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Reconstruction Zone: Chronicling Haiti’s Post-Quake Struggles

See more photos from Haiti, and what you can do to help.

“There was just a 7.0 quake right outside of Port-au-Prince. This will be a big deal.”

Two years ago today, I was the night editor for a national radio show. Around 5:20 p.m. Eastern time, the AP newswire flashed this sparse dispatch from a videographer working in Haiti, who had seen a collapsed hospital in a town up the hill from Port-au-Prince. "People are screaming for help,” the message added. Within seconds, we were calling everyone we knew with a Haitian phone number.

A colleague’s friend gave me the phone number for France Neptune, a driver for an orphanage, and I began dialing it over and over again. I was the first person to reach Neptune that night—almost all attempts to call Haiti yielded a foreboding variety of beeps. International media wouldn’t arrive until the next night, all flights were cancelled. On the phone, Neptune told me about chaotic streets filled confused throngs wandering, unsure where to go. He asked me to tell his girlfriend Mallery, who ran the orphanage and was in the U.S. on a supply run, that he was safe.

Neptune gave us a short update on the radio before dawn the morning after quake, the scene clearly but sounding dazed when asked about his plans. “I don’t know what I will do,” he said in a shaky voice that began to hint at the scale of the disaster. 

By sunrise the next day, it was clear that Haiti faced a worst-case scenario: More than 200,000 people were dead, another 300,000 injured. One and half million people were left homeless, hunting for shelter, water, and basic medical care. Two years later, more than 500,000 people still live in more than 800 makeshift tent camps in and around Port-au-Prince.

I met Neptune and Mallery, who are now married, while visiting the still-shaken country last week. They invited me into the shipping container they're calling home while their new orphanage and apartment are built next door. “Last year was tents the whole year,” Mallery says. “So to go from tents to something that doesn’t blow in the wind is great.

The Neptunes are in better shape than most because of their connections with American donors. Two years later, they say they are almost back to where they started, able to help a tiny fraction people still living in tent camps. Like many Haitian nonprofit leaders, the Neptunes reacted to the disaster by working harder.  “I like what we are doing, it’s part of my heart," France says. "It’s hard for me at the same time, because I would like to do lots more for the people, but… we can’t reach everybody.”

They have “adopted” two tent camps, as they put it, purchasing supplies and funding small medical clinics, mostly for girls. Before the quake, their work focused on the nation's huge child malnutrition crisis, but now they’re treating a new scourge: Sex crimes, they say, are a major problem for Haitian women.

Wearing multiple layers of clothes is the only many girls and women can try to protect themselves in a country with about one police officer for every 100,000 people. “They were begging, you know crying," France Neptune says. "And the OB-GYN doctor would want to see them, and see like 10 underwears or lots of shirts. They are afraid to get raped.”

“People are getting raped because they are still living under plastic,” says Leonard Doyle, a spokesman for the International Organization for Migration, which coordinates humanitarian services in the tent camps. “They’re just a little razor blade away." Transactional sex is common in the camps, he adds. Many women submit to sex with a man in exchange for living closer the latrines for safety, or being added to a list for social services.

Overall, reports of rape and gender-based violence have roughly tripled in the past year. A UNHCR spokesman characterized the rate of rape in the 800 remaining camps as “alarmingly high.”

One of the organizations focusing specifically on women who have been sexually assaulted is the Commission of Women Victims for Victims, known by its Creole acronym KOFAVIV. One of its workers, Claucina Jean, took me on a tour of Champs de Mars, a sprawling public plaza across from the broken presidential palace akin to Hyde Park in London or the National Mall in Washington, D.C. Today, the park is filled with tents and shacks.

Many of the women who live here have sought Jean's help after being raped. She knows at least 50 women in this camp who have been assaulted, and she assumes many more are staying silent. One rape survivor, Guinize Jean (no relation to Claucina Jean), tells me she was raped, an act of bravery in itself. Wearing a purple streak in her crisp braids and flashing an incongruous smile, she says she doesn’t know who raped her. When asked whether she feels safe, she flatly responds, “no," pausing to rescue a yellow terrycloth hair tie from deep in her baby’s mouth.

Another Brick in the Wall

Amid the rubble, there are signs of hope. The government has stabilized after a prolonged power struggle that left many recovery projects stalled. The battalion of aid agencies—well into the hundreds if you include smaller charities—are finding their rhythm, finally coordinating with each other efficiently enough to chip away at some of the most complex impediments to rebuilding, like relocating tent residents. Jean and her family will soon receive a years rent and assistance in finding housing elsewhere in the country. 

Still, every rebuilding project comes with dozens of complications. Consider rubble removal: The United Nations Development Program is coordinating 46 agencies and the local government to clear the streets. UNDP staff took me to a rubble-clearing site in Bel-Air, a neighborhood only recently deemed safe enough for aid workers to enter. Making the area accessible required special outreach to local factions, including gangs, by aid group Viva Rio, which specializes in dangerous communities, with experience forged in the violent favelas of Rio de Janeiro. Viva Rio spent months working with various constituencies to let local groups choose who gets the coveted jobs, which can pay up to $9 a day. Various community leaders each got to appoint a certain number of workers, while an entrepreneurs' association chose others.

The 300 workers on the Bel-Air site work hard because they are paid by how much they carry out, the foreman says. The quake left about 10 million cubic meters of rubble, enough to fill several football stadiums. Half of that remains where it fell two years ago, yet we're watching women—40 percent of the jobs are required to go to women—carrying single slabs of concrete out to the street, a tremendously inefficient process.

The remaining rubble isn't sitting in the road like it was a few months ago, exacerbating Haiti's already-infamous traffic. The craggy heaps are trapped on steep hillsides, or—as at this Bel-Air site—behind inhabited homes with large cracks in the walls, clearly unsafe in the event of another quake. The final alley to this site is so narrow, not even a wheelbarrow can pass. The bricks must be carried out by hand, bucket by bucket.

One problem is that crews can’t knock down half-broken houses without authorization from the owners, a tricky proposition considering the quake's death toll. On this site, all nine family members were crushed, and finding a living heir to authorize demolition poses a huge challenge.

You can’t just dump football stadiums worth of brick in a vacant lot, either: Crushing the debris and re-using it requires an elaborate plan from a U.N. support agency. Cracked houses must be transported to special machines on the edge of town, which can only run part-time because the wind blows too much dust over the city. “Now, as you can see, we are really efficient,” says Jean-Sebastien Roca, a UNOPS project manager, gesturing toward two mammoth machines grinding rubble to dust for recycling.“It took time to understand,” he says. “Nobody faced what we have faced here in Haiti.”

A Home and a Job

Most of the people still living in tent camps are the poorest of the poor—those with no other options. The government has instituted what it calls the 16/6 plan, which calls for residents of six of the largest camps to be resettled into 16 neighborhoods that will be redeveloped. Some 30,000 residents are being offered financial assistance equaling about one year’s rent to move, a plan funded and coordinated in large part by international aid groups. Many outside observers are nervous about what will happen in a year when many of these vulnerable residents may find themselves unable to pay their new rent.

Relocation efforts often move residents beyond the borders of Port-au-Prince, to rebuilt villages or suburban neighborhoods. Camp Corail, which sits in a vacant desert 10 miles outside the capital, is the most ambitious relocation project, home to more than 10,000 people and growing. Corail is the country’s only official settlement, with plywood two-room homes neatly laid out on a grid.

Many of the residents arrived here when flood preparation and drainage construction forced them out of J/P HRO, one of the largest tent camps, which was run by Sean Penn’s charity. Other Corail residents came here hoping that a more formal camp would mean more reliable services. The government has touted an agreement to build a Korean factory nearby that would create 20,000 jobs, but it hasn't happened yet.

Last month, a conference organized by the Inter-American Development Bank courted international businesses to set up shop in Haiti. In addition to the much-awaited Korean garment factory, other multinational corporations are exploring setting up shop in the country. An industrial park currently under construction is expected to bring 80,000 jobs near Cap Haïtien, Haiti’s second-largest city.

“I’m really hopeful,” says Patrick Dessources, a local representative of investment firm Root Capital. “2012 is going to be the year that will define Haiti, the year that will tell us, five years down the road, will we be better or not?”

France and Mallery Neptune are also upbeat in their cozy shipping container. They’ve received plenty of donations to rebuild the orphanage and make it bigger and better than it was before the quake. The new building will house about 25 kids and allow expansion of a business-training program for mothers who can’t afford to feed their children.

The orphanage rebuilding project, like many successful recovery efforts in Haiti, melds foreign generosity with local capacity-building. Today, some businesses are able to get loans and investment, foreign companies demonstrate some interest in setting up shop, and nonprofits like the Neptunes' orphanage are doubling down on their commitment to the poorest nation in the hemisphere. Six billion dollars in aid was pledged to Haiti after the quake by a mix of foreign governments and international charities, just over half of which has been spent. That won’t cover the $7.8 billion in damage caused, but it does mean there are still billions of dollars more in the pipeline for years of more recovery work. Most Haitians know that things were so bad before that there is a chance that the long, painful road toward recovery could make Haiti better than it was before the quake.

At Camp Corail, solar streetlights have been installed by international aid agencies, which don't entirely solve the safety issues they were designed to address. Corail resident Evette Pompiles likes the lights, but told me through a translator they don't make it safe in the camp. She still doesn’t go out at night, choosing to stay in her candlelit home. Another group of residents expressed anger that goes beyond the lights—one man said he felt like they were left to live like dogs. There’s no work 10 miles outside the city in a desert, no natural food source, and no commerce. The residents say they’re going to wait it out.

I left the camp at dusk, just before the vaunted solar street lights would turn on. Staring up the sandy hill, through this refugee Levittown of houses the color of dust, a few barely tended sunflowers stalks offered the only spots of color. The backdrop was a bald mountain, shaved of trees, scarred with landslides. There is hope here, because the camp could become a city with jobs if the factory manifests, but it also seems sadder than many of the more haphazard camps in the city. This place had lasting sadness because, unlike the other camps, it looks permanent.

Photos by Alex Goldmark

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Reconstruction Zone: Chronicling Haiti’s Post-Quake Struggles

See more photos from Haiti, and what you can do to help.

“There was just a 7.0 quake right outside of Port-au-Prince. This will be a big deal.”

Two years ago today, I was the night editor for a national radio show. Around 5:20 p.m. Eastern time, the AP newswire flashed this sparse dispatch from a videographer working in Haiti, who had seen a collapsed hospital in a town up the hill from Port-au-Prince. "People are screaming for help,” the message added. Within seconds, we were calling everyone we knew with a Haitian phone number.

A colleague’s friend gave me the phone number for France Neptune, a driver for an orphanage, and I began dialing it over and over again. I was the first person to reach Neptune that night—almost all attempts to call Haiti yielded a foreboding variety of beeps. International media wouldn’t arrive until the next night, all flights were cancelled. On the phone, Neptune told me about chaotic streets filled confused throngs wandering, unsure where to go. He asked me to tell his girlfriend Mallery, who ran the orphanage and was in the U.S. on a supply run, that he was safe.

Neptune gave us a short update on the radio before dawn the morning after quake, the scene clearly but sounding dazed when asked about his plans. “I don’t know what I will do,” he said in a shaky voice that began to hint at the scale of the disaster. 

By sunrise the next day, it was clear that Haiti faced a worst-case scenario: More than 200,000 people were dead, another 300,000 injured. One and half million people were left homeless, hunting for shelter, water, and basic medical care. Two years later, more than 500,000 people still live in more than 800 makeshift tent camps in and around Port-au-Prince.

I met Neptune and Mallery, who are now married, while visiting the still-shaken country last week. They invited me into the shipping container they're calling home while their new orphanage and apartment are built next door. “Last year was tents the whole year,” Mallery says. “So to go from tents to something that doesn’t blow in the wind is great.

The Neptunes are in better shape than most because of their connections with American donors. Two years later, they say they are almost back to where they started, able to help a tiny fraction people still living in tent camps. Like many Haitian nonprofit leaders, the Neptunes reacted to the disaster by working harder.  “I like what we are doing, it’s part of my heart," France says. "It’s hard for me at the same time, because I would like to do lots more for the people, but… we can’t reach everybody.”

They have “adopted” two tent camps, as they put it, purchasing supplies and funding small medical clinics, mostly for girls. Before the quake, their work focused on the nation's huge child malnutrition crisis, but now they’re treating a new scourge: Sex crimes, they say, are a major problem for Haitian women.

Wearing multiple layers of clothes is the only many girls and women can try to protect themselves in a country with about one police officer for every 100,000 people. “They were begging, you know crying," France Neptune says. "And the OB-GYN doctor would want to see them, and see like 10 underwears or lots of shirts. They are afraid to get raped.”

“People are getting raped because they are still living under plastic,” says Leonard Doyle, a spokesman for the International Organization for Migration, which coordinates humanitarian services in the tent camps. “They’re just a little razor blade away." Transactional sex is common in the camps, he adds. Many women submit to sex with a man in exchange for living closer the latrines for safety, or being added to a list for social services.

Overall, reports of rape and gender-based violence have roughly tripled in the past year. A UNHCR spokesman characterized the rate of rape in the 800 remaining camps as “alarmingly high.”

One of the organizations focusing specifically on women who have been sexually assaulted is the Commission of Women Victims for Victims, known by its Creole acronym KOFAVIV. One of its workers, Claucina Jean, took me on a tour of Champs de Mars, a sprawling public plaza across from the broken presidential palace akin to Hyde Park in London or the National Mall in Washington, D.C. Today, the park is filled with tents and shacks.

Many of the women who live here have sought Jean's help after being raped. She knows at least 50 women in this camp who have been assaulted, and she assumes many more are staying silent. One rape survivor, Guinize Jean (no relation to Claucina Jean), tells me she was raped, an act of bravery in itself. Wearing a purple streak in her crisp braids and flashing an incongruous smile, she says she doesn’t know who raped her. When asked whether she feels safe, she flatly responds, “no," pausing to rescue a yellow terrycloth hair tie from deep in her baby’s mouth.

Another Brick in the Wall

Amid the rubble, there are signs of hope. The government has stabilized after a prolonged power struggle that left many recovery projects stalled. The battalion of aid agencies—well into the hundreds if you include smaller charities—are finding their rhythm, finally coordinating with each other efficiently enough to chip away at some of the most complex impediments to rebuilding, like relocating tent residents. Jean and her family will soon receive a years rent and assistance in finding housing elsewhere in the country. 

Still, every rebuilding project comes with dozens of complications. Consider rubble removal: The United Nations Development Program is coordinating 46 agencies and the local government to clear the streets. UNDP staff took me to a rubble-clearing site in Bel-Air, a neighborhood only recently deemed safe enough for aid workers to enter. Making the area accessible required special outreach to local factions, including gangs, by aid group Viva Rio, which specializes in dangerous communities, with experience forged in the violent favelas of Rio de Janeiro. Viva Rio spent months working with various constituencies to let local groups choose who gets the coveted jobs, which can pay up to $9 a day. Various community leaders each got to appoint a certain number of workers, while an entrepreneurs' association chose others.

The 300 workers on the Bel-Air site work hard because they are paid by how much they carry out, the foreman says. The quake left about 10 million cubic meters of rubble, enough to fill several football stadiums. Half of that remains where it fell two years ago, yet we're watching women—40 percent of the jobs are required to go to women—carrying single slabs of concrete out to the street, a tremendously inefficient process.

The remaining rubble isn't sitting in the road like it was a few months ago, exacerbating Haiti's already-infamous traffic. The craggy heaps are trapped on steep hillsides, or—as at this Bel-Air site—behind inhabited homes with large cracks in the walls, clearly unsafe in the event of another quake. The final alley to this site is so narrow, not even a wheelbarrow can pass. The bricks must be carried out by hand, bucket by bucket.

One problem is that crews can’t knock down half-broken houses without authorization from the owners, a tricky proposition considering the quake's death toll. On this site, all nine family members were crushed, and finding a living heir to authorize demolition poses a huge challenge.

You can’t just dump football stadiums worth of brick in a vacant lot, either: Crushing the debris and re-using it requires an elaborate plan from a U.N. support agency. Cracked houses must be transported to special machines on the edge of town, which can only run part-time because the wind blows too much dust over the city. “Now, as you can see, we are really efficient,” says Jean-Sebastien Roca, a UNOPS project manager, gesturing toward two mammoth machines grinding rubble to dust for recycling.“It took time to understand,” he says. “Nobody faced what we have faced here in Haiti.”

A Home and a Job

Most of the people still living in tent camps are the poorest of the poor—those with no other options. The government has instituted what it calls the 16/6 plan, which calls for residents of six of the largest camps to be resettled into 16 neighborhoods that will be redeveloped. Some 30,000 residents are being offered financial assistance equaling about one year’s rent to move, a plan funded and coordinated in large part by international aid groups. Many outside observers are nervous about what will happen in a year when many of these vulnerable residents may find themselves unable to pay their new rent.

Relocation efforts often move residents beyond the borders of Port-au-Prince, to rebuilt villages or suburban neighborhoods. Camp Corail, which sits in a vacant desert 10 miles outside the capital, is the most ambitious relocation project, home to more than 10,000 people and growing. Corail is the country’s only official settlement, with plywood two-room homes neatly laid out on a grid.

Many of the residents arrived here when flood preparation and drainage construction forced them out of J/P HRO, one of the largest tent camps, which was run by Sean Penn’s charity. Other Corail residents came here hoping that a more formal camp would mean more reliable services. The government has touted an agreement to build a Korean factory nearby that would create 20,000 jobs, but it hasn't happened yet.

Last month, a conference organized by the Inter-American Development Bank courted international businesses to set up shop in Haiti. In addition to the much-awaited Korean garment factory, other multinational corporations are exploring setting up shop in the country. An industrial park currently under construction is expected to bring 80,000 jobs near Cap Haïtien, Haiti’s second-largest city.

“I’m really hopeful,” says Patrick Dessources, a local representative of investment firm Root Capital. “2012 is going to be the year that will define Haiti, the year that will tell us, five years down the road, will we be better or not?”

France and Mallery Neptune are also upbeat in their cozy shipping container. They’ve received plenty of donations to rebuild the orphanage and make it bigger and better than it was before the quake. The new building will house about 25 kids and allow expansion of a business-training program for mothers who can’t afford to feed their children.

The orphanage rebuilding project, like many successful recovery efforts in Haiti, melds foreign generosity with local capacity-building. Today, some businesses are able to get loans and investment, foreign companies demonstrate some interest in setting up shop, and nonprofits like the Neptunes' orphanage are doubling down on their commitment to the poorest nation in the hemisphere. Six billion dollars in aid was pledged to Haiti after the quake by a mix of foreign governments and international charities, just over half of which has been spent. That won’t cover the $7.8 billion in damage caused, but it does mean there are still billions of dollars more in the pipeline for years of more recovery work. Most Haitians know that things were so bad before that there is a chance that the long, painful road toward recovery could make Haiti better than it was before the quake.

At Camp Corail, solar streetlights have been installed by international aid agencies, which don't entirely solve the safety issues they were designed to address. Corail resident Evette Pompiles likes the lights, but told me through a translator they don't make it safe in the camp. She still doesn’t go out at night, choosing to stay in her candlelit home. Another group of residents expressed anger that goes beyond the lights—one man said he felt like they were left to live like dogs. There’s no work 10 miles outside the city in a desert, no natural food source, and no commerce. The residents say they’re going to wait it out.

I left the camp at dusk, just before the vaunted solar street lights would turn on. Staring up the sandy hill, through this refugee Levittown of houses the color of dust, a few barely tended sunflowers stalks offered the only spots of color. The backdrop was a bald mountain, shaved of trees, scarred with landslides. There is hope here, because the camp could become a city with jobs if the factory manifests, but it also seems sadder than many of the more haphazard camps in the city. This place had lasting sadness because, unlike the other camps, it looks permanent.

Photos by Alex Goldmark

Importance Of Fiber For Human Body

Men "Pregnant" Want to Lift Uterus

The man who could make a scene pregnant, Thomas Beatie, expressed his desire for hysterectomy after childbirth. His desire was expressed in an exclusive interview with The Doctors.

Hysterectomy is the surgical removal of the womb (uterus) are extremely common.

He also talked about being a man who gave birth and how her life after giving birth to a child.

Beatie was born as a woman. However, he legally became a man in 2002 but his female reproductive organs are not removed. He also made ​​headlines as the world’s first pregnant man with the face and the potbellied berjambang. Now, Beatie has three children with his wife Nancy, namely Susan, Austin, and Jensen.

After giving birth, Beatie was able to breastfeed her child because her male hormones make it stop from producing milk naturally. But during her pregnancy, she should stop her male hormones for their child’s health.

Transgender father will be revealed on The Doctors that the impact of stopping hormones in her body more. And hysterectomy will help stabilize her medically as male, according to RadarOnline.

Beatie also told how difficult it is to get his body back as before pregnancy, ie, with a six pack stomach. Even in her no trace of stretch marks.

As is known, Beatie was born a woman, with the name Tracy Lagondino, in Hawaii in 1974, but he always felt like a man. When in his twenties, he began injecting testosterone, the hairs on his face even grown, lower noise, and change their sexual organs.

In 2002 she had a mastectomy and legally became a man – but he chose to retain her vagina, uterus and other female sexual organs, so that couples can have children

Identity Crisis

Elliott has two scars across his chest where his breasts used to be. He has full sideburns down his gaunt cheeks, a strong chin, and sharp jawline. His voice is not deep enough to be considered baritone. At 22, he looks like a rather boyish young man. You would not mistake him for a woman, although he was born a woman. There’s a chance you might mistake him for Morrissey, which is the look he’s going for. The asexual British rocker poet has long been the patron saint of gay and androgynous youth.

Elliott’s story is one we are hearing more and more these days. About the time he hit puberty, his body started developing in a way that was incongruent to how he perceived himself. Breasts, new thatches of hair, and an emerging feminine shape pushed Elliott toward an identity that felt alien. By 16, he felt as though his body no longer belonged to him. “It was something happening to me. Like it wasn’t even a part of me.”

To say that Elliott felt like a man trapped in a woman’s body or that he was repelled by his own private parts, as the typical definition of a transsexual would have you presume, would be inaccurate. Elliott didn’t want to escape one sex role to embrace another, but he did have a desire to feel “more manly.” Disoriented and nervous about what was happening to him, he told his parents that he thought he was, perhaps, maybe, “bisexual?” But as time went on Elliott found that his feelings had less to do with which sex he was attracted to and more to do with which sex he wanted to be. In fact, for his age, Elliott thought very little about sex. He had somewhat resigned himself to a life of solitude, as lonely teenagers are wont to do. As Morrissey sings, “You don’t have to tell me … I know I’m unlovable.”

His junior year of high school, Elliott found out about hormonal replacement therapy. Once he turned 18 he would be eligible to receive testosterone injections without parental consent and eventually his body would take on more masculine characteristics, including facial hair, a broader brow, deeper voice, and decreased breast size. To get the treatment, however, Elliott would have to undergo 15 sessions with a psychologist to prove that his biological sex caused him enough distress that it merited reassignment. That psychologist would then give him a letter addressed to a physician certifying that Elliott suffered from gender- identity disorder.

Elliott never believed he had a “disorder,” so he feared he would give the wrong answers, or not display enough distress. “It was all so ridiculous,” he tells me. “I was contemptuous of the whole thing. I basically had to keep meeting with this psychology grad student who handed me a fifty-question checklist on our first session. You can look up symptoms online to make sure you get your diagnosis letter, so I made sure I did that.” One thing trans-themed forums and blogs recommend is journaling about a “real life experience” to show a therapist. According to the “standards of care” put out by the World Professional Association for Transgender Health for the medical and psychiatric community, it’s recommended that prior to hormone therapy, the patient has a “documented experience” dressed as the gender he or she desires to be. This ultimately means going in drag to work, school, or among family to confront possible anxieties that come with a new gender and face “external consequences.”

Though the process frustrated Elliott, he did not want to buy hormones on the black market (which you can also do online) and self-administer, so he stuck with it, hoping for a positive diagnosis. Which is to say, he was hoping to be declared mentally ill—at least according to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the standardized criteria written by the American Psychiatric Association and used by clinicians, psychia- trists, and psychologists to diagnose their patients. The DSM lists gender-identity disorder (GID) as a certifiable mental illness. A patient, like Elliott, exhibits not only the desire to become another gender but also demonstrates “relationship difficulties” because of the distress he or she feels about being the wrong one.

However, all that could change.

Since it was initially published in 1952, the DSM has undergone only four major revisions, and with each new edition there comes, rightfully, a great deal of controversy and advocacy, in and around the mental-health field. After all, the DSM is the book that separates the sane from the pathological, the neurotics from the normals. The slightest shift in sentence structure can cause major reverberations across the fields of medicine, biology, and pharmacology. When DSM-IV broadened the definition of bipolar disorder in 1994, there was a huge rise in prescriptions for “mood stabilizing” drugs that, prior to the change, were usually only recommended for people who suffered from convulsions or psychosis.

In certain cases, like, say, homosexuality, revising the DSM can have a vast social impact. The first two editions of the DSM classified homosexuality as a sexual disorder right along pedophilia and rubbing against strangers in public. It wasn’t until 1980
that homosexuality was removed entirely from the DSM, a move to which many activists, scholars, and clinicians attribute the destigmatization of homosexuality in American culture.

So when it was announced last year that the newest version of the DSM, to be published in 2013, would make significant revisions to the GID diagnosis, swaths of activists inside and out of the psychiatric establishment saw an opportunity to have the diagnosis removed altogether. They argue that the diagnosis further isolates transgender individuals, who are already a highly vulnerable and ostracized group.

The DSM work group assigned to gender identity disorder, a panel of specialized field experts, has already bowed to some external pressures. It has made clear that it intends to change the name of the diagnosis from “disorder” to “dysphoria”—which describes a passing mood rather than a fixed state. The work group has also made public its plans to not only preserve the core GID diagnosis, but to retain an even more controversial entry: GID in children.

Those who are in favor of keeping gender identity disorder in the DSM have two main arguments. The first is a clinical utility argument: If a person, especially a child, is distressed, suicidal, or self-harming because he or she feels incongruent with his or her gender, GID offers a diagnosis and path for treatment.

Robert Spitzer, the architect of DSM-III (the edition that removed homosexuality), acknowledged the fundamental question the term “disorder” dredges up.

“The concept of disorder is man-made,” Spitzer wrote in 1981. “Over the course of time, all cultures have evolved concepts of illness or disease in order to identify certain conditions that, because of their negative consequences, implicitly have a call to action” to caretakers, to the person with the condition, and to society. Spitzer concluded, “The advantage of identifying such conditions is that it makes it easier for individuals with those conditions to receive care that may be helpful to them.”

The second argument in favor of keeping GID in the diagnostic manual is where things get ethically murky. The removal of the diagnosis may also remove insurance coverage for transsexual adults who are being treated with hormonal or surgical reassignment. As of now, a diagnosis of mental illness is the only mechanism that transsexuals have for medical insurance to cover mastectomies, testosterone injections, and genital reconstruction surgeries (though very few insurance companies cover any sort of gender reassignment, because it is most often considered “cosmetic”).

Megan Smith, a Nebraska-based psychotherapist and an advocate for the removal of GID from the DSM, claims that the insurance argument is the one she most often encounters. Smith believes keeping the diagnosis for the sake of insurance coverage is “unethical and unscientific.” Smith argues, “I don’t believe it’s our obligation as mental health professionals to change psychiatric evaluations in order to play ball with insurance companies.”

When it comes to the issue of distress in children, the proposed revisions put the burden of proof on the parents. In the current proposal the work group includes a questionnaire to be completed by parents about their young sons:

Over the past six months, how intense was your son’s avoidance of rough-and-tumble play?

Over the past six months, how intense was your son’s dislike of his sexual anatomy (e.g., that he dislikes or hates his penis or testes)?

Over the past six months, how intense was your son’s desire for the sexual anatomy of a girl (e.g., sits to urinate, pretends to have breasts, would like to have a vagina)?

Or their young daughters:

Over the past six months, how intense was your daughter’s preference for the toys, games, and activities typical of boys?

Over the past six months, how intense was your daughter’s preference for boy playmates?

Over the past six months, how intense was your daughter’s desire for the sexual anatomy of a boy (e.g., that she would like to have a penis or to grow one; stands to urinate)?

For the activists opposed to keeping the diagnosis in the DSM-V, like Smith, this brings up a fairly obvious question: Whose distress are you treating—the child’s or the parents’? When Smith worked for a non-profit that served the homeless in Omaha, she encountered several transgender teens who had been cast out by their families. “Childhood is a time for people to explore their genders,” she says. “Much of the distress I see in my young patients isn’t from wanting to be another gender, it’s the anxiety of having to become a total outsider.”

The DSM does not allow much, if any, gender ambiguity—the word “transgender” appears nowhere in the current DSM or in any of its proposed revisions. “A lot of people I’ve spoken with don’t identify as either male or female,” says Smith. “They see themselves as gender queer, or atypical gender, or just plain trans,” never completely going over to one sex or the other.

The most nefarious outcome of GID remaining in the DSM, activists believe, will be the introduction of “reparative treatment” given by psychiatrists to transgender children, adolescents, and adults. Though condemned by the American Psychiatric Association in 1998, reparative or conversion therapy aims to cure homosexuality (there usually exists a moral or religious component to this sort of faux treatment). The APA spoke out against reparative treat- ment because it operated on the assumption “that homosexuality is a mental illness.” As long as gender-identity disorder remains in the DSM, the LGBT community will worry that society will view transgender people as in need of “fixing.”

However, Jack Dresher, a New York–based psychiatrist and a member of the 13-person Sexual and Gender Identity Disorder Work Group for DSM-V, wrote in a recent paper that no one in the work group condones “fixing” trans teens or gay teens. Psychiatry has historically conflated sexual orientation with sexual identity, he writes, but the work group rightfully distinguishes these into separate categories.

While Dresher acknowledges the parallels between the efforts of the gay-rights movement and the trans community to normalize their presence in society at large, he believes that acceptance of queer-identified individuals is progressing rapidly and would not be offset by GID staying on the books. Though he admits there would undoubtedly be some stigma for those diagnosed—as there is for individuals diagnosed with bipolar disorder or major depression—he thinks keeping the diagnosis for people who have distress about their bodies and identities “would be a less harmful choice.”

Dresher ultimately recommends adoption of less “stigmatizing language towards gender variant individuals” and a narrower definition of GID children to include just those suffering distress about their anatomy.

When Emmie told her parents that she was transgender at age 14, there were all kinds of details to work out. Not only would Emmie, who now goes by Jesse, need to change her documented sex at her private school, she would also need to figure out where she was going to change for P.E. and which school bathrooms she was allowed to use. Now 16, Jesse is identified as a boy by his school and peers. To minimize confusion for the other students, Jesse uses the nongen- der faculty bathrooms, changes in a separate room, and was asked by the administration to not wear a skirt, which would be now
be considered “drag.”

“The skirt thing was kinda funny because if you ask me, I don’t believe in a gender binary,” Jesse tells me on the phone after I contact him via the Transgender Student Rights Facebook page he runs. “I think of gender as more of a spectrum,” he tells me in a high-pitched voice that absolutely betrays his biological sex.

Before Jesse came out as transgender, he was in therapy four days a week because of his tumultuous childhood. When Jesse was 9 years old his mother died from anorexia and his father agreed to have the couple’s best friends adopt Jesse. After Jesse came out to his adoptive parents, they told his biological father. Jesse and his dad went to lunch, where his father showed him pictures of himself dressed like a woman. He told Jesse that from time to time he enjoys dressing up in drag, so there was nothing for him to feel ashamed about.

“My dad told me he always thought I’d be a weirdo because I came from such an eccentric family,” Jesse giggles.

When I ask how he feels about the possibility that under the DSM proposals he technically could be classified as mentally ill, Jesse laughs it off. “I think everyone could benefit from therapy, so while I would like to see the diagnosis totally gone from the DSM, because, like I said, I don’t believe in a gender binary, I don’t think therapists are the enemy.”

Jesse hasn’t decided whether he wants to go on hormone treatments once he turns 18. “I might want to have a kid one day and I don’t want to mess with that possibility right now.” Though, he admits, it would be nice to take his voice down to a lower pitch. “I might get top surgery [double mastectomy],” Jesse muses, but still isn’t sure. “You know, there are some days I wish my boobs would go away; there are other days where I kinda like them.”

Hair Styling tips- Thick hair Management

When there are a lot of baldies out there, there are also people who are sick of their ugly thick hair which feels like a massive Wig on their head. Of couse! no one wants to wear that look.  So, here are some of the tips that will help you beautify your thick hair:

1. First things first; Our first advice to you is that you should first cut your hair decent and should get it thinned from a proffessional hair stylist.

2. Either keep your hair short or extra long. If you keep it short perhaps like a BoB or crop it will give you a trendy look and will make your hair more manageable. If you chhoose to keep your hair extra long it will add weight to your hair making it smoother, more manageable and pulled down. If your hair is long, wavy, and thick, then you definitely want to consider a long hairstyle for the same reasons as above.

3. Get your hair straightened and relaxed. By “get” I mean, you consult a proffesional because these processes use harsh chemicals which if not used carefully can lead to irreversible damage to your hair.

4. Try to avoid colouring your hair as much as you can because it leasa to swelling of hair shaft which gives you a more bulky look.

5. To keep your hair from drying out always use a good moisturising shampoo. Wen your hair dries out it will look large and out of control as drying frizzes your hair. Also, if you are using a strong shampoo dilute it say 2 parts of shampoo to 6 parts of water.

6. Avoid layered cutting. Although it is currently very famous but if you have wild thick hair it will defeat the goal as your hair will look fuller.

7. Wash your hair with cold water after two or three days. Do not use hot water in any case if you like your hair as hot water breaks the hydrogen bonds between the Keratin protien molecules of your hair.

8. Try vareity of products and then stick to the product which you find most useful to yourself.

9. Typically, blow-drying hair will make it appear thick and full. However, if done right, it can help. To make blow drying work for you, use shampoo with a moisturizer, followed by a good conditioner, rinsing well. Rinse with cool water and then towel blot your hair. Then apply the leave-in conditioner and with a wide tooth, comb, remove any tangles. Now, divide the hair into two, four-inch sections, blowing each section dry at a time.

10. Finally, Apply a gel to keep your hair slick.
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Body Hair Removal Techniques

Body hair removal

 It is the new epic that has poured in due to the changing trends and fashion. Both men and women want to get rid of unwanted body hair just for the sake of sex appeal, fashion, or as many state, “to feel hygienic” and also what is the fun of putting so much effort in gym? When you can’t show off your well defined muscles. Men define unwanted hair as on the regions of the neck, chest, back and shoulder while women’s unwanted hair is almost everywhere except the head and typically on the legs, arms, underarms and bikini areas.All hairs are made of keratin, which is basically a protein also found in finger and toe nails. Hair growth begins beneath the surface of skin at a hair root inside a hair follicle, a small tube in the skin. There are two types of hair . Vellus hair is soft, fine, and short. Most women have vellus hair on their chest, back, and face. It can be darker and more noticeable in some women than others, especially those with darker complexions. Vellus hair helps the body maintain a steady temperature by providing some insulation. Terminal hair is coarser, darker, and longer than vellus hair. It’s the type of hair that grows on your head. Around puberty, terminal hair starts to grow in the armpits and pubic region. On guys, terminal hair begins to grow on the face and other parts of the body such as the chest, legs, and back. Terminal hair is there to provide cushioning and protection. Also in some cases abnormal increased growth of hair called hirsutism may occur which may be due to several medical conditions. In girls, polycystic ovary syndrome and other hormonal disorders can cause dark, coarse hair to grow on the face, especially the upper lip and chin, as well as on the chest, belly, and back. Some medications, like anabolic steroids, also can cause hirsutism.

Now that you know enough about hair it’s time to explore and understand some of the most important techniques used for hair removal which will help you to judge what kind of treatment will be best for you.

Shaving: Shaving is the easiest method for removing unwanted hair. Using a razor, a person removes the tip of the hair shaft that has grown out through the skin. Some razors are completely disposable, some have a disposable blade, and some are electric. Guys often shave their faces, and women often shave their underarms, legs, and bikini areas.

 Ups: Inexpensive, and you can do it yourself.

Downs: Razor burn, bumps, nicks, cuts, and ingrown hairs are side effects of shaving. Ingrown hairs can happen with close, frequent shaving. When the hair begins to grow, it grows within the surrounding tissue rather than growing out of the follicle. The hair curls around and starts growing into the skin, irritating it.

Duration: 1-3 days. Plucking: Done Using tweezers skin in tightly stretched, hair is gripped close to the root, and pulled out. Devices called epilators, which cost around $25 to $70, can pull out multiple hairs at once.

Ups: Inexpensive.

Downs: Time consuming and can be painful. If the hair breaks off below the skin, a person may get an ingrown hair. After plucking, you may notice temporary red bumps because the hair follicle is swollen and irritated. Epilators aren’t a good idea for use on areas like eyebrows because they pull out a bunch of hairs at once and don’t give you precise control.

Duration: 3-8 Weeks. Depilatories: In this method of body hair removal chemicals in the form of creams are applied to desired area. After 20-30 minutes the chemicals present in the cream simply dissolve the Keratin protein of the hair which is the easily removed.

Ups: Depilatories work quickly, are readily available at drugstores and grocery stores, and are inexpensive. They’re best on the leg, underarm, and bikini areas; special formulations may be used on the face and chin.

 Downs: Applying depilatories can be messy and many people dislike the odor. If you have sensitive skin, you might have an allergic reaction to the chemicals in the depilatory, which may cause a rash or inflammation. Depilatories may not be as effective on people with coarse hair.

Duration: Several Days to 2 weeks.

Waxing and Sugaring: Waxing and sugaring follow the same procedure but differ only in the material used. In case of waxing hot or cold wax is used while as in sugaring a solution of a mixture of sugar, lemon, water, and even citric acid and gum arabic is used. A sticky wax is spread on the area of skin where the unwanted hair is growing. A cloth strip is then applied over the wax and quickly pulled off, taking the hair root and dead skin cells with it. The wax can be warmed or may be applied cold. Waxing can be done at a salon or at home.

 Ups: Waxing leaves the area smooth and is long lasting. Waxing kits are readily available in drugstores and grocery stores. Hair re-growth looks lighter and less noticeable than it is after other methods of hair removal, such as shaving.  

Downs: Biggest drawback to waxing is the discomfort: Because the treatment works by pulling hair out at the roots, it can sting a bit as the hair comes off — luckily that part is fast. People may notice temporary redness, inflammation, and bumps after waxing.

 Duration: 3 to 6 weeks.

Electrolysis: Over a series of several appointments, a professional electrologist inserts a needle into the follicle and sends an electric current through the hair root, killing it. A small area such as the upper lip may take a total of 4 to 10 hours and a larger area such as the bikini line may take 8 to 16 hours.

 Ups: Permanent hair removal except few.

Downs: Electrolysis takes big bucks and lots of time, so it’s usually only used on smaller areas such as the upper lip, eyebrows, and underarms. Many people describe the process as painful, and dry skin, scabs, scarring, and inflammation may result after treatment. Infection may be a risk if the needles and other instruments aren’t properly sterilized.

Duration: Permanent with a few exceptions.

Laser therapy: A laser is directed through the skin to the hair follicle, where it stops growth. It works best on light-skinned people with dark hair because the melanin (colored pigment) in the hair absorbs more of the light, making treatment more effective.

Ups: This type of hair removal is long lasting and large areas of skin can be treated at the same time.

 Downs: A treatment session may cost $400 or more. Side effects of the treatment may include inflammation and redness.

Duration: May be permanent, but people often need to return every 6 months to a year for maintenance and proper body hair removal.

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Gel or Soap? Day or Night Cream? – Choosing Between Alternatives

There is such a mind boggling array of skin care and personal hygiene products available that it can be quite confusing – what to use and what not to. So what skin care products are really necessary and why?

Night cream or Day cream? Should you have separate skin creams for the day and for the night; is there really a difference.

Experts say there is – while day creams are lighter and contain protective elements such as sun screen, night creams are heavier and have repair elements such as vitamins, retinols and antioxidants that help rejuvenate skin while you sleep.

Also night creams could react with daylight and cause a reaction, so it is best to use face creams as indicated.

Soap or Body wash/gel? With the wide range of body washes available, that promise the benefits of aroma therapy and the luxury of bathing without drying out skin, one wonders if soap is at all suitable for the skin.

While it is true that soap tends to dry out the skin more than liquid body washes and shower gels, it is also true that many do not enjoy the moist film that the latter leave on the surface of the skin.

Many argue that they get that squeaky clean feeling only when they use soap and that body washes don’t do the job of cleaning and deodorizing as well. So body wash or soap may be a matter of personal choice, but remember that you do also get soaps now that are pH balanced and which don’t dry out the skin.

Astringent or Toner? As part of the three step skin care routine – cleanse, tone, moisturize, do you use a tone or astringent? The rule of thumb here is that astringents should be used by oily skin because they are alcohol based and drying. Toners are less drying and can be used for dry skin as well.

Shave, epilate, wax or depilate? What is the best way to remove body hair – shaving, using an epilator or using hair removal creams? Well each has its own pros and cons: shaving is quick and convenient but the hair starts to grow back practically within hours. Some prefer to use hair removal creams since there are no shaving nicks and cuts to deal with.

Waxing and epilating can be longer lasting forms of hair removal, but can be painful, and in the case of waxing messy as well. So really this question can only be answered by the woman herself!