I grew up during a time, in a place, & with a family where sex simply was not talked about. It was considered dirty. And talking about it was vulgar. I was an only child of a middle aged couple. Most of the family members I spent time with were born in the late 19th century. So the values I grew up with were those of small town America in the late 1800's.
I began wearing my mother's clothes while still very young. I learned, at a very early age, that this was something I must never talk about. So I didn't. Over the years I developed two personalities. Outwardly I grew up as a normal male child. But inwardly dwelt a secretive mentally ill young girl.
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I have come to see her as my fraternal twin sister. She did not develop physically. But her consciousness dwells within my male body along with me. However, since she has been trapped within my male body for decades, she is now psychotic. She must be kept locked away in a padded cell for her own protection... and for mine. Were she to be let out, or to escape, who knows what vengeance she might seek.
She is heavily medicated. So she sleeps much of the time.

But she does have passing moments of lucidity. When she does I will sometimes try to talk with her and to provide her with some comfort. Sometimes she just drifts off back to sleep. Sometimes she becomes agitated and begins yelling obscenities at me.

It's not unusual for her to be awake late at night. And so, in the depth of the night, when all is quiet and I am lying awake in bed, I will hear her screaming... and scratching at the padded walls of her cell...