By GREG ANSLEY
At the last moment, Alan Finch knew this wasn't right. His fantasy of becoming a woman was about to break into the reality of a sex-change operation in a Melbourne hospital when the 21-year-old coal miner's son finally realised he did not want it.
"It was like something came over me, where the whole world was screaming: this is wrong," Finch recalls. "Now you can imagine: I've got breast implants, I've been on hormones, I'm halfway there and I'm going into the theatre, and my heart's pounding. It's nearly leaping out of my chest and I'm being wheeled in and I'm looking around and I'm thinking, 'Oh ***, this is a big deal'.
"Until then it had been like a daydream or a fantasy world. But this was a reality check. So I'm in there, I've had a pre-med and I'm feeling a bit woozy and I'm saying to the surgeon, 'I'm just not sure that this is right'.
"He says, 'Well, you've come this far, you look fantastic, dah, dah, dah', the room goes black. Next thing I wake up in the recovery ward and I think, 'Oh, they didn't do it. I must have just had a sleep, because I don't feel any pain.' And then I see this sort of a drip thing and I'm looking down and - reality. I just think, 'Oh ***'.
"I lift [the blanket] up and have a look and I don't see a woman's thing, just all the bandages and that, and I'm totally freaking out. It's 3am and I'm screaming and screaming and screaming and carrying on."
Sixteen years later, living again as a man, Finch is seeking to sue the clinic and the surgeons who performed his sex-change operation in 1988. He is asking the Courts to ignore the six-year statute of limitations that would otherwise block his action.
But another former patient of the Monash Medical Centre's gender dysphoria clinic, a woman who underwent female-to-male surgery, failed in a similar application.
Costs of A$40,000 ($43,000) were awarded against her, without the issue of medical negligence being tested in a court of law.
Both claim they were misdiagnosed and the clinic was negligent. The clinic and the doctors involved oppose Finch's application, which is being considered by County Court Judge Michael McInerney.
Finch's story has brought sex-change surgery into sharp new focus, raising doubts about the system of assessment of patients and the operation itself. It follows similar concerns in Britain, despite the recent passage of a new transsexual gender recognition bill, recognising transsexuals as a new gender and allowing them to marry in their acquired gender.
Finch has also created a firestorm around himself, picked up on one side by evangelical Christians who use his case as a cudgel against gender-swapping and homosexuality, and vilified on the other by "hard-core" transsexuals and gay and lesbian activists. Finch shrugs off the born-again label and says he is not a political, anti-sex-change activist.
"I am against the misinformation that's being put out about it by the doctors," he says. "I'm against the fact that people are proselytised into this by others. I believe people are not being adequately assessed, and what I'm questioning is whether this process is the right thing, the only thing."
Surgeons have been carrying out sex-change operations for decades, based on the belief that some people are born into the wrong bodies and that the resulting condition, known as gender dysphoria, will not respond to psychotherapy and can be treated only by gender reassignment - changing gender.
In males, this involves removing the testicles and penis, creating an artificial vagina by forming an internal sheath from the skin of the penis, and shaping the scrotum into labia. Before surgery, patients are treated with hormones, given breast implants and have hair removed by electrolysis. They may also have surgery to reduce the size of the Adam's apple or change facial features.
Most of the procedures are irreversible. Even oestrogen hormone treatment is fairly final, shrinking the penis and testicles and potentially rendering infertile patients who do not undergo surgery. About 30 per cent of patients who start a hormone course finally do not proceed to a sex change.
Similar processes are followed for women who undergo female-to-male surgery, in which a penis is created by taking flesh from another part of the body and rolling it into shape.
The general rules for sex-change operations are the guidelines set down by the US-based Harry Benjamin International Gender Dysphoria Association, which require at least three months' psychotherapy before hormone treatment begins to ensure candidates do not suffer from conditions such as schizophrenia or borderline personality disorder, an extremely difficult condition to diagnose that can lead sufferers to make irrational and impulsive decisions.
The Benjamin guidelines also require surgery candidates to live full-time as the opposite gender for at least a year to judge how they feel and cope with a new world around them.
But Melbourne campaigner Ken McGuire says in Victoria the guidelines were changed in 2001, with no strict requirements for either psychotherapy or a real-life test.
The successes have become famous: British historian and author Jan (formerly James) Morris, New Zealand MP Georgina Beyer - who grabbed world headlines by welcoming the Queen - Bond girl Caroline Cossey, Brazilian model Roberta Close, Carlotta, Australia's first recognised transsexual, and a long list of academic and media personalities.
But international estimates suggest up to 20 per cent of transsexuals regret the change, often with disastrous consequences. Finch and McGuire believe many should never have been prescribed the operation in the first place.
"I don't know if it's complacency or arrogance, or just that this field happens to attract incompetent practitioners, but for whatever reason, they seem to think they can tell the difference between someone with a personality disorder or a generalised identity confusion and someone who is truly transsexual after just one or two appointments," McGuire says. "We see a need for real assessment."
One Melbourne woman, who does not wish to be named, was referred for a sex change at the Monash clinic after a long history of sexual confusion following abuse that began at the age of 5. On her first session she was told her condition was biological and irreversible, and the only option was surgery.
This went ahead, despite a second independent assessment that said her problems could have a psychological base and recommending surgery be deferred. Claiming that other procedures were not followed and the doctors were negligent, the woman began legal action, but delays pushed her claim beyond the statute of limitations. Now living again as a woman and married, she has a complaint against the Monash clinic before the Medical Practitioners Board of Victoria.
Finch's story is similar. Raised in Yorkshire by a brutal, drunken father, his only love and comfort came from his mother and other female relatives, who regarded all men as disgusting and foul. His first job was with two gay hairdressers.
Finch does not blame his upbringing for his later confusion and decision to change sex, but believes it probably predisposed him to the idea that came to him when a friend passed on a book written by a transsexual.
"I saw that book, read it and thought, 'Oh, gee, everything in that book seems to fit a parallel to my life'," he says. "Growing up, feeling different. Maybe I was born like that."
The Monash doctors agreed. "I end up with these people and I say, 'I've got this book and this is how I feel' and straight away they just look at me and - one consultation - they say, 'You feel that's you, okay, yeah, well, you know, we feel that's you', and a prescription gets written out for hormones, on the first visit. Now that's like being on a steam train.
"This is one of my criticisms of it, because you take a man who doubts himself - or a boy, in my case, of 19 - put him on hormones, offer him breast implants and nose jobs and whatever else ... If there was any bit of manhood in there that could be salvaged ... It's just a slippery slope into the pit."
After the operation, and a period during which he considered suicide, Finch tried to make the best of it. But he says he never felt like a woman. "I mean, I have this little pouch, like a kangaroo has. They've made a little hole and they try to make out it's this really complicated, mysterious magical sort of life-transforming male-to-female surgery."
Finch tried, unsuccessfully, living with a man. Later, he and a woman fell in love and she was a catalyst for further psychotherapy and his eventual decision to return to life as a man.
The doctors at Monash told him he was a lesbian. But he also discovered they had ignored a pre-surgery assessment that had declared him masculine and advised against the operation.
Finch has had his breasts removed and is weighing up the considerable risks of having his artificial vagina removed. He has rejected the idea of a reconstructed penis.
McGuire, whose website www.gendermenders.org carries cautionary tales and detailed reports of the issue and the case against the Monash clinic, says not only have patients often not been properly assessed, but that follow-up and outcome studies have not been made.
Two reports by Victoria's transsexual advisory committee in 1990 and 1992 pointed to a "variety of major problems" at the clinic, and a review this year by State Chief Psychiatrist Amgad Tanaghow raised questions over assessment and treatment of patients, and funding.
Another review was ordered by the State Government this year, but no findings have yet been released.
AdvertisementAdvertise with NZME.
Latest from World
‘Chelsea’ asked for nude pictures. Then the sextortion began
New York Times: Young men are being tricked into sending naked pictures to scammers.