Beyond Magenta: Transgender Teens Speak Out (28 page)

SK:
A person arrives at the clinic and says, “I know I want to transition, but I’m not sure how far I want to go.” What’s the process?

MS:
At this clinic the first session is dedicated to figuring out what transitioning means to them. Often questioning gender identity begins way before they start to think about transitioning. They may not know that transition is an option. We ask how they learned about transitioning. What have they already done? What are they interested in doing?

By the time they’ve come here, though, most of the kids have already done a lot of research. They don’t show up at a doctor’s office on a whim, especially an eighteen-year-old, especially here. Many have been dressing as their preferred gender for several years. They’ve figured out what their support system is. They’ve generated the courage to out themselves just by coming here.

SK:
Then what do you talk about?

MS:
Basic things: relationships, food, shelter, money, and education. How are other people going to deal with your transition? Will your family accept you? Will they let you stay in the house? If they kick you out, where are you going to go? Do you feel comfortable transitioning in your job? Or do you feel you have to take time off? How are you going to support yourself at that time? The same questions are true about school.

SK:
What are the social risks?

MS:
A lot of the risks in transitioning have less to do with hormones or surgeries than with how society deals with folks who are transgender. It’s about how you out yourself. It’s really about how society deals with people who are transgender, and the very real experience of transphobia. For example, when it comes to dating, you might find yourself in a dangerous situation. Or if your parents find out, you may get kicked out of the house. Being transgender and wanting to transition is often a very marginalizing experience because of the lack of acceptance in society.

This is also the reason why, as a clinic, we’ve decided to provide hormones and medical care for free to all our teen patients. We feel that removing as many barriers as possible allows these young people to engage with us on a regular basis. We get to help them mitigate those risks and support them in their life decisions. Intervening before they become homeless or before they get in other risky situations prevents a lot of negative consequences and enables them to live their lives fully.

SK:
What about the medical risks of hormones?

MS:
Let me start by saying that cancer is not one of the known main risks. Everybody thinks it is, but it’s not. There are risks like blood clots, especially if you smoke. High blood pressure can be a risk. It can increase the risk of heart attack and stroke over the long run. These are not minor things. But they can be monitored clinically. We measure cholesterol levels. We do liver-function tests.

These risks are the reasons we encourage people to go through their transition in a monitored environment. We’re not going to just give people hormones and never see them again. I tell folks, “You can always get hormones off the street. You know that because that’s what some of your friends do. But the reason it’s important to get hormones here is we can monitor you.”

A big issue is the emotional impact hormones can have on people. Adding hormones to your body is not a benign psychological process. That’s another reason we encourage people, particularly in the beginning, to be engaged in therapy. It is emotionally discombobulating when you start hormones. You might feel a little bit more aggressive than you did before starting testosterone. If you’ve had a hard time managing aggression in the past or you live in an abusive household, that’s where risk can come in.

SK:
What role do genes play?

MS:
This is another part of the spectrum, especially where intersex people fit into the transgender model. There’s definite overlap there. Folks who are born intersex have ambiguous genitalia because of genetic predeterminants. For example, someone who has an extra X or extra Y chromosome may have genitalia that don’t look stereotypically male or female. So they don’t fit into society’s version of bio-male and bio-female. In fact, historically society has forced people to undergo sexual assignment surgery at very young ages, even when they are first born. That’s our need to have people fit into our gender role models. For the vast majority of gender nonconforming people, their intrinsic identity is not determined by genetics. At HOTT, we place heavy value on the patient’s self-identity.

SK:
What kind of exams do you do?

MS:
During the first two visits, we do the lab work, such as blood and urine analysis, to get a baseline and to make sure nothing drastic is going on. We do a physical exam, but if someone declines a physical exam, that’s not a reason to refuse them hormones.

SK:
What else does the clinic provide?

MS:
Transitioning is not just about hormones. For example, we talk about the medical effects of binding, making sure they are tucking properly. I had someone come in the other day who was using an Ace bandage to bind his breasts. An Ace bandage is equally binding front and back, whereas a binder has more leeway in the back so you can breathe. You are less likely to pass out. The Ace bandage limits your lungs.

We also provide legal referrals to help with name and identity changes.

SK:
What about recreational drugs or drinking?

MS:
We talk about the side effects of drugs or alcohol. We try to move them to deal with addiction. We support them in any way we can.

SK:
Can you give a person hormone therapy while they are dealing with overcoming addiction?

MS:
Sure. There are rare contraindications. There’s no medical interaction between most common drugs and hormones. It’s not a good idea to drink when you’re taking estrogen, for example, because your liver metabolizes estrogen. But unless you have actual liver damage, it’s not that problematic.

If a person’s suicidal, we worry that hormones could increase that. But half the time, the reason trans folks are suicidal is because they can’t access hormone therapy. By withdrawing hormones, you can actually precipitate someone feeling suicidal. So you have to be able to differentiate those two things. This is why we do a really good history on somebody.

SK:
What happens when a person gets their first hormone shot? Is it scary? Is it exciting?

MS:
Oh, my God, they’re so excited about it. There’s rarely anything that a clinic can do for a teenager that makes them so excited. Normally, two exciting things are curing an STD or a negative pregnancy test. This tops it all. It’s life changing, and it’s life affirming. This is what they’ve been waiting for their whole lives. It’s a privilege to be part of that process.

To learn more about the Callen-Lorde Community Health Center, visit their website at
http://callen-lorde.org
.

In 1999, thirteen-year-old Sol Kelley-Jones picked up the phone and called Callen Harty, forty-three. Callen was an established actor and playwright at the Broom Street Theater in Madison, Wisconsin. Although they had heard about each other because they were both advocates for gay rights, they had never met. Sol, the daughter of lesbian parents, was interested in theater, politics, and activism. Sol asked Callen to help her start a theater group for gay and lesbian youth. Callen said yes.

The first year, only three gay teenagers signed on. (Currently there are thirty teen actors.) They had no funding. Churches around town gave them free rehearsal space. A few years into the program, some of the adults involved put up money to rent the main theater on the University of Wisconsin campus. They sold out the show and from that point on were able to pay their own way.

Proud Theater is a nonprofit, all-volunteer organization that is composed of LGBT youth, allies, and children of LGBT parents. Sol describes their work as “a belief in the power of art to create change. The process of creating artwork out of youths’ experiences is radical, is transforming, and is healing. It is also healing to communities. It can have profound ripples.

“We consider ourselves an activist organization, an artistic organization, and also a youth-development organization. We’re developing leaders, stories, and strategies about how to use art to create new realities. Not only do we reflect on some of the horrors and some of the oppression that young people have faced — homophobia, heterosexism, transphobia, and racism — but we also look at the joy and the celebration of different identities. We look at what we want the world to be like. I think theater is a magical place where you can experiment with what isn’t yet.”

Proud Theater is often invited by churches, AIDS networks, senior centers, and schools to perform their plays. The company is expanding. They recently started Proud Theater–Wausau. Wausau is a small, conservative city, yet ten kids show up each week.

Callen says, “Proud Theater has become a lifeline to them. That’s what we’re most proud of.”

To learn more about Proud Theater, visit their website at
http://www.proud theater.org
.

androgen:
a male sex hormone, such as testosterone

androgynous:
refers to a combination of masculine and feminine, often in appearance

down-low:
a man who identifies as heterosexual but has sex with men

dysphoric:
a state of unease or dissatisfaction with life

estrogen:
a steroid hormone that is the primary female sex hormone; it promotes the development of female characteristics of the body

FTM (female to male):
a person assigned female at birth but who identifies as male; a trans man

homophobic:
having an extreme revulsion to homosexuals and homosexuality

hormone:
a chemical released by a cell or a gland that affects cells in other parts of the body

intersex:
a genetic condition in which a person is born with external genitalia and internal sex organs that are in between typically male and typically female

metrosexual:
a male with a strong aesthetic sense who spends a great deal of effort on his appearance and lifestyle

mindfulness:
a heightened consciousness or awareness of something or someone else

MTF (male to female):
a person assigned male at birth but who identifies as female; a trans woman

neuron:
a nerve cell that processes and transmits information by electrical and chemical signaling

pansexual:
having a sexual preference that is not limited by gender identity or sexual orientation

placement:
refers to residential treatment centers or facilities

pound:
slang for a manly greeting

synapse:
a place or junction between two cells where a nerve impulse is transmitted from one neuron to another

testes:
components of the reproductive and endocrine systems in male-bodied people; their primary function is to produce sperm and androgens, mostly testosterone

testosterone:
a steroid hormone that plays a key role in the development of male reproductive tissues, testes, and prostate, as well as secondary sexual characteristics such as increased muscle, bone mass, and body hair

transgender:
a general term that refers to a person whose gender identity, expression, or behavior does not conform to that typically associated with the sex to which they were assigned at birth

transphobia:
having an extreme revulsion to transgender people