Thursday, 27 March 2008

Today's Battle

This time, it's about Male Pregnancy.

At StopTheACLU, and Darwin Central (one of my regular haunts as a scientifically literate conservative), with a stopover at the US ABC News, WKRG...

I'll quote from my posts on Darwin Central:

Post 1
From The Advocate :
This whole process, from trying to get pregnant to being pregnant, has been a challenge for us. The first doctor we approached was a reproductive endocrinologist. He was shocked by our situation and told me to shave my facial hair. After a $300 consultation, he reluctantly performed my initial checkups. He then required us to see the clinic’s psychologist to see if we were fit to bring a child into this world and consulted with the ethics board of his hospital. A few months and a couple thousand dollars later, he told us that he would no longer treat us, saying he and his staff felt uncomfortable working with “someone like me.
How does it feel to be a pregnant man? Incredible. Despite the fact that my belly is growing with a new life inside me, I am stable and confident being the man that I am. In a technical sense I see myself as my own surrogate, though my gender identity as male is constant. To Nancy, I am her husband carrying our child—I am so lucky to have such a loving, supportive wife. I will be my daughter’s father, and Nancy will be her mother. We will be a family.”

Post 2
I don't know how he can bring himself to do it.

I know some Trans-guys. Going off their T-shots is like other guys having their balls removed, to put it impolitely. Very distressing for them. Doing it for at least a year.... it takes a heck of a man to do that.

It's worse too: the hormone levels during pregnancy go wayyy off the scale. They can cause real problems, post-partum psychosis. This guy knows that his neuro-anatomy will never be the same again afterwards, there will be permanent neurological changes. There's a small but non-zero risk that he'll become insane, and a larger one that his personality will be as altered as it would be from major cranial trauma. He risks his very selfhood, his identity, his personality.

Just to become a Father. Now *that* takes.... Balls.

Post 3
orionblamblam wrote:
>> Tiamat wrote:
Has anybody described why this guy can't adopt? (other than some potential mental flakiness) If he wants a kid why go to such lengths?

> Because adoption is bland. But by risking his life and his child's he can be "special."

Which is why you chose not to father children, but to adopt, right? And why pregnancy in women over 35 is socially sanctioned, as it "places mother and child at risk".

Depending on the jurisdiction, adoption is probably impossible anyway. No matter what the jurisdiction, it would not be as easy as you assume. There will probably be a legal battle so they can keep the child in any event.

I live in Canberra, Australia. Should I move to Western Australia, the Family Court there would immediately place our son in state care - no need for evidence, the state Family Court there does that as a matter of policy in all cases where one parent is Transsexual. The other parent doesn't get custody either, all contact is severed with both.

I constantly face a credibility problem. People not in this situation have difficulty believing that such things happen. Heck, I have difficulty believing some of the things that have happened to me. The 20 month legal battle just to get a passport, for example. The fact that I was initially issued a travel document good for leaving the country, but not returning, even though I'm a citizen. The fact that I have to spend a whole day travelling interstate for a 15 minute medical appointment every few months, as none of the endocrinologists within 200 miles will treat "people like me". I live in the capital city, BTW, the largest inland city in the country, so its not like I'm in a remote rural area with few medical services. There's 12 accredited Universities here.

I don't want to engage in competitive victimology, and I usually don't mention things like this. Australia is one of the most trans-friendly places on Earth, and those elsewhere have it far worse. But when ill-informed - not malicious, or unreasonably ignorant, just ill-informed - comments such as these are made, maybe I should make a fuss. You quite naturally assume that certain rights you take for granted - the right to adopt, the right to keep children you already have, the right to marry, the right to have children if you're capable of it, the right not to be left to die at a hospital if injured in a car crash - are applicable to Transsexual and Intersexed people. Some are. But many are not. And the ones that are, we often have to fight for to get them actually granted, no matter what the law might say.

It would never occur to you. I don't blame you. But I do think you have a responsibility to do a little research on the matter once it's been brought to your attention. Don't take my word for it, for I can hardly be objective, look things up yourself. The TS Q&A on DC University is a good start.

And I'd be glad to help. Society doesn't need changing, but it does need educating; and if I have a problem due to that, it's my responsibility to help others educate themselves, not for others to find data they have no inkling even exists.

Post 4
orionblamblam wrote:
> It sucks. But *my* interests are not always paramount. Nor are yours. And nor are the interests of someone whose body is a biochemical wreck.

I take what I said before back: Not all the good ones are married or gay. You're a counterexample, and I truly hope that one lucky woman has the sense to recognise that soon. With an attitude like that, you'd make a great father, and I hope that's in your future.

We have a misunderstanding. Several, in fact, and I'll try to clear them up.

Every pregnancy is risky. Some are riskier than others. After age 35, the chances of birth defects steadily rise. By age 45, it's something like 1 in 4. Most will cause spontaneous abortions, and those that don't often can be detected and sometimes corrected. But there's always a risk, no matter what the age. It's not a binary, risk or no risk, it's a difference of degree, and deciding what risk is acceptable.

In this case, I doubt that the risk to the child is any greater than for a woman his age who has had PCOS - polycystic ovarian syndrome. I don't know what the increase in hazard there is, but it would be non-zero. There's no reason to believe that it would be an unacceptable or unreasonable risk, as far as I know.

The risk of temporary psychosis is also there in any pregnancy. The hormone roller-coaster he's already been through may be protective, or may increase the risk, we don't know. We can't be certain, any more than we can in any other pregnancy. Less so.

The risk of permanent personality change is increased though. Women who become mothers get hit with such spectacularly high hormone levels that there are permanent neural changes easily detectable by dynamic MRI. These may or may not lead to permanent effects on the personality, effects comparable to those that happen at puberty. For a man to get the same hormone levels would have incalculable consequences on his mind. Change, not damage as such, and functionality can increase rather than decrease. But he may never be the same again. He can't know. It's a risk. There will be a functioning person in his body afterwards, one whose mind strongly resembles his: but he realises it may not be the same person he is today.

I've been through this kind of thing three times, with noticeable (minor) changes to my very identity each time. Once due to a partial male puberty at 15. Once due to E-II Encephalomeningitis at age 20. Once due to a partial female puberty at 47. The hormone replacement therapy I started after that last has had no effect, other than to maintain the status quo. We think. I'd rather not conduct the experiment to find out.

I console myself with two thoughts: the first is that I had no choice in the matter in any of the occasions. The second is that the person we are today is not quite the same person we were yesterday. We learn, we grow. It's indistinguishable from day to day, but inescapably evident from decade to decade. So it's a matter of degree rather than kind.

In summary -
1. The guy is not a "biochemical wreck" taking insane risks in trying to have a healthy child. He's taking a gamble at odds no worse than many mothers have to.
2. The risks of the baby being fatherless afterwards are comparable with the risk most babies have of being motherless. I include the risk of death in childbirth and post-partum psychosis.
3. He does have an incalculable risk of changes in his personality amounting to personal extinction. But this is his risk, and would not affect his child.

If it helps - I know of 3 similar cases in Australia. In two, it turned out well for the child, and I don't have enough information about the third. But we don't have a large enough sample to say what the additional risks are.

Please pardon me if I supply less data than I'd like to on risks of pregnancy. I find researching it most distressing, as I never did come to terms with the fact that I was unable to bear children myself. I know many other women can't, and I consider myself very fortunate to have the second prize of fatherhood. I really did qualify as a "biochemical wreck" you see, not that I knew that at the time. I was lucky, and the many miscarriages we had on the way before we hit the jackpot we blamed on the technical method we were forced to use, not my own biological catastrophe. The diagnosis from the Fertility Clinic was "mildly intersexed male" then. It wasn't until 5 years later that we found it should have been "severely intersexed female".

But then, had we known, I would never have taken the risk, and my son would not exist.

Post 5
orionblamblam wrote:
> Life, as I'm sure you're aware, can be impressively unfair. And while a defiant stance against that is certainly noble, at some point one must recognize that sometimes the reality is that you can never have what you want. And screaming and hollaring about it and trying to force your preferences on others (including potential offspring) will not help and will not work. Your DNA is all fucked up (I'm assuming).
Having recently met others with the same really rare syndrome - and it has to be at least 1 in a million, probably one in several million - and having compared various skeletal and endocrine anomalies we all have in common - then yes, it looks like your assumption is correct.

Most genetic diseases have "tells", minor anomalies that individually fall within 3 Standard Deviations of the norm, but which taken together show a mutation or single developmental anomaly was responsible. Now we don't know the cause for sure, but now it seems it's probably a minor coding error on a gene yet to be identified.

Some of us have had children, and although the miscarriage and SID rate is high, the surviving kids thrived. My own son is mildly intersexed, but so are 1 in 60 of the population at large.

Anyway, any female reproductive tissue I had was so vestigial it could never have worked, and was removed 30 years ago. And the male reproductive tissue worked partially for perhaps 5 years before becoming completely useless. I had that removed just over a year ago. So the point is moot.

I know of two cases coming up for surgery soon where the diagnosis of "transsexual woman" has been changed to "intersexed woman" as the result of pre-op medical tests. In one case, the female reproductive bits just may be salvageable. We're all crossing fingers for her anyway.
> A physically female woman who has been chopped up and zapped full of alien chemicals such that she now has the physical characteristics of a male pretty much *is* by definition a biochemical wreck. Her body has been extenally forced to become something it was not, if you'll excuse the use of ID-ish terminology, "meant to be."

I'll take that as actually saying
A physically female man who has been chopped up and zapped full of alien chemicals such that he now has the physical characteristics of a male pretty much *is* by definition a biochemical wreck. His body has been externally forced to become something it was not, if you'll excuse the use of ID-ish terminology, "meant to be."

I'll excuse the ID-ish terminology. And I won't criticise the thought: you're not saying it's a case of Human Intervention being Against God's Plan, it's a case of the foetal and post-birth development being screwed up. From the chromosomes, He should have been She. Just as I should have been a He (gosh, that feels weird saying that). The genetic "plan" went awry, either coffee was spilt on the blueprints, or they were read upside down, or materials weren't available so they had to alter it during construction...

I think I'm right in saying that there's a difference in philosophy. If I understand you correctly, you take a look at the world, see how many children don't have good home lives, and think "We don't need another, especially one who has a higher probability than usual of having a tough break to start."

I'll concede your point. I do think though that it would be more productive to concentrate on reducing the number of "crack babies" and those with foetal alcohol syndrome first. This guy has overcome challenges you can't comprehend easily, so should be somewhere near the last on the list of those denied parenthood, not the first. More importantly, I can guarantee that any child he bears will have love and a caring environment, not something that can usually be guaranteed in this world.

> Life, as I mentioned, is unfair. For the world’s more full of weeping than you can understand.

All the more reason to reduce the unfairness and tears when we can then, isn't there?

But of course, I can hardly be objective in this kind of situation.

Post 6
It's not the first time.... although numbers are small, we do know that the risks are not severe...

It's just that not many people know about it.

Post 8 (7 skipped)
phantomworker wrote:
> You may have described a multivariate, multidimensional spectrum view of sexuality. Thinking in terms of a single dimension, sexuality may range from none to homo-, bi-, and hetereosexuality. Transsexuality or intersexuality fits in that continuum as well.

Different dimensional axes though:
Homo-, Hetero-, Bi- sexuality -> Who you want to go to bed with
Gender -> Who you want to go to bed as
There are other axes too: what does your body look like, does it match your gender? And does your societal behaviour match your gender? My match in that last area is not exact: I have the instincts of one, the learned behaviour of another. So that's 3 additional dimensions.

Most intersexed children are just normal girls or boys, with a defect in their body plan. All transsexual children are just normal girls or boys, where the defect is extreme. A minority of intersexed children don't fit into the categories "male" or "female", there are not-males, not-females, neuters, androgynes...

It gets complicated too. Children may be forced into roles, behaviour, and through surgery and hormones, bodily appearance that does not fit them. I deal with many Intersexed people where the surgeons "guessed wrong" when re-constructing their genitalia many years ago, sometimes when they were only days old. It gets even more complicated in the minority of Intersex conditions lumped together as "serial heraphroditism", where the body plan changes from looking mostly like one sex to looking mostly like the other. That presents extreme challenges for those who have it who are strongly gendered - take my word for it. Either waking up from a living Nightmare, or descending into one. I lucked out there.

There are 19 previous cases recorded in a movie - Transparent.
Pink or blue. Male or Female. Mommy or Daddy. Categories that we all take for granted are blown wide open in “transparent,” a new documentary film about 19 female-to-male transsexuals living in the United States who have given birth and, in all but a few stories, gone on to raise their biological children.
“transparent” focuses on its subjects’ lives as parents – revealing the diverse ways in which each person reconciles this part of their history - giving birth and being biological mothers - now that they identify as male and are perceived by the world, but only sometimes by their children, as men. The first-person stories in "transparent" explain how changing genders is dealt with and impacts the relationships, if at all, within these families.
This film has a shocking fa├žade - as a story about transsexual parents – but viewers will be struck by its universality. The subjects resonate powerfully as “normal” parents and human beings dealing with issues like single parenthood, teen pregnancy and their children’s emotional and physical development.
But through these extraordinary men, the film challenges, like never, before the ways that we relate to one another, particularly within our immediate families, based on gender.
"normal" parents rather than "normal parents". Oh well, one step at a time.


Stellewriter said...

There are those who have indicated that I should be eradicated, a danger to the common existence of society and the fabric of society. Beign Transsexual as any other issue of minority is one of fight or die. Since some have indicated that is a reality, I guess I should take it seriously, as should all who face a life of inequality and disparagement under the law. For certain I have come to disbelief and will never be fooled again regarding the seriousness of those who would see that all Intersex and Transsexuals be shut out and removed from the palate of life.

No longer playing by the rules, this one!

Zoe Brain said...

You're right, it's a war for existence.

The only question is, what tactics do we use? What is our strategy? I feel that merely being who we are, quietly showing that we're people rather than some Awful Menace is the way to go, and that's what I'm doing. Others may differ, and use different methods. I'm not sure a diversity of approaches is a bad thing, either.

One thing's for sure: with the backlash against same-sex marriage, we're caught in the crossfire. We can't hide any more.

Lloyd Flack said...

This discussion on Darwin Central was less over transsexuality as such than it was over how far one should be willing to go to become a parent.

The primary issue was should one seek to become a parent if there was a significant risk of genetic or developmental damage to the offspring.

The secondary issue was how much risk and what sort of violation should one be willing to endure to have children. These points were being raised by someone who appears to not have a desire to become a parent. They are still valid issues.

Dave said...

They are, as you say, valid points, however they seemed to rest on shaky logic. One line of reasoning was (if I can paraphrase), "other people have bigger problems than you, so suck it up and give up."
By that logic, everyone would give up on their battles, because there's always someone else with bigger problems.
I read this point as really saying "stop agitating for a right that I don't believe belongs to you.'

On regard to risks of pregnancy (either for parent or child), until there's some modicum of consistency on this from society at large, then it's a non-starter.

You could also argue that procreation is the ultimate biological imperative, and it is everyone's right to roll the dice and take their chances. That's certainly my opinion. To do anything else is to second-guess evolution as well as play God, all at once.
Right to life? What about the right to breed.

Lloyd Flack said...

Part of the problem here is that the more you accept a person's sex change, the more you accept that what you see now is who they really are, the more this feels wrong. I can understand the desperation but should they be willing to go this far? It is definitely their right and I can understand how someone with his life history might see it differently. But it looks like violation of their identity.

Also I don't know what the developmental risks are. Some problems with sexual differentiation are believed to be due to unusual levels of hormones in the mother. I don't know what risks if any are involved here.

Anonymous said...


Just because it's different than anything that you have experienced or known about before and you feel uncomfortable doesn't make it wrong, not by any means. As you say, it may *feel* wrong to you, but that doesn't mean that it is.


Stellewriter said...

Sexual Differentiation,...Hmmmm!

One might research the effects of DES and other endorine blockers that have been introduced into natal care. Born like a fish swimming in a polluted stream, the idea of my sexuality as a matter of someone else's discomfort is rather confusing. I guess it is a violation to be anything other than the accepted "norm" regardless of how minute, or major the differentiation may be.

Zoe Brain said...

Just a remark - I value Lloyd's friendship highly, for his kindness, his understanding, and his rigorous intellectual honesty.

Getting his head around my change is a big ask. He did that. Having done that for me, he extends the same logic to other TS people. But having done *that*, to then accept the "Oh but.....", that takes some real intellectual gymnastics.

My own view: that in the future, pregnancy will be possible for factory-model 46xy males. For those whose wives can't have children, it may even be an option that a few may consider. I'm just treating this guy the same way I'd treat them.

If you look at it that way, it makes the situation easier to accept. It's only those who have lingering, possibly unconscious doubts about this guy's masculinity that have problems then. But if they do have these doubts, I can't really blame them. It goes so much against "common sense", and that's a really good guide. Not infallible though, as here.

Anonymous said...

He will be a guest on Oprah Winfrey's show in the USA on Thursday.


Zimbel said...

I'm surprised that the "crack babies" myth made it to Australia. But in any case, have you ever wondered why there were "crack babies" but never "cocaine babies"? After all, they're pretty much the same drug.

It just so happens that in the U.S.A., one is consumed in disproportionally high amounts by Blacks; the other is consumed in disproportionately low amounts by Blacks (obviously, this is in the U.S.A.). Whatever the source of the myth, it was used to disproportionately imprison Blacks in the U.S.A. (warning: 2-year old link - last I'd heard, there was a bill in committee to make crack and powder cocaine sentences equitable in the U.S.A.) Quote:

Recent data indicates that African Americans make up 15% of the country’s drug users, yet they comprise 37% of those arrested for drug violations, 59% of those convicted, and 74% of those sentenced to prison for a drug offense.7 Specifically with regard to crack, more than 80% of the defendants sentenced for crack offenses are African American, despite the fact that more than 66% of crack users are white or Hispanic.8 (emphasis added)

Here's a link a brief overview in the National review of Medicine of a medical study on the topic of cocaine babies, and a quote:

Since 1993, she and Dr Behnke have been following 154 children exposed to cocaine in utero and 154 unexposed kids who were matched on race, parity, socio-economic status and prenatal care.

"We did extensive physical and neurologic exams at birth and found no group differences," says Dr Eyler. There were no developmental or cognitive differences found in these kids at age three either. These results can be found in the April 12 issue of the Journal of Pediatric Psychology.

Stellewriter said...

One of the miracles of blog is that a thread never dies! Here we are months later and it lives..... Like Frankenstiens monster the heart never quits. However, the bigotry and hate that abounds in the USA as does around the world seems to have been created from the same bolt of lightening that the mad Doctor Frankenstien used. Not only are the statistics askew regarding the avantaged and those who are not, but the black booted cops that enforce the law are also backed up by the same arian mentality of the justice system. I live in teh heart of the darkest heart of America. It is dark because the people accept the state and face of inequality and ravish in its death hold. Of course the Black population will be treated as animals, and the unfortunate Transgender will be slaughtered, and no one will care. I have been on the steps of the legislators and in their offices, and they do not care.

So a post that was brought to my attention via a notice from a blog in stasis months ago leaves me reminded that nothing has changed, .... that is except me, I have. I no longer play in traffic, nor do I respect traffic signs. (The invisible people are important!)