Excerpt from Trapped published by Xlibris.

TRAPPED DANIEL C. MERRILL MD Introduction Dr Donald W. Hastings was Professor and Chairman of the Psychiatric Department at the University of Minnesota Health Sciences Center when the transsexual program began in 1966. This world renowned psychiatrist had spent much of his professional life studying gender identification problems and had become convinced that, irrespective of its cause, which remains unknown to this day, people with transsexualism could not be treated successfully with medication or any form of psychological or psychiatric therapy. He ultimately came to the conclusion that the best, and indeed the only, option for people afflicted with this kind of gender disorder was to grant their wishes and, by surgery, transform them into members of the opposite sex. At the time, these sex-reassignment surgical procedures were called sex-change operations by the lay press. The majority of transsexuals are men who believe they are females who somehow became trapped in a male's body. A few, about one in seven, are females who consider themselves to be males. I do not recall having been involved in any female to male sex-change operations during my tenure at the University from 1996 to 1973. However, my mentor Professor Colin Markland, who led the surgical team that performed the sex-change operations, informs me that he carried out four or five female to male procedures before the program was discontinued in the mid-1970's. Although it doesn't seem so today, the sex-change operations Dr Hastings purposed were considered to be extremely radical in the 1960's. A handful had been performed in Europe over the previous 20 or 30 years, but the operation had been outlawed in most of the civilized world. I doubt that he would have been able to get his research program approved in the culturally conservation state of Minnesota if it were not for the high esteem Dr Hastings was held in the medical community. In those days, there was a significant fear that transsexualism might be some type of temporary mental aberration and many of those who were skeptical of sex-reassignment surgery worried that a transsexual might change his mind after surgery, which was irreversible, and regret having undergone the procedure. Dr Hastings was not one them, since his extensive experience treating patients with gender disorders led him to the opposite conclusion. His experience, to the contrary, suggested that once an child or adult thought they were a male or a female, they never changed their minds. Furthermore, there was nothing he, or anyone else, could do to alter the way they viewed themselves, with respect to their sexual identity. Nonetheless, possibly in part to placate his critics as well as to assure that he didn't make a mistake, Dr Hastings set up an comprehensive program to evaluate prospective candidates for sex-change surgery. Patients who were candidates for sex-reassignment surgery had to be referred to him by someone in the psychiatric community before they were accepted into his research program at the University. Thus, prospective candidates for sex-reassignment surgery had been studied extensively before they walked through the front doors of the University hospital. Once considered a candidate for surgery he, or she, was admitted to the psychiatric ward where they underwent an extensive one month period of observation by a special team of doctors and nurses whose sole purpose was to determine if the candidate was a true transsexual. One can only imagine the chicanery these males were subjected to by the sexy and cunning nurses Dr Hastings had recruited to help him unearth unworthy candidates for his transsexual program. Apparently, one glance at the long legs of one of his attractive nurses was enough to send you packing. As we will see as the this novel unfolds, a person could be rejected as a candidate for surgery simply because an evaluator felt that something just didn't feel right about the situation. Dr. Hastings was taking no chances, his reputation and, indeed, the reputation of the University, depended on him making the right choices every time, no if ands or buts about it. Dr. Donald Creevy, a world renowned figure in Urology and a man in his late 60s, was Professor and Chairman of the Division of Urology at the University in 1966 when his staff performed the second sex-change operation in the United States. Dr. Hastings, a man of the same age, was one of his best friends and closest confidants. I knew Dr Creevy to be an extremely conservative individual and one can only speculate as to his reaction to Dr Hastings's request that the Urologists on his staff perform the mutilating procedures inherent in the sex-change operations. In the end, however, he agreed to allow the members of his staff perform the procedures. Dr Creevy was at the end of his long and distinguished surgical career at the time and no longer performed open surgical procedures, confining himself primarily to transurethral resections of the prostate, a procedure he had pioneered years before. He delegated the performance of the sex-change operations to his junior partner Colin Markland an Englishman who had immigrated to the United States several years before. Dr. Markland, who is now in his early 80s, tells me that Dr. Creevy had no interest in transsexuals or, more to the point, sex-change operations. In 1966 Dr Markland was rapidly establishing himself as a leading American Urologic Surgeon. As I recall, he had more innovative ideas each day than most stray dogs have flees. I can safely say, now some 46 years later, that Dr Markland could hardly wait to sink his teeth into the challenges inherent in the surgical transformation of a man into a woman. I came to the University as a first year resident in Urology in 1966. I was a third assistant in Shalimar's surgery in the fall of that year. It was one of the most exiting days of my young life. Six years later, as a junior member of the University's Urology staff, I was performing the procedures myself with the assistance of our residents and under the ever watchful eye of my mentor Dr. Markland. I have selected three of the fifteen or so transsexuals I met and cared for at the University as the main characters of this novel. These people were real and I have made every attempt to portray them as accurately as possible. Unfortunately, at this point in time, all these years later, I do not recall, with the exception of the Cuban dancer Shalimar's stage name, their actual names. I never did know much about their lives before, or for that matter after surgery, with the exception of one person, the truck driver. This person, and her husband, subsequently moved to California in the 1980's and I met her again when she resurfaced at the Martinez Veterans Administration Medical Center Hospital in Martinez California where I spent the last years of my career as Chief of Urology. I selected these three individuals because I felt that they each had a unique story to tell with respect to their lives as transsexuals before, and in one instance, after sex-reassignment surgery. Hopefully, the lives I created for these people reflects what they endured to become normal in the way that each of us considers ourselves to be either a normal male or a female. Finally, my experience strongly supports the hypothesis that Dr. Hastings championed nearly 50 years ago, once a transsexual always a transsexual. He was right, it's futile to try to talk them out of it!