the very best care and treatment plan.
AS HUMANS – of course we are gonna have conditions above and beyond TGism , and as the post above mentions…SRS may not, should NOT be looked at the end of the JOURNEY – on the contrary , its ONLY a NEW chapter. ITs critical to get the very best medical care you can possibly afford. One’s overlaying conditions may not dissapear after SRS , or with Hormones. Life will absolutely continue to present its stresses. Its very important to have a support system. A transition never includes a character transplant.
…A good therapist is a highly educated guide for the TG client. The lgbTq comm. is a good place to start for referrals.
Find out from others, how they score the treatment providers they have experienced. You are NEVER at the Mercy of these providers, if you feel that way, discuss it with them. It may be a mis understanding. WE have often been mistreated by the medical community a good advocate/therapist will understand your misgivings and fears.
If you have stories or experiences, feel free to share them in this thread or others. Keep confidentiality of course, as that is an ethical code. But lets learn from those who have had both good and bad experiences. Many readers and our allies, have been through some experiences, others may not have..WE are also our own guides. Networking and sharing, is critical for forwarding our cause, do you have favorite forums..etc. Information shared in a civil manner in important to our growth as a community. We live in geographic different areas. Do you have a family/medical story to relate ? Success/horror stories cautionary tales, tales of hope ? How many of us know people who have resorted to “pumping” parties or black market hormones…its no shame..Its about learning and growing..NONE of US know everything about TG/TS – they day we say we do, we ought to check ourselves big time..because it means we have stopped growing.
so feel free to share anything ! Becoming our own best self Advocates is JOB ONE and we do this by Networking and exchanging information. KNOWLEDGE IS POWER. This blog is here to EMPOWER to help build great self Advocates. No experience you have had is wasted, and your experience can and will help others. For example here where i live we have a plastic surgeon who is also in our STATE LEGISLATURE, who will happily take SRS folks money, then stand up in our state legislature, and argue against OUR CIVIL RIGHTS !!!
..if u are choosing a doctor, is big money , ask em what their politics are, because they may be another board ceritified clinician down the road or in the next town..that will not only TAKE YOUR MONEY – but believe in your reality and cause, wouldn’t you rather as a medical consumer give them your money ? I certainly would.
Thank you for taking the time to educate the masses about transsexuality.
I’m a transman and I want to add some updates and addition to your descriptions.
1. the SOC no longer espouse a RLT. It is now a RLE (Real Life Experience) and is usually not undertaken by FTMs. See http://www.wpath.org – 6th SOC version.
2. FTMs also choose transdermal methods of HRT (patch, cream, gel, lotion) in addition to injections. We also may inject weekly rather than biweekly, as this lessens the mood swings.
3. Most FTMs do not refer to chest reconstruction or top surgery as a masectomy, nor do we tend use the term breast to describe our chest.
4. In the FTM community we rarely use the terms pre, post and non operative. Many transmen have top surgery/chest reconstruction, but few have bottom surgery/phalloplasty or metoidioplasty due to high cost of the procedures.
5. Many FTMs never have a full hysterectomy, unless it is medically necessary. Some do opt for an oophorectomy or an salpingo-oophorectomy though, to decrease estrogen production.
6. Hormones can be administered by a knowlegable physician who is not an internal or endo specialist. FTMs have the fortune of access to a transition document written by an FTM medical doctor at http://www.nickgorton.org. In the San Francisco Bay Area many FTMs do not ever see an endo. Our primary care physicians prescribe our hormones & moniter our blood labs.
7. According to the SOC, FTMs (& MTFs) are guided to either acquire 3 months of therapy, which does not need to be completed by a psychiatrist, but can be an MFT or LCSW, or to experience 3 months of living in the male role. Since many FTMs are former lesbians/dykes/butches, the 3 months of living in the male role is already satisfied upon entering the therapists office and we can usually, if we request to, begin hormones right away.
I have been surfing the web for trans related information (medical, legal, social, political, etc) since 1997 and I have noticed one very interesting trend: transwomen write and talk about not only their own transitions and identities, but about transmens’ as well. Yet, I rarely discover a transman writing or talking about transmwomens’ transitions or identities. I think that is because FTMs know the FTM version of things (to more or lesser degrees) and transwomen know about the MTF version of things (to more or lesser degrees). Since in the 2nd part of your essay I noticed several incomplete or out of date references, as they pertain to FTMs, I suggest that you focus on MTFs or invite an FTM to co-produce these sorts of esaays.
Zander, my friend, thank you for your input.
I may have been a bit incomplete and out-of-date, and I’m no expert on FtM medical procedures, so I really appreciate your additional references. I couldn’t find too much information on FtM therapies, and I apologize if I said something offensive (I really don’t mean any offense) to my transbrothers. We’re all family. Of course you know as well as I do, we educate ourselves on transexualism according to whether we are MtF or FtM and don’t pay too close of attention to the opposite end of the spectrum, but again, I thank you for your updated information. In the future, I will only focus on MtF issues, but I will keep the information you have disclosed to me in mind.
Again, thanks for the update, brother.
-Chloe
Zander I second that , thank you so much, its all about family, and building community and sometimes the carpenter is best working on the frame and the plumer on the pipes..etc. Together we will build a great house..and lets not forget the electricians there is a place for them too. Its a team effort, and we are on the same teams..the analogies can go on and on..pinch hitters, runners, catchers, and coaches…What does all our hearts good is TEAM WORK. Each of us bringing our special gifts, knowledge and areas of expertises together..THE KEY being TOGETHERNESS….in other words the T = together. So thanks and if you have time , away from your own projects PLEASE feel free to add as much as you are willing to, to the comment sections…Your perspective is VALUED and DESIRED. We love to weave things together, have more insights in the comments etc. Its all about growing the community , fostering knowledge and understanding…but you embody that as we can see !
soooo thanks for finding us , and hope you will pop in often !
It’s obvious to me that there should be more government funding on research to make all of these procedures less costly and difficult. It’s equally obvious to me that governments often are negligent of social responsibilities.
Libhom , there have been so many OUTSTANDING studies done, medical research that is beyond compelling, IF NOT JAW DROPPING regarding the Transexual phenom. and of course its been suppressed. Count on it, it shall be a topic of future posts..thiings have been a weee bit hectic around here at NOTES ..so stay tuned.
oh and GO OBAMA ! The borg queen is getting desparate, and the liberal old time feminists are knee jerkin away, spastically sic’in N.O.W on David Shuster at MSNBC – this is a rhetorical question, but can the left on all fronts/issues EVER stop with the circular firing squads ? I mean dammit, Msnbc is one of few MSM stations that actually gives the “left” a seat at the pundit table, has people like Rachel Maddow on regularly. And is home to Keith Olbermann.
That is progress for gawd sake..and what does NOW (national organization of women) do ..they go after Shuster of all people,for using the word “pimp” He is has been suspended because of this!
I tried to tell this “friend” of mine that sexism goes beyond the binary of M-F its (the whole gender model)..it fell on deaf ears. As some males think with their “second head” some females think with their “cooters” (my current fav non technical term for female parts) soooo anyhow stay tuned…medical research will be covered, I can promise you ALL some medical findings that will make you say ooh maw gawd why the hell is this not common knowledge !
I can’t stand to see this type of injustice played out in America. I’ve lost one friend to such hate and I’m just sick and tired of it.
I’m not promoting my site, but if you are any of your readers get a chance please visit one of my sites Let’s Talk God. ParisL0ve2 has wrote a very good post on Bigotry.
My own experiences with “gatekeepers” have been quite positive.
After a long analysis, originally for depression and then for support as my mother died from lung cancer, I had absolutely no difficulty in convincing the man who became my secondary reference of my necessity.
When I first contacted the woman who helped me with my transition I asked her quite directly, “Will/can you help me with my gender transtion?”
In fact, I thought of her more as a “transition assistant” than as anything else. I suggested the term to her and was very receptive to it.
A trend I have pbserved is the mounting criticism of caring and competent professionals by too many who view them as “gatekeepers” and not as the compassionate persons I have come to know.
While I understand–too well!–the tendancy to suspicion and abusive response, it disturbs to see the openness of these guides contract in the face of attacks from our “community(ies).”
Sadly, these attacks are not reserved for them but have become a fixture in our “community(ies)” that I also understand–also too well!
In recent months I have come to a thorough understanding of the term “lateral violence.”
jessica, welcome! It sounds like you found a good, competent transition guide! The counselor that I have been going to is the same way… she’s more of a guide than a “gatekeeper”. She really helped me with a lot of issues, and to come to terms with my parents rejecting me. That’s what a good counselor/psychiatrist will do for you.
The attitude that these guides are in some way “barring” the gate to transition irks me. Fortunately, not too many transfolk keep this attitude. But I understand exactly what you mean about “lateral violence”. There are transfolk fighting against other transfolk, and it’s really saddening that we can’t all come together as one community. I think that’s one of the biggest problems the T community faces these days is dissension from within. It perplexes me, and really bothers me… we need to stick together.
United we stand, divided we fall!
-Chloe
Sorry its taken a while to reply.
:/
I have worked for a number of years in the “community,” in quotes because other than a number of truly good-hearted people I am not convinced there IS a “community.”
I have long been the recipient of the attitude that the “community” must be protected from me. Yet, the initiative I have recently abandoned because of all the attacks is not being continued, certainly not by the person who lead the attack.
Recently–since my last post to this thread–I have had surgery. Basically the dream of a lifetime.
I never really needed the “community” to continue my life. On the contrary, I am living quite well indeed and continuing with my life.
I doubt it, but there might well come a time when it realized that I am needed.
It saddens me a bit, but we all have to get on with our lives–and it there are places where lateral violence, any violence, toxic environments, etc, we leave.
This is precisely what I am doing.
:/
jessica so glad you stopped back in , and congratulations on your dream of a lifetime coming to fruition – i wish you many joyful , content healthy full life ahead of you. !! I hear you on the “community” its my belief that “we” need a pamphlet for all PRIDE EVENTS and TENTs and lgbT CENTERS – called understanding the T, in the lgbT – so many misperceptions. Myself i am astounded at the amounts i have been learning lately – i took for granted i knew more than i did, and i have no excuse (hangs head in shame) as a life long lgbt activist since the mid 60’s i assumed too much understanding in myself, in my second coming out as TG’s on the middle path, has taken me to places – where many many “aha” moments of come to me. (and i never want to stop learning, on all levels, i mean sociology, politically, medically , psychologically, historically, gender theories, etc. SO that i can be a better educator eventually.
the VERY same nuances society at large does not grok, homosexuals who are cisgendered have troubles understanding too. And hold the same misperceptions about the TS and TG’ d poeple that society at large hold. We need to educate, its not our job , but its something i want to do out of love and hope for a better world for us, and those TS/TG not even born yet. We are still only on the trail head in a jungle – we are cutting brush, and charting new territories and our lives depend on it.
As you can see from the top posts regarding the DSM working group on revisions, many outstanding guides . our advocates , and care providers are marshalling themselves to impact the DSM GID stuff in a positive way. Its a reality that the DSM and Medical part of treatment are to be wed , and this is aa chance to make this marriage happier and thus increase the quality of care for people with GID. Thats the hope at any rate. by the look of the petition and the advocacy going on in the meat world – they will hear from our providers , clinicians and us as indivduals…YAY
Anyhow its great you stopped back in
you had wonderful reason for a long abscence – welcome back ! BIG HUGS JESSICA -
just wanted to give people an idea about what kinds of things are available for sweet life when you look continuously smooth.
tnxxxxxxxxxxxx