Living Full Time vs Trying To Live Full Time

This is another post challenging some of Walt Heyer's rubric about his failed transition.

In this post, I'm going to take apart and analyse Heyer's own narrative about his life as Laura a piece at a time, and expose the glaringly obvious problems that contributed enormously to the outcome of his attempt to transition, and explain why Heyer is not an example of typical transitions.

A big part of the motivation for writing this post comes from the following doozy of a comment on his blog:

The key quotes I present will be taken from Walt's own autobiography Trading My Sorrows, Kindle Edition.


Hmmm...so at four years, he was pretty positive about the outcome of his surgery?  I'm not so sure about that.  In fact, about the only time he seems even remotely happy about the outcome of his surgery is when he woke up in the recovery room after surgery.  It all pretty much seems to go downhill from there if I understand his narrative correctly:

Sometimes it feels like the "anti-trans" crowd is like a broken record, making the most assinine claims over and over as if repeating their lies will somehow grant them a degree of truth.

Over at Mr. Heyer's blog of "my failed transition means nobody else should transition", we find him arguing Hormone Blockers -- Criminal Experimentation, and getting it dead wrong.

Walt Heyer: No Discussions For You

Apparently Mr. Heyer isn't interested in actually discussing his views.  I took the time to make it over to his blog and responded to his post So Many Different Issues Drive The Transgender To Surgery, and pointed out how wrong he was to infer from a Swedish study that increased rates of mental health issues among transsexuals meant that transition and GRS were an inappropriate treatment.

He deigned to allow the first couple of comments to stay, but after that he has just been deleting them.  As shown below.

Step 1, add new comment:

Step 2:  An hour later note that the commment has been removed:

Roughly translated, like most other anti-trans wingnuts, Walt Heyer cannot, and will not discuss the problems with how they are mangling data when it doesn't suit their particular dogma.

Stunning ... or Stunned? You Decide!

In a pattern consistent with the anti-gay junk science of Paul Cameron, we find Walt Heyer grossly misconstruing two important studies in the last couple of years about transsexuals.

A recent Swedish study reports that having gender surgery increases suicide attempts and lowers the quality of life. It also points to increased occurrence of psychiatric issues and depression after sex change surgery. This research allows us to claim that changing genders is frequently more folly than effective treatment for the wide range of gender issues that do exist.

Shall we go take a closer look at what that Swedish study actually says?  Looking at the study in more detail, it claims that suicide among post-op transsexuals is approximately 19 times higher than in the general population.  That's bad - very bad by any measure. 

However, before we go diving off the deep end, let's examine the raw numbers a bit further, because they are very informative.

The Swedish study covers a very long period of time, from 1973 to 2003 - healthy thirty year period which is good for a longitudinal study like this.

Of these, we find that 10 of the patients tracked committed suicide in that thirty year period.  That is 10 out of a total population of 324 - approximately 3% of the transgender population.

If we go a step or two further, and look at suicide attempts as well as suicides, we have a total count of 39 out of 324 or 12%.

Both of these are disturbingly high numbers, but frankly any suicide is tragic, and deserves to be addressed.

However, that's nowhere near the brutal numbers of suicide attempts recorded by the NTDS Report on transgender health released in 2010.  (Unlike Heyer, who merely links to an MSNBC report on the study, I've linked to the study's download page so you can look for yourself)

When asked “have you ever attempted suicide?” 41% of respondents answered yes. 

Intriguingly, the Swedish study actually demonstrates a significant drop in the overall suicide rate compared to the raw data of the NTDS report.  Please recognize that the NTDS report didn't specifically study transsexuals, but rather the entire spectrum of transgender people, so we can't quite make an "apples to apples" comparison, but the numbers are interesting when compared with each other, since the NTDS study would include both pre and post operative trans people.

Heyer concludes that surgery is not a solution for transsexuals.  The Swedes are much more measured in their assessment, concluding that surgery alleviates the gender dysphoria aspects of transsexualism, but does not address other issues that the transsexual may be facing.

Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group.

While Heyer is quick to leap to conclusions that suit his agenda, they aren't really borne out by reading the studies that he is referring to.  He then goes on to claim that transsexuals suffer from a whole host of other conditions, and that the referring professionals are being negligent in their conduct:

Transgenders suffer from psychiatric issues ranging from dissociative disorders, separation anxiety to full blown delusional disorders. I don’t fault the individuals who suffer and eventually request the life changing surgery. In my view, the responsibility lies with the surgeons and approving psychologists, unqualified and unfit, who do not care about the long-term results of changing genders. The approving psychologists in too many cases are more about giving the wanna-be transgender anything he or she wants, than in providing effective diagnosis and treatment for real psychiatric disorders.

Yes, there may be comorbid conditions that the transsexual is suffering from in parallel with the gender identity issues.  A carefully executed transition will include dealing with those additional conditions.  Long term follow-up post-transition, post-surgery is also a valuable support, as transsexuals do face significant discrimination pressures in the world.

The real issue is one of dealing with the social hostility and discrimination that transgender, and especially transsexual, people face on a daily basis just living their lives.  The NTDS report is quite clear about the higher levels of stress and discrimination that transgender people face in society, and it isn't exactly rocket science to understand the connection between discrimination, economic and social, and suicide attempts.

Wherein Walt Heyer Attempts To Invalidate Transsexuals In One Paragraph

I'll give Heyer this much - on the whole, he has tried to stay out of the usual language of invalidation and erasure that is so common among those who claim transsexuals are less than human.  However, somewhere along the way, he must have decided that he couldn't turn down the opportunity and makes the following statement:

It's easy to point out that DNA tells the true story of male or female.  In a court of law, you can convict a man of rape and murder just on the strength of a DNA test alone.  But a DNA test is never permitted to determine male or female sex gender for transsexuals in court?  Why is this?  Because a DNA test would prove with absolute certainty the transgender hormone therapy and surgery had failed to change a male into a female, or a female to a male.  Transgender activists know using DNA would expose the fraud and damage the social acceptability of changing genders.  Therefore, they have successfully prevented DNA from being used as the criteria to identify gender in the courts.

Wow.  Just Wow.  In one paragraph, Heyer has claimed that transsexuals are engaging in deliberate fraud, and on the other hand, the transsexuals out there are so astonishingly powerful politically that they have been able to stop the courts from using a particular piece of evidence to determine sex.

I'd love to know where this all powerful transsexual lobby is.  You'd think that it would be paying more attention to shutting down the malice and discrimination that transsexuals face on a near daily basis.  Further, I'm more than a little mystified how a tiny minority of the population which isn't terribly wealthy could hold that kind of clout.

Ah well.  I'm going to chalk that one up to being the fanciful musings of someone who lacks any coherent evidence to explain things more rationally.

Looking at his other claim about DNA, however, requires a little more careful handling.

First of all, Mr. Heyer is really referring to chromosomes and specifically Sex Chromosomes.  Men have XY chromosomes, and women have XX chromosomes.  Or so the general rule goes.  Sadly, general rules are prone to strange little things called exceptions.  Consider women born with Complete Androgen Insensitivity Syndrome  for a moment.  A woman born with CAIS has a Y chromosome, and yet developed in utero a female body.  To all outward appearances, and socialization, these people are women even though they have a Y chromosome. 

No doubt, Mr. Heyer would claim that an exception could be made in such a situation, after all the person had been born female.  (or was declared female at birth, more correctly)  His argument would be that such cases are so rare as to be irrelevant, or some such.  How rarity of a condition fits into dealing with transsexuals is a bit of a mystery to me - it's not like transsexualism constitutes a very large portion of the population to begin with, so making exceptions based on rarity seems a trifle ridiculous.

My underlying point is that there are very real conditions which Mr. Heyer's test would not work for, and these are people who are not transsexual themselves.

However, as other writers have pointed out, there is a great deal of evidence emerging that suggests that transsexuality may well have significant biological factors which influence it.  If you are going to make an exception for one case, why would you not make a reasonable exception in the case of a transsexual?  Especially in the absence of any conclusive evidence that transsexuality doesn't have significant biological factors involved?

However, Heyer seems to have fallen for the standard rightwing dogma that transsexuals are "fraudulent" somehow, simply because changing chromosomes isn't possible (yet!).  Well, unfortunately for him and his "allies" (I'm reluctant to call the likes of Peter LaBarbera an ally to anyone or anything), there are enough exceptions in the real world that trying to argue against transsexuals on this basis is really quite ridiculous. 

Allowing the original birth record gender to be altered has unintended consequences.  It can be misused, perhaps by a terrorist to hide his identity.  Or, some would say it will legitimize same sex marriage.  With an amended birth record in hand (changed from male to female), the new female would be free to enter into a legal marriage with a man.

First of all, the supposition about terrorists is really quite ridiculous.  You don't just walk into a clinic and have GRS one day on a whim.  No surgeon would touch you without supporting documentation from a therapist.  That's a red herring at best.

His comments about legitimizing same-sex marriage are equally ludicrous.  A gay male is a man who loves other men ... as a man ... having GRS would be anathema to such a person as they would no longer have something that they would consider essential to their masculinity. 

Ah ... the joys of listening to arguments that boil down to little more than a poorly considered attempt at erasure.  Sorry, Mr. Heyer, but you just haven't got this one.

Paper Genders: Taking Down The Arguments - Part 1

I've already given an overview of Walt Heyer's book Paper Genders in the Book Review: Paper Genders post.  These posts will delve into the details of the specific arguments and themes that Mr. Heyer relies on in making his case.  The problems in his arguments come in many flavors - some of them simple factual errors, others are more serious issues that need to be addressed.

Book Review: Paper Genders

I recently read through Walt Heyer's book Paper Genders.  What follows is a summary of my impressions of the book itself, and the validity of its arguments with respect to the treatment of transgender people.

To be nice about it, Walt Heyer is a man in a great deal of pain.  He’s been through a lot, and he bears the scars of some unfortunate choices.  Anyone reading his books should recognize this, and weigh his arguments accordingly.

Heyer wants to raise some serious questions and issues related to the whole process of transition and gender reassignment as it is carried out today.  Unfortunately, raising serious questions by making bold accusations of professional misconduct and “activist conspiracy” doesn’t exactly make for a compelling argument. 




For example,  the book starts off by borrowing heavily from a relatively recent study that talked about the high rates of suicide ideation and attempts within the transsexual / transgender community.

Heyer’s own interpretation of this seems to be that the suicide rate is a consequence of dissatisfaction with the results of treatment that went down the transition and surgery path.

The gender change activists would argue the suicides are a direct result of bullying, a popular scapegoat these days.  The advocates also say the lack of transgender acceptance and the difficulty of being gender variant in a society of heterosexuals lead to suicides, but as the last transgender support site disclosed, transgenders harm themselves either by cutting or self-mutilation which points to deep unresolved psychological issues.

The actual study makes no such inference at all, and in fact is much more clear on the probable causes of suicide ideation and attempts among transgender people than Mr. Heyer’s conjecture:

Actual Study:
http://www.thetaskforce.org/downloads/reports/reports/ntds_report_on_health.pdf

Those who were bullied, harassed, assaulted, or expelled because they were transgender or gender non-conforming in school also reported significantly elevated levels of suicide attempts (51% compared with 41% of our sample as a whole). Most notably, suicide attempt rates rise dramatically when teachers were the reported perpetrators: 59% for those harassed or bullied by teachers, 76% among those who were physically assaulted by teachers and 69% among those who were sexually assaulted by teachers. These numbers speak to the urgency of ending violence and harassment of transgender students by both their peers and their teachers. 

Education and income both correlate with suicide rates, with those earning $10,000 annually or less at extremely high risk (54%), while those making more than $100,000 are at comparatively lower risk (26%), while still astronomically higher than the general population. Those who have not completed college attempted suicide at higher rates (48% among those with no high school degree, 49% for those with a high school degree only, and 48% for those with some college education) while those have completed college (33%) or graduate school (31%) have sig- nificantly lower rates. 

Those who had survived violence perpetrated against them because they were transgender or gender non-conform- ing were at very high risk; 61% of physical assault survivors reported a suicide attempt, while sexual assault survi- vors reported an attempt rate of 65%.

It is disappointing to note that although Mr. Heyer has spent some time pulling his information from a couple of reasonably good community websites (Laura’s Playground, and other Transgender community websites mostly), but does not seem to have been willing to find the actual report itself and reflect upon its contents.

Perhaps somewhat unique is Heyer doesn’t spend his entire time trying to accuse transsexuals of being deluded people.  Instead, he seems to reserve much of his ire for the “treatment community”, and engages in a wholesale attack upon the mental health practitioners, surgeons and doctors who provide treatment to transsexuals.

He attempts to discredit some key people in the early days of clinical research into transsexuals by tying them to Alfred Kinsey, and using a rather sloppy 'guilt by association' argument, tries to imply that these people were all pedophiles or supporters of pedophilia and therefore should not be trusted at all.

The pedophile connection is very difficult to ignore with Dr. Alfred Kinsey followed by Dr. Harry Benjamin, then Dr. John Money, the co-founder of the Johns Hopkins Gender Identity Clinic.  All three men, it appears, did not advocate for any other therapies, only for the freedom to switch genders.  They set out to redefine how men and women were made and for them it was not in the womb.  ...

As the Kinsey Institute has pointed out in its refutation of the attacks on Kinsey, he was not a pedophile.  Since it appears that he derives his idea that Kinsey was a pedophile from Dr. Judith Reisman, I'll point out what happened when she tried to sue the Kinsey Institute after they refuted her claims that Kinsey was some kind of sexual predator.  Further, "guilt by association" arguments don't exactly make for terribly convincing reading.  They tend to lead me to suspect that someone was desperately reaching for it. 

Heyer also draws upon Dr. Paul McHugh's arguments related to transsexuals as expressed in McHugh's First Things opinion piece a number of years ago.  The problems with Dr. Paul McHugh's claims are addressed on this blog in an article called "Debunking Dr. Paul McHugh".

Overall, the arguments that Heyer makes in his book come across more as an expression of rage and frustration rather than a coherent call for meaningful changes in the diagnosis and treatment of transsexuals.

I respect that Mr. Heyer has been deeply traumatized by his experiences, and that this book, along with Trading My Sorrows is a sincere effort on Heyer’s part to give voice to what he has experienced and how it affected him.  However, much of what Heyer has said in his book, as I will discuss in more detail later, is almost pure allegation lacking any meaningful grounding in objective evidence.

His accusations against the treatment professionals are profound and troublesome, as he does little to provide concrete evidence to back up his claims.  Inference and innuendo are his primary tools of attack, with a healthy dose of borrowing from the standard religious right-wing book of accusations against Alfred Kinsey.

Although he claims to be an advocate for “better” treatment paradigms, Mr. Heyer fails utterly to even begin the process of exploring what form those treatments might take, a flaw in his overall approach that leaves one wondering just what it is that he has in mind for transsexuals beyond squelching the current treatment paradigms.

It is very much my opinion that while Heyer may have set out to raise some significant questions and issues related to the treatment of transsexuality, he ended up seeking an externalized justification for his own actions over the course of his life.  Instead of taking responsibility for his own actions and the outcomes thereof, his book reflects an attempt to make someone else responsible for what he has experienced.

Walt Who?

Recently, I came across someone who seems to have become the latest darling of the anti-transsexual crowd.  His name is Walt Heyer.  Mr. Heyer appears to be one of those unfortunate enough to have attempted gender transition, only to discover that it was the wrong path for them.  Unfortunately, Mr. Heyer has decided that blame for his misfortune lies at the feet of the treatment community, and now he has set out to discredit the treatment community.

In the last few years, he has published a couple of books that I will be discussing in some detail on this blog:  Trading My Sorrows, an autobiography of his transition and detransition, and Paper Genders which is his first attack on the treatment community that deals with Transgender people.

I'm going to spend more time on Paper Genders in a subsequent series of posts, as the nature of the book requires a substantially more in-depth treatment to adequately address.

However, I am profoundly concerned with Mr. Heyer putting himself forward as a spokesman for the treatment of transsexual people.  There are a few problems with his story that lead me to suspect that while he may be transgender to some degree, he attempted transition in one of the most dangerous ways that is possible.

Consider the following from his book Trading My Sorrows:

Alcoholics can be baffling and incomprehensible in their way of thinking.  I formulated a simple plan for living my life after surgery.  I would live as two people, living simultaneous lives.  The male, Walt, would continue to work as a male after the surgery, using a male identity.  Off-work time would be reserved for the female persona known as Andrea West.  This way I thought both the female and the male could each reign supreme, and my conflict would be resolved.  This seemed very logical and workable.  I thought that I would finally be at peace.

It’s hard to describe how the desire for surgery takes over, especially when combined with abuse of alcohol.  It took on the appearance of an obsessive-compulsive disorder, like a bulldozer pushing me relentlessly and single-mindedly toward surgery, while destroying every obstacle in its way.  Lying, cheating, and manipulating were my tools of the trade.  I became expert at persuading everyone that surgery was the treatment I needed.  In my compulsion to have surgery, I plowed right through and over everyone and everything that stood in my way.  Too bad hindsight always comes too late for us to see how truly stupid our process is.

In preparation for the surgery, I underwent a series of plastic surgeries, such as breast implants, buttocks implants, a nose job and removal of my facial hair through the painful process of electrolysis.  People at work were starting to look at me funny.  They knew something was changing with me, but they were mostly silent.  I anyone asked, I made up something in my usual cover-up behaviour

Okay, so, by Heyer's own admission he was struggling with alcoholism, was clearly not living full-time in role prior to surgery, and more distressingly had no apparent plans to live full time as a woman post-surgery either.  Even more important, we find Heyer admitting to engaging in deceit to get to surgery in the first place. 

To my understanding and experiences of the subject of transition, this is a recipe for disaster.  Not only does the candidate have significant comorbid conditions which are arguably likely to impair their judgement (in particular alcoholism), but it's also quite debatable just how honest the individual is being with themselves. 

A key aspect of a successful transition requires the person undertaking the transition to be brutally honest with themselves throughout the process.  Further, it is vitally important that the patient be very frank with their psychotherapist about what they experience, especially when it comes to living in the chosen gender role.  If, as Heyer says, his "tools of the trade" became Lying, cheating and manipulating, it is hard to believe that he was being completely honest with himself or the treatment professionals he was working with.

Heyer made a couple of feints at getting Gender Surgery, and for one of them he relays the following story:

Depending on whom you talked to, I was going on a “business trip” as I told my family, or taking a “vacation” as I told my employer.  Lying came so easily to me now.  There’s a saying:  “How can you tell if an alcoholic is lying?  His lips are moving.”  My true destination was Trinidad, Colorado.  My true purpose was surgery.  I shared the details with you earlier:  how I panicked and walked the streets of town, torn apart by the conflict raging in my head, and finally I backed out, and returned home to tell my wife what I had almost done.

So, not only did Mr. Heyer lie through his teeth to his employer at this stage, but he also lied to his family.  This does not sound to me like someone who is setting the groundwork for a supportive environment as they move into a new gender role.  If you are lying to everybody around you, how honest are you being with yourself?  More distressingly, Mr. Heyer freely admits to experiencing significant concerns about having the surgery done.  This is another sign of someone who is neither ready for Gender Reassignment Surgery or for that matter even living full time as a woman. 

In mid-October, six months after my surgery, my boss Tom and I met for one of our regular evening meals together.  Somehow I managed to get  the words out:  that I had undergone gender reassignment surgery and my new name was Laura Jensen.  As he gasped for air, I thought I may need to call 911 to revive him.  He was more than stunned.  He asked me to clarify what I had said.  I told him again.  "I have no idea how to handle this," he said.  "I'll need to take this to the president."  That seemed reasonable.  Having an employee undergo this kind of radical surgery was hardly an everyday occurrence.

About noon the following day, Tom asked me to go home until they could work out the details.  I could understand that.  They needed to work out the details of how they would handle it with the other employees.  Maybe they would move me into an inconspicuous office, away from intense scrutiny.

So, when Mr. Heyer finally did screw up the courage to undergo surgery, he still wasn't living full time as a woman.  Nor did he set the stage at his workplace prior to undergoing surgery.  This was the early 1980s, and at the time most formal gender treatment programs would have been exceptionally strict about the idea of a one to two year "Real Life Test" (RLT).  How he managed to side step this requirement is a bit of a mystery to me, but I don't have his clinical history at my fingertips, so I'll take it as a given that he found a way to do so.

It wasn't a birthday party.  They had their ducks lined up.  In return for six months' severance pay, I was to go away quietly.  I wasn't ever to tread on Honda property again or discuss my termination with anyone.  If I resisted or fought them, they would justify their decision to "lay me off" by saying that my position had been eliminated.  They had a document they wanted me to sign.  They assured me that fighting the termination would not be in my best interests, and promised that they would make my life miserable if I didn't go quietly. ...

Dropping the idea of GRS on your boss after the fact is not a tactic that is going to win you any friends in the workplace.  A successful transition includes workplace transition, as that is a place that we spend a significant chunk of our lives.  I don't find it particularly surprising that Heyer found himself in deep trouble work wise after that.  Not only had he dropped a significant bomb on his boss's desk, but his boss would also find himself feeling that his employee had been lying to him for an extended period of time. 

I picked a lady who specialized in dissociative disorder and met with her in her elegantly decorated office on the top floor of a plush Beverly Hills office building for many weeks in order for her to evaluate me.  When her evaluation was complete, she called me to come in.  Sitting there in her office, she began to tell me I indeed had a dissociative disorder and for the first time, I wanted to know what it meant.  She said it was the latest name for multiple personality disorder.

In her view, the combination of the discipline by my mom and dad, the cross-dressing in the purple dress by Grandma, and the molestations by Uncle Fred, all together, were the ingredients for the development of the dissociative disorder, or multiple personality disorder, that I had been suffering from and dealing with all my life. ...

Tragic as this is, we have to recognize that Mr. Heyer admits earlier on that he was not being wholly honest with himself and those around him.  It is entirely likely that his interactions with the therapists who ultimately gave the recommendation for surgery in the first place that his deceptiveness was sufficient to hide the symptoms of his conditions from his therapist(s).

Mr. Heyer seems to have failed a key aspect of transition - namely that of being honest with yourself and your treatment team.  The results of that dishonesty, while tragic, cannot be attributed solely to the treatment team.  Mr. Heyer needs to take responsibility for his own role in the tragedy of his attempt at transition.