Andrea von Kaenel's Question and Answer page

What is GID? Gender Identity Disorder (GID) is a recognized clinical condition characterized by a conflict between outward biology (what is commonly referred to as sex) and their gender. Gender being an internally defined characteristic. In most people sex and gender are aligned. In a very few cases, gender and sex do not match - this results in a large amount of conflict and discomfort. People with this conflict have GID. GID is also the nicer way of saying someone is a transsexual.

Who has GID? Men and women can have GID. Recent research puts the numbers at about 1 in 10,000 people as having GID - though the numbers only reflect those who have sought help for the condition (some researchers think it might be 1 in 250 has the condition). Men who have GID have a female gender but male biology. Women who have GID have a male gender but female biology.

Why do people have it? The research is not exactly clear on what causes GID. Some current investigations are focused on the role of certain hormones during fetal development (specifically what happens to the BSTc area of the brain). There does not appear to be a genetic, hereditary component. It is not something one person passes to another. More a result of random chance during a very precise time of human development. Studies on the brains of those with GID show them to be wired in the opposite sex of their bodies. Societal and upbringing influences do not appear to be involved with causing GID.

What can be done to fix it? Not much. Some people learn to live with the conflict of being of one gender and the sex of the other. Some people turn to alcohol or drugs or even kill themselves to escape the conflict. Most get to the point in life where all efforts to mitigate the conflict have failed. The only known solution is to make the outward sex and appearance match the inward gender, thus removing the conflict. There is no known treatment (medical or psychological) that will re-wire the brain and gender to match that of the outward sex.

What does the treatment involve? It is a long, painful process of physical, mental and social changes. In the United States, the Harry Benjamin International Gender Dysphoria Association, Standards of Care (SOC) are followed by most professionals treating GID. The SOC defines a process that includes: Several years of psychological testing and therapy. Hormones administered by an endocrinologist to induce physical changes. A year of living fully in the gendered sex role to learn socialization skills. Finally Sexual Reassignment Surgery (SRS)

What is it like? It is impossible to describe to someone who doesn't have GID. The best approximation is to imagine, you have just awoken in a body that is opposite the sex of who you really are. You know you are the same inside, but outwardly you don't match anymore. You are treated by those around you and by society as if you are as you outwardly appear to be. If you try to tell anyone you are not who you appear to be, you are ridiculed, insulted and forced to conform. It is a feeling of total confusion, of being totally alone and of being constant conflict and pain. In other words - it sucks.

What is your plan? Continue making change to my appearance - beard removal, weight loss, letting my hair grow, etc. Start a year period of living in the female role (the real life experience). At the point of beginning the real life experience - I will make some bigger changes in my appearance - such as wearing women's clothing, hair style, etc… I will also make some legal changes - like change my name and adjusting all formal paperwork to reflect the name change. At this point I will begin to operate my life, 7 x 24, as a female. After the year period of living full time in the female role - I will be eligible for the final surgery. After the final surgery - I will be able to get a court order that legally changes my sex to female. (I've done all these things at this point - Early 2004 - including the sex reassignment surgery, legal changes and facial feminization surgery)

What are the common issues and concerns? The biggest issue is related to the real life experience, that of what bathroom to use. While doing the real life experience I will need to conduct all aspect of my life as a female - however I won't legally be female until after the final surgery. Looking female and using the men's bathrooms isn't very realistic. Women have valid concerns about the appropriateness of having to share bathrooms with someone who looks female but doesn't have all the correct "plumbing". I've coordinated with the appropriate group at work and the solution we've decided on, is that I will only use a single person bathroom with a lock on the door.

Why are you doing this? Because I can't stand living with the conflict between my brain and body. 37 years of my life have been spent trying to make the conflict, and resulting pain and unhappiness, go away, and nothing has worked, ever. Choosing this course of action is the only chance I have of being happy. I have made a decision, that I am willing to lose everyone and everything in my life, in order to have this chance at being happy. Yes, it really is that serious and important to me.

Are you nuts, crazy, insane? Nope. I did spend a long time (30+ years) wondering about it - but my psychologist who has tested and met with me frequently - assures me I'm not "nuts". I have a recognized condition. I'm approaching treatment head on, and in a very rational manner. My decisions and actions are carefully thought out and planned. I'm as sane as everyone else. Probably more so - since I've spent a huge amount of time in self examination, being psychologically tested and counseled.

What have you done so far? To date I have lost 65 lbs, had 5 laser hair removal sessions, and 200+ hours of electrolysis on my face and body. I've taken propecia to grow hair back on my head, and had hair replacement surgery. I've taken female hormones and an antiandrogen to induce female secondary sex characteristics (making my fat shift around into a more female body shape, and I've experienced a sort of female puberty). I've grown my hair out. I see a psychologist regularly. My ears are pierced. I took voice lessons. I present myself as a woman 100% of the time. (I started my real life experience on April 29th, 2002). I've legally changed my name. I've had sex reassignment surgery, updated my birth certificate, and had facial feminization surgery. Basically I just live my life as a woman would - most of the changes to make that happen are finished.

What did you going to change your name to? I have legally changed my name from Andrew Mark von Kaenel to Andrea Marie von Kaenel. I go by Andy or Andi. Most people are used to calling me Andy, so this way it's easy on everyone. This isn't as big a change as some folks expect.

What is gender identity? Gender identity is hard to describe. I guess the best description is that it's how you feel inside. Most people don't notice or understand it because their body, and gender identity are aligned. People like me notice because we feel one way inside, but have bodies that look the other.

Are you straight, gay or what? Hard to answer. GID is about gender - not sexual orientation and attraction. Currently I am a person with a male sex, and a female gender identity, who is attracted to women. By normal definition I am considered to be a straight male. However, and here is where it starts to get confusing, after I make all planned changes, I expect to be a person with a female sex and gender identity, who is attracted to women. By normal definition I'd be a lesbian. And to confuse things even more, there is also about a 50% chance that after my changes, I will be a person with a female sex and gender, who is attracted to men - if that happens, I'd be considered to be a straight female. Bottom line is I won't know who I'm attracted to until I get done with all the changes.

What about your kids? My kids fully know what I'm doing and are for the most part supportive. Sure we've had our ups and downs but I have a strong, loving, relationship with my kids and we work at it. My kids also have my odd sense of humor so we tend to see the humor in my changes. It helps us to keep things fun, positive and less serious.

What about your parents? Mom and Dad know about my situation. They are extremely supportive. They understand I am someone who has lived in conflict & pain for a long time and who was profoundly unhappy. As most parents would, they are reacting to finding out their child has been in pain and is unhappy - by doing everything they can to support their child's attempt at making things better. My parents are amazing people and I'm very lucky to have their help through all the difficult parts of this transition.

What is Facial Feminzation Surgery (FFS)? FFS is a form of cosmetic surgery done to feminize the face. It involves changing the structure of the skull (male and female skulls are rather different) in addition to some of the more traditional soft tissue changes. In my case I had forehead contouring, reduction in my brow bossing, a scalp reduction, upper lip reduction, rhinoplasty (nose job), jaw tapering, and a sliding genioplasty (chin moved). It was a 10 hour operation and was the most invasive, complicated and painful thing I've done.

When will your transition end? I believe my transition will never end. I simply have too much to learn about being a woman to think my transition is now over, or will ever be over. The bulk of my legal, psychological and surgical changes are finished as of now (early 2004) but again - I still have much to learn. I think of myself as a work in progress and describe myself as a woman with an unusual past. My unusual past is something that I'll be working to deal with, and transcend for the rest of my life. Not good, not bad, just something I acknowledge as being part of me, and something I'm working to move forward from.

Do you think God makes mistakes? No, I don't think God made a mistake in making me like I am. I believe I was made this way for a reason. I've stopped trying to understand or worry about what that reason is. I have become stronger in my faith, I've met some of the most wonderful people in the world and I think I've been able to have meaning in people's lives - because I am exactly who I'm supposed to be and I'm doing what I'm supposed to do.

Questions and Answers about Transition