Basic TG/TS/IS Information
- by Lynn Conway
- Copyright @ 2000-2005, Lynn Conway.
- All Rights Reserved.
- Part IIa:
- Transsexualism (Continued)
- Part IIa - Contents:
- Transitioning early in life:
- In the last section, we discussed the issues facing those
who transition late in life. Fortunately, there are increasing
opportunities for T-girls to transition early in life. The clear
and visible difficulties facing late transitioners should be a big warning
bell for young transsexual girls, who should seek help and learn of all the
options for resolving their conditions at the earliest possible age (see Andrea James' page
Early in Life).
- The wonderful effects of transition in one's twenties or
younger are seen in many webpages documenting early transitions. When these photos were first added here, "Katie"
was a young
TS woman in her mid-twenties who'd recently underwent
"on-the-job", and was in her RLE. She has since completed her
transition and is very successful in her life and career, and her story and
website give lots of hope to other young transsexuals.
Here's a photographic overview of Katie's gender transition:
- An increasing number of transsexual youngsters are also now
able to gain the support of their families.
Many are transitioning
while in college, and some even have the chance to transition
while in high-school if their parents approve.
- Such an early transition provides incredible advantages to
a TS girl, because she can avoid the heavy damage to her body
structure and facial features caused by male hormones during
the late teens and twenties. The recently released
Standards of Care, Version Six now support such early medical
interventions in cases of intense MtF transsexualism.
- By beginning anti-androgens and estrogens in her mid-teens,
the TS girl's puberty can be shifted into a transition towards
womanhood. Her SRS can then be done at age 18 or so. Such a TS
girl can begin dating at a normal age, and share in all the experiences
that other high school girls enjoy. For a heartwarming example,
I Need to be a Girl, by "Just Evelyn", Walter
Trook Publ., 1998. See also the salon.com article "Teen
transsexuals: When do children have a right to decide their gender?"
- The Netherlands - At the forefront of the treatment of
teenage GID and early transitions:
- The Netherlands is in the forefront of providing for early
diagnosis and treatment of cases of intense GID in children and
teens. Professor dr. Peggy Cohen-Kettenis (is klinisch psychologe
en psychotherapeute bij het Medisch Centrum van de Vrije Universiteit
van Amsterdam) is a major advocate for the humane treatment of
children and teens who suffer from intense gender dysphoria,
She developed the new protocols for treating gender dysphoric
teens over a number of years in an extensive research programme.
For more information about Dr. Cohen-Kettenis, see these links:
In cases such as Nicole's in the Netherlands, reversible hormone
treatments can now begin early so as to delay puberty, and then
cross-sex hormones can be begun at age sixteen. If all indications
are positive, then SRS can be done at age eighteen.
- Following is a link to a Dutch article about a teenage transitioner
named Nicole, showing what it could be like for trans
kids in other countries if their societies were more merciful
and understanding. Nicle is now on the treatment trajectory pioneered
by Dr. Cohen-Kettenis:
Nicole, age 13 (her story in Dutch)
- A pretty young Dutch trans girl
- with full family and medical-system
- By the time Nicole is eighteen her gender correction will
be complete, and she can then look forward to a full and normal
life as a woman. Meantime, her teen years will be spent as a
girl, and she will be able to assimilate socially during those
years as would a normal girl. All of the counseling and medical
care in these cases is covered by the Dutch health service. The
many positive outcomes under Dr. Cohen-Kettenis' treatment protocols
are now becoming more widely known in the west. Hopefully more
and more counselors will pay close attention to these results
and begin to explore bringing the Dutch protocols into wider
use in more countries.
- See the following links for more about Nicole's story and
translations of other stories about Dutch teenage transitioners.
Much of this information comes from the Dutch gender dysphoria
information website Landelijke
Kontaktgroep T&T (LKG T&T). These stories were translated
into English by Barbara Blake, herself the mother of a transgender
- Photos of Dutch trans children
- in the 'Volkskrant' magazine article "Wrong Body"
- by Ellen de Visser, 13 September 2003
- Jasmijn, age 9
- Manon, age 10
- Kristel, age 11
- Willem, age 12
- Valentin, age 13
- Jamie, age 14
- Germany sets a new precedent:
In a landmark ruling in Germany, a 14
year old transsexual teen named Johanna has been given permission to receive
hormone therapy to begin her physical transition from boy to girl. With
the full support of her mother Anke, Johanna had been raised as a girl from an
early age. Anke and Johanna then convinced a German ethics commission to grant
permission for Johanna's early transition, and in a race against time were able
to intervene to avoid her physical masculinization by testosterone. Anke's
wonderful story about Johanna's life,
"My Daughter’s Brave
Choice", was published in English in the June 14, 2004 issue of
Woman's Own, a UK magazine.
As Johannes, age 3
now as Johanna, age 14
My Daughter’s Brave Choice (English),
decisión de mi hija (Español),
Le courageux Choix
de ma fille (Français),
Entscheidung meiner Tochter (Deutsch),
La scelta coraggiosa di mia figlia (Italiano),
A lányom bátor
Wybór mojej córki (Polski),
моей дочери (Russian)
See also "Nina’s
Story, the story of another young German girl, translated by Barbara
Blake from an article in
Suddeutsche Zeitung Magazin,
2 August 2008 (DE,
The Situation elsewhere:
- Meantime, in most other "advanced countries" the
situation regarding early diagnosis and treatment is a very mixed
bag. The same services can be accessed by those parents who learn
about them, and who are insightful enough and courageous enough
to help their child in this way. But most families will not know
about these options, or if they did will not visualize the seriousness
of forcing a teenager to grow up into the wrong gender and have
to make the much more difficult correction later - as an adult.
- Therefore, many a teen-aged TS girl is confronted with the
desperate decision of whether or not to even "tell her parents".
Will she find help from them for her transition? Or will she
be summarily thrown out onto the streets? She may have no way
of guessing the answer to this life and death question. It is
still all too common for families to totally reject and excommunicate
a TS child who comes out to them and seeks help from them. Even
more frequently than with gay children, TG/TS children are often
simply "thrown away" by their parents: Expelled from
their homes, they are doomed to attempt unsupported early-transitions
on their own, often ending up living marginalized lives as prostitutes
on the streets of inner-cities (as
- Even in cases where the parents want to help a child diagnosed
with gender identity disorder (GID, which is a term sometimes
used for transgenderism/transsexualism), the state may intrude
and PREVENT appropriate gender assignment. For example, in a
recent case in Ohio, the State took
custody of a six-year-old transgender/transsexual girl away
from parents who sent "him" to school dressed as a
girl. The little child had been diagnosed with GID, and had strongly
self-identified as a girl since the age of two. Social workers
represented that the child could be cured of this behavior rather
than "encouraged" by the parents.
- In other cases, the child may be expelled from school for
"cross-dressing". TG/TS students may face serious hostility
from teachers and administrators who lack a basic understanding
about gender identity variations and about how our gender is
the most basic underlying component of who we are as a person.
Fortunately, an important
court case in Brockton, MA sets an important precedent: A
Brockton school justified its exclusion of a TG/TS student based
on other students' discomfort. The superior court rejected this
argument, holding that prohibiting "Pat" from wearing
girls' clothing was akin to "the stifling of plaintiff's
selfhood merely because it causes some members of the community
- Well-meaning parents often take a child who "wants to
change gender" to a traditional psychiatrist. However, GID
is still considered a mental disorder by many psychiatrists (under
John Money's now discredited theory). Such psychiatrists often
believe they can "cure children of this disorder",
and their cures usually involve aversion therapy and strict enforcement
of gender stereotyping. TG/TS children suffer enormously under
such treatments, which only delay their transitions - often till
late into middle-age - costing them the best years of their lives
outside their innate gender. These cruel and unscientific treatments
of innocent TG/TS children are the moral and medical equivalent
of unwanted genital surgeries on intersex infants. Such treatments
inevitably fail, and hopefully will fall into disrepute as time
- But there is good news too. Recent developments, including
far easier access to female hormones (ordered from overseas websites)
and the establishment of
sex-change surgery clinics in Thailand, where SRS costs $4000
to $6000 (see article in the May 6, 2001 New York Times),
have made it much easier for younger transsexual girls to achieve
complete gender transition before or during their twenties. Many
young T-girls can now simply manage their own cases, starting
themselves on hormones and then socially transitioning when they
are sufficiently androgynous - and all along saving money for
surgery. The Thai surgeons do not insist on the full HBIGDA protocol,
thus reducing the financial burden of having to go to a counselor
or psychiatrist for several years, and then yet
another one for a "second opinion", in order to get the "letters
of approval for SRS" needed here in the U.S.
- [Note: It is useful to know that
has a long tradition of socially accommodating the transgendered
(known in Thailand as 'katoey'), who can crossdress and live
openly as women there. Although they do not have full social
privileges, they nevertheless do not have to live in fear and
destitution as in many other countries. Thus the publicly visible
and known number of transgender/transsexual girls in Thailand
is vastly larger than in western countries where the transgendered
must usually pass (and be invisible) as women or else remain
hidden and closeted.]
- As an even less expensive alternative, transsexual women
can now take advantage of fairly easy access to orchiectomy (castration),
which costs about $1000 to $2000 and which does not require the
full "SRS permission letters" (see Lynn's SRS
webpage for links to surgery clinics). After castration,
a T-girl's body will no longer be maimed by testosterone and
the feminizing effect of estrogen will become much more pronounced
(especially in younger girls). This approach can enable younger
T-girls to rapidly become passable, and to "buy time"
to save money for SRS without feeling such terrible, desperate
- Spanish actress
Carla Antonelli's website contains a
of photos of pretty TG/TS-girls where you can see the wonderful
results the girls obtained from feminization early in life. The
moral to the story is simple: If a TS-girl knows for sure that
she must inevitably become a woman, then there is no time to
waste. She should intervene to stop any further masculinization
and to begin her feminization as early as possible - in her mid-teens
if she can.
- As our society begins to better understand and accept gender-transition
as a treatment for the transsexualism condition, more and more
transsexuals will be able to transition at younger ages than
now. Transitioning early in life, especially while in their teens,
enables transsexual children to avoid growing up into the wrong
gender and allows them to live full lives in their correct gender.
(See the UK's Sunday Express article about children who want
to change sex entitled: "I
am never going to be a man, mummy, when I grow up it will be
as a woman").
- Take a look at the happiness in the face of
Davis, the pretty young Australian woman in the following
photos. At the tender age of 17 she became the youngest Australian
TS child to have undergone MtF SRS. Her courageous story was
told in Australian Woman's Day in 1998. Try to imagine
the joy that Deborah felt at the early release from the gender
trap she found herself in. Also try to imagine what might have
been in store for Deborah had she grown up in a less-supportive
- Photos of Deborah Davis, copyright
Australian Woman's Day, 1998.
- After looking at the above photos, please ask yourself: What
would you do if your own child were transsexual? Would you take
her to a psychiatrist and attempt to "cure" her of
her "sexual deviance" by "conditioning" or
"aversion therapy"? Would you try everything possible
to prevent her from transitioning until she is much older, and
thereby doom her to having her appearance horribly maimed and
masculinized by testosterone? Would you throw her out onto the
streets, as so many other parents do to their transsexual children?
Or as a loving parent would you visualize the terribly frightened
girl inside that young boy's body? And would you love her enough
to help her escape from that trap so that she can go on to a
full and normal life, as young Deborah did?
- For young TS girls who cannot get the support of their parents,
there are still many paths to early transition. Of course, some
girls are so overwhelmingly compelled to transition that they
simply run away to big cities and hit the streets on their own.
Others struggle to cautiously wait until they finish high school
and can get away from home and be out on their own - either working
and making money, or going to college - and then begin their
- Kids who run away to big cities like New York City, San Francisco,
or Los Angeles can find some help these days. They can usually
locate other kids like themselves and thus at least have some
friends for social support. Some large cities, such as San Francisco,
also have free clinics where TG/TS kids can get help with transition,
get started on hormones and find entry-level jobs in their new
gender. However, as we've seen in Part I, many of these kids
end up in sex work, with all its risks and dangers of drug abuse,
HIV, sexual exploitation and transphobic violence.
- Kids who can hang on and wait until they graduate from high
school have a much better chance of making it. Many begin working
on their transition in secret while still in high school, by
learning everything they can from the web and by beginning to
plan ahead on how to do it. Some find ways, without anyone knowing,
to start on estrogen and anti-androgen hormones while still in
high school, and that can greatly improve their long-term transition
- Education as a key to earlier, easier transition and success:
- Whatever else they do, Lynn strongly advises TS kids to study
very hard while in high school, get the best grades they possibly
can, and then try to get into a good college. Transitioning while
in college has now become one of the best and easiest paths to
a successful early transition, and is an even better path than
just going directly into the workforce in an entry-level job
and trying to transition on the job there.
- Students are very anonymous while in college, much more so
than in high school, especially if the college is reasonably
far from their hometowns. A TS girl's college classmates will
be much more mature, much less "gossipy", and far less
insistent on conformity to group norms than her high school classmates.
The atmosphere in most modern colleges and universities is very
accepting and tolerant of diversity. Very few of a TS girl's
classmates will be transphobic, as long as she goes to a modern,
mainstream college or university (as opposed to some religious-based
school, or a school in a southern "redneck" area, etc.).
Also, in most college towns or locales she will find areas for
shopping, recreation and socializing that are relatively safe
and fun places to hang out, even while in mid-transition.
- If at all possible, college-bound TS kids who do not have
the support of their parents for transition should try to get
a scholarship to college and/or consider going to a community
college, state college or state university. That way they will
be less dependent financially on their parents, and are more
likely to be able to finish school even if their parents find
out they are TS and try to stop them from transitioning. By working
hard at part-time jobs they can make the extra money needed for
hormones and electrolysis, and can get far enough along in their
physical feminization to be able to socially transition while
in school. The girl can then socially transition and get her
ID's changed over one summer, for example between her junior
and senior years or between graduation and grad school, and then
return to school in the fall without her classmates realizing
who she is/was - especially in the anonymous environments of
the large state universities. By completing her hormonal and
social transition while in college, the TS girl can graduate
in her new name and identity. She can then more easily find employment
and start her career without having to generally reveal her hormonal
and social transition.
- That is not to say that transitioning while in college is
easy to do. It can be an incredibly scary time. Few colleges
and universities have any formal procedures or points of contact
for helping transitioning students. Even such basic things as
getting student ID's and records changed in a coordinated manner
can sometimes be a huge hassle. The girl will need to get her
nerve up and go see the various records' offices at her school
and tell them that she has changed gender and has a new name.
If she passes OK, and if she makes these requests calmly and
without too much fear showing, many schools these days will simply
accept her gender change at face value and change her records
to her new name. However, if she is unlucky and runs into the
wrong administrator, she may have to explain her situation in
more detail and have letters from a gender counselor, etc. And
if she becomes ill or injured in an accident, she may face outing
and huge hassles from the college's health service. Nevertheless,
it is a lot easier to transition while in college than in most
other times and places in life. Even when procedural hassles
and outings do occur, they are usually confined to within the
university and few others find out about it later.
- More and more universities are quietly taking notice that
transgendered students are occasionally transitioning. Although
most schools don't yet know quite how to deal with this reality,
transitioning students who are persistent can usually negotiate
the bureaucracies at most schools and eventually get their records
changed correctly. Once the girl graduates she can start her
new life with the option of stealth and without being perpetually
followed by rumors and gossip. Then, once she has started in
her career and can save some money, she can complete her transition
- For more information about the advantages of early transitions, see an article
Claire magazine (UK edition) in July 2002 that profiles three
young trans women. Those considering early transition and those
helping an early transitioners should also be sure to see the following
really important website:
- The great obstacle to transition:
The challenge of confronting and coping with fear
- People often ask Lynn "How were you able to cope with
intense fear, and make the hard moves involved in transition
back in the 60's?" This question is important , because
fear is probably the biggest obstacle to transition, even today.
Even a person with intense motivation, positive attitude, effective
planning, and an ability to rapidly learn new skills can "stall-out"
and fail to transition, if they cannot learn to cope with fear.
- Fear causes many TG/TS people to delay for years taking even
the smallest steps, such as coming out to someone, making an
appointment with a gender counselor, doing some tentative cross-dressing
in public, or even going into a store to buy some make-up or
women's clothing. Beyond these simple tasks, many TG/TS people
over-worry about whether they'll ever pass, whether they can
avoid violence, and whether they can face the pain of many surgeries.
These fears derive from real concerns. But fear itself cannot
be allowed to control your life and block progress towards important
- Fear does its greatest damage when a person reduces anxiety
by NOT doing something frightening. For example, when someone
terrified of public speaking finds a way to avoid giving a talk,
the resulting reduction in anxiety feels like a "reward
for talk avoidance". NOT doing scary things rapidly becomes
habit for such a person, because they reward themselves for not
doing things. However, by NOT doing scary things, they may never
make progress towards important goals. The only way to break
out of such avoidance-behavior is to learn to PUSH through fear
and DO things in spite of fear. Then you experience rewards from
decisive positive action.
- However, this is easier said than done. If you can act while
feeling intense fear, bystanders sense your fear and experience
great unease. The unease people feel around a frightened TS in
transition is like the unease we feel when a public speaker gets
"stage-fright". It isn't that they dislike the person,
or are bigots - it's just instinctive to feel uneasy around a
very frightened person. This "fear-feedback" from bystanders
then further frightens the transitioner. Therefore, taking actions
when freaked-out doesn't work. Instead, you have to find ways
to acclimate to fear and calm it down.
- Lynn learned to cope with fear when she was in her teens,
by getting into rock climbing. As she advanced to leading climbs,
she had to face difficult moves, calculate whether they could
be taken, and make decisions about risk and about the technical
protection she had placed. By leading more and more difficult
climbs, she learned to make difficult moves gracefully as if
just off the ground, even when there were big dropoffs below
her. Later, whenever Lynn faced something fearful she would think
of it like a climbing move. Once she worked out the move, she
would just go DO IT. Methodically "stepping through fear"
became a habit. Many of Lynn's friends over the years learned
similar lessons from adventures in skiing, figure skating, gymnastics,
horseback riding, whitewater canoeing, motocross racing, and
other demanding physical pursuits. Maybe you can find an activity
that will help you this way too.
- The gender transition experience itself can teach these same
lessons. By starting out carefully in the initial stages, the
beginner can learn how to confront and calm fears before going
on to the harder steps. The key is to find modestly fearful things
that you MUST DO and CAN DO, and then DO them in a timely, decisive
manner. This can help you learn how to calm yourself before going
on to harder steps.
- The fears and embarrassments of the beginner fade as one
makes progress. The accumulating physical changes and the skills
learned in the early stages of transition can bring on a cheerful
smile, a better attitude, and an eagerness to overcome harder
challenges yet ahead. With practice along the way, fear can gradually
be contained and replaced with hope, determination and anticipation.
- Fear is often heightened
by GLBT activism which portrays all TG's & TS's as "victims"
- Why are so many young TS people too terrified to admit to
anyone that they are transsexual? What causes all this crippling
- All young folks remember the strict gender behavior constraints
imposed on them as kids. They intuitively sense the risks of
transition, and visualize that it would take hard work, gritty
fortitude and persistence. However, many young TS's can quietly
transition without facing a lot of humiliation or difficulties,
especially if they plan their transition well and carry it out
calmly with grace and dignity. So why do so many let fear hold
them back for years or decades before seeking help?
- A lot of fear among young TS's is a side-effect of well-intentioned
GLBT activism. Activists work hard to uncover hate crimes and
discrimination incidents, and then publicize them widely and
dramatically. As a result, TG and TS people are constantly portrayed
as "pathetic victims" in the media. Victimization stories
are turned into major news articles and movies, furthering the
pathetic-victim image of gender-variant people. These stories
are intended to demonstrate how despicable such hate crimes are.
Emotionally outraged supporters send in contributions, and the
activists are able to publicize more hate-crime stories. These
efforts have the beneficial effect of alerting society to the
outrages that are committed against some TG and TS people.
- The problem with all this is that it spotlights the lives
of only the small minority of TG/TS people who are victims of
violence. The effect is made more harmful by the incorrect assumption
that transsexualism is incredibly rare (which it is not; see
section above). As a result young TS's get the totally false
impression that almost ALL people who transition end up as constant
targets for harassment and brutality.
- Hopefully activists will someday help in building a more
balanced, positive, realistic image of the lives of transsexual
people. A better balanced image might actually help reduce public
hostility towards TG and TS people. It would certainly reduce
the level of fear among young TS's.
- Lynn created her
Successes" webpage for that very reason. She wants folks
to know that there are tens of thousands of postop TS women out
there who are doing just fine and living wonderful lives. If
more young TS girls knew about all these successes, they would
be less frightened by occasional reports of discrimination, would
be less afraid to seek help, and would be more hopeful that they
could successfully transition too.
Be sure to visualize the real risks of TG and TS transitions
and the factors that affect success
- Discrimination, intolerance and harassment, although widely
feared, are not usually the worst risks faced by most transitioners.
The real risks are those that arise within oneself. There's the
risk that you simply may not be competent enough to transition,
the risk of losing employment and not being able make money,
the risk that you just aren't self-reliant and adaptable enough
to negotiate the maze of trials involved, and even worse - the
risk that maybe you aren't transitioning for the right reasons,
in which case you may become totally miserable afterwards. This
is serious stuff that you need to carefully consider!
- One of the most important requirements for success is the
ability to shed all feelings of shame, embarrassment and guilt
about one's transsexualism, and go forward with grace and dignity
- even though those around you may react negatively. If the transitioner
cannot shed feelings of shame and embarrassment, those feelings
may grow rather than diminish as they get further into their
transition, triggering serious emotional difficulties. Difficulties
in handling shame and embarrassment, combined with a strong need
to somehow express her femaleness can cause the transitioner
to "act out", and present herself and talk about her
transition in strange, uncontrolled ways that shock other people.
Learning self-acceptance and shedding all feelings of shame and
embarrassment is an area where counseling is critical and can
be very helpful.
- On the other hand, it is important to be realistic and know
whether you have the "street smarts" to do something
this difficult. However, it can be difficult for you evaluate
your own "competence" for doing something like this.
people don't realize that they are incompetent! They can't
see competence in others, nor can they see themselves as others
see them. Thus they can't make the corrections needed to succeed.
Such people often think they pass when they don't, and then accuse
those around them of being mean instead of working on their own
very real "passing problems".
- Successful transition may simply be beyond people who cannot
rapidly learn new skills by carefully watching others do things
and then calibrate the reactions of others when they try to do
the same things. Successful transition requires lots of street
smarts and common sense, an ability to quickly learn new practical
skills, a lot of drive and a lot of hard work.
- A good counselor can help you objectively examine your options
for transition and help you figure out whether you've got what
it takes to "make it". Support groups and other groups
of TG/TS friends can also help you a lot by providing a gauge
to measure yourself against. It is very difficult, almost impossible,
to do this on your own, and a willingness to seek help and the
advice of others will be important for success. Seeing what others
are doing and how it is working for them can provide invaluable
insights into how well you yourself might do. However, remember
that TG/TS friends will often be too kind, and won't tell you
that you need to make some major improvements in your presentation.
Then too, sometimes when you are doing well TG/TS friends may
turn jealous and try to hurt your confidence. Therefore, you
must listen to your own heart when making major decisions, and
not rely solely on the opinions of others one way or the other.
- Careful financial planning, employment planning, budgeting,
and contingency planning are also essential to success. Remember,
you run the danger of getting "stuck in transition"
if you run out of money and become unemployably unpassable "somewhere
in between". Don't ever go there! Some attractive T-young
girls may be able to resort to turning tricks, but this occupation
brings on a whole new set of dangers and risks, as we've seen
in Part I. The best bet is to get some skills so that you are
readily employable, and then work very hard to save money for
- An ability to steel oneself and be able to live with unresolvably
negative reactions by family members and friends is also important.
Otherwise the emotional pressures may become overwhelming when
added to the other stresses of transition. Parents and family
members may try to stop you from transitioning or try to stop
your surgeries, even if you are an older transitioner. In some
states they may even try to have you institutionalized. Being
able to make lots of new friends can help compensate for losses
of family and friends. Many TS's make lots of TS friends during
transition, and then carry-over their improved "friend-making"
skills into their postop lives.
- NOW THE REAL WARNING: What if you "succeed"
in completing a TS transition, but did it for the wrong reasons?
- Yep, you get the idea! This is one place you definitely
do NOT want to go!
- In many cases, TS transition works out really well long-term.
However, in some cases TS transition totally fails to meet very
unrealistic expectations. Way too late the person may realize
that undergoing SRS was a BIG mistake. This seems especially
to be the case with older intense crossdressers and fetishists (including
those who self-identify as "autogynephiles") whose drive to transition is based solely
on male sexual feelings.
- These people gradually lose their male libidinous responses to their new
female body as time passes after the removal of their testicles during SRS.
(This effect is quite different from the experiencing of a heightened female libido and
improvements in lovemaking capability that occur in many other postop TS cases).. The loss of libinous rewards, combined with the accumulating practical difficulties
of postop life, can lead to serious long-term adjustment difficulties
for those who've "made a mistake". EXTREME CAUTION
is advised IF you are unsure of your motives for SRS.
- For examples of postop women who had later
regrets about undergoing SRS, see the information about Renee
Richards, Dani Berry and Sandra (Ian) MacDougall on Lynn's
- SRS WARNING PAGE
- There have also been occasional cases of gay male drag queens
who fall in love with straight men and some who talk themselves
into suddenly going off and getting SRS in order to please and/or
keep their lovers. These cases often turn out very badly, as
the gay man increasingly freaks-out over the loss of his masculinity
as time passes by. Such cases are the basis of many "urban
myths" in the gay male community about "sex changes
being a really insane idea", and may be behind some of the
virulently transphobic writings and speeches of gay thought leaders
as Jim Fouratt) in recent years.
- Therefore, you must be very, very honest with yourself about
"why" you need to transition, and whether a TS transition
will meet your expectations over the long term. No one else can
know your inner feelings of "why you need to do this",
and no one else can predict how competent you might be at doing
this. It is VERY important to be brutally realistic with yourself
about your motives, capabilities and expectations before committing
to a transsexual transition and undergoing SRS. If you sense
that you might be doing this for your own autosexual pleasure,
be careful and think about all the warnings. However, if you
feel a deep need to be a female in body as well as socially,
and if you feel a deep need to fully express your female sexuality
in lovemaking, then maybe this is right for you.
- Listen to your heart and to your body, and don't let perceived
social pressures force you into something you'll regret. If you
really enjoy your male sexuality preop (especially male "mounting,
thrusting and penetrating" urges, and a focusing on your
external genitalia as the main source of sexual arousal and pleasure),
then you are unlikely to develop and enjoy a female sexuality
after a TS transition. Instead you may simply regret losing your
male sexuality and become sexually "cold". If you think
this is a possibility, you should seriously consider TG transition.
- Sometimes the situation is reversed. There are some intensely
TS women (who have deeply female sexual arousals and urges, and
who lack male "mounting" urges and male sexual urges)
for whom SRS is probably the right path, but who avoid SRS out
of a deep fear they might lose their warm female "turn-ons"
and their ability to experience orgasm after SRS. Some of these
women try to think of their male organ as simply a "large
clitoris", and manage to accept it that way. Others may
elect to have an orchiectomy rather than undergo SRS. Some TS
women who are otherwise very feminine can attract love partners
who accept them as women without SRS, by discreetly concealing
their genitalia during intimacy. If you are terribly fearful
of SRS and are not sure you will be happy afterwards, it's best
to consider the option of a TG transition. On the other hand,
if you learn more about the wonderful sexual and orgasmic pleasures
that many intensely TS women do experience after SRS, you might
gradually realize that SRS would open up a better life for you
- [Note: For more detailed information about sexual
arousal, lovemaking and orgasm in postoperative TS women, see
that section in Lynn's SRS webpage.]
- Unfortunately, the option of TG transition often leads to
difficult long-term passing and health issues. TG/TS women and
she-males who do not undergo SRS must continue to take very large
"preop-level" doses of estrogen and anti-androgen year
after year if they want to retain their feminine secondary sex
characteristics. Therefore, they risk likely liver damage and
major health problems unless they make difficult tradeoffs between
feminization and those health risks. If they must drop back to
safe "postop-level" doses of hormones for health reasons,
the testosterone produced by their testicles inevitably causes
a steady coarsening of their features. Testosterone also escalates
the aging process in TG transitioners, robbing them of their
youthful beauty much earlier in life than is the case for postop
TS women (this effect has long been known in the gay male "drag
queen" community). TG transitioners and she-males who were
once very soft and pretty in their teens and twenties may have
great difficulty finding male companions and lovers as they grow
into their 40's and beyond. Old age can become a frighteningly
lonely time for such people, and this factor should be carefully
considered before undertaking a TG transition.
- In many cases, TG transitioners eventually elect to undergo
an orchiectomy (castration). Castration is a much simpler, less
expensive and less painful surgery than SRS. It frees the TG
transitioner of the health problems caused by testosterone, eliminating
the need to take high levels of cross-sex hormones. TG transitioners
having strong libidos can continue to enjoy penile erections
and orgasms after castration, and thus continue to enjoy the
male aspects of their sexuality. All in all, orchieictomy is
an important option for TG transitioners to consider.
- The real test of success in the end is whether you can make
a full adjustment to your corrected gender situation, assimilate
well into society, and then find loving partners with whom you
can be mutually happy in your intimate life for the long term.
Above all, do not let the currently rigid social views of gender
affect your decision about whether to undergo TG vs TS transition.
After a TG social transition you should feel comfortable being
authentically "you" somewhere "in-between"
the two bipolar social models of gender. It would be far easier
to adjust to being "in between" than adjusting to a
"TS transition that went too far"! Remember, people
who are "in between" can find love partners too.
- Even if you are sure of your motives and your need for complete
TS transition, there are other important practical things to
consider before committing to the transition. Some TS women have
such highly masculine physical characteristics that they inevitably
fail to pass, no matter what surgical corrections are made. This
can lead to such social "noticeability", continual
stares and humiliations that it is impossible for the person
to assimilate as a woman in society. The ongoing humiliations
can ruin the person's own internal feelings of having corrected
their gender, and can force them into a socially marginalized
existence after transition. These are very tragic cases for which
there are no good alternatives.
- Another key factor in success is whether you are self-reliant
enough. Caregivers can only deliver bits and pieces of "gender
technology" for transition. It is up to the transitioner
to "put it all together and make it work". If you do
not have that sort of "street smarts" and adaptability,
you may be in danger of getting in way over your head if you
attempt gender transition. You have to work it out for yourself
day-to-day. Others cannot help you with all the details. Your
counselors and surgeons are like the crew of the ship that deliver
you to that far shore. Once there, you are mostly on your own.
You better be sure you really want to go there and will have
no regrets about what you left behind, and you need to be very
adaptable and self-reliant to succeed there.
- Accessing current knowledge,
assessing risks, making decisions, and taking actions during
- As you can now imagine, the person who faces gender transition,
either TG or TS, must negotiate a labyrinth of risks and difficulties,
and must do this mostly on their own. They can get help from
counselors and support groups, from TG/TS friends and acquaintances,
and from information and contacts via the internet. However,
each individual situation is so very different, and has so many
unique factors, so that there is no one "best way to do
this". Instead there are many options and many ways. Each
person must do a lot of background information gathering and
then be very imaginative and creative in putting together the
best path for them to follow.
- Once a person has committed to transition and can see a path
that may work, they must be decisive and take those actions and
not let fear hold them back from every step. Otherwise they will
make little progress over time, and may get stalled in their
transition. On the other hand, they must be flexible and able
to handle contingencies and problems along the way. Sometimes
things won't go at all as planned, and they will have to find
a way around those problems. Plans that are to "tight"
and inflexible, and timing that is cut too close, can sometimes
go astray. Always leave room in your plans for contingencies.
- Accessing current knowledge, assessing a lot of risks, making
timely decisions, and then taking decisive actions in the face
of fears - these are things the transitioner must get used to
doing, and doing well if they are to succeed. It's no wonder
that people in transition often seem "obsessed" to
outsiders. In a way, they have to be a bit obsessed in order
to negotiate all the challenges they face.
- In fact, one of the major difficulties transitioners face
is how to remain calm and do things with grace and dignity during
a time when they are frightened to death, experiencing a lot
of pain and embarrassment, and facing lots of worries about how
it will all turn out.
- Fortunately there are many many stories and role models that
transitioners can now use to visualize how to transition. There
are also many excellent support sites on the web to gain knowledge
about current treatments and services, and to help in planning
the details of a particular transition - with
James' TS Roadmap being the premier guide for MtF transition.
All this expanding information is increasingly smoothing the
paths for those who transition. Here are some excellent websites
that transitioners should pore over as they begin their journeys:
Guidebook to MtF Transition:
Addams' wonderful information exchange and forums:
discussion boards for young transitioners:
Website of internet message boards and forums for TG/TS
- How can family, friends,
teachers and co-workers help a transsexual woman in transition?
- Once initiated, transition is a life or death matter for
the transsexual. It's not done for sexual kicks, nor to outrage
other people. However, the dramatic physical changes of transition
can shock and frighten those who know the person. There are also
many practical quandaries such as what name to use, what rest
rooms to use, what pronouns to use, and how to explain it all
to family and friends. It can seem like an unending gauntlet
of dangers and trauma that must be run.
- One major problem is that friends and loved ones often have
a difficult time "letting go" of the former person,
who seems to have died, and "getting to know" the new
person. If the new person has strong vestiges of the old, loved
ones will cling to the old identity and mis-gender the new person.
If the vestiges are weak and the old person seems to have disappeared,
the new person may be intuitively hated for "killing off"
the old person. Many TS women lose all connections with their
loved-ones, family, relatives and pre-transition friends, and
have to start all over to find any friends, companionship and
love after transition (that was certainly Lynn's experience during
her transition). The closer someone was to the former you, the
more imprinted your former identity is upon them, and the more
likely it is that they will completely reject the "new you"
during and after transition.
- Also, the morphing of physical appearance resulting from
sex hormone therapy and surgery can be so profound as to cause
deep internal conflicts in other people. For example, some males
may initially see the person as a "man in a dress"
and make fun of "him", but then become internally distressed
a year later when they unconsciously begin to react to the increasingly
feminized transsexual as a sexually attractive woman. Other people
may simply "not see" the later changes and blindly
keep thinking of the person as a "man in a dress",
thus subjecting themselves to stares and rebukes when they make
gross errors in the use of pronouns (for example, referring to
her as "him" all the time, when everyone else now sees
- Thus the transitioning woman must daily cope not only with
the enormous changes underway within her own body and emotional
setting, but also with the widely varying changes underway in
the minds of everyone around her. A little understanding and
polite assistance on practical matters from friends and coworkers
can go a long way towards easing some of these burdens of transition.
- The media doesn't help in all this, because for decades it's
been a media habit to refer to a post-op TS woman as a 'man who
had a sex change', and even use male pronouns when referring
to her. This horrible practice was instigated decades ago by
the Associated Press news service, and stories about TS women
usually come over the AP wire in that form (see
this example*). This practice has done incredible damage
in the lives of TS women by grossly distorting their image in
the eye's of society, and making transition a more difficult
time for them.
- [*Note: This AP practice was successfully
challenged by the activist groups GLAAD and GenderPAC. The new
AP Stylebook informs all reporters to ask the transsexual woman
herself what name and gendering she wants used in any news articles
- Because of ongoing medical, legal, bureaucratic, employment,
religious and interpersonal complexities, each transsexual will
also encounter hundreds if not thousands of people over their
lifetime in situations where they are "outed" by their
past history no matter how well they pass. At the present time,
a TS woman may be treated with anything from disdain to contempt
to shocked reactions in many of these encounters.
- The cumulative effect of all these push backs and hurtful
encounters can sometimes discourage even the most sturdy soul.
To the transsexual woman in the midst of transition, it seems
as if she is constantly undergoing a rather irrational, unrestrained
"mobbing" by people all around her. Even those who
cope well with fear and who have a very positive attitude can
be worn down by these constant pressures. However, there is a
danger of becoming angry and pushing back against these pressures,
and that can be extremely counterproductive when trying to assume
a warm, happy female persona.
- Counseling and guidance can help these women cope with some
of these impacts. However, better understanding, especially among
the medical, legal, religious and human resources communities,
would go a long way in reducing the stress and sense of stigmatization
that many TS women experience.
- Family members, friends and others interacting with a transitioner
can become better informed about what the person is going through
by reading books such as
Selves : Understanding Transsexualism-For Families, Friends,
Coworkers, and Helping Professionals by Mildred Brown
and Chloe Ann Rounsley.
- Fortunately, for most MtF TS women there is "light at
the end of the transition tunnel". The social difficulties
usually die down as they complete their gender transformations
and gradually assimilate into society as women. In order to optimize
social opportunities and avoid unnecessary social difficulties,
many postop women desire to "woodwork" or live in "stealth
mode" after transition. They do this by keeping their past
very private. Friends and coworkers who know about a transsexual
woman's past should be very careful to honor her wishes for privacy.
They should also act promptly to put a stop to any rumor-mongering
by others who are not so honorable.
- Having learned a bit about transsexualism, perhaps you can
help others understand it better too. With increased understanding,
concerned people can help ease the practical problems and reduce
the difficulties that a TS friend, student or co-worker faces
during transition. Once through transition, the new woman usually
blends quietly back into society to mostly live a rather normal,
but ever so much happier, life.
- A wonderful novel by Chris Bohjalian,
Radio, helps communicate a lot of deep insights about
the MtF transsexual transition experience, and not just from
the perspective of the TS woman herself, but also for everyone
around her. Bohjalian's novel works its magic by shifting the
dialogue from character to character at each stage of the transition
process, showing how everyone involved or touched by the situation
goes through many changes in thoughts, attitudes and responses.
This excellent book can be used to establish a common context
for communication with people willing to be educated in depth
about transsexualism, transition and transsexual love-partnering.
Lynn highly recommends this book to the families and friends
of women in transition.
- A brave book, a compelling story
- Reviewer: A reader from Philadelphia,
After knocking one out of the park
with Midwives, Bohjalian has both capitalized on his singular
knack for topical story-telling, and one-upped himself. For this
conventionally phallo-centric male...[the] surgery wasn't an
easy subject, but Bohjalian earned the right to make me squirm.
The cleverest thing about this novel is the way in which, by
the end of its pretty speedy 300 pages, a whole lot of things
that had seemed pretty far out to me suddenly seemed not so strange
at all. .... These lovely people, whatever their plumbing, deserve
some happiness, and Bohjalian is wise and kind enough to give
it to them. This is a love story that's both moving and makes
- Exquisite, Painful, Emotive and Necessary
- Reviewer: A reader from South
- I read Mr. Bohjalian's wonderful prose
while recovering from my own sexual reassignment surgery so perhaps
I am biased. Having endured many indignities in my own life,
yet now living a life that is both exceptionally normal and amazingly
wonderful, I identified with Dana and her struggles for self
and dignity. I believe Mr. Bohjalian is masterful as he captures
the spectrum of reactions and responses both to transsexualism
as well as it's collateral effects on those who date, marry or
are the parents, siblings and friends of those seeking to resolve
their transsexualism and recapture their birthright as women
or men, as the case may be. - - - Mr. Bohjalian captures perfectly
the ignorance and fear we often face as we attempt to do nothing
more than seek treatment for what is, pure and simple, nothing
more than a recognized medical condition. And not unlike cancer,
transsexuality has been around forever, yet the reprieves available
through medical advances have and are changing to afford us increasingly
higher qualities of life. I think this notion comes across in
his work also. Thank you Mr. Bohjalian for humanizing the efforts
of myself and everyone else in the world like me.
- With better understanding, how might
transsexualism be treated someday?
Transsexualism is far more common than previously thought. Instead of being
a total medical rarity, intense cases of MtF transsexualism probably occur
in about one in every 300 to 500 boys. It is a condition that will
occasionally occur in every large, extended family (it occurs at least twice
as often as either multiple sclerosis or cleft palette). The condition
probably triggers many unexplained teenage suicides among kids who couldn't
find any other way out of their angst. Loving, concerned parents and
relatives should be aware of the nature of the condition, so they can
humanely treat any affected child in their family.
- Someday, when a teenage child realizes that they have transsexual
feelings, and tells their mom "I need to be a girl", the common reaction
will be one of love and concern and compassion. Instead of seeing "a boy
with a mental problem", the parents will actually see "a girl with a
physical problem", will see how desperately she needs help, and will
lovingly support her medical treatment and gender transition.
- A wonderful book for teenage MtF TS kids and their parents,
Need to Be a Girl, tells yet another story of a teenage child's recent
gender transition (see photo of Danielle below). This captivating story and
its artistic sketches provide a heart-warming introduction to MtF
transsexualism and the process of modern gender transition. You can read this book on
Lynn Conway's website, including
translations into Arabic,
I Need to Be a Girl
The 2nd Edition of Evenlyn's book is
now in print at Amazon.com! NEW!
- Someday, schools and other social institutions, having become more aware
and understanding of gender issues, will also be much more supportive of
girls like Shauna and Danielle during their transitions, and will prevent
discrimination and harassment by others from hurting their chances for
- Then once such a girl's transition is completed, not only her parents, but
also her relatives and friends will welcome her into their lives and treat
her and love her just as they would any other girl. She will have the chance
to experience all the things that other teenage girls do, and will grow up
to be a young woman without having experienced all the incredible hardships
now so common for transsexual girls.
- In addition, the law and society will treat her just as any other girl or
woman, providing her with full civil and legal rights, including the
opportunity to later marry and to adopt children if she so wishes, and the
chance to go on to a full and happy life.
- Lynn hopes she will live to see that day.
- Success Stories: Links to Post-op TS
- There's nothing quite like successes in any new endeavor to prove that "it
can be done", and to provide role models for others to follow. The same is
true of transsexual transition.
- We learned above that there are at least 32,000 to 40,000 postop
transsexual women in the U.S., and that many thousands more people are now
in transition. However, the many successful transsexual transitions have
remained "off society's radar screen", because most post-op women live in
"stealth mode" to avoid stigmatization. Although all around us, they are
"hiding in plain sight" and thus are "invisible".
- Fortunately, the web is now lifting that veil of invisibility, as more and
more successful postop women create websites where others can learn from
their experiences. You can put a compelling human face on transsexualism by
looking at websites containing personal diaries and information about these
women's experiences and successes. These women and the stories of their
experiences can provide great role models and examples for other
transitioners to learn from. In Part III,
we'll learn more about life as a woman after TS transition by drawing on
many of these women's experiences. Here are just a few examples from a
webpage Lynn has compiled listing photos and stories of many successful
women who have transitioned:
- TG/TS/IS Links and References:
- For a wider range of information about transgenderism, transsexualism
and intersexualism, you can now access many excellent informational
websites and books about these subjects. To get started exploring
such websites and reference books, see Lynn's
TG/TS/IS Links and References webpage, and follow the links
there to the larger world of TG/TS/IS web resources.
- A final thought about the word "transsexual":
- Although well intentioned as a descriptive medical term,
the word "transsexual" is a bit off-putting and misleading.
As a "label" it often stigmatizes people unnecessarily,
especially when it is used as a noun. Calling someone "A
Transsexual" makes them sound like some kind of alien instead
of a human being. It also implies that there's something still
wrong with the person even after they have undergone a complete
gender correction. It's much better practice to use "transsexual"
as an adjective, and refer to someone as a "transsexual
woman". Referring to her as "a woman who transitioned"
or a "woman who has a transsexual past" is an even
- After all, why should someone who has survived transsexualism
after a long, traumatic medical and personal battle be any more
stigmatized than a cancer survivor who has similarly fought a
long medical battle? Shouldn't both be admired for their courage
and tenacity in the face of adversity?
- Lynn's own personal perception of her life-experience is
that she was "mis-gendered" by nature and society as
a little child. After growing up as a boy and enduring years
of terrible trials, she finally managed to have that mis-gendering
fully corrected during her gender transition in 1968. She has
since gone on to live a full and happy life as a rather normal,
- Photo of Lynn and her little grand-niece
Baylea, April 15, 2000
- V-9-30-04 + Update of 10-14-05