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Frequently Asked Questions? FAQs

I am 53 years old an am struggling to come to terms with being a transsexual. I was reading a web site that said you had written an article about confronting one's gender issues "before it is too late". I looked for it on your web site but couldn't find it. Could you direct me to it, please?

I am not at all certain as to what essay the author of the web site was referring to. Although I think I know what the author means, I would never advise anyone to transition "before it is too late". First of all I have never advised anyone to transition. That is a decision only the individual can make. If a client of mine decides to transition then I am there to help him or her through it. I can, however, tell you that the median age of my current client load of MTFs is about 48. As you might expect, the problems a 48 year old MTF has far exceeds those of someone younger who has not had the time to become so heavily invested (family and career obligations) in being male.

Other than that, if I recall correctly, there is a section in the following essay of mine that deals with mid-life issues. Check it out. http://www.avitale.com/developmentalreview.htm

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One question for my wife. She would like to know --after we read your entire site - if antidepressants could help make a TS happy enough to not care whether they are TS, or need to transition. Basically it's become a life or death issue for me. I know I can't continue living like I am. Its taking it's toll on my mental well-being. I know we are grasping at straws, and I'm sure we are not the first to ask this, but is getting on zoloft, welbutrin, or any other antidepressant a viable option? Has it been tried? Does it work?

Your question regarding antidepressants (SSRIs) is very common. Antidepressants-- usually prescribed by a primary care physician these days-- is usually the first thing most males try before they come into see me or any other gender specialist. No doubt SSRIs have some mitigating effect on mood but they are, at best, a Band-Aid. Since depression in gender dysphoric males is secondary to their gender issue, the underlying problem continues to persist. We know that to be true because estrogen (which is something of an antidepressant itself), even in moderate doses, routinely resolves both the dysphoria and the depression while SSRIs alone do not. I know this answer leads to further concerns but that is an issue that needs to be addressed in person between you and a therapist. I hope this has led to some clarification.

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I have read your web site and the FAQ. There is much to consider and understand. I think that I have some form of GID. Sometimes I want to be a woman, and sometimes I really love being a man. I often tell people that if I had a choice between male and female I would choose neutral, the qualities of both sexes. Why can't I be both? Or maybe, how can I be both? Is this like trying to have your cake and eat it too?

Millions of people live their lives somewhere other than at the extremes of the male/female binary. This includes people you pass on the street each day. Legally you have to choose one or the other-- male or female-- but privately, where it really counts, just do what comes naturally. It is a little discussed fact but because cross sex hormones effect the brain so drastically, it is exactly the state everyone who transitions will come to find themselves in. They may look like the gender they had aspired to--and that is very satisfying-- but in reality they have become a being who is now both male and female, free to express as much of each side as they like. In effect they do indeed have their cake and eat it to (at least as far as gender expression goes).

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Could you enlighten me as to what would be an acceptable solution to my lifelong dilemma. I am a female and definitely heterosexual, I tried the lesbian thing and although I think women are beautiful, I have no interest in them sexually. I have been all my life distinctively male in my interests and behavior. I have no interest in female clothing or activities and feel very uncomfortable when I force myself. It just doesn't feel like me. I am not aggressive like many males, although I am somewhat dominating. At best when I am engaged in a male-like activity, such as doing construction work, the guys forget I'm a female and treat me as one of them. I have never had a successful long-term relationship (I'm 48). I am uncomfortable every day and have no idea how to resolve my dysphoria or to have a successful relationship.

Most of my gender dysphoric female clients seem to be a bit more certain than you about having a male inner sense of self. As a result they come to see me with more of an intent to transition than to sort things out. Your situation seems more like the gender dysphoric males I see in that they do want to try and sort things out first. Transition seems to be way in the back of their minds even for those that do go on to transition. A good gender specialist should be able to help you fit all the pieces together and find your place in the gender spectrum. With that knowledge you can decide what to do next. If you tell me where you live and the names of a couple of other cities you are willing to travel to, I will try to find someone to refer you to.

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How can I safely transition around my parents when I know they disapprove of transsexual or transgendered persons. I am moving out of state soon to live my life far from home so I want to hide this as much as possible. Do you have other advice for me on this topic?

The only way to transition around parents is by telling them what you are up to up front. If you decide to move away from them, unless you do not want to see them again, you still have to tell them. Hopefully you can get them to understand that transsexualism happens and being disapproving of it, in my opinion, constitutes irresponsible parenting. If you are working with a therapist--and that is always a good idea-- she or he can help provide educational material for them and perhaps personally intercede for you.

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Nothing on this site should be viewed as providing therapeutic advice. No formation of a client/therapist
relationship with Dr. Vitale is intended or to be implied or inferred. The information provided in this site is for educational
purposes only. I attempt to keep the information current but make no representation or warranties in that regard. You should
not rely upon this information as a substitute for consul with a qualified mental health professional.