Martin Luther King Jr., speaks at a Selma, Alabama church in this January 1965 photo. King wrote in his "Letter from Birmingham Jail" that "injustice anywhere is a threat to justice everywhere."
By Rev. Dr. Dennis W. Wiley | August 17, 2011
At last month’s 102nd annual convention of the National Association for the Advancement of Colored People, a historic workshop focused on overcoming homophobia within the black community. As an African American, heterosexual, male pastor of a traditionally black Baptist church in the inner city of Washington, D.C., I was glad to see this legendary organization take this small but important step in its increasingly inclusive perspective on civil rights.
There are some, however, including the Rev. Keith Ratliff Sr., an NAACP national board member, who see no parallel between gay rights and civil rights. Expressing this conviction at a rally last May, he demanded that the gay community “stop hijacking the civil rights movement.”
This statement, subtly suggesting that “civil rights” is a black issue and “gay rights” is a white issue, implies that lesbian, gay, bisexual, and transgender, or LGBT, equality is not a priority for black people. This sentiment, particularly prevalent regarding the issue of marriage equality, is often expressed in a variety of ways, including, “This is not our issue,” “This is not a priority for the black community,” and, “We have more critical matters to consider.”
One of the problems with this “either/or” approach—that this issue is either “black” or “white”—is that it creates a false dichotomy between LGBT issues and other issues of social justice. Another is that it fosters a hierarchy of oppression in which certain matters are placed at the top of the political agenda while others are tabled.
The greatest problem with this approach is its failure to highlight how multiple forms of oppression are interconnected. This failure to “connect the dots” deceives black and other marginalized groups into believing that dealing with vital issues impacting our communities can, at best, be postponed indefinitely, or, at worst, be ignored completely.
The civil rights movement of the 1950s and 60s offers several examples of this type of failure to connect the dots. For instance, when Martin Luther King Jr. accepted the invitation to lead a nonviolent, direct-action, voting rights campaign in Birmingham, Alabama in 1963, white liberals criticized him for being an “outside agitator” and for moving too fast.
In his famous “Letter from Birmingham Jail,” he responded by first informing his critics that what was happening in Birmingham was directly connected to what was happening in his hometown of Atlanta. “Injustice anywhere is a threat to justice everywhere,” he wrote. Second, he replied that the word “‘Wait’ has almost always meant ‘Never’” and that “justice too long delayed is justice denied.”
Another example occurred when King spoke out against the war in Vietnam. Although his detractors failed to discern the relationship between the civil rights and peace movements, King was clear that the goal of his controversial stance was not only to save lives in Vietnam, but also to “save the soul of America.” In so doing, he connected the dots of what he called “the giant triplets of racism, materialism, and militarism.”
Two other examples reveal King’s own inner struggle to detect the interconnectedness of various forms of oppression.. With regard to the role of women, the civil rights and black power movements were characterized by rampant sexism. Although women played pivotal roles in each, they were primarily relegated to subordinate positions and often treated as sex objects. This was not unusual because, throughout most of the 20th century, race consistently trumped gender as the primary social justice issue within the Black Church and community. Black women were expected (and usually consented) to suppress any notions of women’s liberation—often characterized by black men as a “white” issue—in the interest of black unity, racial solidarity, and the affirmation of black manhood.
This leads us to the other issue of oppression with which King privately agonized—homophobia. Like women’s rights neither King nor any other civil rights leader lifted up gay rights as a goal of the movement. Bayard Rustin, however, one of his chief nonviolent strategists, was openly gay. King staunchly supported Rustin’s role in the movement, despite objections from some of his closest allies, until 1960.
When Adam Clayton Powell Jr., the powerful, influential, and charismatic black pastor and U.S. congressman from Harlem, New York, threatened that year to circulate a false rumor that Rustin and King had been involved in a homosexual affair, King—much to Rustin’s disappointment—promptly accepted Rustin’s resignation. It was not until 1963, when King again stood solidly behind him, that Rustin was assigned the responsibility to plan, organize, and orchestrate the phenomenally successful March on Washington.
These examples of connecting, or failing to connect, the dots of oppression help us to understand that the quest for human justice, freedom, and equality cannot be fragmented. The layered complexity of human identity forbids it. To claim that we are for racial equality while ignoring women’s equality, or to insist that we support justice for the poor but disdain justice for LGBT persons, is to engage in a precarious game of self-deception in which the ultimate irony is that we ourselves become the inadvertent objects of our own rejection, self-hatred, and internalized oppression.
If Martin Luther King Jr. were alive today at the ripe old age of 82, I believe his consistently evolving consciousness would have removed his blind spots of 43 years ago. Just as he was a trailblazer in protesting the Vietnam War, I contend that he also would have been a pioneer in the struggle for women’s rights and LGBT equality. This is why so many of his former associates who are still alive—including Congressman John Lewis and the NAACP’s own Julian Bond—are unequivocal in their support of gay rights, including marriage equality. The same was true of his late widow, Coretta Scott King. They have understood that LGBT oppression is not some alien or superfluous concern that has little or nothing to do with other justice issues critical to the black community and that, in fact, it is a critical issue of civil rights.
The Reverend Dennis W. Wiley, Ph.D., is pastor of the Covenant Baptist United Church of Christ in Washington, D.C. He is a contributor to the Fighting Injustice to Reach Equality, or FIRE, initiative at the Center for American Progress, which explores the impact of public policy on gay and transgender people of color. This is his first of a series of columns in which he will discuss progressivism within the black church.
Friday, August 19, 2011
When boys would rather not be boys
Kids are being diagnosed—and identifying themselves—as transgendered younger than ever before
by Roberta Staley on Friday, August 12, 2011 posted on MacLean's website. http://www2.macleans.ca/2011/08/12/when-boys-would-rather-not-be-boys/?utm_source=_BOTm-pB8c365zF&utm_content=ml25&utm_medium=email
Reposted at Keystothecloset
Cormac O’Dwyer entered Grade 8 in Vancouver as a girl named Amber. All traces of femininity stopped with the name; Amber looked, dressed and acted like a boy. “It was awkward,” admits Cormac, sleeves rolled up to reveal downy, muscular arms, elbows resting on the kitchen table in the family’s immaculate home in upscale Kitsilano. From the other end of the table, Cormac’s mother, Julia, pipes up. “People would use the male pronoun,” she recalls. Usually Julia felt obliged to correct the error, leaving new acquaintances flustered and confused.
But solecisms were the least of Cormac’s worries during the transition from female to male. Becoming a boy involved wearing a breast-flattening binder, changing for phys. ed. in the teachers’ change room, declining invitations to go swimming, and carrying a cellphone to call for help in case of bullying. And then there was the therapy: testosterone injections, counselling and surgery that removed his breasts and contoured what remained into the flat, square planes of a male chest.
Now 16, Cormac is one of a growing number of teenagers in Canada who have been diagnosed with gender identity dysphoria (GID), or transgenderism. These kids feel that they have been born into the wrong bodies, and are actually members of the opposite sex. Cormac recalls his epiphanic moment following a presentation by a peer-counselling group for lesbian, gay, bisexual and transgender youth at Lord Byng Secondary School. “I always sort of knew I wanted to be a guy,” says Cormac. “They explained to me what transgender was and, for the first time ever, I ‘got it’ and went home and told my mom.”
Julia, too, clearly remembers that day, and how difficult it was to reconcile her eldest child’s dramatic declaration. “You don’t know how to answer,” she says. “That’s the one thing for someone who isn’t transgender—it’s very hard to understand what is inside a person to need to make that change.”
Treatment of GID is highly controversial. Some experts believe that the best way to help children and teens is to convince them to accept their bodies and not undergo the therapies that will cause dramatic physical changes. Cormac, however, lives in Vancouver, where pediatric endocrinologist Dr. Daniel Metzger and the B.C. Transgender Care Group are based. The loosely organized group, of which Metzger is a member, is the sole provider of care for transgender youth in B.C. and offers the most extensive suite of medical services for GID adolescents in Canada. Metzger believes that the best course of treatment for teenagers diagnosed with GID is hormone therapy: either blockers to stop puberty or, if post-pubescent, hormones that physically alter the body in a way that reflects their chosen gender. For some teens like Cormac, who are confident, psychologically stable and have family support, this transformation can be complemented further with cosmetic surgery.
Without treatment, Metzger argues, the path to adulthood for GID teens can be torturous, as evidenced by shockingly high suicide rates: 45 per cent for those aged 18-44, in comparison to the national average of 1.6 per cent, according to the U.S. 2010 National Transgender Discrimination Survey Report on Health and Health Care. Cormac carefully considers what life would be like today if he were still Amber. He pauses for a few seconds then gravely announces, “I think that would push me to be suicidal.” He is much more calm now, he says, free from his obsession with wanting to be a boy. “Before I transitioned I thought about it a lot, like, every minute. Now, I feel like I have so much extra brain space,” says Cormac, who is an honour roll student.
The sense of calm also comes, he adds, from the unburdening of secrets. He is a young man both in body and spirit, rather than a girl trying to pass as a boy. “I have friends that I’ve had for a year or more and I don’t know if they know or not about the transition. It’s not important to where I am right now. I guess I could tell them but I don’t even think about it.”
Transgender experts like Harvard Medical School professor and endocrinologist Dr. Norman Spack, co-director of Boston Children’s Hospital’s clinic for disorders of sexual differentiation, speaks highly of the B.C. Transgender Care Group. In fact, Spack deems the B.C. program one of the more progressive in the world. While progressive, the B.C. Transgender Care Group is not radical. The group’s psychology or psychiatry transgender specialists will ensure that an adolescent who is diagnosed with GID is mentally healthy before referring them to Metzger for hormonal therapy. If a child has GID in combination with depression or anorexia—which can occur in youngsters trying to cope with the stress of GID—then the hormonal cocktail that transforms their sexual development is delayed. For Cormac, who had already finished puberty, a regimen of testosterone injections stopped his period and thickened his jawline. He began shaving and started to speak in the lower registers. During the transition, Cormac also consulted with Vancouver plastic surgeon Dr. Cameron Bowman—one of only three sex-reassignment surgeons in Canada—about getting a mastectomy. After a panel of psychiatric transgender specialists assessed and approved Cormac’s readiness, he had the operation a week after his 15th birthday, making him one of the youngest transgenders in Canada ever to undergo a provincially funded mastectomy and chest contouring. Pronoun confusion was, at last, a moot point.
Some specialists question whether such a metamorphosis is appropriate for young patients. Psychologist Kenneth Zucker, who heads Toronto’s Gender Identity Service in the Child, Youth, and Family Program at the Centre for Addiction and Mental Health, leans toward counselling to get his patients—especially the younger ones—to accept their birth sex. He worries that the Internet, which has opened up a world of information for children and teens confused about sexual orientation, may be making “transgenderism fashionable: it’s kind of cool to be transgender, as opposed to being gay or lesbian,” says Zucker, who sees at least 50 new GID cases a year, a “quadrupling compared to 30 years ago.” To illustrate his point, Zucker describes one 15-year-old female patient as a “tomboy” who is attracted to other girls—but interprets the attraction as transgenderism. Such “internalized homophobia” can emerge in homes or cultures that oppose homosexuality, Zucker says. The teen thinks, “It would be easier if I were a boy attracted to girls, because then I wouldn’t be teased for being a lesbian.”
Zucker also cautions that psychological disorders like Asperger syndrome, a form of autism characterized by repetitive patterns of behaviour and interests, can also spark GID. Kids with Asperger’s “can get obsessed with a particular idea, and gender is one.”
Unsurprisingly, given all this, Zucker does not approve sex-reassignment surgery for his adolescent patients at all. And he prefers they wait until they’re at least 13 to take puberty blockers—which are reversible—and especially estrogen or testosterone hormone therapy, the effects of which are not reversible.
Harvard’s Spack is well acquainted with Zucker’s contributions to the study and treatment of GID in children and adolescents. The transgender medical fraternity worldwide, Spack adds, generally supports Zucker’s data showing that about 80 per cent of prepubescent children who identify as the opposite gender will change their minds, while 20 per cent will persist. However, Spack disagrees with Zucker’s counselling methods, which reflect the Toronto psychologist’s fundamental assumption that encouraging a child to play and dress in a way that reflects their biological sex may help them to grow out of their GID. Children who undergo this type of psychological therapy can be devastated by it, Spack believes.
What is the root cause of GID? Clinicians and researchers worldwide are mystified, according to Peggy Cohen-Kettenis, a professor of medical psychology at Free University Medical Center in Amsterdam. Considered one of the world’s foremost experts on transgender adolescents, Cohen-Kettenis believes genetics likely play a strong role; abnormal levels of sex hormones in utero during fetal development may also play a part. Or, brain receptors may be unusually sensitive to developmental hormones, says Cohen-Kettenis. She also points to recent magnetic resonance imaging (MRI) research, which indicates that the brains of those with GID have striking similarities to the brains of the opposite sex with which they identify. For example, according to a study published last year in the Journal of Psychiatric Research, specific regions of female-to-male transsexuals’ brains strongly resemble male brains.
But neither Metzger nor his young patients fret about the cause of a GID diagnosis. The adolescents simply want it dealt with—now. For some male transgenders, Metzger says the prospect of their first period is horrifying, while some female transgenders view their penises as offensive foreign appendages. Anxiety, depression, suicidal thoughts and drug use can follow, he adds. To help patients cope, the B.C. Transgender Care Group follows a “harm reduction” model of medicine. Puberty blockers—which are reversible and can be administered to patients as young as 10—can be initiated before undesired secondary sex characteristics emerge, says Metzger. The treatment not only changes the course of sexual development but also temporarily eliminates patients’ sex drive—a huge relief to kids who need to “focus on their transitioning, school and therapy,” Metzger says. The hormone blockers—usually Lupron, a $400-a-month injectable synthetic hormone—can be stopped at any time, allowing puberty to resume. For individuals like Cormac who have already gone through puberty, hormone therapy is initiated. This is either oral estrogen or, in Cormac’s case, injectable testosterone, replicating the hormones that are normally produced by the ovaries or testes.
Metzger defends early intervention by arguing that the cessation of undesired—and unmistakable—secondary sex characteristics is key to ensuring that transgender adolescents blend seamlessly into an image-obsessed society when they mature. “I have met lots of adults who transitioned in their 20s and 30s and they look at me like I’m the saviour,” says Metzger, who began treating transgender adolescents 12 years ago—and none of them have regretted their transition. “They say, ‘Oh my God, if there had been someone like you when I was younger, my life would have been totally different. I wouldn’t have spent bazillions of dollars on electrolysis or I wouldn’t have this enormous square jaw.’ They think that the new generation of young transgender kids are so much luckier for being able to do what they knew they wanted to do when they were 12.”
Nonetheless, the mental health experts with the B.C. Transgender Care Group are cautious when it comes to approving the irreversible, final step of GID treatment: sex-reassignment surgery. Cormac O’Dwyer’s surgery was one of only about five that have been approved for adolescents by B.C.’s Medical Services Plan (MSP) in the past 20 years, says Dr. Gail Knudson, one of the group’s psychiatrists. Teens must first complete a full two years of what is called Real Life Experience—engaging with the world at school, work and socially in their chosen gender—in order to be considered for surgery. (Adult transgenders who apply for MSP-funded sex-reassignment surgery only have to make it through one Real Life Experience year.) “It’s better for teens to live two years of Real Life Experience, as their identity as a whole is changing,” says Knudson. “Think of how many times you changed going through adolescence, not only externally but internally: your hairstyle, clothes and beliefs.”
Zucker’s point exactly.
Teenagers, never known for their patience, tend to advocate a swifter process. North Vancouver’s Nikki Buchamer, for one, feels that this conservative approach can cause unnecessary mental anguish. This past spring, Buchamer, a six-foot 17-year-old with blue-black hair and porcelain skin, went before a panel that included Knudson, hoping to be approved for a vaginoplasty, a procedure that is performed at Montreal’s Centre Métropolitain de Chirurgie Plastique, where Canada’s two other sex-reassignment surgeons practise. The complex surgery, which when approved is paid for by B.C.’s MSP, creates female genitalia from penile tissue. Wearing a conservative dress, jacket and leggings, with her hair neatly up, Nikki answered questions from the panel that included queries about her early childhood. In the end, however, the verdict on the surgery was no. “I wanted to bawl my eyes out and walk out,” says the Grade 11 student.
Nikki, whose birth name was Brandon, had only logged 16 months of Real Life Experience as a female, following counselling that crystallized her understanding that she had GID. She estimates that, by the time she is granted another panel hearing, it will be the end of Grade 12 before she is approved for a vaginoplasty.
Matching her physical body to her gender, she says, will lift a crushing weight off her shoulders. “To wake up and not have to think about being trans, to just think about being a person—life will start at this point,” explains Nikki, who has booked surgery this August with Dr. Cameron Bowman to decrease the size of her Adam’s apple.
Michele Buchamer, who accompanied her daughter to the sex-reassignment assessment, which was held in Victoria, was also distraught over the decision. “To a teen, every day is equivalent to three weeks. She just wants to be a normal teenager,” says the interior designer.
Not all parents of teens with GID are as supportive as Nikki’s and Cormac’s. Some oppose their teenager’s transgendering and refuse to give consent for hormone therapy or puberty blockers. Metzger currently has 60 adolescents under his care, the majority referred to him by the psychologist or psychiatrists at the B.C. Transgender Care Group, a few by their family doctors. But some have come to Metzger on their own initiative without their parents’ knowledge after discovering him on the Internet. In B.C., the Infants Act allows Metzger and the B.C. Transgender Group to provide care to these patients without parents’ consent so long as the “young person is capable and the medical treatment is in the young person’s ‘best interests.’ ”
In Canada, common law dictates that a “person under the common law age of majority who is capable of appreciating the nature and consequences of a particular operation or other treatment, whether recommended by the treating physician or chosen by the capable young person, can give an effective consent without anyone else’s approval being required,” David C. Day wrote in 2007 in The Canadian Bar Review. The rub, of course, is that a young patient’s care is limited by what their physician, psychiatrist or endocrinologist will consent to.
Even though parents can’t legally prevent Metzger from initiating hormone therapy for his young patients, he will counsel them to postpone such treatment if it will put them at risk or alienate family members. “If they are going to get kicked out of the house and have nowhere to live, then we might come up with an alternative plan or try to encourage the kid to wait a little longer for therapy, just for their safety,” Metzger says. One of his transgender patients, Karina, who asked that her last name not be used, says that her conservative Korean family opposed her transition when she started estrogen therapy at age 17. Her mother sent angry emails to Karina’s psychiatrist and lashed out at her daughter. “She tells me that I’m ugly and I sound funny and that I’m screwing up my life,” says the petite, long-haired 19-year-old, who is looking for work so she can afford to leave home.
Metzger sighs as he ponders how difficult it is for parents to accept that their child has GID. “I always tell the kids that they are running faster than their parents and the parents are a little bit behind.” Some, however, do catch up. “I’ve seen some super hyper-resistant dads who have come around amazingly.”
When Nikki Buchamer thinks back to her childhood, she realizes there were early signs of GID. She was mesmerized, for example, by any TV show, cartoon or book where a character changed gender. GID, indeed, often begins in early childhood, experts say. And many transgenders say that they knew as young as four or five that they were born in the wrong body. Again, however, the most efficacious treatment for young children is cause for debate.
In Toronto, Kenneth Zucker treats children as young as five who exhibit early signs of GID. These include, he says, unconventional play behaviour: a little boy might prefer dolls instead of Bionicles and tiaras instead of hockey helmets. Such cross-gender play should be discouraged, says Zucker, or it might become permanent in adolescence. “They just have an easier life—they don’t have to go on lifelong therapy or have these incredibly invasive surgeries,” he reasons. About 80 per cent of his preadolescent patients outgrow their cross-gender behaviour by puberty, he claims, which supports the rationale for a highly conservative approach to therapy.
In Vancouver, however, Gail Knudson argues that stymying cross-gender play can cause kids to become secretive and hide their behaviour. “It’s okay for children to explore their gender at home in a safe way. If they want to dress differently or do different types of activities, that should be encouraged—if not, it goes underground,” Knudson says. “Practising different gender roles decreases their dysphoria.”
With evidence such as the MRI research pointing toward GID as a physical condition, Knudson questions the notion that it is a mental disorder at all. “If it was a mental disorder and you gave people psychotherapy, it would go away—and it doesn’t. If you give people an antipsychotic or antidepressant, it would go away—and it doesn’t,” she says.
But teens like Cormac care little about the cause of their dysphoria, being more focused on the present. Cormac points out that he can now concentrate on his budding acting career and maintaining honour roll grades at Lord Byng Secondary, rather than obsessing “every minute” about his chromosomal infelicity. Looking to the future, he muses that he might consider undergoing a phalloplasty—the creation of a neo-penis—to complete his transgender journey. But for now, he is simply content in his own skin, happy to be just a normal teenage boy.
by Roberta Staley on Friday, August 12, 2011 posted on MacLean's website. http://www2.macleans.ca/2011/08/12/when-boys-would-rather-not-be-boys/?utm_source=_BOTm-pB8c365zF&utm_content=ml25&utm_medium=email
Reposted at Keystothecloset
Cormac O’Dwyer entered Grade 8 in Vancouver as a girl named Amber. All traces of femininity stopped with the name; Amber looked, dressed and acted like a boy. “It was awkward,” admits Cormac, sleeves rolled up to reveal downy, muscular arms, elbows resting on the kitchen table in the family’s immaculate home in upscale Kitsilano. From the other end of the table, Cormac’s mother, Julia, pipes up. “People would use the male pronoun,” she recalls. Usually Julia felt obliged to correct the error, leaving new acquaintances flustered and confused.
But solecisms were the least of Cormac’s worries during the transition from female to male. Becoming a boy involved wearing a breast-flattening binder, changing for phys. ed. in the teachers’ change room, declining invitations to go swimming, and carrying a cellphone to call for help in case of bullying. And then there was the therapy: testosterone injections, counselling and surgery that removed his breasts and contoured what remained into the flat, square planes of a male chest.
Now 16, Cormac is one of a growing number of teenagers in Canada who have been diagnosed with gender identity dysphoria (GID), or transgenderism. These kids feel that they have been born into the wrong bodies, and are actually members of the opposite sex. Cormac recalls his epiphanic moment following a presentation by a peer-counselling group for lesbian, gay, bisexual and transgender youth at Lord Byng Secondary School. “I always sort of knew I wanted to be a guy,” says Cormac. “They explained to me what transgender was and, for the first time ever, I ‘got it’ and went home and told my mom.”
Julia, too, clearly remembers that day, and how difficult it was to reconcile her eldest child’s dramatic declaration. “You don’t know how to answer,” she says. “That’s the one thing for someone who isn’t transgender—it’s very hard to understand what is inside a person to need to make that change.”
Treatment of GID is highly controversial. Some experts believe that the best way to help children and teens is to convince them to accept their bodies and not undergo the therapies that will cause dramatic physical changes. Cormac, however, lives in Vancouver, where pediatric endocrinologist Dr. Daniel Metzger and the B.C. Transgender Care Group are based. The loosely organized group, of which Metzger is a member, is the sole provider of care for transgender youth in B.C. and offers the most extensive suite of medical services for GID adolescents in Canada. Metzger believes that the best course of treatment for teenagers diagnosed with GID is hormone therapy: either blockers to stop puberty or, if post-pubescent, hormones that physically alter the body in a way that reflects their chosen gender. For some teens like Cormac, who are confident, psychologically stable and have family support, this transformation can be complemented further with cosmetic surgery.
Without treatment, Metzger argues, the path to adulthood for GID teens can be torturous, as evidenced by shockingly high suicide rates: 45 per cent for those aged 18-44, in comparison to the national average of 1.6 per cent, according to the U.S. 2010 National Transgender Discrimination Survey Report on Health and Health Care. Cormac carefully considers what life would be like today if he were still Amber. He pauses for a few seconds then gravely announces, “I think that would push me to be suicidal.” He is much more calm now, he says, free from his obsession with wanting to be a boy. “Before I transitioned I thought about it a lot, like, every minute. Now, I feel like I have so much extra brain space,” says Cormac, who is an honour roll student.
The sense of calm also comes, he adds, from the unburdening of secrets. He is a young man both in body and spirit, rather than a girl trying to pass as a boy. “I have friends that I’ve had for a year or more and I don’t know if they know or not about the transition. It’s not important to where I am right now. I guess I could tell them but I don’t even think about it.”
Transgender experts like Harvard Medical School professor and endocrinologist Dr. Norman Spack, co-director of Boston Children’s Hospital’s clinic for disorders of sexual differentiation, speaks highly of the B.C. Transgender Care Group. In fact, Spack deems the B.C. program one of the more progressive in the world. While progressive, the B.C. Transgender Care Group is not radical. The group’s psychology or psychiatry transgender specialists will ensure that an adolescent who is diagnosed with GID is mentally healthy before referring them to Metzger for hormonal therapy. If a child has GID in combination with depression or anorexia—which can occur in youngsters trying to cope with the stress of GID—then the hormonal cocktail that transforms their sexual development is delayed. For Cormac, who had already finished puberty, a regimen of testosterone injections stopped his period and thickened his jawline. He began shaving and started to speak in the lower registers. During the transition, Cormac also consulted with Vancouver plastic surgeon Dr. Cameron Bowman—one of only three sex-reassignment surgeons in Canada—about getting a mastectomy. After a panel of psychiatric transgender specialists assessed and approved Cormac’s readiness, he had the operation a week after his 15th birthday, making him one of the youngest transgenders in Canada ever to undergo a provincially funded mastectomy and chest contouring. Pronoun confusion was, at last, a moot point.
Some specialists question whether such a metamorphosis is appropriate for young patients. Psychologist Kenneth Zucker, who heads Toronto’s Gender Identity Service in the Child, Youth, and Family Program at the Centre for Addiction and Mental Health, leans toward counselling to get his patients—especially the younger ones—to accept their birth sex. He worries that the Internet, which has opened up a world of information for children and teens confused about sexual orientation, may be making “transgenderism fashionable: it’s kind of cool to be transgender, as opposed to being gay or lesbian,” says Zucker, who sees at least 50 new GID cases a year, a “quadrupling compared to 30 years ago.” To illustrate his point, Zucker describes one 15-year-old female patient as a “tomboy” who is attracted to other girls—but interprets the attraction as transgenderism. Such “internalized homophobia” can emerge in homes or cultures that oppose homosexuality, Zucker says. The teen thinks, “It would be easier if I were a boy attracted to girls, because then I wouldn’t be teased for being a lesbian.”
Zucker also cautions that psychological disorders like Asperger syndrome, a form of autism characterized by repetitive patterns of behaviour and interests, can also spark GID. Kids with Asperger’s “can get obsessed with a particular idea, and gender is one.”
Unsurprisingly, given all this, Zucker does not approve sex-reassignment surgery for his adolescent patients at all. And he prefers they wait until they’re at least 13 to take puberty blockers—which are reversible—and especially estrogen or testosterone hormone therapy, the effects of which are not reversible.
Harvard’s Spack is well acquainted with Zucker’s contributions to the study and treatment of GID in children and adolescents. The transgender medical fraternity worldwide, Spack adds, generally supports Zucker’s data showing that about 80 per cent of prepubescent children who identify as the opposite gender will change their minds, while 20 per cent will persist. However, Spack disagrees with Zucker’s counselling methods, which reflect the Toronto psychologist’s fundamental assumption that encouraging a child to play and dress in a way that reflects their biological sex may help them to grow out of their GID. Children who undergo this type of psychological therapy can be devastated by it, Spack believes.
What is the root cause of GID? Clinicians and researchers worldwide are mystified, according to Peggy Cohen-Kettenis, a professor of medical psychology at Free University Medical Center in Amsterdam. Considered one of the world’s foremost experts on transgender adolescents, Cohen-Kettenis believes genetics likely play a strong role; abnormal levels of sex hormones in utero during fetal development may also play a part. Or, brain receptors may be unusually sensitive to developmental hormones, says Cohen-Kettenis. She also points to recent magnetic resonance imaging (MRI) research, which indicates that the brains of those with GID have striking similarities to the brains of the opposite sex with which they identify. For example, according to a study published last year in the Journal of Psychiatric Research, specific regions of female-to-male transsexuals’ brains strongly resemble male brains.
But neither Metzger nor his young patients fret about the cause of a GID diagnosis. The adolescents simply want it dealt with—now. For some male transgenders, Metzger says the prospect of their first period is horrifying, while some female transgenders view their penises as offensive foreign appendages. Anxiety, depression, suicidal thoughts and drug use can follow, he adds. To help patients cope, the B.C. Transgender Care Group follows a “harm reduction” model of medicine. Puberty blockers—which are reversible and can be administered to patients as young as 10—can be initiated before undesired secondary sex characteristics emerge, says Metzger. The treatment not only changes the course of sexual development but also temporarily eliminates patients’ sex drive—a huge relief to kids who need to “focus on their transitioning, school and therapy,” Metzger says. The hormone blockers—usually Lupron, a $400-a-month injectable synthetic hormone—can be stopped at any time, allowing puberty to resume. For individuals like Cormac who have already gone through puberty, hormone therapy is initiated. This is either oral estrogen or, in Cormac’s case, injectable testosterone, replicating the hormones that are normally produced by the ovaries or testes.
Metzger defends early intervention by arguing that the cessation of undesired—and unmistakable—secondary sex characteristics is key to ensuring that transgender adolescents blend seamlessly into an image-obsessed society when they mature. “I have met lots of adults who transitioned in their 20s and 30s and they look at me like I’m the saviour,” says Metzger, who began treating transgender adolescents 12 years ago—and none of them have regretted their transition. “They say, ‘Oh my God, if there had been someone like you when I was younger, my life would have been totally different. I wouldn’t have spent bazillions of dollars on electrolysis or I wouldn’t have this enormous square jaw.’ They think that the new generation of young transgender kids are so much luckier for being able to do what they knew they wanted to do when they were 12.”
Nonetheless, the mental health experts with the B.C. Transgender Care Group are cautious when it comes to approving the irreversible, final step of GID treatment: sex-reassignment surgery. Cormac O’Dwyer’s surgery was one of only about five that have been approved for adolescents by B.C.’s Medical Services Plan (MSP) in the past 20 years, says Dr. Gail Knudson, one of the group’s psychiatrists. Teens must first complete a full two years of what is called Real Life Experience—engaging with the world at school, work and socially in their chosen gender—in order to be considered for surgery. (Adult transgenders who apply for MSP-funded sex-reassignment surgery only have to make it through one Real Life Experience year.) “It’s better for teens to live two years of Real Life Experience, as their identity as a whole is changing,” says Knudson. “Think of how many times you changed going through adolescence, not only externally but internally: your hairstyle, clothes and beliefs.”
Zucker’s point exactly.
Teenagers, never known for their patience, tend to advocate a swifter process. North Vancouver’s Nikki Buchamer, for one, feels that this conservative approach can cause unnecessary mental anguish. This past spring, Buchamer, a six-foot 17-year-old with blue-black hair and porcelain skin, went before a panel that included Knudson, hoping to be approved for a vaginoplasty, a procedure that is performed at Montreal’s Centre Métropolitain de Chirurgie Plastique, where Canada’s two other sex-reassignment surgeons practise. The complex surgery, which when approved is paid for by B.C.’s MSP, creates female genitalia from penile tissue. Wearing a conservative dress, jacket and leggings, with her hair neatly up, Nikki answered questions from the panel that included queries about her early childhood. In the end, however, the verdict on the surgery was no. “I wanted to bawl my eyes out and walk out,” says the Grade 11 student.
Nikki, whose birth name was Brandon, had only logged 16 months of Real Life Experience as a female, following counselling that crystallized her understanding that she had GID. She estimates that, by the time she is granted another panel hearing, it will be the end of Grade 12 before she is approved for a vaginoplasty.
Matching her physical body to her gender, she says, will lift a crushing weight off her shoulders. “To wake up and not have to think about being trans, to just think about being a person—life will start at this point,” explains Nikki, who has booked surgery this August with Dr. Cameron Bowman to decrease the size of her Adam’s apple.
Michele Buchamer, who accompanied her daughter to the sex-reassignment assessment, which was held in Victoria, was also distraught over the decision. “To a teen, every day is equivalent to three weeks. She just wants to be a normal teenager,” says the interior designer.
Not all parents of teens with GID are as supportive as Nikki’s and Cormac’s. Some oppose their teenager’s transgendering and refuse to give consent for hormone therapy or puberty blockers. Metzger currently has 60 adolescents under his care, the majority referred to him by the psychologist or psychiatrists at the B.C. Transgender Care Group, a few by their family doctors. But some have come to Metzger on their own initiative without their parents’ knowledge after discovering him on the Internet. In B.C., the Infants Act allows Metzger and the B.C. Transgender Group to provide care to these patients without parents’ consent so long as the “young person is capable and the medical treatment is in the young person’s ‘best interests.’ ”
In Canada, common law dictates that a “person under the common law age of majority who is capable of appreciating the nature and consequences of a particular operation or other treatment, whether recommended by the treating physician or chosen by the capable young person, can give an effective consent without anyone else’s approval being required,” David C. Day wrote in 2007 in The Canadian Bar Review. The rub, of course, is that a young patient’s care is limited by what their physician, psychiatrist or endocrinologist will consent to.
Even though parents can’t legally prevent Metzger from initiating hormone therapy for his young patients, he will counsel them to postpone such treatment if it will put them at risk or alienate family members. “If they are going to get kicked out of the house and have nowhere to live, then we might come up with an alternative plan or try to encourage the kid to wait a little longer for therapy, just for their safety,” Metzger says. One of his transgender patients, Karina, who asked that her last name not be used, says that her conservative Korean family opposed her transition when she started estrogen therapy at age 17. Her mother sent angry emails to Karina’s psychiatrist and lashed out at her daughter. “She tells me that I’m ugly and I sound funny and that I’m screwing up my life,” says the petite, long-haired 19-year-old, who is looking for work so she can afford to leave home.
Metzger sighs as he ponders how difficult it is for parents to accept that their child has GID. “I always tell the kids that they are running faster than their parents and the parents are a little bit behind.” Some, however, do catch up. “I’ve seen some super hyper-resistant dads who have come around amazingly.”
When Nikki Buchamer thinks back to her childhood, she realizes there were early signs of GID. She was mesmerized, for example, by any TV show, cartoon or book where a character changed gender. GID, indeed, often begins in early childhood, experts say. And many transgenders say that they knew as young as four or five that they were born in the wrong body. Again, however, the most efficacious treatment for young children is cause for debate.
In Toronto, Kenneth Zucker treats children as young as five who exhibit early signs of GID. These include, he says, unconventional play behaviour: a little boy might prefer dolls instead of Bionicles and tiaras instead of hockey helmets. Such cross-gender play should be discouraged, says Zucker, or it might become permanent in adolescence. “They just have an easier life—they don’t have to go on lifelong therapy or have these incredibly invasive surgeries,” he reasons. About 80 per cent of his preadolescent patients outgrow their cross-gender behaviour by puberty, he claims, which supports the rationale for a highly conservative approach to therapy.
In Vancouver, however, Gail Knudson argues that stymying cross-gender play can cause kids to become secretive and hide their behaviour. “It’s okay for children to explore their gender at home in a safe way. If they want to dress differently or do different types of activities, that should be encouraged—if not, it goes underground,” Knudson says. “Practising different gender roles decreases their dysphoria.”
With evidence such as the MRI research pointing toward GID as a physical condition, Knudson questions the notion that it is a mental disorder at all. “If it was a mental disorder and you gave people psychotherapy, it would go away—and it doesn’t. If you give people an antipsychotic or antidepressant, it would go away—and it doesn’t,” she says.
But teens like Cormac care little about the cause of their dysphoria, being more focused on the present. Cormac points out that he can now concentrate on his budding acting career and maintaining honour roll grades at Lord Byng Secondary, rather than obsessing “every minute” about his chromosomal infelicity. Looking to the future, he muses that he might consider undergoing a phalloplasty—the creation of a neo-penis—to complete his transgender journey. But for now, he is simply content in his own skin, happy to be just a normal teenage boy.
New HIV Incidence Estimates Confirm Increased Impact among Latino Gay Males
WASHINGTON, DC – Today the Centers for Disease Control and Prevention (CDC) released new HIV incidence estimates in the Public Library of Science Medicine (PLoS) which indicate that the overall number of new HIV infections has remained fairly steady from 2006–2009. However, the National Latino AIDS Action Network (NLAAN) is alarmed by the new estimates which identify Latino gay men as moving from the fourth to third most impacted population.
“These estimates underscore the historic challenge that Latino communities, particularly Latino gay men, have experienced in terms of the development of HIV prevention and testing efforts that are culturally and linguistically relevant,” stated Francisco Ruiz, Senior Manager at the National Alliance of State and Territorial AIDS Directors and co-chair of NLAAN. “These new HIV estimates point to the depth of the HIV crisis among Latino gay men and the consequences associated with paltry efforts to prevent HIV transmission and combat multi-faceted forms of stigma,” he added.
As health departments and community-based organizations continue to experience drastic cuts in funding, we must carefully weigh the results of slashing prevention budgets. “The nation is at a turning point in the history of the HIV/AIDS epidemic,” noted Oscar Raul Lopez, CEO/Lead Trainer of Connected Heath Solutions and co-chair of NLAAN. “We need to examine existing funding streams to ensure the development and support of effective behavioral, structural, and biomedical interventions for Latino gay men, including strategies that employ the use of technology like the Internet,” he stated.
The issue of immigration is a significant challenge faced by some Latino gay men. “As the disparity worsens with little relief promised to the newly immigrated Latinos under the Affordable Care Act, new measures to insure that the undocumented and new residents within the 5-year window have access to prevention, outreach, testing and treatment are imperative,” according to Dr. Britt Rios-Ellis, Director at the NCLR/CSULB Center for Latino Community Health and co-chair of NLAAN. She further explained, “This is particularly true given the fact that many immigrant Latino males often report facing particular challenges in accessing healthcare, including isolation from traditional social support systems, discrimination and a strong apprehension toward law enforcement.”
In light of the new HIV incidence estimates released today, NLAAN calls upon community-based organizations, health departments, federal agencies, policymakers, faith-based institutions, media outlets and other community entities to recommit to the goals outlined in the National HIV/AIDS Strategy. Only together can we effectively tackle this public health crisis.
About NLAAN: The National Latino AIDS Action Network (NLAAN) was developed as a response to the HIV/AIDS crisis within Latino/Hispanic communities and is a participatory, collaborative and diverse network of community-based organizations, national organizations, state and local health departments, researchers and concerned individuals that identifies and prioritizes the key needs of Latinos regarding HIV/AIDS prevention, research and care and treatment.
“These estimates underscore the historic challenge that Latino communities, particularly Latino gay men, have experienced in terms of the development of HIV prevention and testing efforts that are culturally and linguistically relevant,” stated Francisco Ruiz, Senior Manager at the National Alliance of State and Territorial AIDS Directors and co-chair of NLAAN. “These new HIV estimates point to the depth of the HIV crisis among Latino gay men and the consequences associated with paltry efforts to prevent HIV transmission and combat multi-faceted forms of stigma,” he added.
As health departments and community-based organizations continue to experience drastic cuts in funding, we must carefully weigh the results of slashing prevention budgets. “The nation is at a turning point in the history of the HIV/AIDS epidemic,” noted Oscar Raul Lopez, CEO/Lead Trainer of Connected Heath Solutions and co-chair of NLAAN. “We need to examine existing funding streams to ensure the development and support of effective behavioral, structural, and biomedical interventions for Latino gay men, including strategies that employ the use of technology like the Internet,” he stated.
The issue of immigration is a significant challenge faced by some Latino gay men. “As the disparity worsens with little relief promised to the newly immigrated Latinos under the Affordable Care Act, new measures to insure that the undocumented and new residents within the 5-year window have access to prevention, outreach, testing and treatment are imperative,” according to Dr. Britt Rios-Ellis, Director at the NCLR/CSULB Center for Latino Community Health and co-chair of NLAAN. She further explained, “This is particularly true given the fact that many immigrant Latino males often report facing particular challenges in accessing healthcare, including isolation from traditional social support systems, discrimination and a strong apprehension toward law enforcement.”
In light of the new HIV incidence estimates released today, NLAAN calls upon community-based organizations, health departments, federal agencies, policymakers, faith-based institutions, media outlets and other community entities to recommit to the goals outlined in the National HIV/AIDS Strategy. Only together can we effectively tackle this public health crisis.
About NLAAN: The National Latino AIDS Action Network (NLAAN) was developed as a response to the HIV/AIDS crisis within Latino/Hispanic communities and is a participatory, collaborative and diverse network of community-based organizations, national organizations, state and local health departments, researchers and concerned individuals that identifies and prioritizes the key needs of Latinos regarding HIV/AIDS prevention, research and care and treatment.
Friday, August 5, 2011
Last ‘Pink Triangle’ Gay Holocaust Survivor, Rudolf Brazda, Passes Away
98-year-old Rudolf Brazda died peacefully in his sleep on Wednesday. Brazda was considered to be the very last known gay survivor of the Holocaust.
Gay holocaust survivors were known as Pink Triangles due to the identifying patch (akin to the gold star of David marking Jews) they were forced to wear in Nazi concentration camps during World War II.
The intense trauma and shame of persecution by the Nazis kept many survivors from identifying themselves in the aftermath of the war. Brazda didn’t “come out” until the mid 1980′s, when the gay rights movement began sharing the stories and contributions of the Pink Triangle, both surviving and those lost too soon.
Rudolf Brazda had been part of some 10,000 deportees under Hitler because of their sexual orientation, the Nazis considering homosexuality as a threat to the perpetuation of the race.
He was deported to Buchenwald concentration camp where he wore the pink triangle, before choosing to live in France.
Born in 1913 in Saxony (Germany) in a Czech family germanophone, Rudolf became aware of his homosexuality as “a natural disposition to accept as such, aware that he was lucky to have always had a companion at his side” , he told.
In 1937, he was sentenced to six months in prison for “debauchery of men”, then deported to Czechoslovakia. There, after the annexation of the Sudetenland by Hitler, he was again tried and convicted for similar facts, this time to 14 months in prison.
This time served, Rudolf, considered a repeat offender, was interned in the concentration camp of Buchenwald in central Germany. He survived 32 months of hell in this camp, thanks to his friendship with a kapo communist and “a little luckier than others.”
Brazda’s cremated remains will be placed alongside those of his partner of more than 50 years, Edward Mayer, who passed away in 2003.
Rudolf Brazda’s passing marks the end of one of the most important chapters in not only gay history, but in the history of the entire world. Our lives today are surely made better by the incredible and seemingly impossible life Brazda lived. He will be missed.
Posted at Unicornbooty, reposted at keystothecloset.blogspot.com
Gay holocaust survivors were known as Pink Triangles due to the identifying patch (akin to the gold star of David marking Jews) they were forced to wear in Nazi concentration camps during World War II.
The intense trauma and shame of persecution by the Nazis kept many survivors from identifying themselves in the aftermath of the war. Brazda didn’t “come out” until the mid 1980′s, when the gay rights movement began sharing the stories and contributions of the Pink Triangle, both surviving and those lost too soon.
Rudolf Brazda had been part of some 10,000 deportees under Hitler because of their sexual orientation, the Nazis considering homosexuality as a threat to the perpetuation of the race.
He was deported to Buchenwald concentration camp where he wore the pink triangle, before choosing to live in France.
Born in 1913 in Saxony (Germany) in a Czech family germanophone, Rudolf became aware of his homosexuality as “a natural disposition to accept as such, aware that he was lucky to have always had a companion at his side” , he told.
In 1937, he was sentenced to six months in prison for “debauchery of men”, then deported to Czechoslovakia. There, after the annexation of the Sudetenland by Hitler, he was again tried and convicted for similar facts, this time to 14 months in prison.
This time served, Rudolf, considered a repeat offender, was interned in the concentration camp of Buchenwald in central Germany. He survived 32 months of hell in this camp, thanks to his friendship with a kapo communist and “a little luckier than others.”
Brazda’s cremated remains will be placed alongside those of his partner of more than 50 years, Edward Mayer, who passed away in 2003.
Rudolf Brazda’s passing marks the end of one of the most important chapters in not only gay history, but in the history of the entire world. Our lives today are surely made better by the incredible and seemingly impossible life Brazda lived. He will be missed.
Posted at Unicornbooty, reposted at keystothecloset.blogspot.com
Wednesday, August 3, 2011
Who is ACT OUT Delaware? Advocacy+Community+Teaching Openly United Together
Who is ACT OUT Delaware? Advocacy+Community+Teaching Openly United Together
At one time we were under the name of Delaware Gay Straight Christian Alliance (DGSCA). As of Oct 2010, that group became ACT OUT Delaware and DGSCA is now one of several committees under our umbrella. We are now a 501 c 3 non-profit corp.
We are open to all LGBT persons and their allies and there are no age restrictions or fees/dues. Our membership is open to anyone from anywhere around the Delaware County area: older, younger, male, female, transgendered, or straight ally. We have members from as far north as Mt Gilead, to south of Columbus and ranging in age from 22 years to 70 years old.. We have some kind of social event at least once, but usually twice a month in addition to any special events. The 2nd Friday of every month is game/cards night in Delaware, and the 3rd or 4th week is usually dinner out somewhere.
We participate in the Knox Co. Fair, Delaware Co. Fair, and Marion Popcorn Festival with booths and literature and a chance to get to meet the public as LGBT people who are out and proud. We held our annual Wine & Sign party the week before Pride and of-course we were in the parade (we had the rainbow poodles), and we marched in the 4th of July parade in Delaware. We've recently sponsored 2 speaking events at Beehive Books in Delaware; 1 was one of our members published in the "It Gets Better" book did a book signing and we had a panel discussion on Bullying, and the other was a lecture on spirituality versus religion titled "Faith on the Margins" with author Linda Mercadante. On June 8 we had the privledge of doing a 1 hour program on issues facing LGBT people for the diversity committee at the U.S. Southern District Federal Courts in Columbus with over 30 people attending (including 2 judges) and got rave reviews. You can find us greeting the public with a table and literature in front of Beehive Books on the Downtown Delaware's 'First Fridays'. You can see more about us at our website www.actoutdel.org or check us out on facebook. As you can see we have been very busy since our new group was formed in October of 2010 and our focus is now on advocacy, education and community building through social events.
Our up-coming special events include a day at the beach at Alum Creek August 20th, September is our Delaware Co. Fair booth from the 17th - 24th, October 29th we have a bonfire potluck Halloween Party in the country (great for ghost stories), In November is our annual Family Of Choice Thanksgiving Dinner followed by December's Christmas/Holiday Party. Watch for details either on our wesite or facebook, or you can contact us at bumblebeeismydog@yahoo.com.
At one time we were under the name of Delaware Gay Straight Christian Alliance (DGSCA). As of Oct 2010, that group became ACT OUT Delaware and DGSCA is now one of several committees under our umbrella. We are now a 501 c 3 non-profit corp.
We are open to all LGBT persons and their allies and there are no age restrictions or fees/dues. Our membership is open to anyone from anywhere around the Delaware County area: older, younger, male, female, transgendered, or straight ally. We have members from as far north as Mt Gilead, to south of Columbus and ranging in age from 22 years to 70 years old.. We have some kind of social event at least once, but usually twice a month in addition to any special events. The 2nd Friday of every month is game/cards night in Delaware, and the 3rd or 4th week is usually dinner out somewhere.
We participate in the Knox Co. Fair, Delaware Co. Fair, and Marion Popcorn Festival with booths and literature and a chance to get to meet the public as LGBT people who are out and proud. We held our annual Wine & Sign party the week before Pride and of-course we were in the parade (we had the rainbow poodles), and we marched in the 4th of July parade in Delaware. We've recently sponsored 2 speaking events at Beehive Books in Delaware; 1 was one of our members published in the "It Gets Better" book did a book signing and we had a panel discussion on Bullying, and the other was a lecture on spirituality versus religion titled "Faith on the Margins" with author Linda Mercadante. On June 8 we had the privledge of doing a 1 hour program on issues facing LGBT people for the diversity committee at the U.S. Southern District Federal Courts in Columbus with over 30 people attending (including 2 judges) and got rave reviews. You can find us greeting the public with a table and literature in front of Beehive Books on the Downtown Delaware's 'First Fridays'. You can see more about us at our website www.actoutdel.org or check us out on facebook. As you can see we have been very busy since our new group was formed in October of 2010 and our focus is now on advocacy, education and community building through social events.
Our up-coming special events include a day at the beach at Alum Creek August 20th, September is our Delaware Co. Fair booth from the 17th - 24th, October 29th we have a bonfire potluck Halloween Party in the country (great for ghost stories), In November is our annual Family Of Choice Thanksgiving Dinner followed by December's Christmas/Holiday Party. Watch for details either on our wesite or facebook, or you can contact us at bumblebeeismydog@yahoo.com.
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