Saturday, 4 January 2014

Detransitioning

Detransitioning is the process whereby someone post sex reassignment surgery, living as the opposite sex, regrets their decision, and returns to their original sex. It's hard to know how common it is for sure, since reports vary widely. Wikipedia reports a 2009 review article reporting it may be as high as 8%. For some in the trans world, it's an uncomfortable subject.

The oldest example may be Tiresias, a mythical blind Greek prophet. The story goes that he was changed into a woman by Hera as punishment for striking two copulating snakes with his staff. Tiresias's powers of prophecy were unaffected, and she lived successfully as a woman, including marrying and having children, before being turned back into a man after the (mythologically significant) seven years.

But mythology is all very well. What about reality?

Samantha Kane
Born in 1950 in Iraq, Sam Hashimi was always different as a boy. When he could, he dressed in girls' clothes, and even had sex with other boys. He moved to the UK at the age of 16, and grew up to become very successful. He married a woman in 1984 and had two children. His business thrived and he became a millionaire.

He announced his gender dysphoria to his wife, and she soon divorced him. He went on to spent £100,000 on a series of operations to make him into Samantha Kane, culminating in sex-reassignment surgery in 1987. Samantha Kane was glamorous and attractive (the "ultimate male fantasy"), and enoyed a jet-set lifestyle as an interior designer in London and Spain.

However, after a few years Samantha began to regret her decision to transition. She disliked the way oestrogen made her feel emotional and moody. No matter how feminine she looked, she felt she was merely playing a role.
Kane: In fact, I found being a woman rather shallow and limiting. So much depends on your appearance, at the expense of everything else. I wasn't interested in shopping. My female friends would spend hours shopping for clothes, trying on different outfits. But having been a man I knew exactly what would suit me and appeal to men. I could walk into a shop and be out again in five minutes with the right dress. Nor have I ever been interested in celebrity magazines or the things that interest other women, but when I tried to talk to men about blokey things they didn't take me seriously.
Samantha Kane was engaged to a wealthy property owner, but the relationship collapsed, ostensibly because he did not consider her to be a "real woman".

So in 2004, Kane spent a large sum of money on further surgery, and returned to being a male, Charles Kane. He has reconciled with his son, and has found a new, female partner, Victoria. You can read a 2010 interview with the couple here.
Kane: I feel very philosophical, rather than bitter about what happened to me. Based on my own experiences, I believe sex-change operations should not be allowed, and certainly not on the NHS. People who think they are a woman trapped in a male body are, in my opinion, completely deluded. I certainly was. I needed counselling, not a sex-change operation. In many ways I see myself a victim of the medical profession.
Ria Cooper
Kane's story is not unique. Ria Cooper, the UK's youngest sex-change patient, was accepted for transition at the age of 17, but after less than a year, came to regret the decision. He has stopped the hormone treatment, and cancelled the sex-reassignment surgery. He says he suffered such torment living as a woman that he tried to take his own life twice. Currently Cooper sees his identity as a "trendy gay man". Somewhat disturbingly, the newspaper article suggests he is going to pursue a career in the forces. I predict it won't go well if he does. (Ironically, Cooper's birth name is Bradley).

Here is an articulate and powerful account of one person's detransition. The author is himself a doctor.
If I could only go back to the day before my surgery in March of 2005 -- I would run from that surgeon’s knife. I have lived and worked as a surgically altered man trying to play the part of a woman for six years. I spared no expense at trying to make it work. In fact, I spent an estimated $250,000 on various surgeries, and probably at least that amount in clothing and accessories. I took estrogen in every conceivable form. In return, I lost my lucrative job, my family, my social standing, and vital body parts. All for the sake of being true to myself—how tragically laughable.
It's well worth reading that essay all the way through; the bitterness is palpable.

When I started researching this article, I found much more than I expected to on this subject. As sometimes happens, this subject was intended to be a footnote to a different post, and has become a whole post by itself.

Many people who have detransitioned are vocal and angry, such as the author of this blog. There are support groups out there, such as this one. What strikes me about Kane is that, although he admits transitioning was a mistake, and asserts he is not bitter, he has come to think that surgical transitioning should never be permitted; that instead people should be counselled. What further strikes me is that he did not change back from Samantha Kane to Sam Hashimi, but instead into somebody new, Charles Kane, keeping that surname. Does this imply that his original dysphoria wasn't with his gender, but perhaps with his persona? I cannot possibly say.

Some commentators on the blogosphere have suggested that Kane did not spend enough time getting to know what it means to be a woman; that if he had, he would have found real contentment, instead of seeking to detransition. And it is absolutely certain that transition is an enormous life event; a rebirth, a renewal of you as a person, which must create enormous emotional, as well as physical, stress. I completely understand people who think: have I really done the right thing? Am I going to regret this? (I felt the same the last two times I bought a house!) On the other hand, I have it in their own words, and I believe that both of these people think that transitioning was ultimately wrong for them, and it looks to me like both of them gave it their very best shot.

Walt Heyer
Some of the links and articles I have found have come from this website, SexChangeRegret, which is maintained by Walt Heyer, a man who transitioned and later detransitioned. Heyer has written books about this subject, and also keeps a blog here. Heyer has become an advocate against sex reassignment surgery, and argues against it on television and in print.

On the other hand, there is a wonderfully balanced discussion here on this blog, Third Sex. I commend you to read the whole article, which is sensible, insightful and sympathetic. Diana writes:
Detransition is not bad, or inherently negative. If someone is detransitioning because they made a terrible mistake, that is obviously horrible, and I wish that person the best for their mental, physical, and spiritual health. But it seems to me that many others experience detransition as a more fluid change in their gender identity. Perhaps it is not common, but I do believe that gender is varied and that as people we are constantly changing. The idea that one transitions to the other sex today, never to traverse the bounds of gender again - is absurd.
The reality is that some people detransition. And I think a lot of us are scared that we could do that one day, and that this decision is wrong for us, too. The easiest way to combat that insecurity is to look at it in the face, and answer the question yourself, today. Personally, I had to address where that insecurity came from. Was it indeed from a part of myself that knew the real truth about who/what I was? Rather than denying the existance of detransition and writing those who detransition off as anything negative - we ought to acknowledge and accept this experience. Our own realities are not validated or invalidated by that of someone else. My transition is not harmed or hindered by anyone. I am in control of where I take my body, and why.
For me, I think what this subject boils down to is this: what did Sam Hashimi, and the anonymous writer above, tell their doctors before the surgery? And how could those doctors be expected to differentiate them (educated, articulate, informed) from others, for whom transition is the right choice?

I believe surgical and hormonal transition is the right choice for some people. But I don't believe it is for everyone.

If we take a group of men who request sex change, a line needs to be drawn across that group, into some people who are suitable to have it done, and some who are not. If we draw that line strictly, fewer operations will be performed. Only those who are absolutely suitable will have the surgery, and detransitions will be fewer, but some people who yearn for transition (and might be fine afterwards) will be denied it.

If we draw that line more permissively, more operations will be performed. Fewer people will be denied transition, but here is the most important point. Inevitably, some people will transition who will come to regret that decision.

There is a very important discussion to be had on exactly where that line should be drawn, and what criteria are used to judge who falls on either side of it; including how old you need to be to make the decision rationally about whether or not to try to cross it. See this article for a more detailed discussion of one way this might be handled.

I wish you all a wonderful 2014.

===

Addendum: 26th January 2014

My thanks to Laura who drew my attention to Don Ennis, who transitioned and detransitioned within a very short time, citing a case of transient global amnesia as his reason. Ennis' case has not been widely reported in the media, perhaps because he is himself a senior figure at ABC News. However, there is no shortage of scornful articles about him out there, and I must admit his excuse sounds pretty flimsy to me.

35 comments:

  1. Hi Vivienne,
    I have just discovered you wonderful blog and am looking forward to exploring every nook and cranny.
    I have read a lot of regretters stories and while I am sure there are genuine cases of those who 'fell through the cracks' it seems to me the majority knew what they were doing was possibly not the right thing but forged ahead anyway. They rarely take the blame but insist the medical profession was at fault.
    When I presented to the gender clinic in my forties, like most with AGP, the first thing I said to my psychiatrist was "I promise to be truthful" and second " I am here to be talked out of transition"
    He gently explained to me that it was not his decision but mine and his job was to assess my mental stability so that I was able to make that decision rationally. I now know what he meant and I fully agree with him.
    We read of those who go in prepared to say what the Doctor needs to hear to give permission whether it is the truth or not. Then they complain after the fact.
    Our clinic was nearly destroyed by one such person and had it not survived this attack the many true girls who have successfully transitioned to happy fulfilled lives would have been stranded and helpless on their own.
    Thank you for your wonderful post.
    Jan.

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    1. Hi Jan,

      Many thanks for posting, and I look forward to your comments on the articles in my archive.

      I agree that some people can tell the doctors all the right things in order to secure transition for themselves. I am certain that both Sam Hashimi and the anonymous commenter above did exactly that.

      Had the doctors refused their transition request, they would no doubt be as bitter about that as they are now that they have detransitioned (although each was wealthy enough that they could have made it happen regardless). Hashimi/ Kane is blaming his doctors, which I think seems very unfair (although I don't think the anonymous person is blaming anyone except himself).

      I am glad I am not involved in making any of these decisions! Your psychiatrist sounds excellent, but, if I may say so, your own mindset going in there was ideal for the conversation you were about to have.

      Kind regards,

      Vivienne.

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  2. Detransition does not always involve regret, something the medical profession intentionally turns a blind eye to. There are quite many transgender people who are forced to transition because it is the only way they can access the needed "sex change" surgery that is otherwise denied to them. They want/need the physical change but do not want/need the social change. As soon as surgery is complete they change back socially, and that was the plan and the intention all along. In my experience (San Francisco) this is quite common among so-called FTM people who wish to present in the new sex (male) at work but the old sex (female, lesbian) outside of work.

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    1. Hi Henry,

      Thanks for your very interesting comment, which suggests a very different perspective. It opens a whole new suite of questions. Why would someone want the physical change but not the social change?

      And surely a FtM could present quite successfully as a male at work (after hormones, etc) without needing actual surgery? I wrote a blog post which included several women who lived all their lives as men without (basically) anyone suspecting, including their wives.

      http://bluestockingblue.blogspot.co.nz/2012/10/women-who-crossdress.html

      Please read it and let me know your thoughts. Different perspectives are always very welcome.

      Vivienne.

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    2. Why would they want a physical change?
      Because they are transgender, I don't know that there is any better reason, it is how they see themselves, at least how others see them. Man at work and lesbian at home works well for some.

      As to presenting or passing, an XX adult with an average bust is going to find it quite difficult not to be seen as a bearded lady at work. If you have a devel0oped bust then binding all day hurts darn it, top surgery is a must.

      As the the girls, I'm guessing it is fear of being exposed as a she-male. Just because they can't pass at work doesn't mean they don't want to be female with their lover. I'm guessing.

      Surgery and hormones without psychiatry, male in the workplace and female at home, for both FTM and MTF works well for many.

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    3. Hi Henry,

      I can see people wanting surgery because of how they see themselves, but not because it's how others see them.

      I can understand having top surgery performed, but to me this is analogous to MtFs who have breast implants done. It's not as irreversible as genital reassignment surgery. (But why not just be a butch lesbian at work as well as home?)

      I can also understand the impatience of some trans people with psychiatrists, who may seem unnecessarily obstructive with respect to access to surgery or hormones. On the other hand, I am on the side of the docs here. I think they need to make sure people can function in their new role, and be sure it's what they want, before going ahead.

      Vivienne.

      Man at work and woman at home does, I guess, work well for many.

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    4. >> I think they need to make sure people can function in their new role, and be sure it's what they want, before going ahead.

      That is a direct cause of detransition. People have to go through so-called transition or RLE in order to access surgery. As soon as surgery is complete the transition is undone. But the psychiatrists require that it be done (and it's hard but not impossible to circumvent that) hence the stupid and wasteful transition-detransition when it would have been preferred to do neither. On the other hand fooling psychiatrists is dead easy, they are among the most gullible people in the word.

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    5. Hi Henry,

      That may be because psychiatrists operate from a default position that their patients are being honest with them in the hope that they can help them.

      Vivienne.

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    6. Physicians have a duty of candor to their patients. Which duty they frequently (and illegally) flout whenever they think non-candor is better medicine. There is no reciprocal duty; patients are not medical experts and are free to say whatever the patient thinks is good medicine. As a practical matter, anyone seeking surgery through the WPATH SOC had better tell the psychiatrists what they want to hear or risk being denied. If what the psychiatrists want to hear just happens to coincide with what is actually the truth then so much the better.

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    7. Hi Henry,

      Physicians do have a duty of candour to their patients, but I am not sure there is evidence that they flout it frequently, or just when it suits them. I do accept that some physicians are more comfortable being candid than others.

      I disagree that there is no reciprocal duty. I believe that people have a moral duty to be truthful, not just when seeing the doctor, but whatever the nature of the interaction. I don't simply accept that it's OK for people to tell lies to get what they want.

      The very existence of people telling lies to get transition is only likely to make doctors more cautious in future; in other words, every person who gets away with it makes it that little bit harder for everyone who comes behind them.

      Vivienne.

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    8. Whether there is a moral duty of candour (love your old world spelling) depends on ones moral code. It is a matter of religion, not law or social life.

      There is a legal duty of candour by physicians. There is no reciprocal legal duty of candour on behalf of patients. Even if you stretch the common law principle of good faith and fair dealing it does not extend to patient candour if a medical patient has a good faith belief that their (arguably deceptive) position constitutes good medicine solely in the patient's own medical view. Unless the patient is himself or herself also a physician.

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  3. Sadly, my first reaction to the article was "How on earth did they come up with the money to have the surgery once, let alone twice?" I have to save up for months just to get a new pair of glasses, and ordering a new dress from Woman Within is like an early birthday for me. *sigh* Must be nice...

    But seriously, I see so much of the "fantasy is better than reality" problem in SRS. People get this idealized fantasy of what it would be like to be a woman and the only thing holding them back is that I'm not the only one who doesn't have that kind of cash to throw around.

    It's also a good rule of thumb for identifying fetishists and/or autogynephiliacs -- they go on and on about how much pleasure they'll derive from having their own full sized breasts. Really, is that what you think being a woman is all about?

    Oh well. I have a lot of weird issues that arise from the crossdressing, but at least that's not a "cross" (ha ha) I have to bear. I'm very happy being a man and I never want to change that.

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    1. I deliberately chose those two examples, because it was clear that both Kane and the anonymous doctor had the resources to take transition all the way. Otherwise people might have said: well, I'd never be happy as a woman without my own boobs. Well, I might have boobs, but I'd never be happy without full reassignment surgery. Well, I might have boobs and a vagina, but I would never be happy unless I could buy whatever fabulous shoes and jewellery I wanted. Those two individuals were wealthy enough to have everything, including the glamorous lifestyle to go with it.

      I agree with you that I believe that some transsexuals find that the reality of living post-transition isn't quite what they expected. I think that's one reason why I am quite supportive of the Real Life Test. For anyone, transition must be a phenomenally stressful experience, which could understandably cause emotional problems which take a long time to work through.

      Vivienne.

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  4. Hi Vivienne,

    I have always been of the mind that being transgender is as as much about gender as it is about self esteem. So, I can't help but wonder if a decision to de-transition is the result of a person's self esteem expectations going unfilled after transition. In other words, going from one gender to the other didn't make that individual feel any better about himself.

    I have not transitioned but I know that dressing as a woman did not enhance my self esteem. In fact, I don't believe I would be able to function in public as well as I do dressed as a woman without the positive level of self esteem I possess innately. I can't help but think that there is a similar correlation to transsexuals that make the decision to transition, and for them, it may be worse because they cannot go back. So, if someone has self esteem issues to begin with and those issues remain or they get worse after transition, I can see where regret would certainly set in.

    In my humble opinion, I think that when evaluating individuals regarding their suitability for successful transition, clinicians need to focus as much on the individual's self esteem and self image issues as their gender issues. I think a positive self image and a high level of self esteem are both critical factors to transitioning successfully and unfortunately transition alone is not going to improve those factors.

    Sally Stone

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    1. Hi Sally,

      Many thanks for your insightful post.

      I wholly agree with you. I think that some transgender people feel terribly unhappy, and they may come to think: if only I could transition, everything would be OK.

      I also think many transgendered people are also carrying a lot of emotional pain from the very fact of living as a transgendered person in a hostile environment. It is very hard for such a person to achieve a positive self-image before transition, but managing this is likely to cause them to have a positive self-image afterwards. This is the tone of the points put forward by Diana in the main blog post.

      Put bluntly, profound emotional suffering cannot be put right with a scalpel.

      Vivienne.

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  5. Excellent post, very interesting to read, and seems like you did some good research and looking around on the topic. I think it's an important topic to bring to light in the blogging world, in the conversations about transgender issues, SRS, etc. While your post is about the hard facts of these people's experiences, and not really so much about making an argument for or against SRS, it is good for all of us to know the truth about some individuals like this. For those struggling with gender dysphoria and thinking about SRS and living as the opposite sex, it's good for them to know these stories are out there, not just the stories of people who speak of how content they are with the decision.

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    1. Hi Thorin. Thanks for posting your comments. Vivienne.

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  6. Hi Viviene-Its Molly Thomas. I'm not actually Anonymous but I don't seem to fit into any of your boxes for attribution.

    Interesting post. I really appreciate the research and thought you put into your blog as well as the willingness to entertain different points of view. Below is something I posted on the TG Woman site we belong to. I am truly looking forward to exchanging views with you over the coming months.
    *****
    Many transwomen I have come to know whether pre, post or nonOp have related a similar theme: That as their transition progressed their close women friends have remarked that they were just hiding something. Or as one woman said it so well "Honey, you were never really a guy." While they looked like men and tried so hard to act in stereotypical male ways, it never really worked and only when they shed the mask and started presenting as a female did all the pieces start to fall into place. For them transition was a natural progression, not easy, but natural.

    Not everyone has ended up having SRS but everyone who did is very happy they took that final step. Not because it made any difference to the rest of the world because only a chosen few get to see the results of the surgery or even know that it was even performed. Rather it was a final affirmation of their transition and made them feel complete. That said, not every transwoman needs that final step nor is it always medically possible.

    As to detransitioning-every population will have its anomalies. It is human nature to make mistakes, especially with something as inherently complex and difficult as gender. Living FT helps but doesn't assure success. Even great counseling prior to surgery doesn't assure success (and finding great counseling isn't easy). So many other factors go into a successful transition including being able to find work, establish relationships, find love and acceptance, that it can be overwhelming when it doesn't workout the way a person hopes. Good counseling can warn off a person who is just unrealistic or has a fetish but even then, if someone really wants surgery there is a doctor somewhere in the world who will do it, consequences be damned.

    Sadly, that old axiom that you don't know until you know applies here. You can only guess what full transition means. Living FT is like practicing a sport and but it isn't game day (trite male sports analogy but women play sports too). You don't know what it means to be fully transitioned until you commit to it and live it, with all of its ups, downs and unexpected twists and turns (including having an insensitive guy say you aren't a real woman-or is insensitive and guy redundant? Not always but sadly too often for a transwoman).

    But when its right it is very right and to foreclose that option to a transwoman who needs that final step for closure and affirmation is as bad as denying hormones as a first step in her journey or in my case to keep my brain from making me crazed. These are all terribly personal decisions and in the end only the individual, her therapist and surgeon can make them. It is elective surgery after all.

    Molly

    PS I would note that angry bloggers can often drown out the successful stories because so many successful transitions don't hop online and blog about how wonderful life is. Often it isn't wonderful-its just life. But it is genuine for that person and that makes the ups and downs that come with changing gender OK.

    Note of full disclosure-I am dual gendered. I take hormones, they help keep me sane. But it is unlikely I will ever transition. Most of my friends in the community are in some stage of transition but certainly not all. I spend way too much time presenting male because of work and family but that is changing. Now if I could just drop about 20lbs. But isn't that what most women say (fill in your own number) this time of year. M.

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    1. Hi Molly,

      Many thanks for posting your perspective, and your insights.

      I think it must be very affirming for transwomen to be told "you were never a guy" by their women friends. But what I want to know is, what did their male friends say?

      I am certain that many people having undergone SRS think it is the right decision and go on to lead fulfilling lives. The fact that there have been some disasters doesn't change that. What it says to me is that the phenomenon of detransition shows that the medical profession is right to be cautious and stringent about whom it performs SRS upon. I think there is pressure to fast-track the process, and I think this is very unwise.

      What's also interesting is how several commentators have remarked that they don't need full SRS to feel, live and function as a woman. Some people have said they enjoy having access to both male and female roles. Some people say they live full-time and take hormones, but haven't had surgery. All of this is very powerful and interesting to me.

      Do please browse the archive and comment on anything you find!

      Kind regards,

      Vivienne.

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    2. After reading the blog and all the comments, something struck that maybe we need to talk about: stereotypes of gender. The fact that many people tell a transwoman that she was never really a man. Perhaps it is our society's almost too rigid. Our expectations and definitions of what a woman or a man is way to limiting. We tell our sons "not to throw like a girl" or "Don't be a sissy." But if a child who is male at birth is not sports inclined or is emotional why can't we celebrate his unique traits? If we did this perhaps people who don't fit into the "norm" wouldn't have to worry anymore or compare themselves to someone else because they grew up knowing who they were and accepting themselves. Perhaps then less people would go for SRS and then detransition.

      Shaun
      PS I am a pre-op transman

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    3. Hi Shaun,

      Many thanks for dropping by to post your comments. I'm delighted to hear a transman's perspective.

      I can't tell you how often as a child I was told to be a "big brave soldier". I wasn't one then, and I am not one now! I agree with you that if boys were permitted a wider range of emotional expression, that gender identity disorders would be much less common.

      I think the problem is less severe for girls. A "boyish" girl is seen as a tomboy, which is generally considered laudable in Western culture (especially as those of us who read Enid Blyton as children know well enough). However, I would be interested in your take on this.

      I would also be very interested in your insights on this other blog post I wrote: http://bluestockingblue.blogspot.co.nz/2012/10/women-who-crossdress.html

      Kind regards,

      Vivienne.

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    4. I am not sure what you mean by fast-track. The fastest track I've personal knowledge of was 27 months from declaration of true gender to date of surgery (and she is doing just fine). Electrolysis alone can take over 2 years and frequently longer. Then there is FFS. And keep in mind that assumes financial resources. This process isn't cheap and for the most part, at least in the US, isn't covered by insurance. So for many gals, just paying for hormones and some clothes is a big deal.

      Maybe some of the individuals who decide to "detransition" can be weeded out with more stringent standards but my guess is that if they went through a medically supervised course of transition they had more than enough therapy to tip someone off if they were being dishonest with themselves. Sad truth is humans make mistakes in all sorts of areas and this is just one of them. We can even be convincing liars to ourselves. If the patient isn't being honest and forthright, how can anything be changed? Or what if things actually do change postOp in unforeseen ways? And in this world, money will buy anything including GRS with less that critical scrutiny if that is what the patient wants.

      I do agree that transwomen have "transitioned" with and without GRS. That is why there is a gender spectrum, not a gender binary or a transgender binary or even a triad. But as a practical matter we just aren't talking about that large of a population on either the transition or especially the detransition side of things. But I can assure you detransition is a very, very small number of the total of all F2M transwomen who do have GRS. While there are no statistics I am aware of I suspect that worldwide the number of transwomen who have had GRS numbers in the tens of thousands while detransitioners perhaps in the hundreds to a thousand. Not statistically irrelevant but pales in comparison to the successful surgeries.

      Personally, I think this conversation and its focus genital surgery is an interesting but largely irrelevant discussion for the broader trans community. Rousing discussion (even if uninformed from some corners), which sparks debate but in the end doesn't really speak to the bread and butter issues so many trans people confront.

      There is a great clip of an interview of Laverne Cox-Orange is the New Black on Showtime- by Katie Couric (who quite a botch of things) where she speaks eloquently to the whole misguided focus on genital surgery and being a transwoman. See http://katiecouric.com/videos/orange-is-the-new-black-laverne-cox/

      Her comments speak to transwomen who are out and open (or even not so out and open) whether or not they transition. These are the bread and butter issues.

      For those of us who are not in full blown transition mode or not so out and open there are a whole other range of other issues which center on relationships and the question of why. Why are we this way, why can't we stop, why do we purge, why do we feel ashamed, why guilt. Followed by HOW do we deal with all of the the WHYs.

      Ops-this is turning into a rant. More later.

      Molly



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    5. Hi Molly,

      Don't worry about ranting! It's perfectly fine!

      My comment about "fast-tracking" is because I understand that groups such as "Press for Change" in the UK are attempting to reduce or eliminate the Real Life Test, as not necessary.

      It's absolutely true that people make mistakes. I am certain we will never eliminate detransition. I am sure you are right that people who detransition are a small subset of people who transition.

      On the other hand, it is worth having the discussion. I think that some people hold out for transition because "it will make everything OK" when in fact, you need to make everything OK before you transition.

      The purpose of this blog is to answer as many of the Whys and Hows for myself as possible. That's why I welcome everyone's perspective. I am finding some answers, but I am aware that not everyone agrees with the answers I have found. I think we each need to find those answers for ourselves.

      I watched the Laverne Cox clip without knowing either her or the show she is on (or even the show she was interviewed on!). However, the clip has gone a bit viral. I don't think she was especially eloquent. I thought she sort of dodged the question and started to talk about violence against trans people.

      Vivienne.

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    6. I'm not sure where you get your evidence, but UK Press for Change is basically defunct and doing nothing much these days.

      On the other hand so-called Real Life Test, Real life Experience, or the preferred WPATH term ("continuous living in a gender role that is congruent") is -
      incompatible with the Yogyakarta Principles on the Application of International Human Rights Law in relation to Sexual Orientation and Gender Identity. Which has been approvingly cited by the European Parliament. See yogyakartaprinciples.org

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    7. That was LaVerne's point. It seems like whenever there is an interview of a postOp transwoman, the subject always turns first to genitals and surgery. It is an easy interview topic and it sensationalizes the event. Jerry Springer Effect but on a more eloquent level. However, it is boring, demeaning and misses the point.

      The Katie Couric Show isn't a medical program. Its social/entertainment. LaVerne Cox had a forum to surface important issues facing transwomen and she grabbed the stage. These issues get swept under the rug all too often. Like a great politician she answered the question that was asked by answering the question she wanted to answer. Plus, I was really disappointed in how seemingly uninformed Katie Couric was in her questions. She used to be very sharp when she did hard news.

      We agree that if things aren't right going into transition, neither transition (in and of itself) and certainly GRS, will make a person's life turn around. If anything transition makes everyday life more difficult. Transition is a process that essentially has a beginning and an end and when it ends there is still a life to live. I sense you are a cautious person by nature so all these rules might appeal to you as safeguards against mistakes. To others they make absolutely no sense but the process of transition imposes its own order on things.

      Meanwhile, I do think you have done some amazing work here. I wish I had a trip to NZ planned. I was in Auckland and the South Island 10 years ago with my family for a graduation trip to Oz and NZ for my son from University. Loved the country and plan on coming back just to New Zealand in the next few years for a few weeks during your summer. We were there in early July. Skiing was awful but had fun anyhow.

      You are too beautiful to be cooped up in your house. I tell my CD friends who are still painfully closeted that their house is just a bigger closet with more doors but the most important door is the front door because that leads to the sun and wind and rest of the world. I hope you and I will have a chance to spend some girl time (and some guy time-I don't discriminate against my male self, just need better balance going forward) together when I come south.

      Molly

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    8. Hi Henry,

      Two of the founders of "Press for Change" were decorated by the Queen, which I think makes the group pretty powerful and recognised.

      However, thanks for drawing my attention to the Yogyakarta Principles, which I will read more closely when I get the chance.

      Vivienne.

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    9. Hi Molly,

      Cautious! It's practically my middle name!

      I agree that Katie Couric's questions were superficial and quite sensationalist. I thought the whole transgender thing was quite well understood by journalistic types these days, and I would have thought the questioning would be a bit more subtle and a bit less Jerry Springer.

      I would love to catch up with you if you ever make it to NZ, or as we are now calling it, "Middle Earth".

      Vivienne.

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  7. Follow-up on LaVerne Cox post. Great article in Huffington Post that sort of puts the whole interview in perspective. Here is the link.

    http://www.huffingtonpost.com/fiona-dawson/when-will-nontransgender-_b_4592439.html?utm_hp_ref=fb&src=spcomm_ref=false#sb=1443512b=facebook

    The author is a frequent contributor to Huffington Post on Gay/Lesbian/Transgender issues. She had a great analogy for the fixation of talk show hosts with genitalia and surgery when they interview a postOp transwoman. She posed the question whether it would be appropriate for someone to ask Katie Couric how her vagina was doing today? How having two children impacted its elasticity. Totally inappropriate? Sure. But transwomen get asked all the time and it takes all the air out of the room for discussions of what life is like for a transwoman and how it differs from the cisgendered women experience. That is important and a very teachable moment. Anyhow, read the article. Its well done.

    Molly

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    1. I agree this is an excellent article. However, two things cross my mind. The first is that, for quite a lot of ordinary people, Katie Couric's questions were the sort of ones that they would be looking for answers to. "You look like a very beautiful woman, but what's going on, you know... down below?"

      Katie Couric's job is only to attract viewers to her show. She will accomplish that by reaching out to the lowest common denominator.

      The second point I would make is that a lot of people get very sensitive when discussing their gender. My point would be (to both Cox and Carrera) this: if you don't want to get asked uncomfortable questions in public by an underinformed interviewer, don't agree to go on a talk show!

      Vivienne.

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  8. Hi.
    Do you know where I can watch the documentary about charles jane "make me a man again"?

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    1. Hi Sosso. I am very sorry. I don't. I had a quick search on Google, and found many sites which discuss the documentary, but none (not even YouTube) were offering it to be watched. I myself haven't seen it.

      If you do find it, please let me know, so that I can watch it myself and post a link.

      Vivienne.

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  9. I've got a number of comments:

    1) Far from being contrary to the Y' principles mentioned above, their intent is totally compatible, as in "freedom from medical abuse" would mean that the physician has a duty to do no harm. We don't let psychotic people make certain decisions, nor very young children. Similarly, we do make certain medical protocols...

    2) I totally agree with the above poster that many detransitions are the result of preplanning. During my four decades since my own transition and having observed literally hundreds of individuals in the so called "gender spectrum". I can tell of the several that I've seen detransition, most would have gladly have had SRS without RLE, but had to jump through that "hoop". On the other hand, I knew of one individual who was clearly schizophrenic, had lived pre-op for over ten years prior to SRS... and still detransitioned as his mental illness progressed. He should NEVER have received SRS or any other elective surgery, since he clearly could not be given informed consent.

    3) The concept of requiring the RLE is based on the very questionable premise that social transition will be correlated with satisfaction or even desire for SRS. As already noted, many individuals do not desire SRS, yet socially transition full time. The reverse is also true, but not allowed under the SOCs. Many individuals find a middle path of "bi-gendered" lifestyle, going to work and having a married social life with their wife as a man... yet spending time as a woman in the evenings or weekends, on retreats. We usually label such as CD/TV, etc. and deny them SRS. I find this denial to be irrational and without medical evidence to support it, given that both "late transitioning" transwomen and such "bi-gendered" individuals are both simply autogynephiles working out a reasonable accommodation to their sexuality.

    4) The RLE is in accuality a "cooling off" period.. in which one has time to reflect on whether one really needs SRS. I would recommend changing the SOC to simply require such "cooling off"... and NOT requiring one make potentially life destroying career and family announcements regarding social transition if they weren't desired in and of itself.

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    1. Hi Cloudy. Many thanks for your comments, which are interesting and thought-provoking. To take your points in order.

      (1 and 2) Agreed.

      (3) I can accept that a genetic male can live and function full-time quite successfully as a woman without SRS. The reverse is the bit which puzzles me. Someone who wants to still function (and present) as a man, but be physically a woman? I'm afraid I would really struggle to see the motivations of someone who wants to do this.

      Isn't the surgery performed on people who insist they are female on the inside, and the surgery will align their inner and outer genders correctly for them? (And isn't that what they are always saying? Make me the woman I know I am inside?) I think this is reasonable. On the other hand, what you seem to be advocating is that surgery should be permitted as a sort of lifestyle choice? I don't want to be a woman; I don't feel like a woman inside; I am quite happy being a man at work, but actually I want breasts and a vagina because I quite like the idea?

      We already have a paradigm of performing surgery on healthy people just because they want it. That surgery tends to be in the realm of cosmesis: bigger breasts, facelifts, tummy tucks. But to include SRS is taking things to a new level!

      (4) I can see how the RLE could function as a "cooling-off" period, but I am not in favour of performing permanent sex reassignment surgery on people just because they ask for it, and not in tandem with full social transition. Psychological problems cannot be put right with surgery. Surgery is (IMO) just one facet of a multi-disciplinary approach to the treatment of transsexual people, and for me, that needs to come as a package, not simply a pick-and-mix.

      Vivienne.

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    2. It's completely possible that a trans person would have strong dysphoria around their genitals yet choose to live as a man for practical reasons (job, family). Also, not everyone has strong dysphoria around their social role, and presentation may be unimportant to them, or they may not be inclined towards a feminine gender expression in the first place, and not every trans person has a need or desire to pass. Not every male-assigned trans person is a stereotypically feminine binary trans woman. A genderqueer androgynous trans butch dyke who has no problem being gendered male can still desire a vagina.

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    3. Thanks for posting. It would be helpful if you would give some sort of name to differentiate you from other anonymous posters.

      While I think I agree with your fundamental point, that "not every male-assigned trans person is a stereotypically feminine binary trans woman", I can't help thinking that someone who requires five adjectives to describe their gender ("genderqueer androgynous trans butch dyke") is just being deliberately recalcitrant.

      I have written widely about both these topics elsewhere on this blog.

      Vivienne.

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