I get it.

Most of my social media feeds are full of kindness. Really, y’all are a sweet bunch of voting, do-gooding, funny, and freethinking protectors of the planet and champions of the less privileged. Some get gussied up for countless events requiring large donations to noble causes; others give your time to help an elderly neighbor, staff the local food pantry, create art, and redesign all of our public spaces to be accessible and fun for everyone. A disturbing number of you have a near pathological savior complex for condemned animals and strays. And my how progressive we’ve all become! Two years ago I attended my first gay wedding with a boatload of Republicans shedding happy tears of love and support. Locally, my affluent town has voted to pay higher taxes to fund programs to bolster our vulnerable citizens. And 97% of you didn’t balk–even cheered– when our most iconic Olympic athlete transformed from the man we grew up with into the woman she was all along.

Most of you.

Some of you “will still call him Bruce,” or feel squeamish, or will compare him to a delusional white girl whose tangled web of lies included an impressive, unearned portrayal of a black woman. Indeed, there are few medical, scientific experts who study and treat these exceptional people who are at odds with the gender of their bodies. And unless you are a member of a thriving gay community, or live in New York or LA, or are Anne, you probably don’t have a single transgendered friend in your social media feeds. But armed with only un-peer-reviewed studies, a Wikipedia base of knowledge, and with no first hand experience, I think the only dissenting opinion anyone should launch onto social media regarding Caitlyn is this:

“I don’t get it.”

Of course, mainstream media wants you on board. The liberal masses don’t want your bystander nonchalance; they want full-throttle endorsement! And I suppose those who “will still call him Bruce” cannot stomach the cheers and accolades and awards for this flagrant display against God’s creation or nature or decency. The world has gone loony tunes! It’s OK. Take a beat. Remember our own parents’ opinions about homosexuals in a pre Will and Grace world? Well, regarding the transgendered, we’re still a few must-see-TV moments away. And no one will fault you for not understanding this brave new future of women-becoming-men and vice versa. But fabricating arguments in denial of something scary and true for thousands is unkind. Tying those opinions to religion makes Jesus facepalm.

Because I spent a regrettable amount of time murdering rats with a guillotine in order to study their still fresh brains, I have a small and gruesome credibility to dissuade you from comparing Caitlyn Jenner to Rachel Dolezal. Though it pains my heart to read these articles, my arguments derive quite literally from the noggin. Some of you might be able to dredge up this long forgotten fact about human development: we’re all designed to be girls. The human default setting is Lady. If people had a browser that popped up automatically, it would be called Chyx. Without the effects of boy hormones (androgens) on our brains and bodies at key moments, we’re all going to need training bras and develop a complicated relationship with our bangs.

Testicular feminization syndrome is a remarkable example of the strength of our ontologic destiny– where chromosomally male fetuses whose receptors cannot respond to dude hormones can develop into completely physical girls. Luckily for some of them, their teeny growing brains are bathing in the same girly milieu, and so develop into women, too. They are able to lead less complicated lives as their brains and bodies respond to hormones in harmony. But for others, this:

Another case is instructive. An [XY] individual who is now living as a woman had been assigned as a girl at birth but was switched by a physician to live as a boy at the age of 3 months when testes were discovered. At the age of 13, her physician recommended that “he” have a mastectomy for his breast development. The surgery was performed and this individual continued to live as a boy although she had felt from early childhood that she would be more comfortable living as a girl. At the age of 22, she felt that she could not continue to live as a man and switched to living as a woman when she learned that she could obtain breast implants to regain what had been removed.1

For the transgendered, this sort of mismatch happens. Somehow the endocrine soup around the brain doesn’t gel with how the body is shaping up. It’s not a choice or a delusion; it’s biology. It’s also devastating, confusing, scary, and rare. For those who want more scientific proof than my watered-down biology lecture, I can point you to any number of rat labs with guillotines. There are also peer-reviewed research studies revealing structural differences in the transgendered human brain.

But despite more credible, kinder arguments, some of you will “still call him Bruce.” Otherwise thoughtful, smart people will keep citing the one doctor who doesn’t approve of gender reassignment surgery, or will make false comparisons to body dysmorphic syndrome, or worse, liken Caitlyn to a white girl using an enviable twist-out to be something she can never be. Caitlyn is a woman because her brain was always female. Rachel was never black because, well… she was never black.

I have another, more personal reaction to those who champion a fierce attachment to The Body the Lord Gave Us. Mine is no longer whole, but I am no less womanly for having amputated my breasts. Also, I’m alive. Like Caitlyn, I removed the parts that were endangering me, forcing me to be something I didn’t choose at all: a person with cancer. When your queasy disapproval of corrective surgery fetishizes a holy beauty of our native bodies, elevating the importance of our God-given bits and pieces over everything, how do you suppose your breast-cancered sisters feel? Well, this one stands with Caitlyn.

I get it.

Hello, Caitlyn

Hello, Caitlyn

1. Gottlieb B, Pinsky L, Beitel LK, Trifiro M. Androgen insensitivity. Am J Med Genet 1999; 89(4):210-7

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The Importance of Angelina Jolie

The Breast Conservationists are on full alert. Angelina Jolie bares everything but her new rack, and now responsible scientists and doctors are scared that stupid, stupid women will be lining up for bilateral mastectomies like it’s the wedding dress sale at Filene’s Basement. Otherwise healthy women will be demanding expensive genetic testing, insisting on amputations, and requesting Jolie Boobs from their plastic surgeons. If Angelina Jolie did it, then it’s possible that stupid, stupid women will start shopping for their own, Celebrity Cancer-Preventing Surgery.

Have we demonstrated an uncontrollable need to Be Like Angie? Do we all have slit-up-to-there dresses in our closets and a gazillion babies? (To be fair, I do have my own, Asian Brad Pitt… but I had mine first.) I have to believe that we’re smarter than this. Most of us aren’t Golden Globe-winning UN ambassadors. And most of us don’t carry BRCA mutations: only about 5% of us with breast cancer have the unlucky genes. Angelina Jolie’s story is one of access to superb health care, intelligent, informed consent to risk reduction treatment, and bad-ass, story-sharing bravery. The Breast Conservationists worry that her boldness will undo years of work informing women that they do not need to suffer barbaric surgery to live. But I think Angelina Jolie has done more for breast cancer awareness than all of the pink crap in the world. Angelina heralded the possibility that breast cancer isn’t a dreaded path to ugly.

Perhaps we are all a bit more informed about BRCA mutations and statistics and recommendations than we were on Monday. But what this beautiful woman did in one day was to put a spotlight on breast reconstruction after mastectomy. Living in Boston, and specifically in the same home as someone who does this sort of surgery every single day, (and personally with my own set of silicone bags), it is impossible to believe that only 30% of women are offered or encouraged to seek breast reconstruction options after body mutilating surgery. Despite many, many studies showing that quality of life is significantly improved with breast reconstruction, many women are still discouraged from “unnecessary” or “cosmetic” or “long, painful, and risky” operations that would restore their sense of self. They are (ill-) advised that reconstruction will delay their cancer treatment. Of course I need to insert all sorts of disclaimers that some women are not eligible for current reconstructive efforts because of radiation or extent of disease or other underlying conditions, that some opt out of reconstruction and live comfortably with that choice, that there are always more risks with more surgery. However, everyone should have the information about and access to breast reconstruction. And although there are thousands of cancer bloggers cheerfully over-sharing about their bikini-rific , gravity-defying post-Cancer boobs, you know who they’re really going to believe? Angelina Jolie.

Because Angelina went public with the story of her reconstruction, it’s possible that she has inspired other women to advocate for their right to restore their bodies, to feel empowered, to feel whole. While any diminishment of her hotness was always impossible, she explains how it is also surgically preventable. She writes,

“On a personal note, I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity.”

Of course, those of us in the shitty sorority know what she’s not telling us: that she is changed, she’s scarred, and where there was once sensation, there is now the numb reminder of an ever-lurking Cancer. Strong, indeed. And she’s more beautiful than ever.

Bringing sexy badass to the Big Cancer Fight

Bringing sexy badass to the Big Cancer Fight