Gender Vs. Sex

Recently I had a conversation with my in-laws about a “Gender Revealing” party they saw on television. The expectant couple had the ultrasound technician find out the sex of the baby, write it on a card, and the couple didn’t peek at it. (Now that’s self-control!) They gave the card to a bakery, and a special cake was made based on what the card read.  At the “Gender Revealing” party, when they cut it open, a pink or a blue cake was discovered, thereby revealing the “gender” of the baby to be. My response? “I went to a party like that! Except they called it a ‘Sex Party’, which is what it was… they were revealing the sex of the baby, not the gender.  The true gender won’t be revealed until the baby is much older.” The blank stares I was met with weren’t surprising. So few people ever think of the distinction between gender and sex, but due to my work and experiences with loved ones, I understand how important this distinction is. Do I need to be educator at every turn, or explain the distinction any time someone mentions something like this? Probably not. But, the reason I do it is this: the more people in society who understand the distinction between sex and gender, the better off gender nonconforming people will be.

To be perfectly clear… sex refers to genitals and sex organs; either male or female genitals/sex organs make one biologically male or female.  One’s gender identity comes from the brain, and may or may not align with one’s sex.  I believe gender identity is something that is formed in the womb along with the genitalia; sometimes they just don’t match.

Gender is in reference to what a person feels like as a result of having a male or female brain.  If one identifies as having a male gender, he is most likely going to be comfortable with being called a male name, having male pronouns used for him, and will want to present as male. If one identifies as having a female brain or gender identity, she is going to want to be referred to by a female name, female pronouns, and will want to present as female.  Often I simplify this so-not-simple concept with this question: “When you check out at the grocery store, do you want someone to say ‘Thank you, Ma’am’, or ‘Thank you, Sir”?  I say this because it relates it to an everyday experience which we all can relate to. It just wouldn’t feel right to ANY of us if someone addressed us with the “wrong” title. In these everyday experiences, sex organs don’t matter, but brains certainly do. And yet transgender individuals have to deal with being referred to by the “wrong” gender (due to their sex) often for years before transitioning.

So when a baby is born and the parents hear, “It’s a boy!” or “It’s a girl!”, that is a statement of what sex the baby is. One’s true gender (may match the sex, or may not) is revealed much later when the individual becomes old enough or aware enough to express the gender identity of their brain.

What Are You Going To Do About It? (Deciding About Transition)

I’d like to talk about two very important arenas of working with transgender people: one is their gender identity, and the other is what they are going to do about it.  One is who you ARE, the other is what you DO.

A woman I was speaking with recently made reference to a transgender acquaintance of hers: “He is in the process of becoming transgender.” “Transitioning”, I said. “What?” she asked. “Transitioning is the process”, I said.  “Being transgender is who he is.”

One does not “become” transgender. One is born transgender.  What one eventually does with that is an entirely different issue, and is different for every individual.

Understanding, knowing, discovering, realizing one’s gender identity is a unique process for everyone. Some people understand what gender they are from the very start, never think about it, and never have to worry about it, not even once in their entire lives. These people are usually those whose biological sex match the gender of their brains. For transgender individuals, coming to understand their personal gender can look many different ways. Some have an immediate sense of identifying as the “opposite” gender (forgive my reference to the gender dichotomy!) and depending on temperament, family influence, etc. that awareness can cause very different levels of distress in the individual. Some are vocal about it, since childhood. Some guard it like a secret. Some don’t really know exactly what’s going on, but they have a sense there is something not quite right. Some individuals don’t realize their gender doesn’t match their biological sex until they are much older, but when they do, a lot of pieces fall into place. (Having a child or family member not realize until they are much older is often more difficult for the family members, but that’s a subject for another blog!)

By the time a client makes it to my office, they are usually pretty darn sure about their gender identity. In fact, MOST transgender clients I come into contact with are completely sure of what gender they are. I have been known to facetiously say, “that’s the easy part!”.

After understanding and coming to peace with one’s gender identity, the next task is deciding what they are going to DO about it. For those of you not completely savvy with all the concepts and terms, the process of aligning one’s biological sex with one’s gender identity is called “transitioning”.  Mainly this includes changing one’s appearance, name, and pronouns to “present” as the gender with which they identify. It often includes hormones and sometimes includes surgery.

This is the hard part.

Much of the agony for my clients comes from not trying to figure out what gender they are, but what they are going to do about it. Transitioning from one gender to the other, and coping with all that entails, is a very scary thing.  Some clients will come saying they identify as “third gender” or something in the middle. (Of course, some people really feel this way, and they refer to themselves as genderqueer. In this blog I’m discussing those who ultimately identify as transgender.)  What usually causes someone who is transgender to say this is the fear of the transition. In this case it is the “what to do” wreaking havoc on the “who I am”!

In my experience with my clients, fear of transitioning mainly comes from outside sources.  They may fear the reaction of significant others, family members, co-workers, or society at large.  If the fear of this remains greater than the desire to make themselves happy by aligning their body with their mind, the transgender person may decide not to pursue transitioning. This does not make the person any less transgender. It just means too much got in the way of doing what they needed to do for themselves, to make themselves happy.  Having a transgender person decide not to transition is not cause for a sigh of relief, it is often cause for concern.  Not transitioning due to fear of reactions or to please others may be the recipe for an unhappy future.

For some, deciding to transition is easy, even if the process is still a challenging one. Once their gender identity is realized, transitioning to match their body and outer appearance is a natural next step. For many transgender individuals, transitioning is a very positive process, one that brings much relief, joy, and satisfaction.

It’s my wish that over time, with an increased understanding of what it means to be transgender and extensive de-pathologizing of the concept, the gap between who someone is and what they are going to do about it will become much, much smaller.

To my transgender friends, clients, and blog followers, I’d love to hear your feedback about this! Either comment on this blog or email me privately. Thanks as always for reading!

Published in: on July 28, 2011 at 9:04 pm  Comments (11)  
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Pride Parade 2011: Marching with the “T”

 

 

I had the honor of marching with the transgender contingent in the San Diego Pride Parade on Saturday. This was my second time marching, the last time being 3 years ago. In 2008, some clients of mine were marching, and I knew others from the FTMI meetings I attended. This year, I didn’t know anyone marching ahead of time and I wasn’t sure what reception I would get when I introduced myself.  Trying to find the group, I walked past the bold, bright floats of the other contingents; loud music, dancers, bubbles, and of course, a lot of rainbows. When I got to spot #119, I almost walked past it. There were about 6 people; 3 sitting on a curb, 3 standing up. I couldn’t believe it. I thought, “This is it?” I shouldn’t have worried about the reception I was going to get; when I introduced myself as an ally and said I was there to march, those in the group were welcoming. Most of them commented on and liked my sign: “Celebrating Trans Bravery”.

 

As the time to march grew closer, more people gathered. One trans man who was slated to march with Canvass For a Cause (a very trans-friendly employer, I hear!) opted to march with the transgender contingent. When his co-worker walked by and asked why he wasn’t marching with them, he said “the numbers were kind of low in this one so I’m going to march here instead.” I was impressed.

 

I felt honored to march with these people; heroes in my book. To march and be recognized as transgender is a brave thing to do, especially considering (at best) the lack of knowledge about this group and at worst, the stigma.  Those who march are doing important work. As one sign said, they are sending the message: We Walk Among You. Without those daring to walk, the transgender community would be even more invisible than it already is.

 

One of my former clients jumped in near the beginning of the march and I felt a surge of pride walking beside him. It’s quite amazing to know his journey from pre- to post- transition and to see the man he has become.

 

At its highest, the number of people in our group numbered around 17. No music blaring, no bubbles blowing, no beads being thrown. Just 17 people with a banner, some signs, and some flags. Pretty amazing considering this parade is for the LGBT community; THOUSANDS of people marching to represent the letters LGB and 17 to represent the T?!

 

I’m sure there were plenty of transgender people marching with other contingents, for other causes.  I just couldn’t help but think of how important it would be to have a large, vibrant group to represent this under-acknowledged part of the LGBT community.

 

Of course, I would love to do a “call to march”; enlist my clients to walk with the group next year, explain the importance, coerce if necessary! But I wouldn’t do that.  I understand why most people opt not to march. It’s a private issue, and one that most people don’t care to broadcast. I understand when those who transition would rather move on than stay to be the poster children of the trans community. There is no judgment on this issue from me, and I respect each and every decision made about whether or not to march, or to be stealth. Those who have transitioned and are now stealth are also heroes to me; they have undergone a more challenging process that most will ever know.

 

Somehow we need to figure out how to get the numbers up; to make the transgender contingent better represented. Perhaps more friends, family members, and allies need to be stepping up to celebrate and normalize this group of heroes.

 

My client remarked to me that when he first started marching with the group several years ago, the group would get “crickets”.  Why is that? Is it because even in their own community, they are misunderstood? Does the crowd not know where this group fits in? Or are they picking up on the energy of the group? The mood of the group when marching can admittedly be hesitant at times.  This year, when those of us in the group marching would cheer, or wave, the reception was positive.  Gone are the crickets! Later my client said he noticed an improvement in the response of the crowd each year he’s marched.

 

A big reason why I march is because I want to say to everyone who will listen: “It’s ok to be transgender.” In fact, not only is it ok, but transgender people deserve a lot of admiration and respect for the process they have to go through to be true to themselves. So, because I can’t sit down with each person in San Diego and explain this, I cheered, I held my sign as high as I could get it, I waved, I smiled, and I looked at as many people in the crowd as I could.  I hope they heard my message.

Published in: on July 18, 2011 at 9:29 pm  Comments (1)  
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Important Medical Info for Trans Men

I finally watched the documentary “Southern Comfort”; it’s one I’ve been meaning to watch for years. I wouldn’t recommend it to someone trying to find out more about the trans community, but it addresses a VERY important topic. It’s the story of a Female to Male transgender individual named Robert Eads, who died from ovarian/cervical cancer after being refused medical treatment. It shocks and saddens me that anyone in the medical field would refuse to treat someone in need of help, regardless of their race, gender identity, social status, anything… and as recently as 1999!

The main reason the doctors cited not wanting to treat him was that it might make the other patients in the waiting room uncomfortable or that treating him would damage their reputation. As a result, over the course of the movie you see a very vibrant and loving person diminish and then pass away.

However, I’m not necessarily writing this blog about the outrage of refusing to treat a trans individual medically. The main reason I chose to write this is to remind trans men: if you still have a cervix, ovaries, or a uterus, you are at risk for cancer in these areas! I know reading this, thinking about this, or talking about this is just about the last thing you want to do, and many trans men avoid the tests for these cancers like the PLAGUE. Having a pap smear is an uncomfortable experience at best for most women. For trans men, I can only begin to imagine how awkward/humiliating/discouraging having to go to one of these appointments must be. PLEASE GO ANYWAY. It’s better to feel like you’re going to die of embarrassment then to actually die of cancer. Yes, I am trying to scare you into going. To quote Mr. Eads himself, “The last part of me that is female is killing me.”

I have a couple of practitioners in San Diego to whom some of my trans male clients have gone for these types of exams, and have had nothing but nice things to say about the doctors. In addition to this, I have called both of these doctors’ offices and asked if they are open to having their names on my resource list for my trans male clients. They both said yes! Please see the bottom of this post for their names and contact information.

If you don’t have medical insurance and can’t afford to pay out of pocket for these providers, there are some low-cost clinics in San Diego that could perform these tests. If you don’t live in San Diego and you need help finding a place to go, email me and I will help you research this. Or, if you are too shy or scared to call a doctor’s office to find out if they would be trans-friendly, let me know! I will call for you. Client or not…even if I’ve never met you.

Once you have an appointment, one thing you can do to make the experience more comfortable is call the doctor’s office or clinic the morning of your appointment. If you are too nervous to do so, have a partner, family member, or trusted friend do it for you. You or they can let the front desk staff know who you are, what you will be seen for, and how you present so there is no confusion when you arrive. You may need to gently remind them they are to use male pronouns and your chosen name (if not yet legally changed).

One important point made in the documentary is that since Robert transitioned later in life, he was close to menopause. Because of this, he was advised he did not need to have his uterus and other female reproductive organs taken out. I believe the loose guideline for getting a hysterectomy after taking Testosterone is 5 years. If you are an existing client of mine and need a letter to have the hysterectomy performed, let me know.

The most important thing is that you don’t ignore this.

Come on, be a man… go get a pelvic exam!

For more information go to:

http://www.ftmguide.org/tandhealth.html#pap

http://www.checkitoutguys.ca/

http://www.ftmguide.org/hysto.html#why

San Diego Providers:

Dr. Alisa Williams*

619-299-3111

4060 Fourth Ave Ste 640

San Diego, CA 92103

*Dr. Williams also does hysterectomies

Dr. Laura Norton Petrovich

(619) 435-2234

1224 10th St Ste 200

Coronado, CA 92118

National Association of Social Workers policy on gender

In Kim Pearson’s talk at the LGBT Center on May 23, 2011, she mentioned that NASW had one of the most comprehensive policy statements on gender non-conforming individuals. Below is an abstract of the public policy statement. One of the many reasons I’m proud to be a social worker!

Transgender and Gender Identity Issues

NASW supports curriculum policies in schools of social work that eliminate discrimination against people of diverse gender and encourages the implementation of continuing education programs on practice and policy issues relevant to gender diversity. In addition, to foster public awareness, NASW supports collaboration with organizations and groups supportive of the transgender community to develop programs to increase public awareness of the mistreatment and discrimination experienced by transgender people and of the contributions they make to society. NASW also urges development within schools and other child and youth services agencies of programs that educate students, faculty, and staff about gender diversity and the needs of transgender children and youth. Further, among other activities concerning transgender expression, NASW advocates for:NASW recognizes that there is considerable diversity in gender expression and identity among our population and believes that people of diverse gender — including those sometimes called “transgender” — should be afforded the same respect and rights as any other person. Discrimination and prejudice toward anyone are socially, emotionally, physically, and economically damaging. A nonjudgmental attitude toward gender diversity enables social workers to provide maximum support and services to those whose gender departs from the expected norm. Social workers must encourage the development of supportive practice environments for those struggling with gender expression and identity issues, including both clients and colleagues.

  • education and support of parents of intersex children;
  • development of and participation in coalitions to lobby for the civil rights of people of diverse gender expression and identity;
  • increased funding for education, treatment services, and research;
  • repeal of laws  and discriminatory practices, especially in employment; and
  • adoption of laws to facilitate individuals in identifying with and expressing their gender choice in education, housing, inheritance, health and other types of insurance, child custody, property, and other areas
Published in: on May 29, 2011 at 10:07 am  Leave a Comment  
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Trans Youth Family Allies

On Monday 5/23/11, I had the pleasure of listening to Kim Pearson speak at the LGBT Center! I have heard so much about her, and I was thrilled to finally get to meet her in person. Kim is an amazing woman and mother of a trans individual. She is the Executive Director and co-founder of Trans Youth Family Allies (TYFA), an organization that connects and supports families of trans children. The “little t” in LGBt, as Kim would say! 🙂 Her organization plays a crucial role in advocating for and educating for this underserved population.

I approached her after the talk and told her we must connect, so the next day we met up for coffee.  It was wonderful to talk to someone who is so passionate about working with gender variant and transgender children, and completely validated my beliefs about the work I do with them. As she said at the end of our meeting, “It’s so nice to meet like-minded people!” Likewise, Kim! Thank you for all the work you do. See the link below for more information about Kim and TYFA.

http://www.imatyfa.org/aboutus/bio-kimpearson.html

Also, consider donating to keep this AMAZING, volunteer-based program alive. http://www.imatyfa.org/permanent_files/donate.html

Stay tuned for more blogs about valuable information and insights I gained from connecting with Kim.