We Are Born That Way

May13 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.

TransMSU Promotes Inclusion in Bozeman and Montana State University (dgsmith.org)
Newsman Becomes Newswoman Due To Hormone Imbalance (987ampradio.cbslocal.com)
ABC News Editor Don ‘Dawn’ Ennis Comes Out As Transgender (businessinsider.com)

Montana LGBT Youth At Increased Risk for Suicide

Mar3 by D Gregory Smith

Today, a groundbreaking piece in the Billings Gazette:

Icon for Wikimedia project´s LGBT portal (Portal:LGBT). (Photo credit: Wikipedia)

Getting through adolescence is hard enough.

There’s the agony of puberty, the mood swings and the withering self-consciousness. Then comes the clumsiness of emerging sexuality.

It can be overwhelming.

For some young people, the passage can be even more daunting. For a few Montana kids coming to terms with their attraction to the same gender — in a religious and rural culture that doesn’t always know what to make of them — the challenge can be deadly.

A 2009 survey of more than 7,000 lesbian, gay, bisexual and transgender middle and high school students aged 13 to 21 found that in the past year, at least eight of 10 students had been verbally harassed at school; four of 10 had been physically harassed; six of 10 felt unsafe at school; and one of five had been the victim of a physical assault, according to the Centers for Disease Control and Prevention.

LGBT youth also are at far greater risk for suicide. A national study of adolescents in grades seven to 12 found that LGBT youth were more than twice as likely to have attempted suicide as their heterosexual peers.

There is little specific research in Montana concerning how much of a role sexual orientation plays in youth suicides, said Karl Rosston, Montana’s suicide prevention coordinator. However, national studies have shown about 15 percent of youth who reported suicide attempts also reported same-sex attraction or relationships.

In Montana between 1999 and 2009, suicide was the second-leading cause of death for young people ages 10 to 24, behind unintentional injuries like auto and farm accidents.

In the two years between 2010 and 2011, at least 57 youth ages 15 to 24 killed themselves in Montana.

It’s difficult to figure the current number of gays and lesbians in Montana. However, according to a report from the Williams Institute, a national think tank at UCLA researching sexual orientation issues, there were 1,600 same-sex couples in Montana as of 2005, up from 1,200 in 2000. This number is almost certainly higher, especially since the study didn’t include youth. The number of male couples and female couples were nearly evenly split, with 806 men and 853 women.

About 2.6 percent of Montana’s population — around 26,000 people — is gay, lesbian or bisexual, according to the report.

Teen suicide is a microcosm of what’s happening throughout the state, which has had one of the highest rates of suicide in the nation for more than 30 years. Consider that during 2010, at least 227 Montanans took their own lives. Another 225 people committed suicide in 2011.

D Gregory Smith, a Bozeman-based licensed mental health counselor and executive director of AIDS Outreach, counsels LGBT high school and college students, gay men and a handful of heterosexual men and women. He also counsels parents wondering if their child’s sexual preference can be changed, although he doesn’t believe that’s possible. He counsels parents on how they can better understand their child’s sexuality.

Most of his youth and young adult clients have contemplated suicide.

“Their biggest fear is believing they cannot have a good life,” said Smith, a former Catholic priest who is gay and HIV-positive. “They believe they cannot stay in Montana, be who they are and be happy.”
There’s so much more here: http://billingsgazette.com/news/state-and-regional/montana/lgbt-youth-at-increased-risk-for-suicide/article_d7e8360a-f437-5ba6-8d03-8aeb2d67d701.html#ixzz2MVkAw1EE

LGBT youth at increased risk for suicide (billingsgazette.com)
Former Priest: “I got the cue he’s falling in love with me” (Billingsgazette.com
Musical Nun Sings: ‘You Are Not Alone’ (dgsmith.org)

Identification of LGBT Needs in the Exam Room

Dec12 by The Mind Alive

A physician performs a routine checkup on a patient at the medical clinic. (Photo credit: Wikipedia)

Last time you were in an exam room, did you feel that the attending physician received all the information needed to gain an accurate perspective of your plight? Did you share everything you felt you should, no matter how personal? Did said physician even ask about anything, aside from the usual short list of inquiries we are all too familiar with in that particular setting?

If you are a physician, do you really get the answers you need from your patients? Or perhaps it is just too uncomfortable when talking about sexual health and behaviors. More likely, they do not disclose the details out of discomfort, or even fear.

LGBT persons have shown to have some unique healthcare needs, sometimes experiencing disparities in care. LGBT patients are often uncomfortable or inhibited from talking openly with healthcare providers about sexual orientation, gender identity, and sexual behaviors. Certain sexual behaviors do not automatically define that patient as LGBT, and not all LGBT patients are going to have similar sexual behaviors. Truthfully, it’s not about whether a person is a member of the LGBT community or not. It’s about the individuals choices and behaviors that could be putting their health at risk, as well as the health of others. In order to cover everyone’s needs, patients must speak openly with providers. Providers must delve into the patients behaviors and understand where the risk behavior is at for each patient. I am going to lay out a few examples, ideas, and suggestions for physicians, as well as patients.

In any healthcare position, you will find people from diverse backgrounds and lifestyles. Different interests, tastes, and mindset. The right approach will reassure patients that the provider is knowledgeable, genuine, concerned, confidential and accepting. This enables the patient to open up and discuss the very private matters of sexual behavior, often in this society a ‘taboo’ subject.

Ask the patient to tell a bit about themselves. As the patient, make sure you indulge your sexual partner(s), safe sex practices, and concerns. Some behaviors have an amount of risk attached to them that is often unknown to the patient. A physician might ask “Do you have any questions or concerns about your sexuality, sexual orientation or sexual desires?”. Use gender-neutral terms and mirror the patient’s terminology to better understand how they identify. For example, asking “do you have a partner or spouse?” “Are you currently in a relationship?” “What do you call your partner?” are all good ways to decide how the patient will identify without offending them with clinical terms which may sound cold and ‘labeled’. From here the in-depth sexual questions begin: “Are you sexually active?” “When you have sex, do you have sex with men, women or both?” “Are you and your partner monogamous?” “How many sexual partners have you had in the past year?” “Do you have vaginal sex, anal sex, or both?”. These and many more are the key to finding out just what unique needs your particular patient might have.

It is important to differentiate between sexual identity and sexual behavior. Providers need to discuss sexual behavior with patients regardless of sexual identity in order to define risk-assessment, ascertaining what activities they engage in and to learn what they are doing to prevent the transmission of disease.

And for the majority of readers, as patients we have a personal responsibility to find the courage to openly discuss in confidence all of our behaviors and desires with our doctors, nurses, therapists and counselors, etc. This is extremely important. We cannot rely on someone to read our thoughts and know the truth.

Stand up and be proud of yourself. I can almost guarantee that the person treating you has heard it all. And if they haven’t, they will soon enough.

Bisexual Men and Women Less Likely Than Gay Men, Lesbians to Disclose Sexual Orientation

Dec10 by D Gregory Smith

English: Illustration of the double moon symbol used by bisexuals who wish to avoid the use of triangles. This example is in the colours of the Bisexual Pride flag. (Photo credit: Wikipedia)

New research shows that bisexual men and women are less likely than gay men and lesbians to disclose their sexual orientation to healthcare providers. The study, which examined nondisclosure of sexual orientation among lesbians, gay men and bisexual men and women, found that concealment of sexual orientation from healthcare providers was related to poor psychological wellbeing.

“This study adds to a growing literature that shows that a one-size-fits-all approach to understanding the health of sexual minorities ignores differences among subpopulations within this community,” said Laura Durso Ph.D., Williams Institute Public Policy Fellow.

Nondisclosure was higher among bisexual men of whom 39% did not disclose to any medical provider and bisexual women of whom 33% did not disclose to any medical provider. Disclosure was much more prevalent among gay men and lesbians among whom only 13% and 10%, respectively, did not disclose their sexual orientation to any medical provider. Among lesbians, greater nondisclosure was found among racial/ethnic minorities, women with lower educational level, and women with children. Among both gay and bisexual men, greater nondisclosure was found among younger men and men who were born outside the U.S.

The study, entitled “Patterns and Predictors of Disclosure of Sexual Orientation to Healthcare Providers among Lesbians, Gay Men, and Bisexuals,” was funded by the National Institute of Mental Health and is published in Sexuality Research and Social Policy.

Full study: click here.