From Donald to Deirdre

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

Deirdre McCloskey from the December 1999 issue

(Page 5 of 6)

"So you canceled a surgery because the patient's sister threatened you and then didn't tell the patient? May I speak to the doctor?"

"I'm sorry, but the doctor's not in. I have to go."

"Good-bye. Have a nice day."

Great, Dee thought, I've found a surgeon who's a coward. All psychiatrists and at least one surgeon. Can't go to Holland to teach with this male voice.

Dee made an appointment with another voice surgeon, one in Philadelphia. After the operation the voice didn't seem to work, but Dee hoped. She would have to go back to Philadelphia to have the operation assessed. She would stop off in Philadelphia again on the way out to Holland.

A few weeks after Dee arrived in Holland to teach at Amsterdam's Erasmus University, a full-page article with a flattering photo of her appeared in the leading Dutch newspaper, NRC Handelsblad, the New York Times of Holland. It focused on her views about economics and love, treating her gender crossing as an interesting sidelight. That's how the Dutch press reported on her. A Dutch-language business magazine did a long article on the revival of Adam Smith, noting that "Deirdre McCloskey is een Chicago girl," a free-market feminist, and quoting her at length on an economics that might make sense to women. A sidebar noted that "Donald is Deirdre" and reported her opinion that "tolerant Nederland is de goede plaats om te transiteren van het mannelijke naar het vronwelijke bestaan": that tolerant Holland is a good place for the transition from a masculine to a feminine way of life. Yes.

The world's largest program on gender crossing is at the hospital of the Free University of Amsterdam. The program is well-known among gender crossers. Dutch people are amazed at where the program is, because the hospital is part of a university founded in the late 19th century by religious conservatives (thus "Free": free to be reactionary), and the university still tends a little that way. It would be like Oral Roberts University developing in its second century a program for the support of gay marriage. The Free University program has helped many thousands of gender crossers on the model of "illness," with diagnosis and treatment. Dee needed to visit it to get hormones, since American prescriptions are not honored outside America.

They wanted a psychiatrist to interview her, though to Dee it seemed pointless. She was not officially in the Free University program, which for political reasons has to extend the transition to two years of agony between the genders, following the Benjamin Standards, the accepted medical protocols for gender-change operations. But the program would prescribe hormones, so she couldn't offend its personnel by standing up for patient rights. Anyway, she liked the Free University program. It's good, she said to herself, a lot better than the hospital programs in the United States dominated by the example of Johns Hopkins. The big university hospitals at home, run by psychiatrists, try to cure gender crossing, and fail. The Free University Hospital, run by an endocrinologist, tries to help, and succeeds. Though on the silly model of illness.

The young woman psychiatrist asked Dee the usual questions, mentally running down a checklist of the gender crossing illness. "When did you first want to be female?" "Were you effeminate as a child?" Dee could see the psychiatrist's eyebrows rise when she got an answer that did not fit the conventional "diagnostic" list thrown together for the Diagnostic and Statistical Manual of Mental Disorders out of junk science. Dee thought, She does not realize how silly the list is.

So what? Does it matter? Can she hurt me? Can she stop my prescription for estrogen or tell my potential surgeon in Australia that I'm not "really" a gender crosser?

Damned right she can.

Time for action.

Dee started lying. They all do it. A psychiatrist proposes to withhold a desired and harmless life from a free, sane adult based on no scientific evidence and no intelligent empathy for the patient and no understanding that the DSM's list of symptoms rewrites the society's myths about gender. We need to examine you. For two years. Wait, wait. We might not ever approve you. Chances are we won't. Dee knew a gender crosser from Galesburg, Illinois, an otherwise normal working-class person, who after two years and $2,500 of "therapy" from a local psychologist was still being delayed: You have more issues to work on. You will always have "more issues to work on," dear. It's therapy for the therapist, Dee thought indignantly.

Of course the gender crossers lie. They can read the DSM just a well as the psychiatrists can. Pat Califia, who wrote Sex Changes: The Politics of Trans-genderism (1997), notes, "None of the gender scientists seem to realize that they, themselves, are responsible for creating a situation where transsexual people must describe a fixed set of symptoms and recite a history that has been edited in clearly prescribed ways in order to get a doctor's approval for what should be their inalienable right."

"Oh, yes," Dee said to the Free University psychiatrist, "I've always had these desires. Oh, yes, Doctor, ever since I can remember. Oh, yes it's just like being a woman in a man's body. Oh, yes, I hate my penis."

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