Saturday, 27 January 2007

Kim's Mirror Image

From Spiegel Online International ("Spiegel" is German for "Mirror") :
Kim P. is 14 years old. She wears light eyeshadow, a navel-baring top and embroidered jeans. She plays with strands of her long hair as she describes her dream of going to Paris one day to be a fashion designer. Her attic bedroom in her parents' house is a girl's paradise in pink, with the requisite fashion magazines, a makeup table, a sewing machine and even a clothes mannequin near the window.

She's had enough of psychiatrists who ask weird questions. She's had enough of doctors who reject her case because this fashion-conscious girl -- previously called "Tim" in her patient file -- unsettles them.
Well, I know that feeling!
The family was at a loss when it came to seeking medical advice. "If your child has a heart defect you send him to a specialist," says Kim's mother, "but when your child is transsexual everyone seems to have an opinion."
"Hormone treatment! Gender adjustment! How could you possibly do this to the child?" the family's pediatrician barked at the father -- in Kim's presence. Then came the sessions at the state psychiatric hospital, where Kim would sit in green rooms with high ceilings, playing with experimental blocks, while her parents answered endless questionaires.

Sitting in the waiting room, Kim thought to herself: Does this mean I belong in an insane asylum?

The family's whole life up that point was suddenly in question. "Are boys unwelcome in your family?" they asked the mother. "Have you ever considered, instead of manipulating the child, sending him to be cared for by others for a while? Putting him in a closed children's psychiatric institution, for example?"

"What's wrong with being a real guy?" a doctor in a white coat would ask Kim. "Have you ever tried it? What do you think about your mother? Were you ever in love? With a boy or a girl? Do you like your penis?"

Kim answered their questions to best of her ability, but the whole thing felt humiliating. "All of a sudden I had the feeling that it was my fault, that there was something dirty going on."
Enough. Look, late transitioners like myself often feel sorry for ourselves. We envy the girls who transition early, almost as much as we envy the girls with 46xx chromosomes. But we forget the helplessness of the youngsters, the powerlessness. If their parents are supportive, it's wonderful - though even then the general ignorance in the medical profession is astounding. But if the parents aren't supportive, it's hellish.
From a purely medical standpoint we are dealing with the mutilation of a biologically healthy body," says Meyenburg. "We face a real dilemma. If we do something about it, it's irreversible. And if we allow nature to take its course, that too is irreversible."
That's why the treatment of choice in cases like these involve gonadotrophins. Drugs that delay puberty, rather than reverse it. It's not easy even for competent medics, for example, the ideal is to let puberty proceed far enough so some sperm can be collected for artificial insemination later. This is the only way an early transitioner can have children. Great if she's Lesbian, but most aren't, and that involves heartache too. They can never bear their husbands' children.
But in Kim's case, says Meyenburg, "it would have been a crime to let her grow up as a man. There are very few people in whom it's so obvious." It takes a great deal of experience to be able to differentiate between a temporary gender identity disorder and "true" transsexuality. Meyenburg recently met a 15-year-old girl who didn't want to be a woman. It took a while, but he discovered that the girl had been brutally abused by her father when she was seven.
The trauma of the experience had triggered a deep identity disorder, but not transsexual development. In the end, the girl chose not to undergo a sex change.

Based in part on such experiences, Meyenburg says "psychotherapy is always worth a try -- not because being a transsexual is such a bad thing, but because it is probably easier to go through life as an effeminate dance instructor than as someone who has had a sex change operation."
Probably. Easier still to go through life looking like an overweight ex-rugby player, one who would look terrible as a woman. That's what I thought anyway. But was it Really easier? I was so looking forward to an early and honourable death.
Even if the process goes on to indicate a sex change, most adolescents also benefit from psychotherapy. "After all," says Meyenburg, "there are also parents who attempt to beat it out of their children."
They are the lucky ones. The unlucky ones "run away from home", at least, that's the cover story. They're actually buried nearby. The really unlucky ones are often thrown out on the streets, to peddle their bodies in order to survive. Most die from drug-related illness : HIV, OD, hepatitis. Some die from violence. These are normal kids, just children, yet anathematised and rejected, having to earn big money just for the hormones to keep them sane.
Two years ago, Tanja Pfeil says, she wept uncontrollably after a TV report about a girl like Kim. She mourned the girl she could have been, and the life she'd missed as a woman. The girl on TV looked perfectly female and showed no male characteristics at all, said Tanja. At that point, to the outside world, she was a businessman from northern Germany, in her mid-forties and named Michael. "I attribute it to my sunny personality that I didn't fall apart," she says now. "Being transsexual is something for people who are completely healthy."
Oh I know that feeling! I was lucky, my denial was so strong I literally could not have watched such a program. If I'd seen part of it, I would have forgotten it within minutes of seeing it, forgotten that the program even existed. Ironically, it was when I healed that I transitioned.
As a 13-year-old, Tanja asked her grandmother where people came from. "They're made by our dear God in heaven," the old woman replied. "And when will I finally be a girl?" Tanja asked. "Never," her grandmother said, "God made you a boy." Her first thought at the time was that something had gone wrong in the cosmic factory: God had cobbled her together wrong.
He forced himself into the role of a man. He met a woman, fell in love, married and fathered a son. When the boy was born, Michael wished that he himself had given birth.
And there we have an example of how even well-meaning jounalists get it wrong. It should have been
"She forced herself into the role of a man. She met a woman, fell in love, married and fathered a son. When the boy was born, Michael wished that she herself had given birth ."
See what I mean? That corrected sentence shows how perverse it feels to be transsexual, how abnormal and uncomfortable acting according to societal expectations feels. Honesty compels me to say that when Carmen was actually giving birth - and it was not an easy delivery - when the obstetrician did the epesiotemy with surgical scissors (and there was still terrible tearing), my feelings were decidedly mixed. Most of me wished it was me simply because I'd rather have the pain than it be inflicted in someone I loved. Part of me was very glad it wasn't me! It was only beforehand, and afterwards, that I wished it had been me that carried Andrew and gave birth as a woman. Even now there's a pang, but I've known that couldn't be in my fate for 35 years. You think I would have gotten used to it by now.

Anyway, please go and read the whole thing. I don't believe that God (if he exists) makes mistakes. If a child is born with a hole in the heart, there's a reason for that - but we should fix any congenital problem to the best of our ability, that's part of His plan too.

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