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Female to Male Breast Reconstruction

The great challenge in reconstructing a male- appearing chest from a female breast is the management of the overlying breast skin. There is always a “skin excess” when the underlying glandular and fatty breast tissue is surgically removed. One goal in gender reassignment surgery is to manage this skin excess with a minimal amount of scarring. Excess skin can easily be cut away but every incision in surgery leaves a scar — the challenge for the surgeon is to remove this excees skin and to “hide” the incisions in natural folds, previous scars, or in the pigmented skin of the nipple-areolar complex.

The most critical factor in determining the appropriate procedure for each patient is the breast size. A very large breast (C-cup or larger) always requires a more extensive incision or series of incisions. Obviously, the larger the breast size, the more overlying skin there will be left to manage after the underlying breast tissue is removed. My preference for the large breast is to place an incision in a horizontal direction with a gentle curve that follows the curve and lower border of the pectoralis muscle. This scar, although it is long, can heal very nicely and can be “hidden” in the fold that is created by the well-developed pectoralis muscle. With a long incision, there is no problem removing the skin that is in excess after the breast tissue is removed and this procedure can be performed in one stage with only a small percentage of patients requiring any surgical revisions. Chest hair growth is also very beneficial in helping to conceal the scarring. With this procedure, I often will completely remove the nipple areolar complex, decrease it to the appropriate size, and replace the nipples in their new elevated and more lateral position as skin grafts. Liposuction also is an integral part of any breast reconstruction surgery to help create a smooth contour and transition from the breast to the surrounding chest wall.

The B-cup breast size has always created controversy for the plastic surgeon. A patient could be evaluated by 10 different surgeons and receive 10 different opinions on how the procedure should be performed and where the incisions should be placed. Common incisions used are: 1) the inverted “T”, 2) a horizontal incision on either side of the nipple, 3) a vertical incision under the nipple which curves outward near the fold of the pre-existing breast, and 4) the peri-areolar incision.

My preferred incision for the B-cup breast and smaller is the periareolar incision. The average male nipple-areolar complex (NAC) size is about the size of a dime or slightly larger. The average female NAC size is about the size of a half dollar, but it will be much larger in larger breasts. An incision is always made around the entire border of the NAC to reduce the size. This incision is called a periareolar incision. Because this incision is placed at the junction where the normal skin joins the pigmented or colored skin of the NAC, this incision can “hide” nicely and can appear to be the border of the pigmented skin. The excess skin is removed in a circular fashion around the NAC. The challenge is then to close the large skin circle to the dime-sized new NAC. The discrepancy in size of the outer skin circle to the inner circle (NAC) creates a very pleated skin closure — much like a drawstring purse. With normal healing, all skin will contract and tighten. We are relying on the skin contraction properties (which are different in each patient) to tighten the skin and to reduce the appearance of the pleating. Almost every patient will require a minor surgical revision to manage persistent pleating after the first stage procedure. If bothersome pleating exists after the revision, then the patient and surgeon must decide on creating another scar and in which direction. Often this additional scar or scars will be short and well-accepted by the patient because residual pleating rarely extends for more than an inch from the border of the NAC. Obviously, if the scar can be limited to the periareolar incision, this is the most desirable situation as there would be no obvious scarring that the patient might have to “explain” to someone when the chest was exposed.

In summary, the goals of female to male breast reconstruction surgery are to remove the glandular and fatty breast tissue with a smooth transition to the surrounding chest wall, to decrease the NAC size, and to perform the surgery with acceptable and minimal scarring.

Originally published in 1998 True Spirit Conference book.

Gender Reassignment Surgery: Female to Male Breast Reconstruction

By Beverly A. Fischer, M.D, 2002, amboyz.org

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Transgender Pride

A person I shall call “G.” wrote:

Dear Gender Gifted Brothers and Sisters

Last thursday I visited a friend of mine who had her surgery two months ago. It was somewhat frustrating trying to communicate with her as she appeared rather depressed, or aggressive, or whatever, I don’t know how to describe that kind of mood. I just knew her since shortly before her SRS, and obviously she was very happy in, looking forward to it. Her first reaction after the surgery was that now she was not a ts any more, now she could start living as a normal woman without having to think about all those problems. Now, two months later, she was rather angry (or how should I put it) about the fact that the neighbour’s kids (for example) still call her “Sir” (I suppose they do that because it upsets her, which they find funny). I wonder if she seriously expected strangers to notice the difference. I don’t think she’s walking around naked in the neighbourhood.

She used to have two ts friends (other than me). One got her surgery some four months ago. She had (has?) a relationship to a guy who considers himself gay and tried to convince her not to have surgery because it would be the end of their relationship. At the hospital he showed up and said it was over, but since she didn’t have anywhere else to stay she went to his place after the surgery anyway, and they continued the relationship. However, he told her that she would have to stop dress en femme etc. as he could only love her if he saw her as a man, and she apparently accepted that. So she broke up with all her ts friends (including my friend) because she had to live as a man.

I hope the story isn’t true. Not only because it’s terrible, but also because it would be bad PR for the relatively liberal Dutch SRS policy.

The other friend of hers send her a postcard last Christmas, in which he explained her that he had decided to halt HRT and live as a TV, and that he didn’t want to have any contact with any ts people anymore.

Then she asked about how things are going between me and the gender clinic, and she came with the most incredible suggestions, obviously being somewhat out of her mind. One suggestion was that I should just go to Iran (where you can have anything if you have a credit card) and have the surgery done right away instead of going through this lasting Dutch SRS permission procedure. They would just give me an enormous doze of hormones which should be good for one year so that I wouldn’t have to buy hormones on the black market.

The other suggestion was that since I don’t parse it would be better to dress as a man. This is similar to some suggestion I got from this newsgroup when I complained about the difficulty of finding a job as a not-passible pre-everything ts. It was somewhat frustrating not being able to make her understand that while this stay-in-closet approach may work for a good actress in an intolerant social environment, it is both impossible and unnecessary for me.

I think I will try to explain it to her in letter. It is sometimes difficult to talk when you are a little but pissed of with each other. And Dutch is a foreign language for both of us.

Thanks for reading this.

G.

I responded:

Hi G.,

This is a very sad story that you have told. Thank you for sharing, even if it is so painful.

It does bring up some difficult issues related to surgery. Surgery really does only two things. Obviously, it makes significant changes to one’s genitals. Second, to the degree that one’s self-image is tied to one’s body, one’s self-image will change. But that’s it. There is no magic. Surgery does not change your past. Any human being who rejects such a sigificant part of hir past is running an extreme risk of emotional difficulties. This is why I have such trouble with the idea of a “former ts”; “former male” I agree with, but our heritage of being transgendered will stay with us forever. It is not a bad heritage, but it is one that many of us have trouble accepting.

Given her rejection of her male past, I can certainly understand her difficulties and her bitterness. There is an aura of magic about surgery, and it does lead to problems. I have lost my best friend in the community to this same issue, because she does not want reminders of her past in her new life. I am one of those reminders, simply because I knew her before, and I am a part of what she no longer wants to associate with–or perhaps more to the point, what she doesn’t want associated with her.

It is also a caution to all of us to be sure that our support networks are in place, and that they are truly functioning to support us. It is one thing that she had those neighboring kids calling her “sir”; it was almost certainly a taunt, destructive and mean-spirited. It takes a lot of positive support to balance these insults. But the boyfriend who wanted her to remain male–well, I don’t think I need to explain to anyone here how destructive that could be, and apparently is.

It is one thing to know that we are one the right path, but few enough of us are strong enough to walk that path alone. We need our support within the community. We need our support in every-day life, too; our friends, our social circles, the people we work with, and our relationships, for those of us who have them. When those around us work against us, for whatever reason, we need to find ways to balance the negative influences, or change them, or eliminate them if necessary. No one needs to be hit over the head with a club when we are trying to come to terms with our identity, or to make the changes that are necessary to live our lives as we choose.

For G.: I’ve let some distance grow between myself and this community, so forgive me for not being current with your situation. There are few enough of us who pass flawlessly; the rest of us, including me, have to adapt to being read some of the time. My experience has been that it is much easier to deal with these incidents if I expect them, and if I don’t make an issue of them. Yes, sometimes they hurt. Most of the time, though, I simply don’t worry about it. If it happens, it happens. I’m still me, I still know who I am, and I am still proud of the fact that I am living the life that I want to live and need to live. Getting read takes nothing away from who I am.

Over time, hormones and electrolysis do make a tremendous difference in passability. Some of us are impatient, though, and I certainly do understand that! When I was pre-everything, I didn’t pass well at all, and there were some who didn’t think that I ever would. But that has changed, even to the point of passing in jeans, a simple blouse or t-shirt, and no makeup.

How we feel about ourselves makes a difference in passing, too. Fully accepting ourselves as women (or men) makes a difference in how we feel about ourselves, and how we treat ourselves, and how we present ourselves to others. Other people pick up on this in subtle ways, and the most important thing that they can perceive–in terms of how they react to us–is our own self-acceptance.

It is essential to learn and to remember that we were born as women, or as men. What we have between our legs does not alter that. What other people see from the outside does not alter that. We are who we believe that we are; those feelings are too deeply rooted to be changed, ever. When the body does not match, it can set up a terrible conflict, and it is that conflict that causes us to suffer. Not our womanhood or manhood, but the conflict between mind and body. Changing our bodies is part of the resolution of that conflict. But the other part of resolving the conflict takes place in our minds, not by rejecting the gender that we feel, but simply by accepting the fact that we were given this conflict to resolve, that our experience of life will be different because of it. Not better, not worse, but different and uniquely ours.

We have every right to struggle to achieve our true identity. We have every right to be proud of what we achieve in the struggle, because we know the pain that each of us has faced, and we know that this pain has killed others. We have every reason to be proud of who we are, and that we have come to peace with this conflict, by whatever path that we need to take.

This is what transgender pride is about. It is about being true to ourselves, to both our true gender that has come to the surface after being buried and rejected for so long, and to our heritage, which includes the struggle and the pain, as well as the triumph. It is about taking our true place in the community, and not accepting when others see us as less than we are.

We have no reason to be ashamed of who we are. We are human, and we are strong. When we live as our true selves, other people will perceive this and understand this. Pride in ourselves is an important part of passing, because what I want in my interactions with others is to be respected, and that respect starts with me.

—————

In another context, I wrote:

Speaking of which, in private email with another person in swlab, I mentioned that “out and proud” is something that you don’t hear very much in the trans community.

R. responded:

Makes sense to me. I mean, I’m quite happy being lesbian. If I had a button I could press that would make me like guys, I wouldn’t press it, not for anything. But being TS is a bit different. I don’t think there’s anything to be ashamed of, but what’s to be proud of? A woman should be proud that she used to have a messed up bod that looked like a guy’s?

To which I responded:

There is a lot to be proud of. I have an unusual heritage–not unique, but unique within the experience of many people who know me. Although my experience of life is different from that of single-gendered people, I know some of what it means to live as each gender. This has been useful, both to me, and to others with whom I share my life, even when the topic has little to do with what we tend to think of as gender issues.

I have learned to deal with difficult issues, both internally and in relating to others. In itself, this is something to be proud of. This, too, is something that I can share with others, because we all experience difficulties in life, and for many of us there are common problems that we face, including depression, isolation, shame, anger, and fear. Single-gendered people can and do learn from my experience, and I am happy to be able to share in ways that will improve and enrich their lives.

But pride runs deeper than that. Although I might not have chosen this life, I can truly say that I like who I am. I don’t like everything that has happened in my life–who does?–but I like the person that I have become. That includes the part of me that is transgendered.

Being transgendered gives me a different outlook on life. It has given me a keen appreciation of ambiguity and irony that helps me understand so many things in this world. It has been, and continues to be, a rich source of humor, something which I need every day in order to survive. It is ambiguous, and sometimes even absurd, but then so is much of the rest of life. Being transgendered helps me to appreciate the richness of life, its diversity, its pain, and our triumphs over that pain.

What is there to be proud of? The same things that any person can be proud of–who we are, what we have made of ourselves, what we leave behind for the benefit of others. Being transgendered has made me a better person than I would have been otherwise, all other things being equal. Why would I not be proud of that?

firelily.com/gender/diane/tgpride.html – 2002

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Transgender Employment and Job Seeking

Transgender people comprise 0.3 % of American adults, or about 700,000 people, according to a 2011 study by the Williams Institute. And their unemployment is 2X the rate of the general population, with athema also 4X more likely to live in poverty (according to the 2011 National Transgender Discrimination Survey, (n=6,450.) The challenge then is how do we get our community employed and above the poverty line?

The U.S. Equal Employment Opportunity Commission (EEOC) ruled that discrimination based on gender identity is sex discrimination, triggering Title VII of the Civil Rights Act of 1964. President Obama has also signed Executive Orders protecting federal employee and federal contractor transgender workers. Some states and localities have passed laws protecting transgender workers. Despite this, many transgender people struggle to find work.

And now, many states are are pushing back and try to remove protextions for the transgender community, just as President Trump announced his intensions to block the trans community from serving in the military.

Aside from the surface issues of presentation, (how you look) there is the issue of legal identification. Almost all job applications ask for legal name, social security number, and past references. If you haven’t changed your name yet, you face the ugly requirement of putting your legal name on your application instead of your gender conforming name. You may also have to check the dreaded M box instead of the F, or vice-versa.

Macy’s, no doubt as a result of the Macy vs. Holder decision, has adopted a very trans-friendly application that adds a space where you can put down the name you prefer to be called by, in addition to your legal name.

Companies can’t get around the legal name issue for obvious reasons. Even if you have changed your legal name, you have to deal with all of your references knowing you by your birthname. So many transgender people wonder, often with some level of desperation, how they will find gainful employment other than the local street corner. Below is some advice to help you land a decent job.

LGBT Job Fairs

Hey, if companies have tables at these, they are looking to hire you! That should give you a great confidence boost. Even if they are looking for the L or G component, at least you know your odds are better than a blind interview. Affirmations in Ferndale, MI has a LGBT career fair, and many large cities host LGBT career fairs. You may have to travel, but you hook up with some local girls and make a day out of it while you are there. Getting hired will take some effort; be prepared to put some mileage on your car and be prepared (and willing) to relocate.

LinkedIn

I have to admit that I’ve been a bit disappointed with this one, but it is obligatory that you at least have a good profile there. Most HR departments will look you up online, and LinkedIn is one of the first places they look — so you need to have some good info on your publicly accessible profile. ou can also search for jobs and networks there, and it is good for at least seeing the ebb and flow of local jobs in your area.

Networking

As transgender people enter the workforce, we have an obligation to help one another. Flat out, yes we do. In the same way that there is an good ol’ boys network, there needs to be a “former old boy’s network,” (or former girl’s network.) Affirmative actio — regardless of your political views as to the fairness of it — helped African Americans. Employee support groups, both company led and privately formed, definitely helped move more African Americans into the professional workforce. We need to help each other in the same way, and this includes those closeted individuals who aren’t ready to come out themselves, but can definitely help a sister (or brother) out.

Be That Much Better

You need to be stellar awesome in your communications, interview, and preparation. The cards will be stacked against you, not only from being one of hundreds of applicants (potentially), but realistically because of your transgender status. You need to be that much better than everyone else so as to shine so brightly that your ability transcends your gender. Proper research on the company you are interviewing with is essential. Preparation, such as practice interviews, and presentation (dressing) skills are essential. Record yourself in a practice interview and lsiten to it over and over until you’ve worked out all the flaws. Get a friend to work with you. Let them ask off the cuff questions so you can get comfortable in your responses. You can learn a lot about what the interviewer sees; then work to correct any mistakes and perfect your responses.

Human Rights Campaign Foundation’s Corporate Equality Index

This is a great resource to quickly check up on how LGBT friendly companies are. Companies are rated on a score of 0 to 100. The higher the score the more inclusive the company is. You should also check out the company website and find their diversity and non-discrimination language. If they have transgender listed, then it is an indication that at least someone in HR is aware of transgender people.

Be Confident

Confidence is a huge asset! You are an asset tho the company, you know, and need to let them see and feel it too — without coming across as arrogant or conceited. There are many out there that will patronize you, and/or be condesending. Don’t let them. You can be confident is who you are and what you’re capable of contributing, all while maintaing your composure. Be upfront about your status, don’t hide it, but don’t overly volunteer more than they want, or need, to know. You may also have to walk the fine line between being a “crusader” and getting hired. Some questions that are put to you may be illegal, so do some homework and be prepared. But remember your goal is not to be confrontational, it’s to get hired. Grace and gentle education can go a long way. Finally, always follow up. You can never close a sale if you don’t ask for it. Proper manners and etiquette are always appreciated, but show them through your eagaerness and persistance that you want this job.

Take Acton if You are Wronged

If you are definitely discriminated against you are unlikely to sue — it’s expensive, time consuming, and in some cases very public. However, you could file a complaint with the Equal Employment Opportunity Commission. You can also inform national and/or local advocacy groups, such as the afore-mentioned Human Rights Campaign, or your local LGBT organization. At the very least, it will help inform others about how companies treat transgender people.

Hope this helps.

Jenni Contrisciani, MBA

08 April 2001 @tglife.com

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A Gay Track Coach Tells His Story

In the spring of 1993, Eric “Gumby” Anderson was scared.

He was a closeted gay man behind the “Orange Curtain” – the term commonly used to refer to the politically ultra-conservative Orange County in California. He didn’t know a single other gay man. And, he was also in the homophobic world of high school sports-track in particular, where no coach had ever come out in America.

Later that year, that changed.

Gumby-a childhood nickname that everyone knows him by-became the first openly gay high school track coach in America when he told the administration and members of his team at Huntington Beach High School that he was gay.

“I just couldn’t lie and hide anymore to anybody,” he says.

Today, he is anything but hiding. Still living in Orange County, he has a jumbo-sized rainbow flag flying from the front of his house. He has a rainbow flag on his car. He even has a rainbow flag on the screen door to his back patio. The license plate on his Avalon is “GAYRNNR.” And, he’s had a very high-profile part of the campaign to end discrimination against gays at the high school level for years.

“The only thing I’ve ever really kicked myself in the ass for was not coming out sooner,” he says.

His closeted past long behind him, Gumby has chronicled his long struggle to bridge the gap between sports and being gay.

In his new book, “Trailblazing: The True Story of America’s First Openly Gay Track Coach,” he tells an intense tale of the first four years of coaching as an openly gay man.

He brings the reader time and time again into the principal’s office to face unfounded allegations of sexual harassment and illegal recruiting. He gives us the vivid details of the brutal beating of one of the runners on his “Fag Team.” He also shows the incredible powers of winning, overcoming tremendous adversity, and sportsmanship.

oach Gumby, now 32, knows the role of coach well. A PhD candidate at University of California Irvine, Gumby has spent years researching the psychology of sports. He has published two books on the subject of distance running, delving into the subject at every level from motivation and enthusiasm to nutrition and injuries.

It should be no surprise that one of the areas he has spent the most time researching is homosexuality in sports. He has written various articles and academic pieces on the subject including his Master’s thesis, “Gays In Sport: Is It As Bad As They Say?”

“Trailblazing” stands out from the rest of his works. This isn’t a training program or an analysis of statistics or facts. It’s a very personal story that the author hopes will have a very different effect than his non-narrative works.

Gumby began writing the book as a research project-a possible chronicle of two Olympic runners, from high school until, hopefully, Olympic gold. After four years, he realized he didn’t have two Olympic-caliber runners on his hand; but he did have a gripping story of a team and a coach dealing with what it is to be gay in sports.

“I realized that what was going on in [my runners’] lives had to do with what was going on in my life, as I was coming out of the closet as an openly gay coach,” he says.

It is very hard to find an openly gay coach at any level, as most choose to stay in the closet. In fact, Gumby is one of only two known openly gay high school coaches, the other being Dan Woog of Connecticut, the author of “Jocks,” a book about gay athletes.

When you hear Gumby’s story, it’s easy to understand why so many coaches fear what could happen to them if they are outed.

Within days of coming out, Gumby came under fire from the school administration. On a daily basis he got notes in his mailbox to “please see the principal.” He was asked about his reasons for coming out and accused of making sexual advances on his runners, illegally recruiting other runners, holding illegal practices, or any of a number of other missteps. Often these were “anonymous.” They were always unfounded.

As if that were not enough, while Gumby was being attacked by the administration, his team was being attacked by their classmates. Labeled “The Fag Team” both in their school and by other cross-country teams around the county, the Huntington Beach runners were assaulted verbally on a daily basis. Their cars were keyed. They were forced to change in the bathroom rather than the locker room. Sometimes they were even physically attacked.

“I’m not the hero,” says Gumby. “The heroes are the kids who chose to fight this fight.”

The situation totally consumed Gumby.

“With all the crap that was going on,” Gumby says, “I was running around putting out little fires, and trying to prevent big ones from happening non-stop, so I had absolutely no social life. Zero.”

Of course, that was the particular situation he had to deal with. In much of Orange County, being openly gay carries risks. And, to make matters worse, he was coaching boys, which helped feed into the hateful stereotypes. Being the first and feeling isolated meant added pressure.

“24 hours a day I lived, breathed, ate Huntington Beach High coach. I had something to prove to the world about gay coaches or gay athletes. There was a period when I had to win. It was the proof. So, that attitude and love just didn’t seem to go hand-in-hand.”

And win he did, bringing national attention to a perennial loser in Orange County, winning the County Championship in back-to-back seasons, sending various runners to Division I colleges and sending a team to the California State Meet for the first time in school history.

uickly, track began to be less and less a part of Gumby’s life and started to become his life.

“I wasn’t just going out there coaching, and the kids racing on the weekends,” he says “There was so much more involved; so much more going on.”

All of this also led to a non-existent love-life for Gumby in those days. “Love and track don’t seem to mix,” he says in his book after a short section on his first boyfriend.

Despite all of the meetings with the principal, hearing “fag” every day, and having to constantly take a larger role in the lives of his runners, for Gumby, coming out was an important part of his coaching.

“I didn’t come out until I was 25, and one of the reasons I didn’t come out is because I didn’t know anybody [who was gay]. I knew I had gay runners out there, there’s no question about it, and I knew that me being out would give them a breath of hope-that they’d think, `Yeah, there are other people out there, I’m not the only one.’ ”

Certainly not. Since coming out, Gumby has had seven of his own runners come out to him.

“I really am a lousy recruiter,” he says. “They ought to take my toaster back, because, for all the athletes that I’ve had, I certainly didn’t get many out of the closet.”

“Lousy recruiter” or not, Coach Gumby could never have been called just an “ordinary” coach.

“The average perception of a coach is somebody who goes out there, blows a whistle, tells athletes what to do, and goes home. That’s not the kind of coach I am. Coach and friend go hand and hand.”

Which is a big part of why his runners continue to stay in close touch with him, and continue to call him “Coach” long after they’ve graduated.

At a recent book signing at his house, most of the major characters of “Trailblazing,” including UCLA National Indoors 800 Champ Jess Strutzel, were there to offer their support and “hang at Coach’s place.”

Gumby’s new “in-laws” were also there, a sign that he has even managed to make the bridge between love and track. He has had a boyfriend, Grant-Tyler Peterson (right), 20, for two years. Grant-Tyler is a senior at UCLA and just starred in the school’s production of “Fahrenheit 451.”

Though he presently doesn’t have to balance his personal life with coaching runners on the track, Gumby continues to coach gay teen athletes in life. Many of them are scared and confused, wondering how they can be an athlete and be gay at the same time.

Gumby say the environment has changed a lot for the better in the seven years since he’s come out. His doctoral thesis is on the 42 openly gay high school and college athletes he has found. He hopes a more accepting society translates into more athletes feeling comfortable being open about their sexuality.

Many young gay athletes find him through his Website, coachgumby.com, which features his e-publication for gay teens, The Gumby Gazet. They contact him looking for advice and someone to confide in. They come from all over the country from all different sports. The word on the Web is, if you’re a gay teen athlete, you’ve got to track down Coach Gumby.

“I saw my book in Barnes & Noble on the shelf and I thought, ‘Some 16-year-old kid is going to pick this book up and is going to get a lot of inspiration out of it.’ And so, what this all means is that this is going to help somebody, this is going to help a lot of people. At least, that’s my goal.”

That 16-year-old couldn’t find a better coach. While he’s anxious to get back to coaching runners, right now Gumby’s just focused on changing the world.

By C. Zeigler, Jr. Out sports – 2000

Posted on by Queer News

My Teenage Son Wants to be a Woman

Beth Thomas always knew her son Adam was different she just couldn’t put her finger on it. At times she grew despondent at his mood swings. Adam was spending more and more time alone in his bedroom and when Beth asked what was wrong he wouldn’t answer properly.

“I’d always wondered if Adam was gay,” says Beth, 49, an office manager from Southend, Essex. “Even when he was growing up he’d always choose girls’ clothes instead of boys’ and play with the girls at school. I thought it was just a matter of time before he told me.”

But a few years later, when Adam was 18, he dropped a bombshell. He wasn’t gay but he wanted to change sex.

“I knew telling Mum would be one of the hardest things I’d ever have to do,” says Adam who’s now living as Zoe. “She’d always been quite open-minded but I knew telling her I wanted a sex change was going to be difficult. It would be hard for anyone to deal with.”

Five years earlier, Adam had started to feel uncomfortable about his identity and sank into a deep depression.

“It didn’t help that I was being bullied at school,” explains Zoe, 19. “I simply didn’t want to do any of the things other boys did like play football, fight and so on. I even took ballet lessons for a while. I’d get called a poof and be pushed around. I felt suicidal”

But when puberty hit, things got worse. “I started growing facial hair and it simply didn’t feel right,” adds Zoe. “I felt disgusted by it. I developed a sex drive too and that was very confusing. I wondered if I was gay but I fancied girls, though I felt more like them than a teenage boy.”

Adam left school at 16 to take a course in computing. There he found an outlet for his frustrations and made some friends. “There were boys at college who experimented with makeup.” recalls Zoe. “So I could wear lipstick and dress in sarongs without other students thinking I was strange.”

It was six months later that Adam discovered why he was feeling the way he was.

Surfing the Internet one night in July 1999 he came across the word ‘transsexual‘.

He logged on to the website and everything began to make sense. “There were stories about women trapped in men’s bodies,” recalls Zoe. “I identified with them strongly and nearly shouted out that’s me! Suddenly I didn’t feel so alone. I was frightened about the future but the overwhelming feeling was one of relief.”

Adam discovered there were operations and hormone treatments available for transsexuals to help them cope with their feelings.

“Almost immediately I knew I was really a girl,” says Zoe. “I asked Mum what she would have called me if I’d been born a girl. She said Zoe and that’s what I decided to call my alter ego my real self.”

Adam confided in friends first of all. “My closest friend Michelle said, ‘Oh, cool! If that will make you happy,'” remembers Zoe. “My other friends, Alex and Mike, didn’t seem shocked at all. The only comment they made was at Christmas when Alex said he didn’t know what to get me as he’d never bought anything for a girl before.”

Adam, an only child who’s had no contact with his father since his parents split up five years ago, was still petrified about telling his mum. It wasn’t until Christmas Eve 1999 that the truth came out.

“I came home and found him wearing one of my Chinese dresses,” recalls Beth. “I was stunned and asked him what he was doing. He burst into tears, sat down and hid his face. He told me he wanted a sex change. I told him he was messed up. I didn’t think he could be serious. The only transsexual I knew was Hayley in Coronation Street. He was far too young to be making decisions like this. Looking back I feel awful about the way I reacted.”

Over the next six months, Adam and Beth often rowed about his identity crisis.

“She kept saying it was stupid.” says Zoe, who works for an Internet company. “I tried to explain that I was really Zoe but she wouldn’t listen.”

Beth tried desperately to come to terms with her son’s feelings. She began surfing the Net for more information and also phoning helplines.

“I spoke to other transsexuals and realised they were ordinary, nice people,” she says. “I discovered it was a medical condition, diagnosed from psychiatric assessment, not a lifestyle choice or perversion.

“I suddenly understood why Adam had been behaving the way he had and that having a sex change might finally make him happy.

“I spoke to my GP and he said it was a good thing that Adam had made the decision so young, as it would save him years of anguish having to live as a man.

“I’ve found the fact that I’ll never have grandchildren very hard to deal with. But I’ve learnt to accept it. If things had carried on the way they were, then my son may have committed suicide and I’d have lost him altogether.”

One day last summer, Beth came home with a surprise. She held out her hand and gave Adam a keyring with the name ‘Zoe’ on it.

“I hugged him and told him I’d support him,” she says. “I knew he was determined to go through with it. I told him I wanted to meet Zoe, to see my son dressed as a girl.”

A few days later Beth took Zoe on a shopping spree to buy skirts and tops. “When he put on the clothes I was a bit shocked,” says Beth. “But the striking thing was how his personality changed. He was like a kid in a sweet shop. I could see he was so much happier being Zoe.”

Zoe discovered help on the Internet and visited a psychologist in London. He was diagnosed as transsexual and on his very first visit in August last year he was prescribed a course of female hormones.

“It can help to have the operation earlier rather than later,” says Dr Russell Reid, consultant psychiatrist specialising in gender identity, who’s treating Zoe.

“One in every 10 coming to see me is now under 20. For many young people with a crisis about their gender identity it can lead to confusion and hold them back. Having the operation can help them get on with the rest of their life.”

“Since I’ve been taking the hormones my skin is softer and people tell me my figure is much more feminine,” says Zoe. “I’ve even started to develop breasts. I’m a lot calmer but I find myself getting much more emotional, especially at the end of soppy films!

“When it comes to relationships I think of myself as a bisexual female and most people I mix with are transsexuals or very open-minded, so I don’t think I’ll have many problems.”

Adam began living as Zoe 24 hours a day.

“When I told my boss, my stomach was churning,” says Zoe. “But he was really understanding. I wore I women’s clothes to work and sent an e-mail to everyone asking if they’d call me Zoe. I’m sure there was gossip but everyone has been great.”

Beth knew she’d have to tell her friends. “Not one of them batted an eyelid:” says Beth. “They were just intrigued.”

Zoe is now saving for the private £9,000 operation which she plans to have next year. The surgery, which takes four hours, involves cutting the penis and inverting it to construct a vagina. Before then Zoe has to live as a woman for 12 months.

“Mum has gone from one extreme to the other,” says Zoe. “She wants me to be really girlie. But I just like to be natural and wear denim skirts, a blouse and not much make-up.”

Beth has surprised herself at her change of attitude.

“I genuinely think it’s for the best,” she says. “Zoe is a much happier person than Adam ever was. Adam had difficulties growing up and was a very difficult child. Zoe is much more happy-go-lucky. There was a period when I felt like I was in mourning for the son I’d lost. A little bit of my heart still misses him. But now I think of it as losing a son but gaining a daughter. And Zoe is a lovely daughter too!”

by Chris Morris
From Woman
19 February 2001, mermaids.freeuk.com/woman2.html

Posted on by Queer News

Gender Benders

Little boys in high heels, jewellery and make-up seem cute at three, less so at school age. And what if your little girl would rather play footie than dress her dolls? Denise Thornton has some sound advice

All societies treat boys and girls differently and expect different things from them, so understanding about gender is a crucial stage in a child’s development. As soon as children understand that they are a boy or a girl, it helps them to organize the way the will relate to the world around them.

You shouldn’t panic if your child seems to behave in a way more typical of the opposite sex. Preferring to play with girls may get a boy teased but it isn’t that unusual. In most cases this sorts itself out quite naturally as the child develops, though sometimes it happens much later than parents expect (or feel comfortable with!). Even when teenagers are displaying cross-gender behaviour, it generally sorts itself out by the end of the teenage years. Over-reacting may do more harm than good as it can make children feel inhibited and criticized by their parents and peers.

Discovering gender

We become aware of gender differences very early on. By 9 to 12 months most infants can discriminate between male and female faces. At 15 to 18 months old, they can identify features that are typical of men or women such as hairstyles and clothes. And by the age of two they can usually pick out a picture showing a person of their own sex.

But few children understand that a person’s gender stays the same and does not change until they are nearing their fourth birthday. As a result children can often pick out pictures of men and women, but a picture of someone who is obviously a man dressed up as a woman will confuse them until they are nearer to five years of age. The lack of understanding that a man is a man regardless of what he is wearing is the reason why so many young children are confused by pantomimes.

By two years old, many children have already learned that certain tasks and objects are associated more with males or females. However, most children are almost five years old before they link personality traits with being male or female. As a result, four-year-olds generally think it is fine for boys to play with dolls, while six-year-olds think it is totally wrong. By the age of nine, children will have changed their attitudes once again, with boys, for instance, deciding that there is nothing wrong in a boy playing with a doll after all.

Once children understand about gender they tend to look for rules to explain how they should behave. At first they are very rigid in the way they interpret their roles, which is why young boys think doll play is wrong – it breaks their rules. As they get older, they realise that lost of things break the rules and they become less worried by doll play, even though they might still feel they don’t want to play with the boy concerned.

Nature and nurture

Gender specific behaviour is a complex mix of nature and nurture. Studies point to the importance of both biology and learned behaviour. Children biologically born as boys but brought up as girls (because of freak accidents which robbed them of their male organs and so on) show that some boys take on female characteristics easily, while other studies have confirmed that at puberty boys become more boy like and go on to take on traditionally male jobs despite their girlie upbringing.

Mostly, children learn about gender from watching and copying and then re-enacting their observations in play. Male stereotypes develop faster than female stereotypes. Boys generally choose to be in larger groups and rely on status to organise the group. They tend to learn more from boys, give each other more feedback and expect boys to play boy-type games. Girls typically prefer to make fewer close relationships and are less concerned if girls prefer boy-type activities.

Obviously, children have to understand whether they are boys or girls before they start to choose behaviours which fit their gender. Parents play a key role in the development of gender as they tend to respond differently to boys and girls. For example, parents tend to be more robust with newborn boys than girls. A study from the 70s and 80s, called Baby X, showed that when baby boys are dressed as girls adults respond differently to them. The differences may be so subtle that parents are totally unaware that they have changed their behaviour.

Stereotyping continues, and even intensifies, as babies become children. People give girls different kinds of presents < often more arty or creative, while the gifts they give boys are more action based. Children of parents who consistently reinforce gender behaviour often learn to label things as being for boys or girls earlier. Television is also a major influence in boy/girl stereotyping.

Dressing-up play

Play is essential for normal development and should be encouraged, particularly pretend and imaginative play. Most three-to four-year-olds love dressing up, to explore how things feel and use their imaginations. If a child constantly wants to dress up as a policeman, few parents seriously believe that he can only be a policeman when he grows up. But if boys carry on dressing up as girls once they pass five years old, their parents soon start worrying. These worries are usually unfounded as most cross-dressing adult males are heterosexual anyway. This is simply another phase your child is going through. Stay relaxed and let him play in peace.

Daniel’s story

Daniel’s older sister, Miriam, loved dressing up. When Daniel was six he was still playing imaginative games with his nine-year-old sister, often involving him dressing up as a girl, a ballerina or wearing make-up carefully applied by Miriam!

Daniel’s parents began to worry when he seemed to be avoiding the kind of games other boys at school played because he thought they were too rough. They had always thought that dressing up was a phase that Daniel would grow out of, but they were increasingly criticised by Daniel’s grandparents, who believed they should take a more active line and stop him dressing up. They tried, but Daniel just carried on, hiding in his room quietly so that he wouldn’t be noticed.

Things seemed to come to a head when Daniel asked for ballet lessons for Christmas. His parents patiently explained that there were no boys in the ballet class. Daniel said he didn’t mind and that he wanted to go anyway. After much discussion, the family agreed. To their astonishment, Daniel showed real talent, the teacher constantly praised him and put him in for exams much earlier than his sister.

Now aged 13, Daniel rarely dances (despite being picked out by the Royal Ballet scouts, who recognized his potential as a young child) as he has lost interest. His parents cannot remember when they stopped worrying – they just did! In the last six months, Daniel has become more ‘masculine’ and he is more often found in the company of boys. At this same time, his hormonal changes have gathered pace and he is beginning to show an interest in girls – not so much for the companionship he used to enjoy, but as members of the opposite sex.

Daniel’s parents believe that if they had sought help for the son, they might have done more harm than good. They wish there had been someone they could have talked to, who could have reassured them that by following their own instincts, they were actually doing the right thing.

What to do if you’re worried

If your child is happy at school or in a social situations with other children, and seems to be developing well in other ways, it is most unlikely that your have anything to worry about. Only one child in a thousand has any real difficulty with gender identity and most of these problems are resolved in adolescence.

For parents who want reassurance, it can be difficult finding the right person to talk to. In this country, we are fortunate to have Mermaids, a support group set up to help children and parents with gender identity issues. They can advise from a position of experience, rather than just theory. Mermaids offers support and information to parents, families and carers. The Mermaid helpline is 07020 935066 (12 noon until 9pm [UK Time – Mermaids Editor]) or you can contact them via their website http://www.mermaids.freeuk.com or at Mermaids, BM Mermaids, London WC1N3XX

Denise Thornton is a chartered educational psychologist

Reproduced with the kind permission of Right Start magazine, Adam House, 7-10 Adam Street, The Strand, London WC2N 6AA Editor: Lynette Lowthian

Britain – Right Start magazine… August 2001… BLS transcribed text pages 18 – 20… Behaviour matters

by Denise Thornton
From Right Start Magazine
August 2001, mermaids.freeuk.com/rstart.html

Posted on by Queer News

Male on Male Sexual Violence

Male Survivors of Incest or other Sexual Assault

It is estimated that 5-10% of reported cases of rape or sexual assault each year involve male victims (Scarce, 1997) . Some rape crisis centers see nearly equal numbers of girls and boys up to age 12. Researchers report one out of six boys will have been assaulted by age 16. Experts believe the number of cases are under-reported because survivors are less likely to report than are female survivors. Any male can be assaulted. Survivors are gay, straight, and bisexual. Most reported perpetuators are male. Several reports stated that the majority of rapes of males are perpetrated by heterosexual males (Isely & Gehrenbeck-Shim 1997, Scarce 1997).

The identification of sexual assaults committed against males is a recent phenomenon. Previous to the feminist efforts of the last 30 years, resulting in much more comprehensive laws and growing public awareness, rape was the only “sex crime” recognized by law. Only males could be charged with rape and females were the only victims recognized by law. Rape meant vaginal intercourse. Now, the term sexual assault includes many more of the behaviors by which people could be hurt. Many, but not all, states use the phrase sexual assault. Many states are beginning to recognize the sexual assault of males as a problem.

Boys tend not to be taught to empathize. We haven’t taught boys that they deserve the right to feel safe in their bodies, that the autonomy of their body is sacred, that “no” equals “no” for everyone and that when stated it should be respected. Without teaching little boys to expect these rights for themselves, how can we expect young men to respect these rights for men (or women)? Little boys are not taught how to say”no” to abusive clergy, scout-masters, coaches, uncles, fathers, baby-sitters, and other potential male perpetrators.

Males are only beginning to recognize how many of them have experienced sexual assault. For reasons similar that female survivors, male survivors deny their victimization. Their reasons include 1) a lack of information to define their experience as sexual assault; 2) a sense that they will be disbelieved by people; 3) a fear of reprisal by the perpetuator(s); 4) an unwillingness to think of themselves as survivors of sexual assault and fearing all the potential changes in themselves that might inevitably ensue; and 5) a resentment that the behavior of the perpetuator(s) had or has the power to cause the survivor to expend time, energy, emotional and financial resources-and therefore essentially take control of their life-for an unknown length of time.

Sex or Sexual Assault?

Sexual assault is commonly defined as forced intercourse or sexual contact that occurs without consent as a result of actual or threatened force (Crooks & Baur 1998). Only recently, however, have many states amended their criminal codes to include adult males (meaning sixteen years of age and older) in their definition of rape (Isely & Gehrenbeck-Shim). All sexual assault is an expression of power, hate, and control. To many heterosexuals, an assaultive male is, crudely put, manifesting “homosexual” behavior. The majority of rapes of males are perpetrated by Caucasian, heterosexual men who often commit their crime with one or more cohorts (Scarce 1997) This demonstrates, again how straight culture confuses sex with sexual assault.

Any male who has been assaulted by another male has a disincentive to report the incident because many people assume that any male assaulted by another male is automatically gay. If the survivor is gay and the perpetrator is gay then reporting the sexual assault may involve “coming out” to authorities, which can be unsafe. Living in a homophobic culture which equates the rape of males to homosexual sexual behavior; a male survivor, who is gay or presumed to be gay, may assume that he will be disbelieved and harassed by the police rather than supported.

Some sexual assaults of gay males are committed by perpetrators who self-identify as heterosexual. The motivations of these men to assault gay males is similar to their motivation to assault females-to dominate and express hatred. Some sexual assaults of gay males are committed by other gay males. Estimates of numbers of assaults are impossible to come by with the prevalence of homophobia in the United States. Consent is what separates sex from sexual assault. Consent is not adequately taught to straight, bisexual or gay teens.

Sexual assaults are not sex. When a male sexually assaults another male: 1)neither male becomes a homosexual as a result of the assault; 2) it is not the manifestation of latent homosexual behavior. There are homosexual men who commit assault but the assaults they commit are not homosexual sex acts. When a man punches another man we do not call it “homosexual battery.” “If you hit someone over the head with a frying pan, you wouldn’t call it cooking.” says Mike Lew, author of Victims No Longer: Men Recovering From Incest & Other Sexual Child Abuse.

Males Who Sexually Assault Other Males

Most of the perpetuators of sexual assault committed on male are other males. As stated before, the majority of perpetrators are heterosexual and Caucasian (Scarce 1997). The boy or young man who is a survivor can be confused, angry, blaming himself, hurt, desperate to understand. The hysteria and misinformation rampant about homosexuality makes understanding their assault very difficult for male survivors.

How Sexual Assault Affects You and Others

Some male survivors’ confusion about their sexual orientation, can hinder their recovery. While some males assaulted as boys by older males come to realize that while they don’t want to replicate the abusive component of their experience, they do want to explore consensual interactions with males. Gaining clarity about one’s sexuality is much more difficult for sexual assault survivors.

 

When you are dealing with survivors who you know, they may “frustrate or anger” you by not wanting to report their assault, call it assault, change behavior that you find problematic or even destructive, or other things. You may be irritated with the survivors’ rate of recovery or unwillingness to do things that you objectively know would be positive for them. Since the root of eating disorders, depression, and addictions is often incest and others sexual assault, our attention can be misdirected by manifestations of these “symptoms.”

When you are dealing with perpetrators who you know, they too may “frustrate or anger” you by not wanting to call their behavior assault, change behavior that you find problematic, etc. Their resistance may be maddening. Their alleged act may well contribute to the polarization of their circle of friends. The presumption of innocent until proven guilty can be sorely tested. Additionally, you may know or like them as people, and experience difficulty believing they could “do” this.

You don’t have to arbitrate, heal or solve this problem alone. Survivors need support not rescue. You will be helping yourself if you first look at your resistance or denial. Know your own biases and prejudices. And if you can’t/won’t listen at that particular time because you are busy/stressed, or this brings up discomfort from personal experience; you so not have to at the moment.

How to be a supportive listener for a friend/lover/relative who is a survivor of incest or other sexual assault

Most survivors never tell anyone that they have been assaulted. If someone tells you about their abuse, consider it an honor. You may not feel lucky but you are. Welcome to a very confusing, murky world.

  • Believe them-they are telling the truth. Tell them you’re sorry and it wasn’t their fault.
  • Really listen, don’t jump to solutions. Ask what help they would like.
  • Do not distract yourself with heroic fantasies to beat up the perpetrator.
  • Offer to make an appointment with them to see a counselor, clergy, police, etc.
  • Do not say that you know/understand how they feel. You don’t, even if you’re a survivor yourself. Your experience was not identical to his/hers.
  • Suggest counseling in addition to talking to you. Professional counselors are very useful.
  • There is no limit to how long the healing process takes. Saying things like, “You’ve got to forget about this.” won’t help and may harm recovery.
  • Be aware of school/local support resources and share those.
  • Sometimes you can’t “do” what seems to you very much, but the “little” that you do may be sufficient for survivors now. Don’t assume for them what they need.
  • Give them time and space. If you’re talking more than they are, you’re probably not helping.
  • Do not give advice, even if asked for it. Survivors of sexual assault have had their power profoundly taken from them. Making decisions overprotects them and may send a message that you think they’re incompetent. Help them problem-solve by offering all possible options. Offer to support whatever decision they make, then do it.
  • Get support for yourself too-the more you care, the more you are affected. Look inward; pay attention to your own feelings, your needs are valid too.
  • Don’t burden the survivor with your “stuff.” Males learn to expect others to “take care of” our emotional needs and want them to explain to us what we are thinking/feeling about their trauma. It isn’t wrong for us to have emotional needs. It is wrong for us to add to the survivor’s burden.
  • Respect their need for absolute confidentiality. Not making their secret public may be the only safe thing for them to do as they see it. If you get support for yourself as an affected “significant other,” do not tell the details of the abuse to anyone. If a person who you confide in presses you to identify the survivor, do not tell them. If you help make the details of the assault public, you will do the survivor harm.
  • Check-in with a person before leaping into an intense follow-up discussion. Don’t assume that the level of disclosure that you shared previously is acceptable currently or later when you talk to that person. If you want to talk further, recognize that this might not be a good time for him/her to talk.
  • Sometimes a friend/lover/relative will share that they were assaulted by someone. Some survivors never bring it up again. Some refuse to talk further about it. Some even avoid you. This doesn’t necessarily have anything to do with you. You might be the only person they have confided in and every time they see you they recall their abuse. Don’t punish them for your feeling of being used if that is how you feel. Similarly, you may choose approach them at a private time and ask them if they want to talk further. If they don’t, that’s fine. If they do,that’s also fine as long as you both feel comfortable and safe.
  • When a survivor tells you tell you that they have been abused, you may feel uncomfortable for a variety of reasons. You have the right to state that what they are telling you is too difficult for you to hear. You may help them find someone else who can be there for them.
  • If anything you hear or feel resonates for you as you hear their story, it does not prove that you are a survivor. If you are a survivor and you are feeling old feelings again, there are (hopefully)caring resources available in you community.
  • Some people will seek out a stranger to tell their story to. They may feel safer telling their story to someone they won’t see again, feeling safer with anonymity this person provides. We all deserve the right to feel safe. ( Protective Behaviors, Inc).
  • Remember the value you place on a friend who took the time to really listen to you.
Possible Reactions of Male and Female Incest or other Sexual Assault Survivors

Note: I include this sections to illustrate the multitude of sometimes contradictory effects that sexual assault survivors experience. This list was created from several lists that compiled responses of many survivors, both male and female. Not all survivors necessarily experience all or even most of these.

  • Nightmares
  • Swallowing and gagging sensitivity (suffocation feelings)
  • Alienation from the body-poor body management. Manipulating body size to avoid sexual attention.
  • Fear that everyone is a potential attacker
  • Eating disorders, drug or alcohol abuse; other addictions; compulsive behaviors
  • Self-destructiveness; skin carving; self-abuse
  • Suicidal thoughts, attempts, obsessions; Depression (sometimes paralyzing); seemingly baseless crying
  • Inability to express anger; fear of actual or imagined rage; constant anger
  • Intense hostility toward entire gender or ethnic group of the perpetuator
  • Depersonalization; going into shock, shutdown in crisis
  • A stressful situation is always a crisis; psychic numbing
  • Physical pain or numbness associated with a particular memory, emotion (for example anger), or situation (for example sex)
  • Rigid control of one’s thought process; humorlessness or extreme solemnity
  • Nervousness about being watched or surprised; feeling watched
  • Trust issues; inability to trust; trusting indiscriminately
  • High risk behaviors; inability to take risks
  • Boundary issues; control power, territorial issues; fear of losing control
  • Obsessive/compulsive behaviors
  • Guilt, shame; low self-esteem, feeling worthless, high appreciation of small favors by others
  • No sense of own power or right to set limits or say no
  • Pattern of relationships with much older persons (beginning in adolescence)
  • Blocking out part of childhood (especially ages 1-12), or specific person or place
  • Feeling of carrying an awful secret; urge to tell, fear of its being revealed
  • Certainty that no one will listen; feeling “marked” (“The Scarlet Letter”)
  • Feeling crazy; feeling different; feeling oneself to be unreal and everybody else to be real, or vice versa; creating fantasy worlds, relationships, or identities
  • Denial; no awareness at all; repression of memories; pretending
  • Sexual issues: sex feels “dirty”; aversion to being touched (especially in gynecological exam); strong aversion to or need for) particular sex acts; feeling betrayed by one’s body; trouble integrating sexuality and emotionality; compulsively “seductive” or compulsively asexual; must be sexual aggressor, or cannot be; impersonal, “promiscuous” sex with strangers concurrent with inability to have sex in an intimate relationship; sexual acting acting out to meet anger or revenge needs; sexualizing of meaningful relationships. Note: Homosexuality is not an after effect.
  • Limited tolerance for happiness; reluctance to trust happiness

youthresource.com/library/ygm5.htm – 2000

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What Are Young Gay Men’s HIV Prevention Needs?

Are young gay men at risk?

Unfortunately, yes. Accumulating research shows alarmingly high HIV prevalence rates among young gay men and high rates of sexual risk-taking, suggesting that young gay men in their 20’s are forging a “second wave” of the AIDS epidemic. During the 1980s, the median age at HIV infection was older than 30 years. It dropped to 25 years during the period from 1987 to 1991. From 1987 to 1991, one in every four newly infected individuals in the US was age 22 or under.

A recent study of 425 gay men aged 18-29 in San Francisco, CA found that 18% were already infected with HIV, with a seroincidence rate of 2.6% per year: among the 27-29 year olds, 29% were HIV+. Another study which sampled young gay men aged 17-22 from public venues such as bars, street corners, dance clubs and parks found 9% of the men to be HIV positive. Young African-American men were found to have especially high HIV seroprevalence (21%). A study of gay men aged 18-24 in New York City found 9% HIV positive.

What places young gay men at risk?

In contrast to studies with older gay men which demonstrate dramatic reductions in HIV risk-taking behaviors, a variety of studies show that young gay men are engaging in high rates of unsafe sex. In a survey of gay men aged 18-25 in three medium-sized West Coast communities, 43% of the sample reported having engaged in unprotected anal intercourse during the previous 6 months.(7) A study of gay and bisexual adolescent males in Minnesota found that 63% were at “extreme risk” due to unprotected anal intercourse or intravenous drug use. A San Francisco telephone survey showed that 44% of gay men under the age of 30 had engaged in unprotected anal intercourse during the previous year, compared to 18% of the men over age 30.

What contributes to risk taking?

A complex array of factors – at individual, interpersonal and community levels – contributes to the high sexual risk-taking of young gay men. Since the bulk of AIDS cases among gay men is among men aged 30-40, many young gay men perceive AIDS as a disease of older men and feel it is safe to have unprotected sex with other young men. Most young men know how HIV is transmitted and men who engage in unprotected sex do label their behavior as putting themselves at risk for AIDS. Nonetheless, with their feelings of invulnerability typical of youth, young men may feel the negative consequences “won’t happen to me”.

Young men are often in an exploratory phase with regard to sexuality which may entail high numbers of partners and a willingness to try a variety of activities. Due to inexperience, young men may be less competent in negotiating low-risk sex and less knowledgeable about making safe sex activities enjoyable. Coming out as gay can also be a period of great emotional turbulence, resulting in low self-esteem and depression which may reduce their feelings of self-efficacy and motivation for safe sex.

Further, protecting one’s health is not necessarily a young gay man’s top concern. Interpersonal motivations may be more pressing – wanting to fit in, to find companionship and intimacy. However, interpersonal issues can also contribute to unsafe sex. For young gay men, unsafe sex is most likely to occur with a boyfriend – someone whose affection is very important to them.(7)

The social structure and norms of the young gay subculture may not be entirely conducive to safer sex. In many communities, gay bars and public cruising settings provide the main opportunities for young gay men to meet and socialize. Yet each is highly sex-charged and the bar scene’s emphasis on alcohol sets the stage for engaging in sex while high – consistently found to contribute to unsafe sex.

What works for young gay men?

Despite enormous need, only a handful of programs specifically targeting young gay men have been designed and evaluated. Individualized risk-reduction counseling followed by peer education and referrals to drug, counseling and health services were reported to be an effective strategy for decreasing unprotected anal intercourse among gay male adolescents in Minneapolis, MN. In New York City, an intensive, multi-session small group intervention was offered to gay youth aged 14-19 seeking services at a community-based agency for gay youth; the more sessions youth attended, the more dramatic the changes in risk behavior.

Community-level programs can reach large numbers of young men. One successful program promoted a norm for safer sex among young gay men through a variety of social, outreach and small group activities designed and run by young men themselves. Rates of unprotected anal intercourse dropped from 40% to 31% after the intervention. The program found that young men engaging in unsafe sex who were unlikely to attend workshops were more likely to be reached through outreach activities – such as dances, movie nights, picnics, gay rap groups, and volleyball games.(13) STOP AIDS’s Q Action, in San Francisco, CA, is a community organizing model that promotes HIVprvention by putting the power for designing and implementing interventions directly into the hands of young gay men.

Youth-oriented media can also be used creatively to reach large numbers of young gay men. In Australia, ads promoting HIV prevention peer support groups appeared in popular youth magazines across the country. Over 1,300 young men responded. Follow-up questionnaires showed that 73% had not told a family member about being gay, and 48% had told no one. Direct mail was also found to be highly successful for sending AIDS and sexuality information to gay adolescents in rural, isolated, or culturally difficult environments who would otherwise not access support.(14)

What needs to be done?

Since there are multiple factors that contribute to HIV risk-taking among young gay men, multi-level prevention programs are necessary – programs that impact variables at individual, interpersonal and social system levels. Funding, designing, implementing and evaluating HIV prevention programs for young gay men must be a high priority to halt the AIDS epidemic.

The myth that the gay community has been saturated with AIDS prevention services is in serious need of debunking. New young men will come out each year who have not been exposed to prevention campaigns of previous years, thus HIV prevention for young gay men must be ongoing and dynamic.

Engaging, creative programs are needed that address HIV prevention within the contexts of young gay men’s lives, incorporating issues of self-esteem, coming out, substance use and interpersonal and social needs. Community-level and peer outreach programs are especially promising, and services for young gay men of color are particularly needed. Since previous sexual history is a strong predictor of current risk-taking behavior, intervention at an early point in a young man’s sexual initiation will be maximally effective.

Societal homophobia may impede implementing effective prevention programs for gay youth and may discourage young gay men from accessing prevention services.Political concerns must not interfere with HIV prevention services for young gay men. A comprehensive HIV prevention strategy uses multiple elements to protect as many of those at risk of HIV infection as possible. Targeting young gay men with AIDS prevention messages and services is not “condoning” or “promoting” homosexuality, it is acting responsibly in the face of a grave public health threat. Unless action is taken quickly, we will lose a new generation of gay men.

 

caps.ucsf.edu/YGMtext.html – 2000

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Making Colleges and Universities Safe for Gay & Lesbian Students

The following is a summary from Making Colleges and Universities Safe for Gay and Lesbian Students: Report and Recommendations of the Massachusetts Governor’s Commission on Gay and Lesbian Youth, Warren J. Blumenfeld, Principal Author. (For a free copy of the report, write to: The Governor’s Commission on Gay and Lesbian Youth, Room 111, State House, Boston, MA 02133)

I. Policies
  1. Enact nondiscrimination policies on the basis of sexual orientation in >matters of hiring, tenure, promotion, admissions, and financial aid.
  2. Have policies and procedures for dealing with homophobic violence and harassment.
  3. Have a written, inclusive, and affirming definition of “couples” that is nondiscriminatory towards same-sex couples in a way that is appropriate for each institution.
  4. Ensure equal access and equality of all benefits and privileges granted to all employees and students.
  5. Have policies of active outreach in hiring openly GLBT and/or GLBT- sensitive faculty, staff, and administrators in all segments of the campus community.
  6. Actively recruit openly GLBT prospective students. All of the above policies should be written, clear, consistent, accessible, and well-publicized throughout the campus.
II. Training and Development
  1. Homophobia and other “diversity” workshops should be implemented for the entire campus community to sensitize and educate staff, faculty, and administrators.
III. Services
  1. Colleges and universities provide official recognition, support, and funding of campus GLBT student organizations.
  2. Physically safe, secure, and appropriate space with a welcoming, emotionally safe atmosphere should be available to GLBT organizations for meetings, social events, coffee houses, lectures, fora, workshops, and other events.
  3. Legal and fundraising support services should be available to GLBT students.
  4. Campus housing should include GLBT living options.
  5. University leadership should make strong, clear, public statements on a regular basis that state the college’s commitment to ending discrimination, conviction that violence and harassment are entirely unacceptable, and appreciation of the value of diversity on campus, including diversity of sexual identity.
  6. Colleges and universities hire openly GLBT or GLBT-sensitive therapists/counselors, faculty, staff, and administrators.
  7. Peer counselors and/or campus crisis hotline volunteers be adequately trained in sensitivity to sexuality, sexual orientation/identity, and “coming out” issues.
  8. Effective AIDS education, imperative for all people of all sexual orientations, must be available and widespread.
  9. Social activities through residence halls, Offices of Student Activities, and other organizations must be not only inclusive of all sexual orientations and identities, without pressures toward heterosexuality, but actively welcoming of GLBT people as well as same-sex couples.
  10. College and university presidents have a standing advisory committee, panel, or board, appointed or elected in consultation with GLBT students, staff, and faculty members.
  11. Student opinion should be assessed regularly, by the above mentioned panel or in some other manner, in order to gauge the effectiveness of implemented changes.
  12. Campus publications should take care to provide adequate and fair coverage of GLBT events and issues, both on and off campus.
  13. Colleges and universities should aid students in alumni outreach.
  14. Internship opportunities may also be cultivated among local GLBT- owned businesses and GLBT activist and community service organizations.
  15. The diversity within the GLBT community should be recognized and affirmed.
  16. The location and availability of resources of value to GLBT people should be published in materials distributed to all students, faculty, staff, and alumni.
  17. Personnel at the Career Planning/Placement Center, like personnel in every college area, should be sensitive to GLBT issues and be aware of employment opportunities in GLBT owned or GLBT friendly businesses and community service organizations.
  18. While needs differ greatly at each of the hundreds of institutions of higher education, it seems clear that for many, if not most, the most critically important and invaluable resource is a GLBT campus resource center with a paid administrator, staff, and resources.
  19. In institutions where financial resources do not allow for centers and/or administrative support for any “minorities,” there should at least be an ombudsperson or other clearly recognized, identified, and publicized as an official liaison to the campus GLBT community.
IV. Curriculum / Educational Materials / Academic Affairs
  1. Issues relating to GLBT people should be formally and permanently integrated into existing courses across the curriculum.
  2. Speakers on GLBT topics, and particularly those who present scholarly research on GLBT topics, should be brought to campus regularly.
  3. Courses dealing specifically with GLBT issues in the humanities, natural sciences, education, social sciences, and other disciplines should be established.
  4. A visiting scholar position in GLBT studies should be created and supported on a continuing basis.
  5. College and university libraries should increase their holdings of GLBT books, periodicals, and computer networking systems.
  6. Campus facilities should be available for regional GLBT studies conferences, with administrative support provided.
  7. Fellowship opportunities should be created and funded for teaching and research of GLBT topics.
  8. Scholarship and research into GLBT history, culture, and theory should be encouraged and supported in faculty and students.
  9. All multicultural education should be inclusive of the issues, history, culture, and experiences of GLBT people in the United States and worldwide. Multicultural awareness (social diversity) courses should be mandatory for all students at some point during the undergraduate years.
  10. An archive and history of GLBT organizations on campus should be created.
V. Employee Concerns
  1. Policies regarding equal benefits and nondiscrimination should be made clear in recruiting brochures, informational materials, campus publications, and orientation sessions.
  2. The university should aid, support, and fund the creation of GLBT faculty and staff discussion, support, and networking groups.
  3. Trade unions and professional organizations should have inclusive policies and supportive services available to their members.
  4. There should be equality in all benefits, including, for example: bereavement leave, insurance coverage, library privileges, access to gym and other recreational facilities, listings in directories if spouses are customarily listed, housing for GLBT couples where the qualifications are analogous to the qualifying basis for heterosexuals, “couple” rates must be made available to GLBT couples, access to any and all other privileges and benefits by GLBT partners if access is available to heterosexual spouses.
  5. There should be ongoing sensitivity training and staff development on GLBT issues for all employees.
  6. Colleges and universities should cover the expenses of employees attending conferences on GLBT issues.
VI. Community / Off-Campus Concerns
  1. Community GLBT groups should be invited to attend campus events as participants, guests, and event leaders and facilitators.
  2. Information regarding social, religious, and other community resources should be made easily accessible to all students, staff, faculty, and administrators.
  3. Counselors, administrators, and faculty should be available to parents or other community members to alleviate any concern that may arise out of the implementation of any of the above recommendations, as well as any concerns arising during their child’s coming out process, if that is the case.
  4. Representatives of GLBT student groups from different schools should meet regularly to keep each other appraised of upcoming events, plan events together, and strengthen the GLBT community.
  5. Publications, fundraising materials, and all other publications distributed to parents and alumni should include relevant and appropriate stories, essays, and news regarding GLBT issues, organizations, and events.
  6. Corporations, public agencies, and government, religious, and community agencies and institutions that do not have official written policies against discrimination based on sexual orientation should be strongly discouraged or prohibited from on-campus employment or enlistment recruiting.

youthresource.com/library/blumen.htm – 2000

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Intersex and Gender Identity

There is a growing tendency to assume that all the varieties of phenotype (apparent physical sex), gender identification and sexual orientation are all merely different shades in one large rainbow. It is becoming increasingly common to hear people lump together transsexual, intersexual, transgender, gay and lesbian in the one sentence with the implication that all these issues share a common history or have common interests.

In many respects it is reminiscent of the attempts in Britain in the 80s to create a “Broad Democratic Alliance” of oppressed people consisting of left-wing and liberal political activists, women, gay people, ethnic minorities, disabled people and those who were unemployed, homeless and otherwise socially-disadvantaged. This was based on the presumption that, as all were victims of economic and social discrimination, there could be constructed a shared platform from which they could combine to resist the policies of the somewhat right-wing UK Government of the time.

It was unsuccessful for several reasons: it presumed that the experiences of discrimination by these diverse groups were similar in substance; it presumed that these groups all shared a common opposition to the Government; it presumed that the interests of those groups in ending discrimination could result in them all speaking with one voice, under one leadership; it ignored the diversity of views and experiences not just between but within each of these groups and presumed that each was homogeneous.

The presumed commonality turned out to be illusory. The reality was that each group held radically different views of who “the real enemy” was, not just from other groups, but from other views within their own groups. For example, Asian men did not on the whole regard lesbians as natural allies against discrimination, Sikhs did not perceive their interests as coincidental with those of Muslims or Hindus, Conservative women did not take kindly to alliance with left-wing men, Afro-Caribbean women regarded themselves as doubly oppressed, as black and as women, and so on. All these contradictions carried an in-built guarantee of failure and the alliance never got off the ground, except in the minds of its proponents.

The lesson is clear – the idea that discrimination and oppression indicate commonality of interests among those oppressed is wishful thinking. While collaboration and co-operation may be possible where interests coincide, attempts at coalition are unlikely to be successful.

There is a similar set of contradictions facing those who would try to combine the various interests of those within the intersex, transsexual, transgendered and gay communities.

Yes, there are many areas of overlap. There are gay trans people, there are intersex people who are also trans, there are crossdressers who are gay etc. But these do not imply natural alliances.

As one who is intersexed but also has a history of involvement in the trans community, let me talk about my own experience for a moment.

I was born physically intersexed and was medically assigned as male. If you like, I transitioned at an early age, without my consent. Like many intersexed people, neither I nor my parents were given any information regarding my condition or treatment (“trust us, we’re doctors, this is all for the best, you wouldn’t understand the big words we use”), I was one of those who slipped through the net of follow-up medical care and only uncovered the truth in later life, slowly and painfully, after a lifetime of confusion and conflict and undiagnosed health difficulties as I refused to go anywhere near anyone in a white coat for several decades.

I had never heard of “intersexed”, had never heard of “Congenital Adrenal Hyperplasia”, had no idea of the fact that I was living with several potentially serious endocrine malfunctions or that the whole secrecy surrounding my condition left my health in a very exposed and dangerous position.

I had been assigned as male – but I was not, I was intersex. But that is not an option in our society. There are only two possible classifications of sex, “male” or “female”, and the doctors in those days, pre-Money, before it became routine to surgically modify people like me to “female”, decided they could make “a man” of me. Nobody ever asked me what I was.

After many, many years of social ineptitude and blundering through life, I reached the point where I could no longer continue trying to live in the very restrictive social role assigned to me through medical intervention and I rebelled. There were only two possible options open and it was patently obvious that I did not fit the box marked “male”, so therefore I must belong in the other box, that marked “female”.

I could not understand why I was the way I was and I had no language with which to express what was inside me. So I began to search and finally came across the word “transsexual”. This concept seemed to offer an explanation and so I sought out the trans community and realised that transition of gender roles was a possibility. I then began to seek medical treatment in order to transition and the recovery of the truth of my history began.

And, as I learned more about my self, a fundamental difference between people like me and those in transition who were “trans” began to surface. I was transitioning out of a role assigned to me, most trans people seemed to be similarly transitioning out of but they were also transitioning into. Equally valid but with different objectives.

The majority of trans people I know have the desire for confirmation of gender in one of the two categories accepted by society, which is why they transition, i.e., to express a definite gender identity, male or female, different from the one usually indicated by their current phenotype. The major topics of discussion within the trans support spaces are concerned with such confirmation and, in my opinion, it is entirely a legitimate objective and one which I have worked hard to support.

However, given the choice of “male”, “female”, “intersex”, I would unhesitatingly select “intersex” – but society does not give me that option so I select “female”. I do so with deep reservations, gritting my teeth at a society which will not accept my right to simply be who I am.

I do not know many trans people who would experience such a conflict; there may well be, but I have never heard any express it. Most trans people I know identify themselves absolutely comfortably within one or other of the specified classes. And they have my full blessing in so doing. My life would have been a lot less problematic had I been able to do so as well.

Yes, I regard myself as a woman – but I am an intersex woman … there is a multi-faceted complexity to my sense of self which the two labels imposed by society cannot embrace. My desire was not to transition into female – it was to transition out of male. Period.

To use experiences such as mine as evidence of commonality between “intersex” and “trans” is erroneous. My experience is not typical of intersex people – but neither is it typical of trans people. My conflict is not an internal dichotomy between gender identity and physiology – it is between the integrity of my being and the consequences of medical intervention. The conflict is an artificially created one. Had I been left alone and raised as I was at birth, there would have been no conflict and my identity would have been secure.

Because the question of gender identity is such a fundamental element in trans experience, many trans people have difficulty in understanding that gender identity is usually not quite such a big deal to most intersexed people. It is only a minority who feel a need to transition, usually those who have been surgically or hormonally coerced into a role to which they have serious difficulty conforming. For example, while there are those who are also trans, most people with XXY chromosomes (“Klinefelter’s Syndrome”) usually quite happily identify as men, most people with Turner’s Syndrome or complete AIS usually identify quite happily as women and so on. The need to transition is nothing like a common experience for all intersex people. But it is the defining experience for all trans people.

This fact causes fundamentally different views between trans and intersex people on many issues.

One example – when it comes to views of medical reassignment of “gender”, the interest is very different. In general, trans people seek medical intervention to assist them in physically becoming who they really are while (again, in general) those intersex people affected by medical reassignment seek the abandoning of medical intervention because it makes us physically other than who we really are.

Another example – for most trans people, the question of birth certificate correction is a very serious and basic human rights issue; for most intersex people it is a complete non-issue.

It is the frequent overlooking of this basic existential difference between the experiences of trans people and intersex people which gives rise to the caution and suspicion amongst intersex people which greet attempts by members of the trans community to broker the idea of commonality of interests between the two communities.

It is not my purpose here to discuss the “trans is a subset of intersex” argument. The debate on this has a long way to go before it is resolved and there is still no definitive aetiology of transsexualism.

For those intersex people who find themselves with a need to transition there are many areas of experience which are shared with trans people and which can create areas of co-operation, provided both are aware that there also many areas where our experiences are different and that they make construction of a common agenda problematic.

The solution to that is to listen.

Experience suggests that intersex people already know pretty much where the line needs to be drawn, trans people less so. So it is important for trans people who wish to co-operate in areas of common interest with intersex people, where such exist, to learn as much as they can about us, about the medical priorities which are sometimes essential for life-preservation, about the very distinct natures of the various intersex conditions and therefore about the special interests of each group, about the instinctive resistance to outside influence and about our overriding need for each of us to speak for ourselves in our own voices.

We are people whose very lives have been affected by outside interference and by others, especially the medical community, presuming to speak on our behalf. Therefore, in general, we are distrustful of those who wrongly presume that their experiences are similar to ours. We tend to view suggestions of alliances built on this basis as invasive and attempting to appropriate our experiences for agendas other than our own. And we are particularly suspicious of those who imagine that our various histories can be reduced to a matter of gender identity.

I would suggest that there are actually fewer areas of common interest than most trans people suppose there are. This is not to say that such do not exist but they are usually those areas involving intersex people who are also in transition. The clear distinction should be acknowledged and respected.

A personal viewpoint by Mairi MacDonald
UK Intersex Association, ukia.co.uk/voices/is_gi.htm – 2000