After five decades as a man living with guilt, shame and constant fear of being found out, she underwent gender reassignment surgery last summer to physically become the woman her mind told her she was.
She was comfortable in her new body with Wichita neighbors who never suspected she was anything other than a normal middle-aged divorced housewife.
But then the movie "Transamerica" opened in Wichita this week, with Oscar-nominated Felicity Huffman portraying a man preparing for his final surgery to become a woman.
"People like me tend to do a disservice to the transgender community," she said. "Once we finish our surgery, we just want to disappear into the mainstream. We don't want to become the poster child for anyone.
Lisa, a name she chose to protect her privacy, is one of about 15 people in Wichita who are diagnosed as "transgender" -- born and socialized as one gender but psychologically wired to be the other.
National statistics suggest that about 1 in 30,000 people are transgender. Although transgender is listed as a mental disorder, Wichita psychologist Dale Neaman -- Lisa's doctor -- is hopeful that will change.
"It's not a mental illness, it's a medical condition," said Neaman, the only psychologist in Kansas certified to work with transgender patients through the Harry Benjamin International Gender Dysphoria Association, based in Minneapolis.
Gender identity is fixed during the third month of pregnancy. Even if a child is born with ambiguous genitalia, the mind knows whether it's male or female, Neaman said.
About a quarter of Neaman's patients are transgender, often called simply "trans." Since she opened her practice in 1992, she has worked with about 50 people like Lisa.
Lisa said that when she was growing up in the 1960s in a strict, small-town Kansas environment, she never heard of "transgender." She recalls being confused about her sexual orientation.
"I thought I might be gay and a transvestite," she said. "I thought it was that simple. I thought I could outgrow it or that, with age, it would become unimportant. But it only gets worse. It's only a matter of time until you crack up."
"Being trans is not about sexual orientation," she said. "Gay is how you love others. Instead, trans is about gender identity. That's internal."
"But they see themselves as women who are interested in men. They are not men interested in other men," Neaman said. "After their surgery, they can have a perfectly normal relationship with a man."
The science of gender reassignment surgery goes back to the 1930s but didn't become widely known until World War II soldier George Jorgensen Jr. went to Denmark for a so-called sex-change operation.
He returned in 1952 as Christine Jorgensen, the first transgender American to go public. She became a celebrity but remained a mainstream curiosity.
Then, in 1975, tennis player Renee Richards successfully sued the U.S. Tennis Association for barring her from the Women's Open. She was born Richard Raskind and was a Yale-educated ophthalmologist, husband and father before her surgery to become a woman.
But Lisa, who married a woman and fathered children because "that was the expected game plan," said none of those cases' sensational headlines meant anything to her. She didn't make the connection with herself.
"There weren't any books to go to," Lisa said. "It wasn't until the Internet came along that I found what I was looking for. The pieces were all there. Suddenly, it all made sense."
Neaman said that virtually all of her referrals for transgender patients come from the Internet. She is currently working with seven individuals.
"You can tell a difference in them from the very first month. Once they have been given permission to be a woman, the depression lifts," Neaman said.
She calls for a minimum two-year transition. The first year involves therapy and minor physical changes, such as electrolysis to remove excess hair.
The second year, when hormone treatments begin and the body begins changing shape, the patient dresses and lives as a woman. That's a crucial and delicate part, Neaman said.
"When I told my best friend for 35 years, he told me he couldn't approve because of his religion," Lisa said. "One line in the Old Testament cost a friendship we had for so long. That really hurt."
Lisa's transition took three years. Some patients take longer because of the cost, Neaman said. The cost for the final genital surgery ranges from $11,000 in Asia to $20,000 in Canada to $30,000 or more in Arizona, Colorado and Florida. Such surgery is not available in Kansas.
"Some people decide never to have surgery to save a marriage or a career," Neaman said. "They try to live with it in subtle ways: Wearing women's underwear, using clear nail polish or colorless lip gloss."
Lisa said she's spent about $80,000 so far, from facial feminization surgery to reduce her brow, shave her Adam's apple and alter her cheekbones, to genital reassignment surgery.
Lisa said she was inspired to go through the expensive and sometimes painful process by a passage in Hermann Hesse's "Steppenwolf" that says to "take a risk or die."
"You set your own execution date three years in the future," she said. "If life is as bad as you imagine, there is always an exit through suicide. But there is the flip side. That gives you the power to go forward."
"I'm no longer 'trans,' " she said. "I'm not even 'ex-trans.' The bottom line is I'm a woman. I'm out there. I'm right in front of you."
"There's no established procedure," she said. "It's up to the person at the DMV. I had to plead with them to just look at me. They put down I was a woman."
"I have a lot of experience and skills, but I can't put any of that on my resume because as soon as any company checks, they'll find out," she said. "Everybody I know who has been 'outed' has been fired."
"Once I began to function as a woman, I realized that I had no concept of what it was to be a man," she said. "I didn't know what men truly want. There was no way I was ever a man."
This is cache, read story here
