And yet… if I had been born with the body that matched my mind, I wouldn’t have my son. Other children yes, but not him.
So all in all, 40 years of Hell was worth it. I’m glad those days are over though, no matter what the difficulties transition has caused.

I better add a disclaimer: I’m one of the weird serials. The diagnosis was changed from “undervirilised male” to “severely androgenised female” before I started a course of treatment for inducing transition, as the result of the natural changes. The medical team had to be a bit creative with the SOC too. But psychologically, I’m so vanilla standard TS I could have been taken straight out of True Selves. Never did dress though, that would have been like putting lipstick on a pig. I looked far too male before the change.

I don’t consider it to be perverse, unnatural, and wrong. I do consider it to be deeply frustrating and would rather not have gone through it.

Or… Transsexuality For Beginners.

This is a primer for those who don’t know too much about the issue. They see weirdos and freaks, obvious nutcases who get their bodies mutilated for some perverse reason, and think they’re crazy, dangerously so. They disapprove anyway, and just based on grounds of “common sense”, I can’t blame them. It seems obvious that it goes against Nature, and for Believers, God.

But here’s the medical facts. It explains why these people do what they do.

I have to start with Intersex conditions generally, where people have bodies neither wholly male nor wholly female. It’s estimated that 1.7% of the population qualify technically, but essentially only about 1 in 1000 have problems from it. If say 1% of your cells are of the opposite sex to the majority, it probably won’t affect you.

There are hundreds of different serious Intersex conditions. Some result in ambiguous genitalia or none at all, or partial ones of both kinds. People can be Chimeras (fusion of opposite-sexed twins in the womb), Mosaics, or Kleinfelters, the latter with neither 46xy (male) nor 46xx (female) but 47xxy. Most such people are just normal men with a few anomalies in their bodies (and sterility). A few are normal but infertile men, a very few are normal fertile women.

The most disconcerting ones are the serials – those born looking like one sex, then changing to look like the other from natural causes. 5ARD and 17BHD deficiency are the most common causes, though there are others.

It can be devastating for a young woman to find out that the reason she has been unable to get pregnant is because she has no ovaries or womb, just the external genitalia. Some are even chromosomally male, they have “complete androgen insensitivity syndrome”, so look totally female, with female brains, minds, and genitalia. It’s only on an ultrasound that the differences are apparent.

Now talking about female brains and minds, there are two papers on the subject:

Zhou J.-N, Hofman M.A, Gooren L.J, Swaab D.F (1997)
A Sex Difference in the Human Brain and its Relation to Transsexuality. (PDF here)

Kruijver F.P.M, Zhou J.-N, Pool C.W., Swaab D.F. (2000)
Male-to-Female Transsexuals Have Female Neuron Numbers in a Limbic Nucleus (PDF here)

Male and Female brains differ, both on the coarse scale (BSTc layer of the hypothalamus) and fine scale (number of neurons – brain cells – in each structure). Autopsies on transsexual women, that is, women with mostly male bodies, have shown they have female pattern brains.

Note that gay men have male pattern brains though.

From ArzteZeitung this year, detailing studies using fMRT – “brain scans” of living people:

“Radiologists can now confirm what transsexuals report – that they feel “trapped in the wrong body” – on the basis of the activation of the brain when presented with erotic stimuli. There is obviously a biological correlation with the subjective feelings.”

So to say that a transsexual woman is “male” is at best a half-truth. The visible parts are. The parts that determine her personality, her gender (since we know that neither chromosomes nor external appearance is reliable), are female.

So anyone can just “say” they are Transsexual, dress up as the opposite sex, right?

Wrong.

To go through gender re-assignment – to modify the body so it fits the brain – a number of hurdles must be crossed.

The first is a full assessment over at least 3 months, sometimes years, by a qualified psych. Then and only then will a formal letter be written authorising an endocrinologist to start the process of hormonally altering the body.

After some time, usually years, enough so that the body is changed enough to look ambiguous, a period of living in the target gender is required. This is at least 1 year, often 2 or more. During this period, the patient must use the correct restroom for their target gender, and also maintain employment. If they break either condition, the period starts over again, and they may be refused treatment altogether.

That’s not the end. For a second psych, who must be a post-doctoral specialist in the area, must then review the case and provide yet another letter formally authorising surgery.

This formal procedure, a “best practice” adhered to scrupulously in the USA is at http://wpath.org/Documents2/socv6.pdf.

More data on Intersex conditions is available from the Intersex Society of North America at http://www.isna.org/ , the UK Intersex Association at http://www.ukia.co.uk/ and Organisation Intersex International http://www.intersexualite.org/English_OII/English_OII_index.html

People born with any of these congenital conditions suffer terrible stigma. Most Intersex people can and do hide their condition. Those with “serial hermaphroditism”, and those who are transsexual, cannot. They have to endure being confused with Gays, called “perverts”, and even subject to violence or arrest. But you knew that. Now you know why though.

I’ve simplified some things – for example, not *all* of a TS person’s brain is cross-gendered. To have the condition, it’s only necessary that the bit determining whether the person is a Boy or a Girl is mismatched, and the mismatch has degrees. Usually many parts of the brain are affected, but this varies between individuals. They may also have other Intersex conditions too, not just the neurology is cross-gendered. But sometimes adding details only clouds the issue.

These are Men born with feminine bodies, or Women born with masculine ones. If you think that is perverse, un-natural and wrong, well, so do they. That’s why they try to fix the situation, no matter the great cost to themselves. Though as with all Intersex conditions, it’s technically not “Un-Natural”. Like other congenital conditions, it happens to other species too. It’s as natural as Cancer.

I want to thank everyone for this really interesting and enlightening post and thread. Thank you to those of you who mostly answered questions for being so patient and sharing your personal feelings and experiences. And thank you to those of you who asked questions for asking questions I have also had. Reading this was very timely as I was just recently thinking about trans* people and realizing that there are things I don’t understand and that consequently make me uncomfortable. I wanted very much to really talk to someone about it and try to get beyond the things I didn’t understand. This post was exactly what I needed to become a much better informed and more understanding person in relation to trans* people and issues. I also intend to add Whipping Girl to my reading list. Thanks again.