What Is Benjamin's Syndrome?

Overview

Essentially, Benjamin's Syndrome is a congenital condition in which a girl is born appearing to be male (ie she has a penis), or a boy is born appearing to be female (ie he doesn't). This results in them being raised in the gender role opposite to their actual gender, leading to social and psychological distress, on top of the distress inherent in having the wrong sort of body. They must undergo painful and expensive treatment to correct their physical deformities, seldom with any help from public health services or private medical insurance.

Though the body is the most obvious distinction between the sexes, the mind is by far the most important. Whether you consider it to be a product of the structure and chemistry of the brain, or prefer a more spiritual outlook, psychological gender is a central part of human identity, and not simply a matter of physical characteristics. The type of gonads a person has is insignificant in comparison. In the vast majority of cases, physical sex and gender identity match, so it may not occur to people that they are not one and the same thing. But a little bit of thought should make it clear that that is not the case - if you woke up one morning to find your body had been magically transformed into the opposite sex, or if your mind was transferred into a robot body with no sexual characteristics of any kind, you'd still be the same person inside; you wouldn't suddenly cease to be male or female just because your body had changed. But you might be very upset at no longer having the sort of body you feel you're supposed to, and having no easy way to get it back. That is part of what people with Benjamin's Syndrome have to deal with.

The level of distress experienced by people with Benjamin's Syndrome does vary from person to person. Society's gender-related expectations are far from perfectly suited to all individuals, and not everyone would find being treated as the opposite gender to be all that terrible. People's degree of concern for their own appearance and anatomy is also highly variable - some couldn't care less what they had between their legs or how others percieved their gender. But it is perfectly normal, and probably much more common, for people to place a great deal of importance in both their own and other people's physical and social gender. It may be something they take for granted and hardly think about, but that is only an indication of how deeply rooted it is. People with Benjamin's Syndrome almost always experience growing dissatisfaction and unhappiness with both their bodies and their social gender role until they can correct them, even to the point of suicide if they feel they have no other solution to their problem.

The pain of Benjamin's Syndrome is exacerbated by society's attitude towards it. Employers, friends and especially family are often disbelieving and hostile towards people who reveal they've discovered they have Benjamin's Syndrome. Society in general does not treat people whose appearance is gender-ambiguous at all well, targeting them for verbal abuse, discrimination, and sometimes violence. This is hard enough to deal with without the loss of family support and possibly employment that often accompanies it. Though the cause of Benjamin's Syndrome is uncertain, and indeed there may be more than one cause, the most likely explanantion is some kind of hormonal irregularity during pregnancy. But whatever the cause, it is a genuine, traumatic condition that deserves understanding and compassion.

Treating Benjamin's Syndrome

The main treatment for Benjamin's Syndrome is Hormone Replacement Therapy (HRT). Begun early enough, it can eliminate virtually all the symptoms of the condition. At any stage, it is of great psychological benefit and at least some physical help. If begun after puberty, as is usually the case, other treatments may be necessary to reduce the symptoms. These may include electrolysis and voice training for women, and breast reduction for men.

Genital Reconstruction Surgery (GRS) is the other primary treatment for people with Benjamin's Syndrome. It is easier and more effective for women than for men, though it is expensive major surgery in either case. However, modern techniques are very good, and the results (for women at least) can be close to indistinguishable from the natural version. Women with Benjamin's Syndrome who have had GRS are effectively in the same position as women who've had total hysterectomies.

What Benjamin's Syndrome Isn't

People with Benjamin's Syndrome do not have to be heterosexual. Just like anyone else, they can be straight, gay/lesbian, bisexual, asexual, or whatever. This should be obvious, but for some reason many people seem to get gender identity and sexual orientation confused. Who you are and who you find attractive are completely different things, though (in English, at least) the label for orientation can depend on both. An unpleasant physical deformity certainly has nothing to do with personal taste in sexual/romantic relationships. In fact, people with Benjamin's Syndrome may be more likely than average to identify as non-heterosexual, probably because changing gender roles forces them to think about our orientation in a way most people don't, and they are brought up to think it's ok to like other people of their gender. Asexuals are also represented unusually strongly, which should not surprising for a group of people who've felt so negatively about their bodies for so long. It's also not all that uncommon for people with Benjamin's Syndrome to change their orientation (in any direction) during transition or after surgery.

Benjamin's Syndrome is also confused with cross-dressing, transvestism, and drag. Though there may occasionally be some visual similarities, on closer examination they bear very little resemblance. A man who has female genitalia and is very upset about it doesn't have much in common with a man who enjoys wearing lacy underwear or performing on stage in outragous makeup and dresses. A woman who endure hundreds of hours of painful and expensive electrolysis to remove masculine facial hair isn't much like a woman who wears men's suits and fake mustaches for fun. People with Benjamin's Syndrome are often perfectly happy in jeans and t-shirt - they don't have any particular interest in presenting as extemely masculine or feminine, as long as they can be recognised as the man or woman they are. It's even possible for Benjamin's Syndrome to coexist with an interest in cross-dressing - there are plenty of drag queens with Benjamin's Syndrome (ie men born with the wrong sexual organs who also enjoy performing in camp outfits).

Some women with Benjamin's Syndrome think they may be male cross-dressers for a time while they are first coming to terms with their condition and figuring out who they really are, because they aren't aware of any other explanation for their desire to be percieved as women, or they are scared to admit to themselves that their real situation is so much more serious. This does not mean they really are cross-dressers, or that cross-dressers can develop Benjamin's Syndrome later.

External Links

• The Harry Benjamin International Gender Dysphoria Association, Inc. - guidelines for treatment of people with Benjamin's Syndrome.
• Transsexual.Org - general information about Benjamin's Syndrome.
• The Looking Glass Society - UK based Benjamin's Syndrome site.
• Press For Change - a UK based organisation for people with Benjamin's Syndrome.
• The International Foundation for Gender Education
• It's Time, America! - US based civil rights action group.
• GenderPAC - US based anti-discrimination, anti-violence group.
• AEGIS - the American Educational Gender Information Service, Inc.
• Gianna E Israel Gender Library - articles of interest to people with Benjamin's Syndrome by a gender therapist.
• A Message In A Bottle Thrown Into The Electronic Ocean... - interesting writings on Benjamin's Syndrome.