Difficult Transitions 

• Matthew Thorsen

Coralyn Guidry's 20-year-old son Michael looks like a typical young man. He has short, brown hair, so dark it's nearly black. It continues down his cheeks in thick sideburns that extend to his jaw. The whiskers on his otherwise pale chin suggest that he has forgotten to shave. Dark, downy hairs sprout on his arms, beyond the sleeves of the T-shirt that hangs on his flat chest, and on his legs below the cuffs of his shiny green, knee-length athletic shorts.

He looks so comfortable in his body that you probably wouldn't look twice if you saw him on the street. But unlike most guys his age, Michael isn't just looking forward to going back to college in the fall or to turning 21. He's also eagerly anticipating his hysterectomy.

Michael is a female-to-male transsexual. He says he's felt male for as long as he can remember. "I always asked for GI Joe or Ninja stuff," he says of his childhood toys, during an interview at his mother's home.

He was 8 or 9 when he started liking girls, but was reluctant to let them know how he felt. "Because I wouldn't want to be with that person if I was still in this body," he remembers thinking.

Michael began transitioning at 16. Today his family, his friends and his girlfriend refer to him using male pronouns, and address him using his new chosen name, which is not actually Michael; his mother has insisted that he not reveal his identity in this story. She speaks openly only because she doesn't share his surname. "I don't want him to be murdered because of who he is," she explains.

Guidry is fiercely protective and supportive of her son. She has driven him to doctors' offices in Vermont and in other states, and has helped pay for his hormones and surgeries. She lobbied the Burlington School Board to keep him at Burlington High School after they moved to Swanton, because she thought he would be safer there. She has accompanied him to trans gatherings, and has defended him in a world where his unconventional identity puts him at the mercy of others' prejudice. "Sometimes it feels like an extra job," she says wearily.

Lately Guidry has felt more embattled than usual. In May, Governor Jim Douglas vetoed a bill that would have made it illegal for anyone to discriminate against her son on the basis of his gender identity. That blow was followed a month later by a traumatic experience at Burlington's Fletcher Allen Health Care, when Michael went in for his hysterectomy.

As Michael was being prepped for surgery -- in fact, moments before he was to receive anesthesia -- the anesthesiologist informed him and his mother, father, older sister and girlfriend that, due to a financial misunderstanding, the hospital would not allow the operation to proceed. Guidry says the hospital staff apologized but asked the family to leave; a FAHC spokesman declined to comment on the case, citing restrictions on patient confidentiality.

"I'm so blazingly mad that you can go in the hospital and be told, 'Get out, get out,'" Guidry fumes. "I just don't understand how people can be so cruel."

She suspects that the dismissal was motivated by transphobia, and she's angry about the way her son was treated. "They looked at him like he was a freak," she says.

Guidry contacted Seven Days shortly after this episode because she wanted to share her family's struggle. Often the experiences of transsexuals and the transgendered -- people whose gender identity is at odds with their biological sex, but who may not seek surgery -- remain untold because of fear and shame. That's especially true where their families are concerned. Parents, children and other relatives often have trouble dealing with a loved one's transition. Many trans people are estranged from their families.

But Guidry says she's proud of her son and wants to explain the long and sometimes painful process by which he is becoming a man. "If there's more talk about it," she says, "maybe people would understand."

At first glance, Guidry seems an unlikely trans activist. She resides at Lone Pine Campground in Colchester, in a small, fifth-wheel camper. She lives alone; she and the father of her two children divorced in the early 1990s. Guidry sold her house in Swanton last spring and plans to live in the camper until the weather turns cold. She'll spend the winter house-sitting for her housecleaning clients.

Her decorating tastes are more patriotic and religious than one might expect. A piece of fabric festooned with American flags covers the camper's trailer hitch; a small red, white and blue banner bearing a "Support the Troops" yellow ribbon sits beneath it on the small lawn. Inside, a framed likeness of the Last Supper hangs, without irony, above her kitchen table.

And Guidry, a petite woman with a light-brown bob, is not exactly a rabble-rouser. She smiles easily, but even then her brown eyes remain guarded, making her seem suspicious of outsiders. She spent part of her childhood at the St. Joseph's Orphanage on North Avenue, where she was abused and molested. She was one of the plaintiffs who settled out of court with the Roman Catholic Diocese in the late 1990s.

Guidry finished high school but never went to college. She confesses to having been a poor student. "I'm not a very good advocate of being able to speak and have the right words," she readily admits. "I'm simple-minded."

She's similarly frank when discussing her son's journey. Two decades ago, when the doctor told her she had given birth to a daughter, she was surprised; she had thought she'd been carrying a boy. The doctor seemed to question the baby's femininity, too, Guidry says. When she suggested the name "Mandy," he told her he didn't think it fit. Guidry adds that early baby pictures show her daughter's genitals were somewhat elongated. "I think she was supposed to be a boy," Guidry says.

She remembers that her daughter always dressed and acted like a boy. She resisted the pink dresses Guidry bought, and tried to urinate standing up.

Guidry meticulously archived Michael's childhood photos, and gladly displays them to provide evidence of her daughter's burgeoning masculinity. "This is him," she says, as she opens one of the large vinyl-bound books. She has almost completely weaned herself from the female pronoun when discussing her younger child.

Guidry opens the book to a series of Halloween photos of "Michelle." She's dressed as a football player, a pirate, a vampire, and a hobo wearing a battered suit and tie. In each shot, the child looks like a little boy. "That's how he wanted to look," Guidry explains. "It was boy, boy, boy."

She recalls instances when others discouraged her from letting her daughter dress this way. When Michelle graduated from Edmunds Middle School, for example, the girl showed up at the ceremony wearing slacks and a dress shirt. When Guidry arrived to meet her backstage, however, her daughter was in tears. Some well-meaning parents had forced her into a skirt and a scoop-necked blouse.

"My son was embarrassed and ashamed," Guidry tearily recalls. "He said, 'I thought they liked me.'"

When Michelle was 8 or 9, she told her mother that she liked a girl. When the girl was 13, she confided that she "didn't feel like a girl." At first, Guidry thought that meant Michelle was a lesbian, but her daughter corrected her, saying that she actually felt like she was in the wrong body.

Guidry had trouble accepting this at first. "It took me two years to ask him, 'So what did you mean?'" she says. "I didn't know where to put it." During that time, her daughter became depressed.

Guidry's epiphany occurred when her daughter was 15. Though she allowed Michelle to pick her own clothes, when the teenager grew breasts, Guidry began insisting that she wear a bra.

Mainly, says Guidry, she was concerned about her daughter's back. "He was hunched over all the time," Guidry remembers. "He used to run and jump, but he was turning into this old person. I thought, 'If I can get him to wear a bra, he'll stand up straight.'"

Guidry threatened to take away all of her daughter's savings if she took the bra off, and watched closely to see that she was following instructions. Guidry eventually caught her cheating. When Michelle left to go to BHS each morning, she ducked out through the back door of the North Avenue duplex they were renting, and took a long time to appear out front.

One morning as Michelle left for school, Guidry went upstairs and looked out the window to see what she was doing. After the girl left, Guidry saw her duck behind a trashcan. "He's behind the trash can," she recalls, "and I'm thinking to myself, 'He's got cigarettes. He's doing something. He's smoking.'"

Her voice cracks as she reveals that that's how she caught Michelle removing her bra. "He couldn't even wait until he got to school," she whispers.

Guidry confronted her daughter. "I asked him if he wanted it off, and he said, 'Can I?'" Guidry pauses to choke back a sob. "It was painful to watch," she says.

It was around this time that Guidry and her daughter began to navigate the confusing world of trans medicine. Though there are local general practitioners, psychotherapists, endocrinologists and surgeons who work with trans patients, it is not easy to access this network. Even some medical providers don't know the best place to refer trans patients.

Dr. Bill Nash, a Williston psychologist who directs the Green Mountain Gender Clinic, says he doesn't advertise his services, though his name popped up on a therapist referral website in a recent Google search for Vermont therapists who deal with gender identity disorder, or gender dysphoria.

Nash has been working with Vermont's trans population for 15 years. Despite his low profile, he says he gets three to six phone calls a month from people who want to transition. Clients who are willing to undergo a year of therapy and assessment prior to physical intervention can gain access to his network of connections.

He's not eager to share them with a reporter. "Quite frankly," he says, "they're a little bit protective." He says many providers are afraid of being deluged with calls from people demanding surgical intervention.

But Nash isn't the only one with connections. There are others, too -- the Community Health Center in Burlington, for example, has a good reputation among the local trans population. And several people interviewed for this article mentioned a supportive endocrinologist at the Dartmouth-Hitchcock Medical Center.

But Coralyn Guidry has never heard of Bill Nash, and she's not familiar with the local care network. Four years ago, when she decided to help her daughter transition, her first call was to the child's pediatrician. "I knew that the breasts were killing him somehow," she reflects. "I just knew I had to call the doctor and ask if he could take them off."

She remembers telling the woman who answered the phone that her daughter wanted her breasts removed. "She said, 'We don't do that here,'" Guidry remembers.

But when Guidry spoke to Michelle's doctor, he had a different reaction. "I know that, having watched Michael over the years, he knew," she suggests.

The doctor referred the family to a Massachusetts psychotherapist, who started Michelle in therapy. Guidry, her two children and her ex-husband and his wife all drove to Massachusetts on different occasions to meet the therapist. She later conducted sessions with Michael over the phone.

The pediatrician also referred Guidry to a Massachusetts endocrinologist, who eventually prescribed testosterone for Michelle, who was now becoming her son.

When Michael returned for his sophomore year at Burlington High School, he spoke with his teachers and his friends and asked them to call him by his new name and to refer to him as male. For the most part, he reports, it was easy to transition at BHS. "The upperclassmen were nice," he says. But he did experience harassment. "I got yelled at," he recalls. "When I went to this thing called winter ball, I went to use the bathroom, and a guy was like, 'What are you doing here?'"

During the summer between Michael's junior and senior years at BHS, he had surgery to remove his breasts. Because they were unaware of providers who could operate locally, Michael and his mother traveled to a clinic in New York for the operation. They had to return a second time to complete the procedure. Guidry calls the experience "horrific."

"To have to go to another state for something traumatic like that, to have no family around to support you, nobody should have to do that," she complains.

Bill Nash reports that gender reassignment surgery at Fletcher Allen is "fairly routine," but Guidry and her son's experience of having to travel out of state for surgery is hardly unique. Vi Luginbuhl, a former Republican State representative who testified in support of the gender identity bill last winter, says that her trans grandson had a similar experience, even though his mother is a doctor and his grandfather was once dean of the Medical College at the University of Vermont.

After their final New York trip, Guidry decided to seek a local surgeon for her son's hysterectomy. The first one she found didn't work out; when he found out the procedure would not be covered by Michael's insurance, he told the family it would cost $30,000.

Guidry balked at the exorbitant fee. "That's not what they charge people," she offers. "That's what they charge people like Michael."

A few months ago, the family finally found another local surgeon who agreed to remove Michael's uterus. Guidry says this surgeon -- who did not return a phone call for this story -- contacted the hospital and received an estimate for how much the procedure would cost. Guidry has detailed notes on this estimate. She keeps them in a Zip-loc bag inside her datebook, on a sheet of pink stationery that reads, "You're only as good as your last haircut."

Guidry points out the figures: $1800 for the surgeon, which she paid up front; $7800 for the operating room; $1600 for the anesthesiologist.

Michael's insurance would not cover the elective procedure, so he spoke with the hospital billing department several weeks prior to the surgery. He says they told him that he was eligible for a 47 percent discount on the operating room and anesthesiologist costs. And they told him he'd be able to set up a payment plan for the rest after the surgery.

But Michael says the Fletcher Allen billing department called him the day before the surgery and told him there had been a mistake. He was not eligible for the discount and would instead be required to pay 50 percent of the full cost -- more than $4000 -- up front.

Guidry says the call seemed suspicious. "Why would they raise the price the day before?" she wonders aloud.

Michael says he knew he didn't have the money, but he decided to show up at the hospital anyway. He, his mother and his sister all say it was a bad experience from the start.

When Michael and his family arrived at hospital registration, the woman who checked them in got up before she was finished and walked away. Another woman who didn't introduce herself walked over to them and stared at Michael.

Michael's sister, Jessica Barrett, says she assumed that the woman who had been checking them in had gotten up and told her co-worker to take a look at the trans person. "She was just gawking at him," Barrett recalls. "We all felt the same thing at the same time: 'Take a picture, it'll last longer.'"

Barrett, a licensed nurse's assistant, says she felt the first woman had violated patient confidentiality. "I know what they did was wrong," she says. "Doctor's offices and professional people shouldn't be acting like that. A doctor's office is the last place you'd expect to be treated like that."

When Michael was instructed to report to the surgical ward and told to put on a johnny, the family thought the procedure was a go, that original terms of payment applied. They were mistaken.

Guidry says she was disappointed with the way the hospital staff handled what was a delicate situation. "Nobody looked me in the eyes," she says. "Everybody said, 'I'm sorry, I'm so sorry.' But nobody offered to help us work out a payment plan."

Guidry later called the hospital and asked for a meeting with a patient advocate to discuss the situation. A registered nurse called her back to set up the appointment. During the phone call, Guidry says the woman referred to her son as "a he-she." Guidry says the slang term is demeaning.

"And this is the person who is supposed to be our advocate?" she asks rhetorically. "She knew what she was calling about. She should have had all the ducks in a row before she called. She should have had all that information in front of her."

The meeting Guidry requested happened three weeks ago. She, her daughter, son and his girlfriend attended. They say they expressed their frustration, and asked the hospital to provide them with a payment plan. The two women who met with them promised to get back in touch in two days. After two weeks of waiting for that call, Guidry finally called the hospital back and requested another meeting, on August 25. This time she'll be bringing Samuel Lurie, a Vermont-based trans-sensitivity trainer who is also a member of the trans community.

Lurie has conducted trainings on how to provide health care to transgender people in 25 states at a wide variety of institutions. In Vermont, he has spoken to groups at the Waterbury Hospital, the Veterans Administration Hospital and the UVM Medical College. He has never been asked to speak with the staff at Fletcher Allen.

Hospital spokesman Mike Noble says he was sorry to hear that Michael and his family had had an unsatisfactory experience. "We do look at these things pretty carefully when something like this comes to our attention," he says.

Noble reiterates that he can't discuss the specifics of this case -- "Patient confidentiality is paramount here," he notes -- but he can shed some light on Fletcher Allen's billing procedures. "Prepayment of 50 percent or 100 percent, depending on the service, is required for all elective procedures that have been determined by an insurance company's care-management people to be not medically necessary, and are being paid for by an individual out of pocket," he says. Michael's hysterectomy falls under this category; a vasectomy reversal or in vitro fertilization might, too.

But Noble can't say why the price for a particular procedure would change the day before it was scheduled to occur. As for the 47 percent discount Michael mentioned, Noble says that's only available to patients who don't have insurance. It doesn't apply to patients who do have insurance, but whose insurance companies won't pay.

"There's always the possibility for the misunderstanding of various payment processes that apply to health care," says Noble. "One of our customer-service goals is to ensure that appropriate steps are taken so that patients and families receive accurate information about their payment responsibilities prior to receiving services. We may not do this 100 percent of the time, but that's the standard we set for ourselves."

When asked about the kinds of sensitivity training Fletcher Allen provides, Noble responds that new employees attend an hourlong session on "being sensitive to the diversity of people who come to us for care." And all employees who have direct patient contact are required to take an annual course on patient sensitivity.

Does this course include appropriate terminology for someone in the process of transitioning from one gender to another? Noble says no. "It's not targeted to any specific group," he says. "It's really training them to accept the differences they may encounter."

Unlike the UVM Medical School, Fletcher Allen has not included gender identity in its non-discrimination policies.

But Bill Nash, whose patients work with Fletcher Allen on a regular basis, says that as far as he can tell, the hospital has improved its ability to work with trans patients. "Is everyone up to speed? Nope," he says. "But I can tell you that Fletcher Allen is a whole lot better now than it was 10 years ago."

Nash remembers sending a patient there for gender-reassignment surgery a decade ago. "They absolutely balked," he recalls. "It took a lot of persuasion and a lot of conversation." Now, he says, that kind of procedure is "not a big deal anymore."

He adds that Michael and his family may have misinterpreted the motivations of the hospital staff. "You get this kind of fear," he says. "It's pretty easy to feel like people are looking at you strange . . . It's pretty easy to misread cues when you're feeling that emotional and vulnerable."

That said, Nash points out that the kinds of attitudes he's talking about have not disappeared. "I can't say this stuff doesn't exist," he concedes. "Of course it does."

As Guidry and other trans advocates have pointed out, one way to fight that insensitivity is by including gender identity on Vermont's list of protected categories in the state's non-discrimination statutes. "If our government treated people equally, so would everybody else," Guidry insists. "But when we have to fight our own government to treat us right, that's when we have prejudice."

She says she called Governor Douglas to ask him to pass the legislation, but she got a recording that wouldn't let her leave a message.

Douglas' Press Secretary Jason Gibbs suggests that Guidry must have called the governor's main line after hours; if she had called the 800 number, he says, she would have been able to leave a comment. Gibbs insists that the governor read and responded to every message he received about the bill, though he admits that often that response consisted of a form letter.

Gibbs says the governor does not oppose protecting transgender Vermonters; rather, Douglas' concerns were specific to the "ambiguous language" of the bill. "If I were caught committing some kind of inappropriate action in, say, the women's locker room of my gym," Gibbs explains, "I could, as a reasonable defense under this law, argue that I was self-identifying as a woman at the time. It sounds silly when you say it, but there were some loopholes like this in the bill . . . We feel like if we can close those up, and make it a little bit more specific, we can make progress in that area."

Gibbs points out that Douglas has assigned a member of his staff to work on an acceptable draft of the bill, and notes that he met with representatives from the TransAction group for the first time on Tuesday, August 15.

Prior to that meeting, Kara DeLeonardis, executive director of the Burlington-based R.U.1.2? Queer Community Center, which helped TransAction orchestrate the opposition to Douglas' veto, said she felt "optimistic" about the possibility of a bill passing this term.

Regardless of what happens at the legislative level, Coralyn Guidry says she will continue to support her son. He plans to reschedule his hysterectomy, and eventually follow it with reconstructive surgery that will create a penis using skin from other parts of his body.

"Children might not turn out the way you want," Guidry observes, "but you're supposed to love them unconditionally."

She says she understands parents who grieve the previous incarnations of their children. "I miss the child I lost," she says. "It feels like a death." But ultimately, she accepts that the real struggle belongs to her son. "I'm not the one who has to live my life like that," she says. "My son is the one who has to live his life like that. Why wouldn't I want to make it easier?