Body Vs. Soul
Anne told her wife two and a half years ago. "That was the most traumatic thing," she muses. "I certainly didn't want to hurt her."
Thoughts of suicide had come, often. "Sometimes I felt like I should just kill myself rather than put them through it," she says softly. "It would be easier for people to deal with my killing myself than to deal with my being transgendered."
She never tried. Though she does remember driving down a highway and staring at an oncoming semi, thinking, "This could be over real quick."
Her wife was devastated. But she was also understanding.
"It really signaled to her the end of a lot of hopes and dreams she had for us as a couple," Anne explains. "She was very appreciative that I told her. We could have parted ways, and she never would have known."
They wed when Anne was 22 years old and stayed married for 25 years. Though their divorce became final eight months ago, they still share the same home in a Twin Cities suburb. They are still best friends. They will probably remain so, even as Anne continues to figure out who she is, at the most fundamental of levels: her gender. Hers might be a man's body, but she has always felt more like a woman.
Anne is 47 years old. She is six feet tall, weighs 200 pounds, and wears a shoulder-length honey-brown wig cut in soft layers to frame her face. Her voice is grainy and deep. There are hints of the facial and body hair she has removed. Because she is not out to all of her friends and clients, she is careful to shield information that might too closely identify her.
Anne has spent a lifetime grappling with issues of her gender identity. She remembers a day, decades ago, when she was four years old and went shopping with her mother at Dayton's in downtown Minneapolis. Anne noticed a saleswoman there, and something clicked. "I realized at that point that I wanted to grow up and be like her," says Anne.
In junior high school, she was jealous of all the girls. "That was a time when everyone was starting to grow up, develop," she says. "Their clothes were more interesting. They got to wear makeup, to do things with their hair."
But those feelings, Anne told herself, were wrong, bad, sick. A little editor grew inside her brain, continuously monitoring what she did, what she said.
To convince the world, to convince herself, in college she enrolled in a military training program run by the Marines. She stuck it out for a couple of years before she quit. She married. She became a successful commercial photographer. She and her wife didn't have children, but they settled into a home, a life. She tried to do all the things a man is supposed to do. "I pushed this down," she says. "I repressed this."
But in time, as is usually the case, the truth grew restless. It wanted recognition. It began to shove its way through the tiniest cracks. Her disposition, usually mild-mannered, became rancorous, even volatile. "I was a difficult person to be around," Anne says. "I was angry--primarily at myself, but it came off as being angry at the whole world....It didn't take much to set me off."
Friends and family, she later learned, were so perplexed by her behavior that they began to wonder what deep secret so consumed her. Perhaps she was reliving abuse from her childhood, they told her later. Maybe she was a Mafia don. Or a drug connection for a Colombian cartel.
Anne never had a great epiphany, no sudden moment of realization that pushed her to seek help. The truth had simply bubbled up, gradually, until it demanded attention--and action. Several years ago she began to look for information online. Eventually she decided she wanted to talk to someone. "I took out the phone book," she says quietly, as if reliving the nervousness. "I thought of all the words that had to do with gender, sexuality, transgender, and I went through all the words one by one."
She found the Center for Sexual Health, a clinic run through the University of Minnesota's Program in Human Sexuality (PHS). "One day in May, with great fear, I called up there," Anne begins, exhaling a long breath. "I talked to a receptionist. I was connected to a doctor. She was so comforting and so relaxed about my issues, yet took it seriously. It made me feel okay about it. Or better about it."
Soon she started individual and group therapy. She grappled with her fear of admitting the truth. To herself. To others.
Today she is more comfortable. Just a few weeks ago she told her 87-year-old mother, who was accepting and supportive, though full of questions. It's been a year and a half since she first went out publicly dressed as a woman, and it no longer scares her to express her identity. "I thought everyone would be pointing and staring," she says, remembering that terrifying first outing. "Of course, no one did. It was actually kind of no big deal."
She doesn't always dress as a woman ("It's a lot easier to mow the lawn without a wig on," she explains). But she does look forward to the day when she can live full time as a woman and forever leave "boy mode" behind.
"I feel like I'm lying," she says, describing what it's like to dress as a man now. "People don't really know me. I feel like I'm not expressing myself the way I want to express myself. Like I'm not being seen the way I want to be seen."
Even though she's traveled far from her early fear and anxiety, Anne knows that the path ahead won't be easy. Understanding her condition is, as she puts it, an amalgam of extremes--good news and bad news, highs and lows.
"I pretty much felt like I knew when I called PHS," Anne remembers, a little wistfully. "Still, there was a part of me that hoped I was wrong. When they confirmed it, it was both kind of a relief, and kind of, 'Oh rats. It's true.'"
The scientific term for the condition when the gender of the body and the gender of the mind are incongruent is gender dysphoria. According to True Selves: Understanding Transsexualism, a 1996 book by Mildred L. Brown and Chloe Ann Rounsley, it's difficult to estimate the number of people in the United States affected by gender dysphoria. The country doesn't have a centralized reporting system. But even if it did, there would always be people who went undiagnosed or remained closeted.
Nonetheless, Brown and Rounsley write, data from smaller countries in Europe indicate that one in 30,000 adult males and one in 100,000 adult females seek sex reassignment surgery--less than 0.01 percent of the population. In the United States, approximately 6,000 to 10,000 transsexuals had undergone surgery by 1988. But again, the book points out, the figures don't include people who, for whatever reason, have opted not to have surgery: "Experts say that it is reasonable to assume that there are scores of unoperated cases for every operated one."
Walter Bockting is the coordinator of Transgender Health Services at the University of Minnesota's Program in Human Sexuality. "The basic gender of being a man or a woman is very much tied to the body--genitalia and biology. For transgendered people, that's not always the case," he explains. "For most of us, those things are in sync--or sufficiently in sync. If it weren't for transgendered people, we would not have known that it's a separate dimension. Sex is not identified by a single thing."
Bockting is a slender man with a quick stride. His words are polite but guarded--perhaps in part because of the crisp accent of his native Netherlands--and he is protective of this community he's so connected with. A gay man, he notes that his firsthand knowledge of being a minority has helped him understand some of what transgendered people go through. Bockting took an interest in transgender issues while studying clinical psychology in the Netherlands in the 1980s. When a friend underwent a gender transition, Bockting wanted to understand more about it. He later came to the U of M for further training; he's been with PHS since 1988.
The University of Minnesota's first documented treatment of a transgendered person was in 1966. In 1969 the U's psychiatry department established a program to take care of transgendered patients. (It was only the second of its kind in the country.) Today it is part of a larger U effort, the Program in Human Sexuality, and is the longest continuously running university-based program dealing with transgender issues.
PHS is one of very few institutions that does research and education, as well as clinical service to help treat transgendered individuals. It provides individual and group therapy for clients, holds educational seminars to teach the public about gender and health issues, trains therapists, and performs research studies to learn about the transgendered and, by extension, the larger population.
(The program's long history is one of the reasons that the Twin Cities is considered such a safe and friendly place for the transgender community. It also helps that Minnesota is one of two states that legally protects transgendered individuals from discrimination.)
When Bockting started in the field, the idea of treatment was to help transgendered people transform, or "transition," via hormone therapy and surgery, from the sex of their birth to the sex they were more comfortable being. But that wasn't always a successful solution. While some people were able to easily "pass," or effectively look like a member of the other sex, not everyone had that privilege.
And, more important, passing sometimes effectively moved people from one closet (a transsexual who wants to transition) to another (a transsexual who has transitioned). Their pasts were still the same, and they were still different from their peers in their newly actualized gender. And nothing--not surgery, hormones, clothing, hair, or force of will--could change that.
Male-to-females, or MTFs, would never menstruate or bear children; even after surgery, they would still have their prostate, and would need to watch out for cancer. Female-to-males, or FTMs, were more likely to have chest surgery but not "lower surgery," and would still need to worry about the risks of cervical, uterine, and ovarian cancers.
Today, instead of insisting that someone be in one of only two roles, it's considered more important that they live comfortably, even if they end up somewhere in between. Of the PHS's clients, two-thirds opt for hormones, Bockting says. Only one in five opt for sex reassignment surgery.
Interestingly, he notes, far fewer FTMs opt for genital surgery. That's in part because of the size of the population (he estimates that there are three times as many MTFs as FTMs) and because the surgery itself is more invasive and more experimental, with less reliable results both aesthetically and functionally. It's also more expensive, with figures ranging from $40,000 to $70,000.
For now, at least, the fact remains that there are limits to what surgery can do. Both MTFs and FTMs need to live through something like a second puberty. They need to get to know their bodies all over again. They need to learn to act like men and women--and to assume society's roles for them. And if they succeed at that, they often discover a need to connect to a community of people who have shared the experience.
"We can only do so much in terms of physically changing someone," Bockting explains. "They need to accept and grieve the fact that they can't be born again in this lifetime."
The pronouns are extremely important. "She's a transsexual. She lives full time. He's a drag queen." Morgan O'Sullivan pauses for a moment, then explains. "The reason I say he," she says, nodding toward a petite man wearing heavy pancake makeup and a silky robe, "is because [I think] he identifies as a gay man."
O'Sullivan is standing in the upstairs lounge of the Gay 90's, a downtown Minneapolis bar. It's late Friday night and the lounge, smoky and hot, is packed with people who've come to watch the drag show. Many of them have spilled over from the Pride block party a few streets away. O'Sullivan shouts over the loudspeakers, which are disgorging the booming, crowd-pleasing strains of ABBA and Dolly Parton. She knows all about each of the performers. You see, before, she was Morgan Taylor, drag queen.
Some of these performers are drag queens, too. For the most part, that means they are gay men who dress ostentatiously in women's costumes for show. But some are transsexuals, born into one gender (male, in this case) but feeling like they belong to the other (female). Some plan to alter their bodies through hormones and possibly surgery. Some "live full time," which means they live completely as the opposite gender, though they may not undergo hormone therapy or surgery. There are nuances to the distinctions, but they all fall under the umbrella term transgender.
Morgan O'Sullivan is a striking woman. She's 36, 5-foot-11, with a pile of auburn curls atop her head, smooth skin, light eyes, and a voice that's both soft and sandpapery. She walks--or, more accurately, struts--with confidence. She had her breasts augmented last September and they are, as she puts it, "quite large": 44 DD. "But they don't look that large," she insists. "I'm big-framed."
If pressed, she will admit that she still has her penis. But she hates to be asked.
"That's always the first question," she complains. "Do you still have your penis? Are your breasts real? They're such personal questions. You wouldn't ask a genetic person."
Though she does plan on eventually having sex reassignment surgery, she's not in a rush. "Who knows where I'll be in five years? I know I won't be a man in five years. I might have a vagina. I might not. No one's going to know if I have it or not," she insists, wondering aloud why people are so fixated on it. Then, offering a coquettish little mind game: "How do you know I don't?"
In a world so eager to define gender based on anatomy, is there really any room for a place in between? And, more important, how do you get past the labels, and start focusing on the person?
O'Sullivan started the transition from male to female four years ago. It's been complicated, expensive, and painful. She's spent about $20,000 so far on laser treatments, electrolysis, hair extensions, and those breasts. Later this month she plans to have surgery to lift her brow and lower her forehead. If she wants to have the sex reassignment surgery, it will probably cost $10,000 to $15,000.
All of which is why O'Sullivan is amazed when people act as though she somehow opted to be the way she is. "Do you really think I'd choose to go this way?" she asks flatly. "It's not fun. I wish I had been born a female. It would have been a lot less painful."
And a lot less lonely. "I'd love to be in a relationship right now," she says. "Am I ever going to meet anyone?" True, that's a familiar refrain to most single people, male or female, gay, straight, or bisexual. But for transgendered people, dating and relationships are even more difficult.
She herself is drawn to masculine, heterosexual men. "Even if I did have the surgery, I'd have a vagina, but I'd always have that thrown back at me: You were born a man," O'Sullivan laments. "I wish I were attracted to women. It would be easier. Gay men aren't attracted to me. Why would they want to be with me?"
Susan Kimberly has smooth, soft skin, a blond pageboy haircut, and curves even a prim blazer and slacks don't disguise. Her chronological age is 59, but she looks at least a decade younger. She looks like a woman. But once she was a man.
Kimberly, as she puts it, was once the "world's most famous transsexual." At least in St. Paul, where, in 1983, she very publicly cast off her male identity--that of Bob Sylvester, a former city council member--and became Susan Kimberly. The attention faded somewhat while Kimberly went through lean, difficult times, without a job, without any money. But her story popped up again in December 1998 when former St. Paul Mayor Norm Coleman appointed her deputy mayor.
Despite the publicity around her transition--the barrage of questions, so prying, so often inappropriate--Kimberly's journey has been a personal one. Nearly two decades ago, when she was in her early 40s, Kimberly began the process of going from male to female. And that, she stresses, was precisely the goal at the time--both hers and the prevailing attitude of the doctors and therapists who treated gender dysphoria. The idea was to end up looking good enough to pass as a woman in society.
Even then she wasn't thrilled with the notion. She boycotted the then-mandatory makeup and modeling class. But she still believed that she would lie down on an operating table (in Trinidad, Colorado, in 1984) and simply switch from man to woman. She'd be done with it, and go on with her life in her new body.
"I never started out to be a transsexual," she says. "That wasn't my goal, it wasn't my fantasy. I thought I'd go through the transition, and no one would figure it out."
But more and more she realized that it wasn't that clear-cut. Finally, the identity of her mind and the anatomy of her body matched. Finally, there was peace. But, even after all that, she was still different.
"I realized I have no pretext anymore about being a woman. I'm a transsexual. There's no longer this magical twist and turn," she says. "We don't go from anything to anything. We come to terms with what we are.
"People are starting to get this sense, that if there's A and B, there's something in between," she suggests. "Although that's deeply unsettling for us--and the rest of the world--it's a powerful attack on the idea that there are men in the world and women in the world, and that's it.
"I don't know how many genders there are," she muses. "But there are more than two."
In other cultures and eras, transgendered people usually weren't lumped in with the other sexes. In Myanmar, for instance, they have been respected as people who transcended gender. The same has been true in certain Native American cultures. But in our society, they are often shunned. Or hated, or even killed.
"Transgendered people, no matter how hard they try to fit into one of the genders, they continue to be stigmatized," Bockting says. "Rather than be one of the two and not be accepted, they have established their own space."
As a result of their special experience, transgendered people can help us understand our own cultural beliefs. They have lived in the roles of both men and women, and their unique perspective can illuminate the way women and men interact in society.
"They have a special awareness," Bockting says. "People who are not transgendered, we often take gender for granted. We don't realize the assumptions out there. When you change roles, you become increasingly aware of the difference."
Perhaps even more important, transgendered people have lived outside of society, as something else--something other. They have destroyed the distinction of categories.
Categories have their limits. Some people fit into them, some people don't. If anything, the transgender experience breaks apart the most basic division of male and female.
Today there is more openness to the notion that a person may find comfort in one of those categories or somewhere in between. Though that evolution is significant, it doesn't necessarily mute the painful struggle transgendered people face as they try to discover who they are. It does, however, give them options.
Anne, for instance, is aware that her own journey is far from over. She plans to start hormone therapy, perhaps before summer's end. And she envisions eventually undergoing sex reassignment surgery. The standard rules for treatment mean that she must be on hormones and live full time in the role of a woman for at least a year before she can have the surgery. She's taking it at a comfortable pace, making sure that she's honest with herself about who she is and what she wants.
"I'm still not certain I'm totally there yet," she says. "There are still some days when I still don't know what I'm doing. I'm not trying to act one way or another. I'm just trying to be me."
On a sultry night in late June, Anne hung out with a group of friends at the block party in downtown Minneapolis that kicked off the weekend's Pride celebration, the 30th anniversary of the Twin Cities' annual gay-lesbian-bisexual-transgender festival. She sipped her drink and chatted with her friends, a group of other transgendered people who meet once a month to socialize and support each other.
And she talked about the first Pride festival she went to, three years ago. She wore a baseball cap and sunglasses and hiked up her jacket collar to conceal her face. Terrified that someone might recognize her, she stayed for just 20 minutes.
On this night, she wore her hair down and a Hawaiian print shirt. Perfectly pedicured toes peeked out from her sandals. She knew that a stranger looking at her would realize that she is, genetically, a man. But it didn't matter. This one night, at least, was about being open and free and honest.
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