Monday, February 20, 2012

A Cis Take on Transgenderism

For the record, I consider myself to be moderately gender-fluid, but for all intents and purposes am cis-gendered.  Adam, being trans himself and going through the transitioning process can talk on this with more medical and emotional accuracy, but I think it's important to explore things from the perspective of someone who is not transgendered, because that's the perspective a majority of people will view it from.

It's something that is difficult to explain.  So much of who we are is wrapped up in our sex and gender and how we relate to them, that it can be difficult to be confronted with an individual that doesn't fit into what we've accepted as "norms."  I think that unless you are transgendered yourself, or an expert in medicine and psychology, you will never truly understand what it means to be transgendered and what transgendered individuals feel and face.  Still, even with that disconnect, I think that cis people can develop a basic understanding of gender, gender identity, and the transition process, or at the very least eliminate some misconceptions.

The inspiration for this topic is this article from CBS News that talks about the increasing number of gender-related therapies.  The focus is hormone blocking therapy which delays the onset of puberty so that those who are diagnosed as transgendered can make a decision as to their gender when they are mature enough.  It doesn't address the issue from a medical standpoint as much as I'd like, but it does a good job detailing the process for gender reassignment.  Here's the breakdown:

  • The transitioning process is a long one, beginning with counseling, diagnoses, and if necessary puberty blocking drugs, sex-changing hormones, and reassignment surgery.
  • The counseling process is extensive and designed to separate those that are simply gender-non-conforming from those that have gender identity disorder or whose gender is different from their sex.
  • Once the patient is thoroughly analyzed, they can begin taking hormone blockers which delay puberty.  This process is reversible.  What it does is it allows them to wait until they're more emotionally mature before they decide to take sex-changing hormones, or advance as their biological sex.
  • Sex-changing hormones develop the secondary sex characteristics (i.e. breasts, facial hair) of the applicable sex.
  • If they choose, patients can elect to augment this with surgery once they are of age.  Typical surgeries are the removal/addition of breasts (top surgery), or the removal/addition of lower genitals (bottom surgery).  It has been my experience that top surgery is far more common than bottom surgery.
  • There is a shockingly small "regret" rate. This study showed that 98% of the trans individuals surveyed were satisfied with their post treatment gender with 91.6% being satisfied with their appearance and the other 8.4% being neutral.
I felt like the article did a good job in dealing with some of the common misconceptions, but I'll rehash some of them.  Truths in italics.

Kids don't know what they want.
Yes and no.  While kids are fickle, many of them are aware of their gender and orientation at an early age, regardless of what they are.  Furthermore, there is a physiological backing to gender identity disorder.  Many who transition were in fact born with the brain chemistry of their perceived gender.  They are (or were) one gender living in another's body.

It's often just a phase.
Again, yes and no.  While there are some kids who are merely gender-non-conforming, there are some that are not.  Just like there are some kids that have ADD and some that don't.  That's what the extensive counseling process is for, to ensure that any type of therapy involving hormone blockers or hormones is the right decision.

It's harmful. 
No, it's harmful to not, at the very least, pursue counseling to get a handle on what the issue is.  Allowing a child to live life with untreated gender identity disorder is like allowing a child to live life with untreated schizophrenia, harmful and dangerous.

Surgery is a big deal.
Correct, it is, that's why surgery is only performed after the age of 18 is reached, and usually after an extensive process of counseling and hormone treatment.

It's probably harder to be transgendered right now than it is to be anything else (aside from dying).  Not only are there so many misconceptions, but it's so difficult and complicated to educate...and it's something a lot of people will never be able to fully grasp.  But we are getting there.  Transgendered individuals today are starting to enjoy protections in some of the more liberal parts of the country.  As we delve deeper into the mysteries of gender, physiology, brain chemistry, and beyond, we'll grow in leaps and bounds.

And that's the other aspect of this.  We've come so far, not only in what we understand about transgendered people, but what paths they can travel in pursuing an orientation and a gender that feels right to them.  But we can always do more, can always smooth the process, evolve so that the surgeries are less invasive, that the transition is easier.

Stay tuned for Adam's take, hopefully coming within the next few days.

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