From Donald to Deirdre

How a man became a woman--and what it says about identity.

Deirdre McCloskey from the December 1999 issue

(Page 2 of 6)

After a year of hesitation, two years from beginning, I found to my delight that I had crossed. Look by look, smile by smile, I was accepted. That doesn't make me a 100 percent, essential woman--I'll never have XX chromosomes, never have had the life of a girl and woman up to age 52. But the world does not demand 100 percents and essences, thank God. An agnostic since adolescence, in my second year of crossing I came tentatively to religion and then could thank God in person, who made me inside in my comfort a woman.

You become a woman by being treated as one of the tribe. Nothing else is essential. Being Dutch is being treated as Dutch. You can be a masculine woman, as by some stereotypes many women are, yet still be treated as one of the tribe. No piece of conventionally feminine behavior is essential if the overall effect makes you accepted in the tribe. Biology is not decisive. Big hips, small frame, high voice, hairless face, sexual interest in men, more-than-male amounts of sympathy and readiness to cry: We all know women almost anywhere who vary on these dimensions, in this direction or that, but who are still part of the tribe.

And you treat yourself as one of the tribe too. Being Dutch is being homesick for Holland, inside your head. The dialogue with other members of society about whether Deirdre was part of the women's tribe has a personal side. Does Deirdre treat herself as a member of the women's tribe? Am I a woman? Yes.

Why, then, did Deirdre join the women's tribe? The question does not make sense, because it asks for a prudential answer when the matter is identity. Asking why a person changes gender is like asking why a person is a Midwesterner or thoughtful or great-souled: She just is. An identity is both made and not made. It is a romantic idea, which is strangely paired in the modern world with the antiromantic ideas of positivism in social science, that we all have an internal identity, fixed and ready made, and the only task is to express it. Will the real Deirdre please stand up? The "realness" is not right. We make ourselves, which is our freedom as human beings.

The romantic view does have something in it. You make yourself Dutch or American, a nurse or an accountant, a recluse or a social butterfly, piece by piece. But you have tendencies, which can be traced back to childhood. Anyone who has watched a child grow is impressed by the thrust of character. The dismal, fretful infant in arms will in 80 years be a dismal, fretful old lady. The cheerful infant will always be an optimist. No wonder people devised a word for it, the soul.

Operative Traumas

There Dee finally was in Dr. Ousterhout's waiting room in San Francisco the day before the cheek and jaw operation, having been photographed and relieved of gigantic checks, $10,000 here, $15,000 there. All her treatment from now to the end of her transition, she reflected as she sat there happily, was going to be paid out of her own pocket and was not tax deductible. Blue Cross and the IRS take a dim view of gender reassignment surgery. They take an equally dim view of cosmetic surgery to make one passable; also of voice surgery for the same; also of fixing the glitches from all of these.

Donald had complained to Blue Cross: "The DSM-IV [Diagnostic and Statistical Manual of Mental Disorders] you rely on calls transsexuality a `disorder,' and, unusually among such `disorders,' this one has a cure--surgical, including facial surgery. But then you won't pay for it. You can't have it both ways. Either it's a personal choice, in which case the psychiatrists should butt out, or it's a disorder, in which case medical insurance should pay for the cure." Donald was always engaging in little campaigns for justice. Dee was more realistic: Blue Cross will never pay for this, not in America--except in Minnesota, if you turn yourself over to an ignorant and self-important psychiatrist for two years of "certification" as "genuine." We Americans like telling people what to do, as in Prohibition or the war on drugs. It's not even Blue Cross' money: Over the years I've paid 10, 20 times more in medical insurance than has been paid back to me in expenses. From an actuarial point of view, there's no moral hazard. It's not as if millions of men will step forward to take advantage if gender reassignment and jaw pointing are paid for. The policy is sheer, stupid crossphobia. Sweet land of liberty and of stubborn, self-justifying hatreds.

Dr. Ousterhout's office manager, Mira, came into the waiting room and interrupted Dee's reflections on American character.

"Dee, I have some bad news."

Uh oh.

"Your sister has been calling and writing the hospital and threatens to sue if we go ahead."

"Oh, no, no, NO!" Dee wailed and raged through the waiting room. "A third time. She's tried four times to stop me and succeeded three. When, when, is she going to leave me alone?"

Ousterhout came out to comfort her. "It's a setback. But I'm going to do everything I can."

"She claims I'll go crazy when I wake up and realize what I've done."