Doctors

[SaraAngelinaD]

Subj: (no subject)
Date: 11/6/2002 12:29:09 AM Eastern Standard Time
From: Sara Angelina D
To: altermd@<hidden>



Hello again Dr Gary Alter,
Your last reply did not surprise me at all. However., Im not sure that I previously sent you a link to this web site (please see below) but.... It has many good postings from many different Intersexed people whom are a lot like.... myself. Some of which are from many different places with-in the USA as well as some from outside the USA.

You might like to perhaps see things from where we stand as intersexed individuals. So, this is an invitation for you, to see things through my eyes.... if you will.

I say this since Im sure that likewise I / we might have a hard time understanding the reasons that govern your actions (doctors as a whole) or non-actions..... and, likewise please if there is a web page that you could refer me to..... then please let me know ? So that I might learn a little bit more about your world from where you sit.

The web site that I speak of is Bodies Like Ours or http://www.bodieslikeours.org/


Thanks : )

Sara Angelina D



For those of you wondering. Dr Alters web page address is http://www.altermd.com/md.htm

[Natasha]

First I want to welcome you.

I am curious to know what this is all about, even though it is of course none of my business at all. Some nerve huh? =)

[Betsy]

Sara Angeline,

Thank-you for those kind words of support! I wanted to reply last night but was busy seeing red and getting incensed over a conversation on another listserv populated by doctors. I needed to "GRRRRR" at a couple there.

As is Natasha, I'm curious about the rest of story!

Betsy

PS..welcome back...it's nice to see you posting again!

[Wendy]

Sara & All,

The reason adult ISs have a hard time with getting corrective surgery is becasue Dr. Harry Benjamin of NYC, NY, wrote up what are called the Benjamin Standards. BS for short, for TSs, doctors and shrinks to abide by when TSs seek SRS. They were never originally intended for ISs, but are so used now.

One major rule for the doctors is to keep the surgery price high so as to discourage as many TSs as possible from getting SRS. So from that, and their having to go by the BS, many ISs use a different term for the BS!

[Natasha]

Welcome!

Yeah the Benjamin Standards. I think it is a basically good idea, but it is been misused often for purely economic reasons.

I asked my therapist, when I went for my letter, why we even needed letters. She told me that some surgeons are even more hesitant to do surgery on adult IS people than on TS people. The reason being, that we often change our minds several times. She said one of her IS clients had gone M2F, then F2M , and then wanted to go back to F. I was surprised by that at first. But when I thought about it, it made perfect sense.

Lucky for me my therapist has known me for over 20 years, and she knew I was consistently living as female and that I was rock steady certain. I still had to get another letter though. But it only took three appointments total, for both doctors to write my letters.

Amazingly, even though I agonized over getting surgery for years, and I was absolutely 100% certain I needed it. GRS still really threw me for a loop emotionally afterwards. I think on some level deep inside, it took me back to the first one somehow a little.

I am doing just fine though. I couldn't be happier!

Glad you are here dear. =)

[Betsy]

Hey Sara,

You may want to get ahold of my friend, DaleLynn Sims. We spoke of your posts over this past weekend and I decided to post her site here instead of in an email because others may be able to benefit from DaleLynn's expertise in this area:

Her website is:

http://www.kindredspiritlakeside.homestead.com/

You can reach her there and sometimes she even comes here but is quite busy.

Betsy

[SaraAngelinaD]

Well, hello everyone,..... the reason that I had contacted Dr Gary Alter was due to the fact that via his web page he mentions intersex corrective surgery. However unlike when he mentions the surgery for TSs whereby it is clearly mentioned that the two professional letters are required..... I thought.... Hummm., Just maybe here is a Dr that honestly understands and knows what it means to be have been born intersexed.

So, I wrote to him about some corrective surgery that I would like done ASAP.

As it turns out after a few letters back and forth ... the question came up as for his requirement for the two letters from professionals. I told him that on my birth cirt it says female.

I wrote back saying that I can see the need for men or women whom are seeking to change their gender.... However unlike them we are " born " this way ( intersexed ). Or and I hate to have to put it this was..... A birth defect if you will ( just to keep the point simply)

I said that. For example: Im sure that in the case where a women might need to get a radical hysterectomy ASAP (due to cancer concerns) he would do the surgery right away., then advise her to seek counseling later on in the case that " she " felt that she needed to speak to a professional about it. Thus saving her life. After all isn't that what Dr's do. However., please take note that. In this example she would not be required at all to go out and get two letters and prove that she was living full time as a women etc. 100%

I don't question my gender. I don't think most IS women or IS men do. Never have never will. I totally refuse to go via a TS program.

I told him that.... I did in years past acquire one letter for surgery. But, when I found out that the program that I was in was for TSs I dropped out and asked them. Well, then, where is the program for us Intersexed women... I was quickly told it doesn't exist. I thought I was being lied to. But to date. It still doesn't exist. Sad fact but still true. I said. Dr Alter sorry but I cant lie and say Im a TS to obtain surgery. Lies and acting aren't my thing. The thought of, all of that., really turns my stomach.

I even wrote to the Benjamin people ( the TS police ) to no avail nor resolve. Why should I pretend and be humiliated into being made to say that I am something or someone that I am not. It just didn't make any sense then.... Nor now.

I have cancer concerns as noted by my female local Dr, MD, has asked me to get surgery ASAP and that was some 2.5 years ago. Im now starting to get much more pain as I had told Dr Alter. So the above letter was sent after he had mentioned the letter thing.

I did get one letter as I had told him but I wasn't willing to get a 2nd. Dr Biber got the first letter years ago. I then was going to go to Dr Melter but I later found out that those Drs where predominately Dr's that worked on TSs knowing very little if at all about IS women. I was asked ... well what's on the inside ? What's if I get in there and things are very different ... what would I do ? I thought to myself. Is he really asking me that ? After all he is the Dr....... right ? So.

I didn't say it but ... what was I to say. Just wing it ? ! I don't think so !

So, needless to have to say. I canceled surgery via those two MDs. And so it recently seemed that Dr Alter might be much more skilled and progressive. And., I mean he might still be. I don't know 100% but him seems to be an excellent Dr. Im sorry to have to say that haven't heard back from him. You all might want to write to him and tell him how you feel via his web page. It would be nice if he and others like him got to knowing us and putting themselves into our shoes.

I cant see the TS police coming after him. I mean is there such a thing ? Really ?

And if there where an IS program I would go to it and get the last letter. So long as I, wasn't made to lie about whom we are and I am. Its just that simple.

In prior e-mails I has also explained that I was raped at age 12.5 and my father elected to have me closed up. He tried to force me to live during my teens as a guy. I was a tomboy so I kinda tried to have fun with it but., that wasn't me at all.

I mean regarding our being able to elect as adults or non adults for, or not surgery ... listen I am for pro choice 100%. My choice.

However. And this is very important. But the problem is when we finally become adults we should still be able to say OK I want surgery since my parents wanted me to be a guy and I didn't thus I had to wait till I was a legal an adult to elect what I wanted without there consent. And non surgery ... followed by personal choice is great. But where is the follow up. Where is the IS program so that we can get those silly letters ( yet seemly important ) that they require?

Question / comment / suggestion: cant we just go to an attorney and get a letter saying I wont sue my Dr. After all that's all they are really worried about isn't it ? So it seems.

Cheers : )

[Natasha]

Hi SaraAngelinaD,

Well you finally answered. =)

You wrote:
"cant we just go to an attorney and get a letter saying I wont sue my Dr. After all that's all they are really worried about isn't it ? So it seems."

Yes, legal liability is their chief concern I believe. That is why they require those letters. They let them off the hook. Yet the present structure of medical ethics, bad as it all is, and the law being what it is. They are required to follow established guidelines of acceptable medical practice. A letter promising that you wont sue them, is not adequate coverage.

I asked the therapist who wrote my letter why we even need them. She said that some surgeons are even more hesitant to perform SRS on IS than TS people. The reason being that we change our minds after surgery, more often than TS people do. She told me that one of her other IS clients went from MtoF, then FtoM, and last I heard wanted to go back F.

Considering these things I find their liability concerns understandable. Yet certainly I also understand your concerns, Sarah. One thing I don't understand though. Since you need surgery so badly, and you must play their game to get it. Well why not just go along to get what you need? I mean that is better than risking cancer isn't it?

[SaraAngelinaD]

Hi Natasha,
You wrote:

Considering these things I find their liability concerns understandable. Yet certainly I also understand your concerns, Sarah. One thing I don't understand though. Since you need surgery so badly, and you must play their game to get it. Well why not just go along to get what you need? I mean that is better than risking cancer isn't it?


Natasha




Hi Natasha,
I am very much a spiritual person. I don't fear death at all. We are whom we are inside. And., moreso then via what we look like on the outside., which is just a vehicle to transport the souls that we are inside.

I believe in the karmic rules of life yet, I don't go to any church groups at all. I have read a lot in the past to find those answers for myself via books which typically can give you direct info without to much opinion blended in. Life and death. Its a process of life. But., I don't believe in suicide. Never have never will. Thats for the weak. Plus it only regresses ones soul.

Cancer isnt a good topic at all but, if I happen to die from it., then so be it.... I would only have to blame the medical community for "its" close minded veiw points.

Other have died for less in the history of mankind.

I refuse to live a lie to get what I need. Others should get together and pool resorces together to pave the way for the future IS men or women to follow us.

There are vast differances as Im sure you know, that Dr's dont understand between TS men that want be women.... versus IS born women that still want to be women yet need corrective surgery due to there birth condition.

This borad is great since it helps to voice how and what we feel. But if Dr's arent invited on an ongoing basis then they will never learn what it is to be, us.

Untill they can place themselves directly into our shoes and look out at this world from where we stand.... we will still have to live the current lies that they have forced for us to sign onto.

As an Example: Its like being made to confess to a crime that you didn't do since you where on the other side of the world on that day. But they tell you.... Listen we got you where we want you but if you sign this confession. Your free to go. Sure that's a convent and fast resolve to that then problem at that then moment ... but what about years later. That lie will be with you always. How about the harm that this might case ones self. I for one seek peace of mind with-in myself. I cant live a lie to appease ignorance of the truth. Sorry no can do.

Dr's are fairly smart people. And they are good at playing dumb. But without any joint effort by any IS organization/s and the help of a good attorney. These arguments and truths wont be heard by the medical profession nor ever be taken very seriously. Sure I might agree that one on one they will say... yes your right but.... thats not the way it is right now.

SO, no matter how much we complain... untill we get together and " make " things change. Nothing will happen.

History will prove this to be true over and over again. After all... as women we can now vote. And years ago that wasnt the case as Im sure you know. Change takes much joint effort. Writing letters etc. Signing affidavit's etc. And others have died for changes that we now take for granted over the years.

But thats my point. If I lie now and take the bait... then the others after me are told to lie and go for the bait to get surgery and so on and so forth etc etc....... when will it end ?

[Betsy]

but I know for a fact that several do read these boards...

In fact, some even link to us!

In a pervasive and really persuasive way, it makes us all activists by just sharing our thoughts and stories. They read, and some listen.

The thing about the HB standards, it is a protocol that doctors are taught. On the most most base level, it is no different from the protocol that says genitals should be cut on unconsenting infants for cosmetic reasons. Both courses of treatment are mere pages in medical textbooks.

To change the treatment, you need to change the way the new doctors are taught about the issue and the protocol.

Betsy

[Natasha]

Hi Sarah,

You wrote:
"There are vast differances as Im sure you know, that Dr's dont understand between TS men that want be women.... versus IS born women that still want to be women yet need corrective surgery due to there birth condition."

Not that I in any way discount changing gender to be who one is. After all, I myself have done so. I really needed to, and I am very glad that I did. Yet I feel that sex and gender issues, including changing sex as adults, are very secondary to the issue of non consensual surgery performed on IS infants and children.

The reason for my prioritizing this so, is not because of gender issues either. But for the emotional and physical trauma resulting in damaged lives, and the shame which compounds all of it. All of this pain caused just to make us conform to some arbitrary standard. Such cruel policy sends a strong message to all of us, from the very beginning of our lives, that we are somehow abominable, shameful, and should not be allowed to exist as we are born.

I want to make it very clear that although I do understand how you feel, and even though I feel differently, that does not mean that I care any less for you. That is another thing Sarah. What we hold in common with Transsexuals is our human status, and that both communities are likewise stigmatized by an ignorant society, for their sexual differentness.

I do not believe that "we" are more valid than are "they". It is not a "we" apart from "they" situation for me. For one thing, I was not "born a woman". I was born something other. I was born intersexed.

It is merely that within the present context of our culture. I feel a far greater sense of belonging to the group known as females than I do males. Right now for the most part it is "choose one", and I chose from my heart what best fit me. To be entirely frank. Changing my sex was also a declaration of my autonomy, taking back my own sexual body and restablishing my bodily integretrity which was robed from me. I do not consider myself to be more of a woman than anyone else is.

Sarah, sweety, I do not ascribe to biological essentialism myself. I truly do believe that at least most of the TS women I have met, consider themselves women and in fact are women, as much as am I myself, and for the same reasons as well.

Of course there are exceptions. But then they too help to dissolve this silly culture's worship of both biological essentialism and the dimorphic paradigm. Really we all show that society's assumptions are simply that, and the artificially sacred status of the actually arbitrary nature of sex and gender, are really anything but sacred. For surely it is not sacred above the many lives harmed and even destroyed, by those who presume it is.

Sarah, I feel that if you truly need to have genital surgery to be happy. Then you should do what you must to obtain it. If the surgeon does not believe you are intersexed. Then so what? Intersex people are required to have the letters of recommendation also. I had to get them to have surgery. So I got them, obtained what I needed, and then moved on.

I believe that if you really need to, then you should do the same. Believe me there will plenty for you to do to help change all of this afterwards. Risking cancer and allowing your life to be taken up short, would deprive both yourself of that opportunity, and all of the many you could have helped.

All the very best.

Oh. Did I mention how glad I am that you are here? Well I surely am dear one. ... =)

Now quite yer mesin round and go get yer op. NO CANCER! K?

[Natasha]

I think part of the problem lies in the fact that many SRS surgeons also perform IGM. I know Dr. Meltzer of Portland does both. Much of the technique for SRS used on TS people, in fact comes from lessons learned doing IGM.

I think that the medical community still thinks gender is a socialization attribute. They still hold to John Money's theory. I think they deny the large amount of evidence to the contrary, because they do not want to accept the fact that they have been really messing up our lives by assigning us a sex.

Some SRS surgeons even deny medical verification that those who seek SRS as adults, really are intersexed. Now could this bespeak subconscious guilt on their part, for causing this in the first place by performing IGM? I think so.

Although gender identity, in my view, is secondary to the trauma adversely affecting the lives of all victims of nonconsensual sex assignment, whether they have gender issues later or not. Gender ID is certainly a very important consideration, and another very good argument against IGM.

[claraJane]

Dear Sarah,

I spent a year overseas in a fairly dangerous area. Our group gave us training on how to respond to terrorists or kidnappers. They emphasized the need to become a real person to them, the theory being that even a terrorist is less likely to kill someone they've developed any sort of relationship with.

The other thing I learned there was that people who have power use that power. If you try to go around them they'll burn you. If you approach them respectfully and ask for help they'll generally do at least something on your behalf.

My surgeries were done in a hotel room by a surgeon who lost his license in 1977 but who continued to "practice" until recently. I was left to recover in a small townhouse just off of Judah in S.F. My results were good. Others died.

There are several wonderful doctors who are on our side in the battle to end cosmetic surgeries on infants. Were I in your position today I'd work on my friendships with them and with other similar people. It might take time but eventually I'd meet someone who could help me.

So, I understand how desperate one can become. Call me and I'll try to get you hooked up with someone who can help.

jane ;)

[dalelynnsims]

HI there all

While I read often I do not always post but after a visit to this thread again I wanted to comment. As I am sure you all know there are some surgeons that cater to both the IS and TS individuals. This I believe was possible because of the study of the procedures used on IS individuals and them refining their procedures so that they can provide similar to the TS individuals. That said Surgery is not right for everyone and surely not right for anyone that cannot provide consent or understand the ramifications of the surgery.

Today however I bring another issue to the table and that is something that we may like to begin to think about as a group, how to address it and then educate others on the facts. As some of you know I was subjectively assigned male at birth and it has taken years to clear up that mistake given the state of political affairs in Florida where I was born however that to has been overcome to the mutual good of everyone involved. There are actually two things to be addressed here and not to belabor on them here but to simply identify these and they are, one the face that we in the US do not have the ability to identify intersexed individuals at birth and on the birth record, allowing time for the individual to choose that which is right for them. The second is the unwritten (as far as I can determine) issue of the surgery being mandatory or elective subsequent to ones 18th birthday. Not my words here but others.

Having been one that has gone through corrective procedures at their own request I found myself in the unique position of having to present myself to the caregivers to go through the same battery of requirements, or should that be requirements brutality, required by the SOC. Having read the threads here and reflected on them I have no doubt that there are people that vacillate between the dimorphic genders of society. Could the contributing factor for that vacillating be because people attempt to live up to unrealistic expectations of a dimorphic gender society?

For me I needed the time and received some great help from those on my care team. A select few but great people non the less. When I need a sounding board, a friend or a shoulder to cry on I knew who I could count on and for me nothing more than assurance and validation of me just being me. Today I am better for all of it however I often wonder if it was all necessary and even worse of thought are those that may need these things and cannot benefit for what ever reason. We must all admit that we are blessed. We have one another here on this support forum, many do not. I know that I have a loving family, great job and wonderful friends old and new. I have provided two things for thought here and hope to hear from you all on these. Ponder them but lets not forget those that for what ever reason we speak for, who are not here with us.

HUgz

[SaraAngelinaD]

I wanted to say in here tonight that I have met many TSs. Most don't ever pass very well., even after surgery etc. Male voice for one etc. Very few look good and some of the ones do look good might have be IS and they never knew the difference. Or they had a ton of surgery all over.

In the past I thought to find out more about them... thinking., well, ( I thought ) they might be close cousins to us ?

I want to honestly say in here that I did not like what I found to be perfectly 100% honest.

Now, I don't know about all of you. But I don't care to be grouped into the same category as they are by anyone's standards.

The females to males generally seem to pass better yet most Ive found are on the shorter side for whatever reason. That's just my observation. The male to females seem to be at the taller side for whatever reason.

I am one of these people that believe in., live and let live. Trust me on that one. I am very sympathetic to them as well. I try not to judge anyone. The H.B. standards are a good percussion in "there case" I might add. However, please understand that Im only just trying to be honest here.

Im saying all of this since I think it needs to be said. Its long over due. And if I hurt anyone's feelings due to my honest view then that wasn't my intention at all. So please read on.

I just don't think.... That " if " this issue was to get put to a vote. That most of us that are IS would feel very good about having to sign paper work that was worded for TSs just prior to surgery due to the much needed surgery consent forms. Kinda like saying, one size fits all. I really think that's adding insult to injury.

I feel that we, as IS are very much different no matter how you look at it.

I will say that. All this talk, talk, talk is good but it can make for a confusing message to Drs whom don't live from birth as we have on a day to day basis like we do.

So, my personal plans are to never sign any forms that refer to my being even remotely anything other then what I am., and that is Intersexed.

To me it makes a big difference. Night and day difference.

If I only " just " wanted surgery.... Well, let me tell you all right now that I could have had that done many years ago.

Read back and you'll find that when I found out that the program I was in was for TSs and no program was avail for ISs well then I dropped right out even though I had one very positive letter to show for my time and troubles. I personally cant stand lies. And that entire program isn't meant for us.

Yes, perhaps Im bold enough to say in here very clearly as day light. Hey, Im from NY and a Scorpio and Italian. So I do speak my mind whenever possible.

The more we give in to being treated as though we were the same as TSs the worse it will be for the IS children now being born when they seek to have genital corrective surgery. Yes, this overall dilemma...... its much better now but its still no good. Or lacking.

Meaning we should have our own pathway for surgery, and not be made to be humiliated into signing onto saying that we are something that we are not.

I know that a lot of you out there had just signed the whatever papers blindly to simply " just do it " and get it over with. But I cant do that nor will I ever do that.

Women can vote today because years ago women got together and they spoke out in groups and spoke there minds and made it extremely clear. One voice. One message. Not 2000 different messages. Keep it simple.

Being TS is totally different then being IS. Its that simply. Drs need to understand that message very clearly and its long past due.

If I was TS my surgery would have been over with and I wouldn't be a member of this board.

We should not be made to have two letters. The only exception might be if anyone might be prone to suicide or if the Dr wants one for his files. Yet, it should be outside the H.B Standards which should not ever be applied to us.

[dalelynnsims]

HI there again SaraAngelinaD and all

I do not disagree that there are differences and one of the things that my caregivers agreed on is that all of my documentation indicated that the surgeries I had were corrective. This and the other documents I believe do currently separate the trans community from the IS community.

You spoke of passing and for me I can agree that there is no problem. One of the things that I did some research in a few years ago was if there had ever been a study of the number of trans identified individuals that later found themselves to be intersexed. I corresponded with many as well as reading everything I could and there has been nothing more than speculation on this and many including Dr Diamond agreed with my summary that a control study in that would be a budget breaker. That said everyday we are discovering more biological facts that provide an ever widening arena of inclusion of people outside the common dimorphic expectations of society.

I would only add that for me the applied SOC requirements were done to meet their intent. My caregivers understood where I stood and what was needed and for me at least I am glad of all that happened. Knowing that many wait years for the gatekeepers to do their things I agree that this would have been a bit much under the circumstances.

What ever the case I do believe as you indicated that things are getting better but are still lacking. Only through education and understanding can we begin to have an impact and slowly we are beginning to feel that impact and the results thereof.

Hugz to all