So, is there a choice apart from transition? If there were then transsexualism would not be what the UK government calls “A widely recognised medical condition”, it would be a lifestyle. If an acceptable alternative choice existed there would not be such universal international agreement on treatment methods. Even in that most fundamentalist of Muslim countries, Iran, a country where homosexuality is punishable by death, the state carries out more Gender Reassignment surgery per capita than any other country. If there were a choice there is absolutely no way I would choose to transition..
Gender or Sex? At the turn of the 20th century transsexualism was thought to be a mental illness. At that time it was thought that gender, the sex our brains identify ourselves as, and physical sex were the same, gender was the result of nurture, being brought up as boy or girl. Through the middle years of the 20th century all sorts of techniques were carried out, often with international collaboration, to try and find a “cure”, from hypnosis to electro-convulsive therapy, from surgical intervention such as lobotomies to chemical intervention even with drugs like LSD. These were not only miserable failures they also cost thousands of lives. These failures had one positive outcome though, they caused a massive international rethink generating intense research. Now we know different. Development of brain sex is a separate process to development of physical sex . Transsexualism is not a mental illness, it is a medical condition caused by the brain sex developing opposite to the physical sex. Our gender is something we are born with, not learnt. Put quite simply as we cannot change our brains we can only change the physical sex to achieve harmony. Without harmony there is only misery often leading to self destruction. An international study in 1981 concluded that 50% of transsexual people without help will destroy themselves before the age of 30. 1 in 2 will die unless helped. Even for people such as me, receiving massive medical help, the estimate is 1 in 20 will still destroy themselves. Even when people such as myself manage to supress conscious symptoms for a large part of their adult lives it has not gone away and the effort needed to keep up the distractive manic activity to continuously supress will often prove to be just another form of self-destruction.
Transvestism: Whilst estimates vary wildly a consensus of the incidence of "men portraying women" in society would be that that for every 12,000 natal men, 1,200 will at some time dress in some female clothes, 600 of those will go further to emulate as close as possible the female form. Statistics vary but of those 12,000 a only 1 to 3 of those will be transsexual and that 1 will in general go to extraordinary lengths not to be noticed. Therefore it is not hard to understand how the public perception of someone who is transsexual is that of a transvestite yet Transvestism is a recreation, not a need. It is done for pleasure, sexual, fetish or emotional, and generally speaking a lot of transvestites are quite happy to continue to live otherwise normal lives in their birth sex. Theirs is a choice and The public see it as that and assume people like me are the same, indulging in a choice. However transsexualism is a need, it is caused by a medical condition. It is not a man giving way to a “strong female side” or getting a buzz out of cross-dressing, it is someone who is of female gender and needing to live in the role of a female. I do not have a strong female side, I am a female, but because I was born with the physical bits of a male I have been forced to live as one. I do not have a choice other than as one psychiatrist said to me "to continue down the path of suicidal depression and if by chance you don't succeed in destroying yourself you will end up in a mental hospital and probably only ever be released as She, not He"
Pain of rejection: If I had any other illness and was told "follow medical advice or risk a 50% chance of dying" all my friends and family would probably rally round and make sure I followed Doctors orders. For many people like myself however often we hear "of course I understand but don't let my friends see you" to "you are always welcome, but as him , not her" to "don't ever darken my door again" Thanks to growing up in an environment where "to be different" was seen to be "inferior" I may well have uttered the same words. It takes a brave person to risk being associated with people who are "different". I am not going to venture an opinion on why there is a social stigma regarding people like myself, I am not a sociologist and there are dozens of theories around already, however what is agreed on is that it is a relatively recent social phenomenon and one only really prevalent in the western 1st world
So why does it hurt so much? I have not fundamentally changed, my personality is still the same, I have just swapped roles to living in a way that gives me peace and happiness and makes me a far more enjoyable person to have around. The person that to many was the rock of strength when they needed support, was the comfort when they needed comfort, was the carer when they needed care, was the benefactor when they needed help is still there, still the same, only to some is now is a pariah to be turned away or to be entertained behind closed doors and shut curtains. Simply because I have chosen to live rather than die, to be sane rather than insane or, at the very least, chosen to be happy rather than desperately unhappy I risk rejection where once there was warm embrace.
Postscripts: As this was written first hand it was written from the perspective of a Male to Female Transsexual. This is not to ignore all Female to Male transsexuals, just my take on my experience.
Apolgies to the vast majority of close friends and family who have stuck by, who have not been ashamed of me, who have said "Our home will always be your home". This is in no way meant to denigrate the massive help you have been to me, merely to focus on one of the most painful parts of being transsexual.
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