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[METAL CLINKING] CHRIS ROBERTS: In the transition from woman to man, 35-year-old Terry is thankful he's held on to many of his female qualities, including empathy, an ability to listen, and a willingness to do more than his share of the dishes. Terry, with his short, stocky build and fully bearded but youthful face, believes his life officially began four years ago when he started taking male hormones. So far, the testosterone treatments have resulted in only two losses he regrets.

TERRY: My singing voice and my hair.

CHRIS ROBERTS: You're starting to lose your hair?

TERRY: Yes. You never realize how vain you are until you start to lose your hair.

CHRIS ROBERTS: Terry's early childhood memories are similar to most transsexuals, characterized by confusion and a loathing for the gender he was being trained to assume. His family's Sunday churchgoing ritual made him squirm, especially around this time of year.

TERRY: I detested Easter because it was always meant a new dress that was very frilly and black patent leather shoes. I'm so sick of hearing black patent leather shoes when I was a kid. And the Easter bonnet and that whole thing was just torture.

CHRIS ROBERTS: As Terry moved into adolescence and was unable to float between genders as easily, he began a sullen retreat inward and became rebellious. He also started to identify as a lesbian, as an escape.

TERRY: It was easier to deal with being a lesbian than to deal with being a transsexual.

CHRIS ROBERTS: But was that the way you viewed yourself, as a lesbian, fundamentally?

TERRY: No, not when I was honest with myself. I spent a good deal of time, many years, actually hating men.

CHRIS ROBERTS: Because men could so freely express what Terry was forbidden from expressing. He describes his coming to terms with his gender identity not so much as a revelation but more as a painfully gradual realization that he could not go on as a female.

TERRY: It was just a matter of-- how would you say-- like waking very gently in the morning, where you're kind of groggy. And you come out of a fog. And then you open your eyes, and you're wide awake. And it was at that point that I said, I can't do this anymore. I'm at the point now where I can risk losing my family and my friends and everything that I have because I have to live true to myself.

CHRIS ROBERTS: Terry keeps a scrapbook with pictures tracing his female-to-male transformation. The snapshots begin at age 15, showing Terry as an innocent, feminine-looking teenage girl with shoulder-length hair and a low-cut dress.

TERRY: The next picture is my senior prom, when I was 17, looking much more mature-- a white eyelet dress, very feminine, sitting at the piano. Have a flower in my hair.

CHRIS ROBERTS: Were you looking forward to the prom? At that moment, how were you feeling?

TERRY: Actually, I was-- the guy that I was dating at the time-- it sounds really strange-- [LAUGHS] was very nice man. And I ended up breaking up with him shortly after that because I knew what was going on inside.

CHRIS ROBERTS: One picture features Terry pointing at a cake, celebrating his 32nd birthday with his family. On that day, Terry informed his parents he was going to start taking male hormones. And that decision triggered a string of personal losses.

TERRY: I didn't see my family for three years. We are recently starting to get back together and repair the relationship. My parents call me "she" frequently, although it's about 50% now that half "he" and half "she." I lost my job.

CHRIS ROBERTS: What were you doing?

TERRY: I was working in the mental health field in a rural area.

CHRIS ROBERTS: All of this has made Terry extremely cautious when divulging details about his personal life. He won't say where he lives or works, because his employer doesn't know he's transsexual. Terry is also married to a woman.

TERRY: Because we met through friends, she already knew but never saw me as anything other than male.

CHRIS ROBERTS: After he got a mastectomy, hysterectomy, and began hormone therapy, Terry says, in his home state, he was able to change his gender on his birth certificate because he was no longer capable of bearing children. He says, in his opinion, that makes his marriage legal. All that remains in his gender transition is sex reassignment.

In terms of surgery, there are generally two choices for female-to-male transsexuals. In what's called a metoidioplasty, patients have their female genitalia, already swollen by testosterone, converted into a male's. The other procedure is called a phalloplasty, where plastic surgeons take flaps of skin from the arm, inner thigh, or abdomen and construct what they call a neopenis, which is much larger than what a metoidioplasty could produce. Despite the possibility of scarring at the donor site, Terry is opting for the latter.

TERRY: Oh, the super-duper deluxe model, of course. Why settle for anything less? I would go and have it done today if I could afford it.

CHRIS ROBERTS: Most insurance companies won't cover the cost of a sex change operation, which can run anywhere from $25 to $100,000, because they view it as elective or cosmetic. Transsexuals say the surgery is vital to their mental and emotional well-being. The issue has yet to be resolved in the courts, because usually, when transsexuals sue their insurance companies to have it paid for, the company settles. According to St. Paul psychologist Diane Olson, the numbers of female-to-male transsexuals are underestimated because they often don't pursue surgery and are invisible to the public.

DIANE OLSON: They blend in so much easier. And many of them don't ever consult a psychologist or even go through the hormonal therapy. They live out their life in what the outside world would perceive as a lesbian relationship. And yet their partner sees them as a male. And in all the activities that they do, there's a male-female role played out.

CHRIS ROBERTS: University of Minnesota psychiatrist Sharon Satterfield, a specialist on transgender issues, says female-to-male transsexuals generally have an easier time changing genders than their male-to-female counterparts because for them, it's a climb upward in society. Satterfield says male to females have to deal with losing male privileges.

SHARON SATTERFIELD: Whereas the female-to-males strut around and brag about how all of a sudden it's as if they gain 20 IQ points, and isn't this wonderful-- now, I have to admit, I get a little jealous sometimes when I listen to this.

CHRIS ROBERTS: While the transition may be smoother for postsurgery female-to-male transsexuals, the pathway to that point can be perilous.

[CHATTER]

When I went to meet 34-year-old Scott Gerdes at a West St. Paul bar for an interview, I was expecting to find a female-looking person with a beard. From his short haircut to his goatee to his basketball sneakers, Gerdes was dead-on male. And his eyes lit up when I told him so.

SCOTT GERDES: That's the greatest compliment I could get. You can say that all you want. You can tell me that over and over again.

CHRIS ROBERTS: It's only been a few weeks since Gerdes had his sex reassignment surgery. And he still walks gingerly with a slight limp. Even though he grew up surrounded by a loving family in Des Moines, he doesn't mince words about his unhappy childhood. Having to live and behave as a girl-- his name was Caroline-- filled him with such anxiety he would often sweat or get sick to his stomach. And he grew more self-destructive as he got older.

SCOTT GERDES: I'd just look in the mirror and go, you're just all wrong, and I hate you. I hate this. I would take things like razor blades or even fingernail clippers and pinch my skin and just do these awful things, I mean, terrible things to myself. I'd hit myself.

I thought I was some kind of freak of nature and I was the only one in the world that was like this. And I was too afraid to tell anybody about it. And I was really too afraid to die. And I knew I really didn't want to. But in a lot of ways, I thought, God, that's my only way out.

CHRIS ROBERTS: The agony continued with no relief until his college years, when he took a human sexuality course, watched a film on transsexuals, and a light went off in his head. With help from his professor, he started heavy therapy sessions and hormone treatments. Soon, his whole physical persona began to change-- more body hair, a more male distribution of body fat, a bigger appetite, and a sex drive that shot up.

SCOTT GERDES: It's like going through, what I imagine what guys go through with puberty, except a lot faster-- a lot faster.

CHRIS ROBERTS: In the years that Scott Gerdes has lived as a male, he's been able to view his newly claimed gender from both the male and female perspective. He's been the beneficiary of the perks and respect males enjoy in society. And he's been disgusted by the way his male peers treat women. Sexually, he considers himself a heterosexual male. But his experience on both sides of the gender dividing line has come in handy in relationships with women.

SCOTT GERDES: The first woman I ever dated, she did not know about my past and that I was going through a change. And she had cramps really bad. And I understand that because I used to get them really bad too. And it was awful. And she was just in tremendous pain and very upset.

And I just sat down next to her and without saying anything, I just started rubbing her in the area that I knew and that I had felt was the problem area. And she just stopped her complaining and being upset and just looked at me with her eyes wide open. Oh my god, that feels so good. You're just wonderful. You're a god. You're an angel. [LAUGHS]

CHRIS ROBERTS: It was a near tragedy that enabled Gerdes to secure sex reassignment surgery and have it paid for. Two years ago, he had a couple part-time jobs with no health insurance and was suffering through the rejection of a woman he had fallen in love with. He says, one night, he fell into a bottle of scotch and made a serious attempt at suicide.

SCOTT GERDES: I was found and taken to Ramsey Medical Center. And a couple of days later, a woman with a briefcase and a bunch of papers sat me down and said, hi, I'm so-and-so. I don't remember her name. I represent the state of Minnesota. And this is-- I don't remember the other woman's name too. Another woman showed up and said, I represent Dakota County. And we understand that you are a transsexual and you are wishing surgery but don't have the funds for it. And that is basically what brought you here. And we can help you.

CHRIS ROBERTS: Because he qualified as low-income, Gerdes had his surgery paid for by medical assistance. And he says it probably saved his life. Since then, criteria for transsexuals receiving state aid for such operations has been tightened. Gerdes is now on much more solid ground mentally. But he's not sure whether society will ever become truly tolerant of people like him. He says he has no time for people who judge him morally.

SCOTT GERDES: Who am I hurting? Nobody. I'm not hurting anybody. I didn't go through this for attention. I didn't go through 6 and 1/2 hours of painful surgery and how many-- 15-plus years of mental torture for someone to stand up and say, I think you're sick.

CHRIS ROBERTS: Gerdes believes he's a transsexual because of a chromosomal miscommunication, a birth defect. Because he corrected that defect with surgery, he now looks forward to a life filled with hope and possibility in his new outward identity as a male, not the unmitigated misery of his past life. For Minnesota Public Radio, this is Chris Roberts.

JOHN RABE: It's All Things Considered. I'm John Rabe. Ski resorts in Northern Minnesota are reporting one of the best seasons ever, thanks to the abundance of snow and lingering cold weather. The season is extending weeks beyond normal. Many skiers are in no great hurry for this great season to end. And that includes Bill Mattson of Duluth. Hello, sir.

BILL MATTSON: Hello.

JOHN RABE: You skied, so far this year, 81 times.

BILL MATTSON: I've been on skis 81 times, yes.

JOHN RABE: Do you keep a journal of that? Or do you mark it on your calendar?

BILL MATTSON: Mark it on the calendar.

JOHN RABE: Is that a lot for you?

BILL MATTSON: Last year, I was right around the mid 60s.

JOHN RABE: OK. So this has been a very good season for you.

BILL MATTSON: Yes, it has.

JOHN RABE: Would it be impolite to ask how old you are?

BILL MATTSON: No. I'll be 58 come June.

JOHN RABE: OK. Is skiing 81 times a lot for a guy that old?

BILL MATTSON: We have quite a few people out at Spirit Mountain that are retired and range anywhere up to the 70 years old that ski quite regularly.

JOHN RABE: How's the skiing this year?

BILL MATTSON: Oh, it's just been fabulous.

JOHN RABE: And right now, how is it?

BILL MATTSON: Well, we're getting a snow up here in Duluth. And I'm looking forward tomorrow to have a wonderful day again. The hill's in excellent condition.

JOHN RABE: So you're not depressed by the fact that winter is not over yet?

BILL MATTSON: Absolutely not.

JOHN RABE: How many years have you been skiing in Minnesota?

BILL MATTSON: I came back to skiing in 1985. This will be the 11th year now.

JOHN RABE: Is this the longest season you can remember?

BILL MATTSON: Yes, it is.

JOHN RABE: What do you think about when you're out skiing?

BILL MATTSON: How wonderful it is to be out in the outdoors and the fresh air and the nice people that you meet on the ski hill.

JOHN RABE: So I guess you're long past the point of thinking about the exertion? More meditative for you?

BILL MATTSON: Yes, although it is wonderful exercise and tone your body up and enjoy it.

JOHN RABE: Sure. Well, apparently. Have you talked with the folks who run Spirit Mountain? Are they pretty happy?

BILL MATTSON: Oh, yes, they are. They're very pleased with the year.

JOHN RABE: I think we talked with some folks at-- was it in Lutsen or a while ago? It was a few months ago. And there was some cause for concern about the season. Maybe it was because of the intense cold and people couldn't get up there. But I guess they've been doing pretty well. How many more days do you think you might be able to get in this winter?

BILL MATTSON: Well, it depends on how long the hill is going to be open. I took today off because of the severe wind that we have up here. But it's snowing now. And I think that I'll ski maybe another three, four times, maybe five.

JOHN RABE: What do you do during the summer?

BILL MATTSON: The summer, we bike ride the trail and walk the waterfront here in Duluth. And we're pretty much exercise orientated, like myself.

JOHN RABE: Yeah. Doing that every day?

BILL MATTSON: Just about. No, I would say maybe three, four times a week we do that.

JOHN RABE: All right. Well, thanks for talking with us.

BILL MATTSON: All right. Thank you.

JOHN RABE: Bill Mattson of Duluth.