Mildred L. Brown and Chloe Ann Rounsley Jossey-Bass Publishers, San Francisco, 1996 256 pp-$25.00-Cloth ISBN 0-7879-0271-3
Reviewed by Jamie Faye Fenton
Mildred Brown is an institution in the San Francisco Bay Area, widely regarded as one of the best gender therapists in the world. My wife and I have seen her many times during the past few years, as have many of my transgender friends. Chloe Rounsley is a local freelance writer, and met Millie while doing an article about a transsexual who was transitioning at a Silicon Valley company.
The result: a book containing high quality writing that is a pleasure to read.
The book begins with a description of transsexuality and how transsexuality is different from transvestism and the other designations. Transsexuality is a condition in which one’s gender identity (or internal self identification) is opposite to one’s anatomical sex at birth. There are many theories about causation: nature (the influence of hormones on prenatal brain development), nurture (early social learning), or a combination of the two (seen as the most likely explanation).
Awareness of gender dysphoria comes to most transsexuals in grade school. FTMs wish to play with the boys, MTFs with the girls. This flouting of school-yard convention causes teases and taunts and can make childhood an unhappy experience indeed. Inside, TS kids long to have what is wrong made right, often praying for divine intercession. Parents who become aware of their child’s gender issues often seek help, usually from inexperienced professionals. Frequently the interventions do more harm then good. A TS child learns to pretend to be normal.
When the secondary sex characteristics emerge, hope in magic ends: the wrong body changes happen. Sexual maturity brings more stresses. The TS teenager feels profoundly alone. Common experiences include despair, substance abuse, conflicts with parents, confusion over sexual orientation. The strategy “perhaps if I act normal, I will become normal” is adopted.
The self is deeply buried by adulthood and the defenses are up. Some transsexuals enter military service or try other highly masculine or feminine pursuits. They try marriage and parenthood or become intensely involved in community affairs. They secretly bear feelings of guilt, shame, and a fear of being exposed. Repeated episodes of cross-dressing and purging take place.
All of this merely delays the inevitable. Cracks emerge, often caused by stressful events, and gender dysphoria bursts forth. It can’t be buried this time. Depression sets in. Desperate, the transsexual seeks the advice of a gender therapist and starts the transition process.
Therapy begins with an initial assessment. (Many of Millie’s clients are transgendered but not transsexual and many are not sure what they are when they begin.) Each client writes his or her life story. The layers of illusion are be stripped away. Therapist and client explore feelings of guilt, anger, fear, and shame.
Once a course is selected, the practical steps begin: electrolysis, name changes, practice at passing, hormones, voice training, plastic surgery. The most momentous is the “coming out” to family and friends. As the news is not always welcome, there is anxiety with each disclosure.
As the real life test approaches, the circle of revelation expands to friends and coworkers. Letters are written and the momentous day arrives.
The real life test year is intense. Challenges are faced at work and at home. Some outcomes are heartbreaking: estrangement from family, divorce, loss of job, child custody disputes. Personality changes take place. As this book focuses on helping family, friends, and coworkers understand transsexuality, there is much detail about the transition process, its effects on others, and how to help.
After a year or longer, the denouement: sex reassignment surgery. Millie’s MTF clients often hold a “Weenie Roast” a week or two before hospital admission. Chapter nine gives full technical details of how the operations are performed, the possible complications, and the recovery.
Some SRS patients report an immediate end to gender dysphoria. For others the lifting takes some time. Most transsexuals who pursue treatment report eventual satisfaction with the outcome.
Ultimately the advice is basic: Adapt to the change at your own rate, grieve for the loss of the old self, avoid blame, talk to others. Learn. Treat the transsexual as a human being.
The last chapter is a collection of triumphant poetry — another window inside.
The appendix contains a well-constructed resource guide listing organizations, West Coast support groups and hot lines, and Internet news groups and web pages. There are also footnotes, a bibliography, and an index.
I approached this book as a transvestite with many transsexual friends, some quite close, whom I wish to understand better. As many TG Forum readers know, there are many divisions in the gender community, particularly between transvestite and transsexual. I discovered that I have had many of the experiences, feelings, and dilemmas that transsexuals have faced, including a touch of gender dysphoria. The knowledge will help when I answer the hot line calls, visit the TG Forum chat room, and interact with my friends. I recommend this book to transvestites seeking empathy for transsexuals.
Empathy can be misleading. Readers of psychological subjects often see themselves in the descriptions and should guard against self diagnosis. If questions arise — see a gender therapist before jumping to conclusions!
The resource guide emphasizes U.S. West Coast organizations and services which at time of publication is generally up-to-date. Beyond these brief descriptions, there is little discussion of the transgender community and how it operates. Perhaps in later editions more coverage can be given to the international situation, as I am curious about how transsexuals manage in other countries and cultures.
Chloe and Millie are careful to give equal time to FTMs — using FTMs in half of the examples. They are
inconsistent in their use of male and female names — for example, sometimes calling a MTF by her male
name. This actually helps by leading the reader well down the garden path before they know which kind of
transsexual is being discussed in each example.
True Selves is still in the distribution pipeline and will not be available everywhere for several weeks. It has not yet received much publicity. It is up to us to put this resource in the hands of those around us who need it.
Being a transsexual is not easy. The fact that you were born into the wrong body is only the beginning of the problem; a great majority of the headaches--at least in my case--come from having to share your troubles with friends, family and co-workers who will at the least be stunned and at the worst be aggressive and uncaring.
I was delighted to find this book by Mildred Brown and Chloe Rounsley: it is the perfect way to help the transsexual explain his or her problems to those around them. Brown is an extremely well-respected gender therapist; Rounsley is a freelance writer. The book is what you would expect from such a collaboration: an accurate, compassionate, insightful and well-written description of what it's like to be or to have a relationship with a transsexual.
A dear friend of mine who lives in the Bay Area sent me a copy of True Selves after I told her I was transsexual. I shared this with her on a Friday night. Obviously understanding the sense of urgency I was feeling, she posted it priority mail and it arrived here in North Carolina on Monday. In one sitting of less than three hours I read the whole book. I can't recall looking away from it even once. It is a well-conceived and well-organized piece of writing, obviously the result of several years It is liberally sprinkled with comments from male-to-female (MTF) and female-to-male (FTM) transsexuals used to illustrate the points being made. MTF and FTM are represented about equally, which is admirable. Often books on transsexualism are unreasonably slanted towards MTF. While this might make it easier for me, Alaina, to identify with them, they do the reader a disservice by implying that transsexualism equals MTF, and mentioning FTMs as an afterthought.
I did find the use of nouns and pronouns a bit confusing, because there didn't seem to be any consistency between whether a transsexual was called by a name appropriate to birth gender or chosen gender. To be fair, maybe that helps dispel any preconceived notions of the percentages of MTF and FTM, showing that we all have common experiences and opportunities.
Fairly early on the book explains the differences between transvestites, transsexuals, homosexuals, drag queens, female impersonators, fetishists and other "variations upon a theme," making it clear that gender is not a black-and-white issue. It explains some of the prevailing theories about what causes gender identification and sexual orientation, taking care to note that sex and gender are distinct concepts.
The explanation of the possible causes of transsexualism leads into an analysis of the experiences of the transsexual as a child growing up in the wrong body. Every book I have ever read on transsexualism makes me say "me too!" True Selves is no different. I too have thought of myself as a little girl as long as I can remember. I recall asking my grandmother when I was about three why I didn't get to wear a dress to church like the other girls did. I too used to lie awake at night praying to wake up a girl.
My parents are very caring though they did not (and still do not) understand my situation. I am lucky and know it. True Selves shows the whole range of reactions: from the parents that understand and accept their child to the parents that reject and abuse their child because of their gender dysphoria. It specifically speaks to the readers who are parents of transsexuals, explaining to them that "it" wasn't anything they did wrong or for which they should somehow feel responsible.
Puberty segues into young adulthood and then into adulthood. During this long stretch of lifetime, many transsexuals try to adopt the role that is expected of them by society. For example, to assert their masculinity, MTFs may start playing rough-and-tumble sports or join the military when they come of age. Some transsexuals marry, hoping that their spouse can "cure" their problems. Often this just drives the transsexual even deeper into depression or self-loathing.
Finally, the transsexual decides that he or she can no longer deal with the insurmountable obstacle of hating their body, and finds out that there are steps that can be taken to fix this affliction. The book describes the transition process--what I like to think of as the "rites of passage"--through which all transsexuals must pass on their journey to find their true self. The steps of therapy, hormone treatment, RLT, and surgery are all explained in detail, making a point to follow the Standards of Care With all of the information that this book provides for the transsexual, you might think that there is hardly any room for discussing issues relevant to the "families, friends, coworkers and helping professionals" mentioned in the subtitle. If that is the case, you will be shocked. There are quotes aplenty from the families and friends of transsexuals; snippets of memos and emails sent from supportive coworkers, HR departments and management offices. Not only does True Selves address the issues with which a transsexual must struggle his or herself, but it explains these issues in a way that loved ones and interested parties can understand and appreciate. It even offers suggestions to these friends and family on how to comfort and aid the transsexual on their journey, and how to deal with any unjustified feelings of guilt, responsibility or anger which inevitably arise.
All in all, this is probably the best book I have ever read on transsexualism. It is without a doubt the best book I can imagine for explaining to my family, friends and colleagues how nature made a mistake with me and how I intend to fix it. Whether you are a transsexual, another member of the gender community, a concerned relative or friend, or a professional who must deal with this situation, you will get more than your money's worth from True Selves.
The friend who loaned me this book tells me that it's not in wide distribution yet. Call your local bookstore and order it; it's well worth the read and well worth the wait. Alaina gives two thumbs up!