New Year's Reminiscences in the Context of the Ongoing Struggle for Cultural Change

A friend recently asked me to look back on my life and recall the decisions I've made that I consider my best. The question was raised shortly after I heard the news about the gruesome suicide of 17-year-old Leelah Alcorn, the young trans woman who committed suicide on I-71 in Ohio after leaving a social-media note pleading for us to "[f]ix society." It left me wondering about stigma -- why it is that with so many trans persons contemplating suicide, and many actually making the attempt, some follow through and others don't. I could talk about learned hopefulness vs. hopelessness, resilience in the face of culturally induced stress disorder, and PTSD in the brains of trans children. Instead I will simply report on my personal experiences, on some of the decisions I've made in my life, and leave the deeper questions for another time.

Here is my new year's look back at the best decisions of my life:

The decision to finally complete my gender transition after a decade of dallying, due to concern about the impact it would have on my children, and address my traumatic depression. It turned out that I needed the therapy to deal with associated emotional-health issues or I wouldn't have had the strength to proceed. The concern for my children was overblown, as we've learned over the past decade. The mantra "Think of what it will do to the children" was used to keep us in our place. We now know it's the children who are the most flexible and adaptable.

The decision to send my elder son to boarding school and offer the same to his brother. After finally getting my sons back to the States after they'd spent their childhood in Israel, tensions from the divorce and the custody dispute proved too much for my elder son. My wife suggested that we consider private school, and after we'd studied the options as a family, he decided to attend what many consider the best high school in the country. Most importantly, he considers it the best decision of his life. That's good enough for me, even though it meant I would be deprived of having him living at home after his childhood sojourn abroad.

The decision to trust my girlfriends with my gender "secret," back in the day when betrayal would have ruined me professionally. I did it out of necessity, because I needed at least one witness to such a fundamental aspect of my life, but I also realized that they (who later married me) were women of integrity whom I could trust. Throughout all the trauma and drama of our lives, they never betrayed that trust and have treated me with respect and friendship ever since.

The decision to act with the utmost integrity every day, to the best of my ability. I often run up against ethical dilemmas, as I believe we all do, but my personal commitment to integrity led me to develop self-confidence and live an authentic life. The refusal to lie, particularly to myself, made my life so much easier than it could have been and allowed me to continue to heal myself while I worked as an advocate to improve the lives of others. When you don't start off "weaving a tangled web," you're never at risk of getting caught up in those tangles when it matters the most. There may be a price to pay, socially and politically, but it's much better for one's emotional health. My elder son recently told me I was living "discordantly" and that doing so was a good decision. I agree.

The decision to pursue a career in medicine so that I could help children who had suffered the way I did. I came to that decision while recovering from a near-fatal illness due to my exposure to DES in utero, and while the journey has been a winding one, I'm proud of having helped so many others, both clinically and politically. In particular, helping change the cultural and medical attitudes toward trans children and participating in university medical programs to teach LGBT health have brought me the greatest satisfaction.

The decision to travel while still young. My wife and I traveled around the world twice, in our 20s, against the wishes of our parents and colleagues. "Settle down, get a mortgage, have kids," they all said, in one form or another. Yet without the burden of family or professional responsibilities, and without any money, we were able to experience the world in a manner few are so privileged to do. She wrote magazine stories from Kenya and Malaysia, India, Nepal and Afghanistan, while I practiced medicine in Kenya and Nepal. It was a time of possibilities, and we seized the moment -- twice.

The decision to take responsibility for my life -- the most fundamental decision of all. For four decades I had been enveloped in a simmering rage, blaming my parents for poisoning me with DES and causing my intersex condition. From six weeks post-conception, my life was overdetermined by that exposure to an endocrine disruptor. But when a friend suggested to me to drop my hypermaterialism for a moment and shift the blame from my mother to my choice to be born under those conditions, I scoffed, laughed, and finally accepted. That self-acceptance allowed me to follow through on my transition, meet my family halfway, absolved of all blame, and stride forth as the best person I could be.

That final decision highlights for me the fact that doing something that is totally inconsistent with previous behavior and runs counter to personal philosophical and spiritual beliefs can nonetheless free one to live in a more positive and healthful manner. It's not a cure-all and did not relieve me of the PTSD that had dogged me for decades, but it gave me the tools to overcome stigma, live authentically in service to others, and not see myself as a victim. Relieving myself of that sense of victimhood is one of the most important things I've ever done. For others in a similar situation, I would recommend making the effort as well. It's the best new year's resolution you can make.

My colleague, Professor Jenny Boylan, wrote last week week in Leelah's memory in The New York Times:

Leelah was no mistake. The world abounds with all sorts of ways of being human, one of which is being trans. It is a tragedy that Leelah was never given the chance to be proud of who she was, and that she thought the only way to change the world was through her death.

We are, in America, a fundamentally libertarian people. Live and let live.

That holds for trans persons too.

I'd like to close with an excerpt of the heartfelt acceptance speech Jeffrey Tambor gave at the Golden Globes Sunday night upon receipt of the award for Best Actor in a TV Series, Musical or Comedy, for his role in Transparent:

[I]f I may, I would like to dedicate my performance and this award to the transgender community. Thank you. Thank you. Thank you. Thank you for your courage. Thank you for your inspiration. Thank you for your patience. And thank you for letting us be a part of the change. Thanks.

Thank you all.

Need help? In the U.S., visit The Trevor Project or call them at 1-866-488-7386. You can also call 1-800-273-8255 for the National Suicide Prevention Lifeline.