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Posts from the ‘post-transition’ Category

On Regret of Gender Transition

There are some people who undergo a gender transition (either fully or to some extent) and then regret having done so and “de-transition”.  This post attempts to explore this phenomenon.

Some reasons why this might occur include:

  •  The person is not transsexual.  The person may have found by going through their transition that they are not in fact comfortable living in the other gender and that they feel either gender queer or more closely aligned with the natal gender.  Certainly instances of transitions involving surgery might have been prevented if there were a greater attempt to determine this beforehand; however, just like with non-trans issues, we often go ahead with things we think are right for us only to discover that they aren’t.  Sometimes the discovery just isn’t possible without trying it out.  The ‘real life experience’ (see WPATH’s standards of care) is an attempt to systematize this discovery process before any major surgeries.
  • Regardless of whether the person is truly transsexual or not, it’s possible that because of having lived so long with gender dysphoria and accompanying social and physical dissatisfaction, one may think of a full gender transition as a magical ticket to happiness.  I have seen this (sometimes unconscious) wish accompanied by other unrealistic expectations such as:  the idea that one will have a social community, better social skills, be more popular, etc.  When this turns out not to be true, there can be confusion and uncertainty that tends to focus on one’s gender transition.  It may be that the gender transition was in the person’s best interest, yet other causes of unhappiness and personal problems had not been sufficiently explored and worked through.  Sometimes with gender variant people, work on other problems are delayed because the gender issues tend to take precedence.
  • The person encountered too many problems with transition (i.e. dissatisfaction with their post-transition life).  These problems could include lack of family support, loss of partner, problems with transition in the workplace, disappointment with the outcome of surgery and problems “passing” as the new gender.  Additionally, transitioning is hard.  There are many hoops to jump through and one enters into a group of discriminated against people.  This can be exceedingly disconcerting for some.

Levels of regret

Certainly a person who has made a gender transition can have certain regrets that are not extreme enough to cause them to wish to de-transition.  The WPATH Standards of Care notes that “cases are known of persons who have received hormone therapy and sex reassignment surgery who later regretted their inability to parent genetically related children”.  Other less extreme regrets can involve loss of certain benefits of privileges commonly associated with one gender or another.

Some research on regret:

Pfafflin F., Junge A. (1992) Sex Reassignment: 30 Years of International Follow-up Studies after SRS: A Comprehensive Review, 1961-1991 [publication online]. Translated from German  into American English by Roberta B. Jacobson and Alf B. Meier. IJT Electronic Books.

This study looked at 70 previous studies and reviews on outcomes following sex reassignment surgery.  These included 2000 individuals from 1961 to 1991.  This doesn’t take into account individuals who transition without surgery.  About 70% of MTF individuals were satisfied and 90% of FTM individuals.

Krege S., Bex A., Lummen G., et al. (2001). Male-to-female transsexualism: a technique, results and long-term follow-up in 66 patients. BJU International. 88:396-402.

 This study shows little or no regrets possibly due to surgical advances.

Find out about Psychotherapy when dealing with Gender variance in yourself or someone close to you. email: info@amikaplan.net

The Need for Post Transition Support (Part 2)

A follow up to the Mike Penner/Christine Daniels saga.

The LA Times posted a long follow up article on the suicide of Mike Penner/Christine Daniels, the late LA Times sportswriter who transitioned on the job (and which I wrote about in a previous post)

A few things stand out as contributing to the suicide:

  • A very painful separation and divorce from her wife.  Complicating matters was the fact that they worked in the same office and wife expressed her wish to avoid all contact with Christine. (I’m certainly not blaming the wife for contributing to the suicide; I’m just saying that the separation and circumstances were painful for Christine.)  There was also the loss of the wife’s family, who Penner was close to.
  • Being a public figure, she got some harsh (and ignorant) public criticism of her ability to “pass”, which was hard on Christine.
  • Christine being thrust into and accepting the role of spokesperson for transgender issues when she probably wasn’t ready or personally strong enough to deal with the media scrutiny.  Then having disagreements with trans activists who objected to Daniel’s emphasis on appearance in her blog.
  • Daniels withdrew from friends, church and public appearances.
  • Daniels’s mother died.
  • Daniel’s focused on her transitioning as the root of all her problems and tried to de-transition in hopes of reuniting with his wife.

What are the lessons that can be gleaned from this?

  • There is a great need for support during and after transition.  Don’t underestimate the need for supportive people and institutions.  Including friends, family, support groups, therapy, religious institutions, knitting circles, etc…  Its like drinking water in the desert – you have to do it even if you’re not feeling thirsty – if you feel thirsty its too late – you’re already dehydrated.
  • Withdrawing is not the answer.  It will only make things worse.
  • Very often when people find themselves a part of a new group they feel they have to be a spokesperson/activist/possess complete knowledge of said group.   That’s great if you want to do that, but it should be a conscious choice and not an obligation.

Find out about Psychotherapy when dealing with Gender variance in yourself or someone close to you.


Confusion around changing sexual orientation for trans people

I’ve been working on an article (hence the lack of posts lately) and midway through I went on a little tangent (OK, it was a rant) about this issue of confusion around changing sexual orientation for trans people, so I thought I would excerpt it here:

There is a commonly heard idea in the transgender literature and community asserting that the transgendered individual will sometimes change sexual orientation after transitioning.  I have found that many patients come in with this belief.  Arlene Istar Lev (2004), a family therapist, clinical social worker and gender expert notes that “gender transition can have a tremendous impact on sexual orientation, sometimes affecting one’s sexual interests…” and in the next paragraph “Sexual orientation is not malleable and cannot be changed through force or will” (p. 301).  There seems to be a good deal of confusion and disagreement on the topic in the transgender community.

Putting aside for a moment the fact that transitioning is a long process with no particular end point (where a change in sexual orientation could be assessed) and can often mean different things to different people and that most transsexuals do not have surgeries; perhaps what is really happening in these cases is that individuals are choosing partners more for the complex array of factors that help the individual feel confirmed in their authentically felt gender rather than for their desirability based on their maleness or femaleness.

Just thinking about this logically for a minute one sees that claims of so called “reparative therapies” on non-trans homosexuals have been thoroughly debunked over the past few decades (for summaries see Haldeman, 1994; Drescher, 1998  and Bright 2004).  What bit of alchemy would then achieve this momentous transformation on the transsexual?  Hormone replacement therapy?  By this same logic, scores of menopausal lesbians taking feminizing hormones would have suddenly switched to becoming attracted to men.

A 1998 research paper titled “Changes in the Sexual Orientation of Six Heterosexual Male-to-Female Transsexuals” by Christopher Daskalos of the Department of Sociology, Arizona State University asserts that

“These respondents stated that before transitioning they had been sexually orientated towards females. After transitioning, these same respondents reported that they were sexually orientated towards males. Five of the six respondents reported having various sexual encounters with males since transitioning. The respondents explained the changes in their sexual orientation as part of their emerging female gender identities. Three of the respondents claimed that the use of female hormones played a role in changing their sexual orientation” (from the abstract p. 605).”

The paper was challenged in the same journal in a letter to the editor by Anne A. Lawrence (an arguably controversial figure in her own right due to her advocating the concept of  ‘autogynephilia’) who noted that “Daskalos purports to document dramatic changes in the sexual orientation of six of his transsexual informants – changes that seem to have occurred almost effortlessly.  However, a careful reading of Daskalos’ paper reveals that he has demonstrated no such thing” (p. 581). Her reasons include that sexual behavior is not the same as sexual orientation, that (a somewhat dated idea) “Sometimes such self-reports may be conscious deceptions, designed to increase the likelihood that the transsexual will qualify for sex reassignment surgery” and that “In other cases, such self-reports by transsexuals may reflect the autogynephilic fantasy of sex with a male partner” (p. 581).

However none of these refutations shed light on the reasons behind changes in behavior.  I believe Dozier’s (2005) comments from her cohort of 18 trans men to be most in keeping with what I have seen with trans people in my practice:

Respondents also challenge traditional notions of sexual orientation by focusing less on the sex of the partner and more on the gender organization of the relationship. The relationship’s ability to validate the interviewee’s masculinity or maleness often takes precedence over the sex of the partner, helping to explain changing sexual orientation as female-to-male transsexual and transgendered people transition into men (2005, p. 297).”

I’m interested in hearing your thoughts.

References:

Bright, C. (2004). Deconstructing Reparative Therapy: An Examination of the Processes Invovled When Attempting to Change Sexual Orientation. In Clinical Social Work Journal, Vol. 32, No. 4, Winter 2004 (_ 2004)

Daskalos, C. (1998).  Changes in the Sexual Orientation of Six Heterosexual Male-to-Female Transsexuals. Archives of Sexual Behavior, Vol. 27, No. 6, 1998

Dozier, R. (2005) Beards, Breasts, and Bodies: Doing Sex in a Gendered World. In Gender & Society, Vol. 19 No. 3, June 2005. 297-316

Drescher, J. (1998).  I’m Your Handyman: A History of Reparative Therapies in Journal of Homosexuality,Vol. 36(1) 1998

Haldeman, D.C.  (1994) The Practice and Ethics of Sexual Orientation Conversion Therapy. In Journal of Consulting and Clinical Psychology, Vol. 62, No. 2, 221-227

Lawrence, A. (1999) Letter to the Editor. Archives of Sexual Behavior, Vol. 28, No. 6, 1999

Lev, A. (2004). Transgender Emergence. Binghamton, NY: HaworthPress.


Find out about Psychotherapy when dealing with Gender variance in yourself or someone close to you.


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