The Riddle of Gender - Deborah Rudacille [129]
However, as Kit Rachlin points out, there is no outcome research proving that these young people will not at some point regret their decision. Transitioning at forty-five, after a lifetime of pain, one can be reasonably sure that the individual has thoroughly considered the positive and negative effects of the decision. But what about someone who transitions at twenty or even younger? “A typical case would be somebody very young, queer-identified, going through top surgery, and the parents saying to me, ‘What does the research say? Is my fifteen-year-old capable of making this decision?’ “ says Kit Rachlin. “ Are people happy after doing this?’ And I have to say, I don’t know.’ There’s no good research data on queer-boy identified butch fifteen-year-olds making this decision. And so we need more therapists and doctors documenting what’s happening right now in terms of medical care.”
The lack of data creates conflicts for health care providers working with trans youth. According to the Benjamin Standards of Care, kids under eighteen are not candidates for hormone treatment or surgery, despite the fact that puberty tends to be a nightmarish experience for some transgendered kids, whose bodies grow daily more estranged from the kids’ gender identities. Some find a way around the rules by taking hormones they purchase on the street, without medical supervision. Others may find a health care provider willing to prescribe hormone blockers, which don’t create permanent changes, but slow or postpone the morphological changes of puberty. Some providers who do adhere to the Benjamin Standards of Care will prescribe hormone treatment for adolescents if they seem emotionally and intellectually mature enough to make the decision. Medically and ethically, the decision is a tough call, as Maria Russo, author of the Salon article, discovered in her interviews with health care providers. “As more young transsexuals push to begin transitioning at a younger age, the social workers and medical providers who work with them are confronting a new frontier in gender ethics. What’s the best way to help kids who say they want to switch sexes? Should we make them wait as long as possible, to be sure their decisions are not simply adolescent rebellion? Or should we take them at their word and let them begin hormones during puberty?”
As even this brief treatment of the issue shows, questions far outnumber answers in the realm of transgender health care and research. In no area is this more true than in the biggest and most controversial question of all—what causes gender variance and why do there seem to be so many more gender-variant people in the world today than there were fifty years ago?
CONVERSATION WITH DANA BEYER, M.D.
Dr. Beyer was trained as an ophthalmologic surgeon, though she no longer practices in that field. She currently serves as co-moderator of the DES Sons Network, founded by Scott Kerlin. I interviewed Dr. Beyer on two separate occasions; during our first meeting we addressed general issues and in the second, personal history. When I met Dr. Beyer early in the summer of 2002, she was still living as a man, though actively planning her transition. When we met for the second time, she had become markedly more feminine in her appearance, owing to estrogen therapy and electrolysis, and was preparing for facial feminiation surgery in January 2003 and genital surgery in June. At the time we spoke, Dr. Beyer was living with her second wife and two teenage sons. The couple later separated. What follows is a portion of the transcript of our second conversation.
Q: So what has changed since the last time I saw you?
I’m out with my wife and kids. I haven’t been doing anything differently since I last saw you, but she just finally came out of denial, even though I had transitioned and de-transitioned