I recently wrote about my transgender realness, and what it currently means to be me in the world I live in. But I knew I needed to address the other part of me, the intersex part that has driven the need for the transgender procedures, and that has been an underlying chemical truth of my life. I need to explain the biology behind the mental illness of my own gender dysphoria.
As far as I know, I have Late Onset Congenital Adrenal Hyperplasia, an inherited condition that causes masculinization in XX individuals and hyper-masculinization in XY individuals. In my life and family medical history this has presented as facial and body hair, fertility problems, anxiety, high libido, short stature, and masculinized features in the XX females on my mother's side for at least the last 5 generations. On my father's side, there were hyper-masculinized XY males, very early onset puberty (age eight for my father himself), short stature, anxiety, anger management issues, high libidos, and massive amounts of facial and body hair. In the XX females I know of in that lineage there were fertility issues, uterine and ovarian cancers, anxiety, some masculinization, and again, shortened stature. These are all known characteristics of Late Onset CAH.
Personally, I knew myself to be male from the time I was three, but my body sent mixed messages about this. I was physically strong, quite tall for my age, was developing some body hair, and mimicked only the males in my life. But on the other side, my body was missing a penis, and I was in perpetual disbelief that somehow I had not been given one or worse yet, that I had lost it. I began packing (using different materials to create an appearance of male genitalia under clothing) at a very early age, but stopped when I realized that it was something I just wasn't supposed to do.
By the age of twelve I had gone through female puberty, and six months later I began male puberty, one however, that did not result in the expression of all male secondary sex characteristics. This confusing, and ultimately horrifying experience of two bodies fighting within one to exist, left me in a state of shock. I was troubled. And turning to my family and even doctors proved just as lacking in answers.
I learned from my mother that this male part of myself was something to be horribly embarrassed about, shameful, disgusting, and should be hidden at all cost. Stories of birth control pills gone wrong, useless electrolysis, and ways to be more womanly through wigs, makeup, clothing, and behaviors were standard topics of our discussions from as far back as I can remember. Being who I was, what my body was expressing completely naturally, was a tragic error on the part of G-d. It constituted a burden that I was supposed to bear, rather than a gift to embrace. And I felt a deep and persistent hatred for my own body because it, and therefore I were mistakes. Never female enough to be the woman my mother wanted me to be, never male enough to be the man I knew I was.
From my father, I learned masculine ways, traditionally male gendered activities, and that he had really wanted a son. Never male enough to be the son he desired, never female enough to know what to do with.
I lived in my disparate selves for more than twenty five years and then something changed. In a dichotomy of life and death my body decided to take over, the rest of the way, and allowed my true self to shine through. It was possible only because of a life threatening illness, one that literally took my life multiple times, but for the grace of G-d and the dedication of the medical staff who saved me. For me, it was through this physical death that my inner core was able to be born into corporeal existence.
I was twenty eight years old, and in my second semester of seminary. My mother-in-law had died of terminal lung cancer barely two months prior, and my now motherless wife and I had a five month old son. I was taking nineteen, yes, 19, credits, and consequently chose to live on campus two nights a week in order to be physically able to attend all the classes. I was camped out in a tiny bedroom doing as much schoolwork as possible and then rushing home to be a parent to our new son, be a loving partner to my wife, and to continue my ridiculously heavy graduate course work. It was exhausting and I began unravelling quickly.
One Monday morning, six weeks into the semester, I was hurrying out of my home when I slipped and fell on the ice, sliding partially under my car. I banged a few ribs, but shook it off, threw the rest of my stuff in my car, and drove the two hours to school. That day I became very ill with a high fever, blurry vision, and extreme nausea. I made it to the Emergency Department, was diagnosed with pneumonia, treated with antibiotics and promptly sent home.
A few hours later I returned to the Emergency Department, half-dead, and saw the panic in the physicians' eyes as I faded in and out of consciousness. The following days were largely a blur, being taken to the ICU, seeing my wife, x-ray after x-ray, oxygen masks, and then nothing. I would later learn that I consented to being put on a ventilator, and then a few days later my wife consented to having a temporary pacemaker inserted into my chest so that I wouldn't die every time my body was moved. I spent more than two weeks in the ICU, was resuscitated multiple times, was drugged out of my mind, watched all of my skin peal off from the megadoses of antibiotics, and celebrated my 29th birthday in a hospital bed. I can only imagine the fear my family must have experienced during this ordeal. But for me, fear was not a part of it at all.
During my hospital stay I was largely unconscious, though a few bits and pieces of events remain. Once, I saw a great, warm, white light that I wanted to go toward. It was inviting, and I felt a sense of calm as I approached it. Then in an instant it was gone, and I was returned to a darkness filled with strange noises and visions. More importantly though was a dream that involved a surgery of testicular implants, and I remember lay feeling elated by my great fortune. But again my joy ended when I looked up (in the dream) and saw two doctors at my bedside discussing my case. As one man flipped through my chart, the other looked down at the silent/sleeping me and said that they [the hospital, the doctors, the nurses?] "didn't take care of patients like that." I was hurt, yet still happy that my body matched my mind. Of course this was just a dream, no surgery was performed, at least not that particular one, and when I awoke from the medically induced coma I was heartbroken that the implants were not there. And again in my mind, they were lost, just like my (imaginary) childhood penis.
The turning point in my life, to begin the transgender transition process, occurred not from the illness, the near death, or the dreams. Rather, it came at the end of my month long stay, when I awoke to find my mother in my room. She was distressed, physically upset, crying, and obviously concerned about the situation. I, in my ever hopeful desire for a loving mother, wondered if she was thinking about nearly having to bury her only child. But this is my mother, a woman with untreated Borderline Personality Disorder, and nothing could have been further from the truth. No, she was devastated that during those weeks, one minuscule, meaningless, and pointless act of care had not been done. My face had gone unshaven. I had three and a half weeks of facial hair growth, and this was a fate worse than death itself for her. I must point out that this terrible outcome of not being groomed had nothing to do with me, and everything to do with the hatred she had for her own body. At the time of course, I didn't see that.
Her words penetrated into my very soul, "For G-d's sake, why didn't they shave her?"
She seemed to be reliving a conversation with someone, and it was as if I wasn't even there, despite the fact that she was speaking directly to me. And once again, I felt like I was not a real woman, nor was I a real man. I was a creature betwixt and between the two. And I was left to hang in that dark place of despair, alone, afraid, and secretly thrilled to have my body trying to show its true self. I had a beard. It was all mine. And even though I shaved it off that night, I knew for the first time that the world would not end if I let it grow. I was given the gift of authenticity. I could finally move forward on my journey.
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| A real intersex man. |
As the years passed I went through all the necessary steps to becoming the real intersex and transgender man that I am today. And it has been nine years since my body, my soul, my mind, and my heart finally came together to integrate into one whole being. Even through the horrid Beast of Bipolar Disorder I, PTSD, and suicidal ideation, I have remained true to my male self and gripped fast to the real man I am inside. I am a real man.
For now I am happy, content perhaps, with who and where I am in my life. Yes, there is more to do. Yes, there are hardships and hollow times I will endure. And yes, I will have to navigate the devilish waters of puberty with my own sons, and how I will fully explain who I am at a biological level that will have positive meaning for them. But in the meantime, I will continue to advocate for the realness that we all deserve. I believe in the real purpose of that. And I believe in the G-d that makes it so.
Thank you for staying on this sometimes all too real journey with me.
Be well, love your neighbor as you love yourself, and remember to actually love yourself.
-Ari
