Advice over Sex Change Op for Cousin

I'm sure someone else with some first hand experience will jump in here.

What I will say is that it is unlikely that any surgeon will perform any operation without being sure that this is the right thing for your cousin. And they will determine that based on counselling and assessments. I believe (perhaps from watching a documentary on the topic) that transgender people are encouraged to start living / presenting themselves as their gender (as opposed to how they were born) for some time before any kind of surgery will be performed. Hormone therapy would likely come next, and only after all that would there be an operation - if your cousin was still interested.

So I would suggest being as supportive as possible, and encouraging them to start into counselling with someone who specializes in this area. They will need LOTS of support and understanding, because that must be one of the most difficult things for a person to do. If your cousin feels that strongly about it, then that is likely what they need to do.

Just like someone like me coming out as gay - saying that I'm attracted to the same sex - for some people that sounds silly, like I'm making a mistake, like I'm just seeking attention. That I can't possibly know what I really want. But that's because they aren't gay, and haven't walked a mile in my shoes.

Likewise, when a transgender person comes forward and says who they really are, it isn't going to be based on a whim. They will have agonized over it themselves. I would tend to believe them, and give them the support that they need.

 

(1) Yes, you are right in asking him to wait a bit longer. Although his parents have no legal claim anymore, the tendency to change one's mind and mood during age 25 and less is too great to pursue such an enormous change.

Some people might quote that marriage is granted very early in life, but that legal contract can be amended and changed, whereas a surgery cannot.

(2) "When there's a will, there's a way." If he is determined, he'll find a way to pursue this surgery regardless of any objections or actions you take otherwise. My best suggestion is to try and talk to him-- understand his passion for it. Maybe then, by understanding him more, you'll be (A) more comfortable with his desire for change and (B) be able to voice your thoughts on it, too.

Although I am not promoting this, his parents could merely remove him from their insurance. Numerous, frivolous health procedures are allowed for a child who is on their parent's insurance (weight loss, for example). But I would consider this an absolute worst-case scenario option and it'd bring more trouble than good.

 

OP, could you clarify a few points?

1) Does your cousin identify as a woman?
2) Do they present as female/ have tried to be not been allowed to/ want to upon entering college?
3) They have been asking for SRS for 3 years; have they ever specified why?

While awaiting reply, I will ease your concerns by informing you that they will have to wait a minimum of about 1.5 years anyway. You can't just drive to the doctor and have SRS! The protocol is as follows:

- See a counselor; at some point (usually within a few months but can take longer), counselor prescribes hormones
- After a maybe 6 mos - year on hormones, counselor/ doc may give letter for breast augmentation; 2 docs may prove letter for an orchiectomy but this can also be postponed and completed during penectomy/ vaginoplasty.
- After a MINIMUM of 1 year on hormones AND living full time as female, 2 doctors may sign off on SRS (last two surgeries above +/ - orchiectomy)

None of these decisions are made lightly so, there's no reason to worry too much yet. But I will point out that SRS is performed on 18 year olds, and it's fine if they're really sure.

 

In the UK, it's 2 years of Real Life Experience (presenting as female, full time, in this case) before they'll do any SRS. Plus you have all the counselling and blood tests and such beforehand!

 

As people have said, SRS is not an instant process, and it's most likely a decision that they made long before telling any of you, not a whim. Also, I know that there is definitely a lot of improvement at making long term decisions with age, but that doesn't mean that younger people are any less qualified to make important decisions about their life simply because they are young. If your cousin has come forward with this, I would have a lot of issues with people telling them that their preferences for their own life choices don't matter. Your cousin is 18, that should be old enough to make this kind of decision carefully for themselves.

Another thing that I might add is that if your cousin does ultimately end up going through with this, (I'm assuming that since you keep referring to them as male that they're biologically male? But please correct me if I've gotten that wrong.) MtF surgery is more effective earlier, since unlike estrogen, testosterone changes the body in more permanent ways. The less time she has been exposed to testosterone, the better she will "pass" as her preferred gender later in life. This is probably something she is worried about, which could at least partly explain why it seems like such a sudden whim to the rest of you.

 

I'll echo what others have said here - there's quite the process to be followed for SRS, you can't just turn up at the doctor one day and have it done the next. I'm lucky enough that my insurance will cover it (though I'm not trans*), but in the literature for the insurance they dedicate an entire page to the conditions for coverage, and they include living full-time as the other gender for a period of a year, without reverting to the gender assigned at birth, counseling, a recommendation by a second mental health professional, hormone therapy, and probably some that I'm forgetting right now.

From what you said, it doesn't sound like this is the case - it seems that they are presenting as both male and female. The counseling that's required as well might resolve some of that, perhaps there's an amount of shame in being trans* that just can't be overcome. We have trans* members of the staff that have gone through several identity changes on the way to them realizing that they are fully trans*, but I'm sure they'll chime in here.

One thing that I would do is to avoid stereotypes. Simply because your cousin is interested in certain sports, etc does not necessarily mean that they are male - there are plenty of females that are interested in similar things. One of our staff members here is a transwoman who works in computer security, a traditionally male dominated profession. I'm not going to deny her her identity simply because "oh, that's a male thing to do!!!". The same applies to sports or pretty much any other field - just because something is male dominated does not mean that females (both cis and trans) cannot and do not participate in it. In fact, a Navy SEAL came out as transgender after she left the military. Bardley Manning, the Army private that leaked data to WikiLeaks, is really Chelsea Manning. These anecdotes are meant to say that simply because something is dominated by cisgendered males, don't think that either trans or cis women can't do them as well.

The best thing that I can say for your cousin right now is to support them in the best manner possible, and perhaps even refer them to this website. There's a trove of people here that can help assist them in what they are going through (yes, I'm very intentionally using gender neutral pronouns), including finding out if they truly desire to be perceived by the world as female.

 

A lot of really great advice given. Just a small thing I wanted to add. This is going to be hard to write, but I think it will be invaluable for you and people in your shoes. When I went through the Navy, my drink of choice was either whiskey neat or Guinness, I'd been in 3 fist fights - one of them resulted in my being moved to another command - I lifted weights, I was a firefighter for a living, and even though it killed me inside in ways I can't begin to describe here - please excuse my bad language, it doesn't reflect the Navy's core values anyway but I was literally a sailor - I was a misogynistic homophobic asshole a lot of the time. I was still a lot more open minded than a lot of my shipmates, but I went a long way to hide who I was.

Even after I'd admitted everything to myself, I was not the effeminate kid I was at 12 right after coming out. I thought when I stopped acting, and just started letting me be me, that all that stuff would come back. What I learned is that some of it did, sure, but I missed out on all the important development that women go through in their pre-teens and teens. It's really unfortunate, but we don't get a handbook. And even if we did, it would be how to be stereotypically female - which I did do for a while while my wings were drying so to speak - not how to be you. Womanhood is a form of adulthood, and adulthood only comes from experience.

I'm hoping just to give you some "inside experience". If your cousin is a transsexual, they might not be able to act feminine. Some of being a woman is natural.

And by the way those natural parts never went away. They caused me no end of problems when I tried to have a "normal" relationship with a woman that ended up being completely unfair to both of us and ended up in a painful break up after being engaged for 5 years and 1 year before I would have followed through with the marriage.

You are right about needing to be a responsible adult. I was 18 once too. We know what we were like. I'm really glad your cousin has you Just the same, the consequences of my waiting until I was 32 to start transitioning were severe and incredibly painful.

But a lot about being a woman, is about not being a child. That's what this last year has been for me, me going through the pain of growing up all over again. And I'm not done yet. I still get overwhelmed by all my new emotions sometimes, and end up in situations that I just do not have the slightest clue how to deal with.

Everyone else has said that transition is not just the surgery. And that is completely true. I'm hoping with everything everyone else has said, and I have said, you have a clearer picture of what is involved. As a responsible adult in your cousin's life, if they do decide to go through the transition process, I know it must have been painful to watch them over the last 8 years, and the thought of watching all that all over again compressed is probably not fun. But I really think you have a good head on your shoulders, just from the concerns you raised here. And I think given that, your cousin will come out just fine.

 

Well just something else to consider, but it's not just what's on the outside. Everyone's body makes two kinds of "drugs", and we're all "hooked" on one or the other from birth. Testosterone and estrogen. We have no choice but to take 'em. They affect every single part of your body. Every sex difference is because of these drugs. Everyone's genitals are the same stuff, just exposed to different hormones.

And the one part of the body with more hormone receptors than anywhere else? The brain.

We know if someone is not transsexual transitions, it's bad news for them, and they usually feel terrible and want to switch back as soon as possible. That's no matter what their outsides look like. That's the position a transsexual starts out in.

Being body positive is important. So is being secure and happy with who you are. But... this is at a deeper level. This is like trying to go without sleep for days at a time. When I was in the military, I had to be secure and happy with the knowledge I'd be operating on 2 hours of sleep a night. I ended up having a positive outlook on the situation. But that doesn't mean it was healthy.

 

I don't know what it means to act "like a guy" or "like a girl." There's really not much difference in my perspective, but maybe that has something to do with my orientation. :lol: But what it comes down to for genderqueer people is how they feel, in the end.

I'm glad you're being so supportive of your cousin, even though what they're going through is not something you have a lot of understanding about at the moment. =) That's truly wonderful of you!

 

Really ask me anything

And something else, I am really not here to be preachy. I will be the first to admit it's possible a transsexual transition is not right for your cousin. I think I need to say that up front; I'm not trying to "win you over". I'm just here to help. If you walk away understanding things better, I have done my job no matter what you decide.

So something else. I have actually wanted to like boys. There was a time it would have made me feel more "normal". But I can't. My sexuality isn't fluid. I like some things about boys, I'm not one of those "boys are icky" lesbians. I like when they hit on me for one thing :icon_redf But yeah, clothes come off, sex shuts down. It's just the way it is. I just need... I don't know. Kind of a sameness? Something about being with another woman.

I know it's confusing because I said I had to leave a straight relationship. The fact is I can't really... do things the "boy way" if you catch my meaning. Really anything with that part of me kind of sucks. And straight women really need something I can't give them. So yeah, there was about one sex act that worked for us, and it was one sided.

But I am totally comfortable answering as though I liked boys. It's actually a lot easier from this perspective. You know the truth is, some of us do find happiness and solace as gay men, and don't transition. I have a few friends myself that went down that path. I have considered myself what it would be like to have a husband. It would make me feel more like a woman, and that validation would be really nice.

I think that situation would get rid of one of the biggest reasons for my decision. See, I have life goals. I went to college. I want to be able to focus on work. I'm actually a pretty ambitious person. Maybe it's crazy in this day and age, but I am trying to start a non-profit business. If it fails or succeeds I tried, that's kind of the attitude I have.

So the thing is... in order to really do any of those things, I can't be fighting myself half the time. I tried for a really, really long time. I would just kind of... keep everything out of the way. I lived a double life. I was very quiet and not social at all by day. By night I would be ashamed and crying, but at the same time, relieved. Every day was an exhausting act, every night was a mix of taking the weight of the world off my shoulders and wondering why I was this way.

I think there are some trans women, that aren't as ambitious as me, that can get into the "kept woman" lifestyle. They have validation at home. I'm sure it has happened at least once or twice.

That said, I think it's rare. Partly because, boy hormones make me feel like absolute ass. Pretty much everything about them. When my adreneline goes up... a personal problem I have some mornings or when I'm next to an attractive woman. Basically everything, it's coupled with this really draining, hopeless, wrong feeling.

I'm not saying your cousin feels all these things. I'm not in your cousin's head. This is just me trying to explain some things about me. Sorry also that I tend to get long winded.

But yeah, living this, I really feel like a lot of people in my shoes, they're only going to be able to do this for so long before they have to change something in their lives.

---------- Post added 24th Apr 2014 at 05:39 PM ----------

Just to let you know, if I don't reply tonight, I have a friend whose band is playing their first show tonight. I am totally not ignoring you. But please feel free to PM me if you have anything else. You can PM me since I'm an adviser and those go to my e-mail. I promise to get back to you as soon as I can

You are such a great cousin by the way!

 

Based on what I am reading, your cousin is a woman. That's why she wants the sex reassignment. I know it may be difficult for you, but I hope you can maybe think of your cousin as a woman even though her body is male. Her mind is that of a woman. And it appears to me that she's straight. (Meaning, that, as a woman she's interested in men, that is, she's straight.)

I can understand your concern about sex reassignment surgery. Surgeries of any kind should not be undertaken lightly. However, if your cousin has been asking for years, it's safe to say that she's not having fleeting thoughts, and this has been on her mind for some time now.

I think you need to give her a little bit more credit for knowing who she is and what she wants for herself. Your love is strong, but I humbly submit that your protectiveness is a little misplaced here.

I think that your dilemma is solved here by simply engaging with her and supporting her decision if she ultimately begins gender therapy.

 

It sounds like he is going through some gender confusion. Just how serious is he when he says he wants sex reassignment surgery? Has he given a reason why he said he wanted it? Based on what you've said, he could just be a gay male with a femme presentation, that could be why he identifies and presents as both male and female.

 

I don't get that sense at all. She seems to be pretty clear about who she is.

 

So by the way I am home.

While I have my own suspicions, I don't think sharing "could be" scenarios with the OP is going to be very helpful. I don't know if you have heard me rant about what I call the "why don't you justs" before, but when I do, this is basically what it is. Even when it's correct, it still sucks hearing everyone's theories. You know my mom, when I came out to her, suggested I might be two spirit? Worse, and I am not trying to make either of you feel bad, it's just a coincidence and the way it comes off, people always work personal experience in.

The fact is that the OP's cousin is the only person on Earth who can tell us whether the OP's cousin is trans. We can't very well ask the OP to give his cousin some space if we aren't doing the same thing.

I really want to be respectful to both of you because you've given some really great advice. Just, this is kind of a pet peeve of mine. It almost always gets in the way of self discovery, or people having the room they need for self discovery.

 

Sorry, I wasn't trying to give a "could be" scenario, I was just trying to analyze and get more information, not put forth a "this is definitely what's going on" assertion, because there really isn't enough information to go on here. The cousin is not even here to speak for himself.

Just speaking from personal experience, having gone through periods of severe gender confusion, although the thought of SRS always scared the hell out of me. However I ultimately settled on being a gay male-sexed person with femme presentation, it was my mother who probably triggered my confusion by telling everyone she knew that I was transgender "like Chaz Bono" just because I wore girls pink leggings, I had to address this issue so many times with family members and family friends that it had me questioning my own gender identity. So I do think it can definitely be damaging to speculate on someone else's identity, and only make them more confused about who they are.

So my advice to the OP is definitely not to jump to conclusions one way or the other or speculate too much about her cousin's gender identity, let her cousin work through these issues on his own, give support and advice if asked. I think it's extremely premature and ill-advised to jump to the conclusion "your cousin is a woman" based on what little second-hand info we have about him provided in this thread. There's nothing "pretty clear" about this situation.