Trans Woman's Journey

Columbia University Irving Medical Center

Throughout most of her life before she became Stacy St. Clair at 54, the insurance industry executive says people would have described her as a "man's man."

"During hunting season I'd grow a beard, go hunting with a bow and arrow, drag the deer out of the woods, dress it and then go home and cook it," says St. Clair. "No one would ever have questioned who I was."

Except for St. Clair, who always knew deep down exactly who she was but held the secret until 2018 when she mustered the courage to tell her younger brother that she thought she was a woman. "I didn't tell him I like to dress up as a woman," says St. Clair. "I told him I really think I am a woman."

That's when her journey began. The former member of the 1986 men's NCAA Fencing Championship Team at Notre Dame, a husband for more than 30 years, and a father of three finally decided it was time to discard her male persona and "boy costume" and admit she was female, and had been, her entire life.

"I have been pushing up against gender issues since I was a toddler," St. Clair says. "I was raised in a very strict Catholic family with old fashioned sensibilities so I fought gender issues and denied them even to myself."

Columbia Gender Identity Program offers help

Psychologist Melina Wald, clinical director of the Gender Identity Program at Columbia University, says St. Clair's story is not unusual for older transgender, nonbinary, and gender non-conforming individuals.

Melina Wald, clinical director of the Gender Identity Program

"It can be incredibly challenging, especially for folks who have gotten messaging from family members, friends, or partners who wouldn't accept them and have heard them saying negative things about LGBTQ individuals," Wald says. "It can be daunting sharing something that has the threat of rupturing relationships."

Wald and psychologist Walter Bockting, director of the Gender Identity Program, and their team of psychologists, a psychiatric nurse practitioner, pediatricians, endocrinologists, and doctors specializing in adolescent medicine at Columbia University Irving Medical Center have seen older adult patients like St. Clair, including individuals in their 70s. But the majority of those who come to the program for evaluation are children, adolescents, and young adults been the ages of 13-25

"We also have parents who bring in really young children, around the age of 3, 4, and 5, because they are noticing their child is expressing their identity differently than the sex assigned at birth or are making statements that they are a different gender," Wald says. "Parents are looking to find the best way to support their child at home and in the community."

The Gender Identity Program offers mental health care and social support geared toward instilling pride and celebrating gender diversity in transgender, nonbinary, and non-conforming children, adolescents, and adults. The Columbia program also offers assistance with gender-affirming medical treatments, including surgery.

If this type of support was available when St. Clair was growing up, Wald says she doesn't think she would have had to spend years thinking there was something wrong with her.

"Stacy is an incredibly lovely and thoughtful and resilient person," Wald says. "She came into therapy ready to change and cast away a fake persona that she had clung to throughout her whole life. She was ready to stop hiding and come into her own as a woman."

She always felt comfortable, but guilty, being a girl

From a young age, St. Clair liked dressing in girl clothes and trying on her mother's wardrobe. When she got older, she would collect dresses, shoes, makeup, and jewelry to wear when no one was around or under her boy clothes. It was a ritual that always made her feel guilty, and one she promised herself would stop.

"I remember telling myself I would never do it again, that this wasn't me," St. Clair says. "I'd throw the clothes away, but a few months later, I would do it again."

Still, no one knew. St. Clair got married, became a father, and achieved a successful career as an insurance industry executive. She was relatively happy, loved her wife, adored her two daughters and son, but continued to harbor the same secret she held as a child.

She still didn't feel connected to her birth gender. As an adult, she would shop for women's garments and shoes in neighborhoods where she didn't know anyone and told salespeople she was shopping for her sister, even though she had only a brother.

Telling the world her truth

After telling her brother who she really was St. Clair knew she had to confront this truth head on. She understood there was no going back.

She told her wife, who had suspected something was wrong and thought her husband might be having an affair. "But she never imagined what I was about to tell her," St. Clair says. Before the couple told their children, St. Clair made an appointment at Columbia, where trained staff offered her support in coming out and managing her gender dysphoria, the condition of feeling one's emotional and psychological identity to be at odds with one's birth sex.

Then came a session to discuss how to move forward and tell their kids. It was a time, she says, "filled with lots of tears."

St. Clair recalls her first appointment at Columbia. She remembers thinking that if her feelings of being a woman were validated she would feel as if it was her birthday. "I worried that Dr. Wald would say, 'Mr. St. Clair you are just a cross-dresser,'" St. Clair says. "Instead, Dr. Wald said, 'Happy Birthday, Stacy.'"

St. Clair calls Wald her "angel" and believes that it is because of the support and guidance of Wald and others at the Gender Identity Program that she allowed her true self to emerge and continue her relationship with her children. Wald helped her navigate gender-affirming medical treatments and surgical options.

St. Clair knows now that her journey to become herself is not about dressing up, which restroom to use, or sexuality. It's not even about wanting to be a woman.

"I did not choose to be a woman," says St. Clair. "I simply, with the help of Dr. Wald, allowed myself to stop fighting my personal truth, to accept my nature, to begin living authentically and congruously to what I am."

Tremendous gains, with some painful losses

While her transition has led to an impending divorce, job loss, and an estrangement with her parents in addition to some family members, business colleagues, and close friends, St. Clair still has a strong relationship with her children as well as many family members and friends who have accepted her as she was always meant to be.

There are no regrets. "Regrets do not apply after one accepts that choice is merely an illusion," St. Clair says. "Life's challenges are different for women, and they can often seem harder than they are for men, but women's lives can be so much richer too."

"This may sound silly," she continued, "but even being allowed to cry is wonderful. Being caring, nurturing, and supportive is not reserved for us, but it is also wonderful to have such things judged as strengths instead of weaknesses. I love being who I am."

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