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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.

Authenticity and “Passing”

I originally wrote most of this as a comment to another blog I follow. But I realized it’s useful and wanted others to have the chance to consider this as well.

I really really dislike the term “passing” but I’m going to use it here because so many people in the community understand it. I prefer to think of it as just acceptance of who I am.

One of the things about “passing” seems to be a lack of effort. And I don’t mean that in the way some people might think. In fact, perhaps I mean it the opposite way.

When we’re unsure of ourselves, when we’re not authentically ourselves (which I agree is hard!), we start to “act”, and our role in society becomes performance art rather than just who we are.

But the funny thing is that people seem to be able to detect performance art versus authenticity. Maybe we try to hard. Maybe we make subtle mistakes or maybe we’re acting so hard that we don’t make mistakes. Maybe we “act” too hard and it sends signals to others.

I’m not really sure. But what I do know is that as I acquired personal inner peace, as I began to simply “be me” as opposed to someone society thought I should be, my issues with “passing” vanished.

Yeah, I admit I’ve had medical help along the way as an MtF trans woman but that help, while it definitely helped, wasn’t the final piece of the puzzle for me.

It was when I finally found a way to “be me” that I stopped acting. And almost as soon as I stopped acting, I stopped getting misgendered, etc. I know it’s not that easy for everyone. I know that hormones need time to work. I know that there are other aspects. But regardless of all those things, it does seem to me that “passing” includes being authentic, just “being you” rather than a construct.

NOTE: Part of finding that inner peace, for me at least, did come from surgery. Once I completed GCS, then I began to finally, for the first time in my life, begin to feel positive about my own body. So surgery played a role there too, but only a role.

A Response to the Lies of “A Sacred Androgen”

Recently, the Antioch Review has published an article full of hateful lies, stereotypes, and absolutely incorrect medical information about transgender people titled “The Sacred Androgen” (link marked as “nofollow” so as not to boost the page’s rank).

In response to this, Brynn Tannehill wrote a scathing condemnation of the article and The Antioch Review itself, titled “Antioch Demonstrates Why Mid-West Kills Queers from the Inside Out“.

And in addition to Brynn’s article, I sent the following email to Christina Check who is listed as the contact for The Antioch Review. I encourage all of you to do likewise. The more they hear from us, the more they may realize they have done something ugly and horribly wrong, and perhaps retract and apologize for that piece of garbage they published.

My letter to the editor lies below this line


 

Really?

If you had published such a pile of garbage laden pile of tripe about black people, your offices might have been buried under angry responses from across the nation already.

If you had published such a garbage laden pile of tripe about gays, you would have been dragged through the major press and rightfully pilloried publicly destroying your reputation.

Yet you think you can get away with it against transgender people?

Your author uses every bad stereotype, ignores all the current medical evidence including neurobiological evidence that has led the American Medical Association, the American College of Physicians, the American Association of Pediatrics, the American Psychological Association, and the American Psychiatric Association all to conclude that:

1. Being transgender is not a mental illness (and it’s no longer listed as one in the DSM)
2. Being transgender is a neurobiological medical condition caused by in utero hormonal ratio variations during early pregnancy.

Your article goes on and paints trans women as sex obsessed fetishists which couldn’t be further from the truth and which theory has been totally destroyed. Bailey’s work on “autogynephelia” has been refuted because what he thought was solely trans obsession turns out to be common natal female behavior as well.

Your author asserts that transgender people are mentally ill while mental health professionals say that being transgender is not a mental illness. Your author then goes on to support reparative therapy which has been proven to increase suicidality, and never ever “cures” anything.

Your author cites the 41% suicide attempt rate as proof of mental illness and ignores that mental health professionals cite that as proof of the deep systemic hatred and oppression our culture has displayed towards transgender people. Mental health professionals say YOU need to change your attitudes towards trans people, and not that trans people need to change.

Your author launches into rape culture objectification of women and then tries to use that as a reason to see trans women with disgust.

Your author tries to assert that trans women are just gay men but ignores actual biological evidence that trans women are as different from gay men, in the brain, as they can possibly be.

The above microscope slides are just one of many studies demonstrating that trans women have brain structures very similar to cisgender women and nothing at all like gay men.
In short, your article, “The Sacred Androgen”, is hate speech targeted at a minority group that is being actively attacked and oppressed today in popular media and by right wing politicians and churches for being different. Yet the medical community, across the board, supports trans people and who they say they are. There are only a few old fossils, like Paul McHugh, Bailey, and others who get regularly trotted out by the right wing to support these hateful views.

With the publication of “The Sacred Androgen”, The Antioch Review demonstrates that it is not a rational nor respectful publication and that anything it publishes should be ignored, discarded, and that the Review itself should be driven into the ground as a purveyor of hate speech.

You should be ashamed of yourselves but bigots never are. Just like racists have been hiding in the closet for the last 40 years until Trump came along, bigots never give up their ugly ways and we now know that The Antioch Review is a publication of bigots and bigotry.

Cara Ramsey

Looking Back at 2015

The year 2015 will be a pretty important year for me in numerous respects. A lot happened and I learned a lot along the way. 2015 was the first year I lived as myself full time. My legal paperwork was done in September 2014 and I was full time thereafter, no looking back.

In January of 2015, I decided to make things happen and stop waiting for them to happen. I have one life to live and I decided I wasn’t sacrificing that life for my spouse’s retirement, especially since she no longer plans to be with me. So I cashed out one of my IRAs and put that money to work.

In February I scurried about getting paperwork submitted for my passport, which I paid extra for “express” handling and I got it just a few weeks later. My name, photo, and a nice big “F” in the gender box made me smile. March became a waiting game, basically waiting for April, and also further realigning myself at work as my colleagues continued to become accustomed to my new presentation.

I underwent FFS in April with Dr. Cardenas, in Guadalajara, Mexico, where I also met the amazing Anne Kelley. We shared a particularly powerful moment during both our recoveries that was bonding, and was a revelation. It was about Anne so if people want to know the details, they should ask her, but for me it was emotionally powerful to see someone coming to terms with themselves in such a beautiful and loving manner.

May was recovery. Let me tell you right now that FFS was far worse and harder in terms of recovery than my GCS, which came later in 2015. FFS was so worth it, but it was a bear in terms of recovery for the first few weeks. I’m happy with my appearance though and I’ve gotten compliments on it, and most importantly, it helped me to stop seeing “him” in the mirror anymore.

June was more waiting and continued recover. Friends and I began planning for Ren Fest in November. We always try to plan several months in advance to give people time to plan for a specific weekend. There were also details to complete, medical tests and exams before my GCS surgery, all of which had to be submitted to Dr. Chettawut’s staff in Bangkok before I even left.

July came and a good friend, Ashley Wilson headed to Thailand ahead of me by about two weeks. I did get to see her while I was there later, before she flew back to the US. And after seeing her, it was my turn. I awoke from GCS and really wasn’t in much pain at all, mainly just uncomfortable. They kept me pretty well controlled with pain meds and such. And my dear, dear friend, Julie Jeznach, had traveled to Thailand with me and was there to visit while I was in the hospital and to help me with my recovery for the three weeks afterwards. We had a lot of fun for the month we were there. I over stressed myself once, got scolded for it, then spent a day and a half recovering from it. Fortunately, no permanent damage. And I learned the tedium and the joys of dilating! And yet we saw things, ate fascinating food, met people, and Julie got to see the Tiger Temple!

In mid-August we flew back home. It seemed almost surreal, Julie and I going our separate ways. I also know that Thailand had been good for Julie too. Good food, regular exercise, walking (for us both as little as I could do) all contributed to Bangkok being a positive experience for us. But then it was over. I rested another week then returned to work while working from home. Working from home was a blessing. As circumstances turned out, and as the changes on our team at work developed, it would arise that I wouldn’t need to actually go back into the office until some time in January, 2016. The rest of 2015 was 100% from home, which gave me time to adapt to my dilation schedule, take breaks as needed, etc. Often my work day the rest of the year went past 6 pm, but that included time for breaks and medical necessities throughout the day as well.

September and October were much the same, except the reminder and the ongoing lesson that I don’t really have family anymore.  I know there are some who might disagree, but being ignored, having things said behind your back, pretending you don’t exist on important family days (birthdays and holiday), does not constitute “love” except in some sort of deranged “religious” mind. I won’t comment further about that except that their behavior reveals a lot more about them than it does about anything else.

Out of that comes a lesson, for me at least. We’re repeatedly told to remove toxic people from our lives. I subscribe to that idea, but implementing it in practice is complicated and is often a process, not a single decision. It’s a process because our hearts don’t always listen to what our heads tell us, and vice-versa. In this case, my head knows I don’t have family and I need to let go and treat them like I treated my father, someone to whom I was biologically related but who are anything except family, based on their behavior. But the heart takes time to let go, often not wanting to accept what the mind otherwise knows to be true.

The last few years have been that process for me and I think I hit rock bottom and was finally able to put this behind me in December of 2015. And no, there was no danger of self harm, just a great sadness and listlessness as my heart realized what my mind has been telling me for a number of years now – you have no blood family.

I also began an online dating experiment in autumn of 2015, and discovered that clearly stating that I am a post-op transgender woman, up front, is a sure way to not get responses from anyone except thoughtless men, who in turn blocked me when they did find out, or from identity thieves, whom I seem to be getting better at identifying, especially since some of them are so pathetic. Out of nearly 400 messages received thus far, only 4 read my profile and realized I was trans, and only 2 of those were really interested in some sort of friendship or relationship. Unfortunately, both of them were very far away and both they and I were looking for someone closer.

November was fun, with time at Ren Fest spent with my friend Elizabeth and myself both dressed up in garish costumes. But I think I want to modify mine more for next year. Maybe replace the heavy leather shoulder pauldrons with fur ones and a few other changes. There were also minor outings, manicure and pedicure, buying some new clothes, and otherwise enjoying myself.

November blended into December, and for the most part, I ignored the Christmas season. Dwelling on it too much was painful. And my mind and heart had to work that out in their own way, as I described earlier.

2015 ended and I was in a sense, relieved. It was over. Time marches on and 2016 is before us. I’m hoping to carve out time for at least one trip this year, perhaps back to Memphis. And maybe, if I can financially swing it, a trip elsewhere. We’ll see.

Choosing to be myself has had a cost, a saddening cost but one which I would still pay, because the alternative was no longer being able to live with myself. Despite rejection from those I’ve loved and to whom I’ve literally given my heart, my life, and even my finances for over thirty years, I still would make the same choice. My choice was to live and I am content with that choice, despite the costs.

September 7th, A Day To Remember

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It was 19 years ago today, September 7th, that I was wheeled into surgery to remove the remains of a tumor that had been destroyed by months of chemotherapy. Prior to that chemotherapy, I had been about 195 pounds. By the end I was around 140, and honestly probably more in the 130s. By the end of chemotherapy, most days were enough time awake to eat, maybe watch a single TV show or two, and then sleep, 20-22 hours per day. And then I was told the tumor was dead.

Chemotherapy was over in mid-July of 1996. I was given basically 6 weeks to gain a little strength, then the surgery would ensure that the remains of that tumor were gone.

What was supposed to be a 4 hour surgery became 10. The tumor had apparently been wrapped around my aorta and in dying to the chemo, it had become this rock hard substance. My surgeon visited me later and apologized for the extra time but said he was literally chipping that stuff off my aorta, like flakes of cement.

The tumor had also been wrapped around the nerve to the left vocal cord. That nerve is a bit weird and shows how evolution does things, not always in the most sensible way. That nerve comes from the spine, over to the heart first, then back up to the left vocal cord. There was no way to separate the remains of the tumor from that nerve so it got cut.

This left me unable to speak since the left vocal cord was flaccid and unable to flex to meet the right cord, since no neural signals could now reach it. To correct that, a plastic implant was inserted in that vocal cord in another surgery in early November of 1996. I still have slight numbness in my hands and feet from chemotherapy. My scalp was ravaged by chemotherapy and never really recovered. And my hearing, already a 20 decibel loss in my good right ear, became a 50+ decibel loss and I finally admitted that I needed a hearing aid.

Despite all this, I survived. But this all also made me think very hard about myself, who I was, what I’d done to myself emotionally and psychologically to get to where I was then. I also got to see my children graduate from high school, get married, go to college, have children of their own. It took me another 8 years, to about 2004, to really learn about and understand the words transsexual and transgender but I’d bought into another lie – that if I hadn’t transitioned early, I couldn’t transition at all. It was six more years after that, 2010, that the mother of all dysphoria episodes began that simply would not relent and which drove me to the brink of suicide, before I finally admitted I needed help, and with prodding from Julie Jeznach, I finally sought that help.

The rest, as they say, is “herstory”. People to whom I gave my life, my time, my love, my earnings, have rejected me. That’s their choice and I have to accept that, but it’s still bitter. And knowing what I know today, I can honestly say that I do have regrets. We’re not supposed to have regrets and I know that I can’t change the past so I don’t plan to wallow in these regrets at all. But I do acknowledge them. And if I’d known 30 years ago what I know now, I would have just walked away instead of worrying about other people’s emotions and opinions.

So I write this today with my younger trans friends in mind. Being trans can suck. People can be ugly, cruel, callous, hateful. But we’re trans and we can’t escape that truth. My advice to you, to each of you, is make your decisions for yourself first. Anyone who can’t handle the decisions that you need to make for you neither loved you nor is your friend so is not worthy of your consideration of their opinions.

While I am very happy with where I am in life right now, in one sense, I write this today to my younger trans friends to say “Don’t be me.” Don’t put others ahead of yourself. Don’t defer what you need to be happy to make others happy first. Most of the time they won’t care about you. Not really. And those that do care? They’ll have your back and be there for you.

Have a good September 7th, a good Labor Day, and a good day for yourself first and foremost.