I shall start off with my favourite question as this
question deals with a few issues.
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Q1.
A1.
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Why would a guy want to be a woman?
There are a number of issues that are raised by this question.
- First and foremost, what is wrong with being a woman?
- The next issue is the common misconception. I am not driven by a
want to be a woman. This is not a life-choice.
What drives me to become a woman? For reasons that the doctors and
psychologists do not understand, a few people are born with the
wrong sex-gender combination. Things run smoothly when one has
either of the two common sex-gender combinations, referred to as
cisgendered. These combinations are female-feminine or
male-masculine. However, what happens when the other two
possibilities occur? You have a transgendered individual, either
female-masculine or male-feminine. At the present time, the
psychologists and doctors cannot change the gender. Consequently,
the only option is to alter the sex. Thus, it is a need, not a
want, that drives transsexuals to change their sex. For a
male-to-female (MTF) transsexual, this means becoming a woman.
- A guy? Me? No, I have never thought of myself as a guy. I am, and
have always been, a gal. Granted my body was a normal male body,
but my sense of self has always been feminine.
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Q2.
A2.
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Why can you not live with the transgendered condition, without
your changing sex?
What may be difficult, if at all possible, for the cisgendered to
understand, about being a transgendered individual, is that the
sex-gender conflict, in essence, is a deep, hurtful rend in one’s
personality. The transsexual seeks to mend the tear in her personality
through any feasible method. Yes, I have gone through denial, where I
deny that I am a transsexual, but my gender re-asserts itself and
prevents the healing process. I try to shift my gender, but I cannot
achieve this end. (The psychologists do no try to shift the gender.) I
am left with either one of two common ends. Change my sex or end my
life.
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Q3a.
Q3b.
A3.
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When did you first become a transsexual?
When did you first become aware that you were a transsexual?
These two questions have the same answer. There has never been a moment
where I knew that I was masculine. Never a moment where I accepted
myself as male. All memories are either non-gendered or
feminine-gendered. Even during my pre-memory, pre-school period, there
were indicators that I was not cisgendered. At three years of age, my
playmate preference was girls, and my play preferences were girls’
activities.
So, to answer the questions, I have always been transsexual, as far as
anyone can determine.
As far back as I can remember, I thought of myself as a girl. However,
it would not be until Dr. Harry Benjamin published his book The
Transsexual Phenomenon in 1966 that I would learn what I was and
that I was not the only one with the condition. I was 12 at the
time.
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Q4.
A4.
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What hormone regimen are you on?
I am a male-to-female transsexual and the discussion here is pertinent
to male-to-female transsexuals. I suspect a similar discussion applies
to female-to-male transsexuals.
When one reads the various texts on hormone treatments, there is a
recurrent concept. The hormone regimen must be custom-tailored to each
patient. So, the regimen that is good for me won't be necessarily good
for you.
My endocrinologist has explained the route through which the hormone
regimen should be administered. The quantities of the estrogen drugs
are adjusted until the body's regulatory hormones, FSH and LH, effect
normal female levels of the free testosterone. The use of estradiol and
an anti-androgen permits reducing the serum free testosterone level and
increasing the serum estradiol level to the normal female ranges.
Essentially, one should monitor the estradiol, progresterone and free
testosterone levels. Adjust the estradiol dosage until the free
testosterone level is within the normal female range. Use an
anti-androgen (usually an androgen blocker) to counteract the presence
of the free testosterone. Adjust the progesterone dosage until the
serum progesterone level is within the normal range. Periodic checks of
the prolactin level should be made to monitor for a possible
prolactinoma (prolactin-producing tumor in the pituitary gland.) An
excellent source of information is Dr. Anne
Lawrence's web pages on hormone regimens.
My pre-surgery hormone regimen is Estrace (oral estradiol, 3.0 mg per
day), Spironolactone (anti-androgen, 200 mg per day), and Provera
(medroxyprogesterone acetate, 2.5 mg per day.) I would prefer to
replace the Provera with Prometrium (micronized progesterone), but
Prometrium contains arachis (peanut) oil and I am allergic to
peanuts.
My post-surgery hormone regimen is Estrace (oral estradiol, 3.5 mg per
day.) I no longer need the anti-androgen, since my free testosterone
level is now extremely low. Also, I am no longer on any form of
progesterone / progestin, as my body cannot tolerate progesterone.
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Q5A.
Q5B.
A5.
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Where did you get the "strong will" to take the first step?
What are the difficult steps int the gender transition process?
There are several difficult steps for a transsexual to take in the
gender transition process. What are the more difficult steps? (Some of
the steps are specific to male-to-female transsexuals.)
- The first come-out, to anyone
else.
This is usually the hardest step for a transsexual to take. The
shame and the guilt that are inherent with being transsexual
usually keeps one in the proverbial closet. How does one break
through the closet door? Who does one tell first? How about your
doctor? He or she is a professional who cares about your health.
Also, he or she will be involved in your medical treatment for this
condition; so, he or she will know in the end anyways. How about a
gender psychologist, psychiatrist or psychotherapist? Again, you
will need one to make full progress; so, why not talk to one and
get suggestions on how to proceed?
Another suggestion is to contact a local transsexual support group.
Talking to other transsexuals will reveal to you what others have
done and how they are coping with this condition.
- Making the first trip into the public
while cross-dressed.
This has to be the second hardest step to take. There is no easy
way around this one, but I would like to make a few suggestions.
- Pick a time when there are few people out and about. Sunday
mornings around 9:00 (before people head to church.) Weekday
mornings around 10:00 or 11:00 (while most people are at work.)
- Plan a trip to somewhere where you are less likely to run
into the general public. For example, a doctor’s visit or a
visit to a quiet park.
- Make your first trip to another town, or another part of the
big city, where anyone that you meet will be a stranger who is
very unlikely to see you again.
- If you have a family-member or friend who knows about your
condition, then ask them to help you. Have them come along when
you take your first trip out.
- See a description of my first-trip experience on the web
page: Cassie’s First Time Out
A couple of comments that I would like to make about how the public
has responded tome:
- Most people in the general public generally just gave me a
once-over look. They had to satisfy their curiosity. I usually
ignored them, or gave them a quick eye-to-eye glance. That was
the extent of the contact.
- The group that has given me the most problems has been
teenagers. These individuals usually have a maturity problem
with regards to sexuality. Gays, lesbians, bisexuals, and the
transgendered represent areas of sexuality that teenagers have
little, if any, understanding. So, it is the "ridicule the
unknown" syndrome. The worst that has happened is giggling and
teenagers elbowing each other to have a look.
- Coming out to family and friends.
See my web pages: Preparing To
Come-Out and My Come-Out Letter.
- Coming out at work.
See my web page: Tansitioning At Work -- My
Experience.
- Talking to a psychologist, psychiatrist
or psychotherapist.
Why? Once you have told someone that you are a transsexual, why
should talking to a psych be problematic? There is the fear of
opening up, of being exposed, and of being thought to be crazy.
Suggestion: belay the fear of talking to a psych since he or she is
a professional who will help you to understand your condition and
to take the necessary steps to relieving the condition.
Recommendation: make sure that you are quite comfortable with your
psych. You need to be able to open up completely with him or her.
(If you are not completely at ease talking to your psych by the end
of your second session, find another psych.)
- Buying the first pieces of
clothing.
For us MTF TSes, this can be a real issue. Some suggestions:
- Visit stores during their slack periods. Examples: weekdays
during workhours, Saturdays as soon as they open.
- Visit stores in other towns and cities. They don't know you
and the public there is unlikely to see you again.
- If you have someone who knows about your condition, take her
(or him) with you. A support person is really great here.
When people tell me that they admire my "strong will" or my
"courage", I know that it was not either of these qualities. What was
it? Could it be desperation? Was I motivated to make the changes to
avoid committing suicide? Did I finally reached the point where it was
"do or die"? It was a combination of these issues. At mid-life in an
empty life, there was no way that I could live the future as I was. I
had to change!
So, if you want to admire me for my strong will and courage, remember
one thing. Before the changes, I was weak willed and not all that
courageous! The strong will and courage have come from taking the
necessary steps, taking the steps to change sex, and having become a
member of the correct sex for me.
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Q6.
A6.
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Aren't the new parts of a high-maintenance nature?
Initially, yes. However, the maintenance requirements lessen over time.
The degree and the speed that the maintenance requirements lessen is
highly variable, from individual to individual.
Immediately after the vaginaplasty, one is dilating at least four times
per day and douching at least twice a day. Two weeks later, douchings
are down to once a day. Four to six weeks after the surgery, the
dilations is down to twice per day. Then at about four months after the
surgery, the dilations drops to once day.
After six months, the maintenance requirements drop for years to come.
For example, at four years after surgery, I dilate once a fortnight and
douche on alternate days. (The high rate of douching is part of my
regimen to combat yeast infections.) My current dilation and douching
regimen will like remain unchanged until my fifth year. Hopefully, I
will be able drop the dilation period to once each three weeks in
January 2007. A copy of my dilation history can be viewed on the Cassie’s Dilation History page.
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