I try not to get either too personal or too political in this blog. This post will be both, and I apologize in advance. There are things that I really don’t want to talk about. However, the movement to pass what they are calling “Leelah’s Law” has convinced me that I cannot in good conscious stay silent any more.
I have told very few people about the period in my life when I believed that I was transgendered. I am relatively open about my history of mental illness, but talking about being an “ex-transgendered person”, not to mention my own convictions regarding the effectiveness of surgical reassignment, seems to be asking for trouble.
I realize that going public with my experiences and convictions will make me a target–ironically with many of the people who form the core audience for my books, since my fiction deals with sexuality and identity issues. But I’m not making a living from my writing in any event, a boycott would be unpleasant but not financially crippling.
I, personally, was in therapy for gender identity issues in the early 1980s. At the time my life was a mess, due to a number of self-destructive behaviors. Alcohol, drugs when I could get them, irrational bursts of violence, an inability to keep to any kind of a schedule.
I had been experiencing feelings that I was in the wrong body since childhood. I had read everything I could on the subject, both memoirs and clinical research. I could see my own life in the writings of Christine Jorgenen and Rene Richards. The therapist whom I was seeing reinforced my delusion that all of my problems were do to my being male when I really wanted to be female. I fit all the right boxes on the checklist.
She encouraged me to begin what she called the process. I received a prescription for female hormones, although I wasn’t able to afford to get it filled. I was able to afford some electrolysis on my beard and still have some funny patches of bare skin on my face. My focus was on simply finding a way to get the money to make the change. My therapist encouraged me to try to find relatives willing to underwrite the expense.
Fortunately for my long term health, my behavioral issues and self-care grew so erratic that I was unable to continue therapy. Things got really bad for me for several years–well, most of the 1980s–and I ended up living on the streets, first in Missouri and then in Southern California. At the time I blamed everyone and everything else, looking back now I can see how I wrecked my life with a consistency that seems deliberate.
It wasn’t until I was living with a similarly damaged woman in California and we were trying to care for an infant daughter that I started to take the steps necessary to secure some kind of financial stability. My mental issues, however, were still unresolved.
In the early 2000s I started therapy again, this time as an attempt to convince DFS to return our children, who had been taken from our home. Fortunately–and by blind luck–I was assigned a therapist who specializes in early childhood trauma and was able to correctly diagnose me with Dissociative Identity Disorder.
After several years of cognitive therapy I am now comfortable with who and what I am–for the most part. As much as anyone is, I suppose, and more so than many. I have a full time job doing maintenance and I write. I’ve published three science fiction novels that draw heavily on my experiences with dissociation.
Reading the experiences of people who have undergone gender reassignment surgery has made me realize how very lucky I am that I wasn’t able to raise the money to have my own body altered. Many are, like me, dissociative, and it’s clear that surgical reassignment is contraindicated for dissociation.
The long term prognosis for patients of surgical reassignment is difficult to assess. Some clinics report that up to 90% of their patients cannot be reached for followup. Of those that can be reached, most report no change in symptoms related to comorbidities–that is to say, people who have problems with alcohol and drug abuse, sexual addiction, self-harm, or social pathologies prior to surgery continue to have those problems following surgery.
The suicide rate for gender reassignment patients is actually higher following surgery. That fact has become so obvious that an attempt is being made to reframe the statistic to blame bullying or some form of social pressure. I don’t believe that accounts for it at all, particularly taking into account the high profile transsexuals who have taken their own lives following nigh-universal praise in the media for their choice.
I believe that gender reassignment surgery is bad medicine. I believe that it is not an effective treatment for the conditions that it claims to address, and in many cases makes a person’s problems worse. The rate of patients who regret the surgery and seek to reverse it may be as high as 20%. Certainly the number of clinics which now offer reversal therapy would indicate that the number of patients who regret the surgery is far higher than advocates of the procedure would have us believe.
I can’t say that it doesn’t help anyone. It may help some. It is very clear, however, that it is misapplied in many cases. In my own case I am sure that it would have been a tragic mistake. I didn’t need to change my body–I needed to learn to accept myself as a human being and to deal with the unresolved issues from my early childhood. Cognitive therapy–“talk therapy”–gave me the tools to do that.
The legislation that people are calling “Leelah’s Law” would criminalize the therapy that I can say without hyperbole gave me my life back. I don’t know the details of the therapy that the young man in question received–neither, of course, do the advocates who have made his death into their rallying cry. Clearly the therapy did not save his life. It may have contributed to his death. There are, sadly, many bad therapists.
Outlawing any therapy that encourages a patient to accept his or her birth gender rather than seek to change it is simply unconscionable, however.