Hypochondria


IMG_0198Jerome K. Jerome in his book Three Man in a Boat gives a hilarious example of how a lay person, without proper medical training, can easily get fooled and become hypochondriac. The narrator in that book walks into a library and looks at a book listing all diseases with its symptoms, and by checking each one, he concludes he has got all diseases in the book (except for housemaid’s knee… which he finds frustrating). Besides the humour of the situation and the narrative, Jerome is actually giving a good example of what happens to someone with little expertise in medical diagnosis, and it is meant as a criticism of the time.

But self-diagnosis is still around, a century later. The overall mistrust of doctors still prevails – today, like a century ago, many people still believe that the doctor’s main purpose is to get rich on our behalf, by deliberately misdiagnosing us. How many of us, for instance, consider that sneezing a bit, having a bit of a fever and a running nose are the symptoms of the ‘flu, and tell everybody how ill they are? When, in fact, it’s almost certain taht we just got a rhinovirus, or common cold. If the running nose persists for several days, even without fever, we tell our friends that we have ‘a nasty case of the ‘flu, which, instead of just taking three days to disappear, is taking several weeks’. Very likely, however, all we have is just a rhinitis, or perhaps a sinusitis, and nothing really serious.

As a child, I was always misdiagnosing myself and believing I had the most serious diseases. I was also prone to several psychosomatic illnesses as well. When I felt particularly down and not wanting to go to school, I would develop all symptoms of the ‘flu – except for high fever. Soon my mother learned how to figure out if there was really something wrong with me or not – by learning to look for the right symptoms. Our mind is quite clever at self-deception, and so my psychosomatic diseases became increasingly more sophisticated over time.

The cool thing about psychosomatic diseases is that they are easy to cure! During a certain period of my childhood, I was having some difficulty to sleep, and my mother was worried. The doctor, knowing me well, gave my mother some special pills, tell her to dissolve them into water and give me to drink before going to bed, and telling me that it would be fine to take that medicine, since it wasn’t addictive or had any side-effects, and I would surely sleep well. And, indeed, the treatment worked wonderfully – I would drink the dissolved pills and sleep like an angel. Decades later, my mother told my wife that all she gave me was sugared water. The placebo effect was more than enough to ‘fight’ my ‘disease’.

Even in my adult state, I’m still a regular ‘victim’ of my mind playing tricks. Thrice I went to the hospìtal with ‘strange symptoms’ regarding my heart. In one case, my blood pressure was going up every half hour, as I took it, and finally decided I shouldn’t wait longer some artery burst or something. In all cases it was just an anxiety attack. Of course, if you’re anxious, your blood pressure goes up; if you measure it every half an hour, and it’s already a bit over the average, then the anxiety drives it even higher. And so forth. The doctor frowned at me, even though he obviously told me to get my anxiety attacks treated.

Not to mention taking blood samples. I’m fine with syringes, so long as they’re used to inject medicine. But if it’s for taking blood samples, I become faint, pale, and almost lose consciousness. Obviously it’s not the tiny amount of blood that makes any difference! In fact, to prove that it’s all psychosomatic, I usually tell the following story: once I was explaining to the nurse taking some blood how I react so badly. We chatted for a while, I was making fun of myself with my stupid psychosomatic reaction to taking blood, she laughed with me, and then turned her back to me and went to the lab table. I was a bit confused and asked: ‘So aren’t you taking any blood samples?’ She answered, ‘But I already did!’ I hadn’t even felt the slight prick from the needle! But once she said that she had taken the blood sample, then I immediately became faint and dizzy. So it was more than obvious that it was just psychosomatic: the actual act didn’t make any difference because she was such an expert that I didn’t feel anything; it was only the knowledge that she had finished that made me dizzy!

Unfortunately, when I started crossdressing and was almost going insane because I couldn’t explain my strange behaviour, there was no doctor I could ask – I was far too much ashamed of myself to consider doing that. Also, like so many crossdressers, I thought that my case was unique, and outside the scope of medical science.

Thanks to the (emerging) Internet, I soon learned that my ‘case’ was anything but singular. Nevertheless, the idea of consulting a doctor was absolutely out of question. I imagined that my backwards country would not  have trained doctors able to correctly diagnose my condition and know how to deal with it. Instead, I tried to diagnose myself. Back then, there were basically just two options, each with a list of characteristics: transexual or crossdresser. There was not much choice. Based on each list of characteristics, I picked ‘crossdresser’. Why? Because I most definitely didn’t feel the urge to commit suicide unless I went through transition; that was the most important characteristic which I did not share with those who identified themselves with ‘transexual’.

All transgendered people go through phases where they try to apply labels to themselves — something which is quite well researched. This is, I believe, an attempt to better self-diagnose one’s own condition. As more and more definitions are published, our attempt to ‘fit’ into a specific category becomes more and more refined. For instance, back in 1995, I didn’t even know that crossdressing was a form of fetishism. It simply didn’t make sense to the ones who wrote about crossdressing; therefore, I had no idea such a thing existed. It was only much later that all those subdivisions started to become apparent, as I met lots of people online who identified themselves with ‘crossdressing’ but most certainly didn’t share the same characteristics as I did.

Here is the trouble with such an approach. Because self-diagnosis is never objective — you are, after all, biased and conditioned by your own thoughts — there is a high risk of simply getting it all wrong. By contrasting your ‘symptoms’ and characteristics with other people, you assume that you either share something in common with them, or that you are completely different. By mislabeling yourself — due to that subjective bias — you might commit serious mistakes.

This is obviously true for all illnesses and conditions, mental and physical, and not only for transgenderity. The problem is that with other kinds of illnesses and conditions, we go to a doctor, and are open enough with them to aid them in their diagnosis. With transgenderity, things are not so easy. What symptoms, what characteristics should we tell to the doctor? What is important, what is not?

And, most importantly, how do we distinguish cause and effect?

Here is a classical example, and I’ll follow up with another less typical one. Someone is depressed and crossdresses as a form of relief — crossdressing boosts serotonin, and, as a result, the depression is alleviated. What is the chicken, what is the egg? Is that a person who is a crossdresser, probably transgendered from birth, and the depression is a symptom of gender dysphoria? Or is that person just depressed and found out a way to alleviate the symptoms of depression? The American Psychological Association (APA) considers that in such cases, there is something treatable (depression) and something that cannot be treated (transgenderity), so their protocol demands that a patient is treated for their depression first, and afterwards, see what can be done about the gender dysphoria. In some cases, once the depression is cured, the urge to crossdress disappears!

And now a different example. Let’s assume a hypothetical male person (I have, however, met several ‘real’ cases which fit in this description) who has a relatively low self-esteem. They start crossdressing, and suddenly they become the centre of attractions — they get an incredible boost in their ego, improve their self-esteem, gain a lot of confidence. That produces a lot of euphoria and well-being; so much, in fact, that they seriously wonder if they haven’t been born in the wrong gender. After going out having dinner with friends for a long time, with increasing frequency, they start going out in public as women even during the day, move to presenting themselves as females 24h/7, and finally go through transition, starting with hormone therapy and eventually going through surgery as well. At this point, reality steps in, and the transition period becomes a nightmare. After several months, they’re in the nasty ‘in-between area’ — they still don’t look like women, they still don’t talk and behave like women, but going back to being a boring guy is simply not appealing enough. Finally the transition finishes, at least from a legal point of view, but the results are not very attractive: sure, there is a difference, but it’s not as much as they have expected. This makes them lose some confidence and their self-esteem is lowered again; going out with their crossdressing friends is not an option anymore, since they have gone beyond that stage, and actually develop some scorn towards those who never went as far as going through transition. On the other hand, their friends from their male era have been totally and irretrievably lost. This means that they stand alone, in a brave new world, full of discrimination, with a body that doesn’t yet look fully female (and probably will never be), with no friends — neither male ones, much less crossdressing ones — and transition was a nightmare to endure… for what? Life’s not improved that much. Again, in this case, the problem was that the low self-esteem was linked to ‘being male’, while the euphoria from being admired as a ‘woman’ while crossdressing was just temporary and limited to a very specific environment (namely, other crossdressers). Now that they have to face the world as women, they suddenly realize that they are really not much better off than before when they were male. In fact, they have added a lot of more complications and problems to the existing ones.

One would expect that doctors would correctly identify and diagnose such cases. But sometimes even doctors make mistakes. The problem here is that self-delusion — or, if you wish, psychosomatic effects — can be so strong that even doctors can be persuaded that this self-delusion is actually ‘true’. A doctor that sees someone so unhappy and furious with themselves when they are acting as males, and so happy and euphoric when they present themselves as females, might really think that they’re far better off if they go through transition. While in reality such diagnosis takes a lot of time, requires lots of independent advice from different teams of doctors, where information is cross-checked and double-checked, sometimes a mistake can still be made.

The whole trouble started with a misguided self-diagnosis.

Now, I have gone through a series of wrong self-diagnosis myself. About a year ago or thereabouts, I suddenly started to lose interest in my work, and it became increasingly painful to continue to produce results. At the beginning, my self-diagnosis was simple: laziness. I just wasn’t in the mood. But there is a limit to how lazy one can get, and by summer, I was starting to add more complex explanations to my lack of willpower to engage in work: perhaps the weather was too hot, my schedule was too complicated, I had little routine, I wasn’t sleeping enough, I had so much to worry about that there was little time left for work, and, of course, I was getting very, very frustrated in the limitations I had to self-impose upon my crossdressing due to my wife’s wishes.

While thinking about all those reasons — and adding a few more on my own — I was just surprised on how differently I acted when doing something I actually enjoyed. A typical example, of course, was getting crossdressed: I would have no trouble whatsoever in spending hours upon hours in the bathroom, very focused, just to get everything right. I wouldn’t be ‘lazy’ in applying my makeup, for instance. But there was more. I could obviously focus on writing blog posts — there was no problem whatsoever in spending hours to write 10,000 words on my blog, but I couldn’t even do 500 for my work. In fact, starting last summer, I wrote my autobiography — 200 pages — in little more than six months, and it wasn’t something I did every day (again, because of my complex daily schedules): but every time I had a few hours free to write that, I would narrowly focus on just that and spend uncountable hours in writing it.

At about the same time, I got excited about the possibility of writing a script for a comic book. Sadly, the plans did not go ahead, but, in order to finish it as quickly as possibly, to present it to potential artists for illustration, I wrote the entire script in about two weeks, working perhaps 5-6 hours every day, sometimes more. There was not the slightest hint of ‘laziness’ when doing that.

However, when getting back to work, I would just stare at a blank page for minutes and not be able to write a single word.

It was by the end of summer that I knew that something had to be wrong with me, but I didn’t have a clue about what it was. At the beginning, I didn’t feel anything special. I was not more tired than usual, nor particularly sad, or moody — at least, not more than usual. And, in fact, when engaging in things that were not work, I would most definitely get enthusiastic about it and work like crazy on it. It was just things related to ‘work’ and things that I hate to do (like dealing with bureaucracy…) that I drew a blank.

To be honest, I still misdiagnosed myself as just being lazy for a long time. The only reason I started to think about talking to a doctor was when two new symptoms occurred: first, I noticed I was having some difficulty in expressing myself, especially in delicate moments where the wrong turn of words would get someone angry at me — namely, my wife. To those who know me personally, you know that I’m pretty much the extrovert, being able to talk about everything for hours (well, everything except sports…), even to complete strangers (I can even talk to my cats for half an hour until they finally get bored of so much attention from their human friend… 🙂 ). So having this difficulty in expressing myself on those delicate situations where people would get furious at me was becoming increasingly more and more noticeable. I had no idea why that was happening.

And the second thing was that I was taking way too long to do some simple chores. Things that took half an hour would take a whole hour; but in my mind, I was doing them at the same speed. It was just when others started to noticing how slow I actually was — and I could verify they were right by looking at the clock! — that I really thought that something had to be wrong with me at some level.

It was also a period of introspection regarding my gender identity, as you might have noticed from my increasing rate of posting new blog articles. I would compare myself with the many online friends I routinely communicate with, and notice the differences between myself and most of them. In a sense, I felt that I was being drawn to a different stage in my progression as a crossdresser. I still label myself as a ‘crossdresser’ because that describes what I do, but it most certainly doesn’t describe what I feel. And this was starting to worry me quite a lot.

It became apparent to me that all my life was mostly spent as an elaborate lie, and as I wrote elsewhere, it truly feels that I have been acting the male role because I had no choice in the matter. It’s a role that I never truly liked, but even less in the past decade, when everything I had worked for was utterly ruined. As a male, I felt I was a failure. I saw the successes of my male friends, and thought, I would never be like them: everything I started seemed to work well for a while, but, at some point, something pops up that destroys what I’ve done, and I need to start from scratch again. There was a fundamental flaw in me — after all, I cannot put all the blame on external circumstances! The common denominator is always the same: me — and, over time, I concluded that the main reason was that I’m really not such a good actor, pretending to be a nice, regular male in this society. I do my best, I have 45 years of experience of presenting myself as a male, but I’m not very good at it.

This naturally also worried me. Why was I so bad at ‘acting like a male’? Sure, it’s obvious when the answer is ‘because I don’t like that role’. But that seems to be very simplistic. After all, most males are good at acting their roles, and, like myself, they have had no choice in the matter: they were socially conditioned to act like males from birth, and they do good jobs, thanks to so many years of practice. It’s just in my case that all those years of practice never made me achieve anything that a male could be proud of. And probably the fundamental flaw in my personality is that I really don’t like the male role. I don’t like anything male, to be honest. And probably the reason why I constantly fail as a male is because of that.

Of course, a lot of people hate their jobs, hate their families, hate everything they do (my older female cousin comes to mind; she’s just like that), but they don’t question their gender identity. They mostly blame everyone else in the universe but themselves. I wonder why I was just taking the opposite route: blaming myself for not being sufficiently good at playing the male role.

Now, don’t get me wrong. When I present myself as male, I don’t act ‘effeminate’. I don’t wear garish colours or anything out of the ordinary; in fact, two decades ago, I would always dress in a classical suit with a tie. I am a computer geek, which is something currently associated with males, and I’m not ashamed of being a computer geek. I prefer blockbuster action movies to love stories or cooking competitions. I get enthusiastic with gadgets, at least to a degree. I enjoy the occasional computer game. I might draw the line at sports, violence, and unnecessary risks, but I have some tastes and preferences that are typically (or even stereotypically) male. That’s the reason why nobody who knows my male self would ever question my gender identity: I might be a little bit odd, but, in general, thanks to my visual presentation, I ‘pass’ as male reasonably well.

However, I always feel that there is something lacking. Sure, I like gadgets, but I don’t like them that much. I enjoy computer games, but I’m not a fanatic. I dislike driving and cars in general, even though I enjoyed for a few years driving a sports car, when I could afford it. I might like blockbuster action movies, but I hardly watch them. I like to read science fiction, but that never prevented me to read a considerable amount of Victorian love stories — in fact, these days, I read rather little science fiction. So, as my male part goes, it’s never ‘sufficiently male’, at least not when compared to almost every other male I know. I’m sort of a wishy-washy male. In some areas, my own wife is much more masculine than I am!

When I put all that together, and started looking for descriptions on the Internet about mental issues, I concluded that I might truly suffer from gender dysphoria, at least to a mild degree — since I don’t exhibit suicidal tendencies, for example — and that, added to a lot of triggers (the death of my beloved mother, dealing with a demented father, the stress of finishing my PhD in time and emigrate somewhere else…), produced some sort of depression, although I had few of the ‘classical’ symptoms. In fact, I had no idea there were five different classes of depression, until I started reading about them. Clearly I had not the most common type — melancholic depression — because I showed an incredible enthusiasm in crossdressing and anything related to gender issues, including writing about it. Someone who is melancholically depressed doesn’t show any interest in anything, even in pleasant things. Another symptom I didn’t have was a lack of appetite — rather the contrary — nor did I exhibit many symptoms of lethargy, although taking longer to do things (even things I enjoyed!) was probably a symptom, and so was irritability. But a crucial issue was this difficulty in expressing myself in order not to annoy anyone, and getting incredibly frustrated when they got annoyed, no matter what I did. This is a tell-tale sign of what is known as atypical depression and is a mental condition by itself, known as sensitivity to rejection. Everybody hates rejection, of course, but when it becomes obsessive, then it might be a symptom of something else.

Although atypical depression is relatively common, the truth is that I never met anyone who had it, so I had absolutely no idea what its symptoms were. Since I read about it, however, I understood that it’s differently treated from melancholic depression, and it also takes a bit longer to ‘cure’. In my case, looking back, I cannot pinpoint exactly when it started. It could be as early as mid-2013, when my mother died, or go back to 2004, a bit over a decade ago, when I started exhibiting some of the symptoms. It seems clear to me that around 2002 I still had none of them. My issue here is that if this took over a decade to develop, it won’t go away just with a handful of pills and some therapy with my psychologist: it will really take a long time to heal. And that, of course, is a problem, when I’m supposed to be the person that brings home the monthly check. My wife, when she had melancholic depression, took three years to get completely cured. I might take much longer than that.

But is the atypical depression that triggers the gender dysphoria, or is it the other way round? This, of course, is for the doctors to diagnose. The only thing I know is that I started to crossdress with some regularity — and to label myself as crossdresser — long, long before I had any of the symptoms of atypical depression. So it’s clear to me that my gender issues clearly predate the depression. The only difference is that at some point I didn’t really question my gender identity, while now I do it every day.

I try to recall my memories from a time when I just labeled myself as a crossdresser. There are two distinct periods. One was around 1995-1999 or so, when I could regularly crossdress. After 2002, I had very little opportunities to do so — work was intense, and my wife was spending all her time with me, and I had no occasion to be away for a few days to crossdress. During the 1995-1999 period, I would say that I rejected transexuality because I still hoped to be able to live as a male. Nevertheless, it was also during this period that I decided to keep all options open, and worked very hard in order to have enough money to live comfortably for the rest of my life, if I decided upon transition and never got another job again. I almost succeeded, and would have done so, if I hadn’t been cheated out of all my hard-earned money by banks and gangsters (two sides of the same coin? Hah!). So even by 1999, although I labeled myself as crossdresser and nothing else, I still entertained the idea that, in the far future, I might change my mind about my gender identity, even if it sounded far-fetched.

But in the period afterwards, until I revealed everything to my wife in early 2005, I simply didn’t think too much about it. From the perspective of an external observer — like a psychologist — they might question my claims about having issues about my gender identity, since there were many years when I didn’t crossdress regularly or think much about it. Someone with true, diagnosed gender dysphoria, would think about it all the time.

Gender dysphoria, for the medical researchers, is something that is black or white: either you are gender dysphoric, or you’re not. Contrast that to depression, which has at least three levels of intensity, from mild to serious, and is treated differently depending on the case. There is no ‘mild gender dysphoria’, from a clinical perspective, even if I like to label myself like that: because I see some of the symptoms of gender dysphoria, and I certainly have most of them, but I don’t have them all. Until recently, I didn’t even have a mental disorder caused by a misalignment with my gender identity. Now, with the depression (and some anxiety), I’ve added a couple more symptoms to the list. Not enough to get a diagnosis as being gender dysphoric, but it’s getting closer.

On top of that, and once it was clear that I had some mental issues (some of my friends would now yell: ‘I’ve always knew!’ 🙂 ), I looked for more symptoms and what caused them. For instance, one thing that became apparent, especially when I started to go out with friends, was that people really found me attractive, and weren’t just being nice about it.

This truly confused me a lot. I had to re-read my autobiography again. It was clear to me that by the time I was 15, and desperate about getting a girlfriend and being shunned by anything female, I questioned what was wrong with me. I thought that the only problem was my shyness. So I worked hard to get rid of it. I succeeded — but I still didn’t get a girlfriend. By that time, I worried a bit less about it, and just shrugged it off by claiming that I was physically repulsive to women, and that was something I could not change.

So, in my mind, at least since I’m 15 — and that’s three decades of thinking like that! — I’m a very ugly person. I look at myself in the mirror and just see a horribly-looking guy. As a male, there are no redeeming features whatsoever. Nothing which I see in the mirror is particularly appealing.

I can find at least some 30 major flaws in my body, but on this picture, I managed to hide almost all of them!

I can find at least some 30 major flaws in my body, but on this picture, I managed to hide almost all of them!

As a female, things are slightly better. It’s true that I’ve got a nose that spoils everything, no matter what people say, but at least I have large, fleshy, and very female-looking lips. Obviously they’re not perfect — I have a lopsided smile, from a facial paralysis I had two decades ago, which was just cured to 95% — but they’re my most outstanding feature. The rest of the body is awful, but thanks to shapewear and padding, I can make the most of it. One of the many advantages of  presenting myself as a female is that I can correct a lot of my defects: makeup enhance my average eyes and it makes my lips truly shine; the long, voluminous hair hides a lot of the ugly shape of my head; and the shapewear gives me a hourglass figure when I’m actually barrel-shaped and overweight. My legs are not overwhelmingly attractive, but anyone looks good in heels with a nice stocking or hose. So my point here is that although I still don’t see anything ‘beautiful’ when I look myself at the mirror as Sandra, at least I’m aware that, as a female, I can disguise a lot of things. And if I went through transition, I would certainly be able to correct a lot more with surgery.

There is a huge difference between my male and female presentations. The only person in the world who ever said that my male side was ‘attractive’ was my wife — and she doesn’t count, since she’s biased, we’re in love, and, as such, ‘beauty is always in the eye of the beholder’. Not even my former girlfriends ever said that to me. By contrast, when presenting myself as a female, a lot of people find me attractive. Not all, of course; when I’m feeling especially vain, I just join a regular chatroom (not a transgender chatroom) and count the seconds until someone yells at me, ‘you ugly tranny, get your face out of this room!’. Generally it doesn’t take many seconds until that happens, which confirms to me that this is what people really think about me. Still, I can’t explain why some people think differently.

Now, when a lot of people say something, and you’re the only one saying the opposite, then it’s more rational to assume that a lot of people cannot be wrong. It’s more logical to assume that I’m the one who is wrong. In that case, I also suffer from a mild case of body dysmorphia — and, unfortunately, if that’s the case, not even surgery will help 🙁

Body dysmorphia is something completely different from gender dysphoria, but unfortunately many people confuse both. It’s obvious that someone who suffers from gender dysphoria is not happy about how their body looks, but that’s not the same as claiming that they also have body dysmorphia: it’s a completely separate condition. Body dysmorphia is also treatable with psychotherapy and medication, while gender dysphoria isn’t. The ‘cure’ for gender dysphoria might include cosmetic surgery, while surgery will not have any effect on body dysmorphia, or can even make it worse (see the case of Michael Jackson!). If you have body dysmorphia, you can never look ‘right’ to yourself, unless properly conditioned by psychotherapists to start accepting the way you look. Gender dysphoria is ‘cured’ once you finish your transition.

So why do I think I might also suffer from a mild case of body dysmorphia? Mostly because, unlike gender dysphoria, body dysmorphia can come in stages or levels, from minor to major, while gender dysphoria is really an all-or-nothing condition. So I might be deluded to believe that I suffer from gender dysphoria while in reality it’s just body dysmorphia: after all, I tend to perceive my female presentation as ‘superior’ to my male one, because I can hide my physical flaws so much better as a female. That might get interpreted by a therapist in the following way: I use crossdressing as a strategy to overcome the body dysmorphia, and, because I achieve some degree of success using that strategy, I get more attracted to my female gender presentation, which, in turn, leads to (wrongly) concluding that I might suffer from gender dysphoria. So a therapist might attempt to cure me from body dysmorphia, and, while doing so, ‘cure’ me from gender dysphoria as well.

I’m writing this and inwardly smiling, because I find the whole concept ludicrous. However, the truth is that this is what objectively a psychiatrist/psychologist will do. That’s the main reason why I tell them all my symptoms. My hope is that the whole bundle might make some sense to them, and, while they have a detached, objective opinion about myself, they can figure out what is really wrong  — as opposed to what I think that is wrong — and attempt to cure it. The rest of the symptoms might simply just vanish once the real reason is established and cured.

Honestly, sometimes I wonder about what will happen if I don’t feel the urge to crossdress any more. In a sense, I’m now so emotionally engaged with the female aspect of my personality, that I would suffer a lot if it would simply be gone. But the truth is that things don’t really work like that, and let me give you another example.

Most of my readers know that I have a low libido, and have had a low libido for decades. ‘Low’ doesn’t mean ‘zero’, of course. For instance, I would successfully masturbate 2-3 times per week, which, I think, would be considered ‘normal’ for someone at my age. However, I always claimed that if I stopped feeling the urge to masturbate, I wouldn’t regret it. Unlike many crossdressers and even some MtF transexuals I know, I don’t really have a huge emotional attachment to my male genitalia. I don’t particularly enjoy sex; for me, it’s just a lot of exercise, a lot of effort, and the result is a stinky mess that is hard to wash away. There are far better ways for one to enjoy themselves, in my opinion!

That’s also why people sometimes find it strange that I wouldn’t really mind getting sex reassignment surgery. I don’t particularly feel attracted to the idea, like a true transexual would, who simply desires to become fully a person of the gender they identify with. But it’s also not something I reject entirely. The male genitalia is disgusting to me in any case — just practical from the perspective of peeing standing up — and I don’t really mind getting rid of it and replacing it by something totally different. And I have no problem, either, if I became completely unable to get an orgasm ever after — which happens to a lot of transexuals after their surgery. That truly doesn’t worry me in the least.

But one thing is writing about it, the other is actually experiencing it. Once I started on antidepressants and anxiolytics (I had been warned by my psychiatrist), my libido was effectively reduced to zero, and that happened very quickly — after a few days, I simply was unable to masturbate any longer. I still felt the urge, but it simply stopped working. At the beginning, I found that actually curious, and perhaps a bit disturbing that such a tiny amount of chemicals could change the way my brain works so deeply and effectively. After two weeks, I tried to do some experiments, and the truth is that it simply didn’t work any more. To be honest, during the past months, I did manage to masturbate once: I was feeling especially sexy as Sandra, and, before I undressed, I tried it again. This time it worked, but with far less satisfactory results than usual. One thing that tickled my curiosity was to figure out where all those sperms are going, now that they’re not being released as regularly as before 🙂 Maybe their production is also being decreased by the drugs I’m taking, which raises a lot of other questions, too…

Whatever the case it definitely felt a bit strange. Here was I, having claimed that I wouldn’t worry much about never having an orgasm again, but also being aware that it’s easy to claim something like that — in practice, I was still masturbating regularly. Now I’m unable to get an orgasm, even if I wished. The truth is that, as time passes, the ‘wish’ to get an orgasm has become practically zero, and if there is still a lingering urge now and then, the truth is that it won’t work any more. So now I can live up to my claims! Am I worried? Not in the least. Sad, frustrated, anxious? Not at all. In fact, I’m even glad I have one less problem to worry about. If people ‘hit’ on me on the ‘net and ask me to have sex with them, I can truthfully answer them that, thanks to my medication, I have absolutely no desire to have sex with anybody, and are much better off that way.

Knowing that experience, I’ve learned two things. One is that these modern drugs are incredibly powerful to change how your mind works. This means that very likely they can also change the way I think about my self-diagnosed illnesses and conditions. Although I’m confident that there is nothing that can change gender dysphoria — after all, it has been tried countless times, without success — almost everything else can, in fact, be successfully cured or changed permanently, if only the right drugs are been taken, with the appropriate therapy to condition one’s mind correctly. So maybe one day I might even look at myself and find my image attractive; and in a few years I hope to get rid of the depression and be able to work again.

The second thing is that I have little to worry about the final diagnosis by my doctors regarding my gender issues. Basically, if they decide that I have no gender dysphoria, the treatment I’ll be subject by then will prevent me from worrying about it. I might stop crossdressing, for instance, but that will not worry me in the least by then. Or I might continue to crossdress, because it’s still a part of me, but I won’t feel the urge to think that I’m anything else but a common crossdresser, perfectly balanced at the edge of gender, without any issues, and enjoying myself fully, both as a male and as a female, like all crossdressers I know.

The alternative, of course, is that the doctors do diagnose me as being gender dysphoric. It’s far-fetched but not impossible. In that case, I’m sure that, by then, I will have no hesitation in going ahead, no worries and no regrets. Proper medication and therapy will lead me through transition with flying colours, and, at the end, even if physically some things are not as I wished they were, they will know how to treat me to think differently. And, of course, the lack of sex, or even of having an orgasm as a female, will not worry me in the least.

Some of my friends find it strange that I trust doctors so much. Perhaps I should explain things from the reverse point of view: the only person that I do not trust is myself. Self-diagnosis just led to anxiety. Having no clue about what is wrong with me, and desperately clinging to whatever things were said in books or web pages didn’t prevent me from avoiding depression. Putting all the blame on other people, or on the environment, or the dirty tricks played by Fate, most certainly didn’t work at all. It was only when I consciously made the decision to stop trusting in my own judgement, and placed that responsibility in the hands of specialists, that I started to see some results.

For example, I never considered myself an anxious person. But it’s clear that now that I’m taking some drugs to reduce anxiety I’m much less irritated with things happening around me. My Buddhist training was good just up to a point, because I’m a poor practitioner; I hope, one day, to be able to turn my mind away from anxiety just through my training, and not rely on drugs to achieve the same effect. But the truth is that my doctors hit on the nail with their diagnosis of anxiety and I saw results very quickly. I have to reason to believe that they will treat all the other symptoms differently. Whatever might be ‘wrong’ with me, they will figure it out much better than I, and, more importantly, they will know exactly what to do which is best for me.

Obviously this is not one-sided. I’m not a mindless robot that just plods along at the touch of a button on a remote control. Doctors and patients interact with each other. I will have a saying in all that they tell me. But, in general, I will trust their judgement much more than my own, because trusting my own judgement lead me to nowhere. That’s why I trust doctors so much: because they can be objective about my issues, while I can only be very subjective and totally biased about them…