The lack of data creates conflicts for health care providers working with trans youth. According to the Benjamin Standards of Care, kids under eighteen are not candidates for hormone treatment or surgery, despite the fact that puberty tends to be a nightmarish experience for some transgendered kids, whose bodies grow daily more estranged from the kids’ gender identities. Some find a way around the rules by taking hormones they purchase on the street, without medical supervision. Others may find a health care provider willing to prescribe hormone blockers, which don’t create permanent changes, but slow or postpone the morphological changes of puberty. Some providers who do adhere to the Benjamin Standards of Care will prescribe hormone treatment for adolescents if they seem emotionally and intellectually mature enough to make the decision. Medically and ethically, the decision is a tough call, as Maria Russo, author of the Salon article, discovered in her interviews with health care providers. “As more young transsexuals push to begin transitioning at a younger age, the social workers and medical providers who work with them are confronting a new frontier in gender ethics. What’s the best way to help kids who say they want to switch sexes? Should we make them wait as long as possible, to be sure their decisions are not simply adolescent rebellion? Or should we take them at their word and let them begin hormones during puberty?”
As even this brief treatment of the issue shows, questions far outnumber answers in the realm of transgender health care and research. In no area is this more true than in the biggest and most controversial question of all—what causes gender variance and why do there seem to be so many more gender-variant people in the world today than there were fifty years ago?
CONVERSATION WITH DANA BEYER, M.D.
Dr. Beyer was trained as an ophthalmologic surgeon, though she no longer practices in that field. She currently serves as co-moderator of the DES Sons Network, founded by Scott Kerlin. I interviewed Dr. Beyer on two separate occasions; during our first meeting we addressed general issues and in the second, personal history. When I met Dr. Beyer early in the summer of 2002, she was still living as a man, though actively planning her transition. When we met for the second time, she had become markedly more feminine in her appearance, owing to estrogen therapy and electrolysis, and was preparing for facial feminiation surgery in January 2003 and genital surgery in June. At the time we spoke, Dr. Beyer was living with her second wife and two teenage sons. The couple later separated. What follows is a portion of the transcript of our second conversation.
Q: So what has changed since the last time I saw you?
I’m out with my wife and kids. I haven’t been doing anything differently since I last saw you, but she just finally came out of denial, even though I had transitioned and de-transitioned once before, nine years ago. But I didn’t have the strength to do it then. And it’s interesting now as I come out more and more, it’s such a relief. No matter how difficult this is, it is such a relief just to be myself. All of what you’ve been trying to project, express, what society demands of you, the role that you’re expected to play, the way you’re supposed to look and dress and behave. It’s complicated but it all comes down to denying your identity. And I would say that I’ve expended at least 50 percent of my life’s energy fighting this one way or another. All that energy needed to be a man in this society, when you’re not. You can’t imagine. I guess it’s like what it might have been like for some Jews to pretend to be Christian in order to survive. You’re constantly on guard, constantly aware that you are who you know you are but you can’t let it slip. Because when you are a child, if you let your feminine gestures slip, you’re spanked or slapped.
Q: Can you give me some examples of what sort of feminine mannerisms or expression of femininity you would have to hide or repress?
Many things. The trivial are usually the best example. I used to be pretty active with my hands, with hand gestures. Women do this all the time.
Q: Maybe you just need to be Italian? Italian men are pretty expressive.
Maybe, but I wasn’t. My family is Lithuanian and Ukrainian Jewish. We didn’t do that. And I remember my mother saying, “No no no, sit on your hands. Don’t do that.” It’s a trivial thing, really. What difference does it make? Now that I don’t care anymore, now that I’m coming out and I gesture naturally, it’s a relief. Or “don’t cry,” if you feel like crying. Or you have to go out for a sport, or “go out and play with the boys,” even if you don’t want to play with boys. “Go out and play with your friends.” Well, they’re not really your friends, and you know that they’re not your friends. And you know that they know that you’re different. And you keep trying to be more of what you know they expect you to be so that you can fit in and have friends.
Q: Some of the things that you’ve mentioned other XY individuals who feel comfortable being male might also wish to do or not to do—not playing sports, for example. So what’s the difference?
There are some people—and since I do DES work, I’m involved with the intersex community, and you know that I consider transsexu-ality to be a form of intersex—there are some intersex activists who believe that if we could reform society and destroy the gender binary, there wouldn’t be any need for transsexes. There are some very reasonable, caring, loving, intersex people who feel that is the case— because they don’t fit into either category, they don’t want to be in either category. One thing that I’ve come to realize … my wife says, “What kind of woman do you think you’re going to be?” and I say, “I don’t know.” And my son says, “Okay, you’re doing this. Are you going to be sort of froufrou and frilly and have dinner on time every day?” and I’m thinking that this is interesting, that this is what he imagines that women do—and this is 2002?
Q: And he has had a working mother?
Several working mothers! His grandmother barely did that! And yet this is what he imagines. And I said, “No, I’m going to be me.” And it made me realize that I have male parts in me. I have a male history. I can’t forget that. I wasn’t “pinked,” as the feminists say, and of course the Janice Raymond crowd says, “If you haven’t been pinked, you can’t really be a woman.” But I am doing something they have never been asked to do. I am renouncing male privilege. It just hit me about a month ago, just how intense that is. I was lying in bed one night and I go, “You know, I really am giving this up.”
Q: Can we talk about how this all began for you?
My mother was a New York City master teacher. She taught for twenty-five years, math. She took DES in 1951 because her gynecologist told her to. She’d had one miscarriage. I had an older brother who didn’t make it. But it’s kind of strange now, as a physician, to think after one miscarriage they would do this. I mean, one out of every three pregnancies ends in miscarriage.