Twisted Throwback, part 12 of 25

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“I have another question for you. What does it mean to you to be a girl?” After I’d been quietly thinking for a while, Dr. Underwood said: “I’m not your Social Studies teacher, asking you to define gender. What being a girl means to you might not have much to do with what it means to someone else. Just say what first comes to mind.”


Twisted Throwback

part 12 of 25

by Trismegistus Shandy

This story is set, with Morpheus' permission, in his Twisted universe. It's set about a generation later than "Twisted", "Twisted Pink", etc. A somewhat different version was serialized on the morpheuscabinet2 mailing list in January-April 2014.

Thanks to Morpheus, Maggie Finson, D.A.W., Johanna, and JM for beta-reading earlier drafts. Thanks to Grover, Paps Paw, and others who commented on the earlier serial.



The next morning, when I went downstairs for breakfast, Mom said: “Your father and I talked about it, and we decided you can go out with this boy Friday, if you really want to... But I wouldn’t advise it. You’re still so new to being a girl, and I’m afraid...”

“I’ll think about it today,” I said. “We forgot to exchange addresses, so I can’t talk to him until tomorrow anyway.”

Uncle Jack and I left for Atlanta before Mom or Dad left for work. It had warmed up more overnight, and there was no trace of the clouds that had covered the sky yesterday morning. Rush hour was past by the time we hit Atlanta traffic, but it was still almost eleven by the time we got there. We talked about things for a little while, and then I studied during most of the drive, but I was a little less focused on it than usual, thinking about what I might be going through today, and what I might find out.

Dr. Underwood’s office — or rather, I soon found out, the office where Dr. Underwood was meeting us — was in the town of Stone Mountain, just west of the park surrounding the mountain. In the last mile or so of the drive, we caught glimpses of the mountain in between the taller buildings. Once we got closer, we had an almost uninterrupted view of it; Uncle Jack said they zoned things so you couldn’t build anything taller than two stories east of Main Street.

“Wish we had time to go into the park,” Uncle Jack said. “We’re early, but not early enough for that. You want to park a ways away and walk to Dr. Underwood’s office?”

“Let’s park at the office, and then walk around from there. Then we’ll be able to drive straight to the Twist clinic after my appointment’s done, without walking a long way to the car.”

“Good idea.”

We found Evergreen Counseling without too much trouble, a big brick mid twenty-first century house that had been turned into offices some time ago. Uncle Jack’s beat-up old hovercar looked out of place among the fancy new cars parked in that neighborhood. We walked around for a while, over to Main Street and down it for a short distance, then back along another couple of side streets to the one the office was on.

“That’s three streets I’ve never walked on before,” Uncle Jack said with satisfaction as we walked up the porch steps to the office door. “I’ve been in Stone Mountain a few times, but haven’t explored it anywhere near as thoroughly as Trittsville or Spiral or some other places.”

We signed in with fifteen minutes to go until my official appointment time. I barely had time to bring up my calculus textbook on my tablet and read a couple of paragraphs before the secretary called out: “Emily Harper? Dr. Underwood is ready to see you.”

I got up and walked toward the door; Uncle Jack remained sitting. “Good luck,” he said.

The secretary showed me to a room furnished more like a den than an office; there were a couple of straight-backed chairs, two easy chairs, and a sofa, along with bookshelves and several framed paintings, but no desk or filing cabinets, no diplomas or certifications or awards on the walls. A man sat in one of the straight-backed chairs; he rose as I entered. He looked older than Grandpa or Uncle Greg, and was bald except for a few tufts of gray hair behind his ears.

“Good morning — it’s Emily, right? I’m Dr. Thomas Underwood — you can call me Tom, or Doc.”

“Hi.” I looked around. “Do you want me to lie down on the sofa?” It didn’t look like a prototypical psychoanalyst’s couch, more like an ordinary sofa.

“If you like. Or you can take any other chair. I need this one,” pointing to the chair he’d just gotten up from; “my back complains if I sit on something that soft for too long.” He sat back down and I took the easy chair nearest his.

“Let me tell you a little bit about myself, and then you can tell me about yourself,” he said. “I was born with a female body, and started transitioning in my late teens. I studied psychology, and worked as a clinical psychologist specializing in gender dysphoria for a little over forty years. I worked with a few Twisted who were having trouble adjusting to their changed bodies, but mostly with ordinary people with some form of gender dysphoria. I retired about fifteen years ago, but I still meet occasionally with a few of my old patients, and a few days ago I got a call from Dr. Oldstadt at the Twist clinic.”

“About me.”

“Yes. Dr. Oldstadt told me a few things, but why don’t you tell me in your own words?”

I told him about my Twist, what I’d been doing when it happened and how I’d felt so uncomfortable and weird until I finally realized I was supposed to be a girl.

“So do you think you can help me? I mean, I know you’re a psychologist and not a surgeon, but can you get somebody who did this kind of surgery to come out of retirement too, or get some young doctor to do something he’s never done before?”

“I’m sure we can work that out one way or another, if you should decide to go that route,” he said. “Doctors do experimental procedures all the time; reviving old, well-documented techniques should be a lot easier. There are some other things we should talk about first, though. Before your Twist, did you ever feel any dissatisfaction or discomfort with being called a boy, or treated as a boy?”

“No.”

“Or with your male body?”

“No, not until my Twist.”

“Or feel any inclination to wear feminine clothes?”

“No.”

“And it was about two days between your Twist, and your decision to think of yourself as a girl?”

“Yeah. It was when Dr. Oldstadt and Dr. Wentworth showed me those pictures and asked me why I liked them. I realized I liked this fancy blue dress the lady in that old painting was wearing, and wished I could wear something like that — and then I realized why I didn’t like to see myself naked, and why I didn’t like having a goatee, and why I didn’t like the name ‘Cyrus’. It was because all this boy stuff was wrong for me now; I’m a girl.”

Dr. Underwood looked thoughtful. “Was it immediately after that that you began presenting as a girl? I mean, wearing feminine clothes and prosthetic breasts and using the name ‘Emily.’”

“I know what ‘presenting’ means. Yeah, it was just a couple of hours later — we went out to lunch, and then we went shopping for clothes. Me and Mom and Mildred and Uncle Jack. Mom and Mildred helped me pick this stuff out,” gesturing at the skirt and blouse I was wearing. “And I wasn’t sure at first what girl name to use — Mom and I talked about different names, and I tried out ‘Amy’ for a while, but by Friday morning I’d decided on ‘Emily’.”

He nodded. “You’re presenting very well for someone who’s only just realized their previously assigned gender identity doesn’t fit.”

“Thanks... but it’s mostly due to my trick.” I told him about how it had kicked in when I first tried on girl clothes, and the testing and practicing I’d done since then. “I don’t really have any conscious control over it, at least not yet. People tell me I look like a natural-born girl, unless they look at me in a mirror, but I don’t look right to myself.”

“That is a useful trick — I suppose the limitations must be frustrating to you, but I would have considered it a Godsend when I first started presenting as a man. I’ve dealt with a few Twisted in my career, but never I think with a trick like yours.” He was silent for a few moments, and I wondered if I should say something, but before I could think of anything definite he asked:

“So, tell me more about how you’ve been presenting since your discovery. What all have you been wearing?”

“Blouses and skirts every day except Sunday, when I wore a dress. And Saturday evening, I was helping Dad and Uncle Jack work on the attic insulation, and I wore jeans and a T-shirt — but they were girly jeans,” I added anxiously, “with little hearts embroidered on the pockets. Oh, and in gym I wore a halter top and shorts. Both of them pastel green.”

“And you’ve been asking people to call you Emily?”

“Yeah. We filed papers to legally change my name, but it’s not final yet. Emily Ursula Harper. Ursula’s my grandma’s name, my mom’s mother.”

“How are other people treating you?”

“My family’s been great about it. They’re mostly Twisted, and they’re used to people changing in strange ways, even though I’m the first person in the family to change gender. People at school, well — my friends were kind of weirded out by it, but they’re still good to me. And I’ve made a couple of new friends, girls, who are helping me adjust. A few people have made snarky comments about me, but only one or two have insulted me to my face — not like poor Mildred...”

“Your sister, right?”

“Yeah. Did Dr. Oldstadt tell you about her? She Twisted right after me — less than twenty-four hours later. And she looks kind of like a snake or lizard — more like a snake, except she still has arms and legs. The kids at the middle school are being really mean to her.”

“How old is she?”

“She just turned fourteen last month — she’s about three years younger than me.”

“Are you especially close to her?”

“...Yeah. Even more now than before, but I think we were closer than most siblings three years apart even before our Twists.”

He asked me some more questions about my family and friends, and then I remembered something else I hadn’t told him yet. “Oh. And, a guy asked me out on a date yesterday — I told him yes, and then I backpedaled and said I wasn’t sure if my parents would be okay with it, and I’d check with them and tell him later.”

“And what did they say?”

“They said it was okay but they didn’t think it was a good idea.”

“Do you think it’s a good idea?”

“I’m not sure. I don’t know him real well, but he seems like a nice guy, and —” I blushed. “He’s really hot. And he’s bi, so I think he’ll probably be okay with me being trans, but I’m not sure — he probably already knows, but I want to make sure... And then, if we do go out, I’m not sure how far I want to take it. Not very far, 'cause I don’t think my trick will hold up if we do any more than hold hands and maybe kiss — if he puts his hands on my breasts he’ll be able to tell they’re bags of birdseed...”

“There are more realistic breast prostheses available, though they’re harder to find and more expensive than they were before we started preventing gender dysphoria and breast cancer prenatally. Still, your parents are probably right to advise caution. You might wish to get to know this young man better in mixed social settings before being alone with him.”

“That’s probably a good idea.”

“Let me ask a couple more questions. You said you find this boy attractive — were you ever attracted to boys before your Twist?”

“No.”

“To girls, then? How strongly?”

“Pretty much like any straight teenage boy... I dated a girl, Laura Weller, for about a year, and we were — intimate, a few times.” Maybe more than a few, depending on how you define “intimate” and where you draw the line between “few” and “lots.”

“And have you felt attraction toward girls since your Twist?”

“Not much, anyway — not that I can tell. Did Dr. Oldstadt send you the results of that test he did? When he showed me pictures of people and saw how my brain reacted to them?”

“Yes, but I’d like to hear about how you are experiencing things in your own words.”

“Well, I haven’t really been turned on by girls. During gym the last couple of days, I was looking at the hot guys, not the girls like I would have before.”

“How do you feel about this?”

“...Um, excited and scared, I guess? I mean, I’m a girl and it’s typical for girls to be attracted to guys, that’s not unusual, but — but if I get too close to a guy, before I get my body fixed, it would be — without my clothes and fake breasts and stuff I’d look like a guy. I think I’d be too disgusted with my own body to be interested in his, even if he were bi and liked me either way.”

“Hmm. You said you’ve only worn pants once since your Twist?”

“No, I wore pants for the first couple of days after. I mean I haven’t worn pants but once since I figured out I’m a girl.”

“Oh, yes, right. Skirts and blouses, or a dress, then, except when exercising or doing chores?”

“That’s right.”

“What about at night?”

“I have a really pretty nightgown, with lace at the sleeves and hem...”

He smiled indulgently. I realized suddenly that for him it must have been the other way around, for however long it took him to get sorted out — maybe his parents gave him nightgowns like that to wear and he hated it, but couldn’t figure out why at first?

“I have another question for you. What does it mean to you to be a girl?”

That flummoxed me. Ever since I consciously realized why I was interested in that painting — that I wanted a dress like that for myself, that I wanted to be the kind of person who would look good in that dress — I’d thought of myself as a girl, or at least as partially a girl. But I hadn’t consciously thought out what that meant, in all its ramifications. The first several answers that came to mind all seemed flimsy and inadequate or outright wrong.

After I’d been quietly thinking for a while, Dr. Underwood said: “I’m not your Social Studies teacher, asking you to define gender. What being a girl means to you might not have much to do with what it means to someone else. Just say what first comes to mind.”

“Okay,” I said reluctantly. “I couldn’t think of anything that’s true about all girls. The obvious, um, biological things have exceptions like me, and — and, well, all the other stuff I’ve thought of —”

“What it means to you, remember.”

“Okay. Um, so the kind of girl I’d like to be wears things like this,” fingering the sleeve of my blouse, “and listens to people, and pays attention — she knows what to say to make sad people feel better.” I was thinking mainly of Mildred there. “And she’s kind and gentle, and she cares about doing a good job at whatever she’s working on but not about outdoing other people. And — and she’s not a showoff, or vain, but she doesn’t mind when people take photos of her or see her in a mirror. And she doesn’t feel vaguely guilty when people say she looks nice, like she’s deceiving them. And,” my voice broke and it was several seconds before I could say anything more, “and she’s comfortable with her body, she doesn’t shudder with disgust every time she has to shower or change clothes or use the bathroom...” I was crying now, and Dr. Underwood handed me a box of tissues from the little table next to his chair.

He waited patiently until I stopped crying. Then he said: “I have high hopes that you can be that girl, though it will take time and work.”

“So you think we can get my body fixed, even though the people who used to do it are all retired?”

“Very likely, yes. But there are a couple of things I’d like to talk about before we discuss how to proceed with that.

“Your case is unusual; I’m not sure how much my previous experience will apply here. Certainly you resemble a person with gender dysphoria in many respects, but... Your being Twisted may complicate matters. Dr. Wentworth at the Twist clinic sent me your brain scans and her analysis of them, along with some blood test results that you may not have heard yet. There is essentially no change in your genome since before your Twist. Specifically, there are none of the genes that are found in people with various kinds of gender dysphoria. But your brain is, if anything, even more typically female in structure than that of an untreated male-to-female transsexual. Dr. Wentworth’s latest analysis even suggests that you have the nerve structures that would, in a genetic woman’s brain, be used to control the vaginal muscles.”

“What does that mean?”

“I have no idea. Your Twist specialists and I have searched the literature and found no case quite like yours. There are many Twisted who have physically changed sex; in many though not all cases, their gender identity changed to match, but most of them did not experience such a total change in sexual orientation as you seem to have — most retained their original orientation, or became bisexual, but predominantly attracted to the same kind of people as before. And there have been several varieties of gender dysphoria identified, associated with different genes, different ages at which a person first experiences dissatisfaction with their assigned gender, different degrees and kinds of dissatisfaction with one’s assigned gender, different sexual orientations, different brain structures... But you don’t quite match any of them.

“Still, you are clearly experiencing severe distress at having a male body. And you have already taken the initiative to begin living as a girl full-time. I’m going to go ahead and refer you to an endocrinologist — not to begin full hormone replacement therapy just yet, but to get tested for conditions that might make hormone replacement problematic, and to start an appropriate dose of certain drugs to prevent male puberty from continuing while we decide what else to do.”

“I already know what I want to do.”

“I know. Believe me, I sympathize; by the time I got to this stage in my own transition — presenting as a boy, telling my family I wanted to be called ‘Thomas’ and treated as a boy — I was sure I knew what I wanted and when. And if my psychologist had had a time machine to talk to my future self and make sure I still felt the same way ten or twenty or seventy years later, she could have started full hormone replacement therapy right away. Most of the gender-dysphoric patients I’ve treated over the years were as sure and as stubborn about what they wanted as I was, or you apparently are... But over the years I’ve seen a few patients who changed their mind after a few weeks or months of living in their desired gender, or even later, after being on hormone replacement therapy long enough to experience irreversible effects. I want to be cautious here, especially since your situation is not quite like any other I’ve ever dealt with.”

“My being Twisted makes it less likely I’ll change my mind about this. Maybe impossible. Ask Dr. Oldstadt.”

“I’ll be talking with him, and Dr. Wentworth, and your endocrinologist regularly. I think it’s possible that with your unique situation, we can cut short the three months of real life test that we used to require before beginning full hormone replacement therapy, or the year we required before surgery. But you’ve only been living as a girl for a week, yet. I know it’s difficult, but please, try to be patient.”

“I’ll try.”

“I’d like to talk to your uncle as well... Do you live with him? Is he your guardian?”

“No, he’s just taking me to my appointments today because his work is flexible and Mom and Dad’s isn’t. They both took days off work last week because of mine and Mildred’s Twists, and they had several sick days last month.”

“Well, I’d like to talk to him anyway. And I want to meet your parents as well, before we begin hormone replacement therapy.”

A minute later the secretary showed Uncle Jack in. Dr. Underwood — Tom — introduced himself, and Uncle Jack said: “I’m Jack Harper, Emily’s uncle.”

“Your niece is a very courageous young woman,” Dr. Underwood said, which made me blush.

“We’re all really proud of her,” Uncle Jack said, which made the blush worse.

“I’d like to talk to you briefly about what we’ve decided so far,” Dr. Underwood said, and he told Uncle Jack about starting me on hormone blockers right away but waiting a while on the other stuff. “I’ll be sending a message to Emily’s parents with these recommendations, and a list of endocrinologists in north Georgia who can handle Emily’s treatment. I don’t know if there’s one in Trittsville, but you can probably find one closer than Atlanta. And I would like to meet Emily’s parents — I know it may be difficult for them to take a day off work to come, but my own schedule is flexible now that I’m retired, so if they would prefer to come on Saturday or Sunday, or whatever day they have off, I can work with them. I would offer to meet them halfway, but I’m afraid I can’t drive anymore, and a journey of an hour or more on public transit wears me out — I rarely go farther from home than this nowadays.”

Uncle Jack looked pained, and I could figure out why: he was sympathizing with Dr. Underwood’s limited mobility, and worrying that his own Twist-compulsion to travel would outlive his good health. “I’m sorry to hear that,” he said. “I’ll tell Oswald and Kate what you’ve said, though I guess it will be redundant with the message you’re sending them... Thanks for taking good care of our Emily. When do you want to see her again?”

“Weekly would be ideal, but I understand if that may be difficult to arrange, given the distance involved. I’d like to try to meet at least every other week.”

“Hmm... I’d talk to the secretary and make an appointment now, but I guess Oswald and Kate will want to arrange it so one or both of them can come next time.”

“That will be fine. Have either of you any more questions for me?”

I remembered something he’d said earlier. I was embarrassed to ask him what I wanted to know in front of Uncle Jack, but it seemed too trivial to ask Uncle Jack to leave again, so I swallowed my embarrassment and said: “Um, you said I could get better fake breasts than the bags of birdseed Mom used... where would I buy them?”

“I’m not sure,” he said. “It’s been a long time since any of my patients needed them, and some of the companies that used to make them have gone out of business or stopped making them... I’ll look up my old records and send you a list, though.”

“Thanks.”

“Good day.”

As we walked out to the car, Uncle Jack asked me: “What did you think of him?”

“He knows what he’s talking about, I think. And he seems like a good man. I’m a little frustrated that he’s not starting me on hormones right away, but he said he might do it sooner than three months, so that’s better than I expected.” I didn’t tell him that Dr. Underwood was trans; I wasn’t sure it was public knowledge.



If you've enjoyed this and the other free stories I've posted here, you may also enjoy these novels and short fiction collection -- available from Smashwords in ePub format and from Amazon in Kindle format.

Wine Can't be Pressed into Grapes Smashwords Amazon
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A Notional Treason Smashwords Amazon
The Weight of Silence and Other Stories Smashwords Amazon
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Comments

dealing with a gatekeeper

its frustrating to have to be patient, but hopefully, it will work out.

DogSig.png

gatekeeper?

I wasn't getting the impression that Dr. Underwood was behaving in any way like the typical gatekeeper shrink. As a transman himself he's just well aware of the more usual cases.

Of course, as a Twisted, Emily is entirely unusual.

I do need to nitpick a little though, in many countries, including parts of the US, we're already moving towards having the hormones under an informed consent model and there are rumblings in certain places about trying to move at least some of the surgeries to that model as well. This doctor is talking as though WPATH remained the standard all the way up to when they started to prevent gender dysphoria prenatally.

Abigail Drew.

informed consent

I do realize it's not valid if we were writing any kind of research paper, but wiki is still a useful place to start: https://en.wikipedia.org/wiki/Informed_consent

The above gives a general description of what the informed consent model actually is, though in general terms, not specifically applied to HRT or transgender surgeries.

This page talks about what it means specifically to HRT as of right now: http://transhealth.ucsf.edu/trans?page=protocol-hormone-ready

As for the rumblings about applying it to any of the surgeries, that's still just rumblings and there are no real clear references I could point you to for that. I kind of doubt that'll ever actually happen, though I would rather like to be pleasantly surprised about it and certainly wouldn't argue with a piece of fiction set in the future in which it happened, since, due to there BEING rumblings about it, it COULD happen... just very low probability.

Abigail Drew.

It's a first step for Emily.

It's a first step for Emily. It looks like a small one, but it is really a big one.