Faq

I have heard that in some cases, the prostate gland is removed as part of sex reassignment surgery. Is that true?

To the best of my knowledge, surgeons have never removed the prostate gland here in the USA. Estrogen replacement therapy tends to reduce the size of the prostate gland, leaving it quiescent.

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I'm in college writing an essay on SRS. I was wondering if you had anything to share regarding the aftermath of surgery. I understand there are many psychological issues before the irreversible surgery (depression, suicidal ideas) but what about after? Is it completely wrong to think that some patients are putting in all of the time to get the surgery and then cutting off the psychological help? Or is the surgery enough to solve these problems?

That is a good question. Actually a certain percentage of post-ops do stay in therapy for a while after surgery. However, that is mainly to ease out of the years of pre-op work that has been going on. Keep in mind that a letter of referral is given only to those individuals who have come to terms with their transsexual status and have shown that they are living comfortably in their new gender role. To clarify, it is not the surgery per se that solves the problem. It is the hormones and all the years of preparation that solves the problem.

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When breasts grow, how do genetic males handle the look?

One of two ways, either you let them show or you hide them with loose clothes. That is not a glib answer. It is what people do. It depends on your state of mind. Incidentally, it is not unlike what many self conscious 12 year old girls go through as their breast begin to develop.

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I am 50 and disabled. I've read were TS people have been injured by people that see us as less than human. So I have some concerns.

Many hate crimes against the transgendered are reported but in fact they are relatively rare. Of the 650 + clients I have worked with since 1978, I have never had anyone report being mistreated by a stranger. Although there are some notable exceptions, most of the incidence where people have been seriously hurt or even killed have had some thing to do with sexual encounters. Simply follow the same rules of safe conduct that most genetic women follow and you should be all right. (see http://www.avitale.com/actsafely.htm)

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Besides some of the social problems that come with transitioning, what are some of the moral or spiritual issues that come up.

Rarely do I see anyone with religious concerns who has not already worked out their spiritual issues regarding transition with their spiritual leader. However, if the individual has strong religious ties and is associated with a particular church, mosque or synagogue then there could be a problem. That is where a good therapist can help all parties to come to a workable solution.

Familial concerns are much more common. Most people who come to see me are in mid-life with familial obligations. The idea of altering the family structure or even destroying it to save their life can lead to overwhelming feelings of guilt and shame and are much more common and problematical than spiritual issues.

In such a circumstance the therapist should go to great lengths to educate family members about the gender variant condition and make an effort to keep the family together. I am happy to report that success in keeping the family together has increased dramatically in the last several years.

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