Month: July 2018

loss

Another thing. Freaked out into anger and panicky anxiety when someone shot a water gun into my face during the parade. They thought they were being helpful and did so to everyone. My companions helped me get back into function. To me it is the same as what I blogged about here: https://lost-in-transition.tumblr.com/post/164705382944/what-messy-moments-feel-like

That is, I so rely on makeup or grooming to reduce dysphoria that I am deeply shaken from fearing its violation. I find this interesting as it points to how much dysphoria I actually feel, but keep away through coping strategies like these.

vortices

Extremely intensive days. I have loved ones near and feel bonds deepen even further. I know myself loved and am deeply safe and happy therein.

Emotional turbulence in some form really is a thing. It seems very clear that HRT mid-term like this makes me cry easier. I love that it does. I now cry from safety, from being moved, from empathy. I can stop it but don’t usually want to. I cry tears without knowing why or knowing why I am sad, and I can’t but suspect that it is related to wherever my missing emotions actually went (assuming they really do exist, and that my relatively neutral state is not human default). Excited.

Beyond support and safety – marching for LGBTQ++ pride was great, though hot and I am glad we did not do the entire route – I also note people looking, and at one point we were directly and clearly harassed by a fervent man speaking transphobic slurs in Russian. I was very glad to have my partner with me. These and other moments make me sometimes feel a dark and somber fear that I always will be read as male, no matter what my efforts. I suppose this highlights that I want to be able to “pass“ even if I downplay the value of that because the concept has some toxicity.

How much will I have to change to get there? How much can a few more years of HRT do? On patches now. How much more can dieting and posture training and voice training do? In the worst case, how much could facial surgeries do? I fear there are angles from which I look extremely masculine, and ways in which my frame does, especially from back. I will do my best, and I will not lose track of all else that matters more all the same. I am loved and I am blessed. Still these things suck. I knew what I was getting into, though, I never assumed I would become able to blend. But the fact of so much going so well so far has made me hope. I will carry two opposing factors in my mind at once and proceed as I must.

Be strong and be kind.

lacuna maris

I’ve really been crying a lot lately, for happiness, for stress, fear, sadness and without knowing why. Thinking thus I can likely conclude emotional volatility increasing, and loving it.

Also, I probably should find a short-form description of my gender model (e.g. “gender is the reflection of sex characteristic continua in the space of human perception, emotion and action, involving opt-in/opt-out clauses in modern contexts“) to make it clearer to communicate.

nocebo

I ran a tiny, anecdatal and flawed double blinded test of my estradiol HRT. I feel so much better on it that I wanted to see if I could demonstrate it as a direct effect somehow. In this case I tested 8 time points of consecutive 12h periods, for each taking either a placebo (biotin pill) or estradiol. Blinding was done by choosing a placebo of similar shape, place random numbers of each in individual envelopes, writing inside what each was, and writing a random number sequence on outside of envelope, taking them in turn. Then I would take the pills without looking at them.

Readout was whether I could guess from my mood whether I received placebo or estradiol, as checked upon final unblinding.

First night: Received placebo. Nonetheless remained calm.

First morning: Received estradiol. Remained calm.

Second night: Received placebo. Was restless and slept poorly, did not restore from day.

Second morning: Received estradiol, became calm, restored from night.

Third night: Received estradiol. Confounded by first feeling happy while drinking, then surprise misgendering here: https://lost-in-transition.tumblr.com/post/175757193179/lacrimosa . I believe I would
have been calm otherwise, but due to this, believed wrongly it was placebo.

Third morning: Received placebo. Stayed restless, also due to sleep deprivation.

Fourth night: Received placebo. Believed it was estradiol, and felt calm.

Fourth morning: Received estradiol. Remained calm.

In summary thus, guessed 5/8 correctly which is a minor success, but data really is too sparse. Out of morning doses, I was restless the one time I got placebo, and calm the three days I got estradiol. I was calm on all periods I got estradiol, excepting due to a misgendering triggering. However, there were several nights on placebo where I still was calm, possibly because of other factors. Nights I break my 24h intermittent fast, sometimes drink wine, and watch cartoons, not making any demands on myself; nights it makes sense I am anyway quite at peace.

So all in all, I cannot say I always become restless without estradiol, nor that I always am shielded from restlessness on estradiol. Placebo and good things may help and unlucky circumstances may harm. I also cannot rule out that there may be a short-term statistical mood effect, it would need further testing. There is a very slight tendency that there may be, driven by morning doses.

Beyond this, of course there may be long-term mood effects, and there are other types of nervous system effects (differences in sexy scent processing comes to mind), and there are all the bodily effects. This day I am on actual estradiol, and still quite moody, but getting better. Some part of me worries that it would be an issue if I overattach to the concept of mood effects, fog lifting etc., in case it really is mostly placebo, but what if? My trans alignment ultimately is about how my brain cannot relate to me as a person unless I understand myself as a woman; I think this applies analogously to cis persons but the fact of their lifelong lack of misalignment hides it. Ensuring my body and brain and social self has as little of statistical difference to other women as possible is what I need, alongside work in affirming my self-perception as who I need to be to be happy. If I become more calm and happy even as a result of placebo from the medication I take to change my body, that is not a problem, that is an opportunity. Part of me worries that if short-term mood effects really largely are placebo then it might become harder for me to summon them up, but I’ll look into ways of preventing that, and in the end, this study just shows one needs a larger, cleaner study to be able to tell, and that there also are other factors impacting.

Major limitations: First, this tests only short-time effects. It occurs under confounding that my 24h dose was half it should be. It was dirty blinding; my guess from mouthfeel of what pill I received was correct in every case though I never felt certain and think I did not use this for mood assessment. Sampling without replacement from a limited number constrains the readout. Statistical power is woeful, and most problematically, I had only one morning placebo pill, so the power for daily restoration under E vs placebo was not well tested. It also is a test of low-E, low-T conditions, not low-E, high-T, as I did not include my androgen blockers (and since intrinsic production now is low, that would also not have worked). A larger study could be done contrasting 3-day patches with identical placebo patches. This would simplify blinding, give more time for effects to be seen during days. Tracking could be done during this period at regular intervals of mood on a scale using app. Power could be made much higher. The relevant point I want to make is that I think meaningful tests can be done this with with randomly placebo-sabotaged extant HRT, it is not necessary to work on treatment-naïve subjects.

lacrimosa

Nice start of evening going to event for queer women, felt all accepted and OK except for my horrible deep voice. Was OK.

Then randomly sir:ed, I think, by the person selling me fast food. This in full femme presentation. Are my features and voice so awfully masculinized that random strangers can only parse me as some drag queen or something is that it?

Went home. Realized I would weep. Doing so, with support of moon and rain and a fairy child grown strong. Cannot really stop. Feeling, quite simply, sad. Crying because I am sad and despairing, right this minute. Later, I won’t feel that, it will be OK. I will cope and deal and grow stronger.

Right now wondering what the fuck I can even do, wanting to cut away all the despicable horrible flesh that makes me look and sound like something which is not even a person, like some corpse, like some dead thing. Wondering what I can do, not finding clear solution. Hoping my medication will work its wonders over years and years of alternate sexual differentiation. Remembering this pain and sorrow so I really will put in the 10K hours needed to master a voice that lets people hear me as me.

Remembering and habitualizing to ask, “sorry, what did you just say?” by reflex, causing trouble. Not for my sake, the harm will already be done. But a teachable moment for the sake of others.

Still feeling it. I suppose this is good, this is me finally not being an emotionless husk who could just choose not to feel, this is me feeling without having to decide to feel. This is new growth, this is life. Growth hurts. Healing hurts.

pew research

Laser today. Now up at 25 units of whatever that is. Not really bothered by this pain, plus it feels less. Thinking of asking them to do the regions that are recommended for hair removal in preparation for Chettawut SRS, you know, just in case. Just feels awkward to ask one’s laser technician; “Could you laser my perineum? You know, this part here?“ Not least because I don’t know if that would reveal unexpected and hitherto hidden transphobia, “we only do intimate treatment for women“… which also would hurt. Bothered more by this hurt than by the thought of laser blisters on my intimates, which I suppose is interesting.

Doing an experiment involving HRT and placebo on a short scale. Will see if I finish it, and will write it up here if I do. Yay anecdata!

diurnal

Was out drinking and dancing yesternight, getting used to (and blistered from) new nice shoes. This afternoon in a slight moody state, easily worried. Getting up and active should help.

Procrastinating by casually browsing SRS anaesthesia and aftercare, feeling whelmed by how cumbersome/worrying some things seem (anaesthetic catheter in the spine for epidural? what if I lay on it and get paralyzed? skin grant becoming vascularized – but what if I am the exception and it doesn’t and get necrotic, and I am left with no skin to shield myself with?). Though probably this is still the process of getting used to the idea, to my subconscious giving me exposure therapy. Still feels very very whelming, as does the time required for recovery. I wonder if I can learn narratives of women who had SRS while working in similar fields as I, to learn of how they could keep up and maintain their lives during that stage?

Curious on whether I currently have any sexual response. Fascinated again by the feeling of body comfort from genitals no longer getting erect. There used to be lots of microsensations, tiny swelling responses from temperature or posture or mental states, not visible to others. This always made me aware of my genitals on some level. HRT removes those responses for me and so effectively blanks out my genitals from my active body map. I wonder if this is something like an opposite phantom limb? If nothing else, then it does suggest that having these position sensations is something I prefer not to, which may be relevant.

Also need to ensure I do not fall behind on other transition work, either body reshaping, posture or voice work.

visibility

So, in non-anonymous form I spent some time writing things making myself visible on the internet as an LGBTQ++ STEM researcher. Now it’s LGBT STEM pride day and some people are linking these. This is both scary and flattering and heartwarming. Yet another step towards somewhere I want to be. Just need to make sure I stay worthy science-wise.

particip

Wondering over how and why it is that I know I feel strong longings for some things without feeling much in the moment. It does seem dissociative, and certainly I am not all cured – social and medical transition has begun to help, but must proceed, and probably I should help it along with a therapist.

I just realized one way in which it may work here, though. Thinking a lot about bottom surgery these days. I wonder if to a reader or listener, there is a point where I suddenly started talking about it a lot, and now won’t shut up about it? It’s on my mind a lot, mostly in terms of how to work around the problems, what the challenges are, how to deal with those. Planning, almost.

What I don’t do is look at the hoped-for outcome, the result. I don’t let myself think of what I could experience if it really worked out, don’t let myself feel that. The few times I do I’ve felt weepy. I’m recognizing this as how it’s been when I’ve worked hard toward other things, like my PhD. I’m too scared of not reaching the outcome (that is, I am whelmed with the scope and challenge of the path), so to protect myself from disappointment I don’t let myself look forward to it. I veer my mental eye away from it. I know it’s there but don’t want to look at it until I know it can’t be taken away from me any longer.

This may be why I obsess with laying groundwork to allow SRS for myself, but do not feel much as I do so. I sense the longing as a sun behind clouds, and I stay away mentally because if I expected, not just hoped, I could get hurt. Thus I can’t feel how much I want it, most of the time, it’s just evident in my actions.

In a way this is challenging because one part of the preparations is that I feel I must make sure I want it, which I cannot really do unless I have an idea what my body then would feel like. I need to visualize what it could be like having a post-op body, from the context of me as a 37-40 year old woman looking and sounding and moving like I do, and this is hard when I don’t let myself dream of a successful outcome because I fear a failed one too much.

So I guess I should be rational. That means ignoring fear as a motivation, not protecting myself from disappointment by hiding longings, and go right ahead in imagining. We’ll see how hard that gets. Also should look into demo options like tucking.