Sunday, January 1, 2017

Biography

I was exposed to a powerful synthetic estrogen, Di-Ethyl Stilbesterone (DES) in utero starting around Week 10 of fetal development (after genital and body core formation, but before sexual differentiation of extremities and brain).  This was a drug thought to be effective in preventing miscarriages, of which my mother had had several before I was conceived.  The drug is now known to block the masculinizing effects of testosterone in utero.  Some data on me points to feminine bone structure in the extremities, and the female version of some sexually dimorphic areas around the hypothalamus.  

There were clues when I was very young.  I didn't just know anything at age 6. We didn't have the language or concepts. I did know that as little kids got bigger we would change. I hoped that I would change, and be a girl. All I knew was that I had a little bump of tissue that girls didn't have, and maybe it would shrink away or fall off as I grew. 

It was odd, but I knew that I was a boy, a child in a male body.  Once I figured out that this body would be this way for life, the thought of being this way bothered me a bit.  I didn’t think that my wanting to have been a girl was unusual.  I actually believed for a long time that everyone was this way, that all boys wanted be girls.  Other boys were stronger than me somehow, and able to live with being stuck in a male role.  I thought that I was unusually weak because of my difficulty in dealing with this.

I went to a parochial elementary and high school, not great for someone like me.  A few yardsticks broken across my wrist convinced me to not talk about wanting to be a girl, and some of what I heard on the playground back in 1959 told me my dream wouldn't be happening. 

I had a great deal of trouble with socialization in school, fearing male students and their reactions to me.  Many saw through my imperfect disguise, and I was called out and beaten for being a sissy, ‘girly’ and otherwise not male in my appearance and behavior.  I still had the discomfort and a sense that something was wrong, and it got worse when I was about 13. 

At 14 I discovered that if I gave the bus driver an extra dime, I could ride all the way into San Francisco.  In 1967, that was quite the experience.  I wore my boots and flare pants, and in the SF bus terminal I’d change my top to something a bit more Bohemian and brush out my hair, another 14 year old hippie chick running around the city.  Then I’d head off to visit new friends over at Taylor and Turk St, or out near the Panhandle at Haight & Ashbury.

I had an extremely effeminate body, with no hair, undescended testicles, and some breast growth.  At 15 I was sexually assaulted in the high school locker room by several of the ‘jocks’.  I received detention for trying to fight off my rapists.

Later that year I was caught dressing, grounded (no more bus rides into SF and friendly queens), taken to see doctors who just talked and never examined me, and eventually got regular "vitamin shots, so you'll grow up right", as Dad said.  Yes, Vitamin T, testosterone. I received extensive counseling, including from the parish priest for a few years. I was eventually pronounced to be cured.

I went to college, and fumbled about, knowing that something was out of whack with me, but hopeful that I would find a fix.  I decided to enlist in the military when my funds ran low. They could pay for my education, and would teach me to man up properly.

Until recently, a trans person enlisting was considered to be a homosexual by the military and many others, and was supposed to check THAT box on the paperwork.  For decades, that of course meant that with the box checked we couldn’t enlist.  The recruiter helpfully told us to check NO on all the little boxes on part of the paperwork or we would not be allowed to enlist, so of course, that’s what I did.

I didn’t think I was a homosexual.  Heck, I liked girls.  Being one on the inside didn’t change the accessories my body had, so I never thought of myself as being homosexual.

But, yes, I was trans, a worried girl afraid that others would see past my man suit and realize who I was.  I thought of myself as ‘cured’ if only I could keep this side of me suppressed, and avoid these sinful thoughts of being myself.  I tried to ‘man up.’   I fell in love and got married.

I worked very hard, as many trans military members do, and like many other trans folks, was an overachiever.  I was in the Navy Nuclear Power Program, and I impressed the staff sufficiently that I was asked to stay on for two years as an instructor after I completed the Nuclear Power Schools.  Following that tour, I was assigned to a submarine, the USS Parche, the most decorated boat in the fleet, and crewed by more overachievers.  And yes, as I found out years later, that included several other trans folks.  I racked up more awards, including the Navy Achievement Medal, presidential and command citations.  I finished the requirements for a Bachelor of Science degree in Physics.  Besides my primary Engineering duties, I took on duties in the fire control racking party, damage control party, and was assistant ship’s photographer, recording mission data and assembling media for reports to COMSUBPAC.  I was the Engineering Dept 3M Coordinator, overseeing all maintenance and care for the nuclear power plant, engines and support systems.

Trans folks tend to be driven overachievers.  (Just ask anyone who knows me…)  We work hard to try and be accepted, far harder than those born with their assigned sex and gender identity in line, because we really do have something we need to prove.

I wanted to be a good husband and parent, and knew that a Navy career wouldn’t work well for that, so I decided to try civilian life after six years.

I moved to jobs in the tech industry after my Navy tour.  I didn't ramp down from the testosterone and treatments until I was in my late 20s.  The dressing restarted, and even then I didn't consciously realize what was up until I met a trans woman in my early 30s, who was interviewing for a job on my team.  She was having a rough time passing after our all-day interview process, but I tried to respect her as a person looking for a position with us.  I found my self thinking that she was doing something pretty darn hard, and I thought “I wish I could do that.”  Wait, what?  Where did that come from?

I think my subconscious had just outed me to myself.

That's pretty much when I knew, and finally had a label for myself, “Transgender.”  The transition process was obviously not that great back then, and I was married with small children, so I essentially gave up hope, tried to bury the need, and went about my life of passing as male.  I dressed in secret from time to time, going through the usual purge cycles, regret, withdrawal from dressing, and so on.  I still thought of this as being a weakness, a personal failing that I needed to overcome somehow.

The drive and my suppression slowly corroded away my mental state over decades.  My emotional repression and constant submerged anger and self-hatred caused harm to those around me, which I very much regret.  I finally broke down early in 2016 with severe depression and anxiety.

I came out to my spouse, upsetting her, and started therapy immediately.  I was quickly referred to a gender therapist, and after a few months of delaying while I tried to figure out if what was going on with me was ‘real’, I accepted my transgender nature and started Hormone Replacement Therapy (HRT). 

As part of starting HRT, an endocrinologist ran a very detailed panel of tests, and spotted a number of anomalies, including an unusual prolactin level.   This had me pretty nervous for a while.

Normal for a person Assigned Male At Birth (AMAB) is 0-18 ng/ml; my levels:

Before HRT: 30 ng/mL and 34 ng/mL
2 days into estrogen: 40 ng/mL
4+ weeks on estrogen: 38 ng/mL

A high resolution MRI was ordered in July 2016 (followed up in May 2017)


I have a tiny adenoma, on the pituitary, also known as a microprolactinoma.  It is associated with a high prolactin level tha made my endocrinologist cautious about starting HRT, specifically estradiol, which could stimulate the adenoma. 

Ah, but the standard prolactin test isn't clever enough to tell the difference between monomeric prolactin, the stuff that helps us start nursing, and the giant macroprolactin molecules often produced by a prolactinoma that are inert.  A chromatographic test that separates them (Macroprolactin, Serum; Test ID MCRPL) shows monomeric prolactin at 9 (normal range 3.4-14).  So my little monster is just a boring microprolactinoma and won't be causing me any problems with growth or lactation.

If the microprolactinoma does grow, there is another medication I can take for a while that has very good results in shrinking these growths.

With this resolved, I was able to start Hormone Replacement Therapy (HRT).   Several weeks into HRT I started experiencing these calm periods, at first for several hours, and then for days.  It was amazing.  The irritation that I had felt, sort of like the buzzing of a beehive, not an audible hallucination or anything, just a constant background agitation, had been present and intensifying for decades.  When it vanished at first I didn’t recognize the change, beyond feeling really good, really calm, and able to drop into my daily meditation in seconds instead of 10-20 minutes of trying to calm and center myself.

I think this corresponded to the big drop in Testosterone levels.  As my Estradiol levels rose I had an improvement in mood and energy, also appreciated, but the fading of this odd ‘alarm’ state from the back of my mind is the most significant, critical mental change I got from HRT.

This was the change that told be I was on the right path, that I could survive after all.

I had a number of painful discussions with my spouse.  This was not something that she was prepared to live with.  My having hidden this away for decades was hurtful to her, a breakdown of trust.  My need to transition would put her in a very difficult position, a drastic change in our lives that she was not prepared to make.

After more painful discussions and a mediated divorce, my spouse and I went our separate ways.  I didn’t handle that well, and I regret how things turned out.  I do know that my spouse is comfortable and has friends to help her, and am very grateful for that.  

I found a nice little condo unit to rent in a walkable community, moved in, and immediately went full time as my authentic self after being on Hormone Replacement Therapy (HRT) about 5 months.   

I set about rebuilding my life and taking care of all those details like name and gender marker changes.  I found a welcoming and accepting church, an Unitarian Universalist congregation.  I found a social support group that meets several times a month and joined them.  I made friends, and built a social life.  I found that I wasn’t actually an introvert, but an extrovert once un-closeted. 

A year after going full time, almost to the day, I had my Gender Confirmation Surgery (GCS), from Drs. Thomas and Selim with Kaiser NorCal. Almost a year later, in August 2018, I had Facial Feminization Surgery (FFS) from Drs. Kleinberger and Shih.


My life is much better now.  I am finally living as my authentic self, free of the depression, anxiety, and gender dysphoria that has been with me most of my adult life.  I have been free of that black cloud finally, and this has been the happiest period of my adult life.

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