AJPH
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (2)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Fee, E.
Right arrow Articles by Laylor, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fee, E.
Right arrow Articles by Laylor, J.
Related Collections
Right arrow Gender
Right arrow History
Right arrow Sexual Health
Right arrow Lesbian/Gay/Bisexual/Transgender Persons
June 2003, Vol 93, No. 6 | American Journal of Public Health 899-900
© 2003 American Public Health Association

IMAGES OF HEALTH

One Size Does Not Fit All in the Transgender Community

Elizabeth Fee, Theodore M. Brown and Janet Laylor

Elizabeth Fee is with the History of Medicine Division, Janet Laylor is with the Office of the Director, National Library of Medicine, National Institutes of Health, Bethesda, Md. Theodore M. Brown is with the Departments of History and of Community and Preventive Medicine at the University of Rochester, Rochester, NY.

Correspondence: Requests for reprints should be sent to Elizabeth Fee, PhD, Building 38, Room 1E21, 8600 Rockville Pike, Bethesda, MD 20894 (e-mail: elizabeth_fee{at}nlm.nih.gov).

RICHARD RASKIND HAD BEEN captain of Yale’s tennis team and enjoyed some success on the American amateur circuit. He went to medical school, became an ophthalmologist, served in the United States Navy, married, gained a pilot’s license, and competed in the US Open. Then, at age 41, after 10 years of psychoanalysis and a divorce, he underwent a sex change operation and emerged as Dr Renée Richards.1


Below left: Richard Raskin; below right, Renée Richards. Courtesy of Renée Richards.

Renée Richards moved to California and joined a new medical practice. But when she was recognized playing in the women’s section of a local tennis tournament, the press attention became overwhelming. At this point, she decided to become a professional tennis player, on the women’s tour. When several women pros complained of what they thought would be unfair competition, the resulting fracas was only settled by a 1977 New York State Supreme Court decision, ruling that, because of her sex reassignment surgery (SRS), she was indeed legally a woman.2

Richards went on to reach the women’s double finals at the 1977 US Open. She returned to a career in pediatric ophthalmology in New York and still serves on the editorial board of the Journal of Pediatric Ophthalmology and Strabismus. "I am quite happy with the way my life has turned out," she recently told Elizabeth Fee. "I made the decision after a lot of soul searching. Hopefully, with the progress being made in psychopharmacology, such drastic moves as sexreassignment surgery will not be necessary for everyone." In 1999, she gave an Associated Press interview in which she said, "I wish there could have been an alternative way, but there wasn’t in 1975. . . . Today there are better choices, including medication, for dealing with the compulsion to cross-dress and the depression that comes with gender confusion."3

People who have undergone SRS vary in their satisfaction with the results. Some Web sites contain warnings "for those considering MtF [male-to-female] SRS,"4 warning, for instance, of reduction or loss of sexual feeling and appetite, for both emotional and anatomical reasons. SRS may sever nerves in an area where nerves are essential to sexual arousal and response, although surgical techniques continue to improve. Some male-to-female transsexuals who go through SRS experience problems because, after the operation, they still possess masculine facial features despite the obvious feminization of the rest of the body. Although facial feminization surgery can address this particular problem, such procedures may cost upwards of an additional $30 000.

But surgery should not be regarded as the gold standard for all. Indeed, the example of Renée Richards is but one specific case in a continuum of responses to "gender dissatisfaction" that both men and women may experience to a greater or lesser degree.

Counseling for "gender dysphoria" should help each individual clarify what troubles him or her, what he or she wants, and what steps, if any, will help him or her get there.5 The medical, surgical, legal, and emotional issues involved need expert interpretation, including the odds of achieving what one seeks, exploration of the risks and practicalities involved, and the likely financial and legal consequences. Counseling requires skilled professionals who can integrate detailed and accurate information with psychological skill and sensitivity.

Legal requirements for SRS as a condition of changing one’s gender need to be carefully reexamined. Overall, encouraging a greater diversity of transgender options seems the best policy for the near and more distant future in terms of increasing the success rate of transgender care and expanding the possibilities for human happiness.6


   References
TOP
 References
 
1. Richards R. Second Serve. New York, NY: Stein & Day; 1984.

2. Richards v United States Tennis Association, 400 NYS 2d 267 (NY Sup Ct 1977).

3. Richards R. Cited in: Liaison legacy. Tennis Magazine. March 1999:31.

4. A warning for those considering MtF SRS. Available at: http://ai.eecs.umich.edu/people/conway/TS/Warning.html. Accessed February 8, 2003.

5. The Harry Benjamin International Gender Dysphoria Association’s Standards of Care for Gender Identity Disorders, Sixth Version, February 2001. Available at: http://www.hbigda.org/soc.html. Accessed February 8, 2003.

6. Feinberg L. Trans Health Crisis: For Us It’s Life or Death. Am J Public Health. 2001;91:897–900.[ISI][Medline]




This article has been cited by other articles:


Home page
 Am. J. Public HealthHome page
R. M. Mathy
ON CULTURAL COMPETENCE AND SCIENTIFIC RIGOR IN TRANSGENDER TREATMENT
Am J Public Health, January 1, 2004; 94(1): 6 - 6.
[Full Text]

This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (2)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Fee, E.
Right arrow Articles by Laylor, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fee, E.
Right arrow Articles by Laylor, J.
Related Collections
Right arrow Gender
Right arrow History
Right arrow Sexual Health
Right arrow Lesbian/Gay/Bisexual/Transgender Persons

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2003 by the American Public Health Association