Monthly Archives: August 2013

Sex, Lies and Suicide

If I had to choose only three events in my life that have shaped who I am today, they would be:

1 – My decision to transition (Jan 2004)

2 – My friend A—‘s suicide (Apr 2005)

3 – My father’s death (Sep 2005)

I’ve had other key events in my life, like the move from Prince George, Canada to Pretoria, South Africa when I was 11 years old. Or the trip my father and I made to the Yukon the year before that. Or in 2001, when I ended up in the psych ward on suicide watch. Or 1999, when I won a scholarship to study French in Quebec City.

But the impact those events had pale in comparison with the three events above.

My decision to transition

In 2004, when I decided to start hormone treatments, I had very little reason to live. I had been severely, suicidally depressed since my late teens and simply could not shake it, despite heavy doses of medication and regular counselling appointments. Transition was a last kick at the can before calling it a day and ending it. I mustered the last of my energy and dove into a new existence, a more authentic one. I had never been so terrified in my life. But the transition itself went smoothly. I got a job as a man just 4 months after starting hormone treatments. People called me “he” and “sir”, with a few exceptions, basically from Day 1. My height helped, as did the hair that sprouted all over my legs and arms, thick and dark. Later it sprouted on my face too, and I welcomed it with open arms. The physical act of transitioning seemed fairly painless. Emotionally, though, it wasn’t so easy.

The Suckiness of Suicide

As I recently learned at the Gender Odyssey Conference, the trans community’s suicide rate is astronomically, disproportionately, unacceptably high. While the general public has an attempt rate of 1.6%, 41% of trans people have attempted suicide. Think about that. That’s almost half of the trans community. That’s crazy.

When A— died, I wasn’t ready. Not that anyone can ever be ready for something that cuts so close to the bone. It broke something open inside me and left me bleeding in ways I didn’t know was possible. Part of me felt jealous that she got there first. Why couldn’t it have been me? I wondered. I was the one who was always on the brink of slitting my wrists. I was the one who talked about overdosing, hurling myself in front of oncoming traffic (something I’d never do, btw – as it’s a terrible thing to do to the person behind the steering wheel), or jumping off a bridge. Yet here I was, still alive. And the one person to whom I had always been able to reach out, had beat me to it.

But the real emotion it awoke, the one I still wrestle with on a daily basis, is the guilt of knowing I did not try hard enough to stop her. It’s quite common for suicide survivors to feel guilt; I’ve read the literature. But in my case I know it’s warranted. The day she died, she left me a voicemail, telling me she was going on a long journey. I could read between the lines. Her partner had contacted me a few days earlier to let me know that she was worried about A—. I had brushed her off. And when the message came in, I listened to it, dialed *69 to find out where she was calling from, and promptly let it go when the number was revealed as blocked. I went to see a movie with a friend knowing full well what A— was up to. That is, my head knew that her call was a suicide note. My heart, on the other hand, was completely dead. I simply shut down. A day later I called her partner to find out if she was OK. K— informed me that she had died. I felt like I was acting in play, or that any minute someone would shake me awake. But nobody did. It was all real. There was no going back.

I’m told I need to forgive myself; we all make mistakes. Besides, it’s very likely I couldn’t have done anything to stop her. Even if I’d been there to get her call. Or if I’d contacted her partner when I received that voicemail and we’d been able to track her down, she may well have killed herself another day. You can’t save someone who doesn’t want to be saved. I get all of that. But the guilt stems from knowing that I didn’t even try. I had given up on having a positive impact on her, or anyone else’s, life. I’d given up on my agency. I was simply an observer, separate from the world. What I did didn’t matter at all. Life just happened. That’s how I felt at the time. And it meant that I didn’t reach out when maybe I could have made a difference.

I wish I could’ve at least tried.

The Death of a Father-Figure

When my father passed away five months later, in September, it seemed like more proof that I had absolutely no effing control over the world. The timing couldn’t have been worse. He had found out only months earlier that I had started my transition (I had kept it a secret for fear of upsetting him and my mother). A co-worker had accidentally outed me when she referred to me by my male name in talking to my father (she didn’t know I was trans). My mother disowned me. My sisters refused to get pulled into the drama and simply stayed on the periphery, where they remain. It felt like Karma. Like what my mother had told me, and a few of my teachers too — that I was bad. That I was the architect of my own misery. I deserved to die, my mother wrote in her email messages; she wished I would’ve died instead of my father. Part of me agreed with her. My entire existence seemed like a waste of oxygen. Worse still, part of me felt like who I was, was somehow contributing to all the misery around me. Maybe my act of disobedience, my decision to transition, had unleashed the wrath of God. My father used to believe that AIDS was God’s way of punishing the gay community for their sinful acts. Maybe A—‘s and my father’s death was God’s way of condemning me too, for going against nature. For thinking I could defy God. My mother would certainly agree.

Moving on has proven challenging. Eight years later and I have a good job, a strong partnership, a home, a dog , friends. The suicidal feelings have faded, mostly. But the guilt, for the pain I caused my father and my family, for the lack of empathy that led me to dismiss A—‘s pain, or at least not reach out to her more, those feelings are still pretty raw beneath the surface.

Honestly, I don’t know how one moves on from that.

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Learning to Lead

Becoming a Visible Man by Jamison Green

Becoming a Visible Man by Jamison Green

At the 2103 Gender Odyssey Conference in Seattle, I had the privilege of attending a workshop on leadership, with Jamison Green as the facilitator.

Green is a veteran activist, acclaimed author and the president-elect of the World Professional Association for Transgender Health (WPATH), an international multidisciplinary professional organization committed to promoting evidence based care, education, research, advocacy, public policy and respect in transgender health. Healthcare professionals across the globe look to WPATH’s guidelines to inform the way they treat their transgender clients.

The conference workshop was an open format discussion, with an audience of trans leaders of varying capacities. Many of those present talked about the difficulty of raising funds for anything related to trans issues. First of all, only not-for-profits are eligible for grants and funders want data to inform their decision. But you can only collect data on a population if you already have funding in place.

The only way we’re going to make headway as a community, Green explained, is to institutionalize the various spaces that impact us. E.g. insurance, healthcare, HR policies, government, education, to name only a few key ones. We need to do the research, get the data, and use the data to get the funding we need to provide better services for our community. No use waiting for others to do it for us.

He called upon each of us to lead by influencing and to not underestimate the power of disseminating information to those who don’t have it. One of the workshop participants talked about speaking with authority, even when you feel like you don’t really know what you’re talking about. That’s what he had to do when he became a de facto expert on all things trans after starting an online resource hub that drew questions from parents and trans people far and wide. Find the resources you need, suggested Jamison, and claim your space. With the internet, resources are more accessible than ever before.

I especially liked when Green said leadership is about empowering others. You lead by sharing your skills and knowledge with other people; but leadership is not about making yourself indispensable. Many would-be leaders make the mistake of wanting to do too much themselves or don’t know how to ask for help. Ultimately, though, we are only as strong as the people who support us. And that means allowing others to step up to the plate; trying to do everything yourself is a recipe for burnout.

Green acknowledged that it is tough to lead, that it is easy to get worn down, and that there really isn’t any money in it. But he does it because he doesn’t want to see people suffer anymore. That struck a nerve for me.

If I can do something, no matter how small, to make transitioning a little less painful for the next person, then I want to do it. No better time to start than now.

Gender Odyssey Conference 2013

If I have been quiet over the past few weeks it’s because I’ve been busy gearing up for my first attendance at the Gender Odyssey Conference in Seattle. I was fortunate enough to be able to attend this four day event for the first time since it was started back in the Spring of 2001.

With about 500 attendees, the conference is an opportunity for transfolk across the US and Canada (with some attendees from other countries) to mingle, connect and share experiences. The conference was a good mix of keynote speakers, workshops and discussion groups. In parallel with the general conference was a family conference for parents dealing with gender-non-conforming children. It was inspiring to see parents in attendance who were truly interested in doing the right thing for their children.

The first session of the conference I attended was Ryan Sallans’ overview of his experience getting the metoidioplasty done in Belgrade, Serbia. Sallans is an author and sex educator; he recently published his memoir Second Son.

In 2008, he flew to Belgrade to have the procedure done as the costs were significantly lower than they would have been in the States. He stressed the importance of doing the emotional work of preparing for surgery, as the procedure itself was extremely painful and the recovery period long and drawn out. Be prepared for the worst, he said, so there’s no surprises.

The procedure he underwent included the meta, a urethral lengthening, a scrotoplasty and a vaginectomy and altogether worked out to just under $27,000 for 4 round trip tickets and all the supplies he needed afterwards. He highly recommended taking someone with you as after the procedure you are not able to move around much at all and you are responsible for feeding yourself and buying groceries at one of the apartments where the doctors put you up for your 14-21 day recovery period.

The doctors themselves were extremely helpful and supportive. They make a point of taking out their patients for dinner and hand you a cell phone once you arrive so you can call them whenever you need them. He noted that it was worth going early if you could, as the culture is quite different and going early is an opportunity to explore your surroundings prior to the surgery.

As far as complications went, he had a few of them. He acquired Strep B during his stay there but it was successfully treated with a round of penicillin. He also had a few bouts of urinary tract infections (UTIs) and two stitches pulled loose during the flight back home. The pain, especially those first few days after the surgery was excruciating and he advised learning the word for pain (Boli in Serbian), as this guaranteed you a shot of painkillers in the butt – much welcomed. He said that the entire procedure was the most painful thing he’s ever gone through in his entire life.

Aspects that caused particular pain and discomfort were the stint that jutted out from the superpubic catheter that exited the body about 3 inches below the belly button. Walking around with a catheter bag for 30 days was no fun. Sallans described experiencing some leaking when he finally tried to pee through his urethra – an apparently common occurrence but one that resolves itself on its own in most cases.

The procedure itself was fascinating to hear him describe: the doctors used the inside of his cheek to form the urethral extension (presumably because it is self-cleaning tissue?) and then used the inner labia (labia minora) to create the penis shaft. Turns out female labia minora are made out of the same tissue that men’s penis shafts are made of. We are all born with the same toolbox; but the chromosomes make them develop differently. The doctors used the labia majora to fashion two scrotal sacs for his new testicle implants (18cc). The implants come with a lifetime guarantee. While Ryan decided against it, some folks go back for revisions to have the two scrotal sacks united into one for a more natural look.

In December 2010, two years after his original surgery, Ryan returned to Belgrade to get a mons resection (where they moved the penis and testicles up and outward). He is happy with the final result.

His main reason for getting the surgery was because of severe body dysphoria. He wanted to be able to stand and pee. The surgery has given him a lot of confidence and it has changed the way he walks and moves. While he decided against pursuing the phalloplasty, he was told that it is very easy for someone who has already had a meta to later get a phallo. In terms of the size of his penis, he said it was comparable to the size of his thumb. While he is unable to deeply penetrate his partner, what he now has is enough for him to psychologically feel like he is penetrating his partner.

What I got from this session was that you really need to be committed to getting this procedure if you’re going to make it through it. For me, I do experience body dysphoria but so far I am able to overcome it: my non-traditional genitalia work just fine in the bedroom. And I really do not want to risk losing any sensation down there.

Stay tuned for more feedback on the conference in my upcoming posts.