That time Dr. Norman Spack was my endo, or, The “dollmaker” loves autogynephiles

I was 17 when the psych first told my parents he was ready to refer me to the endo to start hormones, but my dad threw a fit during family therapy. He called the psych a quack, made up some mental illnesses that didn’t exist which he said I had, and yelled a lot. It sucked. I really liked the psych. He was an extremely tall, gentle man, with glasses and a grey mustache. He lived with his (male) partner in a fancy brownstone in the south end of Boston (where he saw patients in his office on the ground floor), had an original Andy Warhol soup can print in the hall, and let me smoke cigarettes during our sessions. I always felt really cool sitting in the leather chair in his office, looking at all the books on his shelves and putting out my unfiltered Camels in a glass ashtray.

Anyway the so-called compromise was that I would go to college as a girl, but put off hormones for a year. Needless to say, at the end of the year I dropped out, got a job in the city, and started buying my own hormones (from the plastic surgeon Benito Risch, who didn’t require a script if he thought you looked trans). But then I got into drugs, and in one of my few acts of self preservation I ran away from my drug friends and went back home to live with my parents. This also meant going off hormones which sucked in a way it’s hard to describe.

Eventually things got straightened out and I had a succession of endos, and got back on E. I also got $5000 from a student loan refund so I got an orchiectomy. I didn’t like the idea of being dependent on the medical-industrial establishment for the rest of my life, and at the time I assumed that post-orchi I could quit hormones if I wanted to, and it wouldn’t be a big deal. At least I wouldn’t have any more of the poisonous testosterone fucking up my body! And they’d been prescribing me premarin (literally made from the pee of pregnant mares), which made my stomach hurt.

I did indeed quit taking estrogen, but actually it stunk. It wasn’t as bad as the first time I stopped, because besides it being my own choice, my testicles were gone (thank god!) and my testosterone production was a lot lower. But your body still produces hormones even without gonads, and my body was making more T than E. Over about a year I became flat as a board again, my face got leaner, and worst of all I started having hot flashes. I wasn’t sure what they were at first but I was dating a woman who was 40-something and she diagnosed it. (I was 23. I was also a vegan, a chain smoker, and an alcoholic, which I’m sure contributed to my problems haha. Though I never would have admitted it at the time.)

My primary care doctor was like “You need to get back on hormones, at least something!” (Meaning: either estrogen or testosterone.) She was worried I would get osteoperosis. But she wasn’t in touch with my previous endo, so she referred me to Dr. Spack.

Dr. Spack’s childhood gender clinic was pretty new at the time, but he also saw patients in “private practice” at a separate office out in the suburbs. I was deemed “too old” for the clinic, though I also have a feeling part of this decision was made based on my looks and my backstory. I had been hanging out in the gay community since I was 16-17, and then from 18-22 most of my friends were artsy lesbians. So, I wore pants from the thrift store that didn’t fit, knit hats in the summer, tshirts with holes and random paint stains, and smoked unfiltered cigarettes. (Though I guess that last was a holdover from teenage boyhood.) Lesbians my age definitely knew where I was coming from because they usually assumed I was one of theirs, but Spack wasn’t sure what to make of me. Not to mention, the fact I had quit hormones of my own choice after the orchi perplexed him. But at the same time, I wasn’t an easy “do your business and get out” client like most of the daddy transitioners. He couldn’t male bond with me, or objectify me! Oh, the horror.

As I came to find out, at my first appointment, the “private practice” was where he saw all his adult autogynephile patients. I didn’t know that word at the time (this is 97-98) but it was totally clear once I read about it on Anne Lawrence’s site a year later. And not only did Spack have two offices, but he had two appointment books, one for each clinic. Everything was separate: his “showpiece” (child) patients, and his money-making patients.

Like my primary care doctor, Spack was worried about osteoperosis, but he wasn’t sure how to dose me because of the orchi (and the smoking), so he put me on the patch. Except it really didn’t work well, they were too weak so I had to wear two at a time, and they gave me rashes. He insisted on patch over pills because he said he was worried about my liver, but I can’t help thinking he was being overly conservative because I didn’t make any sense to him. I certainly wasn’t the beautiful doll he talks about in his disgusting TED talk! The fact that I’d already been living full time for thee years and changed all my id by the time I was 21 just seemed confusing to him.

I only remember two appointments really clearly. The most memorable was certainly my first encounter with a daddy transitioner. Anyone who’s ever taken hormones or worked at a clinic that prescribes them has seen some of the weirdos who come in. The trans providers at Boston City Hospital were always going back and forth about scheduling all the trans clients on the same day, or just mingling them in with the rest of the patients. The theory being, maybe the weirdos will weird fewer people out if they all come and go in a block. Or maybe it’s worse to concetrate them? Who knows?

Anyway I very carefully had my nose buried in a book because I sure as hell didn’t want to talk to anyone at Dr. Spack’s private clinic. And what made it even worse was that there was no receptionist – just Spack in with a patient, and me and the weirdo in the waiting room. I think she had been there when I arrived, but then she left for the evening. (It was a Saturday.) What was left of the weirdo’s hair was a wispy blond ring around the back and sides, grown out too long (think Brian Eno), and he had correspondingly light eyebrows and eyelashes. After trying to make eye contact for a few minutes he finally leaned toward me and said “You’re so pretty, when did you start hormones?” I looked at him, and his long disgusting fingers, and the slight puffiness around his lips and the softening around his eyes that made it obvious that he too was on hormones, and I didn’t even know what to say. Fucking terrifying.

I can’t really remember but I think maybe I said “I don’t want to talk about it” and turned the page. He sat back in his chair, looking unhappy. I felt super tense until Spack’s other patient came out, and he brought me in. And then I left as soon as I could. Later I worried I had acted “transphobic”, but I talked it over with my mom and she was immediately sympathetic and said “That sounds really uncomfortable. You were totally in the right.” Thanks mom! I love you!

The other appointment I remember was mundane, but supremely irritating. The secretary apparently “put me in the wrong book”, so when I showed up to Chestnut Hill they didn’t have me on the schedule. And then Spack made me wait three hours, until he’d seen all his daddy transitioners, and then couldn’t understand why I was irritated. That was the final straw for me with his bumbling bullshit. (If you watch the video, you’ll see what I mean – this man is far from a genius.)

I ended up seeing a really delightful Thai endo after that, who I only stopped seeing because he moved away. Which was tragic because then I had to see a complete fucking creep named Dr. Safer, who frankly looked a lot like that long-fingered blond daddy, except with less hair. Total pervert vibe. He was so horrible I just started ordering hormones off the internet and self-medding for a few years.

A year or so after I stopped seeing Spack, I made friends with a trans girl a few years younger than me, who had started hormones and transitioned while still in high school. It turned out that she had been seeing Spack at the Children’s Hospital clinic, ever since it first opened. It was 2000 now, and we had both been reading Anne Lawrence’s writing about autogynephilia. One day, she confided to me:

When I first read about autogynephilia, it was a relief. It exactly explained my entire experience. When I was a kid I constantly daydreamed about being a girl, and then after puberty I fantasized about it. The thought of being female has always turned me on. But I knew I couldn’t bring it up with the doctors. I just told them I’d always felt like a girl. But it feels great to know I’m not the only one like this!

Once again, it was really driven home to me what total bullshit gatekeeping was, in practice. Spack thought this girl was a “true transsexual”, because she was gender-conforming, she lived in the same suburb he did, her parents drove her to her appointments, and she repeated all the lies she’d been told to repeat by the generations of trans women before her. But based on the way I dressed, the friends I kept, and the fact that I was critical of the trans narrative and trying to live free from gender, he lumped me in with the autogynephiles. Good intuition there, buddy!

The more my trans friend thought about autogynephilia, the more confused she got. She had always had long hair and dressed stereotypically feminine, but she decided to experiment. She got a short haircut, started dating another trans woman, and adopted a kind of “butch” presentation. She and her girlfriend (well, one of her girlfriends – needless to say, these people were all poly) would take turns topping each other in anal. Good for them, I guess? I mean, I’m all about questioning the narrative, but the girlfriend was certainly a male-privilege-denying trans misogynist. Ultimately, I semi-intentionally lost touch with them. Not because of the trans stuff, but because I got fed up with the endless polyamorous drama! Seriously!!

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3 thoughts on “That time Dr. Norman Spack was my endo, or, The “dollmaker” loves autogynephiles

  1. If that’s what you came away with, you obviously did not actually read the post. Dr. Spack assumed I was autogynephilic (or a “secondary transsexual”) because I was gender non-conforming, and critical of the dominant trans narrative. But he thought my friend was a “true transsexual” because she was gender conforming and gave all the textbook answers about her motivations, despite the fact that (as she told me privately) her transition was 100% motivated by autogynephilia.

    I didn’t hate my friend for being autogynephilic. I applaud her because she was able to admit it, and started experimenting with gender and questioning the “true transsexual” narrative after realizing it. (Though, I couldn’t wrap my head around her sex life, probably because unlike her I had strong sex dysphoria.)
    The trans women I have a problem with are daddy transitioners, who decide after fathering children that they’re “really women” due to their arousal at the idea of wearing dresses and having vaginas, which they claim is just “normal female sexuality”. I have nothing in common with those people, and they’ve been creeping on me and saying inappropriate things to me for my whole life (until I started passing well enough that I became invisible to them). They also generally are assholes to women.

    I am not sure the extent to which autogynephilia played in my motivations for transition. By BBL definitions I’m clearly autogynephilic, since I’ve had multiple girlfriends and I work in STEM. I also transitioned at 18, I had zero history of erotic crossdressing, I don’t enjoy forced fem/mystery feminization stories, and my sexual fantasies are not related to having a vagina. But as someone who is physically attracted to females, and has modified their body to look more female, it would be intellectually dishonest to say there was no element of autogynephilia in my motivations. This is something I’ve never written about, but I probably should.

    Future comment policy: all comments must be cray-free and evince reading comprehension. You don’t get a free pass next time.

  2. I absolutely loved this post. What a gem about Spack and his intuition failure. I’ve done the poly thing too and agree about the drama.

    Please keep writing.

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