THE MEDICAL REALITIES OF BREATH CONTROL PLAY

by Jay Wiseman

Author of "SM 101: A Realistic Introduction"

For some time now, I have felt that the practices of suffocation and/or strangulation done in an erotic context (generically known as breath control play; more properly known as asphyxiophilia) were in fact far more dangerous than they are generally perceived to be. As a person with years of medical education and experience, I know of no way whatsoever that either suffocation or strangulation can be done in a way that does not intrinsically put the recipient at risk of cardiac arrest. (There are also numerous additional risks; more on them later.) Furthermore, and my biggest concern, I know of no reliable way to determine when such a cardiac arrest has become imminent.

Often the first detectable sign that an arrest is approaching is the arrest itself. Furthermore, if the recipient does arrest, the probability of resuscitating them, even with optimal CPR, is distinctly small. Thus the recipient is dead and their partner, if any, is in a very perilous legal situation. (The authorities could consider such deaths first-degree murders until proven otherwise, with the burden of such proof being on the defendant). There are also the real and major concerns of the surviving partner's own life-long remorse to having caused such a death, and the trauma to the friends and family members of both parties.

Some breath control fans say that what they do is acceptably safe because they do not take what they do up to the point of unconsciousness. I find this statement worrisome for two reasons: (1) You can't really know when a person is about to go unconscious until they actually do so, thus it's extremely difficult to know where the actual point of unconsciousness is until you actually reach it. (2) More importantly, unconsciousness is a symptom, not a condition in and of itself. It has numerous underlying causes ranging from simple fainting to cardiac arrest, and which of these will cause the unconsciousness cannot be known in advance.

I have discussed my concerns regarding breath control with well over a dozen SM-positive physicians, and with numerous other SM-positive health professionals, and all share my concerns. We have discussed how breath control might be done in a way that is not life-threatening, and come up blank. We have discussed how the risk might be significantly reduced, and come up blank. We have discussed how it might be determined that an arrest is imminent, and come up blank.

Indeed, so far not one (repeat, not one) single physician, nurse, paramedic, chiropractor, physiologist, or other person with substantial training in how a human body works has been willing to step forth and teach a form of breath control play that they are willing to assert is acceptably safe -- i.e., does not put the recipient at imminent, unpredictable risk of dying. I believe this fact makes a major statement.

Other "edge play" topics such as suspension bondage, electricity play, cutting, piercing, branding, enemas, water sports, and scat play can and have been taught with reasonable safety, but not breath control play. Indeed, it seems that the more somebody knows about how a human body works, the more likely they are to caution people about how dangerous breath control is, and about how little can be done to reduce the degree of risk.

In many ways, oxygen is to the human body, and particularly to the heart and brain, what oil is to a car's engine. Indeed, there's a medical adage that goes "hypoxia (becoming dangerously low on oxygen) not only stops the motor, but also wrecks the engine." Therefore, asking how one can play safely with breath control is very similar to asking how one can drive a car safely while draining it of oil.

Some people tell the "mechanics" something like, "Well, I'm going to drain my car of oil anyway, and I'm not going to keep track of how low the oil level is getting while I'm driving my car, so tell me how to do this with as much safety as possible." (They may even add someting like "Hey, I always shut the engine off before it catches fire.") They then get frustrated when the mechanics scratch their heads and say that they don't know. They may even label such mechanics as "anti-education."

A bit about my background may help explain my concerns. I was an ambulance crewman for over eight years. I attended medical school for three years, and passed my four-year boards, (then ran out of money). I am a former member of the American Academy of Family Physicians and a former American Heart Association instructor in Advanced Cardiac Life Support. I have an extensive martial arts background that includes a first-degree black belt in Tae Kwon Do. My martial arts training included several months of judo that involved both my choking and being choked.

I have been an instructor in first aid, CPR, and various advanced emergency care techniques for over sixteen years. My students have included physicians, nurses, paramedics, police officers, fire fighters, wilderness emergency personnel, martial artists, and large numbers of ordinary citizens. I currently offer both basic and advanced first aid and CPR training to the SM community.

During my ambulance days, I responded to at least one call involving the death of a young teenage boy who died from autoerotic strangulation, and to several other calls where this was suspected but could not be confirmed. (Family members often "sanitize" such scenes before calling 911.) Additionally, I personally know two members of my local SM community who went to prison after their partners died during breath control play.

The primary danger of suffocation play is that it is not a condition that gets worse over time (regarding the heart, anyway, it does get worse over time regarding the brain). Rather, what happens is that the more the play is prolonged, the greater the odds that a cardiac arrest will occur. Sometimes even one minute of suffocation can cause this; sometimes even less.

Quick pathophysiology lesson # 1: When the heart gets low on oxygen, it starts to fire off "extra" pacemaker sites. These usually appear in the ventricles and are thus called premature ventricular contractions -- PVC's for short. If a PVC happens to fire off during the electrical repolarization phase of cardiac contraction (the dreaded "PVC on T" phenomenon, also sometimes called "R on T") it can kick the heart over into ventricular fibrillation -- a form of cardiac arrest. The lower the heart gets on oxygen, the more PVC's it generates, and the more vulnerable to their effect it becomes, thus hypoxia increases both the probability of a PVC-on-T occurring and of its causing a cardiac arrest.

When this will happen to a particular person in a particular session is simply not predictable. This is exactly where most of the medical people I have discussed this topic with "hit the wall." Virtually all medical folks know that PVC's are both life-threating and hard to detect unless the patient is hooked to a cardiac monitor. When medical folks discuss breath control play, the question quickly becomes: How can know when they start throwing PVC's? The answer is: You basically can't.

Quick pathophysiology lesson # 2: When breathing is restricted, the body cannot eliminate carbon dioxide as it should, and the amount of carbon dioxide in the blood increases. Carbon dioxide (CO2) and water (H2O) exist in equilibrium with what's called carbonic acid (H2CO3) in a reaction catalyzed by an enzyme called carbonic anhydrase. (Sorry, but I can't do subscripts in this program.)

Thus: CO2 + H20 <carbonic anhydrase> H2CO3

A molecule of carbonic acid dissociates on its own into a molecule of what's called bicarbonate (HCO3-) and an (acidic) hydrogen ion. (H+)

Thus: H2CO3 <> HCO3- and H+

Thus the overall pattern is:

H2O + CO2 <> H2CO3 <> HCO3- + H+

Therefore, if breathing is restricted, CO2 builds up and the reaction shifts to the right in an attempt to balance things out, ultimately making the blood more acidic and thus decreasing its pH. This is called respiratory acidosis. (If the patient hyperventilates, they "blow off CO2" and the reaction shifts to the left, thus increasing the pH. This is called respiratory alkalosis, and has its own dangers.)

Quick pathophysiology lesson # 3:

Again, if breathing is restricted, not only does carbon dioxide have a hard time getting out, but oxygen also has a hard time getting in. A molecule of glucose (C6H12O6) breaks down within the cell by a process called glycolysis into two molecules of pyruvate, thus creating a small amount of ATP for the body to use as energy. Under normal circumstances, pyruvate quickly combines with oxygen to produce a much larger amount of ATP. However, if there's not enough oxygen to properly metabolize the pyruvate, it is converted to lactic acid and produces one form of what's called a metabolic acidosis.

As you can see, either a build-up in the blood of carbon dioxide or a decrease in the blood of oxygen will cause the pH of the blood to fall. If both occur at the same time, as they do in cases of suffocation, the pH of the blood will plummet to life-threatening levels within a very few minutes. The pH of normal human blood is in the 7.35 to 7.45 range (slightly alkaline). A pH falling to 6.9 (or raising to 7.8) is "incompatible with life."

Past experience, either with others or with that same person, is not particularly useful. Carefully watching their level of consciousness, skin color, and pulse rate is of only limited value. Even hooking the bottom up to both a pulse oximeter and a cardiac monitor (assuming you had either piece of equipment, and they're not cheap) would be of only limited additional value.

While an experienced clinician can sometimes detect PVC's by feeling the patient's pulse, in reality the only reliable way to detect them is to hook the patient up to a cardiac monitor. The problem is that each PVC is potentially lethal, particularly if the heart is low on oxygen. Even if you "ease up" on the bottom immediately, there's no telling when the PVC's will stop. They could stop almost at once, or they could continue for hours.

In addition to the primary danger of cardiac arrest, there is good evidence to document that there is a very real risk of cumulative brain damage if the practice is repeated often enough. In particular, laboratory studies of repeated brief interruption of blood flow to the brains of animals and studies of people with what's called "sleep apnea syndrome" (in which they stop breathing for up to two minutes while sleeping) document that cumulative brain damage does occur in such cases.

There are many documented additional dangers. These include, but are not limited to: rupture of the windpipe, fracture of the larynx, damage to the blood vessels in the neck, dislodging a fatty plaque in a neck artery which then travels to the brain and causes a stroke, damage to the cervical spine, seizures, airway obstruction by the tongue, and aspiration of vomitus. Additionally, there are documented cases in which the recipient appeared to fully recover but was found dead several hours later.

The American Psychiatric Association estimates a death rate of one person per year per million of population -- thus about 250 deaths last year in the U.S. Law enforcement estimates go as much as four times higher. Most such deaths occur during solo play, however there are many documented cases of deaths that occurred during play with a partner. It should be noted that the presence of a partner does nothing to limit the primary danger, and does little or nothing to limit most of the secondary dangers.

Some people teach that choking can be safely done if pressure on the windpipe is avoided. Their belief is that pressing on the arteries leading to the brain while avoiding pressure on the windpipe can safely cause unconsciousness. The reality, unfortunately, is that pressing on the carotid arteries, exactly as they recommend, presses on baroreceptors known as the carotid sinus bodies. These bodies then cause vasodilation in the brain, thus there is not enough blood to perfuse the brain and the recipient loses consciousness. However, that's not the whole story.

Unfortunately, a message is also sent to the main pacemaker of the heart, via the vagus nerve, to decrease the rate and force of the heartbeat. Most of the time, under strong vagal influence, the rate and force of the heartbeat decreases by one third. However, every now and then, the rate and force decreases to zero and the bottom "flatlines" into asystole -- another, and more difficult to treat, form of cardiac arrest. There is no way to tell whether or not this will happen in any particular instance, or how quickly. There are many documented cases of as little as five seconds of choking causing a vagal-outlfow-induced cardiac arrest.

For the reason cited above, many police departments have now either entirely banned the use of choke holds or have reclassified them as a form of deadly force. Indeed, a local CHP officer recently had a $250,000 judgment brought against him after a nonviolent suspect died while being choked by him.

Finally, as a CPR instructor myself, I want to caution that knowing CPR does little to make the risk of death from breath control play significantly smaller. While CPR can and should be done, understand that the probability of success is likely to be less than 10%.

I'm not going to state that breath control is something that nobody should ever do under any circumstances. I have no problem with informed, freely consenting people taking any degree of risk they wish. I am going to state that there is a great deal of ignorance regarding what actually happens to a body when it's suffocated or strangled, and that the actual degree of risk associated with these practices is far greater than most people believe.

I have noticed that, when people are educated regarding the severity and unpredictability of the risks, fewer and fewer choose to play in this area, and those who do continue tend to play less often. I also notice that, because of its severe and unpredictable risks, more and more SM party-givers are banning any form of breath control play at their events.

If you'd like to look into this matter further, here are some references to get you started:

"Emergency Care in the Streets" by Caroline (I'd recommend starting here.) "Medical Physiology" by Guyton

"The Pathologic Basis of Disease" by Robbins "Textbook of Advanced Cardiac Life Support" by American Heart Association "The Physiology Coloring Book" by Kapit, Macey, and Meisami "Forensic Pathology" by DeMaio and Demaio "Autoerotic Fatalities" by Hazelwood

"Melloni's Illustrated Medical Dictionary" by Dox, Melloni, and Eisner

People with questions or comments can contact me at jaybob@crl.com or write to me at P.O. Box 1261, Berkeley, CA 94701.

Regards,

Jay Wiseman

EXAMPLES OF HUMILIATION TRAINING

HUMILIATION within BDSM

In BDSM, humiliation is one psychological technique a top may use on a bottom. It is generally considered edge play because it touches strong emotional buttons.

The word humiliation comes from a Latin root meaning earth. To "humiliate" someone is to bring him or her down low to the ground.

Humiliation is a highly subjective issue, and depends greatly on context. Although there are many examples of humiliation as a technique, success in training all depends upon the slave and what they find personally to be most degrading. While in a dominant-submissive scene or relationship, the submissive takes a subordinate role and may be called "slave", "boy ", "dog" or something similar. The submissive may also make displays of subservience, such as lighting cigarettes, walking a pace behind the dominant, only speaking when spoken to, etc.

Humiliation play can involve physical and/or verbal methods. Some seek to be demeaned by acting a role, while others enjoy to be 'tongue lashed' and to be constantly told of their low status, and even be made to repeat this back to the humiliator. One example may be as simple as having a slave call their Master "Sir" or "Master." For some, this in and of itself is utterly humiliating, while other slaves may find that is not humiliating whatsoever. On the flip side, having a slave wear a collar and perform submissive acts in public or within the confines of a scene with other people may seem humiliating to some, but normal and natural to others.

However, a dominant may take care over insulting the submissive. Terms like "fat", "ugly", "stupid" or "worthless" could be considered abuse if this is not part of the understanding the top and bottom have negotiated for their role play scene.

Depending on the roles and persons involved, terms like " slut", "tart", "bitch" and "whore" may or may not be considered humiliation. For some people, such names are a way of achieving ego reduction, entering bottom space, or getting over sexual inhibitions.

A classic technique to put a submissive into bottom space is to combine humiliation with pleasurable physical sensation, including sexual stimulation. Someone who is already inclined to be subby can often be put into a very submissive mental state by simultaneously turning that person on physically while humiliating them.

Sexual role-playing may or may not involve humiliation. For example, one bottom who plays the part of a dog may enjoy being mock-forced into it and the top will emphasize the lowness of the bottom's status as an animal. Another dog-player would rather play the role of the dog without any element of humiliation.

One such form of sexual role-playing is objectification, where the bottom is cast in the role of an object.

It is also widely accepted that there are individuals who seek humiliation as a form of emotional release, thus, doing things like eating out of a dog dish, being forced to always kneel, displaying oneself or being forced to cross dress, are just methods a Master can use to bring their slave that much wanted emotional release.

COURTESY OF: INFORMED CONSENT

House Plants of Gor

I found this little story on Evil Monk  -  I found it amusingly true to some BDSM submissives.

by Ellerol Elvish

The spider plant cringed as its owner brought forth the watering can. "I am a spider plant!" it cried indignantly. "How dare you water me before my time! Guards!" it called. "Guards!"

Borin, its owner, placed the watering can on the table and looked at it. "You will be watered," he said.

"You do not dare to water me!" laughed the plant.

"You will be watered," said Borin.

"Do not water me!" wept the plant.

"You will be watered," said Borin.

I watched this exchange. Truly, I believed the plant would be watered. It was plant, and on Gor it had no rights. Perhaps on Earth, in its permissive society, which distorts the true roles of all beings, which forces both plant and waterer to go unhappy and constrained, which forbids the fulfilment of owner and houseplant, such might not happen. Perhaps there, it would not be watered. But it was on Gor now, and would undoubtedly feel it's true place, that of houseplant. It was plant. It would be watered at will. Such is the way with plants.

Borin picked up the watering can, and mushily watered the plant. The plant cried out. "No, Master! Do not water me!" The master continued to water the plant. "Please, Master," begged the plant, "do not water me!" The master continued to water the plant. It was plant. It could be watered at will.

The plant sobbed muchly as Borin laid down the watering can. It was not pleased. Too, it was wet. But this did not matter. It was plant.

"You have been well watered," said Borin.

"Yes," said the plant, "I have been well watered." Of course, it could be watered by its master at will.

"I have watered you well," said Borin.

"Yes, master," said the plant. "You have watered your plant well. I am plant, and as such I should be watered by my master."

The cactus plant next to the spider plant shuddered. It attempted to cover its small form with its small arms and small needles. "I am plant," it said wonderingly. "I am of Earth, but for the first time, I feel myself truly plant like. On Earth, I was able to control my watering. I often scorned those who would water me. But they were weak, and did not see my scorn for what it was, the weak attempt of a small plant to protect itself. Not one of the weak Earth waterers would dare to water a plant if it did not wish it. But on Gor," it shuddered, "on Gor it is different. Here, those who wish to water will water their plants as they wish. But strangely, I feel myself most plant like when I am at the mercy of a strong Gorean master, who may water me as he pleases."

"I will now water you," said Borin, the cactus's Gorean master.

The cactus did not resist being watered. Perhaps it was realizing that such watering was its master's to control. Too, perhaps it knew that this master was far superior to those of Earth, who would not water it if it did not wish to be watered.

The cactus's watering had been finished. The spider plant looked at it.

"I have been well watered," it said.

"I, too, have been well watered," said the cactus.

"My master has watered me well," said the spider plant.

"My master, too, has watered me well," said the cactus.

"I am to be placed in a hanging basket on the porch," said the spider plant.

"I, too, am to be placed in a hanging basket on the porch," said the cactus.

"I wish you well," said the spider plant.

"I, too, wish you well," said the cactus.

"Tal," said the spider plant.

"Tal, too," said the cactus.

I did not think that the spider plant would object to being watered by its master again. For it realized that it was plant, and that here, unlike on Earth, it was likely to be owned and watered by many masters.

Pet Shaming..BDSM style

Naming and Shaming your Pets. Amusing....

ASH - My True Submissive

 This is dedicated to ASH - My Submissive

To be a submissive is different for everyone. We each have different ideas of what a submissive is, should and might be. 

I meet many different types of submissive in my line of work. Some I will remember for eternity, others not. Some I have enjoyed being Mistress to, others I have not.

I can outline four types of submissive I have come into contact with - all in their own ways unique and interesting.

The Role Play Submissive is just that - They want to play at being a submissive either face to face with a Mistress or online. For a few hours they will "play" the part of a submissive calling Me Mistress in order to fulfil a fantasy they have.

The Sexual Submissive have a kink or fetish they wish to explore. They want and need to be restrained, blindfolded, spanked, flogged, beaten or whatever their fetish is. And once the fetish and sex act is over, they go away happy until the next time.

Then there is the Online Submissive. I first discovered just how many online submissives there were when I joined Twitter. Within this group there are submissives who do genuinely devote their time to one Mistress, there are those who are 'Fans' or active followers of a Mistress. But there are also those who are submissive while in the chat room, write out elaborate serves for the One they serve, vow eternal love and submission to the One but then when they go to another room or another name they're saying the same things to Another. Sometimes, they even have a camera to prove how submissive they are - photos to prove it.

To me, a True Submissive is not easy to find. When you do, it's hard to let them go. These are the submissives I am fond of and eagerly await our meetings. To me, a true submissive serves from his heart, and they don't need a Mistress driving them to do something, they do it willingly, gladly, eagerly.

They have insight and truly care. They see their Mistress's glass as half empty and they fill it, they take care of their Mistress's needs. I have found that True submissives  don't need words of praise showered upon them, it is enough that their Mistress is pleased and comfortable - knowing their Mistress is content  is praise enough. The sparkle in their Mistress's eyes or a touch by the hand of their Mistress is high praise.

Recently, I found one such potential submissive. He had all the qualities to become a perfect true submissive. I call him Ash. He takes what I teach seriously and into his heart. he practices tasks I may have asked of him and endeavours to perfect them. He remembers the rules, the postures and instructions.

He has always chosen to bring me a gift - not because I asked him, but because he wanted to - it is what true submissives do. They think of their Mistress, even at an airport lounge and purchase a little something to see the sparkle in their Mistress's eye. It pleases Me when I know I have a session with Ash, I know it will be, for me, both a spiritual and mental pleasure to have him in the dungeon. In our last session, he informed me that he would probably have to leave at the end of May to return to India as his work would come to an end. This saddened me. For a blinding few seconds, My mind sparked for inspiration as to how I could keep him in the UK - for My own selfish reasons.

A true submissive is difficult to find. I am hoping Ash will find more work in the UK as he serves from his heart. He will do something, willingly, gladly and fervently.

I will purchase him a gift this week - A colour coordinated bra and panty set. I know he will wear them well, even when not asked to.

We need to give up transphobia

March 27, 2013

By: Nico Lang

Trigger warning: Transphobia. A lot of transphobia.

A month ago, my friend Todd Clayton came out as a recovering transphobe in an incisive essay for the Huffington Post entitled “The Queer Community Has to Stop Being Transphobic.” In the piece, Clayton details his own journey on transphobia and inclusion, how a Lana Wachowski speech opened his eyes to the quiet bigotry in his own life. He hadn’t openly attacked trans people or worked against their freedoms. Clayton was transphobic in a lot of the ways our community members are: insensitive and dismissive, not realizing the ways in which trans lives and struggles intersect with our own.

When he asked me to read it, I told him it was a common experience of cisgender people in the community. As someone who came from a similar place as he did, it was my experience. I told Todd that if he ever published it, I would come out with my own story. This is that story. It’s not easy to tell. I’ve been holding onto it for awhile, keeping it secret and safe. But it can’t stay secret any more.

My name is Nico Lang, and I used to be transphobic.

I never thought about myself that way. I thought that my emotions were normal and valid, feeling justified in my passive disgust for trans bodies. The first time I heard about trans people was when my father talked about seeing The Crying Game in the theatre and the way the audience convulsed with shock when the heroine’s “secret” was revealed. My father claimed that people walked out or threw up when confronted with the image of transness or a life that didn’t fit their binaries.

I was a teenager. Binaries were all I knew. Like Patty Hearst, I grew to love my captivity. I identified with my oppressors, working to uphold that marginalization in my own life.

When I met a trans person for the first time, I didn’t think my emotions were hatred, but they had to show on my face. For the purposes of this essay, her name was Megan, and she was one of the oddest characters I’ve ever met, the kind of person you’ll never forget. Megan claimed to be a vampire and drink blood; she also told us stories of being a general’s wife and getting married in Egypt, as if she were a real-life Orlando or Candide. She wanted to believe she led a life that was too big to comprehend.

I thought she was pathetic. Rather than looking at her identity as a natural defence mechanism for a conservative Cincinnati that would always see her as an outsider, I refused to understand her. I didn’t try. My friend told me that Megan had been kicked out of her home and most schools she’d attended. This should have helped me be more compassionate, but my heart couldn’t open to let her in. I still think about her sometimes. I don’t know if she even knows I have anything to be sorry for, but I want to apologize anyway.

Like all hate, I held onto it and secretly nurtured it in my refusal to believe there was anything wrong with the way I felt. On my first day of Human Sexuality in college, we watched a video on transitioning, one that included thorough graphics on gender assignment surgery. Just as the doctor discussed creating a vagina out of the shaft of a penis, I tapped out. I went for a drink of water. I milled around in the halls, checking fake text messages. I didn’t even have a texting service at that time. I just couldn’t go back in there. This wasn’t what I’d signed up for.

I wasn’t sorry yet. I started to feel the void where sorry was supposed to be, the same one I felt when I saw Transamerica and turned away during its brief flash of nudity. I couldn’t look at her, just like a part of me couldn’t comprehend the identity of a trans masculine classmate of mine. When a friend showed me what trans masculine bodies looked like (from a coffee table book he owned of Loren Cameron's work), I almost couldn’t believe it.

This is an actual quote: “But they look so normal.” It would be years before I learned to regret those words. I wish I could go back in time and punch that person in the face.

I wish there were a moment where I look at my behaviour and realized that I needed to change, but life isn’t like that. There isn’t always a moment; there are a million moments, where you are made accountable to your lack of compassion and openness to the experiences of others, and that part of you will always still be there, nagging and pulling. Sometimes hate stays the same way it did before, and sometimes it lives on in racism, sexism and homophobia. Sometimes it just takes a nap.

My hate was always secretly directed inward. From an early age, I identified as female, and it was years before my parents could get me to put on a pair of jeans. I wanted to wear dresses. I settled for sweatpants. Most kids were obsessed with Barney or Chuck E. Cheese; I wanted to be like Jane Fonda, in her spandex and matching headband, commanding a room of women to be their best selves while protesting the war in Vietnam, winning Oscars and being married to an eccentric billionaire. Many of us grew up secretly believing we could have it all. I knew I could. Jane told me so.

My father has the same name as I do, and I didn’t want his name, just like I didn’t want his maleness. I went by the name “Nicky.” When my parents resisted, I started spelling it in increasingly elaborate and stripper-esque ways, like “Nicki,” “Nickie,” “Nikki” and “NICKEE*.” I dotted it with hearts, wrote it in pink and shellacked it with glitter. Some kids have to come out; I was barely ever in.

For a long time, my parents let it slide. This was at the height of my brother Jonathan’s illness, and my mother’s days were too filled with breathing tubes, doctor’s visits and press appearances to pay attention to anything else. My brother was born with a condition that they didn’t have a name for. Basically, his insides swelled until they couldn’t anymore. It was like his brain was trying to push its way out.

They didn’t name my gender variance either. They figured that if they didn’t pay attention to it, the problem would go away, like a car alarm or a Jehovah’s Witness. My father expected that I would grow to only love the things he did; he expected me to give up Barbies for G.I. Joes and teatime for football, the sport he so loved. He just wanted us to be playing on the same team. He didn’t expect to see me in dresses.

As a culture, when we see a man in a dress, we do one of two things: We laugh or we beat it out of him. We do that in different ways. My parents caught me playing Cinderella at daycare one day after work, and they didn’t hit me or punish me. They didn’t throw me on the street or pawn me off on a religiously conservative relative. They just showed me that wasn’t an option. This isn’t what boys do. I was never taught that it was okay to be a woman or that it was okay to be myself. Boys aren’t princesses; they rescue them.

They didn’t realize that one day I would need to rescue myself.

Hating yourself is easy. I found a million outlets to hate myself. I had Jesus, who was nailed to a cross because I wasn’t good enough. I had the locker room, which helped me learn to hate my body, on top of hating my soul. I had the guys who would wait outside my Pre-Calculus class to stare at me as I walked by, treating my queerness as a spectacle. I had the uncle who stopped talking to me when I came out, who would only direct questions or statements to me through my mother. He didn’t hate me for being a socialist or wanting to tear down his capitalist patriarchy because of my political beliefs or any interesting reason. He hated me for the same boring reasons everyone else did. He hated me without even knowing why.

Boring or not, hate sticks. And low-simmering hate is particularly dangerous, because it's easy to ignore. Hate becomes a pattern, and you learn to hate for the same stupid reasons everyone else does. You hate without even knowing why, not recognizing that hate is a reflection of yourself.

You don’t choose to give up hate one day and wash your hands of it forever; the feelings stick with you, and they take lifetimes to cleanse. It’s not enough to simply not hate people, and you don’t get a pat on the back for looking at Lana Wachowski and saying, “Oh, I accept you now. Here’s an award. Go us!” You have to actively work to include trans people in your lives and spaces, accept a callout when you get it wrong and educate yourself to be better. You have to be accountable to yourself.

As Virginia Mamey Mollenkott argues, "It is vital for gay men, lesbians and bisexuals to recognize our movement as basically a transgender movement." Mollenott tells us that it’s not just about homosexuality. It’s about being queer -- or  different from the norm. Our struggle is about gender. She writes, "The fact that the most effeminate gay men and the butchest lesbians are the most endangered among us should alert us to the fact that society cares less about what we do in private than it cares about a challenge to its longstanding gender assumptions."

There was a time when I accepted not hating people as enough and credited myself as a good ally for “having trans friends.” Look how far I’ve come! However, our engagement needs more than love; it needs action. Trans people are some of the most visible and at risk in our collective struggle, and we must actively work with trans people, rather than simply for them. Gay cisgender men need to stop wondering where the T is and realize that the T is all around us, organizing and working to make the community safer for all of us. The trans movement isn’t the next movement.

Look around you. The movement is happening now, whether we care to recognize it or not.

The movement is KOKUMO. The movement is Kate Bornstein. The movement is Monica Roberts. The movement is Julia Serano. The movement is We Happy Trans. The movement is Girls Like Us. The movement is the Trans Month of Action. The movement is being broadcast all around you, and it’s coming to Chicago this weekend with The Trans 100, celebrating the incredible diversity of the trans community. Trans people are here. Are we paying attention?

I thought of Megan this week when GLAAD announced that it would be changing its acronym. The organization will no longer stand for the “Gay and Lesbian Alliance Against Defamation” but GLAAD, as in the emotion. This reflects that the organization not only speaks for gays and lesbians, but also includes trans people in its mission. This was announced even though the G and the L will remain in the organization's name and their board is mostly comprised of white, cis males -- much like HRC, our friendly neighbourhood transphobes.

I don’t discredit them for that. I know personally that we all have to start somewhere, and that we can’t move forward without taking that first step. However, in giving up transphobia, we must do more than just mention trans folks. Trans people are worthy of full inclusion, and they must lead, speak, sign, march, walk and wheel next to us (or in front of us). We must realize that their perspectives and issues are as worthy of championing as ours. We need to shut up and learn to listen. As GLAAD moves forward, I hope they continue to listen and push inclusion further. I hope we all do.

A month ago Janet Mock very politely called me out on Twitter for getting something wrong in an article I wrote on transphobia in The Observer, and I learned from her. I haven't always been great with callouts, but this time, I was happy to get schooled by the best. My work isn’t perfect. My work needs to be pushed and to push itself. I’m still learning -- and that includes learning to love myself, finally. Personally, I’m still figuring out what gender means to me. Like everything else in my life, it’s a journey.

If I saw Megan today, I wouldn’t just apologize to her. I would thank her. After all, she succeeded in at least one way: I never forgot her.

Nico Lang writes about LGBTQ issues in Chicago. You can follow Nico on Twitter, Tumblr or on Facebook.

http://gendertrust.org.uk/