Fight Wisely, Fight Well   By Melissa Tawn   A transsexual transitions in spite of, and because of, a debilitating disease, with unexpected consequences.

I am a fighter, and will always be one. But I fight wisely. They say that the difference between a smart person and a wise person is this: a smart person knows how to get out of situations that a wise person knows how not to get into. Well, it is the same with fighters. A wise fighter knows how to fight only those fights which do not lead to situations best not gotten into. That means, of course, that there are times when one must walk away from a fight in order to live to fight another day. That is very hard for many people to understand.

I am also a transsexual. That is even harder for many people to understand. It took me a while to figure it all out and figure out the implications, but, by the time I was in my last year of high school, I had it analyzed -- more or less. Basically, I had two options. I could “be myself”, live as a female, and eventually undergo surgery. The gain would be greater personal harmony (but perhaps not complete, I read too many stories of post-op transsexuals who still had deep problems); the cost would be ostracism by my parents and a good portion of my family and friends, who could not or would not understand gender dysphoria, and probably considerable difficulties in being accepted by society as a whole. I am 5’9” and rather male in appearance; plastic surgery could change that, of course, but such surgery was way beyond my foreseeable financial means. To many people, I would always be a “freak”. I would certainly have a problem getting married and raising a family.

The second option would be to “live a lie” by continuing to live and function as a male, at least among family and friends, and be myself only when alone at home. Hopefully, I could find a wife who would understand and support me, within these limits.

Neither option was particularly attractive. Henry Kissinger once wrote that, in diplomacy, the choice is never between “good” and “better”; it is always between “bad” and “worse”. I was in precisely that situation. I agonized over it a lot, and finally concluded that the second course would be the wisest. I would swallow my self-esteem and live a lie externally. I would be “under deep cover” like a spy - a female in soul forced to pass myself off as a citizen of the land of men. I called this my Unwelcome Compromise.

The story of the next few years is not pleasant, so I won’t go into detail. I kept my male identity and kept on good terms with my family and friends. I finished college and found a very “macho” job. I also found a woman who was not frightened when I told her that I liked to “dress up” occasionally. We were married and reached a modus vivendi which allowed me to wear women’s clothes around the house so long as nobody saw me. But I would not go out dressed (I doubted if I could pass in any case) and I wouldn’t wear a wig or put on makeup. That was the best bargain I could manage. I hoped, in my heart, that little by little I could push the envelope out a bit.

Over the next ten years, I didn’t manage to do it much, but I survived. As with any animal living in a zoo, I got used to the limitations on my freedom to realize myself. What I lost in self-fulfillment I did gain in having a loving relationship with my wife and a satisfactory relationship with my family. I had a good job, and was well-liked by my colleagues. I was convinced that I had made the wise decision.

And then it happened. One morning, when I woke up, my knees hurt terribly. Within a week, I could no longer walk. My legs were swollen and, slowly but surely, I began to lose my coordination and balance. I was in terrible pain. It took the doctors a while to diagnose what had happened, but they finally settled on a rather frightening diagnosis. I had idiopathic peripheral polyneuropathy. What that means is that the nerves in my limbs were progressively degenerating. Nerves cannot be regrown or regenerated. There is no cure. The only treatment that could be given was symptomatic -- very strong pain relievers that target nerve cells (analgesics such as aspirin don’t work), anti-depressants , and physical therapy to try and slow down the degeneration.

My life, or what was left of it, had become one of increasing pain and decreasing hope. I knew that I could not live much longer in this state, something that the doctors confirmed. Then, one day, it hit me that the basis for my Unwelcome Compromise was no longer valid. I had made it because I thought that the best future I could have would be one of living a lie. But now I had no future -- I was dying a lie. The enormity of this realization overwhelmed me, but it made me reconsider what I wanted to be, and to be seen as being, in my short remaining time in this world.

The University Medical Center, where I was being treated, had a special program of psychiatric help to patients suffering from incurable medical conditions. Ever since my condition was diagnosed, I had regular meetings with Dr. Anna Wong, one of the senior resident psychiatrists. At the next of our meetings, I spilled out the whole story of my transsexuality, and of my Unwelcome Compromise. I told her that since the premises of that compromise were no longer valid, I had decided that I wanted to transition as best I could and as fast as I could, so that I could enjoy at least a few years of harmony between my body and my soul, before the former broke down completely. We talked about it a lot, then and at our next two meetings. Finally, she asked my permission to mention the details of my case to some colleagues (without mentioning names, of course) so that she could come to a final decision. I agreed, of course.

The doctors in whom Dr. Wong chose to confide were Dr. Catherine Gold, a psychologist who was an international expert in handling transsexuals, and Dr. Jayne Mautner, a plastic surgeon in whose clinic Dr. Gold worked. (AUTHOR’S NOTE: background on Dr. Mautner and Dr. Gold -- both of whom are post-op transsexuals themselves -- can be found in my stories “The Doctor, I” and “The Doctor II”). The trio agreed that there was no reason not to allow me to begin hormone treatment. As to surgery, that would depend on the extent to which my nervous system continued to degenerate by the time I was ready for it. Dr. Mautner was rather worried about performing a full SRS under such conditions, if my neuropathy reached beyond a certain “point of no return” on which it was currently rapidly closing. They finally decided that I would begin receiving large doses of hormones and testosterone-blockers immediately, and that I would meet regularly with Dr. Gold as well as with Dr. Wong. A decision on surgery would be made after six months. Should we decide to go ahead, Dr. Mautner would do the surgery, including facial feminization surgery, on a pro bono basis.

It all depended on whether my physical condition continued to deteriorate.

It didn’t! In fact, after six months I was actually better than I had been before - my pain had lessened and my coordination seemed to have improved. All of the signs on my physical tests suggested that the neuropathy had reversed itself. The doctors didn’t understand it and, quite frankly, neither did I. But who was I to argue? Dr. Mautner conducted her own tests and decided to go ahead. I had to be wheeled into her clinic in a wheelchair, and when the operation was over, I had to be wheeled out. But I was wheeled out a woman.

I continued to improve, for reasons the doctors could not understand. When visited Dr. Mautner for a checkup six months after my operation, I walked into her office by myself. I felt so good that I promised her that the next time I visited her, I would walk in again, wearing heels!

EPILOGUE: A year later, my neuropathy had almost completely disappeared. Dr. Wong presented a paper on my case at the annual meeting of the American Psychiatric Association. In the panel discussion which followed her presentation, Dr. Gold emphasized the unknown relationship between mind and body. She hypothesized that my Unwelcome Compromise had caused an existential tension in my mind which my body was unable to handle and which translated into the development of neuropathy. After I restored the concord between my body and my soul, the body responded by halting -- and ultimately reversing -- the neuropathy. Sister Angela Dominica of Fordham University gave a more religious interpretation: centuries of observations by the Catholic Church have shown that miracles can happen only to those in whom the soul and body are in harmony. Thus my transition brought about the condition of harmony which allowed God to perform a miracle and reverse the “irreversible” neuropathy in my body. Prof. Matityahu Kesselman of Yeshiva University cited several Rabbinic and Hassidic sources in support of that view.

AUTHOR’S NOTE: This story is fiction, but is based on the story of a real transsexual with peripheral polyneuropathy whom I have been privileged to know. Unfortunately, the final miracle has not yet happened to her, and I can only pray that the Power which controls her destiny will read it and take the hint.

The person in the picture used to illustrate the story has nothing to do with the content of the story.