Worldwide Trend on legal age of medical transitioning

Thu, Apr 21, 2011

Boy, 10, allowed to turn into a girl

A 10-year-old boy is the youngest Australian to be granted court permission to change his gender, reported Australian media.

Since he was a toddler, Jamie has identified himself as a girl. He has been living and dressing as a girl – and even uses the girls’ toilet in school – for the past two years, reported Sunday Herald Sun.

Family Court Justice Linda Dessau gave the go-ahead for preliminary or ‘stage one’ sex-change therapy for Jamie after hearing that the child saw himself as a “freak” and a “girl in a boy’s body”.

‘Stage One’ therapy involves drug therapy to stop male puberty.

The media reports did not explicitly state that it was Jamie’s family who applied for legal permission for him to undergo ‘stage one’ sex-change therapy, but it is clearly implied.

This is because Jamie is experiencing early-onset puberty, equivalent to that of a 14-year-old. His mother told the court that she was concerned of the “distress” Jamie would go through if his voice breaks and if he developed an Adam’s apple and facial hair. Once these male characteristics developed, they would be irreversible. Australian media reported that Jamie’s family fears that he will harm himself or even attempt suicide if he goes through puberty.

The judge agreed to the request, and also ordered the court to re-convene when Jamie reaches 16 years of age. This is in order to re-examine the case and to decide if he is ready for ‘Stage Two’ therapy which would see him receiving the female hormone estrogen.

The final stage of the sex-change procedure would be to change his genitalia – which, by Australian law, can only take place after he turns 18.

Family accepts Jamie as a girl, not a boy

Jamie’s mother said that the family had started treating him as a girl as far back as 2008, after Jamie’s twin brother accepted his condition.

She related that Jamie had told her that he felt he had to “go to school disguised as a boy”, and that “it is so hard trying to be a boy”, reported the Sunday Herald Sun.

The court was also told by a medical expert that Jamie appears “convincingly female in every way (except for the genitals)” and comes across “as a very attractive young girl with long, blonde hair.”

The judge reportedly has a history of approving “sex change” procedures for young people who are gender-confused.

Transgender people do not identify with the gender that they were born with. In Jamie’s case, he sees himself as a female even though he has the physical attributes of a male. Some have described being transgender as having the body of one gender, but the brain of another. Such people feel that they have been ‘born into the wrong body’.

‘Sick’ definition
Sun, Oct 04, 2009
The Star/Asia News Network

A PERSON wishing to undergo sexual reassignment surgery needs to first have a psychological assessment.
Related link:
» My journey
» Talking straight

‘The clinician’s role is to determine if the transsexual truly wants to have the surgery, as once the operation is done, there is no turning back. He will have to determine if the client is truly a transsexual and not (for example) gay or transvestite,’ says Prof Teh.

In Transgender Emergence: Therapeutic Guidelines for Working With Gender-Variant People, author Arlene Istar Lev proposes that therapy should assist the client in achieving educated self-determination, not ‘cure’ his ‘gender identity disorder’ (GID).

Unlike homosexuality, GID is still classified as a form of mental illness in many diagnostic manuals, e.g. that of the American Psychiatric Association (APA). Homosexuality was declassified in 1973, following which the APA released official position statements opposing ‘any psychiatric treatment, such as ‘reparative’ or conversion therapy, which is based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that a patient should change his/her sexual homosexual orientation.’

American lobbyists are working on getting GID similarly declassified. Will their success make any difference to Malaysian transsexuals?

Sadly, not much, says Dr Kanagalingam K. Kulasingam, vice-chairperson of the Pink Triangle Foundation Malaysia,

‘APA policy statements are used as references – most psychiatrists would use them as a guide. However, we have found that many are influenced by their prior mindset, beliefs, and prejudices. This applies to other medical practitioners as well as most people generally.

‘Also, aside from psychiatrists, many are not familiar with the APA policy statements and therefore these have little impact on a wider scale. I guess the current misconceptions as well as misplaced moral and religious beliefs will prevail.’

Sun, Oct 04, 2009
The Star/Asia News Network

My journey


I REALISED I was ‘different’ when I was six. I hated wearing dresses, I didn’t play with dolls, except to perform surgery on them. Nope, I’m not a psychopath. I have a normal day job, I send money to my mum, and I have a loving partner and a dog named Boo.
Related link:
» Talking straight
» ‘Sick’ definition

My sister, my partner in crime, got married and had a lovely pair of twin girls who call me uncle on occasions, and auntie when their father insists. I let them. But I’ll have to explain myself once I transition completely from female to male.

I was born a female. I had my period when I was 13 plus, and wore my first bra the same year. Puberty was a total nightmare. My body was growing in ways it was not supposed to be.

I had my first crush on a girl when I was 11, and people say it’s normal in girls’ schools. But I never outgrew my attraction to girls. Freak, sick, sinful – these words crossed my mind. I was a lonely teenager and an over-achiever. I hid my feelings from my family. I felt like I was living a lie.

I came across a book on a dusty shelf in my school library that saved my life. Sisterhood is Powerful by Robin Morgan. It told me it was okay to be who you are – a masculine woman, a woman who loves women. That there was nothing wrong with that. It also gave me a name – lesbian.

Knowing a term to call myself didn’t make it much better. ‘Lesbian’ was a terrible word to be associated with, especially in Malaysia. I felt trapped, not knowing another person who was gay, and too afraid to tell anyone.

So I applied for a scholarship to study in the United States. I came out as a lesbian to my college counsellor in 1992. I was 21. Finally able to tell a living soul I was gay, all my bottled up emotions came bursting forth and I wept in her arms.

I was in a relationship with a lesbian woman for seven years. Very unlike her who was completely at ease with her femininity, I was never really comfortable in my female body even though I was then comfortable to be identified as a lesbian.

Some years later, I dated a bisexual woman who became instrumental in my second coming out. Unlike my former girlfriend, she never put my masculinity down. She supported who I was meant to be.

I started reading about transsexuality and realised that I was more trans than gay. In my mind’s eye, I’ve been male ever since I became gender-conscious.

My friends and partners say my behaviour is all male, from the way I walk and the way I talk, to my sexuality. That feeling of ‘should’ve been in a male body’ never left me even when I identified as a lesbian.

I started a blog diary to put my feelings into words and understand myself better. I started to talk to friends about it. Some were supportive, some were incredulous. I hooked up with transgender men (or transmen) through the Internet and got advice about transitioning – where to obtain testosterone hormones, which doctors were friendly and would administer to you, and where to get sexual reassignment surgeries.

I learnt there is no such thing as a ‘sex change’, only a gradual transitioning through hormone therapy and various surgeries. And it depends on how far you want to go.

Meeting my partner

I decided to go to this Kuala Lumpur doctor for my monthly testosterone injections. By the fourth month, my period stopped, and my voiced changed to a lower pitch. My shoulders broadened, and I put on one kilo a month. By the sixth month, I had to shave for the first time in my life. I felt stronger. I could do 50 push-ups without breaking a sweat.

For the first time in my life, I felt at home in my body. Whenever I got the injections, I felt a warm rush, a grounded feeling, like I was meant to have this hormone in my body.

In 2007, I met Nadia, my current partner. She’s a straight woman who had only dated men. When we met, I was still a woman. We were strongly attracted to each other and we started dating.

Later, I told her I was a transman, not a lesbian. I had a hard time explaining the difference between sexual and gender orientation to her. Sexual orientation being which gender you are attracted to, and your gender being what gender you identify with.

So you could be a bisexual, homosexual (gay), or heterosexual (straight) transman. Since I identified myself as male, it would mean that after I transitioned fully to the male gender, she would not be dating a woman, but a man. In that case, she would not at all have to change her sexual orientation, which is that of a straight woman.

Then again, all these are just terms and concepts. Names can serve to empower people – like when I was young and discovering the lesbian identity gave meaning to who I had been. But even as names can empower, so can they limit us.

Nowadays, I believe love is just love. There is no need to taint it with questions of whose body is loving whose body. Or whose identity is loving whose identity. And you can say as much about one’s race, nationality, or religion.

Nadia was worried about but supportive of my transitioning. When I told her that I was going to remove my breasts, she went with me to Bangkok for the surgery, then took care of me until I healed.

Telling my mother

She urged me to tell my mother. I didn’t know how to. I had never spoken to my mum about my sexual or gender orientation, much less my decision to live as a man. How? I didn’t even have the vocabulary to speak about it in my mother tongue, Hokkien.

Finally, I wrote her a long letter just before we left for Bangkok explaining what the operation was about, why and how I had to do it, and that she should not worry because Nadia would be with me. A day after my surgery, I got an SMS message from my mother. It was Boxing Day.

Her exact words were: ‘If u r doing the right thing n r happy about it, am happy 4 u n will b supportive all the way. Am thankful ur friends r caring 4 u. Will always share d meditation merits wif u cos u truly deserve it. N always proud of u. May the TRIPLE GEM GUIDE U N ALWAYS KEEP U SAFE. How r u now?’

I was so moved and I felt so fine, because my mum loved me, whoever I was. I realise it can’t be easy being my mother. I remember the countless times when she had a hard time deciding whether to introduce me as a son or daughter.

Recently, to prepare her friend who had met me when I was younger, she told her, ‘Buddha says we should not judge people based on outer appearances’.’So her friend didn’t do a double take when she met me, but accepted me as a more masculine woman. Or a man. I had no idea which, and it didn’t really matter.

Sometimes people try to find reasons why I am the way I am, suggesting it’s because I never had a good father role model. My father was abusive to my mother, and she left him when we were young.

To me, that’s not a good theory as my sister and younger brother are heterosexuals as far as I know.

I have a loving circle of friends who want to celebrate my 40th birthday with me as a man, in two years. I look forward to that. The only major obstacle I have is my identity card; it has Perempuan (female) and ends with an even number to denote my gender.

I know friends who got into trouble with authorities for not appearing like the gender in their documents.

Even though there is no law in Malaysia that says a woman can’t look like a man, you can be accused of holding an identity card that is not yours.

Of course, a simple thumb print check would show that it is your IC.

A friend who is a male-to-female transsexual was stopped by immigration officials when they didn’t believe she was holding her own passport.

The passport said Lelaki (male) and she appears female in all aspects. I hate to think what might have happened to her if she had been thrown into jail and locked up with male convicts.

I worry a little about myself, but well, I’ll have to cross the bridge when I come to it. My hope and dream is that people won’t be judged based on their form or appearance but on what’s real inside. Isn’t that what being human is all about?

Sun, Oct 04, 2009
The Star/Asia News Network

Talking straight


I HAVE always liked boys, from as early as age six. Then there were four years of ‘drought’, until I met James.

My earliest exposure to the word ‘lesbian’ was in an all girls’ secondary convent school. A few of my classmates were rather boyish and had crushes on schoolmates a year our senior. They would ask for photos of the more popular or prettier seniors.
Related link:
» My journey
» ‘Sick’ definition

I was rather ignorant about gays and lesbians and admit I was not interested to know about them. I only started to read some books and articles about them after dating my current partner, a transgender man.

We met during a fitness retreat. If you didn’t scrutinise him then, you would have mistaken him for a chesty man. That was my first impression. It’s his gait. He carries himself like a man. He walks like a thug, legs wide apart, arms open, quite intimidating. I was rather worried about having him as a roommate.

After the retreat we would meet after our fitness classes for supper. One night, James revealed he was a lesbian. He asked if I had ever dated a lesbian, and if I would like to go out with him. We both sensed there had been some chemistry during the retreat itself. So, we started dating.

James has a library filled with books about gay women – theory, poetry, teen accounts – and gave me some books to read. He educated me on the various definitions for gay women: lesbian, androgynous, dyke, butch. I still mix them up.

I have never been intimate with a woman and had to read up on how to do it (hallelujah for the Internet)! We were both insecure about satisfying each other initially. Yet, you know what, this has been some of the better lovemaking I’ve experienced.

Most of James’s close friends are women. He talks very openly with them and is physically affectionate with them. In the straight world, most men are more restrained in their language and physical closeness. We are conscious of keeping that ‘polite’ distance.

Sometimes, I don’t know when he is being friendly and when he is flirting with an attractive woman. Physically and socially he is a woman, but I still regard and see him as my male partner. Therefore, I am not accustomed to his casualness and closeness with women. But it’s a fact I have to accept – that his best friends will be women and he will have closer bonds and relationships with women because of his past.

Support from family

My family is a blessing. When James and I started dating, I told my sister first that I was seeing a woman. She has always been very open, so she said that was great! My younger brother had a family meeting (without me) over my latest lover and asked everyone during dinner, ‘Did you know Nadia is dating a woman?’

My dad took me by surprise. He is 75 and the coolest dad ever! He stilled all doubt/protests with his reply, ‘As far as I’m concerned, Nadia, at her age, does not need my approval on who she is dating as long as this person makes her happy.’ Since then, my Pa has treated James like one of his buddies, even offering him a cigar after dinner (unfortunately one of dad’s vices)!

Ma has always been the cheerleader of the family and a source of support. She is worried, but most of all, confused and very curious. She asks questions about our intimacy like a curious child and it’s funny. I answer in a matter-of-fact manner.

After James’s chest operation, my brother asked how he should refer to James, by his male or female name’ My young nephew and niece think he is a man.

James’s nieces are both six and going through a stage where they are gender-conscious. They asked him, ‘Are you a girl or a boy?’ When he said he was a boy, they went and asked their maid, who said James was a girl. They returned to him with mischievous giggles.

Prior to our meeting, James had decided to proceed with a chest operation – a mastectomy, or removal of breast tissue. I happened to come along at that time and took care of him after the operation last year.

He did his own research on hospitals and doctors. I was very worried and did my own research too. I came across a site for female-to-male (FTM) transgendered persons hosted by an American. I wrote in to one of the forums hosted by the site and received a personal reply from the founder.

He was very kind and gave us practical tips and a checklist of things to do before the operation, like rearranging things in the house to be within reach, and to bring along items like a flexible straw (so you don’t have to bend over to drink); a button front shirt (so you don’t have to stretch to put it on); and large safety pins (to secure post-surgical drainage bags so they don’t dangle loose).

I arrived in Bangkok on the third day after James’s operation and went straight to the hospital to collect him. When I first saw him, he was wearing a tight elastic binder around his chest with a thick layer of cotton beneath. I pictured large cuts and stitching all over his chest and gave in to my weeks of anxiety, and cried.

But when the nurse removed the binder and cotton, I was relieved to see only neat stitches around his areolea. The surgeon was rather curt when explaining about post-operation care. James had to return three days later for another check-up. We rented a hotel within walking distance from the hospital.

After the surgery

The hospital was an experience by itself. It was like visiting Fantasy Island (the sitcom of the late 1970s). The rooms are comfortable, like a four-star hotel’s. There is a bevy of beautiful young women clad in baby blue, short skirt uniforms at the reception. There is an international language counter where the staff on duty speak Spanish, French, Japanese, Arabic, Hindi, and Malay. There are girl couriers on roller blades, clad in tennis skirts.

The nurses are all pretty and have flawless skin. They are also dressed in baby blue uniforms, but each with a different design.

It was like a beauty pageant, where the staff are mannequins advertising the hospital’s services – nipping and tucking – to create plastic people. I collected pamphlets of all the services offered, some were as exotic as changing a male voice to a female voice.

James went back to work a week after returning from surgery. In retrospect, I realise how careless we were and I feel guilty for having allowed him to go back to work instead of insisting that he extend his sick leave.

I was naive for not realising how drastic the operation was because, on the outside, the doctor had done such a good job. We could not see all the cutting and removal of tissue under his skin and how vulnerable he still was. Imagine what it was like taking the LRT every day after that.

The chest binder James had to wear to help his chest retain its shape was a physical torture. It was like a corset with rows of hooks. He had to hold in his breath each time I tugged and pulled to attach the 20 tiny little hooks. It was a battle of might – mine against the elastic and my partner’s baby fat!

James eventually found a shop in Ampang (KL) that sells vests for those who have gone through mastectomies and bought one. That vest was a luxury, compared to the binder.

Other than reading about lesbianism, I have not experienced it. James and I are like any other straight couple. Occasionally, the female side of him emerges in tender moments. At other times I find him more masculine than most men.

He is so courageous, and strong, physically and emotionally. Lately, I don’t think about and am no longer conscious of gender issues. I accept and love him as he is. I am ready to walk beside him as far as he allows me to go on his journey.

Because this country doesn’t recognise gay rights, I have so much fear for him; I fear our society will hurt him. James has considered living abroad, in a country where gay and transgender rights are recognised and protected.

But, after the Opposition won in several states in Malaysia last year, we find there may still be some hope here


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