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The Myth of Post-Op Regret And Suicidality

There is a popular myth going around that attempts to quote from this 2003 Swedish study:

Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden

People using this study do so selectively. Let me explain the statistical manipulation going on with gender surgery detractors and the myth they try to construct.

First they note that general population rates for suicidality are around 1.6% in the United States. Then they note that suicidality rates for post-op transsexual people are about 4.1%. They then claim that since this is “hundreds of percent higher” that surgery does not work.

But let’s talk about the reality. What is that reality? It is that the pre-op suicidality rate for transsexuals is 41%!!!

Yep, that’s right. Pre-op rates of suicidality for transsexuals are 1000% higher than post-op rates. How do we know this? From the UCLA Williams Institute study Suicide Attempts among Transgender and Gender Non-Conforming Adults. (Warning! PDF!)

And the Swedish study actually supports gender surgery. Their conclusion?

This study found substantially higher rates of overall mortality, death from cardiovascular disease and suicide, suicide attempts, and psychiatric hospitalisations in sex-reassigned transsexual individuals compared to a healthy control population. This highlights that post surgical transsexuals are a risk group that need long-term psychiatric and somatic follow-up. Even though surgery and hormonal therapy alleviates gender dysphoria, it is apparently not sufficient to remedy the high rates of morbidity and mortality found among transsexual persons. Improved care for the transsexual group after the sex reassignment should therefore be considered.

Note what is said very, very gently and in careful scientific language: “This highlights that post surgical transsexuals are a risk group that need long-term psychiatric and somatic follow-up.”

So what detractors are doing is selective statistical selection to “prove” their biased point. When we take the entire picture, we see that gender surgery actually reduces suicide rates to 1/10th of what they were pre-op. And, as the Swedish study concludes, what trans people need is more support, not because they are trans, but because too many people in society today are just ignorant assholes.

It wasn’t easy

I’m a bit angry tonight. Over at another forum where I am a moderator, people tell me that I don’t understand their pain, that I had it “easy”, that their situation is “different”. Bullshit. Let me explain a little bit of what I went through in reaching the point where I had to transition and what happened afterwards.

My wife never respected me for years and years, until 2009 when I outmaneuvered the stock market the prior two years and avoided the big crash because I had been paying attention. That was 32 years of marriage where my opinions were always treated dismissively. She wouldn’t have cared about that either, except when her father discovered what I’d done and in his eyes suddenly I went from that annoying son-in-law to some financial intellectual heavyweight whose opinion now mattered, because where he had lost large sums of money, hundreds of thousands of dollars, I had increased my 401K pool by 25% by placing my bets smartly right before the big Lehman crash. Suddenly my opinion finally mattered to him and therefore finally mattered to my spouse.

Of course, a few years later I came out as trans and that was the end of that brief period of respect.

Through all the other years of marriage, I convinced myself that my spouse loved me, etc. Once I came out though, the gloves came off. I was nothing more than “a penis and a paycheck”. I already knew she’d had affairs because we had intimacy issues (because of me – I fully take the blame for that) and I caught her in at least one affair (and suspect others), but she only stayed with me to keep up appearances to her parents. If it weren’t for them, I’m sure that she’d have left years ago. And I found myself almost wishing she had. Because the first affair that I discovered was the year I went from 29 to 30, a long time ago in my life. And if she had left, I would have transitioned then, I think, or shortly thereafter.

A great deal of my first year of therapy was with dealing with my sense of rejection, of my sense of worthlessness, and coming to understand myself, to love myself unconditionally, to realize that I do deserve to be happy, not miserable, and that I should not stay in a relationship that was ultimately abusive and destructive of me as a human being.

I would be divorcing her right now anyway even if I had not chosen to transition. I’ve learned too much. There’s too much water under the bridge. Her real feelings for me have been revealed though she later tried to walk her original statements back. But you can’t take back what you say. The best you can do is apologize and try to prove you’ve changed. But she hasn’t changed. We’ve had discussions that prove that. I’m still an embarrassment. She still wants nothing really to do with me.

None of us who transition had necessarily easy roads. When people say to me “Oh you just decided and did it!” that’s not at all true! I agonized over this for years and years. I fought it for decades. And do you know what? My own fighting this was stupid. My own fighting this was dumb. It was one of the worst things I ever did to myself. And I definitely did it to myself. Nobody else did. I convinced myself to be miserable for everyone else’s sake and when I couldn’t take it anymore, after 35 years of marriage and came out to my spouse and my adult children, I suddenly discovered that all the sacrifices I had made were stupid and nobody cared. Nobody. My eldest son flatly told me that I should have gone ahead and killed myself because “that would have been easier on the rest of us.”

Look at that statement. My son told me to go die because it would be convenient for him. His wife, upon hearing me coming out, was reported to have said “My god, what will the neighbors think?” That’s all she cared about. Not one bit about me as a human being. Nothing about the years I had worked, that I had put my son through college, that I had spent hours and hours playing with him as a child, coaching him youth sports, that I had helped him get his first job after college, that I had helped keep him and his family financially afloat for a year when he was laid off from another position… none of that mattered. What mattered was that I was an “embarrassment” who should have killed myself because “that would have been easier on the rest of us.”

I get upset when I see people saying it was “easy” for me. They haven’t walked in my shoes. There’s a certain transwoman who seems to love to wallow in her misery and thinks I had it easy. They (and she specifically) haven’t experienced my losses… because I don’t whine about them on that forum the way some of them do. I work through them with my friends, my therapist, and those who’ve come to be close to me.

So when I tell people they can do this, through all the pain, through all the loss, and that they can come out the other side happier, healthier and more in control of their own lives, I have a real basis from which to speak. It’s not frivolous. I’ve been through it. I’ve cried myself to sleep for two solid months over a marriage ending that intellectually I knew was a worthless dead marriage but that my heart was still broken over seeing it die.

The greatest regret of old people as they approach death is almost universally regretting what they failed to do, rather than what they actually did. I do not regret my decision to transition. I’ve learned so much about myself, and I’ve gained real friends who love me no matter what. Friends who’ve been there every step of the way and who’ve picked me up and carried me when I needed it. And those friends are who I consider to be my “real” family now – not blood, but love defines my real family, my soul sisters (and my daughter – my only adult child who has accepted me and supported me).

So to those who say I don’t understand their years of intellectual agonizing over the decision to face ourselves, I do. To those who think that I had it easy, I did not. To those who are agonizing over this for months or years now, I agonized over it for years and decades. And when I tell you to stop chasing your intellectual tail, it’s because I had to stop chasing my own intellectual tail too! When I tell you that there is life, and love, and hope after a marriage dies, it’s because I had to face that too and I found those things also.

So don’t tell me I had it easy and just dismiss my opinion. You don’t know me. And maybe if you did, you’d realize the advice I gave you was not “easy” advice at all, but given because I care and don’t want you to make the same mistakes that I made for as long as I made them.

–Cara Elizabeth.

Transgender Day of Remembrance 2014 – The Day After

TDOR-2014And… not a word from the official Republican side of the aisle. The number of Republicans speaking about TDOR was small – like an aide to Christie Whitman read a letter from her at a TDOR event.

I tire of hearing that there are “good people” in the GOP. Where are they? Why do almost none speak out even on TDOR? Why do they remain silent in the face of blatant hateful bigotry that celebrates our deaths?

The Republican Party is a moral monstrosity. A hate machine dedicated to subjugation and demeaning of human beings who do not fit their white Republican Protestant middle class ideals. Blacks know this, Hispanics know this, Asian-Americans know this, gays and lesbians know this, and transgender people ought to know this though it seems a few of my brothers and sisters have their heads buried deeply in the sands.

Todd Kincannon, former executive director of the South Carolina Republican Party, says “There are people who respect transgender rights. And there are people who think you should all be put in a camp. That’s me.”

Where were the Republicans when that statement was made by a former high ranking GOP official? They were silently applauding in the background and promising to gut ENDA if any transgender protections were included. That’s where they were.

Meanwhile, in the past we’ve had statements like this from Republicans in Iowa on 2010 when the governor recognized TDOR that year:

IFPC Action President Chuck Hurley commented on the Governor’s proclamation by saying, “Governor Culver not only failed to keep his promise to the people of Iowa concerning the defense of marriage, but now is using the power of his office and the dignity of the state of Iowa to promote sexual confusion and deviant behavior.”

Hurley added, “Iowans know that Governor Culver does not share their values. As if the Governor’s unwillingness to exercise the influence of his office in the defense of marriage wasn’t evidence enough, we now know that he is spending his time creating special days celebrating sexual disorientation. The question that Iowans ought to be asking is why Governor Culver wasn’t proud enough of his work to make his actions public?”

So if you tell me again that there are “good” Republicans in office out there, I’d like to ask you to point them out to me. And if you do, you will find that their numbers are astonishingly small.

I leave you with this thought on the day after TDOR:

“The hottest place in Hell is reserved for those who remain neutral in times of great moral conflict.” — MLK, Jr.

The silence of the GOP shines with a bright heat and I know from whence that heat comes.

I Had A Wonderful Ren Fest

For the weekend of November 7-10 (Friday through Monday), a large number of friends came into town for the Texas Renaissance Festival. It’s always good to see these particular faces and this time was no different, though seeing me may have been a little different for all concerned.

We had another great dinner Friday evening at Vero’s Italian Kitchen. Saturday at the Fest was interesting, as it always is, and led to all sorts of fun discussions among us. Saturday evening we all got together at Willie’s Hamburger place. My only real regret that evening was a friend who had wanted to come this year had passed away a few months previously and was no longer among us.

We did, however, discuss all manner of things, as we seemingly always do and just about nothing was off limits, including my own recent eye opening experiences, at which the other women present said “Welcome to the sisterhood” and “Now you see what it’s really like!” Let me assure anyone who doubts in the least, at all, there very definitely is such a thing as male privilege and I’m experiencing not having it anymore at all and it’s both amusing and annoying. And further, too many men in our culture do treat women as sexual objects instead of people. Believe me, I’m seeing that too, up close and personal.

I also am having trouble getting my head around men either coming on to me or men just looking at me in a clearly sexual manner. It comes with the territory, I know. And intellectually, I was ready for this and even had experienced it in limited ways in the past. But now, since I’d gone full time back in September, it was actually getting common. I understand the annoyance of that woman in the video that went viral and believe me, being a lot older, I don’t look near as pretty as she does, but those comments, leers, whistles, and other things are definitely out there. One fellow at the Ren Fest even looked me in the eye before giving me the “appraisal” look from head to toe, even while he was holding his wife’s hand as she had their baby on her shoulder. I just shook my head at that.

Part of the problem is also realizing what my friends keep telling me – I look very good for an older woman. Now I don’t have a full length mirror at home but there was one at the hotel and seeing myself in that and ready for the day’s activities at Ren Fest, I realized my friends were telling me the truth. I have a pretty nice figure. Of course, it’s one thing to hear certain words intellectually. It’s another thing to really feel them in your heart.

And Monday was some obligatory thrift shop hopping, this time mostly at the Salvation Army store in the next town over from where I live. We discovered that me being over 50 meant half off every Monday on everything for the 50+ crowd and there was also a half off Saturday for everyone in case I wanted to return for that. I’m planning to take my daughter with me there and perhaps a few other people as well. It should be fun.

Work continues to go very smoothly. I work for an awesome company and I appreciate that very much. They’ve made this process easier than I ever expected it to be. I am completely accepted at work and thoroughly supported on any issues I have had thus far.

There are other things I considered writing about here but I’ve abstained because there is someone who stalks me through this blog. I’ll just let her wonder at my early and unexpected Christmas gift. 🙂

Two Weeks

There’s something different, even liberating about finally having legal identification that confirms that you are you. It took me a few days to realize that this and I am still having trouble verbalizing this but society at large has confirmed that I am me and not some defensive shell any longer.

Part of it is the realization that should anyone directly challenge me (it hasn’t happened so far!) I can pull out my driver’s license and a credit card and say, hey, this is me. Got an issue with that?

I discussed this with my therapist last week and yes, I’ve been thinking about this blog post since then but wasn’t ready to write. That lifting of weight has allowed my mind to go elsewhere now. Exactly as my therapist predicted, certain other things have begun to happen that I would not have been ready for had she not warned me and discussed this with me.

Without getting into too much detail, I’m attracting notice and it’s been positive notice so far. I don’t want to get into too much detail here (I have with a few friends in email), but this notice coupled with a lot of exploration of my true self with my therapist has led me to understand some things that I repressed for a long time. So let’s just say that I am noticing back at some of those doing the noticing. 🙂

All of this makes me very aware of the fact that I am sort of “mid-stream” in the medical process and still have quite a ways to go before I’m “done” as I envision things. But these unexpected results also have me feeling very positive about how far I’ve come at this point, regardless of how far there is yet to go.

This is all food for thought as I remember that in 24 days a dear friend will be arriving and the day after that another will as well. And this year, unlike last year when I faced our annual gathering of friends with a little trepidation, I have no such worries.