PROLOGUE Dr. Ira Pauly was once quoted as saying "the suffering
of transsexuals is beyond belief."4 Truer words are seldom spoken.
Few minority groups are subjected to more discrimination and
persecution than the transsexual. The inability of our culture
to overcome the fear of human sexuality and gender-related differences
has resulted in a societal wide hatred for the transsexual person
that manifests itself in a variety of socio-politico-economic
Beginning in early childhood and extending throughout their lifetime,
the transsexual's gender identity is invalidated by a culture
that insists they grow up as the opposite sex. When they assert
themselves and live as Nature meant them to live, they are shunned
by their families, friends, churches, employers, physicians, and
the government -- oftentimes forced to endure acts of violence,
employment discrimination, exploitation, and public humiliation
by the media that would stagger the imagination of most informed
Transsexuals are not the only ones who suffer as a result of
this societal fear, or "transphobia", if you will. Parents of
transsexuals often anguish over feeling like failures as parents.
Many of these parents live in fear of their child failing to
live up to their expectations and of their own rejection by family,
friends, and business associates for producing a gender dysphoric
child. Those parents unable to cope with their feelings of guilt
or fear of societal rejection, deny their children's birthrights.
The message is clear -- conform or be disowned.
Mainstream Christian churches have responded with a virtual conspiracy
of silence, ignoring the spiritual needs of the transsexual and
the social injustice that surrounds them. The idea of accepting
transsexuals as equal members of the church is simply beyond the
comprehension of most main-stream religious leaders and lay persons.
Fundamentalist churches have tended to be very vocal, however,
using the Bible to inflict unnecessary guilt upon the transsexual,
adding to the severity of their uninvited dilemma. In the past
year, the inability of transsexuals to gain acceptance by their
churches has resulted in two suicides. Studies indicate that long
term adjustment depends on the transsexual obtaining what others
take for granted: standard medical follow-up care and acceptance
by their communities.
Congress added to the transsexual's dilemma this past year by
further externalizing society's fear of the transsexual through
the Americans With Disabilities Act of 1990, excluding them from
civil rights protection under the Act and further grouping them
by name with dangerous and aberrant behaviors.7 At the same time,
the Department of Defense has promulgated regulations categorizing
transsexualism as a perversion, and a disqualifying factor for
issuance of a security clearance.7.1 Following on the heels of
their decision to make unlawful an amended birth certificate,
the European Court of Human Rights has ruled that transsexuals
have no right to marry.7.2 The Civil Rights Act of 1990 failed
to overturn the major judicial decisions which have left transsexuals
without civil rights protections for over 15 years. In a somewhat
similar vein, the Health Care Financing Administration--a function
of the Department of Health and Human Services--relying on the
unscientific writings of Janice Raymond8 and others, has decreed
transsexual surgery as experimental9, thus denying the transsexual
medical insurance coverage and access to medical care previously
recognized as medically necessary by the judicial system.
Access to quality medical care is further complicated by the
unwillingness of many physicians to provide even minimal health
care assistance to the transsexual. This unwillingness to provide
assistance is, according to J.E. Hoopes and associates, "a self-
protective one, namely the fear of censure and considerations
regarding reputation."10 Physicians fear community sanctions such
as withdrawal of hospital privileges if they treat transsexuals.
This reluctance is further compounded by a growing inability
to obtain malpractice insurance coverage for medical care of this
consumer group. Faced with these facts, it is simpler for physicians
not to treat them.
This broaches upon the problem of stigma. Transsexuals are a
stigmatized group and as Irving Goffman10.1 writes in his book
by the same name, stigma is infectious. It is the single most
effective obstacle to professionals who want to work with a minority.
To the public, attorneys who defended Blacks in the South during
the 60's had their skin color questioned. The mentally ill are
stigmatized and mental health workers -- especially psychiatrists
-- are satirized as "crazy" themselves, just as those who ministered
to lepers were thought to have Hansen's disease. So it is with
any professional that tries to help transsexuals.
It has not yet become fashionable to champion the cause of this
sexual minority. For those who pioneer, effective patient advocacy
depends on a critical re-examination of the subject. Yet, deeply
ingrained taboos do not disappear overnight and many a career
has suffered on behalf of the oppressed.
The transsexual's existence today is clearly precarious within
our society, and it is growing more socially insecure by the moment.
The foregoing constitutes much of the transsexual's personal
reality -- the consequences of which entails the tremendous waste
of literally hundreds of thousands of talented, intelligent, and
beautiful lives squandered in avoidable life-long suffering, not
to mention how our society may be losing the benefits of a potential
Da Vinci or Einstein.
M. Scott Peck, eminent psychiatrist and author, writes that "In
and through community lies the salvation of the world."10 While
the human race, standing on the brink of self-annihilation, struggles
to build a world community; few transsexuals have developed a
vision of community. They are for the present a politically powerless
and socially unpopular minority group, which can be likened to
The tip of the iceberg is comprised of two small but vocal groups.
The first group is made up of transsexuals who have found the
courage to risk being overt and speak out against the ignorance
and injustice that comprises our society. These individuals suffer
for all other transsexuals by being placed through their openness
permanently in a sort of transsexual ghetto. Their high profile
usually has been initiated through no fault of their own but has
brought them both long-term unemployment or under-employment,
and an inability to obtain medical insurance or medical care deemed
a right by society as a whole. Additionally, they often are hounded
relentlessly through the years by tabloids, news media, or anyone
wanting to make a carnival side show of them.
The second group making up the tip of this iceberg is the narcissistic
notoriety seekers that perpetuate the socially unpopular stereotypes
ascribed to transsexuals, thereby undermining the work of the
The remaining transsexuals can be likened to that part of the
iceberg which is submerged and accounts for its mass. They are
the covert transsexuals, remaining as much out-of-sight as humanly
possibly. They live in denial of who they are, often isolated
and intensely lonely. They are like Dr. Pangloss (satirizing the
philosopher Liebnitz) in Voltaire's play "Candide," who proclaims
with every abuse and injustice dealt Candide that "All's for the
Best in the Best of all Possible Worlds." Candide's (and Voltaire's)
answer to Dr. Pangloss at the end of the play is that "Yes, all's
for the Best in the Best of all possible Worlds, but that does
not mean it is Good!"
Life is not rosy for the pre-operative or post-operative transsexual
and professionals don't want to hear the stories their patients
have memorized from books and articles about transsexualism (the
so called "book-transsexual"). The problem of independent verification
confronts the professional when evaluating a patient for referral
to a surgeon for sex-reassignment. Very often the decision has
been made on the self-report of the patient who claims to be a
primary transsexual; patients sometimes in fact know more about
the syndrome than the physician and can give a credible account
based on this knowledge. Although psychological testing can help
rule out psychopathology, it has been necessary to create further
requirements including having the patient cross-live in the gender
of choice for at least one year. Unfortunately, this so-called
"real life test" is not specific (although sensitive) to primary
transsexuals; many effeminate homosexuals, transgenderists, and
self-stigmatized transvestites have deceived themselves into believing
they are ■women■ for secondary gains and can negotiate the trial
period successfully due to being gifted with a body habitus close
enough to sex-stereotypes. This represents another form of self-
selection based on external criteria rather than internal criteria
as in the case of self-report. As a result of this diagnostic
confusion, these non-transsexual patients get the surgery only
to find post-operatively that they really did have a libidinal
investment in their former genitals; they complain that they made
a mistake and request sex-reversal surgery or even commit suicide.
Let us speak candidly: Physicians expect transsexuals to have
no problems after sex-reassignment surgery (SRS); if they do,
then SRS was a mistake and often the judgement is made that they
are not ■true■ transsexuals.11 Yet, it is unrealistic for surgeons
to expect that a surgical solution is without post-surgical problems;
this is especially true of SRS where fistulas, urethral strictures,
denervation of the dorsal nerves, clitoridectomy, and other complications
are common.12 The post-operative transsexuals with these problems
in some cases are ignored or responded to poorly by surgeons who
do not wish to deal with them anymore. It is also unrealistic
to think that any one person has no problems -- the human condition
is inherently problematical as philosophy attests; this is especially
true with SRS when the whole valence of the patient's life changes.
Having post-surgical problems and problems of human existence
is real; it is not real to deny these problems exist.
One study13 of post-operative transsexuals (N=281) on follow-
up yielded a suicide rate of slightly greater than two-percent;
the figure may be higher in that so many post-operatives are lost
to follow-up. And, this study did not assess the number who have
had suicidal ideations and attempts. The study reported that these
suicides were due to the inability of the post-operatives to obtain
follow-up medical support. Satisfaction post-operatively has been
shown to be related to satisfaction with the surgical outcome.
This observation implicates the transsexual's personal reality
that in spite of complete sex-reassignment he/she continues to
be abused by society post-operatively.14
Transsexuals need the medical profession's support since physicians
heretofore have been the only advocates for them in society; this
is why the DSM-IIIR diagnosis 302.5 ("Transsexualism") is politically
as well as medically necessary for their credibility. Moreover,
transsexuals are in constant fear of losing SRS; some believe
that SRS is magical to begin with in that, like Dr. Pangloss,
everything in their life is perceived as wonderful and all they
need is SRS for their lives to be perfect -- at least that is
how they present themselves to peers and professionals; physicians
often foster this belief by wishfully thinking that SRS should
result in no problems.
Contrary to popular belief, SRS is not really a "sex-change";
candidates have always been of their chosen gender from birth,
and SRS corrects a chronic physical problem that needs medical
attention. SRS is the period at the end of the developmental sentence.
Transsexualism is a sex error of the body at the level of brain
dimorphism; it is not a matter of choice. Evidence is mounting
that an imbalance of the fetal testosterone-estrogen ratio, due
to a defect in fetal gonadal development at the molecular level,
is responsible. This ultimately is determined by the absence
or presence of certain genes in the testicular determining factor
cascade producing defective enzymes responsible for correct genetic
transcription of instructions for gonadal hormonal and neurophysiologic
pathways. Correct understanding of this phenomenon will come from
the molecular genetic level.
Transsexuals, in order not to lose SRS for themselves, must co-
opt into the physician's beliefs which may include, in addition
to hassle free SRS, stereotyped visions of the perfect SRS candidate
as a young, nubile nymph -- a Pygmalion or Punchinella. Transsexuals
must play along and meekly submit to the scalpel, accepting whatever
result the surgeon happens to create for them, without appeal
to physician peer review or State Boards of Medical Quality Assurance
that other patients have as their right to being treated with
dignity. Because of their guilt, fear, and shame, transsexuals
themselves often do not believe they are worthy of medical treatment
equivalent to a non-transsexual patient. Transsexuals must deny
they have problems, and to do this is to deny their personal reality.
The hatred society directs toward transsexuals during their lifetime
is often internalized by acceptance of the labels they are called;
this becomes self-contempt or shame; yet this is denied by most
transsexuals. The anguish their parents suffer creates guilt in
transsexuals for not conforming to familial expectations -- this
also is denied. Growing up as the opposite sex causes continuous
pain and the anger of invalidation -- the grief of all those years
the transsexual could not express him/herself; this violation
and loss of youth typically is not mourned by transsexuals either.
Then there is the cognitive dissonance -- the pain -- of gender
dysphoria itself gnawing away at sanity; this supposedly disappears
with reassignment and can be forgotten. Then there is the pain
and anger of being shunned by family and society when a transsexual
finally has the courage to Name-the-World and become that which
had been continually suppressed inside.
They further deny the socio-political realities of the U.S. Congress,
state legislatures, and the courts taking away their civil rights.
Contrary to current belief, transsexuals are not tormented by
their condition: it is their condition which prompts society to
As early as recorded time, the Right-to-Name-the-World has been
the birthright of everyone in our culture. In Eden, Adam in the
image of God the creator of all these things named the animals
and plants. Throughout the Old Testament, patriarchs gave special
names to persons or places of significance. This tradition of
naming the world continued throughout subsequent history. Poets
named the sentiments, philosophers named newer world views, theologians
named the manifold of God's Laws and Plan for humanity, and politicians
named the codes of secular law. The Bible chronicled the Right-
to-Name-the-World as a unique gift given to all mankind as a sign
that we are, in God's image, wordsmiths and creators of our linguistic
universe as He is of the Natural World. Whereas over time the
anti-democratic cultures of antiquity subverted this right and
placed it into the hands of the wealthy and powerful. The hierarchy
began to name themselves as the definers and all others as the
defined. Gradually, there developed masters of language and their
slaves; a new form of oppression emerged: linguistic imperialism.
Whole philosophic systems were commissioned by the elite to sequester
the Right-to-Name-the-World unto themselves and thereby define
a world view which made the hierarchy seem not only unavoidable
but part of the natural order or ordained by God.
Today linguistic imperialism is still with us despite democratic
reforms to world culture. For almost everyone, our personal reality
is named by those who control the media and the constituency.
Few people are aware that they have a God given right to become
a master of language and name their personal experience of life.
Radical Christian pedagogues like Paolo Fierre, working in Brazil
with the poor, teach the oppressed to name the squalor of the
ghetto, name the abridgement of human rights, and name their oppressors.
Transsexuals are among the few who struggle in isolation against
those who would define them as the opposite sex. They assert their
God given right to name their sex against tremendous odds. They
suffer and fight for this right to be a creator in God's image
motivated by sheer personal survival. As it is with many vanguards,
they unknowingly are not only fighting for themselves but for
all those who are oppressed and slaves of language. As T. Szasz
once wrote, the rule in the human world is define or be defined;
in the animal, eat or be eaten.
To maintain control over discourse, the masters of language must
themselves adhere to certain rules or meta-beliefs which are generally
unknown to the slaves of language who are subject to them. They
are the hidden stabilizers which make common beliefs seem inevitable
and not open to question. Everyone learns these meta-beliefs implicitly
as we come of age in society and pass through the various rites
of passage of our particular tribes. We learn that some subjects
cannot be spoken of and these very often are the ones that matter
most. Meta-beliefs are the crucible in which our belief system
is forged; our beliefs form the out-line of the figure of our
consciousness while the meta-beliefs shape the background or in-
line of this figure and form what is not open to consciousness.
Although meta-beliefs are seldom conscious, their presence is
felt in every day discourse and it is impossible for discourse
to be free with them -- to be free of them requires a critical
re-examination or meta-analysis of the belief system. Yet, a meta-
analysis is dangerous for those who under take it because, by
exposing the meta-beliefs, one is revealing the Real Relations
behind why they exist and the purpose they serve in the society
to maintain the status quo. The Real Relations frequently involve
the oppression of one group in society by another, the splitting
into factions, the bigotry and intolerance, the usurpation of
civil rights, the perpetuation of poverty, and the maintenance
of illiteracy for the purposes of squelching free discourse.
Let us take a simple example: Aristotelian Logic. In Aristotle,
we can find many meta-beliefs which helped his culture justify
the inevitability of slavery, war, and a ruling class of anti-
democratic elite. One meta-belief is the Law of Non-contradiction
that states "an attribute can be ascribe to an object or it cannot
but an attribute cannot be both ascribed and not ascribed to an
object at the same moment." In application, either an object is
A or it is Non-A but it cannot be both A and Non-A at the same
time. In meta-analysis, this is called splitting and is caused
by a cognitive deficit having to do with a lack of object-permanence
in the first year of childhood; the infant cannot keep the presence
of the loved object permanently in consciousness in the absence
of the loved object because the loved object is never there. A
child without object constancy grows up looking at the world as
A or Non-A, Good-cop or Bad-cop, Black or White, Male or Female,
Good or Evil, Self or Other, Object or Subject, Observer or Observed,
Saved or Damned, In-Group or Out-Group, Lumpers or Splitters.
...Masters or Slaves. In short, the universe of discourse is fractioned
into mutually exclusive sets with hard edges and this creates
a mind conditioned to bigotry and intolerance, sometimes referred
to as the Borderline Personality Disorder. In fact, our cognitive
universe is interactional and interdependent, made up of fuzzy
sets whose categories blend into one another forming soft boundaries;
we have come to this understanding via the meeting of modern physics
and Eastern philosophy, general system theory, existential philosophy,
modern logic, and community psychiatry, and the rise of democracy.
It can be seen now that meta-beliefs are the taboos and myths
of a tribe; one can see these easily in other cultures through
the meta-analysis of the anthropologist. In our culture, Alan
Watts identified the taboo against knowing who you are. "One must
not question those who are in authority■ is another taboo. One
must not "tell the emperor he has on no clothes." Aristotle's
Logic might be called the Taboo of the Excluded Middle. For the
transsexual, the operative meta-beliefs are "Society's opinion
of me is true" and "Transsexualism is a psychopathia sexualis.
" Taboos like these create ■permissible talk■ and "no talk." The
No-Talk-Rule is the taboo against naming the world -- the disenfranchisement
of the Right-to-Name-the-World discussed above.
How is the No-Talk-Rule applied to transsexuals? In this society,
transsexuals are punished for breaking this Rule. Suppose the
society defines a person a certain way: the obstetrician, based
upon at best a superficial inspection of one's genitals at birth,
defines one as male or female (the Taboo of the Excluded Middle)
. This sets in motion a pervasive and barely conscious cultural
force that affects how society will treat the child from that
point onward. The infant's perceived or assigned sex from birth
will constitute the person. Pink or blue clothing, choice of name,
pronouns used, legal status, social conventions and a myriad
of other distinctions relentlessly remind and reinforce in the
child's mind that he is a boy or she is a girl. The way the society
defines a person is the way that person is expected to become.
If the self is radically opposed to society's definition, as
in the conviction that one is opposite to the sex of rearing,
a struggle is set up by this tension. The self is victimized internally
by the imposition of the sex-determination from without. With
the No-Talk-Rule in force, the self is powerless and helpless
to live with themselves; this is shame. A psyche, steeped in the
untreated shame of the ingrained societal opinion of them, colludes
and aligns itself with a internalized self-loathing; they take
on an identification with the oppressor as a psychological defence
against facing their shame. A reaction formation develops in some
transsexuals which has been called the ■flight into hyper-masculinity■
or, less so femininity, as a way of denying their identification
with the oppressor.
If any transsexual speaks up and breaks the No-Talk-Rule, they
mark themselves as a victim and by implication others are marked
as the persecutors (Taboo of the Excluded Middle). Defiance such
as this exposes briefly the Real Relations at work in the situation
between the persecutor and victim -- that both are subjected equally
by the meta-beliefs that maintain this society in the clutches
of consciouslessness and set off one powerless group against another
in factions which serve to divert attention from those who really
control the power and discourse.
The No-Talk-Rule is enforced by another Taboo: the Myth of the
Self-Fulfilling Prophesy. The simple act of complaining elicits
persecutory behaviors in others which cause the identified victim
to act as if he were a victim, by becoming defensive, and thereby
seeming to have brought the situation on himself. The ones who
break the No-Talk-Rule are sacrificed by Self-Fulfilling-Prophesy
so that society can remain in its dogmatic slumber. The dynamic
of singling one group out by defining them a certain way, not
permitting them to speak out and making them victims of a self-
fulfilling prophesy if they do speak out is called "stigma." It
explains how a person defined by society can become that person
to avoid stigma; even though the defined person is self-loathed,
this is still preferable to becoming a martyr but in untold cases
transsexuals have opted for suicide. The No-Talk-Rule took Hitler
and other tyrants in history to the pinnacle of their powers by
exterminating those who broke the Rule.
The transsexual's uninvited dilemma resolves down to whether
each can break the No-Talk-Rule about their being defined as the
opposite sex. Most transsexuals have done this by objectifying
the struggle. They quietly change their dress, behavior, identification
papers, and their bodies in a kind of guerilla warfare with social
taboos. They are caught up in the momentum of placing themselves
at odds with the definers without breaking the No-Talk-Rule outright.
By not speaking out, they unawares collude and align themselves
with their internal self-loathing and shame.
Within the gender "community," transsexuals usually deny their
insecurity and project it onto other transsexuals by identifying
with the oppressor15, becoming like them, and shunning one another.
By being dealt with cruelly whenever they have come to trust
someone, they distrust everyone's intentions and motives including
their peers and providers of care. Transsexuals by nature are
extremely competitive with their peers at being men or women and,
when given the chance for self-actualization, are the most earnestly
motivated. Understandably, transsexuals have been deprived all
their lives of what everyone takes for granted, and when they
are finally set free, they want it all -- right now. Every transsexual
wants to be recognized as an individual; some deal with this by
drawing attention to themselves in public and in the case of some
narcissists this is taken to an extreme thereby putting transsexuals,
in general, in an unfortunate light.
In this way, transsexuals persecute themselves. "We have met
the enemy," as Pogo once said, "and he is us." Rather than the
personal becoming political, the political is turned inside out
and becomes interpersonal. Usually, transsexuals hate other transsexuals
who are more beautiful than they are, who ■pass■ in society with
less trouble, who are more masculine or feminine. The accidents
of birth endowing one with a body habitus more in common with
the prevailing sex-stereotypes do indeed translate into a better
survival advantage than those who are less fortunate. The ones
gifted enough to pass without problems disappear ■into the woodwork■
-- become covert -- and seldom participate in medical or psychosocial
follow-up contributing to research which would aid other transsexuals
left behind. They are the ■successful■ transsexuals -- yet are
By identification with their oppressors, they have lost their
constituency and solidarity; they have lost the ability to defend
themselves politically: "...And then they came for me, and by
that time, there was no-one left to speak up"16. The covert transsexuals,
in fact, live in constant fear of being discovered, and some
are alone with no-one to share their most intimate accomplishments;
no-one is there to accept and understand with the exception of
other transsexuals. This is the dubious goal of anonymity for
which all transsexuals strive.
Why is this? There is a No-Talk-Rule amongst transsexuals against
telling anyone who they really are -- suffering, courageous, and
talented people. When they break the No-Talk-Rule, they lose their
jobs, careers, friends, social status -- everything -- and downwardly
drift into the transsexual ghetto, or worse, the sociological
sewer where prostitutes of San Francisco's Tenderloin District
or the "entertainers" of Hollywood's demi-monde dwell. Those that
are "successful" learn to keep silent and mind their own business.
Hence, transsexuals, in striving to deny problems, project security,
and identify with the oppressor, are not being real -- they are
being caricatures of people -- something pointed out by early
gender researchers when transsexuals appeared to them as ■caricatures■
of men and women. Instead today, it could be said that they are
good at being men and women, but not people. This is Transsexual
What are the alternatives? On the one hand, transsexuals can
continue to behave like Dr. Pangloss with one another, dancing
through the gender programs, conventions, newsletters and magazines
with their meat-markets declaring to each other ■Isn't life wonderful?
I'm fine. I'm peachy. I'm glad I don't have your problems!■ Thereby,
transsexuals can continue to be their own worst enemies. Or,
on the other hand, transsexuals can break the No-Talk-Rule with
themselves and be real with one another. They can admit squarely
and without denial that the manifold of their personal reality
exists. They can explore and deal with the ideas and issues outlined
here in order to gain acceptance of themselves. They can be mutually
open to one another and see that the other's personal reality
is his/her own too. They can realize that this is the best of
all possible worlds yet that does not make it good. They can express
the pain, the self-contempt, the shame, the grief, the distrust,
and the guilt to one another and let go of it. With self-acceptance
comes a more tolerant acceptance of societal intolerance; in the
same way, many people will have less trouble with transsexuals
if others are accepting of themselves. It is a myth to believe
that if you have no trouble with yourself then others will not
have trouble with you -- this is simply an application of the
No-Talk-Rule. As for the public who will never accept, the trade-
off is between what the transsexual needs from others in comparison
with what he/she is willing to give up to them -- the old zero-
These points are vital to the pre-op transsexuals. They should
use the trial period in group and private therapy working on issues
and feelings instead of just marking time with the professionals
who monitor the referrals to SRS. Pre-ops will save themselves
a big mistake17 post-operatively -- even suicide -- if they openly
deal with the unpleasant realities of their life situation.
What I have been writing about in this article advocates the
setting of priorities. It is healthy to have "feel good" gatherings
across the country; it builds networks and has a salutary effect
on people's morale. But such activities should be done in the
context of a political consciousness. Transsexuals absolutely
must make the personal political, because surely if transsexuals
don't hang together, they will all hang separately.
Here are some suggestions for what the gender-community can do
for itself right now:
1) Establish a national twelve-step recovery program called "Transsexuals
Anonymous" for the purposes of providing support for recovering
transsexuals based on principles and not personalities. This will
assure that the locus of control for therapy is within the gender-
community but not in the hands of personality cults created by
certain transsexuals in domineering positions. Presently some
leaders are unqualified to give advice or therapy.
2) Create a national ad-hoc medical committee on gender identity
consisting of physicians and surgeons who are gender-conflicted.
This committee would meet regularly in confidence to protect
the professional identity of its members. Its tasks would include:
a) physician peer review of unethical or unprofessional treatment
of transsexuals by other physicians, b) liaison with state boards
of medical quality assurance to enforce sanctions, c) publishing
anonymously under the committee name of scientific papers related
to gender and position papers regarding treatment of gender-conflicted
professionals as ■consumers■ by other professionals and other
3) Create a national legal defense committee on gender identity
consisting of attorneys who are gender-conflicted. This committee's
task would be to take under advisement cases of abridgement of
the civil rights of the gender-conflicted, prepare anonymous defense
briefs, and hire pro se litigants to represent the committee in
court on behalf of the defendants.
4) Create a national ad-hoc committee on gender and the media
consisting of gender-conflicted entertainers, writers, producers,
and publicists, to prepare public service announcements on national
prime-time television and radio to educate the public about gender
dysphoria syndrome and the people who suffer with it.
5) A regional and national political action committee for the
purpose of advising and lobbying legislators on legislation of
interest to the gender-community.
6) Revision of the HBIGDA Standards of Care to extend to the
pre- and post-operative period in order to guarantee continuity
of medical care.
There is a vast pool of talent amongst transsexuals. Psychological
assessments indicate that as a group transsexuals have superior
intelligence. The trend with SRS is toward older, mature candidates
who have already established themselves as physicians, surgeons,
lawyers, judges, political leaders, media professionals, scientists,
engineers, educators and business executives. The power is there
to harness, the question is: does the transsexual have the courage
to do what it takes to survive? They must use that talent now
before there is no-one left to speak up.
1. Szasz, T., Law, Liberty and Psychiatry, Beacon Press, 1970.
2. Hoenig, J.L., ■The Legal Position of the Transsexual: Mostly
Unsatisfactory Outside Sweden,■ Can. Med. A.J., Feb. 5, 1977,
3. Woodman, S., ■Renee Richards takes Stock,■ New York Woman,
Dec/Jan, 1990, 118-121.
4. Pauly, I., ■Outcome of Sex Reassignment Surgery for Transsexuals,
■ 15(1), Aust. NZ. Jn. of Psychiatry, 45-51 (1981).
5. Leff, G., ■Genes, Gender and Genital Reversal,■ Medical World
News, April 18, 1977, at p.56.
6. (■. . . [t]hese people are often hurt by other people . .
. . ■) Hynie, J. ■Treatment of Transsexualism,■ Vol. 44, DIALOG
Abstract 16739; (■. . . [a]re in my view contemptuous of transsexuals,
with an intolerance and prejudice that is palpable.■) Ulane v.
Eastern Airlines, 581 F. Supp. 821, 832 (N.Il. 1983).
7. The Senate version of the ■Americans With Disabilities Act
of 1990■, Senate Bill 933, and the House version, H.R. 2273, were
both amended to exclude pedophiles, kleptomaniacs, pyromaniacs,
voyeurs, exhibitionists, drug addicts, transsexuals, and a host
of other sexual disorders from protection under the Act.
7.1. 52:67 Federal Register, 11222-11254.
7.2. Cable News Network, October 1, 1990.
8. Raymond, the author of The Transsexual Empire: The Making
of the She-Male, (Beacon Press, 1979), ■has criss-crossed America,
ensuring through non-medical testimony that insurance companies
provide no medical coverage to transsexuals.■ Fisher, Lia, ■What
Sex Am I,■ The Philadelphia Inquirer, (5/9/85).
9. HCFA Transmittal 883, dated October, 1981; HCFA Publ. 14-3,
10. Hoopes, J. E., Knorr, N. J. and Wolf, S. R., ■Transsexualism:
Considerations Regarding Sexual Reassignment,■ 147(5) Jn. of
Nerv. & Mental Disease, 510, 512 (1968); (■. . . could not the
time and effort of such talented researchers be put to better
use, to more legitimate challenges? If a glamorous challenge is
insisted upon, we suggest that brain transplanting be preferred
to castrating and altering `sick' males.■). Letter from Nicole
J. Michaud and Elliot Bold, G. F. Strong Laboratory for Medical
Research, to the Editor, Am. Journal Obstet. & Gynecol., 135(1)
, 163 (9/1/79).
10.1. Goffman, Irving, Stigma,
11. ■It has frequently been said here that the term 'transsexualism'
has come to encompass a variety of conditions that under other
circumstances might be labeled extremely effeminate homosexuality,
transvestism (particularly, conscience-ridden transvestism),
schizoid or borderline personality disorder, polymorphous perverse
psychopathology, as well as individuals who apparently have manifested
cross-gender drives -- the classical 'transsexual.' Other patients
occasionally found among applicants for sex reassignment are obsessional
neurotics with profound masochistic trends, notoriety seekers,
vocationally motivated homosexual prostitutes, borderline patients,
and the overtly psychotic.■ Meyer,J.K. ■Some Thoughts on Nosology
and Motivation Among 'Transsexuals',■ Proceedings of the Second
Interdisciplinary Symposium on Gender Dysphoria, 32 (1972).
12. SRS surgeons in many cases do not provide an enervated clitoris
during the reconstructive part of the surgery. As a result, the
post-operative transsexual is unable to satisfy herself sexually
and must depend upon intercourse with males in order to experience
orgasm. This is very reminiscent of certain male chauvinistic
Third-World countries such as in Africa which practice clitorectomies
on young girls so that as grown women they will be bound to men
for sexual satisfaction.
13. Pauly,I., ■Current Status of the Change of Sex Operation,
■ 147, Jn. of Nervous and Mental Disease, 460, 1968.
14. Transsexuals have suffered under the deliberate negligence
of medical personnel who hold grudges against what they are. In
one case, a transsexual was allowed to suffer a cholelithiasis
to the point of emergent cholecystectomy without proper diagnosis
and treatment. The examining physician wrote in big red letters
in her medical chart ■sex change■ and from there onward the chart
was passed around and read by other physicians, nurses and staff
members. The result was ■unethical, illegal, immoral, and totally
unprofessional hospital care.■ (Sister Mary Elizabeth SSE, Legal
Aspects of Transsexualism, IFGE Press, 1990). In another case,
a surgeon completing an operation unrelated to gender remarked
to his anesthesiologist off-handedly that the patient on the table
was a transsexual; when the surgeon turned away the anesthesiologist
cut off the oxygen to the patient. (Brown, G., Unpublished Manuscript)
15. By the oppressor, I suggest a culture based upon the patriarchal
supremacy of a male-dominant ideology which through agents such
as Madison Avenue or Hollywood defines what a man or a woman is
supposed to be. Woman's image in the media for example is male-
defined not woman-defined. Michelle Pfeiffer or Kim Bassinger
are not typical women, as they represent perhaps a tenth of a
percent of the women in this country; their prominence is attributable
to their being male-imagos projected for the sexual-fantasies
of other males. The common man has been flooded with these images
and has come to expect women to look and act like these fantasies.
So do SRS surgeons expect this of the MTF transsexual; the ■pretty
boys■ that were operated on using body habitus criteria later
committed suicide when their male homosexual lovers rejected them
as women. Fat women, ugly women, lesbian women are ridiculed in
comparison and so is the burly transsexual who can't ■pass■. The
medium is the message: the anorexic starving to achieve the ultimate
16. The Rev. Martin Niemoller (1982 - 1984).
17. It has been reported unofficially by gender clinics over
the years that as many as nine post-op transsexuals have requested
surgery to change them back to their original sex . In the Gender
Dysphoria Program of Orange County, 96% of the candidates decided
before surgery that SRS was not for them. However, it is not certain
how many of these clients went elsewhere. (Personal Communication,
Sr. Mary Elizabeth, Coordinator, Gender Dysphoria Program of
SOURCE: J2CP Information Services