CAMH Support Group, Part 2

As I was seating myself, I commented to Maxine, CAMH's facilitator (a trans woman herself), that I was surprised to find the group so small given the news.

"I had expected it to be a full house, given last week's announcement."

"So did I," she said, and then paused for a second, before continuing "but they still hate us."

"Yeah. I'm part of that group, actually" I admitted as I settled into my seat.

Turning towards Maxine, Helen, the other woman in the group, asked "why does everyone hate CAMH?"

Maxine turned towards me, lifting her face and raising her eyebrows to pass the question my way.

I was worked up. Just being in that place again was making me crazy. Receiving care from a sexology clinic at a mental health hospital is implicitly pathologizing. The doctors at CAMH believe that people like me are slavishly pursuing a self-destructive course because we love (in a fetish-like way) the notion of ourselves as women. This is not the prevailing view among transgender care professionals.

I had smoked weed and taken a Clonazepam (anti-anxiety med) before going over, because I could tell I was ready to bite someone's head off. The drugs didn't take much edge off, but I think they helped me avoid flying off the handle. I was aiming for a forthright sharing of conflicting opinions, not a counter-productive conflict. And when I'm upset, I can be possessed, and let fly too angrily and meanly, damaging my cause.

"I'm upset because you encouraged me to fight myself. You offered to counsel my parents, and then encouraged them to frustrate me instead of support me!"

"I did not! I have never encouraged a family member to frustrate anyone."

"Well, after my Mother came here, she developed a strategy that we later called 'the doctrine of frustration.'"

"I have no idea what that means!" she said, looking hurt, rather than hostile.

"That's fine. She comes up with things on her own. I can accept that," I demurred. I wasn't sure who had coined 'the doctrine of frustration' (DOF), and I was prepared to believe that it wasn't Maxine. My mother had never told me that Maxine had outright told her to frustrate me. What she had told me, repeatedly, was that Maxine "seemed to be suggesting that they shouldn't offer me any help."

A year later, by the time she and my father were meeting with Dr. McDermid, my trans-positive MD, this had matured into something McD referred to as the DOF. He told me that Maxine Peterson seemed to have advised my mother to adopt this strategy.

When you're the only advisor that people have on an issue, there's little difference between explicitly encouraging someone to oppose a loved one and implying that frustration would be the best course of action. But I backed down anyway.

"Ok fine. There's a better reason that people hate you. And I don't dislike you, Maxine--I dislike your organization. I'm not sure how I can criticize the CAMH Gender Identity Clinic without criticizing you, since you are the clinic, but I respect you--just not your modality. You're pathologizing. You are massively out of step with the rest of the transgender care world. I worked SO HARD to finally accept that I had gender issues, and to start to deal with them. And then I came here, and you made me feel worse. From your vantage point, I'm sick. You diagnosed me with Gender Identity Disorder! My experience here made me feel so much worse about myself, it set me back months!

"If there weren't a disorder, there wouldn't be care," she said. She probably says those words in exactly that way several times per day. She's right, too.

"I realize it has to be listed somewhere in the manuals that doctors have, and until it's listed somewhere else--as an endocrine disorder, perhaps--it should remain in the DSM" (the diagnostic manual for psychiatrists). "But the fact that it's listed in the DSM has no implications for care. There's no treatment! So providing care from the vantage point of a sexology clinic isn't helpful. It's not supportive."

So far as I'm concerned, the sexologists should be free to do their research. If they, as people who strive to explain everything they can in terms of sex, need to believe that I'm motivated by sex, I can live with that. But there is no synergy between a group of somewhat renegade sexologists and the delivery of care for trans people. A separate organization that can be honestly trans-positive is the best thing for trans people.

"And we're not out-of-step. Several provinces (she listed four or five) use the same standards that we do."

"Which are?"

"Two years in full gender role."

I gathered, after more discussion, that legal name change and proof of income, using the new name, were critical components of my full-time womanhood. So, though I live as a woman full time, I can't punch my card to begin my interminable two year wait until I change my name.

Adopting regressive standards just because they happen to be in place in other jurisdictions is foolish. We should be asking what standards are appropriate.

I wonder if I could keep my given name, and just change my M to an F, or perhaps a question mark, since I think that the gender binary is a bullshit construct. Insisting on legal name change and proof of income is hugely demeaning, especially to anyone who feels most comfortable between the genders. It would be appropriate to insist on a sustained, rational understanding of what it is that they want to do, and to determine that they're not suffering from Dissociative Disorder (trying to build themselves a new persona so they can dissociate from some trauma in their past). Anything beyond that is discriminatory. What if I'm independently wealthy, or an incredibly successful leech, or a sex worker who can't declare legal income? What if I want to live my life as a woman, under the name "John Thomas?" What business do they have telling me I can't?

I don't want to live between genders. I want to live as a woman. I don't believe in the gender binary, but our entire world lives by that model. My goal is to bend my gender to my will, so I can become more comfortable as myself inside our gender-binary-loving society. But I know people who would like to live between genders, but desire surgeries.

For example, I know an FTM person who isn't comfortable specifying hir gender. When ze was coming to terms with hir transness, ze decided that ze didn't want to take hormones. So, ze binds hir breasts, and dresses as a man. Ze is as trans as I am, and would very much to have hir chest surgically reconstructed without breasts, but can't qualify because the blatantly hetero-normative standards applied by places like CAMH don't provide for hir existence. Ze is well into hir 30s, in a stable, long term relationship with a female partner, and lives life dressed as a man, with breasts bound tightly against hir chest, so as to be undetectable. In what way would the removal of those breasts, which would make ze much more comfortable in hir body, risk making hir life more difficult? Oh no! The invisible breasts are gone! Think of the ramifications!

"How often do you review your standards? What's the process? Who takes part in the review?" I asked.

"It's usually a group thing," she replied, "but Dr. Dickie has the final say, obviously."

"So do you expect to be changing those standards anytime soon?"

"I highly doubt it. I've been here 26 years, and I think that you and the community can take that to the bank. We will not be changing our standards."

I refrained from asking how any conscientious transgender care provider could have made it through the last 26 years without modernizing their standards. Were I her, I would have been embarrassed to admit to that sort of rigidity, but it seemed a matter of pride to her. Her chest puffed up with implacability--like she was certain that she had always been right, was still right, and was going to prove it by refusing to yield, regardless of how marginal her views become.

The rest of the session was fairly unremarkable. l had accomplished my goals: finding out what I needed to do to qualify for surgery coverage, and letting Maxine (aka CAMH) know that I disagree with their approach, and that I was submitting to their care under duress. Once that was done, we chatted more amicably about my transition, and about Goodhandy's.

Neither of them were familiar with Goodhandy's the darling of the trans community. GH's is a queer sex club. Sex among customers is encouraged. The trans community loves GH's for giving trans sex workers somewhere safe to go. But don't rush over there right away. You have to go on your day(s). On Wednesdays, gay male porn studs have their ways with one another on stage. On Thursday, it's MTF night. The trans sex workers have a safe place to go, perform, and dance. They meet new clients, and turn tricks inside small private booths. No money is supposed to change hands in those booths--referred to as The Diamond Room--but the reality is almost certainly quite different. Friday is FTM/dyke night (but I've felt quite welcome), and Saturday is pansexual night. Anything goes!

"This is the Toronto outside these walls!" I exclaimed to the two of them, trying to point out how cloistered and pessimistic things are inside The Clarke.

Right about then, the clock struck 7:30, and the session was over. Clearly weary of clashing with me, Maxine collected her things, and we left the room as a group, pretending I hadn't just verbally assaulted her life's work, or maybe that the assault was ok, since she's a professional, and I'm entitled to my opinion.