Becoming Niko: a journey to happiness

Johannesburg - Almost a year-and-a-half ago Niko McElroy began a physical transition that has made him more comfortable in his own skin.

“I've only been on testosterone for a year and five months,” the 24-year-old, from Ohio in the US, says.

“I finally felt like myself. I gained so much self-respect, regained my self-confidence, re-ignited my passions and, most importantly, I was actually happy. And it showed.” McElroy, born in a female body, describes his childhood self as a tomboy.

“Since age four, when I started forming memories, until I was about nine, I thought I was male and didn't understand why my brother looked differently than I did.” The term transgender refers to people whose gender identity does not match the conventional cultural expectations associated with the biological sex they are born into. There is, however, no correlation between transgender identity and sexual orientation.

Sexologist, academic and clinical social worker Ronald Addinall says the importance of support to transgender clients cannot be over stated.

The trans community face a number of additional stressors, including negotiating their gender identity with their families, communities and society.

“Thus it is essential that support services exist and are accessible at the personal level, the familial level, the community level, in education and work spaces, as well as access to good quality medical care.” McElroy recalls the time before he began his transition. “I was just angry all the time pre-T. No one ever really understood why. Not even me.

“I just had this deep-seated anger that would rear its ugly head, quite often over meaningless things. I was never violent, nor did I self-harm, but it seemed I was just a very short-fused time bomb waiting to explode.” He felt particularly uncomfortable about wearing traditionally feminine clothing, which “made me vulnerable, anxious, and exposed”, and from teenage years adopted a more masculine wardrobe.

When he reached the decision to begin the process of transitioning, McElroy felt somewhat daunted at the prospect of having to “come out to my parents a second time Ä the first time, telling them I was a lesbian,” at age 16.

In the event, McElroy's close family were extremely supportive.

“The first thing my dad said to me was: 'Well, you're going to need a better hair cut'. My mom said: 'So what's your name going to be?'“ After some discussion McElroy, who was previously known as Meghan, and his mother settled on the name Niko.

He says he was “absolutely ecstatic” at beginning the hormone replacement therapy (HRT) injections that would help bring his physical appearance in line with his gender identity.

“Initially (I was) a bit nervous due to the need for self-administered intramuscular injections... every 10 days for the rest of your life.

“Once I had gotten used to administering my medicine and started seeing and feeling changes, I knew that this was the best route and the only one for me to take.” McElroy enjoyed an “extremely seamless” physical transition.

“At about 30 days I started to notice a significant change in my facial structure. This is unusually fast.” In his mid-teenage years, prior to his HRT, McElroy and his family moved to a larger town.

“I have seen a few people that I grew up with since and they either didn't recognise me, or were unfazed.

“Some of my closer friends and relatives said that it's because it seems so much more natural; it fits.” In common with a number of trans people, McElroy refers to his former self in the third person.

“But only because I feel completely different in every way, shape, and form... I'm pretty open to my past. I don't hide from anything. I embrace it.” Asked if he has any regrets, he says:

“None. I only wish I had figured this out sooner”.

“I don't really remember how I started questioning my gender identity, but I do know that I began watching YouTube blogs from other transmen and listened to their explanations about how they felt prior to transition and related to most of what they said.” McElroy feels that reaching this realisation was even more important than the physical transition itself.

He and a friend subsequently started a YouTube channel, NikoandKage, to document their own experiences with testosterone and masculine lifestyle.

However, McElroy was somewhat enigmatic when asked to provide an insight into what masculinity physically feels like.

“Masculinity feels like the opposite of what femininity did, if that makes sense?”

Transgender support in SA

There are a number of organisations offering support to the transgender community in South Africa.

However, executive director of Gender Dynamix (GDX) S'bu Kheswa says: "Trans-specific health services are still very limited in this country, particularly in state hospitals, hence people take drastic measures to afford private health care."

GDX is dedicated to supporting the transgender community and advocating for acceptance, with outreach work in under-served communities.

Sexologist and clinical social worker Ronald Addinall has been the facilitator of the Triangle Transgender Support Group in Cape Town since October 2006.

Triangle Project provides services including face-to-face trans-positive and trans-affirming counselling, as well as supportive counselling to the significant others, family and friends of transgender persons.

It provides support through the process of negotiating the social transition in the workplace.

"Triangle Project has a working agreement with the Transgender Clinic at Groote Schuur Hospital (GSH) to which clients are referred after the initial counselling process for access to hormone treatment and gender alignment surgery," Addinall says.

"It is essential that support services exist and are accessible at the personal level, the familial level, the community level, in education and work spaces, as well as access to good quality medical care."

Addinall, who has helped with over 120 clients' transitions, co-wrote an article with University of Cape Town psychologist Dr Adele Marais and the GSH transgender clinic team.

According to the paper, "Transgender issues in South Africa, with particular reference to GSH Transgender Unit" published in the SA Medical Journal in June, the state hospital has offered an intermittent psychiatric, surgical and endocrine service to transgender patients since the 1970s.

"The primary mandate of the unit is to provide a comprehensive package of care for the transgender patient and to facilitate follow-up support in the local community."

It offers telephonic technical support to providers of psychological and endocrine services elsewhere in the country.

However, limited resources and the growing number of transgender client referrals have led to long waiting periods for patients requiring gender reassignment operations -- in some cases up to 20 years.

Marais said at this year's Trans Health, Advocacy and Research Conference that the clinic has helped over 110 clients over the last five years.

South Africa's transgender population also grapples with problems of stigma and discrimination.

Kheswa says: "South Africa has high levels of hate crimes directed at LGBTI (Lesbian, Gay, Bisexual, Transgender and Intersex) persons and the most vulnerable are those that are gender non-conforming.

"The challenge is that most of those hate crime incidences are reported as gay and lesbian attacks."

Addinall et al. wrote that the social stressors of high levels of stigma, discrimination and persecution further burden the health of transgender people.

Sapa