If you're not a trans person yourself, you probably know, as I do, one or more people who used to be one sex (externally anyway) and are now another or are on their way to becoming another (and if you don't, there's always Chaz Bono).
And hooray - Toronto will have its first Trans Pride march at this year's Pride.
I've never looked down to discover I was wearing the wrong genitals myself, but I've never questioned the validity of the desire to alter your gender to fit your mindset.
Whatever the changes trans people seek, from hormone therapy and surgery to mere cross-?dressing, the level of commitment and courage involved is mind-?blowing. Besides facing the harshness of medication, hormones and/or surgery, they have to deal with the reactions of friends, family and community. And that's the worst of it.
What the experts say
"When people are in transition, they bring the outside into alignment with something that already exists. They don't go through as much of a change as the people around them do. Internally they remain consistent, and much of transition is managing everybody else's experience. The decisions people make when they transition are based on a very stable, enduring sense of self. They tend to really know who they are. It just confuses the rest of us. People may postpone transition because they don't want to be shut off from friends and family."
KATHERINE RACHLIN, clinical psychologist, New York City
"With transition comes the beginning of your ability to be honest with friends and loved ones about who you are, what you need and what you have to give. Transition brings the gift of a second adolescence and the ability to rediscover your relationship with your body. It can represent a chance at a new life and self-?confidence, and offers the opportunity to finally look into a mirror and see your self - your soul - reflected back. Transition is a feat of modern medicine and, frankly, for some undeniably a miracle."
KYLE SCANLON, trans programs coordinator, 519 Church Community Centre, Toronto
"One person may experience anxiety from hormones, while another may have a tremendous sense of relief. Individuals undergoing gender transition don't know how they themselves are going to be impacted. Gender transition, in the conceptual sense, is an attempt to have a second, gender-affirming puberty. There are potent barriers to transgender people receiving proper health care services, and one is the idea that they are mentally ill. Some providers don't feel comfortable treating them and feel they don't have the expertise even if they do."
CARRIE DAVIS, Lesbian, Gay, Bisexual & Transgender Community Center, New York City
"Anybody who has had PMS knows that estrogen isn't always that much fun. You get moody, tearful, weepy, aggressive, angry. Testosterone isn't either, with the acne, hair loss and rage. Acupuncture can be helpful. So is basic nutrition, because there are foods that help your body metabolize estrogen effectively, which is important if you're transitioning either way. How the body metabolizes the hormones is going to be affected by how the rest of your body is working. How's your liver health? Stress is aggravated by hormones, but if you're transitioning into the body you believe to be yours, maybe your anxiety will decrease. For surgery, I recommend a cleanse beforehand and then specific vitamins and homeopathics. I'm a fan of Traumeel."
MASINA WRIGHT, naturopathic doctor, Toronto
"One of the most important issues is human rights for trans people. Transphobia, racism, homophobia, etc, are social determinants of health, and the continuum of violence against trans people is pervasive, from discrimination and harassment to physical and sexual assault to suicide. Right now trans people are in a grey area in terms of rights. Isolation and marginalization are huge. If they live in a city like Toronto, they are probably better off. "
RUPERT RAJ, LGBT counsellor/psychotherapist, Sherbourne Health Centre, Toronto
"Non-?trans people tend to focus a lot on the hormonal and surgical needs of trans people. But these are in reality a very small proportion of trans people's health needs. You have to look at and care for whole people, not genitals."
KRISTA SCOTT DIXON, Trans-?health.com