Five Years
As Becky

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"The Real Life Test" -
A True Autobiography


A List of Therapists Who Treat
Transgendered Persons


State - By - State Instructions
For Changing Name And Sex
On Birth Certificate


Topics Related to


Lefty: A Short Story


Parallel Lines: A Tribute 


 Christmas Messages

1998: Christmas Remembered
1999: What's In A Date?
2000: Peace On Earth
2001: Dark Days
2002: The Little Things
2003: Shop Till You Drop
2004: Survivor
2005: What Are You Waiting For?
2006: Peace In Our Heart
2007: The Greatest Of These


Real Life:
Five Years Later


The Grace Letters

Answered Prayers
One Day At A Time

Self Discovery
Strength Through Weakness


Play It As It Lays
The Way We Weren't

Share It Or Bear It

I'm Not One Of Them

What Have We To Fear?
God Don't Make No Junk

Work It Out!
What's In A Date?

Life In The Leper Colony

I Love You IF...

Homeland Security

One Thing I Know
Letting Go

The Least Of These

Will...or Grace?
The Word

What Plank?

Believing The Lie
The Greatest Of These


Facial Plastic Surgeons


SRS Surgeons


"Feminization of the Transsexual"
Douglas K. Ousterhout,
M.D., D. D. S.




November 29, 1998

It's a night for reflection. I'm watching CNN's "Cold War" segment on the Cuban Missile Crisis and remembering those moments in my childhood when we doubted we would have a future. At the same time, I'm thinking back to this night in 1993 - five years ago - when I again had no idea what my future would hold.

On November 29, 1993, I was busy in my rented apartment in Jackson, Mississippi, loading my car with shirts, slacks, business suits, ties, shoes and socks. I had identified an inner city mission which would be very glad to receive such a supply of men's clothing. I reserved one set of clothes to wear on my last day of work November 30.

Over the previous eight months the changes in my life had ben profound. The physical changes from electrolysis and hormones were minor in comparison with the changes in my personal and professional relationships.

My cardiology practice in Jackson was coming to an end. If I had had any thoughts of transition on the job, they were dispelled by my partner who made it clear I would no longer be welcome in his office. Setting up a solo practice was not an option either. Many (although not all) of the doctors who referred patients to me let it be known they disapproved of my "lifestyle choice." (I tried to tell them, "It's not a lifestyle and it's not a choice," but it fell on deaf ears.) One of them told me, "This sort of thing may be all right in California, but not in Mississippi." I would have no hope of the income needed to meet the demands of my alimony. It would be necessary to re-establish a practice in my specialty in another state.

My personal life was in chaos. I was paying the price for years of silence and denial. When I married, I already had years of experience in covering up the feeling that I should have been a girl. I had been able to sustain the denial thus far; why should it change, with the added masculine reinforcement of being a husband? I had no information and no support; I had no idea of the intense dysphoria the future would bring.

I was never an assertive person, especially compared to my spouse. Much of our compatibility (and in many ways we were quite compatible) would have been in danger if I had been more strong-willed. But my meekness made it so much more difficult to discuss with her my growing awareness of inner womanhood. Adding to the difficulty was our spiritual background as Southern Baptists. The denomination had become much more conservative or "fundamentalist" in the late 1980s and early 1990s, and my own spiritual concern and doubt took years to resolve. I felt that, for someone unafficted by the dysphoria, it would be easy to consider my feelings were motivated by strictly selfish desires.

My fears were confirmed: both my spouse and my son, then in his third year of college, excluded me from their lives. It was a crushing disappointment, and five years later it remains the one source of grief in an otherwise joyful life.

In the years that followed, I met many other transsexual persons. Most had experienced rejection similar to mine, although not always as absolute. But a few have been able to maintain friendly, even loving relationships with their children. I have such envy of them. If only I had taught him more tolerance and acceptance...

Why, then, did I take actions which resulted in the loss of my medical practice and of my family's affection? The question takes on new significance as I have become a source of support and information to other transsexuals through this Web site. Frequently I hear from others who are following the same road, facing the same losses. "Why?" they want to know. "I am giving up everything - for what?"

I've used words such as "personal identity," "peace," and "congruity" to describe the result of transition - the matching of external and internal identity which finally relieves the intense discomfort which we transsexuals experience. For me, and for most transsexuals I know, this congruity is worth the losses we suffer. I feel secure in my choice, knowing I'm finally complete and able to function in society.

One reason I've never given for transition is "sexual pleasure." In recent months, however, there are those who would assert that eroticism is the chief cause for all late transition transsexuals. For this we jeopardized - maybe sacrificed - family, friends, and career? For better sex?

I don't dismiss Dr. Anne Lawrence's feelings or experiences, as she relates in "'Men Trapped In Men's Bodies:' an Introduction to the Concept of Autogynephilia." Her experience has validity for her; and no doubt for some other persons for whom the sex drive, and the eroticism of feminizing a male body, are the main reason for their transition.

But we are cut from different cloth. I, and many others with whom I've corresponded, have had occasional erotic experiences associated with the concept of feminization. They are rare, and a very minor part of my life. In my case I could give them up and never miss them.

I still maintain that the condition defined as transsexualism is characterized by a sense of discomfort with one's body. It is not a pleasurable sensation. The pleasure of sex, if it occurs at all, is minor in relation to the need for congruity between body and spirit.

There may well be another condition, similar in some ways to classic transsexualism, in which the sexual experience is paramount. It is perfectly acceptable for these persons to pursue feminization by medical and surgical means. The questions raised by the existence of this second group of persons transitioning in midlife are interesting. How do the Benjamin Standards of Care apply to someone whose motivation for change is primarily erotic? How do surgeons feel about treating them, realizing that loss of sexual responsiveness is always a possibility in any sex reassignment operation? How will insurance companies react when asked to pay for surgery to fulfill an erotic fantasy?

I'll explore this further in my next essay, "Janice Raymond and Autogynephilia."