Sunday, 28 June 2015

A new visibility

There has been an explosion in the number of kids and parents seeking counseling for transgender issues recently. As the reality of this condition continues to sink into the public psyche as something real and tangible, people who suffer gender dysphoria are speaking out in larger numbers. This is hardly surprising because in the past going to your parents would have meant being taken to a priest or counselor and told you were mentally ill.

Those of us who grew up during those years have first hand experience.

Now with the diagnostic community and legions of transgender people serving as protectors and advocates for others seeking answers, there is a growing support network that is being established.

While it may appear to the uninitiated that there is an epidemic afoot what we are actually seeing is the reality that always lay beneath the surface but dare not emerge. The people with the most to lose were those in established families with strong religious principles who saw this as a sexual deviance that needed to be eliminated. The ones who did brave trying to be themselves suffered the stares and ridicule of a society too ill prepared to accept them.

But with new found credibility has come the courage of people who might not have come forward otherwise. We now see the doctors, lawyers and engineers with established reputations as upstanding citizens coming out and being who they are. Whether they transition or not is less important than the demonstration that gender identity is more fluid than we have been allowed to express in our repressed western societies.

Yes the times they are a' changin'




Tuesday, 23 June 2015

From where we've come....

When Magnus Hirschfeld was treating his first patients, he started noticing the same thing that Harry Benjamin eventually saw years later; namely that these gender variant people were sometimes blurring a line between what he was then coining as transvestism and the later identified transsexualism.

Today we understand gender dysphoria to be a kind of continuum and don’t make the clear cut distinctions because we can’t. Part of the reason the hard line existed was because advocates like Virginia Prince who insisted that crossdressing was a heterosexual practice of men who had no intention of transitioning. Ironically, she pursued full time living later in life as did some other members of her entourage. Prince also liked to think that all crossdressers were heterosexual but clearly some were homosexual, bisexual or asexual and some were clearly transsexual.

Over the last third of the twentieth century, we began to develop a better understanding of how gender identity and sexual orientation varies in individuals and what resulted was less than a uniform portrait. This is how today’s concept of the transgender spectrum came about and why we don’t place people into categories. We just don’t know what they will end up doing.

For example, the current version of the DSM (which I referenced a few posts ago) now states that only when cross-dressing occurs for erotic purposes over a period of at least six months and it causes significant distress or impairment, is the behavior considered a mental disorder and the term "transvestic fetishism" is applied. This is a change that slowly took place as an understanding was developed which removed the assumed connection between abnormal sexual practice and gender variance. In other words, we began to separate gender identity from sexual identity.

This process took longer than the removal of homosexuality as a mental illness but eventually we got there.

The challenge now will be to have a public policy that defends the rights of people who exhibit gender variance and allows them to be who they are provided they don’t break the same laws that apply to the cis-gendered. However there are still people who see this as a lifestyle choice rather than as an inherent difference which is hard wired in an individual. Until that misconception is put to rest, there will still be pockets of resistance among the population at large.

Mike Huckabee was only one example of the kind of inconsiderate comments that can come from the mouth of the uneducated, misinformed or the ideologically driven. The problem is that he panders to a base that agrees with him and votes along those lines. For some people being gay or transgender is tantamount to being an abomination. Even if these people may not represent a majority but they are sizeable nonetheless and among this group there are more extreme fringes who might attack or murder young transgender women.

We can at least take solace in the fact that there’s never been a better time in history to be transgender.


Sunday, 21 June 2015

Happy Father's Day

As I write this entry I am sitting having a coffee dressed like a woman. It is a Sunday morning and at 8 AM I will be attending mass as Joanna and having a coffee with my friend Janet who does not even have Internet or own a computer.

It is an odd feeling to think that it's father's day today and that I am able to live in this odd way. It is a lifestyle that I never envisioned needing to adopt. But here I am.

My seventeen year old daughter is off with a group of friends camping and my son won't be up for many hours. At fifteen years of age he can sleep far more than I and is showing no signs of being the early bird I have always been.

They are both at an age where their attention focuses inward as they try to establish an identity for themselves in this very strange world of ours. I won't be offended if they forget to text or call as they will begin to come out of their teen angst in a few short years.

So I say happy father's day to all those transitioned and not whose life has taken a turn they had not expected. Life is challenging in many ways and this is just one of them. We need to count our blessings and be happy we have our mental and physical health for this counts above all.

Last week I looked at a photo of a family that existed about 13 years ago. That family didn't know what lay ahead and I was as surprised as they eventually were at the turn of events. All of us stared out at the camera which captured a moment in a life which I now have trouble relating to even if I recall the events that took place.


Thursday, 18 June 2015

Authentic lives

I was reading through Jack Molay’s blog yesterday and came upon this entry on his entry titled “The Autogynephilia Theory Again...” which was published in July of 2014:

“The trans activist and philosopher Julia Serano refers to a subconscious sex which has been repressed throughout a misogynistic, homophobic and transphobic upbringing. Dr. Jaimie Veale argues that many crossdreamers start out as introvert people pleasers, who are willing to do anything to gain the respect and love of family, friends and peers -- to the point of completely obliterating their gender variance. This is a reaction similar to the total denial found among some gays and lesbians. The sex drive is strong, though, and it pushes its way through into dreams and fantasies.

The difference between crossdreamers and non-crossdreaming transgender, or between "late onset" and "early onset" transsexuals, is therefore not primarily about sexual orientation, but about personality traits and temperament.

As a shy kid I managed to completely separate my crossdreamer fantasies from my understanding of myself as a non-transgender straight man. I interpreted my gender dysphoria as anxiety and depression caused by other factors. The fear of being considered a freak was so strong that I found it hard to approach women”

This paragraph really struck me because it described my own temperament and challenges with pairing up with a woman. I wanted to desperately fit in and be normal and to make sure I didn’t stand out.

Had I continued to do live that way to this day it would have killed me. I was also reminded that we are never too old to start living authentic lives.


Monday, 15 June 2015

The DSM-5

The newest version of the DSM (version 5) describes gender dysphoria as a marked difference between the individual’s expressed/experienced gender and the gender others would assign him or her, and it must continue for at least six months. In children, the desire to be of the other gender must be present and verbalized. This condition causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

It also notes that gender nonconformity is not in itself a mental disorder. The critical element of gender dysphoria is the presence of clinically significant distress associated with the condition. Therefore if you are happy with your particular expression of gender you do not suffer from gender dysphoria.

This is an important fact that transgender people should remember. Your expression of gender may vary from a societal norm but as long as you are psychologically stable you are not considered to have a condition according to this latest incarnation of the DSM.

This change in language from gender identity disorder to gender dysphoria has been made in an attempt to not stigmatize transgender people any more than they already are by their respective societies. It also makes the diagnostic name more appropriate to the symptoms and behaviours that they exhibit without jeopardizing access to treatment options.


Saturday, 13 June 2015

Reparative therapy

Reparative therapy for transgender children is a controversial topic. Kenneth Zucker has practiced it for years at Toronto's CAMH where Ray Blanchard used to also call his home base. Whether it works or not is open to debate but in the wake of Leah Alcorn's suicide in 2014, more and more legislators are examining the possibility of outlawing the practice.

If indeed there is a biological source for this condition, then this sort of therapy would border on witchcraft. Yes there are always children who exhibit gender variance and then outgrow it but what about the ones who are clearly transsexual and in need of a different type of assistance?

It's a fine line to walk because we could fall prey to putting kids on androgen blockers too early and set them on a path that could lead to personal disaster. On the other hand employing exorcism-like practices based on the belief that God does not allow for mutations of gender identity smells an awful lot like the 15th century.

There is likely a careful middle ground here and it needs to be tread very carefully. Growing up in silence as I did is definitely not the right way; that much I know. But with an ethical and unbiased approach I believe it is possible to treat a child without undue leading and badgering.

Andrea James covers this topic very well in her recent article and it is well worth the read

http://boingboing.net/2015/06/11/sexologys-war-on-transgender.html

Thursday, 11 June 2015

The new transparency

I try to focus quite a lot here on the science (or lack thereof) which might explain the transgender condition because it matters more than some of us might like to think.

Even if the newer generations of transgender people are prouder and more transparent about their identity, they might not realize that the scientific and psychiatric communities see them a little differently than they see themselves.

I have not made a secret here of saying that perhaps gender variance may be rooted in mental illness but not in a way that means that the person is not lucid or is crazy. I am making more of a comparison with conditions like chronic depression, OCD or even schizophrenia all of which are rooted in biology but yet form part of technically abnormal conditions of the brain.

I pointed recently to the 2009 Australian study which concluded that there could very well be a genetic tracer to gender variance if the brain were not sufficiently masculinised at birth. This would then technically be a genetic abnormality which would just form part of the myriad of mutations that we observe in nature. If we were to conclusively be able to settle on such an explanation it would go a long way towards further advancing the cause of people who don’t fit the mould when it comes to gender expression and identity.

Right now that science vacuum is allowing people who see this more as self propelled mental illness or even as a lifestyle choice free reign to opine without trepidation. There is enough doubt about the origins of this condition that permits this sort of speculation.

Acceptance by society is coming regardless and there are enough well-spoken and highly intellectual spokespersons for the community that help dispel the idea that this is all rooted in delusion. But then there are other targets that are considerably easier to hit. Just because we share a condition does not mean we are all the same.

People attack what they fear and what makes them feel uncomfortable.

In past decades transsexual women would attempt to go stealth and meld into the background as much as possible but with the new higher visibility and outspoken advocates we are seeing equal bravery on the part of detractors that would see them discredited.

The generation that created Casa Susana is now dead and buried and the former secretive underworld of gender variance has been morphed into the daily transparency of a YouTube posting which is both good and bad.

In an age of instant everything where people post their everyday mundane on the internet, I suppose I shouldn’t be too surprised.


Sunday, 7 June 2015

Long way to go

Its going to get uglier before it gets better.

This morning I was reading about a transwoman being attacked by five men in a Sydney hotel and ending up with a bruises including a black eye. Apparently the hotel staff knew the perpetrators who were regular patrons at the hotel bar where this woman was going to play bass with her band. She was called faggot and had her hair pulled before things got even uglier.

The new trans visibility is pushing a new envelope in our respective societies and the more low brow elements of each one will need to be curtailed. This issue gets to the heart of the emasculation anxiety of every insecure male on this planet and for some it's an invitation to violence.

If you read the comments after every story dealing with transgender issues you will see a plethera of bile from the knuckle draggers and from the supposedly spiritual yet strangely mean spirited religious fundamentalists. There is also an astonishing amount of misinformation being posted as truth.

Yes its going to take a while. But I maintain that better this than hiding in the shadows and admit defeat. Whether its defending the rights of a man walking around in a dress, of a transgender woman who doesn't pass the scrutiny of onlookers or the kind of violence that genetic women have experienced since time immemorial, its all about protecting human dignity from those who would see it denied.

If I've learnt anything in my time on this planet is that almost nothing worth having comes without sone effort and some fight.

Its going to get uglier before it gets better.




Thursday, 4 June 2015

A genetic tracer?

Back in 2009, an Australian study (the largest ever undertaken) on transsexualism was conducted which tried to see if there were genetic links to the condition. The researchers looked specifically at androgen receptor (AR), estrogen receptor (ERB) and aromatase (CYP19) genes for evidence.

The main function of the androgen AR receptor is as a DNA-binding transcription factor that regulates gene expression; however, the androgen receptor has other functions as well. Androgen regulated genes are critical for the development and maintenance of the male sexual phenotype.

The study group included 112 male to female transsexuals and 258 non-transsexual males and associations in repeat lengths of the aforementioned genes were examined.

The conclusion found was that the transsexual group showed longer repeat lengths of the AR gene than the non-transsexual group with no association for transsexualism found in the EB or CYP19 genes. No links to the interaction between the three sets of genes and transsexualism were found. Therefore the only link to the condition was the androgen receptor.

The researchers found that the reduced androgen signalling might contribute to a female gender identity in male to female transsexuals. The longer repeat lengths signified a reduced binding ability with a protein co-activator which was responsible for testosterone signalling in the brain.

Females lack the testosterone surge and so their AR gene is not activated. The report concludes that it is possible that the reduced testosterone levels during development could result in incomplete masculinisation and thus a partially or fully feminised brain.



Tuesday, 2 June 2015

The grand reveal

Seeing Caitlyn Jenner on the cover of Vanity Fair really hit home for me.

Although I am 12 years younger than Jenner, we both come from the same generation that predated the internet. Back then we lived in the dark and suffered in silence in thinking we were the only people in the world who doubted their gender identity. We would surreptitiously look up books in the library trying to understand what was wrong with us and why we were such freaks of nature.

Now at 65 years of age, she is finally having her coming out party.

No doubt that Caitlyn’s grand reveal will be a boost to the transgender community if for no other reason than to put the issue of gender dysphoria even more on the public radar. Kids who grew up watching Jenner on the Kardashian reality series (which I confess to never having viewed) now can witness a media figure undergo a very public gender role transition.

Much to her credit, she presented herself to the world with glamour and style. She looks like a woman at ease with her body and happy with herself probably for the first time in her life. Seeing her on the cover jars me into the realization that the world has become so much smaller and more transparent than the one I knew growing up.

We had to hide from the world and pretend the feelings we had were hallucinations of a delusional mind. In retrospect we know better but during those times it was hard.

I suppose it’s easy when you have money to do what she is doing; other transgender people are far less lucky. Her kids are grown and no longer depend on her and she has waited all this time presumably for their benefit. We all want to do right by the families who didn’t ask to have a father with a deep dark secret. I applaud her fortitude for having proceeded in this way.

Enduring the heckling of reporters and derision from media spectators hungry for public fails, this might be her moment of triumph to put those detractors in their place.

Here’s hoping that she proves to be another worthy role model and joins others who have already gone before her.


Monday, 1 June 2015

It just happens

Paul McHugh of John Hopkins argues that the gender treatment of young trans kids will come back to haunt their therapists in the years to come. He states that these young people, who presumably transition down the line thanks to misguided help, will eventually realize they have made a mistake thus proving that gender reassignment is the wrong approach to take. Ironically he uses the example of David Reimer who was reassigned as female without his consent and not told he was born a boy until much later.

If anything the flawed work of John Money proves that there is indeed such a thing as a gendered brain and whether we have a penis or not our brains know very well what gender we are very early on. Had David Reimer not suffered a botched circumcision, he would have been raised as the normal boy that he always felt he was.

But if the brain is gendered at birth then what about those kids who believe their identity is somehow in opposition to their birth sex?

The reference to McHugh’s essay was contained in a May 29th article in the Weekly Standard by Charlotte Allen who takes the same route as McHugh. Not surprisingly the Standard is a conservative (right wing) publication which panders to a type of audience who is more susceptible to believe that gender variance is a form of mental illness and Ms Allen does not disappoint as she serves up the same old suspects. Blanchard, Bailey, Lawrence, Alice/Richard Novic, Alice Dreger, Andrea James and Lynn Conway are all trotted out in the article as she does her best scribe the reader’s digest version of the history of gender variance and the transgender community’s plot to discredit those who see their plight as mental illness. She clearly leans in that direction herself.

It is no secret that Michael Bailey’s use of offensive and derogatory language is his 2003 book “The Man who would be Queen” raised the ire of Andrea James and others who saw it as an affront to their plight and an attempt to discredit and marginalize an entire community.

All of this only reinforces what I have seen my entire life: people being people and defending their interests. Some are likeable and some are not and all have a stake in this issue and defend their point of view with the type of passion that extensive experience brings. The problem of course is that this issue is like picking up a pile of sand and watching it bleed between your fingers; there is simply a pile of inconclusive dead ends to deal with.

I always prefer to give more weight to the person who has actually experienced gender dysphoria for themselves, so while Andrea James, Lynn Conway, Anne Lawrence and Alice Novic may not all be on the same page nor on the same place in the transgender spectrum, at least they have first-hand knowledge of what it’s like to desire to be the sex you were not born as.

The transgender umbrella concept may have confused the public a little because what we used to call “classic transsexualism” has been included alongside different types of gender variance and non conformity and even fetishism. Some of this is the fault of Blanchard who insisted on a sexual motivation for his two types of transsexualism.

But times and definitions change and so do the people who suffer from gender dysphoria. For example, we are now seeing gynephilic transsexuals transitioning younger than they used to as the public intolerance for gender non conformity is relaxing and the education on the subject increases. You will find some of these transitions chronicled on YouTube.

Regardless of whether the transgender condition is rooted in mental illness or not, it must be reckoned with and there are plenty of examples of happily adjusted transgender women out there to prove that transition works for many if not all. What hurts the activists most is that in entrenching and formalizing this as an accepted theory is that it stigmatizes and indirectly lays blame at the doorstep of the transgender person. It’s the same type of thinking that plagued the gay and lesbian community when it was still seen as a lifestyle choice: “it’s all in your head and you can change” was the underlying message.

One thing is for certain: no one wakes up one day and says “I’m going to be transgender”. It just happens.

The article can be read here.