"Girls will be boys and boys will be girls,
     It's a mixed-up, muddled-up, shook-up world..."
         - the Kinks, "Lola"

"I am a transsexual."

Like a gunshot in a canyon pass, those words reverberate across the landscape of a life, with a resonance extending far beyond their initial utterance. Similar to Alcoholics Anonymous, that simple phrase, signifying recognition and acknowledgment of one's condition, is not only the first step, but also the most difficult.

For Kelli M., born male, that recognition finally exploded--like a gunshot--on a mountaintop at Lake Tahoe. "I was attending a country-western show at Harvey's Resort on the final night of a week-long family vacation, and one of the show's featured performers was a female country singer. At a specific moment midway through the show I experienced an epiphany of sorts, when I realized, 'That should be me up there.' Not necessarily singing country music, but being that specific singer. A woman.

"I tucked this revelation away, aware my family--and definitely my girlfriend--wouldn't understand. I had no idea how to begin such a journey, having no ties whatsoever to the gay or transsexual communities."

Once back in her Ventura county home, and after a call to the Los Angeles Gay & Lesbian Community Center, she drove to Hollywood to pick up a copy of the gay-focused Community Yellow Pages, and began calling physicians in her quest for a doctor willing to start hormone therapy.

CH-CH-CH-CHANGES
In reality, Kelli's journey began years earlier--if not at birth, certainly somewhere in early childhood. But any discussion of transsexual issues must first define the terms.

A transsexual (TS) can theoretically include anyone manifesting any form of the clinical gender dysphoria. This includes crossdressers (CD) or the less-PC term transvestite (TV), a subculture of which includes the iconic and oft-satirized drag queen. CD's, TV's, and queens enjoy dressing as the opposite sex, and frequently receive sexual gratification or psychological release in doing so, although they have little to no interest in actually becoming their gender opposite. Several So. Cal. groups exist specifically for CD's to congregate safely and socially on a regular basis.

Those on hormones designed to alter their physical body to conform to their psychological identity, may be either Female-to-Male (F2M) or Male-to-Female (M2F). Among those engaged in such hormone replacement therapy (HRT) are the pre-op's, who have not had sex reassignment surgery (SRS), and the post-op's who have. There is disagreement even within the community whether the TS designation should be limited specifically to post-operative HRT individuals; thus from this alphabet soup emerged the umbrella term transgender (TG or simply T), currently the most accepted one-size-fits-all description of anyone living either full- or part-time as a member of the opposite sex. Finally, and rather sweetly, a TG (M2F) will distinguish themselves from a GG, or genetic girl.

For any TG engaged for more than a year or so in the tricky business of reinventing themselves, the actual physiological alterations induced by their HRT assume a secondary importance to the social and psychological aspects of man- or womanhood. "99% of it is life," said Lori M.

Nevertheless, from the outside looking in, these physical changes are often the most compelling aspect of the journey. "Chicks-with-dicks" videos maintain a prominent presence at any X-rated arcade, and transsexual hookers never wonder whether this month's rent will be paid.

So for the curious among us, here's how a boy becomes a girl (and vice-versa).

HRT for M2F's inevitably involves estrogen intake, usually Premarin pills, dosage from 2.5-5.0 mg/day. The estrogen provides breast growth, size customarily limited genetically to one or two cup sizes below mom's. The estrogen also softens the skin, redistributes body fat, makes body hair finer, and eventually produces a host of subtle psychological changes, from increased emotional sensitivity to greater social interaction. (One recent study determined women speak 25,000 words per day more than men).

Estrogen does not alter the vocal range, nor remove the beard. Some effects, like increased tenderness in the breasts, may begin to be felt after a few weeks, and most effects are completed in three to five years, though secondary effects may continue to be felt long afterward.

Estrogen is frequently taken in conjunction with an anti-androgen, such as aldactone or its generic equivalent spironolactone, typically at 100 mg/day. This drug acts as a testosterone suppressor--it is also prescribed as "chemical castration" for rapists since it severely reduces sexual libido. As a result, since one is rarely "in the mood," orgasms become much more unpredictable and difficult to achieve.

The penis becomes noticeably smaller, and after several weeks can no longer achieve spontaneous erection. Many changes are reversible, but after six months of HRT the M2F is permanently sterile. Erections of any sort ultimately become ineffective for intercourse, and eventually all sperm production ceases, though traditional male orgasm is still possible, sans ejaculation. Some M2F's report acquiring the ability to achieve "female" orgasm in conjunction with their normal "male" orgasm, experiencing multiple orgasms of varying degrees of intensity and duration. One M2F reported having three "female" orgasms in fifteen minutes, followed by her regular "male" orgasm (she reports after a male orgasm she still needs to roll over and go to sleep ...)

A wide range of alternative HRT, from injectable estrogen to Provera to exotic combinations of four and five drugs, may be prescribed by different physicians. No conclusive studies have been undertaken to determine the comparative efficacy of the differing treatments, so most physicians rely on some combination of medical information and personal experience for their HRT patients.

Beyond the HRT, the M2F typically has to undergo hundreds of hours of expensive and painful electrolysis for beard removal. Many also elect to undergo the risk and expense of extensive surgeries to feminize their facial characteristics or thin their vocal chords, and some choose breast implants or body resculpting to complete their female form.

The most important component of the non-binding Harry Benjamin Standards, instituted several years ago by a pioneer in transsexual medical research, states that a TG should live full-time in their opposite gender for one to two years, and be certified by two separate psychiatrists, before becoming an eligible candidate for SRS. Although one may presume this final surgery to be the goal of nearly every M2F, in reality perhaps as few as 10-20% ultimately undergo genital reconstruction.

For F2M's, the percentage who choose genital SRS may be even lower than that, and their road is very different. Testosterone is usually injected, and changes begin almost immediately. Within a couple of months the voice drops and beard growth is clearly visible. These changes are usually irreversible. A full mastectomy is a customary surgical procedure, and many also undergo a hysterectomy.

Ironically, though a baritone voice and full beard usually allow an F2M to "pass" virtually undetected in normal society, their hidden gender--genitals--proves much trickier to perfect. It can truly be said that only God can create a penis, and most F2M's choose not to undergo the crushing expense of a fleshy protuberance that often has no urethra and cannot achieve erection.

Beyond the surgical and hormonal changes, T's of either gender must "go to school" to learn how to walk, talk, and act with the demeanor of their new persona. How one presents oneself via body language, attitude, speech patterns, and a host of additional subliminal cues, plays a critically important part in social perception. Just perfecting their non-surgical M2F female voice is a grueling process replete with long months of falsetto more appropriate to Minnie Mouse than Heather Locklear. It's easy to see how this social reorientation can take years.

"It's like puberty, we're all 14 years old again," said Deni, "learning what to wear, how to sit, what phrases to use. It's a lot of work."

FROM LITTLE ACORNS
There is a growing sentiment within the psychiatric community that--as with gays--transsexuals are born, not made. Yet in spite of nearly unanimous awareness from their earliest memories of identifying with aspects of the opposite gender, most T's live in denial, carrying their "embarrassing secret" inside them for years.

"I knew I wanted to be a girl as far back as I can remember," said Dee L. "Instead of facing it, I became super-macho: lifted weights, played football, and served in the army for 14 and a half years."

Though certain specifics may vary, nearly every T spins a similar tale. "One of my acquaintances from the L.A. support group Androgyny is a lady named Millie, who transitioned at 65, and has never been happier," said Cathy W., leader of a Santa Barbara TG support group. "And two years ago I met a 70-year-old Santa Barbara man who was born a hermaphrodite, possessing both male and female genitalia. He started out as a female for the first few years of his life, when his parents decided he should live as a male. He resented this new gender identity being thrust upon him, but lived his next 60 years as a man. Finally, nearing age 70, with tears in his eyes, he revealed that he intended to return to his true self, a female. It was a very touching moment."

Dr. Richard L. Wulfsberg, of the Medical Group of Encino, has been involved with HRT for over two decades. "Most of my transsexual patients are in their late 30's, early 40's," he said. "It takes a lot of courage to finally admit who we are."

Understandably, this pattern of lifelong denial creates its own fallout among family and friends, who feel disappointed and betrayed when a TG does admit the truth. Many associates of M2F's cannot grasp why anyone would voluntarily give up the inherent privilege concomitant with White American Male, that elite group at the top of the food chain. It's especially hard for those who are married with a family.

"You make a family unit, then blow it all apart. You leave far more wreckage than suicide would have caused," said Cheryl, currently engaged in bitter divorce proceedings with his/her ex-wife, who is attempting to deny Cheryl all visitation rights to their two children ages 10 and 13. "I weep for my babies and feel sorrow for my wife. I pray she find a good, kind man that will take care of her."

Many people, especially those who knew T's in their former "birth" gender, mistakenly assume one awakens one day and "decides" to become the opposite gender. "There is no choice," said Deni. " I have known this about myself since the age of 5, and it has taken me over 40 years to come to terms with who I really am. I have over the years, built a wall of bricks made up of bits and pieces of what my family, friends, and peers saw on the outside. But I would rather die happy knowing who I am, than to live unhappy as someone that I'm not."

SEXUAL HEALING
According to Dr. Randi Ettner, clinical psychologist and author of the book Confessions of a Gender Defender, "Three to five percent of the population has some degree of this transgender condition. Most of them are closeted, though, for obvious reasons."

Could your boss even now be wearing the other gender's undergarment? How about your co-worker? Remember, during his decades as macho Head Honcho of the FBI, none suspected J. Edgar Hoover's penchant for panties. More recently, no one visualized Marv Albert in a bra. And Eddie Murphy's fondness for transsexuals is a secret long known within the T community that only recently entered public consciousness when he was questioned by the police for picking up a Hollywood TG hooker.

In practice 17 years, Marie Keller, M.F.C.C., founded the Los Angeles Gender Center eight years ago to provide counseling and therapy to the transgender community. With anywhere from 20 to 40 clients at any one time, the LAGC staff has treated hundreds of local T's over the years. "I've heard estimates anywhere from one in 30,000, to one in 100,000, transsexuals per general population," said Keller. "Of course, when one includes crossdressers or those with closeted gender issues, the estimates grow as large as one in 10."

The Ventura Gay & Lesbian Community Center is the home for weekly meetings of the Ventura TransGender Outreach (VTGO) support group, with over twenty participants in their active phone network and social calendar. For most of its members, it's not primarily about sex. Within the group nearly all were, or still are, married, in their struggle to live normal lives within the parameters of their birth gender.

"It bothers me when someone's first question is, 'Have you had the operation?' referring to SRS," said Cheryl. "Unless you want to sleep with me I don't know why my genitals should be an issue. No one else is asked to drop their drawers and prove it."

A recent article in Transgender Magazine described five categories of gender identity: (1) Biological--XX vs. XY; (2) Genital--what's between your legs; (3) Social--how you look when you go to the grocery; (4) Psychological--how you see yourself; and (5) Sexual--perhaps the most controversial, embracing the normal heterosexual pairing of women with men and vice-versa. Any individual, straight, gay, or "other," can have differing self-perceptions on any of these five gender-defining categories. Many T's often don't fully commit to either gender, grabbing perhaps two from Column A, three from Column B.

In her landmark book Gender Outlaw, author Kate Bornstein writes, "I don't know how to be a girl. And I sure don't know how to be a boy. And after 37 years of trying to be male and over eight years of trying to be female, I've come to the conclusion that neither is really worth all the trouble."

PASSING LANE
So? Did you know, when you picked up this Reporter, that those eyes staring back at you from the cover were born to a male body? And does it matter to you? Should it matter? The reality is, it does matter--a lot--to every TG trying to live successfully in the conservative social climate of 1990's America.

To most T's after transition, passing is everything. "The fear of being read as a transsexual weighs so heavily on an individual that it focuses even more attention on 'passing,'" writes Kate Bornstein in Gender Outlaw. "It's a conundrum, because more and better passing brings about an increased fear of being read. I know too many transsexuals who deny their lives as transsexuals for the sake of appearing 'normal.'"

But is it just internal paranoia, or some mythic quest to become a GG, that places such emphasis on a flawless female performance?

"This is the only group of people it's politically correct to mock," says Dr. Ettner. "There is no protection for these people under the Americans for Disability Act ... It's especially painful for the children. Our society tortures these children, and they're very damaged by that."

Any transgender who's lived even a few weeks in their new gender identity quickly becomes familiar with the pragmatic aspects of such discrimination. "As a musician, I was booked every week at a Ventura county restaurant for nearly two years--the owner said I was one of the two best performers she'd worked with in her twenty years of restaurant management," said Kelli M. "I had transitioned in all areas of my life except this gig. After meeting me and with her blessing, I finally transitioned there, at my last male outpost, showing up Friday night as Kelli. Just eight hours later I got fired by e-mail, with the invitation to continue if I'd show up as a male. I couldn't do it."

It's not just discrimination that forces some T's to distance themselves from their former lives. It's their own poignant psychological need to become, like Pinocchio, "a real boy (or girl)." The founder of the VTGO support group no longer attends any meetings, fearing her former TG associations might contaminate her current struggle to become a woman. And even though they'll never ovulate, several Ventura-area M2F's swear they get PMS regularly from the hormone therapy, hoping to capture as much of the authentic experience of womanhood as possible.

Unfortunately, even changing four of the five aforementioned defining gender characteristics still isn't sufficient to change every body cell from XX to XY, nor to erase one's own memory of another gender life or personal history.

"I worked in this flower shop for years," said Sara, post-op and married to a straight man for more than three years. "Even though I completely 'pass,' the owner discovered I was born a man, and immediately everyone in the store knew, customers and co-workers. I had to quit."

Francesca, an occasional visitor to L.A.'s Androgyny support group, is completely indiscernible as anything other than a genetic woman, having had SRS 15 years ago, at age 15, in her native Italy. A gorgeous, petite blonde who looks similar to Michelle Pfeiffer, she was engaged to a doctor--right up to the moment she revealed her past. She never heard from him again.

BUDDY, CAN YOU SPARE A DIME?
When one moves beyond the social pressures which stem from the censure of everyone from family and friends to total strangers--when one moves beyond the psychological pressure inherent in redefining one's gender to oneself--after all that, the biggest issues remaining for most TG's inevitably revolve around how to make a living.

Employers rarely leap at the opportunity to bring such a potentially disruptive force into their workplace, and many T's live the most meager of lifestyles during their transition and long afterward.

"I was called to provide the music for a Halloween party in Toluca Lake," said Kelli M. "I'd been their entertainment for each of the previous three years, and they said on their voicemail message to me they just couldn't do the party without my participation. Once I told them about my sex change I never heard from them again." She also lost her association with an agent she'd worked with for three years in Woodland Hills, and a company whose annual picnic she'd played for four years.

"Even though I'm still as talented as ever, have the same extensive musical gear, and the same 1000-song repertoire, I've lost thousands of dollars in gigs because no one who knew me before wants to book me now," she continued. "And I can't play the straight clubs, out of fear one of the customers might 'read' me and I'd not only get fired, I could get hurt."

Before she recently began her job as a bus driver, Wendy W. was unemployed for nearly three years. Previously a pastor at parishes in Ventura and L.A. counties, she discovered the church hierarchy was less than eager to support transsexual pastors.

Gene, a senior at Cal State Northridge working on her teaching credential, is currently a student teacher under her alternate choice for an instructor at an area school. "The director of the program assigned me a teacher, but she didn't want to work with me. Although it could have been for any number of reasons, I always wonder if it was because I'm transsexual."

Sometimes social rejection, set within these litigious times, may work in a T's favor. Lori M.'s Ventura Co. boss decided he'd rather see her leave, with four months' full severance pay, contingent upon her signing a five-page document promising no further legal action stemming from her dismissal.

Adding insult to injury, their frequent difficulty in earning a living is made worse by the massive expense of a gender journey. Hormones can cost $100 per month, excluding doctor visits; electrolysis can run into thousands of dollars; and as for surgery, forget about it. Factor in such significant incidentals as a whole new wardrobe, and it's easy to see why many struggle financially on their road to gender completion. No one ever said contentment came cheap.

On a positive note, there are companies who address this growing awareness of gender dysphoria by seizing upon their first association with a transgendered individual as an opportunity to institute new policies in the workplace. "In my job as a morning carrier for a local newspaper, I got a call from the supervisor responding to a 'transition letter' I'd sent," said Kelli M. "He told me he'd scheduled a meeting with their human resources department to discuss ways to avoid sexual harassment in general, and the most effective approach to my situation specifically. I was grateful he'd take the time to respond in such a caring fashion."

Deni H. has worked as an east Ventura Co. postal carrier for more than 13 years. "I was sure I could never transition here, I just didn't think the community or my co-workers were ready for it. Imagine my surprise when the postmaster made 300 copies of my letter explaining my transition, and distributed them to every single person who worked there. He also started a series of small group meetings to address my situation, and so far everyone's been great."

GENDER PILGRIMS
As we've seen, the question isn't "Why do they do it?" By now, it's clear that it's not a choice. Rather, the question should be, "Is it worth it?" TG's pay a heavy price, including loss of family and friends, unemployment, and relentless social embarrassment, for the ultimate trophy of plus-or-minus an "S" in front of their "he" pronoun.

"It's like cancer," said Dee L. "No one chooses to get cancer. But once it's a part of your life, you're pretty much forced into the chemotherapy. The cure may seem almost as bad as the disease, but in reality it's your salvation."

And, as in cancer, if you're ever lucky enough to achieve remission--or for a T, transition--your life acquires a patina previously unknown. "As scary as it is, I feel as though I am completing myself," said Deni H., "a self-fulfillment that fills my entire being with a love and happiness I never in my wildest dreams could have expected to happen to me!"

They are pioneers across an unfamiliar wilderness, growing in visibility but still so far from acceptance. Indian cultures revered their berdache, that unique member of the community who manifested both genders. One legend tells of placing a bow and arrow on one side, and a weaving basket on the other, outside the teepee. The child's choice of tools determined their life's gender.

Dr. Ettner says, "The Europeans don't [discriminate], these people have dignity, they're protected under the law." We're still a long way from such reverence in this culture.

I know firsthand, how far we as a people have yet to grow toward understanding and acceptance of gender idiosyncrasy. From my own personal journey, I know the pain, and the struggles, and the joy. You see, besides being the author of this piece, I am Kelli M. I am the face on the cover.

I am a transsexual.

BREASTS DON'T GROW ON TREES, Y'KNOW
Following are approximate costs of various surgical procedures. Costs vary widely based on individual surgeon and geographic region:

Facial
Rhinoplasty - $4-9,000
Facelift - $5-15,000
Coronal Lift - $3-4,000
Upper/lower eyelids - $2-4,000 each pair
Brow lift - $2,000
Brow bone resculpting - $2,000
Cheek implants - $3-5,000
Chin implant - $3,000
Lip augmentation - $2-3,000
Submental liposuction - $1,500
Dermabrasion - $2-4,000
Laser resurfacing - $2-5,000

Body
Breast augmentation - $4-8,000
Mastectomy/reconstruction - $4-8,000
Abdominoplasty (tummy tuck) - $3-6,000

Gender-Specific
Vocal surgery (M2F) - $8-20,000
genital (M2F) - $8-12,000
    (invert penis to form vagina)
Hysterectomy (F2M) - $8-25,000
genital (F2M) - $50,000-$120,000
    (Metaoidoiplasty and phalloplasty are the two major phallus procedures; sometimes but not always done in conjunction with vaginectomy, scrotoplasty [testicular implants], and urethoplasty.)

Costs from Nips & Tucks by Diana Barry, Kelli M.-M2F, and Jacob Hale-F2M.

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