Susan's Place Transgender Resources

What's the earliest in Transition, that anybody's had her bottom surgery done?

I am looking into the possibility of doing it as soon as possible, even though I am only part time; for the following reasons:

• It's covered by my current employer's insurance... but in the volatile world that we live in, who knows how that may change tomorrow?


• It enables legal document changes and a seamless Go Live as a legal woman, by the time that I'm ready for full time;


• As a full time female, the physical recuperation period would be already over, and i could enjoy myself.

Much appreciate the wisdom here.... thoughts?

Thanks,
Karla

PS Haven't seen this topic discussed before.  Shouldn't we be thinking out-of-box, rather than allowing ourselves to be encumbered by the way things were done in the past?

In terms of age the youngest was about 13...

In terms of length of RLE done I know one girl extremely well (no names no pack drill) who technically did no RLE whatsoever and she is still well adjusted and happy after around 30 years post op...

HOWEVER - these are very exceptional cases... and what you have to understand is that from the doctor's perspective, in the absence of a definitive medical test that we can do to see if you are Trans or not, a doctor is being asked to do an irreversible operation, which if performed inappropriately, WILL do you harm. Thus you are effectively asking us to risk violating a founding principle of our hippocratic oath "First Do No Harm."

Unsurprisingly most doctors, me included when I qualify, WILL want some sort of proof that you are not going to have regrets, and like it or not, currently, doing an RLE is the best we have. It doesn't guarantee success - but at least it demonstrates that you have some idea of what life MAY be like on the other side...

So I am afraid that from a medical point of view, unless the operation could somehow be made reversible, or there could be some form of accurate genetic screen test or brain scan or something to give a reliable and less subjective diagnosis - the requirement for an RLE period is simply NOT going to reduce - in fact if anything it will probably progressively increase with each person that de-transitions (and possibly sues the doctors) after surgery.

So if you all want fast surgery - then I would suggest you use forums like this to literally do your utmost to actively discourage anyone who who any sign of any doubt. When the trans community gets all "come on in the water is lovely" and encourages people to go for SRS who are not 100.0% sure - it becomes its own worst enemy, because with every failure the pressure for an ever harsher, longer RLE tests builds.

Sorry that's not what you will want to hear I know - but unfortunately this is a situation where it takes two to tango - and while I'm sure most doctors understand and are sympathetic to the fact that the RLE situation places you under stress, they also have to weigh that up against the potential loss of their medical licence if they were found to have operated on someone inappropriately.

Quote from: Doctorwho? on September 11, 2013, 05:51:47 PM

So if you all want fast surgery - then I would suggest you use forums like this to literally do your utmost to actively discourage anyone who who any sign of any doubt. When the trans community gets all "come on in the water is lovely" and encourages people to go for SRS who are not 100.0% sure - it becomes its own worst enemy, because with every failure the pressure for an ever harsher, longer RLE tests builds.

Total agreement. I see so many here with starry eyed and high hops for the easy way. The magical make me happy HRT pill. The way to the front of the line with out having to deal with the gatekeepers. Skipping any pain that might come in the process of transition.
All this scares me, then in a few post down i see someone de-transition posts, and i made a mistake.

So yes i agree with you on this post. Maybe we are wrong but as someone who has been around many years and know many who have GID i would have to say slow down it is not worth rushing anything with this......
Izzy

I personally advocate the Informed Consent path....

...meaning, I feel that adults should be able to make adult decisions about their lives and bodies. Thankfully, there are many doctors, therapists, and others who agree with this. You may want to research  "ICATH" and "Informed Consent"...there are lists of doctors and resources that you can use, and therapists that will give you letters that you can use for reputable surgeons.

That said, while I support anyone's right to make these decisions...it is not always wise. Personally, I feel that a couple of years of HRT, and living full time is simply the smart way to go. Your body will change a lot during HRT, and things will move and settle in various ways.

For the same reason that many suggest waiting until after a couple of years of HRT to have breast augmentation surgery, it may be a good idea to wait for SRS until the body has had a chance to do it's thing.

However, we each have our own path. And I support our right to find it, and walk it.


And, I am fond of saying...I could go have my entire body tattooed green, my tongue cut in half, have horns surgically implanted into my head, and call myself a lizard....with no therapist letters, no RLE, nothing but my own judgement and money. We are who we are, and I cannot think of any reason at all why we should be singled out and treated as mental patients for simply wanting to live life as a whole person.

Quote from: mind is quiet now on September 11, 2013, 06:17:26 PM
Total agreement. I see so many here with starry eyed and high hops for the easy way. The magical make me happy HRT pill. The way to the front of the line with out having to deal with the gatekeepers. Skipping any pain that might come in the process of transition.
All this scares me, then in a few post down i see someone de-transition posts, and i made a mistake.

So yes i agree with you on this post. Maybe we are wrong but as someone who has been around many years and know many who have GID i would have to say slow down it is not worth rushing anything with this......
Izzy

+3. I also am in agreement. I always say this is an evolution not a revolution. It happens very slowly over many years and there is no way to know if a gender transition will make you happy without taking that first step, the RLE. The changes are slow, the social transition takes time and the legal aspect is slow.

Quote from: TaoRaven on September 11, 2013, 06:45:37 PM
I personally advocate the Informed Consent path...

And, I am fond of saying...I could go have my entire body tattooed green, my tongue cut in half, have horns surgically implanted into my head, and call myself a lizard....with no therapist letters, no RLE, nothing but my own judgement and money. We are who we are, and I cannot think of any reason at all why we should be singled out and treated as mental patients for simply wanting to live life as a whole person.

You can certainly call yourself a lizard but there is one thing that separates a green bodied, forked tongue, lizard man (or woman) from a post-op transsexual. You can still reproduce and have children. That makes things different. A thousand piercings and hundreds of body mods, even boob jobs, are not the same as SRS. None of those changes requires the removal of your sex organs and refashioning them into something else. That's why it will always be different and require a higher standard.

Quote from: Zumbagirl on September 11, 2013, 07:08:02 PM
You can certainly call yourself a lizard but there is one thing that separates a green bodied, forked tongue, lizard man (or woman) from a post-op transsexual. You can still reproduce and have children. That makes things different. A thousand piercings and hundreds of body mods, even boob jobs, are not the same as SRS. None of those changes requires the removal of your sex organs and refashioning them into something else. That's why it will always be different and require a higher standard.

Ditto, ditto and ditto.

Izz

Thanks to all those who replied, whether you agreed or disagreed with me :)

I am asking for some technical reasons why early SRS would not work...

What i neglected to mention was i have 6 months of RLE from 1987.   I stopped hormones unwillingly, faced with no job, a worthless college degree (remember Black Monday and the hiring freezes which followed?)  Faced with being jobless & homeless, I choked it all down and pronounced myself 'cured', stomped Karla down into the depths of my psyche with jackboots... and spent the next 25 years regretful and angry.

Oh, I know.... I more than know.   

These rules are made by folks who have never known hardship.  Have never stood in our shoes, personally subjected to those rules.

Yes, the body changes during HRT.   Certain 'raw materials' atrophy... and then the surgeon needs to consider skin grafts to create a vagina. 

I'm curious how many suicides (particularly teen suicides) might be prevented, by the removal of gatekeepers to HRT and SRS.

Can't we bury Harry Benjamin and move on?

Quote from: TaoRaven on September 11, 2013, 06:45:37 PM
I personally advocate the Informed Consent path....

...meaning, I feel that adults should be able to make adult decisions about their lives and bodies. Thankfully, there are many doctors, therapists, and others who agree with this. You may want to research  "ICATH" and "Informed Consent"...there are lists of doctors and resources that you can use, and therapists that will give you letters that you can use for reputable surgeons.

That said, while I support anyone's right to make these decisions...it is not always wise. Personally, I feel that a couple of years of HRT, and living full time is simply the smart way to go. Your body will change a lot during HRT, and things will move and settle in various ways.

For the same reason that many suggest waiting until after a couple of years of HRT to have breast augmentation surgery, it may be a good idea to wait for SRS until the body has had a chance to do it's thing.

However, we each have our own path. And I support our right to find it, and walk it.


And, I am fond of saying...I could go have my entire body tattooed green, my tongue cut in half, have horns surgically implanted into my head, and call myself a lizard....with no therapist letters, no RLE, nothing but my own judgement and money. We are who we are, and I cannot think of any reason at all why we should be singled out and treated as mental patients for simply wanting to live life as a whole person.

Just a quick comment..

If I'd been able to 'fast track' my SRS early on, I'd probably have had it.. And then regretted it. The 2 and a bit years I've been on hormones have allowed me to get to a place where I'm happy as I am. I don't need SRS to feel 'complete'.

The current process enabled me to avoid what could have been a very big mistake..

The statistics are quite interesting.

In Adelaide a popn of 1.5million, most Trans*people have been treated at the same practice. Suicide pre SRS has been zero. Post SRS there have been 9. Four of which were using on demand consent.

In Whittle's study in the UK N>2000, pre SRS suicide rate was 33% (the oft quoted figure) post SRS the rate was 27%, no significant difference.

I'm unsure of the use of the term 'gatekeeper' it is often used in the trans*community as a disparaging and hateful comment. In practice ALL medics are gatekeepers in any procedure. They have to be by definition of the work.

Quote from: Cindy on September 12, 2013, 12:08:51 AM
The statistics are quite interesting.

In Adelaide a popn of 1.5million, most Trans*people have been treated at the same practice. Suicide pre SRS has been zero. Post SRS there have been 9. Four of which were using on demand consent.

In Whittle's study in the UK N>2000, pre SRS suicide rate was 33% (the oft quoted figure) post SRS the rate was 27%, no significant difference.

I'm unsure of the use of the term 'gatekeeper' it is often used in the trans*community as a disparaging and hateful comment. In practice ALL medics are gatekeepers in any procedure. They have to be by definition of the work.

I almost ruined the zero pre-SRS stat earlier this year..

And I've never seen my medics as 'gatekeepers'.. Just professionals with ethics..

I'm now 3 months into my RLE.

It's not giving me a clue whether or not SRS is right for me. It's telling me whether living as a woman socially is right for me (it is). I still don't know whether my life would be better or worse with SRS and living as a woman won't tell me that. (Though I've come to the conclusion, independent of my RLE, that I will never be comfortable with a body that doesn't have a vagina.)

I've come across several Susan's members and trans women IRL who say they need a female body but have no desire to live socially as a woman. They'd be perfectly happy hiding the shape of their new genitalia and continue living as a man.

Why won't we let them?

After all, we have no problem with trans women living socially as women hiding male genitalia for the rest of their lives. Why not the reverse?

I think the concept of the one-year RLE was devised under the false notion that physical and social transition always MUST MUST MUST go hand-in-hand.

Why?

Suzi,

Excellent, insightful points and final question, 'why'.

And 'Why won't we let them'?   I'm not seeing a 'we' from our global community, doing the letting; rather, I see a new crop of old men.

'Standards', a quarter century ago, disqualified me from HRT through an endocrinologist, for being a lesbian.   Loving according to your heart, just wasn't in the ken of old men who presumed to decide for us.  I suppose I'm too outspoken as well :)   <hands on hips>

As for ethics, if there were ethics, doctors wouldn't be injecting our children with every new formaldehyde-laden vaccine that comes out of Big Pharma, whilst forcing women at risk to wait months to get a mammogram.  After my friend's child died from a flu vaccine, my trust in the medical establishment was shaken to the core.

This is not a battle that I have the resources to fight.... indeed, spironolactone has taken away much of my desire to tilt at windmills.

Which leaves me just like everyone else... getting as much information as possible and making my own plan.   The right to choose for myself but for nobody else.

Each person is unique; therefore the lawnmower of standards, nipping off any head that raises itself above the herd, makes no sense.  It may be convenient for professionals to insulate themselves from lawsuits.   I won't fight it, but I also won't believe in the standards of yesteryear just because a majority do.

Quote from: suzifrommd on September 12, 2013, 07:04:02 AM
I'm now 3 months into my RLE.

It's not giving me a clue whether or not SRS is right for me.... Why won't we let them?

I think the concept of the one-year RLE was devised under the false notion that physical and social transition always MUST MUST MUST go hand-in-hand.

Why?

Quote from: suzifrommd on September 12, 2013, 07:04:02 AM
I'm now 3 months into my RLE.

I think the concept of the one-year RLE was devised under the false notion that physical and social transition always MUST MUST MUST go hand-in-hand.

Why?

I think this all dates back to the good old Christine Jorgensen days. Back then it was srs first, hormones and social transition. I think doctors began to realize that wasn't working. They didn't want to operate on people who regretted it as soon as the anesthesia wore off. So they came up with the standards of care. If you want the surgery and want to live as a girl then prove it. It's pretty simple really. The people who were really motivated and wanted it jumped through the hoops got the surgery and then disappeared. The ones who regretted forced doctors and shrinks to keep re-evaluating the system. And that's what we have today. The real test toying is that pesky RLE. If you can endure the slings and arrows of  that one year and STILL want the surgery, then you are probably a good candidate. In reality we all know its not perfect but it seems to work pretty darn well.

If you want srs surgery on demand then its not really a question for us but a question of medical ethics. Would it be ethical for a doctor to perform a surgery that prevents reproduction if such an operation has the possibility of being detrimental to that's persons life? In the absence of answering that question we have the standards of care as the only reliable yard stick that determines whether such a medical undertaking is beneficial or not.

Quote from: karla.allen on September 11, 2013, 10:47:18 PMCan't we bury Harry Benjamin and move on?

EXCUSE ME??!! Harry was the greatest advocate for the medical treatment of transsexuals that the world ever had! Without him, shrinks would still be putting us in institutions for "testosterone therapy" and frontal lobotomies! He believed transsexualism had a physiological basis, not psychiatric, and believed it should be treated as such - but I may be biased because I was diagnosed by Harry in 1966. The "garbage" came later and not from Dr. Benjamin!

Quote from: Zumbagirl on September 12, 2013, 11:09:37 AMI think this all dates back to the good old Christine Jorgensen days.

That is strange - I never heard of anyone regretting transition/SRS until Rene Richards. Christine didn't (to the best of my knowledge) despite the unwanted publicity.

QuoteBack then it was srs first, hormones and social transition. I think doctors began to realize that wasn't working.

That is NOT true! Hormone therapy was started as long before SRS as possible and living in one's target gender was a requirement! Fair or unfair, "passing" was an absolute requirement. (I KNOW - I was there!)

Well Thailand made the min age for it there 21 a few years back. Any age works if your deemed fit and had your full time period met for it.

Quote from: karla.allen on September 11, 2013, 10:47:18 PMThese rules are made by folks who have never known hardship.  Have never stood in our shoes, personally subjected to those rules.

I'm curious how many suicides (particularly teen suicides) might be prevented, by the removal of gatekeepers to HRT and SRS.

Can't we bury Harry Benjamin and move on?

this. as far as i'm concerned, the only people who have any right to decide whether and/or when they want srs are trans people themselves. the role of doctors, therapists, and psychologists in this is to advise about the benefits and drawbacks of the surgery, as well as whatever surgical risks may be involved. it should not be their role to tell us what we are are or aren't allowed to have based on their understanding of how we're supposed to be or how we're supposed to look.

The book "True Selves" lists ten reasons someone might request SRS when that won't meet their needs but instead will make things worse for them.  Transitioning, both socially and physically, is a BIG deal.  It's not like deciding to take up skydiving or getting a tattoo, which require only informed consent.  A gender change affects every aspect of your life.  While I have some issues with the Standards of Care, I believe there still needs to be a process to weed out those who only think transition would be a good idea from those who need it. 

Are you willing to bet your life on something you haven't tried?  Something on which you have gotten only minimal guidance?  Just getting a vagina doesn't make you a woman and doesn't make you able to live as one.  We all want a quick fix, but perhaps we should be a little cautious before doing something that will irreversibly and drastically change our lives.

- Kate

Quote from: Zumbagirl on September 11, 2013, 07:08:02 PM
You can certainly call yourself a lizard but there is one thing that separates a green bodied, forked tongue, lizard man (or woman) from a post-op transsexual. You can still reproduce and have children. That makes things different. A thousand piercings and hundreds of body mods, even boob jobs, are not the same as SRS. None of those changes requires the removal of your sex organs and refashioning them into something else. That's why it will always be different and require a higher standard.

Oh, I don't know...how quick do you think anyone would be to hop in the sack with a lizard person?? ;)

Seriously though, this would have a MASSIVE impact on this person's life...dating / marriage, employment, social stigma....the list goes on. I actually think it's quite an appropriate analogy, especially since we have the option of banking sperm before SRS. In fact, I think we might have things a little better off than poor Mr. Lizard, as long as we pass well.

But people do these things....they use their adult right to decide what is best for them in their lives, and make it happen. And they don't need to spend years in therapy, and voluntarily accept the diagnosis of a mental disorder to do it.

I suffer from a birth defect. I was born in a male body. There is no logical reason in my mind that I should not be able to enjoy the benefits of modern medicine, just like any other American, and pay to have my defect surgically corrected at my own judgement.

But I also don't think that any one should be able to tell me how large my soft drink can be ;)

I think as long as you are assessed to be mentally competent enough to make another legal decision you should be allowed to make this one.  Other decisions we may make have equal or greater capacity to have drastic consequences on our lives and aren't regulated at all - having sex without protection, binge drinking, self harm up to and including suicide (not actually illegal in most places anymore). 


[edit: just wanted to point out that I do see that the difference between this and the other decisions I listed is that you are asking someone else (a doctor) to assist you and they may feel bad about helping you do something that you might regret later.  So clearly the rules are in place not for our protection but for the protection of the health care providers.  Does this make it right?]

Hi Kate,

Thanks for replying.... I did indeed try it.  Six months, composed of fruitless job interviews, not being able to repay pay student loans or even pay the rent

Why did I stop transition?  No, i did not have doubts.  It was because I couldn't pay the rent, was evicted and faced with the prospect of living on the street ... and then caved in to an ultimatum from my parents, by which I could stay with them as long as I detransitioned and got a job.

Interviewing for the same jobs as a man got me employed quickly... 25 years of wage slavery can pass quickly.

I'm not proud of this at all.   I feel that I was weak and dumb and should have stuck it out, rebelled against my parents... but it's fruitless to dwell on what might have been.   This is how it played out.  Now I'm picking up where I left off, for once living my life for myself rather than for the benefit of others.

If I seem impatient, that's why.... partially.  Having insurance through my job that will pay for SRS today, is no small motivator.  I've always worried.  Some people get laid off.  Other people don't have to worry about money!

Karla

Quote from: K8 on September 12, 2013, 06:41:32 PM
...I believe there still needs to be a process to weed out those who only think transition would be a good idea from those who need it. 

Are you willing to bet your life on something you haven't tried?  Something on which you have gotten only minimal guidance?  Just getting a vagina doesn't make you a woman and doesn't make you able to live as one.  We all want a quick fix...
- Kate

Hi.
I personally think that the optinions on this topic shifts with time in each person. I certainly can imagine that after the coming out or beginning transition, the desire to get there fast is strong, while later, one is more considerate. For me, this is now about 14 years in the past and I must say that as bad as the process felt back then, I think it was all right. I had some doubts back then, in part if I could manage to be accepted in society as the new me. I was one of those TS who desired SRS more than the social changes though I did not really consider doing SRS without the social changes. They are a package to me. I honestly cannot understand why someone would want to do SRS without transitioning. Yes, it is their choice in a way, but also it is a matter of what works - and I am not sure doing such a think in the long term works without that person getting depressed. After all what is the fundamental motivation for SRS even in these cases? It is the identification as a female. Why do some not desire the role change? My first thought - and I have heard of people who expressed that desires - was that it is out of fear of rejection. They want to be "women in the closet" sort of - know for themselves that they are women with a vagina and maybe even boobs but live as males because it is easier in some way. I doubt that this can work out in the long run - this is just another closet to hide in, that one has to come out again later. Still I think every one is unique and maybe for some thats it, its hard for a surgeon to justify his work though, creating a "guinea pig situation".
For the majority who want to transition as well as SRS, I think the focus on SRS is unhealthy. After all it does not change much at all in the social interaction. It does a couple of things that are desired: enabling sexual intercourse, get a legal gender change, allow participation in places people are naked. As neat as all of these are, they do not have nearly as much impression on your life as HRT or RLE. I think a key point in doing the RLT is to see if a person can adapt to the new social role, if it is healthy, if it works out for the person, if the path feels "right" and if that person can actually pass well and/or deal with not passing in a good manner that does not cause too much depression. If any of this does not work out, SRS will  not change this, so I can understand that "gatekeepers" basically want to see if you can manage transition before they finalize the step. As I have written elsewhere, SRS is sort of a rite of passage - it is an irreversible step, that takes dedication and requires a decision to be made with the knowledge that it is irreversible and the person doing that decision has to be ready for it - rally ready and not just eager to go on or in an emotional longing, but seriously mature enough to be ready. This is not depending on time or months of RLT, but on emotional maturity and dedication. The person has to be able to make an informed decision that is irreversible and stick to it. There can be no rushing this as to avoid later regrets which are not the end of the world, but seriously should be avoided. Agent_J had this experience in a way now that the doctors rushed her towards SRS - the opposite of what was discussed here and finding herself not ready for the passage.
I think doctors are trying to understand and figure out how to determine if a person is ready for such a decision, if the person is dedicated enough. One sign of dedication is of course going through RLT, another is to do HRT and feel great about it. I had the impression that even being a bit rebellious is actually a plus - as I told the therapist that I was doing DIY HRT he disapproved from a medical standpoint but also took this as a sign of dedication I believe, as I am even risking my health at that time to get where I wanted. So the gatekeepers want to see if you are dedicated enough, thats the whole point I think. Plus of course you grow in experience about yourself in that time. One learns abot oneself and ones motivations which informs a later decision for SRS.
If therapists could find a way to shorten this, that would be good. In the end what they do is to assess how stable your wish to transition and SRS is - if it can be swayed by setbacks in RLT or such. I know cases where this took only a few months to show the "gatekeeper" that indeed there is not much to talk about. In fact when I went there - we talked about nothing really - 7 or 8 times that was and then I got my paperwork.

So i think for SRS it can easily be justified to demand a certain period and several sessions to explore the desire for that and the dedication to that and the matureness of the patient to be able to make an informed irrevocable decision to accept the rite of passage. My opinions on HRT are very different as in contrast to SRS, hormones have an immediate and noticeable effect on social transitioning as well as physical changes - while being reversible to a large degree. To keep this from people who are transitioning for 12 months or more after starting RLT is IMO cruel. So I think that part should be revised, but not the part about SRS.
Greetings

Anjaq that was a nice post .

I can understand Karla's point of a window of opportunity financially as well. And she may be in a unique position from her past to make the decision.

It is very personal. Not all of us make a good decision based on logic, particularly over surgery like this, it is such an emotive topic.

I'm certain; I have my letters. But I can't decide where to go! Why? Emotions!

Will my vaj be perfect? Hell at my age it will probably never be used!!!

Cindy, thank you.

Just wanted to say that I understand Karlas situation as well. I was speaking more generally. And tried to point out that the timeframe IS individual. I definitely understand that if financial pressures exist like that, some things may have to get priority and with that past, certainly there are some plus points. I understand also that obviously as transition failed last time due to financial reasons, she does not want to take that risk this time.
Now I am not too familiar with health insurance in the US - except that it seems to be a totally messed up chaotic system ;) - what would happen if you get sick while being insured and then as a result you loose the job and the insurance? Lets say if you have an accident? Would that also mean you have to rush your healing to get it over with before the job is lost? Or do they have to finish payments until the treatment of one diagnosis is finished? If the connection really is that you need RLT for SRS and insurance to cover for SRS and you loose insurance if you start RLT, then that is a serious dilemma. I would hope then to find a therapist that can help. I know some people who "cheated" in the RLT for similar reasons (going to work in DRAB). I think this is a special case though - and it shows to me more the inadequacies of the US health system in terms of paying for needed procedures equally rather than in a problem with the standards of care, as I think most people do benefit from the more or less standard timeframe of 15-30 months.
Here in Germany we are lucky. I was without job and money at the time and still was able to transition and get SRS (and even only had to do a partial payment for BA). So these are different circumstances obviously...

Quote from: Cindy on September 13, 2013, 04:20:31 AMIt is very personal. Not all of us make a good decision based on logic, particularly over surgery like this, it is such an emotive topic.

I'm certain; I have my letters. But I can't decide where to go! Why? Emotions!

Will my vaj be perfect? Hell at my age it will probably never be used!!!

Aw dont say that - if you want to, it will be.
Of course the whole issue is emotional. All of transition is and SRS is no exception. But emotional decisions also can need time - not so much to gather more information and make lists and do pro and cons and all that logical stuff - the decision is more made from intuition and is already made when the question comes up, IMO. But it takes time to manifest that decision within ones self, to convince all other parts of the mind that this has to be so and to get emotionally used to it. I think this is needed to ripen that decision and then to make that leap once that internal process has finished. For Karla that may be different again, as she already did some of that work many years ago, but also some things may be different now, the self has changed, some things have to be again emotionally accepted and refreshed. I assume that this time this is a faster process or even done already, I dont know. But for all those who come out and are convinced now that they want to transition and do SRS, that is said emotional decision that was already made before coming out - but this decision has to sit there for a while to be fully accepted by that person, to the point it feels "right" for all parts of ones mind, a time when one is truely ready to make that leap of faith.

Quote from: TaoRaven on September 12, 2013, 06:50:24 PM

But people do these things....they use their adult right to decide what is best for them in their lives, and make it happen. And they don't need to spend years in therapy, and voluntarily accept the diagnosis of a mental disorder to do it.

I suffer from a birth defect. I was born in a male body. There is no logical reason in my mind that I should not be able to enjoy the benefits of modern medicine, just like any other American, and pay to have my defect surgically corrected at my own judgement.

But I also don't think that any one should be able to tell me how large my soft drink can be ;)

The problem I see is that using this line of reasoning, SRS surgery is equivalent to "cut off my leg because I want to be crippled". Is it safe or ethical for a doctor who swore an oath to "do no harm" to cut off someone's leg? Without having some kind of test then how does a doctor know they are doing no harm? What should a doctor do to make sure in your case they are doing the right thing?

I also agree that no one should tell me how large my soft drink should be :)

Karla, I understand the pressure to zip through this, especially considering the opportunity for your insurance to pay for the SRS.  Your own experience shows some of the hazards of trying to transition socially.  Like anjaq, I really don't understand how anyone can want to transition physically but not socially, other than the physical transition is easier.

I really would like to understand the thinking behind "SRS on demand."  Those who support this view, please explain to me – I'd like to know. 

What is wrong with a doctor wanting some reassurance that he is helping you, not making things worse for you?  What is wrong with a chance to change your mind once you learn what it is like – kind of like the buyer's remorse laws in some places?  What is wrong with transitioning socially, which is reversible, before transitioning physically, which is not?  Having your genitals rearranged is of little help in the social transition unless you live in a nudist colony.

I started RLE less than 3 months after coming out.  I had SRS 367 days after starting RLE.  It can be done quickly.  I had a lot of help during the process and am very grateful I didn't have to do it alone.  I have made some poor decisions in my life.  I was glad to get some guidance as I made a really big one.  I feel very fortunate.

- Kate

Quote from: K8 on September 13, 2013, 09:05:28 AM

I really would like to understand the thinking behind "SRS on demand."  Those who support this view, please explain to me – I'd like to know. 

I'm not sure I support it, but I understand the thinking.

No doctor understands my needs as well as I do. Any test designed by someone else placed in the way would have questionable validity.

As a trans woman, I deeply resent cisgendered people who could not possibly understand my condition making decisions about my medical care.

Quote from: suzifrommd on September 13, 2013, 09:50:22 AM
I'm not sure I support it, but I understand the thinking.

No doctor understands my needs as well as I do. Any test designed by someone else placed in the way would have questionable validity.

As a trans woman, I deeply resent cisgendered people who could not possibly understand my condition making decisions about my medical care.

I think this is my concern, my medic has about 30 years experience of looking after trans clients. At what point do we say someone doesn't know what they are talking about?

Yes if I have someone with no experience I'll ignore them, but if they have experience?

Quote from: Cindy on September 13, 2013, 11:30:16 AM
At what point do we say someone doesn't know what they are talking about?

Yes if I have someone with no experience I'll ignore them, but if they have experience?

Good point. My case is similar to yours. My doctor and therapist are both cisgendered but have decades of experience working with us. Both of them share the point of view that they would never dream of telling a transgender patient what was right for them. Inform us of the risks, yes. Ask probing questions, yes. But both of them respect us enough to believe that we are capable of making adult decisions once we were given all the information.

But I came across other, equally experienced therapists, recognized experts, who gave me horrible advice and did not understand what I needed or what I was going through at all. I guess the common denominator in their cases was arrogance. They assumed they knew better than I what was good for my emotional well being.

Bottom line: If an experienced professional thinks I'm making a decision without all the information I need, then give me the information. Then trust my informed decision about my own medical care.

That being said, there is certain knowledge that can only be gained experientially. I couldn't know whether living as a woman were right for me without doing it.

IMO, SRS is not one of those decisions. There is no experience that will tell me whether life will be better with a different bottom.

I have to admit, maybe with some alarm, RLE ended up being extremely important to me.
Yes my team supported me to make my own path, and yes I was successful, whatever that means. But there has been nothing like walking into life as me without a mask.

If my life as me had been miserable I had another chance. There is, in my opinion, nothing like trying it out. 

One thing I have realised, there is no magic wand. If I had total control and had grs straight away, I'm not sure in retrospect that I could have coped. I say that with an open mind and some surprise.

Being me isn't about GRS, being me is far more complex than that - to be brutal, I didn't know that. I thought I did. I was naive, even though I thought I was prepared.

Quote from: Cindy on September 13, 2013, 12:14:58 PM
If I had total control and had grs straight away, I'm not sure in retrospect that I could have coped.

Oh, me either. Luckily I was so sure early on that I'd never let someone do that to me, that there wouldn't have been danger of my jumping the gun.

I wonder if some sort of waiting period that wasn't so tightly prescribed would be better. Like asking people to spend a year making themselves certain but letting us decide how to do that. Maybe some of us would want therapy, some of us would want RLE, some would go on a spiritual retreat, some would just think about it once in a while.

Still paternalistic, but at least puts more faith in our own abilities to understand our own minds in our own way.

What do you think of that?

The problem as I see it is the diversity. Anyone can be whoever they wish. But when we counsel people we do so in a spirit of understanding.

I need to say this carefully and I shall still get criticised.

I had a consult recently and she was a very nice person. Her wig was terrible, make up awful, wearing basically clothes that no one would wear in public, topped with work boots, steel capped at that. She was an impressive sight.

She commented that she had put a special effort in to look feminine for her outing with me. She genuinely and completely thought she looked good, fitted in and would not attract negative attention. She felt safe and comfortable.

Fortunately Adelaide is a welcoming place, and the place I took her for lunch knows me.

She was impressive. She had no concept what so ever of her appearance and the impact it had in public.

She expressed her desire for immediate HRT, she wants "big tits" she wants surgery and I will not repeat why but it would lead to prolonged sexual satisfaction.

She is in danger.

It is not in my power, but if it was, should I sign the papers?

When we criticise the "gatekeepers" are we aware who wants to walk through the gate?

I have had the comment that it is still that persons choice, and we should not have the right to intervene. When I suggest that the client may suicide, I was told that it was the clients choice and I had no right to prevent that.
I can't accept that point of view.

Cindy

I got some terrible advice but knew it was terrible.  He was some big expert who knew everything but in the end ruined too many lives.

Fortunately, I was really lucky when I finally decided to transition: My family physician fully supported my medical needs despite the fact I was his first trans patient.  My counselor had limited trans experience but knew me well enough to trust me. 

I learned a lot during RLE.  SRS was just icing on the cake.  I wonder if you have SRS but continue living in your birth gender, wouldn't the dysphoria be even worse?  I've met a couple of women who thought SRS would make them who they wanted to be but were disappointed when it didn't help them pass, didn't change their behavior to more feminine, didn't solve all their problems.  They were the ones who cut corners, so perhaps that's why I think the requirements are good. 

I agree there needs to be some flexibility in the system, on both sides - the professionals and the patients.  But I also think a reality check needs to be built into it somehow.

- Kate

Quote from: Cindy on September 13, 2013, 01:42:29 PM
It is not in my power, but if it was, should I sign the papers?

When I got my letters, I was a little surprised how much emphasis was on an evaluation of whether I would be successful living as Kate.  But on reflection, it makes sense.  A good surgeon, a good doctor, a good counselor does not want to make life more difficult for the client. 

We don't always see ourselves clearly.  We don't always have realistic expectations.  Sometimes we need a little guidance to help us along the way.  We want to work with the doctor and the counselor to help us.  If the professional is autocratic, you need to find someone else.

Quote from: Cindy on September 13, 2013, 01:42:29 PM
It is not in my power, but if it was, should I sign the papers?

Wow, Cindy, I love the way your posts encourage thought.

That one raises really interesting questions.

Should someone of limited intellectual or social ability be deterred from SRS, especially if her limitation will prevent her from passing?

Should interest in being sexy as a female be a disqualifying factor? I hope not. In my case the desire to be attractive was a major player in my interest in transition, and a desire for female sexual response played a huge part in my motivation to start HRT. (I should add that I haven't been disappointed on either count).

All of those things increase the risk of bad effects, but risk is a probabilistic effect. Not everyone at risk has a bad outcome. Do you tell someone that they cannot have a procedure because their risk is higher - their chance of a good outcome is 30% instead of 95% - even thought they might well be part of those 30% who defy the odds?

I don't have answers of course, but the questions are worth thinking about.

Hmm - The concept of allowing other ways of reflection than RLE and therapy is one that sounds tempting. My concept of this whole roadmap and gatekeeper thing is that transpeople need time to really familiarize themselves emotionally with the change that is happening and is going to happen with SRS and this gives them time and tools to explore this. If there would be other tools that work, I would not deny that this could work. What I think cannot work is to proclaim that each person has the right to decide at any time if SRS is to be done or not. That would cause a lot of misery I believe because people who think they are ready or have unrealistic expectations will go for it and then have regrets or problems coping. Even if SRS would have been the right choice for them, I believe that if it happens too early, the spirit of that person isnot ready for it and then things go sour.
Who should be denied access to SRS by the gatekeepers? People who do not pass? People with sexual feelings at genderchange? I dont think so - this should not be - and IMO usuall yis not - a matter of denying access forever but it is about giving the patient more time to adjust, to prepare spiritually, emotionally and socially for the permanence of SRS. See, one starts with something easiyl reversible - like changing clothes. Then one does something that is harder to reverse but possible - HRT and then something basicall yirreversible like SRS - it is a progression of determination. The person transitioning can learn in that time how to deal with the lasting effects and the increasing permanence of the decisions made and until SRS can basically pull out.I know people who did that - either because transition was not for them or because of practical reasons like not being able to pass ever and notwanting to suffer from that forever. They often state at first that yes they are sure they want to transition and SRS of course. If they had been given SRS right away, I dont want to know what would have happened then...

So I think no one should be denied SRS, but I do think that it is good if there are guides and people who watch the whole thing and basically have the power to steer the transition and the pace of it to a degree as to give the person transitioning the time to make it properly.

Quote from: Zumbagirl on September 13, 2013, 08:06:05 AM
The problem I see is that using this line of reasoning, SRS surgery is equivalent to "cut off my leg because I want to be crippled". Is it safe or ethical for a doctor who swore an oath to "do no harm" to cut off someone's leg? Without having some kind of test then how does a doctor know they are doing no harm? What should a doctor do to make sure in your case they are doing the right thing?

I also agree that no one should tell me how large my soft drink should be :)

Well, in that scenario I would certainly rather assist the patient with conforming their body to their needs, especially when considering that they may try to remove the offending limbs themselves.

Maybe I am a horrible person, but I respect each individual's right to live life in the fashion that they see fit, and to do with their body what they will.

And I expect the same courtesy.

I may not agree with or understand all of these people, but that's not really necessary. It's none of my business. What John Q. Public does with his life and body is his own business.

As is his gender identity, sexual preference, and religion. And I would certainly never dream of imposing my "ethics" on anyone.

Wow.

I wouldn't know where to start, responding to every, equally wonderful post.  And my feet are killing me... here's what I have learned from my first full day of RLE:

• Break in new heels before spending all day in them.
  

Here's my take on transitioning... there are physical, emotional, social, legal and even political aspects (as TaoRaven eloquently expresses). Many aspects, but they all blend together.  The aspects interact: they can't be (or shouldn't be) taken in isolation. 

I would be more comfortable with the idea of gatekeepers if they were themselves transgendered. 

Waiting 6 months for hormones did not benefit me one bit.  It didn't make me wiser.  In fact the anxiety of having to deal with a foot-dragging therapist (whom I've since swapped out for somebody that I 'click' with) probably held back my progress toward RLE... which we all agree is the sine qua non of transition. 

So back to my first day of RLE... I'm soaking my feet in a basin of salt water right now and laughing.  First time I've had a chance to turn on my laptop today. 

Began the day last night, on a red-eye from the West Coast... waited an hour for beverage service to be over and folks to fall asleep.... went to the stall bathroom and changed there, emerging as Karla.

It could have been a pain, in such cramped quarters, but thanks to previous experience and a dry run the day before, I emerged smoothly, glided back to my aisle seat in the darkened cabin... and fell asleep myself.

On landing in the morning, my neighbour appeared not to notice or care that he had fallen asleep next to an androgynous-dressed guy, and woken up next to a younger redheaded woman.  So far so good.  The rest of the trip was uneventful... more smiles than usual seemed to be the only difference.  Maybe they just saw that I was happy, and responded in kind.  Picking up my car, I chatted and laughed with the lady in the booth where I paid too much for parking. 

Watched the speed limits on my way home, worried about what would happen if pulled over...

On returning home, I dropped by the neighbour's for a scotch... had come out to him a few months previously, so no surprises... and again, today we just picked up our friendship as if nothing had happened.  The dress was a marginal change, compared to my personality changes (for the better).

On returning home, discovered a box waiting for me from Zappos: two pairs of heels which did not fit, and a beautiful formal dress that had me in tears of joy when i tried it on, a black side-draped dress that moves really nicely with me, and a designer blouse that pinched me under my arms, looked terrible on me and had me wondering why I bought it... because it cost as much as the formal dress.

Picked up my son from my ex for the weekend... interesting: she was nicer to me than she'd been in months.  Shock?  Perhaps.  We made small talk. 

Must go, time to tidy up and start the woodstove.   I'm so sleepy... but I'd rather stay up!   

Anyway, that was my first full day; it was a good one and I'm happy to share it with all of you as a pleasant switch from my angst of the week previous...

I think the point many of you are continuing to miss is that this is not just about you and your needs. There are also the needs of the doctors that you employ to feel satisfied that they are treating a valid medical necessity. Now as I said in my earlier post, RLE may not be a great way to do that, and it may indeed fail comprehensively with non binary folks, but until we have a more robust diagnostic test it is all we have.

Now the bottom line to this is while you may WANT to see informed consent - that would only happen if doctors treating the condition were happy for it to do so. My experience suggest to me that the evidence is that they aren't - ergo hell will probably freeze over before anything like this happens. So by all means go on having a lovely debate - but the bottom line is it is all academic because it hasn't got a rats arse of a chance of happening unless you suddenly develop the ability to do the op yourself.

Until that happens you will need someone like me (once I am qualified) to treat you. Now I consider myself pretty sympathetic - I have a couple of friends who have transitioned in the past so I understand the territory better than many, but I have to tell you that even I would baulk at this, so with the best will in the world I really don't think you have much chance of finding a doctor who would operate on that basis.

Every doctor worth his or her salt is likely to have diagnostic criteria which need to be fulfilled before they will operate. Ergo further discussion about informed consent SRS pretty well "on demand" is pretty pointless cos it simply won't be happening anytime soon. endof.

Oh - one other thing occurs to me - ironically I had a lecture on informed consent just today in medical school, and from a clinicians point of view it does not mean what you all seem to think it means. It is NOT licence for a physician to operate recklessly and without due regard to the risks and benefits to the patient. The physician is still charged with acting as the responsible professional and using their best judgement to decide whether a treatment SHOULD BE OFFERED AT ALL - just because you are prepared to sign a form does NOT free the physician from the charge of misconduct if they are deemed to have carried out inappropriate treatment.

Instead informed consent is merely a device to prove that an attending physician has properly explained the process of the treatment proposed, and the likely risks and benefits there from. In effect it is merely informing the patient correctly , and then asking the patients permission to carry out the agreed treatment. It is NOT giving the patient the right to demand a treatment that the doctor does not wish to perform.

Karla, thanks for sharing...that was a wonderful read!

And this is why I am afraid of ordering clothes/wigs/etc online...I need to be able to try stuff on first. That and it's fun ;)



And Dr. Who....there is an entire list and network of ICATH affiliated physicians and therapists who disagree with your assertions. See, I guess the whole "helping people" and "doing what's right" concept is catching on.

And there are therapists who will write referral letters with as little as a single visit, should one wish to employ the services of a WPATH adherent surgeon.

Interestingly, when Colorado first contemplated the ideas of Medical Marijuana, there were those who insisted that no Doctor would prescribe it, for fear of lawsuits, etc. The next thing we knew, we had dispensaries with Doctors on site, who would prescribe on the spot for as little as a muscle ache. Seems those predictions were a little bit short sighted, and on the "wrong side of history".

I don't mean to be rude...but you may want to put aside your predispositions and actually look around a bit. Things aren't quite as cut and dry as you seem to want to believe. endof.

Quote from: karla.allen on September 13, 2013, 07:28:15 PM
Wow.

I wouldn't know where to start, responding to every, equally wonderful post.  And my feet are killing me... here's what I have learned from my first full day of RLE:

• Break in new heels before spending all day in them.
  

Here's my take on transitioning... there are physical, emotional, social, legal and even political aspects (as TaoRaven eloquently expresses). Many aspects, but they all blend together.  The aspects interact: they can't be (or shouldn't be) taken in isolation. 

I would be more comfortable with the idea of gatekeepers if they were themselves transgendered. 

Waiting 6 months for hormones did not benefit me one bit.  It didn't make me wiser.  In fact the anxiety of having to deal with a foot-dragging therapist (whom I've since swapped out for somebody that I 'click' with) probably held back my progress toward RLE... which we all agree is the sine qua non of transition. 

So back to my first day of RLE... I'm soaking my feet in a basin of salt water right now and laughing.  First time I've had a chance to turn on my laptop today. 

Began the day last night, on a red-eye from the West Coast... waited an hour for beverage service to be over and folks to fall asleep.... went to the stall bathroom and changed there, emerging as Karla.

It could have been a pain, in such cramped quarters, but thanks to previous experience and a dry run the day before, I emerged smoothly, glided back to my aisle seat in the darkened cabin... and fell asleep myself.

On landing in the morning, my neighbour appeared not to notice or care that he had fallen asleep next to an androgynous-dressed guy, and woken up next to a younger redheaded woman.  So far so good.  The rest of the trip was uneventful... more smiles than usual seemed to be the only difference.  Maybe they just saw that I was happy, and responded in kind.  Picking up my car, I chatted and laughed with the lady in the booth where I paid too much for parking. 

Watched the speed limits on my way home, worried about what would happen if pulled over...

On returning home, I dropped by the neighbour's for a scotch... had come out to him a few months previously, so no surprises... and again, today we just picked up our friendship as if nothing had happened.  The dress was a marginal change, compared to my personality changes (for the better).

On returning home, discovered a box waiting for me from Zappos: two pairs of heels which did not fit, and a beautiful formal dress that had me in tears of joy when i tried it on, a black side-draped dress that moves really nicely with me, and a designer blouse that pinched me under my arms, looked terrible on me and had me wondering why I bought it... because it cost as much as the formal dress.

Picked up my son from my ex for the weekend... interesting: she was nicer to me than she'd been in months.  Shock?  Perhaps.  We made small talk. 

Must go, time to tidy up and start the woodstove.   I'm so sleepy... but I'd rather stay up!   

Anyway, that was my first full day; it was a good one and I'm happy to share it with all of you as a pleasant switch from my angst of the week previous...

Glad you had a great day!!!

Well done. And heels Oh ye.

I remember an orthopaedic surgeon friend saying to me 'Thank God woman love high heels, otherwise I could never have afforded the Ferrari'

Hee hee

QuoteThere is an entire list and network of ICATH affiliated physicians and therapists who disagree with your assertions. See, I guess the whole "helping people" and "doing what's right" concept is catching on.

And there are therapists who will write referral letters with as little as a single visit, should one wish to employ the services of a WPATH adherent surgeon.

I don't mean to be rude...but you may want to put aside your predispositions and actually look around a bit. Things aren't quite as cut and dry as you seem to want to believe. endof.

I think you may have misread me slightly. Maybe my language was unhelpful but I certainly don't believe anything is cut and dried at all.

In fact that is precisely my point. In all medicine there is a process or tests to be gone through and the outcome of that process can not be at all certain until you have followed the path and arrived at a differential diagnosis. Even then the diagnosis is only a best probability, and can be changed as new information arrives. The diagnostic process itself can also be changed in response to evidence, and there are always people who will trial new processes. However in this regard, at least, the evidence is difficult to establish due to the the lack of reliable physiological tests.

Now you may be right, in your part of the world there may indeed be people who are using a different approach, and it may indeed eventually become more widespread, but it hasn't as yet, at least not in my part of the world.

Finally let me slightly apologise. Perhaps I lost sight of my own main point here - which was really that this sort of discussion always has to bear in mind that while the patient is rightly at the centre of the process, a clinician attending them will also have human thoughts, emotions, etc and cannot be simply regarded as an "on demand" automaton. I felt this was the tone that I was hearing from some of the comments. I feel that the thread had started to sound as if the clinician and their need to feel that they were genuinely helping someone was completely irrelevant, and that all that mattered was that they were doing what you asked them to do, irrespective of any reservations or questions that they may have had. That would not be medicine as I understand it. I apologise if perhaps I slightly over-spoke in irritation at that.

Yes the aim is to alleviate suffering, but the fact that there are people who later have regrets proves the point that this is not a situation with 100% certainty. All I would want to feel as a clinician is that I had done my very best to ensure that the patient has made a good choice. As a future clinician I feel I would I need a process or test of some sort which enables me to have confidence that I had done my best to ensure that the patient was indeed making an informed decision, because I care about the outcome. I'm sure there are those who can adopt the position "well the patient chose badly so that's their fault, and I've got their fees so it's all good." I'm afraid I and most others I know couldn't. That's all I'm saying really.

In any case my views are only my views and unlikely to affect anything, as gender work is not really my intended field.

This may be an odd post, for a change.

I love children.

I gave up being a pediatric oncologist because I could not take the personal emotion. It was literally killing me. (It was a he at the time).

I'm fine with adult oncology and I dabble in paediatric now as my opinion is asked for.

I was talking to the 'gatekeepers' in psychiatry recently on trans issues. Many are leaving, there are no new people coming on (here); Why?

Guess what? they are fed up with the abuse, the constraints and the ignorance of their position.

Is their any appreciation of their opinion, their position? No.

Put yourself in my position, for a second.
Most trans*people under informed consent can get (MtF) HRT in 3 sessions. If they have co-morbidities it is longer.  If you want surgery, IMO opinion it takes time. The socialization, acceptance everything then comes into play.

I do not think that is unreasonable.

But I'm old


And I have had enough of this discussion.

It is going circular.

Hugs

Cindy

Yes, it is going circular. Some people will always think that an individual's choice is primary and other should more or less follow that decision if that is perceived to be their job, but I get the impresison that even most transpeople understand that there is value in doing this in a reasonable pace, that it is good to have a guide that minds that pace and personally I do understand the doctors well who do not want to rush things. Especially permanent decisions. The timeframe indeed can be much shorter. I know of people who prepared everything, then did RLE and shortly thereafter HRT (within less than 3 months) and within the year had SRS. Of course they worked a lot with the therapist, spent more money on therapy hours and more time sitting in there and going through the usual stuff with the therapists. Of course the decisionmakers are a position of power and I understand well that some of them may abuse that power, e.g. if they have their very own sterotypes that they want to be fulfilled, like those who will not count it a RLE if you do not wear skirts. But overall I think they are here to help and want to make sure that their patients know what they are doing before consenting to a surgery. And heck, even the more decent and professional tattoo shops and body modificators do such things, they will tell people to consider this more or even refuse to do some modifications if they do not think that their client really permanently wants that change. Undoubtedly there are cases where people think they want something to happen and later regret it and that has to be minimized - for the sake of the people themselves and the sake of the professionals who are the cause of it. It is little relief in emotional terms if a patient commits suicide because of a surgery you performed even if you cannot legally be touched because of some paperwork.
I must admit that there were times I saw this differently - when I was in that situation of "I need to have this". This was more true with HRT than with SRS though. I found it annoying to have to talk to the therapist so often and was afraid that he might deny me my path. Which now I realize is nonsense as this is not their job at all. I was afraid that he would after a year of RLE say "no, sorry, you are not transsexual, please go back" - which he NEVER would do to anyone as there is no such test and it already all depends on the patient. So in reality the worst he could have done to me is to postpone my SRS plans for some more time to allow me to sort out my own insecurities. Luckily that was not needed. I had a watershed moment some months before SRS that basically eliminated any doubts in myself about it and I think he knew that and then agreed to the surgery.

Anyways, nice to hear the story about the plane and all that - what an unusual place to start the RLE - hehe, but pretty neat. Sounds like you are doing well and I am sure that if you are determined to get there, you do not have to wait for too long to get the treatments you want to have. And I know again why I hate these high heeled shows after reading this LOL.

Well I honestly hope that I didn't accidentally make it seem like I was expecting Surgeons to dispense SRS like machines. That is not it at all.

I personally think that a couple of years of HRT, and as much RLE that can be had should proceed an SRS. But not as some mandatory condition.

Many of us don't figure out (or admit to ourselves) that we are transgendered until our middle years or later. At that point, some of us have led some very painful, broken lives as a result of trying to fit in as the wrong gender.

To have to spend an obscene amount of money over an artificially lengthened process getting permission from gatekeepers to finally live happy, whole lives seems to me to be an atrocity. "No, I am sorry, you have not suffered enough, and you have not paid the toll."

Some less fortunate, and less financially well-off people end up going broke on therapist bills and never achieve SRS, following the traditional WPATH method. One wonders how many suicides and cases of self-mutilation result from this barrier alone??

Yes, of course some people are going to have regrets when all is done...but that is true of pretty much every decision in life. I don't think there really is any way to rule out that possibility. People regret having children and drown the poor things. Are there gatekeepers involved in childbirth??

In my part of the world (being the United States, by the way), there is a growing network of people who are asking these, and other probing questions about the nature of ->-bleeped-<-. Some of us (including some researchers in Arizona) are even beginning to wonder if this birth defect might even be hereditary.

The "old system" has for so long been focused on this issue being a mental disorder that the medical aspects have been long swept under the rug. This is changing now, and the system really needs to keep up with the times. This is not the 50's, or the 70's. We are not mentally disturbed freaks. We are people who are suffering, and that suffering needs to be alleviated without an unbearable financial cost or artificially inflated timeline.

I am sorry if I have posted too frequently in this thread, but this is a very sensitive, and important subject to me. I have not meant to offend anyone, only to make a viewpoint and some resources known that might not have been. My words can come across as harsh or hostile at times (so I am told) and this is not my intention. I think I sometimes lack the empathy, or "humanity" to see how cold and unfriendly I may sound.

For that I apologize. 

Hi, Raven

Quote from: TaoRaven on September 14, 2013, 09:23:14 AM
I personally think that a couple of years of HRT, and as much RLE that can be had should proceed an SRS. But not as some mandatory condition.

I think for few not it is years. Rather 1-2 years I figure. Plus the time maybe you need to get the money, but thats not the therapists fault.

QuoteTo have to spend an obscene amount of money over an artificially lengthened process getting permission from gatekeepers to finally live happy, whole lives seems to me to be an atrocity. "No, I am sorry, you have not suffered enough, and you have not paid the toll."

I hope that you realize that this is most certainly not what is going on. I doubt any of the medical people wish to see you suffer and honestly this is what pre-SRS "RLE" is about - living that full life and see if it fits. SRS is then just the finalization of that step and I think no one will deny this after doing RLE for some time. I think it has to be understood that RLT or RLE is all too often thought of as a temporary thing one has to burden oneself with. But what should happen and that is what the shrienks are waiting for is that you skip the last letter of that and it simply becomes your RL, your Real Life. At that point, I would say, you are ready for SRS and an experienced gender therapist will notice that point - be it less than a year in the process or after 2 or even 3 years.
I really hate it if financial restrictions come into play in this whole issue, this is just not right. No one should have to rush towards SRS out of financial pressures, because therapists are too expensive or therelike. It is a process that has to be carefully managed and not given up to libertarian ideas. I would never have made it financially (and as a result probably overall) if I was not in Germany and I am grateful for that. I guess all that is left for US people then is to choose a therapist that does a good job with a low number of sessions?

QuoteYes, of course some people are going to have regrets when all is done...but that is true of pretty much every decision in life. I don't think there really is any way to rule out that possibility. People regret having children and drown the poor things. Are there gatekeepers involved in childbirth??

One can at least minimize the number of regrets and with childbearing there is a huge difference - you are not asking of anyone to do anything that could be harmful. No one has to put a knife to your body and take part of the guilt on himself if things so south.

QuoteThe "old system" has for so long been focused on this issue being a mental disorder that the medical aspects have been long swept under the rug. We are not mentally disturbed freaks.

Yes that is true and I am actually a bit surprised that there is new medical evidence of this. I did not look at all at TG issues for the past decade and back in my days there was basically only one study that looked at brains of TS people compared to others and that had interesting results. But that does not change everything unless a diagnosis can be developed from them that is reliable. So I agree with the doctor here that until then, the guidance is needed and maybe even beyond that because medical or mental reason - transition is exactly the same with the same issues, the same social consequences, the same dysphoria and the same need to take care of a person before going forward with SRS. It still remains a huge surgery and a big step and a huge change in the body that a patient has to mentally prepare for, ideally also be prepared for the risks. I was not prepared for that for example and had still quite pink glasses on going to the hospital. I was not mature enough to fully realize the risks. I would have done it even if I would have been better prepared but as it was the partial failure of my first SRS had really ill effects on my mental health. But I disgress - maybe it is also an age thing. A 40 year old may be more able to judge for herself than someone like me at 25 or someone at 18.

Quote from: anjaq on September 14, 2013, 11:36:25 AM
Some Stuff

Indeed, it would seem that 1-2, or in some cases three years is the optimal length of time for HRT before SRS surgery. The longer one waits after beginning the HRT, the more the "materials" that will be used in the SRS surgery may shrink. Sadly, many people spend much more time, simply because of the cost of the SRS surgery.....especially if they are paying for therapist bills to boot.

Honestly, RLE should not be a mandatory, prescribed exercise, but rather the ultimate goal of transition and a natural occurrence. There are examples on this very forum where people are forced to undergo RLE for an extended time before even being prescribed HRT. There are examples in the state that I live in where people are forced to undergo RTL without a prayer of passing, and are physically assaulted as a result.

The current, widely mandated system of WPATH is broken. It simply causes more issues than it prevents, and I'm sorry, but I find it inhumane. Using the ICATH model of Informed Consent, the years of therapist bills and dancing through hoops are eliminated. Therapy becomes an option for those who feel that they need or want it, as it should be. No sadistic gatekeeper (not saying all of them are, but they do exist) can force a trans woman to wear skirts to work for a year, or conform to some parody of womanhood, as a condition to obtaining a letter.

And this is, as I have said, also about adults making adult decisions. There is no therapist at the liquor store making sure that customers will not regret their decisions under the influence of alcohol. No therapists at tattoo shops. No therapists at tobacco shops. Consistency, please. There is really no sound reason to single us out. People make decisions every single day that impact the rest of their lives, in major ways.

I agree that the risks and possible consequences of the steps along transition, including SRS, must be clearly explained to the patient. It is not a decision to be taken lightly. For many of us, myself included...it is not a decision at all, but a need in order to feel whole, and comfortable in their own skin.

See, the ICATH model puts forth (and science and medicine are making some interesting supportive findings) that trans people are not mental patients who believe that they are a gender other than the one they were born with, but rather they are the gender that they are claiming to be, and were born with the opposing gender's body parts.

To make this clear...It is not that I think or want to be female....I am female. But my body is not. There is nothing wrong with my mind, it is my body that needs medical attention, to correct a birth defect.

Which of course makes the large part of the WPATH system redundant and irrelevant.

It is time to advance transgender studies, and bring them in line with modern science and medicine, and to cast off old, out-moded lines of thinking that cause more harm than good.

Quote from: TaoRaven on September 14, 2013, 12:47:13 PM
Indeed, it would seem that 1-2, or in some cases three years is the optimal length of time for HRT before SRS surgery. [...]Sadly, many people spend much more time, simply because of the cost of the SRS surgery

So how exactly is that the therapists fault then? I doubt that many therapists or "gatekeepers" demand of their patients to wait for more than 2 years after HRT and RLE

QuoteHonestly, RLE should not be a mandatory, prescribed exercise, but rather the ultimate goal of transition and a natural occurrence. There are examples on this very forum where people are forced to undergo RLE for an extended time before even being prescribed HRT. There are examples in the state that I live in where people are forced to undergo RTL without a prayer of passing, and are physically assaulted as a result.

We have to agree that we disagree on some accounts here. I think RLE should be mandatory before SRS for the reasons I wrote about previously. I agree however that RLE should not be mandatory for HRT, these two should go more hand in hand. That is my opinion of course, maybe there are arguments for RLE before HRT, but I can only say that my personal experience was that I would have been very afraid to do a RLE before HRT and in fact it would not have worked with my kind of transition which was basically a sliding over as HRT changed my body, I dropped more and more of the fake male behaviour and slightly shifted clothing. I think it may have been hard to justify in front of therapists that I considered walking around like that as RLE. So I cannot comment much on that part - I DIYd with hormones and found a nice general practitioner that did the blood levels for me. But in case of SRS I think the waiting period is bearable and needed, as I keep saying, SRS does not change 1% of your daily life - better get the 99% done first.

QuoteNo sadistic gatekeeper (not saying all of them are, but they do exist) can force a trans woman to wear skirts

I get that. But I would think that it is your own choice to change therapist, isnt it?

QuoteAnd this is, as I have said, also about adults making adult decisions. There is no therapist at the liquor store making sure that customers will not regret their decisions under the influence of alcohol. No therapists at tattoo shops. No therapists at tobacco shops.

Again that is very different. a) the impact of SRS is a lot bigger than drinking a beer and b) at the tobacco shop you are not asking anyone to put a knife to your body in a surgery that could kill you.
Again, this argument is about SRS. I would be inclinded that HRT should be something that should be prescribed by others than just therapist-advised doctors, but maybe general practitioners. To give it over-the-counter would be harmful however as well.

And regarding adults - not all TG people would be considered adults (meaning over 21) plus many do not act as adults in the time they basically have a female adolescent persona emerging that did not have the chance to be an adult yet - I mean this not as a multiple personality kind of thing but those aspects of a TG that have not had the chance to grow up but had to hide behind a fake persona suddenly take over the steering wheel - Just look at some of the TG in their first days of transition. They wear clothes appropriate for a 16 year old! But again, the main arguments are others and I have elaborated on them before.

QuoteI agree that the risks and possible consequences of the steps along transition, including SRS, must be clearly explained to the patient. It is not a decision to be taken lightly. For many of us, myself included...it is not a decision at all, but a need in order to feel whole, and comfortable in their own skin.

Yes of course - and it is not as much about the decision itself, as I said before that decision is often already done when transition is started. But it is about being ready for that moment, so rushing this within less than a year is IMO dangerous and doing SRS before any RLE is reckless.

QuoteTo make this clear...It is not that I think or want to be female....I am female. But my body is not. There is nothing wrong with my mind, it is my body that needs medical attention, to correct a birth defect. [...]
It is time to advance transgender studies, and bring them in line with modern science and medicine, and to cast off old, out-moded lines of thinking that cause more harm than good.

No argument against that - yes, there should be more research done, but fact is that ATM there is not enough data, not a test you can do to test for trans - you cannot go and make a CT or MRT and have a doctor tell you that indeed your brain is female. If that ever happens, I can imagine that some things change. But even then I would argue that one will need some counselling when transitioning and some guidelines and caretakers who make sure that one does not get into a rush but rather acts considerate.

Yes, trying on is great fun, TaoRaven... not unlike diving in the deep end without knowing the water temperature, but oh so much fun once you're in !!!

There's a trans-friendly thrift store in Dallas, when I'm there i take an afternoon off and spend it chatting with the ladies there and trying things on endlessly.  The hours pass quickly... 

Because I live in the sticks, there's no shopping unless on a business trip.  So i mail order most things... even some groceries.

I order from Zappos because of their free shipping and free returns... one pair of shoes _almost_ fit width-wise... the M appears to be a tad too narrow; I plan to also order the W so i can tell the difference.  Not too many mail order houses that allow craziness like that... but they sure got my business. 

Quote from: TaoRaven on September 13, 2013, 10:01:28 PM
And this is why I am afraid of ordering clothes/wigs/etc online...I need to be able to try stuff on first. That and it's fun ;)

Kia Ora,

The simple truth.....When it comes to the "Pros & Cons of SRS".....In the long run, only time will tell....

Metta Zenda :)

Quote from: karla.allen on September 14, 2013, 03:56:22 PM
Yes, trying on is great fun, TaoRaven... not unlike diving in the deep end without knowing the water temperature, but oh so much fun once you're in !!!

There's a trans-friendly thrift store in Dallas, when I'm there i take an afternoon off and spend it chatting with the ladies there and trying things on endlessly.  The hours pass quickly... 

Because I live in the sticks, there's no shopping unless on a business trip.  So i mail order most things... even some groceries.

I order from Zappos because of their free shipping and free returns... one pair of shoes _almost_ fit width-wise... the M appears to be a tad too narrow; I plan to also order the W so i can tell the difference.  Not too many mail order houses that allow craziness like that... but they sure got my business.

Oh really?? I am planning on doing some of my more sensitive hair removal in Dallas, and have some friends down that way I was planning to visit. We were going to try to have the ultimate "Epic Shopping Trip" while I was down there :D I may just have to find this thrift store you speak of :)

I feel your pain on the shoes.....I am a 10w. Thankfully my room mate is a tall German woman, and has the same shoe size as me, so I borrow her shoes regularly :)

Quote from: anjaq on September 14, 2013, 02:39:18 PM
some more stuff

I will quickly address a couple points, and then I feel that I must back off here. As much as I am enjoying this stimulating conversation, I feel that I am hijacking the thread, or maybe making people uncomfortable, and that is the last thing I want to do. I also don't want to seem "preachy".

You asked me "So how exactly is that the therapists fault then?", and my response to that would be that it is rather indirectly the fault of the therapist. These people charge a lot of money, and depending on the patient's insurance, these visits may not be covered. It is very difficult to save up $20-50k for many people, and when paying steep therapist bills, it can become neigh impossible to do so.

I agree that RLE should be a natural occurrence. As HRT does it's thing, it should just happen on it's own. I don't agree that it should be FORCED, however. Maybe the patient wants to be a bit of a tomboy?? Maybe the patient doesn't care for traditionally "girly" attire, and prefers leather pants and band shirts? It is not unheard of for a therapist to decide that this does not fit the criteria that he/she expects the patient to adhere to, and to be hesitant or out-right refuse to grant a letter on these grounds.

I don't draw a harsh line between life-altering decisions. SRS is simply one among countless decisions that can change or end one's life (including other forms of elective surgery). We will have to agree to disagree on this point. And yes, some adults don't necessarily ACT like adults, but that doesn't invalidate their rights...at least in this country.

And no, there is currently no medical way to observe a physical phenomenon within the body and draw a medical diagnosis for ->-bleeped-<-. This may change, but honestly, I don't feel that it is necessary. SRS is a form of cosmetic, elective surgery. There are many different procedures that fall under this category, but only ONE that has such restrictive and draconian restrictions and guidelines. Is this because this surgery is really so different, or because of the perceived social, ethical, and moral stigma of modifying one's physical gender??

I believe it is the latter. I think it's simply part of the stigma attached to be a trans person....that we are being singled out simply because of the nature of our condition. And I believe with my whole heart that this is wrong, and unjust.

100% equality. Nothing more, nothing less.

Agreed - we do disagree and I will refrain from replying to this. I still think that a better fix for the financial issues would be a better health care system because I think financial considerations should have no place at all in any stage of transitioning.
And I believe in my case at least, going to the therapist in jeans and t-shirt but definitely identifyable as a female actually helped the whole process. That way I was myself and not a sterotype. It was hopefully obvious to him that what I wanted had zip to do with clothes but all to do with my body and my identity, so I did not have to wait at all really. But I accept that there are shrienks out there that may see this differently and I dont get them - which woman with a testosterone-poisoned body would want to dress in a way that sticks out - I personally think that doing the whole skirts-only and high heels and tons of makeup thing actually is a minus for some therapists, as they will have to make a differential diagnosis and have to exclude fetishism.

Anyways - last words. Thread already is hijacked sadly. Sorry for that.

Thrift stores are cool, if you have a size that is common. So many different looks to try for not a lot of money.

Here you go: Larger than Life, http://largerthanliferesale.com/   12817 Preston Rd # 136, Dallas,TX 75230
Conveniently located on the SW corner of Preston and LBJ/635

Transition ought to be fun.

Quote from: TaoRaven on September 14, 2013, 04:31:55 PM
Oh really?? I am planning on doing some of my more sensitive hair removal in Dallas, and have some friends down that way I was planning to visit. We were going to try to have the ultimate "Epic Shopping Trip" while I was down there :D I may just have to find this thrift store you speak of :)

I feel your pain on the shoes.....I am a 10w. Thankfully my room mate is a tall German woman, and has the same shoe size as me, so I borrow her shoes regularly :)

Quote from: karla.allen on September 14, 2013, 06:28:33 PM
Here you go: Larger than Life, http://largerthanliferesale.com/   12817 Preston Rd # 136, Dallas,TX 75230
Conveniently located on the SW corner of Preston and LBJ/635

Transition ought to be fun.

AHHH!!! Thank you!!!! :D 

I am such a shameless shop-a-holic :P 


And yes, I agree...it SHOULD be!!! In fact, these are the happiest days of my life :)

as my best friend says to me..."make the rest of your life, the best of your life". :)

Oh...one more thing...found this tid bit, and thought it relevant:

Many plants and animals can be both male and female, biologically speaking, at the same time or at different points in their lives. In a comparison of 34 postmortem human brains, scientists found that the part of the brain comprising a small group of nerve cells thought to pertain to gender and sexuality were similar in trans women and non-trans women. Although the study only had one trans man's brain, it found that group of nerve cells to be similar to that of a non-trans man. Perhaps Dr. Milton Diamond put it best when he said, "Biology loves variation. Biology loves differences. Society hates it."

perhaps a medical diagnosis is not as far off as we might have thought....

I've often wondered why it is such a big deal to society. Why all the concern? Why all the hate?

All a person such as myself wants to do is change their gender.

Yet so much trouble & concern for a persons private decision. If a person wants & needs this improvement for their life why does society & our medical system make it so difficult?

MTF always since childhood. So many therapist & delays I could write a book, etc.........

Quote from: TaoRaven on September 14, 2013, 04:57:13 PM......... I agree that RLE should be a natural occurrence. As HRT does it's thing, it should just happen on it's own. I don't agree that it should be FORCED, however.......

That would, of course, be the ideal case!

At 15 or 16 years of age I was living part time as either gender (as the situation allowed or demanded) and had no difficulty switching back and forth and being accepted (though I am not sure my 'boy mode' was as convincing). I started HRT at 17 and by the time I went to college at 19 I simply could not pull off 'boy mode' though there was no way to change my legal status in those days (1969) without SRS (which wasn't available). I had met with the Registrar and all my college records were set up as gender-less and I refused to admit my gender so I must say that I confused the heck out of most people. The general assumption was that I was a girl trying to pass as a guy to attend technical school, very much like the movie "Yentl" When SRS became available (1974) 'transition' was a snap.

Quote from: FrancisAnn on September 14, 2013, 10:59:57 PM
I've often wondered why it is such a big deal to society. Why all the concern? Why all the hate?

Quite simple my dear! Sex/gender is something deeply seated in the human psyche and at the base of how people define themselves. The connection between sex and gender is assumed to be innate and immutable so must people never think about it ....... until they encounter a transsexual. At that point the very basis of their own identity is no longer as secure and that makes them uncomfortable.

There is also the fragility of the male sexuality. The vast majority of men are extremely homophobic and the very idea that they could be attracted to or become involved with someone who "wasn't born female", either knowingly or otherwise, calls in to question their own heterosexuality and that scares the dickens out of them!

Why such a big deal? Because we call into question the security of their own 'sacred premise' of sex=gender=sexuality.

Quote from: Northern Jane on September 15, 2013, 05:15:10 AM
Sex/gender is something deeply seated in the human psyche and at the base of how people define themselves. The connection between sex and gender is assumed to be innate and immutable so must people never think about it ....... until they encounter a transsexual. At that point the very basis of their own identity is no longer as secure and that makes them uncomfortable.

There is also the fragility of the male sexuality. The vast majority of men are extremely homophobic [...]

I personally do not think this is a thinkg of the "human psyche". I think it is very much a social issue that genders are seen that restriced in our cultures. Others do not have that issue in that way. They have official and accepted placed for transgendered people, like the "two spirits" in indigenous North America. I think the second part hits it on the nail though - it is about male insecurity regarding sex plus the homophobia that is rampant in our society. Again, that is not a universal truth. I personally believe that patriarchial ideologies - and they still dominate vastly our cultures - are causing much of that harm, but then again I am a feminist, so that is my opinion.

Quote from: FrancisAnn on September 14, 2013, 10:59:57 PM
MTF always since childhood. So many therapist & delays I could write a book, etc.........

Yes, sadly. If one gets to the right people who are educated and know their stuff, it is usually going quite well, but to find them is a heck of a search. I guess even if I told my childhood shrink what I was feeling directly, she would not have understood. Instead I was treated for being isolationist and non-social. Gnaa - lost chance, whatever. Now is now...

Quote from: TaoRaven on September 14, 2013, 09:58:22 PM

QuoteIn a comparison of 34 postmortem human brains, scientists found that the part of the brain comprising a small group of nerve cells thought to pertain to gender and sexuality were similar in trans women and non-trans women. Although the study only had one trans man's brain, it found that group of nerve cells to be similar to that of a non-trans man.

perhaps a medical diagnosis is not as far off as we might have thought....

Yes, that may be. It could prove harsh for some though if the diagnosis says "no, you are not TS in the bilogical way" but they still feel as they do. Double edged sword. I read that study yesterday BTW, browsing the science journals for new stuff on TS. Lots of things have been found out it seems since I transitioned. Like that difference in that small region of the brain. OTOH they also found that heterosexual transwomens brains are in some of the gender-specific regions close to that of genetic females, while homosexual transwomens brains do not differ significantly from biological males. This would sort of support the old theory of the two TS types - the one that transitions early, has severe GID problems since childhood and prefers heterosexual realtionships post-transition. And the other type that transitions later, is homosexual after transition and was able to hide the gender issues until later in life. Of course much can go wrong in such studies, like maybe age is a factor in the development of these brain regions and that is why they did found these differences within the TS test group - who knows. I just hope they do not develop a test that is then used to tell people that they are not trans and cannot get HRT or SRS... but I think it will always remain an issue of counselling and going to therapists as such a brain difference does not 100% determine gender identity and in the end it is the patient who has that feeling and if that feeling is there, even a physiological test would not change that, right?

Well, I would hope that any physiological test would only be used to support one's case, and not used to refute it. Perhaps a hetero trans woman with physiological evidence of her gender might have an easier time getting corrective surgery, and/or insurance coverage for the procedure.

Yeah that would be great. But AFAIK this cannot be analyzed with MRT or something like that yet, right? But I can imagine that it will be possible in some time. There was quite a spread in the study though with some males being in the female range and some females in the male range. The average was clearly different and significantly so, but individuals seem to differ. So it can probably only be a good supporting hint... I think I am not winterested in the medical side of this. Didnt know that there were so many new studies out. Maybe I can read some of them...

Quote from: TaoRaven on September 14, 2013, 09:58:22 PM
Oh...one more thing...found this tid bit, and thought it relevant:
[...] In a comparison of 34 postmortem human brains, scientists found that the part of the brain comprising a small group of nerve cells thought to pertain to gender and sexuality were similar in trans women and non-trans women.

Sorry to dig on this again, its a bit off topic, but do you think that such physiological differences in the brain give merit to the claims of some people that these physiological differences also may reflect in the body? What I am getting at is that the science seems to say that these structures in the brain develop during pregnancy because of hormones. Depending at what time during pregnancy some hormones are having an influence on the fetus, the body will change in a gender specific way (causing IS if there is a mismatch between hormones and genetics) and at another time it is the brain (causing TS if there is said mismatch). Would it then not be fair to assume that there is at least the possibility that some body features could provide a hint for a prolonged exposure to these hormones which also cause the brain to change? I am not saying that this is so, but I read that some people get really angry when others suggest something like that, calling them "elitist" and such because they suggest that maybe a TS person that also has some body properties that are less male could be more certain of being TS. But maybe they have a point then if the reason for changes in the brain and body are both happening for basically the same reason.
Just a thought, maybe I should have put this in another thread.

anjaq, I have done a LOT of reading on human sexual differentiation and medical literature is quite definitive about the "road map" for the physical body being set down, "cast in stone" if you will, by the 12th week of gestation and that the changes after that time are in growth. The development of the human brain, however, does not begin in earnest until AFTER the 12th week of pregnancy and continues to occur primarily in the middle trimester. Unless the factors that cause the brain to develop contrary to the chromosomal pattern (XX or XY) were also present throughout the first trimester as well, the body would not be effected.

On the subject of "brain sex" there was some testing done within the last few years (using MRI if I remember correctly) studying the brain activity patterns in response to certain stimuli and it was found that male and female responses to the same stimuli showed pronounced differences. The tests were preformed on ("normal") mature adults and no conclusions were drawn aside from noting the differences.

Were the sames tests to be repeated with transgendered/transsexual people (pre and post hormones) with "normal" people as a control group it may be possible to show a functional difference between the transgendered brain and the normal person's brain activity. THAT would prove a physiological connection to TG/TS. To the best of my knowledge, that has not been done yet. The mere fact that a functional difference is provable has already become VERY unpopular with 'the politically correct' crowd since so many people equate "different" to one being "better than" or superior to the other.

[Personally I believe that hormones play a large role in shaping thought patterns, maybe with life's experience also being a factor. When I look at how much my own thinking has evolved between starting hormones at 17 and at some point a few years post-everything, there is very little similarity. I fit squarely within the female range and totally outside of the male range and it has been that way a LONG time. Was it the hormones that changed me so much or was it living a woman's life? I don't know but I do know that "the wiring" was there and it just needed to be activated.]

everyone is not the same. everyone of us may require a different approuch. but since its plenty of us..they have to treat us with all the same requirements. i think if i had of gotten srs right off the back i would have been just as fine. but being on hrt nearly three years has givin me time to learn and grow. everyone is different. 

Jane -
Well yes, the changes post-HRT and post-transition are big and certainly will have an effect, which is why those studies try to look at pre-everything people or try to eliminate adult hormonal influences. I am a scientist, so I am not so much interested in dropping studying a subject for political correctness reasons. If there is a physiological marker, then it does exist. If people take it then in an elitist way, that is an issue that has to be dealt with then, not the fact itself.
So that 12 week mark is what I was wondering about. Consider that for some reason or another there is a time - some days or weeks - in which the XY fetus gets hormones that cause feminization (just as an example now). That time starts at some point and ends at another later point. Now if it starts some days before the 12 week mark and ends sometime later, it would affect body a little bit, brain a lot. This would be the most likely case then actually - more likely than the hormone surge coming only before the 12th week or only after the 12th week and of course the control group are the ones not having any such surge at all. In that case, I would almost guess that quite a few people who got that hormone surge had it in a way that was spanning over some part of the body development as well as the brain development. I know this is a bit dangerous to think about politically as there may be that idiotic idea coming from it that some people are "more legit" than others, but that is nonsense as obviously there will be cases where the surge comes only after the 12th week and thus only brain is affected and that is not less "legit" than anything else. But such a overlapping surge would be quite common then and explain possibly why for some TS people the body is not quite male as well.

AFAIK there is no MRT technique yet available that shows structures that differ between male and female on birth. thinking patterns are just too susceptible to change with life experiences. AFAIK they had to do the analyses post-mortem to get into these differences they are mentioning. Its a bit of a tough subject as obviously it is hard to divide brain structures or patterns that developed before birth from after birth, pre-puberty to adolescence. Learned behaviour adds to that. And certainly does being post-op for many years. Even worse if the data can only be gotten post-mortem.

Quote from: Northern Jane on September 18, 2013, 07:05:47 AM
I don't know but I do know that "the wiring" was there and it just needed to be activated.

That's been my experience as well. 

I have gone full time despite not having all my ducks in a row... forced because I have to prove myself to non-transsexual, non-queer authority figures, to obtain treatment.  Interesting debate... I'm going along with the charade, but damn them, I'm having such fun along the way !   

In retrospect, we all reach a point where we have to 'go live' even if things aren't perfect.  Holding back and waiting for perfection may never happen.  So what if I'm not 100% passable?  As long as I learn from each situation, I'm improving.

Sorry if I seemed to disparage Harry Benjamin earlier.  Of course his work was revolutionary.  I criticise the little people who stand on his shoulders, little people who have adopted the 1950's attitudes toward women that Harry's generation held.   And no, I have no forgiveness for therapists who take our cash and then insist that we have to be 'straight women' to qualify for HRT & SRS.  We're here, get used to it.

The debate over whether your body belongs to you alone... won't be resolved here.