LynnConway.com Web

Basic TG/TS/IS Information

by Lynn Conway
http://www.lynnconway.com/
Copyright @ 2000-2005, Lynn Conway.
All Rights Reserved.
 
Part IIa:
Transsexualism (Continued)

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Part I: Gender Basics & Trangenderism

Part II: Transsexualism (MtF)

Part IIa: (TS continued)

Part III: Life as a Woman After TS Transition 
 
 
 

 
 
Part IIa - Contents:
 
 
 Transitioning Early in Life
 The great obstacle to transition: The challenge of confronting and coping with fear
 Fear is often heightened by GLBT activism which portrays all TG's & TS's as "victims"
 WARNING: Be sure to visualize the real risks of transition and factors that affect success
 Assessing risks, making decisions, and taking actions during transition
 How can family, friends, teachers and co-workers help a transsexual woman in transition?
 With better understanding, how might transsexualism be treated someday?
 TS Success Stories: Websites of Successful Post-op TS Women
 
 
 

 
Transitioning early in life:
 
In the last section, we discussed the issues facing those who transition late in life. Fortunately, there are increasing opportunities for T-girls to transition early in life. The clear and visible difficulties facing late transitioners should be a big warning bell for young transsexual girls, who should seek help and learn of all the options for resolving their conditions at the earliest possible age (see Andrea James' page Transitioning Early in Life).
 
The wonderful effects of transition in one's twenties or younger are seen in many webpages documenting early transitions. When these photos were first added here, "Katie" was a young TS woman in her mid-twenties who'd recently underwent FFS, transitioned "on-the-job", and was in her RLE. She has since completed her transition and is very successful in her life and career, and her story and website give lots of hope to other young transsexuals. Here's a photographic overview of Katie's gender transition:
 
 
 
 
 
 
 
An increasing number of transsexual youngsters are also now able to gain the support of their families. Many are transitioning while in college, and some even have the chance to transition while in high-school if their parents approve.
 
Such an early transition provides incredible advantages to a TS girl, because she can avoid the heavy damage to her body structure and facial features caused by male hormones during the late teens and twenties. The recently released HBIGDA Standards of Care, Version Six now support such early medical interventions in cases of intense MtF transsexualism.
 
By beginning anti-androgens and estrogens in her mid-teens, the TS girl's puberty can be shifted into a transition towards womanhood. Her SRS can then be done at age 18 or so. Such a TS girl can begin dating at a normal age, and share in all the experiences that other high school girls enjoy. For a heartwarming example, see: Mom, I Need to be a Girl, by "Just Evelyn", Walter Trook Publ., 1998. See also the salon.com article "Teen transsexuals: When do children have a right to decide their gender?"
 
 
The Netherlands - At the forefront of the treatment of teenage GID and early transitions:
 
The Netherlands is in the forefront of providing for early diagnosis and treatment of cases of intense GID in children and teens. Professor dr. Peggy Cohen-Kettenis (is klinisch psychologe en psychotherapeute bij het Medisch Centrum van de Vrije Universiteit van Amsterdam) is a major advocate for the humane treatment of children and teens who suffer from intense gender dysphoria, She developed the new protocols for treating gender dysphoric teens over a number of years in an extensive research programme. For more information about Dr. Cohen-Kettenis, see these links: Nieuwsbrief april 2000, Biosketch. In cases such as Nicole's in the Netherlands, reversible hormone treatments can now begin early so as to delay puberty, and then cross-sex hormones can be begun at age sixteen. If all indications are positive, then SRS can be done at age eighteen.
 
Following is a link to a Dutch article about a teenage transitioner named Nicole, showing what it could be like for trans kids in other countries if their societies were more merciful and understanding. Nicle is now on the treatment trajectory pioneered by Dr. Cohen-Kettenis:
 
 
Nicole, age 13 (her story in Dutch)
A pretty young Dutch trans girl now transitioning
with full family and medical-system support.
 
 
 
By the time Nicole is eighteen her gender correction will be complete, and she can then look forward to a full and normal life as a woman. Meantime, her teen years will be spent as a girl, and she will be able to assimilate socially during those years as would a normal girl. All of the counseling and medical care in these cases is covered by the Dutch health service. The many positive outcomes under Dr. Cohen-Kettenis' treatment protocols are now becoming more widely known in the west. Hopefully more and more counselors will pay close attention to these results and begin to explore bringing the Dutch protocols into wider use in more countries.
 
See the following links for more about Nicole's story and translations of other stories about Dutch teenage transitioners. Much of this information comes from the Dutch gender dysphoria information website Landelijke Kontaktgroep T&T (LKG T&T). These stories were translated into English by Barbara Blake, herself the mother of a transgender teenage daughter:
 
 
 
 NEILS BECAME NICOLE:
"Now I am able to be whom I actually am"
 
Nicole's Speech to Her Class
 
Wrong Body….They have that 'pecker'
 
 
Photos of Dutch trans children
in the 'Volkskrant' magazine article "Wrong Body"
by Ellen de Visser, 13 September 2003
 
Jasmijn, age 9 
Manon, age 10
Kristel, age 11 
Willem, age 12
Valentin, age 13 
Jamie, age 14
 
 
Germany sets a new precedent:

In a landmark ruling in Germany, a 14 year old transsexual teen named Johanna has been given permission to receive hormone therapy to begin her physical transition from boy to girl.  With the full support of her mother Anke, Johanna had been raised as a girl from an early age. Anke and Johanna then convinced a German ethics commission to grant permission for Johanna's early transition, and in a race against time were able to intervene to avoid her physical masculinization by testosterone.  Anke's wonderful story about Johanna's life, "My Daughter’s Brave Choice", was published in English in the June 14, 2004 issue of Woman's Own, a UK magazine.

 

 

          

As Johannes, age 3                now as Johanna, age 14

 

My Daughter’s Brave Choice (English)La valiente decisión de mi hija (Español),

Le courageux Choix de ma fille (Français),  Die mutige Entscheidung meiner Tochter (Deutsch),

La scelta coraggiosa di mia figlia (Italiano) A lányom bátor választása (Magyar),

Wybór mojej córki (Polski)Смелое решение моей дочери (Russian)

 

See also "Nina’s Story, the story of another young German girl, translated by Barbara Blake from an article in Suddeutsche Zeitung Magazin, 2 August 2008 (DE, DE print).

 

 

The Situation elsewhere:

Meantime, in most other "advanced countries" the situation regarding early diagnosis and treatment is a very mixed bag. The same services can be accessed by those parents who learn about them, and who are insightful enough and courageous enough to help their child in this way. But most families will not know about these options, or if they did will not visualize the seriousness of forcing a teenager to grow up into the wrong gender and have to make the much more difficult correction later - as an adult.
 
Therefore, many a teen-aged TS girl is confronted with the desperate decision of whether or not to even "tell her parents". Will she find help from them for her transition? Or will she be summarily thrown out onto the streets? She may have no way of guessing the answer to this life and death question. It is still all too common for families to totally reject and excommunicate a TS child who comes out to them and seeks help from them. Even more frequently than with gay children, TG/TS children are often simply "thrown away" by their parents: Expelled from their homes, they are doomed to attempt unsupported early-transitions on their own, often ending up living marginalized lives as prostitutes on the streets of inner-cities (as discussed above).
 
Even in cases where the parents want to help a child diagnosed with gender identity disorder (GID, which is a term sometimes used for transgenderism/transsexualism), the state may intrude and PREVENT appropriate gender assignment. For example, in a recent case in Ohio, the State took custody of a six-year-old transgender/transsexual girl away from parents who sent "him" to school dressed as a girl. The little child had been diagnosed with GID, and had strongly self-identified as a girl since the age of two. Social workers represented that the child could be cured of this behavior rather than "encouraged" by the parents.
 
In other cases, the child may be expelled from school for "cross-dressing". TG/TS students may face serious hostility from teachers and administrators who lack a basic understanding about gender identity variations and about how our gender is the most basic underlying component of who we are as a person. Fortunately, an important court case in Brockton, MA sets an important precedent: A Brockton school justified its exclusion of a TG/TS student based on other students' discomfort. The superior court rejected this argument, holding that prohibiting "Pat" from wearing girls' clothing was akin to "the stifling of plaintiff's selfhood merely because it causes some members of the community discomfort."
 
Well-meaning parents often take a child who "wants to change gender" to a traditional psychiatrist. However, GID is still considered a mental disorder by many psychiatrists (under John Money's now discredited theory). Such psychiatrists often believe they can "cure children of this disorder", and their cures usually involve aversion therapy and strict enforcement of gender stereotyping. TG/TS children suffer enormously under such treatments, which only delay their transitions - often till late into middle-age - costing them the best years of their lives outside their innate gender. These cruel and unscientific treatments of innocent TG/TS children are the moral and medical equivalent of unwanted genital surgeries on intersex infants. Such treatments inevitably fail, and hopefully will fall into disrepute as time goes on.
 
But there is good news too. Recent developments, including far easier access to female hormones (ordered from overseas websites) and the establishment of excellent sex-change surgery clinics in Thailand, where SRS costs $4000 to $6000 (see article in the May 6, 2001 New York Times), have made it much easier for younger transsexual girls to achieve complete gender transition before or during their twenties. Many young T-girls can now simply manage their own cases, starting themselves on hormones and then socially transitioning when they are sufficiently androgynous - and all along saving money for surgery. The Thai surgeons do not insist on the full HBIGDA protocol, thus reducing the financial burden of having to go to a counselor or psychiatrist for several years, and then yet another one for a "second opinion", in order to get the "letters of approval for SRS" needed here in the U.S.
 
[Note: It is useful to know that Thailand has a long tradition of socially accommodating the transgendered (known in Thailand as 'katoey'), who can crossdress and live openly as women there. Although they do not have full social privileges, they nevertheless do not have to live in fear and destitution as in many other countries. Thus the publicly visible and known number of transgender/transsexual girls in Thailand is vastly larger than in western countries where the transgendered must usually pass (and be invisible) as women or else remain hidden and closeted.]
 
As an even less expensive alternative, transsexual women can now take advantage of fairly easy access to orchiectomy (castration), which costs about $1000 to $2000 and which does not require the full "SRS permission letters" (see Lynn's SRS webpage for links to surgery clinics). After castration, a T-girl's body will no longer be maimed by testosterone and the feminizing effect of estrogen will become much more pronounced (especially in younger girls). This approach can enable younger T-girls to rapidly become passable, and to "buy time" to save money for SRS without feeling such terrible, desperate urgency.
 
Spanish actress Carla Antonelli's website contains a page of photos of pretty TG/TS-girls where you can see the wonderful results the girls obtained from feminization early in life. The moral to the story is simple: If a TS-girl knows for sure that she must inevitably become a woman, then there is no time to waste. She should intervene to stop any further masculinization and to begin her feminization as early as possible - in her mid-teens if she can.
 
As our society begins to better understand and accept gender-transition as a treatment for the transsexualism condition, more and more transsexuals will be able to transition at younger ages than now. Transitioning early in life, especially while in their teens, enables transsexual children to avoid growing up into the wrong gender and allows them to live full lives in their correct gender. (See the UK's Sunday Express article about children who want to change sex entitled: "I am never going to be a man, mummy, when I grow up it will be as a woman").
 
Take a look at the happiness in the face of Deborah Davis, the pretty young Australian woman in the following photos. At the tender age of 17 she became the youngest Australian TS child to have undergone MtF SRS. Her courageous story was told in Australian Woman's Day in 1998. Try to imagine the joy that Deborah felt at the early release from the gender trap she found herself in. Also try to imagine what might have been in store for Deborah had she grown up in a less-supportive environment.
 
Photos of Deborah Davis, copyright Australian Woman's Day, 1998.
 
 
 
After looking at the above photos, please ask yourself: What would you do if your own child were transsexual? Would you take her to a psychiatrist and attempt to "cure" her of her "sexual deviance" by "conditioning" or "aversion therapy"? Would you try everything possible to prevent her from transitioning until she is much older, and thereby doom her to having her appearance horribly maimed and masculinized by testosterone? Would you throw her out onto the streets, as so many other parents do to their transsexual children? Or as a loving parent would you visualize the terribly frightened girl inside that young boy's body? And would you love her enough to help her escape from that trap so that she can go on to a full and normal life, as young Deborah did?
 
For young TS girls who cannot get the support of their parents, there are still many paths to early transition. Of course, some girls are so overwhelmingly compelled to transition that they simply run away to big cities and hit the streets on their own. Others struggle to cautiously wait until they finish high school and can get away from home and be out on their own - either working and making money, or going to college - and then begin their transitions.
 
Kids who run away to big cities like New York City, San Francisco, or Los Angeles can find some help these days. They can usually locate other kids like themselves and thus at least have some friends for social support. Some large cities, such as San Francisco, also have free clinics where TG/TS kids can get help with transition, get started on hormones and find entry-level jobs in their new gender. However, as we've seen in Part I, many of these kids end up in sex work, with all its risks and dangers of drug abuse, HIV, sexual exploitation and transphobic violence.
 
Kids who can hang on and wait until they graduate from high school have a much better chance of making it. Many begin working on their transition in secret while still in high school, by learning everything they can from the web and by beginning to plan ahead on how to do it. Some find ways, without anyone knowing, to start on estrogen and anti-androgen hormones while still in high school, and that can greatly improve their long-term transition prospects.
 
 
Education as a key to earlier, easier transition and success:
 
Whatever else they do, Lynn strongly advises TS kids to study very hard while in high school, get the best grades they possibly can, and then try to get into a good college. Transitioning while in college has now become one of the best and easiest paths to a successful early transition, and is an even better path than just going directly into the workforce in an entry-level job and trying to transition on the job there.
 
Students are very anonymous while in college, much more so than in high school, especially if the college is reasonably far from their hometowns. A TS girl's college classmates will be much more mature, much less "gossipy", and far less insistent on conformity to group norms than her high school classmates. The atmosphere in most modern colleges and universities is very accepting and tolerant of diversity. Very few of a TS girl's classmates will be transphobic, as long as she goes to a modern, mainstream college or university (as opposed to some religious-based school, or a school in a southern "redneck" area, etc.). Also, in most college towns or locales she will find areas for shopping, recreation and socializing that are relatively safe and fun places to hang out, even while in mid-transition.
 
If at all possible, college-bound TS kids who do not have the support of their parents for transition should try to get a scholarship to college and/or consider going to a community college, state college or state university. That way they will be less dependent financially on their parents, and are more likely to be able to finish school even if their parents find out they are TS and try to stop them from transitioning. By working hard at part-time jobs they can make the extra money needed for hormones and electrolysis, and can get far enough along in their physical feminization to be able to socially transition while in school. The girl can then socially transition and get her ID's changed over one summer, for example between her junior and senior years or between graduation and grad school, and then return to school in the fall without her classmates realizing who she is/was - especially in the anonymous environments of the large state universities. By completing her hormonal and social transition while in college, the TS girl can graduate in her new name and identity. She can then more easily find employment and start her career without having to generally reveal her hormonal and social transition.
 
That is not to say that transitioning while in college is easy to do. It can be an incredibly scary time. Few colleges and universities have any formal procedures or points of contact for helping transitioning students. Even such basic things as getting student ID's and records changed in a coordinated manner can sometimes be a huge hassle. The girl will need to get her nerve up and go see the various records' offices at her school and tell them that she has changed gender and has a new name. If she passes OK, and if she makes these requests calmly and without too much fear showing, many schools these days will simply accept her gender change at face value and change her records to her new name. However, if she is unlucky and runs into the wrong administrator, she may have to explain her situation in more detail and have letters from a gender counselor, etc. And if she becomes ill or injured in an accident, she may face outing and huge hassles from the college's health service. Nevertheless, it is a lot easier to transition while in college than in most other times and places in life. Even when procedural hassles and outings do occur, they are usually confined to within the university and few others find out about it later.
 
 
For Lynn's thoughts about things colleges and universities could do to provide better environments for students who are transitioning, see:
 
IMPROVING THE ENVIRONMENT FOR
TG/TS COLLEGE STUDENTS
 
 
More and more universities are quietly taking notice that transgendered students are occasionally transitioning. Although most schools don't yet know quite how to deal with this reality, transitioning students who are persistent can usually negotiate the bureaucracies at most schools and eventually get their records changed correctly. Once the girl graduates she can start her new life with the option of stealth and without being perpetually followed by rumors and gossip. Then, once she has started in her career and can save some money, she can complete her transition with SRS.
 
For more information about the advantages of early transitions, see an article in Marie Claire magazine (UK edition) in July 2002 that profiles three young trans women. Those considering early transition and those helping an early transitioners should also be sure to see the following really important website:
 
 
All early transitioners should carefully read and study Andrea James' webpage about
 
TRANSITIONING EARLY IN LIFE
 
 
 
The great obstacle to transition: The challenge of confronting and coping with fear
 
People often ask Lynn "How were you able to cope with intense fear, and make the hard moves involved in transition back in the 60's?" This question is important , because fear is probably the biggest obstacle to transition, even today. Even a person with intense motivation, positive attitude, effective planning, and an ability to rapidly learn new skills can "stall-out" and fail to transition, if they cannot learn to cope with fear.
 
Fear causes many TG/TS people to delay for years taking even the smallest steps, such as coming out to someone, making an appointment with a gender counselor, doing some tentative cross-dressing in public, or even going into a store to buy some make-up or women's clothing. Beyond these simple tasks, many TG/TS people over-worry about whether they'll ever pass, whether they can avoid violence, and whether they can face the pain of many surgeries. These fears derive from real concerns. But fear itself cannot be allowed to control your life and block progress towards important goals.
 
Fear does its greatest damage when a person reduces anxiety by NOT doing something frightening. For example, when someone terrified of public speaking finds a way to avoid giving a talk, the resulting reduction in anxiety feels like a "reward for talk avoidance". NOT doing scary things rapidly becomes habit for such a person, because they reward themselves for not doing things. However, by NOT doing scary things, they may never make progress towards important goals. The only way to break out of such avoidance-behavior is to learn to PUSH through fear and DO things in spite of fear. Then you experience rewards from decisive positive action.
 
However, this is easier said than done. If you can act while feeling intense fear, bystanders sense your fear and experience great unease. The unease people feel around a frightened TS in transition is like the unease we feel when a public speaker gets "stage-fright". It isn't that they dislike the person, or are bigots - it's just instinctive to feel uneasy around a very frightened person. This "fear-feedback" from bystanders then further frightens the transitioner. Therefore, taking actions when freaked-out doesn't work. Instead, you have to find ways to acclimate to fear and calm it down.
 
Lynn learned to cope with fear when she was in her teens, by getting into rock climbing. As she advanced to leading climbs, she had to face difficult moves, calculate whether they could be taken, and make decisions about risk and about the technical protection she had placed. By leading more and more difficult climbs, she learned to make difficult moves gracefully as if just off the ground, even when there were big dropoffs below her. Later, whenever Lynn faced something fearful she would think of it like a climbing move. Once she worked out the move, she would just go DO IT. Methodically "stepping through fear" became a habit. Many of Lynn's friends over the years learned similar lessons from adventures in skiing, figure skating, gymnastics, horseback riding, whitewater canoeing, motocross racing, and other demanding physical pursuits. Maybe you can find an activity that will help you this way too.
 
The gender transition experience itself can teach these same lessons. By starting out carefully in the initial stages, the beginner can learn how to confront and calm fears before going on to the harder steps. The key is to find modestly fearful things that you MUST DO and CAN DO, and then DO them in a timely, decisive manner. This can help you learn how to calm yourself before going on to harder steps.
 
The fears and embarrassments of the beginner fade as one makes progress. The accumulating physical changes and the skills learned in the early stages of transition can bring on a cheerful smile, a better attitude, and an eagerness to overcome harder challenges yet ahead. With practice along the way, fear can gradually be contained and replaced with hope, determination and anticipation.
 
 
Fear is often heightened by GLBT activism which portrays all TG's & TS's as "victims"
 
Why are so many young TS people too terrified to admit to anyone that they are transsexual? What causes all this crippling fear?
 
All young folks remember the strict gender behavior constraints imposed on them as kids. They intuitively sense the risks of transition, and visualize that it would take hard work, gritty fortitude and persistence. However, many young TS's can quietly transition without facing a lot of humiliation or difficulties, especially if they plan their transition well and carry it out calmly with grace and dignity. So why do so many let fear hold them back for years or decades before seeking help?
 
A lot of fear among young TS's is a side-effect of well-intentioned GLBT activism. Activists work hard to uncover hate crimes and discrimination incidents, and then publicize them widely and dramatically. As a result, TG and TS people are constantly portrayed as "pathetic victims" in the media. Victimization stories are turned into major news articles and movies, furthering the pathetic-victim image of gender-variant people. These stories are intended to demonstrate how despicable such hate crimes are. Emotionally outraged supporters send in contributions, and the activists are able to publicize more hate-crime stories. These efforts have the beneficial effect of alerting society to the outrages that are committed against some TG and TS people.
 
The problem with all this is that it spotlights the lives of only the small minority of TG/TS people who are victims of violence. The effect is made more harmful by the incorrect assumption that transsexualism is incredibly rare (which it is not; see "TS Prevalence" section above). As a result young TS's get the totally false impression that almost ALL people who transition end up as constant targets for harassment and brutality.
 
Hopefully activists will someday help in building a more balanced, positive, realistic image of the lives of transsexual people. A better balanced image might actually help reduce public hostility towards TG and TS people. It would certainly reduce the level of fear among young TS's.
 
Lynn created her "TS Successes" webpage for that very reason. She wants folks to know that there are tens of thousands of postop TS women out there who are doing just fine and living wonderful lives. If more young TS girls knew about all these successes, they would be less frightened by occasional reports of discrimination, would be less afraid to seek help, and would be more hopeful that they could successfully transition too.
 
 
WARNING: Be sure to visualize the real risks of TG and TS transitions and the factors that affect success
 
Discrimination, intolerance and harassment, although widely feared, are not usually the worst risks faced by most transitioners. The real risks are those that arise within oneself. There's the risk that you simply may not be competent enough to transition, the risk of losing employment and not being able make money, the risk that you just aren't self-reliant and adaptable enough to negotiate the maze of trials involved, and even worse - the risk that maybe you aren't transitioning for the right reasons, in which case you may become totally miserable afterwards. This is serious stuff that you need to carefully consider!
 
One of the most important requirements for success is the ability to shed all feelings of shame, embarrassment and guilt about one's transsexualism, and go forward with grace and dignity - even though those around you may react negatively. If the transitioner cannot shed feelings of shame and embarrassment, those feelings may grow rather than diminish as they get further into their transition, triggering serious emotional difficulties. Difficulties in handling shame and embarrassment, combined with a strong need to somehow express her femaleness can cause the transitioner to "act out", and present herself and talk about her transition in strange, uncontrolled ways that shock other people. Learning self-acceptance and shedding all feelings of shame and embarrassment is an area where counseling is critical and can be very helpful.
 
On the other hand, it is important to be realistic and know whether you have the "street smarts" to do something this difficult. However, it can be difficult for you evaluate your own "competence" for doing something like this. Remember, incompetent people don't realize that they are incompetent! They can't see competence in others, nor can they see themselves as others see them. Thus they can't make the corrections needed to succeed. Such people often think they pass when they don't, and then accuse those around them of being mean instead of working on their own very real "passing problems".
 
Successful transition may simply be beyond people who cannot rapidly learn new skills by carefully watching others do things and then calibrate the reactions of others when they try to do the same things. Successful transition requires lots of street smarts and common sense, an ability to quickly learn new practical skills, a lot of drive and a lot of hard work.
 
A good counselor can help you objectively examine your options for transition and help you figure out whether you've got what it takes to "make it". Support groups and other groups of TG/TS friends can also help you a lot by providing a gauge to measure yourself against. It is very difficult, almost impossible, to do this on your own, and a willingness to seek help and the advice of others will be important for success. Seeing what others are doing and how it is working for them can provide invaluable insights into how well you yourself might do. However, remember that TG/TS friends will often be too kind, and won't tell you that you need to make some major improvements in your presentation. Then too, sometimes when you are doing well TG/TS friends may turn jealous and try to hurt your confidence. Therefore, you must listen to your own heart when making major decisions, and not rely solely on the opinions of others one way or the other.
 
Careful financial planning, employment planning, budgeting, and contingency planning are also essential to success. Remember, you run the danger of getting "stuck in transition" if you run out of money and become unemployably unpassable "somewhere in between". Don't ever go there! Some attractive T-young girls may be able to resort to turning tricks, but this occupation brings on a whole new set of dangers and risks, as we've seen in Part I. The best bet is to get some skills so that you are readily employable, and then work very hard to save money for your transition.
 
An ability to steel oneself and be able to live with unresolvably negative reactions by family members and friends is also important. Otherwise the emotional pressures may become overwhelming when added to the other stresses of transition. Parents and family members may try to stop you from transitioning or try to stop your surgeries, even if you are an older transitioner. In some states they may even try to have you institutionalized. Being able to make lots of new friends can help compensate for losses of family and friends. Many TS's make lots of TS friends during transition, and then carry-over their improved "friend-making" skills into their postop lives.
 
 
NOW THE REAL WARNING: What if you "succeed" in completing a TS transition, but did it for the wrong reasons?
Yep, you get the idea! This is one place you definitely do NOT want to go!
 
In many cases, TS transition works out really well long-term. However, in some cases TS transition totally fails to meet very unrealistic expectations. Way too late the person may realize that undergoing SRS was a BIG mistake. This seems especially to be the case with older intense crossdressers and fetishists (including those who self-identify as "autogynephiles") whose drive to transition is based solely on male sexual feelings.
 
These people gradually lose their male libidinous responses to their new female body as time passes after the removal of their testicles during SRS. (This effect is quite different from the experiencing of a heightened female libido and improvements in lovemaking capability that occur in many other postop TS cases).. The loss of libinous rewards, combined with the accumulating practical difficulties of postop life, can lead to serious long-term adjustment difficulties for those who've "made a mistake". EXTREME CAUTION is advised IF you are unsure of your motives for SRS.
 
 
 For examples of postop women who had later regrets about undergoing SRS, see the information about Renee Richards, Dani Berry and Sandra (Ian) MacDougall on Lynn's
 
SRS WARNING PAGE
 
 
There have also been occasional cases of gay male drag queens who fall in love with straight men and some who talk themselves into suddenly going off and getting SRS in order to please and/or keep their lovers. These cases often turn out very badly, as the gay man increasingly freaks-out over the loss of his masculinity as time passes by. Such cases are the basis of many "urban myths" in the gay male community about "sex changes being a really insane idea", and may be behind some of the virulently transphobic writings and speeches of gay thought leaders (such as Jim Fouratt) in recent years.
 
Therefore, you must be very, very honest with yourself about "why" you need to transition, and whether a TS transition will meet your expectations over the long term. No one else can know your inner feelings of "why you need to do this", and no one else can predict how competent you might be at doing this. It is VERY important to be brutally realistic with yourself about your motives, capabilities and expectations before committing to a transsexual transition and undergoing SRS. If you sense that you might be doing this for your own autosexual pleasure, be careful and think about all the warnings. However, if you feel a deep need to be a female in body as well as socially, and if you feel a deep need to fully express your female sexuality in lovemaking, then maybe this is right for you.
 
Listen to your heart and to your body, and don't let perceived social pressures force you into something you'll regret. If you really enjoy your male sexuality preop (especially male "mounting, thrusting and penetrating" urges, and a focusing on your external genitalia as the main source of sexual arousal and pleasure), then you are unlikely to develop and enjoy a female sexuality after a TS transition. Instead you may simply regret losing your male sexuality and become sexually "cold". If you think this is a possibility, you should seriously consider TG transition.
 
Sometimes the situation is reversed. There are some intensely TS women (who have deeply female sexual arousals and urges, and who lack male "mounting" urges and male sexual urges) for whom SRS is probably the right path, but who avoid SRS out of a deep fear they might lose their warm female "turn-ons" and their ability to experience orgasm after SRS. Some of these women try to think of their male organ as simply a "large clitoris", and manage to accept it that way. Others may elect to have an orchiectomy rather than undergo SRS. Some TS women who are otherwise very feminine can attract love partners who accept them as women without SRS, by discreetly concealing their genitalia during intimacy. If you are terribly fearful of SRS and are not sure you will be happy afterwards, it's best to consider the option of a TG transition. On the other hand, if you learn more about the wonderful sexual and orgasmic pleasures that many intensely TS women do experience after SRS, you might gradually realize that SRS would open up a better life for you too.
 
[Note: For more detailed information about sexual arousal, lovemaking and orgasm in postoperative TS women, see that section in Lynn's SRS webpage.]
 
Unfortunately, the option of TG transition often leads to difficult long-term passing and health issues. TG/TS women and she-males who do not undergo SRS must continue to take very large "preop-level" doses of estrogen and anti-androgen year after year if they want to retain their feminine secondary sex characteristics. Therefore, they risk likely liver damage and major health problems unless they make difficult tradeoffs between feminization and those health risks. If they must drop back to safe "postop-level" doses of hormones for health reasons, the testosterone produced by their testicles inevitably causes a steady coarsening of their features. Testosterone also escalates the aging process in TG transitioners, robbing them of their youthful beauty much earlier in life than is the case for postop TS women (this effect has long been known in the gay male "drag queen" community). TG transitioners and she-males who were once very soft and pretty in their teens and twenties may have great difficulty finding male companions and lovers as they grow into their 40's and beyond. Old age can become a frighteningly lonely time for such people, and this factor should be carefully considered before undertaking a TG transition.
 
In many cases, TG transitioners eventually elect to undergo an orchiectomy (castration). Castration is a much simpler, less expensive and less painful surgery than SRS. It frees the TG transitioner of the health problems caused by testosterone, eliminating the need to take high levels of cross-sex hormones. TG transitioners having strong libidos can continue to enjoy penile erections and orgasms after castration, and thus continue to enjoy the male aspects of their sexuality. All in all, orchieictomy is an important option for TG transitioners to consider.
 
The real test of success in the end is whether you can make a full adjustment to your corrected gender situation, assimilate well into society, and then find loving partners with whom you can be mutually happy in your intimate life for the long term. Above all, do not let the currently rigid social views of gender affect your decision about whether to undergo TG vs TS transition. After a TG social transition you should feel comfortable being authentically "you" somewhere "in-between" the two bipolar social models of gender. It would be far easier to adjust to being "in between" than adjusting to a "TS transition that went too far"! Remember, people who are "in between" can find love partners too.
 
Even if you are sure of your motives and your need for complete TS transition, there are other important practical things to consider before committing to the transition. Some TS women have such highly masculine physical characteristics that they inevitably fail to pass, no matter what surgical corrections are made. This can lead to such social "noticeability", continual stares and humiliations that it is impossible for the person to assimilate as a woman in society. The ongoing humiliations can ruin the person's own internal feelings of having corrected their gender, and can force them into a socially marginalized existence after transition. These are very tragic cases for which there are no good alternatives.
 
Another key factor in success is whether you are self-reliant enough. Caregivers can only deliver bits and pieces of "gender technology" for transition. It is up to the transitioner to "put it all together and make it work". If you do not have that sort of "street smarts" and adaptability, you may be in danger of getting in way over your head if you attempt gender transition. You have to work it out for yourself day-to-day. Others cannot help you with all the details. Your counselors and surgeons are like the crew of the ship that deliver you to that far shore. Once there, you are mostly on your own. You better be sure you really want to go there and will have no regrets about what you left behind, and you need to be very adaptable and self-reliant to succeed there.
 
 
Accessing current knowledge, assessing risks, making decisions, and taking actions during transition:
 
As you can now imagine, the person who faces gender transition, either TG or TS, must negotiate a labyrinth of risks and difficulties, and must do this mostly on their own. They can get help from counselors and support groups, from TG/TS friends and acquaintances, and from information and contacts via the internet. However, each individual situation is so very different, and has so many unique factors, so that there is no one "best way to do this". Instead there are many options and many ways. Each person must do a lot of background information gathering and then be very imaginative and creative in putting together the best path for them to follow.
 
Once a person has committed to transition and can see a path that may work, they must be decisive and take those actions and not let fear hold them back from every step. Otherwise they will make little progress over time, and may get stalled in their transition. On the other hand, they must be flexible and able to handle contingencies and problems along the way. Sometimes things won't go at all as planned, and they will have to find a way around those problems. Plans that are to "tight" and inflexible, and timing that is cut too close, can sometimes go astray. Always leave room in your plans for contingencies.
 
Accessing current knowledge, assessing a lot of risks, making timely decisions, and then taking decisive actions in the face of fears - these are things the transitioner must get used to doing, and doing well if they are to succeed. It's no wonder that people in transition often seem "obsessed" to outsiders. In a way, they have to be a bit obsessed in order to negotiate all the challenges they face.
 
In fact, one of the major difficulties transitioners face is how to remain calm and do things with grace and dignity during a time when they are frightened to death, experiencing a lot of pain and embarrassment, and facing lots of worries about how it will all turn out.
 
Fortunately there are many many stories and role models that transitioners can now use to visualize how to transition. There are also many excellent support sites on the web to gain knowledge about current treatments and services, and to help in planning the details of a particular transition - with Andrea James' TS Roadmap being the premier guide for MtF transition. All this expanding information is increasingly smoothing the paths for those who transition. Here are some excellent websites that transitioners should pore over as they begin their journeys:
 

The Essential Guidebook to MtF Transition:

 

 

Calpernia Addams' wonderful information exchange and forums:

 

 

Resources and discussion boards for young transitioners:

 

 

Website of internet message boards and forums for TG/TS transitioners:

 

 
 
How can family, friends, teachers and co-workers help a transsexual woman in transition?
 
Once initiated, transition is a life or death matter for the transsexual. It's not done for sexual kicks, nor to outrage other people. However, the dramatic physical changes of transition can shock and frighten those who know the person. There are also many practical quandaries such as what name to use, what rest rooms to use, what pronouns to use, and how to explain it all to family and friends. It can seem like an unending gauntlet of dangers and trauma that must be run.
 
One major problem is that friends and loved ones often have a difficult time "letting go" of the former person, who seems to have died, and "getting to know" the new person. If the new person has strong vestiges of the old, loved ones will cling to the old identity and mis-gender the new person. If the vestiges are weak and the old person seems to have disappeared, the new person may be intuitively hated for "killing off" the old person. Many TS women lose all connections with their loved-ones, family, relatives and pre-transition friends, and have to start all over to find any friends, companionship and love after transition (that was certainly Lynn's experience during her transition). The closer someone was to the former you, the more imprinted your former identity is upon them, and the more likely it is that they will completely reject the "new you" during and after transition.
 
Also, the morphing of physical appearance resulting from sex hormone therapy and surgery can be so profound as to cause deep internal conflicts in other people. For example, some males may initially see the person as a "man in a dress" and make fun of "him", but then become internally distressed a year later when they unconsciously begin to react to the increasingly feminized transsexual as a sexually attractive woman. Other people may simply "not see" the later changes and blindly keep thinking of the person as a "man in a dress", thus subjecting themselves to stares and rebukes when they make gross errors in the use of pronouns (for example, referring to her as "him" all the time, when everyone else now sees "her").
 
Thus the transitioning woman must daily cope not only with the enormous changes underway within her own body and emotional setting, but also with the widely varying changes underway in the minds of everyone around her. A little understanding and polite assistance on practical matters from friends and coworkers can go a long way towards easing some of these burdens of transition.
 
The media doesn't help in all this, because for decades it's been a media habit to refer to a post-op TS woman as a 'man who had a sex change', and even use male pronouns when referring to her. This horrible practice was instigated decades ago by the Associated Press news service, and stories about TS women usually come over the AP wire in that form (see this example*). This practice has done incredible damage in the lives of TS women by grossly distorting their image in the eye's of society, and making transition a more difficult time for them.
 
[*Note: This AP practice was successfully challenged by the activist groups GLAAD and GenderPAC. The new AP Stylebook informs all reporters to ask the transsexual woman herself what name and gendering she wants used in any news articles about her.]
 
Because of ongoing medical, legal, bureaucratic, employment, religious and interpersonal complexities, each transsexual will also encounter hundreds if not thousands of people over their lifetime in situations where they are "outed" by their past history no matter how well they pass. At the present time, a TS woman may be treated with anything from disdain to contempt to shocked reactions in many of these encounters.
 
The cumulative effect of all these push backs and hurtful encounters can sometimes discourage even the most sturdy soul. To the transsexual woman in the midst of transition, it seems as if she is constantly undergoing a rather irrational, unrestrained "mobbing" by people all around her. Even those who cope well with fear and who have a very positive attitude can be worn down by these constant pressures. However, there is a danger of becoming angry and pushing back against these pressures, and that can be extremely counterproductive when trying to assume a warm, happy female persona.
 
Counseling and guidance can help these women cope with some of these impacts. However, better understanding, especially among the medical, legal, religious and human resources communities, would go a long way in reducing the stress and sense of stigmatization that many TS women experience.
 
Family members, friends and others interacting with a transitioner can become better informed about what the person is going through by reading books such as True Selves : Understanding Transsexualism-For Families, Friends, Coworkers, and Helping Professionals by Mildred Brown and Chloe Ann Rounsley.
 
 
 
 
Fortunately, for most MtF TS women there is "light at the end of the transition tunnel". The social difficulties usually die down as they complete their gender transformations and gradually assimilate into society as women. In order to optimize social opportunities and avoid unnecessary social difficulties, many postop women desire to "woodwork" or live in "stealth mode" after transition. They do this by keeping their past very private. Friends and coworkers who know about a transsexual woman's past should be very careful to honor her wishes for privacy. They should also act promptly to put a stop to any rumor-mongering by others who are not so honorable.
 
Having learned a bit about transsexualism, perhaps you can help others understand it better too. With increased understanding, concerned people can help ease the practical problems and reduce the difficulties that a TS friend, student or co-worker faces during transition. Once through transition, the new woman usually blends quietly back into society to mostly live a rather normal, but ever so much happier, life.
 
A wonderful novel by Chris Bohjalian, Trans-Sister Radio, helps communicate a lot of deep insights about the MtF transsexual transition experience, and not just from the perspective of the TS woman herself, but also for everyone around her. Bohjalian's novel works its magic by shifting the dialogue from character to character at each stage of the transition process, showing how everyone involved or touched by the situation goes through many changes in thoughts, attitudes and responses. This excellent book can be used to establish a common context for communication with people willing to be educated in depth about transsexualism, transition and transsexual love-partnering. Lynn highly recommends this book to the families and friends of women in transition.
 
 
 
 
A brave book, a compelling story
Reviewer: A reader from Philadelphia, PA

After knocking one out of the park with Midwives, Bohjalian has both capitalized on his singular knack for topical story-telling, and one-upped himself. For this conventionally phallo-centric male...[the] surgery wasn't an easy subject, but Bohjalian earned the right to make me squirm. The cleverest thing about this novel is the way in which, by the end of its pretty speedy 300 pages, a whole lot of things that had seemed pretty far out to me suddenly seemed not so strange at all. .... These lovely people, whatever their plumbing, deserve some happiness, and Bohjalian is wise and kind enough to give it to them. This is a love story that's both moving and makes you think.
 
 
Exquisite, Painful, Emotive and Necessary
Reviewer: A reader from South Carolina
 
I read Mr. Bohjalian's wonderful prose while recovering from my own sexual reassignment surgery so perhaps I am biased. Having endured many indignities in my own life, yet now living a life that is both exceptionally normal and amazingly wonderful, I identified with Dana and her struggles for self and dignity. I believe Mr. Bohjalian is masterful as he captures the spectrum of reactions and responses both to transsexualism as well as it's collateral effects on those who date, marry or are the parents, siblings and friends of those seeking to resolve their transsexualism and recapture their birthright as women or men, as the case may be. - - - Mr. Bohjalian captures perfectly the ignorance and fear we often face as we attempt to do nothing more than seek treatment for what is, pure and simple, nothing more than a recognized medical condition. And not unlike cancer, transsexuality has been around forever, yet the reprieves available through medical advances have and are changing to afford us increasingly higher qualities of life. I think this notion comes across in his work also. Thank you Mr. Bohjalian for humanizing the efforts of myself and everyone else in the world like me.
 
 
 
With better understanding, how might transsexualism be treated someday?

Transsexualism is far more common than previously thought. Instead of being a total medical rarity, intense cases of MtF transsexualism probably occur in about one in every 300 to 500 boys. It is a condition that will occasionally occur in every large, extended family (it occurs at least twice as often as either multiple sclerosis or cleft palette). The condition probably triggers many unexplained teenage suicides among kids who couldn't find any other way out of their angst. Loving, concerned parents and relatives should be aware of the nature of the condition, so they can humanely treat any affected child in their family.
 
Someday, when a teenage child realizes that they have transsexual feelings, and tells their mom "I need to be a girl", the common reaction will be one of love and concern and compassion. Instead of seeing "a boy with a mental problem", the parents will actually see "a girl with a physical problem", will see how desperately she needs help, and will lovingly support her medical treatment and gender transition.
 
A wonderful book for teenage MtF TS kids and their parents, Mom, I Need to Be a Girl, tells yet another story of a teenage child's recent gender transition (see photo of Danielle below). This captivating story and its artistic sketches provide a heart-warming introduction to MtF transsexualism and the process of modern gender transition. You can read this book on Lynn Conway's website, including translations into Arabic, French, German, Hebrew, Portuguese and Spanish:
 

Mom, I Need to Be a Girl

NEW! The 2nd Edition of Evenlyn's book is now in print at Amazon.com!  NEW!

 

 

Someday, schools and other social institutions, having become more aware and understanding of gender issues, will also be much more supportive of girls like Shauna and Danielle during their transitions, and will prevent discrimination and harassment by others from hurting their chances for success.
 
Then once such a girl's transition is completed, not only her parents, but also her relatives and friends will welcome her into their lives and treat her and love her just as they would any other girl. She will have the chance to experience all the things that other teenage girls do, and will grow up to be a young woman without having experienced all the incredible hardships now so common for transsexual girls.
 
In addition, the law and society will treat her just as any other girl or woman, providing her with full civil and legal rights, including the opportunity to later marry and to adopt children if she so wishes, and the chance to go on to a full and happy life.
 
Lynn hopes she will live to see that day.
 
 
Success Stories: Links to Post-op TS Women's Webpages
 
There's nothing quite like successes in any new endeavor to prove that "it can be done", and to provide role models for others to follow. The same is true of transsexual transition.
 
We learned above that there are at least 32,000 to 40,000 postop transsexual women in the U.S., and that many thousands more people are now in transition. However, the many successful transsexual transitions have remained "off society's radar screen", because most post-op women live in "stealth mode" to avoid stigmatization. Although all around us, they are "hiding in plain sight" and thus are "invisible".
 
Fortunately, the web is now lifting that veil of invisibility, as more and more successful postop women create websites where others can learn from their experiences. You can put a compelling human face on transsexualism by looking at websites containing personal diaries and information about these women's experiences and successes. These women and the stories of their experiences can provide great role models and examples for other transitioners to learn from. In Part III, we'll learn more about life as a woman after TS transition by drawing on many of these women's experiences. Here are just a few examples from a webpage Lynn has compiled listing photos and stories of many successful women who have transitioned:
 
 
 Andrea James
Advertising Executive, Consumer Activist
  Joan Roughgarden, Ph.D.
Biologist
Kurara Motoki (Japan)
Showgirl, Actress
Deborah
Architect
 
Sarah
Captain (Boeing 767), American Airlines (es)
 
 Robertina Manganaro (Italy)
Fashion Designer
 
 
 For many more examples of successful postop women, see Lynn's webpage:
 
TS WOMEN'S SUCCESSES.
 
 
 
TG/TS/IS Links and References:
 
For a wider range of information about transgenderism, transsexualism and intersexualism, you can now access many excellent informational websites and books about these subjects. To get started exploring such websites and reference books, see Lynn's TG/TS/IS Links and References webpage, and follow the links there to the larger world of TG/TS/IS web resources.
 
 
A final thought about the word "transsexual":
 
Although well intentioned as a descriptive medical term, the word "transsexual" is a bit off-putting and misleading. As a "label" it often stigmatizes people unnecessarily, especially when it is used as a noun. Calling someone "A Transsexual" makes them sound like some kind of alien instead of a human being. It also implies that there's something still wrong with the person even after they have undergone a complete gender correction. It's much better practice to use "transsexual" as an adjective, and refer to someone as a "transsexual woman". Referring to her as "a woman who transitioned" or a "woman who has a transsexual past" is an even better practice.
 
After all, why should someone who has survived transsexualism after a long, traumatic medical and personal battle be any more stigmatized than a cancer survivor who has similarly fought a long medical battle? Shouldn't both be admired for their courage and tenacity in the face of adversity?
 
Lynn's own personal perception of her life-experience is that she was "mis-gendered" by nature and society as a little child. After growing up as a boy and enduring years of terrible trials, she finally managed to have that mis-gendering fully corrected during her gender transition in 1968. She has since gone on to live a full and happy life as a rather normal, fun-loving woman.

 
Photo of Lynn and her little grand-niece Baylea, April 15, 2000
 
 
 
 

 
 
 
Continue to next part:
Part III: Life as a Woman after TS Transition 
 
 
 
V-9-30-04 + Update of 10-14-05
 
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