“Examining staff feel little would be accomplished by attempting to reverse subject’s current personality trend. Attempts to do so would likely result in psychological and emotional damage to both subject and adoptive mother. In view of the information assembled the study team recommends encouraging the subject’s feminine development."

TWINS by Marie
Part 20 - Diagnosis
by Marie C.

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Darlene rose early to look his girlish best for the appointment. He and Linda were going to San Francisco today for a big consultation with the doctor, part of Linda’s plan to see what could be done with Darlene’s increasingly feminine behavior. For the event he picked a pink and magenta plaid jumper to wear over a white jabot blouse with long bishop sleeves. He loved the airy feel of his thin nylon underwear and pantyhose and felt slightly embarrassed because it was like he wasn’t wearing anything underneath. His hair was long enough for a chignon which he had pinned together with tortoise shell hairsticks. Pale lipstick and nails coordinated with the jumper. Pearl studs graced his ears and his own mother’s pearl pendant hung from a delicate gold chain around his neck. His low heeled tan strap sandals and shoulder bag matched perfectly.

He insisted that Linda change her clothes when she tried to leave the house wearing a dowdy brown polyester pants suit. Nothing less than her best pastel skirt suit and a jewel neck back button blouse would do. With a firm expression he stood over her while she changed into hose and heels with a big sigh. He insisted on picking the colors and accessories and she thought he was being too fussy.

As they were leaving he took another look in the hall mirror at the two of them together and was pleased with what he saw. The girl looked self-confident with a smooth, creamy complexion, wide open eyes, slender neck and sophisticated hairdo. Her mother looked city chic.

On the long drive he compared the scrawny body he saw in the mirror every morning to the girls’ figures he shared in his curious dreams. He especially remembered the feel of their firm skin and the shock of touching their intimate places. More and more often he wished he was different.

His thoughts drifted to Emma, his favorite “dream.” He wanted the best for her. She deserved it because she had struggled so much. He felt good about helping Ana find an adult’s place in her family with no sense of who she was. And if Ana wanted girls instead of boys wasn’t that her right to decide? But why did Michi’s ceremony seem so familiar?

The events with Emma and Ana all happened long, long ago he realized, if they happened at all. What were the dreams about? He looked over at Linda in the driver’s seat and she smiled back.

There were three appointments at the doctor’s office: a just-before-lunch interview by psychiatric social workers; an after lunch battery of tests administered by a psychologist; and a late afternoon physical exam including X-rays, blood and urine samples. Darlene and Linda would come back the following week for a fourth appointment after the examination team had met to compare notes and test results were complete.

The following week Dr. Gardner gave Linda and Darlene a summary of their findings. The full technical report was not shown to them but read as follows:

“The subject is a thirteen and one-half year old male in good health. Seeing him for the first time on the street one would assume without question that he was a preteen female. He prepares his clothing, hair and makeup without help according to his adoptive mother. At all times his behavior is graceful and pleasing. His dress is totally feminine, in good taste and done with attention to detail. As some women would say, “Not a hair out of place.” He seems quite self-assured as a female. Subject and his adoptive mother were cooperative at all times.

“As far as the adoptive mother knows his first episode of cross dressing began as a punishment by the boy’s father about five years ago at a birthday party of Mrs. Sullivan’s missing daughter. She hinted that he may have cross-dressed informally a few times before that with said missing daughter but was not paying attention at those times. The behavior resumed markedly when he moved to her home after losing both parents in quick succession.

“Subject’s responses to personality testing rate very high on the feminine attitude scale to the 95th percentile. Attempts to elicit masculine attitudes even as normally found in girls of this age yielded minimal results. Intelligence was scored at well above average (i.e. IQ 150-165). Subject describes a somewhat bizarre dream life and in view of that admission sections of the testing procedure were designed to elicit psychotic or severely neurotic ideation. Neither was forthcoming.

“Social responses during interviews were normal for a girl of 14 to 16 years. Frequently subject exhibited the behavior and speech of a girl nearer to 18. Grief for his natural parents was expressed openly and normally.

“Physical examination showed no anomalies. Subject’s voice is somewhat higher than would be expected in a boy. His skin is unusually delicate. Facial features while young and therefore androgynous appeared feminized perhaps because of the use of cosmetics, shaping of eyebrows and hair style.

“Adoptive mother, formerly his aunt, does not know what to make of the dreams and feels guilt about subject’s feminine development and her responsibility for it. She recently lost her daughter, apparently a female twin to the subject. Photos of the missing girl show a remarkable resemblance to the subject. The adoptive mother also lost her brother on military duty who was the subject’s father.

“On the other hand subject’s assistance to the adoptive mother in her business is described as phenomenal, subject having learned care and preparation of women’s apparel, both outer and intimate, and related fabrics within a remarkably short time. He has worked in other settings much in the manner of a professionally trained house manager apparently in a satisfactory manner.

“Subject displayed little interest in male-oriented activities throughout the interviews and considerable excitement, knowledge and practice about girls’ and women's’ interests.

“Etiology of the subject’s feminization is unknown but probably related to the loss of his parents. We conclude that the emotional trauma has triggered a latent desire to bring back the subject’s mother if only metaphorically. Subject’s dreams are interpreted as a symbolic way to make his feminization self-acceptable.

“Recommendations:

“Examining staff feel little would be accomplished by attempting to reverse subject’s current personality trend. Attempts to do so would likely result in psychological and emotional damage to both subject and adoptive mother. In view of the information assembled the study team recommends encouraging the subject’s feminine development.

“If both agree, estrogen and progesterone therapy shall be instituted immediately at extremely low experimental levels. Depending on results medication may be increased to levels common to girls of his age. Such a procedure would begin to match subject’s physical development with that of his personality. While such courses of treatment are normally contraindicated for children under the age of 16 there was no objection by any staff to initiating such an experiment.

“Full clinical evaluations shall be conducted monthly for at least three months to review the effects on subject and monitor his/her social development. A long term follow-up schedule will be developed after 90 days. Eventual goal should be sex reassignment surgery, date to be determined after at least one year of subject living and presenting himself successfully in public as a female, and in this case probably much longer, barring, of course, any contraindications .”

After reviewing the report with Linda and Darlene Dr Gardner urged them to begin. “Therapy consists of taking the prescription as ordered. Darlene will feel nauseous for about a week and then normal after that. In a few weeks time we think his development processes will shift from that of a young male to that of a female. We can see no reason to delay the procedure. Next month’s appointment will tell us how things are working and we can terminate the procedure any time. But the big question which we have asked several times is “Do you want to go through with it?”

All eyes were on Darlene. He spoke unhesitatingly - “Yes, I want to try it and see what happens.”

With no further coments from either Linda or Darlene Linda was told to call anytime if she had questions or if she noticed anything odd. Dr. Gardner then looked at Darlene and said “You will soon start to look like your mom.” Darlene blushed and turned his face away.

Linda’s spirits were rising as they stopped at the pharmacy. At long last somebody else was sharing the burden of Darlene’s problem. When he came down to breakfast the following day he saw the first pills sitting next to his bowl of oatmeal.

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To Be Continued...