I would really appreciate if you can explain to me few confusing
aspects of transsexuality. My question is about the danger of hormones. I'm trying to start a treatment (e.g. estradiols) and  I've been reading a lot about the danger of cancers and other health problems and I'm very scared now. it seems that there are a lot of contraddiction about this subject.What is the risk of getting cancers if one is on a low dose treatment of estradiol valerate?

There are several dangers associated with hormone use. Sex hormones, by themselves, in the correct proportions within the body are useful and necessary. Not only do they grant us our sexual characteristics, but also affect a myriad of other functions in the body, including affecting bone density and the uptake of calcium, overall neurological functioning, and even the chemistry of our blood.

This last mentioned effect is one danger, as seen with regard to men: testosterone affects blood chemistry so that the blood becomes thicker, and this increases the chance of clotting. Clots, of course, if they occur in a vital organ, can be fatal.

The higher the level of hormones in the body, generally the higher the risk. When we take 'paradoxic' hormone treatments, we recieve a double dose of hormones at minimum: the sex hormones produced by our body already, pre-surgically, and the hormones we are taking added to that.

Interestingly, high doses of estrogen can often act like androgens, like male hormones, because of biochemical conversion, and thus actually defeat the purpose of taking them. For this reason, among others, the lowest effective dose is prescribed, often in concert with an androgen suppressor.

The risk of cancer, heart attack, stroke, kidney failure, liver damage, and so forth varies individually. This is why it is vital to be carefully monitored by a physician during pre-surgical hormone use. With so much hormone of both types in the body, the risk is certainly higher than not taking hormones at all. There is danger, yes, but the level of risk is something one must face if one is serious about gender issues.

The level of danger can be estimated by physical tests, and by lifestyle. Smoking, drinking, and poor diet all dramatically effect the danger level of using hormones. If you smoke or drink especially, the risk of stroke, heart failure and cancer increase incredibly under the condition of hormone therapy. In fact, the vast majority of hormone incidents always include one or both of these primary factors.

If you live a healthy lifestyle, have been screened for risk factors such as heart disease, and are under supervision to catch problems early, your level of overall risk is fairly low, only a few magnitudes greater than the general population. If I remember correctly, about 4 to 5 times greater overall.

Ultimately it is remiss for your doctor to not have already taken the time to explain these things to you, so I would recommend that you make a point of asking your doctor to do so, just to make sure my memory is correct, and to get the precise information in case I am wrong. Always ask your doctor to explain risks and probabilities regarding any procedure. You have a right to know such matters, from the mouth of the person you are paying to treat you. If they do not have the time, you should not spend your money on them. Find somebody better.
 

I have a question about  'shemales'
What is it that 'shemales' actually are? Are they real transsexuals? My confusion  arise from the fact that  on pictures or movies they can actually have  erections, while from reading on 'hormone treatments for transsexuals' in  the litterature, i've got the impression that, after months of treatment, the subjects cannot have erections and/or  ejaculate any
more.

'Shemales', 'Mollies with Gollies' (a 40's term, that one), 'transgenderists', 'Chicks  With Dicks' and the like, are all terms for a special type of individual which is not, by definition, a transsexual. However, such people are not merely transvestites either, but lie in the gulf between the vague polarity of physical sex.

A transsexual is an individual sure of their gender, whose physical body simply does not conform. They will do whatever is required to correct this problem.

A 'Shemale' is an individual that has strong transsexual-like leanings, but no desire to have surgery to complete the process of sexual transformation, rather they enjoy the unique state of possessing a body literally between the sexes. It should be noted that some transsexuals do perform and masquerade as 'shemales' in the sex industry in order to obtain the money needed for surgery, but this is not the same thing as a true transgenderist or 'shemale'.

The transgenderist enjoys being a little of both sexes, and prefers to remain in a half-way state. The transgenderist may take hormones, have some forms of plastic surgery to complete appearances, but retain their original sexual functioning even if they have the means to surgically alter their genitals.

Sex is a vague polarity, as I have mentioned, but a polarity nonetheless. While intersex accidents and mutations can rarely occur, almost all non-microbial creatures on the earth are physically clearly male or clearly female. There are some exceptions, such as the earthworm, which is naturally hermaphroditic, but amongst species, clear sex differentiation is the norm.

Gender is far more of a spectrum, and even somewhat fluid. Gender is real, it has a biological basis and is hardwired into the nervous system, but is often less dramatically polar than physical sex.

The transsexual is a highly polarized being, commonly motivated by gender wiring that is at a polar extreme on the gender spectrum. The transgenderist is more fluid in gender definition than that, and can find contentment in expressing a mixed gender situation in the shape of their body.

To complete this definition group, the transvestite is simply a person with a sexual fetish for appearing as a member of the opposite sex...a learned behavior rather than a function of neurochemistry. Transvestism can be so pleasurably reinforcing, however, that it becomes a permanent desire and fascination even to obsessive levels. Anything seriously pleasurable can do this. From rubber to whips and chains, sexual fetishism knows no bounds. It is not specifically a gender issue however.

I add this because some people still confuse transvestites with transsexuals, and transgenderists with both, and the motivations, causes and needs of each are very, very different. In a patriarchal society, the male-to-female side of these matters gets far more attention than the reverse, and indeed seems at times to be the only side at all. Because of the incredible onus associated with males appearing as females -a social loss of power and status in a male dominated society- many people simply lump all of the definitions above together as a single unified 'threat' to the patriarchy.

While indeed gender issues and expression do threaten patriarchy, there is enormous difference with regard to the many varieties of gender expression, the appearance of which can even overlap mere sexual fantasy, as in the case of transvestites.

So, in summary, we have three groups defined now, so far, which are Transsexuals, Transgenderists (Shemales), and Transvestites. Transsexuals require a complete and permanent sexual transformation, transgenderists need a partial transformation only, and transvestites simply get a thrill out of dressing up as the opposite sex.
 

I am 43 years old and married 18 years.  2 children and all grown.
I feel i am transsexual, and i have felt this way since the age of four.
I have dressed up my whole life and I continued to dress up to getting married,  I felt if I was married my feelings would change,  they didn't!  I did not tell my wife I was a cross dresser!  As my desires grew along with my frustration she felt that it wouldn't hurt to allow me to dress up in the privacy of our bedroom.  She allowed me to wear panties under my work clothes and she said I could have 2 hours a week alone in the bedroom.  She allowed me to sleep in a nightgown, bra, and panties.  She felt this would ease the tension and would satisfy my needs.  After about three months of this I confessed to her that I wanted to have a sex change and that is when she said we needed counseling.  The consular said I was a transsexual and that if i didn't change he recommended my wife should file for divorce.  I couldn't leave her so I chose to go back into the closet. This was about 8 years ago.

Since then there have been incidents where after she has gone to sleep I would slip on a pair of panties and she reached over to get close she would have a fit and threaten to tell the world, so I backed off again.
This is where I am at today!  I want to be a woman, but for fear of the embarrassment I am still in the closet.

Question:  Will my wife ever understand and accept this or will our marriage be over.  Before I am exposed I need to know how to handle this.
 

I assume that you have read the contents of my site, and perhaps even taken the COGIATI, if not, please do, you might find something that is of help. Ultimately, you must decide what you need to be happy and make being alive worthwhile for yourself. Only you can decide what is truly important and necessary to you.

There is no way that I can predict how your family, your wife and kids, will react to you, nor what the future will bring. I can give you some very vague guidelines however, to try to determine for yourself what is most likely. The benefit of experience, if you will.

The bottom line in determining whether you will eventually be accepted or kicked like a dog is actually pretty simple: it consists of one single factor. There are many factors overall, of course, but this one vital factor is the most important. It is relevant to any relationship, with anyone, in your life.

What I speak of is the nature of your basic relationship...with wife, child, anyone. The question here is if any individual relationship is based on actual love and feeling for your personality, your 'self', or if the relationship is mostly based upon fulfillment of expectation: whether you fulfill a 'role' in the other person's life.

If the relationship is deep and true, then it will be based on genuine love of you, and your form or shape, sex or role will not determine whether the relationship continues. There may be trauma, difficulty, or upset because of change, but in time, things will stabilize and no love will be lost. So long as there is mutual honesty and emotional closeness and support, any change you go through will simply be one more shared misadventure. This is the kind of love that survives crippling accidents and any problem or circumstance. It is real friendship. It is rare, and the greatest treasure in life.

If the relationship is based mostly on the specific role you play in the other person's life, on what you do rather than the fact of you being a unique individual, then the relationship is shallow, and will not endure. You will lose such a relationship, probably in a very traumatic and miserable way, if you stray from fulfilling your agreed 'function'. This is a relationship based on emotional commerce, and is the most common human relationship. Most marriages, families and friendships held by most people, sadly fall into this category. Essentially a business contract, it possesses very defined boundaries and limitations. Role-play forms the basis of this kind of relationship, and the world is divided into terms and labels such as 'father', 'mother', 'husband', 'wife', 'daughter', 'son', and so forth....rather than in regard to the people involved as people first. When a role is not performed adequately, all affection and seeming attachment is lost.

This factor, the most important factor in any relationship, the 'love' vs. 'role' issue determines everything.

If you were to tell your family and friends, for instance, that you were a transsexual, that you were miserable, that you had to solve your problem or die, you would soon know which kind of relationships you share: shallow or real. If your relationships are real, then after the traumatic reactions die down, you would still retain your relationships, though they might alter and grow a bit. This does happen, and I know a few transsexuals that have kept spouses and children, friends and relatives, despite their situation.

The most common circumstance, however, is brutal, total, and often cruel rejection. The sham of the commerce-based relationship exposed, the poor transsexual loses everyone in their current life, and then must make new family and friends entirely. The upside of this is that, once this occurs, the new family and friends are selected by virtue of acceptance and often much deeper feeling than the lost family and friends. Love is a learned behavior in part, and it takes experience and practice to actually get any good at it. Shocking but true: believe it.

What you face can only be guessed at, even by you, with all of your knowledge of the people in your life. The only way you will ever know is to actually face the issue, and the risk of losing everyone. You can never know for sure, until a trauma in life shows you who is for real, and who is not.

So, if you truly are transsexual, and dealing with your gender issues is necessary to your happiness and ultimate survival, then you will be motivated by biology to do what you must. When that occurs, you will see what kind of relationships you are actually in. You can estimate what might happen, but you cannot know. This point cannot be stressed enough: sometimes the deepest seeming love can prove to be a sham, and also sometimes the most clear cut case of inevitable rejection can surprise with a loyalty and depth that astounds.

The issue is saving your life. In doing that, there are serious risks, and often, serious costs. How much are you worth to you? That is the question. Everyone is responsible for themselves. That includes your family...they are responsible for how they react to you. If you suffer agony, then either they will care and help you, or...to be brutally honest... they are not worth your time. Even if they were the result of, or the partner to, your reproductive actions.

From you spouse's actions so far, I would say your chance of keeping her in your life is very small, but then again, as I have said, sometimes people can surprise one with true loyalty.
 

I am a 17 years old male to female. I am on hormones now, but not by a doctor. I'm getting the mones on the black market. I cannot live full-time as a girl, because I am still going to school. I'm taking hormones for about two weeks only, but I am quite happy with  it. And my problem is: What can I say to my parents? I know that my father had found female clothes in my warderobe, but he didn't say something to me. I have very nice parents and I don't want to hurt them, especially my mother because she's not a very strong person. I am so worried  that I smoke all the day about 40 cigarrettes. I have holidays now and I go out nearly every evening to drink as much  as I can. I am afraid that my problem will later make me an alcoholic. Perhaps you can help me. By the way I also smoke a lot of grass, also my friends are  " potheads". We have all problems. But even my best friends don't know that I am a transsexual. How can I tell it without loosing everything??? I also made the COGIATI test. It says that I am "classification five transsexual".

Your situation can be made useful to you.

First off, you need to be careful.

Hormones are incredibly powerful chemicals. They affect every organ and system in the body. When we take hormones, and our bodies still produce hormones already (pre-surgery) we get a double dose of conflicting hormones. The idea is to have the desired hormones overpower the existing ones, but this must be done carefully.

The reason for this is that if the hormone level is too high, the hormones, in this case female hormones, become metabolized by the liver and become mirrored in function. This means that the female hormones can act like male hormones. So watch your dosage, and keep it the lowest possible dose to do the job. Too much estrogen will actually do the opposite of what you want.

Female hormones, among other things, cause cells to grow. Estrogens signal cells to divide and redistribute, and also affect the way that genes inside the cells are expressed.

Smoking and drinking introduce chemicals that cause cancer, and under hormones, especially a double dose of conflicting hormones, this effect increases very, very dramatically. Many transsexuals have died at a rather young age because of smoking and drinking during hormone use. The effects pile up and kill later in life, around age 25 to 40, just as the transsexual starts to have some happiness. It is really tragic.

If you want to see age 40, and life as a woman, and surgery at all, stop smoking and drinking immediately, and start hoping that you have not caused too much damage already.

The toxins in smoking and drinking cause errors to occur in the genetic code of the rapidly dividing cells that estrogen causes. These errors in the genes are the beginnings of cancer. When the errors pile up, eventually cancer begins. The rapid growth caused by hormone treatment makes this happen much faster than in nontranssexual people.

Now, if you are an intelligent person, and choose to save your life, we can move on to the next part, how to get what you want.

Assuming that you survive to adulthood, then you can hope to get surgery and live as your proper sex. Because of the early hormone use, if done carefully -you really, absolutely should be under a doctors care, even if you see one on the sly, to make sure your dosages are correct- you should have great passability and should find your road easier than some. Make use of this.

Here is the most important thing: you have a great opportunity to get what you want and to live as you need too. To achieve this, you have to start taking really good care of yourself, and preparing for that future. You can do this, you can have your life the way you want it, if you make the effort. I know, for I have done just that, and so have my friends, and many, many others.

Take care of yourself, plan for a future, and make it happen carefully.

How do you deal with this? Unless you can trust your current friends with your secret, keep it a secret! Survive and plan and prepare until you are old enough to take action. Then, take action. That is how most successful transsexuals do it.

When you are underage you are vulnerable. You need to survive until you can have power. It is as simple as that. I want you to survive, and be happy. Please make it so!