How Colleges and Universities

Can Improve their Environments for TG/TS Students (cont.).

by Lynn Conway
Copyright @ 2002-6, Lynn Conway. All Rights Reserved.
[Updated version of 2-26-06]
 

IMPORTANT ALERT: After years and years of inhumanely treating its transgender clients, the UMHS-CGSP has been re-invented.

"UMHS-CGSP: Understanding the past, seizing the moment, shaping the future", by Lynn Conway, lynnconway.com, Sept. 11, 2013:

"During the past two years, a wave of change has swept through the University of Michigan Health System’s Comprehensive Gender Services Program. Under the leadership of its new director, Nancy Quay, the program has broken with its infamous past, and moved to the front of the emerging transgender-healthcare movement. We can learn much by reflecting on CGSP’s past, on its reshaping via new leadership, and by envisioning the impact it could have in the future . . . " [Printable PDF]

[The following original Appendix from 2002-2006 is left intact for historical reference.]

APPENDIX:

An e-mail from "Kelly" reveals challenges faced by transitioning students at UM.

The following is a message from a graduate student named "Kelly" who had transitioned just before entering the University of Michigan (UM) in 2002. She  had encountered some problems at UM and (knowing about my website) had then contacted me. 

I was assisting the Gender Identity Working Group (GIWG) of the University's Division of Student Affairs at the time, and was accumulating information from trans students at UM to learn about the difficulties they faced here.  It was that information that led me to build the list of recommendations above.  Although the problems that Kelly faced would be different in different universities, her experience hints of the myriad of practical problems that transitioning students often face.

Kelly had originally applied to UM as a boy (under her old name).  However, she had entered UM as a girl after socially transitioning during the summer preceding her arrival here (including getting her legal name change, a new driver's license, etc.). Kelly was a highly talented, well-liked, very sociable, very pretty girl, and she did excellent work in her graduate studies at UM.

However, Kelly faced continual emotionally draining encounters with "the system" at UM.  In her message, she identifies many problems in UM's services in response to questions Lynn had e-mailed to her. She endured a lot of fear and angst due to difficulties in changing her name and gender on her student records, and difficulties in her interactions with UM's infamous "Comprehensive Gender Services Program" (see note below*).

This student's experiences are typical of the many challenges that transitioning students face in universities. Remember that these challenges are in addition to the many other social, legal, family, medical and relationship challenges these students face during this difficult period in their lives. Our colleges and universities really need to DO something to make things easier for these students!

E-mail from "Kelly", in 2002:

*Important note regarding the Comprehensive Gender Services Program (CGSP) at UM:

The above e-mail reveals how Kelly got entangled with the now infamous "Comprehensive Gender Services Program" (CGSP), which purports to be a "gender clinic" at the University of Michigan.  Incredibly, the intake staff member at CGSP tried to compel Kelly to de-transition, even though she had been on estrogen for an extended period of time, had already successfully socially transitioned, had obtained a legal name change and new ID's, had registered at UM as a girl, and was already doing very well in her graduate studies here as a girl.

Background on CGSP:

UM's CGSP was founded in 1993, and had once been a respected (though small) exploratory university gender program.  However, it drifted into decline after the retirement of its founder, Sandra Cole.  CGSP is now staffed by minor administrators who are NOT gender clinicians, and who cling to old-time theories of transsexualism as a mental disorder (i.e., mental illness). The main intake and case management work is done by one part-time person who is NOT a gender counselor or medical specialist.

Rather than being a clearinghouse of information about services, and referring students to independent gender counselors who can function as primary case-managers, the intake person controls gender clients' access to medical and clinical practitioners (at UM and in the local Ann Arbor area).

CGSP will only provide referrals to counselors who "affiliate" with the program, and who let the part-time CGSP staff member maintain control over clients' transitions. Affiliation with the UM program is seen as a stamp of approval by affiliated gender counselors and other caregivers, so many go along with this monopolization of case management by CGSP.  Clients from SE Michigan often view UM as being an elite medical institution (which it is), and thus think that professional affiliation with CGSP at UM is a sign of special significance (which it is not). 

Under this system affiliating counselors cannot take UM trans students (or staff) as clients unless those students sign up with CGSP and follow its highly regimented Standards of Care (SOC's) (which are the equivalent of very outdated versions of the HBIGDA Standards of Care). 

By this means, CGSP has gained monopoly control over access to local gender services in the University and the Ann Arbor area - and exploits this control to push the CGSP ideology, belief system and protocols for "management" of gender transitions.

UM students and staff cannot readily access the excellent local counselors and medical caregivers outside the program, because those caregivers won't take UM clients who try to circumvent the CGSP.  Thus students and staff cannot easily find local counselors who can independently tailor their transition plans to their own special circumstances.  For this reason, some students cave in and go through CGSP's intake procedures and follow CGSP SOC's, and then encounter problems due to the regimen involved. Others cave in in order to gain access to "in-program" surgeries covered by UM's health plans, even though the competence of the surgeons involved is highly questionable because of their lack of experience (they do only 3 or 4 SRS's each year).

When Kelly went to CGSP, they did not give her a list of local counselors, primary care physicians and endocrinologists who are trans-knowledgeable and friendly.  Thus she was unable to easily find help for her own particular case. Instead, CGSP told Kelly that she must "return to GO" and start over again in the CGSP program, and only then would they refer her to caregivers.  This illuminates how CGSP maintains control over access to local gender counseling, and places itself in the middle of many transitions (thus maintaining its turf and relevancy as a "gender clinic").

Avoidance of CGSP by young transitioners:

Few serious young transitioners go near CGSP, because the program is well-known for its strange attitudes towards transsexual people (especially young MtF transtioners) and for its retrograde protocols of treatment. The situation is quite similar to that at the Clarke Institute in Toronto, Canada (now called "CAMH"), which is also avoided by serious transitioners (especially the young).  Knowledgeable transitioners at UM try to find someone among the experienced local counselors who (i) will take them as clients outside the CGSP program, and yet who (ii) have managed to maintain client access to UM medical caregivers. (Anyone needing the names of such counselors should contact Lynn).

Because of this avoidance of CGSP by younger transitioners, their clientele primarily consists of older crossdressers and transgender people from the SE Michigan region (outside of UM).  Thus the program is slanted ever more towards gatekeeping, and to holding back many of these people from attempting TG or TS transitions (which in the case of lower-intensity older cases is probably a good approach).  In interviews with CGSP staff members, I've heard them proclaim "we try hard not to break up families", as if that were a primary CGSP mantra.  It appears that CGSP staff members consider gender transition as a last resort to be done only if someone is seriously "mentally-ill".  I also noticed that CGSP staff members refer to MtF transitioners behind their backs using male pronouns. This may derive from the high percentage of CGSP clients who are older cross-dressers.

Limited case-management numbers raise serious questions of competence:

One measure of a gender clinic's competence and experience is the number of clients whom they've assisted through transition. According to recent news reports, CGSP has helped only 35 people to complete gender transitions during the past 10 years.  Although CGSP may interact with many crossdressers from across southeast Michigan, they do NOT have significant experience with actual gender transitioners. 

The CGSP numbers are so small that they bring into serious question the competence of the UM surgeons performing SRS in those cases. The prominent SRS surgeons in the U.S. and abroad specialize in such surgeries, and the surgeons who are achieving good results all perform over 100 such surgeries a year.  It is difficult to believe that a surgeon performing only 3 or 4 sex reassignment surgeries a year (and who is not known to network with the trans-care medical community regarding recent advances in SRS surgical techniques) can be fully competent in this area of surgery.

Questioning CGSP's beliefs about transsexual people as being "mentally ill":

The reason why CGSP staff members attempt to compel young trans girls (such as Kelly) to de-transition, stop hormones and start over again in their program is simple: they view intensely gender dysphoric MtF trans kids as being "confused gay boys". Such clinics believe that these "gay boys" should try hard to accept the idea of becoming gay men, instead of transitioning and becoming women.  In doing so, CGSP follows the teachings of Blanchard and Zucker at the infamous Clarke Institute in Canada, and of the Catholic psychiatrist McHugh's teachings at Johns Hopkins (another of the old-time university clinics which highly stigmatizes trans women). 

Thus of course it comes as no surprise that CGSP recommends J. Michael Bailey's rampantly transphobic book on their website (Bailey became a careerist spokesman for Blanchard's, Zucker's and McHugh's teachings). This also explains why CGSP staff members suffer observable unease when talking with successfully assimilated trans women (as I myself directly experienced).  Such transphobic staff members experience severe cognitive dissonance and emotional distress when confronted by secure and accomplished transitioned women - women whom they've been indoctrinated into visualizing as mentally-ill sexually-paraphilic men.  

Young transitioners are indeed wise to avoid CGSP (and similar clinics):

Until and unless CGSP drops its mental-pathology model of transsexualism, and adopts a more modern, informed-consent model of gender counseling and gender transition, it is a totally inappropriate place to send young students who are in the midst of  gender transitions.

As a prominent gender researcher (who is not TG) from another university says:

"The CGSP appears to be thoroughly self-centered, as is my experience with university research-based "gender clinics" in general. They are staffed with people who objectify and pathologize "patients" and engage in nothing like a client-centered approach. There is a persistent problem from the way that these folks are attracted to this work and trained for it."

A scattering of other universities around the U.S. have programs similar to CGSP.  Trans students would be well advised to steer clear of those clinics (unless they can fully confirm that they follow a modern, humane model for assisting trans students).  They should instead seek help from outside gender counselors in private practice (i.e., NOT affiliated with a university "research" program) who follow a more modern "informed-consent, options-presenter, advisor and coach" approach, and who are well-networked with the best specialized medical caregivers at the national level.

For more background on the unregulated authoritarian control exerted over the lives and freedoms of gender transitioners by psychiatric and medical elites, see the following report on TransHealth.com:

"The Medicalization of Transgenderism: Whitney Barnes ... brings us an academic work on how the medical establishment has historically treated transsexual and intersexual people and how we are beginning to wrest control of our bodies back from them.", TransHealth.com.

Update of April 26, 2004:

On April 26, 2004, the University of Michigan published the "Report of the Task Force on the Campus Climate for TBLG Faculty, and Staff and Students at the University".   The TBLG Report builds upon the concerns and recommendations originally published on this page back in 2002, and like the earlier GIWG report includes many of those recommendations. That Report is highly recommended as a model for discussion and planning regarding transgender issues by other universities.

After hearing many complaints about CGSP as above, the TBLG Task Force members unanimously recommended a formal outside review be conducted of CGSP, in order to insure that the needs of trans students and staff at UM are better served.  ( See Recommendation C1 on the following page: http://www.provost.umich.edu/reports/tblg/reporttext.html#IV )

Hopefully outside review of CGSP will be conducted someday. At the very least CGSP's monopolistic control of access to gender counseling and treatment by UM community members should be eliminated, taking CGSP out of the loop for most trans students and staff.  Lists of local gender counselors and gender medical caregivers should be maintained instead, and provided to trans students and staff by the University Health Service, Student Counseling Services and the Office of LGBT Affairs. Trans and questioning students and staff could then identify and approach trans care-givers in confidence on their own.

If local professional gender counselors and others now affiliated with CGSP could take on transgender clients who are NOT signed up with CGSP, then trans students and staff at UM would finally have access to many excellent local caregivers - without having to put their personal lives under the control of the ill-informed minor administrators of CGSP. 

Meantime, as of two years later (now in 2006) we are still waiting for the outside review of CGSP.