Tuesday, November 27, 2007
Love Your Body! A Transwoman's Guide to Health & Wellness
www.lgbthealth.net
Our transwomen's bodies come in all colors, shapes and sizes, and all of us need to take care of them. However, good health care can be hard to get, due to discrimination, lack of medical clinicians who understand our needs, and lack of health insurance coverage. To keep our bodies healthy and whole, we must become informed consumers, educating our health care providers and ourselves.
HORMONE THERAPY involves taking estrogen and sometimes an anti-androgen to promote breast development, soften skin, lighten body and facial hair, decrease fat in the belly and increase fat in the hips and thighs. It is not risk-free, and you should not take estrogen without medical supervision and regular blood tests. If you are taking estrogen or considering it, keep these points in mind:
- Every transwoman's body is different ñ there is no way to predict how your body will respond to estrogen. Taking more estrogen than prescribed by your clinician will not speed up the changes you desire, and will possibly make you ill.
- After breast growth occurs, you should learn how to do a monthly Breast Self-Examination (BSE). You also should get an annual breast exam and an annual mammogram.
- If you smoke, quit, because smoking increases the risk of blood clots while taking estrogen. Blood clots can stop the blood flow within your legs, lungs, brain (stroke) or heart (heart attack), all of which can cause permanent damage, including paralysis and even death.
- If you want to become a biological parent in the future, you should consider freezing your sperm prior to starting estrogen. Estrogen lowers your sperm count and will eventually cause infertility. However, you still could make someone pregnant, especially in your first year of hormonal use. If you have penetrative sex with someone who can get pregnant, you should use condoms or some other protective barrier.
- You still should get an annual prostate exam, even if youíve had Sex Reassignment Surgery. Taking estrogen should reduce prostate problems, but there is a slight chance it may cause prostate enlargement.
- If you inject estrogen, never share your syringes with anyone. Discard used syringes immediately and safely. If you can't afford new syringes, contact your local needle exchange program.
Injecting silicone is dangerous to your health. The safest way to get your curves is still through medically supervised hormone therapy. Contact a local transgender support group for the most experienced doctors in your area, or inquire at a local gay and lesbian clinic.
SEX REASSIGNMENT SURGERY - If you want Sex Reassignment Surgery (SRS), follow the Standards of Care of the Harry Benjamin International Gender Dysphoria Association (HBIGDA). Although imperfect, these guidelines still offer the best protection for patients and surgeons. After SRS, see a gynecologist for a pelvic exam once a year.
SEXUAL HEALTH - Use condoms or a protective barrier with your sex partners. If youíve engaged in unsafe sex, be sure to get tested for Sexually Transmitted Diseases.
MENTAL HEALTH - Living in an intolerant world can cause stress, anxiety and depression. A mental health therapist can really help you deal with things. Take care of your body and your mind. . . .
Intersex Children: Into the Hands of Babes
By Melissa Hendricks
Reprinted with permission from the Johns Hopkins University Magazine. Visit the JHU Magazine website here.
"It was a little 7-year-old," says Reiner, "who just about tore everybody's guts out."
A urologist turned psychiatrist, Reiner had devoted his career to treating young patients born with irregular genitals. Some had ambiguous genitals--a scrotum along with a phallus that resembled a clitoris, for example. Others, though genetic males, had no penis or had an extremely rare condition called micropenis.
Physicians for several decades had recommended that children in this latter group be raised as girls--thinking based largely on pioneering work done in the 1950s and '60s at Hopkins, one of the few medical centers in the world that specialized in treating children with such disorders. Common practice in a case of a boy who lacked a penis or had a micropenis was to surgically remove the testes, construct female external genitals, and prescribe female hormones--then send the child home to be brought up as Sally or Susie. To do otherwise, it seemed, was to subject these babies to an unimaginably cruel childhood of locker room taunts and psychological pain, followed by a frustrating adulthood of sexual inadequacy.
Gender reassignment occurred in other cases too, depending on the diagnosis. But in all cases, the standard was to decide promptly whether the infant ought to be a boy or girl and then to be consistent in rearing the child as that gender (a process described in my story "Is It a Boy or a Girl?" in the November 1993 Johns Hopkins Magazine).
Reiner had wholeheartedly subscribed to this model throughout the 1970s and '80s, first as a urology resident at Hopkins and then as a urologist in private practice in central California. But over the course of his career, he had become troubled by a dearth of information on the psychological and sexual outcome of children with urogenital conditions.
In 1992, he returned to Hopkins to train as a psychiatrist and to specialize in treating patients with urogenital disorders. He now directs Hopkins's Gender Identity and Psychosexual Disorders Clinic. Recently, he concluded the first phase of an outcomes study that included 36 genetic males who had been born with a complicated birth defect that included the lack of a penis. It was during the course of the study that Reiner met the 7-year-old I'll call Kayla.
Like most of the other children in the study, Kayla had been castrated and was being raised as a girl. But she was not a happy child. Small and aggressive, she had gotten into a number of fights with her classmates. Rather than the dolls her parents gave her, she played with cars and trucks, and she had insisted that her schoolmates call her by the biblical boy's name she had chosen for herself. Eventually she had refused to go to school altogether.
Reiner gave Kayla a battery of psychological tests and found that she came out overwhelmingly male on measurements of gender-typical behaviors and self-concept. He told Kayla's parents what he had observed. After some reflection, the parents decided that their child ought to know that she had been born a boy. They asked Reiner if he would tell her.
So the next day, Reiner explained to Kayla that she had been born a boy who had no penis, so her doctors and parents had decided to raise her as a girl.
"His eyes opened about as wide as eyes could open," recalls Reiner. "He climbed into my lap and wrapped his arms around me and stayed like that."
As Reiner cradled the child in his arms, he felt as though an enormous weight had been lifted, and he himself was overcome with emotion. The child remained in his arms without moving for half an hour.
Reiner now believes children are born either boys or girls, and that no matter what happens to them, be it surgery or rearing, they remain that way. "When you work with these kids, you see that they're not making a decision," he says. "They have always known. The sense of who one is--[boy or girl]--is a crucial existential aspect of humanity. It is powerful and inborn." The absence or presence of a penis is incidental. "The most important sex organ is the brain."
Reiner now says that surgeons ought to hold off on surgically castrating patients like Kayla. Further, he suggests that the same cautious approach should perhaps apply to patients with other urogenital conditions. "One can draw inferences, but one has to do it with caution," he notes, given that having ambiguous genitals stems from myriad causes. "But if it's not life threatening, I would favor prudence." If a child has ambiguous genitals, he says, families and physicians might decide using the best medical information available whether to call them boys or girls, but wait for the child to decide whether to opt for genital surgery. . . .
Pam Bennett set to run for council again
Pam Bennett
11/20/2007
By J.C. O'Connell
Aurora | Pam Bennett, an at-large candidate for city council who missed unseating one of two incumbents this November, says she intends to start her next campaign this December for a seat on city council in 2009.
"It's one of those things I'm looking at as an option. I had a wonderful run, surprised a lot of people this time. I'm going to do it all the way (in two years)," Bennett said.
In two years, the city's other two at-large seats will be up for grabs with one incumbent - Councilman Steve Hogan - term limited.
Bennett came in third in this fall's race, within 2,400 votes in a five-way contest. She won 21 percent of the vote while Councilman Ryan Frazier received 26 percent and Councilman Brad Pierce got 25 percent of the vote. In Adams County, where Frazier lives, Bennett pulled ahead of both candidates with 24 percent of the vote.
Many spectators thought voters would be turned off by the idea of a transgender candidate, but Bennett openly talked about her experience while running on the issues of smart growth, water rates and Aurora's importance in the Front Range's future.
"We did something historic, and we're going forward now and having a good time and wanting to be a public servant," said Bennett of herself and her campaign team.
Although a few transgender candidates have been elected to offices across the United States in recent years, an openly transgender candidate has never held office in Aurora.
"Pam is absolutely a pioneer - not the first, but part of the first handful," said Mara Keisling, executive director for the National Center for Transgender Equality, an organization that does not make political endorsements.
Joanne Conte ran successfully for Arvada city council in the 1990s before she was outed as a transgender official and was subsequently defeated in her re-election bid.
Keisling described Bennett's effort as "a really good first run for a candidate."
"She didn't run as a 'trans person' but she didn't hide that fact - I think the people in Aurora really appreciated that, apparently," Keisling said.
During the campaign, none of Bennett's rivals attacked her transgender status.
"People get to see we're pretty much just like anybody else; they also see the focus and integrity it takes to survive as a transgender person," Keisling said. . . .
Two Transgender Members Quit Group
November 27, 2007
WASHINGTON (AP) — Two transgender members of the Human Rights Campaign quit Tuesday, saying the group's support of an employment nondiscrimination bill that excluded transgender workers put them "in an untenable position."
Jamison Green and Donna Rose's resignations from the Human Rights Campaign's business council are effective immediately, according to a joint letter.
"Considering recent broken promises, the lack of credibility that HRC has with the transgender community at large, and HRC's apparent lack of commitment to healing the breach it has caused, we find it impossible to maintain an effective working relationship with the organization," they said.
The House, with support from the Human Rights Campaign, earlier this month passed the Employment Non-Discrimination Act. The measure would make it illegal for employers to make decisions about hiring, firing, promoting or paying an employee based on sexual orientation.
But it does not protect transgender workers. That term covers transsexuals, cross-dressers and others whose outward appearance does not match their gender at birth.
Supporters of the bill say it would not have passed the House if it had included transgender protection. However, many transgender activists and their supporters were furious at their exclusion from the legislation and lobbied to scrap it.
The bill is now in the Senate.
"We at HRC look forward to continuing our groundbreaking work on building support for policies that help transgender workers in corporate America," Human Rights Campaign spokesman Brad Luna said. "We wish Donna and Jamison well in their future endeavors."
Male voice pitch predicts reproductive success in hunter-gatherers
Researchers studied tribe that lives much as humans did 200,000 years ago
Deeper voice pitch predicts reproductive success in male hunter-gatherers, according to a new study from researchers with Harvard University, McMaster University and Florida State University. This is the first study to examine the correlation between voice pitch and child bearing success, and the results point to the role of voice pitch in Darwinian fitness in humans.
The study, published online this week in the journal Biology Letters, was led by Coren Apicella, a doctoral candidate in the Department of Anthropology in the Faculty of Arts and Sciences at Harvard University, with David Feinberg of McMaster University and Frank Marlowe of Florida State University.
“The results of this study have implications for the evolution of vocal dimorphism,” says Apicella. “While we don’t know the exact reason that these men with deeper voices have fathered more children, it may be that they have increased access to mates, begin reproducing at an earlier age or their wives have shorter inter-birth intervals because they provide more food to them.”
The anthropologists studied the reproductive patterns of the Hadza, a Tanzanian hunter-gatherer tribe that lives much the same way that human beings did 200,000 years ago. According to the Apicella, the Hadza were chosen because they provide a window to our past. The females gather berries and dig for tubers, while the males hunt animals and collect honey. Marriages are not arranged, so that men and women choose their own spouses. The Hadza are monogamous, but extra-marital affairs are common, and the divorce rate is high.
For the study, voice recordings were collected from 49 men and 52 women between the ages of 18 and 55, in nine different Hadza camps. Participants provided the names of children born to them, whether surviving or deceased, and were then recorded speaking the Swahili word for “hello” into a microphone. These vocal recordings were analyzed for fundamental frequency.
The researchers found that, controlling for age, males with lower vocal pitch had more surviving children. Lower voice pitch did not have an effect on the number of deceased children; however, men with lower voice pitch were found to have fathered more total children, leading to a greater number of surviving children.
It was previously known that women find deeper male voices more attractive, especially during the more fertile phase of their menstrual cycle, but understanding the relationship between mate preferences and fertility is difficult in most modern populations, because of the widespread use of birth control methods. The Hadza, however, do not employ birth control methods, and therefore reproductive success corresponds directly with natural fertility.
Hadza females may choose mates with deeper voices because they are perceived to be better providers, according to the researchers. Previous studies have also shown a relationship between testosterone and deeper vocal pitch, and so increased testosterone may contribute to the male’s ability to hunt. Because of their similarity to the hunter-gatherer lifestyle of our ancestors, the reproductive success of the Hadza could be indicative the way that human beings evolved.
“It’s possible that vocal dimorphism has evolved over thousands of years, partly due to mate selection,” says Apicella. “Perhaps at one time, men and women’s voices were closer in pitch than they are today.”
University of Illinois: Community feels transgender care, services lacking
Specialty pills, shots necessary
By Andrea Cheng
11/27/07McKinley Health Center is the primary source of health care for many students. McKinley patrons include those who identify themselves as transgender, and a lack of specialized care services has them concerned, said Rod Githens, graduate student and participant in a recent Lesbian, Gay, Bisexual and Transgender community forum.
"For transgender students, hormone treatment is very vital," Githens said. "When you're dealing with something as central to someone's well-being, it's important to get that through to your only primary source of health care."
McKinley officials have said that, though they address issues of gender identity, they do not offer specialized services for the transgender community.
The doctors hired by McKinley are all general practitioners, so no one doctor specializes in a particular field, said Dr. David Lawrance, medical director of McKinley Health Center. There have been no alterations to McKinley's health care service in the past several years, he added.
Specialized care services would include a specific area a general practitioner would not normally handle, which could range from cancer treatment to allergy treatment to hormone replacement treatment, Lawrance said.
Having specialized care services at McKinley is an issue that not only affects the transgender population, but the entire student population as well, Githens said.
McKinley doctors refer students to specialists if they are seeking or need specialized care, said Kim Rice, sexual health educator at McKinley.
McKinley providers can administer a valid prescription from a specialist, which could include hormones, Lawrance said. In the past, transgender students with a prescription have received testosterone shots or estrogen hormone pills, he added.
"We try to provide the best care possible where gender identity is concerned," Lawrance said.
Even though there are no specific services that directly address transgender students and gender identity, there are medical services applicable for everyone, which include counseling services, Lawrance said.
"In our mental health unit, psychiatrists and therapists certainly see patients that address gender identity," Rice said.
There are advocacy, education and outreach projects within the counseling services that deal with educating students on gender identity, Rice said.
In addition to promoting gender identity sensitivity, McKinley has unisex bathrooms so that transgender students will feel more comfortable, Rice said. The counseling services are now in the process of creating an educational handout on gender identity, soon available on the Web.
"The transgender student population is a pretty small segment," Githens said. "It's a sensitive issue." . . .
