Susan's Place Transgender Resources

Consider for a moment that the latest studies show that 1 in 250 babies may be born with an intersex condition and that there are at least 25 known intersex conditions. You may or may not be as cisgender as you thought.

I also see transgender or being transsexual as a neurological version of an intersex condition to some degree myself. I also know from personal experience and meeting others that you can be intersex and transgender at the same time. Sometimes even you are forced into a situation where you need to transition simply because a doctor did surgery and assigned you the wrong sex, they don't always get it right with obvious intersex babies.

It is wise I think for one to discover if they are indeed intersex, some conditions will make it so it is harder or easier to transition. I have partial ais or maybe mild ais, so anti androgens may not be effective on me.

I think intersex people are overlooked by the rest of the lgbt community, if transgender is the step child of lgb, then intersex is the uncle who lived in the mountains for years and no one really knows about. Yet in reality many of us may be just that intersex and transgender.

However not every intersex person will be transgender or transsexual, it just depends on how they feel about themselves and thier body. But i find it interesting that there may be a person who considers themselves cisgender and straight and dislikes people that are lgbtqqi and yet they themselves may be intersex. Food for thought.

Quote from: Shawn Sunshine on February 06, 2013, 01:15:27 PM
. I have partial ais or maybe mild ais, so anti androgens may not be effective on me.

Not exactly my sphere of experteese, but I'm pretty sure that is incorrect. Anti-androgens will be somewhat more effective since you metabolism would already be resistant to the effect of androgen.

But this is all just gossip and has no value in itself. These are matters for your own medical practitioner.

I also am not really sure if the point about the attention intersex people get is adequate, is really true either. Though I do understand it, especially in your case. The point is, here and for most of us generally, we approach our problems, whatever its causes or sources, by seeking to move toward varying degrees of transition.

Incidently, I absolutely know how you're feeling right now.  Big Huggggs

I was only trying to point out that hardly anyone that I know even is aware of what being intersex is. I asked one friend and they said "oh your a ->-bleeped-<-"

which is true ,yes, for me personally, but not the actual definition of being intersex. Also again I wanted to point out the fact that some people who think they are cisgender and are the so called "normal" people of society, may want to re-examine themselves.

I did not learn I was intersex until 7 months ago. I did not even know about how many conditions there were until a few months after that. Learning all these scientific things have helped me to broaden my mind.

I can imagine someone learning something about themselves, or accepting things about themselves and becoming quite the eye opener.

It is akin to that movie with Robert Duvall and James Earl Jones "A Family Thing"

Where the character learns he is half black and well things get interesting from there.

The moral story of my post is really this "Don't judge a book by its cover, the pages inside may be interesting and unique"

I fully understand Jamie. No negative judgement was intended.

These are valid points, but I wonder if causes are quite as significant as solutions?

The thing about intersex is that it's about as far from a black and white issue as one can really get.

In general, the only intersex conditions that people really think of when they hear 'intersex' are babies with 'ambiguous genitalia'. Many take this to mean genitalia somewhere between a penis and a vulva, but it's not so simple, and is often subject to the biases of society. Cases of micropenis have often seen the babies reassigned as female, with the micropenis becoming a clitoris. Conversely, cases of a considerably larger than normal clitoris but otherwise 'normal' genitalia has led to children having the clitoris amputated *shivers*.

But then there are other intersex conditions to consider, in particular the nature of chromosomes. A cis male can have XX chromosomes, and a cis female XY chromosomes, and they can go for decades without ever knowing! In general, those with the condition often only find out because of the infertility it causes.

And even then there are so many other conditions to think about, and where the line should even be drawn regarding what is 'intersex' and what is 'dyadic'. For instance, take a cis male who has normative genitalia and XY chromosomes, but a larger than normal amount of estrogen, leading to secondary sex characteristics which are traditionally considered 'female' - by medical standards, he wouldn't be considered intersex, even though his 'sex' is evidently different from what is 'expected' of cis males.

The simple truth of the matter is that nature doesn't cut and paste people into 'male' and 'female' categories as readily as most people presume. Rather, there is considerable variation, and it is the pressures of society that lead to the medical establishment assigning genders based on how the person's body looks.

Somewhat related personal side-note: when I researched intersex conditions a few months back, I saw some information on those assigned male who have two X chromosomes, and I thought that I had a lot of the symptoms. However, as it turned out, my mother had to have my chromosomes tested while she was pregnant with me (she was over 40, so they wanted to test for Down's syndrome) - turns out I have the standard XY. At the time I thought "Damn, that would have explained so much..."

I've heard that when trans people get their chromosomes examined (which is not a common procedure at all) a lot of us do not have the normal XX or XY combos, but they aren't anything like XO or something else that would attract notice by being related to other stuff. Not sure if this is true. I think that this will ALL be found to be biological at some point or other and we are just not bright enough to know what all the situations may be. But of course, they could be in the brain and not the chromosomes or organs.

--Jay

I recently saw a XXY female (who was also mtf transsexual) who was on anderson cooper, she said she felt different her whole life and yet finding out the condition for her personally made her feel a sense of confirmation, because she simply wanted to know.

Of course there are also hormonal variations in addition to chromosomal ones:

here are the known conditions so far:

Quote... Aphallia - A rare occurrence where a male is born without a penis or where a female is born without a clitoris. As of 2005, only 75 cases of aphallia have been documented.[7] It should not be confused with intentional or accidental amputation of the genitalia...

Diphallia (also known as penile duplication, diphallic terata, and diphallasparatus) - A condition where a male is born with two penises. It's extremely rare, with only 100 cases being recorded since 1609 and an occurrence rate of 1 in 5,500,000 in the United States. The penises may be side by side or one on top of the other, being of equal size or with one penis being distinctively larger than the other, and both penises may be suitable for urination and intercourse. Men with diphallia may be sterile...

Uterus didelphys (also known as double uterus) - A condition where a female is born with two uteri. It is often accompanied by two vaginas. It is generally not considered a health issue and women with uterus didelphys usually have normal sex lives and pregnancies.[12]

For the full list see: http://en.wikipedia.org/wiki/Sex_development_disorder (http://en.wikipedia.org/wiki/Sex_development_disorder)

But this page forgot another one which is :

QuoteXX male syndrome (also called de la Chapelle syndrome, for a researcher who characterized it in 1972[1]) is a rare sex chromosomal disorder. Usually it is caused by unequal crossing over between X and Y chromosomes during meiosis in the father, which results in the X chromosome containing the normally-male SRY gene. When this X combines with a normal X from the mother during fertilization, the result is an XX male.

This syndrome occurs in approximately four or five in 100,000 individuals, making it less common than Klinefelter syndrome.[2][3]

http://en.wikipedia.org/wiki/Xx_male (http://en.wikipedia.org/wiki/Xx_male)


I also decided to bold the ones that were the most rare and different. But all of these are just the known ones.

Quote from: spacial on February 06, 2013, 04:54:54 PM
I fully understand Jamie. No negative judgement was intended.

These are valid points, but I wonder if causes are quite as significant as solutions?

LOL WHEN DID MY NAME BECOME JAMIE?  :D

You must be sleepy my friend.... tee hee  :icon_bong:

Quote from: Shawn Sunshine on February 06, 2013, 06:59:37 PM

LOL WHEN DID MY NAME BECOME JAMIE?  :D

You must be sleepy my friend.... tee hee  :icon_bong:

Sorry Dave.

As for genetics. I stay away from that nonsense.

OK I know we're all suppose to see it as some arithmetic final word for everything, but the reality is few really understand it.

We can say, for example, 'Oh look, this one has XX so they must be female'. Except we know that isn't necessarily the case.

Now other evidence demonstrates a clear mendelian link between genetics and personality, yet the XX doesn't lie! Or is it that we are just trying to play with a toy we don't really know anything about and are not entirely sure even exists?

I've seen too many variations in almost any aspect of life to think I will ever have enough understanding of genetics to be talking about individual strands of DNA in any meaninful sense.

We are what we are. Flawed Humans. We are endowed by our creator with with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.

That is the fundamental principal we must live by and insist upon for all people.

We need nothing else.

Ok then Jack,  ;D

I don't think genetics is nonsense at all, nor is studying the brain and body for hormonal interactions.

However this brings up another thing, i personally also feel spiritually female more than i do male, for those of us who believe or are aware of ourselves I wonder how much of a factor this plays into someones overall sense of self.

yeah theres alot of trans folks around of all kinds, and specially also the intersex. I have know a few intersex people but not many and its very ignored topic specially if your to convince some ignorant they complitely ignore it even exist and even so there all into force surgery on them. brbrbr.. :embarrassed:

it might sound wierd but I wish I would be intersex.
I already say my body is intersex, cause I feel my body biologically is a mix between E and T had made, but I dont think I got any intersex conditions as I used to get very strong and horrible periods back when I had it,
also im neither very hairy (this also a general fact in my famely that we arnt that hairy) or very maculine by look, more androgyne.

Of course, cisgender is the wrong term. Refers to someone who is not trans. But I know what you mean. Not sure what the term is.

--Jay

I read the first message in this topic and LOVE it.  I love the replies.

There are a number of intersex conditions and for some conditions, multiple causes.  Take AIS for example, it can be due to improper folding of the androgen receptor (actually one primary androgen receptor and a plethora of minor receptors) that leads a slightly different shape in the binding site which then leads to an inability or reduced ability of the specific androgen to bind.  There are at least five primary androgens, the metabolites of which are also active.  Figuring just 5 receptors and 5 androgens, all with equal binding propensity and that gives 3125 possibilities of an error.  Given the redundancy in the body, it's probably just over 20 but 20 is a big number when we are talking about determining our sex.   And that's only this one problem.  Science doesn't know all the answers or even all the right questions.  We know so very little. 

In the end, because of numbers of hormones and numbers of receptors, it is highly probable that there is a significant portion of the population that do not meet the conventional definition of man or woman, at least in part. If that part is the brain, well, here we are, cause unknown in many cases.....  If that part is a sex organ, well, here we are, exact cause sometimes known..... But we are both trying to get the mind and body to agree.

Quote from: Shawn Sunshine on February 06, 2013, 07:36:47 PM

I don't think genetics is nonsense at all, nor is studying the brain and body for hormonal interactions.

With respect, the two are entirely different.

Hormonal interactions are well understood and can be predictable.

Studies of the brain really depend upon what you mean by the brain, but it's basic function is also quite welkl understood, can be studied and is reasonably predictable.

But genetics is mostly just guess work and babble.

For example. I see a rainbow in the correct way, as two colours, yellow and blue. Many others see it in that lesser way, with the seven colour nonsense.

Yet it has been suggested that the gene controlling what colours we see is located on the X chromazone.

So, is my ability to see the correct two colour rainbow a sexual thing-a-ma-jiggy?

An I suppose to get that high that so many claim to get from sex, simply by seeing the correct two colour arrangement?

And what of those unfortunates who see all those seven colours? Do they deserve a bit of equality here?

QuoteAnd what of those unfortunates who see all those seven colours? Do they deserve a bit of equality here?

You are very strange, It's hard for me to tell when your being sacrastic  :icon_clap:

Besides everyone knows that rainbows are black and white

Quote from: Shawn Sunshine on February 06, 2013, 01:15:27 PM
Sometimes even you are forced into a situation where you need to transition simply because a doctor did surgery and assigned you the wrong sex, they don't always get it right with obvious intersex babies.

From what I've read, this "wrong handling" is very common (and the rationale comes mainly from John Money, whose faulty research, prejudices and outright failures have been well-documented).

This is a part of the problem with looking at the "community" in very narrow terms -- those on the margins often get very little attention, and if someone is just beginning to become familiar with the various dialogues and controversies within the umbrella community, and those within its various factions and sub-communities, it can often turn disheartening. When I first started engaging with the trans community (mainly online, starting before the WWW existed, going back to stand-alone BBS days) there was already a lot of friction between some intersex individuals and others in the trans community, concerning allegations of "appropriation" and so on. Of course, a lot of the more recent research that suggests a neurological (and therefore organic, medical, and "real" basis for transgendered identities) was either in its infancy or hadn't been done yet. And of course it remains unconfirmed and not entirely accepted, largely because many people tend to ignore some of the historical evidence, that trans identities (or what drives them, creates them, in a sense) has always been present across just about all the cultures that have been studied or can be studies in retrospect.

The bias about genitalia is one that is (to me) largely a cultural artifact, and speaks to the effects of misogyny in our culture, a misogyny that if fueled in large part by some aspects of Christian dogma than continue to inform and affect culture, even for those who were never raised in a Christian sect or community.

One point that may be of interest or relevant to your situation and to others, Shaun, is that, despite the fact that the DSM has made it clear for many years now that practicioners should eliminate intersex conditions as a part of their differential diagnosis, I don't think that is really happening consistently at this point. I raised various concerns with my (non-MD) therapist about possible intersex factors in my history, and felt largely dismissed as I brought them up. I was also married to an MD, but one who had a strong vested interest in perceiving me as male for her own personal, psychological reasons, I suspect. So raising those same concerns with her was also dismissed. But it seems to me that, unless there are profound signs, an intersex diagnosis is often far harder to come by than it probably should be, if one were to read the standard texts and passages from common medical texts, such as Harrison's (what was the standard internal medicine text book, at least when my ex was in med school).

I just want to echo your main point here, that there are probably more undiagnosed intersex conditions than anyone imagines, in part because over time medical people have become aware that aside from those they couldn't help missing (those where external appearances and genitalia were clearly outside normal ranges of variation), there are a great many more subtle forms and cases, where there might be some signs, but cultural bias and other factors that stand behind the idea of gender as binary, are a great part of why those who have such conditions have tended to find themselves patronized, ignored and abused, both by people in everyday life and by those in the medical-psychological professions.

Quote from: Shawn Sunshine on February 07, 2013, 12:38:46 PM
You are very strange, It's hard for me to tell when your being sacrastic  :icon_clap:

Besides everyone knows that rainbows are black and white

The point is Shawn, I took what we are informed about the sex chromazone, added it to what we are told about apparent predominance of males with one of the several colour blind conditions, then described, quite accurately, one of those colour blind conditions. I then twisted the conclusions to create a social division.

Quote from: Elspeth on February 07, 2013, 12:54:24 PM
there was already a lot of friction between some intersex individuals and others in the trans community, concerning allegations of "appropriation" and so on.

This sort of unacceptable consequence is what can be expected when we search for reasons for divisions.

The common denominator is an expectation that, those who choose to express their gender in manner that is varient from others in society are justified on the basis of the fundamental right of all humans to pursue happiness.

Once we seek or even tolerate, these sort of random, often questionable, frequently specious and generally unnecessary, explainations for an aspect of self expression we create reasons for some to have their basic right removed.

Quote from: spacial on February 07, 2013, 05:30:14 PM
This sort of unacceptable consequence is what can be expected when we search for reasons for divisions.

Actually, I think it's in the nature of human nature, more than anything.  Particularly for those who identified as intersex only at the time, their particular issues were very different in many respects, from issues that had prominence among the transgendered, and they definitely had a point, in terms of wanting to be sure that their own issues were being heard more clearly, since for many intersex individual, there greatest concern was in being coerced into a role without consent, yet in different ways. For some, they had no particular desire in hiding their identity or melding in with one gender or another... some wanted visibility as neither one gender or the other. I don't think there has ever been universal agreement there, in part because there are too many different types of intersex conditions for there to ever be a consensus position that would serve everyone.

One of the more interesting aspects, though, going back to John Money's early claims of "success" seems to be at this point the growing acceptance among at least some part of the medical profession that assigning gender to the intersexed individual should not be done until the individual has a voice and freely expresses some preference.  Frankly, I think such a principle, if it were widely accepted for everyone, regardless of presumptions about whether someone is intersexed or not, would possibly do wonders for many of us, or at least for those of us yet to be born.

Sidebar on trans and intersex community history:  Sometimes it could easily come across that some transgendered individuals wanted to identify as intersex in part because a biological explanation would eliminate the questions of choice and volition that often tended to be raised by those antagonistic towards transgendered folk, often coming from people in the gay and lesbian communities, who interpreted transgendered identities as somehow an act of passing judgment on, or reflecting badly on them, especially back in the era when some in the GL parts of the community tended to take the line that "Everyone would treat US better if it weren't for the freaks, drag queens, ->-bleeped-<-s, radical faeries, stone butches, yaddayaddayadda.

Quote from: Elspeth on February 07, 2013, 07:05:12 PM
Particularly for those who identified as intersex only at the time, their particular issues were very different in many respects, from issues that had prominence among the transgendered, and they definitely had a point, in terms of wanting to be sure that their own issues were being heard more clearly, since for many intersex individual, there greatest concern was in being coerced into a role without consent, yet in different ways.

............ that assigning gender to the intersexed individual should not be done until the individual has a voice and freely expresses some preference. 

You see, these two points are the issue?

You highlight a sub group who present with a problem concerning their physicality as being distinct from those whose problems are their attitude with an otherwise healthy body. But that division is, with respect, arbitrary, though I can fully appreciate that those affected might see otherwise.

That some born with physically identifiable problems may see themselves as more deserving or different from those whose problems are less identifiable is irrelevant. The problem is the same. The triage should be based upon immediate need, not a value judgement, to separate the neurotic vanity from the unfortunates.

Or we could simply say that god doesn't make mistakes and leave all of them accept their assigned genders with stoical gratitude.

The second point is exactly it. That an issue such as assigned gender for example, is a matter for the individual. People don't complain about somehting as innate as their apparent gender without good reason. Granted, some complain of many strange things and attaching themselves to transgender is no different. But they still have a serious problem and are equally deserving our our support.

Not ignoring you, spacial, but at the moment I'm too exhausted to give this the attention it deserves. I can barely type, much less think as clearly as I'd need to in order to give this the respectful response it deserves and requires. If I'm snowed in tomorrow morning, and still have power, this should be one of the first post I'll respond to, along with your thoughts on defining gender.

If being cis or trans is some kind of neurological or physiological disorder, I'm almost certainly cis.

Part of why I doubt.

Quote from: Trixie on February 08, 2013, 05:13:54 PM
If being cis or trans is some kind of neurological or physiological disorder, I'm almost certainly cis.

Part of why I doubt.

What makes you think you could detect it?  Particularly when, of the relatively recent and preliminary studies that do suggest it might have physiological roots in certain brain structures (triggered, it seems to be assumed, by atypical events in fetal development) there are very few signs that the structures involved are massive or large enough in volume (physically speaking, NOT in terms of the impact on deeply seated notions of identity) to be detected or diagnostically analyzed, except post mortem, as part of a physical autopsy. 

A few more recent studies have suggested some more obvious differences that might lead to diagnostic tests, but they are far from confirmed at present.  None are anything that seems to have any other significant symptoms associated with it, besides those we've come to consider largely "mental" in nature.

More on this when I have a fresh mind and eyes and fingers.

Quote from: Elspeth on February 08, 2013, 05:28:08 PM
What makes you think you could detect it?  Particularly when, of the relatively recent and preliminary studies that do suggest it might have physiological roots in certain brain structures (triggered, it seems to be assumed, by atypical events in fetal development) there are very few signs that the structures involved are massive or large enough in volume (physically speaking, NOT in terms of the impact on deeply seated notions of identity) to be detected or diagnostically analyzed, except post mortem, as part of a physical autopsy. 

A few more recent studies have suggested some more obvious differences that might lead to diagnostic tests, but they are far from confirmed at present.  None are anything that seems to have any other significant symptoms associated with it, besides those we've come to consider largely "mental" in nature.

More on this when I have a fresh mind and eyes and fingers.

I have kind of assumed that I have a fully "male" brain because I don't really experience physical dysphoria.

I am interested, but not very knowledgeable in psychology or biology, so I really don't know much about this. Apologizes in advance if what I say is way off the mark.

The two biggest questions are

1. Do people really dwell into intersex possibilities because they need a medical excuse to validate how they feel to others so that it may not be as "taboo"?

or

2. Do people really dwell into intersex possibilities for the future medical enlightenment/processes that may derive from it?

Sometimes I think  it's number 1.

I bring this up because of the current discussion in this thread and a video I watched called "For the Bible told me so."

The documentary felt more like a "dont hate us cause this is natural....not a choice; therefore not a sin."  I just shrug my shoulders and think to myself, those who think homosexuality or trans is a sin will not change their minds because of a documentary or new medical evidence. Nor will it changes peoples' perception of LGBT. Change comes from getting to know people who are LGBT and realizing they are human beings. Medical journals and documentaries aren't going to do that.

So I just say I am who I am. Regardless of chromosome tests, blood work, lab work. Straight Cisgender people don't need the labwork to prove they are straight or cis. Neither do I

i am exactly as cis i think i am. ;)

nah, i don't know why i'm trans, and honestly, i don't even really want to know.  usually i'm really interested in dissecting stuff, deconstructing it, figuring things out, and a year ago i'd have been thrilled to find out what it is, but in the mean time, i've realized that they could figure out tomorrow that TRANS PEOPLE ARE JUST SOME CRAZY HOMOS or something even more ridiculous like our brains have been taken over by gender changing fungi and i wouldn't care, because i'm happy, and that's all that matters.

QuoteThe documentary felt more like a "dont hate us cause this is natural....not a choice; therefore not a sin."  I just shrug my shoulders and think to myself, those who think homosexuality or trans is a sin will not change their minds because of a documentary or new medical evidence. Nor will it changes peoples' perception of LGBT. Change comes from getting to know people who are LGBT and realizing they are human beings. Medical journals and documentaries aren't going to do that.

Actually I watched that documentary and Mel White has done a lot for the lgbt community and his organization he started called soulforce.

I have won people over in my family already just from medical and spiritual web pages. It won me over as well.

Learning about the various intersex conditions changed my perception as I go with number 2:

QuoteDo people really dwell into intersex possibilities for the future medical enlightenment/processes that may derive from it?

Informing people of the actual science does help those who are open enough mentally and not so close minded spiritually, but it doesn't always help, in the case of my mom it did not help as she thinks all the doctors who discover these conditions are quacks.

But it helped me immensely and also like i said a few others in my family. Its great to meet people and get to know them in person, but its also great to have science helping along. It is even greater in my opinion to see scriptures in a new light instead of trying to make it something it is not. I have learned a great deal about what the clobbering verses mean now.

I look forward to whatever scientific studies are learned in the future. This is why I personally believe intersex and transgender and orientation have a relationship with one another and we should embrace it.

QuoteStraight Cisgender people don't need the labwork to prove they are straight or cis. Neither do I

Maybe, but in studying the brain in animals and humans it may also show why people are attracted to what they are attracted to, I think 20 years from now we will learn more than we thought. I think the reason certain lgbt organizations are after some science facts is because they are tired of being attacked by people who won't listen.

For me I started getting breasts when i was 16 and did not develop like a typical male, i always wondered what the heck was wrong with me. Then I was diagnosed as schizophrenic and I knew that was wrong as i got older, finally able to get doctors to realize im bi polar.

As science becomes more exact we are better able to understand ourselves and treat conditions. I was glad to finally find out why I had breasts and a micro penis. I was glad to get a proper diagnosis of my mental problems as well.

Quote from: Annah on February 08, 2013, 05:49:28 PM
The two biggest questions are

1. Do people really dwell into intersex possibilities because they need a medical excuse to validate how they feel to others so that it may not be as "taboo"?

or

2. Do people really dwell into intersex possibilities for the future medical enlightenment/processes that may derive from it?

Sometimes I think  it's number 1.

I bring this up because of the current discussion in this thread and a video I watched called "For the Bible told me so."

The documentary felt more like a "dont hate us cause this is natural....not a choice; therefore not a sin."  I just shrug my shoulders and think to myself, those who think homosexuality or trans is a sin will not change their minds because of a documentary or new medical evidence. Nor will it changes peoples' perception of LGBT. Change comes from getting to know people who are LGBT and realizing they are human beings. Medical journals and documentaries aren't going to do that.

So I just say I am who I am. Regardless of chromosome tests, blood work, lab work. Straight Cisgender people don't need the labwork to prove they are straight or cis. Neither do I

Surely someone with an intersexed condition has the opportunity to choose between going either way or remaining in the middle.

What would govern that choice?

We know that some who have been assigned one gender as infants and grown up within that, do later change their minds and attempt to switch. That surely reduces the importance of the nurturer argument.

Quote from: Annah on February 08, 2013, 05:49:28 PM


So I just say I am who I am. Regardless of chromosome tests, blood work, lab work. Straight Cisgender people don't need the labwork to prove they are straight or cis. Neither do I

Fathering children is a firm confirmation of being a fertile cisman...heavy beardgrowth and bodyhair as well...
So I don't understand some things you wrote?

Quote from: Annah on January 17, 2012, 12:46:00 AM


I am intersex. Transsexualism is a freakin walk in the park compared to the physical struggles I went through growing up (and being transsexual is hard too...i changed genders...i know the hell but its miniscule compared to the physical conditions I suffered from being intersex). I have lost count the many times I was rushed to the hospital because my hormones went out of whack every other year, developing co morbids that were extremely painful, having breasts in junior high school (not the man boobs....real breasts), not dating in high school for fear of sexual discovery.

When a transgender can say "oh im intersex" without even really knowing the hell some of us intersex people went through (because they don't like the word transsexual) is insulting; not to mention the attempt to romanticize the intersex condition.

Quote from: Annah on February 08, 2013, 05:49:28 PM
So I just say I am who I am. Regardless of chromosome tests, blood work, lab work. Straight Cisgender people don't need the labwork to prove they are straight or cis. Neither do I

TRUTH BOMB DOT COM

My original point, which has gotten off track ,was that I can imagine all of the people who are sitting there hating on someone who is different than them and not even knowing that they too may be different in a very similar way.

I think its helpful to learn about our bodies and brains in general, cisgendered have been been learning about how they tick in sex ed class way before others have been taught about.

Quote from: Annah on February 08, 2013, 05:49:28 PM
Sometimes I think  it's number 1.

I bring this up because of the current discussion in this thread and a video I watched called "For the Bible told me so."

The documentary felt more like a "dont hate us cause this is natural....not a choice; therefore not a sin."  I just shrug my shoulders and think to myself, those who think homosexuality or trans is a sin will not change their minds because of a documentary or new medical evidence. Nor will it changes peoples' perception of LGBT. Change comes from getting to know people who are LGBT and realizing they are human beings. Medical journals and documentaries aren't going to do that.

One question: Can't it be both? I agree that, especially in some cultures it's almost essential to find a medical reason, something that shows that, if God doesn't make mistakes, then the fact that I was born this way, and can show you physical evidence, tends to more or less force those whose belief systems run like that to start reconsidering their interpretations of scripture.

I say this in part because I only recently managed to connect online to some Mormon transgen people (I grew up Mormon, but distanced myself from it in my teens).  Having followed transgen discussions and debates for decades now, it was a bit shocking to me to find that, at least in concensus, there is a belief that's strongly held among them, and used as a negotiating tactic in some ways within the church to make the case that being transgendered (which to them is mainly defined as transsexual (pre-op)) and excludes het. crossdressers and just about everyone else one might label trans, comes down to making a case that being transsexual is a neurological form of an intersex condition.  So it does wind up having some real relevance for those in that culture, at least for those who wish to maintain a connection to that religious community, and continue to expect, at least, some degree of tolerance. More than a bit disturbing to me, but that was probably, deep down, part of why I left.

In turn, their strategies and negotiations very much turn on providing a compelling case for their assertion, based on as much scientific data as is available. Some also point to the various issues with environmental estrogens and estrogen-mimicking compounds, and the increased commonness of intersex conditions in wildlife to bolster this case, and even to make an argument that, because Mormons believe that spirits choose the bodies they are placed in at birth, transgendered individuals are especially "valiant" for choosing bodies they know will have a very challenging life to live.  It probably makes no sense at all if you weren't born into that church. And I don't mean to ridicule it by describing it briefly. In fact, it tends to break my heart, at least at some level, because staying within those communities as a transgendered person requires a special kind of courage that I fear I may be lacking. Granted, I do feel I've had greater peace of mind in some ways, and it's not like my life has been a cakewalk.

Quote from: Trixie on February 08, 2013, 05:37:32 PM
I have kind of assumed that I have a fully "male" brain because I don't really experience physical dysphoria.

I don't want to assume too much about you. There are people who seem to be perfectly happy with the bodies they were given at birth, who still feel a strong urge to crossdress or engage in other trangendered behaviors. Unless you fill in the blanks we won't know, and many of us do tend to focus mainly on what's personally relevant. I don't feel qualified to comment, at this point, on where things stand with those quite sure they are fully male, and also, people do sometimes alter their POV over time, for instance, realizing that they may be grasping at a way of identifying that leads to the least potential turmoil. I personally find some aspects of the current categories to be open to a lot of potential questions.

I'm also aware, mainly from having been with a doctor from pre med school through to private practice, that there are many more things that remain unknown and unexplored than is probably the common impression for people outside the medical and academic communities that study such things. Psychology, for instance, seems to me to be about where internal medicine was in, say, the 1890s or so.  Meaning, it's more dangerous in some ways to trust a psych practitioner's so-called "knowledge" than it is to trust your own intuition and instincts.

Our culture is hugely biased when it comes to sex, gender and sexual matters in general. Until there's a lot more actual science, I don't tend to trust that the existing theories are more than 20% based in reality, and 80% on prejudice and assumptions that are questionable. That's a wild estimate, by the way... given how things are, I doubt it could be anything else.

Quote from: spacial on February 08, 2013, 07:45:46 AM
You see, these two points are the issue?

You highlight a sub group who present with a problem concerning their physicality as being distinct from those whose problems are their attitude with an otherwise healthy body. But that division is, with respect, arbitrary, though I can fully appreciate that those affected might see otherwise.

That some born with physically identifiable problems may see themselves as more deserving or different from those whose problems are less identifiable is irrelevant. The problem is the same. The triage should be based upon immediate need, not a value judgement, to separate the neurotic vanity from the unfortunates.

I see a couple of tough issues here, though.

One, "physically identifiable" -- how is detectability relevant to need?  And whose detectability are we talking about? If the affected person detects something easily, but medical pros find it difficult or impossible to confirm, you can easily be faced with a fairly crazy-making situation, especially if it turns out, in time, that the condition was something that could have been detected with the right tools or tests. Unfortunately, this applies to a lot of things that wind up being shuffled off to psychiatry, sometimes due mainly to cultural bias and prejudices.

Detectability changed with technology, but if people are consistently distressed in a similar pattern, that doesn't mean they aren't in need of attention and some form of help. One of my long-standing opinions, though, is that we wind up medicalizing something that may have been handled better in other cultures, simply by trusting what people detect in themselves.

One of the first things my ex-therapist pointed out to me was that the problems I was having were not so much in myself -- I knew who and what I was. The problems were mainly in society. It's society that therefore needs the real cure.  Some past societies didn't seem to turn this into a problem the way ours does, and I think a lot of insights over the years, especially in feminist research and discussions, have relevance, because antagonism against women is often at the heart of antagonism against those whose gender identity is atypical for their presumed physical sex, as well as it is against gays, and even the antagonism within gay communities against their more feminine members. (It also plays out in some conflicts against FTMs, particularly among some radfems, but that gets fairly tangled, or at least even more tangled than some of what plays out elsewhere).

Quote
The second point is exactly it. That an issue such as assigned gender for example, is a matter for the individual. People don't complain about somehting as innate as their apparent gender without good reason. Granted, some complain of many strange things and attaching themselves to transgender is no different. But they still have a serious problem and are equally deserving our our support.

The problem being, societies don't tend to leave individuals alone. Societies tend to exploit individuals, to recruit them to play roles, in many cases informally policing members to take on roles in that society for the benefit of either the society as a whole, or those in the society who enjoy being on top, or are desperate not to be put under the treads.

Quote from: Elspeth on February 09, 2013, 05:09:32 PM
I see a couple of tough issues here, though.

One, "physically identifiable" -- how is detectability relevant to need? 

I don't think it is.

But I'm pretty sure you and I have already come to a meeting point on this issue, we just haven't realised it.

It's been a good discussion though and I'm pleased to have learnt so much from you and other. I a;so pleased I have been able to alter my own viewpoint in such an interesting manner.

I'm a little lost with this thread and it is so very important to me.  If I miss understand something that someone has said, I apologise in advance.  I tend to come at problems very differently than some or even most.  I search for causes.  It's the way I'm wired, it's what I do in my job.  I answer "Why" and then I fix the cause as much as possible.  Others deal with the damage.  To me, dealing with an effect is a partial but necessary answer in solving a problem.  Finding the cause and dealing with the cause is the other part of the answer.   The unfortunate truth is often that the state of science or medicine is such that we don't always know the cause.  But, in dealing with someone to whom the cause is important, the truth in figuring out why we are the way we are can sometimes be answered more completely than "here are some hormones and just deal with it".  I would also assert that with a cause, someone with a personality type that needs to know a cause may find options not normally thought about.

So, looking back in this string....

I am trying to figure out what is going in in my mind and body for one reason: PAIN.  Physical PAIN.  In August, I cracked three ribs and ripped an 18" gouge down my side.   I had no idea how serious the accident was it was until my wife screamed and pointed at a lot of blood running down my side.  That pain didn't even compare to what I feel every month when my testicles swell and my pelvis feels like I've been shot.   Pain didn't compare.

Because my gender identity is in question, medical doctors don't pay attention to me - even when their own test data shows something is wrong.  I had a series of meetings early yesterday morning, followed by an ugly work day followed by my wife's grandchildren getting here for the weekend.  I forgot to change my estrogen patch and Friday was day 4.  My left testicle was the size of an orange late this morning and into the afternoon and by about 2:00, I almost couldn't move.  Then I remembered and changed the patch.  It's now seven hours later and the swelling is down and it doesn't hurt that bad anymore.  But is identifying me as MTF and putting my testicles to sleep with estrogen so they don't swell and hurt a good thing?  Is being MTF and swollen testicles related?  If so, how? And now we are back to looking for a cause.

If I find out that I have a biological reason for my being a MTF, I'm using it.  I don't know about anyone else but I know that I will.  Using that as a reason really wouldn't be for me either, it would be for my wife who is really having a problem with this and I think it would help her.  Not worried about anyone else.  My friends know and accept without a physical reason.  I was talking to by boss at work Thursday about some pain in my chest and I promply got the "Where does it hurt?  You know, the pain of a heart attack is different in women than in men."  (She's a first responder.)

Lastly, intersex people blurr the lines between male and female as well as straight and gay.  Intersexed people make some people uncomfortable for that reason.  How can you judge someone when there is a biological reason for at least part of that? 

I'm going to go be with my wife right now - she looks like she needs a foot mesage.  I have enjoyed this thread and the depth of intellectual capacity by the authors is great.  I wish I could write like Elspeth. 

Quote from: Dahlia on February 09, 2013, 09:20:06 AM
Fathering children is a firm confirmation of being a fertile cisman...heavy beardgrowth and bodyhair as well...
So I don't understand some things you wrote?

Truth bomb dot com? Lol :P

Quote from: JLT1 on February 09, 2013, 09:03:50 PM
Finding the cause and dealing with the cause is the other part of the answer.   The unfortunate truth is often that the state of science or medicine is such that we don't always know the cause.  But, in dealing with someone to whom the cause is important, the truth in figuring out why we are the way we are can sometimes be answered more completely than "here are some hormones and just deal with it".  I would also assert that with a cause, someone with a personality type that needs to know a cause may find options not normally thought about.

Unfortunately, your preference for knowing causes is not necessarily relevant to how medicine works. They usually come up with a differential diagnosis (DDx) -- fit symptoms to a probable and generally known condition, and treat from there. If they do the DDx poorly, you wind up with treatment that may be entirely wrong.  It's very rare for MDs or other health care pros to be certain of what condition you have, much less to be certain of causes, as science is a work in progress, and the commonly held conjecture of today may be entirely discredited or very much revised in another 3-6 months.

But to address specifics, since that's what tends to count with getting a proper diagnosis... and keep in mind that I'm not a doctor, don't play one on TV, and my copy of Harrison's is several years out of date, so I won't even try to diagnose someone I've never (to my knowledge) seen.

QuoteI am trying to figure out what is going in in my mind and body for one reason: PAIN.  Physical PAIN.  In August, I cracked three ribs and ripped an 18" gouge down my side.   I had no idea how serious the accident was it was until my wife screamed and pointed at a lot of blood running down my side.  That pain didn't even compare to what I feel every month when my testicles swell and my pelvis feels like I've been shot.   Pain didn't compare.

Because my gender identity is in question, medical doctors don't pay attention to me - even when their own test data shows something is wrong.  I had a series of meetings early yesterday morning, followed by an ugly work day followed by my wife's grandchildren getting here for the weekend.  I forgot to change my estrogen patch and Friday was day 4.  My left testicle was the size of an orange late this morning and into the afternoon and by about 2:00, I almost couldn't move.  Then I remembered and changed the patch.  It's now seven hours later and the swelling is down and it doesn't hurt that bad anymore.  But is identifying me as MTF and putting my testicles to sleep with estrogen so they don't swell and hurt a good thing?  Is being MTF and swollen testicles related?  If so, how? And now we are back to looking for a cause.

This is not something I've heard very often, and I'm not aware of it ever being specifically related to being MTF. It does sound like it could be associated, maybe, with some kind of intersex condition or some other form of infection, growth or probably a long list of other things.

I haven't gone back to read earlier posts... was the swelling something that was happening before you were given estrogen?  I ask because I'm wondering whether something else hormonal is going on... but it's also possible that they haven't pinned down what is causing the swelling... estrogen ought to reduce it, in any case, since it tends to counter much that is active there. Think of it as using a shotgun, or better yet, a spraycan... it hits all sorts of things that might be the cause, but since it coats everything, they may not have pinned down just why the swelling began.

Also, the doctors could be ignoring things for other reasons. Some are just incompetent, or too rushed, or don't hear clearly key things that are said... or you might not have brought up something they would have listened to more closely... Doctors are somewhat trained to conduct history and physical exams, but patients are almost never expert at saying what is relevant in the most efficient manner, and some doctors are less patient with patients than others.

If you have any doubts about their confidence or dedication to your care, you may want to seek a second opinion. A third one if you really have cause to suspect your being given inadequate time and attention.

QuoteIf I find out that I have a biological reason for my being a MTF, I'm using it.  I don't know about anyone else but I know that I will.  Using that as a reason really wouldn't be for me either, it would be for my wife who is really having a problem with this and I think it would help her. 

There are some tentative bits of research that do suggest some physical roots related to certain brain structures. They're still controversial and are likely to remain so for a long time, but more and more studies have come out in the last decade or two that seem fairly suggestive, and perhaps reading some of those would be some comfort to her? The problem is, confirming most of them requires an autopsy, so it's not possible to confirm right now that any individual has these structures, and there are other questions about the finding too that I don't feel qualified to declare an opinion on, since I can only barely understand the medical jargon, and probably misread some significant chunks of it.

Anne Vitale provides a fairly brief summary of her perspectives (http://avitale.com/etiologicalreview.htm), which tend to focus on the recent research related to physiological factors.

Unlike the Wikipedia article on causes (http://en.wikipedia.org/wiki/Causes_of_transsexualism), which has what amounts to a dumpbin of all the various theories that have been spun out over the years, Vitale's effort seems to look mainly at the physical, to the extent that such research has been done.  I can't be sure it's unbiased. And it does seem to me that many of the older theories should be read very critically, if at all. Wikipedia does have the advantage of listing most of its source material on those theories, however, and you never know when you might run into someone who still subscribes to some of the older notions.

Quote from: JLT1 on February 09, 2013, 09:03:50 PM
I answer "Why" and then I fix the cause as much as possible. 

I am trying to figure out what is going in in my mind and body for one reason: PAIN.  Physical PAIN.  In August, I cracked three ribs and ripped an 18" gouge down my side.   I had no idea how serious the accident was it was until my wife screamed and pointed at a lot of blood running down my side.  That pain didn't even compare to what I feel every month when my testicles swell and my pelvis feels like I've been shot.   Pain didn't compare.

What we are doing here is trying to answer that very question. We know there are many reasons. We know the matter is serious. The best we have so far are ways to take it further.

But there doesn't seem to be a single cause. There isn't a single set of symptoms. there is certainly not a single solution.  There isn't even a single point at which it became evident.

There is just this single problem. That we here are experiencing a serious dysphoria over our gender identity.

As for not feeling pain, that is also a not uncommon symptom. I once cut off the top of my thumb. Again, not sure why.

But I have found there are a number of symptoms and experiences I have in common with others.

Part of me wants to believe it's something physiologicaly wrong with me, because that would justify it all and legitimize me, and make transitioning "okay", even from certain "haters" standpoints.

Quote from: Trixie on February 10, 2013, 10:21:09 AM
Part of me wants to believe it's something physiologicaly wrong with me, because that would justify it all and legitimize me, and make transitioning "okay", even from certain "haters" standpoints.

Yeah, can relate to that. But it won't happen. The haters will continue because they can. Like all bullies they go for easy targets.

Best thing we can do is rise above it I'm afraid.

"Unfortunately, your preference for knowing causes is not necessarily relevant to how medicine works. They usually come up with a differential diagnosis (DDx) -- fit symptoms to a probable and generally known condition, and treat from there. If they do the DDx poorly, you wind up with treatment that may be entirely wrong.  It's very rare for MDs or other health care pros to be certain of what condition you have, much less to be certain of causes, as science is a work in progress, and the commonly held conjecture of today may be entirely discredited or very much revised in another 3-6 months."

I have never heard that explained better.  Thank you.  I would assert that the the more common the condition, the more likely the DDX would lead to successful treatment.  Likewise, the fewer or less complex the symptoms, the better the DDX.  Similarly, the more knowledgeable the doctor, the better the DDX.  Then, there needs to be a clear definition of "successful treatment".  Lastly, and this is based on my experience, cost is an issue, if a definitive diagnosis does not change the treatment or the probability of a successful outcome, the diagnostic test will not be run.

In the case of an intersexed condition, the condition is not widely known, the symptoms are often complex with poorly understood causes, the manifestation of the condition can be different between individuals, knowledgeable doctors are few, diagnostic tests may or may not be available and there doesn't seem to be a uniform definition of successful treatment.  This is a problem.

So, what does a person with an intersexed condition do?

I used myself as an example.  The main part of my assertion was above but I needed the excellent summarry to make it.  That's really all.

If you could help me, see "My body is changing without hormones" thread.  Swelling was before hormones.  Probably a growth, some type of cancer, it's in my mind or XX/XY intersexed. (In addition to what I wrote, I have two eye colors, blaschko's lines (dermatologist got that one), a female bone structure, my male anatomy is slightly offset, I'm a 40D bra size, my pelvis is typical for a woman and one month into estrogen has produced an effect normally seen at six months.)  If someone could help me know how to ask a doctor for a certain MRI, I think I can get an accurate diagnosis.  (I was an NMR director before I took my current position.  NMR is a chemist's version of MRI and I know MRI instrumentation.)  Doctors won't order it because there is no standard protocol.  All I want is a standard protocol with an adjustment in one setting (relaxation time) for data acquisition.  I would even pay for it without insurance. Instead, they run every test they can think of running.

Quote from: JLT1 on February 10, 2013, 11:51:03 AM
If you could help me, see "My body is changing without hormones" thread.  Swelling was before hormones.  Probably a growth, some type of cancer, it's in my mind or XX/XY intersexed. (In addition to what I wrote, I have two eye colors, blaschko's lines (dermatologist got that one), a female bone structure, my male anatomy is slightly offset, I'm a 40D bra size, my pelvis is typical for a woman and one month into estrogen has produced an effect normally seen at six months.)  If someone could help me know how to ask a doctor for a certain MRI, I think I can get an accurate diagnosis.  (I was an NMR director before I took my current position.  NMR is a chemist's version of MRI and I know MRI instrumentation.)  Doctors won't order it because there is no standard protocol.  All I want is a standard protocol with an adjustment in one setting (relaxation time) for data acquisition.  I would even pay for it without insurance. Instead, they run every test they can think of running.

Wow. With your NMR background I would (naively) assume you might have better access to this than I do. As it so happens, my ex is a radiologist, but subspecialized. However, I did help her when she was studying for her boards following residency, listening to and asking her questions as she would explain to me the workings of NMR physics.  I don't know if there are useful protocols for this.

I scratched out "it's in my mind" above, because I tend to think that's an easy out, and it's very rarely strictly true, whatever some people want to believe about the power of the mind... if it IS all in your head somehow, there's still probably some physiological aspect of that that means saying it's all in your head is pretty meaningless. If nothing else, the fact of the swelling, and the other oddities you list pretty much proves it's not all in your mind unless these symptoms and physical traits are not detectable to anyone but you.

What you've described sounds like it could be intersex (most likely some form of mosaicism) -- please know that I'm saying this only from memory. My textbooks are mostly outdated on this, and I really haven't kept current with where the research stands on these things. I say mosaicism, mainly because of the different eyecolors... as you say, considering the nature of mosaicism, yours could be a nearly unique case, and this could be at least part of why those treating you are not hunting too hard for a conclusive diagnosis.

I would imagine, though, that if it IS mosaicism, that it would be easier to confirm that through some kind of genetic analysis. MRI can't get that fine grained (that's the problem, for instance, with the BTSc structure that's under examination as a root cause of gender identity, it's just too small, and chances are there's no safe contrast agent that could isolate it from neighboring brain structures).  Given how MRI works, if you have internal oddities it might not be conclusive what the nature of the structures would be -- densities are just that, densities -- MRI doesn't give any cytological info, just pattern matching that can sometimes suggest cell types.  Still, I'm puzzled as to why they wouldn't look harder for some suspicious mass, considering the swelling pattern/cycle (I did dig back to your intro to refresh myself on the rest of what you've said). But again, my ex is the trained radiologist, not me, so there may be some reasonable explanation as to why they haven't felt MRI could sort this out.  There are many things MRI can't differentiate well, particularly in soft tissues.

I'll see if my ex is open to looking at this or at least have a discussion with her on whether she knows of anything, but she's going through a lot with my son (trans) at present, and while she is gradually educating herself on this more, she started off from a place of denial (wanting me to be the man she saw, even though or maybe because I was completely atypical for a man) -- trangendered issues are something she has emotional reasons for avoiding, is what I'm saying... she went to one of the top med schools, and one of the top 5 radiology residency programs, and a top fellowship in her subspecialty. She's very good at what she does, and also very clear on the fact that doctors rarely know anything with certainty.

Quote from: Dahlia on February 09, 2013, 09:20:06 AM
Fathering children is a firm confirmation of being a fertile cisman...heavy beardgrowth and bodyhair as well...
So I don't understand some things you wrote?

you may wish to research various intersex symptoms before trolling next time. Your statement that intersex people cannot have children tells me enough that you know very little or nothing of the subject.

JLT,

I would recommend you to see a doctor. Normally intersex conditions are throughout a person's lifetime starting at puberty. It doesn't usually show symptoms when you feel that you may be transgender.

Personally, if I were you, I would see a doctor and get bloodwork drawn up before thinking your body is becoming female wthout hrt because you have that strong desire.

Better to err on the side of caution.

Quote from: Annah on February 10, 2013, 02:11:07 PM
I would recommend you to see a doctor. Normally intersex conditions are throughout a person's lifetime starting at puberty. It doesn't usually show symptoms when you feel that you may be transgender.

With all due respect, unless she's fabricating something, JLT is already seeing at least one, and probably more doctors. You might want to trace back to the earlier comments she's posted. While I can't rule out imagined effects, some of the items she lists sound pretty physical to me. And in general, only those DSDs that present with obvious and clearcut symptoms tend to get diagnosed, and variations are often profound even for some of the more frequent ones.

Granted, as she did say, one of the things on the differential here, besides a possible intersex/DSD condition is some kind of mass or tumor that could be producing further hormones.

A second or third opinion from an actually doctor, though, couldn't hurt; on that I entirely agree with you.

Quote from: girl you look fierce on February 10, 2013, 05:48:15 PM
It feels somehow silly that intersex feels like a dirty word because so many people latch onto the thought of being intersex in the TS community, makes me feel weird... also ironically trans is a dirty word in the intersex community for the same reason.

So yeah I feel pretty weird looking into being AIS... though I told myself I was def. not intersex until I had an unusual response to HRT and googling about my symptoms said that is what happens in AIS.

At the end of the day it doesn't matter... just be glad you weren't born with weird ambiguous genitals and forced into a gender role.

I'd be very upset if such a notion were to be suggested.

True, many people seek to rationailise what they do and claiming medical necessity to confront naysayers is not uncommon. Yet could any of us seriously criticise or find fault? We each need to do what we can to survive. I'd prefer someone sought defense in medical imperative if it will give them the peace to live.

Quote from: Elspeth on February 10, 2013, 06:19:14 PM
With all due respect, unless she's fabricating something, JLT is already seeing at least one, and probably more doctors. You might want to trace back to the earlier comments she's posted. While I can't rule out imagined effects, some of the items she lists sound pretty physical to me. And in general, only those DSDs that present with obvious and clearcut symptoms tend to get diagnosed, and variations are often profound even for some of the more frequent ones.

Granted, as she did say, one of the things on the differential here, besides a possible intersex/DSD condition is some kind of mass or tumor that could be producing further hormones.

A second or third opinion from an actually doctor, though, couldn't hurt; on that I entirely agree with you.

Oh I wasn't referring that JLT was fabricating anything.

Her first post was about how when she started to have a strong desire to transition, her body started to feminize itself without HRT. Typically, Intersex traits occur during puberty and not many years later.

I was simply implying that she may wish to see a physician to make sure it isn't any "malice" physiological symptoms that may be developing. Others may state how wonderful it is to have a body start to feminize itself without aid once the person started to have a strong desire to transition. Me, living in a family numbered with Medical Doctors (my mother is a Cardiologist of 20 years, my Uncle is a Neuro Surgeon, my other Uncle is a Cardiologist Pediatrician) tend to think on the safer side to get it checked out because one doesn't grow breast all of the sudden without aid. Now, if she was 14 saying this, I would still recommend her to see a doctor. Wouldn't you want to see a doctor if your body was reverting to another gender during middle age? I know I would..just to be on the safe side.

A lot of medical research has shown that men who developed an increase supply of estrogen and a decrease supply of testosterone (without the aid of Hormone Replacement Surgery or Orchiectomy) are early warning symptoms of Carotid artery intima-media thickness and will triple the risk of a stroke.

I go by the adage to always see a doctor whenever your body starts to change contrary to its design naturally without pharmaceutical aid. In my opinion, that is good advice and something everyone should look into and no one should take offense when someone suggests it.

Quote from: Annah on February 10, 2013, 08:38:21 PM
Oh I wasn't referring that JLT was fabricating anything.

Her first post was about how when she started to have a strong desire to transition, her body started to feminize itself without HRT.

This threw me too, and I'm very much aware that differential diagnoses can contain a lot of things, and the details she's given so far are confusing enough that I can't really draw any conclusions that I would want to stand by. If you follow more closely, though, it's not clear to me that this was an entirely accurate statement, and some of the things she describes, such as different eye colors, open the door for other possibilities. Frankly, if I had to bet right now from what she's written, I'd lay my money on some sort of mass, or something like that. I don't like going against Occam's Razor or I'd consider something involving both a mass and some form of mosaicism that involved very undeveloped ovaries floating around somewhere, maybe even some kind of mixed tissues in the testes...

Most intersex conditions present at puberty (or earlier) depending on the type, but most is not ALL. And it's fruitless to try an amateur DDx when I haven't even seen her in person. And potentially harmful to try. Especially when my main handy source is a 16th Edition copy of Harrison's, whose section on DSD is brief and schematic at best. I probably have other sources somewhere, but they'd be equally out of date. (The current edition is the 18th edition).

If you happened to read my posts from today in response, then you know I was married to a radiologist. And I was sort of bridesmaid at her sisters wedding, her sister being an Ob/Gyn. And it may not have been clear that I was living with her from before the time she started med school. I would have gone into medicine myself if my grades and family support had been there. With various non-trans conditions, though, it's probably for the best that I didn't. Certainly, my ex is the better mind for this, and while I was a National Merit scholar, her SAT scores were way better than mine, and she went to a somewhat better undergrad college.

No one was taking offense at your suggestion of seeking further opinions. I suggested it at least twice over the course of my posts.  Something is going on and it probably is not entirely good, if the changes (such as extreme groin pain) are part  of the picture. But people are often (and sometimes for good reason) suspicious of or projecting upon doctors and their approach to problems, sometimes projecting prejudice when there's a simpler explanation... as long as there is a sense that something is being missed, though, I tend to feel (especially given my own history and my mother's) that it's a good idea to get another opinion, especially if you feel you're not being heard correctly, and that does seem to be an element in JLT's story, at least as I've read it.

For reasons I suspect you agree with, from what I've gathered of your own medical history, there is at least some reason to be skeptical when it comes to how some doctors treat DSDs/intersex conditions, but at least some part of that is the great variety of conditions there are within the DSD category, and how widely varied some of them can be in terms of symptoms, timing and triggering of things that could lead to a diagnosis.

Elspeth and Annah - you are both correct.  Doctors - my GP, 4 endocrinologists (passed up the chain to ever increasing specialists), 1 dermatologist, 5 urologists (passed up the chain to ever increasing specialists), 1 heart doctor, 1 geneticest.  The last urologist sent me to a very odd research center staffed by retired Mayo Clinic folks where there was a three month wait to get in to see that specialist.  It's expensive and half of what they do doesn't seem to be covered by insurance. That guy separated things out, looking for more than one problem and managed to find one problem, which left everything I have discussed on this board as a second problem.  Should make things easier.  He did determine that my first pelvic/abdominal  MRI was not sufficient (which I had been saying).  A second abdominal MRI showed the problem he did identify (new instrument, experienced staff - beautiful images).  He is working on trying to figure out the rest.  I have a follow up scheduled.  The geneticest confirmed a suspected genetic problem with metabolism and wants to focus on that.  She really didn't know what to do about the rest.  I'm going to get that MRI somehow - even if I have to go to a research grade instrument and then get it redone by a diagnostic instrument.  I also get my bonus in April - 1/3 of my salary - I'll get the expensive genetic work done. 

In a strange way, I'm not totally worried about me.    And I sincerely thank you for support and suggestions, sometime I do get a little depressed. I'll crack this rather tough nut. I worry about others who don't have good insurance, who don't have a significant other for support or who don't have the money to work through things.  So, I ask, what can I do to help anyone else in this or a similar situation to solve their issues?

Quote from: girl you look fierce on February 10, 2013, 07:24:17 PM
Well I meant more how people are always questioning if they are intersex even if the symptoms of IS conditions preclude them, cause It hints at a kind of desire to be IS that a lot of IS people take as offensive because they struggle immensely with their conditions... I don't think it has much to do with medical necessity though because medical professionals are more experienced with and more willing to treat transsexual people than intersexed people.  :)

This ties in well with a point Padma made in another thread:

Quote from: Padma on February 10, 2013, 08:11:08 PM
What tires me out is how third parties seem to require "expert opinion" before they will accept that someone experiences their gender as incongruent. So often I hear people being told variations on "you don't know yourself." This is what puts tremendous pressure on trans folk to self-justify. None of this should require justification in the first place. And by extension, people with non-binary gender identities should not find themselves having to justify their genders to other trans folk.

We don't need to and shouldn't try to explain anything to anyone.

Our choice.

Quote from: spacial on February 11, 2013, 07:43:12 AM
We don't need to and shouldn't try to explain anything to anyone.

Our choice.

While I agree in principle with Padma's statement as it applies, especially, to those with non-binary genders, there are situations where description and explanation are not done simply to satisfy someone's unqualified, irrelevant or sometimes misguided curiosities or "concerns."

Oftentimes, though, someone who is questioning, or beginning to question binaries, or some other aspect of a friend or relative's condition, may be doing it out of genuine concern, or even budding curiosity and questioning (which may be related to their own anxieties about their own gender identity). And they may be asking questions in ways that seem rude, in many cases because they don't have the vocabulary, and are too well entrenched in prevailing and essentially mistaken assumptions that gender is binary, just because they don't know any better, and are at the very start of their own journey of understanding and/or questioning.

If one can avoid personalizing the questions, in at least some (possibly large) percentage of cases, one might find that one was helping that person expand their horizons.  Likewise, responding reactively could lead that person to avoid asking questions they could really benefit from discussing. Of course, in many cases the entrenchment runs deep... and even if you happen to have an impact on that person's thinking, you might not notice the effects immediately, or even see them become clear over the course of months or even years.

And if someone is searching for causes, some seemingly rude questions or speculation might also come across as "appropriation" to some people who've lived with terrible distress and repeated treatments, probings and surgeries because of their particular DSD (intersex) conditions.  There's also the problem that having a condition, while it often means one will become very well-versed in the details of that specific condition, and at least some of those that present with similar symptoms, can mean that each person who has a personal history that is informed by their treatment at the hands of medicos for DSD-related problems is likely to have a different, and sometimes profoundly different and incomplete understanding of just what falls into the DSD category. A trained doctor has the small benefit of knowing that their own understanding is incomplete, but many laypeople still suffer under the delusion that medicine "knows" things, when it actually tends (almost always) to deal in statistics and probabilities.

There's an excellent video on this from James Burke, part of his classic series on how the scientific age came to be, The Day the Universe Changed (http://youtu.be/wM2UZ26b1EQ).

I do tend to think, over time, and especially if some of the more recent research is confirmed on etiology of transsexual identities (and perhaps transgendered identities in the broadest terms), that those conditions could wind up being recategorized as part of the DSD collection. It won't mean that someone who might now be called transsexual  now has Klinefelter's, Turner's, AIS or any of the other conditions on the DSD laundry list... it would only mean that doctors were recognizing that the condition comes from a specific range of physiological causes during fetal development (or whatever turns out to be the etiology of the condition).

This also does have relevance for non-binaries, in the sense that growing evidence to suggest that gender IS a continuum and not a binary, even though the population distribution may be shaped more like a dumbbell, that kind of evidence, once it's found and fairly unimpeachable, might very well lead in part to a shift in social prejudices. In the present moment, though, it has very little practical relevance, as long as many people do remain attached to the prejudice that gender is simple and visually detectable.

I understand your points Elspeth, but completel agree with Padma here.




A personal perspective.

I think, as humans, we need a level of self esteme, a recognition that we are of value to ourselves and others, as the fuel, if you like, to simply go on.

In another thread Felix is talking about how so often, the strong seem to impose their position, their standing, to harmful effect upon others.

Now we don't tend to see this same effect, so often with children. We do impose authority, but hopefully, our intentions, at least, are good.

But with peers, I think the strong can frequently be quite nasty. Not so much for the sake of it, but to reimpose their own standing, even their own self esteme, back onto us.

For example, we announce that we are transgender. This puts them into unfamiliar territory, a point where their own sense of self and worth are not so apparent. They respond by asking for information then work the discussion round to an evidence situation where they can and I suggest, know, re-impose their own esteme onto us. In their mind, by exposing an apparent lack of recognised evidence, they have disproven us and shown they have the greater knowledge, standing.

We can end up crushed. Worse, we can end up doubtful of ourselves, that leads to a spiral of self doubt, loss of self esteme and in extreme situations, put ourselves into a target status, for bullies.

I've been working on this sequence of notions for a number of years, but have only now, managed to find a coherent way to describe it. 

Quote from: spacial on February 11, 2013, 10:09:54 AM
A personal perspective.

I think, as humans, we need a level of self esteme, a recognition that we are of value to ourselves and others, as the fuel, if you like, to simply go on.

In another thread Felix is talking about how so often, the strong seem to impose their position, their standing, to harmful effect upon others.

And perhaps nowhere has appeal to authority and expertise been done more blatantly, and more cruelly (especially during the mid-20th century, when HRT and SRS first became options) than in the medical profession. I'm not disagreeing with either of you on that.  There are countless examples I could name, especially for anything that was classified as any kind of psychological "disorder" when many such conditions were probably more accurately described as natural variations.

Maybe the most blatant example: when my ex was in med school, her professors were still referring to pregnancy as a disorder.

Our culture has so much glaringly obvious bias, and so much of it tends to still surround classifying female as other, faulty, sinful, the cause of original sin. Is it any wonder that those in power feel empowered, justified, even obligated, to "put us in out place"?

My ex's main concern for our son at this point is not really whether or not he is trans... it centers in her recognition that being trans identified puts him in a potentially harder place to be within society, even though there seems to be some sense from history and experience that, despite some terrible individual cases, those who transition to male often experience some objectively measurable benefits, at least in terms of status, income and other material measures.  But those benefits do not necessarily translate to full acceptance in all areas of society, and as long as the society remains ill, and poisoned by its strange and unproven notions about the nature of gender and physical sex identity, that second-class status is likely to persist.

I once heard a doctor tell me that she had been told in medical school "Not to do a test unless she would know what to do with the answer".   Could this be part of the problem that some less than totally cis individuals are facing?

I think I agree with you here Elspeth. It ties in with something that I mentioned in another thread on a similar discussion. (Apologies if I seem to be publicising my own sounds).

Re: Psychiatry expert: 'scientifically there is no such thing as transgender'
« Reply #31 on: Today at 12:50:30 pm »
https://www.susans.org/forums/index.php/topic,134014.msg1084097.html#new (https://www.susans.org/forums/index.php/topic,134014.msg1084097.html#new)

I feel hopeful about the future.

JLT1

Yeah, sometimes, they doth protest too much!

Quote from: JLT1 on February 12, 2013, 01:14:25 AM
I once heard a doctor tell me that she had been told in medical school "Not to do a test unless she would know what to do with the answer".   Could this be part of the problem that some less than totally cis individuals are facing?

This comes (at least this would be my ex's view, because we discussed it many times, enough that I think I understand the logic) from the fact that the more one does exams, the greater the odds of finding something that might be something very bad, but in the vast majority of cases, if not supported by other symptoms, could just be a variation with no great significance. Some of the logic here is that once they see something, they're obliged to admit, and in present-day practice, discuss with patients those possible problems.  The patient, especially if they are not a math wiz and very comfortable with statistics, is very likely to get anxious about something that might be a 1 in 12 million thing, that might require major surgery or other intrusive measures to rule out.

Consider the worst case scenario: A test to rule out something for which there is no adequate treatment or cure at present. There's a 10 percent chance, let's say, that the patient has that condition and a test would confirm it. They might die in 2 days (10% chance) or they could live to over 100, barring other problems.  Where is the advantage in doing the test if the doctor won't be able to do anything for the patient, particularly if the test itself has any risks associated with it. But even if it doesn't, the only outcome would be to tell the patient that they might be dead in 2 days. Did you help the patient by telling them that, when you couldn't do anything else to help them?

Human bodies, not only in sex organs, have a huge range of variations, and in many cases, the research there is on rarer conditions tends to be very imperfect when it comes to things like sample size and methodology. Even research on some common things, and ideas about the ranges of "normal" findings for any given test can often be unreliable or based on fairly thin research and sample sizes, that could mean that the true range of variations are simply not well understood.

In some ways it might seem like triage, but in others it's an effort to be responsible and follow the core Hippocratic oath. Doctor know that less than 100 years ago, one was at much more risk going to a doctor, than not going to one, and the same could still be true in some conditions (I suspect that is still very much the case with many psych conditions, considering how problematic the origins of psych theories are, and the difficulties inherent in doing any objective research, when the research has to be done by biased and imperfect human beings who may have their own psych issues affecting their approach to the research).

Quote from: JLT1 on February 12, 2013, 01:14:25 AM
I once heard a doctor tell me that she had been told in medical school "Not to do a test unless she would know what to do with the answer".   Could this be part of the problem that some less than totally cis individuals are facing?

I wouldn't agree with that Doctor.

On many occasions, when a test is administered for unknown symptoms, the results could yield answers that the doctor wasn't expecting at all...or if the answers are still a mystery then usually the test results are sent to someone who is an expert in which the results stated.

When my mother doesn't know the answer or is confused about symptoms she ALWAYS administers a test. Well...because if a test was not administered in which a problem could have been caught, then a doctor may be liable. Tests almost always benefits the patient or brings them one step closer to an answer. Doing no tests will leave you in the same exact spot as you were in the day before.

Quote from: Annah on February 12, 2013, 12:10:00 PM
I wouldn't agree with that Doctor....

When my mother doesn't know the answer or is confused about symptoms she ALWAYS administers a test. Well...because if a test was not administered in which a problem could have been caught, then a doctor may be liable. Tests almost always benefits the patient or brings them one step closer to an answer. Doing no tests will leave you in the same exact spot as you were in the day before.

There may nearly always be a test that could help to narrow the diagnosis, but that, by definition, would not be the kind of test this doctor was describing. It's a pretty standard part of commonly accepted practice "Not to do a test unless she would know what to do with the answer"  But in practice this far more often means considering the possible outcomes of the various tests one might be considering, to select those tests that are most likely to lead to a proper diagnosis, by the least harmful, and preferably the most direct route that does not rely on making unwarranted assumptions.

I am fairly sure your mother is not one who would do a test she would not be able to use to some clinical benefit. Even ruling out something and not yet reaching a firm diagnosis, would still be part of the logical flow of the diagnostic process.

if a patient was having problems and she could not figure out what the issue was, the first thing she would do is administer some labwork (tests) regardless whether or not she would know the answer. Even if she thought she would not know the answer before hand, she would still run a battery of tests and have a peer look over the results if she was stumped.

I think we missed something here....Some doctors, right or wrong, do seem to ask that question about doing a test.  The question I was throwing out there was "Do you think this is part of the problem so many less that cis-gendered people are facing?"  A situation where doctors are not running a test because they don't know what to do with an intersex person and therefore, the diagnosis is incomplete? 

Quote from: Annah on February 12, 2013, 09:31:12 PM
if a patient was having problems and she could not figure out what the issue was, the first thing she would do is administer some labwork (tests) regardless whether or not she would know the answer. Even if she thought she would not know the answer before hand, she would still run a battery of tests and have a peer look over the results if she was stumped.

You're misreading. It's not about whether she would know the answer, but whether she would know what to do or have anything useful to do with the result of a specific test under consideration, in the event of any of the possible answers. If the results of a test were likely to provide no actionable result, not even the action of additional tests, then the particular test under consideration has no practical value to the patient or the doctor. Still not sure I'm stating this clearly enough. You might want to try re-reading, or maybe just show the thread to your mother. I thought I was clear earlier, but this can seem like a somewhat counter-intuitive thing for people, even those who have lived with doctors for a good part of their lives.

Maybe a specific example would be better? My ex often got approached by friends who wanted full-body MRIs, thinking that a full scan would be more likely to show up whatever might be wrong. Aside from the costs, and the fact that scanning protocols tend to be tailored to a highly specific diagnostic question, one of the reasons she almost always told them this was a bad idea was essentially what JLT1 kind of suggested, and is reflected in that doctor-friend's comment. A full body MRI could show masses and all sorts of anomalies that the doctor might then need to explore further, just because they were odd, not because there were any symptoms that led anyone to suspect anything was wrong in that location.

Having started on a hunt for zebras, the doctor might be obliged, at the very least, to suggest an intrusive biopsies, surgery or further testing to rule out things the anomaly might be, in part, because of potential liability, but also common prudence, now that they had seen something that had a very limited chance of being something awful, and even though its potential awfulness might never show up. Few procedures come with no risk at all, so doing something where the outcome could lead to a whole chain of  diagnostic tests, when there had been no specific reason to suspect anything, can lead to things like MRSA, or complications related to a test that turned out to be unnecessary, but seemed at the time to be at least borderline prudent, even if it was based off an essentially blind attempt to find something.

Now, if there were a strange set of symptoms, and all the likely causes had been ruled out by other tests, doing a full body scan might be prudent, because you still have the symptoms, and you've ruled out all the most likely causes. So going on a random search under those circumstance, might have a better chance of revealing something relevant and actionable. 

This may seem odd to laypeople, but most of them have never read an MRI and have little appreciation how many people (possibly all people, especially with a full body scan) are likely to have one or more odd things, or suspicious patterns, scattered around in their bodies, most of which will remain a mystery unless someone had a symptomatic reason to go looking for them in the first place.  I'm sure there are probably similar issues in each of the other sub-specialties.

Quote from: JLT1 on February 12, 2013, 10:44:46 PM
I think we missed something here....Some doctors, right or wrong, do seem to ask that question about doing a test.  The question I was throwing out there was "Do you think this is part of the problem so many less that cis-gendered people are facing?"  A situation where doctors are not running a test because they don't know what to do with an intersex person and therefore, the diagnosis is incomplete?

I'm hesitant to say that's it, but in the case of someone not current on, or highly skeptical about more recent research, given that some of them may still assume that the old theories that transsexualism is somewhat  of a schizotypal disorder or bordering on delusional, some individual docs might justify to themselves avoiding exploration for fear of adding fuel to something they are still assuming is a kind of delusional thinking.  But I can't really say whether or to what degree any doctors really subscribe to the more outdated theories and speculations about where being trans comes from.

A woman comes into a doctor's office because she can't get pregnant.  The doctor checks things out and determines there is a possibility that individual has nearly complete AIS - genetically XY with mostly female genitalia and therefore cannot have children.  There is no cure and telling the female patient that she is actually genetically male could cause some emotional disturbances.  Does the doctor order the test? 

(One reason I didn't go to medical school was questions like this.....Another was grades my first couple of years!)

Elspeth and Annah - you both have wonderful minds.

Quote from: JLT1 on February 13, 2013, 12:31:01 AM
A woman comes into a doctor's office because she can't get pregnant.  The doctor checks things out and determines there is a possibility that individual has nearly complete AIS - genetically XY with mostly female genitalia and therefore cannot have children.  There is no cure and telling the female patient that she is actually genetically male could cause some emotional disturbances.  Does the doctor order the test? 

(One reason I didn't go to medical school was questions like this.....Another was grades my first couple of years!)

In those cases, the problem generally first presents as failure to start periods.

But I thing the original statement as quoted was saying that, when you test, be prepared to find out things you would rather not know. Especially when we assume there are no porblems.

This isn't your child.

You have AIDS.

For example. These are things which it is necessary to know. But if when we do these tests, we do need to be aware that sometimes we discover things which are a bit more complicated than we would have preferred.

The only current tests for mental illness are by observation. What medical testing exists is backup. If there ever is a medical test for mental illness, the world will become an altogether more scary place.

Quote from: JLT1 on February 13, 2013, 12:31:01 AM
A woman comes into a doctor's office because she can't get pregnant.  The doctor checks things out and determines there is a possibility that individual has nearly complete AIS - genetically XY with mostly female genitalia and therefore cannot have children.  There is no cure and telling the female patient that she is actually genetically male could cause some emotional disturbances.  Does the doctor order the test? 

Almost certainly yes, because in most cases, AIS has a fairly significant risk of testicular cancers, and unless the patient is a child, suspecting AIS and not exploring (and most likely removing any vestigial testicular tissue) would be very irresponsible, despite the significant distress that can come from learning in early adulthood that one is genetically male, if one has lived one's life and identified as female for all the time preceding this discovery.  Also, knowing the patient is infertile and not disclosing why would probably be considered malpractice or at least an offense to informed consent.

AIS has known risks associated with it. And the patient needs to  know what the known risks are, and also be aware of the condition in case further risks come to light over the coming years, as more research reveals new things, or as other treatment options could emerge over time.

Quote from: spacial on February 13, 2013, 08:11:18 AM
But I thing the original statement as quoted was saying that, when you test, be prepared to find out things you would rather not know. Especially when we assume there are no porblems.

It may seem that way, but this really is not the case. It's probably the interpretation, though, that Annah took away from how I imperfectly described it. Medical paternalism died (for the most part) a couple of decades ago.

Will try to fill in the distinctions later, as I have to be somewhere soon.

Quote from: Elspeth on February 13, 2013, 12:48:27 PM
It may seem that way, but this really is not the case. It's probably the interpretation, though, that Annah took away from how I imperfectly described it. Medical paternalism died (for the most part) a couple of decades ago.

Will try to fill in the distinctions later, as I have to be somewhere soon.

I'd like to believe that, I really would. But.....

Agree with spacial +1

I keep hoping, I keep trying.  However, I don't think medical paternalism died, it just moved up here....

Quote from: spacial on February 13, 2013, 02:18:25 PM
I'd like to believe that, I really would. But.....

You are probably right. But many of the worst features did die off, if you compare the Dr. Welby stereotype to today. Also, MDs training today and for several years now, have been women in the majority. Not to say women can't be paternalistic, but if they are, it's more subtle.

Thinking now of my ex having a hard time listening to our daughter about stuff than happened in 2nd grade. My ex is a bit impatient, and quick to seek fixes or push for someone to repress feelings in favor of problem-solving, and that is still very true of many docs.  I had a wonderful convo with my youngest today about some of these things, that allowed her to vent and to realize that those things had not been at all her fault or responsibility -- she had a very dismissive, abusive teacher that year, whose husband had just gone off to Afghanistan or Iraq, and who was taking out her issues on our child in particular, with repercussions that still echo in her relationships with classmates who were there, or formed opinions about her based on what went on in that class. I felt like our conversation was a kind of emotional breakthrough for her, and something that may gradually help her move on, and get rid of the feelings that she's had that she was responsible for the teacher's frankly abusive actions.

Then I got Skype messages later on, when she tried to have a similar discussion with my ex that sort of ran into a wall, from what I can tell, having only heard my daughter's side. Hopefully I'll find out more details tomorrow when we're next face-to-face.

sorry to reactivate this year old thread, but i must ask

so if I was to have a genetics test done and it confirmed that I do have some DSD, say xx chapelle's, and i am also transitioning from being assigned male to female, would that actually mean that I'm closer to cisgender than transgender since my genetic sex would match my gender identity? o.O

Hi,

I wont go into details as its not worth it, im intersexed and thats it, i dont need tests to tell me what i know or prepared to talk about it with Dr's  again not worth the hassle, all i said 20 years ago what i knew at age 10 and i made no comment then had i i would have been droped in to some nut house and meded up and lost my mind its that simple i was born in 1947.and things were very different then,

i'v had surgerys and before i went on any meds my body started changes before 20 years ago,  .

in a nut shell  im an intersexed female with masculine  facial feature;s  ,  about myself i dont have my womb or related organs and less of male ones , any way it does not bother me im a 66 year old woman and have a fantastic life, and contented and happy,

it matters not what xx or xy or ony other of some 15 different types we do have or not is after the fact not the deciding feature  of what we are, and some of us intersexed people can have a number of changes take place, with out out side interferance and we should be left alone to decide  who and what we are not some dam so called dr, and what he thinks.

Im just happy  that my people in Germany have got it right we decide and by decree of the Govt we can make the answer for ouir selfs.

als  Frau  ich habe mein Laben wie es sein solite, =

as a woman i have my life as it should be

...noeleena...