Sex Changes Are Confusing Enough When You Have Accurate Information

I have assisted several people in changing gender. Most of them have been middle-aged. To me, it is simply a sort of birth defect.  Sometimes the chromosomal sex does not match the brain for a variety of very specific reasons, some of which we know something about, some of which we do not.

I am now far less involved with these folks.  Not that I do not venerate them and respect their struggle.  Rather, the condition of being a person requiring transgendering is so mainstream, that plenty of types of medical insurance pay for this.

Then again, several do not.  In fact, I had two patients in one year who worked for a major international conglomorate, and the sexual reassignment surgery was covered by their company benefits.  Let’s see if Obamacare is going to take that into consideration.

At times, I have sat in public informational meetings as a sort of volunteer technical adviser.  I expected exotic questions from a well-instructed patient base, which is what usually happens when I am in this role. Instead, I found something very different.  I discovered, even in this group, that nobody knew anything about the basics of sex.  Nothing. Like what-goes-where and how you get diseases or how you get pregnant and what it takes.

I was shocked.  And they did not ask me.  They were sure they were right.  I tried to interrupt and redirect, but my efforts were feeble and useless.

I usually left those meetings early.

It reminds me of a meeting in a rural clinic in which the university for which I was teaching asked me to go in as the big city expert — a very humble one, of course.

Someone — some kind of male nursing-level person — told me I was very fortunate to have a job where I could talk about sex all day.  I don’t.

There is no part of medicine with more fear, more taboo, and more desire to be “normal” where nobody has a clue what normal is.  As usual, the Brits were ahead of us and figured out nicely how wonderfully easy it is to invent inadequacies that can only be treated by pharmaceuticals, especially in a sexual garden of neuroses.  The date was 2003.

Now wait — If 43% of women experience sexual dysfunction, it’s kind of like all the children who live in Lake Woebegon being above average, in the fictional home town of Garrison Keillor.

If that many people experience it, I doubt it is sexual dysfunction.  It sounds like “normal.”

There is another Dr. Goldstein.  He works with someone opening a clinic in Beverly Hills.  And he has come to San Diego.  “Science is science,” the alternet folks quote him as saying.  But I know that doctors who take money from drug companies to do research seem to have an amazing facility and finding ways that those drugs are useful.

Well, nobody is going to confuse me with him.

I found a story of a woman filmmaker who initially wanted to make a documentary about pleasure and science and ended up, coming very much from the outside, seeing what is going on.

Think of the things we know least about in life and worry about most.  Probably being overweight and being sexy.

I remember from my own childhood how a single commercial slogan, “Fun comes first to the slender ones,” brought on worries about body size for many that became eating disorders.

If there is one thing people worry about more than their weight, it is sex.  And we have come up with a bunch of mixed up statistics that would convince any woman she has a disorder.

Now, not even people who are profoundly sexually ill (needing transgendering) have basic knowledge about how sex works.

I know from my own research in transgendering people that perilously little is known about human sexual function.  As a matter of fact, it is a field that has the reputation of destroying careers.

Most people have a great taboo and mystique surrounding sex.  This taboo and mystique may be so great they are wildly neurotic and have no idea what they are doing.
I can tell you for a fact that nobody knows exactly what a normal (heterosexual) female testosterone level is.  And testosterone is indeed generally given to women with estrogen which can increase risks for cancer and for dementia.

So well-meaning doctors and nurses tell women that they are not enjoying sex enough and that it is something they can fix with a pharmaceutical.

When you are in the middle of the system — the pharmaceutical-based insurance system — you cannot tell what is going on.  You cannot tell that it is the pharmaceuticals that are determining who thinks they are ill.  If you are in the middle, you cannot tell that it is the pharmaceuticals that are determining the disease classifications.  They — pharmaceutical companies and insurance companies — are telling us who is sick and who is not.  Why?

When the question is “Why” the answer is usually “Money.”

Sex is complicated.  It is even more complicated if you look at it cross-culturally.  There is too much at stake here to be slapping hormone patches on people for money.