Mildred L. Brown and Chloe Ann Rounsley Jossey-Bass Publishers, San Francisco, 1996 256 pp-$25.00-Cloth ISBN 0-7879-0271-3
Reviewed by Jamie Faye Fenton
Mildred Brown is an institution in the San Francisco Bay Area, widely regarded as one of the best gender therapists in the world. My wife and I have seen her many times during the past few years, as have many of my transgender friends. Chloe Rounsley is a local freelance writer, and met Millie while doing an article about a transsexual who was transitioning at a Silicon Valley company.
The result: a book containing high quality writing that is a pleasure to read.
The book begins with a description of transsexuality and how transsexuality is different from transvestism and the other designations. Transsexuality is a condition in which one’s gender identity (or internal self identification) is opposite to one’s anatomical sex at birth. There are many theories about causation: nature (the influence of hormones on prenatal brain development), nurture (early social learning), or a combination of the two (seen as the most likely explanation).
Awareness of gender dysphoria comes to most transsexuals in grade school. FTMs wish to play with the boys, MTFs with the girls. This flouting of school-yard convention causes teases and taunts and can make childhood an unhappy experience indeed. Inside, TS kids long to have what is wrong made right, often praying for divine intercession. Parents who become aware of their child’s gender issues often seek help, usually from inexperienced professionals. Frequently the interventions do more harm then good. A TS child learns to pretend to be normal.
When the secondary sex characteristics emerge, hope in magic ends: the wrong body changes happen. Sexual maturity brings more stresses. The TS teenager feels profoundly alone. Common experiences include despair, substance abuse, conflicts with parents, confusion over sexual orientation. The strategy “perhaps if I act normal, I will become normal” is adopted.
The self is deeply buried by adulthood and the defenses are up. Some transsexuals enter military service or try other highly masculine or feminine pursuits. They try marriage and parenthood or become intensely involved in community affairs. They secretly bear feelings of guilt, shame, and a fear of being exposed. Repeated episodes of cross-dressing and purging take place.
All of this merely delays the inevitable. Cracks emerge, often caused by stressful events, and gender dysphoria bursts forth. It can’t be buried this time. Depression sets in. Desperate, the transsexual seeks the advice of a gender therapist and starts the transition process.
Therapy begins with an initial assessment. (Many of Millie’s clients are transgendered but not transsexual and many are not sure what they are when they begin.) Each client writes his or her life story. The layers of illusion are be stripped away. Therapist and client explore feelings of guilt, anger, fear, and shame.
Once a course is selected, the practical steps begin: electrolysis, name changes, practice at passing, hormones, voice training, plastic surgery. The most momentous is the “coming out” to family and friends. As the news is not always welcome, there is anxiety with each disclosure.
As the real life test approaches, the circle of revelation expands to friends and coworkers. Letters are written and the momentous day arrives.
The real life test year is intense. Challenges are faced at work and at home. Some outcomes are heartbreaking: estrangement from family, divorce, loss of job, child custody disputes. Personality changes take place. As this book focuses on helping family, friends, and coworkers understand transsexuality, there is much detail about the transition process, its effects on others, and how to help.
After a year or longer, the denouement: sex reassignment surgery. Millie’s MTF clients often hold a “Weenie Roast” a week or two before hospital admission. Chapter nine gives full technical details of how the operations are performed, the possible complications, and the recovery.
Some SRS patients report an immediate end to gender dysphoria. For others the lifting takes some time. Most transsexuals who pursue treatment report eventual satisfaction with the outcome.
Ultimately the advice is basic: Adapt to the change at your own rate, grieve for the loss of the old self, avoid blame, talk to others. Learn. Treat the transsexual as a human being.
The last chapter is a collection of triumphant poetry — another window inside.
The appendix contains a well-constructed resource guide listing organizations, West Coast support groups and hot lines, and Internet news groups and web pages. There are also footnotes, a bibliography, and an index.
I approached this book as a transvestite with many transsexual friends, some quite close, whom I wish to understand better. As many TG Forum readers know, there are many divisions in the gender community, particularly between transvestite and transsexual. I discovered that I have had many of the experiences, feelings, and dilemmas that transsexuals have faced, including a touch of gender dysphoria. The knowledge will help when I answer the hot line calls, visit the TG Forum chat room, and interact with my friends. I recommend this book to transvestites seeking empathy for transsexuals.
Empathy can be misleading. Readers of psychological subjects often see themselves in the descriptions and should guard against self diagnosis. If questions arise — see a gender therapist before jumping to conclusions!
The resource guide emphasizes U.S. West Coast organizations and services which at time of publication is generally up-to-date. Beyond these brief descriptions, there is little discussion of the transgender community and how it operates. Perhaps in later editions more coverage can be given to the international situation, as I am curious about how transsexuals manage in other countries and cultures.
Chloe and Millie are careful to give equal time to FTMs — using FTMs in half of the examples. They are
inconsistent in their use of male and female names — for example, sometimes calling a MTF by her male
name. This actually helps by leading the reader well down the garden path before they know which kind of
transsexual is being discussed in each example.
True Selves is still in the distribution pipeline and will not be available everywhere for several weeks. It has not yet received much publicity. It is up to us to put this resource in the hands of those around us who need it.