Jeffrey Hampton is a transgender man whose health problems have made transitioning into the man he wants to be a battle of will.

The sound of Jeffrey Hampton’s heartbeat overwhelmed him. He didn’t know why he had chosen this night, Halloween, of all nights to make his first attempt at going into a men’s public bathroom. Perhaps it was because he could play off his appearance as a costume to any other man who might ask why he was there.

Perhaps it was because he was finally done censoring himself in public.

Regardless, he was there. Then something Jeffrey never thought would happen ... happened. Nothing. He simply walked into the room, past a porcelain trough he didn’t quite understand, and into a stall. He did his business and left. The same has been true ever since.

“It was one of the most liberating moments of my life,” he said.

Jeffrey is a transgender man, an LGBT activist and a devoted husband. He also lives with multiple sclerosis, a degenerative autoimmune disorder. These elements are at the same time familiar and unfamiliar to me. In 2014, I knew 26-year-old Jeffrey as Laura Hampton, a Fort Smith native and a concerned Fayetteville resident unceremoniously thrust into the debate over the adoption and repeal of Fayetteville Civil Rights Ordinance 119. The ordinance was designed to give equality based on race, gender, sexuality and gender identity in workplace and business transactions. I covered the entire showdown as a reporter. Laura was a valuable source because of her unique position as a disabled and open transgender individual. At the time, Laura was married to her husband, Hunter Hampton, and she was still uncomfortable using male identifiers and pronouns. The only clues to Laura’s male identity were a short-cropped haircut and a slightly tomboyish sense of style.

Since September of that year, however, Jeffrey has identified in public as male. Jeffrey hopes that through hormone treatment and a mastectomy, he can come closer to his ideal self-image. Whatever the case, it will be a better situation.

“It was the period of my life when I was the most unhappy with who I was,” Jeffrey said at our initial meeting.

Jeffrey has gender dysphoria, or gender identity disorder. The disorder involves depression and anxiety that arise from the feeling that one’s physical gender identity does not match one’s mental gender identity, said Janet Tekell, a behavioral health psychiatrist. Tekell, a behavioral specialist at Mercy Hospital, works regularly with gender dysphoria patients and is a colleague of Jeffrey’s physician.

Like many people with gender dysphoria, Jeff is seeking medical and surgical options to correct the dissonance between his mental and physical identities.

Roughly 1 in every 2,500 individuals was diagnosed with gender dysphoria in 2009, compared to 1 in 80,000 individuals in 1998.

This increase, which coincides with the softening of cultural taboos on the issue, means therapy is no longer a solo effort or the Wild West of medical fields. Instead, there are physicians and psychiatrists who specialize in diagnosing gender dysphoria and provide the corresponding treatment. Still, it’s rare for women to choose surgery as a solution to the diagnosis.

Transgender men are more than three times as likely to seek such an option compared to transgender women, according to surveys conducted by the Massachusetts Department of Health and Human Services.

Emergence (1995)

A bitter December wind aided the chilly atmosphere already present from the ice pack resting on Laura’s cheek.

Her legs rested over the edge of the miniscule concrete porch  These types of wounds were not uncommon for 7-year-old Laura during her time in the Fort Smith public school system. The tears had stopped a long time ago. She was used to being hit for trying to ride bikes or play GI Joes with the neighborhood boys. All that remained was a glassy stare. A familiar set of hairy legs entered her peripheral vision. Laura’s neighbor rested his hand on her head.

“Did you let out Ernie again?” he asked, leaning in front of her and smiling. “Those brats aren’t cool enough to hang out with him anyway.”

  The friend, a 50-year-old shop owner, was the first person to recognize Laura’s male ego. He dubbed him Ernesto, or Ernie for short. Jeff asked that his friend remain anonymous to protect his reputation amid a community that would shun him.

His sympathy is the only reason Jeffrey is able to live openly today, he said.

“When I thought back to him, the name choice was obvious,” Jeffrey said.

However, he will never know the impact he had on Jeff’s life. He died four months before our interview. It’s still something Jeffrey is coming to terms with.

“I never had the chance to tell him he was right,” Jeff said, tears rimming the corners of his steel-blue eyes.

Facing Surgery

Tears pooled on the pristine white seat in his apartment bathroom. A severe burst of back pain caused by his multiple sclerosis brought his hip crashing into the side of the toilet. Hunter Hampton, hearing the crash, rushed into the bathroom to find the short, boxy frame of his husband sprawled out and sobbing. He tried to lift him to his feet, but a sudden burst of pain brought Jeffrey and Hunter down on the tile floor. Jeffrey’s hip was dislocated.

“It’s situations like that that keep me home more and more,” Hunter said later.

Both sporting short chestnut hair, black suits and rainbow ties, the two married April 1 under Jeffrey’s legal, female identity after two years of using the Hampton name. They wanted to make it official in case the law would be applied differently if Jeffrey outwardly identified.

They discovered that Jeffrey identified as transgender a year into their relationship in 2012. Hunter said he had identified as bisexual until his relationship with Jeffrey, but he had never been in a serious relationship with a man. The discovery of Jeffrey’s true gender led Hunter to question, but ultimately dismiss, thoughts of his own sexuality. He had fallen in love with Jeffrey, not his physical identity, he said.  After a brief period of questions, the two decided the relationship would continue.

“I did something right. I got him to marry me,” Hunter said.

Finding Help

The following day, hours before our scheduled interview in April, Hunter gently placed Jeffrey’s left leg into his wheelchair. The accident meant Jeffrey would have to use a wheelchair, regardless of daily pain fluctuations. Hunter’s lips gave a sour curl, and his forehead wrinkled. Jeffrey let out a whimper as the chair’s foam slab made contact with the injured hip.

“You know I hate this damn thing,” Jeffrey said, turning a sympathetic, moist gaze toward Hunter.

Hunter hated it too. The thing hardly rolled on the thick strands of brown, stained carpet in their one-bedroom apartment. He might end up injuring himself too, considering the apartment was on the second floor and there was only one rickety, rusty staircase that connected to the parking lot.

“Just don’t end up putting me in one,” he said, running his fingers through Jeffrey’s hair.

Hunter sank to his knees to administer the final pre-travel adjustment. He folded the leg of Jeffrey’s jean shorts and slid a needle into his upper thigh. Another wince, and the day’s injection was finished. If they left now, they could still make the bus.

Jeffrey’s dislocated hip presented a troubling situation for him, medically and financially. After receiving a prescription for testosterone injections from his physician at Northwest Medical Plaza, Jeffrey’s insurance agency refused to pay for the gender reassignment treatment. Many insurance companies consider gender reassignment a cosmetic treatment and, therefore, nonessential. The Hamptons pay for Jeffrey’s injections out of pocket, which is no easy feat for the unemployed couple.

For now, living expenses and treatments are covered by Jeffrey’s disability payments and Hunter’s unemployment benefits. Hunter quit his job at Chartwells to take care of Jeffrey. Part of this care includes giving Jeffrey testosterone injections because hand tremors, a symptom of multiple sclerosis, prevent him from doing so himself.

Scraping by on savings, government assistance and the charity of others, the two hope to correct their economic situation through education at the University of Arkansas. In fall 2014, Jeff enrolled in courses, and he hopes to become an LGBT outreach advocate for local churches. Hunter attend the university the following spring semester to train for a role in municipal politics.

The Importance of Escapism

The bus ride was worth it. Jeffrey sat relaxed in a high-backed chair, snugly pressed against a white, circular table at Gear Gaming Store on College Avenue. Jeffrey had progressed significantly in his transition since I last saw him in November. He sported a meticulously waved hairstyle, blue jeans, a plaid button-up shirt and a little stubble just below his sideburns. He was glad to point out the latter to me, considering the first facial hair he had presented to me was comprised entirely of thick marker strokes.

Jeffrey rubbed a set of multi-sided dice in his palms and dropped them slowly, one by one, into a paper cup.

“Here it comes,” he said, revealing the dice to the rest of the players.

Kassey Desmond, the game organizer, slapped her knee in protest. Hunter lowered his baseball cap and showed a tiny grin. The trend of attacking each other’s characters during the games had reached an all-time high.

“I hope you realize the irony of attacking each other in a co-op game,” Desmond said, rubbing her temple. “At least tone it down when the rest of the group gets here.”

Gear is one of 26 LGBT safe spaces in Fayetteville that are officially sanctioned by the NWA Center For Equality. It’s also co-owned by UA student and transgender woman, Olivia Demille.

“Gear is important because safe spaces should also be places that people can enjoy,” she said.

Jeffrey, Hunter and their group visit the store two days a week. They play several tabletop role-playing games, including Pokémon, Dungeons & Dragons and Vampire: The Masquerade. The role-playing games are important to Jeffrey because they allow him to escape from periods of pain and exhaustion. They also allow him to act out scenarios that he is unable to do in real life.

Surrounded by swirling mist, vampires, magical fires of forgotten realms and the comfort of childhood memories, Jeffrey can breathe easily in this environment, one of the few where he feels truly at home.

To What Extent?

The next step for Jeffrey in his gender reassignment is to have upper-body surgery to remove his breasts. Jeffrey’s physician said the surgery was necessary because the extra 20 pounds of breast weight contribute significantly to his back pain and immobility. He and his physician believe the surgery will provide considerable relief on a mental and physical level.

“They are my own personal chest tumors,” Jeffrey said.

Time is of the essence for Jeffrey because of the degenerative nature of his disease. He fears that in five years, his level of immobility will make the surgery nearly impossible. Jeffrey had a consultation for the surgery scheduled in Eureka Springs on April 23, 2015, but it remains the only meeting he’s had.

Jeff can’t pay for the surgery on his own. He started a GoFundMe page to help pay for the surgery, but the campaign has raised only $240 of a $500 goal.

“I guess we’ll just have to find a way to pay for it out of pocket,” he said.

For Jeffrey, surgeries stop there. He will not pursue genital surgeries because he thinks the risks associated with his case are too high. Genital surgeries have an 18 percent risk of infection, and there is often a need for a second surgery, according to a study conducted by the National Institutes of Health.

The upper-body surgery is the ultimate milestone, Jeffery said.

“It’s enough for me to feel comfortable,” he said.

The Future of His Activism

 A bead of sweat trickled down Jeffrey’s cheek as he stared blankly into the back of a red T-shirt, worn by someone an arm’s length ahead of him in line. The April humidity added an extra layer of stuffiness to the whole experience. His hand drifted into Hunter’s while his head rested on Hunter’s shoulder. The faintly yellow ceiling tiles at the Fayetteville Human Services Department were hypnotizing.

“Fags,” a gruff voice said from behind.

Both men turned to face the voice, and Hunter began to yell. The argument lasted long enough for an employee to approach and separate them.

Much of the harassment Jeffrey and Hunter receive is not from transgender-fearing parents in public bathrooms as they had feared. The vast majority of public harassment comes from individuals heckling them as a gay couple, and the majority of overall harassment comes in response to Jeffrey’s extensive online activism.

“In some ways, it’s humbling because now he’s passing, but the slurs keep coming,” Hunter said.

A visit to Jeffrey’s apartment on April 17 reminded me of our first interview in September. This is where I saw him truly come alive,  in the subtle, intimate glow of his laptop.

Jeffrey typed elegantly, seeming to only brush the keys, as he opened multiple tabs to Twitter, Facebook and Tumblr. His phone vibrated furiously on the wooden coffee table. This high-tech news feed is part of his daily life.

Since the repeal of Ordinance 119 and the passage of Arkansas Senate Bill 202, Jeffrey has engaged in a social media crusade against misinformation about the LGBT community.

“Someone’s got to keep it up,” he said. “Since the repeal and SB 202 passed, we’ve all been exhausted. I basically have an unlimited amount of time, and I’m still mad as hell.”

His perseverance was rewarded Sept. 9 when a revised anti-discrimination ordinance was passed in Fayetteville. That ordinance is built to last, he said.

“We worked so hard to understand and address the issues people had, and I think it’s a much more effective law that way,” he said. “We’ll never be done fighting, but this is a great step.”

Jeffrey  uses Facebook as the main way to engage with supporters and critics. His timeline serves as an activist announcement board, as well as a means of tracking his own progress in his transition.

“If you don’t get why I am upset about your ‘preference’ that I use a different goddamn bathroom, get off my page,” Jeffrey wrote in a Facebook post. “I am sick and tired of people who are supposed to be friends being the ones making me feel like a mistake of nature and not a goddamn-person. If you’re waiting around hoping that this is a phase and that girl you used to know is coming back someday, sorry. She’s dead, and to an extent, was never real in the first place.”

The social media world has had as many landmines as the physical. In August, a picture of the couple was posted to a blog advocating violence against transgender individuals.

“It was terrifying,” he said. “We took it to the police and wiped all our accounts.”

At the time of publication, the blog remains active.

For this hatred to stop, political change must continue, and he hopes to take a political role to ensure that it does.

“Let’s be honest, the solution isn’t in ordinances created by national organizations like the HRC,” he said. “Even these nonprofits are in it for politics. We need the law to be made by us, for us. We aren’t middle-class Californian gays.”

The Human Rights Council wrote the original draft of Ordinance 119 and several other ordinances around the country. Jeffrey and Hunter hope to give a face to the transgender struggle by continuing to take an active role in the public eye.

Jeffrey is as sure of his activist role as he is of his gender identity, and he hopes that by befriending skeptics, he can increase understanding. Meanwhile, Hunter spearheads a political standard, which will maintain and expand transgender rights.

“It’s sort of a role reversal,” he said. “I had my taste of politics, and now I want to bring this community together around who we are, the people we are.”

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