Genderation X

You can change your body with surgery and hormones, but what happens after that might surprise you

In December 1989, the FTM newsletter announced that providers would no longer discriminate against gay FTMs; it must have been a sweet victory for Sullivan, who had tested positive for HIV in '86. He died of AIDS in March 1991, after handing off the newsletter to James Green, a man he knew only slightly but a prescient choice, since Green has walked well in Sullivan's big shoes.

"We can credit him with raising the medical profession's consciousness of a separation between gender and orientation," Green says. Sullivan's insistence punched holes in closed minds, and his questions challenged the way all transsexuals were treated. In some localities the situation for transsexuals is changing rapidly, though sign-offs from a therapist are still required for every phase, including hormones.

Until very recently, the rules transsexuals had to abide by were draconian and downright dangerous -- like requiring people to cross-dress for up to two years without benefit of hormones. Only after this trial by fire was the person allowed to begin hormones. After another specified passage of time, an FTM could undergo the "top" surgery, to remove the breasts and reconstruct the chest, and later, if he could afford it, he could whip out a cool $100,000 for the "bottom" surgery, in which a penis and testes are fabricated -- or substantially less for a procedure in which the clitoris is freed and the labia formed into testes. During or after the surgeries, the patient was encouraged to move to a different area, take on a new name, and not associate with other transsexuals. A successful transition meant being able to pass even with one's wife.

It's easy to see how this script would appeal to heterosexual doctors, and how repellent it would be to queers who teethed on Stonewall. Being in the closet is being in the closet, and besides, not everyone wanted to take the same path. At a February FTM meeting, Alice Webb, a longtime gender psychotherapist and one of the gatekeepers who establishes guidelines for who receives care and on what time schedule treatment is parceled out, tried to convince a somewhat skeptical crowd that the medical establishment really was raising its consciousness, really was hearing what transgendered people had been trying to tell them for years: that all of this is a lot more complicated than anybody wants to believe, and that it would benefit both parties if doctors would work in partnership rather than as Orwellian social police. Webb said the prime aim of the medical community now is to bring people to where they feel comfortable: If that means hormones and no surgery, fine; if it means surgery and no hormones, sure; if only the top and not the bottom, great. This would have been heresy even five years ago, and to many doctors still it means stranding people in a freakish no man's land.

But with the opening up of options -- and with telling the truth (not everyone feels trapped in the wrong body, as we've learned on talk shows infinitum) -- comes other questions. Who chooses such a difficult path?

A friend -- certainly not the one who's miffed by all this -- is in the process of making the change. She (she hasn't changed the pronoun yet) and I spend a lot of time talking about our childhoods. "But it was the same for me," I cry, again and again.

"Precisely," she says, and fixes me with insistent eyes. She thinks I'm way deep in denial land, thinks I should be plunging that needle into my hip. I talk to other people with childhoods similar to mine. They're not bounding off to "Tranny Tuesday" at the San Francisco Department of Public Health's Tom Waddell Clinic either. Did my friend's discomfort reach a point she could no longer bear? Or is it that just about any day of the week I'd choose discomfort over change? Coward or not, I can't help but believe most of the denial of who I am comes from the outside, not from within. If I altered my gender, who would I be satisfying, me or them?

"I am a transsexual man, and in my opinion that's a different gender from what people commonly think of as 'man,' " says David Harrison in his soft British accent. Gone is dreary late February, with its fitful rains; we're basking in the bright March sun on the plant-filled patio at Josie's Cabaret and Juice Joint, at the con-fluence of 16th, Market, and Noe. A couple of squat tiki gods, a few orange-and-purple-flowered lantanas, and a passel of succulents masquerade as a trop-ical paradise. What's surprising is how well it works, though there's plenty else to see through the cutouts in the fence, what with the constant parade of queerdom up and down Market Street.

David is 36, a gentle, sweet man who began hormones about two years ago. He beams when he tells me about his recent chest surgery and shows off his pecs with barely concealed glee. "I feel more identified as a male than I thought I would. But the irony is, as David I'm more able to express what one would call female qualities. What's actually happened is that a whole barrier has come down. I'm far more open and nurturing than I was as Katherine."

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