1

Chronological History and Analysis

Of

Gender Identity Issue and Breach of Trust with Calgary Health Region Also, Concerning: Complaint &Proposal to Fed. Health Min. Request & Proposal to Fed. MP Response by Calgary Health Region
By Mark Duncan Calgary, Alberta E-mail: thoth_hermit@yahoo.com

Contents

Pg./Par. 4. / 1. Introduction 5. / 4. Arrival to Calgary 5. / 6. Gender Identity and Medical History 6. / 7. Verification of Medical History 7. / 11. Attitude of Medical Community 7. / 12. Coordinated Activities 8. / 13. Limitations of Professional Help 8. / 15. Research on Gender Identity 9. / 18. Test Results 10. / 19. End of Counseling Sessions 10. / 20. Self-analysis 11. / 22. Return to Biological Cause 11. / 23. Billing Information 12. / 26. Repressed Memory 14. / 30. Trying to get a Second Opinion

Pg. / Par. 14. / 31. Witness and Credibility 14. / 32. Refusal of a Second Opinion 15. / 34. Gender Identity and Subjective Spiritual Truth 16. / 38. Visit to Lab 17. / 42. Problems with Chromosome Report and Lab-Work 18. / 44. Duplicate Paperwork 19. / 47. Considering the Facts 19. / 48. Freedom of Information Requests 21. / 55. Verification of Testing 22. / 60. Conclusions Concerning Inner Conflict 22. / 61. First Step Toward Transitioning 23. / 64. Analysis 25. / 73. A proposal for a Moral Solution Appendices 1. Complaint to Federal Health Minister 2. Request to Federal MP (Stephen Harper) 3. Request to Provincial Health Minister 4. Documentation (sent to Federal & Provincial Health Ministers) Amendment: Copy of sent complaint - Response from Calgary Health Region on Dec. 21, 2005.

4.
Introduction 1. As a chronological account of my issue concerning Gender Identity, it is also my intent to provide some of the argument behind my reasoning process. Additionally as it is inclusive of my problems with the Health Region, Ive included interpretation and analysis to provide a basis for my perception of a breach of trust. It is my hope that the reader will suspend their disbelief while following the chain of events and reasoning, whereby, I might establish my credibility by illustrating the basis for my belief, that my Gender Identity issue is rooted in a biological cause. As the time period spans from June 2002 until the present, the actual record is only inclusive of the measures Ive undertaken since arriving in the Health Region. Additionally, actual identification of organizations or individuals has been restricted to the accompanying documentation, which I have accessed through Freedom of Information requests and sent to the Federal/Provincial Health Ministers office. The purpose is to protect revealing information as individuals outside of the complaints process may review this material. Furthermore, although general headings are present, the chronological sequence provides a better example of reasoning as events unfolded. As the text has been produced under time constraint, it went from draft to print hastily. Thus, I would ask the reader to overlook any technical errors in favor of considering the overall argument. (first par. revised ) 2. I should begin by stating that I am an individual who is Gender Dysphoric, meaning, that while biologically male my mind states that I should be female. However, that is not to confuse it with a persons sexual preference or other forms of expression. It is the realization that ones true perception of self states that he should be female. My problem had remained under the surface until becoming overt in conjunction to a period that was relatively prosperous for me. A brief analogy might be useful to understand the context by which the issue emerged. Thus, if one were to go through life knowing that they had problems and in acknowledging them, worked toward their resolution. Yet, having worked to discover and excise the root, found it unfathomable and eventually gave up, believing they would never know. Then an event occurred to draw the spotlight to something previously thought unimaginable, whereby the root becomes visible; that would then describe how I came to possess my Gender Identity issue. It came unlooked for yet once it was apparent there was no denying it. 3. In regard to my present circumstances, Ive come to acknowledge that transitioning would represent the cure to my problem, yet my specific problem concerns reconciling my issue with my reasoning, spiritual beliefs and life. Though my current situation is stable, this issue and my perception of a breach of trust have taken its toll emotionally and physically. However, Ive maintained stable if not illustrious employment as a dishwasher, while trying to sort this issue out. Where, I have not been a burden upon the system nor have cost the Province any expense. Additionally, initial analysis from the medical community assessed my judgment as adequate while describing myself as insightful.

5. Arrival 4. I initially moved to Calgary on Oct. 30th 2003 to seek help with a gender identity issue which had become overt and documented on June 25, 2002. This overt instance was out of character and served to focus my attention on a specific point wherein I could investigate underlying personal problems, which I had previously thought unfathomable. Since I had deemed questions concerning sexuality, heterosexual or otherwise, already answered years earlier; I was at a loss to answer why this problem should emerge un expectantly and with inexpressible impact. Additionally, personal efforts to manage the problem by taking less stressful work when the opportunity arose (June 2003) and a vacation, merely heightened my anxiety. At that time I recognized that this was a deep-rooted problem affecting myself emotionally and physically, which prompted a determination to seek the means and environment to investigate my problem. The physical symptoms were secondary to the issue, yet I was also experiencing, chest pains, high blood pressure and a dull ache in the testes. Therefore my plan was to move to Calgary from living in rural areas, wherein, the amenities the medical community and Gay & Lesbians resources might be accessed. Where, it was with some measure of self awareness that I approached the medical community in an effort to seek direction with my health concerns. 5. I approached a walk- in Health Center with my Gender Identity issue and health concerns on Oct. 31 2003, wherein, I expressed my need to determine the cause, for my Gender Identity problem. Their response was a referral to a Counselor in regard to my issue, while they prescribed medication for my high blood pressure. Additionally, an exam of the testes(Nov.14) and resultant ultrasound revealed, innumerable microlithiasis [calcification] throughout both testes. I proceeded to follow their advice in regard to seeing a counselor while also utilizing the local Gay &Lesbian Centers monthly meeting of a Transgender Group. Furthermore, personal research via peer reviewed sources in conjunction with socializing with Transgenderd people, convinced me that I shared similar traits to such a degree, that I acknowledged to my counselor (Dec.) I identified myself as Transgender. However, it wasnt until January of 2004 while investigating medical history that a connection emerged between childhood memories, medical history and gender identity. Gender Identity and Medical History 6. Briefly stated, I found that as I considered behavioral or environmental factors concerning my issue; further reading revealed that individuals born intersexed also portray similar traits. While comparing my medical history with the physical symptoms of being inter-sexed, I was astonished to find direct similarities. At that time my certain knowledge was that I was born six weeks premature, I had shots for un descended testes at approx. age nine, had delayed puberty(with the option to take growth hormones)and the possibility of infertility (discovered in adulthood). However childhood memories which surfaced while digging for evidence of behavior in regard to gender identity, also revealed memories of my medical history. These included memory of a scar on

6. my groin as a small child, inadvertent talk of chromosomes as a child, which led to a scene and a resultant trip to the family physician where the questions, do you like being a boy, was posed. Conversely, the most common characteristics of being inter-sexed, as described by a medical dictionary are: cryptorchidism (undescended testes), delayed puberty, sex chromosome abnormalities and the possibility of infertility. Verification of Medical History 7. Common sense prompted me to attempt verification of these memories before sounding an alarm to my counselor, which I initiated by trying to access past medical records and through contacting a family member. However, barriers existed which left these measures ineffectual. Firstly, it had been well over ten years since I had last had a family physician, although my childhood physician was still in business. Initial consultation with his receptionist revealed that he may have old records at a different location, but a follow-up reported that no records were available. Secondly, having been an adopted child, the agency involved would have medical records from birth until the age of official adoption. Lastly, the only reliable medical information from a family member is restricted to an older sibling, whose occupation is as a registered nurse. 8. Contact with other family members is untenable simply due to circumstances that include: the age and health of foster father (80 yrs.), combined with an estranged personal relationship between himself and I (22 yrs.). Additionally, more than twenty years has elapsed since last encounters with uncles, aunts (age 70s +) or cousins. A brief social history includes, fostered out at six weeks of age, adopted by foster parents at two years of age, adoptive parents were in mid-forties at time of birth, lower middle class family, evangelical fundamentalist Christians, little formal education of parents ( grade 8), foster mother deceased at age 12, sister was legal guardian until 15, then became independent (last visit with sister was 1991). 9. Her response to my issue concerning Gender Identity and emergent memories was unexpected and evasive. What I had expected was, dont be ridiculous, Ive changed your diapers a million times there was nothing abnormal. What I received was, you know how closed-mouthed Mom and Dad were, they never told me of any surgery being done. Additionally, direct questions concerning each memory were met with, I dont remember, while she also attempted to discourage me from requesting medical records from the adoption agency. Thus, having been stalled in my verification attempts by my childhood family physician, yet, curiously suspicious by the interview of my sister, there remained only two viable courses available to obtain verification of these memories. They included, having my chromosomes tested and obtaining my medical records from the adoption agency. 10. However, before presenting my findings to my counselor, I made inquiries as to the procedure for accessing chromosome testing which uncovered additional information. I discovered that the type of calcification affecting my testes was also a symptom or by-

7. product of having had undescended testes, moreover, I also found out that the groin is also a point of surgical intervention for a case of undescended testes. Hence, the childhood memories of a scar and abnormal chromosomes seemed more realistic giving rise to the possibility that my Gender Identity issue could be biologically based, meaning, I may have been born inter-sexed. Pursuant actions, which I coordinated with my Counselor, was to access a family physician(Jan 22, 2004) and gain a referral to a genetic specialist, who could then order a chromosome test to determine if any anomalies existed. The interview with the specialist was conducted and blood was sent for chromosome testing on Mar. 2, 2004. Attitude of Medical Community 11. As an aside, I should mention a noticeable reluctance on the current medical communitys part to investigate the matter. Initial responses from the medical community to my inquiries into a biological cause, have been met with hostility, skepticism and the patented reply of, studies have shown that most males with gender identity issues have normal sex chromosomes. The hostility stemmed from the Jan.22 interview with a new family physician where amidst explaining my problem and request for chromosome testing, he replied, I dont know if I want to accept you as a patient. Although in the end he did accept me as a patient and forwarded my request for chromosome testing, he still remained uncomfortable and evasive during any discussion of Gender Identity. During the interview with the genetic specialist, I recounted the same chain of events concerning the overt incident in 2002, yet also explained, subsequent actions taken and my growing suspicion of a biological reason. His response seemed disinterested offering little input. At the close of the interview he casually stated that, approx. 1 in 2000 live births have some sort of genetic abnormality. Coordinated Activities 12. Nevertheless upon my interview with the genetic specialist and in coordination with the Counselor whom I had been seeing; a direct course of action was followed. The specialist agreed to order the testing while I agreed to have my medical records, held by the adoption agency, sent to his office. My Councilor agreed to assist by enclosing a letter explaining my situation along with my letter requesting medical records which was then sent to the adoption agency during approx. end-March of 2004. The purpose of my Counselors involvement was to fast-track the release of my medical records which could bring the wait time down from ten months too approximately, two or three. Additionally, I was told by the genetic specialist that the turnaround time for my test results would be approx. three months. I questioned the specialist concerning the turnaround time, as I had been informed by my initial search into chromosome testing, that it could take up to six weeks. The specialist then amended his statement by saying that the testing was done by

8. Lots, where, depending on which lot the sample was placed in, would determine the turnaround time of either six weeks or three months. Since the focus of my Gender Identity issue had shifted to biology, my last regular visit with my counselor was during Mar. of 2004. The general consensus was that the counseling sessions demanded a hiatus, as I had reached an impasse concerning my Gender Identity issues resolution. Limitations of Professional Help 13. Again as an aside, I should briefly outline the limitations and extent that professional counseling proved useful. The counselor whom I had received was a young male with a Bachelor of Social Work who was working toward his Masters. The specific problem I presented him with was, why is my mind saying that I should be female. I had a general idea, about sectioning the problem off into categories such as childhood, relation to mother, religion, relation to authority etc. However, the approach I received was relatively superficial in contrast to my needs. Thus, while receiving pamphlets on Gay and Lesbian services proved useful, it wasnt what I was looking for. Conversely, Transgender people whom I had spoken with, directed me to a psychologist who specializes in Gender issues. The problem was cost which ultimately dictated that I seek assistance from a source which charged on a sliding scale. However, the Counselor was helpful within the scope of his field. Thus, as a social worker, he proved beneficial by providing a personal contact looking out for my wellbeing. 14. Although, what neither a social worker nor a psychologist can provide, is any insight into how to reconcile a Gender Identity issue with spirituality or religion. If psychologists, social workers or doctors could explain how spirituality affects my specific issue then they would be priests and science could then be called a religion. Conversely if I were an atheist, the impasse concerning my Gender Identity issues resolution would be nonexistent since I would not have to consider anything outside of my own pleasure. Hence, in context to the problem of Gender Identity, the extent of the medical communitys assistance is limited to an examination of biology or behavioral classification (psychology). Research on Gender Identity 15. It was with considerable anxiety that I awaited the chromosome testing results, which prompted a call to the genetic specialists office at the six week point and an appointment to discuss anxiety with my counselor during mid-April 2004. Further reading had initiated myself into the hitherto unknown realm of gender politics, standard medical practice and Dr. Moneys infamous gender experiment(turning a biological male infant into a female [it will never know the difference] and its eventual failure [ why do I think I should be a boy?] ). Essentially, I discovered that there is no uniform consensus as to whether gender is determined by nature or nurture. Some sources even argue for both. In regard to individuals born inter-sexed it has been acknowledged that some develop Gender Identity issues while others do not. However, the standard

9. medical practice is to treat an inter-sexed condition as a medical emergency, wherein, the true gender is determined by deciding which characteristics are more predominant. The focus is to affect the gender assignment when the child is young as to avoid any later psychological problems. However, it has been acknowledged by the medical community that the pressure for medical intervention stems from societal values. Simply stated, the binary system or God made man and woman. 16. In regard to justifying the practice, the solution is straightforward depending on your point of view. Both inter-sexed individuals and normal genetic males complain of Gender Identity issues, therefore, Gender Identity must be a product of the mind. Whereas, an opposite view could argue that the medical community doesnt know why an inter-sexed person or a normal male could share the same problem; just as it has no consensus concerning the nature or nurture debate. Since the cause of Gender Identity issues are unknown to science, yet standard medical practice dictates that gender must be decided based on societal values, then it is society that determines Gender. 17. Incredible as that may seem, there is only one position that the medical community can take and remain moral; that is to maintain the position that Gender Identity issues are a product of the mind alone. To concede otherwise would mean that science acknowledges the existence of God or science is immoral. If science were to proclaim Gender Identity a product of biology alone, then the standard medical procedure concerning inter-sexed individuals is wrong(it would be easier to flip a coin), whereas, to acknowledge the existence of God would be to refute science. Finally, to argue that Gender Identity is a product of both biology and mind, denies the existence of normal genetic males with Gender Identity issues. In practicality, as an individual possessing a Gender Identity issue, my position in regard to discovering the cause, whether it is biological, mind, God or a combination of the three, is wedged between the medical communities values(mind) and societys dogma (God created man and woman). Test Results 18. Needless to say, the culmination of my wait for my test results was like a self-fulfilling prophecy. I called the genetic specialists office on June 3, 2004 at the exact three month mark and was informed that my results needed to be reviewed by the lab Director. It took until June 15 for the results to finally arrive, whereupon; I arrived at the specialists office to find a single page electronically signed along with my medical records from the adoption agency, waiting on the receptionists desk. The physician was not present, no interpretations of results were offered and a follow-up was deemed necessary. The results stated that I had a normal 46 xy male karyotype, although the medical records which had just arrived, were not official records but a synopsis of my medical records compiled by a third party. There were no abnormalities reported. I was devastated as this result was in stark contrast to my reasoning, emergent memories and medical history. I left the office thinking that my issue was either seriously affecting my

10. judgment or that I had just been given the ten cent tour and brush-off. Since this result left myself in a continued impasse concerning my Gender Identity issue, I fell into a general depression, while quite aware that any attempt to cry foul would likely, to be deemed hysterical. Thus, I let the biological reason rest and returned to examining behavior and environment. End of Counseling Sessions 19. Another pertinent point to consider, was the continued usefulness of seeing my counselor. Checking boxes on the Hartman happiness scale survey, or identifying, indicators which might lead to a mood swing, were inadequate in regard to determining the cause of my issue. At best, I reasoned that continued sessions could serve only to find effective masks by which to find no cause as palatable. My issue and its solution were already a given, what I lacked was the understanding to justify the solution with my reason and spiritual beliefs. During a follow-up session in late Aug. 2004, after a hiatus of several months, we agreed to wrap up our work in regard to my Gender Identity problem. However he brushed off my verbal request for a copy of the letter, which he had sent to the adoption agency on my behalf, whose contents I had not seen. Contrasted with the third party synopsis which I had received, I felt it might be pertinent to know exactly what was written. Although, ultimately I let the matter lay for the aforementioned reason of appearing hysterical. Self Analysis 20. In regard to examining behavioral or environmental factors underlying my issue, the methodology was relatively simple. I had initially brought the idea up to my counselor, months earlier as a subtle way of suggesting that we section off the problem and dissect the parts. Matters as they were, being depressed and dissatisfied with the assistance which I had already received; I decided to continue on my own until I could afford to see a psychologist. Hence my approach was based on the simple method of triangulation. For instance, if one is lost in the woods you merely have to orient your map to the ground, shoot a bearing to two prominent features and where the reverse bearing intersects on the map, is where your true position will be located. Thus, I took the available information on Gender Identity as my map, shot a bearing to the past and present, then worked along my back bearings in the hope of arriving at my true position. Once I did the necessary exhumations noting instances of behavior or environment, I gave a generous nod to Freuds Oedipus Complex and Stages of Psychosexual Development, while also reserving a salute to Jungs archetypal symbols concerning the Hero, Mother, Trickster and Rebirth. 21. While not pretending to be an authority on any facet of psychology, I can (albeit reluctantly), pretend to be an expert on my problem, as only I could know

11. for certain, the personal significance of the contents of my psyche. The point is, I could find any number of personal instances which could argue for a behavioral or environmental cause for my Gender Identity issue. Ultimately, a psychologist would help you pick one and once you did, then that would serve as the focal point for future action. Thus, in regard to Gender Identity being a product of the mind alone, I have narrowed my issue down to two significant events which could be reasons for a psychological cause. One is based on certain memory while the other involves a newly emergent memory. However a problem exists, as the certain memory can stand alone as the cause or work in conjunction with the emergent memory, whereas; the emergent memory cannot work with the certain memory or stand alone without verification. Nevertheless, as this emergent memory is from early childhood, connected directly to my issue, whose surfacing also coincided with external provocation; I found myself set back to investigating the biological cause once again. Return to Biological Cause 22. The catalyst for a return to an investigation into a biological cause was the result of sifting through memories, behavior and self-analysis, in conjunction with the occurrence of, an unlooked for problem. On Nov.19 2004, I received a call from the public library informing myself that my health card and medical information had been found. Unaware that it had been missing, I retrieved it from the librarys security desk to find that someone elses medical information was clipped to it. My actions were to report the incident to Alberta Health & Wellness in addition to checking if it had been used. I reported that the last billing should have been for my chromosome testing from Jun. 15th 2004. The card had not been used, yet I was greatly distressed to discover that no billing information was recorded for my chromosome testing. Billing Information 23. Thus, I revisited the specter of the ten cent tour and brush-off, which was what my intuition and chain of previous events suggested. On Nov. 21 2004, I explained to the health nurse at the walk-in Health Center, my anxiety concerning the validity of the testing. I raised questions involving the attitude of the medical community toward my issue, chain of events, the lack of billing information, an impasse over resolution and the need for verification of the chromosome test. The nurse I spoke to complimented me as to the work I had done to understand my problem. However, any attempt to focus on the validity of the testing was associated with buzzwords such as, letting go, taking responsibility or being obsessive. 24. The conclusions I arrived at were clear: acknowledging Gender Identity as a product of mind was progress, whereas, any doubts concerning the testing or biological cause were obsessive. Since I had also expressed the shortcomings of my counselors assistance concerning my issue, the outcome of our discussion was to receive direction to

12. a Human sexuality program, which dealt specifically with issues involving Gender Identity. I didnt bother trying to fathom the inherent contradiction, in a referral to an inadequate source (my previous counselor) on my first visit of Oct. 31 2003, in contrast to, one which specialized in Gender Identity issues. However, as I was in a continued impasse concerning the cause and resolution of my problem, I declined to follow the advice of the referral at that time. 25. Needless to say, two other initial attempts to find a method of verification also proved fruitless. I didnt make it past the receptionist at the local Legal Aid office (lack the resources for a private lawyer), before being informed that the College of Physicians and Surgeons patient advocacy department handles such inquiries. I then called the Patient Advocacy and left a message explaining my question. The response was, In most cases when people call about billing, we find that it is just the slowness of paperwork, hence, their suggestion was for myself to call the lab and ask if they did the testing (personally, I almost laughed out loud over the phone thinking, are people actually calling concerned about billing in a publicly funded system on a regular basis?, what would the lab say? , No sir we were just joking, we didnt actually do the test). Repressed Memory 26. It was during Nov. 24th to the Dec. 16th 2004 time period that I made a breakthrough in regard to early childhood memory. While replaying my previous interview of a family member and focusing on the statement, you know how closed-mouthed Mom and Dad were, they never told me of any surgery being done. I began to reminisce, thinking, the only remembered instance of being in the hospital as a child (slept in a crib, but old enough to eat unassisted), was the time I was told; I fell down the stairs and knocked myself out. Unless As soon as I thought unless, I simultaneously heard the words you tricked me and began to experience jumbled flashes of memory concerning: a toy gun, relatives and a celebration. Over the course of several days I was able to piece these memory fragments together as more details began to surface. 27. Thus, the picture which surfaced represents a key childhood memory concerning Gender Identity. I place my age at approximately two to three years, while the event itself was a family gathering where I was the focus of attention. I was on the floor, while my foster Mother and Father were sitting to either side of me. It was like a game with my family and relatives observing. My Mother and Father were both vying for my attention, wherein, my Mother held a toy doll, my Father a toy train. I was to make a choice of which toy I liked better. My Father wound up the train and it moved, prompting me to choose it, which caused my Mother to become upset and say, you tricked him. She then put the doll away and went to her room where my visiting aunt talked to her in private. The reward for choosing the train was a cowboy outfit complete with shiny toy

13. guns. I remember holding the gun up and saying Im a boy which made me a hero to my visiting uncles who were also present. Later I went to my Mothers room and told her that, I wanted to be a girl too, whereas my choice for saying I wanted to be a boy was to acquire some new toys. As my relatives left, my Aunt took a small pink dress with her and I heard her telling my Mother, that she hadnt known what to bring. 28. The problem this memory raised was linked to the work Id done concerning environmental factors in regard to my Gender Identity issue. While I looked for connections between the Oedipus Complex, stages of development and the past, in relation to instances of identification with the father; I discovered examples of behavior which indicated my rejection and open hostility. Yet, the socializing environment was relatively sterile, wherein; while my hierarchy of needs was met according to Reich, personal interaction with either parent was negligible. Additionally, an event associated with certain memory during later childhood, clearly; cut any attachment to the Mother figure which I may have held. Thus, to my reasoning the newly emergent memory underscored a contradiction which involved: hostility toward both parents in spite of possessing the basic hierarchy of needs. It wasnt overt, and could conceivably be the product of premature birth (lack of initial nurturing etc.). In which case one could argue for a psychological cause. Yet the memory itself implies that my gender was in doubt, hence some biological indication. Stood alone, the memory represented a key childhood psychological event directly concerning Gender Identity, whereby; regardless of the implied biological cause, it was still indicative of repressed contents of the psyche rising to consciousness. However, when contrasted with the later event of the Mothers rejection the following picture emerged; which also required a reevaluation of my earlier chromosome and doctors visit memory. 29. Those early childhood memories concerned my sister doing homework with her boyfriend under the supervision of my foster Mother. I was nearby and overheard talk of chromosomes which piqued my interest as I had a keen enjoyment for science fiction. Her response to my question, what are mine was offhand, yet when I discovered that her response signified that I was a girl, I became excited. The identification I had made was between a female science fiction character who could shape- shift and myself However, the look of oops, which she gave my Mother, dispelled any doubts concerning her subsequent denial. The result was a scene and a future visit to the doctors office where the question, do you like being a boy was posed (doctors visit out of character for my family unless you were bleeding). The relationship I discerned between those memories was as follows. The chromosome memory was rooted in identification with a fantasy figure, the symbolic cutting of the apron strings event concerned an object of fantasy which was denied, while the newly surfaced memory involved a choice between being male and female. Thus, in regard to Freuds Oedipus complex, either one or the other parent should have been identified with. Yet, I harbored notable hostility toward both parents while transferring my gender identification onto a fantasy image (the subconscious?). Therefore in regard to Gender Identity, I discovered an instance where my problem could be linked to both biological and psychological causes.

14. Trying to get a second opinion 30. On Dec 9th 2004, I sought out the opinion of a second physician for three reasons: the electronically signed report and inadequate medical records, the absence of billing record and surfaced memory; while also the potential of professional bias. The physician was female and her approach and tone were notably positive, however, her decision was to refer me back to my regular family physician. I called my sister on Dec 13th to re-question her regarding my medical history and newly surfaced memory. Her manner was the direct opposite to our previous conversation of almost a year earlier. It was if she had my medical records in front of her. Now it was, she was there and would have known. However, our conversation was long, drawn-out and emotional, wherein, I discovered some new information. Apparently I had surgery to bring down the right teste at one yrs., she remembered the cowboy suite though nothing else about the new memory, she also insisted quite forcefully that I fell down the stairs. Oddly, she also made an allusion to past medical practices where more time might have been needed. The whole conversation served to further arouse my suspicion. I decided to attempt to bring this matter up again with my regular family physician as a checkup and ultrasound were soon due. Witnesses and Credibility 31. At this point I should also mention, that since the moment my attempt to secure a second opinion from a different physician was redirected, while also recognizing the difficulty I was receiving in my initial attempts to verify the report and billing; I had decided to take proactive measures to verify what Id learned. Thus, as my position of presenting this problem to others also involved credibility, I briefly chose a course by which to borrow that specific quality belonging to other people (what I needed was a witness.) Hence, the possession of an old microcassette recorder ( the type used for taping lectures) proved useful and provided a verbal record of the second conversation with my sister along with three from physicians. The recordings are of a poor quality, yet discernable, though the machine gave up its ghost. Refusal of a Second Opinion 32. During my appointment with my family physician on Dec. 16 2004, in relation to my Gender issue, the doctor stated that no billing information existed because it was done through the facility where the lab was situated. Upon bringing up the chromosome testing he stated that the genetic specialist had, never gotten back to him on my testing how did it go?, while also evading the almost certain verification of the scar memory. He did this by linking calcification of the testes (current), shots for undescended testes

15. and surgery together, while completely ignoring the fact that formerly the only concrete evidence was of calcifications, the rest had been either memory or conjecture. My argument was that since my memory seems verified on the early childhood scar memory; then my other memories (chromosomes, doctors visit, cowboy suit) might also be true. However, my physicians response to this reasoning was to specifically state, you are either xx or xy, gender identity [my issue] is just in your head. Additionally, he denied myself a second opinion on the testing and refused to assist (drawing blood etc.) should I choose to pay for it privately. 33. Additionally, I had difficulty in receiving a report regarding the direct purpose of my visit, which concerned screening for low risk cancer of the testes. I discovered by telephone that my physicians practice was to report the testing results, only if a problem was discovered. Since the purpose of the resultant ultrasound also concerned the discovery of a lump(which my physician couldnt verify), I had assumed he would call back to inform myself as to the outcome of the test. However, my later telephone calls (approx. Dec 21) and conversation with his receptionist revealed, that while something had been discovered it couldnt be discussed over the phone. Thus, her solution was to book myself an appointment for Jan. 3rd 2005 as there wasnt an opportunity for a visit before the Christmas holidays. The subsequent anxiety and appointment, revealed the lump was a newly developed cyst (nonmalignant) thought insignificant; yet it was deemed too controversial to explain over the phone. Combined with the outcome of my Dec. 16th appointment, in addition to the hostility Id perceived from my initial consultation of Jan. 22nd 2004, I had lost confidence in my physicians ability to serve my Health concerns. Gender Identity and Subjective Spiritual Truth 34. After considering all that I had learned concerning my Gender Identity issue in regard to: literature, medical history, memory and practical experience, including the personal conflict over the issues eventual resolution; the task of also reconciling my Gender Identity issue with my religious or spiritual beliefs still remained. Knowing that an individuals belief could at best only be viewed as a subjective truth, they still constitute contents of the psyche of personal value which could promote well-being or discord. Thus, it is reasonable to say that just as I found myself lost in the woods concerning my Gender Identity issue, therein also, lays my spiritual dilemma. Hence, while the methods of triangulation remain the same, the map must also include tools for interpretation: belief there is a God (belief in the existence of spirit), a system of belief in which to conceptualize God (cosmology) and the lessons one has learned betwixt the two (life experience) which could lead the individual to their true position. Albeit having value only to the individual, to deny the resolution of ones spiritual truth (subjective), prevents half the question concerning Gender identity from being resolved. Taken to its conclusion one might argue: since mind, gender and spiritual beliefs are in conflict; wherein, the mind is in conflict with the body and spiritual beliefs with the

16. mind. To act according to the wishes of the body (desire) or mind (reason) alone, discounts the validation of spirit or ones personal faith; without which true resolution will not be known. 35. By way of illustration a hypothetical model may suffice. Supposing one has literal belief (faith there is a God insert deity of choice) and that one at minimum, nominally follows the system of spiritual or moral values associated with that belief, then at a fixed point (past) in ones life an event or action occurs, involving another individual which both deem good. In addition, that specific event, changes ones behavior then what it otherwise might have been(which both deem good), yet, over time one changes their opinion of that previous fixed point by deciding it didnt truly reflect ones individual belief or associated values. Through faith (action of prayer) and changes in behavior(action of will) according to values, one then arrives by chance at the same fixed point only it is set years in the future. The prior individual is present in the same relative situation, yet his subjective good is now your subjective evil, although you both nominally share the same value system. Thus, for both it is a coincidence of time and place as well as the subjective interpretation of values. To an objective observer the coincidence might be interesting or unremarkable, however, its interpretation for the individual would nevertheless constitute a subjective spiritual truth ( unique to oneself). 36. Therefore, while spirituality or religion may have no value to scientific method, it does have value to the individual by providing further incentive to acts of personal refinement. In short, it provides parameters to interpret ones life according to an individuals personal efforts. Thus I am required in regard to determining the cause and resolution of my issue, to also reconcile it with my life and the contents which are of a subjective spiritual truth. 37. In the practical sense of initiating action to obtain results, I decided to pursue a course which would best resolve my original question which I had raised by requesting the chromosome testing: was I born to some degree inter-sexed? . My plan was to gather all my personal medical information via Freedom of Information requests. The purpose was to maintain personal records and a secure reference point should any discrepancies arise. Visit to the Lab 38. On Jan. 5th 2005, I arrived at the facility where the lab was situated; who were responsible for the chromosome testing, to present a Freedom of Information request. It contained a request for a complete file (meaning lab-work) concerning my testing. I explained my purpose to the lobby receptionist and asked to be directed to the correct location to deliver my request. Uncertain of where to direct me as the labs location was difficult to find for a visitor, while also perplexed that I had not appeared in the facilitys computer records; she decided to call the lab for the best solution.

17. 39. The lab Director appeared in the lobby hastily and seemed somewhat apprehensive. In presentation of my information request, I also raised queries concerning the electronic signature and billing information. The Directors response indicated, that due to the volume of paperwork such reports are electronically sent; while also explaining that funding for the laboratory was derived from a Global Budget. However, the Director was vague about details on the latter point; being unsure whether AHW as financial agent for the patient, received a record. In reference to my purpose of maintaining records, I asked for a signature which the Director produced; then queried about my absence from the facilitys computer file. The response explained that my information was in the (main, I had assumed) facilitys records, although I was unable to determine the exact location. Further questions concerning my information request in regard to length of time or procedure remained inconclusive. 40. Since I was already there, I decided to visit the facilitys records department to ascertain whether a clearer, quicker route was available. In contrast to the previous meeting in the lobby, I discovered there was an F.O.I.P office situated in the records department; which specifically handled such requests. The clerks manner was relaxed, my information request handled routinely; Although she became curious upon noting that I wasnt present in the facilitys computer records. She then phoned the main lab who indicated my absence from their computer as well. Somewhat apprehensive, I asked directions to the lab I was concerned with, which was again described as difficult to access independently. However, her day was not exceptionally busy and she agreed to lead the way. My intent was to determine if there were records of my testing in the labs computer files. 41. Unfortunately, I was intercepted just inside the entranceway by the Lab Director who seemed very surprised to see me. As the clerk who had accompanied me was unaware of my issue or thoughts behind my request, I felt the politics of politeness should govern the situation. Thus, I was unable to answer my question concerning a computer record. Though I did discover that the Director had just returned from a meeting with administration, whereby, the request would go through the process. Additionally, I was informed that all information concerning myself was restricted to that particular lab. Problems with Chromosome Report and Lab-work 42. By Jan. 27 2005, I had received the contents of my information request which served to galvanize my suspicions and push the situation between the doctors I had dealt with and myself, into a position of an official breach of trust. The key issue was the complete file relating to my chromosome testing as signed by the lab Director, which I had just received. However, secondary issues concerned duplicate end reports and a breach of privacy. The initial problem which was noted immediately was the lack of information to support the conclusions of the final report for the testing. The report stated that fifty mitoses (cells) were examined while there were only pictures for three slides (cells), karyotype forms for two of them, while the worksheet could only

18. demonstrate that two cells were worked on. Additionally, the picture of the slide without an associated karyotype form had a cross out and corrections made without initials. The correction stated that the chromosome count was 45 xo (- the y). Moreover, the summary sheet associated with the testing indicated that three out of fifty cells were 45 xo, (45 xo is also known as mosaicism), and that the test had been completed on Apr. 21 2004 ( just past the six week waiting mark). Thus, the test results waited an additional two months before being reviewed and signed by the lab Director. Finally, later research also revealed that 45 xo mosaicism of the sex chromosomes is associated with, mixed gonadal dysgenesis, XY Turners Syndrome and the inter-sexed condition, with symptoms in common with my medical history. For instance, if there had been a karyotype form for the picture of the 45 xo slide, then the report would have stated a 46xy/45xo karyotype. 43. The purpose of the test was to determine whether sex chromosome anomalies were present, yet they remained unreported. While the documentation also lacked the evidence to support the reports statement that 50 mitoses were examined. Without complete documentation the reports interpretation of a 46 xy normal male karyotype cannot be verified, although the Directors signed cover letter for the contents of my information request stated, what I had received was my complete file. Furthermore, the inconsistencies concerning corrections made, missing karyotype form (for slide of 45 xo cell), no evidence for 47 out of 50 mitoses, turnaround time, the relationship between mosaicism (45 xo) and intersexed condition in addition my medical history, signified that the reports validity was in doubt Duplicate Paperwork 44. Furthermore, I also noted a curious duplication of paperwork which also contributed to a circumstance for a breach of trust. The report I had received from the genetic specialists office(June 15, 2004) had been electronically signed yet writing on the top edge of the page indicated that it had been faxed (was missing facility logo). However in the complete file which I had just received, an identical report ( had a facility logo), which was hand signed and initialed; stated it had also been faxed on June 15, 2004. Upon my previous interview with the Director (Jan. 5), I had learned that the electronically signed report was sent due to the amount of paperwork. Yet, the procedure would have been to print off a copy of an electronically signed report ( from a computer); then fax it to the genetic specialists office (unless a stack of electronically signed reports with my test results are kept handy for faxing instead of being sent out by computer). Thus out of the two identical reports, the electronically signed report becomes redundant as efficiency would favor the hand-signed one, although both reports indicated they were faxed on June 15, 2004.

19. 45. However, a later F.O.I.P request for medical records (May 10) sent to the genetic specialist, revealed neither evidence of a hand-signed report having been faxed nor any lab-work concerning my chromosome testing. The issue of patient and doctor trust was additionally heightened upon discovering that the records demonstrated the lab Director: failed to report findings of sex chromosome anomalies to the specialist on June 15th 2004; yet reported on my visit of Jan 5th 2005 ( reported as strange in my records from the specialists). 46. Consequently, it could be conjectured that the lab Director informed the genetic specialist, as to the contents of my personal information request. It also lends to the speculation that nonprofessional exchanges of information concerning, my actions, requests and privacy, might happen more than once. Considering the Facts 47. The inconsistencies which the complete file revealed served to focus my resolve concerning my Gender Identity issue. This corresponded to the growing possibility that my memories were correct and consistent with my medical history. However, to be correct concerning my memories and medical history, also suggests unprofessional behavior on the part of the physicians involved. Hence, the situation had also become a question concerning professional ethics, an individuals rights and a personal debate over the problems resolution. Ethically, the sex chromosome abnormalities should have been reported. It served the purpose of the testing to do so. The information was withheld, yet by doing so it prevented further investigation into the biological cause. Additionally, I had been previously denied a second opinion, while legal assistance was also untenable do to cost and credibility. Furthermore, Human Rights legislation is nonexistent for the Inter-sexed or Transgender, though Gender Identity is recognized by the medical community as a genuine issue. The only route concerning advocacy was the chain of accountability or having doctors investigate other doctors. Therefore my solution was to pursue billing question, gather medical records and have a third party verify the lab reports validity. Freedom of Information Requests 48. By mid-Jan. 2005, I had also sent an information request to Alberta Health and Wellness to request a statement of benefits regarding the billing for my chromosome testing. The result was inconclusive which forced a complaint to the Privacy Commissioner (Feb 15) to review the matter. It took until May 9th , for AHW to reply to the Privacy Commissioner, whereby, I learned that the billing was done through the health region. I then let the matter lay, as I was also gathering other information. 49. During Mar. 2005, I had received the contents of an information request from the walk-in health clinic, which also included a copy of my mental health records. The mistakes in their reporting were so numerous that I sent a follow-up letter (Apr. 27) to request that amendments be attached to my file.

20. 50. Unfortunately, an information request sent to my former counselor (Apr.) for my records was ignored. It was explained that since the organization was private and nonprofit, it did not fall under either the F.O.I.P or P.I.P.A process (I would need a lawyer). My request simply asked, for a copy of the letter he had sent, along with an account record of the number of my visits. Without the release of those records I was unable to determine what had been written to the adoption agency or readily prove to a third party that I had visited a counselor. 51. Further information requests (May 10, 2005) had revealed the contents of the specialists assessment of our initial interview, wherein; he explained that based upon my medical history my issue could be chromosomal. However, with the same breath, the assessment continued his thoughts to conclude: that while my issues could be chromosomal they were more likely an abnormality of prenatal development, rather than an acquired phenomenon. The contradiction in the statement has underscored the problem facing myself since the beginning: receiving help yet not receiving help. However, the records also indicated that my visit to the lab on Jan. 5th had been reported to the specialist, whom it did not concern. 52. Additionally, my information request to my family physician arrived at the same time as the specialists (May 10), yet, both had exceeded the 30-day period response period. His records demonstrated that he was in possession of the specialists assessment at the time he stated, Gender Identity is just in your head. There were also difficulties in receiving my records from him, as he had desired, that I receive them in person and pay in cash. In my response letter, I informed him that I no longer felt confident in his ability to administer my health concerns. 53. A request made in May to the radiologists who had preformed my periodic ultrasounds was completely ignored. I issued another request on Aug. 10th 2005 which was partially met although information was missing which prompted another complaint to the Privacy Commissioner (Sept. 27). The purpose of my request was to retain documentation and pictorial records as to the type and extent of the calcifications affecting the testes. As of Dec 12th, the issue has still been unresolved. 54. Furthermore on Aug. 11th 2005, I sent an information request to the Health Region for a statement of benefits concerning my chromosome testing. On Sept. 27th, I filed another complaint with the Privacy Commissioner, as the Health Region had failed to release the requested information. On Oct. 11th the Health region responded and confirmed, no individual billings for that service no records exist relating to the subject of your request. However, the situation hasnt been resolved as the response letter referred to my test as, Karyotype testing. Other signed documentation indicated the test was known as chromosome testing. It is significant from a record keeping point of

21. view to clarify the title, as the word Karyotype only appeared in the reports conclusions. Also, additional inquiries into an understanding of the cost breakdown for the testing are still ongoing. However, I can conclude that all information concerning my testing is restricted to the lab. Meaning, Alberta Health and Wellness would have no billing record for the testing. Hence, no knowledge of what Ive spent tax dollars on. Verification of Testing 55. Attempts at verifying the reports validity have been met with similar difficulties which I discovered on my first attempt to have a physicians opinion, concerning documentation for the chromosome testing. As I had returned to the walk-in Health Center in May to schedule an up coming ultrasound, on the resultant follow-up, I brought up the issue of the chromosome tests documentation. The physician stated she couldnt comment on them but as my current test results recommended a urologist consultation, she referred my questions to him. Thus, I was required to wait until Sept. 7th before another opportunity could arise where I could ask for another opinion. 56. On June 8th 2005, I wrote to the Patient Advocacy dept. at the Alberta College of Physicians and Surgeons, with a detailed complaint and expressed my desire for a third party determination of the reports validity. By June 20th I had received a reply explaining that they could not answer my complaint fully, as the Lab Director was not accredited by the College. Instead my question was changed to, why wasnt enough testing ordered and also concerned, detected bias in the specialists assessment. Those questions were not present in my signed complaint. Additionally, paperwork has proved that he ordered the test; it was the Directors responsibility to enact them according to the procedures set forth in the Labs bench manuals. 57. On July 28th after further research (and a rest), I wrote to the assistant registrar who was responsible for the Patient Advocacy dept. I had tied the question down to standards and guidelines in regard to record keeping and reporting. Again the focus was, could an unbiased third party reach the conclusions of the report based on the complete file which I had received. Ultimately asking if the report was valid or not. I also mentioned that on their web site the lab was listed as accredited, while their bylaws also stated that the director of a lab must be accredited, whether medical practitioner or physician. 58. The response I received on Aug. 8th informed me that the College did not accredit the particular lab in question. The reason stated was that the Medical Professions Act does not empower the college to approve a service that is not a medical practice. Also as the lab in question was not directly under control of a College member it was not within their jurisdiction. However, I was informed that the lab was directly accountable to the Health Region.

22. 59. On Sept. 7th during a Urologists appointment in regard to screening for lowrisk cancer of the testes. I brought up the issue on the chromosome testing and asked for an opinion concerning documentation and validity. However, he explained that it wasnt his area of expertise and declined to do so. Conclusions Concerning Inner Conflict 60. The failure to gain an opinion from the Urologist concerning the report caused depression and anxiety. I was in limbo concerning my issue and the practical issues governing life (work, planning ahead etc.) as their resolution was linked to a single question, was I born inter-sexed. My memories, medical history, reasoning process and reflection upon subjective spiritual truths, all points toward being born inter-sexed. Chronologically, I had arrived at the inter-sexed conclusion first through examining biology and environmental factors. It wasnt until the catalyst of the billing question that I began to seriously reflect upon subjective spiritual truth. Until then, I had been performing mental gymnastics in trying to reconcile my issue to an ingrained literal interpretation of my belief system. Though over the years Ive learned such words as: metaphor, allegory, polytheism and mythology. However, the same triangulation process used for examining behavior and environment, juxtaposes, with spiritual interpretation as well. Hence, I found myself with two independent examinations which pointed to the same conclusion. Based on mind (without God) and spiritual truth (belief in God), both positions could stand independently. Thus, the possibility of selfdeception concerning memories was of lessened importance. First Step Towards Transitioning 61. Realizing that determining the validity of the testing didnt seem likely to be realized in the near future, I decided to move forward with the transitioning process by accessing the Human Sexuality Program which I had been referred to in Nov. 2004. I needed a physicians or psychologists referral so decided to call the private psychologist Id heard about to explain my dilemma. I was disappointed to discover that the information I had received was outdated as the program had been cancelled two years previously. Her suggestion was to access a physician friendly toward Gender Issues whom she named, who could then refer me to one of the two publicly funded psychiatrists in Alberta, who specialize in gender problems. 62. Hence, I was accepted by a new family physician on Sept. 22nd 2005 who seemed interested in helping with my health concerns. However, I entered the relationship without mentioning the previous work I had done regarding the biological cause. When the issue eventually came up concerning the validity of the report, I stated that I would not press him for a determination. I explained what measures I had taken to verify the report through the chain of accountability, whereby; I expressed my desire to keep the process which I had entered separate from the issue of cause.

23. 63. On Nov. 8th 2005, I had my first appointment with the psychiatrist in Edmonton. The outcome was indeterminate as follow-up appointments were necessary. Unfortunately cost of travel and time off work has been a prohibitive factor in accessing the process. Analysis 64. Since coming forward with my issue I have experienced a contradiction with five main sources of information: my sister, adoption agency, former family physician, genetic specialist and lab Director. My sister has given two opposite stories, the adoption agency reported no anomalies ( which sister contradicted), the family physician violated my rights while revealing his bias; the genetic specialist revealed his bias in his assessment and the lab Director failed to report the sex chromosome abnormalities. Combined with the contradictions found in: the tests documentation, problems with accessing information, the inability to acquire an unbiased third party opinion, while also the suggestion that my privacy had been violated (doctors talking between themselves), lends to the conclusion that my perception of a breach of trust is justified. 65. From an ethical standpoint the physicians involved, whether it is design or incompetence; have placed the vested interests of the medical community above the patients. I believe those interests to be that Gender Identity should remain a psychological problem, whereby; their subjective truth might maintain the trappings of morality in regard to treatment for the inter-sexed condition. To be proven correct in my belief that my Gender Identity issue has a biological basis, where, it was also known as a child, would reveal the current physicians involved as practitioners of bad science. Instead, they have denied themselves the opportunity to acquire another example, that the general practice toward the intersexed is wrong. Thus, from the difficulties of initially bringing my issue forward, to attempts at verifying the cause; I have experienced poor treatment from a community who is supposed to put the patients interest first 66. Put in perspective, my situation is the case of having my personal conclusions concerning cause in hand, yet being held in limbo; while I chase the verdict, which would vindicate my solution (transitioning). Personally it has become a case of seeking justice for my reasoning, morality and spiritual beliefs as opposed to the medical communitys values which have been forced upon me. The product of their values has left me in a prolonged state of conflict.

67. In context to the chronological order of events, I believe my childhood memories were repressed contents which have emerged, as opposed to selfdeception. That future information supported these memories in addition to my medical history, lends belief that my reasoning was sound. Thus, based upon memory, medical history, environmental factors and subjective spiritual truth, I believe I was born inter-sexed and that it is the root cause of my Gender Identity issue.

24. 68. Ultimately, societys values and the medical communitys, condone a practice at the expense of the individual. The law defines gender as man or woman which is reflected in Human Rights legislation, at both Federal and Provincial levels. There is no mention of inter-sexed or Transgender. Yet, I have been unable to find the legislation which grants the medical community or the State the right, to determine an inter-sexed individuals gender. Thus, while my issue is a personal problem involving Gender Identity and access to health care, the problem is connected to a larger issue concerning, the freedom of choice to determine ones own gender, for the affected individual. 69. Unfortunately, my circumstances are such that I am reliant upon the chain of accountability to mitigate on my behalf, concerning this breach of trust. However, my perception depicts a marginalized treatment of my health interests in this matter due to Gender Politics. Thus, I have a personal choice between reconciling my reasoning and spiritual beliefs with my issue or to simply forget about them and transition blindly. Although, I would always be burdened with the belief that I was born inter-sexed with its inherent baggage. Where, the problem would be solved without being solved, while I waited for somebody else to expose the inequalities besetting those with Gender Identity problems. Therefore, I have decided to bring the issue concerning this breach of trust to the Publics awareness. 70. The decision to do so is based upon my latest attempt to have an unbiased third party determine the validity of the chromosome testing report. On Nov. 24th 2005, I sent a complaint to the Health Regions Patient Representative Services depicting: my gender issue, breach of trust and the aforementioned need for an unbiased third party to determine the reports validity. I also requested written confirmation of my complaint. Instead I received a message from their office on Nov. 28th requesting a call back. In returning the call on the 29th, I discovered information which confirmed my doubts as I was informed that my complaint had been forwarded to the manager of the lab and the Executive Medical Officer. Further clarification revealed that by manager, she meant Director. I clearly replied that it is of no use to have the person my complaint involved, investigate my complaint. Additionally, I expressed that the unbiased third party, should come from outside the lab or main facility in question. I was then reassured that the Executive Medical Director worked for the Health Region. However, later cross checking revealed that the person she named was the Medical Director for the main facility. Thus, my complaint is currently being investigated by the very organization Ive complained against. 71. Under these circumstances my course of action has been predetermined. For instance, if the investigation revealed no discrepancies yet I wished to contest the findings (by another third party), there would be no viable recourse. The

25. Ombudsmans office does not have jurisdiction over the Health Region which leaves either the Provincial or Federal Health Minister as the last recourse. Although, I could wait in the hopes that the investigators incriminate themselves, and if not, the next level would be Provincial. Albeit, I have no justification to doubt the integrity of the Ministers office, yet I must also consider the implications of the whole issue and my relative position. Delays of process might find a different government in office by the time my complaint reached the Federal level. 72. Thus, the only course of action available is to send a complaint to the Federal Health Minister in hope of receiving a determination on the validity of the chromosome test report. However, the specter of a change in government and resultant ideologies has heightened the circumstances, whereby; to ensure an unbiased determination, would require added weight. Therefore, I am required by my circumstances to gain public exposure to the problem if I wish to resolve my issue. A proposal for a Moral Solution 73. Given that my analysis of the lab-work behind the chromosome test is correct and my breach of trust is justified, meaning, the report is invalid. Then my position is that of Jan. 22nd 2004, when I first put forward my request for testing which initiated the investigation into a biological cause for my Gender Identity issue. 74. In that case my personal rights will have been violated in regard to reporting, access to health care, in addition to the prolonged anxiety and conflict which Ive had to endure. The problem then concerns a second opinion which I have also been denied. However, considering the problems which have already arisen, the question of bias from the medical community would still remain. As my resources are limited, I am unable to leave the Province at this time. The best solution would be to request the Federal Health Minister to verify the validity of the report. I would also request my Federal MP to have the issue investigated by the RCMP since an adoption agency outside of the Province was also involved. Additionally, the agency would have my complete medical records from birth, although what I had received was only a synopsis. In that way, a third party investigation relieves the prospect of a potential problem with the medical community concerning bias. 75. However, there are larger implications concerning this issue, wherein, the practical situation places me back to Jan.22nd 2004; yet my personal conclusions have been drawn for nearly a year. Those conclude that I was born inter-sexed and that it is the root cause of my Gender Identity issue. Therefore, I can determine that my current problem stems from an incorrect decision made in my childhood. Yet, that decision was based on societies values and sciences theories concerning gender, although those values also denied myself a choice as a child and the truth as an adult. In short, that places my position between both science and organized religion. Whereas, the core purpose of my

26. complaint is to make my own determination of my gender by which to reconcile my issue with my spiritual beliefs. 76. In regard to raising public awareness of this issue, my motive is basic. My personal circumstances require myself to act if I wish to receive justice for myself and the situation Ive been placed in. The desire to expose oneself in public has never afflicted me before. Yet stepping forward to seek personal justice also has its moral pitfalls. To be proven correct would also necessitate harming others who might be deemed liable. Individually, those involved are probably decent people who made their decisions according to the prevalent conventional wisdom. That does not mean that I am happy with them either. Hence to act, benefits myself, raises public awareness; yet would harm others. 77. However, stepping forward could also be an opportunity to turn a bad situation into a greater good. Whereas, my purpose is to reconcile my Gender Issue with my spiritual beliefs, society is also conflicted over gender and spiritual beliefs. Yet if I were proven correct, it would be society who determined my gender and spiritual beliefs (I could have been given to atheists instead). Under these conditions a relationship exists between my personal situation and the larger one affecting society. Whereby, my present Gender Identity conflict is the literal outcome of societys gender experiments. 78. In context to the greater good an opportunity exists to examine the problem from an untainted source. The situation has presented an individual with negligible familial connections, no political or religious affiliations nor any vested interest other than to reconcile an individual conflict over gender and spirituality. It is the closest thing to a slide under the microscope that is likely to be forthcoming. Though the question is, would society let its gender experiment speak on its own behalf and present the results? . 79. Under those circumstances an avenue exists to reach a moral outcome without benefiting from harming others. Thus, if one agreed that the argument Ive presented based on the chronological history and accompanying documentation (sent to Fed. Health Min), has a 50 percent chance of being correct, I would argue it has a 100 percent chance based upon subjective spiritual truth. 80. Given the personal necessity for raising public awareness to the current situation of a breach of trust. There could be only two outcomes from my position based on argument, belief and documentation, while four outcomes exist from an outsiders perspective. From my position there could be the moral solution where I could publicly argue my case for defining my own gender, wherein, the afflicted might interject a point between science and religion. The other outcome leads to investigation, placing blame and a Human Rights complaint. To the outsiders view the first two remain the same but the other two would be the inverse. The moral course would remain moral yet the outcome would be personal selfdeception and exposure to ridicule. While the inverse of

27. the second outcome, would be boiled down to shoddy paperwork, reprimand etc. 81. From the perspective that there is a necessity for public awareness, the second choice is the most personally advantageous. Again the problem is the question of morality. It would be impossible to present a spiritual argument to define my own gender if the full course of investigation and reprisal were followed. Could one profess to argue a spiritual subjective truth while seeking justice through legal means?. If not for the threat of the election, I could follow that course with no public exposure, though as my choices are between personal good and greater good, the moral obligation is to choose the greater, if I am to uphold my own beliefs. 82. Thus, if the relationship between my issue, societys values, gender and spirituality were acknowledged, then a moral solution to the breach of trust between my issue and the medical community could be found. Arguing publicly for the determination of my own gender has merit, as subjective truths which might offend from other quarters, would be no threat considering the source. Wherein, the long forgotten practice of forgiving ones opponents might turn a future animosity into co-operation. In favor of that choice, I would forgo seeking the kind of justice which would benefit only my personal good. My interest lies with reconciling my Gender issue with my spirituality, not liability suits, or politics. To state my argument concerning Gender Identity publicly would be precedent enough. 83. However, if that chance arose what would I say? . In truth I have to accept my limitations as I couldnt argue point for point with a psychologist, biologist or a theologian. I am an individual who has learned mostly through life experience. Yet if the problem could be cut down to size, within a specific scope, I believe I could accomplish the moral choice. Therefore, if one conceded that a relationship exists between my Gender issue, spiritual conflict and societys, whereby, a 50 percent chance was a given, that societys values literally determined my gender and spirituality. Then the Public would have a slide under the microscope to examine. In lieu of a political argument I could place a spiritual one by using belief (God exists), system of belief and subjective spiritual truth (lifes lessons). The focus would be specific and would explain how my gender issue and spirituality could be the same thing. Under that context, I could speak with authority without worrying about footnotes as the contents would be the conclusions which have led me to present my proposal. Under those circumstances it wouldnt matter if I was considered sane or delusional as the contents of the argument would be the experiments results. 84. Therefore, my intention is to send my complaint to the Federal Health Minister and request that he investigate my breach of trust concerning the chromosome tests validity, reporting, and access to health care. Additionally, in a letter to my Federal MP, I will request assistance in acquiring a third party investigation should the report be invalidated. Finally, I intend to post this chronological history and proposal on the internet to let the public decide if it has merit. By doing so I will have done my best to seek justice for

28. myself and serve the greater good. Then it will be out of my hands and up to others to decide which choice they like best. 85. Finally, should the moral choice be chosen, I would request a precedent to be set by requiring disclosure from the Health Region involved and the adoption agency without recrimination, though I would expect a public apology. In that manner could a bad situation be turned too good and an example set for future actions.

Sincerely, Mark Duncan Amendments: The Letters to the Federal Health Minister, Federal MP and Provincial Health Minister, are copies and have been modified to protect privacy. The complaint and documentation were priority posted to the Federal Health Ministers office on Dec. 21, 2005. The requests to my Federal MP and Provincial Health Minister were also sent on the same day. Verification of my complaint and requests could be made through the appropriate offices. A response to my complaint to the Calgary Health Regions, Patient Representative Services, was also received on Dec. 21, 2005. I sent a copy of their response to the Federal and Provincial Health Ministers on Dec. 22, 2005. The response to my complaint to the Calgary Health Region has been censored to protect privacy. However, the signature on the document belongs to the Executive Medical Director of the facility cited in my complaint. Thus, the Patient Representative Services has not recognized my request to have an unbiased third party investigate the report and lab-work, nor have my specific questions been addressed.