Everything You Always Wanted to Know about Sex Changes But Were Afraid to Ask
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by Janis Morgan Stevens
Category: General Nonfiction
Description: Non-technical, straight from the shoulder guide to getting a sex change! If you're someone, or know someone, who has always felt they were born in the wrong kind of body and should have been a woman, this is the one book you should read. Based on five years of research, it walks you step-by-step through the entire process of transition from male-to-female. The book covers: A SHORT GUIDE TO TRANSGENDER TERMINOLOGY * How to Tell if Someone is a Candidate for Sex Change * How a Therapist Helps Ease the Transition from Male-to-Female * Physiological and Emotional Effects of Taking Estrogen and Other Female Hormones * What It's Like to Begin Living Full-Time as a Woman * Feminizing the Body: Electrolysis, Breast Enhancement & Cosmetic Surgery * Why Some Opt to Live as Women--But Never Have Surgery* How Surgeons Turn Male Genitalia Female * What Sex is Like Afterward * How to Locate Therapists, Endocrinologists and Surgeons This one-of-a-kind book also includes listings of sex reassignment surgeons, national transexual outreach organizations, recommend reading, and helpful websites. In an appendix, male-to-female transexuals will find tips on how they can walk, talk and speak in ways more likely to cause them to be perceived as a woman. "The author of this book knows her onions!" Merissa Sheryl Lynn, founder The International Foundation for Gender Education. "A remarkable book by a remarkable writer. A must-read for anyone interested in learning more about the process and the phenomenon." Linda De Villers, Ph.D., AASECT Certified Sex Therapist and Sex Educator, author Love Skills. [Cover design: J. L. "Frankie" Hill]
eBook Publisher: Renaissance E Books,
eBookwise Release Date: May 2008
Available eBook Formats: OEBFF Format (IMP) [136 KB]
Reading time: 76-106 min.
CHAPTER 1: SO YOU THINK YOU WANT A SEX CHANGE?
I like to wear women's clothes and all my life I have felt like I should have been born a woman. Does that mean I should get a sex change?
Maybe. Maybe not. For instance, you might be a male-to-female (MtF) crossdresser. These are men who have a strong feminine side (or anima) and enjoy letting it out by making up and dressing up "en femme." But their anima represents only one aspect of their personality. They thoroughly enjoy their male side (animus) as well, and have no desire to change their sex permanently. On the other hand, you could be a MtF transexual (TS). Transexuals feel good when they wear women's clothing for a different reason. When TS dress as women, they feel they are living in accordance with their true or inner gender. More than 98% report they feel like "women trapped in male bodies" (that they are their anima). And a recent European medical study found that key structures in the brains of MtF transexuals resemble those of women--not men. There may be an initial period in the lives of TS where they crossdress some of the time or secretly because they are not in a position to make all the lifestyle changes involved in "transitioning" to living fulltime in the role of a woman. For them, crossdressing provides only a temporary remedy. Most know from an early age that they want to live their lives as women. Typically a MtF transexual will not feel complete until their body, including sexual anatomy, conforms to their inner sense of gender. Only transexuals should have sex change surgery (SRS)--for them it can be lifesaving therapy.
How can I tell if I'm a crossdresser or a transexual who should get a sex change?
Only a psychotherapist who specializes in transgender issues can determine that. Typically this is a psychologist, social worker, marriage and family counselor and/or psychiatrist. Only they are considered qualified to determine whether or not someone is a transexual and qualifies for SRS. If one of them concludes that you are a TS, you will be diagnosed as having Gender Identity Disorder (GID). This means you suffer from Gender Dysphoria (i.e. your body does not correspond to your true psychological gender. Fortunately there is a cure for this "disorder"--sex reassignment surgery--and when you are diagnosed as a transexual, you will receive a "prescription" (recommendation) for it.
(Although the term "transexual" is psychiatrically correct, and accepted in common use--even by most transexuals--many MtFs prefer to simply call themselves "women" or "transexual women." They would say that you are currently "a preoperative woman"--and that, after SRS corrects an anatomical error--you will become a "postoperative woman.")
What does someone have to do to qualify for SRS?
The surgeons and clinics that offer sex change surgery differ widely in their requirements and in how strict they are about your meeting them. The only way to be sure is to write prospective clinics and ask for a list of their current requirements (see Appendix III for a list of clinics). Most are members of the Harry Benjamin International Gender Dysphoria Association, the professional organization for therapists, physicians and surgeons who work with transexuals. All of them require that to qualify for SRS you must meet--at a minimum--the following five basic requirements:
* Provide at least one recommendation from a transgender-knowledgeable therapist
* Have taken female hormones prescribed by a physician for at least six months
* Have undergone electrolysis to remove facial hair
* Have lived full-time as a woman (at the office and on the street, as well as at home) for a minimum of six months (some insist on a year)
* Provide proof of all these to a clinic specializing in the surgery
There is sound sense behind all these steps, and good reasons why no qualified SRS surgeon will accept you if you skip any of them. For one thing, this five-step process allows you to explore your emerging womanhood one step at a time. Thus you spend a few months with a therapist exploring whether or not this is the right path--before beginning trying hormones and electrolysis. Then come more serious steps like cosmetic surgery and living full-time in the role of a woman. Last comes the most irrevocable step--sex reassignment surgery itself.
There is another rationale for this process as well. According to psychotherapists who have studied transexuals, your essential self is--and always has been--female. Since you have always belonged mentally and emotionally to the female gender, it isn't your gender that is changed during surgery, hormones and the rest of the reassignment process, but your physical body and sexual organs. Hence the term "sex reassignment" surgery. Therefore, each required step in the entire sex change process--from seeing a psychotherapist, through working with an endocrinologist and electrologist, to breast augmentation and the final reconfiguration of the genitalia--is viewed as an essential step in one long therapeutic procedure. A procedure intended to heal the discontinuity between your gender and your body's sexual anatomy. However, a sex change doesn't just involve bringing your body into correspondence with your psyche. After years of being "raised" and perceived as a male, it involves changes in your psychology and emotions as well. Thus the need for living in the role beforehand, along with the guidance and support of a qualified therapist.
(For more on this subject see "The Harry Benjamin Standards of Care" Appendix II.)
How do I find a supportive therapist?
From beginning to end of your transition from male to female, your most valuable resource will be your MtF sisters--especially those who are farther along the path than you. If you want to know where to get started, how to find a psychotherapist, the name of the best endocrinologist in town (or the cheapest), which plastic surgeons to see--even simple things like where to buy clothes and who gives makeup lessons for girls like you--it's other transwomen like you who can supply the answers. There are hundreds in every major city who are thinking about having, or have already had, SRS. They have gone through this process step-by-step, and will be delighted to share what they have learned with you. They consider themselves your sisters (in the same way that "genetic" women consider themselves each other's sisters), and you should begin to think of yourself as part of a very special sisterhood too.
It's easy to locate your sisters. There are support groups for MtF identified individuals everywhere. They will be eager to welcome you and assist in your progress. (You can locate the nearest by contacting one of the national organizations listed in Appendix III.) Or, you might try calling the nearest gay and lesbian community center, as they generally liaison with, and will know of, local transgender groups.
How expensive is sex change surgery?
Actually, SRS itself is relatively inexpensive. Surgeons can give you a vagina, vulva and clitoris--so realistic that even gynecologists can't tell the difference without a very close examination--for less than the price of a mid-sized car (and that's a heck of a bargain in any transwoman's book). Currently SRS clinics charge $9000 to $35,000 for the operation, depending on which procedures they use and their location. Many fine clinics outside the US charge less, for instance, than U.S. surgeons. (See Chapter 6 for more on SRS and its costs.)
Note: While SRS itself can be relatively inexpensive--as with a new car, the ancillary options, such as breast enhancement, electrolysis and cosmetic surgery--can run the final price tag up quite a bit. In 90% of all cases, it is not covered by health insurance policies.