Trans 101

(Please be advised, the following post contains a graphic discussion of sexual anatomy.)

Testosterone acts swiftly and dramatically on a female body. My first shot a week before my bike accident had been a measly one cc--one cubic centimeter--of Testosterone Enanthate, a thick, transparent suspension of synthetic testosterone in sesame oil. The nurse who injected me was so quick and painless about it, I wondered afterwards if she'd done it right.

I didn't wonder for long. My shot was on Tuesday and I woke up Thursday morning to find the center of my consciousness had shifted in the night from my head to my crotch--where it has resided ever since. My sex-drive increased overnight by a factor of ten. It has waxed and waned in intervening years, but the constant, visceral focus of my attention on my genitals hasn't.

This is pretty similar to how my male friends describe their feelings.

Biologically, the penis is homologous to the clitoris, meaning that as a fetus grows in the womb, the same group of cells develops to form either a clitoris or a penis, either outer labia or a scrotum, depending on a series of complex hormonal signals and processes. Another way to think of it is that a penis is sort of a very large clitoris--large essentially as a result of the presence of testosterone during fetal development. If you add testosterone to the mix later in life, like I did, the potential for growth—while far less—still exists.

Despite everyone’s original "bisexual" potential, most babies are born with a clitoris, vagina and two ovaries, or a penis, scrotum and two testicles. At the same time, a large number—1 in 2,000, by some estimates—are born "intersexed." They could be seen to have, say, a small penis with a split, empty scrotum, or an enormous clitoris with pendulous outer labia. Internally, they may have a vagina and womb, or not; ovaries or testes, an ovary on one side and a testes on the other, or even what are called ovotestes--a blend of both. Their gender identity—whether they feel like a girl or a boy—can be one, the other, or neither.

Another term for a non-standard mix of sexual characteristics is "hermaphrodite." Unfortunately, modern medicine usually responds to these births as "medical emergencies," surgically altering the infants to cosmetically approximate one sex or the other.

Among other things, the surgery often damages the person’s sexual potential later in life. Not operating—as intersexed activists advocate--is not life-threatening. The real challenge posed by the presence of hermaphrodites is to the fallacy (“phallacy?”) that there are two--and only two--sexes. Their very existence belies this.

So, how does all this fit in with transsexuality?

No one really knows for sure. One theory states that in addition to genitalia, a fetus' brain develops along a female or male pathway in response to hormones. In this way, transsexuality could be viewed as a sort of "neurological intersexuality."

For example, if a woman pregnant with an XX (female) fetus is prescribed a medication containing a masculinizing hormone (or “androgen”) during the first trimester, the probability is increased that her "female" baby will be born with genitals approximating a small penis and empty scrotum. A sort of real-life test of this was accidentally performed in the 1950's and 60's when widespread and misguided use of the androgen progesterone (to prevent miscarriages) led to a documented increase in intersexed births.

In a possible transsexual scenario, the androgen would be given after the 16th week of gestation, when the baby’s external genitalia are formed but before the neurological pathways in the brain are fully developed. The newborn would look physically female but grow up to feel mentally and emotionally male.

Like me.

Of course, this explanation for female-to-male transsexuality is only a theory. And it ignores the effects of genetics, environment, and other factors.

My father remembers that my mother was prescribed a medication while pregnant with me. On more than four previous occasions, she had miscarried or given birth only to have the newborn die. My father doesn't remember what medication, when she started, or how long she took it. But I was born in the era when the synthetic hormone, diethylstilbestrol (DES), often in combination with progesterone, was the drug of choice to avert miscarriage.

Growing up, I had no words to describe my identity struggle. Over time, I came to understand in an inarticulate way that it stemmed from the shape of my body, particularly my genitals. My response was to conclude that some boys had penises and some didn’t, and I was one of the ones who didn’t.

Unusual, you say? Well, scientists who study the formation of gender-identity say that very young children believe what makes a person a boy or a girl are clear, simple indicators, such as short or long hair, pants or a dress, heavy boots or delicate high heels, and to a lesser extend, inclinations, like a passion for rugby and monster trucks or an interest in dollies and tea-parties. Children know about penises and vaginas, but consider them unimportant to gender. Irrelevant, in the face of a person’s long braids or buzz-cut, interest in Barbie or passion for football.

I like to think I never outgrew this primary, elegantly simple stage.

Physically, I was a small-boned but strong and wiry child. With short-cropped, white-blond hair and striking blue-green eyes, I was scrappy and unafraid to take on even larger boys if provoked.

But I didn’t know what sex to call myself. Under pressure from society, I forced the belief that I was a boy without a penis into my subconscious, where it lay forgotten for almost 30 years.

It came back to me in an odd way. A day after visiting a "clothing-optional" beach in San Diego, I was working at a computer terminal thinking back on the succession of nude men I’d seen, displayed along the beach on colorful towels like assorted canapés. My friend and I had been strolling along the gay section and the Southern California aesthetic of male beauty—tan, lean bodies with cut, gym-toned torsos—had been very much in evidence.

And every one of them had a penis. Reflecting back, I realized I'd registered surprise each and every time. Come to think of it, I did the same in locker rooms—in fact, every time I encountered a naked man with a penis, I felt surprise.

What was going on? Men have penises, that's a basic operating principle of society--some would say of “nature.” Why, then, should I be surprised to see the principle in action?

Because, I thought, I don't believe it. I don't equate penises with manhood. That’s the moment I realized that all my life, I had believed some boys had them and some didn't. Deep down, I had cherished the hope that one day, society would come to realize what a meaningless measure of manhood a penis really is.

In the meantime, I’d never stopped looking for others like me. Eventually, I found them, though it took many more years and was in a different form than I’d originally imagined as a child.