turmoil updating further

On the topic of S doubting herself and dissecting all her thoughts and wants and feelings, we’ve had more of that. Some significant part – perhaps a major part – of my feelings of needing to belong with women conceptually probably does bottom in feelings about _how_ women and men stereotypically are, rather than _who_ they are. The fear that comes unbidden would be somehow that if it was only the former, then somehow I could equally assuage my conceptual dysphoria by unlearning stereotypes and establishing myself as a feminine man, which would be a less costly path (for myself and my loved ones) than transitioning. Yet to the extent I even am aware of my emotions in the first place, it seems to me that this is a scary thought, that anything which keeps me away from “really” being (even a trans) woman is scary and painful. So the response itself may suggest something about my underlying needs.

I feel I should inspect things clearly if I can. Part of the whole idea of this, I realize, is that I am so tired of having to defend concepts to protect myself. I want to be able to just be open to the world whatever it might contain, to be able to live free without any need of bias in any assessments. That is one way of being true to myself as I always have valued myself. And for whatever reason, I genuinely feel that unless I am woman rather than man, with nothing keeping me different from those who are women, the world is somehow not tolerable to be fully open to. Accepting myself as woman withut question – even one so androgynous as I usually am – makes it possible to at least accept the world, either way.

This could still be something derived mostly or wholly from me navigating the memeplexes of gender (plus this odd nebulous part of being within the body and caring for the body or not which I can’t know to what extent it relates to my gynephilia or possible minor functional spectral properties). But if it was something I could circumvent by building an identity as a feminine man, or if I could decide to function as agender without changing my body or social position, then surely all the attempts I have made at that for decades now would have worked? I have tried this. It made things tolerable, it allowed me to cope and live and realize other areas of myself. But the conceptual anxiety of my mental fortress is there, and it really has grown worse over time.

As the last time I asked these questions, about two months ago, in the end it amounts to the same conclusion. I can’t know if I have no choice or not. It could be my prenatal hormonal environment skewed gross or fine brain structures so that I never could have been happy and anchored understood as a man. Or it could be that there were paths to get there, where different socialization processes had made me be fine with it. Either way, where and as I am now, I have a choice between a neutral existence bounded by OCD-like processes for keeping anxiety at bay, or a supremely uncertain transition path that may or may not let me just feel I am a person, not just some sort of cloud continuously encircling and judging and assessing the world, anchored in a utilitarian fleshly probe.

I’ve apparently tried to build life so that the costs can be minimized, aiming to reach a point where transitioning raises as few eyebrows as possible, hurts me as little as possible, hurts my loved ones as little as possible. If I can make such a low-cost transition, and take it step by step, trying each in turn – going into serious androgyny, then if I wish going out on the other side within femininity, then based there, be free to move in expression spaces as I wish, as femme or tomboy either way, this is what I want, what I will try. I know that I am not like some, for whom this is a choice between transition or suicide, nor do I match Blanchardian stereotypes of androphile young transitioners. There was no crossdressing at age four, as far as I know.

But what I do believe in is agency, and in taking control over one’s life and one’s place within social constructs, and in the supremacy of the will over biology. That ethos and pathos is mine, and alongside it, a need which I feel more and more keenly, a hope, a wish, a faith. Tearing up again writing this on the train, smudging my makeup. I will be the witch it is my human birthright to be.

some forward motion

Heading back from second therapy meeting. Really not feeling questioned by this one, it’s almost as though she is trying to be open-minded, honest and do a good job… well, we will see. I continue presenting as I have, in the sense of, highlighting the version of my narrative which is least doubt-inducing, but that’s OK. Still in steps of overall anamnesis and demographics, this should take some time given sessions are so short. Two weeks until next, looking forward to. Those will be two pretty hectic weeks anyway.

Also, weight loss slowly continues. I feel bad talking about this because I don’t want to feed the engines of body issues and fatphobia that surround us. But really, I’d probably be quite fine with a body that was larger so long as I was parsed as a curvy woman rather than a chubby man (or a thin man, for that matter). But it really is a matter of being able for me to be seen as female at all, to be able to fit into clothing I would want to wear to further that, and with the assumption that if I indeed do go on hormones, I will gain weight from that no matter what I do, in new locations, but not lose any. For the first time I feel I _can_ do this, and I feel that sense of decision within me which may be a sort of way of feeling I want it.

This week was hectic in part to set up things to get to meet a heavily inspiring successful woman in my field who also happens to have transitioned, at something close to my age. After a lot of challenges this worked out well, it seems, and indeed was inspiring, like seeing one indication of the sort of person I could be ten years from now. As well as learning of some of the various challenges, including exclusion and prejudice, but still. A rewarding way to spend energy.

Other challenges remaining to require coping and energy and work, and I will do those things. I will fight all battles best I can, identify and focus my particular strengths. And perhaps even get some rest…

eyebrows

I just readjusted my definition of “no time to groom/put on makeup“ from meaning “only time to shave and put on sunblock“ to “only time to shave and put on sunblock, then eyebrow pencil“. The latter makes enough of a difference all on its own and I now look seriously scruffy if I do not apply it.

In other notes, this is a week of seriously taxed coping ability. Still I cope. Hoping now to drop-in and get stitches removed.

what messy moments feel like

Some various people, in particular my poor partners have been exposed to situations where I 1) have put myself somewhat in order, grooming-wise and 2) lose some of that grooming by getting sweaty, or by getting rained on. If I expect to be messy, like when going for a run, then no matter. But if both criteria take place I tend to behave as though this is a big deal somehow, even where no-one else will care; I will expend a lot of effort in avoiding anything which might smudge my makeup, if I wear any, or make my hair slick against my head. Same with realizing my breath or smell otherwise is less than fresh. The feelings are those of urgency and of losing something important I’ve scrambled together, of bodily alienation. This has been the case for many years, and I am not proud of those dramatic tendencies, they must make me less comfortable to be around in such moments.

Thinking now that this may be not just be being silly (though it certainly is that!); but that it can also be understood as an expression of gender dysphoria for me. By establishing a non-messiness state, I’m self-conceptualizing in a way which I am comfortable in, which then is nullified by the factors I describe. If I am compensating for the body itself by its surface properties, then it would make somewhat more sense that those surface properties would be such a point of vulnerability for me. Now, my mother would surely point out how as a small child even I never wanted to get sticky or dirty or messy due to some sort of high sensitivity sense-wise, and perhaps these situations more express that? Or rather, some interaction between factors. I don’t recognize this affecting me so except in such regards as impacts the extent to which I present gender cues – appearance of skin tones, volume ratio hair to face, body odours and sweat. Curious.

outforhealth:

QT Says: Considering HRT? What’s right for you?There’s a lot to consider when
you’re thinking about starting hormone replacement therapy (HRT), especially if
you’re nonbinary, questioning or just generally not 100%, “give me hormones now”
about the whole process.

Here are some questions you
may have and our best answers to them. If you think of more, let us know in our
ask box! (We won’t be able to answer
specific medical questions about your personal care but we can share thoughts,
resources, and questions!)

1. What does
testosterone/estrogen do to my body, anyway?

Good question. Take a look for
yourself!

2. Okay, that’s fine, but what
if I don’t want all of that right away?

You get to decide what’s right
for you! For some people, it can be a bit overwhelming to think about ALL of the
changes – some of them may seem exciting, others not so much. One of the things
you get to do (need to do!) as a person considering hormones is weigh the pros
and cons of all of the changes and decide what feels like the right path for
you. You can do that on your own, with a mental health counselor, with your care
provider. Thinking it through and making an informed decision for you is incredibly important.

(Some of our
patients benefit greatly from therapy and report
positive experiences and that’s important. However, at PPSFL we do not require our patients go to therapy to prove
their true gender, or to get permission to change their bodies. One of
the ways we approach our transgender services program at our health center is
called an Informed Consent Model. That means you get to decide what is right
for you and we support what you choose for you.)

Some of our patients are very
happy on a smaller dose of hormones; others feel better on a higher maintenance
dose. We have rules (called medical protocols) that give us guidelines but we
work with our individual patients to make sure they are comfortable with their
care and hormone plan.

We find that most of our patients
are really good at figuring out how they ~feel~ on hormones, emotionally and
psychologically, before some of the bigger changes occur. The key is to keep
checking in with yourself. How do you feel? What’s going on for you? Does this
feel exciting and like a “click” of cool, yes, THIS! Or are you feeling ambivalent
like, huh, sure, I guess, maybe? If you’re feeling less enthused we recommend chatting
with your care provider and deciding what’s right for you. You get to choose
when to start, if you wish to continue, and help make decisions about your
dosage. You get to choose. It’s your body! The time it takes for some changes to
occur can be good news and/or bad news for some folk. The good news is you have
some time to see how you feel. The bad news can be the waiting.

3. Okay, my dude, but what if
I want to stop taking hormones. Can I do that? Will I explode?

Yes, you can stop taking HRT,
and no, you will not explode. That said, like with most medication, just
stopping taking it, cold turkey-style, is not a thing we recommend.

Talk to your care provider about
how you want to stop and you can come up with a plan together on how to lower
your dose or take you off HRT. We look at your care as a partnership. We are
experts in a lot of things when it comes to health but you are the expert on
you and how you feel.

4. Can I just take, like, a
smaller dose of HRT, but permanently?

Yes. Most providers start
their patients on a lower dose and then make adjustments based on the patient’s
experience and medical protocols. Key thing here: what’s right for you? People take different doses of HRT for
a multitude of reasons, and “I just want to see how I feel” is a totally valid
reason to stay on a lower dose for a few weeks, a few months, and also forever. Neutrois has written extensively on this topic, from their POV.

5. If I stop taking HRT, which
changes are permanent?

For trans men/ transmasculine folks, the irreversible (won’t
change back to how they were before taking HRT) changes may include:

Deepening of the voice

Growth of facial and body hair

Changes in hair (possible hair loss, thinning, or male pattern baldness)

Growth/changes in genital erectile tissue (clitoris)

Breast tissue atrophy – possible shrinking and/or softening of tissue

For trans women/ transfeminine folks, the irreversible (won’t
change back to how they were before taking HRT) changes may include:

If sperm production has ceased it may not return if hormone treatments are stopped; it may be irreversible (this can depend on length of time and dosage on HRT).

breast development/growth

Bottom line, if you are
considering HRT and wondering what’s right for you, you get to decide! Ask a ton of questions. Read a bunch. Talk to
your care provider and ask all the questions you have (write them down before
you go for an appointment to help you remember them!). Good luck and take good
care!

This speaks so much to me. I wish there were informed consent options in Europe.

clean streaks

Just noticed while shaving that now, a few weeks post first laser session, there are actual regions on my cheeks – like tiger stripes, sort of – where there currently is no stubble. Assuming there will be new follicle cycles blooming back there, but eventually there will be none. There is actual progress. This might actually work. I might actually become able to see my face clearly. Tears in my eyes at the thought.

Then again, perhaps I’m just latching onto some narrative that makes my drab life seem meaningful, thus doing symptom management of some other state. But really, I feel happy every day when thinking I am another day closer to next laser appointment. That might, just might, be a sign that I don’t need to overthink this quite so much. Giddy with happiness at the thought. 🙂

first meeting with new therapist

So, to those who read this (heh) and do not already know, my first gender therapist pick turned out a dead end; she claimed that all “true transsexuals” she met knew from childhood, and as an actual card-carrying Freudian instead tried for some long shot of how I might be trying to transition to spite my mother. I did not end up scheduling any more sessions with her after that. Instead found another, and now await the train taking me away from there to a circle of cherished people for the weekend. The new therapist might be better. I can’t know this until I’ve gotten what I need, which is a diagnosis. The first one also seemed, while never good, then not like entirely wasted time during the first sessions. But this did feel better.

My new therapist is younger and a behavioral therapist. She said this means she believes all harmful behaviors can be unlearned, which could be a warning bell, but she listened as I outlined the logistics and context of why at this point I seek evaluation for formal diagnosis rather than primarily therapy, and she asked me also to look up as homework what the procedures of my home country are. For the sake of my somewhat sanity, I will take this as a good sign. Unlike the other, she also understood largely my English, did not ask me to pause because she needed to translate into German for her detailed notes, and seemed to actually sort of understand what I was saying, though giving few signs of any conclusions.

I ended up describing overall my slow transition from sad, nerdy AMAB child and teen, via agender political queer student, to now finally trying out some sort of womanhood. Outlining also the specifics of my situation and time frame (with regards to migration, being between states, timeframe, etc.) I did mention how I’ve had crippling anxieties worrying over whether or not some biological underlying essence of sex may keep me from womanhood, and at least was not interrupted, so that I got to outline it in some more detail, as well as how anxieties are reduced with each transition step I take. Further describing dissociation, my distance from my emotions, and ending up crying some during the session, which has not really happened that way before. I understand it as my tears of relief, though still a little concerned she may somehow conclude that I ought to treat the dissociative aspects in some other way than transitioning.

Well, in that case at least I learn more things from the procedure. I’m going to consider this a good step for now, a hopeful step of sorts in the pursuit of passing through gates. The journey continues, and if there is one thing the last years have taught me, it is to persevere until I reach where I need to.

other things I freak out over

Came across another academic paper of note. Now vaguely worrying this tumblr will devolve into “S commenting on papers outside her own field of research”, which would be, I don’t know. But I’m sure I will get more gushing over nail polish or the like to balance it. Also I would hate to read my own blog because of rabbit holes?

Anyway, there is this:

http://www.nature.com/nm/journal/vaop/ncurrent/full/nm.4386.html

where they conclude major depressive disorder (MDD) seems to be essentially two different diseases in men and in women. They look at 40+ brains from corpses, analyze gene transcription levels and conclude that out of those genes whose overactivation distinguishes depressed men from non-depressed men, less than 5-10% also distinguish depressed women from non-depressed women. Now, this is major depressive disorder so not just feeling the blues. But I am really struck by how strong that signal is! It’s really like it’s two entirely different systems involved. Small sample, but validating in another dataset, and seeing the same thing in mice. Presumably all the samples are cis.

The reason it is scary is, of course, that it implies there are very different ways in which some mechanisms of stress and coping that take place in the brains of cis men versus cis women. I don’t want there to exist such differences, but if there are, I need to know I function like a woman, not like a man. Which raises the question on how this works. Among few things which really do differ strongly by sex, are sex hormone levels. Then there is the underexplored realm of menstrual cycle-associated depression, and depression as a side effect of some hormonal contraceptives, and also, for that matter, dysphorias reducing upon hormonal replacement therapy.

No way of telling from these results if the differences build on organizational effects (early differentiation) or activation. But it would be very very interesting to see how these genes respond to sex hormone levels – I suspect many of them will be reactive in this regard. And also, of course, curious on whether trans people with MDD, pre or post HRT, resemble their birth-assigned sex or not in this regard. Are these systems of stressedness/coping activated so that they will shift under hormonal transition? Or may they be related to some dysphorias, so that there is an organizational vs activational interaction taking place where certain brains are organized to be able to deploy some coping mechanisms, but provided the wrong circulating sex hormone levels to be able to have the corresponding genes activated? Further research needed.

This concludes todays rant about things way outside my field, drawing way too comprehensive conclusions, and coping with stress and dysphoria by writing a blog post.

published work along same lines!

Just found this article:

http://www.hawaii.edu/PCSS/biblio/articles/2005to2009/2006-biased-interaction.html

Many things in there, some better, some worse. But the recurring theme of gender identity as being linked to those we parse as same-as-us vs different-from-us, rather than maleness or femaleness as essences definable in themselves, that rings very true to me. Interesting.

Also relevant the misunderstandings of Diamond’s work related, seemingly also by Butler, sadly.

fluctuation of gender feels

Something which I am noting persistently over eight months of questioning and exploration is that the urgency and relevance of my gender fluctuates. This relates both to euphoria over transition steps and their outcomes, and dysphoria over things linking me to my assigned gender. Unlike someone who is genderfluid, as far as I understand that, I don’t really have any times when I feel any yearning to be my assigned gender, or any active genuineness in embodying it. However, during periods of low gender identification I rather don’t feel much either way, whereas during periods with higher gender identification, I feel a need to transition and happiness/unhappiness relative to where I am in such regards.

I haven’t charted this fully. I probably should, because it feels suspiciously like my periods of subdued gender-related emotions span about a week each month. Most human bodies have hormonal cycles, AMAB ones included, and it would make sense if mechanisms underlying gender identity were subject to those. This also makes me very curious if phenomena such as poor body image, eating disorders and so forth also exhibit monthly periodicity in some fraction of cis women.

It generally scares me when I am in a period of low emotionality around my gender. It makes me fear that my need to transition will disappear, that it will turn out to have been some fringe insanity or idée fixe. This would be scary both because of the awkwardness that would follow, given I have started social transitioning, but moreso because if I turn out not to be trans, then I would somehow be doomed to remain in my assigned gender, which even in these periods feels wrong when I think about it. Given this observation, and given the experience over time of these cycles, I find I am inclined to be mindful and ride the wave. So far the urgency has come back a week or so later, and I suspect it shall continue to.

Author: ishtarembedded