I didn’t want to be different. I longed to be everything grownups wanted, so they would love me. I followed all their rules, tried my best to please.

-- Leslie Feinberg in Stone Butch Blues

Chris sits down on the sofa. She clasps her hands together, then unclasps them, reaches over for the porcelain mug of coffee, and takes a sip. She is wearing a grey V-neck shirt and blue jeans. As she talks, her head bobs slightly, shaking the crop of blond hair that descends slightly below her jawline.

Chris, who didn’t want to provide her last name, studies biochemistry and microbiology at UVic, though her main area of interest is synthetic and systems biology. She ponders the possibility of embarking on a master’s degree in that area, at UVic or elsewhere.

She plays piano and enjoys video games (Super Mario is one of her favourites, although she enjoys older RPGs and some first-person shooters). She loves to spend time outdoors and is looking forward to riding her new bike this spring. She is 21 years old.

Chris is also transgendered, a self-affirmed male-to-female in transition.

“I pass [as female] about 80 per cent of the time now when I want to,” she says, playing with the amulet around her neck. “One or two people will notice. It’s something I’m starting to focus less and less on.”

Her voice has a silky, somewhat neutral quality to it, and lilts gently when she emphasizes certain words or phrases. She is perhaps slightly taller and broader than most women, with a stronger jaw, but it’s easy to see why most people would never even realize she was trans.

Chris recalls her identity as having been more complex than her friends from the beginning.

“I always remember my gender being discordant with who I was,” she says. “Two-and-a-half years ago, I started to find blogs and websites about going into transition, and what being trans was. From then on, I immersed myself in all the various material on the subject.”

With the support of her family and friends, Chris accepted that she was transgendered.

“Most of my friends were girls and actually, when I knew I was transgendered, one of the first people I told was my sister,” she says. “She was great. She told me she always wanted a sister. But my parents were very accepting as well.

“I ultimately transitioned to be happy in my own skin,” she says. “As a male, it was harder for me to lead a normal social life, and it was very difficult to talk to people.”

In her Grade 12 year, Chris took an extended trip to Germany, which she credits as allowing her to start with a clean slate.

“Nobody knew me there, so it was much easier for me to get to know myself and sort out who I was. When I came back, I graduated high school halfway through the year.”

All humans are female at some stage in development. Until about six weeks in, all fetuses are considered to be “proto-female,” and afterwards a shot of testosterone will create a boy, and estrogen will create a girl. All humans are a cocktail of hormones; even Chuck Norris has some estrogen. The overall idea, though, is that a fetus exposed to testosterone will produce a boy. Simple.

Of course, it isn’t that simple. If it was, there would be no trans people.

What is a trans person? There is a mist of confusion surrounding the term, largely because of the public’s ignorance of sexuality in general. One of the explanations for trans person goes something like this.

The theory accepted by some experts is that sometimes a shot of testosterone to the fetus will produce a male body with male genitalia, but a brain with a more female structure or chemical component. In this case, the result may be a physical male transgendered person — a person with male sex organs but with a female or non-male perception of self.

One alternative is the social construct theory, which maintains that sex and gender are irrelevant when taken out of the context of everyday social interactions. This is in sharp contrast to the essentialist, or naturalist, theory, which argues that sex (genitalia) are tied permanently to gender.

Dr. Carl W. Bushong, an expert in trans issues and psychotherapy, writes that one of the keys to understanding trans people is to understand “brain sex.” He regularly contributes to TransGenderedCare.com, and also has his own website, Doctorbushong.com.

“There appears to be a male and female pattern of psychosexual behavior,” he writes. “These are modes of behavior — one male, one female which are laid down, like brain gender, in early life and seem to be independent of environment (how, where, and by whom we are raised) and can be independent of both physical gender and brain gender,” he wrote on an article on TransGenderedCare.com.

“Gender is 90 per cent brain,” says Chris.

The experts seem to agree. Gender dysphoria is the term generally used to describe the conflict between gender and physical sex — the feeling that an individual doesn’t belong in their body and that they are better suited to another gender identity. While many people who experience gender dysphoria live with their sex and do not undergo any lifestyle or physical changes, many choose to become transsexuals.

The process for alleviating the gender discord with the physical genitalia can be a complex, lengthy and costly process not be taken lightly. Patients have to adhere to provincial regulations on when they can have sex reassignment surgery.

In B.C., two years of “life experience” (living the role of the gender you choose to adopt) is a prerequisite to surgery.

Before surgery, however, there is a series of hormone treatments, which can come as a shock to any patient. Chris is taking doses of estrogen and progesterone, among other hormones, which allowed her to grow breasts, but have also sapped her of some of her strength, virility and fertility she possessed before hormone treatment, due to the loss of testosterone. She has also had to cope with mood swings, and what she calls “going through puberty all over again.”

Going through puberty is tough enough the first time, but for transsexuals, it is made harder by the fact that a successful transition to another sex also requires the individual to adopt the mannerisms, speech and behaviours of the gender they are adopting.

There are a range of services available for people needing help: speech therapy, voice training, grooming and clothing advice and behavioral expert advice are a few examples.

Websites for trans people say that among the best places to undergo transition is the workplace, although it can present its own challenges. Transsexual.org recommends that subjects find a steady, liberal employer that will allow the transition from male-to-female or female-to-male to go uninterrupted and not allow persecution of any kind to occur. But the website notes that such persecution may be unavoidable, and those in transition should (not to put it too colloquially) suck it up.

The final, irreversible stage of transition is surgery, and even pro-trans groups say it shouldn’t be taken lightly. Many trans people have never, and will never, undergo sex reassignment surgery. Chris says surgery isn’t on the agenda for her. “I like what I see when I look into the mirror,” she says.

Generally satisfied with how she is treated, Chris mentions only one or two occasions where someone in line for a cup of coffee has “booed” her. She does not, however, dismiss what she sees as real discrimination and violence against trans people.

“Fifteen trans people were killed in North America within this last year, all of the killings motivated by hate,” she says. “But there are opportunities to better inform people. A lot of this stuff happens because people are uninformed.”

For many trans people, Chris is no doubt a shining example of a successful transition: she is happy, does well in school and has big dreams. She is just getting used to navigating the turbulent world of dating, but doesn’t lose sleep over such trifles. She has, after all, adopted an identity for herself.

“But I can’t open pickle jars anymore,” she laughs.

What’s covered?

Covered: Removal of breast tissue, removal of ovaries and uterus, removal of vagina, breast implants (if no growth of breasts after two years of hormone therapy), removal of penis and testicles, creation of vagina, clitoris and labia.

Not covered: Creation of penis and testicles, revision to chest after surgery, transportation and accommodation costs outside of hospital, facial feminization surgery or tracheal shave, surgery to raise voice pitch.

-- VANCOUVER COASTAL HEALTH AUTHORITY