| Amy Bloom, "Normal: Transsexual Ceos, Crossdressing Cops, and Hermaphrodites With Attitude", Random House, 8 October 2002 |
| | Approximately two people in every hundred thousand are diagnosed, first by themselves, then by endocrinologists, family doctors, psychiatrists, or psychologists, as high-intensity transsexuals, meaning that they will be motivated, whether or not they succeed, to have surgery that will bring their bodies into accord with the gender to which they have known themselves, since toddler hood, to belong. |
| | Jessie says, "I want everyone to know who reads this that this wasn't easy, it was a really terrible shock. I didn't understand. I said to the first endocrinologist, 'Where did we go wrong?' and he said nowhere, it was biological. I called every single, I'm not kidding you, every single insurance company in the USA, and they said, "No, it's cosmetic." |
| | When Lyle entered puberty, his mother and his late father took him from doctor to doctor, looking for explanations for Lyle's unhappiness and fierce resistance to being treated like a young woman. An endocrinologist who had worked with Don Laub recognized Lyle as possibly transsexual, and Ira Pauly and Judy Van Maasdam confirmed the diagnosis. Then, after extensive hormone treatments, Laub performed the first surgery and the family moved to another state, to allow Lyle to enter high school as a boy. Later, they nursed him after his hysterectomy and his phalloplasty, and used all their savings, and then some, to pay his medical bills. |
| | Until a decade or so ago the clinical literature and the unreliable statistics suggested that for every four men seeking to become anatomically female, there was one woman seeking the opposite change. Now clinical evaluation centers report that the ratio is almost one to one. |
| Aleshia Brevard, "The Woman I Was Not Born to Be: A Transsexual Journey", Temple Univ Press, February 2001 |
| | Mother never said I was not different. She knew I was not like other boys and realized the suffering that dissimilarity caused me. Unfortunately, she was powerless to make my pain go away. "If everyone were the same" she'd say to stem the flood of my youthful tears, "what a boring world it would be". I wasn't sure my mother knew what she was talking about. Nothing could possibly be better than being exactly like everyone else! |
| Leslie Feinberg, "Trans Liberation : Beyond Pink or Blue", Beacon Press, October 1999 1 |
| 1: | Each person should have the right to choose between pink or blue tinted gender categories, as well as the other hues of the palette. At this moment in time, that right is denied to us. But together, we could make it a reality. |
| 1: | I'm not at odds with the fact that I was born female-bodied. Nor do I identify as an intermediate sex. I simply do not fit the prevalent Western concepts of what a woman or man "should" look like. |
| Mary Boenke, "Trans Forming Families: Real Stories About Transgendered Loved Ones", Waterford Press, 31 January 1999 |
| | Steve just turned eleven. His life revolves around rocketry, soccer, and improvising stand-up comedy routines in the kitchen. Still enjoying the comfortable androgyny of childhood, he's in denial about puberty being just around the corner. As his parents, we're concerned about the changes puberty will bring, because we know how distressing it will be for him to begin to develop breasts in middle school. And we're sure that, unless something is done to postpone or stop it, he will develop breasts and begin to menstruate, because this child, who feels and behaves in every way like an ordinary boy, has a normal female body. |
| Gianna Israel, Diane Shaffer, Donald Tarver, "Transgender Care: Recommended Guidelines, Practical Information, and Personal Accounts", Temple Univ Press, 1 January 1998 25 |
| 25: | At the heart of the issue of supporting transgender individuals is the premise that psychiatrist, psychotherapists and mental health counsellors diagnose and treat only that which is disordered and diseased. There is no reason why psychiatrists and other mental health professionals cannot be charged with the responsibility of recognising gender-identity issues without the necessity of labelling them as disorders. |
| 25: | Care providers are advised that although some studies have established a higher-than-normal incidence of sever personality disorders, psychosis, and mental illness among transgender individuals, such studies are unreliable without controlled comparisons with transgender persons who do not require any form of mental health care. Moreover, such studies underestimate the impact of stressors associated with transphobic discrimination. These include sexual assault, harassment, and violence, abandonment by family friends and other support persons, loss of employment and unequal access to career opportunities, self-medication through substance abuse, legal harassment and other forms of gender-based discrimination. |
| Kate Bornstein, "My Gender Workbook: How to Become a Real Man, a Real Woman, the Real You, or Something Else Entirely", Routledge & Kegan Paul, 18 December 1997 26 |
| 26: | Sex-as-gender says that penises are male, and that vaginas, vulvas and clitorises are female. I don't get it. I know too many male men whit vaginas and too many female women with penises to any longer buy into some wishful thinking on the part of old-guard scientists who'd like to have things all nice and orderly in some predictable binary. For a long time, we've tried to explain two different, admittedly related concepts, with one word: Sex. We need to pull them apart if were going to make any sense of it. |
| 30: | I've been living on the border of the two-gender system for the past couple of years. Sometimes I manage to escape the system entirely. I claim no socially sanctioned gender, and I'm trying to retrace the steps it took for me to arrive at this point. I think it comes down to an understanding of gender as simply one aspect of identity. Gender is a kind of identity, that's all. |
| 30: | The question "How do you live without a gender" broadens into "How do you live without an identity?" |
| 30: | I think we create our identities, or actively fortify the identities we seem to be born with. |
| 30: | It's safe having an identity. It's secure. It's save having a gender. |
| Loren Cameron, "Body Alchemy: Transsexual Portraits", Cleis Press, November 1996 |
| | Every time I tell someone I am a transsexual, I have a turbulent series of emotions. At first, I am afraid that whoever I'm telling will have a negative response that they will somehow be repelled and become hostile or in some way reject me. In the end, when I have spilled my guts or exhausted their interest, I begin to retreat a little. A greyness falls over me, and I realise that I feel unsafe. I feel naked. Self-doubt starts to poke holes in my ego, and I begin to think I have exploited myself. I am ashamed of my exhibitionism, I promise myself not to tell anyone ever again. |
| Kate Bornstein, "Gender Outlaw: On Men, Women, and the Rest of Us", Vintage Books, April 1995 |
| | I see fashion as a proclamation or manifestation of identity, so, as long as identities are important, fashion will continue to be important. |
| | When I was growing up, people who lived cross-gendered lives were pressured into hiding deep within the darkest closets they could find. Those who came out of their closets were either studied under a microscope, ridiculed in the tabloids, or made exotic in the pron books, so it paid to hide. It paid to lie. That was probably the most painful part of it: the lying to friends and family and lovers, the pretending to be someone I wasn't. Going through a gender change is not the easiest thing in the world to do, but I went through it because I was so tiered of all the lies and secrets. |
| | I identify as neither male nor female, and now that my lover is going though his gender change, it turns out I'm neither straight nor gay. What I've found as a result of this borderline life is that the more fluid my identity has become, and the less demanding my own need to belong to the camps of male, female, gay or straight, the more playful and less dictatorial my fashion has become, as well as my style of self-expression. |
| | The need for a recognizable identity, and the need to belong to a group of people with a similar identity, these are driving forces in our culture, and nowhere is this more evident than in the area of gender and sexuality. |
| Eric Gordon, "Transsexual Healing: Medicaid Funding of Sex Reassignment Surgery", Archives of Sexual Behavior, 20:3 1991, p. 61 |
| | The author recommends case-specific determinations of eligibility for Medicaid funding, utilizing the standards of care promulgated by the Harry Benjamin International Gender Dysphoria Association. |
| | Hesitating patients should receive intensive counselling with the aim of getting them to make a decision that has been properly thought through in order to avoid an unfavourable outcome of surgery. |
| | The standards of care (1985) developed by The Harry Benjamin International Gender Dysphoria Association provide the clinician with a method for selecting those transsexuals most likely to benefit from SRS. |
| | When a new medical treatment is introduced, it must be considered experimental because its safety and efficacy are unknown. |
| John Cesnik, Eli Coleman, "Skoptic Syndrome: Treatment of an Obsessional Gender Dysphoria with Li Carbonate and Psychotherapy", American Journal of Psychotherapy, XLIV:2 April 1990, p. 204 |
| | These cases are important to report in order that psychotherapists make better differential diagnoses of psychiatric disorders related to body image pathology and gender identity disorders. |
| | It is important to report a medication which was found effective in reducing the threat of self mutilating behavior and making patients more receptive to psychotherapy. |
| | Our choice of lithium carbonate was prompted by our experience in successfully treating other forms of sexually related dysphorias at low doses, its ability to act rapidly, and the minimal side effects. These changes have been dramatic and lasting. |
| Anne Bolin, "In Search of Eve: Transsexual Rites of Passage", Bergin & Garvey, January 1988 p2 |
| p2: | Estimates of the population (of transsexuals in the United States) range from 3,000 to 6,000 |
| Daryl Costos, Michael Fleming, Brad MacGowan, "The Dyadic Adjustment of Female-to-Male Transsexuals", Archives of Sexual Behavior, 14:1 1985, p. 47 |
| | Generally, the transsexuals and their spouses reported good and mutually satisfying interpersonal relationships that are in may ways comparable to those of the matched control group. These findings lend support to the previous clinical interview studies that have reported that female-to-male transsexuals form stable and enduring intimate relationships. |
| | The participants in this study were 22 female-to-male transsexuals and their spouses with whom they had been living for a year or more. The ages of the transsexuals ranged from 2 to 50, with a mean of 31.8. The lengths of their relationships ranged from 1 year to 19 years, with a mean of 3.7 years. |
| | This study only asked the transsexuals and their spouses to identify the biggest problems in their relationships. This methodology necessarily obscured the fact that there are other difficulties in these relationships both related and unrelated to transsexualism. |
| James Gray, Richard Green, Ronald Hellman, Katherine Williams, "Childhood Sexual Identity, Childhood Religiosity, and Homophobia as Invluences in the development of Transsexualism, Homosexuality and Heterosexuality", Archives of General Psychiatry, August 1981, p. 910 |
| | Transsexuals, recalling childhood, perceived their parents as being more religious than did the homosexuals. At intermediate levels of femininity, greater homophobia scores where associated with more transsexual characteristics. These data support the thesis that early developmental aspects of sexual identity, and later concerns over homosexuality that are partly of a religious derivative, may contribute to a transsexual outcome. |
| Stephen Levine, L. Lothstein, "Expressive Psychotherapy With Gender Dysphoric Patients", Archives of General Psychiatry, August 1981, p. 924 |
| | Given the confused state of diagnosis and treatment of GD, it is reasonable to assume that those treatment methods that are the least invasive, such as psychotherapy, ought to be investigated seriously. However, psychological methods, while available, are quite difficult to initiate with an unmotivated, unwilling client. |
| | Many patients are motivated for psychotherapy by their psychotherapist. By internalizing the therapist as a good object, the patient with predominantly narcissistic pathologic illness may begin to change. |
| | It recently has been argued that a more active and directive approach to countertransference issues may facilitate rather than impede the establishment of a therapeutic alliance with GD patients. |
| | IN spite of reported psychotherapeutic successes, most GD patients do not receive psychotherapy. This may reflect the fact that the majority of GD patients are seen by nonpsychiatric surgical personnel who are unfamiliar with psychotherapy. |
| | Which patients among the primary or true transsexuals are the best SRS candidates is still an open question. |
| | An increasing number of clinical reports have suggested positive results with psychotherapy alone or combined with some form of surgical treatment. |
| | Whilst most GD patients are hostile to beginning therapy (since they view it as an obstacle to surgery), many therapists are also reluctant to begin therapy with these difficult patients. It is not uncommon for exploratory psychotherapy to end in a stale-mate. |
| | Initial reports of an 80% success rate for surgically treated transsexuals supported the belief that psychotherapy was of little or no benefit in the treatment of transsexualism. Despite the profound methodological limitations of such studies (eg small sample sizes, no control groups, and inadequate matching of patients on important variables), many members of the medical community supported SRS as the treatment of choice for some transsexuals. |
| | Although the term transsexualism has been used clinically to describe patients with severe gender dysphoria who requested SRS, the issue of diagnosis for gender identity disorders is still a matter of controversy. |
| | While surgery may weaken the man's aggressive drives, psychotherapy can provide the mechanism for integrating psychological structures. |
| | The wide range of clinical variants with wishes for SRS makes it impossible for a single treatment modality, such as surgery, to provide the only palliative or cure. |
| | For those patients who threaten to kill themselves unless SRS is immediately prescribed, we always recommend hospitalizaiton. |
| | To fully understand the patient's history, it is necessary to involve family, friends, partners, or spouse in the patient's evaluation and treatment. With the completion of the evaluation, it may be advisable to document the findings and present them to some patients in the form of a contract. This procedure may help to curb a particular patient who uses manipulations and bribes for SRS, which may surface periodically during the treatment. |
| L. Lothstein, "Psychodynamics and Sociodynamics of Gender Dysphoric States", American Journal of Psychotherapy, 33:2 April 1979 |
| | Not all of our patients exhibited each of the themes. For some patients, there was an intermixture of several themes while for others, a single theme was dominant. There is no suggestion that the list is exhaustive. It does, however, represent an attempt to recognize that transsexualism, not being a unitary phenomenon, cannot be explained by a unitary hypothesis. |
| Leonard Derogatis, Jon Meyer, "A Psychological Profile of the Transsexual 1. The male", The Journal of Nervous and Mental Disease, 166:4 1978 |
| | Popular interest is probably a result of liberalized sexual attitudes in combination with a fascination with the unusual. |
| | The condition excites professional interest because, in addition to being a unique and fascinating clinical variant, it also provides an unparalleled mechanism for understanding the development of normal gender identity. |
| Jon Meyer, "Training and Accreditaiton for the Treatment of Sexual Disorders", Am J Psychiatry, 133:4 April 1976 |
| | Medical or surgical procedures. The diagnostic physical examination and specialized surgical, pharmacological, hormonal and neurological techniques are included in this category. |
| | Physical manipulation techniques. The use of surrogates, the "sexological" examination (involving stimulation of the patient by the therapist) and techniques in which sexual manipulation is carried out or closely supervised by the therapist are included. |
| | While not every specialist will be equally competent in each major category and may wish to avoid using some for ethical, medicolegal or transference reasons, at a minimum the complete specialist will be familiar with the indications and contraindications for each technique and the indication for referral. |
| Kurt Freund, "Parent-Child Relations in Transsexual and Non-transsexual Homosexual Males", Brit. J. Psychiat., 124 1974, pp. 22-23 |
| p23: | Transsexual and non-transsexual androphilic subjects did not differ significantly in unreplaced loss of father in childhood or in father-son relationships. |
| Robert Stoller, "The transsexual boy: mother's feminized phallus", Br. J. Med. Psychol, 43:117 1970, p. 117 |
| | Only if one studies three generations, the patient, his parents and his grandparents, does the aetiology begin to grow clearer. |
| | These two factors (her bisexuality and depression) compel this type of mother forcefully and continuously to overwhelm her infant son with her presence from birth until the symbiosis is pried apart by the child going to school, or, since we have become interested in this condition, by treatment |
| | The transsexual boy begins to show his extreme femininity by age 2-3, though first signs may appear s early as age 1, as soon as any gender (masculinity or femininity) is expressed. The boy indicates at this early age that he wishes to live as a girl and have his body changed to female (he knows it is male). He wears women's clothes as much as permitted, uses natural-appearing feminine gestures and in play and fantasy takes only girls roles. He is not Psychotic. |
| | To what extent does hostility play a role in transsexuals' mothers preventing the development of masculinity in their transsexual son? They have a lifelong hatred and envy of males. Therefore, it is logical, when they have their own defenceless little male and with no one looking (not even father) , that they would create this transsexual as a culmination of their rage against males, doing to the little boy what they have always dreamed of doing to the other males of their lives; we see the mothers of homosexuals doing something of this sort. |
| | mixed are the feelings of many women about maleness, they do not succeed so completely in preventing the development of their sons' masculinity. |
| | While the mother-infant symbiosis that produces a transsexual boy is very rare and pathological, some of its components are part of more normal symbiosis. |
| | The mothers of transsexual boys, having cold, powerful mothers themselves, have good reason to believe in phallic women. Thoughts on how this contributes to their own need for a penis or for creating their sons as women with a phallus would carry us far beyond my data. |
| | Because these separation effects do not occur until age 3 or 4 or later, the massive disturbance in the development of her son's masculinity has already occurred. |
|
| | A salient finding concerning sex and eroticism in the present sample of late-treated women with the adrenogenital syndrome is the relatively high incidence of homosexual inclinations. |
| | The incidence of homosexual inclinations, the erotic response to perceptual material and the personal freedom In sex, indicate behavior more often found in males than in females. |
| K Dawson-Butterworth, N Gittleson, "Subjective Ideas of Sexual Change in Female Schizophrenics", Brit. J. Psychiat., 113 1967, pp. 491-494 |
| 494: | Compared to male schizophrenics, female schizophrenics were more likely to be single. They were also more likely to retain their sexual interest, to exhibit genital hallucinosis, to express delusions of change of size or shape of the genitalia and to express delusions of changing sex, these last four factors being closely associated with each other. The menopause was not a significant factor. |
| J Clark, "Abdominal pregnancy", Am. J. Obst. & Gynec., 96:4 1966, pp. 511-520 |
| p520: | Foetal wastage is very high in abdominal pregnancy. If one considers 28 weeks as the period of viability, 9 of the 26 pregnancies reached viability (33 per cent). Of these, 4 were born living, one of which died a few hours after delivery, giving an over-all foetal salvage of 11 per cent. There were no maternal deaths in this series. |
| Bernard Zuger, "Effeminante behavior persent in boys from early childhood", The Journal of Pediatrics, 69:6 November 1966, p. 1098 |
| | Effeminate behavior in young boys is often dismissed as inconsequential and as something that will be outgrown. There are, however, few long-term follow-up studies on which to base such a belief. |
| K Blacker, "Four Cases of Autocastration", Archives of General Psychiatry, February 1963 P176 |
| P176: | The transsexualist seems to accept his feminine wishes, identifies himself as a female, and wants to function sexually as a female. These men carry out their plans in a logical manner, using every means to have physicians remove their genitalia. Some also want an artificial vagina. Our patients have a somewhat different sexual confusion. These men are usually overly or latently schizophrenic. They are apparently not clear as to whether they are men or women. In a primitive way they attempt to solve their problem by removing their genitalia. |
| Michael Ross, "Cross-cultural apporaches to transsexualism a Comparison Between Sweeden and Australia", Acta Endocrinologica, p81 |
| p81: | It would appear that societal factors may play a part in the ratios and proportion of transsexuals presenting as patients. Two factors which we have tentatively identified include the degree of sex-role differentiation in a society, and anti-homosexual attitudes. |
| Jan Walinder, "Transsexualism: Definition, Prevalence and Sex Distribution", Acta Endocrinologica, p257 |
| p257: | Reliable prevalence figures and the validity of male dominance depend on continued research in this field. |
| p256: | A male dominance is commonly observed among sex deviates. In regard to transsexualism Benjamin (1966), for example, gives ratio of men to women of 8:1. In the Swedish material now comprising 48 personally examined patients (43+5 patients), the ratio is 2.5 : 1, a figure which closely corresponds to that of Randell (1959) who found 2.3:1. These two figures are the lowest rations that have been reported, but still the show a male preponderance among transsexuals. |
| Eli Coleman, Michael Ross, "Theories of Gender Transpostions: A critique and Suggestions for Further Research", Adversaria, , p. 525 |
| | Upon critical analyses of hormonal theories of heterosexuality and transsexualism, there are no robust data to support the role of hormones in the development of these behaviors or identities among humans. While and understanding of the aetiology of these phenomena, including heterosexuality, is intriguing, we need to be cautious in our zeal to find simplistic explanations and not to retreat to oversimplified notions. |
| Henry Biller, "A Note on Father Absence and Madculine Development in Lower-Class Negro and White Boys", Child Development, , pp. 1003-1006 |
| | Underlying sex-role orientation is more influenced by father availability and family background than are more manifest aspects of masculinity. When a boy is father absent in his preschool years, his opportunities to interact with and imitate males in positions of competence and power are usually severely limited. In families where the father is absent or ineffectual and, in addition, little value is attached to being a male and being masculine, the young boy seems to have even more difficulty in developing a masculine self-concept. |
| Milton Diamond, "A critical evaluation of the Ontogeny of Human Sexual Behavior", The quarterly review of Biology, , p. 147 |
| | The proper interpretation of human sexual behavior must not stumble on a debate of nature versus nurture. Undoubtedly both are significantly involved. |