Friday, December 30, 2011

In conclusion

This blog was always intended to be a "limited edition." It's not a transition blog. It's not even really a blog. The blog format provided an easy way to write and publish chunks of information. The date stamps don't mean much. The "table of contents" is arranged from oldest to newest. And if I kept going, I would simply be writing the same things I've already written. It's not really that big a subject.

The principal intent of this blog was to cut through the bullshit surrounding the congenital disorder called transsexualism. Even though the "why" has not yet been determined, the "what" is fairly clear. People who suffer from transsexualism are born with a brain that tells them they are one sex and a body that says they are another. And it matters. We are not neuter creatures. Sex is fundamental to who we are. Even if the gender binary were completely obliterated and gender were deconstructed out of existence, it would still be important whether you were born with a female body or a male body—and with a brain that did or did not match.

The focus of this writing was on transsexualism as a curable medical condition. The condition does not respond to psychotherapy or psychopharmaceuticals. It does not respond to prayer. For those actually suffering from transsexualism, medical treatment, mainly hormones and surgery, is remarkably effective. After recovery from surgery, the disorder is gone. The brain and body are congruent.

In confusion
Forces that work against clarity come from all sides. It is not only from those who insist, against all evidence, that transsexualism is a mental or moral aberration. It is those who confuse a medical need to change one's body with dissatisfaction with societal gender roles or a desire to express onself according to the societal gender conventions of the other sex. It is those who ignore the importance of sex and make the issue all about gender identity and expression. It is those who go far beyond acknowledging shades of gray into claims that black and white do not exist.

There seem to be conditions that are alleviated by the person dressing in clothes typical of the opposite sex. There seem to be conditions that are alleviated by the person living as if they were a member of the opposite sex. There even seem to be conditions alleviated by the person taking cross-sex hormones. These get mashed together with the need to change one's body so that it matches the sex of the brain. That last one is a congenital medical condition that requires serious medical attention. No one seems to know what those others really are.

The advice used to be straightforward. If you know beyond the shadow of a doubt that you were born transsexual and need to change sex, then change sex—all the way. If you're not absolutely sure (and the older you are, the harder it is to be sure), come back if and when you are sure. That might be hard-nosed, but it seems to be sound advice for something with such far-reaching effects. Now, nothing is straightforward. It used to be that only a relatively few transvestites would use black market hormones. Now it doesn't take much effort to get hormones legally, regardless of medical need. Health care providers are encouraging or at least not discouraging all kinds of "transitions."

It's the free market of ideas. Proper help and good information are much more available than they were only a few decades ago. Unfortunately, so are misinformation and quackery. Personal freedom is great—for those able to handle it. For some, it might simply be a rope with which to hang themselves.

In search of clarity
There are also a lot of people with agendas. Those people have not been the subject of this writing. There is no need to go into just what their agendas are. Such people are easy to find on the web. Anyone in search of clarity will find from them only obfuscation, ambiguity, and the above-mentioned bullshit.

The only agenda of this blog is to distinguish the transsexualism congenital disorder from other conditions and to advocate for people who are born with transsexualism to be able to have their condition treated properly and early in life. The difficulty is that there is as yet no test, nor is there an obvious deformity. It's "your word against theirs." Most people would prefer that you simply go away and be "normal." Of course, you want to be normal too, but that's not possible until the birth defect is fixed.

There need to be two realizations: that transsexualism is rare and that transsexualism does occur. Because of the rarity, because other conditions sometimes mimic transsexualism, and because some people are just plain confused, there needs to be caution in the approach to treatment. But when there is clarity, then treatment should be available—and paid for. We should be past the point where someone can't afford to get their clubfoot corrected and so must live with a crippling birth defect. And when it comes to fixing a congenital disorder, the earlier the better. No one should live with it longer than they have to.

Everyone should strive for clarity of thought and of feelings, clarity that persists and indeed becomes stronger over time. Such striving is perhaps more important for someone born transexual, whose decision will be life-altering in a way that nothing else is. It would be a mistake to proceed when in doubt. People can sometimes convince themselves that they need something that they really only want very badly—something that might not be good for them. But it would surely be a missed opportunity not to proceed when one has achieved clarity.

Whatever your path, may you have peace, love, congruity, and the fullness of life.

(Maybe the last post, but not necessarily.)

Monday, December 26, 2011

Gender dysphoria

What is this thing?

Gender, despite efforts to conflate it with sex, means the presentation and behavior associated with one's sex. Society expects men to be masculine and women to be feminine, although what constitutes "masculine" and "feminine" varies from culture to culture. There is no hard and fast link between femaleness and femininity or between maleness and masculinity, but people can still be rather rigid in their expectations.

Dysphoria is the opposite of euphoria. It comes from Greek roots meaning "difficult to bear." Euphoria is being on a high. Dysphoria is being on a low.

So gender dysphoria would be dissatisfaction with one's gender, or perhaps with the gendered behavior and presentation that someone feels are expected of them. A woman for whom stereotypical femininity is not a good fit might experience gender dysphoria. Same for a man who dislikes stereotypical masculinity.

I find it not just puzzling but actually misleading when people use gender dysphoria as a synonym for transsexualism. Dissatisfaction with gender expectations is not at all the same as having a birth defect in which the sex of your brain is opposite that of your body. People who transition to female may or may not be stereotypically feminine. People who transition to male may or may not be stereotypically masculine. People born transsexual change anatomical sex. It doesn't require hormones or surgery to alleviate dysphoria with your gender.

People born transsexual still get saddled with a diagnosis of Gender Identity Disorder, which is also a misnomer. We submit to such nonsense so we can meet our actual need, which is to change sex. One hopes that someday the medical and psychological establishments will finally get it.

Thursday, December 22, 2011


There are gender-nonconforming, transsexual, and even post-transsexual people who talk about "transgender pride." They don't want to hide who they are. They want to show off their distinctiveness.

For those who are publicly gender-nonconforming, that makes sense. If who you are is a challenge to societal norms, then you had probably better stand up for yourself and your right to be who you are. People such as gender queers are out in the open. Pride in their differences is a way of asserting their place in the world.

For those born with transsexualism, however, especially post-transsexuals, "trans pride" makes about as much sense as being proud that you were born with clubfoot—or that you still endure clubfoot. Birth defects are not something to be ashamed of, but neither are they something to be proud of. They are something to be dealt with.

The process of repairing a birth defect might be painful, tedious, and difficult. Coming through such an ordeal is something to be proud of. But it's not usually something we shout from the rooftops: "I overcame clubfoot!" No, it's usually something we keep inside, part of what makes us stronger and better people. And if anyone asks why you have a slight limp, you can tell them, quietly, that it was ever so much worse before.

Sunday, December 18, 2011

The slippery slope

People talk about sliding down the slippery slope until you hit the point of no return. Removal of bodily hair. Wearing certain clothes. Spending time in female-impersonation mode. Hearing someone call you "ma'am." You never know what might act as a "gateway drug."

None of that has to do with changing one's sex in order to fix a birth defect.

A sex change ought to be deliberate. The only sound reason to change anatomical sex is a persistent and overwhelming sense that the body doesn't match the brain. Clarity is essential. You have to know in your mind and in your heart that you have a birth defect and that all you are doing is fixing it. That kind of clarity is probably easier for a young person to achieve, before the corrupting influences of gaslighting and "normal life" have taken hold. The conspiracy works against clear thinking and, perhaps more important, clear feeling.

Even worse, the "gender industry" works against clarity as well. It's all about deconstruction, experimentation, and ambiguity. Of course everything in the world is not black and white. But when there is nothing but ambiguity, then all hope for clarity is lost.

You're either born transsexual or not. You can't slide into it. Sliding down the slippery slope into a sex change seems like a slide from a fascination with femininity through infatuation with femininity into addiction to femininity. Surely there must be better ways to deal with an addiction to femininity than to make irrevocable changes to one's body, one's life, and the lives of others.

Friday, December 16, 2011

Speaking part

This post is not, strictly speaking (no pun intended), about transsexualism as a congenital disorder, but there needed to be a follow-up to the post called Resolution. For a woman born with transsexualism, there is one thing that makes being a woman not quite as easy as just being herself.

When you change sex after puberty, what testosterone did to your vocal cords is not undone. Testosterone made them thicker. That can't be wished away. Despite the old joke, castration will not make you sing soprano, unless it's done when you are still singing soprano.

Part of being yourself is to speak like yourself. And most women speak like women. Just as you get help from an electrologist because you can't permanently remove your own hair, you might need to get help from a professional who knows how to help you find a natural voice that fits who you really are. There are also less expensive and even free resources available.

As anyone who has worked on their voice knows, it's not just about pitch. In fact, it's not primarily about pitch, although it's probably good to avoid the dips in pitch on some vowels that are typical of a male voice. It's more about changing the place of resonance than elevating pitch. It's also about letting yourself be more expressive. Finding a new natural voice is difficult for most, but it can be done. And if it just came to you, consider yourself lucky.

Your voice is an expression of yourself. It is part of the impression you make on people, and in situations where others can't see you, it's the only impression. If you want people to do a double-take every time you speak and call you "sir" on the phone, that's your business. But I imagine most women, when they speak, would prefer that people hear a woman. And prefer to hear a woman in their own ears as well.

Thursday, December 15, 2011

Two-edged sword

In a comment response to Unknown in the post What's in a Name, I wrote the following:
I agree with you about male-bodied children who are more physically feminine. For one thing, there are many physically feminine men who are not transsexual. But a transsexual girl/woman with a feminine body is indeed fortunate.

Someone left a comment that the writer subsequently deleted. I get comments in email, and I thought the writer made a good point. So I shall add
as long as she survives childhood.

Being feminine-looking is indeed an advantage when it comes time to change sex, but first the girl has to make it through the taunts, bullying, and even beatings that are likely to come her way.

As someone who was not as feminine-looking as some but nonetheless endured her share of trouble and pain for not looking or acting like people thought she ought to, I should have remembered to qualify my statement.


Here's how a woman born with the congenital disorder known as transsexualism goes about fixing the condition, not necessarily in this order:

  • Undergo hormone replacement therapy (hopefully under medical supervision).

  • Undergo non-surgical, non-hormonal procedures to mitigate the effects of testosterone, e.g., facial electrolysis.

  • Undergo surgical correction of the genitals (and possibly other surgical procedures, e.g. tracheal shave).

  • Live the life she should have been living since she was born.

Simple, yes? Not cheap, and not easy, but pretty simple. There is no need to make it complicated.

Girls who start hormone blockers early enough can even skip some of the above, since they will not have to mitigate the effects of testosterone.

Notice that there is nothing about how a person dresses or acts. Some women are very feminine. Some are rather masculine. Most are somewhere in between. But they are all women. Most women dress and behave in a way that feels natural to them. Girls as they mature learn what it means to be a woman. And they learn who they themselves are.

If you were born with transsexualism, then being a woman is just that—being yourself. If you are a woman, that's what people perceive. If you're making a lot of effort, there might be a problem.

Tuesday, December 13, 2011

What's in a name?

Quite a lot, apparently.

(In response to some question about appearance or a missing experience) "I was born with a birth defect that made people think I was a boy."

"OMG, that's horrible! What was it?"



A rose by any other name would certainly smell as sweet, but if it were called a turdblossom, would it be as popular? Clearly, Juliet did not work in marketing.

Every marketer knows the importance of a name. How appetizing does a Patagonian Toothfish sound? But as Chilean sea bass, it's so popular that it is now endangered. Does a Chinese gooseberry seem like just the thing for a fruit salad? How about a kiwifruit, the name it was given for export? Would you sauté using rapeseed oil? A hybridized version of this is the popular canola oil.

Transsexualism needs a new name. For one thing, that name is badly tainted. For another, it does not properly describe the congenital disorder. The term describes the solution—to change sex—and not the problem that necessitates the solution. The condition should have a name that conveys the concept of a sex mismatch between brain and body. Perhaps a Latin or Greek scholar could come up with something.

On the surface, Harry Benjamin Syndrome seems as good a term as any, even though it describes nothing. But it also has become tainted. Since few know about the taint (or the term at all), perhaps it could be relaunched, certainly more successfully than transsexualism could be. I have also seen the term neurological intersex. I think that term describes the condition rather well; intersex organizations, however, have quite a different opinion.

At any rate, for a term to have legitimacy, it probably needs to come from the medical establishment. So far, nothing useful is forthcoming. Instead, we get psychobabble like "gender identity disorder" and "gender incongruence."

Now if they used "sex incongruence," they might be onto something.

Sunday, December 11, 2011

The weight of waiting

God bless young transsexuals nowadays! More and more grow up knowing who and what they are. If their parents are enlightened, they change sex early enough in life so that they never have to go through the wrong puberty and the resulting irrevocable physical changes. If they have to wait until they leave home, they will then have gone through the wrong puberty, but at least they probably won't have developed a persona to go along with the physical body they were saddled with, a body that is still fairly maleable.

Changing sex later in life is more difficult physically than doing so when younger. There are all kinds of sex-related characteristics that become more pronounced with age. But perhaps more important than the physical difficulty is the psychological difficulty, at least for some.

The longer a person lives as the wrong sex, the more likely they will develop a persona that matches their physical body. This is especially true if the person has been very susceptible to gaslighting, believing what others and their own bodies are telling them instead of trusting their own thoughts and feelings. As time goes on, people establish lives. They get jobs, become involved in relationships, get married, and even have children. They become more and more invested in the status quo.

The more investment there is in the wrong-sex life, the more distressing it will be when the effects of gaslighting wear off and full realization hits hard. Those who change sex early in life have most of their life ahead of them and very little behind. Those who realize only later in life that their congenital disorder is killing them and must be dealt with have tons of baggage they must also deal with.

Ironically, those who have travelled lightly through life, whether by choice or because of psychological difficulty, might not be in any better shape to change sex than those weighed down with baggage. Or rather, they might not be in any better shape to live a post-correction life. Some have never learned to love or to share intimacy. Some have never learned to live! That can cause other kinds of difficulties.

Changing sex later in life is unfair to everyone. It's unfair to the one changing sex, unfair to parents and family, and unfair especially to spouses, partners, and children. Coming to the truth after living a lie will do that. But whether that lie was conscious but suppressed or hidden beneath layers of social and physical pressure, it still has to go. Someone, perhaps many people, will suffer pain and heartache. But at base, it's still a birth defect, and dealing with it, however freighted with baggage, should be seen as a medical issue before anything else.

Problems happen most when the person neither fishes nor cuts bait. Living in between or trying to have it both ways just causes more pain all around. Better either to fix the birth defect, quickly, or to suffer in silence.

If you were born transsexual and become aware of it early in life, deal with it then. As early as you realize you must deal with it, do so. Don't wait. Don't avoid life; don't cope; just have the condition treated, just as you (or your parents) would a cleft palate or clubfoot. Don't think it's going to go away or be cured on its own. That strategy has never worked.

Friday, December 9, 2011


The majority of people in the world are sex-normative. The sex of their brain matches their anatomical sex. They don't wonder which sex they are. They feel congruent.

Among those people, many think that those who suffer from transsexualism do not have a congenital disorder or a medical disorder of any kind. Some think that transsexuals are psychologically disturbed. Others think transsexuals are morally deviant. Some think both. They seem not to understand that only medical treatment alleviates the disorder. It doesn't respond to psychotherapy. It doesn't respond to prayer. It does respond to hormone therapy and surgery. That does not prove that transsexualism is a congenital disorder, but it certainly undercuts the idea that it is something psychological or moral.

Then there are those who have some kind of sex or gender issues themselves but say they do not have a disorder. They celebrate their difference. They embrace it.

I don't know if those people have the same condition that transsexuals do in a less severe form. Perhaps that's so. Or perhaps there is something else going on that resembles, to an extent, the transsexual condition. What I do understand is that transsexualism is a congenital disorder. If you don't think you are suffering from a disorder, perhaps you have some other condition.

Those born transsexual must fix what's broken. If you don't feel anything is broken, don't fix it.

Thursday, December 8, 2011

Growing up transsexual

I was brought up as a boy. That's what happens to girls born with transsexualism. Society conspires to lock you into your assigned sex. Once those words "it's a boy" are pronounced, then a boy you shall be. Your parents and others around you will expect you to behave the way they think a boy should behave. You will be segregated, to a greater or lesser extent, from girls. You'll be herded with other boys in school. You might even end up in a school in which there are only boys.

Your body is part of the conspiracy as well. You have a penis and testicles. Anatomically, you resemble your father. You're expected to be at least somewhat like him and to aspire to be more like him.

Puberty is a nightmare, when sex hormones kick in with full force. You're literally flooded with testosterone. Imagine the horror for a girl who hears her voice deepen and watches her body become more and more masculine. By the time the flood abates, the body is altered forever. The pressure to be a boy turns into even more pressure to become a man.

The conspiracy of parents, society, and anatomy to convince you that since you have boy parts you must be a boy somewhat resembles a phenomenon called gaslighting. Gaslighting comes from the film Gaslight in which a man conspires to cause a woman to lose touch with reality. He tells her what reality is, and she comes to doubt her own perceptions. That's what happens to someone born transsexual. It's not just people who treat you like a boy, and later like a man. Your body mocks your sense that you are really a girl. Between the two forces of society and anatomy, it's difficult to retain your own sense of self.

Some girls are born with such a severe case of transsexualism or such a strong sense of self or both that the conspiracy fails. Nothing can overcome their sense of themselves as female, despite what people say, despite how people behave, and despite what their own bodies tell them. They know that people and their body are wrong. They demand early in life, or relatively early, that the situation be rectified.

Others, for any number of reasons, do not have such a strong sense of self. They buy in to what those around them and their own bodies constantly tell them. They doubt their own perceptions. They are quite susceptible to gaslighting. They might even reach the point of believing that their perceptions are wrong or mistaken. The tragedy is that this situation can last much of a lifetime, even through marriage and having children.

Whether early or later, the situation must be rectified. The birth defect must be fixed. There seem to be a rare few who live with their birth defect for their entire lives, using various coping methods. But most are compelled to repair the damage so they can have as much of the life they always should have had as possible.

Wednesday, December 7, 2011

A congenital disorder

Congenital disorder is the proper name for a birth defect. A congenital disorder is a condition existing at or before birth. Congenital disorders include physical anomalies and malformations.

Transsexualism is a unique congenital disorder. It doesn’t show. There is, at this time, no test for it. The brain and body in themselves are perfectly healthy. There is no malformation. The only problem is that the healthy brain and healthy body don’t belong together. Not a malformation, but a mismatch.

Despite the lack of a test to confirm the presence of the congenital disorder, the perception of the one suffering from the disorder is strong and persistent. Someone made a mistake. My body is not configured correctly. Why do I have a penis and not a vagina? Why do I have a vagina and not a penis?

All congenital disorders have repercussions on the sufferer’s life, but none as fundamental and far-reaching as transsexualism does. There's no question that being born without legs or arms or something similar is profound, but no disorder other than transsexualism will get you sexed incorrectly. In human societies, the sex of a child is one of the most basic facts about the child. And a child is sexed according to the apparent configuration of external genitalia at birth.

Children with a penis go in one line. Children with a vagina go in a different line. However much parents might attempt to mitigate this division, it remains. Girls will eventually become capable of bearing offspring. Boys will eventually become capable of begetting offspring. Biology is uncompromising. Society is only somewhat more flexible. And even egalitarian parents and families have certain expectations of children because of their sex.

Children in whom the congenital disorder is manifested particularly strongly rebel early against the notion that anatomy is destiny. They refuse to accept the fact that their body dictates which sex they are. Other sufferers reluctantly come to terms with the body that feels wrong and knuckle under to the pressure to behave in accordance with that body. Sometimes they even come to believe that what the body is telling them must be right—for a time.

The congenital disorder does not go away, however. Compromises, coming to terms, attempting to conform all fail eventually. Tragically, the sufferer can often live with the congenital disorder for a long time. Much of society doesn’t even accept that the congenital disorder exists and puts constant pressure on the sufferer to reach the same conclusion. The distress this causes is enormous. And the longer it takes for the sufferer to understand that the congenital disorder must be corrected, the more difficult it is to correct.

Correction of the congenital disorder is the only successful treatment. Technically, it could be considered a disorder of the brain or the body. Neither is more right than the other. But even if a “correction” to the brain were possible, which repeated studies show it is not, it would result in a drastic alteration of personality. The patient would not survive the procedure.

Thus, the only correction that works is to make the body conform to what the brain expects, bringing it as much in line as possible with what it would have been like if the person had been born without the disorder. Hormone replacement therapy alters the chemical aspects and, to an extent, the soft tissue. Surgical procedures change the genitalia and possibly other physical aspects of the person.

Once the congenital disorder is corrected, the person can live a relatively normal life. There should be little evidence of there ever having been a congenital disorder.