In the second term of Year 11 English, Callie MacNaughton and her classmates were given the outline for an assignment: they would each have to give an oral presentation and it could be on any topic they chose, as long as they argued a point and it was something they believed in.
Speech day arrived and students launched into passionate, earnest manifestos on ‘why all cigarettes should be banned’ and ‘why people shouldn’t drink and drive’. Callie nervously waited her turn. She’d chosen a sensitive, potentially contentious, subject: why gay, lesbian and transgender people deserved equal rights.
When the teacher called her name, she gathered her notes and stood. The first thing you notice about Callie when you meet her is she’s tall, over six-foot supermodel tall, although she often slouches like someone in a low-ceilinged room, slightly self-conscious about her height. She is also shy, with a habit of hiding her eyes behind her fringe, and softly spoken. That day last year in class though, Callie didn’t hold back. She began confidently, her words well researched and rehearsed. Then, as she reached one particular sentence she broke down: “Transgender is the name for when people feel like they are the opposite sex to what they’re born with …. And I am one of these people….”
Tears in a classroom in front of 30 of your peers is as close to social suicide as any teenager could imagine. Worse still, this was a classroom where students would wisecrack and holler over each other. Close friends in the room knew the truth, others had heard the rumours. Callie had been at this school before – then she was a boy named Callum who’d left midway through grade nine after being picked on and bullied. “They probably smelled someone different,” she says now. She went to two other schools, and then returned here for grade 11 as Callie. On her first day back someone called out ‘Hey, do I know you?’ She walked away, pretending she hadn’t heard. “I was just really scared.”
Now everyone in her class knew; soon everyone in the school would know. There was stunned silence at first, then, to Callie’s surprise and relief as she finished her speech her classmates applauded – softly at first, then in loud unison. Later, a boy who’d hardly spoken to her all year came up to her. “That,” he said, “took a lot of guts.”
SOME people may find Callie’s transition to female life confronting and strange, but what she’s experiencing almost echoes what 16-year-old girls everywhere experience. Her hormones are doing strange things to her body and she often feels like they’re conspiring against her. At times she’s felt her elegant, long-limbed frame is too thin — right now, she thinks she’s too fat — and she worries about whether she’s pretty. Any parent would recognise these as typical teenage anxieties, although Callie’s are magnified by her condition. If you’re a girl who’s paranoid about excess body hair, imagine the prospect of growing facial hair. You think your breasts are too small? Try relying on pills to make them develop. Having trouble deciding what to wear? Imagine having spent most of your life in boys’ clothes.
The MacNaughtons live in inner Brisbane and Callie’s parents Elly and Tom, both in their 50s, are affable and quick to laughter, although when Tom accidentally refers to Callie as “he”, he winces at his mistake. “Sorry,” he corrects himself. Callie is not in the room, so I ask if such moments happen often. After all, the younger of their two children living as a girl is relatively new. For 14 years she was their son; for a bit over two (she turns 17 in April) has she been a daughter. “We both make mistakes,” Tom says. “I’ve occasionally called her Callum. She gets upset when I do.”
For Callie the feeling that she’d been born into the wrong body was there for a long time. “I just hated the guy thing,” she says. “The grr-toughness and the sports.” She wasn’t into dresses and dolls, video games were more her style. “Well, forty percent of gamers are girls. It might not make much sense, but the girl thing seemed more normal and more sensible for me, and a better fit. I actually tried to put it out of my head. Cartoon shows were making fun of it, and movies too. It was a joke.”
Did she talk to her sister Estelle, now 19, about how she felt? “I didn’t really talk that much with Estelle when I was child,” she says, laughing softly. “Because she is very loud.”
After Callie started high school Tom and Elly noticed her becoming increasingly withdrawn — from friends, from family, from school — but they never suspected if was because she felt like a girl, not a boy. “It makes you lonely,” she says, a note of sadness in her voice. “You become a loner. You don’t really talk, you go hide in your room.”
When she changed schools she started dressing more gender ambiguously. One day she brought home a brochure about gender confusion given to her by her school counsellor. “She was at the computer,” Tom says, “and she just pointed to this document she picked up. We weren’t expecting it.” Tom turns to Elly. “You probably cried a little bit more than I was expecting.” Elly nods: “I got very emotional.” Both consider themselves to be open-minded, but Elly admits she cried for weeks.
Tom, a former assistant professor of virology at a US university, says his scientific background made him skeptical of Callie’s condition. “I assumed there might be some other reason for it: hormone imbalances, that kind of thing. I didn’t want it to be true.”
The family sought out the Australian Transgender Support Association of Queensland (ATSAQ) and were referred to Brisbane GP Dr Gayle Bearman. There were physiological tests, all normal, then sessions with child psychiatrists. Callum was determined to be psychologically female, so after much soul-searching and discussion the MacNaughtons agreed to allow him to assert a female identity. One of the first things they asked Callie was what she wanted to do first. Buy clothes? Do something with her hair? Callie said she wanted to shave her legs. “So that was the first thing we did,” Elly says. “It took so long.”
HOW many people in Australia are transgender, or in medical terms living with the condition of transsexualism, isn’t clear. Professor Louise Newman, a child psychiatrist from Melbourne’s Monash University Centre for Development Psychiatry and Psychology, says studies vary widely, with the number diagnosed with transsexualism or seeking gender reassignment surgery anywhere from 1 in 30,000 to 1 in 100,000.
Bearman has specialised in gender issues for about 30 years and says she regularly turns would-be patients away. “There’s an over-demand and I can’t work 25 hours a day.” In 2008, she started reducing her intake to three new transgender patients each month, now she’s considering cutting it to two.
Is transsexualism easy to diagnose? “Sometimes it is, and sometimes it’s not,” she shrugs. “It does take a lot of conversation. There are lots of things you have to explore.” She can’t give exact percentages of how many teenagers she sees, but says it’s “a lot”. Most come with their parents. “We’ve had a few exceptions,” she says. “I’ve seen street kids, and they don’t really have anyone involved. Kids who are under care and protection of the state.”
Those aged under 18 are referred to child psychiatrists like Louise Newman, who determine whether hormone treatment to help transition to the opposite sex is warranted. “You’re looking for the thing called gender dysphoria, the clinical presentation of being unhappy in one’s biological sex,” says Newman. “Then you’re trying to determine what the child’s psychological gender identification is, and how they perceive themselves internally.
“Children are very articulate. They might not have sophisticated language to [communicate], but they’ll do it in play and behaviour and are very persistent.” Newman sees boys as young as three who are preoccupied with Barbies, fashion, and hairstyling who consistently dress in the opposite gender. “Putting on wigs, false hair at quite young ages. You wonder, ‘Well where do they get these notions from?’”
Newman says there are two main schools of thought: that transsexualism has a biological link, most likely the result of hormonal effects in-utero; or it’s psychological, and related to upbringing and culture, coupled with emotional factors. It’s an old dichotomy: nature versus nurture.
Kathy Noble, a transgender advocate in her 70s based in Cleveland, runs a transgender online resource called Changeling Aspects. She’s encountered many cases of boys as young as three and four identifying as female and attempting to cut their penises off with scissors, and has heard of girls who identify as male who have tried amputating their breasts at the onset of puberty. “These are extreme cases,” she says. “The pressures become so intense from inside and outside, that the child actually become suicidal. There are a lot of kids who go to bed, virtually every night, praying that when they wake up, they’re what they should be.”
The MacNaughtons remember when Callie was aged about three “she was having a bath and she went, ‘cut, cut, cut,’” says Tom, making a scissors-like snipping motion. Callie doesn’t recall that incident but others she remembers very clearly. “There was a time when I was five, and I actually dressed up as a girl for a few days. We went out and I was still dressed as a girl, and I went to the female toilets as a girl. I was called a girl a lot when I was a kid. My Mum always said I was too pretty to be a boy.”
Does Callie wish she’d begun her life as a girl earlier? “Yes,” she says without hesitation. What would be different? “Prettier face. The earlier you come out, the better result at the end.”
Medical practitioners I spoke to agree that the earlier hormone treatment begins the better the results long-term in outward appearance. Yet are children really intellectually and emotionally equipped for such decisions, even with a psychiatric diagnosis?
A landmark Family Court hearing grappled with these questions in 2004. “Alex”, was a 13 year-old ward of the state born a girl but diagnosed with gender identity dysphoria. His female body had caused him so much distress that he said he’d tried to kill himself. The court ruled that Alex could be given hormones to block female development. (Last year it was reported that the court ruled in 2007, when Alex was 17, that he could have breast removal surgery).
The pills Callie takes she’ll have to take for the rest of her life. One arrests the effects of testosterone, such as body and facial hair growth; the other is a dose of oestrogen to encourage female development such as breast growth. “These are, like, a quarter real,” she says, pointing to her chest.
For minors under 18, these treatments require parental consent, something that’s tricky for 17 year-old April from the Gold Coast, who moved out of home after she dropped out of school and began working in a fast food joint. “My mum thinks it’s a phase,” she says, “and I tell her, ‘It’s not a phase, I can tell you that now.’” April’s birth certificate says she’s a boy, but it’s hard to see any trace of male features in her pretty face, framed by long black hair. “When I started going through puberty. It just started hitting me,” she says. “I didn’t tell anyone about it, though. Beforehand, my parents were like, ‘You’re a boy, do this.’ They didn’t make me do any sports or anything like that, because I didn’t like that. But my Mum would just always give me short haircuts and would always do my clothes shopping and stuff. But at a young age though, when I was about five, I did cross dress.”
Not being able to get her parents’ consent and having to wait until she’s 18 makes April anxious. In her mind, it’s a race against the clock. The thought of her shoulders broadening and dealing with facial hair is abhorrent. “Getting huge muscles; it’s just very scary,” she shudders.
However there have been small victories. Recently, a delivery man at her workplace used only female pronouns when talking about her with her manager. “He was referring to me as her and she,” April beams. “That made me so happy.” She’s also begun a relationship. “He’s straight and knows everything,” she says. “So there you go!”
Both April and Callie are determined to have gender reassignment surgery. “I wouldn’t feel complete [without it],” Callie says. “[although] I know there are transgenders who don’t want it done.” Her parents are supportive. “It turns out we had a girl,” Tom says, matter of factly. “Just with the wrong plumbing.” Adds Elly: “Well, we’ll get that plumbing fixed.”
Surgery is expensive, anywhere between $10,000 and $14,000, with only a few health funds offering rebates for some procedures. Medicare only covers consultations leading up to gender transitioning and anaesthetists’ fees. The main choices for patients here are specialist surgeons in Thailand or the Gender Dysphoria Clinic at Melbourne’s Monash Medical Centre — a specialist, multidisciplinary centre of psychiatrists, psychologists, endocrinologists, speech pathologists, and surgeons who perform about 40 sex-change procedures each year. (In recent years the clinic has been under scrutiny with several former patients taking legal action, claiming they were wrongly diagnosed as transsexual.)
For her part, Callie remains resolute. She can take a dip in her backyard pool, but would like to be able to swim in a public pool with her best friend the way she used to. “I can’t wait ‘til I finally can go again, when I finally have swim trunks that don’t show anything,” she says. Surgery will also represent another milestone. Only then will she be able to obtain a new birth certificate that says she’s female.
GENDER expressions beyond the dichotomy of male and female are commonly accepted in many societies. In Thailand, for example, incidents of cross-gender identity are so common that one school — Kampang Secondary School — has a transsexual toilet so students feel more comfortable.
Yet here, acceptance is not so easily won. People I spoke to for this story told of abuse and neglect, and described living with transsexualism as a “living hell”.
For 17-year-old Felicity, born and raised a boy, being caught by her father at age 10 dressing in girls’ clothes led to a life on the streets of Sydney’s King’s Cross. She says she felt like a girl from the age of three, but never spoke of it except to a nun at her Catholic primary school. “She told me that it was alright as long as I dressed like a man, got married and had children.”
Tossed out of home, by 13 she was working as a prostitute, had a serious drug habit, and had attempted suicide several times. It wasn’t until two years ago that she successfully applied to the courts to be emancipated from her parents so she could gain access to hormone treatment. “There are people out there where their family supports them 100 per cent,” she says, “pays for all their hormones and sends them to a gender therapist and everything. I just didn’t have that.”
Family support and tight-knit friendships, however, do not necessarily protect against the taunts most transgender people endure. A few days before I met Callie she’d been greeted at school by year eight girls yelling, “Get the fuck out of here, you transvestite!” and boys throwing empty soft drink cans at her. She spent the rest of that day at home, shaken. “It did break me down,” she says. “I think it was the shock of having it [bullying] all again after so long.”
There’s the inner turmoil to grapple with too, the fear that she won’t “pass” for a girl. “Well obviously I’m a teenager, so I think I’m ugly and look like a boy,” she says. “If you’d seen me as Callum, you could probably recognise me as Callie, but it would take a while. You wouldn’t completely tell …. Well I hope you couldn’t completely tell. You probably can’t tell … but you probably can?” I’m not sure if it’s a question or not, but in the childhood photos Elly shows me of Callie living as a boy, she looks in many of them to be a pretty, apple-cheeked girl.
To help achieve the normal life she craves she’s been having speech therapy to give her voice a feminine tone. One night, her best friend asked her if she could still do her “male voice”. Callie re-enacts the scene into my recorder. “Hi everyone,” she says, purposefully deepening her voice. Listening back to it she sounds like any teenage girl doing a dreadful impression of what she thinks is a male voice. It’s utterly unconvincing. It’s almost as if Callie MacNaughton has no idea how boys are supposed to speak or act at all.
When I ask whether any part of her misses being Callum she doesn’t miss a beat. “Not for a second.”