The Queer Psychoanalysis Society

“The Institute”: an excerpt from Gender’s Hourglass

In LGBT, Literature, Queer Theory, Transgender on May 8, 2012 at 9:24 am

by Cybele Marcia Carter

Author’s Introduction

When I was just 13 I had already seen my first psychiatrist and was committed to a private mental institution for six weeks in San Francisco.  I was not actually mentally ill, neither acutely neurotic nor psychotic.  What I was (and still am) may have been diagnosed as a disease in 1972, but is accepted as (mostly) routine today – a transgendered female.  Neither my doctor, who recommended institutionalization, nor my parents or sisters at that time, understood what gender dysphoria (feeling born and trapped in the body of the wrong gender) or Gender Identity Disorder (GID) were.  They could not know that, while born as a boy, I had always lived with the certainty that I was female and should have been born and raised as a girl.  As such, the “therapy” I received in the institute was misguided, focusing only on “male-bonding” with my father and improving my socialization skills with other adolescents on my ward.  The result was years – decades, actually – of misery, on my part; of trying, and failing, to either fit into the role in which I was cast, or to break free of convention and live true to myself.  I have lived, until now, a mostly hidden or “closeted” existence.

In my actual life, here in 2012, I am finally escaping the bonds of familial ties, guilt, and shame over being a transsexual.  But it occurred to me – what if I could travel back in time, to 1972, with the full knowledge and experience of the past 50 years, and change what was to what I wished it to be?  With the help of my clinic’s medical staff, could I have convinced my parents to allow me to begin living as a girl; as a daughter and sister; and even to help me take appropriate hormones and finance eventual sexual reassignment surgery (SRS)?  And if so, how different would my life have been up to now?  Would I be happier or filled with even more regret?

I have thus combined my actual memoirs of that critical year of 1972 – the year I first started high school, and met my first girlfriend, who would later bear my daughter – with a story of what could have (and should have) happened.  The settings and most of the characters are as real as I remember and speak and act as I believe they would have or do now.  The scientific and medical information I “bring back” with me in time is completely accurate and accepted as of the present.  Naturally, I also bring back “memories” and knowledge of my past future – that is, of the future I already lived for 50 years – which I refer to as my “first time around”.  But my story emphasis is the choices I make and the changes to my life in this, my “second time around” – in other words, a “do-over” of my adult life.

Mine is neither the first nor the last story of its kind.  I am indebted to my predecessors such as Daphne Scholinski and Susanna Kaysen for their inspiring memoirs of their experiences in private mental institutions.  Ms. Scholinski’s book, The Last Time I Wore a Dress, falls on the opposite end of the gender spectrum from my own, but my tale has some similarities.  My complete book, Gender’s Hourglass, could almost be considered a blend of truthful memoir and fiction.  I based it on my own real experiences and people I’ve known and loved, though I’ve changed their names and used artistic license in crafting composite characters and dialogue.  The opinions and convictions I, as protagonist, express are indeed my own.  I hope this story may inspire others to stand for themselves in expressing who they really are.

The Institute

It was 1972.  Late February or early March I think.  The place was San Francisco, California.  And the author, myself — Mark, at that time — was there.  There in a hospital.  A mental hospital (or institution, if you prefer).  Specifically, the McAllister Neuropsychiatric Institute, within a wing of St. Margaret’s Hospital (now Medical Center) located on the corner of Stanyan and Hayes Streets in the Haight-Asbury District.  Five years after the Summer of Love; and right across the street from Golden Gate Park.   At that time my home was in San Bruno and I was in my first years of high school.  My first year of madness.  But I’m getting ahead of myself — an easy thing for a time-traveler to do!

The McAllister Institute, which still exists but is in 2011physically separate from the old St. Margaret’s hospital – now a cancer center at 2250 Hayes St. – and the much newer and larger St. Margaret’s Medical Center, uphill along Stanyan past Fulton.  The building is drab; a light industrial shade of grey.  Near the Institute’s rear, or northwest side, the ward I was on – for children and adolescents – was at ground level; but as the adjacent Grove St. went downhill from there to Hayes St., part of my ward became Level 2 with a first level below. The adult ward was above us on Level 3, with its dreaded shock therapy room (which we were all shown at least once), and bars on the outside of all the windows that are still there in 2011.

I found that I actually kind of liked the Institute.  I had my own room (at first) although I had to sleep with the door open and there were bed checks by the nurses through the night.  The food wasn’t too bad – in spite of what I’ve since heard about “hospital food”.  We got three meals a day, with juice or milk, and in the large Day Room we often played games, or listened to LPs on the record player (some that were kind of “hard” rock even then – Led Zeppelin IV, for example – the one with Stairway to Heaven — or the Beatles White Album, or Traffic (John Barleycorn Must Die), or the trendy (and very much local) Jefferson Airplane (Surrealistic Pillow). All the hard rock and psychedelic lyrics were doubtless appreciated by my peers on the ward.  Most of them were drug addicts and rehabbing there.

We’d also go up to the roof sometimes to play volleyball; made tie-dyed T-shirts for ourselves, and called ourselves the Tie-Dyed Tigers.  I really enjoyed it, although at times I also had thoughts about crashing through the surrounding Plexiglas and falling three or four stories to my possible death. The roof level, above the adult ward, had what amounted to a clerestory of windows, about twice our height, for half its length: not barred, but reinforced with framing.  In photos from2011 you see a large barrier of what looks like athletic backstop material –chicken wire or chain-links, perhaps – sitting atop the clerestory on the eastside of the roof – it wasn’t there in my time here, and we’d frequently hit balls over the unroofed windows to the street below; where sometimes kind-hearted citizens kicked them back up to us.

Of course, life at the Institute wasn’t all fun and games.  There were therapy sessions, both one-on-one and group, led by psychiatric technicians.  At least once a week I also saw Dr. Kilroy in an office.  I was given an EEG(electro-encephalograph) and put on an anti-depressant (Elavil) which one time caused my tongue to swell up.  I was also forced to spend time alone with my father the First Time around, in order to bond and perhaps learn to be a man or something.


I got in a physical fight with several boys on the ward who teased me for “wanting to me a girl”.  After I kicked their asses using Tae Kwon Do techniques I’d learned in the future, I was physically restrained.

Four male attendants grasped by arms from behind and brought me down to the floor.  I knew better than to resist them.  A nurse came over and quickly administered a sedative in my arm, and as I started to lose consciousness I felt the men lift me and begin to carry me – to a place I had seen but never been to previously.

If you read, or saw the movie made from, the novel I Never Promised You A Rose Garden (more about this book later), you may recall a practice that mental hospitals use to control unruly patients.  It involves sheets.  Wet sheets.  They wrap you up in these – naked –  so that, first, your arms are bound at your sides and your legs are immobilized; and then your torso is bound tight in what is essentially a wet and smelly straightjacket.

So I was bound and laid on a bed, sedated to the point where I drifted off to sleep a while.  It was common practice also on this ward to keep patients asleep via injections for up to a week or more.  I guess these were kids who were on drugs, and needed time for their bodies and minds to detox.  Of course, some of the attendants might do this out of spite: some boys (and girls) put up vicious fights when they were strung out.  But, as I discovered, lying awake and alert but unable to move, even to scratch oneself, was far worse torture than “sleep therapy”.

I reflected upon the phenomenon of multiple personalities.  It certainly seemed to some patients on the ward, and perhaps to my own family, that I exhibited a “split personality”: one male and the other female.  But I knew this wasn’t my condition.  I was aware that this phenomenon was very rare, despite some notable exceptions such as the case of Sybill in 1973 (and no, I never patterned my name or my behavior on this person, despite the homophonic nature of our names).  And I also knew that I never acted out in the same way that the girl character, Lisa, did in Dr. Theodore Isaac Rubin’s  stories Jordi/Lisa and David.

I was no Lisa; nor, for that matter, a David or a Jordi.  Lisa frequently spoke to herself in a dissociated, third-person way, particularly when she switched from being the hyperkinetic and childish “Lisa” self to the more adult, but moodier, “Muriel” self.  Lisa had insecurities about herself that often surfaced when she was alone.  And David also had many fears, including one that I related to:  seeing an apparent hermaphrodite at a freak show, and then thinking of himself.

But I was born transgendered, and it  was not until around the year 2000 (my first time around) that I was diagnosed as a transsexual: a person whose inner gender (female in my case) didn’t match their outer gender (male, of course).  Or, according again to the dictionary: “a person who psychologically identifies with the opposite sex and may seek to live as a member of this sex, esp. by undergoing surgery and hormone therapy to obtain the necessary physical appearance (as by changing the external sex organs)”.  True enough, but I like my own definition better.  And I knew it was true for me, even before I began seeing the late gender therapist (and transsexual) Gianna Israel.

I knew it after some 40 years of being trapped in the wrong body and involved in the wrong activities and relationships.  But more on this later.

Feeling despondent while “in sheets”, I thought (not for the first or last time) about committing suicide.  I recalled having read about the author Sylvia Plath’s book The Bell Jar; the story of a woman (based on Plath herself) who was committed to a mental institution for attempting to overdose herself with pills.

Of course, in real life, Ms. Plath did successfully suicide in 1963, after suffering from depression, and having been on anti-depressants for a long while.  They found Plath dead of carbon monoxide poisoning in the kitchen, with her head in the oven, having sealed the rooms between herself and her sleeping children with wet towels and cloths.   At approximately 4:30 am, Plath had placed her head in the oven, with the gas turned on.

She was 30.


Days later, I had my first therapy session with a female tech.  We sat in one corner of the Day Room, while other kids watched TV or listened to records or talked with their own counselors.  Mine was named Emily.  She was short, brunette, around 30and kind of cute.  She was saying to me: “So, Mark.  Tell me what you think about yourself and who you are.  Who is Mark?”

I decided to be flip. “Beats the hell out of me, lady. Mark is a boy’s name.  And I am not a boy, all evidence to the contrary notwithstanding.”

Emily seemed taken off-balance by my precocious response, but said calmly: “I see.  Why do you think you’re a girl?  You look like a boy and your parents named you Mark.”

I sighed.  This was going to be difficult.  I said: “Well now you’re a psychiatric tech.  So I assume you’re familiar with the expression ‘a woman, trapped in a man’s body’?  Does that ring a bell?”

Emily smiled.  “Of course, that applies to what we call a trans-sexual person.  They claim to have been born into the wrong-sex body.  We don’t fully understand this phenomenon, and it appears very rare. There have been some documented cases such a person effectively changing their sex after much therapy, hormones treatments and surgery.  I guess you’ve heard of it somewhere?”  I nodded. “Perhaps you know of a ‘woman’ named Christine Jorgensen?  She was born a man but expressed such a desire to live as a woman that she eventually had the necessary procedures done in Sweden, I believe.  But Mark”, she continued, “the difference between you and someone like ‘her’ is that she was an adult when she had her sex-change operation, and had enough life experience to make that momentous decision. You are still a child.  How can you be thinking such things?”

“I know more than you think I do”, I blurted.  “I know a lot more about the subject than most doctors alive today.  And, pardon me for correcting you, but the operation you refer to is not a “sex” change.  “Sex”, or sexual desire, is very different from gender constructs.  Which is why women can desire women (lesbians), men can desire men (homosexuals), or either can desire both (bisexuals) regardless of gender.  In my case I am bisexual, but with a distinct preference for men.  Which is as it should be, since I am basically a heterosexual female.

“But as for my gender, the dysphoria I feel makes me in truth a trans-gendered person (although that term isn’t being used yet).  I am in fact a male-to-female (MTF) transsexual, regardless of my age; and I want to have the “procedures” taken care of while I’m still young enough to enjoy girlhood.  But I hardly expect you to believe me.  Maybe I can convince Dr. Kilroy.”

Emily, the psychiatric tech, stared at me with wide eyes and mouth open.  Her expression was as if she had just heard an animal talk to her.  I had, of course, used terms and a tone of voice entirely inappropriate for my age.  But she could not deny the validity, or appearance of such, in my words. She shook her head, and said: “Well, thank you for educating me – Mark.  I think our session is at an end.  Why don’t you watch some television with the others” – she pointed to one corner, where cartoons were on the set – “and rest your mind for a while.  Okay?  And I’ll let Dr. Kilroy know that you’d like to see him.”  She put on a false smile.


A few days later, after the morning’s Group Therapy session, the head nurse came up to me and said:  “Cybele, you’re to meet Miss Williams and Dr. Kilroy in his office. Come along.”

Neither Dr. Kilroy nor Emily were ever in the Institute on a Friday, I knew.  So what was up?

When we entered Kilroy’s office, he beckoned me to sit at a small table, where Miss Williams already was, instead of the usual seat in front of his desk.  On the table were a number of papers and booklets and a couple of books.  Standing against the wall, I also noticed, was Kimo’s guitar.

The nurse left and Kilroy closed the door, then joined us at the table.  Both he and Emily welcomed me.  “Good morning, Cybele.”  Then my doctor added:  “We are here today to give you some tests, young lady.  These are both educational and psychological examinations. Taking them and having them evaluated will take up most of the day, I’m afraid.”

“Is there a specific reason for these tests?” I asked, looking from doctor to therapist.

“The main reason, Cybele,” she answered, “is to help us understand you better so that we can help you all the more.”  She smiled sweetly at me.

“But also,” Kilroy added, “these tests – and some questions we want to ask you — may help us understand some of the … unusual … knowledge and talents you’ve started to display since you were brought here.”

Of course I knew what he referred to.  We all did. Yet I still did not disclose outright the reason for my behavior.  Suppose these tests and questions brought the truth out to surface?  All they had to do was ask the right question.

Well, I thought resignedly, they would have to learn the truth soon anyway if I was to move forward with my plans.  So I planned on nodding and saying: Whatever you say, Doctor.  Let’s get started.  But my perverse sense of humor brought forth a memory from the future that I couldn’t help utter: a phrase from a film well-known and almost trite in my time.

Altering my voice to give my best Anthony Hopkins imitation, I quoted:  “’A census-taker once tried to test me. I ate his liver, along with some fava beans, and a nice Chianti.  F-f-f-f-f-h!’”

They gazed at me in shock and horror.  “What did you say, Cybele?” gasped Dr. Kilroy.

“I’m sorry,” I apologized, resuming my normal girl’s voice.  “That was a joke.”

“But … where did that come from, Cybele?  Is it something you just made up?” asked Miss Williams concernedly.

“No, no!” I stammered: “It’s just a line from a movie I saw… once … about a man (I didn’t say a psychiatrist) who was locked up for being a cannibal It wouldn’t mean anything to you. Bad joke.  My bad.  Please, Doctor –continue.”

After a moment in which we all relaxed, Kilroy said: “Cybele, I think we’ll start with an I.Q. test.”  That alone could betray my true age to them, depending on what questions it held and how well my education and life experience could answer them.  Emily handed me a thick test booklet and a standardized answer form.

I didn’t recall what my I.Q. measurement ever was.  I only knew that I had never passed a qualifying test for Mensa, which meant that I hadn’t achieved their exam’s 98th percentile or higher.

An intelligence quotient, or IQ, is a score derived from one of several different standardized tests designed to assess intelligence. The term “IQ” comes from the German Intelligenz-Quotient. When modern IQ tests are constructed the median score is set to 100 and a standard deviation to 15. Today almost all IQ tests adhere to the assignment of 15 IQ points to each standard deviation but this has not been the case historically. Approximately 95% of the population have scores within two standard deviations of the mean. If one SD is 15 points, then 95% of the population are within a range of 70 to 130.  There are two classification systems for IQ scores: the Terman and the Wechsler. Under the first system, an 164 and over would be regarded as near genius or genius level; and under the second system, an IQ of  >= 130 would be regarded as very superior.

My IQ, I discovered after they tested me, was 175.

I did the test – 30 questions in 30 minutes – and the questions were pretty routine: number sequences — which number comes next; word problems — unscramble this word, or which of the following words does not belong here; and some diagrammatic problems — which figure comes next in this sequence?  Not exactly a challenge, except for the time constraints.  When I finished, I handed the paper to Miss Williams (who was also, I learned, a private tutor) to grade, adding:  “I don’t always do well on tests.  Sometimes it takes me too long to answer a question. Also, there are flaws with the I.Q. test; built in racial and gender bias; and it’s not a true measure of human intelligence or potential.”

“Really?” said Emily, her eyes wide.  Turning to Kilroy she asked: “Is that true, Doctor?”

Kilroy looked a bit uncomfortable as he answered:  “It’s difficult to construct a purely objective test without any bias.  I haven’t heard these allegations about the I.Q. test myself.  Where did you hear about them, Cybele?”  He looked hard at me.

I replied casually: “There’s a professor — or maybe he’d still in grad school – at Harvard named Stephen Jay Gould.  He plans to write a book on the subject — so I heard in my psychology class.”

“Hmm,” responded Dr. Kilroy.  “I’ll have to look him up.”

Kilroy then handed me another test booklet and answer sheet.  I could see at once that it was standard ink-blot, or Rorschach, test. That made me think of the graphic novel and movie Watchmen, featuring the tortured crime-fighter named Rorschach.  “I know what to do with this test,” I told him.

“Yes, you may have seen or heard about the Ink Blot Test,” Kilroy told me.  “We usually administer this orally, but here I want you just to write down your first impressions or ideas about what each image means to you.  Don’t think too long or change any answers: just go with the first thoughts in your head.”

“Why don’t you start now,” said Miss Williams.  And I did.

As an example of my answers, for the first card image in the standard Rorschach deck, I wrote down the same thing I did (many years later, F.T.) for a counselor at the University of Maine.  Two angels (Seraphim) stand facing each other in profile with their outstretched wings behind them.  They have grasped the wrists of the female frog-demon, Asmodeus, who is wearing a dress, her hands and fingers pointing upwards, and screaming.

I swear that’s really what I saw, what I interpreted from it.

I knew it would take a while to both fill in the blanks and to have them evaluated.  Afterwards I was given the MMPI (the Minnesota Multiphasic Personality Inventory): one of the most frequently used personality tests in mental health. The test is used by trained professionals to assist in identifying personality structure and psychopathology.  (It was designed in 1939 and later revised in1989.)

A number of clinical scales were designed to measure common diagnoses of the era.  One of them was particularly relevant to me:

Scale 5 (AKA the Femininity/Masculinity Scale) :Measures a stereotype of a person and how they compare. For men it would be the Marlboro man, for women it would be June Cleaver or Donna Reed.

I figured that my responses would define me as a stereotypical woman.  But what the designers of these test may not have realized is just how easily a patient could manipulate them.  If, for example, a person wanted to prove themself insane to avoid a trial, all they need do is give the craziest answers they could. I certainly ensured that my answers painted a very feminine picture of my brain.

Then I was given the Thematic Apperception Test, or TAT. This was a projective psychological test, meaning that it was designed to let a person respond to ambiguous stimuli, presumably revealing hidden emotions and internal conflicts; just as the Rorschach was. This is different from an “objective test” in which responses are analyzed according to a universal standard (for example, a multiple choice exam).

Historically, it has been among the most widely researched, taught, and used of such tests. Its adherents assert that the TAT taps a subject’s unconscious to reveal repressed aspects of personality, motives and needs for achievement, power and intimacy, and problem-solving abilities.

In the TAT, an individual views ambiguous scenes of people, and is asked to describe various aspects of the scene; for example, the subject may be asked to describe what led up to this scene, the emotions of the characters, and what might happen afterwards. The examiner then evaluates these descriptions, attempting to discover the conflicts, motivations and attitudes of the respondent. In the answers, the respondent “projects” their unconscious attitudes and motivations into the picture.  Again, I gave interpretations and answers most likely to show myself gender-dysphoric.

As I handed the materials back to the Doctor, I told Kilroy:  “By the way — I am aware that the current DSM (the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association), DSM-II, has no mention of gender identity disorder (or its predecessors, gender identity disorder of childhood [GIDC] and transsexualism).  I know that this disorder  has attracted controversy as a mental disorder,  on par with the condition of homosexuality, for its diagnostic criteria, as a target of therapeutic intervention, and for its relationship to a homosexual sexual orientation. Another point of controversy is the claim that the diagnosis of GIDC was introduced into the DSM-III later as a kind of “backdoor maneuver” to replace homosexuality, which will be deleted from the DSM-II in 1973.”

Now both Emily and Kilroy gawked at me.  My doctor moved away the exam papers and booklets and, taking a yellow legal pad and pen for notes, stared hard at me, saying:  “I think it’s time you answered some of our questions, Miss Cybele.  Such as: how could you possibly know the details of such an academic journal, let alone what future changes would be made in it?”

I keyed on the word “future”.  Miss Williams looked as intently at me as Kilroy.  And I realized that the time was approaching  to, in the words of the late Paul Harvey, tell them “the rest of the story”.

For the moment, I just murmured:  “I don’t know …”

Dr. Kilroy sighed, and finally looked at the clock.  11:15.  “Well, Mark, I’m afraid our time is up for today.  I think we both have quite a lot to digest and think about before we meet again.”  He rose from his chair and I did also.  As he opened the door to lead me back to the day-room, he added: “You know, I’d like to bring you to explain your thoughts about yourself.  We’re having a meeting next Wednesday at noon.”

“Yes”, I said.  “Gran mal.”  That was the name of just such a conference I’d been brought to during my first stay here.  But it was also a slip.

Dr. Kilroy reeled and put his hands on my shoulders.  “How did you …?”

To cover my slip of the tongue, I said quickly: “I guess that’s what you could say about my condition, truly?  Gran mal, Latin for “very bad”.  I certainly feel bad about my situation.  So it seems an appropriate saying.  Pretty much a fait accompli”, I added in French.  “Accomplished fact.  I picked that up from the novel Love Story a couple years ago.”

The doctor relaxed and covered his nervousness with a half-smile.  “You are so learned for a 14-year old, Mark.  I can’t wait to see my colleague’s reaction!”

I stopped for a second.  He looked at me.  “Doctor, I’d appreciate if you and your staff could stop calling me that boys’ name.  My true name is Cybele.” I spelled it out for him.

About the Author:

Cybele Marcia Carter (1957 — ) is a transgendered author with a long and varied history.    Her first novel (published as Cybele) is a basically autobiographical story, with the exception of its science-fiction element and some artistic license in the creation of composite characters. The names of any and all real individuals in the book have been altered to protect their privacy. Cybele has spent much of her life coming to terms with her transsexualism and is now continuing on the road towards complete transition as a female. She has previously published under her birth name. Although she considers herself a resident of nowhere in particular, her heart yearns always for the rural and wilderness areas of Maine and Quebec. She lives alone with the exception of her cat.

Her novel, Gender’s Hourglass, is available as a Print-on-Demand softcover book through CreateSpace: It is also available as an eBook (Smashwords Edition) through most online retailers such as Amazon and Barnes & Noble.

  1. […] In her previous excerpt from Gender’s Hourglass, “The Institute”, Cybele Marcia Carter explored a fantasy that nearly all queer individuals share—the desire to […]

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