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My son sent this to me, and I don't know how to respond, except that I disagree with it. I am sending him the link to this blog so that he can see what you all think.
Gwen
Sunday, April 24, 2005 -
Surgical Sex by Dr. Paul McHugh
Paul McHugh is University Distinguished Service Professor of Psychiatry at Johns Hopkins University.
Copyright (c) 2004 First Things 147 (November 2004): 34-38.
When the practice of sex-change surgery first emerged back in the early 1970s, I would often remind its advocating psychiatrists that with other patients, alcoholics in particular, they would quote the Serenity Prayer, “God, give me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” Where did they get the idea that our sexual identity (“gender” was the term they preferred) as men or women was in the category of things that could be changed?
Their regular response was to show me their patients. Men (and until recently they were all men) with whom I spoke before their surgery would tell me that their bodies and sexual identities were at variance. Those I met after surgery would tell me that the surgery and hormone treatments that had made them “women” had also made them happy and contented. None of these encounters were persuasive, however. The post-surgical subjects struck me as caricatures of women. They wore high heels, copious makeup, and flamboyant clothing; they spoke about how they found themselves able to give vent to their natural inclinations for peace, domesticity, and gentleness–but their large hands, prominent Adam’s apples, and thick facial features were incongruous (and would become more so as they aged). Women psychiatrists whom I sent to talk with them would intuitively see through the disguise and the exaggerated postures. “Gals know gals,” one said to me, “and that’s a guy.”
The subjects before the surgery struck me as even more strange, as they struggled to convince anyone who might influence the decision for their surgery. First, they spent an unusual amount of time thinking and talking about sex and their sexual experiences; their sexual hungers and adventures seemed to preoccupy them. Second, discussion of babies or children provoked little interest from them; indeed, they seemed indifferent to children. But third, and most remarkable, many of these men-who-claimed-to-be-women reported that they found women sexually attractive and that they saw themselves as “lesbians.” When I noted to their champions that their psychological leanings seemed more like those of men than of women, I would get various replies, mostly to the effect that in making such judgments I was drawing on sexual stereotypes.
Until 1975, when I became psychiatrist-in-chief at Johns Hopkins Hospital, I could usually keep my own counsel on these matters. But once I was given authority over all the practices in the psychiatry department I realized that if I were passive I would be tacitly co-opted in encouraging sex-change surgery in the very department that had originally proposed and still defended it. I decided to challenge what I considered to be a misdirection of psychiatry and to demand more information both before and after their operations.
Two issues presented themselves as targets for study. First, I wanted to test the claim that men who had undergone sex-change surgery found resolution for their many general psychological problems. Second (and this was more ambitious), I wanted to see whether male infants with ambiguous genitalia who were being surgically transformed into females and raised as girls did, as the theory (again from Hopkins) claimed, settle easily into the sexual identity that was chosen for them. These claims had generated the opinion in psychiatric circles that one’s “sex” and one’s “gender” were distinct matters, sex being genetically and hormonally determined from conception, while gender was culturally shaped by the actions of family and others during childhood.
The first issue was easier and required only that I encourage the ongoing research of a member of the faculty who was an accomplished student of human sexual behavior. The psychiatrist and psychoanalyst Jon Meyer was already developing a means of following up with adults who received sex-change operations at Hopkins in order to see how much the surgery had helped them. He found that most of the patients he tracked down some years after their surgery were contented with what they had done and that only a few regretted it. But in every other respect, they were little changed in their psychological condition. They had much the same problems with relationships, work, and emotions as before. The hope that they would emerge now from their emotional difficulties to flourish psychologically had not been fulfilled.
We saw the results as demonstrating that just as these men enjoyed cross-dressing as women before the operation so they enjoyed cross-living after it. But they were no better in their psychological integration or any easier to live with. With these facts in hand I concluded that Hopkins was fundamentally cooperating with a mental illness. We psychiatrists, I thought, would do better to concentrate on trying to fix their minds and not their genitalia.
Thanks to this research, Dr. Meyer was able to make some sense of the mental disorders that were driving this request for unusual and radical treatment. Most of the cases fell into one of two quite different groups. One group consisted of conflicted and guilt-ridden homosexual men who saw a sex-change as a way to resolve their conflicts over homosexuality by allowing them to behave sexually as females with men. The other group, mostly older men, consisted of heterosexual (and some bisexual) males who found intense sexual arousal in cross-dressing as females. As they had grown older, they had become eager to add more verisimilitude to their costumes and either sought or had suggested to them a surgical transformation that would include breast implants, penile amputation, and pelvic reconstruction to resemble a woman.
Further study of similar subjects in the psychiatric services of the Clark Institute in Toronto identified these men by the auto-arousal they experienced in imitating sexually seductive females. Many of them imagined that their displays might be sexually arousing to onlookers, especially to females. This idea, a form of “sex in the head” (D. H. Lawrence), was what provoked their first adventure in dressing up in women’s undergarments and had eventually led them toward the surgical option. Because most of them found women to be the objects of their interest they identified themselves to the psychiatrists as lesbians. The name eventually coined in Toronto to describe this form of sexual misdirection was “autogynephilia.” Once again I concluded that to provide a surgical alteration to the body of these unfortunate people was to collaborate with a mental disorder rather than to treat it.
This information and the improved understanding of what we had been doing led us to stop prescribing sex-change operations for adults at Hopkins–much, I’m glad to say, to the relief of several of our plastic surgeons who had previously been commandeered to carry out the procedures. And with this solution to the first issue I could turn to the second–namely, the practice of surgically assigning femaleness to male newborns who at birth had malformed, sexually ambiguous genitalia and severe phallic defects. This practice, more the province of the pediatric department than of my own, was nonetheless of concern to psychiatrists because the opinions generated around these cases helped to form the view that sexual identity was a matter of cultural conditioning rather than something fundamental to the human constitution.
Several conditions, fortunately rare, can lead to the misconstruction of the genito-urinary tract during embryonic life. When such a condition occurs in a male, the easiest form of plastic surgery by far, with a view to correcting the abnormality and gaining a cosmetically satisfactory appearance, is to remove all the male parts, including the testes, and to construct from the tissues available a labial and vaginal configuration. This action provides these malformed babies with female-looking genital anatomy regardless of their genetic sex. Given the claim that the sexual identity of the child would easily follow the genital appearance if backed up by familial and cultural support, the pediatric surgeons took to constructing female-like genitalia for both females with an XX chromosome constitution and males with an XY so as to make them all look like little girls, and they were to be raised as girls by their parents.
All this was done of course with consent of the parents who, distressed by these grievous malformations in their newborns, were persuaded by the pediatric endocrinologists and consulting psychologists to accept transformational surgery for their sons. They were told that their child’s sexual identity (again his “gender”) would simply conform to environmental conditioning. If the parents consistently responded to the child as a girl now that his genital structure resembled a girl’s, he would accept that role without much travail.
This proposal presented the parents with a critical decision. The doctors increased the pressure behind the proposal by noting to the parents that a decision had to be made promptly because a child’s sexual identity settles in by about age two or three. The process of inducing the child into the female role should start immediately, with name, birth certificate, baby paraphernalia, etc. With the surgeons ready and the physicians confident, the parents were faced with an offer difficult to refuse (although, interestingly, a few parents did refuse this advice and decided to let nature take its course).
I thought these professional opinions and the choices being pressed on the parents rested upon anecdotal evidence that was hard to verify and even harder to replicate. Despite the confidence of their advocates, they lacked substantial empirical support. I encouraged one of our resident psychiatrists, William G. Reiner (already interested in the subject because prior to his psychiatric training he had been a pediatric urologist and had witnessed the problem from the other side), to set about doing a systematic follow-up of these children–particularly the males transformed into females in infancy–so as to determine just how sexually integrated they became as adults.
The results here were even more startling than in Meyer’s work. Reiner picked out for intensive study cloacal exstrophy, because it would best test the idea that cultural influence plays the foremost role in producing sexual identity. Cloacal exstrophy is an embryonic misdirection that produces a gross abnormality of pelvic anatomy such that the bladder and the genitalia are badly deformed at birth. The male penis fails to form and the bladder and urinary tract are not separated distinctly from the gastrointestinal tract. But crucial to Reiner’s study is the fact that the embryonic development of these unfortunate males is not hormonally different from that of normal males. They develop within a male-typical prenatal hormonal milieu provided by their Y chromosome and by their normal testicular function. This exposes these growing embryos/fetuses to the male hormone testosterone–just like all males in their mother’s womb.
Although animal research had long since shown that male sexual behavior was directly derived from this exposure to testosterone during embryonic life, this fact did not deter the pediatric practice of surgically treating male infants with this grievous anomaly by castration (amputating their testes and any vestigial male genital structures) and vaginal construction, so that they could be raised as girls. This practice had become almost universal by the mid-1970s. Such cases offered Reiner the best test of the two aspects of the doctrine underlying such treatment: (1) that humans at birth are neutral as to their sexual identity, and (2) that for humans it is the postnatal, cultural, nonhormonal influences, especially those of early childhood, that most influence their ultimate sexual identity. Males with cloacal exstrophy were regularly altered surgically to resemble females, and their parents were instructed to raise them as girls. But would the fact that they had had the full testosterone exposure in utero defeat the attempt to raise them as girls? Answers might become evident with the careful follow-up that Reiner was launching.
Before describing his results, I should note that the doctors proposing this treatment for the males with cloacal exstrophy understood and acknowledged that they were introducing a number of new and severe physical problems for these males. These infants, of course, had no ovaries, and their testes were surgically amputated, which meant that they had to receive exogenous hormones for life. They would also be denied by the same surgery any opportunity for fertility later on. One could not ask the little patient about his willingness to pay this price. These were considered by the physicians advising the parents to be acceptable burdens to bear in order to avoid distress in childhood about malformed genital structures, and it was hoped that they could follow a conflict-free direction in their maturation as girls and women.
Reiner, however, discovered that such re-engineered males were almost never comfortable as females once they became aware of themselves and the world. From the start of their active play life, they behaved spontaneously like boys and were obviously different from their sisters and other girls, enjoying rough-and-tumble games but not dolls and “playing house.” Later on, most of those individuals who learned that they were actually genetic males wished to reconstitute their lives as males (some even asked for surgical reconstruction and male hormone replacement)–and all this despite the earnest efforts by their parents to treat them as girls.
Reiner’s results, reported in the January 22, 2004, issue of the New England Journal of Medicine, are worth recounting. He followed up sixteen genetic males with cloacal exstrophy seen at Hopkins, of whom fourteen underwent neonatal assignment to femaleness socially, legally, and surgically. The other two parents refused the advice of the pediatricians and raised their sons as boys. Eight of the fourteen subjects assigned to be females had since declared themselves to be male. Five were living as females, and one lived with unclear sexual identity. The two raised as males had remained male. All sixteen of these people had interests that were typical of males, such as hunting, ice hockey, karate, and bobsledding. Reiner concluded from this work that the sexual identity followed the genetic constitution. Male-type tendencies (vigorous play, sexual arousal by females, and physical aggressiveness) followed the testosterone-rich intrauterine fetal development of the people he studied, regardless of efforts to socialize them as females after birth.
Having looked at the Reiner and Meyer studies, we in the Johns Hopkins Psychiatry Department eventually concluded that human sexual identity is mostly built into our constitution by the genes we inherit and the embryogenesis we undergo. Male hormones sexualize the brain and the mind. Sexual dysphoria–a sense of disquiet in one’s sexual role–naturally occurs amongst those rare males who are raised as females in an effort to correct an infantile genital structural problem. A seemingly similar disquiet can be socially induced in apparently constitutionally normal males, in association with (and presumably prompted by) serious behavioral aberrations, amongst which are conflicted homosexual orientations and the remarkable male deviation now called autogynephilia.
Quite clearly, then, we psychiatrists should work to discourage those adults who seek surgical sex reassignment. When Hopkins announced that it would stop doing these procedures in adults with sexual dysphoria, many other hospitals followed suit, but some medical centers still carry out this surgery. Thailand has several centers that do the surgery “no questions asked” for anyone with the money to pay for it and the means to travel to Thailand. I am disappointed but not surprised by this, given that some surgeons and medical centers can be persuaded to carry out almost any kind of surgery when pressed by patients with sexual deviations, especially if those patients find a psychiatrist to vouch for them. The most astonishing example is the surgeon in England who is prepared to amputate the legs of patients who claim to find sexual excitement in gazing at and exhibiting stumps of amputated legs. At any rate, we at Hopkins hold that official psychiatry has good evidence to argue against this kind of treatment and should begin to close down the practice everywhere.
For children with birth defects the most rational approach at this moment is to correct promptly any of the major urological defects they face, but to postpone any decision about sexual identity until much later, while raising the child according to its genetic sex. Medical caretakers and parents can strive to make the child aware that aspects of sexual identity will emerge as he or she grows. Settling on what to do about it should await maturation and the child’s appreciation of his or her own identity.
Proper care, including good parenting, means helping the child through the medical and social difficulties presented by the genital anatomy but in the process protecting what tissues can be retained, in particular the gonads. This effort must continue to the point where the child can see the problem of a life role more clearly as a sexually differentiated individual emerges from within. Then as the young person gains a sense of responsibility for the result, he or she can be helped through any surgical constructions that are desired. Genuine informed consent derives only from the person who is going to live with the outcome and cannot rest upon the decisions of others who believe they “know best.”
How are these ideas now being received? I think tolerably well. The “transgender” activists (now often allied with gay liberation movements) still argue that their members are entitled to whatever surgery they want, and they still claim that their sexual dysphoria represents a true conception of their sexual identity. They have made some protests against the diagnosis of autogynephilia as a mechanism to generate demands for sex-change operations, but they have offered little evidence to refute the diagnosis. Psychiatrists are taking better sexual histories from those requesting sex-change and are discovering more examples of this strange male exhibitionist proclivity.
Much of the enthusiasm for the quick-fix approach to birth defects expired when the anecdotal evidence about the much-publicized case of a male twin raised as a girl proved to be bogus. The psychologist in charge hid, by actually misreporting, the news that the boy, despite the efforts of his parents to treat him and raise him as a girl, had constantly challenged their treatment of him, ultimately found out about the deception, and restored himself as a male. Sadly, he carried an additional diagnosis of major depression and ultimately committed suicide.
I think the issue of sex-change for males is no longer one in which much can be said for the other side. But I have learned from the experience that the toughest challenge is trying to gain agreement to seek empirical evidence for opinions about sex and sexual behavior, even when the opinions seem on their face unreasonable. One might expect that those who claim that sexual identity has no biological or physical basis would bring forth more evidence to persuade others. But as I’ve learned, there is a deep prejudice in favor of the idea that nature is totally malleable.
Without any fixed position on what is given in human nature, any manipulation of it can be defended as legitimate. A practice that appears to give people what they want–and what some of them are prepared to clamor for–turns out to be difficult to combat with ordinary professional experience and wisdom. Even controlled trials or careful follow-up studies to ensure that the practice itself is not damaging are often resisted and the results rejected.
I have witnessed a great deal of damage from sex-reassignment. The children transformed from their male constitution into female roles suffered prolonged distress and misery as they sensed their natural attitudes. Their parents usually lived with guilt over their decisions–second-guessing themselves and somewhat ashamed of the fabrication, both surgical and social, they had imposed on their sons. As for the adults who came to us claiming to have discovered their “true” sexual identity and to have heard about sex-change operations, we psychiatrists have been distracted from studying the causes and natures of their mental misdirections by preparing them for surgery and for a life in the other sex. We have wasted scientific and technical resources and damaged our professional credibility by collaborating with madness rather than trying to study, cure, and ultimately prevent it.
(Paul McHugh is University Distinguished Service Professor of Psychiatry at Johns Hopkins University.)
Comments
For what it's worth.
And it's probably not much.
I know, personally, in what passes for real life, just one TS. I knew her before, during and after SRS. She claims, though I'm not confident of it, that the extensive almost daily email communications we had, helped her through the difficult process of deciding how she should proceed. She went through the hoops at London's Charing Cross Hospital and eventually underwent full SRS a few years ago when she was in her early 30s. At the time I saw my role as urging caution but every step she took was earlier than we had thought was reasonable. I'm a naturally cautious person but, in this case, I'm pleased to report, I was totally wrong.
All I can say is that it suits her perfectly. She still lives in the same community as before her transition and many of her friends and acquaintances are aware of her status and accept her totally for what she is - an attractive heterosexual woman. However she 'passes' easily with people she's met since her SRS and holds down a job which requires her to meet lots of people in their homes, although she isn't totally stealth. Her family have accepted her new life totally. She has a natural outgoing personality, which, I'm sure, has helped her a great deal to cope with the stress of the profound changes she's had to endure.
I certainly don't recognise any of the features attributed to transsexuals in the article. I'm sure there are people like that. In fact there are well documented cases but I know for a fact it doesn't apply to all. My friend had been wishing for some magical solution to her gender dysphoria since childhood and now she is content.
Geoff
Grain of salt
I'd take anything to do with GID, SRS etc that comes out of Johns Hopkins with less than a grain of salt, in the past they did so much damage to the whole science with one mans agenda against it. It discredits anything they may do to make up for it.
A lot of people were hurt as a result of this.
Agreed
Hopkins had a very stratified view of what was the 'appropriate' manisfestation of feminine characteristics should be as a filter for transsexualism. It warps TS people into trying to mold themselves into those expectations - trading one closet for another one. Perfect examples of such silly games are TS people who purposely trained themselves to believe they like men ( honestly, it did happen ) as they were so desperate to fit in with their peers. Where as the reality is the percentage of TS folks who do not change sexual orientation after transition, and are consequently gay, is far higher then non-transgender folks who are homosexual. Also, you are expected to be submissive, passsive to your man *rolls eyes*, worship the ground they walk on - a bit exaggerated but those were still expected in the 60s and early 70s. In short TS folks in that era were not allowed to have any feminist attitudes and were even more rigorously held to that standard then genetic females. You were expected to abhor any independent 'masculine' behaviors prior to transition.
I for one do not miss Hopkin's disappearance. Sure, it has made us being considered 'legitimate' more difficult, as we are without the backing of a prestigious institution, but ultimately I think we gain more by allowing us more latitude to define our own womanhood, just like genetic women.
Kim
It sounds to me as if Dr. McHugh had preconceived notions
… or 'agenda' going in to his ‘studies’ and ifit the data he wanted to use to match his notions. There are many things besides SRS that can still make someone who has had SRS less than 100% totally happy with their life.
His 'study doesn't mention anything except whether the people in the study had "... found resolution for their many general psychological problems" but he seems to have only looked at whether SRS has solved ALL of them.
Many may not have been the cause of why the patient, for lack of a better word, wanted SRS, BUT HAD BEEN caused by factors outside of themselves, that in turn been caused or aggravated by the patient's dissatisfaction with the apparent mismatch between their bodies and their minds, and attempts to explain it to those who were unable to cope with this unusual situation.
His first issue was “the claim that men who had undergone sex-change surgery found resolution for their many general psychological problems.â€
I have personally met over 100 women who have had SRS to make their bodies female to match their minds. I believe around half are very satisfied now that they have had the surgery. I have met only one who wishes she had not had the surgery and wishes she could change back.
Of the remainder, a few have other problems, but the at most of this group are not completely happy, primarily because they have lost their friends and family, who will not accept them as they are.
The remainder may be able to live with this loss, but find that they cannot get a job that will both feed them and make them feel useful
Many, in growing up transgendered, let it prey on their minds to the point they did not get a good education and are stuck in low paying jobs for that reason.
Having a low paying job, or being forced to work multiple jobs keeps them from getting an education to get a better job
Some may have the education, but have been harassed before their surgery, and find it continuing because of prejudice in the local culture, prejudice that follows them when they try to find work. They are found out because they either have no job history, or have it come out in providing a job history, that they used to have a male name, but now have a female one.
They may have continuing psychological problems because it is difficult to eliminate some of the mental trauma they experienced before transitioning. Many had to live with mental and physical abuse, both at home and outside the home.
It has been stated many times that children who were abused are more likely to be abusers themselves. Obviously, their childhood traumas didn’t go away when they became adults. Why should Dr McHugh expect a miraculous switch from traumatized to totally happy with their lives after SRS for 100 per cent of those who had the surgery?
I have met 8 Top Shelf authors personally, face to face, who are in transition, or have transitioned, though only two have had SRS. 8 are living dull time in their new personas. This group runs the gamut from relatively satisfied the way things are to very unhappy for some of the reasons mentioned above. The happier group almost invariably have had acceptance from their families, and live in an accepting area.
I have also met close to 50 others outside of the TG story sites, ( Including those I met while visiting an SRS clinic in Thailand, one that does require that the patients have met the Protocols and whom I have remained in contact with for 2 1/2 years.) who have had SRS.
This group does include the girl who is sorry she had the surgery. But she did not grow up here, just moved here to get away from her family. She managed to find a way to get her surgery within one year of the time she decided to transition by finding one of the doctors mentioned by Doctor McHugh, who will do the surgery for the money, without insisting that the protocols be observed.
I believe there are many reasons that many who have had SRS are not perfectly happy after the fact, but environmental, financial and education all play a huge part in their feelings.
His second issue is the claim that men who had undergone sex-change surgery found resolution for their many general psychological problems.
Most of his long argument has to do not with people who have been diagnosed as Gender Dysphoric, but with those who were born with birth defects that were readily diagnosed at birth. Defects which may or may not have involve Gender Dysphoria at all.
If the percentage of his samples that were Gender Dysphoric is the same as in the general population, but most surgically transformed to appear female, I would expect almost all of those with XY genes to feel wrong. They had both XY genes, AND a mind that felt male, and being in a pseudo-feminine body would feel wrong.
So in my opinion, any statistical analysis of this group has very little bearing on those who did not have a disfiguring physical defect; whose only birth defect was that their minds are feminine but their genes gave them a male body.
Some background notes:
The ‘here’ I mention is the San Francisco Bay Area.
I am in transition. I am not post-operative, nor am I likely to go that far. I will be 65 in less than 2 weeks, and I’m not certain I need to go that far.
But I do plan to begin living as Holly Hart full time as soon as my job situation appears stable. Right now, while looking for work >I< want >MY< job history to match the name I am using. I will say this, though, with the dearth of jobs, I have been closer to living full time as Holly than ever before, and it is liberating.
One of the Top Shelf authors I mentioned is Gwen Boucher, known here as Gwen Brown, who posted the blog this is a reply to.
I have received her permission to use her names, both her pen name and her real name, since I began this reply.
I have spent significant time, over two weeks with her this past year. I know that a large part of what keeps her from being a lot happier, isn't her friends, but the fact that her family is almost completly out of communication with her, BY THEIR CHOICE!
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It’s not given to anyone to have no regrets; only to decide, through the choices we make, which regrets we’ll have,
David Weber – In Fury Born
I have used this quote for a month or so now, but in a way, it seems to go with what I said above. Those who have elected to have SRS have had to decide which regrets they must live with in the future.
Holly
It's nice to be important, but it's more important to be nice.
Holly
He's flawed by his own preconceptions.
Gwen. I try so hard to stay out of these issues, but you’ve been so nice to me, I just can’t keep my mouth shut.
My problem with Dr. Paul McHugh is a fairly simple one. I just spent about an hour reading about his leadership down at John Hopkins, to make sure what it was about to say.
I find his questions on ethics to be well founded. I find his fears that clinicians may be to ready too undertake what is a very drastic surgical protocol to be reasonable in some select instances, because people are misdiagnosed, and it is a phenomenon that
relies almost wholly on what the patient tells the doctor.
I also don’t believe that late life SRS is a very good way to approach this problem, and that it is only necessary due to our infancy when it comes to the understanding of this type of dysphoria, and the way we help such people. I believe, that the only
reasonable way to properly deal with a treatment like this, is to perform it well before
the onset of puberty. Like Dr. Paul McHugh, I am extremely concerned with the ethics involved in my perceived view.
On the other hand, I have one prejudice that I must confess, and one glairing flaw that I see in Dr. McHugh.
My prejudice is that I look upon the eventual success of any given endeavor in Psychiatry with all the subtle anticipation I feel, when watching a 300Lb, club wielding moron trying to sex baby chicks by the sound the club makes. To be sure, many very good people are very successful to a point. They listen to folks, and they
have good hearts. Some are much more naturally adept at this than others, and those folks have good hearts. Likewise, some folks need someone to tell them that
it’s not real, and they really do need to be locked up. When my turn comes, I hope I get the good listener.
I’m fairly good at these things. Listening, and understanding why it is people do what they do. That is why I can say that Dr. McHugh’s problem is that he just does
not get it. He thinks that Gender dysphoria has nothing to do with gender. He doesn’t believe it, leaving him with only the premis that it is to be treated as any other psychiatric problem that is not well understood, so he does what he can to prevent what he sees as an unjustifiable practice.
He is not one wit different than any number of well versed, intelligent, and even eminent men, who in the end just didn’t get it. And it is sad, the damage that one of them can do.
Yes, there are serious ethical issues in choosing a treatment for any patient, and there are many ways that our understanding of this phenomenon needs to be improved, as well as the treatment. To have eliminated the resources of a Johns Hopkins in perusing these the very improvements to the issues for which he is so concerned, is irrational. It did a huge amount of damage, and only makes sense if you take into account that he just does not get it.
As a scientist. I can say that we would never discount a phenomenon or an explanation because of negative syllogisms. A married male who should never have received an SRS in the first place, for erotic reasons, is a problem. A man like Doctor McHugh, who has spent his career trying to make the practice of Psychiatry neater, and more organized, and more codified, is likely to, and should have a problem with that. (I will leave my comparisons of the relative worth of his life’s work to that of a minister in a whorehouse alone.)
Unfortunately eliminating the whole effort to improve the lives of these people, which is the damage he’s tried to achieve, based on his perception of a relative small set if individuals is nothing more than a broad misuse of his professional Cache, simply because he does not get it. He made up his mind long before commissioning any study of the successes of SRS.
That is what I’d tell your son. I would suggest that he speak to, or at least consider, a real post op woman who has the benefit of experience, wisdom, probably humility, and an understanding that Doctor McHugh will never have.
Sarah Lynn
Interesting.
Because of politics within the NHS at the time, I had to wait five years for surgery, so my RLT was a long one. I remained in the same job throughout and for four years afterwards. I met with the public, spoke at regional meetings, even did some talks to WIs and schools. As far as I know I was accepted at face value.
I also had a relationship post op, though I admit, I found the sex uncomfortable despite plenty of dilation - I was just small.
I live in stealth now, I'm still practising my profession, as far as I know effectively, and 22 years after the transition, most people have forgotten and accept me as female. I also do counselling, and have been accepted as female by all the clients I've seen.
I'm no beauty queen, but at the same time, I've seen worse and as I try to merge in, I don't wear flamboyant clothes, I wear what I feel comfortable wearing. I certainly don't dress for others, including psychiatrists - and that frequently includes wearing trousers, in fact my 'uniform' for the NHS is trousers and tunic top.
I can see what this man is getting at, and for some of it I don't disagree. I have long advocated that SRS is only suitable for some, and that a significant proportion of would be candidates have a mental problem and might not be suitable - they should certainly have longer assessment.
Maybe the solution is multi-faceted, as are many of the self referers: surgery is suitable for some; living in role with hormone therapy but not surgery; living in role with support; persuasion that it would be a mistake to proceed, but perhaps allow to move to stage one.
After all, there is nothing to stop someone living in the opposite role, even without medical support.
I was assessed by three mental health experts, plus another two or three doctors. In some ways I feel happy that things were delayed, although at the time it was a pain. At least I could justify what I was doing, and my surgeon, the leading British one at the time, had no doubts whatsoever, that it was right for me. I still agree with that diagnosis.
As for babies and children, I enjoyed helping to look after my own kids and still like babies and children, occasionally treating them as patients. They seem to accept me as I am, as do the parents.
I don't think I'm mad, though I admit I did have a reactive depression when I was made redundant from my previously quite high status job of head of a department. That taught me a lot about myself, including the fact that I wasn't irreplaceable. It also helped me help others who are experiencing depression and anxiety. That was fifteen years ago, it won't happen again, and I am stronger and more understanding as a consequence.
One of the problems is that GID is without clinical signs, the symptoms are reported by the patient, who alone experiences them - except in children who are a different case (although, my aunt and godmother tells me that my grandmother suggested I should have been a girl, at age two or three - I did like handbags and high heeled shoes!).
It requires a very astute clinician to pick up on who is genuine and who has caught the transsexual bug (it's contagious - put one TS in a group of cross-dressers and half will catch it). I remember going with a friend as a guest to a TV group weekend away. I only attended for the evening, and sat with the wives and girlfriends, chatting with them. As I left, a young TV asked me if I'd, "had a good gawp?" I should have ignored it and left, instead I told him what I was. His jaw nearly hit the floor. I then spent two hours explaining the differences in the different sections of the spectrum, and trying to convince him he wasn't transsexual.
As I said, it's an interesting paper and I don't disagree with much of it, at the same time, I'm not sure I recognise myself in it's categories.
Angharad.
Angharad
Angharad
Paul McHugh is an ass
He says "you can't change gender identity." The proof? Intersex children of a particular type were often surgically assigned as female, but the majority of them grew up wanting to be male. So far, so good.
Conclusion A: Don't do medically-unnecessary "normalization" surgery on intersex infants--because you can't change their gender identity. I agree with the reasoning, and this conclusion--as far as I understand intersex issues (though I'm aware of at least some intersex people who disagree, and believe that being surgically "normalized" as infants would have saved them a lot of grief growing up--as long as the surgeon had got the gender right).
Conclusion B: Don't do "corrective" surgery on transsexuals--because you can't change their gender identity.
WTF? No, you can't change their gender identity. That's the whole problem. But you can change their bodies surgically and hormonally to better match it. In fact, that's pretty much all you can do for them.
Apparently, though, he thinks they're all lying about having a gender identity that doesn't match their bodies. He thinks their actual motivation boils down to catering to a perverted sex drive--a mental illness.
He offers no proof of this, only his own assertion based on personal observation; the "research" he quotes is all biased and flawed, driven by his (and his colleagues') particular religious beliefs and (documented) eugenic leanings, and has been contradicted by numerous other studies; his absurd folk-classification of all transsexuals as either "self-hating extreme homosexuals" or "self-lusting extreme crossdressers" has been thoroughly discredited as bigoted pseudo-science at best; and trickles of evidence from numerous recent studies have joined to form a flood to prove that the gender identity of transsexuals is in fact opposite to the rest of their bodies, exactly as they say it is--they're not lying.
Point your son at these pages, where he can read about what the actual science shows:
http://aebrain.blogspot.com/2008/06/bigender-and-brain.html
http://aebrain.blogspot.com/2008/11/another-piece-of-puzzle....
And this one, where he can see a detailed analysis of McHugh's perfidy:
http://ai.eecs.umich.edu/people/conway/TS/Bailey/McHugh/McHu...
I think you should send your
I think you should send your son links to promenant rebuttals --- these are out there.
You won't convince your son of course, but if it were me, I would respond saying something along the lines of...
Son,
If you look hard enough you will always be able to find some "respected" authority that will use bad science to justify a position of intolerance. I will probably never be able to make you understand what it is like to be transgendered, and I am sorry that this has caused you pain. On the other hand, I doubt you will ever understand the pain that I have suffered in my life as a result, or how much your inability to accept me has hurt me.
As for your article, it simply shows that if you begin a research project with an agenda, and discount any evidence that does not agree with your agenda, then you will "prove" your point. McHugh's research has largely been shown to be faulty, but I don't expect you will believe that.
If you actually are willing to open your mind to the possibilty that you are wrong, then I would suggest you read up on the evidence that is countrary to your article. In fact the studies from the intersex children mentioned in the article only prove the point that gender is in the brain, it is NOT conditioned nor necessarily related to the body.
Here is one rebuttal, an exceprt from http://www.tsroadmap.com/info/paul-mchugh.html
Surgical Sex
Hi, Gwen,
Maybe you could send you son a copy of "atypical-gender-development.pdf" from The International Journal of Transgenderism. I put a good web address for this paper in a blog about 2 years ago, I think.
I believe the professor who wrote "Surgical Sex" must be at least 70 YO. I've found that people in that generation, even ones with high intelligence and a scientific and socially progressive disposition just can not grasp even a limited understanding of transsexualism.
I believe that autogynephilia exists. Ann Laurence says she is one and not a transsexual, so I believe her. I think, however, that a small minority of people requesting SRS are autogynephilic. It seems impossible to categorize those young outwardly male sexed people who know they are girls or desparately wish to be girls more than anything in life as autogyn'. This autogyn' is a means of sexual arrousal. Prepubesent individuals are not driven by needs for sexual relief.
I think the prof's paper shows what transsexuals are and are not. After birth surgery to correct an intersex condition by surgically making boys, that > had had the full testosterone exposure in utero <, into girls, did not work. These individuals were males in females bodies, ie. transsexuals, and felt gender dysphoria because of having female bodies. This shows the brain's gender and therefor much of the person's behavior is determined before birth. Those 'male genitaled' ones who had an excess estrogen exposure in utero, at the time the brain's sex was starting to differentiate, are actually females 'inside', that is, inside their head or brain.
There are very many papers and articles on the transgendered or transsexual on the web. You could find something for him on the Dutch procedure of 'stopping puberty' until the individuals are (legally? ethically?) old enough to decide if they wish to become women or men (traditional spelling, just for your son) and then receive the proper sex hormones. You could give him a list of SRS surgeons and GID councilors in the US. They do not have to flee to Thailand to do legal surgery. Show him Gender Dysphoria in the psych symptoms/diagnosis manual, DSM IV xyz or whatever.
I'm sure this group can come up with many more ideas.
Big Hugs,
Renee
Hugs and Bright Blessings,
Renee
Renee, the study and paper you referenced is here
http://www.gires.org.uk/Text_Assets/ATypical_Gender_Developm...
Holly
It's nice to be important, but it's more important to be nice.
Holly
SRS
Gwen: I don't agree with him at all, I do agree with the Holly Hart, Sarah Lynn Morgan, and Angharad. I have known a few that have had SRS and some that are living as females but have not had SRS, and are very with they way they are living. Then I know five that were Hermaphrodite/that were born with both sexes. Three I know were surgerically corrected to female and had babies except one could not take the pressure of the bigotry of people and took here life before she could get that far in life, (I was very close to her and still don't know why she did this to include her parents). and two that were change to male. One was not her choice, her father had the idea that if she had a penis that should of been male and the other choice was to be male. Both found later that were sterile and could not have the kids that they wanted so much. From what I found that just about everyone that took the Male choice was found sterile later, yet the ones that were change to female were able to have babies not always by natural birth but had too use other ways as their bodies parts were sterile but had the right parts to term a birth by artifical methods. Enough Soap Box From ME! Richard
Richard
Thank you all so much!
Gush Gush! !
I did finish reading the article, and found that I did not entirely disagree with it. Some of it I thought missed the mark entirely. In light of the fact that the Johns Hopkins people lacked the understanding of how treat T folk, I am happy that they opted out of it. Better to leave that up to those who know.
OTOH, there are some who shamelessly "farm" us for the money they can make. So, it is up to us to finally deduce just what the hell it is that is right for us.
As I have said before, IMHO, SRS was right for me. It is the pain and suffering that my own loved ones have brought on me that robs me of the will to live at times. I still believe that Education and Research is the way to come to a reasonable solution to it all.
Many Blessings
Gwen Brown
Second, or is it Third thoughts?
Another chunk of his introduction before getting to the studies.
“… they spent an unusual amount of time thinking and talking about sex and their sexual experiences; their sexual hungers and adventures seemed to preoccupy them.â€
In my experience, that is not true, at least not for most of the girls I have spoken to, at least not the part on sexual experiences, hungers and adventures.
“Second, discussion of babies or children provoked little interest from them; indeed, they seemed indifferent to children.â€
Again, my experience is that most of us have been or would like to be parents, and are interested in kids. In my case, my kids are step kids, which may be a god things, as it appears that even before starting SRS, I could not have had kids. Before I met my wife, I met 3 of her kids. In my dating before I met her, I usually dated single mothers.
I have known several in the same position.
I know three girls who arranged before their surgery, to be able to give their wives, with whom they are still living, more children for the two of them to love.
“But third, and most remarkable, many of these men-who-claimed-to-be-women reported that they found women sexually attractive and that they saw themselves as “lesbians.†â€
Not hard to understand, especially for those of us old enough to have been told over and over, “You are a boy, and you are supposed to want to marry a woman.†Combined with the fact we tended to want to be a girl and be with girls, we LIKE girls/women. We didn’t really want to get along with they guys who taunted us and beat us. I can see less of the girls who were abused by their fathers wanting to associate with men.
Okay, that’s a bit more of my soapbox. I’ll try not to say anything more … at least tonight.
Holly
It's nice to be important, but it's more important to be nice.
Holly
big, hmmmm
In one sense I guess I'm not qualified to comment being a pre-op, still having lived as Kristina for a few years I can see some of this. Like others I agree with some of what the Doc says and I also agree that he seems to have more than a few preconceptions and many of the observations are biased to somewhat stereotypical behaviours. I've read several accounts of people transitioning and as they put it having to play the game to convince the various medicos they were indeed serious and committed to femininity.
I think from my own experience that those ideas have shifted somewhat. I am quite tall and not super girly. I do get 'picked' at times and do not hide who, or what as they say, I am. I don't volunteer information but I will and have answered questions, sometimes very personal with the exception of sex and what's between my legs.
I've had discussions of late with a few friends regarding relationships and how such might work. A girlfriend and I both made a similar comment about relationships with a TG, in essence…'oh dear me, GOD they're hard work', which is simple observation not dissimilar to the Docs thoughts in some areas. Many self professed TG people are probably not. An operation will not solve all life's problems and were I to do so, a lottery win would be nice, I imagine I would still have bouts of depression and the usual ups and downs.
This is an area where it is largely patient driven and the professionals are there to as far as possible help and guide and avoid the odd disaster. Are such as we more prone to mental trouble and depression simply because of our incessant questioning, social and or family ostracism and in many cases attempts to hide or overcompensate or whatever? Perhaps so, that I can't really judge. Like I said I'm not particularly girly and considered that I passed as a regular guy. Still I was often thought gay and on more than one occasion was made aware that someone 'knew'. Higher empathy levels or something maybe.
It is not and cannot be a simple thing. Each must find their own way and personally I'm glad some medical types are open and willing to listen and help as and where they can. Glad I never met a Mr , scuse me, Dr McHugh.
I suppose we must individually be as honest as we can be, both with ourselves and those others involved. You might be able to lie and even trick a Psychiatrist, but is that a good idea. You will ultimately pay the price and it can hurt others indirectly. (That 'you might' earlier this par is a generic you and not directed at anyone here and the 'is that a good idea', is a rhetorical question. Guess what, I don't think it is a good idea. Yet some do it.)
Gwen, I think your son, perhaps well meaning, is trying to show you the error of your ways. Ever so politely tell him to stuff it in his pipe and smoke it. It's your life and you have to live it. There has been I'm sure pain and may still be, but you are you and that's a start on life isn't it.
Kristina
Cross-purposes
He seems to be contradicting his own point. He starts by trying to say that transsexuals don't exist, but then he shows those boys who were turned into girls stayed boys in their minds by using the types of play they enjoyed as proof. So it would seem that all we'd have to do is show him some children who were raised as boys but would rather play house and nurture their dolls than enjoy rough-and-tumble games, and he ought to agree that these children truly have the minds of girls.
Not only is it contradictory, Jen...
I found the language in the thing to be very prejudicial, in the
most telling way. The post-ops still had big hands and feet...
Well they have jobs, but they are still black, you know...
I don't even like it when someone on here tries to make a point
that men are so dense. We all want to be treated as we are, no
more or less. This very example might have been chosen for a
lecture given by Stephen J Gould, when he pointed out to his
students that some of the most prejudicial writings he could find,
were written some of the most enlightened men of science in their
time.
The saddest and most dangerous part of any prejudice is that
the person holding them often does not recognize them for what
they are; and, no one can be so sure of themselves to discount
the possibility.
I don't know what time the good doctor thinks he's in, but he
can return whenever he likes. His concerns I agree, are ethical
dilemmas, but his science isn't science at all. (All too common
with clinical psychologists, I fear.)
One thought, though, was the question I'll send to Gwen. What
does the son do? Does he have any training in critical thought,
or the natural sciences? If he does not, then there must be at
lest twenty of us here, who could explain the good doctor's
mental foibles, and logical fallacies. If he would listen.
Sarah Lynn
I don't get the point..
What purpose did your son have in sending you this? Considering you are post-op and don't regret having had the surgery? Because one Doctor doesn't believe in SRS, are you supposed to suddenly NOT be happy? Are you supposed to just go "Oh, one shrink thinks SRS is a bad idea, I am no longer happy. I now regret my actions because this one Doctor I've never heard of or seen says it's a bad idea."
Huh?
Hugs
Frank
What Motives...
Did gwen's son have for sending this paper? Given the history between them, probably not good ones. The obvious one, was to try and cause remorse or regret - I told you so - and consequential unhappiness. Maybe the object was to take her back as a failed female/male, a male without the badge of office - the meat and two veg.
Either that, or - I found this, what do you think? Highly unlikely.
At least he's looking, but from the wrong viewpoint, although if he reads enough positive studies, he might begin to question his own stand point. Um, I know, we'll have to shoot for bacon...
Well at least I'm trying not to just see him in a negative light.... sort of.
Angharad
Angharad
I want to start by saying I
I want to start by saying I agree with what others have already written.
The are a few point in particlar I think are the most important.
First, his point about intersex babies I agree with. Gender can not be changed with surgery and "the environment in which a child is raised". Environment can play a part in how a person reacts to circumstances, but it can't change basics. I believe he is right that gender is in the genes. Therefore, the logigal conclusion is that a person who believes their physical and mental gender do not match, can not be changed by intervention or treatment for mental disorder. He should be embarrasst by putting his flawed reasoning and his bias in writing where any one can read it.
Second, although many are receiving treatment and SRS at younger ages these days, there is no question that the older a person is, the less successful the final result will be. And, however early the treatment, SRS can only go so far. If a person having SRS is not completely satisfied, who can blame them. Even if tommorrow a complete transformation was possible, there would still be the years before, when things were wrong. For a Doctor to expect a perfect result is just being unrealistic. A person that has been treated for cancer and survived, will still have all the medical and mental scarres associated. Why should a tg person be any differnt.
Third, not being interested in babies or children??!! Some people are interested in raising children and some are not. In todays society it seems there are many people of both genders who have little interest in having children. Many people have thoughts and ideas different from me. Some I can not begin to relate to, but I'm not going to judge these people and would hope they would extend the same curticy to me.
Our world is not perfect. We must do the best we can and be tolerant of others.
If we were lucky, we would be able to learn and grow up in an enviroment like is in one of my favorite stories.(Also associated stories.)
"A NEW STYLE OF EDUCATION" by KAREN PAGE. * * * * *
Happy New Year to all.
JP
p.s. Please pardon spelling/ other errors. I would like to think I am a good writer, however I'm not. Therefore, I must be satisfied by enjoying the writings of others. Thank you all.
JP
Black and White Thinking
In a way, I don't blame my son for his current narrow mindedness. At the height of my own denial of my T status, I was perhaps worse. In retrospect, I spent the latter part of my life in abject horror of something within me that I hysterically felt was consummate evil. I wasted much time trying to exorcise the daemon.
He may be just as terrified by his own inner thoughts as I was, and sadly to say, the system of religion that I taught him will do nothing to relieve the horror and nurture acceptance of self. I do not reject all religion but the one I once existed in was nothing but a blind cult, complete with a whole mantra of thoughtless and unrealistic phrases intended to make one a mindless robot.
It was not until about 5 years ago, that I began to recall my very early childhood experiences and things began to fall into place. The incident that triggered the recollection was my own brother, upon my call to inform him of my latest manifestation, came to my apartment, and said,"Now it all makes sense."
I had somehow blanked it all out, but he recalled how my stepfather told him many times that he was going to "beat the woman out of me". I do not understand the psychological mechanism, but my brother's words to me triggered a long process of remembrance that continues today.
As a young man in my late twenties, the idea of raising children was quite frightening to me, and I did not want to recreate the hell that I lived through. So, by divine intervention or not, when I found religion, in my youthful idealism, the expression of it that I gravitated to was a philosophy that explained all of life, and set rigid boundaries to keep my sinful desires in check. I believe that my own inner life was so chaotic that it deeply frightened me.
As painful as the last years have been, I feel that I have gained greatly in the growing realization that humans can not know everything, and that very fact proves that we can not be like God. That realization draws me closer to a right relationship with the Universe around me. I am but a small part in a larger order and that makes me happy.
I find it hard to accept that my own son may not realize these things until he is my age and I am long gone. It is however, part of the circle of life which I first read about in one of Asimov's books.
Thank you all for your wonderful responses.
Gwendolyn
The Harm That the "Know it Alls" Can Do
I know and have known four intersexed individuals and three that I suspect they are intersexed. All of them became or started to become female in later life. Some were surgically made male as infants because the parent couldn't accept their "son" as anything else. One died of natural causes never receiving the love a daughter needed from her father. Another received, without knowing it, male hormones when breasts began naturally as a teen and is now in transistion from male to female. When the child becomes aware the child does know what he or she is.
That is the most important point. The individual does know what he or she is. In many cases, society has forced the individual to be what society see the individual to be, not what is inside. Many transwomen still act like men in some areas, but not all. We also may "start out" as caricatures, wearing dressy dresses, because as children we never or rarely had the opportunity to be little girls playing dress up. To quote a post op that I respect, when we transistion "It is like starting a house with the second floor." No one is perfect in anything. Even a "June Cleaver" is a caricature.
I have heard and seen the pain of not being what they are inside of those who are transgendred. Most feel better about themselves when their body becomes more like what they see themself in their mind's mirror because they get that inner peace. Some who transistion are literally choosing life. It is not just they, as I have been taking hormones for the last nine years. I would have gone further and sooner if it was not for my finances. I accept that that is the best I can do under the circumstances.
I personally would cation anyone who wishes to transistion because it is a difficult and lonely road. Whatever you do, be yourself. Gwen, isn't that what you did when you transistioned, be who you really are? In the end is is not, "to love they neighbor as theyself?" Do you really have to do what those who insist that you do it "their" way? Start loving yourself and then everyone else.
Also, any psychology study is flawed because the subject of the study is complicated, a "Hugh Man"(to quote a Frangi).
Please be aware that I have been involved with the transgender community in various aspects for almost a decade.
For further reading I suggest you read my:
"Devar Torah, Haphtorah Shophteem, You Are Drunk, Without Wine"
http://bigclosetr.us/topshelf/fiction/8678/devar-torah-hapht...
and Heather Rose Brown's "Shoes"
http://bigclosetr.us/topshelf/fiction/3111/shoes
and "My Name is Luka."
http://bigclosetr.us/topshelf/fiction/3157/my-name-luka
shalimar
>> thick facial features...
Presumably, the good headshrinker has a similar contempt for "coyote ugly" women not blessed by the delicate features of the traditional Disney Princess, the "too tall," the "too fat," the "too flat," and the "too boisterous."
Women come in all shapes and sizes, despite the grotesque caricatures of women held up as "ideal," half the height, an eighth the weight, of "manly men," tittering toadies to their "natural" right of precedence and dominance.
We note too, that men are caricatured by this rigid worldview, where God created testosterone so that aspiring manly men could inject great quantities of it into their bodies and grow to become what God intended, muscle-bound oafs with projected lifespans in the low two figures. This noble sacrifice, of course, is quite justified, since only sissies linger in the "average man" category. "Be all you can be" is not just a military slogan.
Feh.
The natural corollary to this sort of misogyny is, of course, the Ancient Greek cult of pederasty, since only young boys embody the *ideal* beauty, and we observe that the church he advises has had "problems" with this over the years.
Cheers,
Puddin'
--------------------
In Boston, it looks like Cardinal Bernard Law is getting transferred to Rome, which is kind of like a promotion. He said today he wanted to thank all the little people.
--- Jay Leno
-
Cheers,
Puddin'
A tender heart is an asset to an editor: it helps us be ruthless in a tactful way.
--- The Chicago Manual of Style
My Opinion. . .
. . .is that this guy is full of it! I had my SRS in Canada when I was 32. I dressed and lived as a girl from my college days on. (Most of the time in "stealth") I had always planned to have the surgery, but it took well over ten years to save the money. I never had a problem passing. I'm small in frame and features, so no obvious clues to the casual observer.
I am very happy with the results of my SRS. While I have net a few TS post-ops who regret having the surgery, I did and do feel that all is right with my world.
I have to agree with the responders who fault John Hopkins as an unfriendly, uncaring institution. There are other medical centers who do care as there are therapists who care and provide sensitive, helpful guidance.
There is much in the way of good information available on the internet... much of which and been posted above.
I hope your son can be enlightened. Good luck!
Diane
McHugh Is An Idiot Of Epic Proportions
This guy is trying to use his own set of values as the measuring stick for the happiness of other people. He has never walked in our shoes nor does he have any real idea about gauging true happiness. My therapist sat me down one day and we talked about where I was on the depression scale before transition and where I am now going on 4 years as a fulltime woman. She said the difference is like night and day. She has been able to chart my progress and she said it is absolutely astounding! I agree with her completely and I couldn't be happier. She told me that she has no doubt that if I had continued to live my life to make others happy, I would be six feet under. Only a person who has truly lived it, can really understand how we feel and know what it really means to be at peace. These so called "experts" like McHugh don't know their asses from a hole in the ground. They siphon millions of dollars in research money out of the pockets of taxpayers to gain a bit of fame and recognition for themselves in well known medical journals. I wonder how much of their garbage is based on actual fact and how much is really smoke blown out of their asses. While it is true that it is nice to have family members in your corner before, during, and after completing transition, I personally, don't concern myself with the opinions of my family especially when they try to act like that my only purpose in life is to please them and make them happy. I did that for 33 years of my life and I was the only one who wasn't happy. I made up my mind that it was my life and I could no longer keep giving it to please others. My family has not all come around, but they know that I am here and I will not go back to being what I am not. I am a woman and I have always been a woman. I do not wear outrageous outfits or overdone makeup. I dress just like any other woman depending on the setting or occasion. I pass the same advice along to any new girls starting out. I tell them that the quickest way to get "read" is to stick out like a sore thumb in the way you dress or do your makeup. I have been very fortunate to pass pretty well because I make an effort at it. I have very rarely been addressed as anything but ma'am or as a lady. It is such a wonderful feeling! I really wonder how the article would have been different if McHugh had been transgendered? I have a strong suspicion that it wouldn't have been written at all. If it had, it would have carried a lot more weight with so many of us who are living this. This life is my truth and I will be damned if I let ill informed people like Paul McHugh tell me otherwise!
Hugs,
Jen