Women Born Transsexual

By ANEMONA HARTOCOLLIS and CHRISTINA DAVIDSON
http://www.nytimes.com/2009/04/17/nyregion/17silicone.html?_r=1&scp=2&sq=silicone%20injections&st=cse

Like almost every woman, Fiordaliza Pichardo just wanted to look beautiful, so a few years ago, she began getting silicone injections from a woman she met through a friend in order to plump up her thighs and derriere.

She never expected to pay such a high price for her looks.

In March, a day after receiving an injection, Ms. Pichardo, 43, died of what the medical examiner later determined was a silicone embolism in her lungs.

The city’s health department fears that the illegal use of silicone as an alternative to cosmetic surgery is on the rise. The city’s poison control center has received three calls in the last 10 months from doctors who have treated patients injected with silicone; Ms. Pichardo’s case was not among them. In the previous two years, there were only two such cases.

Health department officials say there may be other cases that have gone unreported, since doctors are not legally obligated to report silicone poisoning or even death, and since silicone is hard to detect through X-rays or CT scans. The department was planning Thursday to send an advisory by e-mail and fax to thousands of doctors advising them to watch for silicone poisoning cases.

Nationally, reports of buttock enhancement using silicone and similar thick liquids have surfaced from the Northeast to Miami, and the Food and Drug Administration is also planning to issue a warning on the dangers of such practices, Siobhan DeLancey, a spokeswoman, said Thursday.

“This seems to be kind of an underground occurrence, so it’s difficult to get numbers of actual events and to know exactly what these people are being injected with,” Ms. DeLancey said. “It’s important to note that none of the products that are reportedly being used are approved for this purpose.”

Ms. DeLancey said silicone was not approved for injection into tissues at all, only for use in the eyes and in certain implants where it is contained and cannot leak into tissue. She said the F.D.A. had the ability to conduct criminal investigations, and would encourage victims to come forward “so that we can document the problem.”

Across the Internet, chat rooms, Web sites and blogs have sprung up discussing buttock injections.

The victims have become caught up in an underground beauty industry that uses injections of black-market, medical-grade silicone or industrial-grade silicone as a cheap, fast and easily accessible way to plump up breasts, buttocks, thighs and even wrinkles.

The injections are popular among Latina women and transgender women, who may be unable to afford conventional plastic surgery and who tap into it through unlicensed practitioners working through word of mouth, city officials said.

Although side effects are fairly rare, silicone can migrate through the bloodstream, creating potentially fatal clots in the lungs, as it did in Ms. Pichardo’s case, said Dr. Nathan M. Graber, director of environmental and occupational disease epidemiology for the New York City Department of Health and Mental Hygiene. It can also migrate through tissues, leading to ugly lumps and chronic pain.

The injections are administered at home, in motel rooms, in makeshift offices or at “pumping parties,” where the guests take turns injecting one another, officials said.

Young transgender women often seek out silicone injections because they are a quick way of making bodies more feminine, unlike hormone treatments, which may take years to work, said Dr. Nick Gorton, an emergency room doctor who treats transgender patients at the Lyon-Martin Health Services clinic in San Francisco.

“If you go to a pumping party, you can have it tonight,” Dr. Gorton said. “It’s a big temptation, especially among young people who, when you’re 20, you’re not thinking about your own mortality.”

People are often reluctant to report side effects, because they feel that they are turning in a member of their community, health officials said.

Industrial-grade silicone can be bought at a hardware store. But Dr. Graber said there have been reports of the use of substitutes like castor oil, mineral oil, petroleum jelly and even automobile transmission fluid.

Dr. Suhail Raoof, chief of pulmonary medicine at New York Methodist Hospital, treated a woman with silicone poisoning in 2007. She came in complaining of shortness of breath, chest pain and coughing, reminiscent of pneumonia, he said, and told doctors that she had been injected with about 500 milliliters of silicone in each buttock about half an hour earlier.

Because silicone is not visible on an X-ray or a CT scan, Dr. Raoof said, diagnosis is difficult without a biopsy. Doctors used deduction to diagnose the cause of the woman’s symptoms, and she survived, he said.

Ms. Pichardo was not so lucky.

Ms. Pichardo’s 19-year-old daughter, Marinés Rodriguez, said that her mother began getting silicone injections several years ago after a friend introduced her to a cosmetologist.

Ms. Rodriguez said the cosmetologist went to Ms. Pichardo’s home in the Bronx and to other clients in Manhattan and Miami. A cup of silicone cost $800, and the cosmetologist would inject half a cup to two cups in a single session, Ms. Rodriguez said. Her mother, she said, “didn’t really care about the price. It was more that she knew somebody who had this first.”

Ms. Pichardo came to trust the woman. “She felt that was her friend, nothing could go wrong,” Ms. Rodriguez said.

Ms. Pichardo was last injected on March 17, and died the next day. Doctors thought she had pneumonia, Ms. Rodriguez said, and the family never thought to mention the silicone injections — which were discovered during the autopsy — because they thought they were harmless.

The medical examiner has ruled her death a homicide because she was injected by an unlicensed nonmedical practitioner, said Ellen Borakove, a spokeswoman for the medical examiner. No charges have been filed. Paul J. Browne, a police spokesman, said, “We believe she has fled to the Dominican Republic and we are in discussions with the district attorney as to next steps.”

Ms. Rodriguez said the family was distraught, but found it hard to be angry. The day after her mother died, she said, the cosmetologist visited to pay her condolences. “We didn’t think she did it on purpose,” she said.

The Texas Free Market Foundation, an ultra right wing hate group voiced its opposition on April 9th to HB2966, filed by Rep. Garnet Coleman (D-Houston),which would extend current hate crimes laws to grant additional legal protection for transsexual and transgender persons

Jonathan Saenz, director of legislative affairs at Free Market Foundation, who testified against the bill in committee, said, “This attempt to expand controversial special protections to transgender persons is offensive to equal protection and shows that some people think certain persons are more worthy of protection under the law than others,”

He continued, “Texas already has laws that protect all people against criminal activity.”

The current “hate crimes” law increases the punishment to the next highest category of offense for other protected classes of people.

It has become a talking point for the extreme right wing radicals to claim that extending bias crimes laws to protect certain groups amounts to special treatment when historically such crimes of major violence and hatred have gone unpunished or defendants who committed such crimes have been let off with a chastisement and minimal time in jail or prison.

Hate crimes laws are an attempt gain justice for the victims of hate crimes who have all to often had crimes against them treated as being less serious than those committed against people of the privileged classes.

http://intersexnews.blogspot.com/2009/04/cbx2-age-of-chromosomes-is-over.html
By Sophia Siedlberg
[Published with Sophie’s gracious permission]

The New Scientist (1) published an article about a seven year old girl who was “diagnosed” as having XY chromosomes, but has a uterus, ovaries etc. As usual the popular press described what the team in Zurich had found, led by Dr Anna Biason-Lauber as a girl who had violated the rules of “maleness” and she therefore “provided a key to understanding how maleness works”. There is however a bit of a bombshell for all those Chromosexuals out there who get sexual satisfaction in condemning such a child as “a genetic male”. Dr Anna Biason-Lauber has discovered a more important truth here. Sex is not down to chromosomes!

CBX2 on (wait for it) Chromosome 17 acts like the real “Male master switch” and most XX females will have a working copy. So does that makes them genetically male then?

There are two key points to remember here, firstly the MSRs on the Y chromosome are not the “male master switch” (In plain English SRY is not the six pack penis gene it was said to be) and secondly the fact that the “real master switch” resides in Chromosome 17 and everyone, male or female has a copy of it.

Anyone with half a brain may start to realize that sex differentiation is more complex and in terms of chromosomes, more diffuse than the commonly held misconception of everything being on the 23rd pair of chromosomes. What Dr Anna Biason-Lauber has found is simply the fact that sex differentiation is not what people have for years thought it to be.

Look at this both ways (as most people were taught to believe the SRY on the Y chromosome is the root of all maleness): before SRY there is another “master switch” that if present and if expressing “allows” SRY to express. So SRY is clearly not the root of all maleness. Add to this the simple fact that CBX2 is found on every man and woman’s genome, and resides on chromosome 17 not X or Y. Suddenly male and female are not quite so distinct. After SRY we again find a situation where all the relevant genes have to be there, have to express in a given way and they can also be found on either the X or the remaining autosomes. Rendering the “oh so sacred” Y chromosome as something that will increase the probability of a male birth but little more than that.>

What CBX2 shows is that people cannot use genetics as an excuse to say to XY women, “They should be men”. For ten years or so genes expressing after SRY have been shown to be as important when it comes to making someone “genetically male” or “genetically female” (If fools want to be so arbitrary about it) but now it has been found that SRY depends on a gene in the autosomes to express before SRY can. And if it doesn’t, SRY or no SRY, the end result is a female.

There is no excuse now for anyone to think that XX = “Girl” and XY = “Boy”. It clearly does not work that way. You are only “genetically male or female” if you have all the genes line up to produce an unambiguous phenotype of one or the other sex. Since this is also not so clear cut, even talking of “Genetic sex” is foolish, and to claim a woman or girl such as the one mentioned in the New Scientist is “genetically male” is little more than petty minded ignorance.

The next time someone says to me, “Such and such is genetically male because of their chromosomes”, I will simply maintain that in order to draw such a conclusion, they are deliberately ignoring how DNA really works and as such must be “genetically pig ignorant”.

The age of chromosomes is now over. Like it or not, chromosomes are not the final markers of sex and never will be.

The very second Dr Anna Biason-Lauber published her findings was the very second the imagined absolute nature of chromosomes came to an end. If people are going to describe sex in terms of genetics, they can only say it truthfully now: Chromosomes simply hint at the presence of a set of genes (Polygenic array, ah vindicated!) that would lead to a particular outcome, but nothing more.

Being male or female is not a question of genetic checklists involving chromosomes. Being male or female is an adapted state of being as I have always said, and this proves it. Genetically sex is a complex set of variations, more complex than “social constructs and some mythical gender spectrum.” The real spectrum is the entire human genome and that differs from individual to individual. Someone’s approximation to a given sex is like their fingerprint, unique to them. And when people realise the full consequence of that, the two sex system and not just the “gender binary” face a very profound challenge.

Has society got the balls (or ovaries) to grasp that? Or will society still insist on saying something dumb like “XX for a girl; XY for a boy”? Only time will tell, but since Dr. Anna Biason-Lauber published that paper, the age of chromosomes should be consigned to the dustbin of history along with other mistakes like eugenics.

(1) Journal reference:

American Journal of Human Genetics (DOI: 10.1016/j.ajhg.2009.03.016). Issue 2704 of New Scientist magazine, page 14.

http://www.intersexualite.org

http://www.alternet.org/sex/136909/in_search_of_the_%22perfect%22_vagina%3A_women_spend_and_(spread)_to_achieve_porn_ideal/

By Bonnie Zylbergold, National Sexuality Resource Center
Posted on April 17, 2009, Printed on April 17, 2009
http://www.alternet.org/story/136909/

“It doesn’t look right,” said forty-two-year-old Carla Westman*. “Like I’m uneven, like one side is larger than the other and as I’ve gotten older, I think one side is stretching. Before I could close my legs and you couldn’t see anything but now one side peeks through just a tiny bit more than the other, and that just bothers me.”

To clarify, Westman, a pharmaceutical rep from Phoenix, Arizona is feeling old. More to the point, she’s blaming her vagina, or labia to be exact. And bizarre as it may sound, she is not necessarily alone.

According to the American Society of Plastic Surgeons, approximately a thousand “vaginal rejuvenations” were performed in 2006 — the most current year for which U.S. statistics have been compiled — up 30 percent from 2005. In the United Kingdom, the number of labiaplasties performed doubled between 2000 and 2005, reaching over eight hundred procedures per year. While these accounts may be nothing to write home about yet, the limited data available (no one database records all instances of Female Genital Cosmetic Surgery) do suggest that the procedures, and the demand for such, are growing exponentially.

“The search term labiaplasty is one of the highest searched things that lead to somebody finding me on the Internet,” confirmed Dr. Scott W. Mosser, a board certified plastic surgeon based in San Francisco, who has been performing labiaplasties for the past four years. But despite the high traffic to his website, Dr. Mosser only performs about a dozen labiaplasties per year, leading him to speculate that people are less than comfortable with the procedure.

Said Dr. Mosser, “When we look at all the other procedures [that I do], the amount of individuals who search them is pretty proportionate to the actual amounts of individuals who come in for a consult. That tells me that labiaplasty may be a little bit in the dark; that women are nervous about it; or maybe it’s an area that’s perceived to be a little bit of taboo.”

What is labiaplasty?

For those still unfamiliar with the procedure, labiaplasty involves the surgical reduction and “beautification” of the labia. Women typically request the procedure for a triad of reasons. These include both visual and physical complaints ranging from discomfort during exercise and vaginal intercourse, to discomfort simply from wearing clothing, in particular when the labia minora get caught between the elastic folds of underwear, to complaints like Westman’s, where women are dissatisfied with a lack of symmetry, discoloration, or the appearance of their labia in general.

Dr. Mosser admits that while there is no true dirtiness to having labia hypertrophy, there does seem to be a psychological desire amongst women to have their genitals look organized or clean. “There is a real trend towards sort of a perception of a clean look, whatever that means, that is associated with youth,” said Dr. Mosser. Nonetheless, he is adamant that anything that is distracting enough to interfere with a person’s quality of life or lifestyle is something that should be addressed.

Is Porn Pushing ‘Ideal Genitals’?

Others, however, are not so convinced.

“Society has changed across the last little while to a context in which cosmetic surgery in general and cosmetic procedures in general have become incredibly normalized,” said Dr. Virginia Braun, a psychologist from the University of Auckland specializing in women’s health and sexuality, and the current co-editor of Feminism and Psychology. “But our knowledge of women’s genital anatomy is still not — we’re not a hundred percent there yet.”

Dr. Braun is one of a handful of doctors and professionals who are adamantly, and radically, opposed to labiaplasties as well as other forms of FGCS like vaginoplasties and hoodectomies. Both vaginoplasties, which involve the “rejuvenation” or tightening of the vagina, and hoodectomies, also called clitoral unhooding, are meant to enhance sexual pleasure (and neither, it bears mentioning, are performed by Dr. Mosser).

To hear Dr. Braun explain it, there is a huge lack of knowledge surrounding genital diversity for women. “Women who have nose jobs or breast enlargements have a huge pool of comparison to draw from. They’ve seen probably thousands of noses every day, and even though we maybe don’t [often] see naked breasts, we certainly know what breasts look like.”

So where are women like Westman, who yearn for their vulvas of yesteryear, drawing their comparisons from? As Dr. Deborah Tolman, a professor of social welfare at Hunter College School of Social Work and author of Dilemmas of Desire: Teenage Girls Talk about Sexuality puts it, “What happened in the last three years to make women’s labias so big that they can’t walk around with them?”

If the accounts from surgeons and the media are to be believed, pornography is a major influence in what women believe is desirable. While women might not be trading notes on their vaginal proportions, they have become increasingly comfortable with mainstream pornography and that leads to one dimensional representations of what vulvas look like. Add to that the phenomenon that is the Brazilian Bikini wax, where all but the smallest trace of pubic hair is removed, and women are getting the HD version of their vulvas outside of a biology class for the first time.

Controlling Women’s Bodies

The phenomenon, argued Dr. Tolman, is just another means of asserting externalized control over women’s sexuality; testament to the profound dearth of education that both women and men have about women’s bodies.

“It is in only such a vacuum that such notions of what are good and right and normal can be insinuated,” she said. “If we have other regularized ways, and by that I mean ongoing knowledge and discussion about what women’s bodies are really like, then it would be much harder for this kind of thing to sneak in and start to look normal.”

Both Dr. Braun and Dr. Tolman speak from a social constructionist perspective, where desire is understood as a learned behavior, and is not something innate or biologically wired. In other words, people learn to desire such procedures. FGCS, said Dr. Tolman, are commodities to be consumed. We learn to become consumers of surgery:

“We don’t want it. I mean we think we want it. It feels like we want it … but I think that the observation that this has only been going on for the last couple of years is testament to how this has not been a ‘forever’ quality of women’s lives.”

Then what with all the women who truly feel as though FGCS will better their quality of life? Are we simply to ignore them? Tell them that they don’t really know, or understand for that matter, what they really want?

“Individual choice is not the only criterion,” argued Dr. Leonore Tiefer, an associate clinical professor of psychiatry at New York University School of Medicine and Albert Einstein College of Medicine. According to Dr. Tiefer, it is the publicity surrounding cosmetic services that generate discontent. For example, medical makeover shows like Dr. 90210 create a context for which women learn to become dissatisfied with their bodies and genitals, and start wondering how they to might benefit from the procedures, which according to the shows’ doctors, promise better sex for both women and their partners.

Said Dr. Tiefer, “I do not condone doctors having free reign to advertise labiaplasty without scientific evidence of its benefits and lack of long-term harm. Nor do I condone doctors having before-and-after photos on their websites because of the lack of popularly-available information about the range of normal labia.”

As one of the foremost critics of “disease-mongering” trends in the medical management of women’s sexual problems, Dr. Tiefer maintains that while the rhetoric of choice and sexual pleasure around FGCS may legitimate and promote the procedures, all FGCS really produce is a generic model of women’s genitalia. Even worse, it pathologizes female genital diversity. So enraged is Dr. Tiefer, that in 2000 she founded The New View Campaign, an organization devoted to stopping all form of FGCS. The group compares FGCS to Female Genital Mutilation (FGM).

Understandably, most people find that comparison shocking. By and large, individuals from outside the specific cultures that perform FGM regard the practice as foreign and incomprehensible. But, points out Dr. Braun, “In both cases, what’s being done is that women’s genitalia are being altered to conform to a certain set of notions and expectations about what genitalia should look like, what they need to look like if they are to be appropriately feminine and appropriately desirable.”

Even the narratives of women who have undergone FGM and FGCS are similar, with women saying things like, “this is important to me to have genitals that look normal, that look appropriate, that are right,” said Dr. Braun. And although there are big differences as well, some of the same sorts of ideas about norms of what bodies should be like, and that woman’s genitals are an appropriate place to intervene, run across both.

Women’s Choice: A Question of Quality of Life

Nonetheless, Dr. Mosser doubts that the woman with labia hypertrophy who is uncomfortable engaging in intercourse, and is uncomfortable walking down the street, and is uncomfortable looking at her naked body in the mirror, would agree with the comparison. That person, said Dr. Mosser, “would consider it not to be an external pressure but a correction of something which will improve her quality of life.”

Either way, women like Westman would do best to get to know their genitals as they are and should be. If nothing else, it’s a whole lot cheaper.

© 2009 National Sexuality Resource Center All rights reserved.
View this story online at: http://www.alternet.org/story/136909/