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Ray Blanchard and the Clarke Institute: Patient experiences
Although the notoriety of the Clarke Institute and Ray Blanchard's involvement is generally known among transsexual women, there is no online repository of first-hand accounts. This page seeks to remedy that. We are collecting the experiences of people who had direct dealings with Blanchard through The Clarke Institute. If you or someone you know would like to share your experience, please contact me. We will be happy to consider giving your information a permanent and anonymous home. Background According to patients forced to use the Gender Identity Clinic at the Clarke,
it is just a two-day-a-week operation. It's a sub-unit of the sexology department,
whose main job is to work with convicted sex offenders. Trans patients have
to go into the locked, secure, 4th floor section, where the In order to receive federally-funded mental and medical services, patients had to submit to various types of sexualized testing given to criminals, including detailed descriptions of masturbatory fantasies and in some cases penile plethysmography. It is my intent to show that this is not only questionable scientifically, it is potentially unethical. I feel it is as unethical as a lawyer forcing clients to submit to similar testing in order to receive federally-funded professional services. For more, see "Male gender dysphorics, paedophiles, and fetishists": how Ray Blanchard sees us Clarke Clinic Experiences By Ruth Bramham My first experience of the Clarke’s Gender Identity Clinic dates back
to 1977. To set the scene, I was married with a 3 year-old son and my longstanding GID
conflict was definitely causing much stress in my life, to the point that my
wife spilled the beans to our family doctor. To my great surprise I found a
sympathetic ear. My past experiences with the medical profession on this subject
had definitely not been happy. (Oh go get married you silly little boy and it
will go away! I did, “it” didn’t.) The doctor contacted the Clarke
and I was promised an appointment. It was almost 6 months later when I was notified of the December appointment
dates and times. I was given 10 days notice for a series of interviews that
would take up four full days. I held a senior position in a major construction
related company. The week of the interviews I had annual meetings and seminars
already arranged. Needless to say I told them I was busy. Their attitude was
to treat me like a recalcitrant child and put me to the bottom of the waiting
list. I am known for a my acerbic wit in letter writing when the need arises. I let
them know I was not amused, not a know-nothing, and certainly not going to wait
for another six months. I received new dates within the time frame I “suggested”
(February). Those interviews and the procedures I had to endure were a shock. It was as
if I was a sex offender being evaluated for serious sexual deviations. The line
of questioning was all about my sexual experiences, masturbation, fantasies,
etc., as related to crossdressing. The penile sensitivity testing was particularly
demeaning as were the photographic sessions. Six weeks later I received the
results of this “evaluation”–I was deemed to be a transvestite
with transsexual tendencies. They told my wife that with psychotherapy I could
learn to control my “urges”. At the time I kept a diary of everything
that went on in my meeting with the Clarke staff. It would have made interesting
reading today. My wife found it years later and consigned it to the garbage,
along with everything she could find of mine related to transsexuality. I endured about a year of psychotherapy, becoming more and more depressed.
I knew I wasn’t a transvestite, but back then, if I was married with a
child, I couldn’t possibly be transsexual. After all, true transsexuals
had to be homosexual and attracted to men. (It was odd that female-to-male TSs
were never, ever mentioned.) Everything came to a head when my wife finally
decided she’d had enough and I was told to leave just before Christmas
1978. I had never lived alone in my life. The Clarke psychotherapist was no help. In fact he hardly uttered a word during
our bi-weekly sessions. The only direct suggestion I ever received from him
was: “If you want to be a woman, you have to go out and be one, full time,
for at least a year.” There would be no help or guidance. That was counter-productive
to proving I was really a woman. At the time, I was 34 years old, 6'-0",
170lbs, very athletic and extremely hairy with a noticeably balding head. I
also had a fairly deep baritone voice. In my mind, there was no way of accomplishing
the switch to their satisfaction. I tried for one day. I shaved my arms and
legs, “borrowed” one of my mother’s wigs and got dressed–yes,
I had a fairly reasonable wardrobe of conservative clothes. I made one trip
to the local mall, was read by a couple of local yokels (mid-town Toronto) and
had to run for it. I was scared silly. My psychotherapist just laughed at me
when I told him. “What did you expect?” he asked. “There’s
no way you’ll pass for a woman.” I was crushed. Later I learned that the Clarke’s idea of passing successfully was limited
to the so-called homosexual TSs. It was inconceivable to them that a “secondary”
TS could ever pass successfully 24/7. Part-time passing was not acceptable.
Blanchard then was but a twinkle in Dr. Freund’s eye.... Early in the morning of March 25th 1979, I tried to commit suicide. God had
other ideas. I had a profound, religious experience that left me exhausted–and
sleeping like a baby for the first time in many months. All the pain, stress
and the obsessive nature of my GID was gone when I awoke the next morning. What
was still there was my distinct sense of self-identification as a woman. The
psychotherapist was very skeptical as I explained what had happened. I never
saw him again. I did rejoin my family, now able to cope with my sense of self. In fact I didn’t return to the Clarke for another three years after my
wife and I broke up and divorced in 1982. For the next three years I saw Dr.
Betty Steiner every six months and was allowed to have a “palliative”
dose of hormones (a contraceptive pill called Ovral - 0.5mg Estradiol + ). This
was my “stand pat” period. Despite being discouraged from doing so
by Dr. Steiner et al, I met many more TSs, helped run a support group, wrote
articles and generally educated myself like never before. Boy, did I ever have
my eyes opened! And I met Dr. Ray Blanchard and Len Clemmensen. However, I was never invited
to their early group therapy sessions which began somewhere around 1983. At
the support group meetings Clarke bashing was the sport of choice.... yes, even
back then! Generally, the most common complaint was their intransigence over
diagnosis. It was always “Prove it”. “Show us you really are
a woman by living and working full time. Bring us your pay stubs and documented
proof you are working in the gender you aspire to. And we’ll see you every
six months.” Dr. Steiner retired in 1986 (I think) after producing the infamous tome that
was the first attempt to bring together the collective “wisdom” of
GID research to that date. “Gender Dysphoria: Development, Research, Management”.
I recognized myself as one of the anomalies mentioned! No wonder she wanted
to see me regularly for so long! Messrs. Blanchard, Clemmensen, Freund, Zucker
et al all had a hand in its writing. In 1985 I somewhat reluctantly reunited with ex-wife and son as he was definitely
“off-the-rails”. Being both Christians, “living in sin”
was not an option. We remarried, and I was forced to cut ties with both the
Clarke and the TS community. All items of my “sinful” nature we expunged
from my life. My wife made doubly sure not even a single scribbled note remained.
Thus began a period of enforced self denial as my son was put back on track.
My relationship with my wife was purely platonic. I had no interest in sex.
In fact I’d always had a problem with sex. I found it a real chore, distasteful
and not “right”. The word for it is “asexual”. It was a
condition, I learned, that the folk at the Clarke took with a large grain of
salt. After all, I had fathered a child, hadn’t I? This marriage lasted five years believe it or not, the last two with me living
in the basement. During those two years, I was finally invited to join the Blanchard/Clemmensen
“Gender Solutions Group”. What a farce! It was basically meant to
explore alternate solutions to surgery, accepting your chosen “lifestyle”,
and discussing ongoing daily difficulties. Most of those attending were not
transsexual, being a mix of crossdressers, she-males, non-ops and up to four
TSs. The views of the TSs were rarely heard above the aggressive cacophony of
the CDers and she-males. It was definitely an “us vs. them” atmosphere
played to the hilt by the “good cop bad cop” routine of Blanchard
and Clemmensen, the latter usually being the “good cop”. He received
much teasing from the others because of his relatively quiet manner (like us
TSs...). Of course our Mr. Clemmensen was hiding a deep secret of his own. Today
“he” is known as Maxine Petersen. It was during this time that I met Dr. Steiner’s replacement as head of
the Gender Identity Clinic, Dr. Robert Dickey. He would not authorize me taking
hormones again, despite my previous record with Dr. Steiner. “Things have
changed,” he said. It was also early in this period that the clinic was
moved to the 4th floor of 250 College Street, apparently to consolidate all
the departments within the Division of Forensic Psychiatry. We now met with
the staff in a high security area behind locked doors. As you will have gathered
by now, the Clarke Clinic staff had no interest in looking after the needs of
their patients. Seeing the regulars every six months was adequate and the others
could be viewed during the group therapy sessions. Yes, the Clarke Clinic is
purely a research establishment, with staff working mainly on their Forensic
Psychiatry duties and part-time on Gender Clinic duties. With no unauthorized
access allowed, there was no possibility of forming any sort of benign, helping
relationship. It is the epitome of a “gatekeeping” establishment. Fast forward to 1992. I was working in London Ontario and had met “Karen”,
a postop TS woman who had a horrendous story to tell about the Clarke. I now
saw another side to the rigidity of their position. But that’s another
story. The Fall of 1992 saw me out of work (the recession) on hormones at last
through an independent endocrinologist introduced to me by Karen. Dr. Dickey
was not amused. Then, in November, I was diagnosed with Mycoplasmal Pneumonia with Pleurisy.
Part of the symptoms for this consists of coughing up some blood in your sputum.
I was. Frequently. Two series of anti-biotics failed to clear it up as it went
from one lung to the other. By Christmas I was well enough to have Christmas
Dinner with my father. I relapsed shortly thereafter. By the end of January,
they didn’t know what to do, so I was sent to see a pulmonary specialist.
After a lung scan revealed multiple (20+) blood clots in both lungs, I was hurriedly
admitted to hospital. After some further discussion, the hormones were targeted
as the culprit, and in turn, Deep Vein Thrombosis in my right leg. Nobody had
warned me that taking hormones had potentially nasty side effects. Obviously
I recovered. Obviously God wanted me around a little longer! On leaving hospital at the end of February, I made the decision to begin transition
full time 24/7, cold turkey! It was now or never. My next appointment with the
Clarke Clinic was only a week away. So I showed up in “Ruth” mode
dressed appropriately. Another quirk of theirs was the insistence that we MTFs
dress unambiguously, that is, we show up for appointments there in a skirt or
dress, not pants. I expected to see Dr. Dickey. Instead an intern appeared to interview me....
as if this was my first visit there! And yes, he asked all the most inappropriate
sex centred questions, about fantasies, masturbation, etc. I told him not to
waste my time as those questions had been asked many times before and to please
read my file! He actually commented to me that he was new to this and to be
patient with him. There was no supervisor with him. I had to remind him to note
that I was now presenting in the female role full time. It was before this visit
to the Clarke that I learned that Len Clemmensen was now Maxine Petersen. I
met with her briefly in the corridor. She had stayed on the job during transition.
Talk about the ultimate, benign employer. Basically she was her own supervisor
with help from Blanchard and Dickey. In consultation a few weeks later with my endocrinologist, we discussed how
I could resume taking hormones. Since the hospitalization I had been taking
Warfarin to keep my blood from clotting. Now he suggested I could resume hormones
at a low dose level coupled with the Warfarin. To be on the safe side, he suggested
I undergo an bilateral orchidectomy, so that the low dose would have a more
significant effect... i.e., cut off the source of the dreaded testosterone.
Being in Canada and covered by a pretty comprehensive government medical plan,
I was able to have the cost covered. By July, I was back on hormones (Premarin
@ 1.25mg.). Needless to say when Dr. Dickey found out I was reprimanded for not informing
him prior to the surgery, as he frowned on such surgery so early in the transition.
It was irreversible you know! I then discovered he had not started the clock
ticking for the official two year transition period to qualify for government
funded SRS. I had not provided proof that I was now working, or going to school,
or volunteering full time. He wanted signed timesheets or pay stubs or school
attendance records! Fortunately I had started volunteering full time at the
local Employment Help Centre. So I had to arrange with the office manager to
fill out time sheets every week (being volunteer based they didn’t usually
do that). I could see that the Clarke Clinic was going to make my journey as
difficult as possible. The bout with pneumonia and DVTs had left me with a severe depletion in lung
capacity. I was out of breath after walking up four steps. Working full time
three months after discharge, even as a volunteer, was exhausting, but I knew
I had to do it, or wait even longer for surgery. (We were still deep in a recession
with no hope for paid work even if I had the stamina for it. My unemployment
benefits expired and I was forced on to welfare.) I was seen twice more over
the next year (1993-94). They tried to question my records, but my supervisor
wrote to them confirming everything. I had let the other staff in on what I
was going through. The support I received from them was nothing short of exemplary. The second year, I took a government self employment programme, being one of
the 12 selected from 120 applicants. Dickey had told me bluntly that self employment
was out of the question as I could not satisfy the third party verification.
Again I had to bare my soul to the supervisor, and again I received full cooperation,
even to the extent of a custom designed reporting form especially for the Clarke!
My two year Real Life Test was officially completed in July 1995. In June,
I tried to arrange for the final interview. I was ignored for three months.
My letters, faxes, phone calls went unanswered. It was as if the place had shut
down for the Summer. Finally, mid September I received a short note confirming
the date for September 29th. I would see Dr. Dickey and one other. My appointment
with Dickey was for 8:00 a.m. Although I had to drive into Toronto from London
I didn’t argue. However, by 11:00 a.m. he still had not shown up and his
secretary could not locate him. I was sitting in the lobby of the Forensic Psychiatry
department at times in the company of very suspicious characters under escort.
He finally breezed in, unapologetic, at 12:15 p.m. The meeting was over in just
15 minutes. I had his blessing. The second appointment was at a different location
with, guess what, the same neophyte doctor (then an intern) who interviewed
me two years before. He didn’t remember me. And he started to ask me the
same old questions! I couldn’t believe my ears! So I gave him a quick lesson–Gender
Identity 101–including a lesson on the Harry Benjamin Standards. Response?
“Oh yes, I heard there were some sort of guidelines for this. You know
more about them than I do...” I nearly fell over. Here was the doctor responsible
for my second letter admitting he knew next to nothing about the subject! I
bit my tongue. Two weeks later, Maxine Petersen gave me the SRS surgeon’s name (Dalrymple
in London England) and permission to make initial contact with him. I did, via
fax, the same day. Of course he knew nothing about me as the Clarke had yet
to send any paperwork. Despite this we set up a tentative surgery date for November
29th. October expired and November was well under way with still no formal authorization
letter from the Clarke. I started a fax and phone blitz. At last I was contacted
by the government health plan office to tell me they had just received the paperwork
from the Clarke (November 10th). The letter I was to carry with me to England
would be mailed to me. Five days later I received a faxed copy, but it wasn’t
until the 20th that I received the actual document, just one week before departure
for England. By the way, the government plan only covered the surgery itself,
not the travel and hotel expenses. Fortunately my dad, God bless him, came up
with the money for that. I returned to Canada on December 9th, sore but very satisfied. The Clarke had
done their best to prevent or at least delay the inevitable. I was now free
of them. At last I was comfortable in my own skin, the woman I was meant to
be. I did see Dr. Dickey once more but they haven’t bothered to follow
up since. Update 25 May 2003 One last thought: When I first went to the Clarke, I was calling myself Kim Kershaw (Kershaw
was an old family name that my grandfather had dropped). I was told quite bluntly
that was not acceptable. My name must be unequivocally female. Androgynous names
were not allowed. I believe this still holds true today. My family was not keen
(understatement!) on me continuing to identify as a "Bramham," hence
the complete change. Once I was independent of family influence (1990) I resolved not to give in
to that type of pressure any more. So I just changed my Christian See also Experiences at the Clarke Institute by several clients. Back to the Bailey-Blanchard-Lawrence clearninghouse |
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