How Gender Reassignment Works


Announcer

Welcome to Stuff You Should Know, from HowStuffWorks.com.

Josh Clark

Hey, and welcome to the podcast. I'm Josh - Joshua M. Clark; that's my nickname.

Chuck Bryant

M?

Josh Clark

Joshua M. Clark is my nickname.

Chuck Bryant

Okay.

Josh Clark

And there's Charles W. "Chuck" Bryant yapping already.

Chuck Bryant

Already.

Josh Clark

This is Stuff You Should Know.

Chuck Bryant

I broke the rule that you set on like the first week I was here. You were like, "Don't say anything for the first 60 seconds or you're out of here."

Josh Clark

That rule is true, Chuck. I'm afraid - yeah, we'll talk about this later.

Chuck Bryant

I have a prediction really quickly about this podcast.

Josh Clark

What?

Chuck Bryant

I predict that it will be our most serious and joke-free podcast to date.

Josh Clark

Yes, I also predict - piggybacking on your prediction - that by the time we leave the studio we'll have bloody, crescent-shape wounds in the palms of our hands from making this joke-free.

Chuck Bryant

Yeah, you can't joke about this.

Josh Clark

- Not that - no, you can't and the reason why - we should probably go ahead and specify why because we don't wanna give anyone the impression that we find transsexualism or gender reassignment funny.

Chuck Bryant

Right.

Josh Clark

That's not the point. The point is, what we've learned from this research is that more than just transsexuals have a stake in gender reassignment. Like, we could conceivably tick of, like, 80 different special interest groups with this one -

Chuck Bryant

- Yes, we could.

Josh Clark

- podcast. It's our most precarious podcast yet.

Chuck Bryant

Yeah, and my whole point is we just joke about everything. It's not like we find this funny, but we kid about everything and we can't kid about this. We can't because people get so upset if we make jokes about this.

Josh Clark

That's right.

Chuck Bryant

But I will lead with a joke, if I can.

Josh Clark

Yes, please.

Chuck Bryant

I went and typed in "transsexual" into Google because I was trying to - I was looking something up specifically. I can't remember what. And you know how they images that pop up. The first image that I saw was of a woman in a bikini and someone had Photoshopped Don Knotts' head onto the body. And that was like the first Google image for transsexual.

Josh Clark

Weird.

Chuck Bryant

It was a bad - it looked like a Martin Van Nostrand Photoshop job -

Josh Clark

- Got you, yeah.

Chuck Bryant

- with Don Knotts on a bikini. All right, so that's my only joke.

Josh Clark

Are you ready? I wonder if Van Nostrand could pretty much just reuse some of the Photoshop images that he's already sent us for this one.

Chuck Bryant

Yeah, probably. He's put our head on lots of female bodies.

Josh Clark

He has, most recently Roller Derby, Chuck.

Chuck Bryant

That's right.

Josh Clark

So, Chuck, have you heard about a man by the name of Scott Moore?

Chuck Bryant

No.

Josh Clark

Scott Moore is - he's a hefty guy. He was born Jessica Moore and by age 11, Jessica, now Scott, was pretty sure that she was supposed to be a man.

Chuck Bryant

Right.

Josh Clark

And basically got shortchanged by being born a girl.

Chuck Bryant

Sure.

Josh Clark

Scott went ahead and had gender reassignment surgery, but didn't go the full nine yards, and is now the world's second pregnant man. You wanna see him?

Chuck Bryant

Sure.

Josh Clark

He actually just looks like he's been drinking way too much beer lately.

Chuck Bryant

Yeah, he just looks like a big, fat guy.

Josh Clark

But he's living as a gay man, but he's a pregnant man. He's the world's second. As far as I know, the only other pregnant man is a guy named Scott Beatie, who in 2008 became the world's first pregnant man under pretty much the same circumstances. Scott was born a woman, became a man, didn't undergo all of the surgical procedures, which we'll get into later, and was capable of having a baby - a pregnant baby.

Chuck Bryant

- Yeah.

Josh Clark

- I mean, pregnant with a baby.

Chuck Bryant

I' glad you clarified that because I think we misspoke. We just brought him up in a previous podcast off the top of our head and I don't think we said the right thing. So -

Josh Clark

What was that? Cannonball Run?

Chuck Bryant

Yeah, I think so - Joke No. 2.

Josh Clark

Yeah.

Chuck Bryant

As long as we're not joking about the disorder then I think we're fine, right?

Josh Clark

I'm scared.

Chuck Bryant

Okay.

Josh Clark

So, Chuck, let's talk about exactly what people like Jessica, who became Scott, and Scott - and I don't know what the other Scott's first name was originally.

Chuck Bryant

Right. Oh, Scott Beatie's?

Josh Clark

Could it be more confusing -?

Chuck Bryant

- I know.

Josh Clark

- that last little quandary right there? How do you get to that point? Why do you get to that point? And what are some of the paths that they took and didn't take, and what is gender reassignment surgery, okay?

Chuck Bryant

Okay. Well, transsexualism, we should begin there. It is classified as a gender identity disorder and I've actually looked. There's a lot of people that have a problem with that - it's classification as a disorder.

Josh Clark

Even I had a problem with that -

Chuck Bryant

- Me, too.

Josh Clark

- right off the bat.

Chuck Bryant

Uh-huh.

Josh Clark

Because basically what you're saying -

Chuck Bryant

- A mental disorder.

Josh Clark

Yeah, it's classified in two different diagnostic manuals as a mental disorder.

Chuck Bryant

That's being fought though. Like, right now, the battle is going on. I saw that England and France have both declared it not a mental disorder.

Josh Clark

They declared war on it.

Chuck Bryant

Exactly, and critics say that there's no evidence. There's no scientific consensus or evidence that says - that points to the brain in something being wrong. So -

Josh Clark

Right, and one of the reasons why it's still classified as a mental disorder is because our understanding of gender is really - we have no idea whether it's socially conditioned as the radical feminist lobby believes.

Chuck Bryant

Sure.

Josh Clark

Or whether it's natural, which is basically inadvertently supported by the existence of transsexuals.

Chuck Bryant

Right.

Josh Clark

They're saying, "I'm naturally - I was a biologically born man, but I'm a woman, and it's not social. I've been like this all my life."

Chuck Bryant

Sure.

Josh Clark

"I should have been a girl," right?

Chuck Bryant

Right.

Josh Clark

So, that's just two groups that kinda butt heads over this what gender is.

Chuck Bryant

Just two.

Josh Clark

Just two.

Chuck Bryant

Of many that probably butt heads with others.

Josh Clark

Also, the field of psychology has a lot to lose in this one because they've been handling transsexualism. They staked their claim on it decades ago.

Chuck Bryant

Absolutely.

Josh Clark

And now, like you said, there's a lot of debate over whether it is a mental disorder.

Chuck Bryant

Yes, and who knows where that's gonna end up in the future? But transsexualism, we should go ahead and define this because we never defined roller derby. We had some foreign fans that wrote in and said, "You know, that's all great, but we didn't even - you never even said what it was until like 20 minutes in."

Josh Clark

Wow. That's like doing a podcast on hot dogs.

Chuck Bryant

I just figured people knew.

Josh Clark

Yeah.

Chuck Bryant

Roller derby is a sport, by the way.

Josh Clark

We should do a podcast on hot dogs.

Chuck Bryant

Transsexualism is when you are born and you are dissatisfied with your sexual identity, or your gender role, or your bodily characteristics. So -

Josh Clark

Like, if you are a boy, but you're feeling like a girl, you don't wanna look down and see your penis every day.

Chuck Bryant

No.

Josh Clark

And when you do, it's going to have a detrimental effect on your life until you lead it.

Chuck Bryant

Yeah, very confusing, I'm sure. And it's -

Josh Clark

- Not necessarily even confusing, but at the very least, irritating.

Chuck Bryant

Well, yeah.

Josh Clark

You know?

Chuck Bryant

Let's go ahead and say both.

Josh Clark

Okay.

Chuck Bryant

And you'll often hear the term "trapped" in a woman's body or "trapped" in a man's body. I think that's probably how they generally associate it. I have a couple of stats here, too, that seem a little more frequent than I thought. Apparently, 1 in every 2,500 U.S. citizens has undergone male-to-female gender reassignment surgery.

Josh Clark

That is a lot.

Chuck Bryant

So, if you go to a big concert, like a big stadium show with 50,000 people, there are potentially 20 people there - I guess it depends on what show - but 20 people who have undergone male to female reassignment surgery. That seems high.

Josh Clark

It does seem high, but that's the University of Michigan stat and Lynne Conway - that one link I sent you -

Chuck Bryant

- Yeah.

Josh Clark

- was University of Michigan. They have a, if not poorly presented, but very comprehensive site on transsexualism.

Chuck Bryant

Interesting.

Josh Clark

Yeah.

Chuck Bryant

And 1 in almost 12,000 males and 1 in about 30,000 females are transsexual adults.

Josh Clark

And I took that to mean like -

Chuck Bryant

- So, way more men.

Josh Clark

- full on, all the way, done with surgery, has gone step-by-step through the process, whereas that University of Michigan estimate was they've had some sort of surgical enhancement.

Chuck Bryant

Oh, okay, yeah.

Josh Clark

Seriously -

Chuck Bryant

- So, way more men than women, like, almost three times as many.

Josh Clark

Yeah.

Chuck Bryant

So, there's something to that.

Josh Clark

And when we were talking about Jessica becoming Scott, right?

Chuck Bryant

Yes.

Josh Clark

So, Jessica becoming Scott, girl to guy, is transman.

Chuck Bryant

Yes.

Josh Clark

And then going from male to female, or a male identifying with a female gender, is transwoman.

Chuck Bryant

Yes.

Josh Clark

So, transman or transwoman reflects what you identify with, not what you were born with biologically.

Chuck Bryant

Right, and this has been around probably as long as there have been people, but it has just been - I don't wanna say popular - but in the public eye -

Josh Clark

- It's so hot among the kids right now.

Chuck Bryant

- yeah, it hadn't been in the public eye since about the 1950s when a woman - an American woman named Christine Jorgenson - had to go to Denmark, because they didn't do the surgery in the States until 1966, to get her gender reassignment surgery and she was a pioneer along with Dr. Harry Benjamin, who was the physician who first coined that term. He did a lot of work - established a foundation that today is known as the World Professional Association for Transgender Health. They establish standards of care and basically, they are the place to go if you're a doctor, if you're a person who is confused -

Josh Clark

- Right.

Chuck Bryant

- for support.

Josh Clark

So, Christine Jorgenson couldn't have had her operation because - or had it not been for Harry Benjamin, probably. So, I read that a guy who was an influence on him, his name was Dr. Magnus Hirschfeld -

Chuck Bryant

- Yeah, that's a great name.

Josh Clark

- he was an early proponent of homosexual rights.

Chuck Bryant

Oh, really?

Josh Clark

Huge - in the '20s.

Chuck Bryant

Wow.

Josh Clark

He was also a psychiatrist and he influenced Dr. Benjamin, as did Alfred Kinsey, the sex researcher, the sexologist -

Chuck Bryant

- Yeah, Liam Neeson.

Josh Clark

- the sexecutioner. So, these two men were friends of Harry Benjamin's and their ideas, and theories, and research combined into Harry Benjamin, who became, like, this pioneer in the field of transsexualism - basically, took it out of the freak show status that it had.

Chuck Bryant

Right.

Josh Clark

And as with most things that psychology has helped with, especially in the middle of the 20th century, kinda brought it into a treatment kinda view. The weird thing is, is what we've come up with as a treatment for transsexualism is gender reassignment surgery.

Chuck Bryant

Yes, and that's -

Josh Clark

- which is unusual among what would be considered mental illnesses.

Chuck Bryant

I would say so, and that's Step 5 actually in a five-step process that begins long before the scalpel hits the body parts, let's say. The first thing is diagnostic assessment - we'll get into these in detail, but I'll just list them here - psychotherapy, what's called the real-life experience -

Josh Clark

- That's my favorite.

Chuck Bryant

- Mine, too - hormone therapy, and then finally, if you make it through all those steps, surgery.

Josh Clark

Right.

Chuck Bryant

If you want to. You don't always have to get the surgery.

Josh Clark

And you better have some dough, too, depending on where you get it.

Chuck Bryant

Yeah, what does it cost - $30,000.00? More?

Josh Clark

It depends. According to our article, which sourced the San Francisco Gate newspaper, its $37,000.00 to go transman, female to male?

Chuck Bryant

Female to male.

Josh Clark

And then - no, I'm sorry. It's $77,000.00 to go from a female to a male, and the penis is the price-pusher. Apparently, if you want a really good, surgically-constructed penis -

Chuck Bryant

- Right.

Josh Clark

- you'd better be rich.

Chuck Bryant

I would think so.

Josh Clark

Because I guess it's an affordable, functional, sensitized, surgically-constructed is kinda a joke, apparently, among the transsexual community.

Chuck Bryant

A joke as in it's really hard to come by?

Josh Clark

Unattainable -

Chuck Bryant

- Unattainable.

Josh Clark

- unless you're rich, and even if you're rich, I have a feeling that it's not the easiest thing to find. There's probably one guy out there who knows exactly how to do it.

Chuck Bryant

Has the magic touch.

Josh Clark

And he makes like $5 million a procedure.

Chuck Bryant

Right. They also recommend - well, they don't recommend - but they say if you go other countries, like Thailand, you could pay as little as $8,000.00 or $9,000.00.

Josh Clark

Yes.

Chuck Bryant

But, I don't know about you, my friend, this is a pretty important surgery. If I was choosing to become a woman, I would not go to Thailand to do it.

Josh Clark

I think if you're -

Chuck Bryant

- Not to knock their surgeons.

Josh Clark

- going from male to female it's $37,000.00 and I have the impression that it's an easier procedure.

Chuck Bryant

Probably because, I mean, it's cheaper.

Josh Clark

It's just chopping off the bits. Actually, that is not true, and Chuck and I know it. Stop e-mailing right now. Calm down.

Chuck Bryant

That's not true.

Josh Clark

We went through some - on that University of Michigan site, there were illustrations of how to basically, perform transman - no, transwoman surgery.

Chuck Bryant

Sure.

Josh Clark

Removing the penis, etc., etc., creating the vagina. We're quite aware it's not just chopping off the bits.

Chuck Bryant

No, it's pretty amazing, actually.

Josh Clark

It is. Chuck?

Chuck Bryant

Josh?

Josh Clark

So, you talk about diagnosing this as a mental illness and if you're in the United States, and I take it also as in Europe as well, you have to go in to see a shrink and say, "I'm a transsexual. Let's get the mental health aspect out of the way so I can keep going."

Chuck Bryant

Yeah, you can't just say - you can't just sign up for surgery next week.

Josh Clark

Unless you go to Thailand.

Chuck Bryant

Well, yeah, and you have $8- or $9,000.00. In order to get diagnosed though, there's a couple of components. You have to have the desire to live and be accepted as another sex, and you have to have the desire to actually transform your body through hormone therapy and surgery.

Josh Clark

Right, because there's different types of gender association disorders. I make air quotes every time I'm saying disorders, right -?

Chuck Bryant

- Yeah, it bothers me, too.

Josh Clark

- for mental illness, but transsexualism falls under the larger umbrella of gender identity disorder, right?

Chuck Bryant

Yes.

Josh Clark

Okay and transsexualism is, like, the money gender identity disorder.

Chuck Bryant

Yeah.

Josh Clark

Like, if you are a transsexual, you don't wanna be in this biologically-born body any longer.

Chuck Bryant

Right.

Josh Clark

You want your -

Chuck Bryant

- Your container.

Josh Clark

You want your sex organs changed. You want to live as a member of the opposite sex. You probably want to marry somebody who's of your same-born biological sex.

Chuck Bryant

Right.

Josh Clark

And you're willing to go through the steps for that. There's also dual-role transvestism.

Chuck Bryant

Yeah, that's when you don't wanna have the surgery at all, correct?

Josh Clark

No, but you identify with both possibly.

Chuck Bryant

Right. Is that like Ed Wood?

Josh Clark

That's what I took it as.

Chuck Bryant

Okay.

Josh Clark

Transvestitism or transvestism is, from what I understand, cross-dressing.

Chuck Bryant

Sure.

Josh Clark

That's a symptom of it and yeah, like, I don't believe Ed Wood ever wanted to be a woman. He just liked wearing women's clothes or possibly had -

Chuck Bryant

- Or be with men. It had nothing to do with homosexuality either.

Josh Clark

Right, right. But again, it's like you're abnormal because you like angora.

Chuck Bryant

Right.

Josh Clark

So, this is a mental illness. This is No. 2. You're not the transsexual, but you are a transvestite.

Chuck Bryant

I like angora, too.

Josh Clark

There's also gender identity disorder of childhood. Who doesn't, Chuck?

Chuck Bryant

Yeah.

Josh Clark

That's where you like to play with dolls rather than Tonka trucks.

Chuck Bryant

Right, nature or nurture?

Josh Clark

Yes, and then, that one may clear up eventually.

Chuck Bryant

What do you mean?

Josh Clark

Like, I think that that - since it's of childhood, there's another diagnosis according to the DSM-IV that gender identity disorder of adulthood. No, I'm sorry. That's in the International Classification of Diseases 10. There is gender identity disorder in childhood, and then adolescence, and adulthood.

Chuck Bryant

So, if your William wants a doll, they say you might grow out of it and eventually want to play football because, "Guys can't play with dolls."

Josh Clark

Right or William might really want to be Sally, but if you take him in a kid, he's going to get diagnosed as gender identity disorder of childhood.

Chuck Bryant

Right.

Josh Clark

If he stays in therapy, or is treated, or whatever into adolescence and adulthood that diagnosis would change, or if he went back later on as an adult, he would be rediagnosed as that.

Chuck Bryant

There is a lot of diagnosis in - what I gathered from this article is so much has to go into getting this done, they really, really, really want to make sure that you are sure that this something you wanna do.

Josh Clark

Right.

Chuck Bryant

You gotta jump through a lot of hoops. It's not like -

Josh Clark

Yeah, it's just like - go ahead.

Chuck Bryant

I mean, you can go in there and I can get my belly fat removed tomorrow if I wanted to.

Josh Clark

Sure, you could do it right now.

Chuck Bryant

- They don't ask - yeah, let's do it. But I don't know any other kinda, like, plastic surgery you can just go in and get anything want done, but this, you have to jump through hoops for.

Josh Clark

You definitely do.

Chuck Bryant

And maybe for a good reason because it's a big deal.

Josh Clark

For many good reasons, also. Real quick, let's talk about the - there's also other gender identity disorders, which is like the, "I don't know," and "Unspecified," which is like the, "I really don't know what this is." A lot of times, they're associated with intersex conditions like ambiguous genitalia.

Chuck Bryant

Yes, like the old rumor about Jamie Lee Curtis.

Josh Clark

I'm glad you brought that up because her father died yesterday.

Chuck Bryant

I know, R.I.P. Tony Curtis.

Josh Clark

Isn't that weird that we would do this?

Chuck Bryant

Yeah, but the Jamie Lee Curtis thing, I should mention, is not confirmed. It has always been a rumor and the reason it still has legs, I think, is because she's never commented on it publicly and said, "No, this is not true." She's just been like, "You know what? Stay out of my business."

Josh Clark

Good for her.

Chuck Bryant

Yeah, that's what I say.

Josh Clark

You go girl.

Chuck Bryant

That's what I say, too.

Josh Clark

Chuck, apparently ambiguous genitalia is a very, very rare disorder and I was reading up on it on the Mayo Clinic's website - the most trusted leader in health, the most regular consumer - the most voracious consumer of white lab coats. Yeah, that was a lot for that stupid joke, wasn't it?

Chuck Bryant

Yeah.

Josh Clark

And they were saying that most surgeons like to talk the family out of gender assignment surgery - sexual assignment surgery, actually is what I found it's called - sexual reassignment surgery.

Chuck Bryant

What? When they're born with ambiguous genitalia?

Josh Clark

Any time. Technically, this article on our site should be called Sexual Reassignment. Most of the sources I ran up on called it sexual reassignment surgery.

Chuck Bryant

Got you.

Josh Clark

But most surgeons, when a child comes out with ambiguous genitalia, the surgeon is like, "We should wait for the kid."

Chuck Bryant

To see if it works itself out?

Josh Clark

More like, "We want the kid to grow up and decide whether he or she wants to be a boy or a girl."

Chuck Bryant

Got you. Got you. Got you.

Josh Clark

"But we should leave it up to the kid." That's if it's really down the middle. In some cases, apparently, an enlarged clitoris can look an awful lot like a penis. That can be the result of a hormone imbalance. So, they'll just give you hormones and then the clitoris goes woop and shrinks.

Chuck Bryant

Right.

Josh Clark

Then, a lot of times also, the internal reproductive organs will dictate what the external genitalia should be.

Chuck Bryant

Oh, that makes sense.

Josh Clark

Right?

Chuck Bryant

Yeah.

Josh Clark

But if it's really up in the air, the physician apparently likes to wait until the kid can say something.

Chuck Bryant

That makes for a rough adolescence, I bet, but it's probably the right thing to do, you know?

Josh Clark

Yeah.

Chuck Bryant

That's a tough one. All right, Josh, so you're diagnosed. You've gone through the psychiatric evaluation. You're clinically diagnosed and now there are three phases: hormone therapy, your real-life experience, and surgery. It doesn't always happen in that order because every person's journey to their ultimate gender destination is different and you get it tailored for your own path that you wanna take. So, you don't always have bottom surgery - they call it. Sometimes you just have top surgery.

Josh Clark

They do not call it that.

Chuck Bryant

That's some of the common language for it, actually.

Josh Clark

Wow.

Chuck Bryant

Yes, because Chaz Bono says that she had top surgery and she says that, "I'm not gonna talk about whether or not I had bottom surgery. That's my business."And also, these things don't always happen in that specific order. So, let's say you are a female transitioning to a male. You may undergo hormone therapy, and go ahead, and have the top surgery for your real-life experience to make that more realistic, I guess.

Josh Clark

Well, yeah.

Chuck Bryant

And then, you have the hormone therapy after. I mean, it just depends. You can do what you wanna do, basically.

Josh Clark

But that makes a lot of sense because the real-life experience is you immersing yourself pre-operation. You're a pre-op transsexual and you're living for a year, I believe, as a member of the opposite sex.

Chuck Bryant

That's the real-life experience?

Josh Clark

Yes, but the point is, you're finding out if you can stand being treated as a woman or a man, if you are comfortable with it, if it really is the way you're supposed to be, or if like, there was something else going on that that's what you thought, but you found out before it was too late.

Chuck Bryant

It's like a test drive.

Josh Clark

It's exactly right.

Chuck Bryant

It's a one-year long test drive.

Josh Clark

It's a test drive. So, you would think that if a woman is going to try to live as a man, that's a transman, preoperative transsexual, you would want to remove the breasts, which is a pretty standard procedure. And you would wanna do that before you immerse yourself in the real-life experience, or else they're gonna be like, "You're not fooling anybody with that ACE bandage."

Chuck Bryant

Right.

Josh Clark

You know?

Chuck Bryant

Yeah, yeah, sure. Before you can do this though, you need to have a - before you can begin hormone therapy or surgery, you have to actually get a letter of recommendation from your physician and your psychiatrist or psychologist -

Josh Clark

- Or go to Thailand.

Chuck Bryant

- or go to Thailand, and there are also a few other criteria. You have to be 18. You can't get this done as a teenager - or I'm sorry - a pre-18-year-old teenager. You have to have full understanding about hormones and what they can do medically, what they cannot do medically - which is probably more important - and what the benefits and risks are. You have to have that minimum of three months of psychotherapy, a minimum of three months of real-life experience, show stable or improved mental health - which is interesting - and you have to demonstrate you can take hormones responsibly because that's not light matter.

Josh Clark

No. So, Chuck, let's say you go ahead and meet all this criteria. You've undergone your psychotherapy and you have a letter of recommendation from Dr. Egbert Norbert, right, saying, "This man should be a woman," right?

Chuck Bryant

Right.

Josh Clark

You undergo the hormone therapy and there's a lot of stuff you should expect, right? There's some stuff you're going to be expecting and then there's some unexpected side effects depending on which way you're going. By the way, hormones, if you're transman, you're going to be given androgens, like Testrone and things like that. If you're a transwoman, you're going to be given estrogen. These also may be synthesized from animals. There's a huge breakthrough in gender reassignment - the process - in 1941, when something called Premarin, which is a synthetic hormone that's synthesized from estrogen of pregnant mares -

Chuck Bryant

- Really?

Josh Clark

- pregnant horses -

Chuck Bryant

- Wow.

Josh Clark

- hit the market. All of a sudden, it was like, "Holy, cow. This changes everything."

Chuck Bryant

Interesting.

Josh Clark

I think that's when hormone therapy was really introduced was around that time.

Chuck Bryant

Yeah, I think some steroids are from animals, too. So -

Josh Clark

- Sure.

Chuck Bryant

- that makes sense.

Josh Clark

But if you do - do know some of the side effects?

Chuck Bryant

Yeah, well you - just wanna add - you might also be taking progesterone or testosterone blockers if you're a female trying to become a male and you can take it orally, injected, or transdermal. So, those are your options, but yeah Josh, if you're a male, you're undergoing hormone treatment and you're getting your injections, you can expect, as expected, breast growth, decrease in body hair, they're gonna redistribute your body fat into different places, decrease fertility. Your testicles will shrink, and you will get less frequent and less firm erections, which is a key if you wanna be a woman.

Josh Clark

Sure.

Chuck Bryant

That's the first step.

Josh Clark

You probably didn't want them in the first place.

Chuck Bryant

Right. Good news is if you decide about halfway through, "Oh, you know, I don't really like this, actually," most of these changes are reversible if you stop.

Josh Clark

Yeah, you just stop taking the hormones.

Chuck Bryant

Exactly, and it will go back to normal in most cases. Those are the positive effects that you want to happen.

Josh Clark

Right. Well, that's what you're expecting. There's some side effects that you wouldn't want, for example, blood clots, weight gain, and not just weight redistribution, but weight gain, as Chaz Bono has undergone.

Chuck Bryant

Yeah, she's larger.

Josh Clark

Liver disease and hypertension -

Chuck Bryant

- Or he, I should say.

Josh Clark

He, because you wanna refer to the transsexual by the gender they identify with.

Chuck Bryant

- Because she had the surgery. Right, right. He had the surgery in the 2009, late last year, and Chaz is officially a man now. So, I apologize. So, Josh, let's say you're a female undergoing hormone treatment. What are you gonna get?

Josh Clark

You're gonna get facial hair, buddy.

Chuck Bryant

That's one thing.

Josh Clark

You're gonna get testes, gonads, maybe. You're going to - your clitoris will be enlarged, you are going to have a deeper voice, and you're going to have a lot more body hair, but -

Chuck Bryant

- I knew there was gonna be.

Josh Clark

- there's also a "wah, wah, wah": you're gonna go bald.

Chuck Bryant

Yeah, male pattern baldness begins - that, to me, is just nature's cruelest joke. That's nature's cruelest joke, to me, period with men because a lot of guys have a big problem with that.

Josh Clark

Sure. Well, your hair moving down to your back as you age?

Chuck Bryant

Yeah, exactly.

Josh Clark

Yeah, that's pretty rotten. It's kinda like, "Your reproductive years are over."

Chuck Bryant

Well, yeah, but it's really unfair that you're saying, "All right, you're a transsexual. You wanna become a man. Like, this is what being a man is. You're gonna go bald and you're gonna have to start shaving your head."

Josh Clark

And then nature just smacks you on the bottom with the towel in the locker room.

Chuck Bryant

That's right.

Josh Clark

That's what being a man is.

Chuck Bryant

Just one of the guys. That also has some negative effects, too though, like infertility, acne, increased risk for heart attack - also, welcome to being a man - and increased potential for liver tumors.

Josh Clark

And you notice that in both, with hormones, in both directions, there was the risk of infertility. So, there's a lot of talk about ensuring that transsexuals know ahead of time, pre-surgery, pre-hormonal therapy that they need to bank their sperm, bank their eggs, just in case they're happy living as a member of the other sex -

Chuck Bryant

- If you want to - yeah, yeah.

Josh Clark

- but they wanna reproduce using their own genes. And prior to 2008, when Scott Beatie got pregnant, this really wasn't much of an issue, the infertility. It was just impossible to have a kid in utero post-op, right?

Chuck Bryant

Right.

Josh Clark

And now, this is something else that has to be discussed and explored prior to surgery, but before you take hormones, if you're a transsexual or you're considering undergoing gender reassignment, you better bank your junk.

Chuck Bryant

Not your junk.

Josh Clark

Bank you genetic junk.

Chuck Bryant

Right. So, Josh, we've been calling this gender reassignment surgery. We should be calling it gender reassignment surgeries for a very good reason because it's not a single procedure at all.

Josh Clark

No.

Chuck Bryant

And you can have - you can get the full works if you want or you can get just - you can tailor it to your own expectations, but potentially, you can get a lot of surgery.

Josh Clark

Yeah, and I guess, Chuck, we should probably say here that if you are of squeamish type, if you couldn't handle the cremation podcast, you should probably go ahead and just stop listening now. Maybe fast-forward a few minutes.

Chuck Bryant

It's my favorite thing when you encourage people to stop listening to our podcast.

Josh Clark

I don't encourage anybody to even begin listening in the first place, Chuck.

Chuck Bryant

It's a warning.

Josh Clark

Chuck?

Chuck Bryant

Yes?

Josh Clark

If you wanna go from - if you're a transwoman.

Chuck Bryant

Male to female.

Josh Clark

Yes, you are going to undergo a number of surgeries, like you said, including - let's start off with the oriectomy.

Chuck Bryant

Yeah, what is that?

Josh Clark

The oriectomy is the removal of the testicles, but the penis and scrotum remain.

Chuck Bryant

Orchiectomy, by the way.

Josh Clark

Oh, okay.

Chuck Bryant

I just wanna - there might be an oriectomy that's different.

Josh Clark

What is it?

Chuck Bryant

Orchiectomy.

Josh Clark

Orchiectomy.

Chuck Bryant

Yes.

Josh Clark

So, it's removing your orch, which is your testicles, but the penis and scrotum remain until the penectomy.

Chuck Bryant

Yeah, and that one's pretty self-explanatory, I think.

Josh Clark

It's the amputation of the penis.

Chuck Bryant

Yes. What's next?

Josh Clark

Well, there's - we should probably say, as a rule of thumb, when you're talking about surgeries, an ectomy is the removal or the amputation of something.

Chuck Bryant

Right, yeah.

Josh Clark

A plasty, the suffix plasty, indicates that something is being reshaped, remolded, or modified in a way that doesn't include amputation or removal.

Chuck Bryant

Like rhinoplasty, for instance, as everyone knows, is a nose job.

Josh Clark

Yes.

Chuck Bryant

Because they're reshaping your nose.

Josh Clark

Reshaping, yes. Even though they may remove parts of the nose, it's still a reshaping of it. They're not just taking your whole nose off.

Chuck Bryant

That would be a rhinoectomy, I guess.

Josh Clark

I guess it would.

Chuck Bryant

That's probably not a very common surgery.

Josh Clark

No.

Chuck Bryant

So, Josh, since you mentioned plasty, we should mention male to female patients might get vaginoplasty.

Josh Clark

Which is the plasty of a vagina?

Chuck Bryant

Clitoroplasty.

Josh Clark

The plasty of a clitoris.

Chuck Bryant

And labioplasty.

Josh Clark

Yes, they're all pretty self-explanatory. And I think this probably goes in order. It's removing the testicles first, and that's gonna do more than any hormone supplements are going to do by themselves.

Chuck Bryant

Oh, yeah.

Josh Clark

Because, you know, your testicles are your little hormone, androgen-producing buddies, and you take them out, and the hormones really kinda kick in. Then, you remove the penis, and then you start the rebuilding.

Chuck Bryant

Right.

Josh Clark

And again, on the University of Michigan website, there were illustrations. Apparently, there's this guy - I didn't tell you this. There's this doctor who made - single-handedly made - a little town called Trinidad, Colorado, one of the capitals of sex change operations.

Chuck Bryant

Really? How so?

Josh Clark

He started doing sex change operations.

Chuck Bryant

Oh, got you.

Josh Clark

But he was like the town surgeon. So, he did everything, but somebody came to him in 1969 and said, "Can you help me out?" The guy corresponded with, like, the two other doctors who were doing it because remember, we just started in the U.S. in '66. This was '69. So, he started corresponding with a physician in New York and then called Johns Hopkins, probably wrote them a letter, and said, "Do you have any info on this?" They sent him an illustrated step-by-step procedure of how to do this.

Chuck Bryant

So, he took a draw off a cigarette and was like, "Yeah, I can do that"?

Josh Clark

Yeah, that's exactly right, and he actually kept it a secret at first because it was a Catholic hospital and he didn't wanna offend the nuns.

Chuck Bryant

Well, yeah, of course the nuns.

Josh Clark

And then eventually did. So, this community became like one of the capitals of the sex change operation healthcare industry.

Chuck Bryant

Wow, and that town is now called Gender Reassignment, Colorado.

Josh Clark

Well, the guy died in 2006, but he was still - in 2000 article I ran across, he was still doing them.

Chuck Bryant

You know, thank God for all these pioneers that in the 1920s, and '40s, and '60s did things were, what I think, very brave at the time.

Josh Clark

Yeah, very, yeah.

Chuck Bryant

Especially - I mean, they could be ostracized. They could be fired. So -

Josh Clark

Well, we'll get into that, but that still happens.

Chuck Bryant

Well, yeah.

Josh Clark

So, Chuck, if you want to go from a woman to a man - transman -

Chuck Bryant

- Well, hold on. There's a few more male to females.

Josh Clark

Oh, okay, sorry.

Chuck Bryant

That's just to really take care of things. If you wanna go over and above, you can have anything from facial bone reconstruction, like correcting your hairline, making your forehead more prominent, brow lift, cheek implants, lip filling, jaw recontouring, and a tracheal shave.

Josh Clark

You just said recontouring like a Spaniard.

Chuck Bryant

What is that? How would you say it?

Josh Clark

Recontouring.

Chuck Bryant

Recontouring or a trachel shave. The only thing I can think that might be would be maybe your Adam's apple.

Josh Clark

That's exactly what it is.

Chuck Bryant

Oh, is it?

Josh Clark

The thyroid chondroplasty is also called a tracheal shave and that is getting rid of your Adam's apple.

Chuck Bryant

Because that's a dead giveaway.

Josh Clark

Oh, my God. It's like - just imagine real quick -

Chuck Bryant

- Yeah?

Josh Clark

- sticking a bamboo shoot under your fingernail and pulling up.

Chuck Bryant

Ow!

Josh Clark

That's what happens to me when I think about shaving off my part of my Adam's apple.

Chuck Bryant

Really?

Josh Clark

Yeah.

Chuck Bryant

I don't have a prominent Adam's apple. Do you? Oh, not really.

Josh Clark

Shut up.

Chuck Bryant

My buddy, Scotty boy, his is like he's got a golf ball down there.

Josh Clark

Yeah, but like don't you see guys like that and think, "How do you not bump into things with that thing?"

Chuck Bryant

Right.

Josh Clark

Like, doesn't that hurt? Like, it's just kinda out there. It's very vulnerable. I don't want anything to hit my Adam's apple.

Chuck Bryant

I don't either.

Josh Clark

No, it isn't very prominent, is it?

Chuck Bryant

Karate chop? No, not really. Maybe - I don't know.

Josh Clark

I'm feeling fine.

Chuck Bryant

And then you can also have vocal cord surgery or voice training to bring it down a little bit.

Josh Clark

Yeah, because we said with the hormones, if you start taking androgens and you're transman, the hormones are gonna lower your voice. But if your transwoman, you're gonna have to do something about your voice because the hormones probably aren't going to raise it.

Chuck Bryant

Right. So, female to male - let's go there.

Josh Clark

Oh, let's go there, Chuck. So, you need to have, my favorite, the salpingo-oophorectomy, which is the removal of the fallopian tube and an ovary. Apparently, you don't need to remove both.

Chuck Bryant

Oh, really?

Josh Clark

Hysterectomy, of course, which is the removal of the uterus, vaginectomy - removal of the vagina, and then you have all sorts of plasties, which - see if you can guess what the scrotoplasty is.

Chuck Bryant

I bet I know what that is.

Josh Clark

The phalloplasty.

Chuck Bryant

Yeah, that's pretty obvious.

Josh Clark

Again, that's price-pusher.

Chuck Bryant

Right.

Josh Clark

And then you will probably have Neuticals installed - testicular prosthetics.

Chuck Bryant

I have to find out -

Josh Clark

- But hold on. Let's see. We have the scrotum, the penis -

Chuck Bryant

- Creation of a neophallus. Did you mention that?

Josh Clark

That's the phalloplasty.

Chuck Bryant

Oh, okay.

Josh Clark

And interestingly, sometimes the clitoris will be turned into the head of the penis, the neophallus.

Chuck Bryant

Yes.

Josh Clark

And then they'll basically just take other parts. I don't know exactly what the rest of the penis would be constructed of, but the head of the penis is often the clitoris.

Chuck Bryant

Oh, I thought you were saying the other way around because - all right. Here's the deal.

Josh Clark

Okay.

Chuck Bryant

Let me break it down easily.

Josh Clark

Let's hear it.

Chuck Bryant

Sometimes, the head of the penis will be used as the clitoris. Sometimes there will be a neophallus with the clitoris at the end of that.

Josh Clark

Chuck, actually, that's a metaidoioplasty.

Chuck Bryant

Metaidoioplasty?

Josh Clark

Metaidoioplasty, right, which is basically - the clitoris is enlarged chemically, and then it's cut off, and that's the head of the penis now.

Chuck Bryant

Okay, so the goal here with both that and when they - obviously, they're using the clitoris and the head of the penis as - they're trying to give you sensitivity in your sexual organs post-op.

Josh Clark

Right, yes.

Chuck Bryant

That is the goal of keeping all these parts instead of just going complete plastic surgery and making fake things - fake parts - they want you to be able to have a successful sex life after your operation.

Josh Clark

That's a big part of it. There's a lot of study - well, not a lot. I'm sure it's been called for for more, but there's been studies of regret among post-operative sexual reassignment patients, and one of the things that they found is a big factor is the presence and quality of a partner and the presence and quality of a satisfying sex life afterward.

Chuck Bryant

I would say that's a huge, huge factor.

Josh Clark

Sure.

Chuck Bryant

I didn't trust this stat for some reason. Maybe it was because it was from 1992 in the article that said that less than 1 percent of female to males say they regretted it and 1 to 1.5 percent of male to females said they regretted it. I don't know if I - it's so long ago. Do you trust that?

Josh Clark

I - on this study -

Chuck Bryant

- I'd say it was true in 1992.

Josh Clark

The study I saw, there was one that was written in 2006, and I didn't see any stats, but I did get the impression that it's pretty low. But there's really two factors or there's two standards that the - what is the World - WPATH, who, by the way, Chuck, will have just wrapped up this time next year, 2011, their biennial symposium in Atlanta, Georgia.

Chuck Bryant

Oh, really?

Josh Clark

Yeah.

Chuck Bryant

Oh, we should go.

Josh Clark

We totally should, but WPATH, their standards of care says basically like if you have deep, irreversible regret or you're openly saying, "I want to go back -"

Chuck Bryant

- You can't go back though, can you?

Josh Clark

You can. There's a BBC documentary on a guy whose family left him after his business went under.

Chuck Bryant

Oh, really?

Josh Clark

He was a millionaire and he went from - he was a transwoman and the documentary was about how he wants to become a man again.

Chuck Bryant

Got you.

Josh Clark

The two measures of failure or when you shouldn't have gotten the gender reassignment surgery is deep regret and suicide. But I did get the impression that it is fairly uncommon.

Chuck Bryant

Yeah, well -

Josh Clark

- Did you remember what we were even talking about?

Chuck Bryant

Yeah, yeah, and I think it's probably uncommon because of all the hoops and the length of time it takes to really complete this thing -

Josh Clark

- Right.

Chuck Bryant

- which is, like I said, is a good thing. They really, really wanna make sure that you're positive that this is something you wanna do.

Josh Clark

So, let's say that you've undergone it. You're happy with the result. You don't express regret and you're living a new life. What are some of the things that you're going to be facing as a transman or a transwoman who's had top and bottom surgery, as it's put by Chaz Bono.

Chuck Bryant

You're going to be facing bigotry, hatred. You might have things thrown at you. You might get beat up. You might get fired. You might be - you can get married.

Josh Clark

Yeah.

Chuck Bryant

So, that's a good thing, but a lot of bad things are gonna come your way from a lot of people.

Josh Clark

And there's not a lot of protection under the law for transsexuals. They don't fall into hate crime bills and as a matter of fact, see if this strikes you as Draconian: In most states, to undergo a sex change operation legally, you have to put a notice in the local paper, in the legal organ.

Chuck Bryant

Yeah, is that still a thing?

Josh Clark

I think so.

Chuck Bryant

Do you remember the case of Vandy Beth Glenn in Georgia?

Josh Clark

Yeah.

Chuck Bryant

Recently?

Josh Clark

No.

Chuck Bryant

She worked for two years in the General Assemblies Office of Legislative Council as an editor and proofreader of bill language right here in Georgia, and she was fired when she told her boss, "You know what? I want to be a female now and I want you to refer to me as a female. I'm gonna undergo the surgery and this is what I'm gonna do," and he fired her. She just won a lawsuit this year.

Josh Clark

Good for her. That's too, though because there's not a lot of, again, anti-discrimination protection including in the workplace.

Chuck Bryant

Basically, they were able to prove that, "This is the reason that I was fired." What other famous cases besides Chaz Bono? Did you hear about Warren Beatty's daughter? This is alleged.

Josh Clark

What?

Chuck Bryant

Warren Beatty and Annette Bening's oldest kid, Kathlyn, is 18 years old and allegedly, has been living as a man for the past two years as Steven Ira, and wants to have gender reassignment surgery now that she is 18. Apparently - and this is all alleged. I mean, this is as of this week that it's starting come out. Apparently, Annette Bening is trying to be supportive and Warren Beatty is having some problems with it.

Josh Clark

What is wrong with that generation?

Chuck Bryant

Well, it didn't say that he was being a big jerk about it. They just said that he's kinda struggling with it. So, you know?

Josh Clark

Huh.

Chuck Bryant

Maybe he'll struggle through it, and come out the other side, and everything will be all right.

Josh Clark

Remember that Saturday Night Live ad for Homocil?

Chuck Bryant

No.

Josh Clark

It was like an antidepressant for parents whose kids are gay.

Chuck Bryant

Oh, really?

Josh Clark

And they're like, "Because it's your problem, not theirs." That was, like, the slogan for it. It was awesome, actually.

Chuck Bryant

Have you ever seen the T-shirts on Saint Patrick's Day - "Mom, Dad, I'm Gaelic"?

Josh Clark

No.

Chuck Bryant

Those are pretty funny.

Josh Clark

That is funny.

Chuck Bryant

Also, we should mention, too, that my brother, when he lived in Los Angeles, his super underwent gender reassignment surgery.

Josh Clark

Wow.

Chuck Bryant

He went from Calvin to Risa -

Josh Clark

- Huh.

Chuck Bryant

- over Christmas. So, Scott left to come home. Calvin was a man - I think was from Thailand - and he came back, and he was met with Risa, a very lovely woman -

Josh Clark

- Wow.

Chuck Bryant

- as his super that was good with a wrench.

Josh Clark

So, Chuck, I don't know anybody who's undergone gender reassignment surgery, but I'm glad that I know more about this now.

Chuck Bryant

Yeah, me too.

Josh Clark

I'm interested to see in 20 years how the mental health industry - what kinda claim it still has on it, or what it's doing to help it along, or whatever because it's clearly facilitating this process. But again, I don't think it's a mental illness. So, I think probably most transsexuals don't think that they're mentally ill.

Chuck Bryant

Well, we have - I know for a fact we have some transsexual listeners because they have written in before. So, I hope we did a good job with this. I hope we were appropriately respectful and all that stuff -

Josh Clark

- Let us know.

Chuck Bryant

- for a couple of lunkheads who like to joke around about everything.

Josh Clark

And if you're not transsexual and you got a problem with it, don't be a jerk. Just don't be a jerk in life.

Chuck Bryant

That's our motto.

Josh Clark

All right, since we've said, "Don't be a jerk," that means I should probably pitch this article to you: Gender Reassignment. You can find it by typing gender reassignment - actually, just type gender in the search bar at HowStuffWorks.com. We have a lot of cool articles on it, including How Fluid is Gender?, an article I wrote a long time ago about why blue is for boys and pink is for girls - it's all made up - and a bunch of other stuff, including gender reassignment. You can type that at HowStuffWorks.com, which means its listener mail time, right?Oh, well hold on, Chuck. Hold on. First, let's do a little pluggage.

Chuck Bryant

Yes.

Josh Clark

You are a big sports guy.

Chuck Bryant

I am.

Josh Clark

You, my friend, I know where you could get a signed, Tom Glavine baseball.

Chuck Bryant

What?

Josh Clark

Yeah.

Chuck Bryant

Really?

Josh Clark

Yeah, remember our friends CoEd?

Chuck Bryant

Yeah.

Josh Clark

They are having their Fall Fiesta ATL. It's in Atlanta. So, if you're in Atlanta or the southeastern United States, you're gonna wanna be in town on October 21st, which is - what is that - a Thursday?

Chuck Bryant

I believe that is a Thursday.

Josh Clark

It's at the Metropolitan Club in Alpharetta. Anyone who's familiar with Atlanta knows that it's spread far and wide in - 100 million miles in each direction and Alpharetta is in part of that.

Chuck Bryant

Right.

Josh Clark

So, it's gonna be at the Metropolitan Club in Alpharetta from 7:00 to 10:00 p.m. on October 21st, right? So, tell the people about what's going on.

Chuck Bryant

Well, Josh, it's $20.00 to get in. That of course goes to CoEd and it also gets you food, and wine, and beer, and it gets you a chance to meet and hang out with Jerry.

Josh Clark

Jerry.

Chuck Bryant

Jerry is gonna be there.

Josh Clark

Totally.

Chuck Bryant

And we would be there, but we're gonna be out of town.

Josh Clark

Yes, we are gonna be in New York and we are loath that we're not gonna be there.

Chuck Bryant

That's right.

Josh Clark

But if you wanna meet Jerry in the flesh, she will be there in the flesh. CoEd and Guatemala got under Jerry - like our hearts are aligned with CoEd. They own Jerry's skin. They got under her skin. They own her subdermal region.

Chuck Bryant

That's right and they're gonna be auction items and they're raising money for their awesome nonprofit. And you can win, like, signed sports memorabilia. You can win a week-long African safari, dude.

Josh Clark

That's pretty big.

Chuck Bryant

Yeah, you can win a Mama gift basket.

Josh Clark

Oh, yeah.

Chuck Bryant

Emilie.

Josh Clark

Oh, yeah. Is Emilie doing something?

Chuck Bryant

Yeah, she's gonna donate a gift basket.

Josh Clark

That is very nice.

Chuck Bryant

Yeah.

Josh Clark

And all of this goes to help CoEd. For those of you who don't remember, or need a refresher, go back and listen to our two-part, Guatemala adventure episode. And this is a nonprofit that pools money together to buy textbooks for schools in Guatemala. Believe us: They need it. We've seen it firsthand.

Chuck Bryant

Yes.

Josh Clark

And escrow accounts are set up where the schools rent these textbooks. The money goes directly to these escrow accounts and after five years, it reverts back to the school, who can they buy, or which can then buy new textbooks. So, it's a self-sustaining system, and Chuck and I put our Good Housekeeping stamp of approval all over it.

Chuck Bryant

That's right.

Josh Clark

Yeah, so there you go, Fall Fiesta ATL, October 21st, Metropolitan Club at Alpharetta, 7:00 to 10:00 p.m., and there's a link on the CoEd website. It's www.coeduc.org, right?

Chuck Bryant

Yes.

Josh Clark

Okay, so let's get to it.

Chuck Bryant

I have an e-mail from Nick. Nick has this to say: "Hey, guys. I just returned from a run. Listened to your Biospeology podcast in which Josh said the word 'warsh'" in one of our tangents.

Josh Clark

I think - no, you said warsh, and I asked you about it.

Chuck Bryant

Well, regardless, it's in there somewhere. "I grew up in Washington, Pennsylvania, a small, growing coal town in the western side of Pittsburgh." I'm sorry - south of Pittsburgh. "In that area, the whole tri-state area in fact of Pennsylvania, West Virginia, and Ohio, they regularly use warsh in reference to warshing hands or their cars." Did you know that that was an area thing there? They say warsh there.

Josh Clark

I didn't know that that's - I know it's regional, for sure.

Chuck Bryant

Okay, I didn't know that region. "The best part is in my particular situation being from Washington, I always heard it pronounced Warshington." I know. "I do not speak with that particular piece of vernacular as my mother would have sooner cut out my tongue than hear me say that, but I would like to offer a few more unique pieces of vernacular from that area."

Josh Clark

Let's hear it.

Chuck Bryant

Read up. You ever heard that?

Josh Clark

No.

Chuck Bryant

I need you read up the table. I guess that means set the table - ready it. I don't know.

Josh Clark

Or remove one of the four legs.

Chuck Bryant

Oh, actually, here he says the definition is a synonym with clean or clear off. Like, "Read up your room." Babushka -

Josh Clark

That is a kerchief worn by Polish women in the northeast.

Chuck Bryant

Well, that's what he says - a piece of cloth tied around the head, similar to a do rag, and by similar I mean exactly like. Yinz - Y-I-N-Z - you ever heard that?

Josh Clark

No, I have not.

Chuck Bryant

"All yinz come inside. The pierogies are ready."

Josh Clark

Huh.

Chuck Bryant

I guess similar to y'all in the South.

Josh Clark

Right.

Chuck Bryant

And finally, there's no plural to the world mile. Emilie's dad says this.

Josh Clark

Like 80 mile?

Chuck Bryant

Yeah, "Go about 80 mile up the road." Emilie hates it so bad.

Josh Clark

Her dad is from that area, right?

Chuck Bryant

Yeah, from Ohio.

Josh Clark

Okay, that's right.

Chuck Bryant

"Guys, just remember that Washington, Pennsylvania is the town that changed its name officially to Steelers, Pennsylvania -

Josh Clark

- What?

Chuck Bryant

- before the 2005 Superbowl. I however, live in southeastern Virginia now, but I do recall my roots." Thank you, Nick.

Josh Clark

Well, lucky for Washington, Pennsylvania that name change wasn't irreversible as a lot of gender reassignment surgery is.

Chuck Bryant

That's so great.

Josh Clark

If you are a transsexual, and you have undergone surgery, or are considering it, we wanna hear from you. Even just say, "Hi." Send us an e-mail to StuffPodcast@HowStuffWorks.com.

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