Gender on the Spectrum

Gender falls on a spectrum from being completely comfortable with your natal gender, to wanting to transition to the opposite gender, to somewhere in between.

But being transgender is not a sexuality issue, and it may not even be a sexual preference issue; it’s really more about “who I am.” being transgender is something that happens in the brain as opposed to being about genitalia. One category is the person who wants to do everything humanly possible to live their life in the gender that is opposite their natal sex. That would include surgery and all kinds of other things, as well as hormones. Then there are those individuals who know that these are options, but they choose not to take them.

I even get some people who come in and say, “You know, I’d just like to lower my testosterone a little bit.” Or they say, “I’m not really quite sure where we’re going to go with this, but I’d like to start hormone therapy.” I’ve even had someone who said, “I can’t do anything that my wife can ever know about…but can you give me a little bit of estrogen that would not be enough for her to notice?”

“Why do you want to do this? What do you expect as an outcome, and how is it going to help you in the long run?” some patients bring in their wives or their friends, and there are many indications that they have thought this through and they know what the consequence will be.