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This page has been created as "fair usage" entirely to allow assessment and appreciation, by those concerned with the subject, of the unique portrayal of transsexuality in young people in the article, especially by young people affected themselves, their relatives, friends, medical personnel, policy makers and academics. All copyrights are wholely acknowledged.

Daily Hampshire Gazette logo
A.J. Crittendon, a recent graduate of the University of Massachusetts at Amherst

© Daily Hampshire Gazette, Northampton MA, USA, 2003

Thursday, September 25, 2003

Male to female/
Female to male


Editor's note: In referring to the transgender people profiled in this article, we use the pronouns that they use.

Mitch Boucher, a graduate student at the University of Massachusetts at Amherst, has the easy charm and good looks of the all-American boy.
       Sitting at his desk at the Stonewall Center, a drop-in center for gay, lesbian, bisexual, transgender and questioning students, he seems fully at ease fielding questions from those who stream in and out of the office.
      Boucher says many who come into the Stonewall Center assume he is a gay man.
      He's not. But he's not a typical man either.
      Boucher, 34, is a transgender person - that is, according to the American Psychiatric Association, a person who has a deep sense that the gender assigned at birth is not the right one. Born a girl, Boucher has been living full time as a male for about four years, having successfully undergone what is known as "transition," through the use of hormones and surgery.
      A year ago, few students on local campuses would say they were much aware of the fact that there were people like Boucher among them. They might have had a vague idea that some people had "sex changes." Or they might have seen the movie "Boys Don't Cry," which portrayed the life of a transgender teenager in the Midwest who was murdered.
      However, during the last academic year the issue suddenly came to the fore at several colleges.
      At UMass, with Boucher and a second student leading the way, the student government approved a measure to provide gender-neutral bathroom and shower facilities in dormitories and other college buildings to accommodate transgender people. Last spring, students at Smith College were asked to vote on whether to accept gender-neutral wording in their student constitution.
      Outside the Five College area, similar debates took place. At Wesleyan University in Middletown, Conn., a gender-neutral hall was designated in one dormitory in response to transgender students' requests, while at Northeastern University, the rights of a transgender undergraduate who requested gender-neutral dormitory accommodations became the cause célébre for a group of law students.
      No one knows how common transgenderism is; the United States Census does not include it on its forms. Estimates veer from between one in 2,000 to one in 100,000. In addition, there is no good estimate as to how many people have taken the steps Boucher has to transform their bodies.
      Lisette Lahana, a Northampton therapist who specializes in gender issues, says that she has received 140 calls over the past four years from those referred to her for therapy due to their gender identity.
      Boucher says he can name at least 15 people he has met at UMass over the past year who identify themselves as transgender. The former assistant director of the Stonewall Center, Stephen Pereira, says he worked with about 12 transgender students per year in the two and a half years he was at the center.
      In any case, the issue is one that colleges, where housing and other matters are based on gender, are finding themselves pressed to deal with.
      "We are trying very hard to educate our staff about the particular issues the transgender community faces," says Joanne Vanin, vice chancellor of student affairs at UMass.
      Smith College has hired therapist Julie Mencher to serve as a "transgender specialist" on campus. While she says there is only a small group of students at Smith who are taking testosterone to alter their bodies, there is a larger number grappling with gender identities.
      "There's certainly the group of students who say, 'I always felt like I was in the wrong body,' " says Mencher.

MITCH BOUCHER, WHO grew up in Wethersfield, Conn., with an older brother, was raised as a girl. His father was an accountant, and his mother, a social worker.
      Boucher says that as a child he was always a tomboy. The year he spent as one of only two girls on the town children's wrestling team, for example, he describes as "the highlight of my childhood." By contrast, he says, he hated the time he spent trying cheerleading.
      "I was totally jealous of the guys that got to play football," says Boucher.
      In adolescence, he says, things got harder. Watching his body change made him feel "awkward," he says, though he didn't tell anyone. Instead, he worked hard at being feminine but always with a vague sense that "something didn't feel right."
      "There's no role models out there," he says. "There's nobody telling you, 'you can be a trans person.' "
      Boucher says he remained heterosexual until graduate school, when he began dating women. Still, he says, the lesbian label didn't seem right and he avoided it.
      When he was in his mid-20s, a friend gave him a copy of "Stone Butch Blues," a novel about a transgender person based on author Leslie Feinberg's life.
      "I really identified with the character," says Boucher. However, he says, the idea of physically changing his body scared him, and he put the book away for a couple of years and tried to forget about it.
      When he arrived at UMass a year later, he saw a flier at the women's center on campus for a support group for female-to-male transgender people. He says he hung onto the piece of paper for a year before finding the courage to attend one of the group's meetings. During that time, he says, he did a lot of reading on the topic, always telling himself it was for "academic" reasons.
      When he finally decided to check out the support group, however, he knew it was a turning point.
      "I was in a roomful of people who were born female but identified as men," Boucher recalls. "That was the first time it really hit me. Like, 'Wow! This is who I am.' "
      He realized then, he says, that he could go through the hormone treatments and surgery that would allow him to live as a man.
      Yet even before he began his medical transition, he began to live in a gray area between the sexes.
      "I was getting more and more masculine-looking," he says.
      He kept his hair very short, bound his breasts and wore men's clothing.
      "I always felt like I wanted to be more butch, more butch, but I couldn't ever get butch enough," Boucher says. At the same time, his mother, who was divorced from his father, was planning to be remarried. "She wanted me to be her bridesmaid," he recalls. "And as she was looking at me she realized she couldn't put the two pictures together."
      They compromised, and he wore a tailored suit appropriate for either gender. Soon after that, mainly, he says, with the help of his transgender friends and a therapist, he started a process known as transition from female to male.
      While he says it took his parents some time to get used to the idea, for the most part they have been supportive. For the past three years, he has regularly been receiving shots of testosterone. The results are not subtle. Soon after starting the injections, he began getting more body and facial hair. He has increased muscle tone, and a deeper voice. His face is more angular than it once was, and while he says he always had a bit of a receding hairline, it is now more pronounced.
      Boucher says the process was difficult at first, because people didn't always know whether he was male or female. "I was mainly passing as a guy, until I spoke," he says. "And then people would get all flustered and they wouldn't know what to do."
      About six months after beginning hormone therapy, Boucher underwent chest reconstruction surgery in New York, which involved a double mastectomy and construction of a male-appearing chest. Such a surgery ranges in price from $5,000 to $10,000.
      He says he has not considered genital surgery because he doesn't find it to be necessary or anything he'd like to pursue at this point. Dr. Yvon Menard of the Metropolitan Center for Plastic Surgery in Montreal, Quebec is one of the few North American surgeons who performs these operations. Menard says the cost of such surgeries can be anywhere from $6,300 for a fairly basic surgery that doesn't have a completely realistic appearance, called metaidoioplasty to about $36,000 for a phalloplasty, which includes construction of a functional penis and scrotal implants.

LISETTE LAHANA, the Northampton therapist who specializes in gender issues, says that while the changes Boucher has gone through can be a powerful remedy for those who believe they've been born in the wrong bodies, no one should approach the process lightly. "Transition is based on careful treatment with a qualified therapist to discuss their readiness to take such a step," says Lahana.
      Before she recommends a client to a physician for hormone treatment, Lahana, whose clients range in age from 16 to 60, says she conducts an extensive evaluation. It is based on guidelines set out by the Harry Benjamin International Gender Dysphoria Association (, an interdisciplinary board of specialists based in Minneapolis, Minn., that has set the standards of care for several decades.
      Lahana says that her transgender clients often have difficulty getting such therapy covered by insurance companies, some of which have specific wording in their contracts that prohibit treatments for gender-identity disorders.
      Therefore, many of them pay for psychological treatments, hormones and surgeries themselves.
      In addition, she says, most insurance companies are confused by people whose medical needs cross both genders. For example, an endocrinologist may list a person as female while the primary care physician's records describes the individual as male. As a result, she says, insurance companies will sometimes refuse to cover necessary treatment, such as gynecological exams, for a transgender patient.
      An individual can take legal steps to get gender designations changed on birth certificates and driver's licenses, says Cole Thaler, an attorney in Florence who is a female-to-male transgender himself and has gone through a legal name change. He says anyone can get a name changed simply by applying to probate court and paying a fee of about $80.
      To have gender changed on a driver's license, Thaler says, the Registry of Motor Vehicles requires a letter from a physician stating that the person has had irreversible gender-changing surgery. The only cost involved is that of obtaining a new driver's license. To change a gender on a birth certificate, he says, the process is similar. A doctor's letter must be submitted to the city clerk of the community where the individual was born.
      Lahana says she advises individuals to spend as long as possible living as a member of the other gender before making any permanent physical changes. She says she coaches students on ways to make that work on campus. "I suggest clients talk to the professor before class and ask to be addressed by [the preferred] name and pronouns."

TAKING ON A different gender identity, however, isn't easy, as A.J. Crittendon, who graduated from UMass last spring, has discovered. It's not making the transition that's hard, he says, but dealing with others' reactions to it.
      At 22, Crittendon, who lives in Amherst, identifies himself as a transgender person, but has not yet undergone a medical transition from female to male. He has adopted the name A.J. and his friends use male pronouns to describe him, though his parents do not. His mother, he says, is beginning to accept his transgender identity.
      "She said she didn't like it, she didn't agree with it, but she loves me," he says.
      As for his father, Crittendon is hoping his mother will be the one to talk to him about the issue, because he says he hasn't worked up the nerve to do it himself.
      His older brother, he says, has offered to pay some of the costs of the physical procedures he plans to seek within the next year.
      Crittendon, who grew up in Hawaii, has a laid-back athletic appearance. He wears baggy clothes, and keeps his hair cut Marine-recruit short. On the advice of his therapist, he says, he is taking a full year to consider his choice before starting hormones and undergoing surgery.
      Crittendon looks like either a very boyish woman or a young, teenage male. As a result, he says, it is difficult for him to gauge how those around him are perceiving him. He says while at UMass, he had little success talking to professors about his preferred pronoun usage. "They're respectful of the name part but none of them get pronouns," says Crittendon.
      His identity was also an issue among his dorm mates.
      Crittendon says due to his gender-ambiguous appearance, he had trouble in his role as a dormitory Resident Assistant. In spite of the fact that he was hired to oversee dormitory life, he was often the target of suspicion by the very students he was supposed to be assisting.
      Given university rules on bathroom usage, deciding which bathroom to use became particularly troublesome for him.
      "My own residents would harass me in the bathroom," Crittendon recalls. He tells the story of a group of male students seeing him through the window of the women's room, and yelling, " 'There's a man in the women's room! We're going to have you written up!' "
      As a result, Crittendon says, he wrote a letter to the administration in the fall of 2001 requesting a gender-neutral bathroom that he could use without fear of harassment.
      Then he turned to Mitch Boucher at the Stonewall Center for help.
      They sent out an e-mail asking others to attend an organizational meeting. Thirty-five people showed up. "It blew me away," says Boucher.
      Many who came were not transgender themselves, but, according to Boucher, were sympathetic to the cause, which came to be known as the Restroom Revolution. The group formally proposed that there be at least one gender-neutral bathroom in every dormitory. They also asked for a limited number of such bathrooms in other buildings on campus.
      Crittendon says it took a year and a half before the administration responded. In the meantime, the students took their grievance to the Student Government Association, which approved their request. Still, debate persisted in an exchange of pro and con letters in the campus newspaper during much of the last academic year.
      "I look too much like a boy to use the women's room ... but I am not legally allowed to use the men's room," wrote student Eric Delisle.
      Jared Nokes, a student and member of the Student Government Association, countered with the argument that dropping restroom gender rules would be awkward for women. "As a female, could you ever feel comfortable knowing someone can walk in [to a bathroom stall] next to you and lean over at any time?"
      In May, Joanne Vanin, vice president of student affairs, announced that two dormitories and one campus building would contain unisex bathrooms. Though it is less than they asked for, Crittendon and Boucher considered it a triumph.
      So far, three unisex bathrooms are to be installed, one in the Prince/Crampton dormitory cluster and two in Machmer, a classroom building. A letter from Vanin says one other will be added at a later date, most likely in another part of the Prince/Crampton cluster, if there is a need for it.
      "I consider it a step forward," said Boucher earlier this month. "But there's still a lot that needs to be done to make this campus trans friendly."

ACROSS THE river in Northampton at Smith College, which had steadfastly held onto its all-female tradition despite the trend for single-sex schools to go coed, the situation has an added dimension. While Smith has a reputation as a lesbian-friendly campus, the college has struggled to decide how transgender students fit in, if at all.
      Last spring, the Student Government Association (SGA) asked the student body to change the student government constitution so that it contained only gender-neutral pronouns. During the debate preceding the vote, concerns were raised that such a move would steer Smith in the direction of coeducation.
      "We are a single-sex college for women," said Maureen Mahoney, dean of the college at Smith. "That's who we admit."
      "If other people want to be called something else, fine," said sophomore Esi Cleland. "But as women we should be confident enough not to want to be called something else."
      But Toby Davis, a transgender student who graduated last spring, said he believed that his presence at the school was consistent with the college's original mission. "One of the reasons Smith was founded was to serve those who, because of their gender, are having difficulty having a voice," he said during a panel discussion held on campus in May. "We've all had the disadvantages of being raised a woman."
      In the end, the measure passed by 50 votes out of 1,115 cast.
      Lindsay Watson, the former SGA president who came up with the idea, said it was basically an attempt to attract more students to student government. "We do have a population on this campus that doesn't refer to itself as 'she,' and doesn't use that pronoun," says Watson.
      Maureen Mahoney says that as complex as the issue is for Smith, the college is committed to supporting students in their gender explorations, no matter where this might take them. She says she has no intention of looking up students' medical records, and there is no policy in place for the college to expel a student because she started looking like a man following hormone treatments.
      "What we are concerned about is students treating each other respectfully," says Mahoney. "That's a behavior issue, not an identity issue."
      Davis, who is tall and stocky, with features that suggest a teenage boy, says that in general the people he meets view him as male. He says he became aware that he was transgender midway through his time at Smith. He told the assembled students, faculty and community members at the spring panel discussion that it was the accepting environment at Smith that allowed him to come to terms with his situation.
      "Because Smith is so open about sexuality, it gave me a chance to explore my identity," said Davis.
      Julie Mencher, a local therapist, was hired at Smith last year as a transgender specialist. On campus part time to counsel students dealing with gender issues as well as to educate staff members about transgender, Mencher also continues her private practice in Northampton.
      She says that there are only a handful of students at Smith who are seriously considering medical transition, but several more who are experimenting with the idea of being another gender.
      "There are a lot of students here who identify as transgender but don't identify as male. They identify in a more gender-ambiguous way," says Mencher. "There are only some students who request to be identified as 'he.' "
      Just as it was a radical thing at one time to experiment with sexual preference, these days the new edge for many students is to push the boundaries of gender, says Mencher. And, she adds, it is unclear how many of these students will end up identifying themselves as transgender after college, just as many who experiment with lesbianism in college don't always spend their lives with female partners.
      "The ages 18 through 22 are a time of experimenting with various kinds of identities," she says.

BUT FOR Louis Mitchell, an HIV prevention educator at Tapestry Men's Health Project in Springfield and an undergraduate student at the UMass University Without Walls program, youthful gender incongruity had deep roots.
      Born a girl, Mitchell, who is 43, says he knew from the time he was 3 years old that he wanted to be a boy, but didn't know how to express it.
      He says he lived many of his younger years as a lesbian. "The earliest time I thought, 'I'm trans,' I was 30."
      However, it was almost a decade before he took steps to physically change his appearance. For one thing, he says, he wanted to be sure he was ready to tell his mother about it. Also, he says, it was frightening to leave the comfortable world of the lesbian community in the Bay Area of California, where he spent 12 years.
      Deeply committed to his Christian faith and a lifelong member of the United Church of Christ, Mitchell says that he decided to transition only after long discussions with his pastor.
      He began the process in 1999, just a few months after he met Krysia Villon, 30, a development officer at Mount Holyoke College in South Hadley.
      By the time they met, Mitchell had already begun asking friends and family to use male pronouns as a way of beginning the process. Villon says she always knew him as "he," even before he started his testosterone treatments. Mitchell has since had chest reconstruction surgery, performed at Baystate Medical Center in Springfield.
      Villon says she always considered herself a lesbian, and has never been attracted to men.
      Still, the couple says, sparks flew and they fell in love.
      "I wasn't clear in my mind that Louis would really look like a guy," says Villon. "I thought, well, he'll just be a little more masculine."
      According to Mitchell, the hormones changed him physically in many ways: His voice got lower, and he has a full beard. There were other changes as well. His feet grew two sizes, something he says he found annoying, because he had to buy a whole new set of shoes.
      Also, he has a hard time crying nowadays, which surprised him. He had always prided himself on being able to show his tears.
      Villon says that at first she had difficulty getting used to the idea that, given her relationship with Mitchell, people were seeing her as heterosexual.
      "I was feeling invisible," says Villon. "It was scary."
      Still, Mitchell and Villon got married a year ago last April, in a small ceremony at a divinity school in San Francisco.
      Now, Villon says, she accepts that she's being perceived as a heterosexual. Sometimes, she says, she even enjoys the fact that among her co-workers she is seen as just another married woman. She also says that despite her fears about Mitchell's physical changes, she is still very much in love.
      Mitchell says that as he has changed, he has come to understand many issues that mystified him earlier in life. He has started to see the dangers of being a black man in this society.
      He said that when he was seen as a black female, he wasn't perceived by others as being dangerous or a criminal, but as soon as he began to appear male, he was treated with suspicion, particularly by the police.
      "I've been pulled over 600 percent more than before I transitioned," he says.
      Mitchell says he considers himself fortunate to have lived a life that includes both male and female experiences. "How many guys can honestly say they know what PMS feels like?" he quips.
      However, he adds, undergoing transition had nothing to do with changing his gender: He always knew he was male, he says, and it was just a matter of having his body fit.
      "I'm getting to know myself better as a man," he says.

AS FOR UMASS graduate student Mitch Boucher, he says there are many things he has had to get used to now that the world perceives him as male. For example, he says, he finds it's no longer acceptable to smile at children in the grocery store or on the street, because parents react suspiciously. A recent trip to the florist was eye opening, he says, because as he purchased some flowers, the woman behind the counter was so friendly and interested in hearing about whether the flowers were for a girlfriend. In the past, he says, it was a completely different experience.
      "If they thought I was a lesbian, they weren't going to ask me any questions," he says.
      He says he considers himself a straight male due to his sole attraction to women. But he acknowledges the fact that his transgenderism complicates the picture. "I'm a straight queer," he says, laughing.
      On the other hand, he adds, "I feel like I'm different from a guy who was born male."

The numbers are elusive


The belief that transgenderism is rare is a popular misconception, says Sarah Anne Thompson, a staff member of the International Foundation for Gender Education (IFGE), a nonprofit based in Boston that provides information to the public about transgender issues. This, she says, may be due to the fact that transgender people often blend in with the rest of the population.
       "You may have met many transgender people and not even know it," says Thompson.
       The most commonly cited statistic for the prevalence of transsexuality - that is, people who have undergone sex reassignment surgeries - is one in 30,000 males and one in 100,000 females.
       An outspoken skeptic of these statistics, however, is Lynn Conway, a professor of engineering at the University of Michigan and a transgender person herself. She says the commonly cited statistics are based on a study conducted in the 1950s, before sex-reassignment surgeries were widely available. Conway, who underwent transition from male to female 30 years ago and has written extensively on the subject of transsexual statistics, has conducted a survey of surgeons in the United States and compiled her own data about transsexualism. She calculates that at least 1 in every 2,500 adult males in the United States has transitioned from male to female (that is, has undergone complete sex-reassignment surgery). The number of people who are experiencing feelings associated with being transgender may be many times more than that, she says.
       Conway says the numbers issue is important, because it can determine the way transgender people are treated.
       "The rarer the group is, the less careful you have to be in characterizing them," says Conway, speaking by phone from Ann Arbor, Mich. "But if you're talking about 1 in 500, that means every big university is going to have to deal with it."
       There is plenty of debate as to what causes transgenderism, and for each perspective, there is a wagonload of assumptions and prescriptions. Some argue that transgenderism is a disease rather than a legitimate gender identity.
       In an article entitled "Homosexual Agenda," circulated by the Christian conservative group Traditional Values Coalition, the Restroom Revolution at the University of Massachusetts was pointed to as a sign of a "dangerous new social movement."
       The article reads: "Transgenderism, of course, is a serious gender identity disorder ... Individuals with mental problems should not be allowed to dictate social policies at a university nor in legislation that will normalize a mental disorder."
       The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV), published by the American Psychiatric Association, is the bible of the psychiatric and psychological profession. In it, there is a listing called "gender identity disorder," which describes childhood experiences such as taking on the "opposite sex" roles in play, feeling disgust or anger at their genitals, and other signs of cross-gender identification.
       Some transgender activists have, like their gay and lesbian counterparts in the 1980s, lobbied to have this "disorder" removed from the DSM IV. Others have taken advantage of the situation and used it to argue their status under the Americans with Disabilities Act (ADA), which requires accommodation in the workplace for those with physical or mental disabilities.
       According to Lisette Lahana, a Northampton therapist who specializes in gender issues, there is a great deal of debate in the psychological community as to whether transsexualism really is a psychological disorder, or a medical condition.
       "We don't have adequate research yet to come to a conclusion as to what is the real cause of transsexualism," says Lahana. "We have racial diversity and sexual diversity. Gender identity could be seen as another form of human diversity," says Lahana.

Sunshine DeWitt is a Gazette reporter. She can be reached at