Brian, Connie, and Madison answer questions from the moderators and audience. Photo by Kay Richter.

The definition of the word transgender does not include sexuality, Keith Wichinski, a local health care provider, told a group of 20 at the Landa Branch Library Monday evening. “It’s who you go to bed as,” he said, “not who you go to bed with.”

“Come Out to the San Antonio Public Library” is a series of panels and discussions to raise awareness and increase understanding during the month of June, Lesbian Gay Bisexual and Transgender Pride Month.

The event, titled “Break Out” dealt with the transgender “coming out” process and touched on the impact of outside factors such as socioeconomic influence and access to healthcare.

“This is an educational event,” Wichinski stressed. “It’s not a debate.”

The surgical cost of transitioning is cost-prohibitive for most, Wichinski said. Not every person can afford the enhancements available to celebrities such as Caitlin Jenner.

Keith Wichinski, a local health care provider, provides a brief introduction to his film. Photo by Kay Richter.
Keith Wichinski, a local health care provider, provides a brief introduction to his film. Photo by Kay Richter.

“It cost $76,000 for surgery from male to female without insurance,” he said, “It cost $11,500 for the same surgery in Thailand. They have some of the best surgeons over there.”

Wichinski introduced his short film entitled, “The T is No Longer Silent,” which he assembled in Houston several years ago.

A dozen men and women in the film described the problems they faced while receiving health treatment in their transition to the opposite sex. Most voiced complaints regarding the lack of insurance coverage. All had issues with the lack of sensitivity from health care workers.

A panel discussion with Wichinski and three of his patients (introduced only by their first name) followed the film. “There is a disparity in health care that the transgender experience,” Wichinski said, and the people in attendance agreed.

Tonya Pacetti-Perkins and Nick Gooden speak to the panel members during the discussion on Monday. Photo by Kay Richter.
Tonya Pacetti-Perkins and Nick Gooden speak to the panel members during the discussion on Monday. Photo by Kay Richter.

Tonya Pacetti-Perkins, a coordinator of the event and member of the Human Rights Campaign of San Antonio, recognized the learning process that doctors and nurses go through. “People are going to make mistakes,” she said.

Brian, a patient of Wichinski, described the unprofessionalism of one of his doctors during his transition to a male. “My gynecologist said she wasn’t sure what to do when I came to her for help,” Brian said. “I told her, ‘It’s a hysterectomy. Don’t you know how to do that?’

“I changed doctors and they used correct procedures after that,” Brian said. “I am luckier than many. Most of my medical services are covered by insurance.”

Brian said the estrogen and testosterone necessary for transitioning are not covered by most insurance providers, along with a list of other expenses.

“My mastectomy was not covered by insurance,” he said, “and that was $7,390. The hysterectomy was covered, so I only paid $500 for that. It would have been $50,000 without insurance.”

Brian said surgery and pharmaceuticals are not the only expenses in gender transitioning. “It costs $283 to do a name change,” he said. “It’s a long process. You have to send the court document to all your credit card companies and the Social Security office.”

Connie, who has been a transgender individual since elementary school, said she’s thankful she has Medicare and private insurance.

“I stole a bra from my mother when I was six,” she said. “I belonged to the Boy Scouts and the Camp Fire Girls. I started cross-dressing in high school. Dressing up was an escape.”

But the pressure to conform was great. “I got married and had a son,” she said. “I was a father … a policeman … a fireman … an EMS tech … I worked construction … But when the marriage fell apart, I went back to cross-dressing. I felt more comfortable as a woman.”

Although her son has not come to grips with his father’s transition, other members of her family have. “My mom has finally accepted it,” she said. “Two years ago, she stopped calling me by my birth name and started using my girl name.”

Madison, age 25, was the last individual on the panel session to describe her experiences while transitioning. “As a kid, I would wear my grandmother’s lipstick,” she said. “I would put a towel on my head and pretend it was hair.”

Madison said she made her decision to come out at age 19 and has never looked back.

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“I have a very supportive family,” she said. “Mom works at AT&T and I use her insurance. My co-pay is $36 for three months of testosterone blockers and estrogen.”

Wichinski is the founder of Nurse Practitioner Associates in Laurel Heights. His specialty is helping men and women transition.

“Puberty is really scary for transgender people,” Wichinski said. “Genital mutilation goes along with depression.

“We do watch for aggression with testosterone treatment,” he said. “99% of mental disorders usually resolve with transitioning.”

The next Pride event at the San Antonio Public Library is “Cry OUT” at the Great Northwest Branch Library June 24. Andrez Y’Barbo from Project Embrace will discuss the grieving process that some parents experience when their children come out to them. The public is invited to this free event.

*Correction: The term Transexual was changed to Transgender. 

*Featured/top image: Brian, Connie, and Madison answer questions from the moderators and audience. Photo by Kay Richter.

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Don Mathis

Don’s life revolves around the many poetry circles in San Antonio. His poems have been published in many anthologies and periodicals and broadcasted on local TV and national radio. In addition to poetry,...