Category Archives: Medicine

Related to medical issues and transgender patients, including physical and psychological issues.

April 2017 Trans Talk on 90.1 KKFI


Hello, and welcome to the April 2017 Trans Talk Edition of The Tenth Voice! We will have three guests with us on this month’s show from the Children’s Mercy Gender Pathways Clinic, who provide a full suite of beneficial services to transgender children in the Kansas City area. Dr. Jill Jacobson, Chaplain Beth Sonneville, and social worker Kathryn Boman will talk to us about all of the services they provide, the challenges they face, and answer questions from parents, family, and allies of transgender children.

As usual, we will share with you the transgender news and the community calendar update. We do hope you will be able to join us this Saturday, April 22 at 1:00 pm on 90.1 FM KKFI, Kansas City Community Radio! You can also stream the program live on kkfi.org.

March 2017 Trans Talk on 90.1 KKFI


Hello, and welcome to the March 2017 Trans Talk Edition of The Tenth Voice! We will be speaking with two guests on our show this month. Our first guest is Dr. Meredith Gray, who is board certified in Obstetrics and Gynecology and who will discuss reproductive options for transgender persons, as well as transgender health services at KU. After our break at the bottom of the hour we will talk to Ceri Anne Lewis, who will discuss the positive relationship between religion and transgender persons, as well as her own transgender journey.

As usual, we will share with you the transgender news and the community calendar update. We do hope you will be able to join us this Saturday, March 25 at 1:00 pm on 90.1 FM KKFI, Kansas City Community Radio! You can also stream the program live on kkfi.org.

New Historical Upload: Jorgensen, Johns Hopkins, and SRS in 1967

Christine Jorgensen Uncensored
I’m starting the processing of hundreds of archival transgender media, which I’m providing in high-resolution scans and with no watermarks. So let’s begin with this: in the April, 1967 edition of Uncensored magazine, we find an article which purports how Christine Jorgensen is doing in life as a woman, and reports on Johns Hopkins Hospital starting sex reassignment surgery (SRS) and establishing their Gender Identity Clinic. The article features several photographs from Christine Jorgensen’s past, but mainly focuses on the recent history of SRS (well, recent in 1967 anyhow), with some interesting facts and figures.

There is a quote from Jorgensen at the end of the article, referencing the Johns Hopkins programs, where she says: “I am glad I lived to see it happen. The biggest problem I have encountered since my operation is disbelief. Some people refer to me as ‘it.’ This is a smart-alec approach to a serious medical problem. I have received thousands of letters from people who don’t know where to turn. Now at least some of these poor souls have a place to go.”

You may read and download the entire article, scanned in high-resolution, either by going to the Transas City Christine Jorgensen page, or directly from this link here.

November 2016 Trans Talk on 90.1 KKFI

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Hello everyone! We have two guests for our show this weekend – first, we will be speaking with Julie, the mother of a transgender young man, who is suing the Odessa Missouri school district over discrimination against her son. Next, we will be talking with Dr. Peter Raphael, a surgeon with the American Institute of Plastic Surgery who serves the transgender male and female community, about his practice and developments in transgender surgery.

As usual, we will share with you the transgender news and the community calendar update. We do hope you will be able to join us this Saturday, November 26 at 1:00 pm on 90.1 FM KKFI, Kansas City Community Radio! You can also stream the program live on kkfi.org.

August 2016 Trans Talk on 90.1 KKFI

Transition_Family
Hello everyone! We begin this month’s Trans Talk edition of the Tenth Voice speaking with Dr. Courtney Marsh, a Reproductive Specialist at The University Of Kansas Hospital who provides hormone therapy to many of the Kansas City transgender community. Dr Marsh will be answering questions about hormone therapy and other transgender medical issues. For the second half of our program we continue our Transgender Kaleidoscope series, and this time we’re highlighting not just one individual, but an entire family of hope: Libby, a transgender woman who has just finished high school, and her father Michael, mother Louise, and fiancé Eliza – who also happens to be a transgender woman.

As usual, we will share with you the transgender news and the community calendar update. We do hope you will be able to join us this Saturday, August 27 at 1:00 pm on 90.1 FM KKFI, Kansas City Community Radio! You can also stream the program live on kkfi.org.

April 2016 Trans Talk on 90.1 KKFI

KKFI

Hello everyone! We have two great topics this month on Trans Talk. First, we’re going to talk with Bonyen Lee-Gilmore from Planned Parenthood of Kansas and Mid-Missouri, who is going to discuss a new effort by Planned Parenthood to provide health services to transgender men and women. Next we will kick off a new series of interviews with individuals from the transgender community in Kansas and Missouri which I call “Transgender Kaleidoscope,” and our first guest in this series will be Rachel Mollie Martin, a retired Lt. Colonel and decorated Army Ranger, who has recently seen some major triumphs in her transition, and some serious stumbling blocks as well.

Fiona Nowling will be co-hosting today’s program, and she will give us the community calendar update, while I will provide my view of some of the LGBT news this week. I do hope you will be able to join me this Saturday, April 23 at 1:00 pm on 90.1 KKFI, Kansas City Community Radio! You can also stream the program live on kkfi.org.

February 2016 Trans Talk on 90.1 KKFI

KKFI

Hello everyone! On Trans Talk this month the we’re going to be talking with two people in our studio. First we’ll speak with Dr. Hiten Soni, a psychiatrist who strongly supports the transgender community, especially regarding the subject of surgery. Next we will speak to Sieran, an intersex transgender person, about both his own personal journey and the challenges faced by intersex persons in general. And for this month’s show, my wife Fiona Nowling will be a guest co-host.

I will also give a breakdown of some of the LGBT news this week, and we will finish up the show with the community calendar update. I do hope you will be able to join me this Saturday, February 20 at 1:00 pm on 90.1 KKFI, Kansas City Community Radio! You can also stream the program live on kkfi.org.

New Research Report: Transsexual Breast Augmentation – Under or Over the Muscle?

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Exclusive to Transas City: a summary of my research into the question of whether there is a distinct risk of a loss of arm muscle strength or mobility for transsexual women who undergo breast augmentation with the implants placed under the pectoral (chest) muscle. While this is often a subject of conjecture, anecdote, and rumor within the transgender community, very few have the facts at their disposal – including, from my personal experience, the surgeons themselves.

In the report which is linked below I present the results of my literature review of medical testing to determine the facts behind the potential risks of sub-muscular breast implants in transsexual women. Please forward this to anyone who is considering breast augmentation in the near future.

Link to the article: Transsexual Breast Augmentation – Under or Over the Muscle?

Trans*forming the Dialogue – Questioning the Transgender Experience

Trans_forming the Dialogue Logo

Hello everyone, Una Nowling here. I am participating in Trans*forming the Dialogue, Simmons College’s Online MSW Program’s campaign to promote an educational conversation about the transgender community. By participating in this campaign, I will be offering my perspective on what TO ask and what NOT to ask trans*people.

As an activist and “out and loudly proud” transgender woman who works in several professional fields, I am often asked to give lectures on the transgender experience as a whole, as well as specific transgender subtopics. I typically speak at public fora, Pride events, churches, schools, universities, and civic centers. And as part of my opening myself up to the world, I am very frank about my history – I talk about the sexual assault and abuse I suffered, for example, not because I especially enjoy doing such, but because almost certainly there’s someone in my audience who has suffered the same, and been living in silence for years. I invite and will answer almost any question which is asked of me, because my goal is to educate. I do not speak in detail about my genitals and surgeries, and that is my only boundary.

But what about the typical transgender person whom one may meet? Many well-meaning cisgender persons are naturally very curious about us, and this puts transgender persons on the spot, even when they are among friends. They not only are not activists who want to be “out and loudly proud,” they simply want to live, and love, and work, and play, and worship, and be the protagonist of their own life of positivity. Their own personal “American dream,” if you will.

Here are some of my tips for the cisgender folks out there who want to learn more about our people.

First, before you ask any question, ask yourself “is this the sort of question I would ask my grandmother?” Would you, for instance, ask your grandmother if she had had “her penis chopped off?” Or “are you really, really sure that you’re female, or could you just be having a bad month?” Or even “how do you know you’re not a lesbian, grandma? Maybe you should give it a try?” Of course you wouldn’t.


What on earth did you just ask me?

First and foremost, don’t ask us questions which call into question our very existence. Asking us “are we really sure we’re transgender?” essentially overlooks the years of gender dysphoria, body dysmorphia, internal struggles, and heart-rending agony which we have gone through to come to accepting that we are transgender. Many of us would have done anything, climbed any proverbial mountain, to have just had an ordinary, average gender identity. This is one reason why, according to the National Transgender Discrimination Survey, 41% of transgender persons have attempted suicide. Outside of a few transgender celebrities or very lucky persons, most transgender persons are going to face job discrimination, family rejection, sexual assault, bullying, physical violence, and even murder – on top of having to deal with gender dysphoria. If that sounds like fun, please stand on your head.

Don’t ask about our genitals. I confess that I have neither the time, nor the professional qualifications, to understand why laypeople will walk right up to a transgender person and ask them questions about genitals that they wouldn’t even discuss with their physician. Would you ask a friend at church if her breasts were real or not? Many of us are asked that on a daily basis.

Hot dogsNo…just, no.

Don’t ask us questions about our personal romantic and sexual relationships and preference. For one thing, many of us are still working it out, and it’s a highly painful subject. For another, it’s just none of your business, unless you happen to be making a romantic pass at one of us (in which case, go you!). A large number of us will lose our spouse or long-term partner as a result of transition. Within my own transgender community, the rate of divorce as a result of one partner transitioning is over 90%.

It’s generally considered gauche to ask about our specific medications, surgical techniques and procedures, and the cost of transition. Can you imagine asking a co-worker in the middle of a conference call, “hey Bob, generally speaking how do you feel about digital rectal prostate exams versus PSA screenings?” In addition, please note that for many of us a trip to the physician is even less fun than it would be for anyone else, as nearly 1 in 5 transgender persons report having been refused medical care. Last week I myself was a victim of this, having had two physicians refuse to treat me, and having been subjected to a transphobic tirade by a nurse.

NurseElle Driver from “Kill Bill” would actually have been a better nurse than the one who repeatedly and deliberately misgendered me.

There are some “borderline” questions you can ask, if your relationship with the transgender person in question is positive and long-standing. You may be able to ask “how has your family taken the news?” or “are you going to be alright at work?” Just keep in mind that a very large percentage of us will or currently face ostracism or even violence by family members – in fact, 57% of us will experience significant family rejection as a result of transition. In addition to that, 90% of us have or will face harassment or discrimination on the job, and we suffer from double the rate of unemployment as the general population as a result of “coming out.” A large number of us have lost our church community as well, so again, be sensitive of that when asking about topics of personal faith.

Many ask us about Laverne Cox, Caitlyn Jenner, Chaz Bono, and other transgender persons who are in the media. Just as my spouse is English and has in fact never met Queen Elizabeth, almost none of us will have any “inside information” on public figures. Nor do most of us really want to discuss in detail The Crying Game or Dallas Buyers Club. I will however feel free to bore you with discussions of third-wave feminism and Mad Max: Fury Road.

Not quite a positive media portrayal of a transgender person, just in case you were wondering.

Questions which show innocent curiosity and compassion are normally going to be welcome. I’m sometimes asked about the community, from the standpoint of how large and diverse we are. I’m sometimes asked to tell the story of my personal journey, with no qualifications placed on my telling, and many of us will talk a little about our history to those who listen. Other good questions help to define how people should interact with us. Ask us “what name do you prefer I call you from now on?” or “how should I refer to your gender from now on?” Please note that for those of us who are still not fully “out,” some patience may be needed on your part to remember the proper identifiers to use depending upon the context.

Most of us will be grateful to receive questions such as “how are you coping with this? Are you receiving support? Are you doing alright? Would you like to go shopping with me? Would you like to meet my family?”

But above all, the single best question which I believe we transgender persons can be asked is simply:

“How may I help?”

Helping_Hand

Information about Simmons College

Simmons College is the third US women’s college to accept students who identify as transgender. Their admissions policy may be found here, and the official announcement of their change in policy may be found here.

References

Grant, Jaime M., et al. Injustice at every turn: A report of the National Transgender Discrimination Survey. National Center for Transgender Equality, 2011.

The New Girl in School: Transgender Surgery at 18

It was not an easy transition for Katherine Boone, but the question is no longer whether gender reassignment is an option, but instead how soon it should start.

The New York Times is featuring the story of Katherine Boone, a transgender woman who underwent sex reassignment surgery (SRS) at age 18. The article is not entirely positive, and casts SRS for “teenagers” as something new and scary. For the record, at age 18 Katherine is a full legal adult, able to run her own affairs, enlist and die in military service, and be treated as an adult by default by the legal system of this country. So the “teenager” moniker is somewhat deceptive here. In fact, age 18 is not even the youngest at which SRS is performed. In Europe, for example, SRS has been performed at age 16 (such as the case of an anonymous transgender girl in Spain in 2009) or authorized at age 16 (such as English transgender girl Jackie Green who underwent both facial feminization surgery and SRS on her 16th birthday in Thailand).

Katherine Boone

Despite throwing out somewhat discouraging (and not entirely accurate) statements like this:

Given that there are no proven biological markers for what is known as gender dysphoria, however, there is no consensus in the medical community on the central question: whether teenagers, habitually trying on new identities and not known for foresight, should be granted an irreversible physical fix for what is still considered a psychological condition.

The article clearly presents Katherine as a young lady who was clearly suffering deeply from her gender dysphoria, and who very much needed this surgery.

It was the cutting that convinced them that if she could not live as a girl, Kat would kill herself. She still has two angry scars on her left forearm. “It became clear to me that this wasn’t a passing phase or some choice or reaction,” Mr. Boone said. “This was truly the basis of what she was.”

The article further covers the problems of the expense of puberty blockers, which are not covered under pretty much any insurance on this planet, and which can run thousands of dollars per year (unlike estradiol and spironolactone, which are much cheaper). And it does spend some time speaking on how debilitating the surgery was for Ms. Boone, which many of us have either personally experienced, or witnessed via our friends.

There is a lot of information in this testimonial article; it’s worth a look.

Source: The New Girl in School: Transgender Surgery at 18 – NYTimes.com

VITAL UPDATE: Quality of Life in Treated Transsexuals

Woman_Scientist

The research never stops here at Transas City, and I’ve recently completed another batch of lengthy literature reviews to update one of our landmark pages, Quality of Life in Treated Transsexuals.

The full details are available at the links herein, but to summarize the update:

  • More than 350 technical papers and journal articles have been reviewed.
  • From 2004-2015 inclusive, 33 studies were found which met the criteria for determining quality of life changes in transsexual women and men as a result of medical transition (blockers, hormones, and/or surgery).
  • Of the 33 studies found which were within our time frame, 26 studies (79%) indicated a conclusively positive impact on quality of life as a result of transition. Another 5 studies (15%) yielded mild or uncertain results, and only 2 studies (6%) found a negative quality of life as a result of medical transition.
  • In short, 98% of the studies reviewed found that at worst no harm was done via medical transition.

I believe that once again, this research which we have conducted shuts down firmly the anti-transgender criticisms that neither hormone therapy nor surgery are necessary medical procedures for transsexuals. Please share the link below, which contains charts, summaries, and full literature citations, to help us publicize this update, and feel free to drop it into debates with “the usual suspects.”

Quality of Life in Treated Transsexuals.

April 2015 Trans Talk on 90.1 KKFI

KKFIPlease join us today, April 25 on “Trans Talk,” 90.1 FM, KKFI, Kansas City Community Radio at 1:00 pm central. You can also tune into kkfi.org to listen in via live streaming audio from anywhere with an internet connection.

On this program Luke Harness, Sandra Meade, and myself will be discussing surgery within the transgender community, and all of its ramifications. Our special guests include three local transgender persons: MJ, a transgender woman who has completed surgery; James, a transgender man who is just starting his journey; and Amanda, a transgender woman who is at a critical point in her transition. Luke will kick off the program with some LGBT news for the week, and I will finish up the program with the Community Calendar update.

Please tune in if you can, as we hope this shall be a great show!

Personal Update – Liposuction

Hoover_Vacuum_Cleaners_-_Diaper_Removal_Mar_27_1950_Life

Some have noticed that I’ve not updated the site for a week. The reason is that this week I underwent liposuction surgery, and have spent a lot of time catching up work and recuperating from the pain. I expect to start making updates from the tremendous amount of backlog I have this week. I have received many original historical photographs and documents via the post over the last few weeks, and am way behind in sharing them.

The sole purpose of the liposuction I underwent was to shape my waist area into much more of a feminine hourglass shape, so one could consider this to be part of my gender transition. I was not excessively chunky there – I weighed about 136 at the time of surgery, and am 5’5″ tall. However, I had a small band of tough fat right at my waist, much of which were lipoliths (literally: fat stones) from insulin injections in my waist area when I was younger. These could not be dieted nor exercised away. As such, it’s the first of four procedures I have outlined in my path to completion.

I’ve actually experienced some “blowback” in the community about even describing liposuction as surgery, solely from folks who have undergone SRS but have never undergone liposuction. To them, it’s not “real enough” and doesn’t qualify in their artificial gender transition “pecking order” which they’ve established. I also received a significant amount of criticism from people who advised me I didn’t need it, I was wasting my money, it was too risky, etc. Some of the same people whom I supported wholeheartedly as they underwent their SRS, hysterectomies, breast augmentation, and breast reductions, did not support my personal cosmetic surgery decision. Several acquaintances have offered not one word of support nor even attempted to contact me to see how I am doing since the day of surgery, something which, excuse my proverbial French, I find to be really shitty – especially when I was there for them when they underwent their surgeries.

Setting aside all that psychodrama, let me just convey some facts about abdominal liposuction. Please note that my experience may not reflect yours, or anyone else’s experience, and is merely a sample size of one for you to consider.

In my opinion, liposuction is not nearly as simple as they advertise it on television. Just because they don’t make huge incisions and don’t put you under general anesthetic doesn’t mean your body doesn’t take a lot of punishment. In fact, I wish I had been under general anesthetic, because it HURT LIKE YOU WOULD NOT BELIEVE during the start of the procedure. Thankfully after about 15 minutes it stopped hurting, mostly, because I either passed out or succumbed to the massive amount of lidocaine they inject into you. Given that I have large memory gaps, I’m assuming the latter.

They start by putting you on the table, fully awake, and injecting lidocaine into the incision areas. This is a minor pain. Within about 2 minutes they made 5 small incisions with a scalpel, about 3-4 mm in length and perhaps that deep as well. Then the rigid cannula is unceremoniously forced through the incisions, and shoved under your skin to start to “pop” it free from the layers underneath. It’s horrifying to watch your skin move and stretch up from you, like a toned-down version of the chest-exploding scene from Alien.

There is a visceral sound and feeling when they tear through what the surgeon called “gristle,” that sounds like popping bubble wrap under your skin – painful bubble wrap. Then comes the inflation, where the tumescent solution is injected under your skin, and you swell until you appear 4 months pregnant. Shortly afterwards, the suction and motion begins, and you can see what looks like an inordinate amount of dark, bloody tissue being removed by the cannula through its clear hose. About at this point there is a large “SCENE MISSING” sign, and although I have brief flashes of events happening, for most of that first day I remember less than a few seconds of time.

Afterwards they stick what are essentially maxi pads and Poise pads over your incisions to soak up the copious amounts of fluid which will drain from you, wrap you in another absorbent bandage, then put you into an industrial-strength Spanx-type bodysuit, THEN wrap you with a tight binder similar to that used by transgender men to compress their chests. This is intended to make your now loose skin adhere to your body, and to help reduce swelling.

This is where the true pain starts, and the first 2 days afterwards, if you get a complete 360-degree waist reduction, it is difficult to impossible to work, even at a sitting job. By 3-4 days afterwards, light activity is possible. I’m in day 6 now, and doing reasonably well, except for great pain from my ribs to my waist, and a lot of swelling.

The depressing thing is that you will have to wear the tight binder for a full week, and it hurts. The bodysuit stays on for a couple of weeks, then you are fitted for a much tighter bodysuit. While this may help slim your figure itself, it’s intended to really squeeze the last of the swelling out of you. In 1-3 months, maybe 6 (!), you can see your full results. It’s not quick, and it’s not easy. Don’t let the slick advertisements fool you. It’s serious stuff and you will hurt.

Knowing what I now know, I would be reluctant to do it again. I think the pain was very under-appreciated at first, and I was not prepared for it. It was made worse by the fact that I cannot take codeine, morphine, or other strong medication, I avoid acetaminophen because of its liver effects, and they don’t allow you to take aspirin or ibuprofen for a week. I begged for some relief, and they let me start taking ibuprofen after 5 days. But for the first 5 days, I had almost no pain killers at all.

All in all they only removed about 1-2 pounds of actual fat from me. When you take into account fat cells which are damaged or dislodged during the process and which will be metabolized soon, I likely only lost 2 pounds out of 136. Liposuction, as they tell you, is NOT a weight-loss method; it’s a shaping method.

If you are thinking of doing it yourself…think hard. Take it seriously, and don’t let the “pecking order” make you dismiss how disruptive and how painful it can be.

Suicide Attempts Among Transgender and Gender Non-Conforming Adults

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A new study was released today from the Williams Institute at UCLA and the American Foundation of Suicide Prevention. To say that the study was more bad news for an already oppressed minority would be understating the issue. Highlights from the study report an increased risk of suicide among Trans Men (46%) and also among Trans Women (42%) with disabilities (65%). High prevalence of suicide attempts were also found among those who had ever experienced homelessness (69%) and those who reported a doctor or healthcare provider refused to treat them (60%). For more statistics from this report and to read and review the entire report go here.

The Williams Report

Introducing the Transgender Newsbank

Martha_Gellhorn

The Transgender Newsbank is a collection of more than 400 newspaper and magazine articles from 1911-1994, organized by year and date. I have spent 3 months finding and formatting these articles for easy viewing, in addition to typing write-ups about them and linking to other topical pages. The Transgender Newsbank is the largest effort of its kind on the Internet that I can find which is freely available, and like all Transas City features is uncluttered by advertisements.

While a Transgender Newsbank may be unexciting to some, it will form the basis of an online historical library to help researchers, scholars, and anyone who is simply interested in the history of our people.

The Transgender Newsbank