"It's a boy!" or "It's a girl!"
Those are the first words a mother hears
about her newborn. Everything else about this
fresh new life is uncertain. Will the child be
healthy, intelligent, good-looking, happy,
lucky? No one knows at the moment of birth. Only
the child's sex is sure.
"It's a girl!" I was told on that blustery
November morning in 1950 when Tracy was born. I
held my miraculous new daughter, my first child,
and examined her and saw that she was indeed a
perfect little girl. But I was wrong.
Disastrously wrong. Inside the body of that
beautiful girl baby was the personality and
psyche of a boy. It has taken 22 years of
tragedy and misery and hurt for the boy inside
Tracy to emerge.
I want to tell about that change now, in all
its painful detail, because it is an astonishing
story of one human being's successful struggle
for self-fulfillment, of one family's tortured
journey into understanding, of medical
intervention at its most compassionate and of an
astonishing human victory over one of nature's
cruelest whims.
All that I want to say about Tracy's growing
up is that it was rough beyond description. She
was born three days after our first wedding
anniversary and Jim and I couldn't have been
happier about her arrival. Jim was a student
then, getting his degree under the GI Bill and
holding a job at the same time. I had been
working as an office manager, but was delighted
to stay home now and take care of Tracy.
But Tracy was a handful -- restless, fretful,
too irritable to be cuddled, screaming her rage
if she didn't get her own way instantly. When
our second child, Daisy, was born two years
later, the contrast between the two babies was
so sharp that even strangers noticed. Daisy was
sunny, cooling, cheerful -- and very early in
life terrorized by her older sister. Sometimes
Tracy hurt Daisy accidentally in play; other
times she beat her up deliberately. Even when
the girls were 12 and 14, we had to have a
sitter whenever Jim and I went out, to make sure
Tracy would do no harm to her sister.
In spite of her tantrums and sulks, Tracy was
bright and alert and did well in school. She was
big-boned, athletic, "a tomboy." She delighted
in heavy work like putting up screens and mowing
the lawn. During the years when the girls were
in their teens every meal was a battle. We
hardly ever could sit down together without
someone's leaving the table in tears or fury.
Sometimes it was Tracy who slammed down her
napkin, shouting, "Why do you all hate me?"
Other times it was Daisy, wailing over some
wrong done to her by Tracy. Or it was Jim,
normally a kind and deeply concerned father, a
believer in firm and consistent discipline, who
found himself screaming at his daughters and
then bolting from the room, hating himself for
losing control. Or I was the one, listening to
myself shriek like a fishwife and then steadying
myself against the counter in the kitchen,
fighting for calm.
Oh, we did all the usual things to solve our
problem -- we talked to our pediatrician and to
the school nurse and later to the guidance
counselor and after that to a psychologist. Jim
and I searched our souls to discover what we'd
done wrong. We ransacked our memories to figure
out how we'd mishandled toilet training or shown
rejection or made some other crucial mistake. It
was taken for granted by everyone we consulted
that we, the adults, were the ones who were in
error. We had to change in order to bring some
degree of peace and happiness to our troubled
family.
But the experts were wrong, for Tracy was the
one who had to change. And it is a measure of
the world's ignorance of this area of human
suffering that the poor child had to travel
alone to the brink of disaster before she would
find her way.
Her final months in high school were as
stormy as any I remember. The battles continued,
but between them, now, Tracy would retreat into
sullen silences and nothing I tried would
mollify her. Then, suddenly, about a week before
graduation, her mood seemed to switch; her anger
gave way to calm. One night I went to her room
to kiss her good night and as I learned over her
bed she pulled me down to her and moaned into my
ear: "Help me, I don't want to die." I held her
to me and she said it again. "Help me, Mom, Help
me. Part of me wants to live." When I looked
into her eyes I saw such sadness as I had never
seen before.
That night I tiptoed into her room every 15
minutes, watching over her. In the morning
neither or us mentioned what had happened and
she went off to school in a reasonably good
frame of mind. But as soon as she was out of the
house I phoned the psychologist she'd been
seeing. He was greatly alarmed. It was possible,
he told me, that the calm I had noticed in
recent weeks was the result of a decision -- a
decision to die. When anguish gives way to
quiet, he said, it can be a prelude to
suicide.
He promptly took charge of the situation. By
evening Tracy had been signed into a psychiatric
hospital. After three weeks, when it was thought
the crisis had passed, she was allowed to come
home again -- providing she continued her
therapy. Soon after that, she decided that she
was not going to college, although she'd been
accepted by a fine state university less than
100 miles from where we live. She moved out of
our house into a furnished room on the other
side of the city, found a job and practically
cut herself off from us.
That was four years ago, when she was 18. Jim
and I rarely saw her for the next year and a
half and whenever we did, our hearts would sink.
For Tracy was a changed person. She dressed and
acted tough. She wore rough, mannish clothes --
not just the jeans and heavy shirts that so many
young people go in for, but clunky men's shoes
and a woodsman's jacket. Her black, curly hair
was so much shorter than most of the boys' in
town that she had a harsh, butchy look about
her. Jim and I used to exchange glances, but
neither of us dared to give words to the
terrible suspicion that was dawning on us; Was
Tracy a lesbian? Was that it? We couldn't bring
ourselves to talk about it.
But at least Tracy seemed less angry, less at
war with herself, and that was something to be
thankful for. And with only Daisy at home our
family life took on the easy cheerfulness it had
lacked through all the years of battles and
tantrums.
Then came the day, about 18 months after
she'd left home, when Tracy turned up at our
house with "something important" to talk to us
about. Tracy, Jim and I sat down in the living
room; then she dropped her bombshell. "I am gong
to have an operation that will change me into a
man," she announced. "I think like a man; I feel
like a man. Now I'm going to look like a man and
live like a man."
I couldn't believe my ears. Jim couldn't
believe his. We shook our heads and made Tracy
repeat her incredible statement.
How do you go about grasping such a fact --
that your daughter intends to become your
son?
It took us quite a while -- weeks, months.
That first day we heard the words, but not the
meaning behind the words. What the words said
was this: During her stay in the hospital a year
earlier, Tracy had read a magazine article about
a young man who had undergone treatment and
surgery to become a woman. Suddenly night turned
into day in Tracy's mind. "I'm not crazy," she
shouted to herself. "Maybe it's my body that's
wrong, not my head."
She had sent away for further information to
the Erickson Educational Foundation in
Baton Rouge, La, whose name and address were
listed in the magazine. Booklets and leaflets
arrived as well as an announcement that a Gender
Identity Committee had recently been formed at a
hospital in the Midwest city where we live. Such
a committee, composed of a psychiatrist, a
psychologist, an endocrinologist, a urologist, a
gynecologist, a plastic surgeon, an internist
and members of other disciplines, as needed,
evaluates the cases of those seeking transsexual
treatment.
Transsexual
That was a new and frightening word for Jim
and me. What did it mean? Tracy explained (and
so did the leaflets and textbooks we read in
ensuing weeks) that a transsexual is a person
with the physical makeup of one sex but the
psyche of the other. A transsexual is not the
same as a hermaphrodite because a hermaphrodite
has some or all of the physical characteristics
of both sexes. Nor is it the same as a
transvestite, who is one who seeks emotional
release by dressing like the opposite sex. A
homosexual is usually accepting of the sex into
which he or she is born, but engages in sexual
relations with members of the same sex.
Tracy had looked like a girl from birth,
developed like a girl in her teens with breasts
and normal menstrual cycles. But despite the
outside evidences of femaleness, inside her,
struggling to express itself, was a masculine
consciousness -- an almost irresistible drive to
be and act like a man. That's what she meant
when she told us she was a transsexual -- her
psychological gender was the opposite of her
body's.
By the time she told us what was happening,
Tracy had already gone through the grueling
physical and psychological explorations of the
Gender Identity Committee. She'd been
interviewed, probed, poked, examined,
cross-examined, her blood and urine taken for
analysis, her mind checked out by batteries of
psychological tests, her chromosomes counted,
her hormones assayed, her fantasies
analyzed.
Of the 54 candidates who had presented
themselves for treatment by the new Gender
Identity Committee, only two were accepted, and
Tracy was one of them. For the past year she had
been receiving injections of testosterone, the
male hormone, and had been living like a man.
(It was the testosterone which had caused the
coarsening of her face and body that we had
noticed.) That was the committee's basic
requisite to further treatment -- at least one
year of living the life of the sex to which the
patient wishes to transfer. During that time
Tracy was required to be a man in every phase of
daily life, to dress as a man, find work as a
man, join clubs as a man, make new friends as a
man.
This is considered an important testing
period, to see how the new gender "fits," and
how powerful the desire for sex reassignment is
before the candidate goes on to the further and
irreversible stages. Tracy had taken this
initial step without consulting us, because she
feared that if we knew her plans we would try to
stop her. As far as she was concerned, that
first step was a success. Now she needed our
help. Before any surgery could be performed the
Gender Identity Committee insisted on the
permission of at least one member of the
patient's family. (This is required of all
patients --adults as well as minors -- to
preclude later malpractice suits by family
members and to make sure that someone beside the
patient is aware of what's taking place.)
Tracy had referred vaguely to surgery. Just
what surgery did she have in mind? She drew a
deep breath, knowing how hard it would be for us
to accept what she had to say. Then quietly and
seriously she told us that to complete her
gender reassignment, she wold need three stages
of surgery -- mastectomy to remove her breasts,
hysterectomy to remove her uterus and ovaries,
and phalloplasty to construct a penis.
My mind reeled under the impact of her words.
Why would any young woman want to have herself
diminished in such a way -- destroying the
deepest and most precious evidence of her
womanliness? I couldn't grasp it. "But mother,"
Tracy explained patiently, "I'm not a woman --
that's the whole point. I'm a man. Inside myself
I'm a man and as a man it's a horror for me to
have breasts. They're constant reminders that
nature made a dreadful mistake in putting me
together. I have to get rid of all the woman in
me, and surgery is the only way."
That's how it came about that a fairly
average American couple sat in a fairly average
living room trying to hold on to their sanity as
their daughter told them she was in the process
of becoming a man.
It was a weird, incredible afternoon. As the
three of us talked, I found my mind tuning in
and out of the conversation at intervals, as if
I could cope with just so much of this bizarre
situation at one time, and then had to stand off
and give myself time to absorb it.
I tried to study Tracy as if from a great
distance, as if she were a stranger, and I had
to admit that, had I really not known her, I
would have assumed that she was a young man. I
would have described this young man as being, on
the surface, surprisingly composed, considering
the circumstances, earnestly answering our
questions. It was impossible to read anything in
Tracy's eyes; they were, as they had been since
infancy, eyes of indescribable sadness.
Only a slight tremor of her hands and voice
betrayed how much hinged on the outcome of this
conversation. Tracy knew the future could go
several ways, depending on our reaction.
At one extreme we could put a stop to the
whole thing. We could storm into the hospital
and threaten to sue the doctors. If that should
happen, Tracy left no doubt she would drop out
of sight, find a doctor, perhaps in Mexico or
Europe, and go ahead with the operations. That
way, it would all be done furtively, with
greater risk and more trauma, but her father and
I would be spared the notoriety. With or without
our permission, the change would be made
eventually -- Tracy left no question about
that.
On the other hand, if we thought we could
come to accept Tracy as our son, if we could
treat her as a man, address her as a man, learn
to think of her as a man, perhaps something
could still be salvaged from the wreckage of our
battered family life. A question surfaced in my
mind: How do we tell people? How do we face our
friends? But Tracy was our child, after all, and
love for a child can triumph over bitterness and
estrangement. I looked at my husband and knew
that he was thinking the same thing. There
really was no alternative for us but to accept
-- him.
Him
In that moment we made a crucial choice that
turned our lives completely around and started
us off in an entirely new direction. Our
decision was yes. We would approve; we would
cooperate with the doctors in every way we
could; we would stand behind Tracy in her quest
for a new self.
So it began.
We were notified that the committee wanted to
learn more about us in order to learn more about
Tracy. Jim and I therefore started leaving our
offices (I had gone to work for an insurance
company when the girls were in high school and
Jim was sales manager for an office-equipment
firm) to spend exhausting evenings in the
testing laboratory, coping with intelligence and
aptitude tests. We found ourselves putting our
innermost thoughts on reel after reel of tape.
We dredged up recollections about times and
emotions we thought we'd left behind us
forever.
And gradually we began to find some answers
to our questions about Tracy and the whole
baffling problem of transsexualism. We learned,
first of all, that the very concept is still
controversial, but that increasing numbers of
specialists are now convinced of its validity.
We learned, too, that the condition, while rare,
is far commoner than we had dreamed. Dr. Harry
Benjamin, a New York endocrinologist who is one
of the pioneers in this field, has ventured an
educated guess that puts the number of American
transsexuals at about 10,000 [it is now
believed to be about 60, 000]. He himself
has worked with more than 100 such patients.
The most publicized case of sex reassignment
was George Jorgensen, who became Christine
Jorgensen, in Denmark, two decades ago. In 1966,
John Hopkins University in Baltimore set up the
first American center for sex transformation.
Since then Johns Hopkins has done 32 sex change
operations and another 500 have been performed
in other medical centers in this country. Today,
about a dozen medical institutions, among them,
the University of Michigan, the University of
Minnesota, the University of Washington in
Seattle, the University of Virginia, have Gender
Identity Committees. The first national medical
meeting on this subject was held at Stanford
University Medical Center in February 1973, to
coordinate diagnostic and treatment procedures,
and the Third International Symposium on Gender
Identity will convene next September in
Dubrovnik, Yugoslavia.
The experts agree that there is no way yet to
point a positive finger of blame in the creation
of a transsexual. Throughout history, an
individual's sex has been established by the
appearance of his body at birth. But that
appearance may be either ambiguous or deceptive.
Sexual identity within the individual is fixed
through a complex interaction of body and mind,
involving anatomy, hormones, neurological
mechanisms, and cultural and other environmental
factors. The process may go awry at different
points in the course of development.
Dr. John Money, associate professor of
medical psychology and pediatrics at Johns
Hopkins, one of the leading authorities on sex
reassignment, believes that an imbalance of
fetal hormones may create a susceptibility
toward gender identity problems. (In animal
experiments, if the pregnant mother takes
certain barbiturates, antibiotics or
psychoactive drugs, her babies tend to have
distortions of gender identity.) Apparently
hormone imbalance or a viral infection or drugs
taken by the mother may lead to an improper
programming of the fetal brain. Thus the infant
could be born looking like one sex, but
"programmed" to behave like the opposite
sex.
Another thing that could go wrong is the
male-female imprinting that is made at certain
critical times after birth. Dr. Money compares
the process to what goes on in the brain of a
child who is required to use two languages from
birth. "The brain of the natively bilingual
infant," he explains, "must code all linguistic
sounds and utterances as belonging to one
language or the other. In much the same way, the
brain of any child must code all gender-role
signals as either masculine or feminine, and
allocate either positive or negative values to
those signals." If something malfunctions during
codification, the child may become confused or
contradictory in his gender identity.
One of the things that surprised me as I dug
into the research material was that the sex
chromosomes are now the sole key to sex
differentiation. In fact, most transsexuals have
the chromosome makeup normal for the sex of
their physical appearance, the sex that they
will move heaven and earth to escape. I learned
too that true transsexuals almost never respond
to psychotherapy. No sure way has been found yet
to bring a male psyche, such as Tracy's, into
line with a female body. It is in recognition of
the fact that it is less monumentally difficult
to change the body than the mind of a
transsexual that gender committees have sprung
up so rapidly.
Another curious fact is that the change from
male to female is sought at least four times
more frequently than from female to male. That
was one reason why our local committee accepted
Tracy -- they were eager to work with a female
transsexual seeking male identity. In addition,
they were impressed with Tracy's determination
and emotional stability despite the storminess
of her growing-up years.
Make no mistake, it is a Herculean endeavor
to change one's sex. I know from living through
it with Tracy. But once she realized she had our
support, she moved ahead swiftly. She continued
injections of male hormones she'd been having
every two weeks, and will continue them for the
rest of her life. The hormones lower her voice,
cause growth of facial hair, bring about a
redistribution of fat on her body in a male
pattern. She already had a job under male
identity as a shipping clerk and had joined
several male clubs. And she was saving her money
for the expensive surgery she was determined to
undergo.
I've been saying "she" because, of course,
Tracy had always been she to us. But now as I
write this account I will change over to "he,"
exactly as I had to do in everyday life. The
switch in pronouns has been a problem -- it
still is. But I've trained myself to say "he,"
"him," "my son," "my boy," and to drop the
designation, "the girls," which I had so long
used in referring to Tracy and Daisy.
Daisy was the first person we told, and her
calm, poised acceptance of the news set the tone
for the announcement we had to make to others
close to us.
I had been petrified at the thought of
telling people, and over and over I rehearsed in
my mind the words I would use.
But when I told Daisy, she simply closed her
eyes for an instant and then she said, "Oh,
Mother, how he must have suffered." I think at
that moment she forgave her new brother all the
miseries Tracy had inflicted on her throughout
their turbulent childhood.
Naturally we did not shout our news from the
rooftops. To family members and close friends,
we simply said, "Tracy is under treatment for
the correction of a complicated sex
problem."
Most people who knew Tracy replied, "I'm glad
your child is finding happiness at last."
At first we were afraid to tell Jim's elderly
father, who lives nearby, but Tracy insisted.
"It's not fair to deprive me of a grandfather,"
he said, and he was right. Jim was the one who
broke the news. While his father doesn't
entirely understand and almost surely never
will, he accepts his grandson nonetheless. And
that's enough.
The time came for the first step in surgery
-- the breast removal. I don't think I could
ever be as brave as Tracy was, but then I never
thought of breasts as hateful appendages, as
Tracy did, to be bound down so that they would
be less conspicuous. The surgery was done at a
local hospital. Today, the scarring is hardly
noticeable. I wish I could communicate Tracy's
joy when he first put on a low-cut boy's shirt
-- the kind basketball players wear -- and
swaggered toward his reflection in the mirror. I
guess pain and suffering hardly count when
you're achieving something as basic as this was
to him.
The hysterectomy was a little more
complicated because, by this tine, Tracy was
well established in his masculine role and
couldn't figure out how he could enter the local
hospital as a man to have his uterus removed.
After careful consultation with his doctors, he
decided to have this operation performed in a
private hospital in another city. It was done
six months ago and while it did not result in as
much visible change as the earlier operation, it
had an inner, symbolic meaning for him that
brought enormous happiness.
The final -- and most difficult -- operation
still lies ahead. It involves a plastic surgery
procedure that eliminates the vagina and creates
at least a semblance of male genitalia out of
the existing tissue. There are a number of
different techniques now being used for the
construction of a penis, all of them multi-stage
procedures requiring a series of hospital
admissions. The cost in pain and expense is very
great and the results not always entirely
satisfactory, either in appearance or function.
Usually a prosthesis is required to accomplish
intercourse, even after the operation, and there
is no way for the transsexual to father children
of his own.
A booklet published by the Erickson
Educational Foundation, entitled Medical
Management of the Transsexual, states that
the patient should be discouraged from this
undertaking "unless he is unshakably convinced
that to forgo it would deprive him of a
psychological and social sense of security he
may obtain in no other way."
So far, Tracy is determined to go ahead, but
is waiting until his doctors agree on the right
operation for him and until he has saved the
necessary money.
Lack of medical reimbursement is only one of
the hurdles a transsexual faces. To me, the
legal problems have been among the most
upsetting of this whole experience. Many times
my heart pounded when I came home to find an
official-looking letter on the hall table among
the day's mail. Since it is illegal in most
states to crossdress (that is, to wear the
clothes of the opposite sex), you can imagine
the kind of harassment and even blackmail that
transsexual might be subject to in the early
stages of change. In the future, as people and
officials become more aware of the problem, I
hope the legal red tape will be more easily
disentangled. As for what happened to us, I
still shudder when I think how gingerly we all
walked the legal tightrope, while Tracy was
having his draft status arranged, driver's
license shifted and birth certificate altered.
Finally, however, all was accomplished.
Was it worth it?, you might ask. There isn't
a shred of doubt now in any of our minds. The
change in Tracy is a miracle to us. After years
of trying desperately to resign ourselves to an
emotionally disturbed child, Jim and I now find
ourselves the proud parents of a handsome,
well-built, deep-voiced young man who is as
completely in tune with himself and his world as
any other young man of his age I've ever met. He
is affectionate, stable, productive and
confident about the future. Those once-sad eyes
of his are now often alight with laughter and
rich depths of feeling. He has a good job during
the day as a salesman in a men's furnishings
store. He attends college at night, and is
leaping ahead in his studies and talking about
going to medical school. He has developed a
wonderful camaraderie with the doctors and
psychologists who have worked with him so
closely, and his dearest dream is to join them
as a colleague. He'll do it, too, for Tracy now
is capable of doing anything he wants.
One thing I used to worry about was his
social life: Would he be able to attract girls
and form satisfactory relationships with them?
The doctors had assured me that many
transsexuals marry and raise children they have
obtained through former marriages of their
mates, artificial insemination or adoption. And
Tracy, to our astonishment, has had great
success with girls. When he meets a young woman
and likes her, he tells her candidly of his
sexual limitations. Many of them breathe a sigh
of relief and exclaim, "Thank heaven, no
wrestling matches," and they go on to warm, deep
friendships.
Recently, Tracy flew to a medical conference
in a large Eastern city, where one of his
doctors was presenting a paper on
transsexualism, and he sat on the platform and
answered questions from the doctors and medical
students in the audience. His doctors are
convinced that if pediatricians and general
practitioners can be made more aware of gender
identity problems they may begin to recognize
such disturbances in childhood and learn ways to
correct them that are easier than the tortuous
steps Tracy had to take. Eventually, ways may
even be found to prevent gender problems. It is
also possible that lives can be saved, for as
Dr. Money of John Hopkins has pointed out,
"Adolescent and young-adult suicides are
frequently related to gender disturbances. When
young people are terrified by the freakiness of
their fantasies and daydreams, they too often
see death as the only way out."
That's one reason why I have told Tracy's
story -- to move forward just a bit the public's
understanding of the suffering that results when
the psyche of one sex is trapped in the body of
the other. But I have another reason for laying
bare all the misery and anger, the frustrations
and fears that Jim and I and Tracy and Daisy
have lived through. It is to pay tribute to the
remarkable men and women who have helped us find
our way out of the darkness. Their selflessness,
courage and compassion have shown me there is no
limit to what human beings, at their best, can
accomplish.
