About Transsexualism.
Causes of and about Transsexualism.
Introduction: Gender dysphoria is now a recognised medical condition. Those who experience the condition do not feel, on the inside, to be of the gender that their bodies appear to be. Many experience such intense and prolonged discomfort, that they undergo a process of gender role transition in which they express their innate gender identities and, usually, obtain medical treatment to modify their bodies accordingly. They are regarded as having the condition termed transsexualism. In simplest terms; Gender dysphoria (transsexualism) is when a boy or a girl feels they belong to the wrong gender, are in the wrong body. They usually experience these feelings from a very early age.
(See also Transsexual or Transgendered).
I had better explain my interpretation of ‘True Transsexualism’, before I cause any upset. A true transsexual needs to change sex, including the full SRS, Sexual Reassignment Surgery, nothing less would suffice. However, not all true transsexuals are able to have the surgery for medical or financial reasons, even though it is something they desire/ need. I would still class them as true transsexuals, because they would if they could. I believe that those who do not want to have SRS, out of choice, would probably not be a true transsexual. This does not necessarily apply to F-M Transsexuals as their surgeries are more extreme than that of the M-F Transsexual; Hysterectomy, Breast reduction and chest re-contour. These are both major surgeries. If they go for Genital construction this would involve several surgeries. This is far more complex than the M-F and nowhere near aesthetically successful as the M-F SRS. Visually they are undetectable from the Natal vulva.
Medical treatment enabling transsexual people to alter their bodies to match their gender identity is highly successful. The process is known medically as ‘Transitioning’ and may take some years. After a few months of hormone therapy, physical appearance begins to change; social gender can also be expected to change at around this stage (though usual gender roles may be maintained at work, for a while). Corrective surgery, SRS (Sexual Reassignment Surgery) usually follows after one or two years of hormone therapy, although some, for financial, medical or other reasons, do not undergo surgery.
Once a person starts to live full-time as a member of a new sex, their name and other records, such as driver’s license, passport, etc. can be changed. This period, during which you are expected to live and work (or be a student) in your new sex, is referred to as the ‘real life test or experience’ RLE. Gender Specialists look on it as a test but I believe it is the period where you are learning to live, work and socialise in that sex and be accepted into society. We should be doing this for ourseleves and not to keep our ‘specialists’ happy.
Following the Gender Recognition Act 2004, individuals who satisfy the necessary criteria, which include having lived in your acquired gender for at least two years, are allowed to apply for full legal recognition in their acquired gender. If successful, the law regards the applicant, for all purposes, as being of their acquired gender, including being issued with a new Birth Certificate recording your new legal sex. For more information on gender recognition, contact the Gender Recognition Panel.http://www.justice.gov.uk/tribunals/gender-recognition-panel
The Transsexual; There are developmental stages in both male and female, inside the womb of the mother that among other things determine gender.
Sex and gender as you probably know are very different qualities. Sex is mostly related to things we can see, external signs of maleness, or femaleness. Gender while perhaps more compelling to the individual, is nevertheless something that often cannot be outwardly seen.
During the early development of the foetus all children begin as female. At a predetermined time, hormones produced by the mother in this case testosterone become awash in the foetus, the so-called testosterone bath, which changes female to male. Sex is determined by sex chromosomes; XY in the boy, XX in the girl.
Malfunctioning hormones. In rare cases, the hormones that trigger the development of sex and gender may not work properly on the brain, gonads and genitals, causing variations between them. For example, the sex (as determined physically by the gonads and genitals) could be male, while the gender (as determined by the brain) could be female. This could be caused by additional hormones in the mother’s system or by the fetus’s insensitivity to the hormones, known as androgen insensitivity syndrome (AIS). In this way, gender dysphoria may be caused by hormones not working properly within the womb.
The name society gives this developmental difficulty, all of which carry terrible societal stigma is known as transsexuality. It occurs in both biological males as well as females, though the greater majority are male to female. There are thought to be in the region of 5000- 6000 in the UK. In all fairness to other similar yet different problems of biological as well as gender related developmental difficulties are Transsexual, the Intersexed and some other less well-known groups. This is not to be confused in any way with homosexuality, or same sex attraction! To explain simply, I was born with a male body yet a female core identity.
There is no known way to alter the mind to fit the body indeed this has been attempted throughout history with zero success. There is no cure for those affected! It can only be addressed by the inverse, or changing the body to fit the mind. Those like myself, suffer from deep depressions that affects us in differing ways often committing suicide if prevented from doing so. Both suicide attempts and completed suicides are common in transgendered persons. Studies generally report a pre-transition suicide attempt rate of 20% or as much as 40%, with M-F’s relatively more likely to attempt suicide than F-M’s. There is evidence that transsexual people are far less likely to attempt suicide once they have completed the transition to the other sex. In my case it led to comfort eating, causing me to become clinically obese by my late fifties. I was rapidly becoming a candidate for a heart attack. It became a case of do or die. I only regret doing this so late in life and yet there was no other way for me. There is nothing, sexual nor sensual in any of this.
There appears to be more transsexuals in my age group now but this is probably due to our more open society and we are less afraid of letting others know and asking for help. Also the internet has made it so much easier for us to make contact with each other and obtain the hormones to start the process.
I am certain, however that Transsexuals are born and not by influences after birth. The only cure is for surgical/ hormonal intervention to alter the body to suit the mind. The mind cannot be altered to suit the body.
Psychiatrists have tried in the past, including the cruel, misguided use of electro shock therapy, often with terrible and disastrous results, nervous breakdowns, insanity and suicide. No true Transsexuals were ever cured.
Males and females have both sex and gender. Sex is the genitalia of the body and gender is the identity of the female or male brain.
There is good scientific evidence that transsexualism is strongly associated with an atypical neurobiological development of the brain in utero. The condition should therefore be regarded as organic and congenital. This view is supported by the recent article in an international peer-reviewed journal, ‘The International Journal of Transgenderism 9(1), 2006’, which can also be found at the GIRES website, http://www.gires.org.uk. This article reviews the relevant science and is supported by 20 signatories which include many eminent clinicians, some of whom are world famous.
GIRES, (2006). Besser, M., Carr, S., Cohen-Kettenis, P., Connolly, P., De Sutter, P., Diamond, M. (chair), Di Ceglie, D.(ch & adol. only), Higashi, Y., Jones, L., Kruijver, F., Martin, J., Playdon, Z-J., Ralph, D., Reed, T., Reid, R.,. Reiner, W., Swaab, D., Terry, T., Wilson, P,. Wylie, K. “Atypical Gender Development – A Review”, International Journal of Transgenderism Vol 9(1).
How to succeed as a transsexual: I believe that the most successful transitioning is if you plan into the future.
Any problems you have now must be faced and dealt with. If you go into your reassignment surgery with problems, they are still going to be there and afterwards you are going to be less likely to be capable of dealing with them.
Your hormones are going to be out of balance, you are going to be far more emotional, more prone to stress.
You are going through mental and physical changes and must be in a position to deal with that without the distraction of having to deal with problems brought forward with you. Look on it as going through puberty again and all the emotions that this brings with it.
Why do transsexual people have special health concerns? Transsexual people face a unique set of emotional health issues. Living in a body that feels foreign, and being perceived widely as a gender that feels wrong and unnatural is enormously challenging; that feeling of being trapped in the wrong body. In addition, the process of transitioning to the other sex brings up a myriad of specific challenges, some anticipated and others harder to predict. Also, it is a very lonely condition; it is not visible so others do not recognise that there is anything wrong with you and are unlikely to be sympathetic. Transsexualism must eventually be faced. You can fight it for many years but the effects will get stronger, affect you physically and mentally and no exaggeration, if not faced will eventually destroy you.
Transsexual people typically take cross-sex hormones throughout their lives and most will undergo high risk and intrusive surgeries to change their bodies. Both the hormones and the surgeries can have specific health effects that need to be acknowledged and monitored to maintain the good health of a transsexual person. You can greatly reduce that risk by not smoking, drinking, eating healthily, live a less sedentary life style; take up gentle exercise.
Emotional issues for transsexual people. Persons who are contemplating the process of transitioning from male-to-female (M-F) or female-to-male (F-M) may encounter a range of emotional reactions both, in themselves and among those around them. Some of these reactions may be anticipated and prepared for; others may be unanticipated and difficult to manage.
From a very early age, our culture makes a large and specific set of assumptions about individuals based on perceptions of gender. Sex role socialization is a powerful force that our culture uses to define "appropriate" and "inappropriate" boundaries, behaviour and activities for each gender. Transsexual individuals often experience anxiety and stress as they attempt to fit into a gender role that may match the outward appearance of their physical body but not their emotions or their more internal sense of their gender. Society dictates the differences in male and female behaviour, much of this is learnt and not instinctive.
Relief, The decision to transition is often the result of a long and difficult process. Many transsexual individuals identify a sense of great relief that comes with finally being able to acknowledge their true selves and live in the body and gender role that is most natural for them. They often feel enormous satisfaction at watching their bodies change with hormone treatments and surgeries and at being seen by others as they feel themselves to be inside.
Although societies acceptance of transsexual and transgendered people is far from complete, there is a growing and active community of transsexual people, both M-F and F-M, in the UK, thought to be numbered between 5,000 and 6.000. Numbers in the Transgendered community are very much higher.
There are also increasing numbers of books and online information and support for transsexual people. In the UK we also have the Gender Recognition Act 2004 (GRA 2004). This allows you, after fulfilling certain criteria, to legally be accepted as your new sex and have your birth certificate changed to recognise that sex. This gives you exactly the same rights of those born in that sex.
Difficulties, The transitioning process can also bring with it a new set of difficulties (and sometimes dangers) that result from the reactions of acquaintances, loved ones and the larger society to the transitioning process.
From the day you start transitioning you should start planning every stage of your development.
• Your working future, can you carry on with your present occupation or will you have to look for alternative employment? Will you have to retrain?
• Have you told all your family and friends, if not have you thought of when and how you are going to tell them? The earlier you tell them, the more time they have to get used to all the changes that are going to be happening and in particular, the big day of your surgery. Don’t expect too much and give them time.
• Have you told work colleagues? This is another important stage of your transitioning. How will they accept you and your new self? Do you turn up as your new self or do you tell them first? Do you speak to your boss before your colleagues or the HR department? The support of your employer is imperative.
• What about going out in public, such as going to your local shops?
• What about travelling, to and from work on public transport?
• What about Public Conveniences, do you look for unisex or disabled?
Preparing to be a Woman, or a Man: Many TS women delay the start of their RLE, until they have had Facial Feminisation Surgery (FFS), in the belief that it will make them into one. FFS will not make you look like a woman, feel like a woman or be accepted as one. It will help but looking like a woman comes from the inside. It is how you act and behave, your gestures, posture, the way you talk and phrase things. How you dress is also important. There are many natal women with deep voices, masculine features, tall, fat, thin, etc. the physical divide between male and female can be very small and can even cross but you can still recognise them as male or female. Why is that? Confidence, attitude, being bought up male or female. These things are learnt from birth. Being a woman is so much more than just looks. We have to learn this in a very short time. Many TS women think that hormones and the surgeons knife will do this for you. This is where GIC specialists are often lacking. They will talk to you about being a TS and identify the condition. In most cases, they do not have the knowledge or perception to tell you how or help you to be a woman. We have to learn this very quickly. Much also applies TS men, who also have much to learn.
Counselling every three months, or even longer on the NHS, is woefully inadequate, particularly in the early stages of your transitioning.
This was one of the reasons that I decided to become a stress therapist, specialising in helping TS women. I do not like blowing my own trumpet but I have successfully transitioned in a relatively short time, I am never read and have fully integrated into my local community. Probably easier for me due to my small size and build. These Counsellors just do not have the knowledge or understanding to help you through your RLE.
Yes, I have had Facial Feminising Surgery and a face lift, I also had a hair transplant but lived my RLE for 6 months before 'burning my bridges' and fifteen months before my facial surgery. My advice would be to start to live full time and build your confidence and start to learn to be a woman. Do the things that are reversible if it turns out it is not right for you. Once you are certain that it is for life, then go for your FFS, as, by now you will know, or have a better idea of what you need and want.
What about your SRS? Some say that the SRS does not make any visible, external changes to you. They probably have not had their operation yet. It does. Your attitude, how you present yourself, a feeling of serenity that shows. You feel more feminine your disposition as you show yourself to others; it is hard to put exactly into words.
You will not find out, living part time or dressing behind closed doors. You have to be able to live, work and socialise and be accepted in society. Once you achieve that, it is so worthwhile. It is so wonderful being a woman. Natural women cannot appreciate just how special and what a privilege it is to be a woman. There is so much more out there for us. Live it and enjoy it. It is yours for the taking.
We should embrace our life, our gender and sexuality and enjoy it. It is such a joy and privilege to be a woman.
If you want to talk about anything that you have read or have a query in general, please feel free to contact me, details can be found on the cover of this paper.
Michelle J Dibble MASC FASC CCCreg.
Paper last updated, 15-11-'15.
