Posted on 12/19/2001 8:58:59 AM PST by medlarebil
At his brother's wedding, the photographer put Marcus Rene Van with the men in the family and his sister screamed, "That's my sister."
Technically -- and biologically -- she's right. But two years ago, the 25-year-old spoken word artist with a tiny goatee swapped genders and went from she to he.
Van is one of a rising number of young women who are opting to live their lives as men -- a trend on the rise in San Francisco's lesbian community.
Business is booming for doctors specializing in chest surgery, clinics that provide hormone treatment and psychologists who offer gender therapy, with one popular surgeon completing twice as many surgeries as he did five years ago.
When Van -- who lives as a man without the help of hormones or surgery -- made the switch, it wasn't a popular thing to do. Now, he said, he's just another trans man living in The City.
Access to transsexual procedures is helping many be true to their chosen gender. But is easy access to hormones and the deluge of information about transsexuality helping those in need, or is it just plain hip right now to be a boy?
"I think (some young) people are going to end up regretting what they have done," Van said of those who might be too quick to take hormones without considering the effects. "If you take hormones for a couple of years, there is no turning back."
Easy access
Dimensions, the lesbian, gay, bisexual, transgender youth clinic in the Castro-Mission Health Center, is where many trans men have been coming since the doors opened three and a half years ago.
The clinic offers hormone treatment and has at least 25 female to male (FTM) transsexual clients who are on testosterone, according to clinic coordinator Laurie Lenrow.
Before a patient is permitted to take the hormones, they (or their guardians, if they are underage) are required to sign a consent form that outlines the permanent damage testosterone can do. Hair loss, beard and mustache growth, deepening of the voice, increased body hair and enlargement of the clitoris are irreversible, and the risk of cancer and diabetes is increased.
The clinicians here, like many who work with the transsexual community, do not closely adhere to what they consider conservative international standards of care for transsexuals, the Harry Benjamin Standard. The guidelines suggest three months of psychiatric treatment for those wanting to take hormones.
But patients at Dimensions do not have to undergo therapy and most are able to start hormone treatment within five weeks of their initial visit, following lab tests and a staff review of the individual case.
Lenrow compares taking testosterone to birth control pills, and points out there are many who don't take hormones or get operations. Besides, she said, most of their clients have been considering transition since they were teenagers and are usually "well-prepared" to make the decision.
Making history
Barely old enough to buy a drink, Chris Tavelli, 21, got chest surgery to remove his breasts in March and began taking testosterone in May.
He said he has known that his gender was wrong for as long as he remembers, but still admits that he made his decision at a young age, even though his family wanted him to wait.
But he doesn't think he'll have any regrets.
"Anything is possible, but I highly doubt I will ever regret it," he said. "You don't get to this decision on the whim. I'm just not a girl."
Still, many in the lesbian community are struggling to understand why so many young women want to change genders. While some view it as betrayal, others are just confused.
Bonnie Barrett, 33, graphic designer, is one of the confused. Barrett has been mistaken for a boy all her life.
"I'm not that old-fashioned," she said. "But (taking hormones) is a radical decision that I think is taken very lightly. What's wrong with just going to gym? What's wrong with just being butch?"
Why not just be a butch lesbian is a question that Van and Tavelli have all been asked a million times.
"It didn't fit," Van said simply. "I wanted to be myself, and myself is male."
Under the knife
A graceful metal robot with big red lips and voluminous breasts greets Michael Brownstein's clientele in his Potrero Hill loft medical office.
The gray-haired plastic surgeon has been doing sexual reassignment surgery in The City for more than 20 years. He has done hundreds of mastectomies and metoidioplasties -- the transformation of external female genitals into male (see inset) -- and business is booming.
Brownstein is doing twice as many surgeries as he did five years ago for clients who are mainly women in their 20s and 30s and want a mastectomy, or top surgery -- the more common of the two procedures that he does.
But he maintains that having surgery -- or even changing genders -- is not a fad.
"It's not a trendy thing," he said. "It's not like a rave party. This is a real condition."
Brownstein said the reason for the increase in procedures is that there is more acceptance of transsexuals, and more access to information via the Internet.
As chairman of the ethics committee for the Harry Benjamin International Gender Dysphoria Association, he makes certain that his clients are ready to make the decision for surgery. But Brownstein doesn't require a letter from a therapist in every case, as is required in the guidelines.
"Someone who is 40 and has lived as a male for 20 years successfully, I wouldn't have much reservation," he said. "But a 22-year-old doesn't have that same degree of experience."
Getting equipped
Riley Richard is considering his options.
The 26-year-old with a sweet round face and tattoos running up his arm is going to therapy to figure out if hormones are the right treatment for him.
A few months ago, Richard decided to switch genders and went from she to he. Inside, Richard is all man.
"I'm a boy and I always have been," he said behind black-rimmed glasses and a ski cap pulled around his face. "I just don't have the biological equipment."
Richard has made the choice to go by "he" in a workplace that is accepting of his new gender, even though he was blessed otherwise.
Pronouns are important at Good Vibrations, where Richard works as a warehouse clerk. Sometimes it's the only word that gives away a person's gender in the sex toy distribution company where up to 15 percent of the employees are transsexuals -- the majority of whom are female to males transsexuals in their 20s and 30s.
But while Richard contemplates taking hormones, chest surgery is something he plans to do as soon as he can save the money.
Van doesn't plan to have surgery, top or otherwise.
"I want to keep my body intact," he said. "But there are things I can't do. I can't wear a tank top, I can't walk into a men's locker room."
But taking testosterone would change some of that. It would stop his periods, put more hair on his face, move fat off his hips and into his abdomen. It would make his bones bigger, his voice lower. With so many friends taking hormones, it's something Van has been contemplating.
"I think about it every day," he said.
E-mail Tanya Pampalone at tpampalone@sfexaminer.com
Hey, Jesus blew one out of twelve, didn't he?
Ever heard of the hippocratic oath. Also, if you think about it, most things in life are subjective. It depend on your point of view. And I didn't make the requirements, I just told you was some of them were.
If anyone doubts this, they should read "As Nature Made Him," by John Coliptano, a great book.
ProudAmericanConservative, this faulty view, that a person's mental gender is defined by that person's physical gender, can be traced back to the flawed reseach of Dr. John Money.
If want you to learn more on this subject, go check out the book titled: As Nature Made Him: the Boy who was Raised as a Girl, by John Colapinto.
Well if you want to get technical, there are cases where a baby was born with both a penis and a vagina. It is rare, but it does happen from time to time.
A baby being born with both a penis and a vagina is 1 in 10,000.
Some other types of genital deformities are 1 in 1,000.
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