As far as she could remember, Kathy (not her real name) always enjoyed doing “girl things,” but there was one problem—she had a male body. Not content with her life, she decided to change her body to suit her inner feelings; she became a transsexual. From as early as three, she was inclined toward feminine behaviour, Kathy said. “I always wanted to play games with girls. Sometimes I would try my mother’s dresses and shoes. My speech was always more feminine and what I liked was not what a boy would like,” she said.
Attending an all-boys high school didn’t make things easier. Saying her situation was different from that of a homosexual, she said students called her “gay” and even physically abused her. Nevertheless, in search for her identity, Kathy tried to be gay. “I tried to go to gay clubs and tried to be like gay people, and I realised that wasn’t who I was. I couldn’t fit in.”
At 16, with nobody to talk to, Kathy researched her feelings and came across “transitioning”—the process of changing one’s body to conform to one’s internal sense of being male or female, one’s gender identity. “I read about the procedure of becoming trans...and I realised that this is who I am. You can’t hide from who you are, and I always felt I was a girl, not a boy—that was my motivation.”
Unable to make an immediate transition, Kathy tried to tolerate her body, but at times it got the better of her, causing her to consider suicide. “It was getting so bad. I just wanted to be who I was. I just wanted to feel whole and I just wanted to live.” Kathy started taking birth control pills—which contain oestrogen, the chief female hormone—on her own, before visiting a psychiatrist, who sent her to the Endocrine Clinic at Mt Hope for supervised hormone therapy.
She started on antiandrogens, also called testosterone blockers, and then moved on to oestrogen. Kathy’s body responded to the therapy: her hips got rounder, she started to develop breasts, her facial features changed slightly, and hair growth on certain parts of her body decreased, she said. As her body took shape, Kathy, 22 at the time and employed, started to dress differently.
“I did it gradually. It wasn’t like I started ‘boom’ one day to dress like a woman. I made my clothes more feminine by adding accessories and stuff. It was a subtle change at first...I was still kind of in-between. “People would ask: ‘Is it a boy or girl ?’...people didn’t know what I was.” It took her a year to adopt the complete dress of a woman, she added.
Running for her life
Wearing her new identity proudly, Kathy now found herself constantly fending off attacks, verbal and physical, from family, colleagues at work, and the general public. “At home, it is a battle every day. They would wait every morning to scold me...My father used to really abuse me, physically. One day he charged towards my mother and me with a cutlass and we just had to run.” Saying she doesn’t live with or talk to her father any more, Kathy said her mother still treated her “like a human,” which angered her father.
Work was no safe haven for Kathy, neither were the streets of Port-of-Spain or public transport. In highlighting that her colleagues at work witnessed her transition, she said: “It is torture. I have to put up with people telling me all kinds of things and calling me names and telling people who don’t know that I am trans.” “And I have to use the male toilet, which is very embarrassing and very degrading for a trans person like me, even though there is a toilet outside that doesn’t have ‘male’ or ‘female’ on it.”
Walking along Frederick Street, Port-of-Spain, one day, Kathy was attacked by a group of men who pelted glass bottles at her. On another occasion, after disembarking from a public bus, a girl who knew her from high school pulled a knife on her. “I was so scared...I just ran until I got to the office. To see how much people hate was really scary.” Saying these things could happen any time, Kathy said she intended to seek asylum in Europe because it was too difficult to live in T&T.
Although she changed her name, the law in T&T—unlike that in Europe—did not allow her to change her sex, Kathy pointed out. “Not being able to change my sex negatively affects me, because if I go for a job or anywhere where I need to present an ID, it makes people watch me strangely.” She is yet to take the final step in her transition—surgery—which she wanted to do in Thailand, but couldn’t afford.
Transgender people on the rise...
The prevalence of transgender people in T&T is growing, says Prof Gerard Hutchinson, head of clinical medical sciences and co-ordinator of the Psychiatry Unit at the University of the West Indies, St Augustine. “Up to three years ago, I had seen one case in Trinidad. Over the past three years, I have seen seven cases, with many more, I think, out there,” Hutchinson said.
Transgender is an umbrella term for people whose gender identity, gender expression, or behaviour does not conform to the sex to which they were assigned at birth, according to the American Psychological Association. In an e-mail to the T&T Guardian, Hutchinson said “transgenderism” only became a psychiatric disorder—Gender Identity Disorder—if it caused dysphoria, an emotional state marked by anxiety, depression, and restlessness, and impaired normal functioning.
“It’s difficult early in life because a lot of gender identity is about socialisation, unless there are obvious anatomical differences,” he added. Hutchinson said most transgender people took hormones on their own and there was no formal treatment protocol available in T&T. Asked how he approached a transgender case, Hutchinson said he gave his patients freedom to decide and ensured they were not depressed or pressured.
Health Minister Dr Fuad Khan said more transgender people are openly declaring their position. In a telephone interview, Khan said, “More people are coming out and saying this is what I am and I want to change.” Khan, a urologist, said he performed “gender reassignment” surgeries while in private practice, although it was not a common request.
Saying a comprehensive analysis was needed before surgery, he added, “First we send them to a psychiatrist for counselling for two years to make sure this is what they want. We may also do chromosomal genetic testing and then finally, surgery.” He said the surgery was “nothing big,” although it took “pretty long,” and could be expensive.
“It’s basically removing, replacing and reconstructing organs...but they lose feelings and the ability to reproduce.” In advising the general public, Khan added, “One should never feel threatened or uncomfortable by transgender people because it is something we see all around us now.”
IMPORTANT TERMS
• Gender is the socially constructed roles, behaviours, activities, and attributes that a given society considers appropriate for boys and men or girls and women
• Sex is assigned at birth and is one’s biological status as either male or female.
• Gender identity is a person’s internal sense of being male, female, or something else.
• Gender expression is the way a person communicates gender identity to others through behaviour, clothing, hairstyles, voice, or body characteristics.
• Transgender is a broad term for people whose gender identity, or gender expression does not conform with their sex.
• Transsexual is one form of transgenderism and refers to a person whose gender identity is different from their assigned sex.
• Transsexual people usually alter or wish to alter their bodies through hormones, surgery, and other means to make their bodies consistent with their gender identity.
• Gender identity and sexual orientation are not the same.
• Sexual orientation refers to an individual’s enduring physical, romantic and/or emotional attraction to another person, whereas gender identity is one’s internal sense of being male, female, or something else.
American Psychological Association