My Gender Identity Disorder

This is something I wrote some time ago that has been of help for many people:

My Gender Identity Disorder
Background and Diagnosis

Some of my earliest childhood memories are of thoughts and feelings that I was a girl. My playmates of choice were most often girls up through 5th grade. We played “girl” games (pretend, hopscotch, jump-rope, jacks, etc.). Peer pressure (verbal and physical) in 5th and 6th grades caused me to seek to begin to repress these feelings and move away from these activities. From that point on through high school, I became more active in sports and in leadership roles while still nurturing interests in music, cooking, art, and flowers (my dates always had the nicest bouquets!). As busy as I kept and as hard as I tried to keep them down, the feelings and thoughts bubbled up and must have been transparent to some. Girls would frequently seek me out just to talk because I “wasn’t like the other guys.”

In college and adulthood I took on roles and cultural norms which made the thoughts and feelings invisible to most eyes. However, these thoughts and feelings were still there causing anxiety, stress, and feelings of shame (at having to hide this part of me). Temporary relief sometimes came from clothing or grooming (a gold chain/necklace, soft fabrics, etc.) and –whenever possible – clandestine cross dressing. I did the best I could in the roles I was called to fill, but knew they were not me . . . or at least fully and authentically me.

In November 2003 I shared as much as I understood at the time with Joanne concerning my feelings and thoughts related to my gender discomfort. After a tough time of confusion, anger, and tears we began to try and deal with the deep secret that was now out in the open. We talked about events from both my childhood and our married life together that helped us illustrate, substantiate, and define the feelings and thoughts I was trying to express. With Joanne’s support, comfort, and encouragement we begin a process of prayer, study, and conversation that eventually led to my consultation with an international authority in the field and a diagnosis of Gender Identity Disorder. This DSM-IV diagnosis (302.85) was confirmed and supported by my primary care physician, a leading endocrinologist, and, informally, by another therapist. Both my therapist and my primary care physician refer to my condition as a psychological diagnosis of a neurological condition.

Gender Identity Disorder (GID) is typically discussed as both a psychological and biological condition. Psychology tends to place an emphasis on the outward manifestations of depression, anxiety, and stress often connected with the gender dysphoria (feeling/believing one’s gender is incongruent with one’s biological sex). Medical and scientific research tends to emphasize pre-natal genetic/biological explanations and causes for the condition. The most recent medical/biological research points to “clear and incontrovertible evidence”[1] of GID being a neuro-developmental condition of the brain.[2] Because of this, the condition cannot be treated by counseling alone. Persons with my diagnosis require an approach that includes a blend of behavior changes and medical interventions. The stress related to not treating the condition (by following these prescribed medical protocols) is often life-threatening. My treatment includes some grooming and clothing choices, cross dressing, and pharmaceutical assistance. Both psychology and scientific research agree that the condition is treatable (by providing relief and comfort through various means) but not curable.

GID is most often described as having six stages (or types) ranging from persons who occasionally cross-dress to those transitioning to their perceived gender through reconstructive surgery.

My diagnosis is near the more intense end of the spectrum and can be described as follows . . .

My gender “feelings” and self-image are very strongly feminine.
I express these thoughts and feelings through clothing (some all the time and some when dressed totally en femme) and personal grooming choices (primarily make-up and long, manicured nails).
My sexual attraction is to my wife only.
Dressing is not connected with any sexual gratification.
Medical/pharmaceutical support is recommended and helpful. It has both emotional and physiological benefits for me.
Psychotherapy is not needed or advised. My diagnosis summary identifies me as “psychologically stable and upstanding”.
I identify myself as transgendered (or transsexual) and have a feminine identity that finds various expressions including a web site, some online publications, a list-serve/bulletin board for transgendered and transsexual Christians, and participation (with my wife) in a support group. I have also spoken at an international conference for the transgendered and their families on issues of faith development in the transgendered.

People often ask why this is just coming out now. My response is somewhat involved. It is something that I have been dealing with all my life. It is not new. Like many transgendered people I tried my best to raise my kids with a “good” role model; seeking to live up to the macho roles that society expects. I was able to do this (at a great emotional price), but deeply regret that my sons rarely saw the nurturing person behind the “Dad mask”. Once the kids were all raised and married, the emotional energy needed to keep suppressing the real me seemed to disappear. I simply could no longer keep up the façade. So “coming out” combined a desire for authenticity and integrity as well as an admission that my emotional health could not sustain any further duplicity. Once released, the Julie (my preferred name) within has grown in both understanding and expression of the woman within. It feels so right that wearing “guy clothes” often feels wrong. According to my therapist, it is very likely that the day is coming – perhaps soon – when I will be living full-time as a woman even if I do not pursue sexual reconstruction surgery (a shared decision that is based on the relationship between Joanne and me).
I am sharing this information because I value our friendship and believe this information may be of value in helping you understand GID and the transgendered in our world. There is much more I could share (personally, in terms of research, and in terms of transgender-related law), but this is probably enough (maybe more than enough) for now. I am always ready and willing to discuss this. It’s me so it is a topic I can speak about easily. J

[1] Dr. Craig Kinsley, neuroscientist at the University of Richmond as quoted in the AP article Boi or grrl? Youth culture testing the boundaries of gender identity and roles (10/1/05).
[2] This web link summarizes the conclusions of a renowned team of international researchers that included psychologists, doctors, and other specialists in this field. They concluded that GID is “strongly associated with the neurodevelopment of the brain” and that it has “not been found to be overcome by contrary socialization, nor by psychological or psychiatric treatments alone”. They emphasize a treatment that uses a variety or approaches consistent with the needs and circumstances of the individual. http://www.gires.org.uk/Web_Page_Assets/Etiology_definition_signed.htm