Decision

A topic that inevitably comes up when people grapple with understanding transsexuals is the “decision” to transition from one sex to the other. That word – decision – is quite a hot button for transsexuals. It’s often even a hot button among transsexuals.

Because, you see, there is a strong belief among many transsexuals that we didn’t decide anything. We were born with a condition not of our choosing. It wasn’t any kind of decision to be who we are. Transition, for many of us, wasn’t so much a decision as it was a coping mechanism trying to make life bearable after it had become intolerable to live as a person we knew we were not.

I fear I’ve previously been a bit flip about this issue. The most directly I have spoken about this in the past has been to say, “I didn’t decide to transition. I decided not to kill myself. Transition was simply the result of that choice.” I’ve said that more than once.

While that statement is true, I now recognize that characterization as a kind of evasion. It’s a truth that fails to enlighten, and that latter part is not accidental.

At the age of 37 I suffered a total breakdown. I was barely able to leave the house, and when I did I was either drunk or severely hungover. This was not an event. It was my life. And it was getting worse. No end in sight. And I didn’t care.

Here is a comment I placed in response to a nearly identical question on the (incidentally excellent) blog Is This Me?

(in response to the question: “What exactly was the problem you had with being a man?”)

“It wasn’t any one thing, in the end it was everything. I literally couldn’t function anymore. Total breakdown. Psychological, emotional, and physical.

At the time I didn’t attribute this to “being a man,” I attributed it to my life not being worth living. Being a man just seemed like a reality I had to accept, like I accepted that I had to breathe and eat and sleep.

And I did accept it. And also I didn’t want to live any more. It didn’t occur to me until lots of therapy later that these two things were related.

It was through therapy that I came to see that this one embarrassing secret – the thing that turned out to have the name “transsexual” – was at the root of all the rest. I knew I had weird emotional baggage around gender issues, but I was still not my therapist’s most easily convinced patient on the topic. I didn’t tell her I wanted to transition. I insisted it was impossible, so what else could she offer?

But gradually I made baby steps toward transition – purely mental ones at first. Allowing myself to believe hypothetically that such and such was possible, and such and such was true. What would that mean? And I realized that if those things were true I would actually want to live. So that told me those things were pretty important.

It STILL took a lot more convincing to believe those hypotheticals could be possible in reality, but that was the nature of my decision process leading to transition.

So for all of that, I leave it to those who read this to decide for themselves what exactly it was I “decided.”

Edit: p.s. If you want more detail – mine and others – there’s more good stuff in the comments section at the blog I linked above.

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Understanding Benjamin’s Types

A recurrent theme I’ve observed lately on trans blogs is the mis-application of Harry Benjamin’s Sex Orientation Scale (S.O.S). This scale was published in 1966 with the release of Benjamin’s groundbreaking book The Transsexual Phenomenon.

With a few significant corrections (e.g. later researchers have noted that sexual identity and sexual orientation are certainly not as closely correlated as Benjamin’s initial scale implied), I think the scale holds up surprisingly well. But it doesn’t hold up well at all in the case of people who want to use it for purposes divorced from Benjamin’s intent.

The S.O.S. was developed to address the need for a diagnostic tool which accounted for a group which, at the time, was entirely unrepresented in the medical literature. Previously when seeking professional treatment, transsexuals had been (mis)classified as either homosexuals or transvestites and (mis)treated accordingly. Benjamin wanted to call out, in practical terms usable in clinical practice, a more suitable set of guidelines for accurately diagnosing and effectively treating transsexuals.

He knew it wasn’t a perfect tool – in fact he took pains to point out some of its known flaws. Here is a telling excerpt from Benjamin’s introduction of his S.O.S (all emphases below are mine):

“The following chapters will make use of the types from I to VI in relating case histories and in establishing a diagnosis of the respective patients. Referring to Table I will then enable the reader to get a somewhat clearer picture of the particular individual and his or her problem. It should be noted again, however, that most patients would fall in between two types and may even have this or that symptom of still another type.“

Or, in laymans’ terms, these are approximations. They’re intended to help physicians establish patient diagnoses. Don’t expect any single individual to fall neatly and perfectly into any of these types. They’re intended as practical guidelines, not hardbound rules.

He goes on to say:

“It has been the intention here to point out the possibility of several conceptions and classifications of the transvestitic and the transsexual phenomenon. Future studies and observations may decide which one is likely to come closest to the truth and in this way a possible understanding of the etiology may be gained. If this etiology should ever be established through future researches, classifications may have to be modified accordingly. In the meantime, the S.O.S. may serve a pragmatic and diagnostic purpose.“

Layman’s translation: This ain’t gospel. It’s a work in progess. I’m relying on you – medical professionals – to keep this thing in harmony with the best available evidence. I hope you find it useful. If not, please make it better.

Here’s a quick flowchart showing Benjamin’s message about the purpose of the S.O.S.

Another item of note: Benjamin didn’t put much stock into the whole “early” versus “late” transitioner when it came to his standards. And he most definitely did NOT see these types as something any given patient must fulfill to the letter from initial presentation through final treatment. He observed patients initially diagnosed as one type who dramatically shifted to another over time, based on the totality of the evidence. He accepted this as a natural part of the diagnostic process.

Unlike less reputable researchers into transsexual lives, Benjamin didn’t assume that a patient was a liar for revealing something which challenged his preconceptions. He always assumed his own understanding of all the intricacies of how this condition affected individual lives to be incomplete.

Benjamin makes it pretty clear how he himself used these standards in relating examples of three different types of transsexuals. One such story begins with the patient showing up at Benjamin’s office at the age of 28, married, father of three children, a successful salesman, and asking for help because his recurrent transvestism was threatening his marriage.

Type III transvestite, you might think? Benjamin implies that was his initial diagnosis. But as more evidence came to light his diagnosis changed. That person described above is his example of a Type VI “high intensity” transsexual. They don’t get any more transsexual in Benjamin’s book.

If an expert like Benjamin could err so dramatically in diagnosing a patient, why do others seem so certain they can grab a few facts about a person – like marital status, age, and crossdressing history – and make a slam-dunk, unchangeable diagnosis every time?

Benjamin’s work was all about helping people. He found transsexuals a miserably unhappy and tragically underserved segment of the population. He didn’t look for someone else to blame. He rolled up his sleeves and made fixing this problem his life’s work. Those who use that work as a basis for belittling, mocking, and abusing others could not be more divorced from the example of Harry Benjamin himself, and do his legacy no favors.

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Nature’s Children

Just a quick link to share today. It’s not a new article. But I’ve been returning to it recently as a resource for countering some of the usual “transsexuals are unnatural” arguments, and I thought others might find it helpful for the same purpose.

It’s from The Organisation Intersex International (OII) Australia:

“I believe that transsexuals are intersexed individuals.”

Incidentally, the article’s position regarding the proper role of science in addressing these questions is one I strongly share. How come so many people who want to use “nature” to refute our existence seem so resistant to actually examining the natural evidence?

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Stumblings

Recently I’ve been wondering how much longer I can keep this gender transition-themed blog going. When I started the blog, just a few weeks from one year ago, transition seemed to be an endless well of ideas and experiences capable of fueling the blog’s engine for all time. But now?

I’m frankly running out of steam on the topic. While I don’t claim to be finished with transition my any means, my life isn’t about transition any longer. The distinction is important.

I still read a lot of transition blogs – though admittedly not as many as I once did. I keep looking for some hook to make writing about the same kind of stuff seem relevant to a life which has moved into normalcy. I haven’t found it yet.

This revelation pains me in a way. I never intended to become someone who transitioned and then disappeared. While I have longed for a normal life, I have always maintained strong empathy for those who still suffer from the condition I’m increasingly looking back upon.

But I’m struggling to find any relevance in joining the life I am now building with the transition culture I’m unexpectedly leaving behind. These things, I am finding, are not alike. You cannot live in them both at once. One will win out.

I don’t want my life to all be about the “trans” aspect anymore. I understand how and why that stuff remains important to some. But that isn’t what I’m about. After a certain point it isn’t remotely descriptive about the kind of person I am.

I would like to think there is nothing about my new life which is closed off to anyone – the trans aspect is neither excluded nor required. When it comes to anything important I have to say, I welcome any and all challenges to this belief.

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