The Transgender in the Room

I met John through a mutual friend at a birthday party. My first impression of him was better than I make of most. He was funny, in a kind of sarcastic and cynical all-knowing way of how the world works. We talked about my recent travels to Sumatra and what my life was like in Indonesia. Although we didn’t talk about the future explicitly, I got the sense that he was ambitious and optimistic, and had strong ideals. We didn’t talk for all that long actually, but I have always been intuitive around new people. Body language, intonation and their facial expressions reveal far more than they are aware of and unless they are a psychopath, I am usually not wrong about my initial judgments of a person. Suffice to say, John was an enjoyable character to be around simply because the level of our conversation proved to be quite enlightening as to how intelligent he was.

I am leaving out a vital part of the story though. John used to be a woman. The mutual friend we had told me this coolly and my reaction was a composed albeit slightly awkward series of nods. I always thought of myself as someone who was “cool” with the LGBTQs until I found myself talking to a transgender and walking through the conversation as I would figuratively in a land mine, careful not to tread on any potentially sensitive issues that would blow up in my face. I didn’t ask about his family or high school because I imagined neither experience would have been particularly pleasant given how society’s understanding of adversity is often less than forgiving. When the conversation was over, I found myself relieved that I wouldn’t have to run into him again anytime soon because I was only in Malaysia for a short holiday before returning to Indonesia to resume my studies. Nice as the conversation was, I felt I couldn’t keep up the false appearance of ignoring the “elephant in the room”.

Nevertheless, I questioned why I felt this morsel of hesitation. Why did I feel awkward talking to him? Why did it even make me feel strange to acknowledge that he was a “him”? Why did I find myself thinking about what happened to his breasts and vagina? Why did I strip him of his rights to privacy in my mind, treating him like a science experiment result? Why did I subject him to such harsh judgment on the most rudimentary of things like the sound of his voice or the thickness of his beard? I felt disgusted with myself because I considered myself to be open and welcome, but here I found myself feeling a peculiar kind of animosity, the same kind I believe is toxic to humanity. I was raised in a traditional Asian household where the algorithm of our lives had been decided for us without need for much discussion. School, university, marriage, kids, pension. I hated that with blinding rage, and for as long as I can remember, rebelled against social conformity. My teen years can be summed up in one word: misplaced. It is through revisiting these old feelings of confusion and loss that I managed to bring myself down to John’s level, finally able to emphatize and melt away the prejudices that were indoctrinated into my innocent mind from years ago.

The next time I met John was months later, and this time, I showed him who I truly was. I told him I wanted to be educated and that meant starting with a clean slate. Over coffee at a quaint café in Penang, he told me we should start with clarifying definitions. Transmen and transwomen were people whose assigned sex at birth was not the gender identity they resonated with. Cismen and ciswomen were people whose gender identities did. Gender dysphoria is what overcame the trans community when they experience stress from the mismatch between their biological sex and gender identity. We talked on end about how damaging gender roles and stereotyping is to the development of a person, not even specific to transsexuals. Centuries of reinforcement of traditionally grouping individuals into convenient gender assignments with a binary model explains the pedestal on which we place the labels man/woman. I told him how it upset me when people mistake me for a boy merely because I have short hair, and felt reassured as I listened to him explain that femininity and masculinity is what we ourselves make of it.

I watched The Danish Girl, a Hollywood depiction of the life of Lili Elbe, the world’s first transgender woman. Although the movie fell short of most of my expectations, Eddie Redmayne’s portrayal of Lili moved me. The internal struggles had reflected in his placid expression throughout most of the movie, which was about all the accuracy I got from the film. Upon receiving this assignment, I contacted John and expressed my interest to talk to him and write about his experience. He agreed. Preceding the Skype call, I watched videos of trans people in Malaysia and some of John’s meticulously documented transitioning weblog. When we finally talked on Skype, I told him all the research I had done and said, “I know about the first transgenders in the world, the medical developments of sex reaffirmation procedures, how difficult, expensive and dangerous they are, which countries whose insurance pays for it and which doesn’t, and the alarming suicide rates all over the world. But I want to hear your story.”

John came from a conservative Hindu family. He told me how he never felt like a girl, and the years leading up to puberty were all the more confusing because his body was changing into that of a woman’s and he struggled to understand the disparity of his emotions. “The term lesbian just didn’t cut it”, he said exasperated, there was just something fundamentally missing from the explanation of why he felt as he did. From the ages 13 through 17, he tried his hardest to fit in, and joined Christianity. “I prayed everyday, begging God, if you can’t make me a man, then at least make me feel like a woman”, he said, and I felt a lump in my throat listening to the pain in his voice. He asked me to imagine wearing a mask for the rest of my life, and told me that’s the beginning of what it feels like to be a transgender. He told me how this was the time his depression peaked, with the highest frequency of suicide attempts coinciding with his growing despair at his own life. “Coming home at the end of the day and just wishing that it was all over, that I didn’t have to live this lie anymore and then waking up the next morning to go through everything once again”.

One month after he turned 18, his father kicked him out of his house, following the moment John told them about his decision to transition. “It’s one thing to cut your hair short and wear baggy clothes, it’s a whole other thing to tell your folks you’re going to start taking testosterone”. Homeless, John moved to Singapore with his girlfriend at the time. She mentioned at some point, that her ex- boyfriend was a transman. “What’s that?”, John asked, perplexed at the term, not knowing at the time that her answer would quite literally change the course of his life. “That was the first moment I had considered having a true identity”, he said, and the rise in his tone indicated the first inkling of hope he felt about becoming who he was always meant to be.

I listened to him talk about the changes he underwent following the first time he got his testosterone shot, and the top surgery he has been wanting for too long. He showed me where the doctor made the incisions, and how they resized his nipples and stitched them back on where they thought most appropriate. I had to laugh when he told me the scabs fell off and his nipples turned a bright pink, his panic ridden phone call to the doctor and the nonchalance with which the doctor said “I told you this would happen”, and John’s incredulous response of “I didn’t think you were serious”. It was nice to find some humour and relief following the years he spent lugging around breasts he wanted nothing more than to get rid off. He told me about his co-workers who would crassly say to him “Well if you don’t want them, then let us have a feel”, and I stopped laughing.

He told me then about his friend, a transwoman, who was arrested and sentenced to prison for 3 months. She was forced to enter the male prison because her identity card legally makes her a male. The officers stripped her and made her walk in front of everyone, naked to the bone. The men forced her to perform oral sex on them and she did, crying all throughout. When she was assigned a new warden, he too, expected to be serviced in return for protection. “I didn’t do it because I wanted to or because I was happy to, but because if not him, I had to serve all these other men.” I’m torn between feeling the utmost anger and sadness. What did she do to deserve this kind of treatment? Why did her choice to express herself make her less than person in their eyes? Didn’t she have rights, like the rest of us? Why was she exempt from human decency because she exacts her free will?

Here is the analogy John provided me; the life of a cisperson is a race with a start and finish line, but the reality is, many transpeople never even get to start the race, let alone finish it. The simplistic narrative of courage, bravery and happy endings is a privilege celebrities or well-to-do transgenders can afford. The rest of them are struggling to simply make ends meet having been disowned or emancipated from their families because even familial support is not a guarantee. The truth is, it’s not like a Hollywood movie where the character starts out confused and battles a never ending stream of discrimination followed by a series of invasive and life threatening operations, only to come out either dead or saved from the anguish of it all. The struggle is life long. Every single day as a transperson is a living reminder that our world has been constructed in a manner that opposes their existence. Although many developed nations have come to the forefront of LGBTQ issues by covering the surgeries in their insurance plans, and making it possible to legally change your gender, the sheer number of crimes related to violence, hate and abuse is enough to ascertain the need for an overhaul of the word “normal”.

John’s dedication to the fight against transphobia and to take everyday as it comes has tremendously inspired me in undertaking my role as an agent for change in the field of medicine. I believe the responsibility of a healthcare professional does not stop at curing the disease. It extends far beyond merely giving medication and offering advice on grim or positive outcomes the future holds. We are meant to strive and ceaselessly aid people in improving their quality of life. This means giving unequivocal and unconditional care to all patients, without prejudice and discrimination. I believe in a world where the common currency is love and compassion, kindness and acceptance, and I will treat all my future patients to the very best of my abilities. I will make Patch Adams proud, and you too, John