I have a question for the audience. By a show of hands, who here was happy with the changes they experienced during puberty? There’s no right or wrong answer, I’m just curious. Now, by a show of hands, who was unhappy?

I was unhappy when puberty hit. Miserable, actually. On-and-off suicidal. I’m transgender, which means I was assigned one gender at birth (male) but identify as another (female). So when puberty hit, around thirteen, I began developing in all of the ways which are normal for boys: Hair started growing in places I didn’t really want hair to grow (namely, everywhere), my voice dropped, I didn’t grow boobs or get all curvy, I discovered how great masturbation is, and I was slightly irritable, angry, or depressed for the next seven years; any normal boy’s puberty and trans girl’s nightmare.

The things happening to my body felt totally foreign, and not simply because puberty was changing my body from a child to an adult. They felt foreign because my body was changing from a child to a man.

Hormones are powerful. They’re what drive puberty. Testosterone and estrogen, mainly; testosterone for the boys, and estrogen for the girls. They’re what cause our voice to drop, or not. To grow breasts, or not. They impact fat distribution, muscle growth, skin texture, emotional and sexual response – you name it, any part of your body, and hormones likely had a hand in shaping how it works.

Puberty is heralded by the production of gonadotropin-releasing hormones (GnRH), which triggers hormonal and physical changes throughout the body. When I was thirteen, my GnRH levels started to rise, just like they were supposed to. Like however many umpteen million years of evolution had programed them to. Aging leads to GnRH leads to puberty leads to developing into an adult. A-to-B-to-C. A cascade of peptides and neural receptors and hormones and one day I woke up with a cracking voice and a five o’clock shadow.

I would have given anything to get off that train, to halt that cascade of development.

There’s an international group of doctors who make recommendations on how to care for transgender patients. It’s called WPATH, the World Professional Association for Transgender Health. Their Standards of Care cover issues ranging from general health and wellbeing for trans people to when to prescribe hormones and who should be eligible for gender reassignment surgery. And, as it so happens, how to work with and treat transgender youth. According to the WPATH Standards of Care, Version 7:

Adolescents may be eligible for puberty suppressing hormones as soon as pubertal changes have begun.

Delaying puberty buys time. Time to talk with parents and doctors and therapists, to think about what you really want, to make sure if transitioning – going on hormones – is the right decision. But it also buys time, physically. Time to put off all those changes – fat and muscle and hair and voice and more – that come with puberty.

I’ll be honest, I’m of two minds on delaying puberty. I’m an educator, someone who regularly works with kids who are 11, 12, 13, just beginning to change from children to adults. And I know that the idea of giving such young kids – and they are just kids – such long-lasting power over their bodies is terrifying. My students don’t know who they are; how could they possibly know who they are? They aren’t qualified to tell anyone whether or not they should go on life-altering hormones. That’s what my teacher-mind tells me.

But I knew who I was – what my gender was – long before puberty. I wouldn’t have needed to wait until 11 or 12 or 13 to say so, if anyone had been asking the right questions. I know exactly what being trans and going through puberty is like: it sucks. It’s harmful. It’s damaging. Puberty is hard on every child, but when your body starts going the ‘wrong way’ it’s ten million times worse. And it doesn’t end, that feeling of wrongness. Puberty ends, and people who aren’t trans usually find peace with their body. But being trans means every day is a feeling of discomfort, of being in the wrong skin, of a body that doesn’t fit. And so, as a trans person, I’m thrilled that puberty delaying drugs are now an option for doctors and therapists to offer.

I’m not suggesting we hand out puberty suppressors like candy. Parents and doctors and therapists should be involved in these conversations. But – as lucky as I have been and as happy as I am with who I am today – I’d still give anything to go back in time and take some of those puberty suppressors. To avoid just some of the thousands of dollars and lost years I’ve spent on hormones and hair removal and therapy and missed experiences.

One last thing from WPATH:

Neither puberty suppression nor allowing puberty to occur is a neutral act.

I want to repeat that:

Neither puberty suppression nor allowing puberty to occur is a neutral act.

WPATH admits that there are legitimate health concerns about delaying puberty. But there are also legitimate mental health concerns about subjecting a transgender child to an unwanted (and potentially harmful) pubescent experience. There is no easy answer here. No obviously correct decision. And the first batch of trans kids who experience delayed puberty aren’t old enough to tell us how it worked for them. As WPATH says, “the long-term effects can only be determined when the earliest treated patients reach the appropriate age.”

I guess we’ll have to wait and see how it all turns out.

I’ve revisited this question from time to time: Would I wish to not be trans, if given the opportunity? I wrote a story about that question last year. I should try and expand that story, since I sort of dodged the actual question. Because the short answer is, I don’t know. If our lives consist of diverging possibilities, the roads not taken, every day takes me further down the road of being trans. Put another way, every day makes my identity as a trans woman a bit more concrete, a bit less theoretical something to consider for “the future.” The future is here, I’m considering The Surgery. Being not-trans, a cis woman, might make my life prior to transitioning more enjoyable, but it would effectively reshape my life since I began to transition into something unrecognizable.

The question becomes simpler when dealing with healthcare. I would love to be cis when it comes to dealing with doctors and the medical profession. Every time I go to a new doctor, I get asked the same questions: When was the last time you were on your period? Is there any possibility you could be pregnant? Over and over. Most recently, when I had my gallbladder removed, I saw how pervasive gendered assumptions are within the healthcare community. It would have been blissfully simple to give them the answers they were expecting, and not have to reassert my identity every time a new doctor came into the room. Fortunately, none of the doctors were bigoted or gave me any problems, but the possibility was always there, lingering as a fear in the back of my mind.

Last Monday I visited Dr Bowers south of San Francisco. She’s one of the surgeons I’m looking at for gender reassignment surgery, and the first of my top three (Bowers, McGinn, and Brassard) that I’ve had a chance to meet in person. The experience was positive, and primarily for me to get a feel of her personality, but also somewhat surreal. I was sitting in a doctor’s office, with my mom, discussing the possibility of this woman cutting open my penis, removing the spongey tissue, and using the remaining flesh, blood, and nerves to make a vagina. One that I would need to continue regularly dialating for the rest of my life, lest by body decide “Whoops! That shouldn’t be there” and close back up on itself.

So all of my thoughts about healthcare and the queer body are filtered specifically through the lens healthcare and the trans body. I don’t pretend trans people are the only ones who have issues with doctors. (I know lots of lesbians who are sick of being asked “How can be positive your’e not pregnant if you’re sexually active?” Umm, because they’re not sleeping with anyone who produces sperm? Get out of your heteronormative assumptions. )

I keep thinking about this, and keep not coming to any conclusions.

March 1998, from March 2012

Dear Rebecca,

Can I call you Rebecca? I know you haven’t told many people that name. It’s one of the names mom and dad chose for you before you were born, one you’ve been using in your head since mom mentioned it while working on that genealogy project with you. I know it’s a private name for you right now, but things change. I promise they do.

This letter is coming from the year 2012, fourteen years in the future. You’re thirteen, I’m twenty-seven. You’re exploring your identity on the Internet, trying to figure out what “transgender” means and whether it applies to you. I’m writing about my identity on the Internet, trying to explain to others what “transgender” means and how it applies to me. And, from that perspective, I wanted to write you this letter.

Don’t let anyone tell you who you are. You know who you are. You know what you are. Doctors and therapists and family can help with that journey, but that can’t decide it for you. They also can’t do it for you. I know you’re dying for someone to step in and take the lead, to transition for you, to tell you what to do. And you’ll find doctors and therapists who will help along the way. But no one does it for you.

Put another way: it doesn’t get better. But you will make it better.

You won’t magically transform overnight. You won’t wake up one day and be the girl you want to be, the girl we both know you are. But you’ll get there anyway. You’ll get there by standing firm and standing tall and saying, “I know who I am.”

A few pieces of advice.

First, stand up for yourself. There will be lots of people who question your decisions – either out of love or out of ignorance or a combination of the two – but you know better than them. Don’t let their volume win over your identity.

Second, try not to care what other people think. This isn’t because there aren’t important people whose opinions you should value. Rather, it’s because the things you’re now worrying about — being perceived as a “real girl” and transitioning and all that extremely scary stuff — isn’t as scary as you think it will be. People are too wrapped up in their own shit to fret about you. It’ll all turn out OK.

Lastly, trust your allies to help you. You have some awesome friends and family, and some more awesome friends are around the corner in high school. Take advantage of them. Try stuff out, even if you’re not sure about it. It’s always better to say, “Well, that didn’t turn out the way I hoped” rather than, “Boy, I wish I’d done something tonight instead of sitting at home alone.”

Our positions have flipped over the years. When I was your age — when I was you — I imagined this otherworldly Rebecca, from another plane of existence, who was living this perfect, unimaginable life. Now I am Rebecca, and let me tell you: The Rebecca you construct in your mind has some good advice for you, but she also spouts some bullshit. What she says about transitioning? Listen to that. What she says about killing yourself because you’re not good enough to do it? Tell her to shut the fuck up.

Life isn’t easy, but it’s too much fun to end by killing yourself. Laughter and tears and orgasms and friendships and relationships and so many other things I wish I could be there to show you. So take a deep breath. Cry a few tears when you need to; that’s always OK. And get ready to blossom. Because, let me tell you, you’re gonna be amazing.

Much love,

Rebecca

P.S. The video games in 2012 are so great! Can’t wait to play them with you.

No fair! My feet didn't come with a flower!

Below the waist. My feet, like my hands, are slightly bigger than I’d like, hairier than I’d like, but I can’t really complain. They’re not huge, it’s occasionally obnoxious to find shoes in my size but never impossible, and hair removal has thinned much of the worst growth. I still have some patches around my ankles that I need to shave when I shave my legs, but no body is perfect. My legs rival my chest and face for the most dramatic success of hair removal. I shave my legs, much more in warm months, but don’t grow the same thick brambly forest that I used to. As of today, I haven’t shaved my legs in at least a month, and while they’re hairy compared to my shaved-this-morning face, they’re night and day compared to when I was in high school, pre hormones and hair removal. My legs are, like my arms, places of strength. I don’t run – it hurts my knees – but I bike and walk and swim and climb ropes and trees and lovers. I’ve been working on strengthening my hips, something a physical therapist said would help my knees, but don’t have much to complain about.

At the same time, my legs and arms have shrunk the most over the course of my transition. I joke that, since going on hormones, I’ve gone up two cup sizes without gaining any weight. All that mass, my previously mentioned boobs, had to come from somewhere – lots of it came from now-departed muscle mass in my arms and legs. I’m still stronger than lots of my girl friends, who knows whether as a result of testosterone or simply genetics, but decidedly less strong than I was before hormones. I’m not complaining, however, other than the occasional struggle at circus or the gym. But no pain, no gain. Or something.

Stretch marks line my thighs where they connect to my hips. I remember in middle school, shortly after the onset of puberty, asking my mom what these strange lines on my thighs were. She laughed and explained how growth impacts the body and the skin. My calves have the occasional scar or mark: Where I backed into a hot camp stove on a family camping trip, the spot on my knee I hit over and over and over the summer I was learning to ride my bike, marks of time and of growth and of pain. (I forgot, in Part One of this map, that my left hand (with the broken fingers) has a small companion scar on my shoulder where I hit the ground when flipped off my bike.)

My hips and my butt have grown over the course of my transition, shifting and changing like so many parts of my body. But, again, like so many parts of my body, not in exactly the way I’d want. But, again, no body is perfect. I’d love for my hips to be a little wider, my butt a little more rounded, my boobs a bit bigger. But I love the curves of my hips and my butt that are there. The way the right dress or tights or shorts hugs my body on the way down. The exact way the suits and pants and clothing I used to wear before transitioning didn’t.

This is exactly what I was hoping to find when I searched for 'cartoon cock.'

Curving around to the front of my body brings me to a part of my anatomy that has absorbed a lot of my mental energy lately. My dick. My cock. My penis. Whatever you want to call it. (Or, if you prefer (as one partner did), whatever you want to call her.) Searching this blog for penis brings up lots of posts. (I want to make a joke about “raising the issue” but can’t figure it out. Someone make an innuendo in the comments.)

Unlike some trans women, I’ve never felt like my penis was a totally foreign part of my anatomy. (Yet another parenthetical: I don’t think that makes me a ‘better’ or ‘worse’ trans woman. There is no hierarchy of transness! This is an observation I’m making about my experience, not a judgement about myself or anyone else.) I never felt like I wanted the dangly bits between my legs, but – starting around the end of middle school – I was able to identify that doing certain things felt good. Occasionally, it felt great. I, like many teens, became a regular and proficient masturbator.

I wasn’t always sure how to fit that within my burgeoning trans identity, though. Lots of the stuff I read online talked about people wanting to “cut off” their penis. I hid it between my legs sometimes, enjoyed the smooth and tucked look much more than the bulge, but not to the point of seriously contemplating taking a scissors down there for a trim.

But my penis and I didn’t have a great relationship. I remember the first time I masturbated, stopping at one point and thinking “OK, I’ll try this again tomorrow.” Then reaching down and finding all this stickiness - I’d cum without realizing it – and thinking, “That’s what all the fuss is about? That was fun, but not great…” Over time I learned how to elicit better sensations, and I certainly enjoyed masturbating and such, but I feel like going on hormones really opened my eyes to my body. (That’s a shitty metaphor, but you know what I mean.)

My first (and really only) girlfriend in high school and I fooled around a lot. There was a lot of dry humping, under-the-shirt play, general teenage fumbling around. We even attempted ‘real’ sex once, although I don’t think either of us particularly enjoyed it. I know I didn’t get a ton out of it, and I’m pretty confident she didn’t either. (And I just broke all social conventions and sent her a Facebook message asking her about it, so maybe I’ll be able to know for sure! Craziness of the Internet!) She was the only person I was really sexual with until my college girlfriend, the one who continued to date me through much of my transition.

And I’ve never really enjoyed being the penetrator in penetrative sex. I’ll do it if a partner wants to, but am not really equipped – physically or emotionally – to do it particularly well. I think doing it with a strap-on might be more fun, but haven’t had the opportunity to try.

But sex of most any kind, during high school and college, seemed unfathomably confusing. I’m sure that’s true for most (all?) people, but I have a suspicion it’s doubly true for trans and queer folks. I didn’t like my body, didn’t want it, and yet it was still able to provide such please. I’d feel some guilt after masturbating, as it if was encouraging this body I didn’t want, this interaction with myself I would never have selected.

Going on hormons hasn’t changed the physicality of my cock – I can still get hard, for example – but it’s sure as hell changed how it works. I’ve discussed this before, so I don’t know that I need to totally delve into it. But my penis is so much more sensitive now. Stroking must be done with some amount of lubricant, or it’s unpleasant. Vibrators, previously uninteresting, have become a regular and important part of my sex life. And orgasms are much longer, more sustained, more difficult to obtain but so much more delicious when they’re achieved.

The way I think about my body has also changed the way I think about other people’s bodies. I’ve had sex with other trans women and interacted with their cocks (read: sucked and been fucked by) in ways I would never have imagined as a ‘lil baby teen. One of the things I’ve been realizing (and discussed in this post about online dating) isn’t that bodies are unimportant - I’m not ready to renounce my lesbian identity – but that they’re less important than I previously thought.

It’s interesting how quickly thinking about my penis turns to thinking about sex and sexuality. Not shocking, but interesting.  Because, to shift topics slightly, that’s not the only reason I’m considering surgery. It’s about body integrity, a sense of self and personal authenticity, feeling comfortable, all the bullshit cliches I’ve talked about before. But yeah, it’s also about sex.

I remember fantasizing that pure and unsullied desire could transform my penis into a vagina. That tucking it between my legs and wanting it enough would create the change. This was also about the time when I started reading trans fiction (something I haven’t posted about in a while…don’t worry, it’s on my to-do list) which meant I was exposed to tons of stories about magical transformations, medical and scientific transformations, totally and completely unexplained transformations. But, reading these stories, one thing was clear: the universe was full of genders transforming.

Ta da!

I didn’t honestly believe any of this was happening, mind you. I wasn’t really expecting to wake up one day with a vagina. To have my parents say “Whoops, there’s been a mixup. This is yours,” and hand me a box with a cunt. But I hoped like help. I even prayed, although I’m not totally sure to whom: Gods and goddesses and life-forces and universal energies and anyone who I thought might be listening and sympathetic.

This drifted away from a body map quite a few paragraphs ago. Maybe that’s OK. My psychic energy seems to be swirling around my crotch these days anyway. My continual (and occasionally successful) attempts to find dates or get laid. My constant ogling of the women around me. For example, the women coming in and out of this coffee shop as I type this. Women walking down the street. Especially women at the gym. I’m not at the point where I was a few months ago, when I thought (correctly, as it turned out) that my hormones were out of whack. But I’m a sexual person. More broadly, I’m a physical person. I like hugging and cuddling and touching, even if it’s non-sexual and simply sharing energy between friends. So yeah, a lot of my mental energy goes into thinking about sex, sexuality, body issues, gender issues, all that jazz.

Right now, my penis and I have an uneasy truce. We like each other, well enough. Being sexual is lots of fun, and I’m still (12 or 15 years later) masturbating regularly, even if the way I do it has changed a bit. But as I research surgeons and go on consults, it becomes more and more clear that our days are numbered. The relationship may not be drawing to a close – all the flesh and blood supplies and nerves will be reused in constructing a vagina, not simply tossed out with the trash – but we’re preparing for the biggest shift since I went on hormones, and probably the biggest change we’ll ever have.

I wonder how my penis feels about all of this. Is it exhausting, this exploration and discovery and potential (lets be honest: probable) surgery? Or is it exhilarating? Maybe I’m thinking about this whole thing the wrong way.

Maybe my cock is just as read to be a cunt as I am ready to have one.

I was reminded about this when my mom sent me a link to a Chicago Tribune article titled Study: Family ties cut suicide rate for LGBT youth. In fact, my parents responded on a similar script to what the article suggests:

[One of the study authors] said parents can make a difference. It’s important parents respond with love and acceptance from the moment their child tells them he or she is gay, and that’s true even if parents need time to process the information.

“You can say something like: ‘I’m glad you shared that with me and I love you no matter what. This is new for me and I have to think about it, but I want you to know that I loved you before you told me and I love you now,’” he said.

It certainly took my parents time to process. I’d say it actually took them about ten years, from when I came out to them around fourteen to when I was asking all of my friends and family and coworkers to call me Rebecca when I was in my mid-twenties. In all fairness to them, I wasn’t transitioning for most of that time. I wasn’t really talking to them about being trans, or my developing trans identity.

And maybe I wasn’t always as patient as I could have been. I’ve had my issues, particularly with my dad. But he’s come around, too. My performances have helped him understand what I’m going through, which has been incredibly rewarding to see. And he has gotten really into the festivals and tours I’ve been involved with, which feels really good.

And for all my frustrations with my parents, I never doubted their love. For all the times I’ve been driven to tears, I never worried they would kick me out, cut me off, beat me, abandon me. Even when it felt like they were never going to understand, I didn’t think for a moment that they were going to do any of the more horrible things that families can inflict on their queer kids.

In looking for some of the posts I linked to above, I came across this post from June 2008, where I discussed my fears of buying women’s clothing at Target, and some frustrations with my dad.

And now the only ‘boy’ clothing I have left is some old boxers and shirts for sleeping, and my dad readily introduces me as his daughter.

Who said nothing ever changes?

1. Cut open my penis.
2. Remove the spongey erectile tissue. Make sure to leave the nerves and blood supply intact! We’ll need those!
3. Invert all that stuff up into my pelvic cavity.
4. Use that tissue and blood supply to make me a brand new clit.
5. Shorten my urethra – won’t be standing up to pee anymore!
6. Take the extra scrotal tissue and shape me a good labia.

Perfect! Now that’s what I want to see when I look in the mirror.Vaginoplasty, the surgery described above and what most people mean when they say “gender reassignment surgery,” is terrifying. My cock is a sensitive thing, even more so since going on hormones and getting more in touch with my sexual self. Even if I’ll be under anesthesia, the idea of all that happening to me – the cutting and the slicing and the moving about – is scary. Terrifying, even. Violent. Bloody-sounding. The type of thing out of a horror movie, not a consensual and desired and medically-accepted surgery.

We pretend surgery isn’t violent. That knife-to-flesh is an act of healing, of care. We need to, to get through it. I need to, anyway. And I will admit that surgery is controlled. When it’s done right, it’s not messy. But cutting and blood and pain and recovery necessitates an act  of violence. To recover, to have recovery time, means that there is something to recover from. The scars on my stomach, from my gallbladder removal, are the result of an act of violence. Pain-relieving, potentially life-saving (had the infection spread), and absolutely necessary violence.

The Surgery requires about a week in the hospital – a week, in this day and age of outpatient surgery – and months of post-op recovery. It costs tens of thousands of dollars, plus travel and assorted fees and random expenses. There’s a possibility, albiet a very small one,  that Il’l never be able to orgasm again. I know the general consensus – from among surgeons, post-op trans women, and my therapist – is that the ability orgasm is extremely common with modern surgery, and even more likely if the woman is orgasmic and actively sexual pre-surgery (which I am).

But still, the possibility of never being able to cum ever again, and paying twenty thousand dollars for the privilege?

So why am I doing this? Why am I researching surgeons, with the hope and intent of having The Surgery in the next 12-18 months? What the hell am I thinking?

I hate the cliches surrounding The Surgery: That it makes trans women feel complete. Whole. Like themselves. At home in their body. All the things you hear on talk shows and newscasts and radio and best-selling tell-alls.

And yet, for all the pride I take in my ability to use words to communicate how I feel, I’m struggling to come up with a better justification or explanation for why I’m planning to have The Surgery. Gender reassignment surgery. A vaginoplasty. To have my cock turned inside out, and become a cunt. I’ll go into a magical sleep, the vagina fairy will fly through the window, and I’ll wake up with an innie instead of an outie.

In some ways, it’s a logical and natural continuation down the path I’ve been traveling: hair removal and hormones and growing my hair out and makeup and dresses and presenting (and usually being perceived as) a “real” girl. Perhaps the question I should be asking is “Why wouldn’t I want The Surgery?”

(I want to take a moment to clarify that I do not think all trans people “should” or need to have any sort of surgery or medical intervention to be trans or to be happy or to be “real” men, women, or anything else. I am speaking only of my own experience, and my own journey.)

What frustrates me is that there’s something of an inability to fully feel something if you can’t express the feeling. George Orwell knew this:

In the end we shall make thoughtcrime literally impossible, because there will be no words in which to express it.

Language matters.

Lets try this: I want surgery because….

• …when I imagine my idealized or ideal body, I imagine it with a vagina and not a penis.
• …I want to feel someone, something, myself, you, us inside my cunt.
• …I want to be able to wear tight clothing and bathing suits and dresses without resorting to tucking.
• …it would make me feel less different from other girls.

(Yes, I know that last sentence is problematic. Some of my favorite “other girls” in my life have cocks, too. But I’m trying to be honest with this list, even if my emotions or desires don’t always match my politics, and not self-censor.

Perhaps we use such cliches – at home in my own body, whole, complete – because language simply fails us. Difficult as it is to contemplate, maybe I don’t have the words to explain or justify why I want The Surgery.

But there is beauty in transformation. Flowers, butterflies, the changing of the seasons, growth and strength, the rush of blood and tightening of flesh. Of making myself who I am. Chipping away at rock until the final sculpture is made clear.  Hopefully I’m going in the right direction.

I think I am.

During the workshop, however, something came up that I had not previously considered. Specifically, someone asked about how trans youth are (medically) treated. I said that it varies, but that there’s an increasing use of hormone blockers to delay puberty. This allows a twelve or thirteen year old to age a few years and – hopefully – be able to make a more informed decision about transitioning. In my I-am-not-a-doctor opinion, it’s a good compromise: simply doing nothing can result in spending thousands of dollars to undo puberty, but launching fully into hormone replacement therapy opens the door to a twelve year old realizing they weren’t really trans at thirteen or fourteen.

Ultimately, I said to the questioner, there isn’t a perfect solution. Once a child realizes they’re trans, it’s a matter of picking the best choice from some bad options. Which, to be very clear, doesn’t mean that being trans condemns an individual to a life of misery. But it does, as far as I can see, necessitate some tough decisions and a difficult journey.

The questioner then posed something that has been bouncing around my brain this past week: Could allowing fifteen and sixteen year olds to be making informed consent decisions about their healthcare lead to the criminal justice system saying they were able to make informed decisions about crimes, and should thus be tried as adults?

I don’t think she was talking specifically about trans youth committing crimes, but looking at things from a more general question angle. That is, how do we as a society determine in which areas teens are able to make life decisions, and in which they’re not?

For the record, I am very against youth being tried as adults or sentenced to death.[1] At the same time, I do think teens should have some say over their healthcare. In particular, I know what my decision would have been had someone asked, “Do you want to go through puberty as a boy, or wait a bit and go through it as a girl?” There wouldn’t have been any question in my mind. But how do we – or can we – distinguish those areas of judgement?

The first thing that leaps to mind is the difference between “this decision impacts myself” and “this decision impacts others.” Transitioning, at its core, is about changing the self. Crime, at its core, is about impacting others. Which is really why crimes are, well, crimes.[2] So there’s a difference between a teen saying “I know enough about myself and my actions to change my body” and society saying “a teen knows enough about how their actions will impact others externally, so their crime should result in prosecution as an adult.”

But I know it’s not that simple. I can – looking back – say with 100% certainty, “I wish I had transitioned earlier, and I really wish I hadn’t gone through  puberty in the first place.” I know lots of trans people who would say the same thing. At the same time, as an educator who works with teens, it’s scary to think of a student of mine (let alone a child of mine) making such big decisions. Kids’ identities change so much from day to day, that – as an adult – believing something can be that constant feels like a leap of faith.

I suspect that one’s sense of gender, however, is fundamental enough and develops early enough for most people that – by fourteen or fifteen – they do know who they are. Or, at least, they can. Even if they don’t know how they’re going to express themselves, who they’re going to sleep with, what they want to do when they grow up. They can know who they are.

We can know who we are.

[1] – I’m also against the death penalty, period, but that’s only tangentially related to this topic.
[2] – This is why, in my opinion, drugs and prostitution should be legal, regulated, and safe.

I really transitioned to get into bars for free, without having to pay cover.

I really transitioned because I heard there weren’t enough women in science, and I wanted to do my part.

I really transitioned so I could drink sweet pink drinks at bars without being judged.

I really transitioned because when I paint my toes pink, I want to be a boy with pink toenails!

I really transitioned so I could wear tight pants all the time without looking like a member of an 80′s rock band.

I really transitioned because I wanted to save on car insurance.

I really transitioned because the clothes are *way* better (so i still wear BDUs and t-shirts most of the time)

I really transitioned because I was born on Stonewall Day.

Exclusions. Covered expenses of the Plan shall not include … procedures, treatments, equipment, transplants, or implants, any of which are … for, or resulting from, a gender transformation operation. – 215 Illinois Compiled Statutes 105 – Comprehensive Health Insurance Plan Act

It’s unclear whether the State of Illinois has defined – through statute or the courts – what specifically “gender transformation operation” means. But it seems pretty safe to assume that the surgery I’m currently considering would fall under its purview. Surgery in which the “spongiform erectile tissue of the penis is removed, and the skin, with its nerves and vascular system (blood supply) still attached, is used to create a vestibule area and labia minora, which then are inverted into the neovaginal cavity created in the pelvic tissue.” That seems pretty gender transformative to me.

What’s interesting about the Illinois Comprehensive Health Insurance Plan Act (or the ICHIP Act) is what other injuries, procedures, and categories of coverage are excluded.  Gender transformation operations (item 14.iv on the list of exclusions) is lumped in with cosmetic surgery (item 1), anything which exceeds “reasonable or customary” cost (item 4), injury due to war (item 9) , services that are “not provided in accord with generally accepted standards of current medical practice” (item 14), contraceptives (item 19), weight loss programs (item 21), acupuncture (22). Interestingly enough, the act itself does not, as best as I could find, mention abortion or early termination of a pregnancy, but the ICHIP website stil says such services are excluded.

And then there’s my favorite exclusion. Item thirteen. “Blank.” The item isn’t actually blank, but the text reads open-parentheses-b-l-a-n-k-close-parentheses. Blank. I’m assuming there was an item thirteen, but it was removed by some later amendment I’ve been unable to find. Either that or the Illinois State Legislature was worried about the superstitious ramifications of having an exclusion number thirteen. But that seems unlikely, because there is a benefit item number thirteen (diagnostic x?rays and laboratory tests). The ways of government legislatures are opaque and confusing.

As far as I can tell, gender reassignment surgery (or gender transformation operation, or sex change, or whatever you want to call it) is the only accepted standard of medical practice (to use the ICHIP ACT language) explicitly excluded. Nowhere else did the Illinois Legislature say, “Doctors recommend this treatment. There are safe and reasonable guidelines for its use. It has been shown to be beneficial to patients. But there’s no way in hell we’re going to pay for it.”

Because the Illinois State Legislature is obviously the best-equipped body to decide medical coverage and treatment.

I talked to my lawyer, who said this isn’t great news – that would be if Neal decided to cooperate with the EEOC from the beginning. But it does mean that the EEOC hasn’t forgotten about my complaint, and hasn’t (yet) said it’s not under their jurrisdiction.

In other news, my dad sent me a Chicago Tribune article about Dr Schechter, a plastic surgeon in the Chicago suburbs who does gender reassignment surgery. This is very interesting to me, since the only folks I’d found doing surgery were decidedly not in the Chicago area. At the same time, the fact that I haven’t heard of this guy makes me hesitant – all the doctors I’ve been researching are well-established, with reviews online over at this site. The article also says Schecther works with the Drs Etner, who I’m not fans of.

Has anyone heard anything about him? Positive or negative?