Disorder is a recognized medical condition by the American Medical Association
and the American Psychiatric Association. It is considered a birth defect, which occurs about five
weeks after conception. The brain does not match the physical sex of the body.
This is also known as Transsexualism. There are males with female brains
and females with male brains. The
true incidence is unknown but is estimated to be one in one hundred thousand
births. The reason for it is unknown but it is thought to be a
biochemical mistake in the formation of the brain. The result is that the individual has the psychological
and chemical brain of one gender but the body of the other.
Persons with this disorder know from an age of 5 or 6, that they are
different from other individuals of the same physical sex.
Early on, they learn to hide it from all others, even their parents and
siblings. They learn the skills and mannerisms of the gender that their
body is but are aware that they think and feel different.
They want to be of the opposite gender and often characteristically go to
bed at night praying they wake up in the body that matches their mind.
Many do not understand the difference until they see the anatomic
difference between girls and boys. Puberty
is very difficult because the body changes away from the way the mind expects.
individuals learn to cope and often act in a way that exaggerates their physical
gender to compensate. Males
with a female brain join the military or take up hazardous activities.
All learn to hide it and never speak of it to another living soul for
fear they will be considered crazy. Many
internalize their feelings and eventually become moody, withdrawn, and
despondent. No one else knows what he or she is going through.
They are terrified others will find out about their secret.
At some point,
the defense mechanisms and barriers that let the Transsexual function break down
and it is impossible for the person to reestablish the shell that they have
projected to others. This usually
happens about ages 30 to 45. They
develop what is termed Gender Identity Dysphoria. The term Dysphoria is Greek for “difficult to bear”. The
discrepancy between what their mind and soul is and what they see in the mirror
produces the Dysphoria. The
symptoms are physical pain, agitation, and debilitating depression.
Things that used to be meaningful diminish to extinction.
The pain is like what is felt when a loved one dies.
Eventually, the individual has to address the problem or become
nonfunctional. Twenty percent
attempt suicide. It is clearly not
a choice one makes or wants. Many
are angry they have the disease and can speak of it to no one. Often they do not understand the reason for their terrible
feelings until they go through extensive psychotherapy.
Not uncommonly, many therapists do not recognize what is happening to
their clients, who are afraid to reveal their innermost feelings, for fear of
There is no
cure, therapy, or medication to cure the Dysphoria once it breaks into the open.
Treatment is directed towards options.
The brain cannot be changed so the body image has to be altered.
Some live part time in the gender of their mind and that may be
sufficient. For most, about 99%,
treatment is directed towards changing the body to match the mind.
This involves hormonal therapy to match the brain, psychotherapy to deal
with the stresses of transitioning from one gender to another, and eventually
sex reassignment surgery. The Harry
S. Benjamin Institute determines the standards and protocols for treatment.
It is a worldwide illness.
It is a
difficult disease to have because others view it as a choice or an expression of
homosexuality. The illness is about
what your gender identity is, not who you love, which is a separate issue.
Patients often lose their spouses, families, relatives, and employment at
a time when they are most vulnerable and need support the most.
Those that have the resources transition to their new life and if their
employer is knowledgeable, succeed in returning to a productive life.
In some cases, if the individual can, they “disappear” leaving family
and friends behind to start a new life always with the fear they will be
discovered. Those without resources
end up alone on the street, or unable to face the pain and the loss of all they
hold dear, take their lives sometimes with no one knowing why.
It is an illness that with a single stroke cuts the person off from their
identity, their family, and their economic security.
Only one in a hundred who starts the process completes it. The rest are
caught in a type of purgatory neither fish nor fowl.
Insurance does not pay for the treatment. The most common cause of death is suicide
followed by murder, usually brutal.
Little is know
about what happens to Transsexuals after they complete their transition to the
gender of their mind because they want to blend into society and be accepted in
their natural gender. More is
known about the dark side of the moon than what happens to Transsexuals long
are True Selves by Mildred Brown, and Chloe
Brain Sex by Ann Moir, PhD, and David
May 21, 1999
I will also be
pleased to answer questions as time allows by email:
TRANSSEXUAL RESOURCES IN PORTLAND