Transsexualism: Information for the Family
Category: Transsexualism Date added: 04:57:47 AM 12/Jun/2012 Added By: ADMIN
TRANSSEXUALISM: WHAT IS IT?
Introduction
When a member of the
family of a transsexual asks this question, his interest in the answer is
neither general nor academic. His concern is a practical one. He is asking: how
did my son or daughter come to be as he or she is; is his condition reversible;
if not, what professional help is available to him, and how may I help? The aim
of this pamphlet is to provide you, in simple terms, with specific information,
derived from the latest medical research, which will be useful to you. But it is
important for you to understand that professional help is only one ingredient in
the successful rehabilitation of the transsexual. The other, which only you can
supply, is the love, concern and acceptance that are manifested by those people
who are important to him.
When we say that man's gender identity is
psychosexual in essence, we refer not merely to his physical characteristics,
but to an intricate, variable complex of mental traits and tendencies, subtle
and emphatic. For most of us, these qualities and characteristics resolve
themselves into a harmony that declares itself as predominately masculine or
feminine. This psychosexual identity which we present to the world satisfies our
cultural definitions, and many comfortably be taken for granted by us and by
those around us.
Not so for the transsexual. For him, the apparent
sexual balance, as expressed in the primary sex characteristics--i.e. the
genitalia, is deceptive. It does not reflect, indeed it contradicts, the inner
balance he strongly feels, and which to him represents his true psychosexual
identity. In some instances of transsexualism, where the secondary sex
characteristics--i.e. heavy facial or body hair in the male, feminine hips and
pronounced breast development in the female--shade into those of the opposite
sex, the body itself has already begun to bear out this inner conviction. But
physical ambiguities are by no means general in every instance in which an
individual's powerful, intimate sense of self contradicts his sex as recorded at
birth.
There are other gender identity disturbances which are sometimes
confused with transsexualism, but which are distinct from it. The homosexual and
the transvestite experience some conflict between sex and gender. But neither of
these has any desire to change his anatomy. The transsexual, on the other hand,
feels that he has been trapped in the body of the wrong sex and he seeks help to
be freed from this predicament.
How Did It Happen? Is It
Reversible?
The best efforts of skilled, dedicated professionals in
the physical and psychological sciences have so far failed to uncover the
origins of the transsexual condition. The most impressive hypotheses put forward
to date, based upon careful and open-minded clinical studies, indicate that
several possible elements should be considered together: functioning of the
brain and of the endocrine glands, neurological mechanisms, cultural and other
environmental factors.
Most, if not all, specialists in gender identity
are agreed that the transsexual condition establishes itself very early, before
the child is capable of elective choice in the matter, probably in the first two
years of life. Others believe it is set even earlier, before birth during the
fetal period.
These findings indicate that the transsexual has not made a
choice to be as he is, but rather that the "choice" has been made for him
through many causes preceding birth and beyond his control. When you fully
understand that the condition is confirmed so early in life, and that no
individual can a make a conscious decision to be a transsexual, this
comprehension should allay some of your anxieties and help you to deal with the
transsexual with greater sympathy. It will become clear, too, why psychotherapy
is rarely, if ever, successful after early childhood. Yet, some sort of
treatment is urgently indicated, for in many instances the transsexual's
suffering is so intense that suicide and self-mutilation are not uncommon.
Therefore, many professionals have come to share the view of the distinguished
doctor who said: "If the mind cannot be changed to fit the body, then perhaps we
should consider changing the body to fit the mind." Thus scientists, through
painstaking clinical processes, have arrived at the same conclusion to which the
transsexual's suffering led him as he desperately sought a remedy for his daily
sense of dissonance between his mind and body.
Physicians and
psychiatrists have been deeply impressed with the fortitude with which many of
their transsexual patients confront physical pain, economic sacrifice, and
complicated social and emotional adjustments in their commitment to the
liberating process of sex reassignment. Medical specialists who maintain a
careful, long-term follow-up on their transsexual patients have reported that,
where other efforts at treatment have failed, corrective surgery has produced
"subjective and objective improvement in life adjustment in a majority of
cases." The keys to success are: 1) proper screening, 2) counseling, and 3)
family support before, during, and after surgery.
Is it reversible? The
vast majority of medical practitioners seriously concerned with problems of
gender identity in the adult have answered "No", not in the "true" transsexual.
But to this negative answer they have mercifully added positive suggestions for
treatment which offer relief and hope to the transsexual: counseling, hormone
therapy and surgery.
Highly qualified doctors of physical and
psychological medicine all over the world, working singly or in teams, are
increasingly concerning themselves with investigations into the causes and
treatment of transsexualism. Evidence as to causes, and data as to effects of
treatment, are accumulating, encouraging the hope that earlier diagnosis and
more effective preventive and ameliorative procedures, as well as education of
the general public, will successfully reduce this source of human
suffering.
But it cannot be too strongly stated that question "why" is
the scientist's proper job, his alone. It is harmful, and even destructive for
the family of a transsexual to look back for the causes of his difficulties.
Such a search based on one case only and biased by emotional involvement may
easily mask an assignment of guilt either to yourself or to your child. It would
be better to look instead to the present, and share this present with him,
fulfilling his need for your love, understanding, and
acceptance.
Acceptance
Earlier it was stated that each
individual embodies in himself a balance of contrary qualities, masculine and
feminine. Philosophy, religion and science are also agreed in this conclusion:
that each individual forms a constellation with every other, that we are all
members of the same body. If the fate of each influences the fate of all, surely
this is so to a heightened degree for those whom circumstance has brought
together in one intimate familial environment and by one bloodline. It should
then be evident that what nature has united we may sunder only at great personal
cost.
One may regard a problem such as a transsexual child as something
to be pushed aside and forgotten; but in fact, by confronting such a problem one
finds opportunities for growth, a chance to learn about and appreciate qualities
in one's child which seemed undesirable when "out of context" in his male body,
but which not appear lovely. A difficulty avoided inevitably returns to
challenge us in a more acute form. So do not turn from a loved one at the time
of his greatest need.
No parent of an adult transsexual is wholly
prepared for the revelation of his condition. There have generally been numerous
clues, usually from early childhood and always from adolescence, when the
psychosomatic crises of that period produce distress signals that are often most
dramatic. You may have no doubt shared in his embarrassments and traumas, when,
since his natural behavior was inappropriate to his genetic sex, he was rejected
by his peers, looked at askance in public, and finally retreated into a painful
isolation. Remembering your own discomfort on his behalf, recognize that the
primary and more intense suffering was his alone; just as it is he who now bears
the heaviest burdens of readjustment to a new life. Now that he has finally
found a way to correct those conditions that created painful experiences for you
as well as for him, it should bring a sense of relief to you, too.
Almost
any biologically complementary couple may participate in procreation. You are
called upon to assist at a re-creation; your child's second birth. Mistakes are
remedied so that he can begin to fulfill himself personally and as a happily
contributing member of society. Through your vitally important, loving support,
you can be a participant in his adventure, sharing in the release and liberation
of his new life.
RESEARCH ON TRANSSEXUALISM
Although the
causes of the transsexual condition are not yet understood, extensive research
in recent years has indicated some possible biological and psychological factors
which might render one individual more vulnerable than another to develop in
this way.
Experiments with animals suggest that the altering of hormone
balances, during certain limited, critical prenatal periods, will affect those
areas of the brain that regulate masculine and feminine behavior. Other
medications administered to the pregnant mother (barbiturates for example) may
also have an effect on the development of the unborn child, as may certain
intrauterine viral infections.
Transsexual symptoms need not develop
under such circumstances, and of course, usually do not. Predetermining
circumstances may simply make the individual more susceptible to the development
of transsexualism. The postnatal determinants of gender-identity--the child's
relationships with those who form his early social environment--may then supply
the deciding factor, if these relationships are seriously disturbed during the
critical postnatal period of gender identity formation.
Research over the
past 30-plus years has shown that pre-surgical transsexuals as a group are among
the most miserable of people, often exhibiting extreme unhappiness which
frequently brings them to the verge of suicide or self-mutilation. The
transsexual's problems are further complicated by a near consistent trend
towards rejection by both family and friends, harassment and/or discrimination
in varying degrees by most of society, and more often than not, a refusal by
many in the legal and medical professionals to render services; either by reason
of questioning the validity of such a diagnosis, or fear of potential peer
and/or community sanctions.
TREATMENT
Ineffective Modes
of Treatment
If gender identity is set at an age that precedes the
child's ability to make a conscious choice, it is clear that he is without
responsibility for his disturbance in gender identity. To try to coerce the
child into behavior that conforms with his anatomy, whether by threats, physical
force, or the withholding of love, must be seen to be barbarous, as well as
ineffective. It could be fatal.
In medicine, this attitude has its
counterpart in therapies such as electro-shock and aversion therapies, with
results that are sometimes brutally harmful but which never "cure"
transsexualism.
It is generally agreed that an adult transsexual will
not benefit from psychotherapy designed to change his identity. Whether a child
who shows signs of gender identity disturbance will or not is not known, but it
is usually advised so that all avenues of help may be explored.
How
Patients Are Chosen
The first step for an adult transsexual who seeks
treatment should be a consultation with a psychiatrist who has had previous
experience in working with transsexuals and adheres to the "Standards of Care"
developed by the Harry Benjamin International Gender Dysphoria Association
(HBIGDA). A practitioner who is unfamiliar with the theory and practice of
medical therapy for transsexuals may flatly refuse help or blunder in the help
he offers. Thus it is of critical importance to begin with a professional who
has the necessary qualifications and experience.
Gender identity clinics
are usually associated with a university and are engaged in a variety of
research projects in the field of gender identity. If the individual applying
does not meet the precise requirements of the work in progress at the clinic of
his choice, he may be refused treatment there solely on these grounds. This does
not necessarily mean that he is not a good candidate for sex reassignment, and
should not discourage him from applying to another clinic where help may be
available to him.
Apart from the special restrictions of their research
programs, most gender identity clinics agree on certain criteria for accepting
the transsexual who is over twenty-one for diagnosis and treatment leading to
surgery. These requirements are designed to eliminate candidates whose judgment
is impaired or who are otherwise too severely disturbed to benefit from sex
reassignment; those who are not clearly decided on this course and who might
later regret their decision; and those who, in the opinion of the consulting
staff might not, for a variety of reasons, make a successful adjustment to the
new role.
Major gender identity programs are located in San Juan
Capistrano, San Francisco, and Palo Alto, California, Minneapolis, Minnesota,
Galveston, Texas, Denver, Colorado, and Charlottesville, Virginia. Additionally,
an increasing number of physicians and surgeons in private practice, are now
providing treating.
In addition to the interviews, physical and
psychological tests and therapies, and electrolysis of the beard for the male
transsexual, there is one further essential element in the total program of sex
reassignment. After the patient is accepted as a possible candidate for surgery,
and while he is receiving hormone therapy, both gender identity clinics and
physicians in private practice require that he dress, live and work in the new
gender role for a period of twelve months to two years. The patient then may
better judge, through direct experience, whether he will be able to live
comfortably, and without attracting undue notice, in the new role. His physician
will observe the degree of his social and emotional adjustment, and estimate how
convincing an appearance he presents. This testing period is of prime importance
in assisting them both to make a final decision to proceed, or not, with
surgery.
Clinical Treatment of the Transsexual
Surgery is
not the first, but rather the last major step in the remedial program. The
wisdom of this may readily be seen. The results of surgery cannot be reserved,
the original anatomy can never be restored. For better or worse, the individual
must live with his "new" body. On the other hand, hormone therapy, with which
treatment begins, produces physical changes which are generally reversed,
restoring the original appearance, after hormones are
discontinued.
Hormone therapy is beneficial in several respects. His
gradually altered appearance relieves the transsexual of some of his conflicts
and gives him a new sense of confidence. In addition to the physical changes,
hormones produce a tranquilizing effect in most cases.
It is usually
required that the male transsexual complete at least half of a course of
electrolysis of the beard (usually requiring a total of from one to two years)
before surgery is undertaken. If he fails to do this, he will risk radical
confusion as to his gender identity following surgery, with possibly serious
consequences.
During this preoperative phase, it is important for the
transsexual to discuss his social and economic plans in order to gain a
practical basis for the new life he is preparing. Professional counseling may
prove helpful in supporting him through this delicate transitional period. When
the physician is satisfied that the way has been well prepared in all respects,
the patient is ready for surgery.
Gender identity clinics will ask the
transsexual to cooperate in periodic meetings for some time after treatment has
been completed. This is for the purpose of studying and helping with his social,
emotional, sexual and economic adjustments to his new role. By participating in
these follow-up studies, the transsexual makes an important contribution to the
better understanding and treatment of transsexualism. And if further therapy is
indicated, his physicians will be helpful to him in this regard.
Other
Steps On The Way
The transsexual making the change from male to
female, and to a lesser degree his female counterpart, will need to study the
grooming and clothes of the chosen sex. His mirror and his friends and family
may supply all the help he needs. Or the male transsexual may decide to apply to
a charm school for expert instruction. For the transsexual whose field of work
will not permit him to retain his old job, vocational training is essential so
that he may be fully self-supporting.
There will be legal adjustments to
be made: The securing of identification papers and other documents in his new
name, and, in the case of an individual who is married, a decree of divorce. All
gender identity clinics require that a divorce be obtained before they accept a
patient for surgery.
It may be advisable for the transsexual to relocate
to one of the urban areas where the necessary professional help is readily
available. Relocation may eventually be advisable in any case to spare the
patient the embarrassments of working out his new identity under the public eye.
After the final steps in the transition are completed, he may decide to return
home.
The financial burdens of sex reassignment, the cost of surgery and
other surgery, the loss of income during the period of recuperation, may present
the transsexual with a difficult or insurmountable problem. If members of his
family are able to share this burden, hopefully the help will be received with
gratitude.
A Final Word
Imagine that you, the father of a
transsexual, awakened one morning, looked into the mirror, and saw an unfamiliar
reflection returning your glance; that of a woman. Imagine your shock and
dismay. Your feelings were no different from what they had always been; and yet
you, with your masculine sense of self, were now trapped in a body that
contradicted all that you know yourself to be. If you are a woman, perform this
experiment in reverse.
Now you have a slight notion of what your son or
daughter has been experiencing daily, probably since earliest childhood.
Furthermore, he has been under constant pressure to keep up the masquerade at
school, in his social relations, in his job, and perhaps even at home; in his
total way of life. One day, the strain began to be overwhelming. He felt that he
could not sustain this deception, this contradiction, for another moment. In his
desperation, he may have tried suicide. Or he may have realized that skilled and
understanding help is available to him, and set out to find it.
It is
little wonder that the adult transsexual who finds himself in this impasse is
determined to free himself from it. Once he has decided on the course of sex
reassignment, he probably will never look back. If qualified doctors accept him
for treatment, the chances are that nothing will dissuade him, not even the
disapproval or entreaties of those he loves. When you have clearly understood
and felt the reasons for his determination to find help, let him do so fortified
by your support and love.
Source: http://www.tgguide.com/Library/transsexualism-information.htm/