Coming Out...again?

[Guest Carter L]

Hey, everyone. So, the end of the year at my school is fast approaching, and I really want to have my parents be aware of what's really going on. So I drafted this e-mail. I was wondering if someone could look it over and tell me if they think it's ok. Thanks

Mom and Dad --

It has come to my attention that we are not on the same page in regards to the state and subsequent emotions involved in my gender identity. I am aware that this is a sensitive subject for all parties involved, and, due to our previous attempts at discussing this matter, I feel that it would be the most appropriate (and the least emotionally distressing) to address you both in text, as we all have time to collect ourselves and think clearly prior to responding. I recognize that in the past I have not presented my emotions maturely or responsibly, and so I would like to demonstrate to you both that this is not something I feel suddenly or make brash decisions about.

I would first like to discuss my perspective of my gender identity and what "Gender Identity Disorder" is and is not. As you are aware, GID is listed in the DSM-IV and ICD-10 as a mental condition. However, the GID diagnosis of Transsexuality is not listed under this classification because of any origin Transsexuality has in the mind. The reason that Transsexuality is listed in these diagnostic texts is to create a safe procedure to ensure that those who suffer from this condition can be treated and monitored. I have been intensely studying the origins of Transsexuality for over a year now and it is becoming more and more clear that there is a biological origin for Transsexuality that shows the differences between brain sex and secondary sex characteristics such as genitalia and hormone production. This is not only becoming clear to me but it is also becoming more evident in the legal and medical worlds. I am currently in touch with a parent of a student here at MSSM who is working on a presentation in medical school on Transsexuality. After reviewing his Anatomy & Physiology II texts, it is clear that Transsexuality begins in the womb. Chromosomes are not the sole determiners of biological sex -- even students in my class are aware of this, as it is taught in basic Biology. Having an XX or XY or XXY or YY chromosome configuration does not define the sex of the offspring as we commonly define it (based on secondary sex characteristics). This also does not define the development of brain sex. These different developmental characteristics are determined by the functionality and presence of hormone receptors in the developing embryo and fetus. What happens in "Female-to-Male Transsexuals" is that, during the stage of brain sex development, there are active hormone receptors that primarily draw in and bond to androgens. This causes the brain to develop in a masculine, "male" manner. However, from the sixth week on en utero, these hormone receptors either disappear or no longer accept as much androgen (either due to a defect or an excess of feminizing hormones in the mother's womb), thereby allowing estrogen and progesterone dominance and the development of "female" secondary sex characteristics. Not everyone who has this incongruous development feels a wrongness attached to his/her/hir body sex, but many do. This condition is not as rare as was previously thought. It was believed in 1994 that the prevalence of "Female-to-Male Transsexuals" was one in every 30,000 people, as presented in the DSM. However, a study was done and presented in 2007 which clarifies that this number was grossly underestimated. The now-accepted prevalence estimate states that, on the lower end, approximately one in every 5,000 people is "Female-to-Male Transsexual." This study was presented by Femke Olyslager and Lynn Conway at the World Professional Association for Transgender Health (WPATH) 20th International Symposium in September of 2007. Given these numbers and an approximation of the world and United States populations, there are about 1,355,047 "Female-to-Male Transsexuals" in the world and 61,401 in the United States. The original 1994 DSM statistics approximate that there would be only 225,841 "Female-to-Male Transsexuals" in the world and about 10,000 in the United States. These numbers are significantly smaller, and highly inaccurate. This approximation does not include those that identify as "Male-to-Female Transsexual," "Genderqeer," "Transgendered," or "Androgynous/Neutrois." The approximations presented in Olyslager and Conway's paper for "Male-to-Female Transsexuals" are about one in every 2,000 people.

I understand that you both do not feel (or deny that I feel) that I could have this condition. I understand that I did not display any "typical signs" earlier in my life (though this claim is irrelevant because it has been repeatedly determined scientifically and psychologically that "signs" of Transsexuality do not necessarily display during childhood). The fact of the matter is that I was unaware that there were options, and so I ignored what I was born with and preoccupied myself with fitting in, changing the way I dressed according to what my friends would accept. I will now take the time to reiterate some points from my childhood that indeed do display Transsexual tendencies:

--When I was 10 years old (in 5th grade), I was obsessed with learning how to urinate standing up. I vividly and specifically remember the thoughts in my head being that I wanted to "pee standing up like a boy."

--I was secretly thrilled that I did not get my period until long after my friends did (developmentally speaking). I never wanted it, and thought it was disgusting (not just because of the blood, mind you).

--I had repetitive "tomboy" phases between third and eighth grade. I rejected "feminine" colors, wanted pants from the boys' section at Wal-Mart, and wore baggy T-shirts from the men's section at Gap. I also had a period of time where I associated with a group of troublemaking boys (in third and fourth grade). During this time, I had an intense desire to prove to the boys that I was one of them. I was the only "female" in the group, and yet I was accepted as one of the boys.

--I rarely played with stereotypically female toys until I was assimilated into female friend groups (at which point I played with "Polly Pockets" and other toys that I enjoyed because my friends had them). My favorite toys were always (and remain to be) Hot Wheels and Matchbox cars, the "boy toys" from McDonald's, and Legos.

--My role models and childhood idols have all been older male students or my stepbrothers, who I desired to grow up, look like, and act like.

Though these childhood experiences have little bearing on your opinion or mine in regards to my gender identity, I believe that they are important points to bring up, as you both claim that things like the above never occurred or could not have occurred.

I apologize for the distress my gender identity has caused our family. I apologize if it seems that I am "ignoring" or "not understanding" your emotions. I understand, perhaps better than you do, the emotional pain that gender identity conflict brings to families. While you watch your child grow into a person you never could have imagined and struggle to understand or accept it, I have to watch you two argue with and about me, struggle emotionally, attempt to rationalize this, and endure my own personal struggle. I am terrified of losing either of you. Many of my gender non-conforming friends have been disowned by their families. I am prepared to navigate that if I must. I also have to endure pain that isn't associated with you. I know that it is impossible for you to understand as you are not going through this yourselves, but perhaps you can take a step back from your emotions and imagine my struggle, as I have done with each of you.

Mom, imagine waking up tomorrow, having a deep voice, a penis, and no breasts. You get an erection sometimes without warning and none of the male clothes your family gives you feel right. Imagine going out into public being called "Sir" and "Mr. Dodge" though you know in your heart and mind without doubt that you are Cynthia. Imagine being called "he" each day and being unable to explain the anxiety and pain it gives you to your own family because every time you do, they yell at you and tell you to "snap out of it" or "cut it out." It's not a choice.

Dad, imagine waking up tomorrow, having a high-pitched voice, a vagina, and breasts. You bleed from your vagina once a month and endure excruciating cramps from it and none of the female clothes your family gives you feel right. Imagine going to work and being called "Miss," "Ma'am," and "Ms. Langevin" though you know in your heart and mind without doubt that you are John. Imagine being called "she" each day and being unable to explain the anxiety and pain it gives you to your own family because every time you do, they yell at you and tell you to "snap out of it" or "cut it out." It's not a choice.

Transitioning is not committing suicide. My heart, my mind, and my soul have not changed. I am the same that I have always been. I am the child you raised, and I am the child you have dedicated sixteen years of your life to. To act as though the treatment of my medical condition is a suicide and ignore the pain I am in does not make sense to me. If my child were in the pain that I am in now, I would get treatment for him/her/hir. The medical treatments of Transsexuality are medically necessary and are considered so by medical associations throughout the world. Earlier this year, the United States Tax Court determined that a woman's "Male-to-Female" Sexual Reassignment Surgery was both medically necessary and tax-deductible. This decision also cannot be repealed by the courts. The current Harry Benjamin International Gender Dysphoria Association's Standards of Care for Gender Identity Disorders (Sixth Version) state that medical transition and the processes outlined in these Standards of Care are medically necessary. Studies show that the prevalence of suicide attempts in young Transsexuals is about 50% prior to their 20th birthday. To abandon me due to a medical condition that I cannot change and have suffered deeply from really hurts me.

I am writing to you both in the hopes that you can understand that not only is this something unchangeable that I am going through, but that I understand that you both cannot sit there and accept it readily. I am writing to you both in the hopes that you can see that this is something that is seriously mentally and emotionally disturbing to my day-to-day life and that I have felt this way for nearly a year and a half. That year and a half has been a year and a half of hell, and I have become very disheartened and feel very alone because of this struggle. It is about another year and a half until I can make decisions for myself in regards to medical and therapeutic treatment. I will not have the money necessary for either at that time. I will be in college. My biggest dream (that also brings about the most unbearable pain because I know you will not allow it to come true) is to go into college as the man that I am and to socialize there as a young man. Many college campuses have Transgender housing options, and at many colleges Transsexuality is not treated as a mental disorder. In fact, many people throughout the world either are unaware of the presence of a "Transsexual" in their lives or do not treat that individual any different from anyone else. It may seem that there is a lot of anti-Transgender violence in the public, but this only happens to those who are "outed" or "read" as their original biological sex. "Female-to-Male Transsexuals" are also far more successful in their transitions than "Male-to-Female Transsexuals," as they become convincingly male within months of beginning Hormone Replacement Therapy. Though the world is a dangerous place to anyone who is in any way outside of the status quo, it is not an all-bad place. I am just as safe (perhaps even more so) living as a straight man with a treated birth defect as I would be living as a butch lesbian living a lie.

My best suggestion at this point would be for us all to see a Gender Therapist. All of us, together. This would allow for more clarification on my gender identity for everyone involved, and a reliable source of accurate information in regards to what we should do as a family. This is not something I am suggesting in order to begin an early transition. I want us to be able to sit down with a professional who has studied Gender Identity Disorders for years and figure out what we are all feeling and how to deal with the changes to our family that this has brought about. I feel that it is in the best interest of all of us so that we can remain a happy and (at least somewhat) functional family (putting aside our other dysfunctional quirks). I love you both very much and want us to be able to work through this time of struggle together. We are a family. We're supposed to stick together no matter what. If we put our heads together, we can do anything.

I am sorry if this is not something you want to be hearing.

I love you both.

[myname]

[Michelle 2010]

Hi Carter,

You certainly have been well schooled in the art of writing letters which are designed to deliver information...seriously. A budding CEO or attorney in our midst. I had to check your profile for age and gender after reading it. Well done.

I suppose in a volatile or highly charged interaction it could be a perfect way to defuse the emotions of the situation. Delivering information to those who need it. If that is the case I applaud it. It seems clinical and I'm guessing that is the tone you are setting by choice, based on previous interactions that did not produce the outcome you desired...

It is lengthy, but not too much so for parents who need information regarding the future of their child. There are, however, statements regarding current research that maybe drawing speculative conclusions by you rather than the research authors? If I am wrong, perhaps more clarity in the body of your text emphasizing that fact would be appropriate.

It isn't particularly a letter that stands out for love and compassion but rather objectively laying the cards on the table regarding the facts of the situation. It does acknowledge your sorrow for the pain they are suffering which is good to recognize.

Very masculine and non-drama queen-ish. It works well if the goal is to convey the facts. If the goal were to wring compassion from your parents for the journey you have no choice but to take, I would go in a different direction. Perhaps let them glimpse your pain. But I'm guessing you've already done that?

good letter!

Best Wishes

Michelle

[Guest John Chiv]

Carter,

It is your letter, your family, and your coming out. However since you posted it here, I am going to make a suggestion.

The first lengthy part of your letter is too clinical and too long. These are your parents and this is not a presentation in front of a group.

If you edit the first paragraph and trim it or remove it completely, the letter flows. The heart of your letter starts with the second paragraph. In the fourth paragraph, again the U.S. Tax Court and Harry Benjamin Standards of Care is great information, but impersonal. I have no idea what kind of relationship you have with your family. I am looking at this as an editor, writer and someone who also makes a living helping people make an impact with my words.

Take out all that clinical and dry information and what you are left with is an eloquent heartfelt letter from their mature son. The gender therapist suggestion is great in the last paragraph. Why don't you try a draft where all the other information is on separate page. You can give that to them to read as additional material.

They are your parents. It will be the hardest for them (or not) to make that change from daughter to son. You wrote so well about the personal feelings and I feel that the other information takes away from what will touch their hearts the most.

Again, this is my opinion. I wish you well. And I commend you on handling this so calmly, thoughtfully and maturely.

John

[JenniferB]

Hi Carter,

I think I found two problems.

1. Having an XX or XY or XXY or YY chromosome configuration does not define the sex of the offspring as we commonly define it (based on secondary sex characteristics). This also does not define the development of brain sex.

Instead of brain sex, do you mean gender identity?

2. When you quoted the statistic Studies show that the prevalence of suicide attempts in young Transsexuals is about 50% prior to their 20th birthday

you need to include the study itself to make this statement relevant.

Jenny

[Guest Carter L]

1. Instead of brain sex, do you mean gender identity?

Okay. Thanks for the points. And as for your question, no. I do not mean gender identity. Brain sex is not always congruent with body sex. I have a male brain, and my brain performs as a male-developed brain would. This has to do with, as I explained in the e-mail I'll be sending, the presence and functionality of hormone receptors and the hormonal climate of the womb during the first six weeks of development en utero.

[Guest PaintedWingss]

Okay. Thanks for the points. And as for your question, no. I do not mean gender identity. Brain sex is not always congruent with body sex. I have a male brain, and my brain performs as a male-developed brain would. This has to do with, as I explained in the e-mail I'll be sending, the presence and functionality of hormone receptors and the hormonal climate of the womb during the first six weeks of development en utero.

This is true as far as the difference between gender identity and brain sex. The male brain and female brain are very different in make up, as the male brain is bigger, but the female brain is more dense, and they develop differently, as Carter noted. It's this that determines gender identity. Where bigenders like me and androgynous people go in this is beyond me, however. I wonder if maybe one half is male, the other is female? Now that's an image to think about. C:

- Taylor

[Guest kelise]

This is a brilliantly worded letter! It's very clear you've done your homework. I very proud of you!

If you think it would help, I'd be willing to write a short testimonial for you to add. Perhaps it would be good to hear from someone who has gone though the entire process of transition (and is working on expanding it), including surgery, and can relay how this has only effected my life positively.