Kay: Gender Affirmation at Age 60

Kay is a 66-year-old, petite woman who arrives for our interview in a sleeveless red-and-white striped cotton dress, revealing her delicate arms. Her kind face is gently adorned with makeup and modest earrings. Despite her lovely presence, I am unusually nervous as I welcome her into my home. Kay is the first trans woman I am to interview.

I plan to ask her the same questions I have used with the women previously interviewed. But I fear that this conversation will be uniquely awkward. After all, I will ask her to tell her story starting back in her youth, when she resided in a body fueled with ample testosterone. I worry that my questions, designed for cis women, may come off as inept or even offensive.

If I am honest, however, there is another reason that I am nervous. I have invited a complete stranger, and “former male,” into my home to talk about sex. I would never have chosen to be alone with a cis gender, heterosexual male stranger and talk about sex; my intentions could easily be misconstrued. We women learn from early ages to reduce our risks of physical and sexual danger. Even though I know that Kay is a woman, I cannot shake this long-lit, self-protective warning light. Up until now, I have been quite comfortable talking about sex with other women whom I did not know. My trepidation about Kay exposes my persistent ignorance about transgender people. Kay hardly fits my crude label, “former male.” Yes, she endured many years in a male body under the reluctant dominance of testosterone, but she was never a man.

The chagrin of my unconscious reaction still lingers. I am still learning. I give my sincere thanks to the trans women who graciously answered my cis-normative questions and especially to Kay whose story follows.

I invite you to picture a little boy, with short blonde hair, dressed in khaki shorts, blue sneakers and a red t-shirt. Picture a child who is addressed by a male name, given GI Joes and model airplanes, and sorted with the boys during gym class. Picture a boy who entered puberty, and acquired coarse facial hair, a deep voice and a penis that demanded attention. And now use that little child’s rightful pronoun - she.

Kay was born during the early 1950’s in the moralizing bible-belt of the American South. In her non-parochial, public high school, the algebra teacher would spend entire class periods talking about Jesus. Preaching religion in public schools was acceptable. Being gay was not acceptable. Being transgender was not even conceivable.

Growing up, Kay struggled to fit in with the other children. If the boys and girls in her elementary school were analogous to a game of black and red checkers, she shone bright yellow. Her natural demeanor and interests were not accepted. Looking back, she can see that she was experiencing gender dysphoria[1] from an early age. “It was going on in elementary school, when I first started having contact with other children. I noticed right away that the boys were too rough and ‘Ew.’ I was just more comfortable around girls. What they were doing made sense to me. ‘Oh, you want to do that? Okay.’ But they wouldn’t let me join in, so I was just out there by myself. I was very isolated. Gender dysphoria didn’t begin at puberty. It’s never been about sex. Sex is way down the list. It’s not even that much of an issue.”

Throughout middle and high school, she was bullied, beaten up and called “faggot” and “queer.” [2] “I tended to get read as a gay male. Too much of me was bleeding through.” Life was lonely, scary and confusing.

“I have a lot of issues with violence. What I remember most is that they enjoyed beating me up.” Her eyes redden with tears, and she pauses before continuing. “If you’re this terribly vulnerable kid, and you’re being hit and ridiculed, and you have no friends, and people laugh at you, and on top of that you discover that someone is getting their jollies doing that to you, it is horrible. I found that very, very disturbing.”

She learned about sex from using the boys’ locker room. “Locker rooms are as horrible as you think they are. No really. I tell cis women that they are grotesque and blunt. There are no euphemisms. There were drawings on walls, and that was sex education.”

At home, “the talk” from her father did not offer much additional information. Since age nine, when her mother died, Kay had been raised by her widowed father. He neither understood her nor accepted her. “He was deeply ashamed of me. His sex talk was, ‘You stick it in there and you wait.’ That was all. I was like, “Stick what in where?’ It was not helpful.”

As a teenager, she did not masturbate. “Not at all. Zero. I was having wet dreams. But nothing while I was conscious. I couldn’t masturbate because what was down there just absolutely disgusted me.” Later, as an adult, in between partners, she did masturbate. “But my fantasies were about being a woman. That was how I managed it.”

“Sex was associated with male brutality and fear. Someone was going to do something horrible to you because they could get away with it, and because they would enjoy it. Even now, men scare the dickens out of me. There are nice men in the world, but my default is to ask if they going to hurt me.”

The realization that there were other women in men’s bodies, other “yellow checkers” in the world, dawned slowly. “In my mid-teens, I read an article on Christine Jorgensen, the person who went to Denmark for sex reassignment surgery. [3] I was instantly riveted.” When Kay was older, she understood that Christine Jorgensen “was someone like me. She was this articulate, dignified and tastefully dressed person making sense. I also had a college psych text with one brief paragraph that said there are some people with a long-term identification with the other sex. That was it. Everything else was basically pornography.”

Not surprisingly, she avoided sexual relationships. “I must have been 22 when my girlfriend came on to me, and we ended up having sex. I was afraid to do anything. I’ve never pursued anybody. I have never been an aggressor in any kind of relationship. After a few months, she said, ‘This really isn’t working out.’ She was unusually insightful because she said, ‘You know, you’re a girl. You behave like a girl. Your vibe is feminine.’”

Kay has always been attracted to women and identifies as a lesbian. She was married twice to cis gender, heterosexual women. She is now married to a trans woman.

“I would have relationships and usually the women would get very frustrated because they tended to want some guy to take charge, and that wasn’t me. Never was. I’m very uncomfortable in that role. I don’t want to push anyone around. I don’t want to give orders. I just want a cooperative thing going on.”

“I was trying really, really hard not to be trans, but I didn’t have the language at that point. That’s true of most of us. The idea that this is a choice? No!”

I ask her my standard question, “What advice would you have given to your 15-year-old self?” “I’d say, ‘As horrible as this is right now, and believe me, I know how horrible it is, it’s going to take a long time. But you are more resilient than you think you are. You will survive this. And one day when you are much older, you’re going to be able to live as who you are. It’s going to take a long time.’”

“But I’d also tell her, ‘Don’t have anything to do with any man or women or anybody else because it’s going to go up in flames.’ I would. ‘It’s going to end up in disaster.’” I ask if she would choose celibacy, in retrospect. “I don’t know. If at 15 somebody had said, ‘In 2019 you will be living as anatomically female,’ this would not have been believable to me. My head would have exploded.”

Sticking to my loose script of questions, I move on, “When, if ever, did sex involve pleasure for you?” She hesitates, seemingly stumped by the question. “The only benefit I got from sex was that it would temporarily shut down this reflex action going on down there. If I achieved orgasm the involuntary erections would stop for a while. A matter of days usually. I’d get a break, and to me that was the benefit. This monster would go to sleep for a while, and I could get on with my life.” In addition to the temporary relief from involuntary erections, Kay sought affection during sex. “I was starved for it. Nobody touched me during my adolescent years except to hit me. If you have sex with a woman you might get some affection out of it. I was so lonely. But I did not enjoy the sex.”

Agreeing to unenjoyable sex in order to receive affection and love or to please one’s partner – that sounds a lot like duty sex. I introduce this concept to Kay and ask, “Did you ever have sex that might be called, duty sex?” “Oh, absolutely! It is mixed up with the dominance thing. The women I was with wanted to feel kind of possessed. One woman I was with even used that word. I would do my very best to imitate that, but I was bad at it. I was terrible at pretending to be a guy. I would try to satisfy the needs of my partner the best I could. I would do oral sex, or whatever it took to get her there.”

I wonder if, as a lesbian, she enjoyed giving oral sex. “Sometimes. If she was getting off, it gave me a sense of accomplishment. But most women tended to want vaginal penetration, especially my first wife. I was perfectly willing to do this. I had this physiologic need that I had to get rid of, because it was driving me crazy.”

“Often, the only way I could function sexually was to imagine I was going to be penetrated. I regarded my original anatomy with horror and disgust. Gender dysphoria is like a horror movie. Like this alien organism is attached to you, and you can’t get rid of it. It feels like it’s destroying your life, and you have to do something about it.”

Gender dysphoria really does destroy lives. Suicide disproportionally afflicts transgender people in comparison to their straight, lesbian or gay peers.[4] For Kay, the desire to end her life plagued her for decades. She credits writing with helping her through the darkest times. “I used to write fiction in which I would become female characters. I would sublimate by living inside those characters. I think that’s what saved me.” After her first marriage failed, she considered coming out, but she was not ready. During her second marriage, the stress of playing a role, of pretending to be someone she was not, became unbearable. Thoughts of suicide escalated. “I worked out a plan to kill myself. Then it came down to, ‘Death, transition, death, transition. Ok, I think I’ll do transition.’”

But before she sought medical intervention to transition, she came out to her loved ones.

Explaining herself to her wife was harder than she anticipated. “It took a long time. She thought it was all about the clothes. So, at first, she was like, ‘Let’s do dress-up.’ But I kept telling her, ‘This is not something one does on Saturday night. This is not a costume. This is who I am all the time.’ I was banging my head against the wall with people. I am not a drag queen. I never had a secret stash of clothes. I get no erotic satisfaction out of women’s clothes. None at all.” Her wife, like many people, confused transvestites with transgender people.

Fortunately, by the time Kay proclaimed her trans status, the world was more ready to receive her. Although transgender people still suffer from high rates of discrimination and stigmatization, Kay was living in a place and time far, far from the world she had inhabited as a child. Today, many trans people have found each other through the internet, forming support groups and advocacy organizations. Time-tested protocols for hormonal administration help standardize the outward transition.[5] Therapists support people with the internal emotions. And, if one has the financial resources and desire, surgeons with experience and skill complete the anatomical transition.

After 60 years of living in the body of a man, Kay began taking the life-altering medications that would affirm her identity as a woman. Hormone blockers neutralized the testosterone. Estrogen caused feminization including the growth of breasts. For Kay, the most dramatic impact was the relief from erections. “I loved those medications because they just shut it all down.” At long last, she dressed femininely, changed her name, and lived as a woman. But life as a woman with a penis, even an inert penis, presented new challenges. Transgender people are targeted with hate crimes in growing numbers.[6] “When you are a pre-surgical trans woman, you have to be so aware. ‘Is there a bulge that’s going to get me into trouble?’ At the airport, after going through the scanner, they took me back to a room, where I spent an hour with four different people patting me down and going through my purse and luggage. Because I am trans I have to be up to something, right?”

Since having gender affirming surgery, she feels both more authentic and safer. “Now, I am just so comfortable. And I know I won’t be harassed like I was at the airport. I can wear capri pants or jeans that are snug around the crotch. It’s just so nice not to have to filter everything I do - my gestures, my body language, the way I respond emotionally to things, speech patterns. The stress of doing that just wore me down. For years I did not drink because if I had more than one glass of wine, I started to relax, and too much of my feminine self started coming out. People would notice, and they’d say, ‘You must be gay.’ I’m just more comfortable now. My bone structure is delicate enough that I ‘pass.’ I hate that word but I have to call it something. I pass pretty well. I am incredibly lucky. My demographic has horrible statistics on being victims of crimes. I have friends who will never pass; they are the bravest people I know.”

Now that Kay lives as her authentic self, a woman in a woman’s body, she has found a loving, healthy relationship. She is married to an older trans woman. They live as an open lesbian couple, but with their trans identity hidden from most of the world to protect them from discrimination and danger. For example, after being denied medical care more than once for being trans, Kay now has two doctors who do not know her trans status.

She feels happy and content in her marriage. She feels that they work together collaboratively. She has become less deferential, stepping into herself as an equal in her relationship. “For me, it’s about the affection and the love. I love her very much. She’s been very good to me, and I hope I’ve been as good to her. Sexually, we do a little touching and foreplay but nothing very athletic. Occasionally, I get a little twinge of sexual interest, my clitoris is very good, but mostly we are very affectionate with each other. It is about love, love and affection. Everything else is just dessert.”

[1] “a distressed state arising from conflict between a person's gender identity and the sex the person has or was identified as having at birth.” https://www.merriam-webster.com/dictionary/

[2] While in today’s world, “queer” has been adopted by the LGBTQ movement as a proud epithet of difference, in the 1960’s it was a superlative insult.

[3] Ms. Jorgensen’s story first hit the press in a New York Daily News article published, December 1, 1952. https://www.wired.com/2010/12/1201first-sex-change-surgery/ https://en.wikipedia.org/wiki/Christine_Jorgensen

Her autobiography was published in 1967, when Kay was 14 years old. She likely saw an article written around the time of the book release. Jorgensen, C. (1967). Christine Jorgensen: A Personal Autobiography. Bantam Books.

[4] A systematic review article of 64 research projects published in 2019 identified the average suicidal ideation rate of transgender individuals as 47% and suicidal attempts as 27%. Rates of completed suicide are difficult to determine since gender is usually not correctly listed on death certificates.

Kayms, N. J. & Vincent, B. (2019). Suicidal Thoughts and Behaviors Among Transgender Adults in Relation to Education, Ethnicity, and Income: A systematic review. Transgend Health, 4(1), 226–246. doi: 10.1089/trgh.2019.0009

 [5] Deutsch, M. B., ed. (2016). Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People, Second Edition. UCSF Transgender Care.

[6] https://www.fbi.gov/services/cjis/ucr/publications#Hate-Crime%20Statistics