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Karen and Paul as childrenLike most twins, Martine and Karen Hewitt were very close. Born in 1967, they grew up in Reading, a town just outside London, had their own pony, shared a passion for athletics and even talked of having a double wedding. They were inseparable. But three years ago, Martine decided she was not a woman but a man trapped inside a woman's body. Now called Paul, she/he has all but completed a sex change and is coming to terms with living life as a man. Karen, meanwhile, has to learn to live with the fact she has lost a sister…and gained a brother.

It has taken two years for Martine to be transformed - through drugs and surgery - into Paul. Her voice broke, she began to grow a beard and last year she underwent a double mastectomy. Karen witnessed all this, offering constant support, never expressing misgivings. Before treatment, Paul was sent to a series of counsellors and psychiatrists to help him prepare for his new life. Now a technical author, he has just told his story in a book, A Self-Made Man. But Karen and Paul's girlfriend Laura have never spoken publicly about their feelings - until now.

Karen's Story

Karen "At times, I've felt close to a nervous breakdown," Karen says. "I started seeing a counsellor, too. It's painful for me to look back through family albums. When I see pictures of us as girls, I have this really strange feeling of not being able to relate to them. At times, I did have feelings of horror during Paul's transformation. He would do things like run out of the bathroom saying, 'Look, I've got another hair on my chin.' It was a kind of mutation in a way."

PaulIt is ironic that, as her sister finally achieves happiness as a man, Karen is left feeling overwhelmed. For, as they grew up, it was always her sister who was unhappy. "People couldn't tell us apart," says Karen. "Then they'd say, 'Karen's the smiley one.'"

Martine was the tomboy while Karen was very feminine. "We started ballet when we were six and I adored it," says Karen. "But Martine asked to do judo instead. Until we were 13, there were constant fights between Martine and our parents. In the end, Mum and Dad just accepted she wanted different things to me. I knew something was wrong but I didn't know what. I was happy being a woman and Martine wasn't."

As they began dating boys, rivalry entered their relationship. "Martine would say, 'I'll never be a good-looking as you.' She would dress in raunchy clothes, and even took up modelling for a while. Once, someone in the audience shouted, 'Look, it's a man in drag!' She was very pretty but something in her body language didn't ring true.

"When we were about 18, there were constant comments about a double wedding and we used to chat about it ourselves - we always wanted to do everything together. But it was an odd thing to visualise because the previous year we were asked to be bridesmaids and Martine refused, saying, 'There's no way I'm wearing that stupid dress.'"

But, for a long time, Martine was the one who seemed to form stronger relationships with men than her sister. "She had one five-year relationship," Karen says, "though, looking back, it may have been more of a brother-sister thing. I don't think Martine ever had sex with a man. From the hints I got at the time, there always seemed to be a barrier."

Both girls went to university, but while Karen enjoyed herself, Martine was wretched. Things came to a head when the sisters set off travelling around the world at the age of 23. After three months, Martine returned home, leaving Karen to continue alone. Karen was still in Australia when Martine sent her a letter: "She said she had found a word for what she was - transsexual. I can barely remember reacting, I sort of blocked everything out." But when she returned to England for Christmas in 1992, Karen had to face up to the situation. "Martine was still calling herself Martine but, when she took me to the pub, she was wearing a suit. It could be a bit embarrassing." Martin gave up her job in insurance, feeling unable to dress as a woman any longer, and began calling herself Paul.

"It amused me to watch his body language," says Karen. "He'd sit with his legs apart and tell jokes just like Dad." As Paul embarked on the full sex change, Karen was the one explaining it all to her parents. "They were befuddled by it all. My father just shut it out. There was an ambiguous stage where Paul looked neither one thing nor the other, and Dad was embarrassed by what the neighbours would say."

After Paul's mastectomy operation, the twins' relationship was strangely different, yet the same. "He does not act in any way differently towards me now. It's a rather peculiar relationship - I still don't think twice about walking around naked in front of Paul, even though he's a man now. We are now brother and sister, but he's the same person and always will be." But Paul's decision, necessary though it may have been for him, has effectively cut Karen off from an entire section of her past. "I hate going to our local pub in Reading. People say, 'How's Martine?' What can I say? 'Martine was killed in a car crash?' It would be easier to say that than to start the whole story."

But after years of feeling guilty and concerned about Paul, Karen can now rest assured her brother is happy. "The only time Paul was been really well is since his mastectomy," she says. "Since then, he's been like a new person."

Paul's Story

Paul - learning to shavePaul always knew something was wrong. But it was only when he first heard the term "transsexual" that his life changed forever. The treatment that would transform Martine into Paul began with a lifetime course of fortnightly high-dosage testosterone injections. He is now considering having surgery to construct a penis, an operation that is regarded as tricky and uncertain.

"I still have some pretty horrible surgery ahead of me," he says, "but it is an operation I simply must have. I buy a lottery ticket every week in the hope that 'it could be me'. If I win, I'll have the most expensive willy money can buy. I simply need to be a complete man, to look in the mirror and have the right body look back at me."

In the meantime, he has to make do with a strap-on prothesis. These false penises look and feel quite realist: they have veins, retain heat and are waterproof. You can even urinate through them by means of a catheter. For sex, a manual erection device is inserted and a tiny vibrator directly stimulates the wearer's clitoris. Although there's little sensation, Paul says, "Making love with a false penis is better than making love with no penis at all."

Paul's former life as a girl comes in handy. Like most female-to-male transsexuals, he can recall things men did and didn't do when they tried to seduce him to him an advantage over most men. "My biggest fear before I changed over was I wouldn't get a girlfriend," he says, "but I've been proved wrong on that score." He's been going out with Laura for 10 months, a relationship that developed when she wrote to him after seeing him on a TV morning show in the UK, publicising his book.

Paul feels his relationship with Karen intensified as she watched her sister change to a brother. He says in his book, "After her initial devastation at my decision, she now totally accepts it and is being consistently and intensely supportive. We are twins - brother and sister, spirits entwined. I can share my pains and fears and she does not judge. I feel a foot taller and braver with Karen by my side. She is my guiding light, the female part of me, my personal unpaid bodyguard."

He most needed Karen's support when the public hospital he was supposed to be operated at was forced to cancel his mastectomy for the second time. Although he was offered another date, the agony of waiting was driving him crazy. He couldn't handle another cancellation and so he decided to go to a Belgian hospital which agreed to perform the operation whenever he wanted.

In March last year, Paul returned from Belgium flat-chested and one huge step closer to being a man. But he had an awful time in hospital. There were drips pumping antibiotics, glucose and painkillers into his arms, and drains coming out of his chest taking blood and fluid to a bottle on the floor. A nagging bladder infection meant he had to drag himself - and all three bottles and tubes - out of bed numerous times a day. Finally, he decided he had had enough. He asked for the drains and drips to be removed, discharged himself and returned home to England.

Paul's new flat chest, bruised and covered in scabs, was in his opinion, a transformation both physically and mentally. Every day, his growing chest hairs cover more of the scars and last summer he bought his first pair of swimming trunks. "Not a day goes by when I don't admire my new chest in the mirror and do a quick count of the number of hairs," he says proudly. "I live a fulfilling life as a male. I go swimming and I play football - but I still leave early to avoid the showers."

"I cannot change my birth certificate, so I am still a woman in the eye of the law. That's the biggest joke going - just ask my girlfriend! But I wouldn't have life any other way." Paul's work colleagues are unaware of his transsexuality. "Why would anyone guess?" he says. "I look so masculine these days that anyone I tell looks at me in disbelief. I've never been one to hide from anything, so when they find out, I will hold my head up with pride and take whatever is coming to me."

Paul - modeling"I sometimes have a little smug feeling in my heart these days, knowing things are finally going my way and that what I've achieved has been in spite of the odds being stacked against me. I don't feel sorry for myself, ever, because being transsexual and having to fight so hard for everything has been the making of me as a person. It's made me very compassionate and, I think, wise beyond my 28 years. There's nothing like a crisis to open your eyes to the real world, and what's really important."

When asked about his plans for the future, Paul says, "To get married, have babies, play football for a [local] league side, meet the boxer Prince Maseem Hamed, study the mountain gorillas in Rwanda - not necessarily in that order! "I now have a good job, a place to live, a car, money in my pocket, a really fantastic girlfriend and I have my self-esteem back. All these things sound rather basic, but believe me, they can become huge challenges when you're born without the basic equipment - the right body - you need to survive.

"My book was written as tribute to the little boy Paul whom I abandoned all those years ago when I made the unconscious decision to conform in a society defined by rigid rules and shallow stereotypes. This little boy has suffered in silence for far too long, and now he is reborn a man."

Laura's Story

Paul - Happy at lastLaura is Paul's girlfriend. They've been together for 10 months.

"My partner Paul is transsexual," she says, "but that's by the by - primarily, he's gorgeous and I think he's great. To me, Paul is every inch a man. I never see anything else. In fact, he's such a typical man in some respects that I find it hard to believe what he once was."

When Laura saw Paul on TV and realised he'd had a sex change, she was amazed and disbelieving. But, as she got to know him, she says, "I realised he's more of a man than any other man I know. He's honest, sensitive, yet strong with it. He's powerful." While she had no difficult accepting Paul's transsexualism, Laura think other people might not be as tolerant of her. "Some people are very narrow minded and, if they knew my feelings for him, would consider me a lesbian. I only entertained the idea for about 1.5 seconds - he's not a girl, and if that's what I saw, I would surely be gay. But I'm heterosexual, always have been."

"I am behind Paul 110 percent, whatever he does - as long as it's legal! - and I look forward to the day when he is able to realise his dreams. He's a fantastic man and he deserves to be happy and have the best out of life. I know he wants children, and I think it would be criminal to deny him his chance to be a father - he'd be a brilliant dad.

"I don't care what people think or say,' Laura says. "I'm so proud of what Paul's achieved and of what he's been prepared to go through. As far as I'm concerned, I'm with a man, and he's the best man I've ever known."

Citation — Hammond, H. (1995). Paul Hewitt. Cosmo, 1995.

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