The Ranch, by Karin Bishop

Part 7

Chapter 18 — The Proposition

We couldn’t really blame the nurse for making Mom sleep, so we thanked her and picked up our things and headed for Dr. Morrison’s office. His secretary called and we went in. Once seated, Jackie seized the initiative.

“Laurie has been told that you know about Laurence, so you don’t have to cover that.”

“Ah. Thank you. You know, Lauren, it’s pretty darned hard to look at you and talk with you and think anything other than that you are a happy, healthy, genetic girl. You really are remarkable.”

I blushed and said, “Thank you …I guess. I’m not really doing anything …”

“Oh, but you are. Or, hopefully, you will. Let me explain. As you may know now, we have a gender clinic here that is internationally known, largely through the graces of Dr. Mahmoudi. Her husband was one of the world’s leading surgeons in sexual reassignment procedures, and she studied and assisted and may even have surpassed him by this point.”

Jackie looked at me and then asked, “I’m sorry; I’m a little confused as to which Dr. Mahmoudi we’re talking about.”

Dr. Morrison nodded solemnly. “I understand. The doctor you met was Dr. Carlton when she went to study in Zurich with Dr. Mahmoudi. He was already quite famous in the field of gender, and she’d received her Ph.D in Gender Studies at Johns Hopkins. They fell in love and married, but she kept her name because she was already established in her field. Three years ago, Dr. Mahmoudi returned to Cairo to care for his sick mother …and was killed in a terrorist attack. Car bomb.”

My hand flew to my mouth. “Oh, how awful!” I heard Jackie’s sharp intake of breath.

“Yes. But Dr. Carlton took her married name, Mahmoudi, to carry on his research. I assure you, she is among the very finest in the world. It was quite a feat for our facility to be chosen, but truth be told, we had an inside edge. One of our local benefactors had a son who was transgender but had committed suicide because he felt hopeless. With that patron pushing aggressively, we were able to construct the clinic and bring in Dr. Mahmoudi.”

“Quite a story,” Jackie said. “Remarkable.”

“Yes, well …it may be no more remarkable than Lauren’s own story,” he smiled at me. “That a boy–any boy could become so definitely and utterly feminine at so early an age–and so unremarkably socialized as a female–well, that’s remarkable. Anyway, here’s the crux of things. Our hospital is prepared to welcome you to the gender clinic, where we will do everything possible to ease you into the rest of your life as a female, both medically and legally. ‘Legally’ just means we’ll take care of the documentation changes so you’ll have no difficulties later in life.”

“Wow!” Jackie exclaimed.

I had nothing to say at this time; I was both speechless and also waiting for ‘the other shoe to drop.’

Dr. Morrison sensed this, because he went on. “I have to do the disclaimer now. There are a number of factors contingent on my previous statements. It is possible that you may decided that your core identity is male, after all, and–”

“Excuse me, Doctor?” I raised my hand. He nodded and I said, “That’s not going to happen. I never …” I frowned. “You said ‘disclaimer’ and I guess I’ve got to do one of my own. All of my life, until recently, I thought I was male. That’s what I was told, and that’s what I had between my legs. End of story; I was male.” I shrugged. “But I never felt like the boys around me. I sure never looked like ‘em, either!”

Jackie said, “I can testify–and Laurie’s mother can independently verify this–that Laurence never presented as male–in the medical sense of ‘presented’.”

“I understand,” Dr. Morrison nodded.

Jackie said, “Not only the way Evie carried Laurence–and I’m keeping that name for the purposes of this–well, old wives’ tales or not, all signs indicated a female birth. Birth weight and presentation were well within feminine norms, but there was that penis, and there was no getting around that. No genetic tests were performed, to the best of my knowledge, and I have seen Laurence’s medical records.”

“My Aunt Jackie was a nurse,” I said. “Oh, you know that, right?”

Dr. Morrison nodded. “Go on, please.”

Jackie looked at me and back to the doctor. “I wasn’t present on a daily basis, of course. Evie and I are close but we had our own lives and husbands to deal with–Evie’s not as happily as mine,” she frowned. “Anyway, we were in phone contact frequently, and she described numerous occasions over the years of people mistaking Laurence for a girl. From pushing him in a stroller to preschool teachers and parents and so on. I said ‘numerous’ but it was pretty near consistent. The reason I feel this is important because of their insistence that Evie’s child was a girl. Evie was criticized for ‘keeping her pretty little girl’s hair so short’, so she let it go longer and then she was criticized for ‘keeping her pretty little girl in pants’. She was criticized for ‘encouraging her daughter to be a tomboy’ and on and on, over the years.”

I stared at her. “I had …no idea. They talked to Mom like that?”

Jackie snorted. “Talked? They yelled sometimes. You see, Laurie, a lot of people have their world neatly catalogued and filed. Boys over here, girls over there. Anything ambiguous bothers them. Whether it’s just the uncertainty of how to address somebody, or something deeper, they are bothered and some react with anger.”

I knew the phrase ‘or something deeper’ meant something sexual, but I said, “I had no idea that was all going on, Dr. Morrison. It kind of explains some …things in my past. Incidents, playground stuff, you know; not really important. I mean, yeah, important to explain things but not anything I can do about now, years later.”

“Is it years later, Laurie?” Jackie asked with a raised eyebrow, probing.

I frowned. “Um …yeah.”

“What about the dance class?”

The memory flooded back, making me blush.

Jackie said, gently, “Your mother told me, of course.”

I swallowed and turned to Dr. Morrison. “I, uh …” I took a deep breath. “I wanted to take a dance class. I love all of the dancing shows on TV, especially So You Think You Can Dance, and we went to this place, On Pointe, and she tried to sign me up. The problem was that you …well, there’s a tour of the place, and they’ve got the classes separated, boys and girls. Seemed odd to me, but later we found out why.”

Jackie said, “There was no indication, but it was a heavily Christian group, some fundamentalist thing. Evie chose them because they had won some awards at a competition and were in the paper and just, you know, seemed like any other dance studio.” She looked at me.

I said, “You should tell it, Aunt Jackie; I’m curious what Mom told you.”

“Okay, and I know we’re way off topic here so I’ll make it brief. Well, maybe not off topic since the topic is you, but …” She took a breath. “Keeping the names straight again, Evie and Laurence were given this tour and passed the studio with the girls, first. Laurence stopped, entranced.” She looked at me. “That’s the word Evie used, ‘entranced’. And there were girls you knew?”

I nodded. “Heather Singletary and Danielle Cartwright. They go to my school.”

Jackie said, “Evie said it was typical little girls waving and Laurence waved back and giggles and jumps and the guy doing the tour pretty much jerked Laurence away from them. Evie said you were hurt?”

I was blushing. “Um …yes. Left a mark.” I indicated my left upper arm where I’d been grabbed.

Dr. Morrison said, “I hope she filed charges?”

Jackie shook her head. “I told her to do that, too, but she just wanted it put past them. The guy dragged Laurence to the boys’ studio to watch and maybe try a dance move or two.”

“They …laughed,” Laurence said. “Called me names.” There was silence and I figured they wanted more. “You know, the usual. Faggot, fruit. Oh, and girl, like it was a bad thing.”

“That was when Evie was discovering it was a religious group that ran the studio, ‘dancing for God’ or whatever. And that’s why she didn’t press charges because it’d be too complicated with the religious angle. You see, they had assumed that Evie and Laurence were True Believers like them, and that Evie would praise the guy yanking Laurence away from the girls–if you can believe it–because they were so freaked out about boys and girls being together at that age.”

I said, “I’m not …a supporter of that; I think it’s crazy, but it’s their faith and they have a right to practice what they want. Just …not with us.”

Dr. Morrison said, “That’s far more adult and tolerant than they would be, most likely. I don’t know the group so I can’t presume to speak about them, but I still find their actions objectionable. But this occurred when?”

“Five–well, five months before the fire,” I answered.

“So just within the last year, with such an experience, you still weren’t questioning your male status?”

I frowned. “I was …getting closer. Closer to talking with Mom about it.”

“Your mom was already aware, more than aware,” Jackie said gently. “She’s known for years, and that’s why she’s had you monitored–oh, and Dr. Morrison, this needs to be said, while I think of it. To the best of my knowledge, especially my knowledge of my sister, Evie never encouraged Laurence to be feminine. Or effeminate, but he was never swishy. He was just feminine.” She looked at me. “Always. But she never dressed him like a girl, not even unisex clothes. Just jeans and t-shirts, Pendletons in winter, that sort of thing.”

I nodded but asked, “Monitored?”

Dr. Morrison said, “Your file contains several years of fluid and DNA testing, as well as the notes and speculations of …” He leaned over and flipped through my file. “Drs. Kendall, Spiegel, Jennings and Bastian.”

“Sounds like a law firm!” Jackie joked.

I frowned. “I only know two of them, Dr. Kendall and Dr. Bastian.”

“The others are specialists, an endocrinologist and Dr. Jennings is a geneticist.” He leaned back. “The point is, Lauren, that you came to us on two occasions. Well, to our facility. First, of course, was the night of that terrible fire. There was some confusion because even then, with you doing almost nothing but occupy your bed, recovering, the assumption was that you were female. Caused a bit of a shock to the nurses, I understand,” he said with a fleeting smile.

Jackie said, “They quizzed me when I first got there. They were pretty darned sure there was something fishy going on, because they were sure you were female. Never told you before!” She chuckled.

Dr. Morrison went on. “The second time was actually my first contact with you. When she could, your mother authorized the transfer of your medical records so I learned quite a lot about you. So we are actually much farther along than we would have been otherwise.”

“So, the disclaimer?” Jackie prodded. “The possibility that Laurie might want to be Laurence?”

“Not going to happen,” I said firmly.

Dr. Morrison smiled and nodded. “I’m convinced of that, but it has to be said, of course. So with that disclaimer out of the way, I stand by my original statement that we will do everything possible to ease you into the rest of your life as a female. But,” he raised a finger. “You’ve got some work to do for us.”

“I understand,” I nodded. “And I’ll do everything I can.”

“I know you will, Lauren. Well, you will be studied, of course, and a lot of it will be intense psychological testing as well as biological testing. You’ll be working directly with Dr. Mahmoudi, who is the best, as I said. Basically, we get to study a unique individual who can help us with the diagnosis and treatment of countless others, and you get your medical and legal entanglements straightened out. Because,” he lowered his voice, “they will entangle you, and very soon.”

I thanked Dr. Morrison but had a couple of questions. “I certainly understand the idea of studying me, and that you’d help me with the other problems. But can you really learn something from me that you can use with somebody else?”

Dr. Morrison nodded. “This is one of those fields where every new discovery–usually at the individual level, such as your case–answers some questions and asks many more. The field gets wider and wider–well, you’ll have time to talk with Dr. Mahmoudi about that; she’s more current on her field. But, in a nutshell, yes, we can learn from you and apply it to others.”

“I’m glad,” I said. “And it’ll make me work all the harder to help. But I have a problem; I live two hours away and we’re not made of money. With gas prices today, we can’t be going to and fro that often. And we’ve got a season to run–”

“Honey, bless you!” Jackie chuckled. “But, please; don’t worry about the season. We’ll manage; we have in the past. But now things are in much better shape going in, thanks to you.”

I smiled back, grateful, but said, “We still have lots of preparation to do, and I’ve got to work on getting the lake ready, and I want to be certain about the new pool pump–”

Dr. Morrison held up his hand. “I fully understand your situation, especially about the distance and gas and your commitment to the ranch. I believe that, to you, your priorities are your mother, then your aunt and uncle’s ranch, and yourself last. Please consider some options, though. We will be flexible around your schedule, but are also offering to have you stay with us in one of our guest suites.”

“Guest suites?” Jackie asked.

“Yes. We made that arrangement with the hotel for you for the one night. That’s the procedure for simple unplanned overnights for patients’ families, but the suites are for long-term stays. Mrs. Boynton, you are certainly welcome to join Lauren, but it’s not necessary so it wouldn’t take time from your duties at the ranch. I realize how important the preparation for the season must be. We would send a car for Lauren, who would stay for several days to perhaps a week, and then we’d return her to you. During her time here she would not only be involved at the gender clinic but also able to spend a great deal of time with her mother.”

I looked at Jackie; we both had the same thought–we hadn’t realized that it could mean more time with Mom!

Dr. Morrison gently said, “Your mother will be with us for another six to eight months before she can go home. She’ll be returning for additional grafts for the next year or so, because the burns were so extensive and, even as strong as she is, her body can only withstand just so much surgery. Even more importantly, we have to give the skin time to heal before continuing. We probably won’t be inducing coma again, so she’s going to be conscious and getting back into the day-by-day time frame. So you see, you will be as close to her as possible if you come to stay with us. Unfortunately, I can’t validate the use of guest suites to the board of directors if the hospital is not paid–somehow. Your participation in Dr. Mahmoudi’s studies will qualify.”

Jackie spoke for both of us. “I hope we don’t have to give an answer right now; I think we’ll have to discuss this on the way home.”

“Of course,” Dr. Morrison said, “But I’d like to bring in Dr. Mahmoudi for any questions. That way you’ll have more information to think about.” He pushed a button on his phone and I recognized Dr. Mahmoudi’s voice as she was asked to join us. Dr. Morrison offered us drinks and I settled on a cold bottled water from a fridge behind his desk. He commended me on my choice and had one for himself, saying, “Water. Nothing better for all of us.”

A discreet knock and Dr. Mahmoudi entered. I was interested in Jackie’s reaction, since I already had met the doctor. Jackie knew the story but was obviously surprised by how young the doctor seemed. Introductions were made, and Dr. Mahmoudi sat in a chair next to the desk. She briefly laid out her credentials, which were extremely impressive. Then she got down to business.

“Lauren, all of this may seem invasive; you’ve had time to get used to the idea of girlhood while you were isolated on the ranch, so to speak. And you’ve been remarkably successful at it. But you haven’t had too much of a chance to fully socialize as a girl.”

I nodded, trying to keep from blushing as I thought about ‘socializing’ with Mark last night …

Dr. Mahmoudi went on. “Your file is extremely interesting. And, yes, you seem shocked that I’ve read your file, or that there even is a file on you. Your mother authorized the transfer of all medical records pertaining to her child. Right now you probably feel exposed, maybe even a little bit violated, and that’s normal. You resent being kept in the dark, so let’s bring you into the light, okay?”

“Yes, please. And I’m not feeling too violated, so don’t worry about that. Dr. Morrison explained about how you got my file, and told me–what I didn’t know–that all along my doctors have been monitoring me.”

“Yes, they have. I’m a little surprised that you weren’t aware of it, but I can appreciate your mother’s concern to follow the path of least influence–the ‘wait-and-see’ school of thought,” Dr. Mahmoudi nodded. “The fact that you seemed unaware of your feminine presentation and orientation is just one more factor that makes your case so intriguing,” she smiled.

Dr. Mahmoudi began asking if I was aware of my ‘chromosomal condition.’ I told her that I understood that I was ‘XXY.’ She nodded and said it simplified things that I was aware of that. She briefed us on the positives and negatives of my situation.

All four of us immediately dispensed with any thoughts of me trying to be male, so it was simply a matter of determining my body’s endocrinological requirements and adjusting as needed. I agreed for simple tests–height, weight, blood, urine, and cheek swab–to be performed right then, so they could begin getting the info they needed. On my first full visit, I’d be put through ‘the machines’, which seemed to include MRI and CAT scanners and some others I’d never heard of. I knew these were hugely expensive tests, even with insurance, but one of the benefits of being a patient of the clinic was that the costs would be borne by the hospital. And when it came time for prescribing any hormones or medication, they’d be ‘on the house’ as part of my clinical study.

The two doctors had pretty much finished their presentation and looked at us expectantly.

“Could you please excuse us for a moment?” I asked. “Jackie, do you want to have our conference here or somewhere else? And do you want Carl’s input? God, I’m going to have to make it up to him–”

Jackie raised her hand. “Laurie, would you please stop being so darned thoughtful?” she chuckled. “In reverse order, Carl’s impressed with all the work you’re doing around the place and we can certainly spare you this time. Next, I’ve already got Carl’s input …” She grinned wickedly. “Or at least, I told him what his input was!” She laughed openly. “I’d spoken with Dr. Morrison already so I knew this was a possibility. Didn’t know about ‘guest suites’, though; I thought they’d give you a hospital room and I was already thinking of ways to make it more homey.”

Dr. Morrison said, “I assure you, Lauren will be quite comfortable in the suites; they’re comparable to the better hotel rooms in town.”

“I don’t doubt that, doctor,” Jackie smiled. “Everything about your outfit is first rate.” She glanced at Dr. Mahmoudi and back to me. “So Carl already knows about your ‘medical condition’,” she used air quotes, “and told me, ‘Whatever she needs, she gets.’ I told you that you’d completely won him over!”

I blushed at that. “So …it’s okay if I’m gone? I mean, I want to be here with Mom, but I don’t want to desert you guys.”

“Not deserting any more than your mom’s deserting us. You do have a medical condition, but more serious than your mom’s.”

“What? I don’t understand?”

Even the doctors seemed baffled.

Jackie said, “Your mom’s going to be all right. It’s a long, hard and painful road she has to walk, but maybe five years from now–” She glanced at Dr. Morrison, who frowned, shrugged and nodded. Jackie grinned back with a challenge and went on, “–within five years from now your mom is going to be right back where she was, teaching and caring for her child. She’ll have some scars, but basically her world will be right back where it was before the fire. Except for her child.”

Jackie smiled so warmly at me.

“Her child also has a long, hard and painful road to walk, only it will affect every aspect of every moment of the rest of her life. Her new life, as Lauren.”

“Oh,” I said in a small voice. I saw the doctors nodding and smiling.

“That’s a very accurate–although rather stark–way of phrasing it, Mrs. Boynton,” Dr. Morrison said.

Dr. Mahmoudi said, “I agree, but I must also point out that the road will be full of discovery and joy and happiness and, I hope, peace.”

“From your lips …” Jackie nodded.

I said, “Uh …so …you and me …our conference?”

Jackie grinned. “I can speak in front of these folks if you can.” I nodded. Jackie smiled sadly, “I’m going to miss you something fierce; I’ve gotten so used to having you there that even a week is going to be lonely. But I know that the two girls I love most in the world will be getting the best medical care possible. Alright?”

“Alright,” I said, a lump in my throat.

That ‘conference’ with Jackie was a formality, really, since I already knew that Mom approved and that Jackie had been a nurse and I trusted their opinions, and I felt trust in the two doctors, so we got ready to sign the documents necessary for admittance into the clinic.

Jackie looked at me and raised an eyebrow, which could have meant anything but I knew–from our psychic connection–that it was about my name. I explained to the doctors about my desire to put Jamison behind me and to more closely cement my relationship as the daughter of my mother. I actually used that phrase, and they both understood completely. Dr. Morrison paged his secretary who brought in forms. It was explained that I would sign the release for testing today as ‘Laurence Jamison’ and that I’d sign the name-change request with that name–possibly the last time ever–and then with my new name.

I asked for a notepad and took a few moments to practice my new name, Lauren Kenyon. Laurie Kenyon. I smiled to myself. ‘Miss Lauren Kenyon’, I imagined in my mother’s voice. I couldn’t wait to hear it from her lips!

While I practiced, Dr. Mahmoudi explained that since my XXY status was rare, what they learned from my research wouldn’t directly apply to the typical transgender person–as if there were such a thing as ‘typical’, but she meant an XY male-to-female–but that medical literature on XXY was sparse and I could contribute there. The area I would be most helpful in, and which guaranteed the board of directors subsidizing me, was in the psychological area, which had not been as fully explored as the ‘physiological implications’, as the doctors phrased it.

Jackie and I would work out times that I could be spared from the ranch–with Carl’s input, of course–and we tentatively picked a day for the hospital car to pick me up. Dr. Morrison reminded me to bring books, magazines, iPod, DVDs–whatever I wanted for my ‘downtimes’–as well as clothing. Truth be told, I was excited about the whole prospect, because it meant I’d be getting my girlhood firmly on a forward track, I’d get to spend a lot more time with Mom …and I might get to spend some time with Mark.

I signed all the other documents. Then it was time for the samples. I went into a bathroom near a nurse’s station and peed in a cup–thank you, bottled water!–and came back for my blood pressure and to have my blood drawn. They used a thin spatula to scrape the inside of my cheek, snipped the tiniest bits of my hair–and now I knew why my old doctors had done that!–and a quick height and weight check and I thought that was it.

Wrong!

“Now comes the embarrassing part,” Dr. Mahmoudi said. “I’d like to perform a physical examination.”

“I figured that,” I nodded.

“You want me with you?” Jackie asked gently.

“Of course–oh, not that I don’t trust you, doctor,” I smiled at Dr. Mahmoudi. “But because this is something we’re sharing and you’re my aunt and, what the heck, you’re a nurse, too.”

“That’s right–I’ll be checking your bedside manner!” Jackie teased Dr. Mahmoudi, who chuckled.

So I was led into an exam room, I stripped, and I climbed into the stirrup chair. Jackie and Dr. Mahmoudi looked at each other.

“What?” I asked.

Dr. Mahmoudi said, “You did that rather …well. Like you’ve done it before.”

“Well, yeah,” I shrugged. “Wasn’t it right, for an exam?”

Jackie laughed. “Yes–for a gynecological exam!”

“Have you been in a stirrup chair before?” Dr. Mahmoudi asked.

“For the last two physicals I had, yes,” I nodded.

Jackie said, “You weren’t doing any sports, Laurie; why did you have physicals?”

“No, I wasn’t doing …Aunt Jackie, you’ve read my records, right?” She nodded and I frowned. “Then weren’t they just routine physicals?”

“And you were in the stirrup chair with …that would be Dr. Bastian, right?” Dr. Mahmoudi asked.

“Yes,” I nodded. “And now I’m realizing by your reactions that they weren’t typical physicals and a boy wouldn’t be in a stirrup chair?”

“Bingo,” Jackie nodded.

Dr. Mahmoudi said, “We can discuss that later, if we want. Just one question, Laurie; when you were in the chair, what did Dr. Bastian do? I mean, what areas did he examine?”

“Everything down there,” I nodded towards my crotch. “Um …penis, testicles, the …what guys call ‘the taint’.”

“Perineum,” Jackie and Dr. Mahmoudi both said at the same time.

“The perineum,” I nodded. “And my …I guess my anus?”

“Anus, yes,” Dr. Mahmoudi said. Then she grinned as she pulled on gloves. “Well, then this will be quite familiar to you!”

After being poked and prodded–occasionally painful–and photographed and then allowed to dress, we were all back in Dr. Morrison’s office, we all ‘made sure we were on the same page’, and he put it, and then Dr. Mahmoudi surprised me by giving me three things. The first was a binder with a surprisingly thick pile of papers. It fully explained her and the clinic, my condition, and the current medical evaluation of my condition in general.

“Homework!” she grinned. “You won’t be tested, but you’ll want to know this.”

The second was a diary. I told her that I already was sort of keeping a diary. She explained that she still wanted me to keep this one, and try to be as daily as possible, even if I didn’t fill in my regular diary.

“I don’t need events like ‘Today I rode a horse.’ I need–you need–to note absolutely anything physical that you experience, like ‘Today I felt bloated’ or even ‘Today I farted a lot.’”

I giggled and Jackie chuckled. “Might be from my bean casserole, not your meds!”

Dr. Mahmoudi nodded. “Seriously, as we adjust your body’s chemistry, all sorts of things might be pertinent. It would be helpful if you note your weight on a more-or-less daily basis, if your breasts were tender, if you had a headache, that sort of thing. Got it?”

“Sure. Everything physical. Mental? Psychological, I mean?”

“Yep. That’s the next thing. Moods. Not ‘Today Jackie was mean to me’,” she grinned at Jackie, “but things like ‘Today I’m feeling like nothing I do is worth anything’, or ‘Today I feel like I can take on the world.’ Oh, and this may embarrass you; I need you to write any dreams you have, and especially, your thoughts about sex. Your sex, the ‘opposite’ sex, who you’re attracted to, who you’re crushing on, who turns you off. Instead of writing ‘Tonight I went to the movies’, you might write ‘Tonight I saw a movie and I got funny feelings about one of the guys in the movie.’”

“Orlando Bloom, no doubt!” Jackie cracked.

“Oh, God, Jackie; you, too?” I laughed back at her. They’d just re-released some of the Pirates of the Caribbean movies; the commercials were all over the TV.

Dr. Mahmoudi chuckled and continued. “It could be Orlando; it could be Keira. But please be honest. Believe it or not, all of that information is pertinent because brain chemistry can affect a lot of it. And, Laurie, you have my absolute solemn vow, in front of these witnesses: Nobody will read this diary except for me. If I feel that a section is important for medical science, I will discuss the section with you and get your approval and it will be redacted. If you disapprove, I won’t use it. I want you to know that your privacy is absolutely guaranteed by me.”

“I appreciate that. I really do. I’m a little frightened about what I might write down,” I chuckled nervously.

“I understand, but one final diary rule: Never put down anything that you think I want to hear. Don’t try to second-guess your doctor; it might cause more harm than good, and you can’t know what I need to know, anyway. So, truth always. Promise?”

I promised, and she handed me the third surprise. It was a thin gold bracelet with a small flat piece that was engraved with my name, a case number and a phone number.

“This will be your ID while you’re in the program. It’s way better than those plastic bands our patients normally get, and you’ll actually get a bit of VIP treatment because of it. It lets staff know that you’re working with and for the hospital and not just a simple patient wandering around. I’m giving it to you now so you can get used to wearing it.”

“When did you have time to get it engraved?”

“We’ve got a gadget here; I did it while you were having the tests done. Quick and easy. Anyway, deal?”

“Absolutely! Deal!”

“Now, there is one thing more to discuss,” Dr. Morrison looked to Dr. Mahmoudi, who took the lead.

“Lauren, there is a procedure that I can perform that you might want to consider. I’m suggesting it because you are already so far advanced in transitioning to female.”

I looked at Jackie. Procedure? This was obviously news to her, judging from her frown.

Dr. Mahmoudi went on. “Usually this is something for somebody once they’ve been in the program for several months and cleared a lot of hurdles in terms of social adjustment. But you’re already there, as near as we’ve been able to determine, so in your circumstances I want to suggest it.”

“Go ahead. Are you talking about some kind of surgery?” I looked at my frowning aunt with uncertainty.

“No; surgery is a monumental undertaking and unless we can move some mountains along the way, legally you won’t be able to have reassignment surgery until you’re eighteen. I’m sorry, but it’s the law.”

We told her we understood and I could see that it was probably a pretty good law.

Dr. Mahmoudi seemed reassured that we weren’t pressuring her for surgery right away, and she continued. “Let me explain by putting things in perspective. When a male petitions and is accepted in the program, after evaluation there are several physical changes that should take effect and must be evaluated. First and foremost is the psychological health of the patient, so this is usually a step-by-step process.”

She took a notepad from Dr. Morrison’s desk and wrote two columns with the words Physical and Psychological at the top. Then on the side she added a vertical list with Hair, Facial, Tissue, Breasts, and Genitals.

“Many of our patients have never done anything to transition other than dressing up in female clothing in private. Others have been self-dosing on hormones, often dangerously, and have to be ‘de-toxed’, so to speak, so their system is clear. In either case, we need to start with a clean slate endocrinologically speaking–that is, in terms of any foreign substance that could interfere with future doses of pharmaceuticals. With me, so far?”

We nodded. I said, “I’ve been reading some on the internet. And by the way, Jackie was a nurse.”

Dr. Mahmoudi smiled. “I didn’t know that. Well, this will be much easier. Okay, on the list ‘Hair’ is obvious, arranging for a suitable wig, and so on. ‘Facial’ relates to any outstandingly male features that might need to be later restructured–surgery that is purely elective, such as reducing an Adam’s Apple or reconstructing the chin, for instance. But it also relates to things as simple as proper makeup application and eyebrow plucking, to feminize the face. The next one, ‘Tissue’ is actually skin texture, which softens in response to hormones, and redistribution of adipose tissue–the wider hips and butt and general femininizing of the body’s contours. ‘Breasts’ is obvious; some patients have already had implants and others just stuff their bras. And finally, ‘Genitals’ which ultimately means surgery, as we discussed, but also the procedure I’m about to tell you about. Oh, and the other column, ‘Psychological’ is obvious; as the patient progresses we must evaluate each step carefully. It’s not always this order, but usually. Okay?”

Jackie said, “But we’re dealing with a chromosomal rarity, in Laurie’s case …”

Dr. Morrison said, “Exactly.”

Dr. Mahmoudi nodded and said, “That’s right. And since it is a rarity, the hospital wants to study her. But since it is chromosomal, this is you, Laurie–”

She quickly put checks in both columns, going down the list, but left the ‘Genitals’ section unchecked.

“You see? Your hair is long and, I’ve got to say, I’m jealous about how pretty it is. And you’re completely comfortable with your hair.”

“Comfortable with my hair?”

Dr. Mahmoudi smiled. “Some patients desire long hair but then hide behind it. You wear yours proudly and I imagine you’re already trying different styles?”

Jackie smiled. “She’s gorgeous with a chignon or French Braid.”

“She would be,” Dr. Mahmoudi smiled warmly. “That lovely long neck. Alright. Facial …well, you have outstanding bone structure and large, expressive eyes and your lips …” She put her pen to her own lips. “Are you using a plumper, by any chance?”

“Plumper?” I looked at Jackie, confused.

Dr. Morrison said, “Some lipsticks and products have chemicals added to induce a slight swelling of the tissue …I blame Angelina Jolie, personally.”

We all chuckled politely. I shook my head. “Not that I know of. This is Clinique …” I pointed to my lips. “Jackie?”

“No plumper. She’s always had gorgeous lips. We already told you how Laurie’s mother–Laurence’s mother–had strangers complimenting her pretty daughter, and often her lovely lips. I even remember …” She trailed off, and sort of curled her own lips inwards in embarrassment. Then she shook her self. “Aw, hell. I remember seeing Laurence’s lips and thinking they were so wasted on a boy; I wanted lips like that. Imagine! I actually envied my nephew’s lips!” She laughed with her embarrassment.

“Geez, Jackie!” I laughed. “That must have weirded you out!”

Dr. Morrison said, “It really is remarkable how well-adjusted you two are. You have a wonderful relationship and you’re a wonderful family.”

I spoke first. “Thank you, Dr. Morrison. That means a lot to me …” I looked at Jackie. “Because I had two women that are fantastic role models.”

“Aw, you …” Jackie said, squeezing my hand, touched.

I said, “So, no, um …plumpers.”

Dr. Mahmoudi nodded. “Your face, I gather, has always been feminine. Mrs. Boynton, if you have access to any photographs of Laurie as a child, I would appreciate them.”

“I think what Evie had was lost in the fire. We didn’t see Laurence all that much but I’ll check when I get back home. And please call me Jackie.”

“Thank you, Jackie. I was already aware that your sister’s memorabilia was lost. So I’m assuming that other than a sensible skin care regimen–you’re already using Clinique, a good brand–your tissue, the quality of your skin, has always been within feminine norms.” Jackie nodded and Dr. Mahmoudi shook her head. “You must have suffered when you were younger.”

There was a moment of stillness in the room. She had not heard us tell Dr. Morrison about the dance studio. I put my head down. “Some. Not as much as others, I’m guessing. I learned to …keep my head down. Girls usually wouldn’t play with me because I was supposed to be a boy, but the boys wouldn’t play with me because I looked like a girl. Threw like a gir, too. And I didn’t really want to play their games, anyway. So I kept to myself and read.”

“Sweetie …” Jackie said, reaching out to squeeze my hand, this time.

Dr. Mahmoudi said gently, “We’ll be getting into your life in detail, Laurie; I want you to be prepared for that.”

I nodded. “We’ve told Dr. Morrison some, and, yes, I’ll tell you anything you want to know–” I held up a hand. “I mean, I’ll tell the truth, not what I think you want to hear.”

She smiled and nodded. “Good girl. Alright, next on the list is breasts. We’ll be evaluating in our first meeting but I think you seem psychologically accepting of having breasts.” She looked at me.

“Psychologically accepting of having …” I stared at her. “Yes, but I wish they were bigger! Or grow faster, or something!”

They all chuckled politely and Dr. Mahmoudi said, “Spoken like every teenaged girl since Eve.”

“You’re doing fine, honey,” Jackie reassured me.

I thought it was because she knew what was next on the list.

Chapter 19 — Penises and Porn

“Finally, on the list, we come to genitals,” Dr. Mahmoudi said. “Personal question time. You were, of course, naked when I examined you. When you’re dressed, you ‘tuck’, which is the common term for pulling the penis between the legs. You do that, right?” I nodded and she smiled. “I was already certain of that because of the folds in your skin, but I had to ask. And you’re comfortable that way?”

“Very. Much more so than before. Oh, and I’ve kept the testicles inside since the day they went in.”

“Yes, obviously I noticed that but it’s good to know,” Dr. Mahmoudi nodded and made a note and asked when was that date. I told her and it brought a raised eyebrow but a smile, too, as she noted it down and then looked up. “What about swimsuits?”

I looked at Jackie and shrugged. “I’ve got some cute bikinis, but it’s just been me out there, cleaning the pool equipment or diving the lake with Uncle Carl.”

“Are you concerned about your penis being discovered?”

“Yes, of course; especially with guest season coming, it’s like my greatest fear. I’m not totally worried about it because my breasts have started developing, so nobody should question my gender just to look at me, and let’s face it; how many times have strangers’ vaginas suddenly become exposed?”

The doctors looked at each other for a moment and burst out laughing. Dr. Morrison gasped, “Oh my God; she’s right!”

Dr. Mahmoudi wiped her eyes and said, “It’s going to be an absolute pleasure working with you in the program, Laurie! Oh, my; you’re right …and a little bit wrong, if the bulge of your penis can be detected in bikini bottoms or tight jeans. So …I need to ask a few very important questions, but I don’t have to hesitate since you’ve got a pretty healthy sense of humor and have been open about discussing your body.”

Dr. Morrison said, “Before you go any further, I’ve got to check on something with Sylvia and also look into that surgical suite. I’ll be back in a bit; excuse me.”

I could tell it was a polite way of removing himself from the discussion, so I was curious what Dr. Mahmoudi’s questions would be.

“Now then …if you’re embarrassed, please tell me or even just hold up a hand like they do at the dentist when it gets too painful, okay? And let’s face it; you were just naked in front of me and I’ve already seen your genitals, so this shouldn’t be too rough. I have some notes already in your file, but I need to answer these questions personally. First question is, when was the last time you had an erection?”

The question stunned me a little, but not because I was embarrassed; I’d expected something like it but hadn’t expected it to be the next question. “Um, that’s weird to answer, but not from embarrassment; it’s more like an alien question, distant past, something like that. It’s like me asking you, when was the last time you played on the jungle gym at the park? The truth is, if …ever, it’s so long ago I don’t remember …I’m sorry; I can’t be more specific. And it’s not because of embarrassment.”

She smiled. “I can tell that. Thank you for being honest, but you said, ‘if ever’ and are you forgetting what boys call ‘morning wood’, an erection when you wake up?”

“No, I’m not forgetting that, and I know that for the same reason that might answer another question of yours. I always heard boys talk about that, about ‘woodies’ and stuff, and wet dreams. They were always joking about how sexy the girls in their dreams had been, and I heard them talk about wet dreams a lot. They were always bragging and proud and I felt miserable because I’d never had either one. So no wood, no wet, and I really have no idea when the last erection was or even what it was about.”

Dr. Mahmoudi was making notes and nodding. “Is it possible that you’ve never had one?”

“I vaguely remember in the bathtub thinking, ‘isn’t it supposed to be doing something?’ because the boys all talked about it. That’s odd, I know, and I tried poking around at it but nothing happened. What age, I can’t tell you.”

“And other times?” Dr. Mahmoudi asked.

“None that I know of. I mean, over the years I heard the boys talking about hard-ons and boners and stuff and I couldn’t quite …visualize what they were talking about. One time at school I told some guys about a hard-on I’d had that morning–I really hadn’t had one–but I lied so I’d fit in, you know? They were kind of looking at me funny, and I wondered if I even used the wrong words for things …but afterward, I felt even lousier about the lie than I’d felt not having anything to talk about. So I just never talked about it again.”

I let out a whoosh of air and found that my eyes were tearing slightly. The doctor was really good; she had a tissue all ready to hand me. “Sorry,” I said. “So …I went on the internet one time, to a gay porn site–I heard the guys talking about ‘net porn’ and I’d looked at some naked girls but they …”

“Yes?” Dr. Mahmoudi asked, interested. Then she realized maybe she was moving too fast. “We can discuss this later; I hadn’t planned for us to go this far in this direction.”

“It’s okay, Dr. Mahmoudi,” I shrugged. “Today, a week from now …either way, whenever I tell you, the information’s still the same.” I looked at Jackie. “And as embarrassing as it is, I kind of want my aunt to know, too.”

“Sweetie …” Jackie smiled sadly.

I nodded once. “Okay. So I looked at naked girls and didn’t have a hard-on. I know that for sure. But they were so pretty, you know? How soft their skin looked, and how pretty their breasts were, the curves …” I shrugged. “And some of the photos had guys in them, having sex, and I thought that although some of the photos looked like it hurt, in some of them, well …it looked nice. To be cuddled, to be held like that. And something about the girls safe in the strong guy’s arms …But the weird thing was the penises.” I frowned and looked directly at Dr. Mahmoudi. “Doctor, I was freaked. Not by people having sex; I know about that, but …I think I actually gasped the first time I saw an erect penis. I thought, ‘Omigod! Is that what a hard-on looks like?”

I blushed and the women shared a look. I cleared my throat. “So I can tell you that if that was an erection–even allowing for the guys in the pictures to be …remarkable specimens–”

Jackie burst out with a guffaw. “Sorry!” She held a hand up, trying to keep herself under control.

I grinned. “So even allowing for that, I can truly say that I never had anything like that happen to my penis.”

There was a long moment, and then Dr. Mahmoudi said softly, “Thank you for sharing that, Laurie.” She nodded again and wrote quite a bit and then looked at me again. “We know you don’t have any activity in your penis, so this question is for anywhere else on your body, or your mind, okay? Do you ever become sexually aroused, and if so, what do you feel?”

The damned blushing came on and I glanced at Jackie, who was keeping her head down, studying her kneecap. She knew and I knew she knew–just like always. I cleared my throat.

“Last night. For the first time ever. I went on a date with a boy.”

Dr. Mahmoudi was startled. As delicately as she could, she said, “I’m not sure …how did you meet …well, that’s not important.”

I chuckled. “This actually is a little embarrassing–“

“No, it’s not,” Jackie said softly. “It was perfectly normal and it was lovely and you should tell her.”

I nodded three times. “Okay. I met a boy here in town when we were here before to see Mom. We …kind of clicked. Anyway, I never thought anything could happen, but then when we had to spend last night in town,” I gave Jackie a wicked grin, “my aunt kind of maneuvered him into asking me out. We–I mean, the boy and I–walked and talked and then he kissed me …”

Dr. Mahmoudi started to say something but I held up a hand and she stopped immediately with her mouth half open.

I quickly said, “No, that’s not accurate. He didn’t kiss me; he’s too polite to do that on a first date, I think. I kissed him. I just had this overwhelming urge and I stood on my toes and kissed him. Took him by surprise. Took me by surprise, too. After that …well, I’d have to say the kisses were …equally distributed.”

Another chuckle and waved hand of apology from Jackie.

“So …” I thought for a second. “I felt my breasts tingle. My nipples hardened and it was like when I get cold but not just like when they’re cold. I felt a warmth in my …well, between my navel and my crotch is probably accurate. And I felt a sort of clenching between my legs, kind of muscle tightening …kind of like when you’re trying to squeeze out the last drops of urine–but again, not just like that …” I paused and said, “And I felt really, really, really alive.”

Both women looked at me for a long moment, and I realized there was a shared female moment occurring. I dropped my eyes to the hem of my dress. Jackie reached over and placed her hand on the back of mine and gave me a reassuring squeeze.

Dr. Mahmoudi made some notes; looking up, she smiled. “What you experienced, Lauren, is a pretty fair description of a typical female sexual response. Jackie?”

Jackie nodded and said, “Sure sounds familiar to me!”

I squeezed her hand back and looked to the doctor. “So …typical for a girl, or for an XXY?”

“Smart question,” Dr. Mahmoudi smiled. “Typical for a female, okay? And there are biological, genetic women who would tell you they’ve never experienced those feelings, but those feelings are pretty typical–and I’m not using the word ‘normal’ because there really isn’t a ‘normal’, just common responses. And yours weren’t typically male, they were those of a typical female. Are you okay with that?”

““More than okay!” I laughed.

Dr. Mahmoudi got pensive. “You know, Lauren …you might be better off than some of the XXY patients who’ve been studied. The majority in the medical literature were raised female from birth and their genetic anomaly was discovered when they failed to menstruate. They were often emotionally devastated to discover their chromosomal condition and never could fully feel ‘female’ again. They described the feeling that they were ‘half a woman’ or ‘no man’s land’ or things like that. Very unhappy. You, however, are the rarity that’s traveling the opposite route, and you weren’t comfortable–or at least, not un-comfortable–as a boy, but now you are grateful for any movement towards the female side of the scale.”

“That’s a good way to put it,” I said, considering. “I never felt like the tabloid headline ‘Trapped In The Wrong Body!’ but I just had a vague sense that something wasn’t right, wasn’t fitting in, just didn’t click. When I began moving to the female side, as you just said, then everything clicked. Not at first because I was embarrassed–or I guess I was worried what people would think if I acted like a sissy–but I got over that pretty quick.”

“She sure did,” Jackie grinned. “I could tell there was a pretty girly-girl waiting to be let out.”

“Interesting way to put it,” Dr. Mahmoudi noted on her pad, “and fairly accurate. So you can imagine the horror some XXY girls feel when they feel a boy waiting to be let out, so to speak.”

We were all silent for a moment thinking about those poor girls. Dr. Mahmoudi said, “My husband had a theory that a number of unexplained suicides of teenagers world-wide may have been due to the inability to cope with the cross-gender feelings. He got the cooperation of coroners in Germany to do a simple genetic test on all suicides regardless of sex, manner of death, notes left or not left–just totally anonymous with no privacy invasion, but all suicides throughout Germany within a six month period. The results were clear.”

She shook her head in amazement. “Statistically, there was a significantly higher proportion of XXY, and some XYY–so-called ‘super-males’–than in the general population. Or at least, as generally accepted in the general population. The condition is rare enough, but if it doesn’t fully manifest itself and is medically diagnosed, it could be hard to live with. We were working with the World Health Organization to try for a larger study when …when …”

Dr. Mahmoudi’s face tightened and she dropped her head. Instinctively, I grabbed a tissue box next to me and went to her, putting my hand gently on her shoulder and holding the box in front of her. She was sobbing slightly and nodded, taking a tissue and dabbing her eyes.

“Thank you …oh, God,” she gasped. “I thought I was dealing with it, but it creeps up on me and …”

“It’s alright, we understand,” I said, gently patting her shoulder.

She reached up and put her hand on mine and gave a little squeeze. “You just exhibited a typical female response to my grief,” she chuckled through her tears. “God, he would have loved to have met you!”

Jackie said, “I’m so sorry for you, doctor. I can’t imagine …”

This was the scene when Dr. Morrison returned. He looked sadly and said, “Oh, Anna, I’m so sorry. Do you want to take a break?”

She dabbed at her eyes and sniffed. “No, thanks; I’m fine. I was just saying that I deal with it and then it sneaks up on me and kicks my butt.” She sniffed again and grinned. “I was just saying how much he would have loved to have worked with Lauren.”

Dr. Morrison nodded. “Rashi would have liked that very much. The three of you …ah, damn.” He sat in his chair and had to clear his throat. Then he swiveled to address us. “Dr. Rashid Omari Mahmoudi was one of the greats. A great doctor, a great scientist, a great guy …and a great loss to the world. It’s hard to deal with it; he was taken so unexpectedly.” He looked at Dr. Mahmoudi, who was getting it together. “He was also a great friend. Let me explain something to you. I’m your mother’s doctor, but I’m also director of the Burn Ward. Normally I wouldn’t be involved in any of these discussions you’re having, but I had met Rashi eight years ago at a medical conference and we hit it off.”

His face softened with the memory. “Believe it or not, he could quote Simpsons episodes! Wonderful, wonderful guy …and so gentle and kind with his patients, and all the time his mind was in warp drive working on genetic experimentation. Oh, that sounds too science-fiction-y; he was working on gender genotypes, not genetic manipulation, to help patients emotionally and socially. I met Anna when she came to work for him–a barn-burner out of Johns Hopkins–and I was lucky enough to be at their wedding. When we got the funding for a gender clinic here, they were absolutely the board’s first choice. And that brings me full circle–as head of the Burn Ward, I sit on the Board of Directors and therefore have an active role in all aspects of the hospital as well. But it’s Dr. Mahmoudi’s baby.”

I wondered which Dr. Mahmoudi he referred to, and also if he regretted his last word because there would be no Mahmoudi baby now. Dr. Morrison sat silently–we all did–and then Dr. Mahmoudi had her pen and pad and was ready to go.

End of Part 7