Tuesday, February 23, 2010

On Toys and Stereotypes

"When I grow up,
I'll be stable.
When I grow up,
I'll turn the tables."
 -- Garbage, When I Grow Up

The video in the previous post got me thinking about my own childhood.

Listening to other trans women's stories, there are a lot of themes that come up time and time again. One of those is that many knew from a very young age that they were female. That they always wanted to play with dolls. That they hated their genitalia. That they just... knew.

To some extent, I envy those people, because I had no idea.

Some of my earliest memories are of toys, but not dolls. Oh sure, we had a Teddy Ruxpin. I had a stuffed rabbit pillow that I took everywhere for a while. My sisters had gobs of stuffed animals, My Little Ponies, and Cabbage Patch dolls, which were certainly interesting, but I was drawn to something else completely.

I liked Domino Rally, Legos, K'Nex, and Lincoln Logs. I liked to make things, I liked to invent. I liked Intellivisions and computers and Game Boys. I taught myself to program text adventures in qbasic when I was 9, a dot matrix printer is one of my favorite sounds, and I still ask for Lego sets for Christmas and Birthdays.

It took me a long time to realize and accept it, but these things do not mean that I must be male. Sure, for many women-- trans or not-- playing with dolls was an expression of their girlhood, but many other women played with Legos. And they are still women.

I've always had gender issues swirling around in my brain, but as a little kid, I don't think I fully grasped the meanings and consequences of gender, let alone how it would affect me in the years ahead. As I started to realize the implications of the box I'd been placed in, my gut reaction was to prove to myself, and to others, that the boxes didn't exist.

I've spent so much time and energy throughout my life trying to break down stereotypes, trying to show people that gender is not what they think it is, that I couldn't see the forest for the trees. The truth is that nobody fits into the boxes of "male," "female," or "in-between," but that doesn't stop the average person from staking a claim wherever they damn well please. It wasn't until I finally admitted to myself that the boxes do exist, and that I had a right to stake my own claim wherever I wanted, that I saw where I fit in, and where I would be happiest.

Maybe if I had wanted to play with dolls, or wear dresses when I was little, I would've figured it out earlier. In the end though, I think I'm glad that I didn't. I certainly wish I had the opportunity to undo my first puberty, but I know that I would not have been ready to handle this any time before now, and I don't think I would love and appreciate being a woman nearly as much as I do today.

So now I'm curious; what were your favorite toys when you were little?

Transgender Children on the Dr Oz Show

The Dr. Oz Show recently aired this segment about trans kids. Thanks for the link, Mel!

(If you're interested, Part 2 is here.)

I'd never heard of Dr. Oz before this, but the show was surprisingly respectful and well done. I usually watch these programs and wince, for fear that the host will make the trans folks look like a sideshow.

What do you think? Is it okay to delay puberty until the child can make a more educated decision? At what age is a child old enough to start irreversible surgeries?

Friday, February 12, 2010


"But there never seems to be enough time,
To do the things you want to do,
Once you find them.
I've looked around enough to know,
That you're the one I want to go
Through time with."
-- Jim Croce, Time in a Bottle

Today, Erin and I are officially engaged.

I haven't talked much about Erin here in the past, mostly because I didn't feel comfortable putting her on the spot. That sort of thinking is honestly silly, since she agreed without hesitation to stay with me through transition, and has never been ashamed of me. I just tend to feel like she doesn't know what she's gotten herself into, like I have to protect her from the prejudices of the real world, and sometimes I forget that all too often she's the one protecting me.

Four years ago, I saw Erin's profile on MySpace, and was attracted by three things: her gorgeous picture, her nerdiness, and the word "androgyny." I told our mutual friend that I thought Erin was cute, we began talking, and the rest is history.

I won't lie and say that we haven't fought from time to time, or that our relationship has never been rocky, but I believe one major thing has held it together: trust. I have never in my life felt as though I could trust another human as much as I trust her. She has integrity, of a type that I never thought I would find.

Erin was the first person I came out to, about 14 months ago, and though it was hard for her to accept at first, she has always supported me. We've talked about marriage many times over the last few years, but I have a major fear of permanence, and knew that we didn't communicate as well as we should. Over the last year, we've been forced to work together and support eachother in entirely new ways; out of necessity, our communication skills have grown, and we have become closer than ever.

With our relationship becoming stronger every day, I realized that the only excuse I had left was my fear. If there is one thing that my transition has taught me, it's that the things I'm most afraid of can also be the most worthwhile, as long as I'm willing to give them all the effort and energy they deserve.

This realization, along with the fact that we won't be able to legally marry after I change my legal gender, placed an urgency on the subject. A few weeks ago, we again started talking about marriage, about who would propose to who, about how we should go about it. Last week, we made plans to go to the jewelry store together. Later, I found out that Erin had been preparing a romantic proposal with a Ring Pop, to be replaced at a later date, and I almost wish she would have gone through with it; I would've bawled. ;)

Last Saturday, we picked out matching solitaire diamond rings, then held our breath for the next five days, as we waited for them to be assembled. Today, the rings were finally finished, and we "made it official."

As an aside, the person that helped us at Shane Co. was great. Being a transgender woman, in a "lesbian" relationship, with a low budget, and living in Salt Lake City can be a scary combination sometimes, but he was completely professional. He listened to what we wanted, he gave us options without trying to upsell us, and he never once acted like anything was abnormal or out of place.

The rings are beautiful, simple, and effective. The glint catches my eye from time to time, and makes me smile uncontrollably. We haven't set a date for the wedding yet, but we're discussing it, and it probably won't be that far off. Thanks to everyone who has congratulated us so far, it means a lot to have the support of so many friends and family!

Most of all, thanks Erin, for loving me unconditionally, and wanting to grow old with me as badly as I want to grow old with you.

Friday, February 5, 2010

The Standard Process and Substandard Care

"One pill makes you larger,
And one pill makes you small,
And the ones that Mother gives you,
Don't do anything at all."
-- Jefferson Airplane, White Rabbit

I've been on hormones for a bit over six months now (wooh-hooh!), and you aren't taking them away from me. Ever. Unless I run out, and my dumb doctor and pharmacy can't coordinate to save their lives. Ugh.

For those that don't know the process, maybe I should start with the basics. Transsexualism is interesting in that it has both psychological and physical sides to it, maybe we'll get in to that more at another time. Decades ago, many tried "curing" it psychologically, which usually turned out badly. Nowadays, it's generally accepted that it's much more healthy to treat the body to match the mind, rather than the other way 'round. Sure, you run a few minor health risks, but a lot less people are killing themselves.

Eventually, the medical community adopted a semi-standard set of treatment guidelines, which are called the WPATH-SOC (World Professional Association for Transgender Heath - Standards of Care), formerly the HBIGDA-SOC (Harry Benjamin International Gender Dysphoria Association - Standards of Care, after a German doctor who did a lot of work to help transsexuals in San Francisco in the 50s and 60s).

The SOC has a lot of good information in it, but the main effect it has is to limit most physical treatment to those who have gone through psychological counseling and received a letter of recommendation for treatment. For hormones, usually a therapist will require three months of counseling before giving you "the letter," and for major surgeries, a year of being "full time" (living as your preferred gender socially, usually including work and/or school).

This makes sense on some levels, because it limits treatment to those who are serious and ready, but it also causes a lot of problems. Some people don't have money for therapy, especially since most insurance companies have specific exclusions for Gender Identity Disorder in their policies. Some people are perfectly well adjusted, and feel they shouldn't be forced to undergo mental therapy for something they've already figured out. Finally, some therapists are just bad, and either ignore the SOC completely, or get a gatekeeper complex and go on power trips, withholding letters and making trans people jump through unnecessary hoops.

Without the SOC, support from the medical community would probably be a lot harder to find, so I think of the Standards as a necessary evil, though it would be great for us to work out a more ideal solution some day.

Personally, I didn't mind starting with some therapy. The cost thing sucks, but my therapist is awesome. Since I am relatively well adjusted, I only went in every couple of weeks until the three month marker, when she gave me the hormones letter, and now once a month.

I took the letter to the endocrinologist she recommended, who first requested blood tests to make sure giving me hormones was safe. She then gave me a prescription for six months, with a plan to do follow up work before renewing at six months.

A couple of weeks before the six month marker, I had an appointment with my doctor, who gave me instructions to:
1. - Get new blood work done.
B. - Leave a message on her answering machine, telling her when to call me so that we could discuss the results.
Three. - Have my pharmacy fax a prescription refill request to her.

By the way, she also mistook me for a FtM at first, asked if I'd had a pap smear done, and received confused looks in response. I'm still not sure what to take away from this one besides a good laugh.

I went to IHC to get my labs done, so that I could at least have that covered by insurance. The next week, I left a message giving the doc a few days of wide open time in which to call back. No call.

I asked my pharmacy to send the refill request, and I left another message with another wide open time frame. No call.

I ran out of pills, so I called my pharmacy to check on the status of the request, to which they replied, "She declined it, because she wants to discuss your labs." SO DO I!

I left a third message, and a few days later she finally called me back, but I missed the call because I'd gotten sick. She leaves a message that says "Have the pharmacy fax over another request, and here's my pager number."

I have the pharmacy send it again, and leave a message on the pager. Two days later, on Saturday of all days, she calls me again. "Your labs look fine, I'll approve the fax request, but I haven't received it." Ok, ok, ok, I know you probably couldn't tell me about the labs in a message because of patient confidentiality and all that, but couldn't you approve the request, and then mail the results to me? That is, if you can't be bothered to do your job and call me.

And what's this about not receiving the fax? I confirm with the pharmacy that they have the right number, they send it a third time, and finally get a response. My spiro is renewed for five months, and my estradiol for one month. Wait, what!? The pharmacy says they'll call the doc to work it out. "Good luck with that!" I say, but by some miracle, they fixed it that evening, and both are now for five months.

I'm still confused as to why five, instead of six, but I don't care anymore. Once this is up, I'm likely finding a new doctor anyway.