Living Transgender

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Answers To Your Sex, Language And Transgender Medical Questions

We wrap up our series on living transgender with your questions from our Friday live chat:

Why are so many young people comfortable with the idea of “genderqueer”?
How’s sex after sex reassignment surgery?
Which sports team do transgender students play on?

Answers from you and the panelists follow.

0121_trans-live-chat

From left to right: Unger, Moureau and Levi. (Courtesy)

Dr. Cecile Unger, OB/GYN who trained at Brigham and Women’s and Massachusetss General Hospital and is currently a fellow at the Cleveland Clinic where she is training in Female Pelvic Medicine & Reconstructive Surgery and developing a subspecialty in transgender women’s surgery and health.

Bianca Moureau, transgender advocate. A former patient at Boston Children’s Hospital, Bianca transitioned from male to female when she was 14. She was the first person in the country to have Medicaid pay for her surgery. Now 26, Bianca is applying to law school.

Jennifer Levi, runs the Transgender Rights Project at GLAD and specializes in transgender legal issues.

Question from Margaret: Is there an age cutoff for surgery? That is, can someone be “too old” for gender-changing surgery? I have a good friend, born male, who has been transitioning to female for about two years now. She’s in her mid-50s and has been taking hormones most of that time.

Response from Cecile Unger: Margaret, as someone who sees these patients, I can say that there is absolutely no age cut-off.ne-third of patients discover their identity later in life while some patients choose to wait. Many individuals undergo surgery in late adulthood.

Comment From Kelly: [I ] would love to hear you discuss the concept of “genderqueer” and the generational divide. Continue reading

Uncertainty Surrounds Medical Treatments For Transgender Youth

Last of a three-part series.

BOSTON — Jackie cocks her head to one side, trying to recall the first clue that her daughter Natalie wanted to try life as a boy.

“I found something on my Amazon account,” Jackie says. “She had used my Amazon account to buy a binder, so I thought it was a binder for school.”

Jackie giggles as she remembers mentioning the bill to Nate.

Nate Piracini at his home in Boston. (Jesse Costa/WBUR)

Nate at his home in Boston. (Jesse Costa/WBUR)

“‘Oh, you should tell me,’ ” Jackie says she told Nate. “‘I go to Staples all the time. I’ll get you some binders.’ ”

Nate muttered something about it being a different kind of binder.

Then Jackie noticed the charge: $39.95. The product link opened to a picture of a female wearing a thick elastic band that made her chest nearly flat. Breast binders are a common early step for females transitioning to male, but they come with health risks.

Dr. Ralph Vetters, who treats transgender teens at the Sidney Borum Jr. Health Center in Boston, says binders make breathing more difficult, increase the risk for lung infections and, “by compressing the breasts, they can cause a sort of fibrosis. Scars may be a word for it. It hurts.”

The alternative for transgender men — females transitioning to male — is surgery that pulls tissue out of the breast. The procedure costs $5,000 to $10,000 and is only covered by a handful of employers in Massachusetts. (Harvard University, where both of Nate’s parents work, covers transgender medical procedures.)

Teenagers need a parent’s permission for surgery and any other transgender medical treatment before the age of 18. Some doctors refuse to help patients of any age make such a fundamental change. Leonard Glantz, who teaches bioethics at the Boston University School of Public Health, says the main concern is surgery that removes a healthy penis, ovaries or breasts.

Continue reading

As A Transgender Teen, Nate Finds Acceptance At His School

Nate, right, and his friend Carlos rehearse lines during theater class at Boston Arts Academy. (Jesse Costa/WBUR)

Nate, right, and his friend Carlos rehearse lines during theater class at Boston Arts Academy. (Jesse Costa/WBUR)

Second in a three-part series.

BOSTON — On the first day of school last year, 16-year-old Nate came out as transgender to teachers and students all at once, one class after the other. He says so far it was the most difficult day of his transition from living as a girl to living as a boy. Nate was a sophomore, beginning his second year as a theater major at Boston Arts Academy.

“I’m really, like, socially awkward,” Nate says in a matter-of-fact voice. “I was really reserved and insecure about who I was. Even though I go to the school I go to, I was really afraid there would be someone who, you know, wouldn’t be as accepting of me.

“I think I’ve heard every single horror story of trans kids in school and I’m just like, whoa,” he adds.

His theater teacher, Maura Tighe, remembers that first day of school, her finger sliding down the attendance sheet. “Natalie,” Tighe called out. Instead of “here” Tighe heard, “I’m Nate now.”

Tighe says she didn’t flinch. “I’m like OK, cool. You’re going have to remind me ‘cause I know you as Natalie.”

Nate still has to remind Tighe and other teachers who forget and say “Natalie” or “she.”

But as far as Tighe could tell, Nate’s announcement that first day back at school came and went without a stir.

“He just said it right there and no one in the class could have cared,” she says.
Continue reading

Weigh In: What Does Gender Mean To You?

This week we began our series on living transgender, following the story of a 16-year-old female-to-male transgender teenager, and the personal, emotional and medical challenges that arise during the transition process.

But more than telling the story of one teenager, we want to create a space to discuss the larger question of gender and what gender means to you. So we open this up and encourage you to share:

What does gender mean to you? How do you define it? What have been your experiences with gender identity? Tell us by filling out the form below, or email your response to nathang@wbur.org.

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Nate's Transgender Story: Battling Perceptions And Pronouns

Nate, who was born Natalie, shares a laugh with his dad, Tom. (Jesse Costa/WBUR)

Nate, who was born Natalie, shares a laugh with his dad, Tom. (Jesse Costa/WBUR)

First in a three-part series.

BOSTON — Nate leans in, his broad shoulders hunched, his brown bangs almost touching the sewing machine bulb.

“Yes,” says the 16-year-old, with an “s” that lingers. “OK, I’m gonna keep going, it’s not stuck.”

Nate’s fingers push the seam of a sky-blue fleece stocking cap past the pounding silver needle.

“I’m going to do the hood and worry about the cowl later,” he says without looking up.

The hood is part of a costume Nate plans to wear to the next meeting of his cosplay, or costume role-play, group. There are cosplay chapters all over the world. Nate’s is based on a Web comic called “Homestuck.” His transformation from Natalie to Nate began two years ago, when he put on a blue men’s suit and boots, and gelled his hair into thick loops.

“That’s where I started it,” he says. “And then it just kind of took off from there. It was just like, no, I’m a boy.”

As far back as he can remember, Nate, of Boston, was uncomfortable as a girl.

“I felt so wrong as a female, it was just so wrong, and there was so much I didn’t like about myself,” he says in a soft, steady voice.

Nate had never heard the word “transgender” before he got to high school. But once he did, and figured out what it meant, “I was just like, ‘Oh my God, that’s exactly how I’m feeling.’ When you’re trans you just know. It’s not something like…” Nate pauses. “I don’t want to be like this. Who would choose this?”

Nate Becoming Nate, And Heavy Conversations

Nate at his home in Boston. (Jesse Costa/WBUR)

Nate at his home in Boston. (Jesse Costa/WBUR)

Nate’s parents, who are divorced, and his stepfather are trying to understand and accept Nate’s decision, but they are worried and scared.

Nate’s future is hard to imagine, says Tom, Nate’s dad.

“This is a big challenge to a lot of people,” Tom says. “And that’s where it gets scary. When people don’t understand things, that’s when they get the most uncomfortable and we don’t know what they’re capable of. So I want to follow Nate around everywhere and just say, ‘Wait a minute, don’t even try that.’ But of course that’s not possible.”

Nate and his family agreed to do this story in the hopes that it will help people understand transgender issues, but they are also concerned that it will leave Nate exposed and vulnerable. WBUR has agreed not to publish the family’s last name.

“I was just like, ‘Oh my God, that’s exactly how I’m feeling.’ When you’re trans, you just know.”
– Nate, on figuring out what 'transgender' means

Last year, Nate cut his straight brown hair short, started wearing a thick elastic binder to compress his breasts, and gave away his “girl” clothes. Even as Natalie, he’d been wearing a lot of flannel shirts and jeans. Nate has not had surgery to flatten his chest, nor has he started hormones that would produce new facial and body hair, more muscle and a deeper voice.

He still loves the high notes his female vocal cords can hit, but when speaking, Nate very consciously drops his voice into its lowest range to try to sound male.

“My vocal tone, the way it’s deep right now, this isn’t natural,” he says. “My natural voice is — no, we don’t talk about that.”

Nate’s parents say they weren’t shocked when Natalie yelled, during an argument, “I’m a boy,” but they didn’t exactly see it coming either. Continue reading