The Riddle of Gender

by Deborah Rudacille

  I am proud of myself for being there that night In Feinberg, Trans Liberation, 109.

  there was this very strong association formed between gender nonconformity and homosexuality Interview with Simon LeVay, Los Angeles, Calif, September 2001. “The idea of the congenital invert sums it up better than anything, the idea that people like gays and lesbians were pretty much like we now call transsexuals. My guess is that part of the reason for that misconception was that only a very small fraction of gays and lesbians came to public attention, and they were probably the more gender-nonconformist. You come across in the literature about the Mollies and so forth, in the eighteenth century—these very gender-noncomformist gay men who formed their little societies and had their pubs where they met and it’s clear that they dressed as women. And there were probably other homosexual men and women who never came to public attention, and so there was this very strong association formed between gender nonconformity and homosexuality. And then I think that there was a kind of overcorrection in that since the Second World War in the gay and lesbian community there’s been an almost excessive denial between homosexuality and gender nonconformity. However, I think there is a connection and I think that the evidence is particularly good for childhood.”

  Gender issues stood at the forefront of the radical challenge Joanne Meyerowitz, How Sex Changed: A History of Transsexuality in the United States (Cambridge and London: Harvard University Press, 2002), 232.

  the Cockettes, a group of singing, dancing, gender-fuck hippies Susan Stryker was the first person to mention the Cockettes to me. Two years later, the feature-length documentary The Cockettes, by David Weissman and Bill Weber, was released. The film was a nominee for Best Documentary at the Independent Spirit Awards and winner of Best Documentary, Los Angeles Film Critics.

  They were people who brought together clashing styles Author interview with Stryker, September 2001.

  Many of us believed that the best way to eliminate the male/female divide Jay, Tales, 82.

  a novel that reflects hir experience Feinberg prefers the use of non-gender-specific pronouns (hir, sie) and usage in these paragraphs reflects hir preference.

  One day I came home from work Leslie Feinberg, Stone Butch Blues (Ithaca, N.Y.: Firebrand Books, 1993), 135-36.

  As much as I loved my beard as part of my body Ibid., 222.

  strangers had raged at me for being a woman who crossed a forbidden boundary Ibid., 244.

  the real Feinberg was denied medical treatment Feinberg, Trans Liberation, 2.

  In May i£58, the Sunday Express of London Liz Hodgkinson, Michael, Nee Laura: The Story of the World’s First Female to Male Transsexual (London: Columbus Books, 1989), 137.

  Proud of being a woman Mario Martino. Emergence: A Transsexual Autobiography (New York: Crown Publishers, 1977), 246.

  For me, some of the hardest people to come out to Author interview with Ali Cannon, San Francisco, Calif., September 4, 2001.

  It was really hard Author interview with Tom Kennard, San Francisco, Calif., September 5, 2001.

  bitchy, catty, dykey, frustrated, cray Morgan quoted in Jay, Tales, 113. 167 I will not be your “nigger” any longer Del Martin quoted in Clendenin and

  Nagourney, Out for Good, 96.

  called on feminists to cut their ties with men Clendenin and Nagourney, Out for Good, 90.

  for lesbians, the best thing that emerged from the Lavender Menace Jay, Tales, 145.

  Man-hating … is an honorable and viable political act Morgan quoted in Clendenin and Nagourney, Out for Good, 166.

  All transsexuals rape women’s bodies Janice Raymond, The Transsexual Empire: The Making of the She-Male (Boston: Beacon Press, 1979), 104. For a response to Raymond, see Sandy Stone, “The Empire Strikes Back: A Post-Transsexual Manifesto,” in Writing on the Body: Female Embodiment and Feminist Theory (New York: Columbia University Press, 1997), 336-59.

  Raymond andMcHugh echo each other in characterising transsexualism as “an

  ideology” Raymond, Transsexual Empire, 5. 169 and comparing sex-reassignment surgery to a lobotomy Ibid., 131. 169 it is biologically impossible to change chromosomal sex Ibid., 126. 169 Masculinity and femininity … are social constructs Ibid., 3.

  The transsexual has not been adequately conditioned Ibid., 132.

  We know that we are women who are born with female chromosomes Ibid., 114.

  Transsexualism is thus the ultimate … conclusion of male possession Ibid., 30.

  Female-to-male transsexual people … have been assimilated into the transsexual world Ibid., 27.

  The Transsexual Empire is ultimately a medical empire Ibid., 119. 171 One hypothesis that is being tested Ibid., 140.

  I have a newspaper article in my files Author interview with Stryker, September 2001.

  John Ronald Brown, “presented himself as the champion of transsexuals”

  Meyerowitz, How Sex Changed, 271.

  He was exceedingly handsome Jan Morris, Conundrum (New York: Har- court, Brace, Jovanovich, 1974), 155.

  What Erickson did on a small scale Author telephone interview with Aaron Devor, June 10, 2002.

  When the first HBIGDA conference was going to be held Author interview with Jude Patton, June 21, 2003, Philadelphia, Pa.

  HBIGDA recognised the use of private practitioners Meyerowitz, How Sex Changed, 273.

  Six CHILDHOOD, INTERRUPTED

  I wonder what my parents imagined would happen to me in a mental hospital Daphne Scholinski, The Last Time I Wore a Dress (New York: Riverhead Books, 1997), 6.

  Defining a mental disorder Herb Kutchins and Stuart A. Kirk, Making Us Cray: DSM— The Psychiatric Bible and the Creation of Mental Disorders. (New York: Free Press, 1997), 27.

  As early as i<)56, the psychologist Evelyn Hooker Evelyn Hooker, “The Adjustment of the Male Overt Homosexual,” Journal of Projective Techniques 21 (1957): 18—31; Evelyn Hooker, “Male Homosexuality in the Rorschach,” Journal of Projective Techniques 22 (1958): 33—54.

  The deletion of homosexuality from the manual See “The Fall and Rise of Homosexuality,” in Kutchins and Kirk, Making Us Cravj, 55—100, a discussion of the political activism and internal debate in the American Psychiatric Association that led to the deletion of the diagnosis.

  DSM is the psychotherapist’s password for insurance coverage Kutchins and Kirk, Making Us Cravj, 12.

  “transsexualism” first appeared as a diagnostic category American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. (Washington, D.C.: American Psychiatric Association, 1980).

  due to inexperience and naivete Norman Fisk, M.D., “Gender Dysphoria Syndrome: The How, What, and Why of a Disease,” in Proceedings of the Second Interdisciplinary Symposium on Gender Dysphona Syndrome, eds. Donald R. Laub, M.D, and Patrick S. Gandy, M.S., Stanford University Medical Center, February 2-4,1973, 8. The symposium was sponsored by the divisions of Urology and Plastic and Reconstructive Surgery at the Stanford School of Medicine. Laub, a surgeon, and Fisk, a psychiatrist, were the primary architects of the Stanford Gender Identity Clinic. See also D. R. Laub and N. Fisk, “A Rehabilitation Program for Gender Dys phoria Syndrome by Surgical Sex Change,” Plastic and Reconstructive Surgery 53, no. 4 (April 1974): 388-403. For a consumer’s perspective on the Stanford program, see Dawn Levy, “Two Transsexuals Reflect on University’s Pioneering Gender Dysphoria Program.” Levy describes the experience of Sandy Stone and Jamison Green in the program. Stanford Online Report. Downloaded on July 18, 2001, from http://wwwStanford.edu/dept/news/report/news/may3/sexhange-53-html.

  We avidly searched for those patients who, if admitting to homosexual behavior at all Fisk, “Gender Dysphoria Syndrome,” 8.

  intensely and abidingly uncomfortable in their anatomic and genetic sex Ibid., 10. Fisk admits that “the vast majority of patients who qualify for primary diagnosis of gender dysphoria syndrome, as opposed to transsex- ualism, are people who themselves rush to embrace the diagnosis of trans- sexualism.
” He attributes this to the fact that “both homosexuality and transvestism are still affectively experienced by many of our patients and their families as painful and inexcusable moral perversions or fetishes,” im plying that a diagnosis of transsexualism was not, at that time, perceived in the same manner by the patients themselves or their families (14). See also Laub and Fisk, “Rehabilitation Program;” and Norman M. Fisk, “Five Spectacular Results,” Archives of Sexual Behavior 7, no. 4 (1978).

  In 1994, the diagnosis of transsexualism was deleted American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (Washington, D.C.: American Psychiatric Association, 1994).

  a strong and persistent cross-gender identification Diagnostic criteria for gender identity disorder of childhood, from Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (American Psychological Association, 1994).

  Behaviors that would be ordinary or even exemplary for gender conforming boys and girls Katharine Wilson, Ph.D., “Gender Identity Disorder in Children,” http://www.gidreform.org, 3.

  Recent revisions of the DSM Katherine Wilson, Ph.D., “The Disparate Classification of Gender and Sexual Orientation in American Psychiatry,” presented at the 1998 Annual Meeting of the American Psychiatric Association,” retrieved from http://www.gidreform.org, March 31,2001; Katherine Wilson, Ph.D., “Gender as Illness: Issues of Psychiatric Classification,” in Taking Sides—Clashing Views on Controversial Issues in Sex and Gender, E. Paul, ed. (Guilford, Conn.: Dushkin McGraw-Hill, 2000), 31-38. Retrieved from http://www.gidreform.org. See also Justin Cascio, “Bias in Writings on Gender Identity Disorder,” retrieved from TransHealth.com 1, no. 4 (Spring 2002). http://www.trans-health.com/Iss4voL1/research.htm.

  boys diagnosed with GID in childhood “The most extensive and detailed of 199 prospective studies was carried out by Richard Green, a psychiatrist at UCLA. In his study, about four-fifths of the markedly effeminate boys became rather conventional homosexual or bisexual men, one boy became a transsexual man, and the remainder became heterosexual men…. Thus the association between childhood gender nonconformity and adult homosexuality is well established, especially in men,” LeVay, Queer Science, 98, discussing Richard Green, The “Sissy Boy Syndrome” and the Development of Homosexuality (New Haven: Yale University Press, 1987).

  This conclusion has been disputed more recently by some clinicians who treat children and adolescents, for example, Peggy T. Cohen-Kettenis, Ph.D., Department of Child and Adolescent Psychiatry, University Medical Center, Utrecht, Netherlands. “Our data show that GID in childhood is associated with more than just one long-term trajectory. Continuation of GID into adolescence by no means seems to be a rare exception. We believe that treatment should be available for all children, regardless of their eventual sexual orientation, and should depend only on the severity of suffering experienced by the child.” In the Netherlands, adolescent children are eligible for hormone treatment if they meet the clinic’s criteria. Cohen-Kettenis notes that of seventy-four children referred to the clinic before the age of twelve, “17 intensely gender dysphoric adolescents applied for sex reassignment…. Of the 17, 3 adolescents have started cross-hormone treatment.” Peggy T. Cohen-Kettenis, “Gender Identity Disorder in DSM?” Letter, Journal ofthe Amencan Academy of Childhood and Adolescent Psychiatry 40, no. 4 (April 2001): 391.

  American psychiatric perceptions ofetiology, distress, and treatment goals for transgenderedpeople Wilson, “Disparate Classification,” 9.

  No single group has gone more unnoticed by society Gianna E. Israel and Donald E. Tarver II, M.D., Transgender Care: Recommended Guidelines, Practical Information and Personal Accounts (Philadelphia: Temple University Press, 1997), 132.

  If there is any cure for children or youth with gender-identity issues Ibid., 137.

  Parents with resources large or small will spend their last penny Ibid., 134.

  Because gender-identity conflicts are still perceived as a mental health disorder Ibid.

  or… out on the streets A study of homeless LGBT youths published in the American Journal of Public Health in 2002 concludes that “homeless youths who identify themselves as members of sexual minority groups are at increased risk for negative outcomes” such as “greater vulnerability to physical and sexual victimization, higher rates of addictive substance abuse, more psychopathology, and riskier sexual behavior in comparison with homeless heterosexual adolescents.” Bryan N. Cochran, Angela J. Stewart, Joshua A. Ginzler, and Ana Mari Cauce, “Challenges Faced by Homeless Sexual Minorities: Comparison of Gay, Lesbian, Bisexual, and Transgender Homeless Adolescents with their Heterosexual Counterparts,” American Journal of Public Health 92, no. 5 (May 2002): 773—77.

  Children with gender issues frequently are regarded as unruly or disruptive Israel and Tarver, Transgender Care, 135.

  People were really mean to him at school Jeremiah Hall, The Advocate, November 22, 2002.

  I had no fiends Author interview with Alyn Liebeman, Philadelphia, Pa., March 21, 2003.

  Because isolation and ostracism are key components of transgender youth experience Israel and Tarver, Transgender Care, 133.

  skipped over hope, joy, love and anything else positive Scholinski, The Last Time, 93.

  wore Toughskinjeans with double-thick knees Ibid., 46.

  Linda opened her purse Ibid., 104.

  They got to be afraid of me Ibid., 107.

  Genderqueer kids present an ideal profile for sexual predators Riki Anne Wilchins, Read My Lips: Sexual Subversion and the End of Gender (Ithaca, N.Y.: Firebrand Books, 1997), 130.

  The second time I was over, the man kept his hand on my shoulder Scholinski, The Last Time, 132—33.

  loo percent… had been physically abused or beaten as children Wilchins, Read My Lips, 24.

  such abuse “appears not as an anomaly” Ibid., 305.

  I was being physically abused at home all the time Author interview with Brad.

  I’d walk up to him close enough so that his angry face was all I could see Scholinski, The Last Time, 2.

  I didn’t mind being called a delinquent Ibid., 16.

  She held up cards with a picture of a policeman Ibid., 30. 208 Daphne presents a tomboyish appearance Ibid., 56.

  Drug addiction offered itself to me like a blanket of forgiveness Ibid., 86.

  I sneaked a glance, and it was a jolt Ibid., 119.

  Donna wanted me to walk skittery, like a bird Ibid., 124.

  I still wonder why I wasn’t treated for my depression Ibid., 197.

  The limited evidence suggests that individuals are given DSM diagnoses Kutchins and Kirk, Making Us Cravj, 260.

  the designation of Gender Identity Disorders as mental disorders is not a license for stigmativation Harry Benjamin International Gender Dysphoria Association, Standards of Care, http://www.hbigda.org/soc.html.

  DSM is a red herring Author interview with Beyer.

  There’s all this empirical data, exceptional data, data that doesn’t fit their [psychiatric] theory Author interview with Christine Johnson, Philadelphia, Pa., May 13, 2002.

  High rates of polycystic ovary syndrome Hartmut A. G. Bosinski, Michael Peter, Gabriele Bonatz, Reinhard Arndt, Hären Heidenreich, Wolfgang G. Sippell, and Reinhard Wille, “A Higher Rate of Hyperandrogenic Disorders in Female-to-Male Transsexuals,” Psychoneuroendocrinology 22, no. 5 (1997): 361-80; A. H. Baien, M. E. Schachter, D. Montgomery, R. W. Reid, and H. S. Jacobs, “Polycystic Ovaries Are a Common Finding in Untreated Female-to-Male Transsexuals,” Clinical Endocrinology 38, no. 3 (1993): 325-29.

  Researchers currently view PCOS as a developmental disorder D. H. Abbott, D. A. Dumesic, and S. Franks, “Developmental Origin of Polycystic Ovary Syndrome: A Hypothesis,” Journal ofEndocrinology 174 (2002): 15.

  Just because something is in the DSM doesn’t make it a real disease Author interview with Paul McHugh, Baltimore, Md., June 17, 2002.

  I think that it… should not be in the DSM Author interview with Ben Barr
es, Palo Alto, Calif, August 2001.

  To the extent that it is in the DSM, I don’t think that it should be applied Author interview with Anonymous, New York City, July 22, 2001.

  If you talk to post-op transpeople, most are what you would call conservative on this question Author interview with Chelsea Goodwin, New York City, July 2001.

  My fear is that it [the GID diagnosis] will get thrown out of the DSM Author interview with Wheeler.

  To OUT knowledge this is the first transgender marriage case in the U.S. inwhich extensive medical evidence Shannon Minter, press release by National Center for Lesbian Rights and Equality Florida, February 21, 2003. A Florida appeals court ruled the Kantaras marriage null and void in July 2004, sending the custody case back to family court. Further appeals are expected.

  Basically, we know squat about our community Author interview with Julie Maverick, Baltimore, Md., May 1, 2002.

  Transgendered people commonly receive substandard… medical treatment NTAC request for funding, unpublished personal communication, Julie Maverick.

  LGBT patients face many barriers to adequate health care See Hope Vander-burg, “Are LGBT Patients Receiving Adequate Healthcare?” conference summary, American Medical Students Association Fifty-first Annual Convention, March 28-April 1, 2001. Retrieved from http://wwwmedscape xom/Medscape/M … 07.01.vand/mms0507.01.vand-01.html on 5/14/01.

  rates of HIV infection among male-to-female transsexuals in cities See Jessica Xavier, Washington Transgender Needs Assessment Survey, and The Transgender Community Health Project, published by the San Francisco Department of Public Health, February 1999, available at http://hivinsite.ucsf.edu/InSite. See also “HIV-Related Tuberculosis in a Transgender Network—Baltimore MD and New York City 1998—2000,” Morbidity and Mortality Weekly Reports 49, no. 15 (2000): 317—20. “A Plague Undetected,” a news article by Nina Siegal published in Salon, March 2001, correlates high rates of HIV infection among trans communities in a number of cities to needle-sharing in black-market hormone use. Siegal quoted Jason Farrell, executive director of the Positive Health Project, an AIDS outreach program in New York City, as saying, “Due to the lack of tracking, there might be an epidemic out of control and we don’t know about it, nor do we have the resources to address it if we need to.” Siegal also quotes Dr. Paul Simon, a medical epidemiologist at the Los Angeles County Department of Health Services, who helped conduct a survey of 244 male-to-female transsexual people in 1998 and 1999. Simon and his colleagues found that 22 percent of those studied were HIV-positive. “That’s as high as what we were seeing among gay and bisexual men in the 1980s at the peak of the epidemic. It’s a very high rate of HIV infection.” Retrieved from www.salon.com on April 9, 2001.