by Amy Bloom
We should all have such parents.
When Lyle entered puberty, his mother and his late father took him from doctor to doctor, looking for explanations for Lyle’s unhappiness and fierce resistance to being treated like a young woman. An endocrinologist who had worked with Don Laub recognized Lyle as possibly transsexual, and Ira Pauly and Judy Van Maasdam confirmed the diagnosis. Then, after extensive hormone treatments, Laub performed the first surgery and the family moved to another state, to allow Lyle to enter high school as a boy. Later, they nursed him after his hysterectomy and his phalloplasty, and used all their savings, and then some, to pay his medical bills.
Jessie says, “I want everyone to know who reads this that this wasn’t easy—it was a really terrible shock. I didn’t understand. I said to the first endocrinologist, ‘Where did we go wrong?’ and he said nowhere, it was biological. I called every single—I’m not kidding you—every single insurance company in the USA, and they said, ‘No, it’s cosmetic.’ ”
Lyle interrupts—the only time I’ll see him openly angry. “Yeah, right. Like I wanted a nose job. Cosmetic. Well, it was only my life.”
Jessie makes soothing hand gestures, reminding him that it’s all right now. “And of course, the money,” she says. “Our other kids resented it. I understand. But what could I do? What could we do? If your child has a birth defect, you get help. We understood—we understood even when he was little that something wasn’t right. And we knew, when the doctors told us what could be done—we just knew what we had to do. When the doctors said he was transsexual, I felt that I knew that.”
After hearing Lyle’s stories about his hated girl name, his astonished, frightened tears and protracted battles over party dresses, Mary Janes, and even girl-styled polo shirts, and his deep, early sense of male identity—the same stories I would later hear, with minor variations, from almost every transsexual man I spoke with—I ask him about life since the transition. He gives me a glossy friend-filled account highlighted by a two-year romance with an older woman (twenty, to his seventeen) and a successful football career cut short by an ankle injury.
And after high school?
Finally, a bit of trouble: “I had a little money problem and a little drug problem. I got some counseling, came back from Las Vegas, started college. Now I’m taking classes, paying off my bills, working for the state. Eventually, I’ll get my bachelor’s.”
He sighs, and Jessie says quickly, “That’s all right. Lots of older kids are in college these days. Aren’t they?” I say I know quite a few, and we sip our iced tea.
“I did a lot of partying, some wild times,” Lyle continues. “I think maybe I was frustrated. Maybe I did drugs partly because I was so frustrated at not being able to get my bottom surgery right away. Maybe. I just felt not quite right, but the surgery didn’t make the difference I thought it would. It just made me feel me—not macho, just me. Uh, sexually.” He looks at his mother. “It helped me out mentally, not really physically. But it cost so much. Not that Don Laub wasn’t fair—he was. And when it was over, all I wanted to say was, ‘Thank you, Dr. Laub, for letting me be reborn.’ But if it hadn’t been for that I’d have a very nice house by now.”
He laughs and Jessie laughs. “Me too,” she says. “We’d have two very nice houses.” Not looking at him, she goes on. “There is another surgery he could have, to get all the feeling”—a surgery in which a nerve taken from the forearm is run through the phallus—“but we just don’t have the money.”
I didn’t ask any questions, because at the time I didn’t know much about the different kinds of phalloplasties and I thought that it was rude to ask people about the working condition of their genitals, constructed or otherwise.
Lyle says, “What does it cost? Another forty grand? To have more sensation? It’d be nice, I guess, but I’d rather pay off my debts and buy a condo. What I have is fine. I need to get back on my feet financially and own my home more than I need to—” He laughs again and looks at his mother, who laughs too.
“And anyway,” Jessie says, “he wouldn’t ever let us see it, even after we nursed him following the surgery.”
“Did you want to?” I ask.
Lyle is laughing and shaking his head no.
“Well, yes,” Jessie says, slightly injured. “He’s my son. I wanted to know.”
“No, Mom. I’m twenty-eight. I maintain the boundaries here,” Lyle says to me, and his mother smiles, a little puzzled and hurt that this is the thing he won’t share.
“I’m pretty darn happy now. I want to finish school, and when I’m ready I’d like to marry, have a family. I’m not ready yet for a serious relationship. Psychologically, I’m just getting ready to date again.”
He sounds like a lot of the young men in AA or NA, a little ashamed, a little proud of his hell-raising days, understanding that it’s time to grow up, and a little sorry that’s so.
We take a break, and Lyle shows me the photographs I’ve asked to see. It seems absurd to describe the child I’m looking at as a little girl; even in a ruffled blouse, this is a little boy: a sturdy little boy looking adoringly at his dad while happily playing with his electric train, and then a cocky kid in cowboy hat and boots, and then a handsome, shaggy graduating senior being kissed by a pretty girl, and then Lyle as he is now, a friendly, beefy man with thinning blond hair—exactly the look of many West Coast high school football stars ten years down the road.
James Green, a transsexual man who has organized a get-together for me at his Oakland condo, sits beside me in the rental car while I look for the dimmer switch. I’m parked in his parking space, since he has chivalrously moved his car a block away to make room for me. I find the headlights, I find the interior light. I find the wipers. I cannot turn off the brights. James reaches across me with his left hand and adjusts the dimmer switch. The brights go down, and he looks at me exactly as other men have on such occasions: affectionate, pleased, a little charmed by this blind spot of mine. We smile at each other and I shrug. He shrugs too. “It’s innate,” he says, and he laughs, not taking his eyes off me.
We are dining unfashionably early, in an austerely hip neighborhood café, before the other men arrive at James’s place. A huge plate of food is put before James, and he hunches over slightly and begins eating. I notice that he does not say, “Gee, this is a lot of food,” or anything of the kind. Like a man, he just starts eating. I ask him how he met the girlfriend he’d mentioned earlier.
James puts his fork down and gives me the full effect of his green eyes. “She’s a writer. She was interviewing me.” A quick unfolding of a Jack Nicholson smile, and then, with slow mock-shyness, he goes back to his dinner. I smile too.
After dinner, we drive to his condo, which is clearly the home of a writer and a noncustodial father: eclectic reference books spill off the bookshelves, the refrigerator door is bedecked with drawings by and photographs of a cute little girl, dolls and coloring books make a pink-and-purple jumble in a corner of the living room. When James was a lesbian, the woman he lived with had a child, whom he regards as his daughter; after his surgery, they broke up, but he now sees the little girl as much as he can.
The doorbell rings, and James introduces me to Loren and Luis, guys from the local transsexual community.
Loren Cameron, a blond bantamweight photographer, is wearing a billowing tank top and black shorts. He has a tight, perfect build, and startling black stripes tattooed across his chest, on both forearms, and on his thighs. A cross between Mercury and Rob Lowe, he looks like a not uncommon type of handsome, hairless, possibly gay man one sees on beaches and boardwalks.
Loren has been romantically involved with a massage therapist named Elizabeth for the last six years. When I speak to her later, I’m not surprised to learn that she is a former dancer and a fitness fanatic, and to find out for myself that she is marvelously, mellowly narcissistic.
“Well, Loren and I are a striking-looking couple,” Elizabeth says. “We’re both very fit, and I
know that people look at us when we walk down the street. After all, I’m about four inches taller than he is.” Elizabeth describes her two previous lovers: a beautiful Amazon and an unusually sensitive man. “But with Loren, he can communicate, for the most part, like a woman, and he makes love like a man. When I met him, he was a very attractive woman. Now he’s an even more attractive man. And that’s that.”
Luis is a slightly built, gentle South American man, a chemist in Silicon Valley, thirty-five years old, single and bisexual, primarily involved with women.
“I was twenty-two when I went to Don Laub for my surgery,” Luis says. “It was the right thing for me—I can go to the gym, go swimming, and I don’t have to feel vulnerable or be afraid. I was always athletic, and I didn’t want to give that up. And it feels right for sex. What I perceive and what my partner perceives now match up. Inside and outside, I’m a man.
“The surgeries made a huge difference for me. I had the genital surgery, not the full phalloplasty. I don’t know what Dr. Laub calls the other one now, but that’s what I had. The easier one [the metoidioplasty]. I have days when I think about a phalloplasty, but I’d rather save my money, for travel, for my future, for investing. The gender issue isn’t at the center of my life.” He sighs.
“I don’t get the chance to talk about this, it’s not a conversation I’d have with other men. Gender is slippery. I used to see it as black and white—men, women, that’s it. I wanted to be perceived as male, in a male role, with male attributes. I don’t hold on to that anymore. Male, female—I don’t even understand that anymore. Now that I’ve been in a female body and in a male one and spent all this time thinking about this issue, I see that it’s nebulous. You can’t hold on to it and find meaning. Gender is an illusion, an illusion we cherish because we think we’ll ultimately find something clear and meaningful. And we don’t, we won’t. And I find, after all this, it doesn’t matter much.”
The four of us talk for two hours, and Loren and James cheerfully interrupt each other, disagreeing, raising their voices, picking holes in each other’s logic; Luis and I listen, and from time to time we point out the issues on which James and Loren do agree, which seems to matter to us but not to them.
They agree—they both know at first hand—that a number of transsexual men have emerged from the lesbian community, a world in which each of them could maneuver with some success but not with complete ease. “I was excluded from lesbian events even before I started the transition,” James says. “I was just too male—not butch but male. I crossed some line somehow, and everyone, the other women, felt that there were things about me, despite my female body, that were just not female.”
Loren, apparently irritated by James’s calm, even superior acquiescence to rejection by the community that was their world for so many years, adds, “The loss makes me mad, losing the women’s community. And the lack of acknowledgment. Transsexuals are never really accepted, by anyone.”
Luis says, very quietly, reluctant to antagonize the activists, “I’m not really very political. I take calculated risks, I do a little public speaking. I have a lot of other things I like to do and develop besides politics. My parents are apolitical, my whole family is. I’m not a separatist, of any kind. I find separatism ugly. I understand straight men at least as well as I understand gay women. I used to hate and fear men, at least all the ones I knew. Now I don’t. Probably you don’t have to become anatomically male to stop hating men.” He smiles. “But it is effective. I can now meet men that I can trust, I can care for.”
And his view of women?
“I was like a fly on the wall in my childhood world of girls. I grew up with girls, in their world, and I saw how they were treated. I didn’t feel like one of them, but I saw how women were disrespected, were diminished, and I haven’t forgotten that.”
We wind up talking about Virginia Woolf’s Orlando and weightlifting and fathers and children and photography. I like these men, and I know, whatever “knowing” means, that they’re men. I expected to find psychologically disturbed, male-identified women so filled with self-loathing that it had even spilled onto their physical selves, leading them to self-mutilating, self-punishing surgery. Maybe I would meet some very butch lesbians, in ties and jackets and chest binders, who could not, somehow, accept their female bodies. I didn’t meet those people. I met men. Some I liked, some I didn’t. I met bullshit artists, salesmen, computer programmers, compulsive, misogynistic seducers, pretty boys inviting seduction, cowboys, New Age prophets, good ol’ boys, shy truck drivers saving their money for a June wedding, and gentle knights. I met men.
Ira Pauly is one of the acknowledged titans of transsexual psychiatry. He is professor emeritus and former chairman of the department of psychiatry at the University of Nevada School of Medicine. In his bunkerlike office at the university, he cautions me that he hasn’t kept up with everything in the recent literature, which represents a huge body of work and new ideas. He says that he has met a few people who have had regrets after their surgery, but only a few, out of hundreds, and that whatever the etiology of transsexuality may be, there are those for whom surgery is the only true solution.
Pauly is a modest, very smart man with big hands and a UCLA plaque on his desk showing his college football history. He became chairman of the department of psychiatry partly on the strength of his pioneering research on transsexuals. He is always clear, reasonable, fair, and extremely contained. He showed strong feeling only once during our interview—when he talked about Louis Sullivan.
A female-to-male transsexual, Sullivan was also a gay man with AIDS, and he called Pauly in the late eighties in the hope of educating the professionals in the “gender community” about the difference between gender and sexual orientation: that a “real” man might prefer sex with men to sex with women; that the sexual object one prefers says nothing at all about one’s gender, or even about one’s masculinity or femininity. Sullivan encountered massive resistance, even from physicians and mental health professionals who regularly supervised and facilitated transsexual transitions. “But if you want to sleep with a man,” they said, in effect, “why not go on being a woman? It’s so easy.” As if only a nutty transsexual would believe that sex with a man, as a man, is different from sex with a man, as a woman.
In his search for treatment, Sullivan went to several gender dysphoria clinics (“gender dysphoria” meaning that the presenting complaint is one of deep unhappiness with one’s gender). For transsexuals, Ira Pauly told me, such clinics are the only gateways to reputable surgeons committed to meaningful standards of care: under the supervision of a clinic, the patient lives full-time as a member of the opposite sex for two years before surgery and receives documented treatment by a licensed mental health practitioner (the process recommended by the Harry Benjamin International Gender Dysphoria Association, an organization of gender dysphoria professionals—psychologists, social workers, psychiatrists, surgeons, endocrinologists, the occasional lawyer). Sullivan was rejected by the clinics because he not only knew that despite his female anatomy he was male, he knew that he was a gay male.
Pauly loaned me three hours of videotaped interviews he had conducted with Sullivan. The setup reminded me of public access TV: a ficus tree keeps brushing Sullivan’s ears, the carpeting clashes with the chairs, the camera occasionally seems stuck on the sock sliding down Ira Pauly’s bare shin or on Louis Sullivan’s pale hands fumbling with the mike. If you missed the sections on surgery and hormones, you would simply be moved by this increasingly gaunt, youngish, mild-mannered man so ferociously determined to make use of his AIDS death sentence to educate the rest of us.
“They said, ‘It can’t be,’ and I said, ‘It is,’ ” Sullivan says on one of the tapes. “They told me that I must not really be transsexual. After all, they thought, if I just wanted to sleep with men, why go to all the trouble? So, I told them. Again and again, until they got it.”
The notion that gender has a continuum, a fluid range of po
ssibilities, seems to produce such anxious rigidity in many of us that we ignore everything we’ve learned through our own lives about the complexities of men and women, and seek refuge in explanations and expectations of gender that are more magical, romantic, and unrealistic than any attitude I encountered among the transsexuals I met. Ever since Christine Jorgensen, there seems to have been a lot of confusion about what now, thanks to Louis Sullivan, seems so unconfused to Ira Pauly and others in the field. Male is not gay or straight; it’s male. We may not know what it is, but we know it’s not about whether male or female sexual stimuli inspire your erection. Maybe it’s not even about the ability or the equipment to have an erection. Maybe it’s closer to the sensation of inner arousal pushed out—a sense of erectness, of intact outerness—than to the source or object of one’s erotic desires. There are gay men, heterosexual men, bisexual men, masculine men, feminine men. We know that neither the object of desire nor the drinking of beer nor the clenching of fists makes maleness. We don’t know what does, and neither do the transsexual men, and neither do the people who treat them, psychologically and surgically.
I ask Dr. Pauly, who has expressed caution about the usefulness of transsexual surgery—and even more caution about those psychiatrists who wish to have the surgery declared a problem rather than a solution—if he would recommend surgery if he had a transsexual child.
“I would hope not to have a transsexual child; that life is no easy thing, with or without the surgery. I hope that the follow-up studies support the studies we have now. I hope these patients are happier.”
I press him.
“I would probably try to intervene early in childhood. But you know, those studies of strongly effeminate boys—a lot of them grow up to be gay, but they don’t grow up to be transsexual. You’re looking at five in a hundred for male homosexuals, one in fifty thousand for transsexuals.”
In the end, after edging up on saying that he would advise surgery if he had a transsexual child, Dr. Pauly shrugs and nods yes but doesn’t say it, and I stop. There is some kind of gift in having been in both a male and a female body in one lifetime, but it is not a gift anyone wants for their child.