Okay, so your displaying feminine characteristics in front of your mom, and so I assume that you live with your parents? How long has it been since you came out to your parents? The conversation that you described between your mom and yourself, seems more of a dispute over how youve done your nails. Mother and their daughters goes threw the same thing about their nails, make up, and hair style, not so much of the term discriminating but part of the learning process of womanhood. Remember that mothers are also teachers in their own ways. At the end of the day, what matters is the woman in you.

Hi Rhonda,

I never came out to my parents and I don't think I ever will. My mom once guessed it out of the blue and I confirmed it but afterwards she told me never to bring this subject up again. I told my dad once and it was never spoken of again.

I don't think it was a dispute about how I did my nails. It is more. I see how she treats my sister. With me (given that she sees me as male) her critical thinking works and she can think. With my sister all she thinks about is how my sister will get married. She even joked once with my sister, while my sister was having a hard time, that she hoped her boyfriend will marry her as soon as possible so she gets her out of her care. How can a mother say this to her daughter. I just feel very sad when my mom and sister talk. Also if you notice, I am now living in Amman, Jordan (where I was born) so things are a little reserved and old fashioned.

Thanks for your support.

Hanna

Hmmmm... You know, it sounds like discrimination to me. It's probably like what you said about the environment your mother grew up in. As for her flipping out over a base coat of what had to have been clear nail polish, that is totally unfounded. I say this because my grandfather, a very straight masculine man, uses clear nail polish to strengthen his nails. A lot of people do, men and women.

And she may be your mother, but she should respect you. They are your nails. They grow. And change. And the nail polish isn't permanent. I do understand if she is maybe afraid for your safety or something, but if that isn't an issue then I don't see the problem. It is your choice either way.

Ok hun this hits close to home...my mother was the same way. DO NOT GIVE UP ON HER NO MATTER WHAT! She is your mother put yourself in her shoes! No mother wants to believe there is anything wrong with their child. They here transexual/transgender ....or GID which is Gender identity disorder.....(DISORDER!!) they see it as something is mentally wrong not OMG this is my daughter COME OUT OF THERE LITTLE GIRL!! You can try expressing yourself through letters to your mother....it's what I did...she needs to know just how serious you are about this! I went through a lot of pain and heartache with my mother over this...it's taken almost 3 years since I came out...I went through a legal name change from Bradford Nelson to Katie Marie Nelson and Bradford was my recently deceased grandfather's name. So there was some animosity towards my name change as well. Plus she didn't get to choose my new name! Well she didn't accept me from the get go either...STALE MATE.........just this month after hearing how affectionate I have been towards my grandmother (who took me in when I was 16 against my mothers will) hugging my grandmother and kissing her on top of the head and telling her how I love her...it made my mom jealous of this affection....plus I am the only one of my 3 brothers who will come stay with her at her new home or visit her there. Even though every time she slipped up and called me by my old name or had old pictures of me looking like a male on the walls in the spare bedroom I slept in. It was horrible I would cry at night but this is the same woman I use to pick tiny flowers for as a child and tell her how pretty she was...the same woman who I would tell her knees looked like baby faces and she would come over to the couch and tickle me and both us giggle.....I NEVER GAVE UP dispite all the things.....even after my papaw died I had been off ciggarettes drugs and alcohol for a full year and she made the comment compared to crossdressing it was just the lesser of two evils and I broke and went back to smoking,,,,NEVER GAVE UP ON HER THOUGH......I sent her mother's day cards...teddy bears......christmas.......THIS LAST WEEK SHE MADE IT A POINT TO CALL ME "KATIE" LOUD ENOUGH THAT I COULD HEAR HER!!!

DON'T GIVE UP! IN FACT PRINT THIS HERE OFF AND GIVE IT TO HER!!! GOD BLESS YOU! THE REST OF US WILL BE PRAYING FOR YOU!!

Get her to read this site:
"Transsexual gene link identified"
http://news.bbc.co.uk/2/hi/7689007.stm

Hi Katie,
Thank you so much for sharing this with us. It is truly inspiring and encouraging. I will definitely keep the faith wtih my mom. This is a truly transparent post and it will help me big time. Oddly enough my name Hanna is arabic for John and I am the eldest in the family, so I too carry my Granddad's name. So many expectations are there for me (very few of which I fullfilled).

I have a feeling that I will get through to my mom at one point. You are right it is not something to celebrate, especially with my mom. It is way too early for that. I remember when I came out to my mom about being gay and I told her that I wanted to tell me friends. So she asked me why I wanted to come out and I answered her that I wanted to celebrate it :). Here in Jordan celebrate it :) So she screamed at me and urged me not to bring the subject up again.

Thanks again Katie

Hanna

I don't mean to get off topic here.. well just a little lol I'm trying to figure out what is the "Disorder"? It is Dysphoria, it is people in society that don't understand the birth defect, that makes it a "disorder".

It is still listed as a disorder in the DSM by the American Psychiatric Association.

Rhonda it's just a label but you have to have been diagnosed with Gender Identity Disorder and 2 letters of recomendation for SRS or Sexual Reassignment Surgery before any surgeon will touch you.

http://en.wikipedia.org/wiki/Gender_identity_disorder

Gender identity disorder
From Wikipedia, the free encyclopedia


Gender identity disorder (GID) is the formal diagnosis used by psychologists and physicians to describe persons who experience significant gender dysphoria (discontent with the biological sex they were born with). It is a psychiatric classification and describes the attributes related to transsexuality, transgender identity, and transvestism.

Gender identity disorder in children is usually reported as "having always been there" since childhood, and is considered clinically distinct from GID which appears in adolescence or adulthood, which has been reported by some as intensifying over time.[1] Since many cultures strongly disapprove of cross-gender behavior, it often results in significant problems for affected persons and those in close relationships with them. In many cases, discomfort is also reported as stemming from the feeling that one's body is "wrong" or meant to be different.

Some transgender people and researchers have criticized the classification of GID as a mental disorder for several reasons, including evidence from recent studies about the brains of transsexual people.[2] The treatment for this disorder consists primarily of physical modifications to bring the body into harmony with one's perception of mental (psychological, emotional) gender identity, rather than vice versa.[3]

Diagnostic criteria

In the United States, the American Psychiatric Association permits a diagnosis of gender identity disorder if four diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, 4thEdition, Text-Revised (DSM-IV-TR) are met. The criteria are:

* Long-standing and strong identification with another gender

* Long-standing disquiet about the sex assigned or a sense of incongruity in the gender-assigned role of that sex

* The diagnosis is not made if the individual also has physical intersex characteristics.

* Significant clinical discomfort or impairment at work, social situations, or other important life areas.

If the four criteria are met under the DSM-IV-TR, a diagnosis is made under ICD-9 code 302.85. See the classification and external resources sidebar at right for other diagnostic codes for gender identity disorder.

The International Classification of Diseases (ICD-10) list three diagnostic criteria:

Transsexualism (F64.0) has three criteria:[3]

1. The desire to live and be accepted as a member of the opposite sex, usually accompanied by the wish to make his or her body as congruent as possible with the preferred sex through surgery and hormone treatment
2. The transsexual identity has been present persistently for at least two years
3. The disorder is not a symptom of another mental disorder or a chromosomal abnormality

Uncertainty about gender identity which causes anxiety or stress is diagnosed as sexual maturation disorder.

reatment
Main articles: Hormone replacement therapy (male-to-female) and Hormone replacement therapy (female-to-male)

The World Professional Association for Transgender Health (WPATH, formerly HBIGDA) Standards of Care (Version 6 from 2001) are considered by some as definitive treatment guidelines for providers. Other Standards exist (see those discussed in Standards of care for gender identity disorders, including the guidelines outlines in Gianna Israel and Donald Tarver's classic 1997 book "Transgender Care". Several health clinics in the United States (e.g. Tom Waddell in San Francisco, Callen Lorde in New York City, Mazzoni in Philadelphia) have developed protocols for transgender hormone therapy following a harm reduction model which is coming to be embraced by increasing numbers of providers. In their 2005 book Medical Therapy and Hormone Maintenance for Transgender Men, Dr. Nick Gorton et al. suggest a flexible approach based in harm reduction, Willingness to provide hormonal therapy based on assessment of individual patients needs, history and situation with an overriding goal of achieving the best outcome for patients rather than rigidly adhering to arbitrary rules has been successful. (See External Links below.)

Formal gender clinics for individuals seeking medical sex reassignment began operating in the 1960s and 1970s, leading to long-term follow-up studies that began appearing in the research literature in the 1980s and 1990s. These studies have examined transsexuals who received clinical approval to undergo reassignment and proceeded to do so.[4][5] The great majority of patients who met clinics' screening criteria reported being satisfied in the long-term with the results.
[edit] Prepubescent children
Main article: Gender identity disorder in children

The question of whether to counsel young children to be happy with their biological sex, or to encourage them to continue to exhibit behaviors that do not conform to gender stereotypes or to explore a transsexual transition is controversial. Some clinicians report a significant proportion of young children with gender identity disorder no longer have such symptoms later in life.[6] There is an active and growing movement among professionals who treat gender dysphoria in children to refer and prescribe hormones to delay the onset of puberty until a child is old enough to make an informed decision on whether hormonal gender reassignment leading to surgical gender reassignment will be in that person's best interest.[7]

Controversy

Many people who suffer from Gender Identity Disorder do not regard their own cross-gender feelings and behaviors as a disorder. People suffering from Gender Identity Disorder often question what a "normal" gender identity or "normal" gender role is supposed to be. One argument is that gender characteristics are socially constructed and therefore naturally unrelated to biological sex. This perspective often notes that other cultures, particularly historical ones, valued gender roles that would presently suggest homosexuality or transsexuality as normal behavior.[8] Some people see "transgendering" as a means for deconstructing gender. However, not all transgender people wish to deconstruct gender or feel that they are doing so.

Others suffering from Gender Identity Disorder object to the classification of GID as a mental disorder on the grounds that there may be a physical cause, as suggested by recent studies about the brains of men who dress in women's clothing. Many of them[who?] also claim that the treatment for this disorder consists primarily of physical modifications to bring the body into harmony with one's perception of mental (psychological, emotional) gender identity, rather than vice versa.[3]

Little evidence exists to support the claim that Gender Identity Disorder has a neurological basis, and critics of GID denomination say there is no scientific consensus on whether the cause of Gender Identity Disorder is mental or physical.[9]

In December 2002, the British Lord Chancellor's office published a Government Policy Concerning Transsexual People document that categorically states "What transsexualism is not...It is not a mental illness."[10] In May 2009 the government of France has also declared that a transsexual gender identity is not a psychiatric condition in France.[11]

The Principle 3 of The Yogyakarta Principles on The Application of International Human Rights Law In Relation to Sexual Orientation and Gender Identity states that "Person of diverse sexual orientation and gender identities shall enjoy legal capacity in all aspects of life. Each person's self-defined sexual orientation and gender identity is integral to their personality and is one of the most basic aspects of self-determination, dignity and freedom" and the Principle 18 of this states that "Notwithstanding any classifications to the contrary, a person's sexual orientation and gender identity are not, in and of themselves, medical condition and are not to be treated, cured or suppressed." According to these Principles, any gender identity of a transsexual or transgendered person is neither "disorder" nor mental illness, thus the diagnosis "gender identity disorder" can be contradictory and irreverent.

Some people[12] feel that the deletion of homosexuality as a mental disorder from the DSM-III and the ensuing creation of the GID diagnosis was merely sleight of hand by psychiatrists, who changed the focus of the diagnosis from the deviant desire (of the same sex) to the subversive identity (or the belief/desire for membership of the opposite sex/gender).[13] People who believe this tend to point out that the same idea is found in both diagnoses, that the patient is not a "normal" male or female. As Kelley Winters (pen-name Katharine Wilson), an advocate for GID reform put it, "Behaviors that would be ordinary or even exemplary for gender-conforming boys and girls are presented as symptomatic of mental disorder for gender nonconforming children."[9] However, Zucker and Spitzer[14] argue that GID was included in the DSM-III (7 years after homosexuality was removed from the DSM-II) because it "met the generally accepted criteria used by the framers of DSM-III for inclusion".

The GID controversy figured prominently at the 2009 meeting of the American Psychiatric Association in San Francisco, both in presentations in the meeting and in protests outside the meeting; protesters focused on the attitude of the psychiatric community and tried to make the point that GID is not a mental disorder, as well focusing on the role of Kenneth Zucker in leading the DSM-V Task Force on Sexual and Gender Identity Disorders.[15]

http://www.supornclinic.com/restricted/Scheduling/protocol.aspx

Minimum Psychosocial requirements for Patients Scheduling SRS:



It is not Dr. Suporn's policy to deny SRS surgery to any patient he believes to be medically and psychologically fit to undergo it. As far as is considered reasonable, The Suporn Clinic follows the guidelines of the Harry Benjamin Gender Identity Disorder Standards of Care (HBGIDSOC). Additionally, we always comply with the Medical standards of Thailand. We require patients to provide written evidence that they meet the following criteria:

SRS Patients

With effect from 29 November 2009, new regulations issued by the Thai Medical Council regarding SRS patients come into force.

ALL patients undergoing SRS MUST provide an original, signed document from a qualified psychiatrist or psychosexual specialist, confirming as a minimum that:

1.

They have been diagnosed with Gender Identity Dysphoria.
2.

SRS is indicated in their case, and is the recommended treatment.

Ideally, the referral should also confirm that:
3.

They have been living full time as a woman for at least 12 months prior to surgery or - if not - gives an explanation as to why that has not been possible in their case. It is accepted that RLT is not a practical possibility in some countries.
4.

They have been undertaking a course of female hormone replacement therapy (HRT) unless there are medical reasons (to be indicated) that such a course is not advised in their case.

The letter must show the name, address and telephone number of the signee, for possible verification

In order to ensure that there are no difficulties with the documentation that you have, please make sure that you scan the letter and send it to me as an email attachment for review, to make sure it meets the necessary requirements. It is essential that you bring the original with you when you come for surgery (or that the original is sent to us direct). It will not be possible to go ahead with the SRS operation without such a suitable letter.

There are no exceptions to this requirement. Any patient who arrives without this evidence will not be permitted to undergo surgery. If you have difficulty with providing such evidence, please contact the Suporn Clinic, so we can discuss possible ways of meeting this requirement.

Additionally, if the referral letter from the psychosexual specialist does not specify as in items (3) and (4) above, we require you separately to provide evidence that you:

*

have had treatment with feminizing hormones (HRT) and/or anti-androgens for a minimum period of 12 months, unless there is a medical reason why to do so would not be advised in your case.
*

have lived full time in your acquired gender for a period of at least 12 months, evidenced by at least 2 original documents ( ** ), unless there are clearly given and acceptable reasons why this is not possible, or not practical in your case. Some easement of this requirement might be permitted, subject to the contents of the referral letter.

( ** ) Documentary evidence needs only to be sufficient to show the patient's acquired (female) name, and bear a date at least 12 months prior to surgery. Suitable examples would be - but are not restricted to - passport, driver's licence, official ID card, household utility bill, bank statement...etc.

SRS Referral Letter

There is no specific format for a SRS Referral letter. Dr Suporn does not expect a long report or detailed diagnosis, but he does expect it to contain certain minimum criteria. We would expect the doctor to mention how many times he has seen the patient, and since when. The doctor or practitioner does not have to specifically recommend that the patient should undergo SRS, nor do they have to specifically refer the patient to Dr Suporn ( a qualifying referral previously addressed to another surgeon is acceptable ). However, we would expect to see that the doctor or therapist considers that the patient:

*

has been diagnosed with gender dysphoria as the conclusion of a number of personal communication sessions. Confirmation of diagnosis in accordance to DSM IV Code 302.85 and/or ICD10 code F64.0 (or as otherwise appropriate) must be mentioned.
*

shows no evidence of co-morbidity or substance abuse.
*

is demonstrably living full time as a woman for at least 12 months, or shows evidence of commitment to do so, or has satisfactory reasons as to why she is not yet doing so. There might, for example, be legal reasons in any particular country preventing this.
*

is not suffering from any psychological or psychiatric disorders (****) that might be adversely influencing her decision or desire to undergo SRS.
*

has been taking female hormones (for a specified period - usually a minimum of 6 months), unless it is considered medically unsafe to do so.
*

is fully adjusted to living in society as a woman or if not yet living as a woman must have a satisfactory explanation as to why this is the case.
*

is fully aware of the consequences, cost, details, complications and surgical and non-surgical options available to treat her gender dysphoria.
*

is aware that SRS is irreversible.
*

is considered suitable by him / her to undergo SRS insofar as he/she offers no reason why you should NOT undergo SRS and that SRS is necessary for the patients long-term well-being.

If the letter has all (or most of) those "ingredients", and the doctor is competent to write and sign it by virtue of his / her qualifications and credentials, Dr Suporn will accept that as suitable referral.

( **** ) Although it is sometimes referred to as such, in this respect, we do not consider Gender Identity Disorder (GID), Gender Dysphoria or transsexualism to be a psychiatric or psychological condition.

SRS Under Age 20

Under Thai medical regulations, patients under the age of 20 are unable to undergo surgery without the written approval of their parents, legal guardians, a direct blood relative, or an individual who has legal Power of Attorney over your affairs. The signee must, himself or herself, be aged over 20. The signed document giving approval for you to undergo SRS must also be accompanied by an originally signed photocopy of a photo-ID which bears the same signature. If the family name of the signee is different from your own family name, copies of suitable evidence must be given to link the signee with having the authority to sign on your behalf.

If you are able to obtain this approval, Dr Suporn would be quite happy to proceed with surgery - providing you are able to meet the other criteria of our protocol, particularly in respect of having been diagnosed gender dysphoric, and having psychotherapeutic agreement to undergo the surgery. If you do not provide this approval, in original format, at the time of the operation, Dr Suporn will not proceed.

Dr Suporn is unable to undertake SRS on patients aged less than 18 years.

Patients Aged 65 and over

Dr Suporn no longer accepts patients aged 65 and over for SRS or substantial FFS operations. To amplify the meaning of "substantial", please contact the Clinic to discuss specific circumstances.

Pre-Operative Medical Requirements and Surgical Considerations

Patients will only be operated on if they are medically fit for surgery. While a full medical check-up is provided at the hospital prior to surgery, all patients with known medical conditions are strongly advised to undergo a full medical check-up by their own medical practitioner prior to confirming their surgery booking. They should obtain and submit along with other documentation a report from their medical practitioner certifying that detailing date of birth, height, weight, medical history, medical conditions, and a recommendation that the patient is physically fit to undergo major surgery under general anesthesia.

All patients are screened with an electronic questionnaire prior to scheduling for surgery.

Final medical clearance for surgery depends on satisfactory results of the medical admission tests, and consent of the anesthesiologist at Aikchol hospital

Orchiectomy

Bilateral orchiectomy is not recommended prior to SRS, but is permitted. If the scrotal sac has been removed, the applicant must seek elsewhere to undergo SRS.

Genital Electrolysis

Prior genital electrolysis is not required. Permanent genital depilation is unnecessary, expensive and uncomfortable. All hair follicles are manually excised (cut) from the scrotal skin during surgery, and will not grow subsequently. A hair-free vaginal lining is guaranteed. Prior electrolysis of the scrotal area may result in scarring and thickening of the skin which could reduce its elasticity and vaginal depth. If desired, only the perineal region (perineum) between the anus to the scrotum should be cleared (which can also be cleared after SRS)

Blood Transfusions

For all surgery, no blood transfusions are used (no need for patients to bring their own blood supply)

Deep Vein Thrombosis (DVT) Risk Avoidance

Major surgery - particularly SRS - carries the potential risk of incurring Deep Vein Thrombosis. Dr Suporn and his team take every precaution possible to minimize the risk of DVT. However, much of the responsibility for risk avoidance of DVT rests with the patient, not with the surgeon. Patients are recommended to reduce weight to acceptable (non-obese) levels, to remain actively fit, and to take adequate exercise during any long-haul flight. In addition:

*

Hormones. All anti androgen/hormone injections must be stopped 4 weeks before traveling, and anti androgen/hormone oral tablets, gels, patches, and aspirin must be stopped 1 week before traveling to Thailand
*

Smoking and any heavy drinking must be stopped at least 1 month before traveling to Thailand.
*

Patients who fail to stop taking hormones or/and smoking before surgery will have their surgery cancelled.

Patients who smoke must make every effort not to resume until at least one month after surgery. FFS patients - in particular - should be aware of the extreme adverse effect that smoking has on post-operative recovery and results.

After surgery, hormone treatment can be resumed 2 weeks after surgery (in the case of SRS resumption of anti androgens is not necessary unless prescribed to the contrary by your medical practitioner)

HIV

Dr Suporn does not undertake elective surgery on HIV+ (positive) patients.

Patients who have any doubts about being HIV- (negative) should have the test before coming to Thailand. Patients who fail to disclose any serious medical conditions, including clinical obesity, may have their surgery cancelled upon arrival to Thailand, and forfeit all payments made for surgery.



Protocol for undergoing FFS

Dr Suporn considers FFS to be purely elective surgery, and as such does not expect any patient to meet any specific criteria other than being physically fit to undergo the operation. In general, however, he considers FFS likely to be unnecessary and unadvisable for any patient below 18 years of age, assuming she is following a course of feminising HRT, unless she has unusually dominant male characteristics.

There is no requirement for any patient to have started feminising HRT prior to undergoing FFS. HRT in general will have no effect on the underlying bone structure of the face, but might have some feminising benefit by altering the facial skin texture and facial fat distribution, which can have a softening effect. HRT is more likely to be effective in this respect for a younger client, than for a more mature individual.