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We stand at the crossroads of gender balanced on the sharp edge of a knife.


MY DAUGHTER CHANGED SEX

              A deeply moving account of an actual
              event -- how "miracle" treatment
              transformed a girl who was a tragic
              misfit into a young man with hope of an
              almost - normal life.

       Copyright - circa 1970 - Good Housekeeping Magazine

       "It's a boy!" or "It's a girl!"  Those are the first words a

mother hears about her newborn. Everything else about this fresh new life is uncertain. Will the child be healthy, intelligent, good-looking, happy, lucky? No one knows at the moment of birth. Only the child's sex is sure.

"It's a girl!" I was told on that blustery November morning in 1950 when Tracy was born. I held my miraculous new daughter, my first child, and examined her and saw that she was indeed a perfect little girl. But I was wrong. Disastrously wrong. Inside the body of that beautiful girl baby was the personality and psyche of a boy. It has taken 22 years of tragedy and misery and hurt for the boy inside Tracy to emerge.

I want to tell about that change now, in all its painful detail, because it is an astonishing story of one human being's successful struggle for self-fulfillment, of one family's tortured journey into understanding, of medical intervention at its most compassionate and of an astonishing human victory over one of nature's cruelest whims.

All that I want to say about Tracy's growing up is that it was rough beyond description. She was born three days after our first wedding anniversary and Jim and I couldn't have been happier about her arrival. Jim was a student then, getting his degree under the GI Bill and holding a job at the same time. I had been working as an office manager, but was delighted to stay home now and take care of Tracy.

But Tracy was a handful -- restless, fretful, too irritable to be cuddled, screaming her rage if she didn't get her own way instantly. When our second child, Daisy, was born two years later, the contrast between the two babies was so sharp that even strangers noticed. Daisy was sunny, cooling, cheerful -- and very early in life terrorized by her older sister. Sometimes Tracy hurt Daisy accidentally in play; other times she beat her up deliberately. Even when the girls were 12 and 14, we had to have a sitter whenever Jim and I went out, to make sure Tracy would do no harm to her sister.

In spite of her tantrums and sulks, Tracy was bright and alert and did well in school. She was big-boned, athletic, "a tomboy." She delighted in heavy work like putting up screens and mowing the lawn. During the years when the girls were in their teens every meal was a battle. We hardly ever could sit down together without someone's leaving the table in tears or fury. Sometimes it was Tracy who slammed down her napkin, shouting, "Why do you all hate me?" Other times it was Daisy, wailing over some wrong done to her by Tracy. Or it was Jim, normally a kind and deeply concerned father, a believer in firm and consistent discipline, who found himself screaming at his daughters and then bolting from the room, hating himself for losing control. Or I was the one, listening to myself shriek like a fishwife and then steadying myself against the counter in the kitchen, fighting for calm.

Oh, we did all the usual things to solve our problem -- we talked to our pediatrician and to the school nurse and later to the guidance counselor and after that to a psychologist. Jim and I searched our souls to discover what we'd done wrong. We ransacked our memories to figure out how we'd mishandled toilet training or shown rejection or made some other crucial mistake. It was taken for granted by everyone we consulted that we, the adults, were the ones who were in error. We had to change in order to bring some degree of peace and happiness to our troubled family.

But the experts were wrong, for Tracy was the one who had to change. And it is a measure of the world's ignorance of this area of human suffering that the poor child had to travel alone to the brink of disaster before she would find her way.

Her final months in high school were as stormy as any I remember. The battles continued, but between them, now, Tracy would retreat into sullen silences and nothing I tried would mollify her. Then, suddenly, about a week before graduation, her mood seemed to switch; her anger gave way to calm. One night I went to her room to kiss her good night and as I learned over her bed she pulled me down to her and moaned into my ear: "Help me, I don't want to die." I held her to me and she said it again. "Help me, Mom, Help me. Part of me wants to live." When I looked into her eyes I saw such sadness as I had never seen before.

That night I tiptoed into her room every 15 minutes, watching over her. In the morning neither or us mentioned what had happened and she went off to school in a reasonably good frame of mind. But as soon as she was out of the house I phoned the psychologist she'd been seeing. He was greatly alarmed. It was possible, he told me, that the calm I had noticed in recent weeks was the result of a decision -- a decision to die. When anguish gives way to quiet, he said, it can be a prelude to suicide.

He promptly took charge of the situation. By evening Tracy had been signed into a psychiatric hospital. After three weeks, when it was thought the crisis had passed, she was allowed to come home again -- providing she continued her therapy. Soon after that, she decided that she was not going to college, although she'd been accepted by a fine state university less than 100 miles from where we live. She moved out of our house into a furnished room on the other side of the city, found a job and practically cut herself off from us.

That was four years ago, when she was 18. Jim and I rarely saw her for the next year and a half and whenever we did, our hearts would sink. For Tracy was a changed person. She dressed and acted tough. She wore rough, mannish clothes -- not just the jeans and heavy shirts that so many young people go in for, but clunky men's shoes and a woodsman's jacket. Her black, curly hair was so much shorter than most of the boys' in town that she had a harsh, butchy look about her. Jim and I used to exchange glances, but neither of us dared to give words to the terrible suspicion that was dawning on us; Was Tracy a lesbian? Was that it? We couldn't bring ourselves to talk about it.

But at least Tracy seemed less angry, less at war with herself, and that was something to be thankful for. And with only Daisy at home our family life took on the easy cheerfulness it had lacked through all the years of battles and tantrums.

Then came the day, about 18 months after she'd left home, when Tracy turned up at our house with "something important" to talk to us about. Tracy, Jim and I sat down in the living room; then she dropped her bombshell. "I am gong to have an operation that will change me into a man," she announced. "I think like a man; I feel like a man. Now I'm going to look like a man and live like a man."

I couldn't believe my ears. Jim couldn't believe his. We shook our heads and made Tracy repeat her incredible statement.

How do you go about grasping such a fact -- that your daughter intends to become your son?

It took us quite a while -- weeks, months. That first day we heard the words, but not the meaning behind the words. What the words said was this: During her stay in the hospital a year earlier, Tracy had read a magazine article about a young man who had undergone treatment and surgery to become a woman. Suddenly night turned into day in Tracy's mind. "I'm not crazy," she shouted to herself. "Maybe it's my body that's wrong, not my head."

She had sent away for further information to the Erickson Educational Foundation1 in Baton Rouge, La, whose name and address were listed in the magazine. Booklets and leaflets arrived as well as an announcement that a Gender Identity Committee had recently been formed at a hospital in the Midwest city where we live. Such a committee, composed of a psychiatrist, a psychologist, an endocrinologist, a urologist, a gynecologist, a plastic surgeon, an internist and members of other disciplines, as needed, evaluates the cases of those seeking transsexual treatment.

Transsexual.

That was a new and frightening word for Jim and me. What did it mean? Tracy explained (and so did the leaflets and textbooks we read in ensuing weeks) that a transsexual is a person with the physical makeup of one sex but the psyche of the other. A transsexual is not the same as a hermaphrodite because a hermaphrodite has some or all of the physical characteristics of both sexes. Nor is it the same as a transvestite, who is one who seeks emotional release by dressing like the opposite sex. A homosexual is usually accepting of the sex into which he or she is born, but engages in sexual relations with members of the same sex.

Tracy had looked like a girl from birth, developed like a girl in her teens with breasts and normal menstrual cycles. But despite the outside evidences of femaleness, inside her, struggling to express itself, was a masculine consciousness -- an almost irresistible drive to be and act like a man. That's what she meant when she told us she was a transsexual -- her psychological gender was the opposite of her body's.

By the time she told us what was happening, Tracy had already gone through the grueling physical and psychological explorations of the Gender Identity Committee. She'd been interviewed, probed, poked, examined, cross-examined, her blood and urine taken for analysis, her mind checked out by batteries of psychological tests, her chromosomes counted, her hormones assayed, her fantasies analyzed.

Of the 54 candidates who had presented themselves for treatment by the new Gender Identity Committee, only two were accepted, and Tracy was one of them. For the past year she had been receiving injections of testosterone, the male hormone, and had been living like a man. (It was the testosterone which had caused the coarsening of her face and body that we had notices.) That was the committee's basic requisite to further treatment -- at least one year of living the life of the sex to which the patient wishes to transfer. During that time Tracy was required to be a man in every phase of daily life, to dress as a man, find work as a man, join clubs as a man, make new friends as a man.

This is considered an important testing period, to see how the new gender "fits," and how powerful the desire for sex reassignment is before the candidate goes on to the further and irreversible stages. Tracy had taken this initial step without consulting us, because she feared that if we knew her plans we would try to stop her. As far as she was concerned, that first step was a success. Now she needed our help. Before any surgery could be performed the Gender Identity Committee insisted on the permission of at least one member of the patient's family. (This is required of all patients --adults as well as minors -- to preclude later malpractice suits by family members and to make sure that someone beside the patient is aware of what's taking place.)

Tracy had referred vaguely to surgery. Just what surgery did she have in mind? She drew a deep breath, knowing how hard it would be for us to accept what she had to say. Then quietly and seriously she told us that to complete her gender reassignment, she wold need three stages of surgery -- mastectomy to remove her breasts, hysterectomy to remove her uterus and ovaries, and phalloplasty to construct a penis.

My mind reeled under the impact of her words. Why would any young woman want to have herself diminished in such a way -- destroying the deepest and most precious evidence of her womanliness? I couldn't grasp it. "But mother," Tracy explained patiently, "I'm not a woman -- that's the whole point. I'm a man. Inside myself I'm a man and as a man it's a horror for me to have breasts. They're constant reminders that nature made a dreadful mistake in putting me together. I have to get rid of all the woman in me, and surgery is the only way."

That's how it came about that a fairly average American couple sat in a fairly average living room trying to hold on to their sanity as their daughter told them she was in the process of becoming a man.

It was a weird, incredible afternoon. As the three of us talked, I found my mind tuning in and out of the conversation at intervals, as if I could cope with just so much of this bizarre situation at one time, and then had to stand off and give myself time to absorb it.

I tried to study Tracy as if from a great distance, as if she were a stranger, and I had to admit that, had I really not known her, I would have assumed that she was a young man. I would have described this young man as being, on the surface, surprisingly composed, considering the circumstances, earnestly answering our questions. It was impossible to read anything in Tracy's eyes; they were, as they had been since infancy, eyes of indescribable sadness.

Only a slight tremor of her hands and voice betrayed how much hinged on the outcome of this conversation. Tracy knew the future could go several ways, depending on our reaction.

At one extreme we could put a stop to the whole thing. We could storm into the hospital and threaten to sue the doctors. If that should happen, Tracy left no doubt she would drop out of sight, find a doctor, perhaps in Mexico or Europe, and go ahead with the operations. That way, it would all be done furtively, with greater risk and more trauma, but her father and I would be spared the notoriety. With or without our permission, the change would be made eventually -- Tracy left no question about that.

On the other hand, if we thought we could come to accept Tracy as our son, if we could treat her as a man, address her as a man, learn to think of her as a man, perhaps something could still be salvaged from the wreckage of our battered family life. A question surfaced in my mind: How do we tell people? How do we face our friends? But Tracy was our child, after all, and love for a child can triumph over bitterness and estrangement. I looked at my husband and knew that he was thinking the same thing. There really was no alternative for us but to accept -- him.

Him.

In that moment we made a crucial choice that turned our lives completely around and started us off in an entirely new direction. Our decision was yes. We would approve; we would cooperate with the doctors in every way we could; we would stand behind Tracy in her quest for a new self.

So it began.

We were notified that the committee wanted to learn more about us in order to learn more about Tracy. Jim and I therefore started leaving our offices (I had gone to work for an insurance company when the girls were in high school and Jim was sales manager for an office-equipment firm) to spend exhausting evenings in the testing laboratory, coping with intelligence and aptitude tests. We found ourselves putting our innermost thoughts on reel after reel of tape. We dredged up recollections about times and emotions we thought we'd left behind us forever.

And gradually we began to find some answers to our questions about Tracy and the whole baffling problem of transsexualism. We learned, first of all, that the very concept is still controversial, but that increasing numbers of specialists are now convinced of its validity. We learned, too, that the condition, while rare, is far commoner than we had dreamed. Dr. Harry Benjamin, a New York endocrinologist who is one of the pioneers in this field, has ventured an educated guess that puts the number of American transsexuals at about 10,000 [it is now believed to be about 60, 000]. He himself has worked with more than 100 such patients. The most publicized case of sex reassignment was George Jorgensen, who became Christine Jorgensen, in Denmark, two decades ago. In 1966, Johns Hopkins University in Baltimore set up the first American center for sex transformation. Since then Johns Hopkins has done 32 sex change operations and another 500 have been performed in other medical centers in this country. Today, about a dozen medical institutions, among them, the University of Michigan, the University of Minnesota, the University of Washington in Seattle, the University of Virginia, have Gender Identity Committees. The first national medical meeting on this subject was held at Stanford University Medical Center in February 1973, to coordinate diagnostic and treatment procedures, and the Third International Symposium on Gender Identity will convene next September in Dubrovnik, Yugoslavia [the 12th International Symposium will be held in Sweden this coming June (1991)].

The experts agree that there is no way yet to point a positive finger of blame in the creation of a transsexual. Throughout history, an individual's sex has been established by the appearance of his body at birth. But that appearance may be either ambiguous or deceptive. Sexual identity within the individual is fixed through a complex interaction of body and mind, involving anatomy, hormones, neurological mechanisms, and cultural and other environmental factors. The process may go awry at different points in the course of development.

Dr. John Money, associate professor of medical psychology and pediatrics at Johns Hopkins, one of the leading authorities on sex reassignment, believes that an imbalance of fetal hormones may create a susceptibility toward gender identity problems. (In animal experiments, if the pregnant mother takes certain barbiturates, antibiotics or psychoactive drugs, her babies tend to have distortions of gender identity.) Apparently hormone imbalance or a viral infection or drugs taken by the mother may lead to an improper programming of the fetal brain. Thus the infant could be born looking like one sex, but "programmed" to behave like the opposite sex.

Another thing that could go wrong is the male-female imprinting that is made at certain critical times after birth. Dr. Money compares the process to what goes on in the brain of a child who is required to use two languages from birth. "The brain of the natively bilingual infant," he explains, "must code all linguistic sounds and utterances as belonging to one language or the other. In much the same way, the brain of any child must code all gender-role signals as either masculine or feminine, and allocate either positive or negative values to those signals." If something malfunctions during codification, the child may become confused or contradictory in his gender identity.

One of the things that surprised me as I dug into the research material was that the sex chromosomes are now the sole key to sex differentiation [see article on the TDF gene by Sarah Seton, M.D.]. In fact, most transsexuals have the chromosome makeup normal for the sex of their physical appearance, the sex that they will move heaven and earth to escape. I learned too that true transsexuals almost never respond to psychotherapy. No sure way has been found yet to bring a male psyche, such as Tracy's, into line with a female body. It is in recognition of the fact that it is less monumentally difficult to change the body than the mind of a transsexual that gender committees have sprung up so rapidly.

Another curious fact is that the change from male to female is sought at least four times more frequently than from female to male. That was one reason why our local committee accepted Tracy -- they were eager to work with a female transsexual seeking male identity. In addition, they were impressed with Tracy's determination and emotional stability despite the storminess of her growing-up years.

Make no mistake, it is a Herculean endeavor to change one's sex. I know from living through it with Tracy. But once she realized she had our support, she moved ahead swiftly. She continued injections of male hormones she'd been having every two weeks, and will continue them for the rest of her life. The hormones lower her voice, cause growth of facial hair, bring about a redistribution of fat on her body in a male pattern. She already had a job under male identity as a shipping clerk and had joined several male clubs. And she was saving her money for the expensive surgery she was determined to undergo.

I've been saying "she" because, of course, Tracy had always been she to us. But now as I write this account I will change over to "he," exactly as I had to do in everyday life. The switch in pronouns has been a problem -- it still is. But I've trained myself to say "he," "him," "my son," "my boy," and to drop the designation, "the girls," which I had so long used in referring to Tracy and Daisy.

Daisy was the first person we told, and her calm, poised acceptance of the news set the tone for the announcement we had to make to others close to us.

I had been petrified at the thought of telling people, and over and over I rehearsed in my mind the words I would use.

But when I told Daisy, she simply closed her eyes for an instant and then she said, "Oh, Mother, how he must have suffered." I think at that moment she forgave her new brother all the miseries Tracy had inflicted on her throughout their turbulent childhood.

Naturally we did not shout our news from the rooftops. To family members and close friends, we simply said, "Tracy is under treatment for the correction of a complicated sex problem."

Most people who knew Tracy replied, "I'm glad your child is finding happiness at last."

At first we were afraid to tell Jim's elderly father, who lives nearby, but Tracy insisted. "It's not fair to deprive me of a grandfather," he said, and he was right. Jim was the one who broke the news. While his father doesn't entirely understand and almost surely never will, he accepts his grandson nonetheless. And that's enough.

The time came for the first step in surgery -- the breast removal. I don't think I could ever be as brave as Tracy was, but then I never thought of breasts as hateful appendages, as Tracy did, to be bound down so that they would be less conspicuous. The surgery was done at a local hospital. Today, the scarring is hardly noticeable. I wish I could communicate Tracy's joy when he first put on a low-cut boy's shirt -- the kind basketball players wear -- and swaggered toward his reflection in the mirror. I guess pain and suffering hardly count when you're achieving something as basic as this was to him.

The hysterectomy was a little more complicated because, by this tine, Tracy was well established in his masculine role and couldn't figure out how he could enter the local hospital as a man to have his uterus removed. After careful consultation with his doctors, he decided to have this operation performed in a private hospital in another city. It was done six months ago and while it did not result in as much visible change as the earlier operation, it had an inner, symbolic meaning for him that brought enormous happiness.

The final -- and most difficult -- operation still lies ahead. It involves a plastic surgery procedure that eliminates the vagina and creates at least a semblance of male genitalia out of the existing tissue. There are a number of different techniques now being used for the construction of a penis, all of them multi-stage procedures requiring a series of hospital admissions. The cost in pain and expense is very great and the results not always entirely satisfactory, either in appearance or function. Usually a prosthesis is required to accomplish intercourse, even after the operation, and there is no way for the transsexual to father children of his own.

A booklet published by the Erickson Educational Foundation, entitled Medical Management of the Transsexual [out of print], states that the patient should be discouraged from this undertaking "unless he is unshakably convinced that to forgo it would deprive him of a psychological and social sense of security he may obtain in no other way."

So far, Tracy is determined to go ahead, but is waiting until his doctors agree on the right operation for him and until he has saved the necessary money.

Lack of medical reimbursement is only one of the hurdles a transsexual faces. To me, the legal problems have been among the most upsetting of this whole experience. Many times my heart pounded when I came home to find an official-looking letter on the hall table among the day's mail. Since it is illegal in most states to crossdress (that is, to wear the clothes of the opposite sex), you can imagine the kind of harassment and even blackmail that transsexual might be subject to in the early stages of change. In the future, as people and officials become more aware of the problem, I hope the legal red tape will be more easily disentangled. As for what happened to us, I still shudder when I think how gingerly we all walked the legal tightrope, while Tracy was having his draft status arranged, driver's license shifted and birth certificate altered [See Legal Aspects of Transsexualism by Sr. Mary Elizabeth]. Finally, however, all was accomplished.

Was it worth it?, you might ask. There isn't a shred of doubt now in any of our minds. The change in Tracy is a miracle to us. After years of trying desperately to resign ourselves to an emotionally disturbed child, Jim and I now find ourselves the proud parents of a handsome, well-built, deep-voiced young man who is as completely in tune with himself and his world as any other young man of his age I've ever met. He is affectionate, stable, productive and confident about the future. Those once-sad eyes of his are now often alight with laughter and rich depths of feeling. He has a good job during the day as a salesman in a men's furnishings store. He attends college at night, and is leaping ahead in his studies and talking about going to medical school. He has developed a wonderful camaraderie with the doctors and psychologists who have worked with him so closely, and his dearest dream is to join them as a colleague. He'll do it, too, for Tracy now is capable of doing anything he wants.

One thing I used to worry about was his social life: Would he be able to attract girls and form satisfactory relationships with them? The doctors had assured me that many transsexuals marry and raise children they have obtained through former marriages of their mates, artificial insemination or adoption. And Tracy, to our astonishment, has had great success with girls. When he meets a young woman and likes her, he tells her candidly of his sexual limitations. Many of them breathe a sigh of relief and exclaim, "Thank heaven, no wrestling matches," and they go on to warm, deep friendships.

Recently, Tracy flew to a medical conference in a large Eastern city, where one of his doctors was presenting a paper on transsexualism, and he sat on the platform and answered questions from the doctors and medical students in the audience. His doctors are convinced that if pediatricians and general practitioners can be made more aware of gender identity problems they may begin to recognize such disturbances in childhood and learn ways to correct them that are easier than the tortuous steps Tracy had to take. Eventually, ways may even be found to prevent gender problems. It is also possible that lives can be saved, for as Dr. Money of Johns Hopkins has pointed out, "Adolescent and young-adult suicides are frequently related to gender disturbances. When young people are terrified by the freakiness of their fantasies and daydreams, they too often see death as the only way out."

That's one reason why I have told Tracy's story -- to move forward just a bit the public's understanding of the suffering that results when the psyche of one sex is trapped in the body of the other. But I have another reason for laying bare all the misery and anger, the frustrations and fears that Jim and I and Tracy and Daisy have lived through. It is to pay tribute to the remarkable men and women who have helped us find our way out of the darkness. Their selflessness, courage and compassion have shown me there is no limit to what human beings, at their best, can accomplish.

Copyright circa 1970 - Good Housekeeping Magazine