The Riddle of Gender - Deborah Rudacille [13]
Take for example a genitally female, genetically XX girl who tells her mother at age three that she is a boy, and from her earliest childhood spurns girlish activities, clothing, and behavior. “My whole life I’m telling my mom, ‘I’m not a girl, I’m not a girl, I’m not a girl’ and thinking what the hell is going on here?” says Brad, one of the first employees of the city of San Francisco to take advantage of the new policy of insurance reimbursement for sex reassignment surgery for city employees. “When you are little, you’re kind of androgynous. Both little boys and little girls are running around, taking their shirts off, jumping in mud, throwing dirtballs. So if you are a little aggressive and gened as female, they say you’re just a tomboy. But once you get up to a certain age, like six or seven, it starts separating. And I was like, ‘You’re pushing me the wrong way. I’m supposed to be over there with the boys; why are you making me go over here with the girls?’ You look at your body and you are in the wrong body, and it’s a nightmare. You wake up in this nightmare every day and you have to deal with it. And you keep thinking, When am I gonna wake up?”
Brad’s description of his early life was echoed by many of the trans-gendered and transsexual people I interviewed for this book, who struggled for many years to understand their suffering and confusion without being able to put a name on what they were experiencing. Gender variance is not a widely discussed subject, even in medical schools, and as a consequence many physicians, like the general public, know very little about the subject other than what they are able to glean from sensationalist media accounts of cross-dressing and trans-sexuality. Gender variance still seems to be considered a more suitable topic for late-night talk show jokes than for journals of public health and public policy, even though a recent needs assessment survey in Washington, D.C., estimated that the median life expectancy of a transgendered person in the nation’s capital is only thirty-seven years. Poverty, substance abuse, HIV infection, violence, and inadequate health care are the factors behind this statistic. Of the 252 transgendered people surveyed in the district, 29 percent reported no source of income, and another 31 percent reported annual incomes of under ten thousand dollars per year. Half the participants did not have health insurance and 39 percent did not have a doctor, though 52 percent had taken sex hormones at some time in their lives and 3 6 percent were taking hormones at the time of the study. A number of the respondents were working, or had worked, as commercial sex workers—a consequence of the persistent employment discrimination experienced by many transgendered people.
Though many are far better off materially than the subjects of the Washington, D.C., study, transgendered and transsexual people of every social class and at every income level share many of the same vulnerabilities. Public prejudices make it difficult for visibly transgendered or transsexual people to gain an education, employment, housing, or health care, and acute gender dysphoria leaves people at high risk for drug abuse, depression, and suicide. “You do everything you can possibly do to check out, to get away,” says Brad, who at forty-six has been sober for sixteen years. When I asked if his drinking and drug abuse were tied to his confusion about his gender and related traumas, he replied, “Absolutely. Because I couldn’t be who I was after so many years of hiding from myself. At that point I didn’t really know who I was. It’s very much a catch-22, and you’re just like, ‘Fuck it. I’ll just take more drugs. I’ll just do more drinking. I’ll just do whatever because I can’t deal with this.’” Brad began his transition after nearly a decade of sobriety.