25 Jan 2013

Trans Kids and Reproductive Choices

Trans kids today have new options for transition. Few people even know about these possibilities, although awareness is increasing. In my own pre-teen years, I noticed that my girlfriends were starting to change, and I felt different from them. In my private, inner thoughts, I believed I should be a gay boy, but that seemed so very far from what was possible in reality that I wondered from time to time if I was crazy. I didn't know about the existence of transgender people until I was an older teenager, and even then, I had no idea that trans kids could access any kind of specialized medical help.

Photo: Visit Cape May (Creative Commons)
Hormone blockers have long been used to delay the development of secondary sex characteristics in children experiencing precocious puberty. More recently, paediatricians have started prescribing them for trans kids. This prevents a female-to-male (FtM) trans boy from growing unwanted breasts and experiencing other pubescent changes. In the case of a male-to-female (MtF) trans girl, the blockers halt all the powerful effects of testosterone, including deepening of the voice and changing of the face shape. At age 16 or 18, depending on who you're talking to, patients can begin taking synthetic hormones so that they will develop the secondary sex characteristics of their intended gender, or they can take nothing and develop according to their genetics.

The effects of the hormone blockers are completely reversible. Nevertheless, if an FtM teenager takes them and then takes testosterone as a young adult, his female sexual organs will not mature. I don't know if they would ever mature if he stopped taking the testosterone some years later. Testosterone use in FtM trans guys who transitioned after puberty can cause female sex organs to atrophy, and may also result in polycystic ovary syndrome (PCOS), which can lead to permanent infertility. I haven't been able to find good information concerning its effect on individuals who used hormone blockers and never produced natal hormones.

If I'd known about hormone blockers and the possibility of transitioning earlier in my life, would I have done so? I don't know. I didn't have the social supports necessary for transition at that time. It's hard to separate such a support system from an individual's emotional readiness. I wonder if I may have been much happier earlier in my life if I'd been able to transition as a teenager. I don't know if the choice would have been as clear for me at age 12 or 14 as it was at 23.

If you had asked me when I was ten years old if I thought I would ever want to birth a baby, or even adopt one, I would have for sure said no. At age twenty and even twenty-four, I would have still said no. Nobody asked me. When discussing transition, I don't remember being asked by my therapist, family doctor or endocrinologist if I thought I ever would want to have kids. My surgeon definitely didn't talk to me about future breastfeeding. I'm guessing that most trans people and their health care providers assume that infertility is the price we pay for transitioning. Recently, some people have accused me of wanting to "have it all" – meaning the correct gender identity and my child. Well, isn't that what most others can enjoy?

I didn't contemplate having a relationship and a family until after I'd taken testosterone and had top surgery. I wasn't content enough before that to have any inkling of what I really wanted in that regard. Now, my son and my husband are the most precious parts of my life.

Do I think that trans kids shouldn't take hormone blockers so that they can maintain their reproductive potential? Do I think they shouldn't transition at a young age? No and no. Each individual has to make his or her own decision. Others can guess at how badly someone needs to transition and when, but only the person contemplating transition can really know. Some trans kids suffer from such severe gender dysphoria that they are depressed and even suicidal. These children often feel that they need to transition as soon as possible. Others, like I was, can kind of manage by keeping very busy and not being terribly self-aware – they might not need to transition as urgently.

Sometimes I wish that I could wake up in the morning with a physiologically male body, but I would never trade my baby for anything. Most of the time, I enjoy traveling my unique path. I am comfortable enough with my male-sounding voice, my beard, and my flat chest. The parts of me that I don't love so much are what helped to make the family I love so deeply. This is my conundrum.

10 Jan 2013

Malunggay: Breast Milk Super Vegetable

For those of us whose jeans are noticeably tighter as a result of endless holiday feasts, this is a post about an Asian super vegetable, called malunggay, that happens to be great for breast milk production. Ian and I need this more than most right now because we just returned from a trip visiting (and eating heartily with) Jacob's grandparents, after celebrating Christmas at numerous indulgent gatherings with our friends here in Winnipeg. It has all added up to way more meat, baked goods, and candy than we care to admit. We came home vowing to exercise more, eat healthier, and to avoid buying anything other than fresh produce since our pantry is overflowing with slimming foods like lentils and beans (nice that these foods have already been purchased – flying across the country was wonderful, but pricey).

Cooking malunggay into a curry
I first heard about malunggay when my dear friend and the very fancy author Diana West came to Winnipeg to speak at the Baby Friendly Conference in the fall. As a lactation consultant, she says that malunggay is her number one go-to food for increasing milk production. It is native to the foothills of the Himalaya and is sometimes called moringa, horseradish tree, benzolive tree, kelor, marango, mlonge, moonga, nébéday, saijhan, sajna or Ben oil tree. India is the largest producer of Malunggay, although it is also grown in the Philippines, Thailand, Taiwan, Malaysia, Africa, and Central and South America. Cultivation is in early stages in Hawaii for the US market.

Malunggay grows as a slender tree, with all its parts, including bark, stems, roots and leaves, being edible. The most nutritious part of the plant is the leaves, which contain, gram per gram, "SEVEN times the vitamin C in oranges, FOUR times the Calcium in milk, FOUR times the vitamin A in carrots, TWO times the protein in milk and THREE times the Potassium in bananas." A double blind study suggested that consuming malunggay leaves has a considerable positive impact on breast milk production.

Malunggay helps increase milk production
A number of companies include malunggay in capsules meant to increase one's milk supply, but I prefer to buy it fresh. I have found the leaves at several local Asian markets. I simply asked, "malunggay?" and got pointed in the right direction by someone who knew. The leaves are very versatile ingredients – they are wonderful in soup, but also delicate enough to be added fresh as a garnish to salads. One of the most traditional dishes that includes malunggay leaves is sour Thai curry.

Wish us luck with our New Year's resolution and let me know if you come up with your own great malunggay recipes. I'd love to hear them!