Transsexualism in Prison

In This Issue

I was meaning to tell you….
Transsexualism in Prison
THIS JUST IN
SHHH!!! — Going Stealth

I made so many honest mistakes. I honestly thought that there would never be any reason for you to know. I honestly thought it would never make any difference in our friendship, because I honestly thought we were never going to become the kind of good friends we did, close friends, almost lovers. Almost. I honestly wanted to go there with you, and I’m honestly sorry I felt like I had to say no, and I’m sorry that I hurt you because I know that you don’t entirely believe my lame, if honest, excuses. I honestly thought we’d never be in this place together. I always told you the truth, but I never told the whole truth.

When was it, three years ago? I remember I saw a picture of you in the paper, and a brief interview, and when I went to check it out, it wasn’t about you at all, but about what you do. Even when I finally met you, it still wasn’t about you, although I’m sure you’re used to fans wanting to know you. I did, too, but I waited another year for you to approach me first. When we went out for drinks with your fellows, I could never have guessed that I’d ever know you better, so I passed up the opportunity to start us off entirely on the level. Over that first year together, it never seemed to me that it would ever be more than the occasional public social drink, and so I passed up one opportunity after another to set it straight, and though I knew we were digging into a routine of familiarity based upon incomplete truth, I never thought it would ever matter, so I never made an attempt to set it all straight.

I honestly never thought it would be possible, so I put it out of my mind entirely, enjoying our wonderful friendship. So I was oblivious to your increasingly bold advances, and I honestly had no idea what was going on in your heart and mind, and what was developing between us, and I honestly wasn’t being callous all those times I casually looked at my watch and said it was probably time I should go, even when you begged me to stay. Even when you told me you love me, I honestly thought you meant it platonically, and so did I, then. And when we were dancing and you looked into my eyes, I refused to believe what I saw there. I honestly thought there was never anything there. Right up to the moment we kissed.

As we lay on the floor and you professed your love and desire between passionate kisses, probing my remaining shirt with hands that you said had been wanting for many months, I admitted my until-then exiled desire for you also. I wanted to go there with you. I did. I still do. But when you tried to take me there, I stopped us both, because of the one truth I never shared with you, the only truth ever to come between us. And even then, I somehow couldn’t tell you the whole truth, out of some misplaced fear, out of guilt of concealing it from you all this time. So when you called my bluff, said, okay, maybe another time, maybe next year, maybe the year after that, you did two things: You gave me the out I needed to keep lying to you. And you also gave me the time I needed to sort out what I want for both of us, and from you, and to finally, now, after you have told me all that it is in you, give you the one thing I want to give you most of all: complete honesty for us both.

A transsexual is a person of one gender who feels they belong to the opposite gender. A biological male transsexual, for example, has a firmly established female identity and feels trapped in the wrong body.

Prison is a place of confinement and punishment for people convicted of certain felony crimes.

Both transsexualism and prison, individually, can be arduous and even life-threatening. Any average person subjected to either would suffer great pains and losses...sometimes to the point of suicide. However, combine the two together and it would take much greater than the average person to survive.

Being a transsexual in prison is surely a tragic and frightening prospect...but this will be the topic of a separate article.

This discussion focuses on Psychotherapy, one of the prominent forms of medical treatment for transsexualism, and a treatment that has a long history of debate in the medical community.

The main goal for most all transsexuals is the Gender Reassignment Surgery [SRS], also referred to as the "Sex-Change Operation". Other necessary treatments include hormonal therapy, electrolysis and Vocal Chord Modulation, though the most notorious treatment is psychotherapy.

Going back several decades, there has been long standing argument in the medical community over the proper and appropriate treatment for transsexualism. Some medical experts argue that SRS is proper; others argue that psychotherapy is.

As our society has become more accepting, and the medical community has honed and refined its beliefs, transsexuals have gained much ground in their rights to obtain medical treatment. This is especially noticed in cases of transsexual prisoners who fight in lawsuits for such treatments during their incarceration. Many such cases have discussed the issues of psychotherapy versus surgery, and some have even indulged in arguing the issue. In these cases, the prisoner and [her] medical witnesses claim that psychotherapy is ineffective and useless. The prison and their medical witnesses argue that psychotherapy is not only useful and effective but also necessary and required by the medical community. The problem is that both parties are correct. The prisoner refers to countless cases of transsexualism where the experts attempted psychotherapy but failed. In fact, there are very few cases in the literature of transsexualism being cured through psychotherapy. On the other hand, the prison medical witnesses refer to the Standards of Care, guidelines and rules published by experts in the medical community, to guide treating professionals in the proper treatment of transsexualism. The Standards of Care require and emphasize the need for psychotherapy in treating transsexual patients, and go so far as to require such theapy before the transsexual can be approved for hormonal therapy or surgery.

The problem is improper categorization. Psychotherapy, in the treatment of transsexualism, is both ineffective and simultanously necessary an required. Unfortunately, it does not end in this simplified form. Psychotherapy has many forms and levels, depending on the disorder or treatment. The psychotherapy that transsexual prisoners claim in ineffective is a different form of psychotherapy than that required by the Standards of Care. Yet nobody has ever taken the initiative to categorize it appropriately. In this article, I will attempt to do so, for the benefit of transsexualism and for the sake of clarity.

If a person feels wrong or sick and seeks help, the first step is to determine what exactly is wrong. If that person goes to a psychologist or psychiatrist to find out what they are suffering from, it is considered psychotherapy. However, it should be differentiated from other forms of psychotherapy. In this example, I would classify it as "Diagnostic Psychotherapy", which is therapy to determine what disorder a person suffers from and to prescribe the appropriate treatment.

Psychotherapy, as a medical treatment for a disorder can be separated into two individual categories, 1) "Primary", and 2) "Secondary". The Primary Psychotherapy would be the cure, or as close as the medical profession can come to "curing" a disorder or disease. The Secondary Psychotherapy would be the form of therapy that is supplemental to the primary treatment.

An example would be Depression, a recognized medical disorder. Diagnostic Psychotherapy diagnoses the patient with Depression and prescribes treatment in the form of psychotherapy and "Anti-Depressant" medication. The psychotherapy is the Primary treatment, in that it, aside from any other treatment, will cure the patient, or at least improve the patient’s suffering. The medication is supplemental to the therapy and is therefore Secondary to the Primary treatment.

For clarity on the "Surgery versus Psychotherapy" debate, Transsexualism cannot be cured through Psychotherapy. In that situation the psychotherapy is used to cure the person from being transsexual, whereas some may consider Surgery to entertain the person’s transsexual desires. It has been repeatedly proven in many cases that transsexualism cannot be cured through psychotherapy. Therefore psychotherapy as a Primary Treatment for transsexualism is truly ineffective.

Reviewing the Standards of Care, any lay person can see that the whole process of required psychotherapy in the guidelines is established to aid the patient’s transition and assist them in preparing for SRS and acts supplemental to the entire Gender Reassignment process. In that form, the necessary and required psychotherapy referred to in the Standards of Care are clearly a Secondary form of psychotherapy.

In conclusion, the practicing medical professionals in the medical community are the ones responsible for properly diagnosing, prescribing and treating patients, whether for transsexualism or any other disorder. We must rely on them and that their knowledge, training and experience are adequate enough to provide the proper treatment for our ills. However, in the case of transsexualism, there is a serious ned for clarity and the appropriate categorization of psychotherapy in its several forms of treatment. Psychotherapy as a Primary treatment for transsexualism is ineffective and useless as there are simply not enough cases of transsexualism being cured through psychotherapy to warrant any credence to it. On the other hand, Psychotherapy as a Secondary treatment for transsexualism is required by the medical community through the Standards of Care, and necessary to assist the patient through all stages of Gender Reassignment and supplemental to the primary and all other secondary treatments.

Transsexual prisoners, surprisingly, are more in need of proper medical treatment than the average transsexual free in society. The added stress of imprisonment amplifies the depression and anxiety of transsexualism. Further, where a transsexual free in society may not be able to afford the expensive treatments necessary to treat transsexualism, s/he is better situated to gain some form of financial assistance or Medicaid, and can even settle for minor, less expensive forms of treatment until more financially able to go further. In comparison, the transsexual prisoner is denied all treatment and barred from obtaining any form of treatment, even if s/he is wealthy enough to pay for all medical costs and expenses.

The simple misunderstanding and unclear specification of psychotherapy has prevented the courts from properly deciding the proper course of treatment for incarcerated transsexuals.

I hope this article has taken the necessary steps toward solving that problem and help those transsexuals in prison who are thoroughly denied all forms of medically necessary treatment to win such treatment in the future.

For any comments, questions, or criticism, please write to: Mark (Jessica) Brooks, 90A6426-Clinton C.F., POB 2001, Dannemora NY 12929.

References: 1) Gender Dysphoria: A Guide to Research, D. Denny, 1994, Garland Publ., NY; 2) The Standards of Care for Gender Identity Disorders, 5th Ed., 1998, Harry Benjamin Intl. Gender Dysphoria Assn., Germany; 3) Diagnostic and Statistical Manual of Mental Disorders, 4th Ed., 1994, American Psychiatric Assn., Washington, D.C.; 4) Brown V. Zavaras, 63 F.3d 967 (10th Cir. 1995); 5) Lamb V. Maschner, 633 F.Supp 351, 1986; 6) Meriwether V. Faulkner, 821 F.2d 408, 1987; 7) White V. Farrier, 849 F.2d 322, 1988.

A Female-toMale Trans support, information and social groupFor humans labeled as female at birth, who feel that is not an accurate or complete description of their gender.

I catch my best friend halfway across the café floor: "Can I talk to you a moment, alone?" We step to a fairly remote area by the counter: "Is there any way that you think you can persuade your brother to stop referring to me as a guy in front of my friends? I’ve told him several times, and I’m sure he means well, but I’m not sure that he gets it entirely. Maybe if he hears it from you it will stick in his mind better."

It’s a new problem in my life, or, rather, a growing one, and it’s the result of a decision that I made some years back: I decided to go "stealth", TS slang for transitioning secretly, living as if there is not nor has been any transition in your life, keeping your past a secret from almost everyone outside your immediate intimates. Your landlord doesn’t know. Your boss doesn’t know. Your bank doesn’t know. No one knows, in fact, except the select few who have to know.

The reasons for going stealth are probably as varied and numerous as the persons who choose to do so, and I will not elaborate on them here. Further, it is a continuing controversy in the TS/TG communities, and I don’t want to get into that debate right now. Rather, I want to explore the process itself, the pros and cons, the methods and devices I use, and how it affects the lives of myself and my close friends. This is my own experience; others will have a different one, certainly, as all of our lives are different.

The scene above really did happen, quite recently. My best friend’s brother lives out of state, and has recently begun visiting her about once a week. As she works in one of the most central commercial areas of the city and state, frequented by nearly everyone I know, his visits present a new problem for me. I was forced to be out to him, whether or not I wanted; more recently, I’ve had to make him understand. This sort of thing is just part of the regular maintenance of my chosen stealth lifestyle. And I want to clarify that: this is a choice, not a necessity, not really. I believe that being mostly out (instead of mostly in) wouldn’t be that much dramatically easier or harder, just very different, and present a different set of challenges and demands.

Because going stealth is akin to maintaining a huge lie over most of the people in your life, it demands the special skills and abilities of the accomplished liar in many aspects of everyday life. Chief among these is the need to constantly remember who knows how much about you, exactly what they know about you, and, just as important, whom they know who also knows you, or knows someone who knows you. In my adopted state of Rhode Island, which exists in very tight social and professional knots, this is a sometimes nerve-wracking task.

Closely related to this is the need to assess each person’s level of received truth based upon a combination of need-to-know and likeliness-to-cause-problems, as well as what you think they can handle, and the best way to give it to them. An important part of this is being able to set limits on the truth for each person, and the occasional need to amend the truth because of some event, a new association, or a change in how you relate to them. I tend to look for reasons to give people more of the truth, but only to the extent that seems adequate to maintain a good relationship with each person. That is, I’d like to be more completely honest, and I welcome those opportunities, but I don’t go looking for them.

Good friends include those who knew me before all this started, and those I came to know later. Older friends are either in the process of drifting away and so don’t need to know anything new, or they are still in my life and need to know about changes in me and my life. Some older friends, like rarely-seen former comrades, colleagues, classmates, and coworkers, are always a bit of a conundrum, because they know who I used to be, and for the most part don’t know the new me. I could, theoretically, track them all down and explain myself, but this is prohibitively time-consuming and exhaustive, and, reasonably, isn’t necessary. In some cases, I’ve found one or two key people in each setting to spread the word of the new me to all my old friends, which saves a lot of work and hassle, and ties up loose ends in both the past and the future, as, for example, with calls to old employers placed by prospective new ones. (I’ll never know who it was who gave me such a glowing review, but thank you.)

Where this fails is when they come out of the blue into my new life and, in their excitement at seeing me, forget everything they’re supposed to know about how not to screw it all up for me. I’ll never forget the ice-cold feeling in my gut when one of my old students ran into me on the street last year, yelling my old name across about three dozen of my much more recent acquaintances. "Later," I told her, when given a chance to talk to her, but still very much in public, and did write to her, later.

More recently, I declined to refer a friend of mine to my old landlord, who met me under my old legal name, and whom I never bothered to advise of the change, figuring, why complicate my life, I’m moving out anyway. Too bad, because my friend could have used that place, and could have used my reference. In a similar case, I don’t allow my family to give my phone number to anyone in my home state who asks for it, or to any of my other relatives. Not as long as I’m still living with people who don’t all know me that well, yet.

The greatest problem with going stealth, however, is in the area of carnal relations. Okay, there’s this one truth: we can all live without sex, even for years and years on end, or even for our entire lives. Many of us have done so for extended periods, both deliberately and not. But if we want to have sex, and if the opportunity is there, and if it seems otherwise a reasonable option, the stealth navigator is given an often profound dilemma: tell the truth and hope for the best? Or chicken out?

In the last issue of this newsletter, I speculated about how to deal with this situation, but at that time hadn’t really had to deal with it in my own life; in that article, I didn’t actually provide any clear answers. Shortly after that was written, that reality came crashing home for me, in the melodramatic tale described in the romantic rant on the last page of this issue. It’s a story right out of a future-times after-school special, or a movie: Casual friendship deepens and grows, and inflames into true love, with the requisite sex scene. Except it didn’t quite make it that far, because I stopped it. Twice. And despite that, the invitation is still there, waiting for my answer.

I didn’t tell the truth, and now I regret it. Because this one really, really means something to me, and I don’t want to screw it up any further than I have already. And if I want the relationship that’s being offered me, there is no way around, under, or over to get there. I have to go straight down the middle, straight through the wall of deception I let sit between us and ossify into a kind of truth more solid and immovable than I’d intended. Because the complete truth is a little different than that I’ve allowed people to build for themselves, people whose impression of me isn’t supposed to require them to know intimate details about me.

I still don’t have the answer to the riddle I posed last issue, and I’m desperately searching for exactly the right way not only to deal with this immediate situation, that is so significant for me, but also how to prevent the same from happening again in the future, which now seems a lot more likely than I would have supposed just a years ago. I do know that I have to come clean entirely in order to save my existing friendships and relationships. My question is, all other debate aside, is stealth really a manageable way of life for a person’s whole life?