After 25 Years

[janekane (imported)]

I have been aware of EA for many years, have been busy with life events, and find what I have learned after 25 years without significant testosterone may be of some help to others. Thus, I requested membership yesterday and became a member early this morning.

I intend to do nothing that would bring harm to anyone here, however, I am autistic and may not always get words to work as I intend them to work. If I post a thread topic or comment and mess up with words, I would be grateful to be informed of my blunder, the better to learn more about getting words to work decently.

From rather early infancy, my inner sense of self and society's seemingly avowed definitions of boyhood/manhood have been irreconcilable.

The first day of kindergarten, when I first entered the kindergarten room, the teacher pointed to toys at the far end of the room and suggested that I go where the toys were and play with them. I saw undesirable toys to the left side and desirable toys to the right side, at the far end of the room, and went to play with the desirable toys.

The teacher hurried over where I was, and said, in effect, to me, of the desirable toys, "No, those toys are for the girls."

That was in 1944, and I already understood that boys were supposed to learn to hate themselves so they could learn to hate other people and thereby become good soldiers in human warfare.

For first and second grade, we lived in another city. First grade was okay, second grade was a personally shattering experience. I did not meet my second-grade teacher's expectations of what a proper boy should be.

My best guess now is that I so seriously failed to meet my teacher's "standards," that I was deemed incorrigible and intolerably defiant, and I was regularly sent to the principal's office to be paddled as punishment for defiance.

I was, alas, not defiant. I was autistic and significantly trans-gendered, and experienced shattering abuse because I could not learn to not be autistic and could not learn to hate myself in accord with my teacher's and principal's evident demands.

For third grade, we had moved half way across the country, to a city where children were never paddled in public school. Came one Sunday in December of 1952, and my family (parents, older brother, and myself) was listening to the Jack Benny radio program. Early in the program was a joke, though not much of a joke for me.

The joke was of taking a trip to Europe; going to London, where a man was a man; to Paris, where a woman was a woman; and to Copenhagen, where a man was a woman. Christine Jorgensen.

As I was on the verge of "going to the bathroom" before that joke over the radio, I excused myself, did what was physiologically indicated, and went to my bedroom, lay down on my bed and cried, and cried, and cried. As much as I cried with sadness, I also cried with joy.

It was a profound sadness to recognize the tragedy within the laughter of the Jack Benny program audience.

It was a profound joy to know and understand that I was not alone in this world of socially-mandated gender-diversity cruelty.

About the same time as that Jack Benny program joke, testosterone began to intrude into my life. Its arrival was subjectively like a disconcerting, not immediately lethal, yet significantly poisonous invasive pathogen.

Much as I had adapted to the distress of being paddled past personally shattering in second grade, I adapted as best I could to testosterone. As with being shattered from being paddled, my adaptation to testosterone was rather tenuous at best.

When I was 18, during my first semester in college, my dad very nearly died from prostate disease (which I understood included prostate cancer) and I became far more aware of the possibility that testosterone and I might need to part company for me to live a decently long life.

I happen to have earned B.S. and Ph.D. degrees from "a major research university" in a field which is based on biological science. I happen to have worked in a major medical center for more than two decades. Aspects of cancer risk and cancer prevention were core aspects of my undergraduate and graduate school education.

When he was 66, my dad died from cancer. I set out to understand my choices regarding effective cancer prevention. Other close relatives died from cancer, no close relative had ever been successfully treated for cancer; I understood that my only plausible chance to live very long was through cancer-prevention, and I had rather convincing evidence from my available family history that testosterone was evidently a significant carcinogen and/or cancer promoter within my close family.

Being as transgendered as I was (and am), parting company with testosterone was only desirable for me in terms of my personal life. In the early 1980s, I began to search for a way to properly separate my life and testosterone. I talked with a urologist, who summarily dismissed my cancer concerns. I consulted a psychiatrist whose specialty was sexual issues and clearly recognized that my desire to remove testosterone from my life as much as possible was about cancer and not gender.

I could not get any physician to understand my cancer-risk concern. I found that I might need to develop cancer before anyone would believe my concern was a valid focus of medical attention. I went back to the urologist, with a much stronger biological argument, only to be told that the urologist would not "do anything, but some doctor in a third-rate hospital might."

At that time, in early 1985, I searched the medical literature and found that there were a few physicians who might, for a suitable fee, do what I thought was proper to reduce my cancer risk, only none were close by. I was married (and still am) with a young daughter who I deemed it would be harmful to needlessly abandon through dying from preventable cancer.

Of course, I found that people get pushed past desperation and, when so pushed, will do unsafe self-surgery or whatever else is possible, and I rejected doing anything that I thought would put my life at risk.

So, I began calling vasectomy clinics, until I found a doctor whose dad had died in consequence of prostate cancer. Courtesy of the Sears Roebuck farm catalog, I had obtained an Elastrator and bands, not to use myself, but to make clear to a physician that I was really serious about reducing testosterone because of my sense of cancer risk. Because no valid medical reason was deemed to exist, the vasectomy doctor agreed to do the bilateral orchiectomy if paid in cash and if I agreed to never identify him.

In early June of 1986, I the bilateral orchiectomy was done. Within two weeks, my brother was diagnosed with the sort of terminal cancer I had set out to prevent. I had admonished him to be screened for prostate and colon cancer, based on my dad's cancer problems; his doctors, at the same hospital/family practice setting as the urologist who suggested my looking into a "third rate hospital" were so indifferent to cancer risk that they refused to consider my concerns even after my brother's terminal diagnosis.

I sought a second opinion, found a gastroenterologist who was willing to do a colonoscopy on me, learned that I have the same genetic condition as my dad and brother had, and that my concern about cancer risk was terribly accurate. Within two months of my brother's terminal cancer diagnosis, I underwent a total colectomy with ileo-rectal anastomosis to prevent colon cancer.

If no colon, then no colon cancer... If no testicles, then no testicular cancer... If very low testosterone and no prostate cancer, then very low future prostate cancer risk...

The colon cancer genetic condition is now identified as familial adenomatous polyposis (FAP). A recent literature check shows the average cancer onset age for FAP being 39 and the average age of cancer death, without effective preventive surgery, to be 42. I have made it past my 72nd birthday without developing cancer.

My bilateral orchiectomy was done in a properly safe setting, with proper anesthetic, proper antibiotics and infection control, but under conditions such that I cannot ethically specify who did what or where it was done. Having an purchased an Elastrator and bands to show to a vasectomy doctor was really convincing.

I still have the Elastrator tool and some bands; for some small things, the bands make really good gluing clamps.

For a few weeks after the orchiectomy and before the colectomy, my life was going very well, the effects of testosterone which I had found unpleasant since early puberty gently went away and life seemed much improved, except that my brother was dying.

While the orchiectomy (which I guess might best be described as a "radical vasectomy" -- it was done much in the manner of a vasectomy, except instead of ligating and transecting the vas deferens, the entire cord was ligated and transected. I ended up with rather conventional vasectomy scars and became a flatbagger, and the orchiectomy and recovery from it were uneventful.

"Radical vasectomy" is evidence of my having a sense of humor. Without decent humor, how does anyone survive?

Then came the colectomy, general anesthetic, morphine for post-surgical pain (I needed no pain medication of any sort following the bilateral orichectomy or "radical vasectomy")

So, what happened to me following the bilateral orchiectomy and before the colectomy? No hot flashes, no infection, no discomfort worth noticing, no loss of orgasm or erection, and life became much better.

General anesthesia and morphine for post-surgical pain did simply awful things to my mental functioning. Before long, I had voluntarily entered a psychiatric hospital, because I knew that people with malfunctioning brains sometimes did terrible things, and I was resolved to not do any such.

I informed the folks in the psychiatric hospital that I was autistic, transgendered, had been abused to the extent of having developed a severe form of multiple personalities (two of which are named Jane and Kane, hence my user name here) and was informed that my truthful statements about myself were psychotic delusions.

From mid-1986 to mid-1989, I went on a trip through the methods of biopsychiatry, with a collection of psychotropic medications which controlled the clinical signs the psychiatrists mistakenly thought were my mental illness, and which medications eventually put me into a profound dementia which was superficially much like very advanced Alzheimer's Disease; I was, to use the psychiatric jargon, "Oriented times zero." I often could not recognize my name, could not distinguish day from night, and was clueless as to where I was.

In the summer of 1989, I came under the care of a neuropsychiatrist at a world-famous university, who decided to take me off all the psychotropic medications as rapidly as was safe. Over about three months, my tested IQ skyrocketed from less than 10 to 70, and I was deemed able to live at home.

I sought rehabilitation services, which were denied because I was deemed too brain-damaged to benefit from them. So, I made up my own mental rehab program, which worked well enough that, after a year of my rehab effort, I got an IQ test score high enough for Mensa membership.

I have become a very strong advocate on behalf of self-advocacy.

In the summer of 1990, I again needed major surgery to prevent cancer from FAP General anesthesia and morphine for post-surgical pain for the second time. The same sort of messed-up brain function as happened in 1986. Back to the same psychiatric hospital as in 1986.

However, 1990 was very different than 1986. I knew what psychotropic medications did, what they did that I experienced as helpful and what I experienced as harmful.

In 1990, I told the psychiatrist what medication would work and got it prescribed PRN (pro re nata, or according to need as determined by me) so as to not be found treatment-defiant, and it took only three days, not three years, to work through what the second time with general anesthetic, major surgery, and morphine had done to me.

During the extensive psychoanalytic therapy which followed the colectomy, and which lasted until 1992, one of my therapists pointed out that, if my concern was really mainly cancer, it would be thoughtful on my part to allow that many men have serious manhood issues and it would be kind on my part, when going to, for example, a YMCA swimming pool, to have testicular prostheses put in. That was accomplished in 1991.

Testicular implants do not make testosterone, and, for as long as they did not bother me, I did not bother them.

I mid-April of this year, "Lefty" began to act up, became attached, I am guessing, to some aspect of the remaining cremasteric muscle, and would snatch itself high up in the inguinal canal, where it became a source of notable discomfort and, after a few days, apparently helped initiate a groin infection, which was successfully treated after some four emergency room and urologist visits.

The discomfort kept increasing, and the local urologist indicated a willingness to consider removing the prostheses beginning in August of this year. Waiting that long, given the April infection, concerned me more than the discomfort because there can be complications from FAP (such as desmoid tumors), so I gathered up my local medical records and made an appointment with a urologist in a major university medical center, went there in late April, the urologist agreed that removing the prostheses promptly was desirable, and I effectively as though underwent my second "bilateral orchiectomy" (or "radical bilateral prosthectomy"?) this past Monday (June 6, 2011) afternoon.

The university urologist team decided to re-use the vasectomy scars for the bilateral prosthectomy, much as the surgeon who did the 1990 duodenal polypectomy used the 1986 colectomy scar route. By Monday evening, June 6, the prosthesis-induced discomfort was almost entirely gone, and was completely gone by Tuesday afternoon.

Were someone to attempt to convince me that my life would be better with testosterone, I will argue to the contrary relentlessly, though without rancor or violence.

Were someone to attempt to convince me that it is better for me to have prostheses than not, I will argue to the contrary at least as relentlessly.

I lived with testosterone for nearly 35 years, from early puberty until age 47. I have been with low testosterone levels (pre-puberty and post-orchiectomy) for about as long. It is my observation that my brain works far better with very low testosterone levels than with the levels typical of men of my age during the time I had functional testicles. Yet my wife and I have an adult child, and our child is worth far more to me than all the distress of the undesirable effects of testosterone I experienced for nearly half of my life. Therefore, I am glad that I waited until after I was sure that I would not be doing my part in making another baby before getting castrated, and I am glad that I did not wait so long as to have already died from cancer (like my late brother).

It seems to me that less than $25 will get a Nasco Elastrator and a hundred bands, and I wonder whether having one on hand might be a useful way to help persuade an otherwise unduly reluctant doctor to do an orchiectomy for people who cannot reasonably get to the few doctors who are willing to do orchiectomies without unduly difficult evidence of proper personal need for lowered testosterone...

Around 1995, or somewhat before, testicular prostheses became unavailable in the U.S. and it was not until 2002 that the saline-filled Mentor one became available. For seven or more years, TC2 people could not get prostheses installed in the U.S. It took about 20 years for the prostheses I got in 1991 to become problematic and for it to be medically indicated that they be removed. Testicular prostheses are not considered permanent; mine surely weren't.

I did not get prostheses for my benefit or for the benefit of my wife or our physical relationship. Like, I am guessing, almost all women, testicles as such are not much of a concern for her in terms of our marriage. They are not much of a concern to me either, except that I am alive and not dead from cancer, and not having working testicles and associated testosterone, my family history tells me, is probably a major factor in my not being dead from cancer at my age, as my dad and brother were before age 72.

A friend with whom I can talk in depth and detail remarked, of testicular prostheses, "vanity, vanity, vanity." To which I said that my getting them in 1991 was not about my vanity, but about the vanity of men who find their self-hood or manhood fragile and always being lost.

With working testicles or without, with testicular prostheses or without, with a colon or without, I am always a complete person, one for whom nothing is ever "missing."

Yet, were I now dead from the sort of cancer my many surgeries (including polypectomies done by sigmoidoscopy and side-view esopho-gastro-duodenoscopy), I surely would be "missing" my whole life as a living person.

I find life is best lived and not suffered-through. For me, testosterone was not a cause of suffering, but was a cause of a life of subjectively much poorer quality than without it.

Would I have done self-surgery as many people have found necessary? I never got to find out; as with the prosthesis removal earlier this week, I have enough biology formal education and knowledge to have been persuasive. That is quite apparently not true for most folks. How sad.

So, I am introducing myself here, with the purpose of sharing what I have learned in decent and respectful ways. The problems people encounter with gender identity are real and decent care and respect are, to me, of paramount significance.

Every time someone has attempted to define me in terms of themselves, I have found myself being abused. I find that personal integrity and a valid sense of selfhood are essential to a life that is truly decent; those who block or attempt to block people who, like me, cannot fit into social stereotypes of alleged normalcy from living personally meaningful and satisfying lives, I invariably experience as treating me, and others, in often severely damaging ways.

I am not anonymous, though I will here use the moniker "JaneKane" as though I were anonymous to fit in with those who, for personal and occupational safety, find that they need to be anonymous.

There are many items I have put on the Internet using my "real name" and professional identity. I would not discourage anyone from looking for them and reading them. At the same time, I will not link what I post here directly with what I put out elsewhere using my "real name" because I seek not to be an exemplar of openness as though I am being a critic of people's need for the safety of anonymity.

I plan to write and publish the essence of my life with the goal of doing my part to help human society become kinder, more respectful and decent, and more affirming of the diversity of human life than it now is.

It is my personal and professional view that gender identity conflict can be among the most severely distressing and incapacitating conditions people can encounter. I have personally known people whose suicide attempts, as efforts to escape the agony of severe gender issues inadvertently failed to be fatal.

Far better to affirm life, to affirm the need to be free of the distress of gender-dysphoric hormones than to suffer in agony so strong as to make death seem a wiser choice than life.

In a way, I have been "out" all my life. During the first three days of kindergarten, most of the other children figured out that I did not fit the conventional mold of "boy." I was picked on and bullied, though not enough to effectively alert my teacher. Kindergarten included a recess period on the school playground. Using "JaneKane" as a symbol of my actual name, about a third of my classmates formed a circle around me, chanting (to the tune of "A Tisket, A Tasket") something akin to, "Cry baby, cry baby, JaneKane is a sissy."

On the third day of kindergarten, walking home beside my mother, we came to a busy street on which public busses ran. One bus pulled up from our left, stopped short of the intersection, let off and picked up passengers, and, still having a green traffic light, pulled in front of us.

As the bus started up, I realized that I could pull loose from my mother's grasp and dive under the back wheels of that bus, and the kindergarten children who were treating me badly would never be able to do that again. Before I could even twitch, I realized that my diving under the back wheels of the bus would hurt my family "a thousand times" more than the other children could ever hurt me.

Then there was the patient, during my psychiatric inpatient episode, who showed up in the day room, with bandaged wrists and nearly asleep. Some of the other patients in the day room began to talk about that "boy." and "his" being rather young for the unit we were on. When the person was reasonably awake, I introduced myself as asked if talking would be okay. The person said, "Yes." I said, "Some of the other patients here think you are a boy." The person said, "I am." I replied, "I think I may know something about that." "He" was F to M, pre-op. My "gendar" may have been working well.

So was my suicidar. Bandaged wrists. Gender dispair, it was not "his" first attempt to be free of a life which did not belong to him.

Is not despair the alternative to integrity? Erik H. Erikson, in his epigenetic chart of "psychosocial developmental crises" regarded the end of life as being of the resolution of integrity versus despair. For myself, I choose to work for integrity, for wholeness, for authenticity of self. Testosterone drove my life toward despair, being rather free of it drives my life toward integrity. Give me a choice, and I will take integrity over despair every time.

I suppose it would be fair to say that I divorced testosterone from my life because of irreconcilable differences. I wonder whether there was any other practical alternative except divorcing my life from me. My best guess is, "No."

I hold to the view that it is an inherent right of every person to determine for self what one's self-nature is, and to be free from coercive, tyrannical definitions of self by others, and especially free from identity coercion from people who are functionally ignorant of their own inner self-identity.

I do know of what it is to be treated by others as though one is not a valid person. I know of it, and I understand it, and it grieves me. I abhor disrespect of any person's genuine, self-determined validity.

(This being my first posting effort here, I am learning how posting a new thread works for the first time; I expect this to work -- whether it does or not I will learn by submitting it...)

[kristoff]

JK

You give one much to read, to think about and ponder, which I shall. Meanwhile, I suggest you might contact our resident scholar and all around good-guy - I am sure he would very much appreciate speaking with you - Screen name of Jesus. Meanwhile, we welcome you to our zoo.

K

[JessJames1968 (imported)]

Kudos to you for your persistence with the medical community!

It is an imperative to be or have a patient advocate with today's medical community. Many medical professionals have inherited from their ancestors a belief that they are infallible and only they can know what is in the patients best interest.

Definitely a lesson to be kept at the forefront of one's mind.

[erikboy (imported)]

Thanks for such a long posting!

Human brain is truly wonderful piece of hardware, able to adapt and cure itself and body it is attached to.

Other important component that makes brain to work in right direction is willpower.

Willpower again depends on many simple things like blood sugar level and sleeptime.

[janekane (imported)]

Perhaps I add a comment, given the three replies so far to my introduction.

I am a licensed professional (a Registered Professional Engineer having a Ph.D. in bioengineering) whose formal education and professional competence includes being properly able to design prosthetic devices; my concerns with the prostheses removed this past Monday were both professional and personal. When the local physicians did not understand my concerns, I went to people who regularly do research, and found I was adequately understood. The "foreign body" response to the prostheses and the irritation and discomfort from the foreign body response abated rather completely by Tuesday evening.

I wrote as many words as I did because I need to avoid being deceptive in what I do; yet I also allow that it is proper to respect the tradition of anonymity on the Eunuch Archive. Without proper permission from the Eunuch Archive management, I find that I cannot do more than this regarding my personal or professional identity.

Within private emails, I am willing to give my real name and Professional Engineer registration information, if anyone asks, provided that doing so is not against Eunuch Archive policy.

There are hazards to self-modification, and I am not able to dismiss them, nor can I dismiss the exceptional effort it took me to get physicians to do what I deemed personally and medically wise regarding my gender, testosterone, and recent prosthesis concerns.

One thing I am willing to learn is whether I can be of help to others who would prefer proper medical care access, yet have been blocked from it by physicians who "don't get it" yet, to improve access to safe and appropriate care in practical ways.

Not everyone seeking an orchiectomy can readily get to one of the few physicians who will do orchiectomies without the person meeting some variation on the theme of the Harry Benjamin standards. For SRS, I allow those standards are wise and proper; I could never meet them because I did not seek SRS, but only sought to minimize cancer risk and to become free of the way testosterone interfered with my sense of optimal quality of life for me.

Simple orchiectomies ought to be well within the competence of most urologists who perform vasectomies, or so it seems to me.

Being a licensed professional, I cannot, and do not, in any way endorse or support self-castration of any form; neither have I any right to tell anyone not to do what a person finds necessary. Neither can I endorse or support self-castration as a person, regardless of being licensed. Yet I also do know what it is to be desperate for relief from distress.

Having found ways to "finess" the system to get medically appropriate treatment, I am willing to share my methods with interested people, the better to find out whether what I learned can be made useful for others.

There is a paper in the April, 2011, issue of Current Directions in Psychological Science, "Precarious Manhood and Its Links to Action and Aggression," by Jennifer K. Bosson and Joseph A. Vandello. It is my guess that many male urologists "suffer from a sense of precarious manhood," and their "sense of inadequacy" may be a significant factor in the difficulty I encountered, and many others seem to encounter, who prefer to be free of undesired effects of testosterone.

I welcome questions or other forms of replies to my introduction postings.

[kristoff]

In posting to the main boards I would not suggest posting your real name or credentials. What you do in private by email or private mail is your business, and we will not be concerned about it. The only time I get concerned about such things is when someone sets themselves up as a medical authority (real or otherwise) and attempts to dispense advise. You will find, if you look, that there are several PhDs among our membership along with any number of undergraduate and graduate level degrees as well. I am sure you will be able to find intelligent conversation in many quarters here. Your candor and forthrightness in fact sets you apart from many here who are only beginning to explore that which you already have.

[MacTheWolf (imported)]

In posting to the main boards I would not suggest posting your real name or credentials. .

Very true. Few here actually use their real name or credentials. Although Kristoff might look like a friendly nun in red, in reality, he's my rabbi

Welcome jannekane to our Happy Zoo

[YodaNell (imported)]

ZOOOoooo!!!??? Animal clinics are far more willing to castrate than human clinics.

JaneKane...it seems to me that you had NO adverse health problems being without T for so long. How is your bone density?

Welcome to EA.

[janekane (imported)]

YodaNell (and also everyone else):

Because of my close family member terminal-cancer-when-first-diagnosed history, my best guess is that I am in vastly better health for havng been essentially wihthout testosterone (I dislike being indirect, and so tend to write out "testosterone" -- a few Internet binits do not occupy much space...) than I would now be had I kept live testicles and the testosterone they would have produced. My close family history suggests to me that I very well might have no health issues now, had I retained what were, for me, my pre-orchiectomy testosterone levels. Why? Because dead people have no health issues?

Bone mineral density measurements show me to be comfortably within the osteoporosis realm; comfortably meaning that I am about as physically active as I was before the orchiectomy. No bone mineral density measurements were made prior to the orchiectomy, and bone mineral density varies significantly among men who have average to high testosterone levels.

When I was an adolescent (with what may have been average testosterone levels, but that was never measured), I did have bone fracture issues, suggesting to me that I may have had low bone mineral density throughout my life. My solution to bone mineral density has been being rather physically active in ways that encourage osteoblasts to be busy doing their job. I have had no bone fractures since the orchiectomy even though I have done some very few foolish things such as slipping and falling on icy outdoor surfaces that were not properly cleared in a couple parking lots. I have no evidence that my bone strength is particularly less than before the orchiectomy; my bone fracture prevention program is mainly made of much physical activity.

What led to the June 6 "bilateral prosthectomy" was my doing some strenuous, awkward-body-position specialized contracting work in mid-April. The left prosthesis somehow parked high up in the inguinal canal, seemingly irritated surrounding tissues, formed some sort of adhesion, and began doing a temperature-dependent vertical dance which was, at times rather disconcerting, and which greatly interfered at times with physically active work I thought I would wisely do.

When the prostheses were installed, in 1991, the proper technique was, I understand, what was done with me. Groin incision, pop them in, sutures, and done. They were free to roam wherever. More recent surgical methods include anchoring the prostheses down so they cannot rise up as the ones I had did, and also closing off the bottom of the inguinal canal as a further precaution against what finally happened with me.

Once my body had reacted to the prostheses as it did, I determined that it was against my long term interests to have such prostheses. When

local physicians did not understand my concerns

regarding what might subsequently happen, I went off to a university hospital in another state where Internet searching and literature reading suggested I might find a urologic surgeon who would accurately understand my concern, and that, it seems, is what happened.

What happened to me after the 1986 bilateral orchiectomy might be usefully restated in the light of your inquiry. The most useful for me was being able to work steadily without being interrupted by pondering how soon I next could hop in bed with my wife and other some such work distractions. For me, the biologically-driven mandate faded, the option remained essentially undiminished. I experienced no hot flashes and no distress from nearly total, abrupt testosterone departure.

No two people are the same, and I observe that many men report a very different experience than I had if their testosterone goes away. Were I not somewhere within the transgender realm, I suppose I might have prefered to die rather than part company with testosterone. As it is, I am alive and thriving; while my brother's brain died along with his colon, liver, testicles and the whole rest of his body.

Have I experienced depression because of lowered testosterone? Not that I can tell. Have I experienced lessened physical stamina or endurance because of lowered testosterone? Not that I can tell.

Please do not expect the same effects as I got, and please do not expect them. The only advice I would share, were I to share advice, and I am not doing that, would be to men whose family history, rather like mine, included "near fatal" prostate disease in men younger than 50, or other forms of cancer for which testosterone might be a form of promoter.

I had, by 1986, found I needed to push the boundaries of physician willingness to hear my cancer concerns far beyond my comfort level, and persisted because I had evaluated my cancer risk to be much as my brother's death subsequently indicated it to be.

I regard my being bothered by some of the effects of testosterone to have been, prior to the bilateral orchiectomy, around 80-90 percent of the threshold at which, absent cancer risk estimation, I would have sought the orchiectomy. Thus I am well aware of the sort of inner distress testosterone causes in some men (if "men" is the right word), and I am readily able to understand why some people seek castration as a way to solve a serious life problem. What bothers me is what I had to do to get my orchiectomy done with proper sterile conditions, proper sugery, proper safety, proper anesthesia, proper infection control, and done so well that I never missed work, never had any notable post-orchiectomy pain or even bothersome discomfort.

There are stories of "showing the instruments" (of torture) to accused persons during centuries-ago efforts to get accused persons to confess. When I had gotten nowhere, in early 1986, in convincing vasectomy doctors to attend to my concern regarding cancer prevention and testosterone, showing the instruments [Elastrator(TM) tool and green natural latex bands] was effective. Even so, that doctor required that I agree to never identify him, and to pay in cash for services rendered. Never identifying him includes not identifying whether he was she or anything else. Being autistic and very uncomfortable with any sort of deception, part of what I told people while I was psychiatrically hospitalized was fictional, in the manner of case study reports in the medical literature wherein clinically insignificant details are changed to protect individuals from being publically identifiable.

It continues to bother me that I had to go to such extremes to do what I thought then and still think is an important reason why I have not developed (and died from?) cancer as did my dad and brother. I seem to have the same genetic condition (familial adenomatous polpyposis that they had. It seems very unfair to me that I was able to "finagle" safe surgery for myself only because of cancer risk and my being willing to buy and show "the instrurments" as part of my persuasion method, while people whose have serious inner testosterone-related distress may be dismissed as having a "mental perversion" instead of a very real biologically-based need.

While, in the minds of people who "don't get it," my seeking the orchiectomy because of cancer risk estimation might be regarded as a more valid reason than people not at such estimated cancer risk have, I take strong exception that notion. When it is safe to be directly truthful regarding strong personal concerns, I believe that almost everyone will prefer to be directly truthful. When social taboos rule out being directly truthful and something is important enough, people tend to become indirectly truthful because no better way is attainable.

There is a 1996 paper by Dr Russell Reid, found on the Internet at www(dot)gender(dot)org(dot)uk/conf/1996/reid96(dot)htm which has an Editor's Note ending with, "No matter how desperate you are, find the cash to see a qualified psychiatrist, and retain a qualified surgeon under proper operating theatre conditions."

From the Conclusion of Reid's paper, "Since bilateral orchidectomy can and should be considered when gender dysphoric persons are not in a position to start their real life test, this clearly breaches the present Harry Benjamin Guidelines which I would suggest need urgent revision because of this." My real life test began about the time I was born... It became vivid with the onset of puberty. It became intense when my dad died.

I do not need to be identified as traditionally male or traditionally female. All I need is to be recognized as being alive by myself and by others, and, if possible, being accurately recognized as being, and living as, a decently caring person.

There is one item in Reid's paper which really troubles me, and with which I vehemently disagree. In the Conclusion is written, "The cost is significantly reduced when done under local anaesthesia as a day case. It s hould be noted that even under local anasethesia, the procedure is extremely painful for a short while, and so this is not for the squeamish." I have news for those interested. With sufficiently skillful and experienced use of local anesthesia, the vasectomy doctor who did my "radical vasectomy" (orchiectomy, if you prefer) was sufficiently familiar with doing essentially painless vasectomies that my bilateral orchiectomy was never much more painful than a mosquito bite, and was never -- not for one instant, "extremely painful." I attribute my lack of post-orchiectomy pain and post-orchiectomy complications to having eventually found a very skilled doctor, albeit one not particularly comfortable with my use of effective persuasion.

I am now setting out to learn what I may properly be able to do so other people might have easier access to "a qualified psychiatrist" (by helping more psychiatrists become qualified to understand the diversity of genders and gender dysphorias) and to be able to find willing "qualified surgeons" and "proper operating theatre conditions." (by helping more surgeons become qualified in understanding the importance of being able to live in constructive harmony with oneself).

It took me many phone calls and talking with many doctors before I found one who would adequately listen. During that time (months), it is within the realm of possibility that my brother went from not having terminal cancer to having it. For all I know, the time and effort it took for me to avoid dying from cancer kept me from doing what might otherwise have kept my brother from dying from cancer. Yet, I have no way to test that notion.

I oppose preventable suffering. That is why I got the bilateral orchiectomy. That is why I got the prostheses in 1991, so men in locker rooms would not be led to suffer from seeing me. That is why I got the bilateral prosthectomy earlier this month, because my body had, after about 20 years, begun to react with them in ways that were becoming very uncomfortable at times.That is why I am working at learning whether I can be of help for others who, like me, deem life better without much testosterone circulating.

As for Dr. Reid's paper, Fosamax/Alendronate was not available then, and my endocronologist had me taking premarin/provera until Fosamax became available.

One more note. The endocronologist had me taking calcium pills for a while, only I began developing kidney stones and needing lithotripsy. That was a nuisance and rather painful at times. So, in conjunction with the endocronologist, I set out to find a better solution. It turned out to be eating enough cheese, much of it of the low fat sort. Blood calcium levels are appropriate and no more kidney stones.

So, is it true that I have had no adverse health problems since the bilateral orchiectomy? Until I learned what cheese and how much of it to eat instead of taking calcium pills, I did meet with kidney stones. But that was a matter of dietand medication and not really about the results of the orchiectomy. I did undergo the

colectomy with ileo-rectal anastomosis to prevent colon cancer

(no colon, no colon cancer -- just like, no testicles, no testicular cancer) and the colectomy was not made necessary by the orchiectomy, and was not a consequence of the orchiectomy.

When I had major surgery because of

familial adenomatous polyposis (

the 1986 colectomy and the 1990 duodenal polypectomy), I was given general anesthesia with morphine for post-surgical pain, and both major surgeries were followed by what plausibly was a form of morphine-induced psychosis. (Because the orchiectomy, the prostheses insertions, and the prostheses removal were all done with only local anesthetic, I never developed any adverse psychological/psychiatric effects from those surgeries as happend with the two major abdominal surgical procedures.)

My best opinion so far is that my life is much better because of the orchiectomy. I met with no complications or difficulties of any real adverse consequence to me. To know if I would not be alive now without having had the orchiectomy, I would have to not have had it and be dead. And what on earth would I know about it, were that what had happened by now?

The drastic post-surgical effects I did encounter appear to me to have resulted only from the colectomy and duodenal polypectomy, and not at all from the orchiectomy or prosthesis surgeries.

To me, life is much like an experiment. I learn as I live and I live as I learn. And that is sufficient for me.

I welcome constructive comments of all sorts, while prefering what is decent and true to what is not.

[loveableleopardy (imported)]

I haven't bothered to read all of this yet (hardly any of it in fact), but you seem like a very interesting person. I am kind of posting this so I can find you easily when I log in (just refer to my postings)