Category Archives: Health

We Are Born That Way

by Bobbie Zenker

Hey, did ‘ya see the headlines?  “ABC News Editor Don ‘Dawn’ Ennis Comes Out As Transgender” Now generally, I do not appreciate it when the media is the news, but hey, this is really big news!   A career professional at a company known throughout the modern world is transgender, and is going to transition on the job!  Yea, that is big!

I applaud Dawn’s courage and decision to transition.  I hope she will continue to have a long and distinguished journalism career with one of the great news organizations.

However, I admit that I have been critical about the manner in which she couched her announcement. Her coming out statement included this: “Ennis said she suffers from an ‘unusual hormonal imbalance,’ and blames her mother, who fed her female hormones as a child to prolong a commercial acting career.”

“I have a rare medical condition — nothing deadly or infectious — but it has resulted in an unusual hormonal imbalance,” she explains. “One so profound that I don’t resemble the man you first met 10 years ago.”

My posts today have demonstrated my concerns.

“This is good, but to seize upon a “rare medical condition” as the result of a hormonal imbalance induced in childhood seems a wee tad disingenuous. It seems much more authentic to just claim our true selves unabashedly.”

I got a few tepid responses, including one from a transwoman who was the successful plaintiff in a now notorious federal circuit court discrimination case which established as a matter of law (at least in that circuit) that Gender Identification Dysphoria (GID) is a “serious medical condition.”  And so it is true.

I replied: “I could not agree with you more, but our “medical condition” is not the one which Dawn is asserting. Many of us feel & assert that we were born TG, not forced to become TG by some post womb atrocity purposely committed by our mothers. I don’t believe for a moment that you really accord the feeling of being born in the wrong body to mere eccentricity, but you seem to be asserting as much. I also do not agree that gender incongruence can be induced by merely ingesting hormones as a child. It seems like Dawn’s assertion is more of an attempt to legitimize her nature in the eyes of a misunderstanding and judgmental public by reference to some scurrilous outside influence, rather than just claiming her true self as many of us have had to do. Yes, it is disingenuous and a disservice. BTW, I have read, understood and applauded the legal argument “Gender Identity Disorder (GID), is a serious medical condition.” I do not see that Dawn’s assertions are analogous merely because of the “rare medical condition” language in which she has framed the legitimization of her transgender nature. So, there ‘ya have it.”

A friend wrote: “We must just continue to push through to make the world safe and accepting for all. Trans is. No need to legitimize it. It’s already legit. Takes a huge amount of personal courage to be who you are without apology or justification whether you are trans, intersex or uniquely average….”

Another friend wondered: “Can I attribute it to her being somewhat new at this, especially at being SO out?”  She is always the compassionate peacemaker, and I admire that quality in the few people I know who truly possess it.

My response: “Yes, of course. I admire your compassion. The difficulty is that, like a friend of mine says, when we make shit up, we come to believe it, and when we believe it we have to defend it. Thus, I came to believe the lies I told myself to justify my existence, while all the while no justification was ever necessary (Just as my friend so eloquently stated). I am what I am! I am a transexual! I celebrate me. And because it is so, because I am authentic, other people embrace, love and accept me too. Honesty really is the best policy.”

And that brings me to the point of this piece.  (For shame that it took so long, I know).

If you have ever had to disclose your transsexual identity to anyone important in your life, you realize immediately that most people have a great deal of difficulty wrapping their heads around the concept.   Many people simply do not understand.  And there is scant “medical science” to assist them.  They cannot run to the Physician’s Desk Reference, for instance, and read about the scientific, double blind, controlled study of the effect of too much exposure upon a fetus of what turns out to be opposite sex hormones while in utero.  But, that is the current, most widely accepted theory on the cause of GID.

Many would dispute such an unscientific theory as mere poppycock.  The simple truth is that even the best, most widely accepted theory does not help the larger world to understand and accept trans people.  Now here’s the rub.

A very important person in a high profile international news organization is suggesting an even more novel theory – not hormone over exposure in utero, but, hormone over exposure during childhood.  However, the science that we do know suggests that this is unlikely.  Gender identification is fixed by age three and is extremely difficult to change after that.  (Pamela J. Kalbfleisch, Michael J. Cody (1995). Gender, power, and communication in human relationships. Psychology Press. pp. 366 pages. ISBN 0805814043. Retrieved June 3, 2011; Ann M. Gallagher, James C. Kaufman, Gender differences in mathematics: an integrative psychological approach, Cambridge University Press, 2005; “gender identity.” Encyclopedia Britannica Online. 11 Mar. 2011).  So, unless Dawn’s commercial acting career was in full swing as an infant or toddler, the exposure to hormones would not likely have had the impact which she ascribes to them.  Personally, I am rather dubious if they would have that effect even earlier.

Don’t get me wrong.  The hormones would have an effect on her emotional state while she was taking them.  Just ask men who have been treated with Depo Prevara (Reduces sex drive, compulsive sexual fantasies, and capacity for sexual arousal. Some users show increases in body fat and reduced bone density. There may also be other “feminizing” effects such as gynecomastia (development of larger than normal mammary glands in males), reduced body hair, and loss of muscle mass).  Most of these effects are considered reversible when use is discontinued.

Likewise, introduction of anti-androgens and estrogen therapy is a treatment option for men with prostate cancer.  It produces some of the same side effects, including changes in sexual desire, including loss of libido, changes in facial or body hair growth, and mood changes including anxiety, frustration, anger, depression and emotional outbursts.  When my late father-in-law began hormone therapy for his prostrate cancer we teasingly suggested he would grow boobs and develop a new interst in picking flowers.  Unfontunately, cancer occurred throughout his body and took him before we could test that theory.

While some might quip about possible similarities to Pre-menstrual Stress, a uniquely feminine phenomena, with the exception of sympathetic reactions in some men, there is simply no medical evidence that the introduction of female hormones to men cause them to be confused about their gender; or, to believe that they are actually women, or, that they were born that way, that they can do nothing to change that, and that they are no longer able to live in this binary culture unless they are able to become the woman that they believe inside that they have always been.  I suspect the same would be true for a small boy.

So, as a person who has painfully experienced these things over the course of forty eight years in the wrong body, I do take exception.  Yes, it is a wee tad disingenuous to assert that post-utero forced use of opposite sex hormones causes GID.  It suggests that a transperson can be made that way instead of born that way.  And, if they can be made that way, they can choose not to.  That is not the experience of the trans people I have become associated with over the last several years (1500 or so).  We are born that way. We did not and cannot choose to be trans.  Who would?  And it is a profound disservice to their courage and integrity to suggest otherwise.

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Free Montana HIV Counseling, Testing & Referral Training

by D Gregory Smith

English: The Red ribbon is a symbol for solida...

FREE —  3 Days of Training!!!

(1/2 day) HIV/STD/HCV Update, (1/2 day) OraQuick Rapid Test & (2 days) HIV CTRS Training

(Counseling Testing and Referral Services)

June 24-26th, 2013

8am-5pm each day

Big Horn Resort, Billings, MT

Please register by May 14th!!!

Click here for more info:  CTRS Training June 2013-1
~CNE Credit Available~

 

Hepatitis C Seminar In Missoula

by D Gregory Smith

On Thursday, April 25th from 5:00pm-6:00pm, Open Aid Alliance is offering the first of three community seminars on hepatitis C. The first presentation will feature Dr. Rebecca Kinney. Dr. Kinney completed medical school at Mount Sinai School of Medicine in New York City, and did her residency at Family Medicine Residency of Idaho in Boise. She is a family physician specializing in infectious diseases, with specific expertise in hepatitis C. This presentation will provide an overview of hepatitis C infection, transmission, and recommendations for testing. All three seminars are free and open to the public.

Thursday, April 25th, 2013
5:00pm-6:00pm
MCT Center for the Performing Arts (use the Main Street entrance)
Room 302
For more information, call Open Aid Alliance at 406.543.4770 or email stephanie@openaidalliance.org
Please join us for this opportunity to expand your knowledge of hepatitis C

Women’s Health Stats For Montana

by D Gregory Smith

Simplified Health Care

WOMEN’S HEALTH IN MONTANA (DHHS REGION VIII) Female Population of MONTANA

Total state population: 989,415 (492,748 females; 496,667 males)

Health Status (Age-adjusted§ percent of adult females)

In poor general health: 4.4%

Activity limitation due to poor phys/mental health: 8.9%

No natural teeth: 5.4% Sources: 2010, BRFSS

Access to Care (Age-adjusted§ percent of adult females) No health insurance coverage (under 65): 21.2%
No personal doctor or primary care physician: 79.2% Saw a dentist in past year: 61.5%

Fact sheets are now available for each of the 50 states and the District of Columbia. Each fact sheet presents a snapshot of demographic characteristics as well as a variety of health status indicators for females within the area. These include:

·        Health Status

·        Access to Care

·        Health Conditions and Risk Factors

·        Preventive Services and Screenings

·        Mortality

·        Prenatal Care and Pregnancy Risk

·        Birth Outcomes

·        Sexually Transmitted Infections

·        Violence and Abuse

·        Mental Health and

·        Teen Health

For complete Montana stats, click here.

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Demise Of National Association Of People With AIDS (NAPWA) Leaves Uncertain Future

by D Gregory Smith
English: A section of the Berlin Wall with Gra...

English: A section of the Berlin Wall with Graffiti regarding Act Up. (Photo credit: Wikipedia)

Some sad (and possibly troubling) news for those of us living with HIV: NAPWA, the lobbying and rights organization for HIV+ persons in the U.S. has closed and filed for bankruptcy. John Manuel Andriote has the story- be sure to read the last paragraph.

 

From Huffington Post:

Although it wasn’t a total surprise when the National Association of People With AIDS (NAPWA) announced on Feb. 14 that it was suspending operations and filing for bankruptcy, it felt like a shock. Exactly 30 years after its founding by the very first people to go public about having HIV, all of them gay men, NAPWA’s financial immune system finally collapsed under the weight of allegations of misused funds and the demands of creditors, employees and a landlord who wanted to be paid.

NAPWA was never exactly flush with cash, and it restructured itself several times over the decades. But a Dec. 5 open letter to the community from its board made it clear that the end was all but inevitable. Longtime HIV activist and POZ magazine founder Sean Strub blamed NAPWA’s business model and leadership that was “inexperienced or inadequate, and, in some cases, compromised or lacking integrity.” He added that “accountability and transparency were concepts largely absent from their operations in recent years. The problem was so deep-rooted that even the most dedicated and sincerely committed people on their board or staff could not fix it.”

Time (and an apparent investigation by the Montgomery County State’s Attorney’s Office) will shed light on what exactly led to this sad state of affairs. Meanwhile, a history lesson is in order to understand what NAPWA was and why its demise is a sad (and worrying) occasion for tens of millions of people.

On May 2, 1983, a small group of gay men with AIDS carried a banner during the first AIDS Candlelight March in San Francisco. “Fighting For Our Lives,” it said. A month later, several men took the banner to Denver for the Second National AIDS Forum, held in conjunction with the then-annual gay and lesbian health conference. A dozen people with AIDS met together at the forum to discuss how they might organize themselves. They agreed that the slogan on the banner would be their slogan, because it captured what it was that they were doing: fighting for their lives.

The group proposed that local groups of people with AIDS from around the country join together to form a national group. They adopted a manifesto called the “Denver Principles,” a series of rights and recommendations for health care providers, AIDS service organizations and people with AIDS themselves. The Denver Principles became the charter of the self-empowerment movement for people with AIDS. Its preamble said, “We condemn attempts to label us as ‘victims,’ a term which implies defeat, and we are only occasionally ‘patients,’ a term which implies passivity, helplessness, and dependence upon the care of others. We are ‘People With AIDS.’”

After the Denver meeting, Bobbi Campbell, Michael Callen from New York and other gay men with AIDS and their supporters formed the National Association of People With AIDS. For three decades the Denver Principles were NAPWA’s foundational document. “NAPWA was the last keeper of the flame for the Denver Principles,” said veteran ACT UP New York activist Peter Staley, “and it’s sad to think there are few if any institutions willing to defend them going forward.”

But even without the organization built around them, the principles endure because they are now woven into the world’s responses to HIV/AIDS. At the United Nations’ 2006 High Level Meeting on AIDS, 192 nations unanimously adopted the Political Declaration on HIV/AIDS, including the so-called GIPA (Greater Involvement of People With AIDS) Principle. GIPA essentially made universal the principles of self-empowerment and involvement first articulated by that group of brave gay men who met in Denver in 1983.

Still, NAPWA’s demise leaves a void that no other organization has yet shown the capacity to fill. Terje Anderson, who was a NAPWA board member before joining its staff as policy director in 1998 and then serving as executive director from 2000 until 2006, said in an interview that one of the group’s most important legacies is the new community leaders NAPWA trained. “Something NAPWA wasn’t credited for,” he said, “was figuring out ways to identify, train and support leaders, not just white gay men from New York but people of color, women and people in rural areas.”

The group made other major contributions too. NAPWA was one of the first HIV/AIDS groups to advocate for HIV testing as a tool of personal empowerment. Anderson pointed out that the group was instrumental in helping pass the Ticket to Work and Work Incentive Improvement Act of 1999, which allowed people receiving Social Security disability benefits to return to the workforce without losing their Medicaid or Medicare health insurance. This was hugely important as improved medical treatment beginning in 1996 allowed HIV-positive people to live with the virus rather than await an inevitable death from AIDS.

“One of the things I’m proudest of,” said Anderson, “is that when I was there, we were the first domestic group that started to say we need to talk about the global epidemic. Other groups said, ‘Oh, no, that will take away from our funding. We said, ‘No, you have to worry about our African, Caribbean and Latin American brothers and sisters.’”

Tom Kujawski, who was NAPWA’s vice president of development from 2004 to 2010, said the organization “became vulnerable due to lax internal financial systems and controls further complicated by changing senior management.” He said there were contributing factors that hastened NAPWA’s end, including decreased philanthropic and corporate support due to the faltering economy and competition for that support, “fractionalization of the HIV/AIDS movement” and over-reliance upon federal grants.

Kujawski said he hopes NAPWA will endure through the Chapter 11 process “and emerge as a truly new entity.”

Sean Strub said, “I’m sad to see them go but hopeful that this will provide an opportunity for a more effective, representative and accountable national voice for people with HIV to emerge.” Although there are other national organizations run by people with HIV, including his own Sero Project, Strub said a group like NAPWA “is needed more than ever before.” He said a strong national voice is needed “to deal with rising stigma and criminalization, declining interest in and commitment to empowerment principles as embodied in the Denver Principles.” He added, “We have to do it amidst a massive HIV industry where it is sometimes difficult to sort out the real agenda driving individuals, institutions and initiatives.” If these aren’t reasons enough, Strub said, “Most of all, we need to focus on how we bring attention and effective resources to the epidemic that continues to grow amongst young gay men and especially amongst young African-American men who have sex with men.”

One big reason that NAPWA’s loss is shocking is that now gay and bisexual men, who account for two thirds of new HIV infections and most of those living with HIV in the U.S., will have no strong HIV advocates in Washington. The national LGBT organizations for years haven’t advocated forcefully for proportionate HIV prevention funding, or for anything else significant to the health and well-being of American gay and bisexual men with or at risk for HIV/AIDS. Instead, they have been focused like laser beams on marriage equality, an issue dear to the hearts of the privately insured, mostly white professionals who fund them. The young gay men of color at greatest risk and carrying the greatest burden of new HIV infections aren’t priorities. As Sean Strub put it, “Remember how angry we were with the Reagan and Koch administrations when they ignored the crisis and let it rage unabated? What about when we were abandoned by our own community’s leadership and institutions? Why can’t we be angry then as well?”

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Gender Transition a Question of Ethics?

by Bobbie Zenker

Transition (literary journal)

I read an article by an ethicist who answered a question in the New York Times about the morality of gender transition pitted against the harm it may cause a family.  It is a Hobson’s choice, really, as there is no good answer in the end.  But, I guess that’s why ethicists get paid the big bucks.

Gender transition is selfish. No doubt about it.  But,  so is just about any medical treatment, alcohol recovery for instance.  Gender dysphoria might just as surely kill you as alcoholism in my experience.  Yes, I had both, and after several years of living in the proper gender and in recovery with all of the attendant hardship, heartbreak and happiness, I am perhaps uniquely qualified to say that both are a means of survival.  I had to do both, or neither would have saved me from myself, so bad was my sense of demoralization and hopelessness.

Yet, behind me lies a trail of loss, separation and broken relationships.  My decision to transition hurt other people whether or not their reaction may be perceived as just or warranted.  Thus, I might be rightly asked whether it was the right thing to do.  Was it just?  Was it ethical?  Or was it merely necessary irrespective of the consequences?

In reverse order, my need to transition was more than manifest at the time, so frail was my grasp upon a life not hell bent on personal destruction. Some may rightly conclude that my transition should not matter to others if I was going to be dead anyway, even if by my own hand.  At the time, and for all the years since I have believed that I would not have made it, but for transition and recovery.  But what if . . . ?

What if I had found recovery and reserved transition for later in life, if at all?  Of course, I was already 48 when I began.  But, might I have learned a way through recovery to live a sober life as a man, and still kept my job, my friends, my family and my marriage?  Is that possible?  Of course it is?  But is it likely?  That is a much more germane question, given the level of dysfunction following nearly half a century of gender confusion, fear, guilt, shame, ambiguity, etc., which was merely masked and drown out through alcohol dependancy.

The answer, then, is that it is much more likely that as the masks of dependency were stripped away, the difficulty maintaining the duality of self would have only grown worse, not better, and continually threatened the chances of recovery taking hold.  But, even If I could have made it through reliance on God, a sponsor and a recovery group, what difference would it have made.

Would I have kept the relationships and people I lost in my transition – my children, friends, colleagues and acquaintances who have all turned away?  Probably, but I must believe that those relationships would be strained as ever, particularly because recovery involves rigorous honesty.  It is our secrets which often make us so sick.  At some point, I would have had to tell my truth to the people in my life.  I could not have continued to live vicariously through cross-dressing in private, for it would seem ever more the lie.  And what then?  What purpose does it serve to tell the truth and not live it – to be honest, but not authentic?  Forgive me for waxing apologetically.

I never meant to hurt the people in my life, but, I still believe to my core that I did the right thing.  Moreover, I could not foretell a person’s reaction, and, though I knew them well, predictions and expectations of how a person will take the news of gender dysphoria are pure and painful folly.

Therefore, I had to step out in faith, reveal the dysphoria and prescribed treatment and then deal with the reaction.  It does not work the other way around, as there is no way to sort of test the waters before jumping in.   People have no frame of reference, no experience to fall back on when a trans person reveals themself, and they can no more control their reaction than I can.  It is a gut level, sometimes gut rendering response that typically involves either rejection or openness, if not confusion.  If a person can be open and willing to accept the trans person, there is a chance at a continued relationship.  However, if the knee jerk reaction is rejection the door may be firmly closed.  And I have second guessed myself enough times to know that the process of revelation makes very little difference in the long run.  Either a person gets it, or they don’t.  And there is simply no way to know ahead of time which it shall be.

Thus, the trans person can take only one of two paths.  They can remain forever inside their secret gender box with all the dueling emotions and resulting pain and dysfunction that hiding brings for the sake of their family and friends and to avoid the risk of emotional harm to others.  Or, they can stumble blindly and uncertainly along the path to authenticity, assuming the risk that not all will choose to go along.

Gender transition is not a question of right or wrong, per ‘se, but rather it is one of possibility, necessity and risk.  Can the trans person live without transition, and are they willing to assume the risks inherent in either choice – a life forever locked in dysfunction and incongruence, or one without the ones they love who also lose someone dear.