Michael Laurence Dillon, world's first known FTM.

Pride week in Dublin....

I’m scheduled to give a brief talk on transsexual health issues with an MTF friend on Thursday here. (On my lunch break from my corporate job and unbeknownst to my bosses at he bank!) To be followed by a question-and-answer period.

A lot of people don’t realize that sexual orientation is totally separate from gender identity. Thus, while transgendered folks and issues generally get lumped under the LGB banner, the grouping makes further sense because regardless of a person’s sexual-orientation before transition, afterwards trans folks can end up as straight, gay, queer, or bi.

Kinda like the rest of humanity.

Another little known fact is that the first FTM known to employ hormone therapy and surgery was Irish . Michael Laurence Dillon, born Laura Maud Dillon in 1915 in London, the daughter of Robert Dillon of Lismullen, County Meath. Entered Trinity College Medical School in 1945 and graduated in 1951. He practiced medicine at sea and was eventually outed because Burke’s Peerage refused to change his name and sex in their listing so that he could be identified as next in line to his childless brother to inherit their family's title. A reporter stumbled on the information and published a story about his sex-change. So the story goes, Michael was so mortified that he left Ireland and moved to India, where he joined a monastery, was ordained in Tibetan Buddhism and died in a monastery in 1962, at the young age of 47.

So I'm following in a proud Irish FTM tradition.

Another fact. “Lower” or genital surgery is problematic for FTM’s. It’s prohibitively expensive, carries a high risk of sexual or urinary problems afterwards, and offers poor “cosmetic” results.

Therefore, many—perhaps even most—FTMs at this time chose to skip it. We will undergo a double-mastectomy or cosmetic surgery to reduce breast size and re-sculpt our chest. And we'll inject testosterone to produce secondary sexual characteristics. The testosterone works very well, as you can see by my photo. Which means that FTMs can end up living long lives as men without penises. Which has profound implications for healthcare and our sexual lives.

Among other things it may mean that a person looks like me, but has to seek gynecological care. This, naturally, is something we’d much rather avoid. But avoidance could, in a worst case scenario, cost us our lives, as routine pap-smears can detect cervical cancer early enough to successfully treat it.

In the past, females who cross-lived sometimes died rather than seek out medical care for curable health problems. Being outed, apparently, was considered a fate worse than death. One famous example was jazz musician, Billy Tipton. Born one year before Michael Dillon, in 1914 in the US, he cross-lived his entire adult life. He was married five times, told each of his wives that he had been in a grave car accident that had left him with genital disfigurement and sterility, and so they apparently never saw him naked nor had sexual intercourse. He adopted three boys. Only his parents, brother, and cousins knew he had been born female.

In 1989, Billy suffered from hemorrhaging ulcers and refused to call a doctor. After his death, the coroner told his family the truth of his biological sex. None of his adopted sons, ex-wives, associates or band members have ever admitted to previously knowing he was born female.

In my own case, I always come out to my doctors. I do this as a matter of principle: I feel it’s both good for them to understand that life isn’t necessarily so black and white as they might think, and it’s important for me to get the best healthcare possible. It's sometimes an unnerving experience. A few times, the doctor or nurse has been so visibly flummoxed by my revelation that they’ve been obviously too distracted to give me even the most basic care. Luckily, this has never occurred in the context of a critical emergency—and I sincerely hope it never does.

But imagine if a person like me has a serious accident, one that renders us unconscious. We’ll be there helpless and in need of medical help and the doctor or nurse will be confronted with a person who looks male, but who was clearly born female. This is a scenario that freaks me out and one reason I feel it’s so important to educate medical care providers that we're out there.

The closest I came to this scenario was a bad bicycle accident I had. I was knocked unconscious for about 10 or 15 minutes, but luckily, I’d only started testosterone a week before. So though I looked very gender ambiguous, with short hair and men’s clothing, I’d had no surgery yet and was still without a beard and chest hair. So the nurses found no big surprise under my clothing.

The situation now would be very different.