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morphology even though the person is of XY chromosomal sex], and that seemed to me to be the thing that explained it all when I learned it in class. I still remember that day etched vividly in my mind. It just explained it. I thought, “Okay, I’ve always felt like a guy, and I just have testicular feminization and they just didn’t tell me.” I remember going through the literature when I was in medical school and trying to understand. I assumed that the reason I felt so different about myself was the mullerian agenesis. That’s an aspect that a lot of transsexuals don’t have—they don’t have this physical problem. But for me it was a confounding thing, and a confusing thing. I think it kept me from realizing my transsexuality for a long time. I thought that everything was somehow related to that.

I also knew that my mother had been treated during her pregnancy with an androgen-like drug—not DES, one of the androgenic proges-terones. My sister asked the doctor who treated my mother with this hormone many years ago (he’s long dead now) and she was told that it was definitely not DES, but rather an “androgenic progesterone.” I was never told the exact name. Anyway, I’ve always assumed that my gender variance was due to that drug, and that’s what caused this reproductive defect. But then in fact if you look at the [scientific] literature, there really isn’t a correlation between androgen exposure and mullerian agenesis; there is no evidence that mullerian agenesis is caused by hormonal anomalies. And in addition, women who have mullerian agenesis feel like women. They don’t have this gender disturbance. And again I found that very confusing.

So, I just thought, “Well, there hasn’t been a lot of research, and what do they know anyway?” It was really only after I moved to the Bay Area and read a newspaper article about James Green [a well-known Bay Area transman and activist] that I realized that there was anyone else out there like me. I had never really talked to anybody. I just felt kind of ashamed of it.

Q: Yet you grew up in a time when there was extensive media coverage of celebrity transsexuals like Chris Jorgensen and Rene e Richards. You didn’t make the connection?

No, I never did. Partly because while I was in high school, college, and medical school, I never read the newspaper. I never watched TV. I was very intense about my studies. I knew a lot about science, but I didn’t know a lot about other stuff. I was a typical science geek, and I really had no other interests. It wasn’t until I came here [to Stanford] that I started reading the newspaper. I was just very driven. I worked seven days a week, fifteen-hour days, right through training. So I didn’t hear a lot about those people.

Then after two years of being here, I got breast cancer, which runs in my family. My mother died of it when she was my age. So when I had breast cancer I remember going to have the surgery, and even though they had picked it up early and it hadn’t spread, I begged my doctor to do a bilateral mastectomy, even though only one breast needed to come off. I said to him, “You know my mother died of this. I think it’s genetic and I think it would be best to do it [the double mastectomy] as prophylaxis.” This was before the [BRCA] gene test was available. It turns out that a couple of years afterward, I did have the gene test and I did test positive. Anyway, I finally did manage to convince him to cut it off, over a lot of objections. This was one of the things that made me feel very comfortable about the gender change later because I remember leaving that doctor’s office feeling like this was the best thing that had ever happened to me. And I remembered that when my mother went through it, she just had one breast cut off, and it was so traumatic for her. So incredibly traumatic. And I experienced nothing like that. I was happy to have them cut off. I was relieved. “Relief” is a really good word to describe it.

But at this hospital where I had my surgery, they also did sex changes, and I remember one of the nurses talking about this person who