Since the last week, I’m feeling a bit down. That, by itself, should not be a cause of worry: after all, I’m supposed to be depressed, and when people are depressed, they feel down. Right? I do have now two medical reports who testify that I have ‘psycopathological disorders’ (the psychiatrist and psychologist who did their separate evaluations did not specify the exact condition, to protect my privacy). That pretty much means that I’m supposed not to be feeling well (mentally speaking, that is). So why am I surprised about ‘feeling down’?
Feelings of insatisfaction are common and our brain as a chemical factory
Let’s be a bit more precise here.
Most people have periods when they are feeling down, and when they are feeling happy, or even euphoric. Such emotions are, after all, normal. We have coping mechanisms for each, and, in general, we will not feel down all the time, and, by contrast, we do also not ‘feel good’ all the time, either (even if we often pretend to do so). If we want to be more philosophic about it, then our condition is mostly one of insatisfaction, with short periods when we temporarily suspend that insatisfaction for a bit, and this is what we call ‘pleasure’.
It is also related to our wishes, desires, and expectations. A typical example: we are anxiously waiting for the weekend to start, since we might have a party or an event with our friends. It’s the expectation, the long waiting, and so forth that causes us anxiety, which, in turn, might also make us ‘feel down’ — until we are physically at that party/event, we feel that something is missing somehow. We associate pleasure and happiness with an expectation that some future event goes according to our wishes; and while waiting for that event to actually happen, we feel anxiety, insatisfaction, a feeling that something is missing to make us happy.
The more irrealistic the expectation or the desire, the more we suffer. Someone, for instance, who expects to win the lottery or to marry Prince Perfect, and can only dream about that all the time, will naturally be frustrated and anxious during way longer periods of time than someone who is just anxiously waiting for the day shift to finish to return home and relax. In other words, wishing for something impossible causes far more anxiety and long-time suffering than wishing for something which will happen with a very high degree of probability (remember this Calvin & Hobbes cartoon? It’s one of my favourites, which illustrates exactly what I’m saying).
Most people actually have reasonable wishes and desires, most of the time. And therefore their stress and anxiety is, on average, not overwhelming — perhaps so low, in fact, that they might not even be aware of it. Once in a while, however, one of those unreasonable wishes pops in, and then the degree of anxiety starts to increase, and, as that wish remains unfulfilled, the insatisfaction resulting from the lack of fulfillment grows more and more. It might even become unbearable, and this leads to figuring out some coping mechanism.
Unfortunately, for many people, the coping mechanism is some kind of toxic drug to change the way our brain works. The most popular drug, of course, is alcohol — since it’s legal for adults and available everywhere for a reasonable price. Alcohol truly changes the way the brain works, which is something we often don’t really think much about. It’s not merely triggering some sorts of emotional responses from one area or the other. No: it’s actually doing much more. It’s like a mechanic rewiring your car’s motor. From the outside, it might look the same to casual observers. But inside it has a completely different motor. Perhaps an even better comparison would be to have your mechanic switch your car’s internal combustion engine by an electric motor. The car will still work, it will still be recognised as a ‘car’ (or even as ‘the same car’), but it now works completely differently, because an electrical motor is a completely different kind of engine which just happens to pull the car along its path.
Of course, once the alcohol effects are over, the brain gets rewired again. ‘Rewiring’ is actually not a good word, since it somehow evokes the idea that some neurons just get reconnected again. But the change is actually way more deeper than that: neurons simply start working differently, from a biochemical point of view. They are completely ‘off specs’, if you can excuse me this expression. But the effects from alcohol (and all other drugs) are temporary: when they wear off, the neurons revert their chemistry to the original way they used to work.
Proponents of the theory that the brain is just a very complex computational machine tend to overlook the effects of certain chemicals on the brain. Because the resulting effect is not merely ‘a different computation’. It is more akin to suddenly having your computer’s motherboard replaced, and where you had an Intel-based, Windows-compatible PC, you now have an Apple Mac: the components might still be familiar, but the whole hardware has really changed. This is an amazing property of our brain: it can change its hardware on demand, something that our computational machines cannot do.
No wonder that we act so strangely when we are drunk; no wonder that most people don’t retain memories from their drunkenness. The brain was truly so much changed, and back again, that it lost some connection with a continuous ‘memory log’. In other words, it is almost as if we ‘become a different person’ while we’re under the influence of certain drugs. Many people even use that precise expression to describe the experience: ‘I was out of my mind’ or ‘I wasn’t myself’. Actually, although these are colloquial expressions, they might very well describe the experience very well: a differently-working brain will almost certainly produce very different experiences, sometimes so alien to our regular experiences that they fail to register on our ‘normal’ memories.
Drugs are not the only way to affect how the brain works. We actually have ‘natural drugs’ to do the same — we call them generically ‘hormones’ and they are triggered for a variety of reasons. Some can be triggered on demand: a typical example is adrenaline, which gets triggered when we are facing an intensely stressful or fearsome situation. Because adrenaline also changes the way the brain works, just like alcohol, it’s not surprising that so many people are always looking for ‘extreme sports’ where they are placed in situations facing death or serious injury, which triggers an adrenaline release. People call them jokingly ‘adrenaline junkies’, although, once again, this expression might be much more closer to reality: like synthetic drugs including alcohol!), adrenaline really changes the way the brain works.
The most common ‘feel good’ hormones are, however, dopamine and serotonin. The latter is linked to depression, and psychiatrists attempt to ‘cure’ depression mostly by twiddling with the serotonin levels in the brain. To keep yourself in a ‘good mood’, serotonin needs to be maintained at a stable level; certain activities promote an increase of serotonin in the brain (like exercise and some kinds of food). Depression is apparently related to a misfunction in the regulatory system for serotonin. It gets ‘flushed out’ of the brain too soon. What some medicaments do is to prevent the serotonin in the brain to get out so fast, and this, apparently, has the desired effect of reducing depression levels.
So the intriguing, philosophical aspect of this presentation of how the brain works is that it usually seems to be at a ‘neutral’ state. When something pleasing happens, hormones induce the brain to change, and we experience pleasure as a ‘brain reconfiguration’. When something unpleasing occurs, those hormones are washed away from the system, and the brain is reconfigured again, this time to make us ‘feel down’. Actually, ‘feeling down’ seems to be the brain’s craving for those ‘pleasure hormones’. In the neutral state, apparently we don’t feel the craving. But this is just speculation on my part; perhaps there is really no ‘neutral’ state, we’re either having some part of the brain reconfigured to feel pleasure, and that balances out the part of the brain that is feeling unhappy (such an explanation would actually be more consistent with Buddhist philosophy, but I have no idea if it is correct or not — I should read a bit more on this fascinating subject).
Depression is not just ‘feeling down’
Here is what I have learned in the past half year or so. I always thought that ‘depression’ was a recurrent state of ‘feeling down’, because that’s what I’ve read and talked about with people who were ‘feeling depressed’. And, indeed, out of the five different kinds of depression recognized by the medical community, a perpetual state of ‘feeling down’ is known as melancholic depression. It’s the most frequent one, and the one that most people typically associate with ‘depression’.
But it’s not really ‘just feeling down’, or, in other words, you may be ‘feeling down’ and not be depressed. The reverse, however, is way more strange, and therefore very hard to diagnose: with atypical depression you can feel great and happy almost all the time, but still be depressed.
The main difference between both is that melancholic depression does not react to any pleasurable things, even if they are clearly identified by the person as being pleasing. Say, someone might love chocolate, but during a crisis of melancholic depression, chocolate simply doesn’t give them any more pleasure. Because nothing gives pleasure to someone who is melancholically depressed, it’s easier to diagnose.
Atypical depression is not so rare as that. With atypical depression, there is only a limited amount of things that give the person some pleasure, but those things will never fail to make them happy. However, a strange thing starts to happen: for all other unpleasant things, the brain seems to ‘shut down’ and refuse to engage in them.
It’s very hard for me to explain how this works. In fact, it was only after I understood a bit about what was happening to me that I realized what it actually means to have a ‘mental disease’: it’s when your brain really is not working as it should, and you are aware of it.
Let me give you my scenario as an example. You might have read about ‘writer’s block’ (or, if you’re an author or artist, actually experienced it): when someone desires to creatively do something, but the inspiration is lacking, so nothing actually gets done. We might experience the same at work, or doing an exam, or something similar: the brain seems to ‘stop working’, and even if you know you should be doing something, the brain refuses to comply.
A similar scenario is getting tired or bored from a repetitive activity (say, going every day to work!), and it becomes harder and harder to push yourself to actually do it. We procrastinate, find excuses, blame other people (or the universe) just to postpone that unpleasant activity.
In my case, the atypical depression is mostly linked to my actual work, and strongly linked to my gender identity and crossdressing activities. The first case is easier to explain: when I try to do something that my brain recognizes as ‘work’, it goes blank. It stops. But it’s not merely being lazy: it’s simply that the brain refuses to do anything.
I can’t explain it much better than this. It’s more than aversion. It’s just that there is some part of ‘me’ instructing the brain to ‘go to work’ but it has no effect; like something that bounces off an invisible wall or barrier and refuses to go through it. I’m even aware that the barrier is there, and if I could just go over it or around it, I would be able to continue to do my job just as before. But somehow the trick to overcome the barrier eludes me.
What about pushing against the barrier? In fact, part of my ‘homework’, as established by my psychologist, is to force myself to do some work at least just for half an hour per day. You cannot imagine how hard it is — because suddenly the brain, feeling a ‘threat’ on that invisible barrier, starts sending false signals all over the body, which get interpreted as physical symptoms of illness. So I get dizzy, start hearing a buzzing sound, I get a headache, muscle cramps and so forth, and all those symptoms really feel as if they are ‘real’ and that I’m coming down with some sort of strange disease. The more I push myself to work, the more intense those symptoms become.
When I stop working, all the symptoms disappear as if by magic.
Now, I’m very used to psychosomatic diseases; as a kid, I would come up with imaginary ‘flu, which had all the symptoms of a regular ‘flu, except for high fever (that’s how my mother found out if it was imaginary or not). I still felt absolutely awful, and, as a kid, I hated the idea that just because I had an imaginary ‘flu with all the symptoms (cough, slightly running nose, muscle pains all over the body, extreme fatigue, and so forth) except one, why wasn’t I allowed to take some rest until the symptoms subsided. It seemed so unfair! As an adult, by contrast, I rarely tend to worry much about ‘known’ symptoms, because almost always they are imaginary. Unless I start getting new ones — I had three anxiety attacks which brought me to the hospital, because I was getting all those new symptoms I had never experienced before, and I certainly thought they were serious enough! They were not; they were just imaginary symptoms created by the anxiety attack (which, in turn, was connected to depression).
A very simple way to see that all these depression symptoms are ‘not real’ in the physical sense of the word is to look at what I do. My main line of work is to write academic articles and finish up a PhD thesis. This is not that different than what I’m doing right now on my blog: looking up references, formulating some ideas and hypothesis over them, and write. Write a lot. So essentially the difference is minimal — academic writing is more formal, of course, and I work on completely different areas — from the perspective of an outsider. Even for ‘me’ it seems pretty much the same.
But my brain thinks otherwise. It clearly tags and labels some activities as ‘work’ and blocks them; while others it tags as ‘pleasure’ and I have no problem in doing them. This is rather baffling from the perspective of outsiders — my behaviour is not consistent, and can be easily seen as laziness or procrastination — but also from my own perspective: why does my brain persist in tagging some things as work and others as pleasure, even if I know very well that such classifications are perfectly arbitrary? I mean, the actual activity is not different! Why does the brain insist it is?
That’s the reason why depression is a ‘mental disease’: the brain is not really working properly. I think it’s way more acutely felt with people suffering from an atypical depression, since, for all purposes, I can function normally in almost all circumstances: I can drive, I can do house chores, I can do shopping, I can go out and have fun with friends and family, and, in general, when doing all those activities, nobody really believes I’m ‘mentally ill’. My behaviour is pretty much the same as always.
Someone who is melancholically depressed is quite different: nothing is pleasant, so they engage in almost no activity whatsoever — they have even be pushed hard to get out of the bed, eat something, or take a bath, for example. But because all of us have ‘felt down’, for shorter or longer periods of time (say, after the death of a close friend or family member; after breaking up with a significant other; after losing one’s job…), those sensations and feelings are familiar enough. People just assume that instead of recovering from feeling down, depressed people will just continue to feel down for longer and longer periods.
That’s not exactly the case — because there is more to it — but from the outside, that’s what it looks like.
While the atypical depression is much harder to empathise with. Normal people don’t ‘block’ from doing certain unpleasant activities. They might need to push themselves hard to do something particularly unpleasing, but they will, in general, get over it. They don’t get physically ill when they attempt to do such activities. And once the unpleasant activity is over, they simply forget it, treat it as a memory, but go on with their lives. In my case, I cannot stop wondering about if this ‘block’ will ever go away, because it certainly looks like it will remain around for a long, long time!
My coping mechanism for depression
Melancholic depression can lead to suicide — so it’s a dangerous mental illness, and requires treatment. You cannot ‘cure yourself’ — a common misunderstanding about mental illnesses is the ungrounded belief that ‘time will heal everything’. It’s precisely the opposite that will happen: the longer a mental illness is kept untreated, the harder it will be to treat it.
In the mean time, until medication and therapy start having some effect (in my case, I’ve just noticed that the anxiety levels have reduced to normal levels; but the depression itself is completely unaffected, even after two months of medication), it’s normal for those who have atypical depressions to develop coping mechanisms. Remember, this means engaging in activities which actually are pleasant (unlike melancholic depression, where no activity is pleasant) and avoiding the others.
The most pleasing activity for me is, of course, when I’m presenting as a woman. There is simply nothing else which can compare to it (because I have such a low libido — even further reduced by the medication — I can even say that crossdressing is literally ‘better than sex’ for me). All other pleasant activities that I might engage in are just palliatives; merely tiny bubbles of ‘pleasurettes’ which keep me going, but they pale in comparison with the power of presenting myself as a woman — that trumps everything. And I’m keenly aware of that.
So much, in fact, that I cannot stop from thinking about it.
Of course that’s an exaggeration: there are some moments during the day that I might temporarily stop thinking about being a woman — for instance, when I’m deeply engaged in reading something that interests me, or when playing a computer game of some sort. But even the most mundane activities like brushing my teeth will invariably draw me to thinking about the next event when I’m going out, of planning what to wear, how to style my wig this time, what colour I’ll paint my nails, and so forth.
It might be shocking to think that my coping mechanism is basically vanity, and worse than that, a special kind of frivolous vanity that is related to the gender I identify with.
As explained elsewhere on my blog, my wife finds that a very chauvinistic and sexist position: I seem to mostly see women as happy party-goers, only worried about their clothes and appearance and how great they will look in public. Such definition of what a woman does is very insulting — the vast majority of women in the Western world have far more important things to worry about than that.
Of course my wife is right, but one thing is knowing that she is right, the other is feeling that she is right. Let me try to explain this a bit better…
If I were a woman, or living as one, I would very likely not worry too much about what I was wearing or how I looked all the time. I would be worried about, say, my work, for example. However, I would obviously also go out with friends regularly — there would be a ‘life outside work’ and ‘life outside house chores’ for me. That would mean I would also think about what to wear when going out with my friends.
What happens right now to me is that a) I’m not presenting as a woman full-time; and b) due to my depression I’m unable to work. Therefore, the only thing that I still have available in my life is the ability to go out with friends presenting as a woman. I know it’s somehow reducing and perhaps even insulting to say that women only think about work, house chores, and going out with friends. But the truth is that even men just think about that! I might even go as far as saying that most people — no matter what gender they are! — spend their lives worrying about those three things and nothing else.
Of course, we can split some of those things in more clearly-defined issues, but my point is that most of our Western society revolves around work, house chores, and pleasant events spent with friends and family.
As a male, however, I don’t need to worry about my presentation when having ‘pleasant events’ with friends and family; males can afford to be sloppy in most circumstances. Women, by contrast — and I can see the feminists yelling in the back row, ‘because of sexist values imposed by this patriarchic society!’ — are expected to do so much more.
As a transgendered crossdresser, I yearn to identify with women in all aspects. However, I’m limited to just one — the ability to go out with friends. I can say that it is most definitely the most appealing aspect of womanhood that attracts me; but I know hundreds of women who would agree with me as well (my wife would be an exception: she is a workaholic and has no patience for going to events with her few friends).
I don’t really want to enter into a debate on what makes a ‘real woman’ or not — that’s for the feminists to figure out, not for me. I’m just defending every woman’s right to go out and have fun with their friends, if they wish, and to ‘dress up’ when doing so — again, if that’s what they really want to do. This is definitely what I consider to be one of the most attractive things of being a woman. I’m not reducing the whole experience of womanhood to ‘going out with friends’ — there is an infinitely larger amount of experiences that are far more deeper and give a woman’s life some purpose. But I also don’t wish to simply shrug off the experience of looking great when going out with friends and saying it’s just vanity, it’s just frivolous, it’s just what the ‘patriarchal society’ imposes upon women, and so forth. Women actually have fun shopping. They have fun dressing up. They enjoy going out with friends. Why should such pleasant activities be stricken out of a woman’s experience, just because they are ‘not important’ and ‘frivolous’?
I have actually debated with my wife a lot about that. I don’t think that a woman is ‘real’ or ‘complete’ just because she dresses up and goes out with friends; there is so much more. However, I’m also not condemning those women who love to dress up and go out and label them as ‘frivolous’. I think they’re just being allowed to have a pleasant experience.
In my particular case, having access to that pleasant experience which women are allowed to have (even at the cost of being labeled as ‘vain’ and ‘frivolous’) is my own coping mechanism with my atypical depression. It’s the only thing that makes sense and gives me pleasure. Everything else — work, to be more precise — is a huge mess right now. And I can cope with normally unpleasant things like doing house chores and shopping for food and groceries, so long as these are seen as merely part of a life that exists, at this moment, merely for the purpose of having some occasional pleasant moments when I present myself as a woman.
Escapism or correlation?
At this point, it’s worth asking myself how exactly do I view crossdressing. There was certainly a time Before Depression, although these days (with the help of my therapist) I’ve still not figured out exactly when that was. I believe that I viewed crossdressing mostly as a form of escapism, because that’s what I read on those websites that it was.
Later I questioned that reason for crossdressing — I questioned my gender identity — and thought that there was ‘something more’. I couldn’t quite pinpoint it at first. Recently, a few of my friends have shown me the difference: among the non-fetishist crossdressers, there are clearly two groups. One of them perfectly accepts their male gender identity, but also feels they have the need to manifest their feminine side. They don’t want to stop being men, though — even if some of them are happily growing their breasts (yes, exactly) and undergoing similar radical changes to their bodies. They are the ‘happy crossdresser crowd’ — those who enjoy being crossdressed to the fullest, but at the same time, live their normal lives as men and are most happy about it as well.
And then there is the ‘unhappy crossdresser crowd’. Some of them are not so happy about their ‘male side’. They’re fine when they’re crossdressed, but ‘going back’ to live their lives as males is very frustrating. For some of them, this means accepting that they are transgender, and go ahead with some sort of transition. Others will remain unhappy and undecided — like yours truly.
I would say that both groups use crossdressing as a form of escapism which is tied to entertainment, well-being, pleasure, and so forth. There could have been other forms of escapism for them (watching TV, bowling with friends, etc.), but none is so pleasing as crossdressing. Escapism, by itself, is not a ‘problem’. It’s part of the coping mechanisms of the human species. Escapism can simply be reading a book, going to a museum, or watching TV: it doesn’t mean some sort of compulsive-obsessive behaviour or living in a BDSM dungeon, or, worse, joining one of those Virtual Reality environments (like Second Life®) to forget about their mundane existence and the daily grind.
Crossdressing as a form of escapism is even almost socially acceptable — so long as the public perceives crossdressing as not having anything inherently sexual, then it becomes practically tolerable. After all, football club fans also have abnormal behaviour, and they are accepted anywhere (unless they’re drunk!). Cosplaying might be odd in most circles, but it’s totally accepted in Japan, and slowly does inroads in the Western world as well. These are more extreme, odd ways of escapism, but they are, in general, much more tolerated — if they are seen as ‘escapism’.
But is it really only that?
It’s very hard to tell. A large number of the crossdressers I’ve personally met are definitely on the threshold between ‘merely escapism’ and ‘manifesting their true identity’. The dividing line is very small, and it can evolve either way; sometimes all it takes is a slight push in one of the directions, often triggered by external circumstances.
I cannot be absolutely sure that I was completely free from depression and anxiety when I started crossdressing, but I’ll put forward the hypothesis that this was, indeed, the case. And while the urge to crossdress became overwhelming, there was no way I could explain those urges. I didn’t want to live as a woman, after all, even if I sometimes fantasized about the idea — but it was just daydreaming, not a real goal, especially when I started going out with my wife.
At some point, however, the first symptoms of depression set in, and crossdressing became a form of escapism. It was not just pleasure for the sake of pleasure, of experimenting new things, new feelings and new sensations. It was the feeling of ‘being right’ in a certain way: of creating the illusion that, at least for a little while, I could be the person I always wished to be. My favourite phrase of that period was: ‘in the Western world, we are free to pursue whatever job and career we want, we can adopt whatever expression of our personality we wish and nobody can stop us unless we do anything illegal. The only exception is that we cannot cross the gender barrier — that’s the only experience that is off limits’. I found that very sad, because among all possible careers and personalities, the only one that attracted me was exactly the forbidden one — I could not be a woman, at least not in the same sense that I could be a rock star one day or a lawyer the next, or dress like a yuppy this month and as a hippie next year.
As the depression progressed, even without my being aware that it was really ‘depression’, I questioned my gender identity more and more. You can see this on my recent posts: in the past years, I have struggled to figure out where the dividing line between ‘transgendered’ and ‘crossdresser’ is, and developed many theories to explain it. It’s clearly a continuum — but how do we know where we are in this continuum? One of the reasons I also turned to therapy was to try to get some help in defining myself inside this continuum. It seems that I was a bit naïve: psychologists will not diagnose people as being ‘transgendered’. The best they can do is to lay out the options and help us to choose a label that fits us, and, depending on our choices, propose the correct therapy to deal with the choice. But ultimately there is only one person who can know what we are, and that person is ourselves.
So looking back at my ‘evolution’ along this continuum, what I can observe is that the more depressed I get, the more I question my gender identity. It’s rational, therefore, to assume that both are correlated. But that’s not exactly a good sign. Depression is a mental disease, which, as I have explained, makes our brain to work differently, and that’s not necessarily a good thing. So what I can say is that my altered brain condition pushes me to question my gender identity more and more. Right now, the medication is not helping. Rather, after the past few months, my doubts have only increased, and there is no real progress regarding the depression itself. I crave presenting myself as a woman more and more, and it becomes harder and harder to control those cravings and urges. In fact, I deliberately stop myself from crossdressing, and I get some satisfaction of still being able to cling to a bit of sanity that allows my rational mind to prevail over my raw feelings. But for how long will I be able to maintain that sanity?
Already I spend all my time, except for some occasional distractions, deeply thinking about crossdressing. I will write another article about my growing boobs as another typical example of irrational thought being manifested physically. But what it seems to me is that once I was diagnosed as having a mental illness, albeit one that is treatable (depression can take a long time to be treated, but it’s definitely curable), there was something that went ‘click’ inside my head: I no longer felt the urge to lie to myself. I have to admit that I love thinking of my presentation as female all the time. It’s totally obsessive and consumes all my conscious thoughts, but I love it. I don’t even ‘suffer’ from it — the medicine I’m taking against anxiety means that those obsessive thoughts do not trigger anxiety, or, if they do, it’s really very subdued. It gives me pleasure. In fact, it’s the only thing that gives me pleasure!
You know how we, as kids, always tried to imagine how it would feel to be insane? What do insane people think? What do they feel? Do they see all the world as being insane, and they are just the sane ones? I definitely asked all those questions, but obviously I had no answers.
Now I have. My particular kind of insanity pushes me to believe that I can spend the rest of my life crossdreaming, and that nothing else really matters. Of course, reality is going to hit hard on me: jobless, without a regular source of income, and having a wife to support, and now stranded for at least another half year at home to ‘recover’ from depression, it’s clear that all this crossdreaming is nothing else but a coping mechanism for depression, a delusion I create for myself to be able to deal with it, but which serves no other purpose but escapism. I’m not happy being depressed and being unable to work: nobody is. The coping mechanism is trying to get some happiness somewhere, and my delusory thoughts regarding my gender identity and the crossdressing is what keeps me going, because these are such pleasurable thoughts. However, they don’t lead anywhere. I can’t go on like this, and I’m aware of that, at a rational level. But my brain is not healed; it persists in its irrational belief that, somehow, my life as a crossdresser, or even as a transexual, would be so much more interesting and pleasurable than my current life.
What will happen after the ‘cure’?
There are some interesting reports in Lawrence’s book, no matter how wrongly she chooses to interpret them. In some scenarios, she postulates that transgendered feelings in MtF transexuals are actually triggered by testosterone. Once those individuals begin transition, those feelings diminish, and they don’t feel the urge to transition any longer. So they stop the hormonal therapy — which, in turn, will trigger their desire to transition again, and this cycle goes on and on. Lawrence actually recommends to lower the doses of the hormonal therapy — it will take much longer that way, but it means that the desire to transition will persist at a stable level.
I sometimes fear that something similar will happen to me — that after the medication kicks in (it will take a few more months, according to the psychiatrist), and as therapy progresses, I will no longer doubt my gender identity, and will possibly feel happy in remaining male, all the time, until the end of my days. I might even stop feeling the urge to crossdress again.
In a way, I will regret that; and at some subconscious level, I actually fear that this might happen. I don’t want to lose my feminine side. On the other hand, I definitely want to cure the depression. Even at the cost of losing my gender identity as female?
At this point someone (or even myself, a couple years ago) would step in and say that gender dysphoria is not ‘treatable’, and of course we have a vast body of medical research showing that this is indeed the case. However, there is true gender dysphoria, and there could be something else: self-delusionary, psychosomatic gender dysphoria, triggered by other reasons (like depression). In other words: if the brain is not working properly, and, in my case, since I’m so prone to psychosomatic diseases, how can I know that I’m not deluding myself in believing that I’m gender dysphoric — when, in fact, I’m not, but merely believe that illusion because my brain is not working properly?
Consider paranoia, another mental disease. A paranoid individual will see enemies everywhere and fear everything they see, creating an alternate reality in their minds of a universe that is ‘after them’. But paranoia can be cured. Once that happens, the individual will suddenly realize that all those ‘enemies’ didn’t really exist, or, rather, the persons would be there, of course, but there would be no rational reason to believe they were ‘enemies’. So this is a typical case of switching perceptions: change the perceptions, and the whole world will (literally) change.
I have to consider the possibility that my belief in my gender dysphoria is just a question of working under delusional perceptions. These might be correlated to depression. If the depression gets cured, then my perceptions will change. I can already see how my perceptions change thanks to the medication against anxiety: things that irritated me (like the cats doing their antics and destroying half the apartment) now just make me smile or even laugh. That’s because my perceptions changed. The cats (to give that example) are not suddenly behaving as cute little furry animals that are endearing. They still behave as the semi-feral, semi-domesticated beasts that they always were; in fact, as they grow older and stronger, they might even be more devastating than ever. It’s just that my perceptions changed: now they don’t irritate me any longer, thanks to the medication.
Possibly the same might happen once the antidepressants kick in. I might not only acquire the ability to work again, but, at the same time, a lot of other things will give me pleasure besides crossdressing. And, at that moment, there will be no further point in seeing crossdressing as a form of escapism. It might just become a hobby. Or I might drop it completely and not have any regrets. To be honest, I have no idea what will happen. The only thing that I know is that I’m being drugged to get my brain to rewire itself, hopefully in a way where the depression disappears.
But what else will I lose in the process? I dread the answer to that question.
Of course, the reason why I’m being followed by a team of experts in clinical sexology is that if I’m truly gender dysphoric, the depression will get cured, but it will have absolutely no influence in my gender identity. And in that case, this will need to be addressed separately. And it might mean going much further and taking much more dramatic measures than I have ever considered before.
So, in a sense, right now, I live in the best of all possible worlds (or would live, if I was free from financial pressures!): I dream about being a woman all the time, I go out with my friends as much as I can (or am allowed to), I can enjoy the pleasure of thinking only about that — and not worry about anything else, since I have a legal and medical excuse for ‘resting’ — and, at the moment, there are no consequences, and no hard decisions to make. I can go on like this under the pretext that I’m not cured, so I’m allowed some slack. But like all pleasing things in this universe, at some point this will stop: I will need to face the naked reality, once I’m cured of the depression.
And at this moment all I know is that it can go either way, but I don’t know which way it will be.