“Horse medicine?”
Today, this would be called hormone therapy and is used in medical gender reassignment along with counselling. Surgical procedures that follow to alter the body are each individual’s choice. Some choose not to, preferring to just take the hormones. Surgical intervention is a very serious decision and there are safeguards in Australia to ensure that the individual is prepared emotionally, physically and has good mental health strategies beforehand.
In my work as a mental health nurse, I nursed a patient who had been diagnosed with severe borderline personality disorder. Although admitted to the hospital as a male, physical health examination revealed a female with severe self harm scars. She had been abused as a very young child, she told us. She had several admissions to our unit over the next few years for severe self harm and depressive symptoms. I nursed her several times, until the entire institution including the acute unit was decommissioned and replaced by community based units and services. I moved interstate and didn’t meet her again for a few years.
According to her medical records she continued to require admissions to acute care. This isn’t usual for people with serious mental health disorders and is why there needs to be adequate funding and good community supportive services. I’d returned to my former state and commenced a post with an agency as a team leader and worked in many units around the metropolis. One day, I was working in a forensic psych unit and her name on the patient-list caught my eye! One of my duties involved knowing the status and history of all the patients which required reading all the current case file entries.
Unfortunately she had also demonstrated extremely aggressive behaviour in the intervening years and attempted to strangle a social worker. She would have succeeded if a staff member hadn’t found her. She was charged with attempted murder and was sent to a forensic mental health unit. She also attempted to harm other patients and even visitors. She destroyed her property, other patients’ property and vandalised furniture and curtains.
She had been diagnosed with severe anti social personality disorder in addition to her other DSM disorder by then. I must admit that I agreed with this. She had successfully had gender reassignment surgery (paid for under our “national health” and then changed her mind and attempted to bring charges against the hospital. She had gone through every stage of the two year programme. Her “decision to sue” came within the week. Although it was unsuccessful and no legal action occurred, she didn’t seem bothered. She told me that had enjoyed making problems for others and laughed when I asked her about her life since we last met.
I mention this, not as a criticism of gender reassignment which I believe is a wonderful opportunity for those who truly seek it. I only mention her because she was the only gender reassignment recipient that I ever knew firsthand.
