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Let’s Talk Biology Again

I’ve discussed this before, in bits and pieces, here and there, now and again. But perhaps it’s wise to assemble all this under one roof where it can be easily referenced.

Approximately 1 in 15000 females, at birth is XY. They are females with female genitals, the works. XY does not mean male. Of these, 1 in 80,000 is Swyer’s Syndrome, and 1 in 20,000 has complete androgen insensitivity syndrome. Another subset has partial androgen insensitivity syndrome and estimates of those born female vary greatly there, from 1 in 20,000 to 1 in 50,000. The cumulative numbers for these three groups are generally assessed at 1 in 15,000, but the frequency could be even higher. The vast majority of XY females are sterile, but rarely some are not, as documented in this study.

1 in 20000 males at birth is XX, also called de la Chapelle syndrome. They are males with male genitals. XX does not mean female. However, the frequency of XX males where the SRY gene crossed over from the Y chromosome to the X may be even higher than that, as this study suggests SRY gene crossover happens more often than previously suspected.

1 in 600 children is XXY, Klinefelters. For the longest time, doctors assumed XXY were always male, because only XXY males had fertility issues, until some biologists decided to go look. And suddenly they found lots of XXY females. This breakthrough came in the last decade so it is relatively “new” news and not all doctors may have heard this year.

The above situations are all scientific facts and prove, conclusively that sex and gender are not determined solely by 5th grade biology lessons about XX and XY, which were simplified for you because at that point in your life, you couldn’t have handled the complexities involved.

So what determines sex and gender? What sex is a male soldier who loses his legs and genitals to an IED. It’s all gone. He has no testicles, no penis, so what sex is he? Stupid question, isn’t it?

It’s stupid because sex and gender are determined in the brain, specifically in the white matter structures of the brain.

Every fetus starts out female and stays female until week 8. That’s when sexual differentiation begins.

The brain is the first human organ to sexually differentiate. This occurs between weeks 8-16. The fetus doesn’t even have genitals until week 14 and then it’s only the unisex “genital tuber” which will later become clitoris, vagina, labia, or penis, testicles, and scrotum.

What drives sexual differentiation? Not genes. Not XX. Not XY. What drives sexual differentiation in the fetus is hormones. Males develop as male because they received about 4 times as much testosterone as estrogen. Females develop as females because they receive about 5 times as much estrogen as testosterone. This is another scientific fact. Cry about it all you want but this is what creates sex and gender.

Consequently, if the mother, during pregnancy for some reason has hormonal interactions that change the basic hormonal ratios away from the median described above, you can get a child whose brain develops one way then their body develops another. Not enough testosterone in weeks 8-16 then returning to median hormonal ratios for weeks 16 and onward? Transgender child with a female brain and male body. Too much testosterone in weeks 8-16 then returning to median hormonal ratios for weeks 16 and onward? Transgender child with male brain and female body. Here is the American Medical Association’s 2011 Annual Meeting Presentation on how hormonal ratios can vary and thus produce the entire spectrum of LGBT people. The presentation is about 70 minutes long, but informative, so be prepared to sit and listen.

So why not fix the brain? We don’t know how without killing the patient. Further, “fixing” the brain would likely destroy the entire personality of that person, a severe violation of their personal liberty and autonomy. So what do we do? We fix the body, which turns out to be relatively easy.

This is the reality of what being transgender means. And I, for one, am tired of ignorant people not understanding science and trying to impose their small minded bigotry against transgender people.

Educate yourself. The science is all available if you want to understand it. The American Psychological Association, the American Psychiatric Association, the American Medical Association, and the American College of Physicians all support the above statements, and all support social transition, hormonal therapy, and surgery as the proper treatment for being transgender. The AMA supports hormone treatment and surgery for transgender patients. The American Psychiatric Association supports transition related medical care for transgender people.

Those of you who choose to wallow in ignorance and hate are what drive transgender kids to suicide, not being transgender but being hated by small minded bigots like yourselves.

Grow up, and stop hating. And stop claiming 5000 year old superstitions that you call a “bible” are somehow right when compared to science. The rest of us are tired of your narrow minded, childish, and anti-scientific ways of thinking. Transgender women are women. Transgender men are men. Deal with it.

Notes about the Bangkok Rama Hotel (Baansiri) During My Stay In Thailand

Regarding the trip to Thailand, I chose to stay at Baansiri, the Bangkok Rama Hotel, in the cottages in back. The first two weeks there they seemed to have issues with their WiFi which were annoying but I was also not there 4 of those days anyway. Once they got the issues fully resolved, I had only rare hiccups with their WiFi.

The food at the restaurant of the hotel was relatively inexpensive compared to other places (and most places were far less expensive than the US anyway) and was quite good. Being at the hotel, we were provided breakfast coupons to get breakfast for free if we so wished. Lunch and dinner we either had to purchase somewhere, such as the restaurant or elsewhere, or cook our own, which we did a fair bit of as well.

The cottages are fairly basic. If you want to be pampered you might choose the Dusit Princess instead, but I was more than pleased with the cottages and the close proximity to so many other of Dr. Chettawut’s patients. We spoke often, exchanged information, contacts, and shared food and drink on occasion. One of the women chose to not offer contacts as she said she was essentially going stealth after her return to Europe. She was witty, funny, and I’d have liked to have known her better but I understand her choice.

If you have a functioning phone when you get to Bangkok, consider downloading the Food Panda app. You can order from a huge number of local restaurants and have it delivered to your cottage.

Outside the hotel, immediate to the left of the grounds, is a nice little sandwich shop. We enjoyed that. Immediately to the right was a Seven Eleven and then several small local restaurants or other shops, such as a bakery.

About four blocks down to the right you will come to a large concrete bridge going over the street for pedestrians. On the other side of that is a shopping plaza that has a small replica “Big Ben” clock and English themed shops. Across the same parking lot on that far side of the street is Tesco Lotus, a very large store, much like a Target here in the US. It has a grocery area, clothing, house supplies, cosmetics, toys, appliances, etc. Inside the same building as Tesco Lotus are a few shops, such as a bookshop and several bakeries, candy stores, etc. There are also three or four banks inside the Tesco Lotus building, which can give you the most current exchange rate for your dollars to Thai Baht exchanges.

The Bangkok Rama is on the north side of a “loop” and Dr. Chettawut’s office is on the complete opposite side *(south side) of that loop, about 15 minutes away. On the east side of that same loop sits the Dusit Princess. I had a friend staying there who arrived two weeks before me so we stopped by there to visit. Right next to the Dusit Princess is the Seacon Mall (I think that’s the name) which is a very large and interesting mall if you are looking for that sort of shopping.

I was not physically up to it, but my traveling companion took one day near the end of the trip to take the 10 hour round trip and excursion out to the Tiger Temple. She got me some well appreciated souvenirs and her photos just make me want to return someday to see the tigers, both adults and cubs.

If you have questions about the Bangkok Rama, feel free to ask. If I think of anything else to add, I will. The facilities were comfortable and I experienced no serious issues post-operatively while there nor yet at home (knock on wood).

Finally a Sense of Peace

I’ve mentioned before in other venues about how comfortable I was with my body changes almost immediately. I’ll mention them again here now – by the third day after surgery, I realized I couldn’t even remember what the old genitals felt like and it was a massively liberating feeling.

My traveling companion, who I love dearly and who I’ve called my “guardian angel”, said this about my immediate relaxation and sense of self-comfort:

“What was totally freaking awesome was seeing you lose all body modesty and shame the day you came back from the clinic.

Prior to surgery, you went to shower clothed and stepped out of the closed bathroom clothed. First day home you walked naked across the room talking about politics while looking for a dress. No self-consciousness at all.

That made me tear up. I knew you’d crossed into new territory in your life.”

I hadn’t even thought of that but she’s right. I no longer felt completely wrong naked, even and especially in front of my closest female friends.

I still tire easily, and run out of steam at the end of the evening, but last night, Sunday night, August 23rd, was the first full night’s sleep back in Texas. That was a breakthrough as well. I’ve consequently been awake all day today, working at a measured pace from home, dealing with some remaining Human Resources issues after my trip, and while I’m tired, I’m not feeling like I need a nap before bed tonight, probably around 11pm.

Nerve endings continue to wake up and I’m in a bit of discomfort but no real serious pain. A few aspirin now and then seem to work wonders for me. One part of down there has decided to be hyper sensitive at the moment. Hopefully that won’t continue too long, at least not quite like it is at the moment.

As I told friends today, wonderful is slipping on a pair of jeans and not dealing with a bulge or needing to tuck at all. Everything just slides on the way it should.

I didn’t have any real doubts left by the time surgery rolled around. By then, it had been several years of reviewing all the thoughts in my head. I do remember thinking, as they added something to my IV right before I lost consciousness, “Here we go. Let’s hope all this thinking has come to the right conclusion.” Yet when I awoke from surgery, that question was nowhere to be found. I asked a nurse if everything had gone ok, and she smiled and nodded, and gave me a thumbs up. When I saw Dr. Chettawut, he said things had gone wonderfully.

As for how things are going, I’m at the one month mark of my surgery (actually that was Saturday) and doing very well. I am not in any pain at all, just tenderness and general discomfort.

I began dilator #3 this week and that was, at least at first, a breathtaking experience in a very wincing way. Now it’s just tight and I need to be patient and persistent with myself. I’m on day #5 with dilator #3 so I’ve been impressed at the rate that I seem to be stretching to accommodate it.

I seem to be gaining strength each day, which is good. Back on estrogen again and the hot flashes are gone and my body temperature seems a bit more stable, at least to me.

Finally, while I’m improving, a different chapter of my life is closing. Our family dog of the last 11+ years was diagnosed with cancer so we’ll be putting him down soon. He’s been affectionate, caring, gentle, curious, fun, and very much a part of our family. He will be missed.

As one door closes, another door opens.

A Visit With Dr. Chettawut And Other Random Thoughts

IMAG0099-resizedIt’s Wednesday morning in Bangkok and  I had my final visit with Dr. Chettawut today. He said I am healing “beautifully” so far. We took photos and while I guess I look less than stellar, no makeup and clearly physically tired, I’ll excuse myself with it having been just three weeks since surgery.

My only remaining medication is my antibiotic, which I was told to finish. Judging by what’s left that will be sometime next week.

My dilation schedule with #2 changed this week. That’s the dilator that’s getting most of the time now with #1 just basically helping me to relax and loosen up. Strangely enough, unlike a lot of the other women I’ve met here, my most relaxed session is the morning, and I’m at my tightest in the evening, so that session takes the longest.

I’ve stood a few times looking at myself in the mirror now, both dressed and undressed, both frontal and sideways. I don’t think I’m doing too badly for a woman my age either. And I will admit that I’m starting to see what my daughter must see when she teases me about a bikini next summer.

I recently participated in a long Facebook thread started by a woman who posted publicly (if you don’t want dissenting comments, post for friends only!) about her opposition to transgender protection regulations in a Houston suburb school district. I provided fact after fact, but these people refused to consider these facts, or the professional opinions of the American Psychological Association, the American Psychiatric Association, the American Medical Association, or the American College of Physicians. They refused to accept the scientific research, with one paranoid delusional claiming that science and professional medicine had been taken over by “liberals” and “Satan”. Well, buddy, when you’re that paranoid and delusional, you are the one that needs psychiatric help, not transgender kids. And they refused to accept the criminal evidence provided by the states and major cities that have enacted transgender protection ordinances, again claiming “liberal” conspiracy.

This little discussion was absolute proof that these bigots don’t care about facts. They just twist facts to try to justify their bigotry. They totally lack the compassion, empathy, and love that Christ himself told them to show.

That’s what dealing with transphobic bigots is like. Deny, deny, deny, fall back on “cuz Gawd”. It’s a blatant display of willful scientific and medical ignorance. And they are often proud of it!!! You’re left with a sick sinking feeling that these people are the exact sort that would gladly load cattle cars with human beings just so long as nobody disturbs their comfort. And granting equal rights under the law to transgender people? They just don’t want to. One practically admitted he wanted someone else to mock. These are sick, sick human beings.

In other matters, Tuesday evening (last night), Julie and I went to the Japanese restaurant just outside the Tesco department store about 5 blocks down the street. It was a feast for 950 Baht total (roughly $26). We got the beef and seafood. They put hot coals in the little burner in the center of your table and you cook your meal there, with over half a dozen different seasonings provided. We had more beef than we could eat, plus mega-shrimp, small salmon steaks, and various vegetables we could put on the grill as well. There was also a rice bowl that basically looked like fried rice unstirred, so we stirred that and ate about half of that as well. Julie and I split the salad and it was gone, and we each also got Miso soup with the meal. All in all, I came home stuffed and happy. It as delicious.

Today Julie is at the Tiger Temple. I have her looking for a few things for me for other people, plus I told her I wanted my own stuffed tiger if they’re available. She’ll be gone all day as that trip is 3 hours drive each way north of the city and 4 hours at the temple proper. She’s going to try to sign up for the chance to get a tiger photo where the tiger puts its head in her lap. I hope she gets it! If I can return someday, I want to see the Tiger Temple too, when I am healthier.

Our trip to the other side of the world is drawing to a close. Julie and I will see one of the local temples tomorrow, and maybe one other local sight on Friday. Saturday we rest and pack, as our ride back to the airport comes to the hotel at 9pm that evening and our flight back to the US begins just after midnight. We’ll arrive back in Houston on Sunday, August 16th, at about 8:30 am at international terminal D. I need to help Julie get over to terminal B for her flight home to Memphis that leaves around 10:30 so it will be close. We have to come in through customs, collect luggage, take the train to terminal B, then she has to check in at the counter and check her bag again for the separate flight home. We’ll make it but we’ll be busy. After she’s set, I’ll arrange to meet my ride outside terminal B at the arrivals pick up area. And then home, where the process of settling back in, re-establishing my dilation and massage schedules begins, and where I get comfortable for a week before resuming work on Monday, August 24th.

To all who have helped distract me on this trip, keeping my mind off the difficulties of healing early on, thank you. You have my gratitude for simply being there. But don’t worry. I’m not going away, and as I recover, I do hope to meet more of you who are in and around the Houston area.

Of Nerve Endings, and Random Sensations, Coupled Against Unlikely Future Probabilities.

When I came out to my spouse in 2012, I knew the risks. Part of me held to some silly vain stupid hope that my marriage could be salvaged. Part of me wanted to believe that she and I, we, were better than that. I should have known better. I shouldn’t have even given the tiniest spark to such vain hopes. I didn’t choose to end that marriage. She did, no matter what she claims to the contrary. She’s the one that laid down the ultimatum of “transition, and we’re done”.

But I saw this exactly like I saw my fight against cancer in 1996. I had a great medical team, therapists, doctors, endocrinologists, and they all agreed that my health and well being were best served by transitioning. So with great reluctance I began that process, and I spent two months crying myself to sleep in 2012, grieving for my marriage. There’s lots I could say that I learned here about how others felt about me, but I don’t want to focus on such negatives, so I won’t.

Throughout my transition, up to now, this point, after having had GCS, I’ve been celibate and not actively looking at the dating community at all. I am aware that there is an entire fetish subculture that chases pre-op and non-op trans women as “chicks with dicks”. If you don’t like that phrase, it’s the ugly reality of how our society views pre-op and non-op trans women. It’s ugly. The woman is viewed as a “thing” and she’s used as a thing. The complete epitome of male sexual objectification of women occurs in the trans “chaser” community and how they treat those women.

For that reason alone, I stayed out of the dating pool. And because I was technically still married. It’s just a marriage of tax convenience but this too will end soon enough. But now GCS is done. And things are changing. I’m still a long ways off from being a responsive sexual partner to someone, but the nerves are beginning to wake up.

And wake up, do they! Random firings all over the place. An electric shock sensation that would make me leap out of bed except certain sutures are pretty sore at the moment. Random neural firings just all over the place.

Of course, then there’s dilation too. I’m not very far along on this yet but already I’m discovering that certain sensations are pleasant, that they even make me wonder what certain experiences would ultimately be like.

And that leads to day dreams. I suppose many women, trans or not, dream of finding Mr. Right (and some of finding Ms. Right). I admit to such thoughts, such dreams. But I also admit to the cold reality that trans acceptance among those my age, late 50s give or take a few years, is pathetically, horribly low. And that’s where day dreams snap back to reality. Within all probability, my remaining years will be spent alone, fending off dates from men who want nothing but sex, with almost zero chance of finding that person who wants a relationship, a friendship, a sexual intimacy, all together with a person with whom they could spend the rest of their life.

Could it happen? Yes, the odds are not zero. But will it? The odds are not good and I know this. It crosses my mind every single day. And I knew this going into transition and still chose transition, because the alternative was to die.

When people say trans people have a “choice”, it’s not much of a choice when the choice is between finally being yourself or dying. Yet I know people who would have preferred I had killed myself. Unfortunately for them, I chose life, even if that turns out to be a life alone.

In the meanwhile, I have close friends, supportive friends. Two of my three children accept me and want me involved more in their lives. I have nieces, nephews, a sister-in-law all who support me and eagerly want to see me again. It’s been a few too many years since I was back to Ohio.

What I plan to do is live my life. I’ll be open to that day that Mr. Right walks into my life but I won’t pine away wondering if or when he ever will. If it happens, good. And if not? Someone lost a chance to find out how much this trans woman could value a life partner.

The odds aren’t good but if I don’t play the game, I can never win, right?