From the NY Times: The Sea Horse, Our Family Mascot

I just came across this article, which struck me both for the personal connection between writer and subject (as twins) and for the complete open-mindedness and lack of judgement in it.

My twin brother, Eli, is jealous of sea horses. They are the only animal species in which the male gives birth to the offspring. Male sea horses have brood pouches where the female deposits her eggs. The eggs then hatch in the father’s pouch, where the young continue to live until they are expelled into the ocean after strenuous labor that can last several days.

Eli is a transgender man, and lived the first 20 years of our lives as my fraternal twin sister. I have plenty of memories of my twin as a little girl, as Emma, not Eli. More often, though, my memories adjust to represent Eli as I know him now, as my brother.

I am fascinated to read of how the desire for biological children is quite uncoupled from gender identity. I hope that one day Eli will find happiness as a parent.

Read the full article here.

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MSNBC’s ‘Born in the Wrong Body: A Change of Heart’

[Update to the review: Josef has contributed to the discussion forum on the show here. Worth a read. ]

I knew that I wanted to write a post about ‘Born in the Wrong Body: A Change of Heart’ before it even aired, especially so because many of my friends told me they were reluctant or nervous about watching it for themselves. As someone who has not made a gender transition even once (let alone twice, or even three times!) I felt I could view it dispassionately and objectively.

However, after seeing it, I found myself affected in quite unexpected ways. The aspects that I expected to feel negatively about were just not there, and my overall reaction was very mixed – finding both positive and negative emotions rolling together leaving me … somewhat neutral. I have decided simply to write a synopsis of what we were shown, and leave it up to the reader to come to their own conclusions. I’m sure if this spurs you to watch the show, you can find it on YouTube, or coming up in MSNBC’s frequent re-run schedule.

I’m going to use the pronouns that (mostly) match the current gender presentation of the two people shown in the documentary. (If this offends you, I’m sorry – in a case like this, there simply is no “right way”.) Without further ado, here’s what we learn:

It was stressed up front that of all those who transition, only a very, very tiny proportion ever “go back”. In fact, I suspect the two subjects we follow were the only ones who could be identified and were willing to have their stories told. Most similar documentary programs feature three or more subjects to give a wider experience.
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Transgender Access to Health Care

I want to start off by just apologizing for being a little haphazard in my posting here. I am hoping to get on a more regular posting schedule. I have had a lot of different things going on, and I have had a lot that I have wanted to write about but little time to do it. I do appreciate those who have stopped by to see what is going on here, and I look forward to writing more and engaging in some discussions of the topics and issues.

I just got off the Town-Hall conference call with Donna Rose, Jamison Green, and Becky Allison. I thought it was a good start, and I hope there can be more opportunities for our community to come together like this. I think one of the major benefits of calls like this is the breaking down of economic barriers. Today’s topic was essentially health care, and underlying the need for coverage is the need to break down economic barriers. Far too many in our community are unemployed or underemployed. For many, making the journey to a conference may not be possible for economic reasons. Calls such as this will help those members of the community to be able to reach out and interact with the Transgender community at large. I think this will also be of value to those who may live where there is no trans community to speak of. 

Now on to the topic. I think most of us have heard about the AMA resolution in June and the WPATH statement in July. These were both significant statements. I would like to start with the AMA statement, which was actually three statements related to removing barriers to careremoving insurance barriers, and removing financial barriers. The one thing that struck me was the repeated use of GID throughout the statements. They did, however, reference GID as a medical condition, and referenced not only the DSM but also the ICD. Now, I was not familiar with the ICD until this evening. I would appreciate information about it if anyone knows a little more about it, and how GID is treated in the ICD. I think that it is positive that the AMA referred to GID as a medical condition as opposed to a mental disorder. I am curious about how this statement in conjunction with the WPATH statement and other papers could serve to help legitimize our need for treatment if GID were removed from the DSM.

I am behind Kelley Winters’ efforts, my only concern being that we have another avenue by which can can continue to gain the medical treatments necessary to transition. I know some have argued that they do not want to be medicalized. To those I would argue, how can one justify medical treatment in the absence of a medical condition. I want to be medicalized, I just don’t want to be pathologized. I believe that part of our process towards equal health coverage is strengthening the medical need and the recognition of GID in the medical community as a medical condition.

I rather liked the fact the the WPATH statement included things such as chest reconstruction and FFS. As Jamison mentioned, chest reconstruction is the only surgery that many FTM’s want at this time, and for many of them, this surgery is very validating for their gender presentation. The WPATH statement acknowledges that the path to transition is about more than GRS. There are other surgeries and procedures, which some consider cosmetic, that go a long way towards helping to affirm ones gender identity and help make a transition more successful and less emotionally painful (I think anyone who has been through laser or electrolysis knows these don’t reduce physical pain!). 

I think one of the most powerful things in this statement was the AMA’s statement of dispelling the myth that treatments, procedures, and surgeries for trans people are cosmetic or experimental. For us, these procedures are necessary for us to be able to live a life that is more genuine and more true to who we really are. These procedures reduce the emotional stress that can cause so many other health problems. When it comes to insurance companies arguing about cost, I have a few examples of my own situation. Prior to coming out and beginning transition, I smoked almost a pack of cigarettes a day and I was borderline high cholesterol. Within days of coming out, I quit smoking. I stopped cold turkey, now that I was on the road to being me, I didn’t need that crutch. I also changed my eating habits and reduced my stress levels significantly. I was no longer eating the bad foods we eat when we stress eat, fast food, high fat foods, high cholesterol food, you know that stuff that tastes so good but is horrible for you. Since then, my cholesterol is half of what it was before. Not smoking and reduced stress are also significant. Essentially, I likely saved my insurance company easily hundreds of thousands of dollars by transitioning. I greatly reduced my risk of heart attack and stroke, reduced my need for cholesterol and blood pressure reducing medications, slashed my cancer risk each year that goes by, and greatly reduced the potential costs if depression were to lead to suicide or suicide attempts and the related hospitalizations. You tell me, which is better. I think I would take the road of paying for therapy for a few years, GRS and a few other procedures, and HRT. Over my lifetime I bet that it will cost them a lot less then the bypasses and other procedures I was headed towards! 

Another thing I did take away from this was the need for education. Educating our employers, the insurance companies, and the insurance brokers that our companies deal with. There were several stories of brokers discouraging Trans benefits, or pricing them too high to be affordable. I worked in the insurance industry for a brief period of time, and when you are a smaller company, you have little or no ground to negotiate when it comes to benefits. It all comes down to what can I and my employees afford, and what do we have to give up this year. The education has to start with the insurance companies and the larger companies that have the negotiating power. If every company listed in the Fortune 500 index said we want full coverage for out trans employees, I am sure that the insurance companies would take notice.

I find it interesting that many insurance companies offer full benefits to their trans employees, and yet make it difficult and expensive for other companies to provide the same benefits. I wonder about the concept of creating an index that would measure and rate insurance companies not only on the benefits they provide their own employees, but also on how they make the same benefits available to subscribers. Imagine being self employed and having to shop for health insurance with trans benefits, I am sure that is impossible, and if possible prohibitively expensive. 

We need insurance companies to recognize trans benefits as a fundamental part of any group or individual plan. Spread over a sizable group, the costs are negligible. I believe one study showed that it was pennies per premium. I will find that presentation and post it later, I think it was from an Out & Equal conference. If this is part of every policy, cost would not be an issue, and we would finally have equal access to health insurance and the procedures that we need. 

I look forward to future calls, and the discussions and actions that they will generate. There are a few things out there that are dividing some of us, we need to concentrate on many of the things that bring us together. We will always have differing opinions on how to tackle a particular issue, but I think we need to respect the diversity of opinions in this community. We are an educated community, and we need to realize that there is more than one way to approach an issue. Good night to everyone, and hope to talk about some of this more.

Review: “My Secret Female Body” on BBC America

Having reviewed “Transvestite Wives” earlier, I felt it was only fair to give a similar treatment to “My Secret Female Body”, another in the ‘Reveals’ series that premiered on BBC America on June 22, 2008.

This documentary focused on a twenty two year old transman, Danny. From the BBC America web site:

Born as Katie, Danny has been living as a man for four years and has had male hormone injections every two weeks for a year. Now, at 22, Danny undergoes a dramatic surgical transformation, which physically changes his body from female to male. This documentary sees Danny embark on the first stage of this irreversible procedure – a double mastectomy, followed by complicated penis surgery.

Like “Transvestite Wives”, Danny has an amazingly supportive girlfriend who loves him in his pre-op body, and is fully behind him in his decision to undergo SRS. We also get to hear from Danny’s mother (“I had a wonderful daughter, and now I have a wonderful and happier son”), sister and best friend who talk frankly about their initial misgivings and current acceptance. There’s very little discussion of social intolerance – just a couple of anecdotes about altercations “down the pub”.

Much of the focus is on the physical transformation. We see Danny’s doctor administering his testosterone shot, and discussing the bodily changes these have already brought about. We’re also there for Danny’s first consultation with the plastic surgeon who will be doing his top surgery. A note to sensitive viewers – although BBC America did blur out some visuals, probably to bring the show into line with American censorship guidelines, there’s still plenty of detail to the scenes in the operating theater and the descriptions used by the doctor made me squirm just a little.

When the surgical results are not as perfect as they could have been, the viewer is spared none of Danny’s anguish and emotional turmoil. At the end of the hour, we are left with the impression that there is no fairytale ending for Danny and his girlfriend – and yet Danny’s life is clearly a happier one even though he faces more procedures in the future. Just from watching his face as he listens to his friend discuss how his new phallus was fashioned from forearm grafts, we can tell what’s on the horizon for Danny…

This documentary is highly recommended for any FtM pre-op transsexual who is considering the next step. It doesn’t sugar-coat anything, but still manages to convery a message of hope.

For those of you with access to BBC America, this will be shown again as follows:

Wednesday, July 2, 2008 at 8:00 PM and 11:00 PM
Thursday, July 3, 2008 at 1:00 AM
Sunday, July 13, 2008 at 5:00 PM

“Transvestite Wives” will also be shown again on Sunday, July 13, 2008 at 6:00 PM, if you missed it the first time around.

Good news, bad news, the same news?

The intrepid reader may recall that in my last post here, I was talking about the resurgence of my sex drive to some extent.  Well I may have found out why this is happening, although I find it hard to believe myself.

Tuesday, the 20th, I had an appointment with my Endocronologist at the Milwaukee V.A. hospital.  Of course, they did the usual blood tests, I finally got them to do an estradiol test along with the T test and liver and kidney function tests.  I got my test results back on Friday, and, either they tested the wrong blood, or something is really messed up with my testie function.  The T test came back in the mid 500s, I think it was 548 or something like that, the range being 250 to 1000 for a normal male.  The estradiol test came back at 38, below the normal level for post-menapause.  If these numbers are correct, it explains my sex drive, but it also means that my body has developed a resistance to spiro.  I’ve been taking 100 mg daily for over a year now and my last T test last fall showed me at 111.  Also, I’ve been on the Vivelle Dot patch, the .1 size, the largest they make, for more than 6 months, and 2 mg of Estrofem for at least 6 months before that.  So, why is my estradiol level that low and my T level that high?  Do I need to get them removed to solve this problem?  A better question would be, can I get this done through the V.A. health system?   After all, I’ve only thought about having them removed for, oh, about 20 years now.  It just costs so much for basic things like this!  Ugg!

A Slight Case of Cognitive Dissonance

My long-suffering significant other and I went to see Iron Man a couple of weeks ago. This, in itself, is not out of the ordinary: we’re movie people, so we see a lot of them. About halfway through the movie, though, I suffered a bit of a blow to my basic epistemology.

The set-up: I try to watch movies at the theater in one sitting. Sometimes, this isn’t practical: drinking one of the 55-gallon drums of soda they sell at the concession stand and expecting to make it through Titanic (all that water!) is probably foolhardy. Lately, I’ve had trouble with this because spironolactone is a pretty effective diuretic, so halfway through the movie, I had to relieve myself. I made a bee-line to the restrooms only to be stopped short. I momentarily didn’t know which one to use. Actually, this isn’t quite true; my first instinct was to use the ladies’ room, but I stopped myself from actually bursting into the ladies room. There was a brief and very disorienting sensation of confusion as I had to wrestle my brain into the mindset of my gender presentation.

At this point in time, I’m still pretty manly. I usually have some growth of beard to accommodate my electrolysis schedule, so I was in total “guy” mode when we went to this particular movie. And yet, I felt the planks of my gender presentation fall away beneath my feet. It was profoundly weird. I surmise from this episode that the hormones I’m taking are doing a big number on my brain. I also wonder about the dichotomy this suggests in the old mind/body problem. I’ve always “known” that I was a girl, or rather, that I should have been a girl, but this episode suggests that my neurochemistry DIDN’T “know” that I should have been a girl prior to being told so by hormonal intervention. Is this an example of the ineffability of consciousness divorced from the body? Is gender identity parsed and scattered through different sections of the brain, some more aware of it than others?

Y’know, I don’t know. And some of the implications of these questions trouble me.

Cheers.