Marie-Noëlle's Story
Copyright © 2004-5, Marie-Noëlle
Marie-Noëlle, Software project manager (Switzerland)
Hello,
My name is Marie-Noëlle. I live in Switzerland and I am 40 years old. I am post-op since a few years and I have the peaceful life of an ordinary woman. After several months of thinking, I finally accepted Lynn's proposal to publish my history on her site. I am quiet and I do not want to go to the front of the scene. I doubt that I can be a role model for anyone. But I collected an interesting experience which helps me to better explain transsexuality to others. This is why I finally accepted to share my history and my experience through Lynn's site.
Marie-Noëlle
28 septembre 2004
New! (February 2006): Marie-Noelle is training to become a counselor, and is now taking on clients.
New! (July 2007): First results of a respectful counseling
MY STORY (CONTENTS)
It may matter for other persons
Taking our future and our place in the society in our hand
Spirituality, meaning of life and other existential questions
On being a “two spirit” person
February 2005:
December 2005:
For a scientific method respecting all human beings
Feburary 2006: (NEW!)
Training in order to become a counsellor
July 2007:
(NEW!)
First results of a respectful counseling
Original Text:
MY STORY
My childhood
I was born in 1963 in the French part of Switzerland. I have a younger brother. My family was catholic and quite conservative.
Since my early childhood, even before I was able to walk, I spent my time with my girl friends. I was one of them. I played with them, I felt comfortable with them. The first drama happened when I was 5 years old, when I played doctor with one of them. Seeing our physical differences was unbearably painful. I was so much upset that I vividly remember the circumstances and the place where it happened. As it was useless to try to speak with my parents, I kept what I felt for me. I felt completely alone, abandoned, without anyone with whom I could speak.
As many other transsexual children, I was battered by my parents. But I was primarily battered by my mother. My father was her faithful assistant and he did never protect me from the violence of my mother. To the contrary, he helped her battering me every time she asked for some help. My mother did so that she subdued and controlled me in ever respect, including my bodily language. And she succeeded. As a consequence, I grew up without any self confidence, without any self esteem, completely passive and depressive, and I spent my time trying to guess and to satisfy the will of my mother in order to try to avoid her blows. Much later, during my transition, my father admitted that they did not bring me up but they trained me as if I were an animal. Of course, this aspect of my childhood played a huge role later in my life.
As soon as I started school, I started being victim of the violence of other children. I was harassed and beaten by boys. As so many transsexual children, I was once again completely alone, without anyone to help me. Sometimes I had to face the attack of a whole class. Neither my parents nor my teachers helped me. It continued this way day after day until I was 13 when I had to go in another school. Then the aggressions became progressively rarer. But the last one happened when I was 18 years old.
Before school, I had many girl friends and it was very important for me. I started losing them when I started school and the more time passed the more I lost them and the sadder I was. At around 13, girls started looking for boys and for their first love affair. I lost them completely without understanding why. I felt completely desperate. I felt betrayed by the whole earth.
My own teenage was horrible. Even my body betrayed me! What could I do? What was happening? Who could help me? I did not understand what was happening and there was no one to help me. The more time passed, the more desperate I was.
Even at that time I loved jewels and I could not resist buying and wearing some of them. At that time I got my ears pierced and I started wearing earrings daily.
Studying was my refuge, but it was difficult. Life was too painful and it kept me from learning easily. When I was 13, I was in complete failure. Even after that moment, learning was never easy for me. I grew as a depressive, even suicidal, abandonic, person. I was unable to live autonomously, even after I graduated.
I did never feel attracted by men. They did never interest me. And I had a very negative image of them. They were the ones who had harassed and who had beaten me. They were the ones who had not protected me while I was so terrified. They were the ones who had been unable to listen. They were unable of the rich relations I had with my girls friends. They had nothing attracting to me. This element did probably played an important role in my life, as it made more difficult for me to understand and to accept what I felt.
I was 18 when I read an article in a newspaper speaking about a transsexual person. It was the very first time that I read that there was other persons with the same feelings. But it was a sad article about someone who had practiced automutilation and the author was quite negative. And this article did not give any useful information.
I did some computer science studies. I felt that they would give me the ability to have a job without too much problems. They seemed to me abstract enough so that they did not force me to face my body that I hated so much. But I did not understand that most computer scientist are males and not necessarily open minded.
Early therapies
As I was going very badly, my parents finally sent me to a therapist when I was 18 years old. I was extremely careful about what I told him. After all, he was the representative of my parents. So I only spoke to him of more or less harmless things, but certainly not of what made my life so painful. After 4 years of therapy, I tried to speak to him and I gave him a few bits of how I really felt. But he was completely unable to understand what I was telling. I stopped working with him and my parents found another therapist. I worked with her for 8 years. But I did never tell her what was really in the deepest of my heart. I did never trust her enough do so. I finally found a third therapist who was practicing “rebirth”. During the first spell over the weekend I did with her, she noticed that I was different from other people and that my difference was about my sexuality. But she wanted to wait that I was able to speak before going about this topic with me. She had to wait for quite a few years.
I was so terrified by men and by their violence, I was so frightened at the idea of having to face them once again that I started practicing pistol shooting a few months after my graduation. At least, I felt that I was able to defend myself if I really needed it. I practiced IPSC until I started my transition.
When I was 29 years old, I had my first love affair. By chance, I met another woman. It was our first love affair for the both of us. We became partners but it was very problematic from the beginning. After a few years, our relation was seriously broken. I was so desperate that I started planning my suicide. I was 35 years old.
At that moment, I was working as a computer project manager in a hospital. I was not comfortable in my team and I was doing quite badly. I was unable to find another job. Having a partner was not the cure to my problems as I had hoped.
Beginning of acceptance
Through the years and through the Internet (which became available in Switzerland a few years after my graduation under the name “Arpanet”) I was able to learn a bit about transsexuality. I had found a few sites, but they were made by people very far away from my home and I was too frightened. So I put all my feelings under a concrete screed and, when I finally met a partner I hoped that everything would be solved. Of course, it was not the case at all.
I was 35 and the relation with my partner was falling to pieces. During all my life I spent a huge energy trying to fulfill the expectations of my parents and trying to adjust into the role they wanted for me. Despite all these years of effort, it did not work. I was so desperate that I started planning my suicide. In my mind, it was not at all a call for help. I did not want to warn anyone and I wanted to be sure that it would work at the first attempt. I wanted to be finally and forever in peace.
Then something happened. Without thinking, I went back to the web sites and newsgroups about transsexuality that I knew. There I read about Mildred Brown's book (“True selves”) [1] that I ordered through the Internet.
When I read her book, for the very first time of my life, I had the beginning of a hope. For the first time I felt that I was not alone and that, maybe I could find a path for me. At that moment, and once again for the first time in my life, I was able to find and contact another transsexual person who lived in the French part of Switzerland. In addition, she had found a psychiatrist who had agreed to authorize her surgery! It was truly marvelous. I started hoping that I could find another solution than suicide.
Of course, I could not hide such an important book from my partner and I had to tell her what I did really feel. It was a huge shock for her. Then, I had to speak to my therapist. I was frightened and I feared to see her for the last time as it happened before. But I was given a very warm welcome. It was so extraordinary! Someone on earth was accepting me as I am! After so many years of loneliness, it was an extraordinary feeling!
A few weeks later, because of some hitch, I had to speak to my parents. I prepared this moment with my therapist. Saying that I was completely terrified was an understatement. I did not sleep for quite a few days. I prepared this moment as a presentation to them. My purpose was not to ask for their approval but to tell them what was happening. My parents were made senseless. On the other hand, my brother was not surprised. But I was not expelled from my family.
A few days after, I physically met other transsexual persons for the first time in my life. It was a small group where I knew no one before. I was very shy and very reserved, but finally, I felt more comfortable. I was finally able to meet other persons with the same feelings and I had to wait for so many years before this moment! For me, it was a happy omen.
Starting my transition
I started my official therapy with a psychiatrist who has his own practice, instead of someone who was working in a university hospital. He was reserved but he did never impede me and I felt respected by him. And I am very grateful for this.
During the first weeks of my official therapy, I collected all the stories I had found. I wanted to avoid all the big traps so that my transition would be as successful as possible. I created a list of things to do and things to avoid. My purpose was make it obvious for everybody that I was only revealing my true self.
Health insurance was an important topic. Someone had recommended to me to make a «private» contract as quickly as possible, so that my surgery would be paid even if it were done in a private clinic. But it was extremely expensive (around $600 per month), so I decided myself for a compromise, the «half private» category that was «only» $350 per month and I hoped that it would be good enough. It was risky anyway as, for private contracts, an insurance can refuse to pay for some cases and one has to check the contract very carefully (but without being too vocal, in order to avoid problems). I have a few paragraphs about health insurance and surgery at the end of my story.
It still took me a few months until I started electrolysis. I had found a practice where the beauticians were specialized in electrolysis and I chose to avoid laser in order to eliminate any risk of regrowth. The beauticians I had found are very competent, welcoming, warm, and organized too. They have an agreement with a dentist located close to their practice for local anesthesia of the lips, which is very useful. I still have very strong memories of the hours I spent with them. I still remember my first one hour session, which was my first contact with pain, and of my swollen and red skin at the end. I remember their warmth, their mischievousness, our laughter (while they were torturing me!). I remember how painful it was at the beginning to suffer for hours with so few visible progress. I remember how painful it was to let the hairs of my lips grow for long periods in order to better eliminate them. I remember a three hour session to take care of my chin (I was absolutely determined to stay on the bed until it was clean!). I remember the moment where, for the first time, every part of my face had been completely “cleaned” at least once. I remember the moment where one hour was enough to clean my whole face. I remember the moment where anesthesia on the lips were not necessary any more (and where the “Emla” cream was enough). I remember the moment where it was possible to make sessions shorter, and the one where it was possible to make them less frequent.
For me, this time was a true rite of passage. Electrolysis is very painful and I really had to hang on. At the beginning, progress is appallingly slow. I needed all my determination to continue. But, progressively, I saw something extraordinary. I saw my true face appearing from the coating that was hiding it. And it was such a wonder! So, despite the pain, electrolysis sessions became so important that I did everything to avoid missing even a single one and I succeeded. This was also very helpful when the anesthesia on the lips became useless and I had to continue without them.
When I started my electrolysis, I did also start changing my voice with Melanie Ann Philips's method. It was long and difficult. It took me eight months before I got the first successes. But if they are good enough for daily life, I fear that they will never be good enough for me to be able to sing in a classical choir.
I did not stop working with my other therapist when I started my therapy with my official psychiatrist. The work I did with her proved essential. She had accepted to learn with me what is transsexuality. With her, I was able to leave the mask I had to wear for decades and I started discovering my true self, the woman that I am.
At that moment I did also start speaking with my friends. And I was lucky enough to keep all of them! They accepted me quite easily. It is a great joy for me to see that our relation did actually improve over the time.
My parents and my brother did not reject me. But my parents have had a lot of trouble understanding my change. I destroyed their universe when I told them what I was doing. It was especially difficult for my mother. For the first time in my life I was going out of the track she had planned for me! As they do not speak English and as there is no valuable book in French about transsexuality, I translated “True selves” for them. It took me ten months, but it proved very useful. It helped them understanding and accepting what I was doing. I did also help them understanding that I was not bound to fail.
At work, I had a first opportunity when I started my electrolysis. I went to another service where there was much more women and who did seem more open minded. After a few months, I started feeling that this was really a good change. I was creating a relation of trust and mutual respect with my new boss. With time this relation became strong and my boss played a very important role during my transition at work.
After six months of therapy with my psychiatrist, while I had started my electrolysis since a few months, he asked me whether I had started hormone therapy. I told him that it was not yet the case as I needed his recommendation. He gave me the address of an endocrinologist. This one made a blood test and gave me his standard prescription: Androcur and Diane 35. I was on HRT!
The Diane is a mild drug and its effects are slow. In addition, compared to other drugs, the changes are lesser. But it has two advantages. It has much less risks than other hormones (as long as one remains in the standard doses) and I needed very few blood tests. In addition, it is made with a synthetic hormone, which avoids torturing animals, and it is very important for me.
It took eight months before my breast was visible under a blouse or a T-shirt. But during that time, I felt my sensitivity “melting” and becoming fluid. It was so amazing! I became much more emotional, as I should always have been!
With my unofficial therapist (who was practicing rebirth), I worked a lot about the best way to manage my situation at work. I did not want to change of work. I had seen how much it was difficult for others and, considering the local mentality, I doubted that it was possible before all my documents would be corrected. My therapist had the opportunity to collect some information at executives of the public administrations. Sexuality is considered as a purely private question so it was best for me to avoid telling anything as long as possible. It was even more important to avoid writing anything, at least until surgery, even later if it was possible. It was also very important to avoid being in contact with the service of «human resources» of my hospital. And that's what I did for many months. And no one told me anything.
After 10 months of electrolysis and 8 months of hormonal therapy, my face was clean enough (and a one hour session was enough to get rid of all hairs) and my curves were visible enough for me to start a new stage. I changed my clothes. I chose some casual women clothes (t-shirt and jeans), which were quite neutral and discreet but still feminine. I wore them both in my private life and at work. But I did not yet explain anything to my colleagues. And I got rid of my old clothes. I wanted to eliminate every possibility of return to my past.
At work, it took two to three more months for my change to be so visible that it was necessary to explain it. My boss spoke to me. Despite his education (he was a former officer), he could only respect me and the way I was making my change. In addition, for him, the most important point was my professional abilities and they were visible. So he told me that he would speak to my colleagues and to our hierarchy and I accepted. We did also agree to keep the service of human resources out of this as long as possible and to avoid writing anything.
Real life test
A few days after, while I was not at work, he met my colleagues and explained them what I was doing. He did also inform his own boss, but not the top management of the hospital.
The next day was the first of my «real life test». I was very anxious. But, when I came back to work, everyone was calm. That day, I did not get any question, nor any comment. Everything continued as if nothing did happen. During the following weeks, only two colleagues asked me a few questions. But from that moment I had the opportunity to improve my wardrobe. But it did always remain classical and quiet. As months were passing, a few colleagues told me that they appreciated a lot the quiet and non provocative way I was managing my change.
A friend of my dance teacher who owns a perfumery gave me some lessons about makeup. She welcomed me with open arms and she immediately understood my needs. She taught me how to make a subtle and tasteful makeup, which was exactly what I needed at work and I like it a lot. She taught me a lot of things, and, after all these years, it is always a pleasure for me to shop in her store.
After some months, the general management of the hospital noticed me. During a meeting, one of its members asked my boss who was that woman who looked like Mr “someone”. My boss explained him and it was everything. Once again, nothing was written.
Four months after the beginning of my real life test I spoke about surgery with my psychiatrist. He agreed to write the recommendation I needed. I knew two of them in Switzerland, one, the Dr Daverio was easy to meet but is very expensive and the other one, the Dr Kuenzi is working in Zürich in a university hospital and he had already taken care of several of my acquaintances.
The first contact with the Dr Kuenzi was direct and frank. He quickly spoke of the risks and the limitations of the surgery, he mentioned that complete surgical successes are never guaranteed, and so on. I like his attitude. The Dr Daverio was more distant and he basically told me “let me take care of everything”. He has an outstanding reputation and his recovery times are short but he is very expensive and I would have to pay an important amount of money by myself (as my insurance would only pay part of the bill). So I finally chose to go to Dr Kuenzi. The surgery was fixed in spring, approximately ten months after the beginning of my real life test.
Then I had to contact the human resources. I would be absent for three months and I wanted to be paid! The boss of this service wondered whether he really had to pay me during this time (which was a surgery like the other ones after all). I had the law for me and he had to accept that it was the case.
I went to Zürich. The moment where I woke up was extraordinary despite all the drains and the other tubes. It was and it remains one of the best moments of my life. I stayed there for three weeks then I came back home. After three months I went back to work. I was 37 years old.
After surgery
At work, one of the first things I noticed was that I was still not attracted by men! The relations I preferred were still the ones I had with other women, they were the truest, the richest and the deepest ones. After a few months I accepted that I was lesbian and I chose to join an association.
At that moment I had started the legal procedure to update my documents. In theory, everything had to go well. In practice it was the most painful part of my transition. It was a judicial procedure, and the justice was not aggressive nor disdainful, but it was horrendously slow. While the audience lasted less than 10 minutes, I had to wait the judgment for nearly 6 months! When I finally had it, I rushed to the registry office in order to get a new birth certificate. I got it in two days. Then got a new identity card in two weeks and I took me three months to update most of my other documents. Once I had this judgment, the rest followed easily.
At work the situation started changing. I was mastering my duties but I had no opportunity of change and my job was becoming boring. So I started looking for another position. After a few months, I had an opportunity in an administration. For me, it was a big promotion and a welcome change. During my interviews (and later), I had no question about my past. It did not change since that moment.
When I joined an association of women, I met another woman who was interested in me. Progressively, we became friends, then partners. When we have become very close, I was unable to hide my past from her. She welcomed immediately and without any reserve what I told her. Since the years we know each other, my past has never been an obstacle in our relation.
Postop therapy
Over time, I had to notice that life was still difficult. Some things at work were still quite painful (or stressful) and I still had problems in some relations. I now understand that my surgery did not (and was unable to) solve some essential questions. I had still a very poor self esteem. I was still trying to please others instead of living my own life. After having been euphoric for a few months after surgery and after having met a partner my depression came back.
This did also mean that the nearly 20 years of therapy I had done before surgery were not enough for me to progress on these essential questions. It was very unpleasant to accept, but it was a fact.
I was reading Alice Miller's book since several years (http://www.alice-miller.com/) and what she says about child-abuses in education and about its consequences was very important for me. But she is unable to recommend therapists of groups of them, which is a rather sad assessment. In 2001, she opened a French speaking forum (now closed) where I met another woman who was practicing a form of therapy that looked very strange to me. It is called “haptonomy” (http://www.haptonomie.org/vf/index.html).
It has been created by a doctor, Frans Veldman, who was working on the relation between the newborn child (or even the fetus) and his/her parents. It involves contacts through the sense of touch. But it is not a mere manipulation of the body. Each contact involves the two persons (the therapist and the client) completely, physically and emotionally. The person I met told me how much this therapy helped her to change, to find some self confidence, some feeling of being complete and autonomous, that theses changes are lasting and that it made her life tremendously better. As I was not doing well and I felt that I was in a dead end, I chose to try it.
Immediately, I felt close to the therapist I met. But it took us a few months to adjust to each other. I was the first transsexual she met. In addition, haptonomy was born to improve the relation between the child and his/her parents. So, many people who practice it are not used to gender variant people. A transsexual was a big change!
But she accepted to learn with me what is transsexuality, and I gave her all the information I have in addition of my own experience. Progressively, what I experienced during the sessions with her had a real impact in me and I started changing. My friends were the first ones to notice it. I got some self confidence, I became more open, I express myself more freely, I started asserting myself, telling what I want and what I do not want and so on. Over the time, I started becoming aware of my talents and my perception of myself was not the same any more. Today, my life is much fuller and happier than ever before and I am very happy that I dared to go through surgery. I am strongly convinced that my change would not have been possible without it.
It may matter for other persons
I feel that this point (postop therapy) is important for other persons. Even after surgery, I notice that many transsexual persons have difficulties in their relations. I know several of them who have trouble getting rid of very abusing families. In groups, I notice that it is often difficult to create a peaceful and respectful exchange. And many of us have difficulties creating and maintaining lasting relationships in their love life.
In addition of having lived years or decades in the wrong body, many transsexual persons I know quite closely told me about the severe abuses they suffered during their childhood. I hope that they are exceptions and that the teenagers who start their own transition today are not hindered by a similar past. But all the adults I know closely have a terrible past and are survivors.
During his work with newborn children, Frans Veldman, the creator of haptonomy, has demonstrated that an affectionate, respectful and loving contact between the child and his/her parents is essential for the child, for his/her ability to develop self confidence, a positive image of him/herself and his/her ability to make good connections with others and with the world. This contact is made through the sense of touch, but it is not a mere physical manipulation, it involves the two persons completely, with their emotions, their feelings and their capacity of expression and attention.
In comparison, many transsexual persons are born and have grown in a nearly complete affective desert, in families that are violent, abusive, non-loving, and who have no respect for them and for their uniqueness. It is thus not surprising that they did not develop any self esteem and have no self confidence, and it is thus not surprising that, with such deficiencies, they face serious relational difficulties.
On the other hand, it is appalling to notice that some therapists get hold of this difficulty (which is the result of severe abuses) to contest the legitimacy of sex reassignment surgeries. They confuse (I hope unintentionally) two problems, the transsexuality of a person and the abuses s/he suffered and they claim that a sex reassignment surgery is unable to erase the consequences of the abuses (while this has never been its purpose), to contest the need for surgery.
In addition, I see that many transsexual persons get very poor help, when they get some. Many psychiatrists behave as gatekeepers instead of allies. Those psychiatrists are unable to accept and welcome transsexuals as they are and are unable to support them during their own travel of discovery and revelation of their true selves. They react from their prejudices, their own insecurity, their rigidity and their fears, they act in a condemning and pathologizing way. Those persons will do everything to hinder transsexuals on their travel and they can create terrible sufferings for the sole purposes of preserving their own prejudices. When someone is facing a psychiatrist who acts only as a gatekeeper and when it is impossible to go somewhere else (which is the case in some countries), it is really worth to look for a second “unofficial” therapist to do the real work.
Of course, it is possible to find welcoming and respectful therapists and it seems that it is easier to find them in groups who have a more humanist attitude, like, for example, the ones who practice the “person centered approach” created by Carl Rogers or the ones who practice rebirth. If they are able to find a loving, respectful, open and competent therapist practicing the person's centered approach, transsexuals who have been strongly alienated by their family will have the opportunity to experience that they can trust their "inner reference", they'll learn to decipher their feelings, they'll experience that the deepest of their heart is fundamentally positive, that they are the ones who know who they are and what is good for them, they'll explore their inner world and they'll experience that it is not full of monsters (contrary to what so many persons have told them), and they'll experience that they have in themselves what they need to find their way and live an happy life. This experience is extremely precious. This experience is extremely important. But despite all their goodwill, their experience, their respect, their sensitivity and their unconditional acceptation of transsexual clients, their help is not always enough for their clients to find the self confidence, the positive self image they need to fully inhabit their body after surgery and to have satisfying relationships with others.
In her book Gender Loving Care, Randi Ettner [2] mentions very wisely that psychoanalysis is useless for transsexual persons and she recommends humanist therapies. I consider that the unconditional respect for the client that they advocate is the minimum that one has to expect from a truly helping therapist. On her side, Alice Miller is unable to recommend groups or even single therapists, but at least, she has a questionnaire that may be useful for people looking for a one (http://www.alice-miller.com/sujet/art9.htm).
I heard and read many therapists claiming that adults must mourn the parents and the emotional attention they had needed (in order to have a normal life). They claim that this is essential to go forward and to have the life of a mature, free and responsible person. But, with other persons, I experienced that it does not work. I mean that even if one decides to mourn something, this does not mean that we will really able to do it. And it is not enough to create in the heart of a person the experience she needs in order to grow up emotionally. In the best case, she'll continue to have a lame life, as long as she'll lack the emotional confirmation she needs in order to experience her own worth in a durable way. And without this experience, she will not be able to mature emotionally. I did finally find the emotional confirmation I needed during a therapy (both verbal and corporal), and it changed my life forever.
With time I have become utterly convinced that the therapy we need (at least for the one of us who have been severely abused) to live a fulfilling life cannot be achieved before sex reassignment surgery. Before this essential moment, we are unable to fully inhabit our body. As a consequence, it is may usually be wise to undertake SRS quickly. I am also convinced that a purely verbal therapy is unable to help severely abused persons, including transsexuals, to build the feelings they lack and they need to have a satisfying life and satisfying relations. I am convinced that only a global approach that includes the body, and is practiced by a very experienced, ready to try unusual things, deeply loving and respectful therapist is required for us to succeed in our lives.
I am of course deeply aware that each transsexual person, each history, each path is unique, that each person must be understood for who s/he is, without placing him/her in a predefined category and that there is no universal solution to all troubles. I also hope that over the world there are a lot of transsexual persons who have never been abused and who do not need what I am talking about. I especially hope that teenagers who are currently in their transition did not suffer as much as their predecessors. But for all the other ones, especially the ones who have been severely abused during their childhood, there are persons who can really help them.
Taking our future and our place in the society in our hand
During the last months I learned that the persons who start their transition in my area have once again trouble finding therapists who are really accepting them and who are willing to support them during their journey. Some health insurances are also doing everything they can to get rid of transsexual patients, especially the ones with “private” contracts. This means that, unless patients are rich enough to pay by themselves for their surgery, only the university hospital of Zürich is available, and this one does not practice “female to male” surgery. So the situation is again degrading seriously. In a country like France, it is dramatic. A few years ago, the situation in Quebec was very difficult too. I don't know how it turned out since that time.
I also notice that, at least in the French speaking world, many therapists have a lot of difficulties accepting gender varying clients. This may as well affect persons who have a role traditionally granted to the other gender, than homosexual, intersexual, transsexual persons or persons who are combining these different conditions. It is not rare to find clearly homophobic therapists. In her book “understanding homosexuality” [3], Marina Castaneda has a whole chapter on this topic.
It is as if a majority of psychologists and psychiatrists had stayed with conceptions about gender that were prevailing in 1940, as if intersexed persons were not openly struggling since more than 15 years [4], as if the first article of Anne Fausto-Sterling (“The five sexes”) [5] had not been written since 15 years, as if the theories of J. Money had not been publicly attacked by his/her own patients since nearly 20 years, as if the ideas of the feminists in social and gender studies did not exist, as if the Harry Benjamin association (HBIGDA) did not exist, as id the French speaking TV channel had not done a serious and valuable effort to speak about gender varying persons. It is so severe, that the expression “gender variant” has no French translation! This is a very clear symptom of the rigidity of France and of the French language itself about gender.
Considering this situation, I am convinced that it is fruitless to expect from therapists who are in the traditional (and still strongly patriarchal) gender system that they will be able to understand by themselves our uniqueness. It is our duty to do it. It is our duty to describe it both to the general audience and to doctors, psychologists, endocrinologists and so on. We also need to describe our uniqueness with enough credibility and firmness to keep some from using and manipulating our words for the preservation of their prejudices.
As the mere existence of gender variant persons is a challenge against the patriarchal system, which bases itself on the existence of strictly defined and immutable classes (men and women), this education work is important for the whole society.
Any such work must be undertaken by several groups. There are too many histories, paths, self identifications, experiences of gender under the names “transsexual”, “intersexual”, “homosexual”, “feminist” for a single person to be able to speak in the name of a so large community. Only a team can do it. And it will be very important to find persons peaceful enough to collaborate fruitfully with the others, despite the huge varieties of identities, experiences and paths.
I understand all the better that some are frightened to reveal their past, and that it is exactly what I feel. I understand all the better that one may be frightened at the idea of jumping to the front of the scene, and that is also what I feel. I also understand very well that so many persons do not want to reveal a very painful past, after having rebuilt their lives, a life in which they are finally seen, recognized and loved for who they truly are, with the risk that it changes forever the way others look at us. Once again, this is how I feel.
But, beyond the fact that every person is free to get involved or not in a such undertaking, and to place the limits that s/he wants, do we really want to let others define the place that we may hold in the society and what we can bring to improve it? Do we really want to continue to live in a patriarchal, misogynist, homophobic, intersexphobic and transphobic world without doing anything to change this?
It seems to me that this question is essential even for persons who consider their past as a strictly personal affair and who are very happy in a traditional family. As we are hiding, we let others define our place in the society. And, very often, the others who decide are men and quite a few of them have strong or even violent prejudices against all the persons who do not fit into the patriarchal system. Do we really want to let them free to do whatever they want?
Spirituality, meaning of life and other existential questions
Questions around spirituality and about the meaning of our condition are among the most personal ones and every transsexual must find his/her answers and these ones belong to her/him in an unalienable way. I include a few paragraph about these questions because I noticed how much they can be problematic for persons who are grown in religious or fundamentalist families. My experience is that transsexuality is not necessarily incompatible with some forms of faith, but that it is clearly incompatible with fundamentalism (most if not all of them are violently patriarchal), that we may have to find forms of faith that are not among the most traditional ones. For persons who come from fundamentalist families, the conflict with these families may be so strong that they may have no solution but to break completely with them, and in some cases, to find another, more hospitable country.
As so many transsexuals, I wondered what was the meaning of being born with a so deeply distorted body, why this was happening to me, why I was alone in this condition, why, in addition, I had to suffer so many abuses, why it took me so long to find another transsexual in my area and a welcoming therapist. I wondered whether I was really accursed, if God was bearing a grudge against me, why S/he was tormenting me, and so on. For me as for many others, these questions are essential and they have been very painful for decades.
Progressively, I found some answers deep inside me. They are just my answers, but here they are:
I feel unconditionally loved and accepted by the Presence I feel deep inside me, whatever Her/His name. Without this experience, I would be dead since decades. And I felt especially welcomed by Her/Him when I woke up after surgery.
I do not believe in reincarnation and I am deeply convinced that I did not choose to be born, I did not choose my family, and I did not choose my condition of transsexual person. I coped with it as I was able to, but I did not choose it.
I do not believe in predestination and I am deeply convinced that chance has a important place in our lives. If a child is born transsexual, or is handicapped or has any other form of uniqueness, this is only the result of chance of genetics and embryology. No power is fighting against us. There is neither purpose, nor intention, but only the “mechanisms” of life and prenatal development who do not work as deterministically as a machine.
The feelings of absurdity and injustice that some of us have are legitimate, in the sense that we did not do anything to “deserve” our condition. But these are only the result of natural forces, chance, determinisms of our time, our society our families. There is nothing mysterious or magical in itself about our condition. There is neither spiritual path, nor ordeals to go through for whatever purpose. There is only the chance of life and our ability to cope with it.
I am finally at peace with myself and with my history because my sufferings are definitely behind me, because of my surgery, and because I am able to feel and welcome my own value, I can finally accept myself as a lovable person and I can have a fulfilling life.
On being a “two spirit” person
The notion of "berdache", or "two spirit" persons comes from a civilization which is deeply different from the occidental one. Surprisingly, the word "berdache" is of Iranian origin (http://www.arapacana.com/Glossary/B.htm). Nevertheless, it has been adopted by Native Americans to describe people who belong to their third or fourth gender [6]. Some contemporary Native Americans also use it to include their homosexuality into their culture and their historical tradition [6]. Some transsexual people also consider their condition as being part of the same experience. This position is controversial. Among other things, does it make sense to connect a modern experience (many of us are still alive because sex reassignment surgery is now possible, which kept us from committing suicide) with a civilization in which a such surgery was impossible? But it is useful to help us in trying to describe something important: the fact that we are "complete" or "multiple".
A friend of mine often tells me that one of the things she especially likes in me is that “I am complete”. Although it looks positive, this feedback made me very uneasy for a very long time. After all, I know who I am, i.e. a woman. I had to meet another person before I started accepting that I have a deep combination of sensitivity, tenderness and strength that is unique and which crosses the traditional boundaries between genders (as they are defined in occidental culture) and that this enables me to give things that others cannot give. I am in the process of accepting and integrating this.
In the past years, I noticed that this topic is very problematic among transsexuals. Some strongly refuse to admit anything that could be interpreted as a claim that they do not strictly identify themselves according to the traditional gender system. Other ones strongly refuse to define themselves according to this one. Hostility between the two groups is so strong that it is very difficult to have members of each one peacefully listen to the ones of the other. They feel the mere existence of the others as a threat against them.
With time, I start accepting that our self identification (whatever it is) and the fact that our identity may cross traditional gender boundaries can coexist peacefully, even harmoniously. Both are essential parts of us. And if it may give us the feeling of being out of step with the others, it may also give us the opportunity to give something absolutely unique and even rare.
The search for a partner
(February 2005)
I lived for a bit more than two years with the person I met after my SRS. Even
if I saw it coming, our separation was very painful for me. It took me several
months to mourn this loss and I was desperate about my ability to find another
life partner. By chance, I had some very helpful persons around me who spent a
lot of their time with me. Nevertheless, it took me eight months before I was
able to start looking for someone again.
One of the things that I considered very problematic was the possibilities to
find some potential partners. At my workplace women are a small minority. I also
belong to a women's association, but very few people found a partner there.
My therapist told me that a weekly magazine of good reputation has a page for
personal ads, that they come from educated people and that they included ads
from homosexual persons. It still took me a few weeks before I was able two
write and send a first ad.
I got eight answers. Although I did not fall in love of the persons I met, I
received some very personal and moving letters. Two persons I met through this
announcement are now close friends and I share some very good moments with them.
Although I was very frustrated for not having met a partner and I was still
afraid that I would not be able to meet one, I had the opportunity to meet very
nice people and to see that I was able to do it, which was very important. It
took me however a few months to understand how important this experiment was for
me.
Approximately two months after this first announcement, I send a second ad in
the same magazine. That one proved unsuccessful. But, in the same time, my
relation with the persons I met with the first one was becoming really
important, so it was not too painful for me.
It was at that moment that, with my therapist, I was able to really feel that I
am a valuable persons and to feel some of my essential qualities. This moment
was extremely important, even essential. It helped me having a better
understanding of what was frustrating to me in my previous relation, to gain
some real and lasting self confidence and to feel what kind of love relation I
am looking for.
During the two following months, I was able to mourn my previous relation. At
that moment, during a celebration, I met a woman with whom I had a short, but
intense and very important relation. During that celebration, I experienced that
I was able to attract a woman who was moved enough by my presence, by my careful
attention to be willing to start a relation with me despite her own engagements.
During the weeks that followed, I experienced that I could be loved for who I am
(and I was able to accept it, which was completely new!), I felt a growing self
confidence, a completely new ability to take risks and to dare to engage myself
in a relation as I never did before. I also experienced that I was able to share
my past with someone I barely knew, and that I could also be accepted even
respected by others. I also experienced that my combination of extreme
sensitivity and great force helped me giving something unique during the most
personal moments and that it was very much appreciated. It is that relation that
helped me understanding and feeling that I could be a good partner for another
woman.
This relation ended abruptly, which was very painful for me. Once again, I was
very lucky to have extraordinary friends and an outstanding therapist. Posting a
new ad was very important for me. It was a way to avoid being drowned by my
pain. And I was starting getting used to it. But, this time, I chose to post
this ad on local a lesbian web site. I got a few answers and I met interesting
persons, but these relations did not last. This ad did however give me another
essential key.
I have read lots of ads of persons who were looking for relations "without
problem", for persons who have no questions about themselves, about their lives,
their difficulties and so on. And I did not like this kind of ad. I considered
myself as having too many questions to send an answer to those ads. I knew how
much I had to struggle and I was unable to envision me in a relation with
someone who would insensitive to her own difficulties and to the ones of others.
Even more important, I felt that I was looking for the contrary, i.e. for a
person who was aware of her own part of pain, who was enough healed to be
autonomous and to be satisfied of all the inner travel she had to go through. I
thus wrote another ad, a very personal one (and an ad which was very different
from all the ones I did ever read) that I posted on the same web site. I was
accurately telling who I am and what kind of relation I was looking for.
The next day, I got a first answer, by a woman who was answering an ad for the
very first time. We started an email correspondence during a few days. This
correspondence was also very personal and moving and we wished to meet each
other. The woman I met was interested enough to invite me immediately in her
apartment, which is very unusual for persons who meet each other through an ad!
When I came, I was both tense (this was a very important moment for me) and very
entrusting. We liked each other, and since that moment, we are living together!
Several months after the beginning of our relation, we are preparing to move
into a new, common, apartment. Of course, our loved ones were surprised by our
relation and by the fact that we lived together so quickly. But they welcomed
us. And we are having a very beautiful relationship.
For a long time, I believed that my difference was a huge handicap that would
keep me to have a fulfilling love relationship with a partner. Today I am deeply
convinced that this handicap did only exist in my head. Of course, I cannot
please to everybody. But this is true for everyone. Of course, my transsexuality
may frighten some persons and it is still possible that some will reject me
because of my condition. But this is also true for persons who are different in
another way. Of course, when one has a lot to give, it is difficult to find a
partner able to receive the present. But am I willing to accept a second rate
relation? I don't believe it. And, once again, I am not the only person in this
situation. Of course too, being a berdache (or a two spirit person) may push
away some people. But. Now, I have a clear and undisputable experience that it
is very precious for some other ones.
Today, I am deeply convinced that being transsexual is not an obstacle keeping
us from having a fulfilling sentimental life, as long as we know who we are, how
valuable we are, which kind of relationship we are looking for and what are the
places to look for a life partner.
I know that so many transsexuals are alone and have difficulties finding a good
partner, so I understand that my belief may offend some. I did suffer a lot of
loneliness and I know how painful it is. But, today, I am convinced that this is
not an unavoidable misfortune! In her book [7], Geri Nettick claims that
lesbian transsexual women have a much better chance than heterosexual ones to
find a good social insertion and a lasting couple relationship. I don't know
whether this is true. But, although I had to struggle with all my force for
decades, I found a really fulfilling relationship and I did not struggle
fruitlessly! I would be very pleased to know that my experience my give back
home to some other ones.
What stayed over the years
(December 2005)
A few years have passed since my transition. I found my place in society and live a happy life. I also see that some key aspects of who I am did not change over time. A different situation would be surprising, but I am however stricken by this and I see this like a part of the weft of my life.
The most important thing that did not change is that I must find my own solutions to the problems and the questions I am facing. I cannot use the solutions and answers of others persons without studying them and adopting them. I only keep answers and solutions upon which I can agree. If I don't, I must find mine. This is true both in my private and in my professional life. I guess that the fact that, during all my life, I had to find my solution to problems that other ones did not face helped me developing this potential much more than many other persons. For me, it is both a strength and a weakness. I like very much to find my own track and to do things in my own way, to look for new solutions to go to place where hardly anyone ever goes. But, in my job, it may be a problem when I am in a situation where I am expected to comply with the rules of a group. But I can't do it and I do not want to bend myself. And I like to be who I am (which is a real and fundamental change).
I still do not believe that there is a purpose, meaning, or an intent explaining my difference. For me, It is still the result of chance, of embryology and genetics which do not work deterministically as the machines we build. I still do not believe in reincarnation, I still do not believe that I chose my family, its context and my condition. I still do not believe that I faced an initiation that was intended to make me progress on a spiritual plan, as some claimed. For me, there was (and still is) nothing of that. Now, I have the experience that it is possible to create on the white sheet I have in front of me, that it is possible to bring meanings where there was none. It is possible to have a happy, fulfilling and fruitful life, it is possible to find a wonderful partner and a lasting love relationship. So, even if the struggle was terribly long and painful, it is really worth it!
Becoming a counselor
(December 2005)
In the first version my own story, I already had a chapter about the importance to take our fate in our hands. Unhappily, this importance is only growing. In Switzerland, the situation of transsexual persons who want to start their transition is becoming very problematic. Finding a welcoming and respectful psychiatrist who accept to help a transsexual person to go through her/his transition is now extremely difficult. In addition, health insurances are at war against us and do everything they can to avoid paying for SRS and other medical treatments. A growing proportion of insurances refuse any payment for treatment made in private clinics. This is especially dramatic for FtM, as there is not Swiss public hospital practicing SRS for them. I fear that a long and expensive judicial procedure will be needed so that our supreme court decides that health insurances must pay for surgeries made in private clinics when there is no equivalent treatment made in public institutions.
In France, the situation seems even a lot worse. The association 360 in Geneva (http://www.360.ch/) gets desesperate calls from french transsexuals who are very far away from the border. We deduce that the situation in "official" programs is so intolerable that people are ready to do almost everything to avoid them. Obviously, the fact that France has been sentenced several times by the European Court of Human rights did not improve the situation. It is for the same reason that Lynn Conway received pressing call for help from France, and these calls were the reason to start translating Lynn's web site. It is also for the same reason that several new very pugnacious associations are appearing. They are not only working to improve the legal situation of transsexual persons in France. They collaborate to create networks of caregivers that enable French persons to completely avoid official French programs.
I felt especially involved when Lynn needed someone able to translate her site in French. I already had translated several documents, including "Mom, I need to be a girl" which can also be found on her site. In February 2005, Françoise Sironi, the director of the "Centre Georges Devreux" (http://www.ethnopsychiatrie.net/), in Paris, which is very active in ethnopsychiatry, came in Geneva for a public conference. She was there to share her experience about transsexuality, the difficulties encountered by transsexual persons and the way ethnopsychiatry try to help them. Once again, the fact that respectful helping professionals are extremely rare was mentioned and I felt strongly involved. I also knew that my LGBTI friends are in the same situation. So, even if, in theory, it should not be necessary to be homosexual, bisexual, transsexual, transgender, intersexed in order to be able to be a competent helping professional for LGBTI people, homophobia and transphobia is so widespread and so deeply impregnated among helping professionals, that LGBTI people do absolutely everything they can in order to avoid working with them.
It is very likely that the heavy influence of psychoanalysis in Frenchspeaking countries, which is a fundamentally patriarchal ideology, seriously hinder any evolution. As a matter of fact, France has been sentenced several times by the European Court of Human rights and this did not yet change anything. Quite clearly, being sentenced because of their strongly prejudiced attitude toward transsexual people is not a problem for political and health system leaders. One does not change such a situation easily. For sure, it will require pugnacious associations and people. Unexpected allies, like psychiatrists trained with a different background, may also be helpful over time. If the "black book of psychoanalysis" (http://www.arenes.fr/livres/fiche-livre.php?numero_livre=119) has an impact strong enough to cause some change in the french society, then there will be a stronger hope for a relatively quick change.
After the conference of Mrs. Sironi, I looked for the possibilities to become a helping professional myself. I found that most of the training required either a medicine degree or a Master in psychology. So, it would be extremely long to go through the whole process. On the other hand, there is quite a lot of LGBTI people who have a pressing need some respectful counseling. For transsexual people, the need is even more pressing. And I already have the experience that I am helpful, especially with very sensitive people.
During the months that followed, an intuition progressively emerged. By accident, I found websites about Carl Rogers and his person centered approach once again. Contrary to the way many psychiatrist interact with their patients, he has a fundamentally more respectful attitude toward his clients. He did also assert the importance of keeping "professionals" (i.e. psychologists and psychiatrists) to turn counseling into a monopoly. Associations of practitioners of the person-centered approach are providing training available to people with other degrees.
I know his approach since many years. Actually, the first therapist with whom I worked was of rogerian inspiration. But he was member of a group which was created in France and which is strongly connected to the Catholic Church. I tried to share my difference with him when I was 18. But he has been unable to accept me as I am and it took me more than 10 years to be able to do it by myself. Because of the strong ideological connection between this group and the Catholic Church (and its patriarchal model), because of its pyramidal and authoritarian structure, once again very close to the catholic one, I cannot recommend this group to LGBTI people.
But there are other groups, usually groups of psychologists, who are clearly of rogerian inspiration and who have no connection at all with a religious institution. These groups provide counseling training (and a very serious one) to people who do not have a psychology nor a medicine degree. But candidates must be motivated enough to work intensively during four years and this requires a strong motivation. There is at least two groups providing serious training in the French part of Switzerland. There is a swiss multilingual group ( http://www.sggt-spcp.ch/fr/index.html) and another one more centered around the "focusing approach" created by Eugene Gendlin (http://www.focusing-europefrancophone.org/).
As I felt a growing desire to commit myself in this adventure, I chose to work with the first of these two groups. I hope that this will help me being even more efficient and that I'll be able to help people in trajectories very different from the ones I already know. I also hope that I will be more aware of my limitations in this activity, especially with people with real psychiatric problems. I also hope that an official degree will help me legitimating my action. I am at the very beginning of this training which will take four years. So, I can only say that I feel confident and in peace.
Beyond my own commitment, I have the intuition that it is possible to create a network of counselors who have a deep personal experience of what it means to be a LGBTI person. Once again, I do not mean that it is a necessary prerequisite in order to help efficiently LGBTI people. But the purpose is to create a network of respectful, caring, and loving counselor, able to help people who do not find appropriate help elsewhere, or who explicitly want to be helped by someone in a condition close to their own one. I also have the intuition that such a network could also be important for other therapists, as they can publish in depth and well formulated documentation about what it means to be a homosexual, lesbian, bisexual, transsexual, transgendered or intersexed person. I also hope that such a network can act as a challenge to established authority by promoting research work which would be respectful of studied people, even by including them in the research team and by promoting a strong code of ethics among research groups.
For transsexual people, who
are in a situation of emergency, I also hope that this network will help
creating channels in French speaking Europe who do not depend any more on
fundamentally transphobic "doctors", who do not hesitate sacrificing transsexual
people to their own prejudices. In the beginning, this will certainly mean that
we will have to pay for major treatment by ourselves. But, if this enables tens
of thousands of people to make a successful transition, then there will be the
forces needed to face the medical, political, legal institutions and the people
who do everything to eradicate transsexual persons from the society.
For a scientific method respecting all human beings
(December 2005)
Until now, most of the scientific publications about homosexuality, transsexuality, intersexuality and bisexuality were written by people who do not share these conditions. Most of them take the liberty to speak of conditions that they do not know and, quite frequently, without even trying to understand the experience of people who share them. There is, of course, a few happy exceptions, like Mildred Brown [1], Randi Ettner [2], Marina Castaneda [3] and Anne Fausto-Sterling [5]. But most of them do not even try to do as if they understood these conditions. It is enough for them to use the language of science and medicine in order to try to justify their inability to understand us and their prejudices. In this respect, the "publications" of J. Michael Bailey (http://ai.eecs.umich.edu/people/conway/TS/LynnsReviewOfBaileysBook.html) and Colette Chiland (http://www.actupparis.org/article1997.html) are typical. Some authors, like J. Michael Bailey even take the liberty to claim that everyone who disagrees with them is in denial!
The consequence of this situation, which exists since decades, is that there is a real "trenches war" between transsexual people and doctors. The conflict with homosexual people is somewhat less strong, but it is at least as much lasting, and homosexual people are not obliged to visit doctors in order to get vital treatments. On their side, intersexed people use some very pugnacious methods in order to make themselves heard by the medical and legal communities and it order to try to stop the abusive surgeries performed on intersex babies imposed to them by strongly homophobic doctors [5].
In "A way of being" [8], Carl Rogers tells the story of a woman named Ellen West and the terrifying way she was "taken care of" by psychiatrists in the 40s. It makes us feel our blood run cold and it can legitimately outrage any reader with a minimum amount of sensitivity! But, 60 years after, the treatment imposed to many transsexual people is way too often even worse! The lack of ethics and sensitivity of doctors who take the liberty to behave this way and to impose their prejudices to their patients can legitimately outrage us. But the fact that a whole domain of science tolerates such practices and legitimates the use of medical language for the sole purpose of stigmatizing and pathologizing helpless people who are just trying to live in harmony with themselves is a practice that should question the whole society.
Transsexual people who successfully achieved their transition and who found a place in the society have learned to be extremely suspicious of psychiatrists and of scientific studies performed on them. Scientists are only taking them as guinea pigs, as subjects intended to answer questionnaires designed by them, but they do everything to exclude them from research teams, from groups who define studies and questionnaires. It is thus not surprising that they feel deeply betrayed by "results" published without them, and way too often, against them. This does not improve the relation between transsexual people and academic people.
In the USA, some networks are organized and strong enough to react efficiently against the most outrageous attacks. This was the case in the "Bailey affair" in which LGBTI groups have been able to react efficiently against a defamatory book and against practices which have nothing to see with the ethics one usually expects from a research team. A few years ago, Milton Diamond had also been able to prove that the publications of John Money, that were used as a justification to perform surgeries on intersexed babies and to refuse SRS to transsexual people, are, in fact falsifications [10].
But this success did not create a new dialog. Silence has replaced defamation, stigmatization and pathologization. As they are not free any more to say and do anything with impunity, academic groups prefer to look for other topics than to speak with the people they stigmatized without any reason.
More than 20 years ago, Carl Rogers, once again, dared to ask "when researchers and therapists will finally dare to get rid of their professionalism" [8], and all its dehumanizing content. The strongly conflicted situation I have just described shows what consequences this dehumanization can have. The question of Carl Rogers seems essential for me, in order to create a scientific method and studies that are deeply respectful of human beings, and which brings an end to the denial of our affective part by the academic world. Such a change would, of course, improve a lot the relation between LGBTI people and therapist regardless of their backgrounds.
A such renewed scientific method must:
· Take fully into account the dignity of each human being, and respect it unconditionally
· Refrain itself from any form of manipulation and use of human beings (one does not handle them as one handles things)
· Get rid of the so-called dehumanizing "scientific and therapeutic distance" imposed by psychiatrists to their patients
· The research teams must try their best understand the people they study as these people understand themselves
· The research teams must include people belonging to the groups being studied
· The research teams must try their best to favor a respectful and honest dialog with the people and the groups they study
· The research teams must enable the people and groups they study to influence their research protocols, and even help them to create their own studies
· The research teams must fully take into account both their affective dimension and the one of the persons and groups being studied
· The research teams must explicit their ideological biases, from the beginning of a study and until the final publications
Only if these conditions are respected, it will be possible to create relevant studies, such that studied people and groups will be able acknowledge them. Only if these conditions are respected will reconciliation between LGBTI people and academic people be possible.
Training to become a counselor
(February 2006)
In December 2005, I wrote a section name "becoming a counselor". Between this moment and now, things accelerated and I am now actually training in order to become a counselor. This is a wonderful experience and also a superb opportunity for me to give back all the support I received for years!
It was also the opportunity for me to create my own site (http://www.vrais-visages.net) in order to propose my services as I am now looking for clients interested in working with me. So, if you are interested and if you leave in the Lausanne (Switzerland) area, you'll find a lot of information there.
I also wished to build something broader than a mere "internet leaflet" and I dedicated it to all the people of the LGBTI community who are in search of their true self. I hope that it will become a place for sharing between LGBTI people who are looking for a respectful counseling and counselors who are willing to do it. I also hope that it will be a place where people with very different life experiences will be able to share it between each other and that it will become a place where a respectful and positive perception of LGBTI people will arise.
First results of a respectful counseling
(July 2007)
The site "vrais-visages" ("true selves") has been online approximately 18 months. The number of visits is progressively growing. Of course, there are much more popular sites. But this site has also been the opportunity of quite extraordinary contacts and it helps doing a valuable work. In addition, some of these counselings have left visible traces on the site. For example, a person from Canada who is also transgender and metis and who has a public status was able to find the inner resources to make a public coming out. This did not only deeply transform her life, but it also helped other publicly known Canadians to make their own public coming out. Another Canadian (who did actually only write me through the site) has been able to find the local resources she needed for a transition. Another contact came from parents who were concerned for their 8 years old child. There has also been a lot of contacts by email but I cannot tell very much about them as their authors chose to remain hidden.
As a first synthesis of these contacts, I notice that they are approximately divided in three categories. There are some very short contacts (not more than three messages), where the person is centered around precise and practical questions. The person who contact me this way are just looking for a piece of information and they continue on their own when they get it. Almost all these contacts take place directly on the site. The second group correspond to people with who the relation lasts a bit longer, approximately one month. Most of these persons are questioning their identity and the possibility to make a transition. For some reason, they choose to interrupt the relation. The last group is the one of lasting contacts (several months). It correspond to persons who are determined and who engage themselves in their transition.
Having a site enabling people to write directly and the end of an article seems to make a first contact easier, especially for people who need to remain anonymous. The limitation of this solution is that the content of their messages cannot be too much personal. This is largely enough for people looking for precise and practical information. But this is not appropriate for more personal and more lasting relations. In that case, email can be a good and working solution, even despite the absence of physical contact. It is really possible to listen to someone and to practice some valuable counseling, at least for some people, with this media. And it may help them go through an important existential crisis. A question still open for me is whether it is possible in this form of counseling to help the person getting more connected with his/her feelings and with the (often related) reactions of his/her body. I am especially interested in seeing whether focusing can be used (and useful!) in this for of counseling. Email also has the advantage that people can read and answer when they want (or can), which may help preserving their personal life. I am much less familiar with counseling through instant messaging, but I am not attracted by this media. At least, it seems essential to me to avoid using solutions which may endanger the privacy of such relations. It seems also important to me to avoid using solutions who "scream" that this or that person is only as soon as s/he turns his/her computer on. Some open source messaging system, like Jabber seem to offer interesting solutions to these problems.
PRACTICAL QUESTIONS
In principle, here in Switzerland everything has been settled by a few judgments of our supreme court (“Tribunal federal”), and some of them are several decades old. The site “dysphoria” (http://www.dysphorie.ch/) gives basic informations about those questions. The association «360» (http://www.360.ch) is also able to supply informations, by phone, during discussions, or through its group about transsexuality.
But, as usual in Switzerland, practice may be more complicated than theory. Here are a few explanations
Insurances
In Switzerland, there are three categories of health insurances: “basic”, “semi-private” and “private”. The first one is regulated by our law on health insurances, which has very precise rules and is very strict. The two other ones are regulated by our laws about private insurances. In that case, insurances are free to do almost what they want. They are especially free to exclude some pathologies from a contract, which is impossible with the “basic”one.
The law on basic insurance, guarantees, among other things, the reimbursement of stays in hospitals of one's own Canton (State), in the “common” division, (i.e. usually 4 bed by room and no free choice of the doctor who is in charge of your case). A stay in another canton is paid if and only if it cannot be made in the canton of residence of the patient.
The monthly cost of such insurance varies from Canton to Canton and from insurance to insurance. In average, in 2004, in my Canton, it is a bit over $200 per month and per person.
Semi-private and private insurances guarantee the free choice of the doctor in charge of your case, usually an executive (professor or other). Semi-private insurances give access to room with only two beds, while private ones give access to rooms with a single one. In 2004 and in my canton, a semi-private insurance costs around $380 per month and per person. A private one may cost $550 or even more.
Our supreme court has decided that Sex reassignment surgery must be covered by our health insurance system, as long as it is made in a public hospital, under the condition of the basic insurance. If a patient wants a surgery in a private clinic and if s/he has only the basic insurance, s/he'll have to pay for the difference.
Hair removal is reimbursed only if it is performed by a dermatologist, and all work with lasers. Electrolysis done by beauticians (which is the only definitive one) is not reimbursed and can be very expensive ($150 per hour or more).
Hormonal therapy is not covered and must be paid by the patient.
If a patient wants a surgery in a private clinic, s/he will have to conclude a private contract. But s/he has to do it early enough and to be careful enough so that the insurance has no way to refuse to cover surgery when it is time. Obtaining such a contract may be difficult (private insurances are more and more restrictive in this domain), success is not warranted and it is much better to obtain it several years in advance, before any treatment.
Therapy
To get a SRS (and its reimbursement), the recommendation of a psychiatrist is required. But gender therapists and members of HBIGDA are not numerous in Switzerland, if they exist, and the conditions to get this recommendation varies from psychiatrist to psychiatrist.
A university hospital used to require two years of therapy even before the beginning of any hormonal treatment. What followed was of the same style. Of course, patients were strongly tempted to get hormones by themselves through Internet. The team of this hospital was so much at odds with transsexuals that they finally refused to take them in charge, except to try to “normalize” them.
Some psychiatrists with a private practice may be much more respectful of their clients and accept HRT after 3 to six months of therapy and surgery after one year of real life test. But one must admit that these persons are rare and very difficult to find. Unhappily so-called therapist who claim to be willing to support transsexual persons but who actually are not at all ready to help them for HRT and for surgery are not rare.
I have to recommend to transsexual persons to be very careful in the choice of their psychiatrist. Among other things they have to make sure that the person they chose helped other transsexuals all the way through surgery in the recent months. It is also very wise to make sure that the therapist they choose is really willing to help them, instead of trying to take power over them in order to try to “normalize” them.
The whole medical community agrees that so-called “conversion” therapies applied to homosexuals are frauds and fundamentally disrespectful of homosexual persons and of their dignity. It is time that the same medical community applies the same standards to transsexual persons!
Surgery
In Switzerland, there are two main teams, the one of Dr Daverio in Lausanne, who operates in a private clinic and the one of Dr Walter Kuenzi who operates in the university hospital of Zürich. I heard that there is another team in Basel, but I have no information about it.
As sex reassignment surgery is available in Switzerland, no surgery made in other countries will be covered, at least with the basic insurance.
The Dr Daverio and his team practice surgeries in both directions. He has an outstanding reputation for the surgery of female-to-male patients (FTM) and it is known to be excellent for MTF. The team of Dr Kuenzi practices only with male to female patients. He has an excellent reputation too.
In general, stays in Zürich are much longer than in Lausanne. Patients are usually staying for three weeks and they go back to work only after three months. On the other hand, patients of Dr Daverio go back to work after only one month.
In addition, the Dr Kuenzi schedules systematically a small control surgery two months after the main one, which is not the case of Dr Daverio.
I am not a surgeon and I am unable to compare the quality of the work of these two teams.
I did also read that the Dr Kuenzi practices one sex reassignment surgery per month. I have no idea of the number of clients of Dr. Daverio.
Legal changes
The principles of the legal changes are fixed by judgments of our supreme court. It is a simplified procedure “in rectification of civil status”, with a single part. The recommendation of the psychiatrist and the report of the surgeon who certifies that the person has had surgery and is now sterile are required.
But the procedure varies from Canton to Canton. Geneva seems to be especially fast, the judgment is delivered a few weeks after the hearing. Mine is much slower. The request is published for one month in the journal of official notifications before it is possible to fix the hearing. The public prosecutor's office may oppose to it. The court requires additional proofs of the good integration of the person and a witness. Even if the hearing is relatively fast, one may have to wait six months or even more before the judgment is published! In addition, the text of those judgments mentions that the case law of the supreme court is applied restrictively and that the court requires very strong elements to agree to the rectification.
Currently the federal public prosecutor's office contests all the rectifications for married persons. According to some attorneys, the lawfulness of this action is not so clear. But someone will have to go up to the European court of human rights in order to settle this question.
Once the judgment is enforceable, it is communicated to the civil registry of the Canton, and they transmit it to the confederation and to the city of residency of the person.
Normally, the birth certificate is only corrected and not replaced, and one has to ask for an extract of birth certificate in order to be sure that only the new identity is mentioned.
With this document, one can then get a new identity card in 2-3 weeks (which is the normal delay). A marriage is also possible.
Then the person still has to update all their records and documents.
References
[1] Mildred L. Brown, Chloe Ann Rounsley
True Selves : Understanding Transsexualism--For Families, Friends, Coworkers, and Helping
Professionals
Jossey-Bass; Reprint edition (March 7, 2003)
ISBN: 0787967025
[2] Randi Ettner, W W Norton & Cosd
Gender Loving Care: A Guide to Counseling Gender-Variant Clients
W. W. Norton & Company; (May 1, 1999)
ISBN: 0393703045
[3] Marina Castaneda
Comprendre l'homosexualité : Des clés, des conseils pour les homosexuels, leurs familles, leurs
Thérapeutes
Robert Laffont (16 septembre 1999)
ISBN : 2221089820
Also available as a pocket book:
Pocket (7 novembre 2003)
ISBN : 2266140760
[4] Cheryl Chase
Chrysalis: Intersex Awakening Special Issue
1997, fall/winter issue
http://www.isna.org/pdf/chrysalis.pdf
[5] Anne Fausto-Sterling
The Five Sexes
The Sciences, 1993, (March/April) pp. 20-25
http://bms.brown.edu/faculty/f/afs/fivesexesprnt.pdf
Anne Fausto-Sterling
The Five sexes revisited
The Sciences,2000, (July/August) pp 18-23.
Reprinted in French translation in La Recherche 6 2001-2002 pp.58-62;
http://bms.brown.edu/faculty/f/afs/5sexesrevprnt.pdf
Blackless, Melanie; Charuvastra, Anthony; Derryck, Amanda; Fausto-Sterling, Anne; Lauzanne, Karl; and Lee, Ellen
How sexually dimorphic are we? Review and synthesis
American Journal of Human Biology, 2000,y 12:151-166
http://bms.brown.edu/faculty/f/afs/dimorphic.pdf
Anne Fausto-Sterling
Sexing the Body: Gender Politics and the Construction of Sexuality.
New York: Basic Books, 2000
ISBN: 0465077145
[6] Will Roscoe
Changing Ones: Third and Fourth Genders in Native North America
Palgrave MacMillan (June 1, 2000)
0312224796
[7] Gerry Nettick et Beth Elliot
Mirrors: Portrait of a lesbian transsexual
1996, Rhinoceros Edition
Masquerade Books Inc
ISBN 1-56333-435-6
[8] Carl R. Rogers
A Way of Being
1980 Hougton Mifflin
ISBN 0-395-75530-1
(ouvrage non traduit en français)
[9] Carl R. Rogers
On becoming a person
1989 Houghton Mifflin
ISBN 0-395-75531-X
(ouvrage
tranduit partiellement en français: Dans la traduction de Dunod, il
manque les chapitres 2, 6, 12, 15 et 20)
[10] Milton Diamond, Ph.D. and H. Keith Sigmundson, M.D.
Sex Reassignment at Birth: A Long Term Review and Clinical Implications
Archives of Pediatrics and Adolescent Medicine [March, 1997]
http://www.hawaii.edu/PCSS/online_artcls/intersex/mdfnl.html
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