On Losing a Friend (Who Happened to Be Trans)

Today is Transgender Day of Remembrance. In honor of the day, I am reproducing here a memorial I wrote on November 4 of this year.

My friend and colleague Kiira Triea died two days ago. Several people have asked me to provide an obituary that they can share, so I am trying. I find I have begun by turning on far more lights than the morning daylight really requires.

Kiira probably would have approved of me summing up her extraordinary life this way: Science repeatedly nearly killed Kiira, and art constantly sustained her. Kiira had two public lives, which only occasionally overlapped. In one, she was an advocate for children and adults who were intersex and transgender. In the other, she was an extraordinarily talented musician, songwriter, and poet.

This double public life grew out of her own childhood experiences. Kiira’s mother was given a form of progestin when pregnant with Kiira, in the 1950s, in an effort to prevent miscarriage. Kiira was a genetic female, and the progestin caused her genitals to virilize during fetal development. When she was born, the adults presumed her to be a boy. From the start, this child was a very femme boy. Looking back, Kiira would often say to me, “Everyone knew I was a gay boy,” meaning she was one of those boys who was irrepressibly feminine--the kind of boy everyone assumes will grow up to be gay. She sometimes laughed to me about how boy crazy she’d always been.

Kiira’s father was in the military, and as a consequence her childhood was constantly disrupted by the family moving. When she reflected on this with me, she did so with her typical nuance. She knew that it kept her from being able to form friendships, and at the same time, it seemed she felt the moves matched the sort of placelessness she often felt by virtue of being what her biology made her.

When Kiira was fourteen, she landed in the gender clinic of the psychologist John Money at Johns Hopkins University, the place we came to call “the Death Star.” As Kiira wrote for the public just a few weeks before her diagnosis of stage-4 cancer:

“Money himself wrote in a study with Anke Ehrhardt that, although progestin-exposed females might show some tomboyish traits, they seemed to outgrow these and showed no increased inclination toward attraction to females and no increased desire to be boys. So according to Money and Earhardt, progestin-virilized females like me were what they thought of as pretty typical females. Yet still, when I ended up in his clinic, Money tried to surgically and hormonally assign me as a male and, to my knowledge, he did the same to two other female adolescents with histories parallel to mine. His methodology was unethical not only because this course of treatment was obviously harmful to me, but also because I know now that he told me several deliberate lies.”

At the time Money got his hands on Kiira, Money was deep into public insistence that gender was mostly about nurture. Kiira represented one of those problematic cases that suggested otherwise. Rather than change his science for the data Kiira’s gender identity represented, he tried to change Kiira to save his “science.” Eventually he gave up and “let” her present to the world as a girl.

Early in the intersex rights movement, Cheryl Chase (Bo Laurent) asked Kiira what it was like in Money’s clinic, which was known as the Psychohormonal Research Unit (PRU). Kiira later gave me a copy of the letter. There she wrote:

“The hardest question you’ve asked me though is what it was like being Dr. Money’s patient. I think I am so confused and twisted by my experience at the PRU that I’m not ready or proficient to say anything sensible. He seemed so understanding at times, this powerful man who seemed like he wanted to help, and then the same day something would happen to me at the PRU which he ran which would humiliate and embarrass me so much I can barely think clearly of it. All I could say for certain is that something was wrong there, something I’m not sure what, was wrong with him. The PRU was an unhealthy place, a place with some kind of sickness as part of its nature.”

Kiira helped Chase/Laurent and others (including Max Beck, also lost to cancer) in the creation of what we now call the intersex rights movement. In essays like her masterful autobiographical piece, “Power, Orgasm, and the Psychohormonal Research Unit,” Kiira tried again and again to explain to people that the problem with the way people like her was treated was not ultimately a wrong theory of gender; it was a wrong theory of what it means to care for a child.

She used her own experiences to try to illustrate what Chase/Laurent meant when she said that intersex is primarily about shame, secrecy, and trauma, not gender. She tried so hard to explain that it didn’t have to be about any of that. In her most recent essay, Kiira reiterated this point:

“Being raised as a boy, even though I was a normal girl, wasn't a very good thing to happen to me, but I know now that it didn't hurt me so badly that I could not be happy and normal and sexual, had my disorder of sex development (DSD) been treated sensibly. It was the nature of being ‘treated’ at the PRU for being a normal girl who was raised as a boy which hurt me.”

Although so much of her public writing was necessarily deadly serious in tone, Kiira had a wicked sense of humor. Two examples stand out: the phall-o-meter and the “rare interview” with “Dr. Arika Aiert,” to insiders an obvious send-up of Anke Ehrhardt. That “interview” began:

Interviewer: What causes sex?

Dr. Aiert: Well, soft pink lighting, a glass of wine, “If You Don’t Know Me By Now” on the CD, and a nice butch friend who doesn’t think I’m a Feminist Traitor because I wear dresses and heels. That usually does it. ‘Course, that’s just me.

Interviewer: Oops… I meant what determines sex?

Dr. Aiert: Oh! Surgeons determine sex.

Interviewer: In what way?

Dr. Aiert: Well, let me try and explain it to you with an analogy. It’s kind of like fishing. When a doctor “hooks a big one,” so to speak, he keeps it as a good “viable” fish. But if he hooks a little one, he doesn’t throw it back, he makes it into a girl fish. Surgeons feel that fish with small penises will be very unhappy, but if they are just girls, then it doesn’t matter so everything will be OK. So, being a girl fish is not as great as being one of the “real guy fish,” but it sure beats being such a miserable creature as a “guy fish with a little weeny.”

But Kiira’s humor masked her pain. What had happened to her at the PRU left her with profound mental illness. She spent many years with drug addiction and often found herself surrounded with only remnants of intense relationships. During the darkest years, when she had essentially been ejected from the ISNA crowd, I did not know Kiira, except by virtue of asking if I could reprint her PRU essay in Intersex in the Age of Ethics. It was not until 2006 that we met again and became close friends.

That was the year that I started to investigate what had really happened in the controversy surrounding Michael Bailey’s book, The Man Who Would Be Queen. I don’t have the energy today to explain all that in depth; you can always read the article that resulted. Suffice is to say that when I started looking into the controversy over transsexualism made nuclear by the critics of Bailey’s book, I was surprised to find that Kiira was in the middle of the fire. She had helped to found a website called transkids.us, a website that defended the vision of male-to-female transsexualism put forth by Bailey.

Bailey and Kiira subscribed (as I now do) to Ray Blanchard’s understanding that male-to-female transsexuals come in two basic types, divisible by sexual orientation. Kiira (like Bailey, Blanchard, and I) fully respected both routes to MtF transsexualism, but she saw them as fundamentally different. The “transkids” were the ones who, like Kiira, had been ultra-femme androphilic boys, before becoming women. Kiira always felt that, whether or not a transkid could point to a DSD etiology as clearly as she herself could, they all shared in common a brain that had been feminized in utero.

For the sin of supporting Bailey and Blanchard’s work, Kiira was assaulted by the transgender “activist” Andrea James, as was I. There are many things for which I am perversely grateful to James, but surely I am most grateful for the way James’ venom made Kiira my sister.

Kiira and I ended up becoming fast friends, talking and writing frequently, although sometimes with long gaps as life sent us in various directions. But from 2006 forward, we were always collaborating in spirit. She co-wrote (for a special issue of Perspectives in Biology and Medicine that Paul Vasey edited with me) an article with Mike called “What Many Transgender Activists Don’t Want You to Know, and Why You Should Know it Anyway.” Like Mike, Kiira never hated transgender women who were autogynephilic, the way certain activists would claim. But neither did she have any patience for those who would pretend to have had a childhood like hers and the other transkids, many of whom as children had been beaten senseless, literally or metaphorically, for being identified as queer so young.

When I started working on prenatal dexamethasone for CAH in early 2010, Kiira became one of my psychological lifelines. She always took dex personally, because of how her life had come to be. In fact, she never revealed (except implicitly to me) how the way the dex story played out caused her enormous psychological distress. She knew that, in the work, I was actively fighting Heino Meyer-Bahlburg of Columbia University, as she had fought Heino before. She knew--because I told her--that Heino had told me once that Kiira wasn’t “really” intersex because she was “just” progestin-virilized. (I guess his logic was that because doctors had caused her intersex, it somehow wasn’t real.) She also knew that Heino had been downplaying Blanchard’s findings on transsexualism, perhaps out of fear of people like James. And of course there was Heino’s previous relationships with Ehrhardt and Money. Dex was an insider battle at a level only Kiira and a few others could really understand. It was our unfinished business, and we knew that as soon as we knew of it.

The dex battle forced Kiira to examine her own life experiences as she never had done before, because she wanted to try to explain to the parents considering dex today just what they might really be doing to their children. When I told her I wanted to publish a series of “dex diaries,” Kiira quickly volunteered to write the first one. There she confessed,

“Beyond the obvious harmful sequelae of my pre-birth exposure to a drug which turned my life upside down, I sometimes suffer from a strange, haunting confusion. Because my ‘self’ was changed without my participation before I even developed a ‘self’, I have a sense of profound violation, as though I was not born, but rather, ‘made’ and then ‘treated’ for my ‘making’ without regard to my humanity.

“I frequently relate to characters like Rachel in the movie ‘Bladerunner’, who is a ‘replicant’ who cannot be differentiated from a ‘real’ human. I wonder if there is an alternative universe where a different Kiira lives whose life had not been messed with in the way mine was. I wonder what she is like.

“I very much wish I lived in that universe instead, because I do not believe that suffering builds character, but rather, simply reveals it.”

In the course of her adult life, Kiira’s character was revealed again and again. She often put those revelations into music and poetry. Kiira played electric guitar and bass, professionally mostly in metal bands. That fact always made me and her bandmates laugh, because she was not the sort of person you’d look at and say “heavy metal rocker.” In fact, Kiira loved any good music, but I think metal captured her anger and hope. As I was set to debate Heino at IASR in Los Angeles in 2011, Kiira and her bandmates recorded a version of Phil Collins’ “In the Air Tonight” that exactly captured the terror and anger we both felt. I must have listened to it a thousand times, especially the part we both knew was about the way she felt toward Money and Heino:

Well, if you told me you were drowning,

I would not lend a hand

I’ve seen your face before, my friend,

but I don’t know if you know who I am.

Well I was there

and I saw what you did,

saw it with my own two eyes.

So you can wipe off that grin.

I know where you’ve been.

It’s all been a pack of lies.

How many times did we talk about the “pack of lies,” Kiira?

When dex nearly killed me, Kiira stayed by my side. I sometimes tried to nudge her away, because I was afraid dex was poisoning her. That sense became more real when she kept telling me she felt she had a terrible sickness inside, a wasting, a pain. I kept trying to figure out a way to get her to a real doctor, but with her history, there were only a couple she trusted, and they were hard to get in to see. A couple of months before they finally made the terrible diagnosis of cancer all through her body, she wrote and recorded a new song, “Kali’s Day,” a song she told me was about her and progestin, and simultaneously about me and dex. I’m crying too hard to explain that whole song. I’ll just say here that the refrain is this:

Is this the end of the story finally coming?

Is this the end of the story, finally?

It’s the longest way to the shortest ending.

It’s the longest way to the shortest ending.

When Kiira’s sister called me and told me terminal cancer, a few weeks to live, it was hard not to realize that Kiira must have sensed this when she recorded that song.

What more is there really to say? She was angry at the diagnosis. Angrier still when the hospital discharged her for lack of insurance. Still somewhat angry when she landed in a decent hospice, because she wasn’t ready for a short ending. There was so much left to do. She had been writing her own story. . . .

I asked a colleague and friend a year or so ago to go meet and talk with Kiira in Baltimore, where she was living. The colleague-friend called me up afterwards, stunned, asking me if I understood the kind of poverty Kiira was living in. Yes, I said. Sometimes just barely off the street. I knew that Kiira could have lived on social security disability, but she opted instead to remain a working person as much as she could, working sometimes in a hardware store, sometimes in repairing amps and guitars. My mate and I often sent her money. When a bicycle a friend had made for her was stolen last year, we sent her money for a new bicycle so she could still have a way to get around. (I learned then that she had once as a young woman been a leg model, her legs were so long, which is why her friend had made her a bicycle specially. We laughed when she told me of modeling Hanes pantyhose.) When she decided last year to go back to school to try to become a nurse, we sent her rent and tuition. She never asked, but I could tell in her voice when she didn’t have enough heat or food.

Somehow, in spite of having nothing much of the time, Kiira managed to give many people (and many cats) shelter and love, and helped many get access to the medical care they needed. This included many transwomen whom she walked through transition. The most recent one was a transkid who is just now 16, and just had surgery. I’ll call her Tina here. Tina had somehow figured out Kiira lived near her, in Baltimore, and had dragged her mother to a poetry reading, and introduced herself. Kiira took Tina under her wing and made it all okay. I asked Kiira, when I called her at the hospital, if Tina had come to visit, and had asked her whether she’d told Tina her real diagnosis. Kiira said she’d visited, and she looked absolute radiant since her transition, but that no, she hadn’t told her young friend she was dying. She said she wanted to spare the kid.

I yelled at Kiira. “Of all people to withhold medical reality from a 16-year-old, you?!” She laughed at herself, and promised me she would tell Tina. The next time we talked, she told me she had.

Pretty quickly, it became impossible for me to reach Kiira. Her brain was infected with cancer, her body spent. I talked to her sister instead. The last few calls with Kiira lasted only a couple of minutes each. I know because I would look at my phone afterwards to see the length of the call, to tell myself, “Well, I had two more minutes with her.” The last long call, a 22-minute call, was weeks and weeks ago now. She still had enough strength then to talk a while, and she was telling me about how Tina was number twenty: she was the twentieth transwoman Kiira had helped through transition. I asked her to name each for me, and she went backwards, starting with Tina. She made it up to about eight names, but paused to tell me about each, so that she sapped her strength and then had to stop.

It is impossible for me to believe any have forgotten her.

“I do not believe that suffering builds character, but rather, simply reveals it.”

Goodbye, my sister. I can’t bring myself to listen to your music anymore, so I will listen today to the song we always said was the song that understood: Paul Simon’s “American Tune.” You try to get some rest.