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About Just out. (Portland, OR) 1983-2013 | View Entire Issue (Oct. 4, 1996)
Just ou t ▼ O ctob er 4 . 1 9 9 6 ▼ 1 9 of their brain, are completely ineffective. Dr. Richard Green, psychiatrist and author of sever al books on transsexualism, frequently serves as orris was diagnosed with gender an expert witness in legal cases involving dis identity disorder. GID is the diag crimination against transsexuals. In a paper nosis for transsexualism in the published in the Yale Law and Policy Review, Diagnostic and Statistical Manual Green wrote that a transsexual’s “compulsion to o f Mental Disorders, 4th edition, of the Ameri change anatomic sex is not modifiable by psy can Psychiatric Association. The manual, chiatric intervention.” known as DSM-IV, is considered by medical Most medical professionals agree that sex and mental health professionals to be the reassignment surgery is the most effective treat authoritative guide to the diagnosis of mental ment for transsexualism. Drs. Ira B. Pauly and disorders. Milton T. Edgerton, researchers at the Johns Although some questions remain, medical Hopkins Gender Identity Clinic, “Rather than considering this condition a studied the effectiveness of sex reas mental disorder, / find more credible the signment surgery. They concluded that “sex reassignment surgery is the theory that the cause of gender identity disorder is a hormonal process in utero that treatment of choice for carefully evaluated, genuine, primary trans didn’t happen quite right and a more male sexuals.” psyche was bom into a more female body, Pauly and Edgerton draw a clear or vice versa. ” D , . . distinction between primary and sec — Reid Vanderburgh ondary transsexuals. They adopted the definition of earlier researchers who found research has uncovered much about what caus that primary transsexuals have an “unambigu es GID. A recently completed 11-year study at ous cross-gender identity from a very early the Netherlands Institute for Brain Research age,” as opposed to secondary transsexuals, resulted in clinical findings that “show a female who “develop their cross-gender identity much brain structure in genetically male transsexuals later” in defense of another underlying primary and support the hypothesis that gender identity condition. Pauly and Edgerton found that develops as a result of an interaction between “[secondary transsexuals have a higher fre the developing brain and sex hormones.” quency of unsatisfactory results than do true These findings are similar to Reid Vander transsexuals.” They concluded that sex reas burgh’s thinking about his condition. signment surgery should not be offered to sec- “Rather than considering this condition a mental disorder,” Vanderburgh says, “I find more credible the theory that the cause of gen der identity disorder is a hormonal process in utero that didn’t happen quite right and a more male psyche was bom into a more female body, or vice versa. Under this theory, gender identity disorder could be more accurately described as a birth defect than a mental disorder.” In a letter opposing discrimination against transsexuals, written to the Metropolitan Human Rights Commission, Portland psychia trist Barry Maletzky describes transsexualism in lay terms: ‘Transsexualism is an illness recog nized by the American Psychiatric Association and by the medical profession in general. The most recent evidence indicates that it is a condi tion in which an individual is bom with the body of one gender but the brain of the other.” Maletzky expounds, “An individual afflicted with transsexualism is striving to live in the brain’s gender, rather than the body’s, a difficult task sometimes aided by psychotherapy, hor mones and gender reassignment surgery. That individual’s quest to live in the proper gender is not an expression of whim or choice, but a bio logic fact....” Rachel Koteles knew that she was not expressing whim or choice, but biologic fact, from the time she was 5 years old. That’s when her mother began sending her to psychiatrists. According to Koteles, her mother thought psychiatric treatment would disabuse her “son” of the ridiculous notion that “he” was a girl. It didn’t work. ITirough to adulthood, Koteles continued to recite her nursery-rhyme wish to the night sky “Star light, star bright...” each time ending with the same wish—to have the body of a girl. Koteles’ singular goal in life was gender reas signment surgery. Her estranged father paid for the operation “to remove the icky bits,” as Koteles refers to the operation that, she says, gave her life. “My father, who’s gay, said he couldn’t understand what it was like for me, but he said, i f you’ve wanted this so bad, for so long, you must need it.’ After my surgery,” Koteles recounts, “I went outside at night for the first time, and I automatically started making my usual wish on the stars. It wasn’t until I was near the end that I realized my wish had come true. I needed a new one.” With tears in her eyes, Koteles smiles and shrugs, as if to say, what else: “I wished for world peace.” Ken Morns Medical professionals now know that ical professionals. Medical protocol for the treatment of trans attempts, such as Koteles’ mother’s, to dissuade sexualism is detailed in the Harry Benjamin transsexuals from their true gender, the gender Continued from page 1 M W hen M i rrors LIE Dealt a difficult hand by nature, excluded by mainstream society and many queer activists, transsexuals reflect their own truths by Teri Ventura photos by Linda Kliewer among other things, that transsexuals live full time for one year as their targeted gender—the gender to which they are physically transition ing. This is known as the real-life test. People with GID must follow this protocol, completing all of the requirements under strict medical monitoring, to receive a recommendation from their doctors for surgery. Without that recom mendation, no reputable doctor will perform gender reassignment surgery. International Gender Dysphoria Association’s Standards of Care. The Benjamin standards, fol lowed by virtually all reputable doctors, require. argaret Deirdre O’Hartigan is the act ing director of the Filisa Vistima Foundation. Named after a 22-year- old transsexual who committed suicide in Seattle in 1993, the foundation helps transsexu als obtain medical and legal services. “There are those who want to do away with the GID diagnosis,” she says. O’Hartigan chooses her words very careful ly as she continues: “They cite, among other things, the accounts of some people who were diagnosed with GID, had surgery, then regretted it. I am truly sorry for their suffering. If you look at the life histories of the people who have surgery and regret it, you will see that invari ably, they do not Fit the diagnosis. People who do not fit the diagnosis should not have surgery, unless it’s just someone who wants to change gender because of a personal preference. For those of us who have an appropriate, primary diagnosis of GID, that diagnosis and treatment, including surgery, are our only relief from suf fering.” Dean, who does not want his last name used, speaks softly, yet his deep voice comes through clearly over the phone. “I am transsexual, and I emphasize that is a medical condition,” he says. “Many people con sider it a lifestyle choice. Transvestites, part- time cross-dressers and other transgendered people who are not transsexual are examples of people who are exercising lifestyle choices. That is not the case for transsexuals. There is no connection between their chosen lifestyles and our medical condition.” Continued on page 2 1