population, much like random birth errors (Ettner, 1999, pp.25-29.)
Marilyn Volker, Ed.D. (2007), a therapist and sexologist, states: I think that it is a part of our society and we need to be learning lots and lots of lessons. We are learning a lot of things that can happen in a mother’s uterus – that can affect the shaping of people’s brains which doesn’t always match what is between the legs. There is a lot that we are seeing from pediatric endocrinologists, people who study hormones and chromosome patterns, and yet, the most extraordinary thing of all is that we see the human spirit who is saying to us, “see me, you want me to tell the truth, let me be able to be me.” We have seen in a mother’s uterus there are all kinds of things that can be different. Perhaps a baby girl can be born with an XO chromosome. A baby girl can be born with an XY chromosome. A child born with a vagina having, let’s say, testosterone testicular tissue in the ovaries which can shape the brain in a different way. We’ve seen children who have problems and differences with hormones right from the get go – right at birth and it can shape the brain. So we are very interested and excited about what’s happening - what we call brain sex as related to gender. And that’s what folks are telling us but a lot of research is looking at it.
With the production of the movie, “TRANSAMERICA,” Duncan Tucker and the Weinstein Company provide an opportunity to learn about the process and experiences of transitioning from one gender to another. While viewing the movie, TRANSAMERICA, this guide will assist the viewer in learning about this process and the issues and struggles faced by the people who experience it, as well as for their families and their friends.
To make the best use of this guide:
1.VIEW THE FILM IN ITS ENTIRETY, then
2.READ THE GUIDE, SECTION BY SECTION, AS YOU REVIEW THE CORRESPONDING SCENE FROM THE FILM.
“This Is the Voice I Want to Use”
The setting is southern California. The opening scene introduces Bree Osbourne, a transgendered person who is in the process of transitioning from male to female (MTF). This means that she has been presenting herself as the opposite sex and living as a woman. As part of the transitioning process she has been working on developing her voice to sound more feminine in pitch and inflection, she uses feminine cosmetics and make-up, wears female clothing, including female under garments and accessories to exaggerate her breasts and hide her penis, and she slouches to appear shorter than the average man.
Bree’s transition process appears to be ongoing, for at least three years, during which time she has been through electrolysis, three years of hormone therapy, facial feminization surgery, brow lift, forehead reduction, jaw re-contouring and a tracheal shave. She is in psychotherapy where she feels support for her transition, but is unable to identify any family or friendship support.
Bree says that her parents are dead but later in the film it is learned that this is untrue. Perhaps Bree has become estranged from her family so that she does not have to announce her transgenderism. Perhaps she is estranged from her family because she has announced her transgenderism and has been rejected by them. Lev (2004, p. 299) reports that clients are afraid to disclose to their families of origin. Disclosure of transgenderism can result in excommunication and ostracism from family, which can also be difficult to manage if someone is close to his or her family, but can also be difficult to manage if someone is estranged from family.
Some transgender people have never come out to anyone. It is unknown how many people harbor unresolved feelings and thoughts about their gender but remain completely reticent about these feelings, perhaps never acting on them, even in secret. Others might cross-dress, publicly or privately, and even have an active support system within the transgender community, and keep this information hidden from their significant other. In other cases, only the significant other knows and the secret is kept hidden from the rest of the world. The advent of the computer age and online communication has created a vast support network for people who might otherwise be isolated. Many people are only “out” online, or have opposite sex personas online, although they have no other real-life experience (Lev, 2004, p.293.)
Many transgender people are socially isolated as expressed by Riki Wilchins (1997), a MTF transgendered person who is an internationally known gender activist and advocate, in her book, “Read My Lips: Sexual Subversion and the End of Gender”:
Loneliness, and the inability to find partners, is one of the best-kept secrets in the trans community… Transbodies are the cracks in the gender sidewalk. When we find partners, they must be willing to negotiate the ambiguity of the terrain.
Bree is at the point in her transition process where she is seeking written consent from a psychiatrist to have SRS, to physically become a woman.
Requests for SRS began escalating in the early 1950’s after a young G.I. left the United States to go to Europe and become a female named Christine Jorgensen. Thousands and thousands of letters were written to Christine for support and guidance by individuals who identified with her. Others who did not write, many of who were simply too young to contact her, were indelibly marked by her courageous public disclosure of her transition from male to female. Christine Jorgensen’s story shocked the world, and generated dilemmas and controversies in psychiatry, medicine and law, that persist today. But above all, it gave hope and inspiration to many that perhaps anatomy was not destiny after all (Ettner, 1999, pp. 16-17.)
During Bree’s interview with the psychiatrist, Bree poses the question, “Don’t you find it odd that plastic surgery can cure a mental disorder?” Bree’s sentiment seem to be in congruence with Harry Benjamin, an Endocrinologist and pioneer in the compassionate treatment of gender variant people. In discussing a male-to-female transsexual Benjamin stated that, “Psychotherapy with the aim of curing transsexualism, so that the patient will accept himself as a man…is a useless undertaking…the mind of the transsexual cannot be adjusted to the body, [thus] it is logical and justifiable to attempt the opposite, to adjust the body to the mind (Benjamin, 1966, p. 116.)
Dr. Benjamin’s interest in what he himself came to call “transsexualism” began after he became acquainted, through Alfred Kinsey, with a young patient who was anatomically male, but insisted that he was really female. His interests have led to what is known today as The World Professional Association for Transgender Health (WPATH), an international interdisciplinary, professional organization whose mission is to further the understanding and treatment of gender identity disorders by professionals in medicine, psychology, law, social work, counseling, psychotherapy, family studies, sociology, anthropology, sexology, speech and voice therapy, and other related fields. It was originally named after Dr. Benjamin, as it was first known as the Harry Benjamin International Gender Dysphoria Association (HBIGDA.) It provides opportunities for professionals from various subspecialties to communicate with each other in the context of research and treatment of gender dysphoria including sponsoring biennial scientific symposiums. WPATH publishes the Standards of Care (SOC) and Ethical Guidelines, which articulate a professional consensus about the psychiatric, psychological, medical, and surgical management of gender identity disorders, and help professionals understand the parameters within which they may offer assistance to those with these conditions (WPATH, 2007.) The SOC are clinical guidelines that are intended to provide flexible directions for treatment with eligibility requirements that are meant to be minimum requirements. They include standards for professional involvement with patients; the roles of the mental health professionals with the gender patient; standards for the training of mental health professionals; the differences between eligibility and readiness criteria for hormones or surgery; the mental health professional’s documentation requirements for the differing letters for hormones or for surgery; standards for children with Gender Identity Disorder (GID); standards for treatment of adolescents; standards for psychotherapy with adults; standards for the real-life experience; and requirements for genital reconstructive and breast surgery (Ettner, 1999, pp. 139-150.)
It
