Coming Out to My Brother
But first, news! mfrazercani got a job!!! He got hired back at the same place that fired him, actually, at the same rate of pay. Who knows what happened? The manager broke up with him and then realised he'd made the biggest mistake of his life? They thought 5 months of misery would be good for his character? I'm not going to look a gift horse in the mouth, but the whole thing has me a bit befuddled. I also have an employment prospect, but I'm not certain my technical skills are where they need to be. We're talking back and forth at the moment.
But back to the topic of this post. I need to come out to my extended family, and the one I've been most nervous about is my brother. We haven't been close since I was a teenager - in fact, I could probably count the number of times we've talked on one hand. But since he's my older brother, a big part of me desperately wants his approval. He's pretty consevative, and I have no idea how he's going to react. Neither do my parents.
So here's the letter I wrote to him. It's long, but if any of you feel like reading it and letting me know what you think I'd appreciate it. I focussed primarily on education, since he's someone who prides himself on logic and rationality and I wanted him to understand what exactly was going on. Also, I tried to be as accurate as possible, but this reflects my experience as a binary-identified transsexual. I don't talk much at all about gender fluidity or trans-ness as an identity, because that doesn't have anything to do with my experience and I didn't want to cloud the issue. So this is definitely medical-model centric.
Dear Brother,
One year ago, almost exactly, I realised that I was going to have to face a problem I'd been struggling with my whole life. Something so big and scary that I'd buried it, that I struggled day after day through crushing depression and self hatred rather than deal with it. Something I never told anyone about, and which I never even admitted to myself where I could hear myself think it.
Over the past year I have faced it. It's involved a lot of soul searching, a lot of struggle and a lot of change. And now it doesn't seem like that big a deal. It doesn't seem like something I ever should have hid from or been ashamed of. In fact, it seems obvious and self-evident and . . . simple.
Which makes telling you about it difficult. I know it won't seem obvious or simple to you at first, and I really don't want to revisit that place of confusion and fear and doubt, even vicariously. But you deserve to know. I'm telling you in an email so that I can be certain to be as clear and as thorough as I need to be, and so that you have a chance to absorb everything at your own pace. But I am available and eager to talk to you, so I'd like it if you would call me when you're ready.
Despite what we've all assumed to be true my whole life, I'm a man. I know that at first read-through that statement will seem odd, if not ridiculous, so let me explain. Transsexualism, or Gender Identity Disorder, is a rare, poorly understood condition - and the false, harmful stereotypes of it portrayed by the media don't help that at all. The truth is that you can't change your sex - you're born with your gender already determined, and you're stuck with it forever, no matter how much you may try to change. But it's not your body that determines your gender, it's your brain. And there's no way to see what sex a baby's brain is. So we make our best guess based on physiology and most of the time, we're right. As for the rest, we call them transsexual.
The more science studies gender, the more obvious it becomes that it's not as simple as we all assume it to be. For any physiological criteria one can think of to definitively "prove" another person's gender - chromosomes, internal sex organs, external genitalia, secondary sex characteristics, endocrine profile - there are intersex conditions that prove them to be less than absolute. And yet there is a difference between men and women. They think, feel and experience the world differently than each other, in ways that go deeper than social gender roles or ideals of masculinity and femininity. After all, there are many effeminate men and masculine women who are still most definitely men and women. So what makes a man and what makes a woman?
We don't have language for it, but we know. For most people, their physical sex and their internal gender are the same, so they never have to think about or notice it. If they don't match, the person develops something known as gender dysphoria. This is a dissonance between who they are inside and what they see in the mirror, as well as how people react to them. Our gender identity is such an integral part of who we are that it colours every part of our lives, every part of our thoughts. If you were emasculated tomorrow, even if you woke up in a female body, you'd still be you - and you'd still be a man. And you'd know it, even when all physical evidence pointed to the opposite.
My medical doctor, among others, suspects that because the hormonal washes that gender the brain in utero are separate from the ones that gender the body, sometimes the process can be disrupted and that can result in a male brain development in a person with female body development. This hasn't been proven, but as a theory it makes as much sense to me as any other.
One recent study, which scanned the brains of female-to-male transsexuals who had not yet undergone any medical treatment for their condition as well as the brains of women and non-trans men, found that in several gendered areas of the brain the FtMs' (female-to-male transsexuals') scans matched those of other men, not those of women.
A woman given high levels of testosterone or subjected to a drug that represses her normal estrogen production, such as Clomid, will experience agitation, anxiety, depression, a reduction in mental faculties, a sense of emotional dampening, unpredictable anger, the feeling of walking around in a fog and a general sense of her brain "not working right." A man given estrogen or put on androgen blockers will experience emotional instability, anxiety, depression, a reduction in mental faculties, brain fog and, again, the feeling that his brain "isn't working right." But a transsexual given the correct hormones for their gender identity suffers none of the same symptoms - in fact, they experience the opposite. A trans man given testosterone will feel happier, more stable, more alert more energetic and like his brain is working right, while a trans woman given estrogen will feel happier, more in touch with her emotions, more expressive, more connected to the world around her and like her brain is finally working the way it should.
The incidence of PCOS (Polycystic Ovarian Syndrome) is much higher among trans men than it is among women, there is some evidence that FtMs, even without treatment, have a tendency towards a more male body shape than would be expected, and there appears to be an increased risk of cardiovascular disease among FtMs separate from their hormonal profile. All these things imply the prenatal development of transsexual males is different than that of females.
No one knows why some men are born into seemingly healthy female bodies, nor why some women are bon into seemingly healthy male ones, but the condition has been around since the beginning of humanity. It has existed since civilisation began and many other cultures, ancient and modern, have made space for transgender people in various ways. It has been recognized and treated by modern Western medicine for over a hundred years
Many myths exist around transsexualism. You've probably internalised a lot of them without even realising it.
Transsexuals are mentally ill. There is some correlation between transsexualism and certain psychological conditions, usually depression or anxiety. This is usually because the internal stresses of gender dysphoria, and the external pressures of living in a society that insists that they conform to the gender their body appears to be, cause the depression and/or anxiety. The issue of their body producing the wrong hormone for proper brain functioning plays a big part as well. Transsexualism itself is not a mental illness. There are some people who have mistakenly believed they were transsexual due to other mental health issues and who later came to seriously regret transition, but this is extremely rare. Unfortunately, these are the cases the media usually reports on with great relish. Transsexualism, like homosexuality, was considered for many years by the psychological field to be a delusion or other mental issues, and a lot of horrific techniques have been attempted to fix it, from aversion therapy to psychoanalysis to hypnotism. None have been successful. It's now recognised among ethical health professionals as not being a psychological condition at all, but something more along the lines of a birth defect.
Transsexuals were sexually abused as children, or their parents caused it by raising them wrong. There is absolutely no correlation between early childhood experiences and transsexualism.
Changing sex is just a way for people to be gay without the stigma. First of all, the stigma of being trans is a lot worse than the stigma of being gay. And trans people, just like non-trans people, are of every orientation. Trans people can be gay, straight or bisexual before transition and they can be gay, straight or bisexual after transition. In most cases, their orientation does not change due to transition (though the perception of it by others can change - a straight man may have been perceived as a lesbian before transition, for example, though in reality he was always a straight man.)
Thinking you're transsexual is a common side effect of having a hysterectomy. I've heard this one a lot, but I've never found anyone who actually knows of even one specific case where a woman happy in her gender identity had a hysterectomy and suddenly decided she was really a man. I think this is more in the way of an urban legend.
Gender dysphoria is an emotionally painful, sometimes crippling condition that effects every area of a person's life and can cause extreme depression, anxiety, social discomfort and sexual dysfunction - though most people with the condition are quite adept at covering these problems up, at least for a while. It worsens over time, and most people reach a point where they have to do something about it. The suicide rate among untreated transsexuals is huge - the best statistics available today say that over 40% of trans people attempt suicide at least once, and that's known to be a gross underestimate. According to Dr. Nick Gorton, a medical doctor and trans man, in 2005, "Untreated transsexual patients have suicide rates as high as 20% while treated transmen have suicide rates of less than 1% . . . that decreases the relative risk of a life threatening outcome by 2000%" (emphasis his).
Because gender identity is congenital and immutable, and because transsexualism is a physical rather than psychological disorder, only one treatment has been found to relieve the intense emotional pain of gender dysphoria - transitioning socially physically so that the body matches the internal gender of the patient. Transition typically involves using hormones to basically put the body through a second puberty, creating chemical and physical changes to make the body normal for an adult of the correct gender, followed by surgery to correct those features hormones can't alter. The first FtM to medically transition was Michael Dillon, a physician, who did so in the 1940s. The process is well established, safe and effective.
Social and legal transition usually happens concurrently with physical transition. This involves presenting as the correct gender (there are as many ways to do this as there are personal styles in the world), having the people who know you start using correct pronouns, changing your name (usually), and changing your documents over to the correct name and gender marker. The eventual goal is usually to be able to live as a normal member of society and not have to explain your intimate medical history to others on a regular basis.
Now that I've explained the condition in general terms, I want to tell you more about my personal experience.
You've probably heard a lot, as I had, about transsexuals who "always knew" they were really a boy or a girl, even though everyone around them saw them as the opposite. This idea made me doubt myself for a long, long time. It was kind of like, if I had to ask whether or not I was transsexual I obviously couldn't be, right? Well, I've since discovered two things. The first is that no, not every transsexual always knew - informal statistics seem to indicate that only about 20% had that experience. The second is that even among those who always knew, that phrasing is really a misleading simplification. One guy I know said, "I certainly knew that I was not male-bodied before I transitioned. I thus assumed that I was a girl, although a deeply alienated and fucked-up girl . . . Of course I knew that my anatomy differed from other men's, and of course before I transitioned I assumed that that meant I was a woman. I was, however, quite sure that all of that was some terrible joke or mistake."
Me? As a child, apparently I was just too literal. I knew what the definition of "girl" was, and I knew what was in my pants. I was never particularly happy about being a girl, despite liking some very girly things, and when I thought about it I wanted to be a boy - but I didn't think about it much. Also, Mum and Dad did their best to raise us as people first and gendered second. (Though I've since realised that in a lot of ways this resulted in them raising us both as boys. I don't know of many girls who were brought up to think "It'll put hair on your chest" was a good thing and crying was bad, and none who would have liked it.) This didn't make me trans - but it did mean I had a much happier childhood than most trans people do. And it also means I didn't think about gender much at all in childhood.
But still, I spent most of my life saying, "I may be female, but I'm not a girl." I've always identified primarily with male characters (I wanted to be Luke Skywalker so badly) or with female characters who took a male role, like warrior maidens, or with characters who were transgendered in one way or another. My first exposure to the idea of transsexualism was Lythande from the Thieves' World books. Here was a character who lived, loved and thought like a man and who had to keep her female anatomy as her most closely guarded secret. I felt like her, even at eight or ten or whatever age I first read the book. This near-obsession with transgender characters has continued through my whole life, but it's been something I did my absolute best not to let anyone else know about - I tried not to think much about it myself.
And our relationship growing up was much more that of two brothers than of a brother and a sister. We beat each other up all the time, both in earnest and in fun. (Okay, so mostly it was you beating me up, until I learned to fight back.) Ask your wife what she thought of our roughhousing, and if she ever did anything like that with her brother. I remember what her face looked like that time you came back from the Academy and we spent half an hour at the park by our house rolling around on the grass trying to kill each other and having a grand time. When we were close, it was usually in the context of a shared activity, where neither of us would have been comfortable talking about how nice it was we were getting along or how we felt about the other.
When I was 19 or so I had a class on Human Sexuality that happened to be taught by a former female-to-male transsexual. This was my first exposure to the possibility that one could become a man in real life. Once I'd worked up the nerve, I stayed after class to ask him how you could know if you were transgender. He asked me a few questions, but when I wasn't willing - eager, even - to give up every single aspect of femininity in my life immediately he told me I obviously wasn't and that I should put it out of my mind.
And for the last fifteen years, I've tried. But the thought kept surfacing: would I be happier as a man? Sometimes it would go away for weeks, even months, but it always came back. I'd shy away from it, try to pretend I'd never thought it, certainly never let anyone else know about it, but it was there.
By about four years ago the thought was nearly constant. About three years ago it had got bad enough that I went online and started looking up information about female-to-male transition, though I still tried to pretend to myself that it was merely intellectual curiosity. The process of making such a huge change to my life, the likelihood of rejection and the thought of hurting everyone I knew was so scary and overwhelming that I decided that it obviously wasn't what I needed or wanted. My life wouldn't be any different, I told myself. There was no real difference between men and women anyway. But I couldn't deny that I needed something, so I tentatively began to identify as genderqueer - neither male nor female, but both.
It didn't help. Leading up to my hysterectomy I was starting to realise I needed to deal with it soon, but I delayed making any kind of decisions on how I felt until after the surgery because I knew that hating what my female organs were doing to me confused the issue. What I found afterward was that, on top of and distinct from the intense relief I felt that those diseased organs were gone and wouldn't be causing me so much pain and misery anymore, my body felt more mine than it ever had before. It felt inexplicably right that those parts of me were gone and that, internally, I was no longer stuck being female. This clarified a lot of things for me. For a little while I thought that would be enough, but by March it became obvious it wasn't.
I went back online, and this time I discovered that no, not every transsexual person knows from childhood and no, not every FtM wants to be the stereotypical 1950s ideal of masculinity. Overall I discovered that the feelings and experiences of genderqueer people were completely alien to me, but those of "classic" transsexuals felt like looking into my own head. One guy, in fact, described an experience that was almost exactly like mine: "I kept trying to broaden the definition of 'woman' to include me, until one day I realised that the definition of 'woman' could never contain 'not woman'." He also said that he didn't have the experience many trans people do of a physical revulsion about his female body parts. Instead, he just never had much physical sense of self at all until he began transition. Now that he's in a more properly male body, he feels connected to his body in a way he never has before.
Over the last year, a lot has changed. I did a lot of soul searching and a lot of research. I cut my hair, bought men's clothes, started binding my breasts. I went to a therapist - three, actually, as the first one was some crazy New Age guy I couldn't stand, and the second knew absolutely nothing about trans issues and I spent every appointment trying to educate her, but I finally found someone great who is the local expert on gender and sexuality. The one thing they all agreed on was that I exhibited all the criteria for a Gender Identity Disorder diagnosis. I talked to my primary care physician and got a referral to an endocrinologist. Through all of this Matt and I talked and cried and negotiated and cried some more. I got off of my estrogen HRT, then I got on a very low dose testosterone cream to try to regain some sexual function. I made some friends on line - other guys who had dealt with the same things - and got to meet some of them at the San Francisco Pride Parade. I came out to Mum and Dad, and to my friends. Finally, on the 4th of July, I started injecting a full dose of testosterone. I picked a new name (Tad; the full name is Thaddeus Neill. I'm changing my last name back to XXXX). I changed my driver's license to male.
I'm now living as a man full time, and have been for about 9 months. I've submitted the forms to the court for the legal name change, and am currently waiting on the publication requirement. Once that's done (it should be in about a month) I'll be able to change the name and gender marker on my birth certificate, passport and social security card. Strangers now perceive me correctly as male about 90% of the time. It's a little harder for people who know me, because I still look like me - and years of habit define me as female. But most of them are getting it.
Physically, my voice has changed. I sing baritone now, as far as I can tell, and I sound a lot like you and Dad rather than sounding like Mum. My face has changed shape some, but not dramatically. My body shape is more male, I have more body hair and my body chemistry is definitely male. I can grow about as much of a beard as your average 16-year-old can, which is to say not much. My muscles are stronger and bigger than they used to be, though since I've not been working out you can't really see them. All of these changes will continue to progress the longer I'm on testosterone, and in a few years I should be mostly caught up to my actual age in physical development. Right now I look kind of like a teenager, only a year or two into puberty.
But the biggest changes have been internal. I'm more content than I've ever been. I feel more settled into my life, more confident and more at peace with myself than I could have imagined a year ago. I've managed to stop taking both of my antidepressants, my fibromyalgia has disappeared and my issues with insomnia are gone. This part of me that's always been there (which I didn't like, but didn't think much about, either - I figured it was just part of my personality) that stands outside of everything, observing emotionlessly and analyzing the best way to react, often paralysing me - it's not there anymore. I've realised that my issues with focus and long-term planning aren't just laziness or naive absent-mindedness but undiagnosed ADHD, have gotten a diagnosis and am learning coping skills and starting to get treatment. I've decided to go back to school and get a degree in something I'm passionate about, that will allow me to support myself beyond sustenance level. My social anxiety is greatly lessened and my relationships are deeper and easier than they've ever been. Considering that the objective circumstances of my life are the worst I've dealt with, these changes are miraculous.
What hasn't changed, though, is my essential self. I'm still the same person I've always been. I like the same things, I listen to the same music, I have the same passions, I care about the same people and I'm sure I'll continue to exasperate and annoy you with the choices I make. I'm growing up, but I'm not turning into a different person. The person you know is not an invention or a lie. I'm 34, not 19, and I've worked hard for a long time at becoming a person I like, someone with integrity, someone I can be proud of. I'm not going to give that up. I've always tried to be as true as possible to my inner self, and though I wasn't able to admit until recently that that inner self was male, I've still always expressed that self as honestly as I could. The person you've known my whole life is me. I'm just a lot happier now.
In telling you and the rest of the extended family I'm getting rid of the last area of my life where I have to pretend to be someone I'm not. Please let yoir wife read this email as well. I have sent your mother-in-law a separate email at the same time as I sent this one to you.
You most likely have some concerns about what - and how - to tell your children. It can seem like a difficult subject to approach with kids. What I've found, though, is that it's often actually easier for kids to understand than it is for adults. They don't have as many societal expectations around gender, and they have an innate understanding of their own. Both your daughters know they are girls, and they know that even if they woke up tomorrow in the bodies of boys that they'd still be girls. If it's explained to them correctly most kids will easily understand, "Oh, Uncle Tad has always been a boy, people just thought he was a girl? Okay." There are some possible hazards, though. One friend of mine, not fully understanding what transsexualism is, told her four-year-old daughter that "sometimes people don't like being a girl anymore and so they turn into a boy", and her daughter was scared for days that she was going to suddenly wake up as a boy. So the easiest way for your kids to find out may be if I write them a letter and send it to you, for you to read aloud to them, or if I make a video you can watch together. How they're told is, ultimately, up to you and your wife.
I honestly have no idea what reaction to expect from you about this. I've imagined anything from acceptance and our first chance to have an actual relationship as adults, to recognition (Mum and Dad said, "I'm shocked, but I'm not surprised. You've never been a girl" when I told them), to annoyance ("There goes my insane sibling again"), to denial (after all, you never did even get used to my old name), to hatred and not letting yourself or your family anywhere near me again. I hope for the first one, of course, but even if you react in the worst way possible you deserved to be told, and Mum and Dad deserve to not have to try to keep this hidden anymore.
Nothing much has to change now that you know. I'm still your brother, just like I've always been. I need you to use correct pronouns when you refer to me - he/him/his, not she/her/hers - and to use my real name - Tad or Thaddeus, whichever you prefer. This is important. And if we're ever in public together it is important not just for mental health reasons but for safety reasons. A lot of people are assaulted or killed every year for being trans. I know it can take some adjustment, but with a little practice most people find the switch easier than they expect.
Here are some resources for you if you want to do some further reading:
Wikipedia: http://en.wikipedia.org/wiki/Gender_identity_disorder
A video on transgender basics: http://www.youtube.com/watch?v=UXI9w0PbBXY
An FAQ for those who just learnt that someone they know is transgender: http://www.tsfaq.info/cgi-bin/index.cgi
A page for parents who've just learnt their child is transgender: http://www.susans.org/reference/gfam3.html
A support site for transsexuals and their families, started by the mother of an FtM: http://www.transfamily.org/about.html
A site showing photos and websites of men after transition: http://ai.eecs.umich.edu/people/conway/TSsuccesses/TransMen.html
A biography of one of the first FtMs known to socially transition in modern America, who did so in 1918: http://www.ochcom.org/hart/
Also, if you're interested, I've been keeping a blog of my thoughts and experiences at http://thaddeusdagan.livejournal.com/profile. It gets pretty personal, but it may help you understand a little better the process that brought me to this point. (It's in reverse chronological order, of course.)
You're my brother, and I'll always love you. I hope you'll call me when you're ready. My number is XXX-XXX-XXXX.
With love,
Your brother,
Tad
But back to the topic of this post. I need to come out to my extended family, and the one I've been most nervous about is my brother. We haven't been close since I was a teenager - in fact, I could probably count the number of times we've talked on one hand. But since he's my older brother, a big part of me desperately wants his approval. He's pretty consevative, and I have no idea how he's going to react. Neither do my parents.
So here's the letter I wrote to him. It's long, but if any of you feel like reading it and letting me know what you think I'd appreciate it. I focussed primarily on education, since he's someone who prides himself on logic and rationality and I wanted him to understand what exactly was going on. Also, I tried to be as accurate as possible, but this reflects my experience as a binary-identified transsexual. I don't talk much at all about gender fluidity or trans-ness as an identity, because that doesn't have anything to do with my experience and I didn't want to cloud the issue. So this is definitely medical-model centric.
Dear Brother,
One year ago, almost exactly, I realised that I was going to have to face a problem I'd been struggling with my whole life. Something so big and scary that I'd buried it, that I struggled day after day through crushing depression and self hatred rather than deal with it. Something I never told anyone about, and which I never even admitted to myself where I could hear myself think it.
Over the past year I have faced it. It's involved a lot of soul searching, a lot of struggle and a lot of change. And now it doesn't seem like that big a deal. It doesn't seem like something I ever should have hid from or been ashamed of. In fact, it seems obvious and self-evident and . . . simple.
Which makes telling you about it difficult. I know it won't seem obvious or simple to you at first, and I really don't want to revisit that place of confusion and fear and doubt, even vicariously. But you deserve to know. I'm telling you in an email so that I can be certain to be as clear and as thorough as I need to be, and so that you have a chance to absorb everything at your own pace. But I am available and eager to talk to you, so I'd like it if you would call me when you're ready.
Despite what we've all assumed to be true my whole life, I'm a man. I know that at first read-through that statement will seem odd, if not ridiculous, so let me explain. Transsexualism, or Gender Identity Disorder, is a rare, poorly understood condition - and the false, harmful stereotypes of it portrayed by the media don't help that at all. The truth is that you can't change your sex - you're born with your gender already determined, and you're stuck with it forever, no matter how much you may try to change. But it's not your body that determines your gender, it's your brain. And there's no way to see what sex a baby's brain is. So we make our best guess based on physiology and most of the time, we're right. As for the rest, we call them transsexual.
The more science studies gender, the more obvious it becomes that it's not as simple as we all assume it to be. For any physiological criteria one can think of to definitively "prove" another person's gender - chromosomes, internal sex organs, external genitalia, secondary sex characteristics, endocrine profile - there are intersex conditions that prove them to be less than absolute. And yet there is a difference between men and women. They think, feel and experience the world differently than each other, in ways that go deeper than social gender roles or ideals of masculinity and femininity. After all, there are many effeminate men and masculine women who are still most definitely men and women. So what makes a man and what makes a woman?
We don't have language for it, but we know. For most people, their physical sex and their internal gender are the same, so they never have to think about or notice it. If they don't match, the person develops something known as gender dysphoria. This is a dissonance between who they are inside and what they see in the mirror, as well as how people react to them. Our gender identity is such an integral part of who we are that it colours every part of our lives, every part of our thoughts. If you were emasculated tomorrow, even if you woke up in a female body, you'd still be you - and you'd still be a man. And you'd know it, even when all physical evidence pointed to the opposite.
My medical doctor, among others, suspects that because the hormonal washes that gender the brain in utero are separate from the ones that gender the body, sometimes the process can be disrupted and that can result in a male brain development in a person with female body development. This hasn't been proven, but as a theory it makes as much sense to me as any other.
One recent study, which scanned the brains of female-to-male transsexuals who had not yet undergone any medical treatment for their condition as well as the brains of women and non-trans men, found that in several gendered areas of the brain the FtMs' (female-to-male transsexuals') scans matched those of other men, not those of women.
A woman given high levels of testosterone or subjected to a drug that represses her normal estrogen production, such as Clomid, will experience agitation, anxiety, depression, a reduction in mental faculties, a sense of emotional dampening, unpredictable anger, the feeling of walking around in a fog and a general sense of her brain "not working right." A man given estrogen or put on androgen blockers will experience emotional instability, anxiety, depression, a reduction in mental faculties, brain fog and, again, the feeling that his brain "isn't working right." But a transsexual given the correct hormones for their gender identity suffers none of the same symptoms - in fact, they experience the opposite. A trans man given testosterone will feel happier, more stable, more alert more energetic and like his brain is working right, while a trans woman given estrogen will feel happier, more in touch with her emotions, more expressive, more connected to the world around her and like her brain is finally working the way it should.
The incidence of PCOS (Polycystic Ovarian Syndrome) is much higher among trans men than it is among women, there is some evidence that FtMs, even without treatment, have a tendency towards a more male body shape than would be expected, and there appears to be an increased risk of cardiovascular disease among FtMs separate from their hormonal profile. All these things imply the prenatal development of transsexual males is different than that of females.
No one knows why some men are born into seemingly healthy female bodies, nor why some women are bon into seemingly healthy male ones, but the condition has been around since the beginning of humanity. It has existed since civilisation began and many other cultures, ancient and modern, have made space for transgender people in various ways. It has been recognized and treated by modern Western medicine for over a hundred years
Many myths exist around transsexualism. You've probably internalised a lot of them without even realising it.
Transsexuals are mentally ill. There is some correlation between transsexualism and certain psychological conditions, usually depression or anxiety. This is usually because the internal stresses of gender dysphoria, and the external pressures of living in a society that insists that they conform to the gender their body appears to be, cause the depression and/or anxiety. The issue of their body producing the wrong hormone for proper brain functioning plays a big part as well. Transsexualism itself is not a mental illness. There are some people who have mistakenly believed they were transsexual due to other mental health issues and who later came to seriously regret transition, but this is extremely rare. Unfortunately, these are the cases the media usually reports on with great relish. Transsexualism, like homosexuality, was considered for many years by the psychological field to be a delusion or other mental issues, and a lot of horrific techniques have been attempted to fix it, from aversion therapy to psychoanalysis to hypnotism. None have been successful. It's now recognised among ethical health professionals as not being a psychological condition at all, but something more along the lines of a birth defect.
Transsexuals were sexually abused as children, or their parents caused it by raising them wrong. There is absolutely no correlation between early childhood experiences and transsexualism.
Changing sex is just a way for people to be gay without the stigma. First of all, the stigma of being trans is a lot worse than the stigma of being gay. And trans people, just like non-trans people, are of every orientation. Trans people can be gay, straight or bisexual before transition and they can be gay, straight or bisexual after transition. In most cases, their orientation does not change due to transition (though the perception of it by others can change - a straight man may have been perceived as a lesbian before transition, for example, though in reality he was always a straight man.)
Thinking you're transsexual is a common side effect of having a hysterectomy. I've heard this one a lot, but I've never found anyone who actually knows of even one specific case where a woman happy in her gender identity had a hysterectomy and suddenly decided she was really a man. I think this is more in the way of an urban legend.
Gender dysphoria is an emotionally painful, sometimes crippling condition that effects every area of a person's life and can cause extreme depression, anxiety, social discomfort and sexual dysfunction - though most people with the condition are quite adept at covering these problems up, at least for a while. It worsens over time, and most people reach a point where they have to do something about it. The suicide rate among untreated transsexuals is huge - the best statistics available today say that over 40% of trans people attempt suicide at least once, and that's known to be a gross underestimate. According to Dr. Nick Gorton, a medical doctor and trans man, in 2005, "Untreated transsexual patients have suicide rates as high as 20% while treated transmen have suicide rates of less than 1% . . . that decreases the relative risk of a life threatening outcome by 2000%" (emphasis his).
Because gender identity is congenital and immutable, and because transsexualism is a physical rather than psychological disorder, only one treatment has been found to relieve the intense emotional pain of gender dysphoria - transitioning socially physically so that the body matches the internal gender of the patient. Transition typically involves using hormones to basically put the body through a second puberty, creating chemical and physical changes to make the body normal for an adult of the correct gender, followed by surgery to correct those features hormones can't alter. The first FtM to medically transition was Michael Dillon, a physician, who did so in the 1940s. The process is well established, safe and effective.
Social and legal transition usually happens concurrently with physical transition. This involves presenting as the correct gender (there are as many ways to do this as there are personal styles in the world), having the people who know you start using correct pronouns, changing your name (usually), and changing your documents over to the correct name and gender marker. The eventual goal is usually to be able to live as a normal member of society and not have to explain your intimate medical history to others on a regular basis.
Now that I've explained the condition in general terms, I want to tell you more about my personal experience.
You've probably heard a lot, as I had, about transsexuals who "always knew" they were really a boy or a girl, even though everyone around them saw them as the opposite. This idea made me doubt myself for a long, long time. It was kind of like, if I had to ask whether or not I was transsexual I obviously couldn't be, right? Well, I've since discovered two things. The first is that no, not every transsexual always knew - informal statistics seem to indicate that only about 20% had that experience. The second is that even among those who always knew, that phrasing is really a misleading simplification. One guy I know said, "I certainly knew that I was not male-bodied before I transitioned. I thus assumed that I was a girl, although a deeply alienated and fucked-up girl . . . Of course I knew that my anatomy differed from other men's, and of course before I transitioned I assumed that that meant I was a woman. I was, however, quite sure that all of that was some terrible joke or mistake."
Me? As a child, apparently I was just too literal. I knew what the definition of "girl" was, and I knew what was in my pants. I was never particularly happy about being a girl, despite liking some very girly things, and when I thought about it I wanted to be a boy - but I didn't think about it much. Also, Mum and Dad did their best to raise us as people first and gendered second. (Though I've since realised that in a lot of ways this resulted in them raising us both as boys. I don't know of many girls who were brought up to think "It'll put hair on your chest" was a good thing and crying was bad, and none who would have liked it.) This didn't make me trans - but it did mean I had a much happier childhood than most trans people do. And it also means I didn't think about gender much at all in childhood.
But still, I spent most of my life saying, "I may be female, but I'm not a girl." I've always identified primarily with male characters (I wanted to be Luke Skywalker so badly) or with female characters who took a male role, like warrior maidens, or with characters who were transgendered in one way or another. My first exposure to the idea of transsexualism was Lythande from the Thieves' World books. Here was a character who lived, loved and thought like a man and who had to keep her female anatomy as her most closely guarded secret. I felt like her, even at eight or ten or whatever age I first read the book. This near-obsession with transgender characters has continued through my whole life, but it's been something I did my absolute best not to let anyone else know about - I tried not to think much about it myself.
And our relationship growing up was much more that of two brothers than of a brother and a sister. We beat each other up all the time, both in earnest and in fun. (Okay, so mostly it was you beating me up, until I learned to fight back.) Ask your wife what she thought of our roughhousing, and if she ever did anything like that with her brother. I remember what her face looked like that time you came back from the Academy and we spent half an hour at the park by our house rolling around on the grass trying to kill each other and having a grand time. When we were close, it was usually in the context of a shared activity, where neither of us would have been comfortable talking about how nice it was we were getting along or how we felt about the other.
When I was 19 or so I had a class on Human Sexuality that happened to be taught by a former female-to-male transsexual. This was my first exposure to the possibility that one could become a man in real life. Once I'd worked up the nerve, I stayed after class to ask him how you could know if you were transgender. He asked me a few questions, but when I wasn't willing - eager, even - to give up every single aspect of femininity in my life immediately he told me I obviously wasn't and that I should put it out of my mind.
And for the last fifteen years, I've tried. But the thought kept surfacing: would I be happier as a man? Sometimes it would go away for weeks, even months, but it always came back. I'd shy away from it, try to pretend I'd never thought it, certainly never let anyone else know about it, but it was there.
By about four years ago the thought was nearly constant. About three years ago it had got bad enough that I went online and started looking up information about female-to-male transition, though I still tried to pretend to myself that it was merely intellectual curiosity. The process of making such a huge change to my life, the likelihood of rejection and the thought of hurting everyone I knew was so scary and overwhelming that I decided that it obviously wasn't what I needed or wanted. My life wouldn't be any different, I told myself. There was no real difference between men and women anyway. But I couldn't deny that I needed something, so I tentatively began to identify as genderqueer - neither male nor female, but both.
It didn't help. Leading up to my hysterectomy I was starting to realise I needed to deal with it soon, but I delayed making any kind of decisions on how I felt until after the surgery because I knew that hating what my female organs were doing to me confused the issue. What I found afterward was that, on top of and distinct from the intense relief I felt that those diseased organs were gone and wouldn't be causing me so much pain and misery anymore, my body felt more mine than it ever had before. It felt inexplicably right that those parts of me were gone and that, internally, I was no longer stuck being female. This clarified a lot of things for me. For a little while I thought that would be enough, but by March it became obvious it wasn't.
I went back online, and this time I discovered that no, not every transsexual person knows from childhood and no, not every FtM wants to be the stereotypical 1950s ideal of masculinity. Overall I discovered that the feelings and experiences of genderqueer people were completely alien to me, but those of "classic" transsexuals felt like looking into my own head. One guy, in fact, described an experience that was almost exactly like mine: "I kept trying to broaden the definition of 'woman' to include me, until one day I realised that the definition of 'woman' could never contain 'not woman'." He also said that he didn't have the experience many trans people do of a physical revulsion about his female body parts. Instead, he just never had much physical sense of self at all until he began transition. Now that he's in a more properly male body, he feels connected to his body in a way he never has before.
Over the last year, a lot has changed. I did a lot of soul searching and a lot of research. I cut my hair, bought men's clothes, started binding my breasts. I went to a therapist - three, actually, as the first one was some crazy New Age guy I couldn't stand, and the second knew absolutely nothing about trans issues and I spent every appointment trying to educate her, but I finally found someone great who is the local expert on gender and sexuality. The one thing they all agreed on was that I exhibited all the criteria for a Gender Identity Disorder diagnosis. I talked to my primary care physician and got a referral to an endocrinologist. Through all of this Matt and I talked and cried and negotiated and cried some more. I got off of my estrogen HRT, then I got on a very low dose testosterone cream to try to regain some sexual function. I made some friends on line - other guys who had dealt with the same things - and got to meet some of them at the San Francisco Pride Parade. I came out to Mum and Dad, and to my friends. Finally, on the 4th of July, I started injecting a full dose of testosterone. I picked a new name (Tad; the full name is Thaddeus Neill. I'm changing my last name back to XXXX). I changed my driver's license to male.
I'm now living as a man full time, and have been for about 9 months. I've submitted the forms to the court for the legal name change, and am currently waiting on the publication requirement. Once that's done (it should be in about a month) I'll be able to change the name and gender marker on my birth certificate, passport and social security card. Strangers now perceive me correctly as male about 90% of the time. It's a little harder for people who know me, because I still look like me - and years of habit define me as female. But most of them are getting it.
Physically, my voice has changed. I sing baritone now, as far as I can tell, and I sound a lot like you and Dad rather than sounding like Mum. My face has changed shape some, but not dramatically. My body shape is more male, I have more body hair and my body chemistry is definitely male. I can grow about as much of a beard as your average 16-year-old can, which is to say not much. My muscles are stronger and bigger than they used to be, though since I've not been working out you can't really see them. All of these changes will continue to progress the longer I'm on testosterone, and in a few years I should be mostly caught up to my actual age in physical development. Right now I look kind of like a teenager, only a year or two into puberty.
But the biggest changes have been internal. I'm more content than I've ever been. I feel more settled into my life, more confident and more at peace with myself than I could have imagined a year ago. I've managed to stop taking both of my antidepressants, my fibromyalgia has disappeared and my issues with insomnia are gone. This part of me that's always been there (which I didn't like, but didn't think much about, either - I figured it was just part of my personality) that stands outside of everything, observing emotionlessly and analyzing the best way to react, often paralysing me - it's not there anymore. I've realised that my issues with focus and long-term planning aren't just laziness or naive absent-mindedness but undiagnosed ADHD, have gotten a diagnosis and am learning coping skills and starting to get treatment. I've decided to go back to school and get a degree in something I'm passionate about, that will allow me to support myself beyond sustenance level. My social anxiety is greatly lessened and my relationships are deeper and easier than they've ever been. Considering that the objective circumstances of my life are the worst I've dealt with, these changes are miraculous.
What hasn't changed, though, is my essential self. I'm still the same person I've always been. I like the same things, I listen to the same music, I have the same passions, I care about the same people and I'm sure I'll continue to exasperate and annoy you with the choices I make. I'm growing up, but I'm not turning into a different person. The person you know is not an invention or a lie. I'm 34, not 19, and I've worked hard for a long time at becoming a person I like, someone with integrity, someone I can be proud of. I'm not going to give that up. I've always tried to be as true as possible to my inner self, and though I wasn't able to admit until recently that that inner self was male, I've still always expressed that self as honestly as I could. The person you've known my whole life is me. I'm just a lot happier now.
In telling you and the rest of the extended family I'm getting rid of the last area of my life where I have to pretend to be someone I'm not. Please let yoir wife read this email as well. I have sent your mother-in-law a separate email at the same time as I sent this one to you.
You most likely have some concerns about what - and how - to tell your children. It can seem like a difficult subject to approach with kids. What I've found, though, is that it's often actually easier for kids to understand than it is for adults. They don't have as many societal expectations around gender, and they have an innate understanding of their own. Both your daughters know they are girls, and they know that even if they woke up tomorrow in the bodies of boys that they'd still be girls. If it's explained to them correctly most kids will easily understand, "Oh, Uncle Tad has always been a boy, people just thought he was a girl? Okay." There are some possible hazards, though. One friend of mine, not fully understanding what transsexualism is, told her four-year-old daughter that "sometimes people don't like being a girl anymore and so they turn into a boy", and her daughter was scared for days that she was going to suddenly wake up as a boy. So the easiest way for your kids to find out may be if I write them a letter and send it to you, for you to read aloud to them, or if I make a video you can watch together. How they're told is, ultimately, up to you and your wife.
I honestly have no idea what reaction to expect from you about this. I've imagined anything from acceptance and our first chance to have an actual relationship as adults, to recognition (Mum and Dad said, "I'm shocked, but I'm not surprised. You've never been a girl" when I told them), to annoyance ("There goes my insane sibling again"), to denial (after all, you never did even get used to my old name), to hatred and not letting yourself or your family anywhere near me again. I hope for the first one, of course, but even if you react in the worst way possible you deserved to be told, and Mum and Dad deserve to not have to try to keep this hidden anymore.
Nothing much has to change now that you know. I'm still your brother, just like I've always been. I need you to use correct pronouns when you refer to me - he/him/his, not she/her/hers - and to use my real name - Tad or Thaddeus, whichever you prefer. This is important. And if we're ever in public together it is important not just for mental health reasons but for safety reasons. A lot of people are assaulted or killed every year for being trans. I know it can take some adjustment, but with a little practice most people find the switch easier than they expect.
Here are some resources for you if you want to do some further reading:
Wikipedia: http://en.wikipedia.org/wiki/Gender_identity_disorder
A video on transgender basics: http://www.youtube.com/watch?v=UXI9w0PbBXY
An FAQ for those who just learnt that someone they know is transgender: http://www.tsfaq.info/cgi-bin/index.cgi
A page for parents who've just learnt their child is transgender: http://www.susans.org/reference/gfam3.html
A support site for transsexuals and their families, started by the mother of an FtM: http://www.transfamily.org/about.html
A site showing photos and websites of men after transition: http://ai.eecs.umich.edu/people/conway/TSsuccesses/TransMen.html
A biography of one of the first FtMs known to socially transition in modern America, who did so in 1918: http://www.ochcom.org/hart/
Also, if you're interested, I've been keeping a blog of my thoughts and experiences at http://thaddeusdagan.livejournal.com/profile. It gets pretty personal, but it may help you understand a little better the process that brought me to this point. (It's in reverse chronological order, of course.)
You're my brother, and I'll always love you. I hope you'll call me when you're ready. My number is XXX-XXX-XXXX.
With love,
Your brother,
Tad