Homework towards a cure

There are few things that are more boring than anyone constantly lamenting about their illnesses and diseases. With that in mind, I have just one purpose with this article: to eventually help out some fellow transgender people to recognize some of the symptoms, get encouraged to seek professional help, and have an idea of how the actual process of cure develops.

The mysteries of psychological therapy

I have to humbly confess that this is the first time in my life that I ever went through psychological counseling. Even though at least one third of all citizens in my country have some sort of depression (even though the vast majority merely has the mildest form of depression), there is still a relatively strong social stigma against people looking for psychological therapy. It comes mostly from a misunderstanding and lack of information on what ‘shrinks’ actually do: people still believe that psychiatrists give patients medicine to ‘dumb them down’ (essentially turning them into apathic, vegetable individuals), hooking them on expensive, addictive drugs, while psychologists ‘put ideas in their mind’, essentially ‘brainwashing’ them in order to turn them into different persons. As such, psychology almost looks like some kind of religion, sect or cult, and viewed with suspicion because they are ‘legal’ and have access to drugs that religious leaders don’t have.

I know that all the above is silly for a citizen of the 21st century in the developed world. But old habits die hard. Obviously I have no such qualms; I tend to be overenthusiastic about the ‘miracles’ that modern medical science are able to achieve. While I don’t reject the existence of malpractice, or of ‘greedy doctors’ that only see their job as a way to make a lot of money, in partnership with Big Pharma in a huge conspiracy to keep us citizens in constant dependence of our current health systems, in reality I know that all this is just marginal. In all jobs there are a few rotten apples and black sheep. But the vast majority of people — and that certainly includes doctors! — are qualified professionals, experts in their field, and have actually the desire to really cure their patients.

As such, when it was clear that I needed professional help, I had no hesitations and no doubts that I would get access to the kind of help I needed. Some of my friends raised a few eyebrows, still influenced by the stigma of what ‘shrinks’ were about to do with me, and tried to warn me to be cautious. Looking backwards, I see how silly that attitude actually is. But it certainly explains why a lot of people don’t really trust their mental doctors (be they psychiatrists, neurologists, psychologists, psychoanalysts or psychotherapists…). At the beginning, when they start seeing some effects from the administered drugs, and during the phase where the therapist is trying to establish a ‘bond’, earning the patient’s trust, the patient feels that ‘something is working’ and feel encouraged to continue. But at some point, the real work has to start — and this might happen only after weeks or months of therapy. That’s the moment when you have to face your issues and start dealing with them.

This is extremely hard to do.

At that turning point, most people I know give up therapy. They expect, somehow, that the ‘cure’ involves the therapist patting your back and just tell you how great you are and how much better you’re feeling, and what an amazing person you are once the medication starts having an effect.

But it’s precisely the opposite that happens. At some point, you will realize with your therapist what is really affecting you. And, in conjunction with the therapist, you will see what your options are: you are able to go through one of two possible paths — towards the cure, which requires a lot of hard work, or give up, and continue to suffer from what ails you (possibly forever in a chronic way).

It requires a lot of trust in one’s therapist to travel the ‘right’ path. And, to put it bluntly, if it were easy, then you wouldn’t need medical help at all: you’d do it on your own. It is because it’s so hard that you need the help. But it also means changing your attitude towards yourself, and understand that the cure is within your reach, if you just trust the therapist to lead you through that hard path ahead, even if it often is scary.

My turning point

After summer, being a bit over half a year on medication, I started to feel a bit discouraged. I had attempted a few simple techniques to alleviate the symptoms of depression, but they didn’t really work. There was a bit of disappointment in the way our therapy sessions were held.

Being a ‘newbie’ in this area, I really didn’t know what exactly to expect from those sessions. One strange thing is that most people never talk about what happens in their sessions. My own wife went through a melancholic depression back in 2007 and did several years of therapy (she was pronounced as ‘cured’ after some three years or so, but still continued her sessions for a while longer). She never told me exactly what she did on the sessions. I was obviously curious, but it was clear that she didn’t want to talk about them — except for some minor trivia once in a while.

So on my very first session I was a bit confused of what was expected from me. Having asked for advice from transgendered people who went to the same hospital as I do, I knew that at the very least I ought to write my autobiography. As you might expect, this came out to be a 200-page-long book, where I tried to fit in all major episodes in my life that I still remembered, including, of course, all of those which were related to crossdressing, my urges, dreams, and desires, and what I saw as my motivation to go through all the effort to look presentable as a woman in public. I also addressed everything I could remember about the symptoms of depression, and why I thought I had an atypical depression, which is so hard to correctly identify. My poor psychologist, of course, didn’t have the time to read all 200 pages. So my first sessions were mostly talking about myself.

I expected questions, to which I was prepared to answer in some way, having sort of gone through them mentally weeks before the first appointment. I was also expecting some kind of test, to diagnose my mental condition — some of my friends told me how they were subjected to long tests of over 500 questions (!), taking a whole hour to answer, and which somehow ought to give the doctors an idea of one’s profile. And I was also expecting some hints on how I could ‘fix’ myself — some kind of ‘homework’, some technique or ‘trick’ to help me deal with depression, because I was aware that my own wife was given such techniques and applied them quite successfully.

There are many schools of psychology and many methods of therapy. The hospital I go to adheres to the idea that patients should not be ‘labeled’, fit into tiny little boxes and tagged for their mental diseases, and then go through an established protocol to get cured — like it happens with the non-mental diseases. Instead, each case is dealt with individually. I have at least three friends that went to the same institution, and each had a completely different process. One was desperate to go through transition, and since the doctors delayed her process — apparently deliberately! — she completely lost her patience with them and went to a different hospital (where she finally got what she wanted, after ‘wasting’ a year). Another had to face on her first appointments a battalion of different doctors — psychologists, psychiatrists, endocrinologists, general practitioners, and so forth. She told them what she had in mind, and what was worrying her, and they made notes and asked a few questions; finally they assigned her to the appropriate therapist. And another one had her first appointment with the head of the psychology unit and a general practitioner, told them she wanted to become a woman full time, and their answer was to start making appointments every other week, telling her that ‘they didn’t want to have her spend a lot of time at this institution’ and even starting to look for dates for surgery. At this point my friend told them to go easy on her! She wanted transition, yes, but it didn’t need to be that fast — she was well prepared to wait 3, 4, 5, 6 years, whatever it took, to do it with confidence and certainty.

My own case was much less interesting. There was a psychologist appointed to me. She mostly listened to what I said without interrupting much. She wanted to know if I wished to be a woman. I said that my priority was getting rid of the depression first; full transition, however, requires being able to have a source of income afterwards, but in my country there are no jobs for transgendered people. Even though therapy and surgery are free (hormones are sponsored, but not totally free), the truth is that, once you transition, you will lose your family, your friends, your job, and any means of supporting yourself financially in the future. I honestly admitted I wasn’t prepared to do all of that! So she scribbled some notes, got me an appointment with the psychiatrist, and that was pretty much it.

The next few sessions were not much different. I would basically just talk about whatever crossed my mind. I started doing some sort of diary, making sure that I wrote down the questions I wanted to ask, or some doubts that I had regarding my condition, as well as somehow detailing any progress I made in fighting depression. Once in a while, my psychologist would suggest some way to deal with depression: this was my homework. First, it required sitting down every day and write one line about my current work (I’m doing a PhD). At the beginning, it worked out for a couple of days. But quickly it was clear I couldn’t even keep up with that.

Now I have to open a parenthesis. Depression is very, very hard to explain to anyone who hasn’t been through clinical depression. At best we can try to use some metaphors. I’ve previously explained that it has little to do with ‘feeling down’ or ‘being sad’, even though this also happens with melancholic depression — the most common and widespread type of depression. In my case, I rarely ‘feel down’ or ‘sad’. I’m usually happy and in good spirits. It’s simply that I cannot do anything related to what I label as ‘work’.

From the outside, this just looks like pure, simple laziness and procrastination. And, in fact, the usual reaction is for people to tell me, ‘snap out of it!’ or ‘you have to make an effort!’ That’s precisely what happens when you’re clinically depressed: you cannot ‘snap out of it’, even though you fully understand (rationally) that this is what is required. But it doesn’t work. Somehow, you have lost the ability to ‘snap out of it’. The whole notion of ‘effort’ suddenly becomes overwhelming. It’s like trying to swim in mud: with a tremendous effort, you’re able to make some progress, but it requires so much effort that you are unable to do it at all.

With melancholic depression, everything requires that kind of effort. Atypical depression is way strange, because there are certain activities that require a huge effort (probably way more than what happens to people with melancholic depression), but there are some which are absolutely effortless and therefore very pleasureable. In my case, everything related to presenting myself as a woman is not only effortless, but gives me great joy. However, nothing else matters much. I label most activities as ‘neutral’ — things I have to do, which are neither hateful nor pleasurable, like going to the laundry or shopping for food. But even going out with friends in ‘male mode’ is one of those activities: sometimes, the effort is too great and I simply lose the incentive to join them (by contrast, if any of my crossdressing friends texts me wanting to go out, I run to the bathroom and start applying makeup!). And then there are those activities where no matter how much effort I put into them, it simply doesn’t work. In my case, anything related to my job as an academic student falls in that area. To give you an example, writing a few thousand words on my crossdressing blog is something I enjoy tremendously and can do it for hours, without getting tired, annoyed, or feeling discouraged. By contrast, writing 7,000 words for an academic article — something I used to do in about two weeks, sometimes less — can take me almost one year.

Even my wife has trouble understanding how atypical depression works. When she was at the peak of her own melancholic depression, before getting professional help, she was also unable to do anything (including work). But as soon as few months on medication and therapy elapsed, she quickly managed to work up to two hours, every day, and progressed slowly back to her usual schedule, which is about 12-16 hours of work per day (yes, really). In my case, after ten months on medication and therapy, I’m still unable to write a line per day. Some days I might be able to write one or two paragraphs, then days go by until I’m able to pick up some resemblance of ‘work’ again. It’s really different and very hard to explain. And it’s also confusing for my wife, since she sees how much energy and effort I put in my crossdressing activities, and how much joy and confidence they give me, while I’m apathic towards everything else.

My therapist, of course, is much better acquainted with the complexities of treating atypical depression. So when that ‘trick’ failed, she suggested something else: if I got a lot of energy from crossdressing, why didn’t I dress every day, and did some work at the same time? Later, after doing a few hours per day, I would be entitled to a ‘reward’, like going out with my friends.

This suggestion, as written on a previous article, completely baffled me. But it actually worked! Strangely enough, work doesn’t seem so ‘repulsive’ when I’m dressed, and I actually managed to follow up on her suggestions for a short while. Alas, the way my wife organises my life quickly prevented me from keeping up with that method. I admit I got a bit frustrated and confused about all that. Somehow, there was this hint or suggestion that my brain is able to work ‘normally’ again if I’m in the gender role that I identify with. This should probably not surprise people much — after all, it’s supposed to be a part of being transgendered — but it messed me up quite a lot, and made me think about what it really meant.

In effect, I asked my psychologist on the next session about what that would entail for the future. Suppose that I lose all ability to work as a male, but have no problem in working as a female. Of course, 99.999% of my current work in the PhD is done remotely, at home, and I don’t need to meet anyone. So it’s reasonable to admit that, if I could dress every day and have enough time for myself, I could finish the PhD that way. But what would come next? The whole point of doing the PhD is to be able to get a job as a teacher, as with my age there is little prospect of getting any other kind of job in my area. But in my country there are no transgendered university teachers. So what would be the point in ‘dressing up for work’ if at some point I would really need to be able to work in male clothes again?

To that my therapist was peremptory: ‘Stop worrying about the far future! Who knows what will happen in the future — nothing is certain! Focus on the here and now!’

Well, of course, as a Buddhist, that makes a lot of sense. And thanks to the anxiolytics I’m taking, it was easy to ‘stop worrying’ about the future in that way. In fact, the class of anxiolytics I’m taking, which are relatively new drugs, designed to fight completely different causes but working surprisingly well in cases similar to mine, I definitely worry a lot less about things. Or, rather, I worry at things from an intellectual perspective, not an emotional one. I know that there are things I ought to ‘worry’ about, but, unlike people who are not on medication, that ‘worrying’ is purely intellectual and has no anxiety emotions attached to it. While this feels ‘strange’, it also allows me to look at all sources of ‘worry’ with detachment — and that means that almost all problems and obstacles seem pretty much insignificant that way. All that without feeling ‘sleepy’ or ‘drowsy’ — these new-generation drugs work quite differently! Somehow, I know that this is what a very good Buddhist practitioner feels all the time, without the need of drugs of any kind. I cannot explain the amount of relief that provided me! (one less problem — good-bye, anxiety!)

But after summer I somehow expected that the same would happen with the depression as well. It’s a different kind of mental condition, though, and one that is not so easily ‘shaken off’ by drugs as anxiety. In a sense, what I was noticing was that the few tricks and techniques that my psychologist had given me weren’t having any effect — I blamed mostly my very complex daily schedule, which prevents me from having the freedom to do things according to my wishes — and, in a sense, there was a sense of frustration that after so many months of medication and therapy I wasn’t seeing any real improvements. In fact, things even seemed to get worse, and this also made me ‘worry’ again about the future: maybe I had to change medication and start again from scratch?

While ‘complaining’ about that to my psychologist, talking about all the unsolved issues so far, and how I was noticing little progress, and feeling frustrated about that, there was a turning point with her answer. She actually smiled at what I was saying. And she answered: ‘No, you’re not worse. What happened is that now you realise what your problems truly are. And now that you have to face them — and know what you have to do — you’re finally aware of the tasks ahead of you. And that’s why you feel the way you do. Earlier this year, when you started therapy, you had no idea of what was causing your depression, and therefore this ignorance made you more confident that things were easier to deal with. Now, after counseling and medication, you are fully aware of what is ahead for you. Now the real, hard work really starts. But that means that you’re actually better, not worse, since now there is awareness of your real issues.’

As usual, this made me stop my endless chatter for a minute while I digested her words. And that certainly lighted up a few bulbs above my head. ‘But it’s so hard!’, I exclaimed.

‘If it were easy, you wouldn’t need to be here,’ my therapist told me. And, of course, once again, she was totally right.

Learn to say ‘no’ to others

Just say NO!So what are the (many) issues I have to deal with?

Let’s start with the easier ones — not easy for me, but most people would consider them absolutely trivial.

The first one is to learn to say ‘no’. Since my earliest memories, I was taught to be available for others, and not to be an egoist, but someone who is always happy to help others in some way. During all my life, I put the interests of others above my own. I could, of course, do a long, long list of examples; there are simple things like letting people take my place on a long queue, to more complex ones where I gave dozens of thousands of Euros to ‘friends’ who ‘needed’ that money much more than I did. It’s not merely generosity. The root of the issue is a false belief that others are ‘more deserving’ than I am, and that I ought to be ‘lucky’ to get some scraps and leftovers. So this has to do with my self-image: because I always feel that I’m ‘less worthy’ than everybody else, I put their interests always above my own, even if that means seriously harming myself (not physically — I’m no hero! — but in the many aspects that have to do with my daily life).

Everybody’s ‘excuses’ to get access to things are always ‘better’ than mine. All the ‘problems’ that others have are far more serious than my own — from illnesses and diseases, to financial issues. In a sense, I’m seldom comfortable of talking about my own issues, because everybody else’s are so much more serious, that I feel ashamed of bringing up my own things as well.

But other people’s priorities are also much more important than my own. I can always wait, delay, procrastinate, or give up on things — the needs of others must come first, because they are so important. That’s truly what I believe in, and I act accordingly. I have done that for all my life, so that I always considered it to be a trait of my personality (it isn’t, but I have just learned that very recently).

Now this has two consequences. One is more pragmatical: people routinely abuse me — not only in my time, but I’m the natural target of anyone wanting to cheat me (from professional crooks to institutions like… banks). It’s very hard for me to understand when someone’s ‘needs’ are ‘real’, or if they’re just taking advantage of me. In most cases — I’ve learned in the worst possible way — they were really just taking advantage of me, but I just realized it too late.

The other consequence is more subtle. If you read about depression (all kinds), you’ll see that clinically depressed people almost always feel absolutely worthless compared to others — which often leads to suicidal tendencies. Now it makes sense to believe that this doesn’t happen from one day to the other. Instead, in my case, this was an accumulation of a natural tendency that I have for decades: it’s because I conditioned myself to believe I’m much ‘less worthy’ to others that this typical trait of depression emerged. That took decades of doing the same thing over and over again, until finally my poor brain gave up and started believing this to be ‘true’, triggering depression.

Now, what’s the ‘way out’ of this? It’s simple: learn to say ‘no’. Learn to understand that my own needs are more important than those of others — in most cases, but most especially while I’m depressed. Because putting the needs of others above mine will continue to keep me in a state of depression, I have to make others understand that I cannot go on like this. Now I truly need to break this ‘loop’ that just keeps me feeling ‘less worthy’. Once I’m able to do that with everybody, I’ll be happy.

So where is the problem? It should be simple, right? Well, no, for me it isn’t. I can’t say ‘no’ to everybody. For instance, I cannot say ‘no’ to my wife all the time; we live together as partners, and that means that I cannot do whatever I wish — there are compromises to be settled among us. Sometimes it’s her time to say ‘no’, and sometimes it’s mine. With my demented father I cannot say ‘no’, either — if he has some need or problem, I have to deal with it, no matter how much it disturbs me (one of the many triggers of my depression comes from my sadly departed mother having left her demented husband for me to care for — since my brother doesn’t live near enough to deal with most issues). And there are obviously a lot of examples like this.

When I told my dilemma to my good friend Erin Swallows, she made the following suggestion: create a list of the Top Ten people to whom I won’t say ‘no’. Anyone off the list should simply be ignored. Of course, Erin went on, she was expecting her name on the list 🙂 That’s exactly the problem: everybody agrees completely with me on this issue, and gives me pretty much the same advice: say ‘no’ to everybody else but not me!

So my homework is to slowly learn to say ‘no’ to pretty much everybody, on little things at first, and work towards more complex ones. It’s a good training, even if it’s something that totally rubs against my grain. But I know I have to work hard at that.

Sometimes it’s really, really hard to do so. On a recent episode, I had to say ‘no’ to a friend who wished me to pick her up at home to go out with us to a bar. It was already way too late for that. Under normal circumstances, I would have felt pity towards her, since the place she lives is not a good neighbourhood, and it’s dangerous for her to walk around by night — and find some sort of public transportation. It’s far safer to get picked up in a car at her front door. But I had to do train to say ‘no’. I can tell you that it left my nerves in shatters. I sweated profusely, I trembled, my voice quavered, and all I thought was that I wanted to go back home and take the anxiolytic pill as soon as possible. I drove home in a queasy mood, feeling horrible about myself (later on, I had to profusely apologise to her). But I did it, and yes, it was that hard for me — 40+ years of conditioning leave deep marks in the grooves of my brain.

Don’t wish to please others just to make sure they don’t get angry at me

This is related to the previous issue, but the scope is a bit wider. One of the reasons why I have such difficulty with saying ‘no’ is that I worry that people will get angry/disappointed at me when I don’t do things that please them. Again, this comes from long conditioning. My parents were not really terribly strict, and I didn’t get physically abused by them — and even verbal abuse was rare, even though it was always deserved 🙂 Nevertheless, I guess I had a terrible attitude towards ‘authority’, in the sense that I dreaded doing anything wrong and get yelled at. Over time, this became another trait of my personality: training myself very, very hard to only say and act pleasantly towards others, anticipating their needs, making life easy for them, so that they never got angry at me.

While this sounds actually quite rational to me — wouldn’t the world be a better place if we had more empathy towards others? — the truth is that it degenerated into what the psychologists call interpersonal rejection sensitivity. I’ve alluded to this on a previous article; to summarize, quoting Wikipedia, this is ‘the tendency to “anxiously expect, readily perceive, and overreact” to social rejection’. Interestingly enough, it’s one of the symptoms commonly associated with atypical depression (but not with melancholic depression!), and it was actually one of the hints I had towards self-diagnosing my own condition. I always feel anxious with social rejection in all scenarios — even with people I’m very intimate with. Even with my wife! Especially when she’s in a moody day, I’m especially anxious never to get her angry. Sometimes, the only thing I can do to make sure she doesn’t vent her anger at me is simply to remain silent for hours and hours. She doesn’t mind that at all, while she certainly lashes out at me if I say something ‘wrong’. I obviously have similar experiences with lots and lots of people. In a way, the main reason why I get along with so many different people — even those considered perfectly obnoxious by others — is that I put a lot of effort in never ‘saying anything wrong’. Sometimes I get accused of hypocrisy, or simply of not being sincere enough. There is for me a very fine dividing line in being sincere and offensive; I can always be sincere without offending anyone.

However, one thing is being polite towards others. The other thing is being always anxious about saying anything wrong. In my case, obviously I have long ago crossed the line beyond politeness, never noticing how this constant checking on myself was hurting the way my mind works.

Here, the housework is simple: it’s stop worrying so much if others dislike what I say and do. I’ve been doing that a little on Facebook for training — deliberately provoking others with my not-so-politically-correct opinions. Some will hate me for that. I have to learn to live with that.

Stop worrying about what others think about you!

Who caresYou can see how all these things are connected: one of the reasons for interpersonal rejection sensitivity is that I worry too much about how others see me and what they think about me.

Where is the source of that worry? Well, we cannot read minds; so we create perceptions about others by evaluating what they do and what they say. We correlate their behaviour in different circumstances and see if it’s consistent. By doing that, we create an image of their personality in our own minds.

Therefore, I try to induce the ‘correct’ image of myself in others by acting and talking according to my own self-image and the way I wish other people to perceive me. But that never works. In fact, we all have our perceptions biased or filtered according to a wealth of knowledge we have acquired — no two persons will create precisely the same image of a third person, because those two persons are different. So even if they are seeing exactly the same behaviour, they will nevertheless create two slightly different images of that same person. Sometimes the ‘slight’ difference is enough to get radically different opinions: one person might love what they see, the other might hate it, even though the person may have acted in exactly the same way in that occasion. It’s the perceptions that change.

You cannot change other people’s perceptions — that’s impossible. However, that doesn’t mean that you can hopelessly try and try — and fail all the time. Most people will not think twice about it. Others, however — myself included — see that as a terrible source of anxiety.

I wish to be accepted by others by the way I am, not the way they think about me; but I cannot change their perceptions; so this is one of those unsolvable dilemmas, and, in turn, because it’s unsolvable, it creates anxiety … or even depression. There is something of the need to control other’s perceptions of myself that creates an obsession to please. But you simply cannot please everybody, since everybody will have different perceptions. Even one’s obsession to please can be seen as obnoxious by some, although the intention was to be virtuous.

There are many ways to deal with this, but in my case, nothing is more important than crossdressing. Almost every crossdresser (I have never met an exception) is ‘afraid’ of going out in public for the first time, because they will worry about what other people will say. With time, and repeated expositions to the public, that ‘fear’ lessens. At some point, something gets triggered in one’s head, and one loses all worries about what others will think. Here, I think, I made some progress. I still worry at the moment when I leave my home dressed as a woman — not because of myself, but because of my wife, who is anxious about the neighbours ‘finding out’. After that moment, however, I’m completely careless about what others think. I used to worry about ‘not passing’, but these days, I don’t even worry about that — I guess it’s mostly because of the fantastic experiences when going out in public I have had.

Sure, some people glance. Some snigger and make some rude comments or at least a few jokes. Others look surprised and shocked. But the vast majority of people I’ve crossed on the streets and public places totally ignore me — and I’m not easily overlooked, since in my heels I’m almost 1,90m tall, a giant among women in my country. But ‘being ignored’ is the best ‘remedy’ for my problems about what others think about me. In fact, it’s actually curious, but I worry far less about what others think about me when I’m dressed as a woman. I cannot explain why.

Of course, the biggest hurdle is yet to come. At some point, I will definitely need to ‘come out’ to my close friends and family. In some dark and mysterious way, I have encountered the most tolerant and LGBT-friendly people on the planet in my meanderings dressed as a woman, but, strangely enough, all my friends and family are the exact opposite. I find it very encouraging that so many of my crossdressing friends actually have ‘come out’ to close friends and sometimes even family, and have encountered nothing but encouragement. Yes, some mild surprise at first, as they notice how totally different they look; but afterwards they are really quite open and tolerant about it. In fact, I have met several of them — they are so open and tolerant that they don’t mind going out in public with us.

Ironically, my own close friends and family are at the extreme opposite spectre of tolerance. Even those that might publicly support things like gay marriage or something similar, act completely differently when it is actually something they have to deal with (as opposed to watching it on TV). This makes my choices hard. The sole exception, of course, is my wife. But I have to truly be able to ‘come out’ and say something like: ‘Look, guys, I’m transgendered. I can’t do anything about it, except perhaps transition. Learn to deal with it. If my presence is so utterly unbearable to you, then good-bye, you were not really my friend after all, and I couldn’t care less about what you think about me now.’

Unfortunately, I’m a long way from ever being able to say something like that. I require some ‘baby steps’. There are two or three people in my circle of acquaintances that may be tolerant enough to at least read about ‘transgenderity’ on Wikipedia and try to understand a little better what I’m saying. These may be a good place to start. But, as yet, I haven’t done anything of the kind. The only people that know about me are, of course, the rest of the crossdresser community that knows me personally, and pretty much every woman’s shop or salon where I’m a regular customer, as well as the bars and restaurants where we usually hang out together. But these don’t really count. For me to overcome this hurdle, I will need to address those intolerant people in my close circle of acquaintances and family — those are the ones that truly matter, and by being able to ignore what they think about me, I’ll go a long way towards healing my depression.

Too much repression and suppression of emotions, feelings, thoughts…

One of the first questions that my psychologist asked me was when I started crossdressing and worrying about my gender identity. While there were certainly some episodes from early childhood, I cannot pinpoint them exactly in time — my memories are too vague for that. The first conscious and deliberate step towards crossdressing happened roughly two decades ago. My psychologist was shocked and asked me why it took so long for me to seek professional help? I was at a loss of words at that.

She obviously understood the issue perfectly: my gender issues are something that I have deeply repressed for decades and decades. These days, kids have it much easier: they have the Internet, and they can quickly come in touch with others who have the same issues, even if they are perfect strangers. In my time, however, there was no Internet, and no way to get access to information. I had no idea if I had gone mad, and, in that case, I might have to talk to a doctor about it, but there was no way I could figure out what kind of doctor I needed. There was no way to ask anyone — friends, family, teachers — about ‘transgenderity’, since I didn’t even know what that name meant. I had only vague ideas about homosexuality, and ‘crossdressing’ was not even part of my vocabulary. I was mildly aware of female impersonators, but had no idea where they would hold their shows, although once in a while they would pop up on television (but back then they wouldn’t give their Twitter or Facebook accounts to contact them, since the Internet didn’t exist).

I was, however, lucky in a way. While I had to repress all my feelings and emotions since childhood to young adulthood, twenty years ago there was an Internet — the Web had just started to become popular, and yes, there was some information about crossdressing and transexuality. While we didn’t yet have the full range of social media we have today, there were already discussion forums, chatrooms, and even instant messaging systems (remember ICQ?). There was email, and there were a few — very few — online shops catering to the crossdressing and transgender communities. There was even far less discussion about sex and fetishism (yes, really) but much more about how crossdressing is something ‘perfectly normal’ being done by ‘millions of males everywhere in the world’ for all sorts of reasons. Some academic work of the 1990s was also slowly appearing online — since almost all universities in the world already had some form of Internet access — even though full articles were usually not widely available. But you could get snippets here and there. You could look things up. You could join ‘online crossdressing communities’ and ask questions and learn.

As a result, at least I could stop repressing and hiding those emotions and feelings from myself, and stop suppressing what I was, but just embrace it, accept myself fully, in the confidence that I didn’t need a straightjacket and electroshock therapy, but could lead a perfectly healthy and normal life — while still being a crossdresser. That was a big step!

Nevertheless, as time goes by, it gets harder and harder to repress those feelings from everybody else. Recently I had some dinner with my mother-in-law, and as I’m so fond of saying, she dresses exquisitely well, with a great fashion sense. That particular day she had a pair of classical black high-heeled pumps, and my first reaction was to say: ‘Oh, I have a pair almost exactly like that!’ I just checked myself barely in time!

There is a huge tension between the urge to ‘come out’ to everybody, and the more reasonable and socially acceptable tendency to keep it all private. Still, it’s tough to only be able to partially explain why I’m depressed — I have to come up with complex explanations, saying that my depression has ‘many causes’, and list just the few that are ‘safe’ to talk about. I simply lack the courage to tell the whole story. And often I get this impression from people that I’m not telling the whole truth. I’m sure they don’t think I’m a murderous sociopath, but they might imagine that there is ‘something more’. I simply have to live with that.

My psychologist, however, thinks that I have gone too far and too long with this constant repression and suppression of feelings and emotions regarding my female gender identity. The consequence of all those years is, well, depression. So far, she hasn’t given me a clue on how to ‘fix’ this, except, of course, by taking the Big Step and simply ‘come out’ to everybody — or, at least, to a few people at a time.

I’m not there yet. And in this my wife is also not very encouraging. We share most of the same close circle of acquaintances and family, and she has exactly the same opinion of them as I do: that they are all secretly homophobes and transphobes, and would never accept me. Or, at the very least, they would hope that the psychiatric institution ‘cures’ me — assuming that they believe that transgenderity is a disease — or that at some point I’d ‘snap out of it’, go over that phase, assume it’s just a middle-life crisis, and go on and forget all about that silliness. It will be very, very hard to explain to them that transgenderity is not a ‘disease’ and that it doesn’t ‘go away’. The best I can tell them is that I might be able to keep the urges down and get some professional help to deal with them. However, all the signs I have been getting from my psychologist so far run into the opposite direction: she wants me to stop repressing my gender identity, stop living a lie, and embrace my true self, and care not about what others might think (of course, she’s professional enough to understand that it’s really not that easy, and that this is a very long process until it might  become a reality, and it’s pointless to rush into things).

Live your life, not the life others want for you

This is MY Life!And finally we come to the last issue (well, at least for the purposes of this article). In a sense, I tried to live my whole life according to the expectations of others — first my parents, later my friends, and at some point, according to the expectations of a few past girlfriends and, even later, according to the ones of my wife. This convinced me that there was a ‘right way’ to lead one’s life, according to everybody’s — and society’s — expectations of what my life ought to be, so I strived hard to fit to that role.

There were just minor ‘disagreements’ with that expected role. As a kid, my mother thought I was spending way too much time with computers; but when I decided to become a computer engineer, she guessed it was alright. Later, when I was firmly established in my role as a civil servant working for a State-owned research lab, I fulfilled all expectations of my parents. But things change. My girlfriend of the time believed I was ‘wasting my life’ working in a public institution. ‘Real men’, she claimed, were not afraid to take risks, and I should start my own company. Because I was trying very hard to present myself as a ‘real man’ (at that time, I was already spending my short vacations en femme), and wanted to please my girlfriend, I did as she recommended (which actually surprised her). Things actually worked out great, and I secretly was hoping that the success of my company (every company in the 1990s was successful…) would allow me to retire early and support me during transition. As a matter of fact, I earned enough money until 2000 that would allow me exactly that.

By that time, however, I had lost that girlfriend and was forging a new life with my current wife, rebuilding a ‘temporary’ small apartment until we got a definitive place to live together (which, sadly, never happened). Things really went bad for me during the first financial crisis of the century, in the wake of 9/11 and the collapse of the dot-com bubble. All my banks (except one) lost all my money, and I was conned by petty criminals, who at some point even forced me to sign contracts literally at gun point. This ended with me and my wife exiling ourselves in the middle of the Atlantic, on a tiny island where she had some family, and it was pretty much impossible for the creeps to threaten us physically — while the courts chugged away at dozens of lawsuits against me, because of debts contracted by those petty criminals in my name. These were very tough times, although I actually loved my ‘exile’, which we only abandoned after my wife lost her job, and we were unable to pay rent — returning to the mainland did not solve the unemployment issue, but at least we could continue to live in my old, tiny apartment for free.

At that stage, it was natural that pretty much everybody blamed me for ‘not living my life correctly’ — and who could contradict them? After all, the results were obvious: all my companies (except the very first one, which I sold) were bankrupt, I was full of debts (none of which were my fault, but as a legal partner of all those small companies, and the only one that was available for the courts to notify — everybody else quickly left the country — I got to carry the burden of paying everything) and relied mostly on my parents (again) to help me out (since the banks had lost all my money), my wife and I were pretty much jobless and unemployable (I still had some odd jobs that earned me a bit over the minimum wage for one person, which had to be split among myself and my wife). Things were really not looking good for us. In the middle of all that, I had ‘come out’ to my wife as a crossdresser, and started to dress regularly. I have to admit that it was my main source of escape, and I always asked myself if my life would have been different if I had been born a woman. At least, I would not have been conned in the same way, but I guess that my personality would have defeated me at the end, just in a different way.

There was a short period when things started to get better for a while. My wife and I started another small company where we could both work together from home — no commuting costs, no need of setting up expensive offices. We got some very interesting customers world-wide — some big names too — as the economy started to pick up after the dot-com bubble. But clearly we were out of luck: the latest (still ongoing) crisis of 2007/8 also hit us hard again (our customers stopped all their investments, and therefore didn’t renew their contracts with us — all of them, in a very short time frame), and once more we were both out of a source of regular income. My wife entered a deep melancholic depression, which took three long years to ‘cure’ to a point that she was able to work again, a couple of hours per day at most. It took her a few more years to complete her cure.

Again, at that point, the solution for both of us — not by choice, but through recommendations from parents and family — was to complete our studies and eventually become teachers, either in our country or someplace else.

Looking back at those highlights of my past two decades and a half, I cannot only wonder how much of it was driven by others or a desire to please others. My first company was partially driven by the ambition of a close friend, but the final push to work there full-time came from my ex-girlfriend, who wasn’t happy about my situation of a civil servant. Two other companies were established with the sole purpose of giving my wife a job, since she had been jobless for aeons, her chosen profession having been pretty much extinct. Another one was created to help a good friend, who needed some money and management support to start a family business with some European funding — she was hopelessly cheated by the local mob, though, and the company failed. One was started to help a few former colleagues who were tired with the management and wanted to start something of their own (it didn’t last two years — we got a partner who lied to us about the amount of investment that he was able to get, and the company’s existence was only a façade to cover up his blunders and a huge financial loss in his own company, something we were absolutely unaware when we started). Although my first company was quite successfully, all others were not. I thought back then that I was really not suited for private company management (but even my participation in non-profits did not go well at all) and should abandon that area completely — which I eventually had to do anyway due to lack of money. But now, looking back, I wonder how many of my decisions were motivated by a desire to keep a certain image that others had of me, a wish to help others first, no matter how much it would hurt me personally (financially and emotionally, after being forced to deal with creeps and crooks who simply disappeared in the background, leaving me all the mess to clean up after them). It’s easy to tell me today that I ought to have listened to ‘the voice of reason’ (usually, the person that is telling me that) and never engaged in those ventures. But at that time there were many ‘voices of reason’, all having different intentions and suggestions — my job was to pick what seemed to be the ‘right’ one in order to please as many people as possible. Yes, this backfired, and I can see now why it wouldn’t ever work — but it’s so easy to look back at past mistakes with detachment.

On the other hand, I cannot but wonder what would have happened if I simply followed my choices and pretty much ignored the ‘pressure’ of others to fit me in their tiny little boxes of what I was supposed to become.

Well, this is pretty much what my psychologist has been telling me in the last sessions: I’ve been living the life that others want me to have, and it’s not going well as they had planned. I should start living my life instead!

But it’s so hard!

But its so hardWhen I write these things in a rational and detached way, they all sound rather sensible and logical to me, and I guess you’ll agree. In fact, many of you might be thinking: ‘oh, those are your problems? Honey, you don’t even begin to know what real problems are!’. And you would be right.

Depression is not really about ‘logical’ things, and we Buddhists learn that ‘the pain of an ant is as intense as the pain of an elephant’. The principle behind this is that every sentient being — that is, anything with a central nervous system — is able to feel pain (and fortunately also pleasure!). Obviously the intensity of pain is different for each species, and I’m pretty sure if we could ‘hook up’ an ant’s brain to an elephant, threading on an ant’s legs would probably not register on the elephant at all, while if we did the reverse experiment, a slight itch on the elephant’s ears should explode the poor ant’s brain with sensation overdrive! (Fortunately, for those who care about animals, we cannot conduct such dreadful experiments)

So pain is relative. We tend to look at poor people starving from hunger and feel empathic towards their suffering, which is certainly proper and correct; but filthy rich people with full fridges and no financial problems whatsoever certainly also suffer a lot as well — they just suffer from different things. It’s true that most of us would gladly exchange one’s suffering with the suffering of Bill Gates or Warren Buffett, but that would still not remove our suffering. We would just suffer differently, but, for us, our suffering would be as overwhelming as those who are starving from death.

Obviously it’s ethical to worry first and foremost about the suffering of those that don’t seem to be able to help themselves, for lack of resources — the poor, the diseased, the elderly, and so forth — and that’s how our Western societies work. Those who are rich and well-off are left to their own problems — after all, they have money to solve most of them. Nevertheless, it’s not fair to claim that they have no problems whatsoever. The old saying ‘money does not bring happiness’ is true, but not quite in the way that most people think it is. Money gives you access to food, a roof over your head, and clothes to keep you warm, but you’re still subject to, say, diseases. The difference is that a rich person can easily get access to the best doctors that money can buy. But a rich person will suffer from a terminal disease as well as a poor person; they’re not to be pitied less because of that.

This was just an example, of course, and I know it’s not quite the same thing (I’m comparing apples and oranges), but hopefully you can see my point here. For some people, saying ‘no’ to others and pretty much ignoring their ‘advices’ about how others try to interfere in their lives is straightforward; they don’t think twice about it. It’s not a ‘problem’ at all, nor even ‘an issue’. It’s just something that a normal, healthy person is supposed to do.

For me, however, those are unsurpassable obstacles, because I have been self-conditioning myself for ages to think differently about my relationship with ‘others’. Somehow I have this strange belief that I’m just a tiny piece of the complex puzzle of society, and that everybody is pushing me around to make me fit in that puzzle. I struggle because I want to fit, but, unfortunately, my jagged edges don’t seem to align properly with the existing holes. I try to ’round off’ those edges, saw them off, in order to get a better fit, but the trick to shape myself correctly to ‘fit’ seems to elude me. And this causes me suffering — and eventually anxiety and depression.

Now I have a good therapist who simply says: ‘Why do you have to “fit”?’ and my whole world shatters as I think about how to answer that question.

Probably at a subconscious level there is a tiny, squeaky voice in my head that tells me that if I fit, I’ll be happy. As a good Buddhist I should immediately know that this is obviously wrong. But I’m not a good Buddhist. I just know a few basic principles and a few techniques. I’m still attached to my own prejudices, created by decades of conditioning, that make me think that way, i. e. that I ought to listen to what others think that my life should look like.

You cannot throw away decades of conditioning so easily away, no matter what people tell you.

At this stage, the best I can say is that somewhere along my journey on this planet, I started up picking the ‘wrong signals’ from somewhere, and assumed that I was doing the ‘right’ thing. Now please don’t misunderstand me: I’m still convinced that the world would be a better place if people were less selfish and more generous (not necessarily just with their money, but with their time, and with simple things like smiling at the cash register girls and wishing them a good day). I’m still convinced that we, as a species, share similar goals (we want to be happy and wish to stop suffering), and, as such, we ought to have much more empathy towards our fellow human beings (and, if you wish, towards every sentient species), since we ought to be able to understand them as well as we understand ourselves. Pity the terrorist victims, of course, but also pity the terrorists: they are victims of their false beliefs that what they’re doing will grant them happiness. Such a way of thinking — especially in this day and age — is revolutionary, but it should be obvious that this is how others work. There are really no fundamentally ‘evil’ people, but only people who are completely misguided in their search for what they wrongly believe that will make them happy.

However, there is a fundamental point here, which is that nobody is ‘less’ or ‘more’ important than others in this regard. Yes, everybody else’s rights to ‘Life, Liberty and the pursuit of Happiness’ is exactly the same as our own rights. Here is where I went wrong somehow in my life history: I started believing that everybody else’s rights were far more important than my own. This was encouraged, in a degree, by misunderstanding many of my own philosophical and religious beliefs. I’m not supposed to become a ‘slave’ to others so that others might enjoy their rights; I’m entitled to exactly the same rights as they are.

Naturally, there will be conflicts, when the well-being of others intrude in my own well-being. This is where I apparently have made constant errors of judgement: in the case of a tie, I will always concede others the right to their well-being, at the expense of my own. And I have been doing this constantly, for years and years.

I started this section by stating that the pain and suffering of others is equal to our own, even if our circumstances wildly differ. But I don’t act that way: I always believe that the pain and suffering of others, no matter who they are, are vastly superior than mine. As a consequence, I repress my own feelings and emotions. All I can think is, ‘oh, look at how that person is really suffering, my own problems are a joke compared to theirs’.

Suppose that you, dear reader, have been diagnosed with an incurable terminal disease. If you read my own problems and issues, you can only laugh about them: your own problems are incommensurably much more serious than mine — that’s undeniable. So my attitude towards others is always considering their own problems much more serious. For me, it’s as if the whole world is afflicted with different degrees of terminal diseases, while I just have some scratches and itches to deal with.

In fact, I remember a recurring episode with my wife. She has fibromyalgia — a condition where the nerve signals related to pain are incorrectly ‘amplified’ and transmitted to the brain. This means that she is quite often in pain, even if there is no actual, visible, physical cause. It’s the nervous system that is playing havoc, and confusing her brain, feeding it too much information about pain that is not supposed to exist at all. The exact cause of fibromyalgia is not known — it was not even recognized as a ‘real’ disease until recently; in my country, for instance, the State doesn’t recognize it as a ‘crippling disease’ allowing early retirement — but it is strongly correlated to autoimmune diseases (such as the more popular lupus or multiple sclerosis).

These are a class of very strange instances where the body’s immune system is ‘broken’ and attacks the body’s own cells. Again, the reasons why this happens is not perfectly clear. In my wife’s case, there seems to be evidence of some kind of autoimmune disease in her body, but the exact disease is as yet unknown (if at all) — there are about 80 different types, and each has a different way of being tested.

In any case, the main symptom of fibromyalgia is clearly pain, which can affect any area of the body. Pain is not necessarily constant, but it becomes more intense during the so-called flares, episodes during which certain areas of the body become particularly painful. Flares can occur randomly, but many are triggered by external factors (weather changes, for instance) and internal ones (stress is a typical example). Because of that, fibromyalgia took a long time to be described as an independent disease. Also, it is very hard to distinguish it from many kinds of psychosomatic disorders which can also bring about pain in any area of the body, but the presence of antinuclear antibodies is usually a good sign of an existing autoimmune condition.

Fibromyalgia cannot be ‘cured’ although there are a few medical drugs that may help in dealing with its symptoms; my wife has a few ’emergency drugs’ to take during flares to reduce pain. Also, psychotherapy, namely cognitive behavioural therapy,  which my wife did for many years, can help a lot — especially by detecting the early onset of a ‘flare’ and taking some preventive medicine before it reaches the peak of intensity.

Now, as you can imagine, this is a ‘serious’ condition. And back to my issues: it’s obvious for me that my wife will always feel much more pain than I do, and for longer periods of time. So when I feel some sort of pain, I tend to be quiet about it — my wife’s pain will always be much more important than my own. That makes me tend to neglect whatever health issues I have, because she will always tell me how insignificant they are compared to her many problems (besides fibromyalgia, she has many more chronic illnesses, mostly related to the reproductive system).

This is actually not new to me. As a kid, I tended to sometimes have headaches. But my mother suffered from chronic migraines. This is yet another case where people tend to confuse both things, like the common cold and the ‘flu — simple headaches, no matter how intense they are, have absolutely nothing to do with migraines (even though it’s also true that migraines hurt the head a lot!). So as a kid I was sort of ‘educated’ not to talk about my own pitiful headaches, when I saw what the Real Thing — i.e. migraines — were, and how they affected my mother. I was supposed to just shut up, be quiet, and endure my own pains in silence.

Kids also often perceive how well they’re treated while they’re ill: you don’t need to go to school, you can stay in bed all day long, you get your meals served in bed, sometimes with a few treats. Quickly every smart kid learned to ‘fake’ symptoms to get the ‘lordling treatment’; smarter mothers (as my own mother) are even quicker at putting a stop to that kind of behaviour. As a kid, I was afflicted with chronic rhinitis, which means I would have similar symptoms to the common cold — i.e. a running nose, sneezing, coughing, a bit of fever — but they would be recurring, at least twice a year, but very often all winter long. Before I started getting treated for that (which happened only in my teens), it was hard for my mother to know when I had really caught some bug or just had another flare of rhinitis.

Later on, I tended to suffer from psychosomatic diseases, something which still happens. Psychosomatic diseases are very annoying, because nothing is clinically wrong with you (which also means that no medicine would have any effect!), but you have all the symptoms of a ‘real’ disease and suffer accordingly. For instance, you might have all the symptoms of the ‘flu — muscular pains all over, an incredible amount of fatigue, headaches, some coughing and sneezing (usually not as strong as the common cold, though) and a sore throat, and a general feeling that you’re utterly ill and everything requires a huge effort to do. But — in my case — I wouldn’t even have any fever: that was a tell-tale sign that it was all psychosomatic. So I had to drag myself to flu, feeling awful, hurting in every muscle of my body, and coughing all the way, just because the disease was ‘in my mind’ and I was in reality healthy as an ox. It certainly didn’t feel that way, of course, and it was pure torture to stay awake and paying attention to classes, when all I wanted was to lie down for a while and drink some hot tea.

Because I’m so prone to ‘get’ psychosomatic diseases — something my close family is very well aware of, including my wife — I tend not to take my own diseases very seriously: in most cases, I know I’m quite well and fine, I just don’t feel that way. Sometimes, however, the disease might be real; not knowing for sure, I simply try to ignore it as much as possible. This leads to some communication problems with my wife: very often she’s in pain from fibromyalgia, and sometimes I tell her, ‘weird, today I also feel a pain in my leg’. Of course she discards it immediately as psychosomatic, and I endure the pain in silence. Sometimes it isn’t psychosomatic, but merely some compression of the vertebrae on the spinal cord. Then, after days of pain (without painkillers), I have to drag myself to a doctor. Similar things have happened to me all the time. During my worst anxiety cases, I went to the emergencies at the hospital because I thought I was having a heart attack. After that happened a couple of times, I remember just telling the doctors: ‘look, I know that this is mostly likely just another psychosomatic thing. But in the very unlikely case it isn’t, I’d be glad if you could make some tests’. Roughly speaking, I would say that about half my issues are almost always psychosomatic, but the other half tend to be rather serious conditions. It’s very hard to say which is which. The truth is that I tend to be a bit careless about ‘simple’ conditions because I automatically think they’re psychosomatic — and if I have any doubts, my wife tells me that it’s all in my mind and that I should just be quiet about it. Therefore I have this tendency of keeping all these symptoms to myself — unless, of course, they become completely unbearable (like in the case of the depression, for instance).

This is pretty much my attitude towards everything: all medical conditions, mental or physical, that happen to others are serious issues that require attention and care. All my own conditions are very likely psychosomatic and I should just ignore the symptoms and endure the pain in silence.

Needless to say, I have the same attitude towards the depression and the gender issues. Regarding the depression, I find it very difficult to explain to others that I’ve got a serious case of clinical depression. Nobody truly believes me, because most people are not aware of the five different kinds of depression — and clearly I’m not in a melancholic mood, rather the contrary. This means I’m constantly bombarded by people saying: ‘Oh, could you just finish this for the next week/do you want to take an extra job, I know you’re hard pressed for money?’ and I have to decline, saying that my depression doesn’t allow me to work. They usually make sympathetic noises and answer: ‘Oh, poor thing, I know how it is, sometimes I also get depressed for a while, it sucks, doesn’t it? Well, no problem, this can wait another week, I’ll call you back then.’ When I patiently explain that it’s pointless to call me a week later, because this condition won’t ‘disappear’ or even ‘get better’ from one week to the other, I get completely baffled looks. The truth is, I’ve been noticing, that although most people are familiar with some kind of mild depression (even if they didn’t suffer it themselves, they might have a close friend of familiar which went through that), serious depressions seem to be much rarer. It’s a bit like confusing rhinitis with the common cold or the flu: people automatically assume they got the ‘flu, but in reality the ‘flu is very, very rare, and most people will never catch the ‘flu in their lifetimes — instead, they will catch one (or more) different kinds of rhinovirus (the one for the common cold), many of which can provoke some quite strong symptoms. They’re still not the same thing as the ‘flu!

The gender issues are similar. Among my very mixed group of crossdressing friends, some are clearly transexual, but most are fetichists. A few have definitely gender issues at about the same level as I do; some are actively doing something about it, most are simply coping with it by crossdressing as much as they can. When explaining that to others, they wonder if I have ‘gender issues’, then why I don’t go through transition?

It’s not so simple as that.

I remember another issue I had back in the 2000s. I was afflicted with hemorrhoids — there is a genetic predisposition for that in my family, and sitting in front of a computer 16 hours a day certainly didn’t help. For years I had to endure the discomfort, using all sort of creams (none would work) and similar off-the-counter remedies. Hemorrhoids are not a crippling condition — especially if you have a case like mine, which was not even painful. You’d just bleed every day. It’s not a terminal disease. It doesn’t affect most of your life and lifestyle, except that you have to always be well-supplied with a stock of menstrual pads 😉

At some stage, however, my doctors gave me the option of surgery, to fix the issue once and forever. Now, thanks to the Internet, and after talking to the surgeon, I was aware that hemorrhoid surgery had improved quite a lot in the last decades. Long were gone the days when they simply cut a section of the rectum (the one affected with hemorrhoids), which was extremely painful, had a long post-operative recovery, and could lead to some complications. These days, except for extreme cases, there are much less invasive procedures: the most common kind is simply having a ‘robot arm’ that staples the hemorrhoids in place. I had read that the UK National Health Service routinely performs this kind of surgery on civil servants, and they get the surgery in the morning and can go back to work in the afternoon.

While it’s considered minor surgery, it still means going under total anesthesia. That comes with its own set of risks. Any kind of surgery is always risky by itself, and that’s why doctors are usually so reluctant to recommend it, if alternative methods are available. The option was mine: the so-called alternative methods were simply not working, but I was made aware of the risks of surgery (besides its benefits, of course). Surgery is also not 100% guaranteed. A significant percentage of people might need to get another surgery after 5 or 10 years, if by some reason the staples get loose.

As said, this was not a life-threatening condition. It was annoying, yes, but I wouldn’t die from it. It didn’t significantly limit my lifestyle or my ability to work. So was the risk of going through surgery worth it?

It was not an easy decision, but I agreed to go for it.

And in my case, I was a bit unlucky: the surgery went quite well, and after spending the night at the hospital, I felt great the next day. Unfortunately, my surgeon had recommended that I took some rather strong laxatives, ‘because the bowel movements might become lazy after surgery and it’s best to get them kicked back into action with laxatives’. Bad idea! I’m usually very regular with my ‘bowel movements’, so the laxatives just threw all the intestinal flora out of sync. The result? Extremely acute pain over a period of almost two weeks, when I often could do nothing else but visit the toilet and twist with pain on a couch in the intervals, all day long, and there was no way of stopping the pain. Eventually, after a few days like that, I called up the surgeon and told her that something seemed to be rather wrong in my recovery, since it was not supposed to be that painful. She suggested that I stopped the laxatives, but the damage was done: the bacteria in the guts need some time to get back into sync, and that meant enduring the excruciating pain for several days. After two weeks, however, things went back to normal, and I was never again afflicted with hemorrhoids again. Although it meant changing my habits a bit: I never use toilet paper, for instance, but wash myself afterwards; and I let gravity do its work, as opposed to ‘pushing’ — which can often burst a capillary artery. Besides that, I’m as good as new!

Now, this stupid example is just to show that things are never so easy. Well-intended people might recommend this or that procedure, having really no clue how it works. If someone talks to me and has hemorrhoids, and I said ‘oh, I had that to, but I had a simple surgical procedure to staple them in place, and all my troubles are gone’, I would be oversimplifying the issue — even on such a small medical problem. But such memes are spread by people, making light of the issues, without them even noticing that they’re not being helpful at all. It’s like saying to someone who is depressed to ‘snap out of it’. Or telling your transgender kid that ‘it’s just a phase, he’ll grow out of it’.


Things are never that simple. I believe that human beings have an inborn ability to oversimplify the negative issues. I wish I could remember where I have read that our memories are mostly of good things, and that we forget much easier the bad things that happened to us (it could have been on one of António Damásio‘s books, but I’m really not sure). This is apparently a coping mechanism by the brain, which throws out the ‘bad’ things out of our memories, perhaps because of the risk of depression, I don’t remember exactly — there was a good, plausible explanation for that. By contrast, most people will keep happy memories about past events for a very, very long time.

I remember when I was drafted for the compulsory military service in my country (nowadays it’s voluntary, but it wasn’t in my time). Almost everybody I knew (including my father) just had happy memories of those days. They talk about the laziness, of doing little, sort of paid vacations by the State, where you can ‘male bond’ and be away from the worries of family or work for a while. They talked about how much they ate and drank, the practical jokes they played on each other. And, of course, they talked about the esprit de corps, how the ‘bonding’ between comrades work, the wonderful experience that was, and so forth. In fact, very few people who went through the compulsory military service talk about what they did not like.

I never understood what was so great about loosing your democratic freedom and all your unalienable civil rights to be forced to do things against your will, in a walled environment which you could not leave (at least at the beginning). For me, it was exactly like going to prison, while being sure that I was innocent, except for the crime of having been born with XY chromosomes — hardly a major crime, since half the human population is guilty of the same.

My old military unit, shortly before it was shut down. It didn't look that good when I was at boot camp there. Source: Wikipedia, distributed with a Creative Commons Attribution-Share Alike 3.0 Unported license.

My old military unit, shortly before it was shut down. It didn’t look that good when I was at boot camp there. Source: Wikipedia, distributed with a Creative Commons Attribution-Share Alike 3.0 Unported license.

Military service, for me, only had terrible memories. I had to leave a struggling company with a lot of promise and be completely out of touch for several months; it was almost ruined when I finally returned. I lost my girlfriend, because she somehow put into her mind that I went to the military service on my own volition and didn’t care enough about her to spend some time with her (although I tried to call her up almost every day, she never picked up the phone — not even once. I kept talking to her mother instead…). The physical exertions during the training were having a serious impact on my liver — still recovering after a burst of mononucleosis a few years before — but it was just after a couple of months, after a few appointments with doctors at the military hospital, that they considered relieving me from the most extreme physical exercises. I could go on and on with the negative issues. Comradeship? Yes, to the degree that we all felt miserable, all of the people in my platoon were in their late 20s, most with family and a regular work, and we had no other choice but to endure the time we spent together. The worst case was a doctor, a surgeon specialised in complex heart surgery, who at the time was working in Spain. He got drafted by the army and was told to report himself for duty, or he’d be labeled a deserter and arrested. He didn’t really believe what he read on the letter, but after a few calls, it seemed that it was serious enough for him to postpone a rather complex case he had in hands, catch a plane, and try to sort out the mess. When he understood that they weren’t going to let him go, he became increasingly more agitated. He tried to explain that he had a patient with a complex case waiting for him on a hospital in Spain, and if he didn’t perform the surgery, the patient would die — there was nobody else available who knew the details of the complex procedure he had to perform, and the patient couldn’t be removed to some place else. He tried everything, appealing to everybody — apparently, someone in his family was part of the military — talking to generals and bureaucrats, without success. In despair, he looked at all his upcoming appointments — there were quite a lot in the next few weeks — and he even suggested that he’d come back after two weeks or so, performed only the most urgent surgeries, and tried to push the remaining cases to his colleagues. He was not even allowed to do that. After he was told that all his patients were dying, one by one, he entered an almost catatonic stage of depression. There was something fundamentally wrong with a system that believed that marching around the parade grounds was more important than saving lives. Afterwards, of course, he dealt with the idea that even the best doctor under the best conditions will have patients die on them, so he resigned himself to the idea. In fact, the most important thing that we all learned was resignation, and perhaps a bit of patience as well. And, unlike what everybody told me, that ‘comrades’ would become buddy-buddies forever, I never kept in touch with any of my former comrades, although I still have a couple of them as friends on Facebook.

Happy memories from the military service? I don’t think so. Sure, there were one or two fun episodes. There always are. Even the Jews on Nazi concentration camps found the odd chance to laugh, once in a while. I’m obviously not saying that it was the same thing, of course, that would be ridiculous — only that things are never so ‘easy’ and ‘simple’ as people tell us. What they don’t tell us is always much more serious and worse than the ‘happy, bright things’ we learn.

Assorted images from the Portuguese Colonial War. Source: Wikipedia, released under the public domain.

Assorted images from the Portuguese Colonial War. Source: Wikipedia, released under the public domain.

Still sticking to the military theme, I remember one very weird conversation with some war veterans. This happened while I was a junior researcher at a State-owned lab, before my own military service. Now many of you might remember that Portugal has had the longest dictatorship in the twentieth century (lasting half a century, in fact), but most of you might not know how the regime collapsed and finally became a democracy again. It was due to the colonial wars — our own Vietnam, if you wish. It lasted from 1961 to 1974, spread among the Portuguese former colonies in Africa — so it was quite a long civil war. It was mostly a guerilla war, just like Vietnam, deep in the jungles, with the difference that the Portuguese army was quite well prepared to deal with that kind of war and environment. Under normal circumstances, the guerilla groups and terrorists who caused the disturbances would be quickly settled down. But there was a catch. This was the age of self-determination, in the middle of the Cold War. America wanted that those former colonies became independent — even though Portugal was a strong ally, thanks to its bases in the middle of the Atlantic, it was a dictatorship with the remains of a colonial empire — and this was the perfect excuse to set them free: just arm and train a few selected groups, and let them fight for their independence. But, of course, the Soviet Union had similar plans: they saw an excellent opportunity to turn all those former colonies into communist republics under their sphere, so they supplied guns and training to competing guerilla groups. Of course neither the US nor the USSR could ‘go public’ about the issue, but both were obviously interested that Portugal simply ‘let go’ of their colonies. Very shortly after the war started, it seemed that Portugal was suddenly in an unacknowledged three-sided conflict, fighting simultaneously the US and USSR in the middle of the jungle. Needless to say, both superpowers had far more resources and men than the tiny Portuguese colonial army. The only difference was that the Portuguese military was rather good at guerilla fighting — alone, without allies, Portugal held out for 13 years against the ‘proxy war‘ fought by the superpower-controlled factions, which was clearly a military feat. The war mostly ended because of the growing unrest in mainland Portugal due to the loss of lives in the overseas colonies. When the government refused to pay the military what they demanded to continue the war, the stage was set to overthrow the regime. Thanks to the illegal, underground Communist Party, which had infiltrated itself on all levels of society and coordinated the efforts, there was a bloodless revolution (after several aborted attempts) which finally seized power, sent the current dictator to exile, and turned Portugal into a democracy, although controlled by the Communist Party. The former colonies were immediately granted independence — all them became Communist regimes (so the US lost that proxy war), and, once the Portuguese army was sent back home, they all immediately engaged in bloody civil wars once they declared their independence. Except for one case, those civil wars lasted to well after the Berlin Wall was broken down and the end of the USSR. These countries are relatively peaceful today, even though most are ‘weak democracies’, where civil war can erupt at any instant — the difference being that with the end of the Cold War, it’s not so easy to find funding, guns, and military training from the existing superpowers.

Now that’s the background. During this colonial war, there was compulsory military service after it was clear for the dictatorial regime that volunteers alone would not be enough to fight it. This means that males from all classes of society were drafted (lots, obviously, became deserters and run out of the country — coming back only when the regime was overthrown). And this means that it was not uncommon to find surviving veterans a bit everywhere. A few worked at the lab where I was. For some reason, while we were having a pause, they were exchanging a few hilarious examples they remembered from the war — silly, stupid things like bureaucratic errors, like when a ship delivered the cargo to the wrong place, for example — but at some point they started remembering the ‘serious’ issues as well: how they lost friends, how they faced the enemy in battle, how they had to endure the pain of being forced to kill fellow human beings while their families were anxiously waiting for them to return back to Lisbon. And at that moment, there was an embarrassing silence, as suddenly all the veterans became very serious. They understood that I was an ‘outsider’. I simply didn’t went through the same experience. I could not truly understand what they were talking about. They knew that all I was hearing were pictures of a war, like if it was some kind of movie, or a book I was reading. It was beyond my horizon of understanding. So it was best that they didn’t speak about those things. I believe it was even harder for them because they had been drafted against their will — forced to shoot other human beings without having a will to do so, because they knew if they refused orders, they had no chance to go back home to their beloved ones. When you read stories about the Vietnam, or so many other wars where the US have participated, you know that almost everybody who went to those wars were volunteers. At least they had the choice to be part of it. Each and every member of those military forces, no matter what their reasons were for joining — often they joined for the wrong reasons, of course — at least had a glimpse that somewhere in their future military career they would have to pull the trigger and kill other human beings. They might not be prepared to do so when joining, but they knew it was a possibility.

The Portuguese veterans were almost all drafted against their wills. Yes, there were a few career officers, but the Portuguese army had long kept the tradition of drafting people from all classes of society to acquire useful skills and put them into an uniform and lead troops. Doctors, engineers, journalists, and so forth, all had their uses in the military. At the very least, they could always be used as cannon fodder. But none of those people had any intention of becoming Government-paid murderers. They just did it because it was either that or rotting in jail — under a regime that paid little attention to human rights.

Portugal does not protect their veterans like other modern Western countries, especially the US and UK, which regard their military service highly. This comes mostly from having a relatively small army and navy, something which has always been the case, even during the Golden Age of Portugal’s world-wide empire: it was mostly a trade empire, based on high tech military developments and ships that gave the Portuguese an edge. In modern times, after the compulsory military service was ended, Portugal reduced its ‘conventional army’ to mostly a selection of elite troops — small, highly trained teams that are able to be deployed very effectively in theatres of war. Ironically, this is much more aligned with our almost 900 years of history.

So the sad fact is that most veterans are not really seen as heroes, having fought for their country with bravery — because, in truth, before 1974 most of them would have been drafted to fight a war they didn’t believe in conduced by a government that relatively few people openly supported. They often fought in fear of their lives and their family’s lives. Once both Portugal and its former colonies were rid of the dictatorial regime, there were mixed feelings about all those veterans. It was obviously understood that they had no option but to fight. And it was also true that the regime was finally overthrown by the military themselves, for which the Portuguese population would be grateful. But there was still some resent. As an American, you might imagine how people in the 1870s would feel about those veterans who fought on the ‘wrong side’ of the US Civil War. They might not have been outright mistreated, but they weren’t acclaimed as ‘war heroes’, either. In Portugal’s democracy, those who fought to keep the regime — and its colonialistic influence — alive were not exactly seen as ‘heroes’ either. Even though it’s quite clear that they had to follow orders against their will.

It was just much later than veterans started to get treated for traumatic conditions and get access to psychologists and psychiatrists — at the beginning of Portugal’s new democracy, such things were unheard of. People should just get along with their lives. Most of them had had jobs and an education in certain trades anyway, and it’s not as if they were unskilled or underqualified workers. That made probably a great difference in how Portugal treated its veterans from a conscripted army.

Anyway, by now you’re possibly wondering what all this has to do with the subject 🙂

All these are questions about personal experience — as opposed to ‘reading about the subject’ (or even ‘knowing someone who had the experience’). To a degree, they are all related to traumatic experiences in the past, which are only fully understandable by those who have actually experienced them. Some of you might have had similar experiences or empathize with the ones I’ve attempted to describe. But the descriptions are actually quite poor compared to the feelings and emotions associated with them. And yes, I’m quoting my favourite example once more: it’s like trying to describe the experience of ‘tasting chocolate’ to someone who never ate a single bit of chocolate. It’s not enough to say ‘it tastes delicious’, because chicken can taste delicious, too, and chocolate doesn’t taste like chicken. You could say ‘it’s sour and sugary at the same time’ but, again, so is wine, and chocolate and wine taste completely differently. No matter how precisely and accurately you try to describe the experience of tasting chocolate, there is simply no way to induce others (who never tasted chocolate) to fully understand that experience. Words are not enough; you really need to experience it for yourself. However, when two people have tasted chocolate, they are fully able to understand each other when they talk about the experience, because they have shared it (by the way, this is known as an ineffable experience; Buddhists usually refer to it as a nonverbal experience, in the sense that the experience actually ‘exists’ and can be shared by those who have experienced the same thing, but cannot be expressed with language).

As a consequence, it is hard for those who haven’t had the same experience to actually understand what is going on. This, of course, applies to pretty much all those ineffable experiences. In this current article, I’m mostly describing what it feels to be depressed and transgender. I have awesome friends who are constantly sending me their best wishes of a quick recovery, hoping that I’ll feel better soon, and their constant care and support are genuine and heartfelt — they truly wish me all the best from the bottom of their hearts. Only a few of them, however, have gone through a serious case of clinical depression. As a consequence, they are unable to grasp why it takes so much time to ‘cure’ it — in most cases when people ‘feel bad’ or ‘down’, this lasts only for a few hours or days, and quickly they return to a good mood, and this is the experience that they have and think that it’s the same as a clinical depression. Well, sadly, it’s not that simple!

In fact, if you are reading this and never experienced for yourself a clinical depression, you might wonder why it’s so complicated, and why completely unrelated things — like learning to say ‘no’ to others — have an influence in ‘feeling better’. Let me state for the final time: most days (if not all), I’m actually in a really good mood. Or perhaps I should say, my mood is almost always as good as any other person’s. Sure, there are a few days that I might not feel that great, but that’s rather an exception — I’m ever the optimist, always happy about something, even if once in a while I might get angry or irritated at something. But, in general, I’d say I get much less angry or sad than the average person.

Depression (especially atypical depression) has nothing to do with the ‘mood’ or ‘humour’. It even has little to do with what we call ‘happiness’ (or, more correctly, a state of euphoria), even though it’s true that people suffering from melancholic depression might feel ‘unhappy’ most of their time. The most distinguishing feature of depression, however, is the extreme effort that is required to do some things. One reason why people with melancholic depression spend the whole of their days in bed, doing nothing at all, is not exactly because they’re ‘sad’ (of course that is also one reason), but because it requires a tremendous effort to get out of bed, take a bath, do basic hygiene, get dressed… not to mention going out. Keeping a conversation with friends is as hard as pushing a SUV uphill on your own; that also means that people with melancholic depression will ‘shut themselves down’ and avoid everybody, although it’s more than proved that socialization is a great way to overcome depression. So when someone is depressed, the intangible (and nonverbal, ineffable) expression of depression that makes everything seem incredibly hard to do, always requiring a superhuman effort, actually works against the cure. In other words — while socialization is probably one of the best cures for melancholic depression, it’s actually one of the things that require an amazing effort to do. It’s a negative spiral: the more you need socialization to cure your depression, the harder it becomes to do; but that self-feeding loop needs to be broken at some point in order to get out of the depression. This, sadly, does take time. A lot of time. And it’s almost impossible to do it on your own, because your own perceptions get distorted to tell you that everything is as it should be (but it isn’t). Only with medication and therapy one can ‘break the loop’ and slowly, painstakingly slowly, get back to a ‘normal’ state.

Atypical depression has the same basic mechanism — that’s why it’s the same mental condition, even though the external symptoms are so completely different. I have no trouble jumping out of bed, taking a shower, do my chores, and, in general, feel happy and in a good mood — every day. In my case, the depression mostly affects my work — I simply cannot do it, period. The brain shuts down. It tricks me using all sorts of ‘excuses’ to prevent me from doing any kind of ‘work’. What is most irritating is that what the brain labels as ‘work’ is completely arbitrary. And I’m fully aware of it. Like I’m so often fully aware of my psychosomatic diseases, but I still cannot tell my brain, ‘stop it, I know perfectly well that you’re just coming up with fake symptoms that don’t exist’. It doesn’t work. My brain ‘believes’ those psychosomatic symptoms and I suffer from them, even though I might be aware that they’re merely psychosomatic.

To illustrate how such psychosomatic symptoms work, let me give you a last example. Like so many XY chromosome owners, I react strongly to see my own blood, most especially when I have to take blood for testing. These symptoms are all psychosomatic. I’m always close to fainting when I take the slightest bit of blood, and obviously I cannot even watch the nurse pulling out the syringe with that thick, red liquid — it’s too much for me to bear. But I know it’s all psychosomatic, even though some studies postulate that the brain might react to ‘tiny amounts of slightly reduced blood pression’ which causes the dizziness, the nausea, and the fainting. Well, in my case, I’m pretty sure that it’s all psychosomatic, and this was quite clear to me some years ago when I needed to take a blood sample for testing. Like always, I told the nurse about my silly psychosomatic issues, asked her to sit down comfortably, and then chatted amiably with her, as I always do. She chatted back and at some point she turned her back to me. I was confused. I asked her if she wasn’t going to take any blood today, after all. She seemed surprised and answered: ‘But I just did!’

Some nurses are so competent that I never felt anything — not even the slightest prick on the skin, not even the slight touch of the cotton pad afterwards, and definitely not the slight negative pressure as blood is taken from the veins. I had felt absolutely nothing. And I didn’t feel any nausea, dizziness, or anything at all — not while she was taking blood (without me noticing), not even afterwards when she turned her back to me and stored the sample somewhere on a lab table. It was only after she said ‘I just did!’ that all symptoms appeared. In other words, my brain was completely fooled by her expertise in taking blood, it was not aware that blood was taken, and so it didn’t react with the psychosomatic symptoms at all. It was only when the brain ‘caught up’ with what happened — with a delay of a minute or two! — that it flooded me with all the usual symptoms. I remember that I laughed as my vision clouded and the dizziness started, and I explained the nurse what I was feeling after she took the blood sample and stored it away.

That example showed me very clearly how the brain can trick us to cloud our perceptions with things that simply don’t exist. Awareness training, of course, can help to make you see through the brain’s ‘tricks’, but it really requires a lot of practice to avoid being ‘fooled’ by the brain. I’m definitely not at that stage; at best, I might be aware that the brain is tricking me, but I’m still unable to avoid being tricked.

That’s the reason I need to do ‘homework’ to fight the depression. Sure, I’m quite aware not only of the effects and symptoms of the atypical depression — I know it’s not ‘normal’ to be unable to work, for instance — but I’m simply powerless to prevent them from affecting my brain and the way I think. I’m also quite aware of all the ‘problems’ and ‘issues’ that my psychologist figured out that are at the core of the depression. But ‘being aware’ is still not enough to ‘get rid’ of them. That takes a huge effort (because, well, ‘taking a huge effort’ is a symptom of all kinds of depression…). Perhaps an analogy like the SUV being pushed uphill is a good one. Imagine that you were fully aware that the only way to save yourself is to push the SUV uphill. But you’re not that strong; the task seems impossible for a regular human being. You might be able to believe that if you do a lot of exercise to strengthen your muscles, start pushing up small things, you might eventually be able to become strong enough to push a whole SUV — and maybe even laugh, once you’re able to do it, thinking how easy it actually was, after you made the effort to exercise a lot.

Doing the above homework is pretty much the same thing. There are areas in my mind that tell me, ‘yes, this is the way towards the cure’. And somehow I’m also aware that it will require a lot of training and practice to be able to accomplish the smallest things first, and slowly work up my confidence, to the point where the depression will simply fade away. But that is still in the far, far future. It’s like having the goal of one day running a full marathon, when you have just started to do a brisk walk for 20 minutes every day. Yes, after a while, your training will allow you to run 42 kms in four or five hours, but it’s still something way in the future — for now, the best you can aim is to go from 20 to 30 minutes, or speeding up your pace. But merely having the will to run a marathon, or having it as a clearly set goal, is not enough. Practice and training are still required!

What many people think is that, while physical training works that way, somehow the mental training is supposed to be different: that is, if you merely have the ‘will’ to overcome issues in your brain, you can do it — instantly. But that’s not the case. Look at how many years you had to study to get an education. If all it required was the ‘will’ to become educated, then you wouldn’t need to go to school. Instead, it took years and years of practice and training. Take a look at musicians, dancers, soccer players, surgeons. They need to train for years, acquire knowledge and skills, and put it in practice, several hours per day. If you compare their stories, you will always see how much effort they had to put into it, and continue to do so — on average, eight hours a day — to be able to perform their jobs.

Mental training, just like physical training, requires much more than just ‘willpower’ or ‘setting a goal’. It takes actual practice and training, just like everything else. Anyone who has picked up ‘serious’ meditation knows this to be the case: you can certainly grasp the very basics with a weekend workshop, but to actually get some results, it takes years and years of daily practice — just like everything else.

The last hurdle

Were I ‘merely depressed’, I could have finished with the last section. Unfortunately, I’m not ‘merely depressed’. On top of that, I also need to deal with my transgendered condition.

Part of the issue is that I have made a serious effort to be cisgendered — for years and years forcing myself to become heteronormative. I suppressed and repressed all my feelings and emotions regarding my gender identity, refusing to accept them, pushing them aside for as long as I could. But at some point it was clear that I was losing the battle: twenty or so years ago, I finally gave up and started to crossdress.

These days, as you may have noticed, I truly dress a lot. I’m still far from doing it every day, but it’s not rare that I might dress every other day, even if I just stay at home. Very often I even forget I’m dressed as woman when I’m doing my chores; sometimes it feels so natural that I don’t even notice the tightness from the corset, or the warmth from the wig, or even the pricking sensation from the earrings. This is neither good nor bad; it’s just an ‘experience’ that gets absorbed by the brain slowly over time, and it registers as ‘normal’. I have, however, to admit that it’s not always like that, of course. I still get the thrill from dressing; and I still get anxious when leaving home or entering a public place on my own. But it’s definitely a far cry from what happened back in 1999, when I was shaking so much when leaving a hotel room, that I stumbled on the stairway, falling down a few dozens of steps, and breaking a heel. Today, of course, I can look back and laugh at my stupidity, but that’s just because I’m so much more familiar with being dressed as a woman than before.

Of course I’m fully aware that I’m still not completely ‘adapted’ to my visual image and physical sensations during my dressing as a woman. It’s also a work in progress.

But it gets better and better, easier and easier. Strangely enough, the atypical depression is actually helpful for that — because the only thing that has a positive effect on my brain is dressing as a woman, I believe it’s only natural that I not only feel better about presenting myself as a woman, but I also focus all my energies into it. You can see it as my training for running a marathon.

There is a difference, however, and I certainly went through it with my psychologist. Training for the marathon is a goal in itself; it has positive effects even during the training. However, there might be an ‘ultimate goal’ to keep you going on — actually running a marathon.

In my case, currently, I just view crossdressing as ‘part of the therapy’, i.e. because it releases serotonin in my brain and makes me feel good, it also allows me to do other things (even do a little work). In a sense, it releases the tension of so many years of repressing my inner feelings. While I still dislike what I see in the mirror (that’s a separate mental condition I have…), I definitely vastly prefer my female image to my ugly male one. And it’s true that most of the time I spend dressed as a woman in public is to have fun with my friends, as opposed to do some boring chores (although I’m attempting to do more of those while dressed as a woman as well). I’d say I’m at the stage where a 20-minute-walk is not enough and moved up to 30-minute-jogs instead: stepping up, but still far away from the goal.

But… what is the ‘goal’?

Many transgender persons that I have met, either online or ‘live’, tend to go through transition quite quickly. At some point in their lives, something triggers in their mind the desire to become the gender they identify with, and once that is triggered, there is no way back: in fact, everything will be accelerated. There is no more time to waste: it’s now or never, and all their energy is focused in going through transition as quickly as possible. They have naturally weighted the pros and cons of their decision; but they’ve finally decided that they’re going to live their lives as they wish, as opposed to living a life that others have imposed upon them.

Sometimes this happens very soon, with 6 years of age or so. And sometimes it can last decades until it finally happens, like Caitlyn Jenner in her mid-sixties. There is no rule of thumb to the moment it happens, but when it does, it usually takes a short time to complete the transition.

In my case, I’m still too scared to do that. While I can envision myself as a woman, and I’m quite aware that this would increase my levels of happiness quite a lot, it’s still unclear to me what my life as a woman would be. Those are two different issues, and I’ll try to give another analogy for you to understand the difference.

My wife and I have no kids, which is a rational and logical decision we made decades ago: we simply cannot afford to give them a proper education. Now my wife knows that she is unable to carry a pregnancy to the end, even if she wished, but well before she was aware of that fact, we still made our decision not to have children. If we reverted the decision, we would certainly adopt them. But we haven’t.

When we explain our decision to mutual friends — especially those that have kids — they tell us that we’re incredibly cold and lack empathy, we look at parenthood in a purely intellectual way, and are positively selfish in not wishing to ‘make the effort’ to get kids. Many claim that financial issues are not the point, ‘if you just have the wish to have children, you’ll change your lifestyle in order to accommodate for them’.

We hear that argument over and over again. In almost every of those cases, however, we see the end results of ‘careless parenthood’: broken marriages, long divorce cases, struggling with financial issues (to pay for the divorce and the kid’s education). An endless stream of unhappy circumstances, and the children, having to live between two parents, also suffer a lot. Many develop horrible moods and personalities, and they’re clearly not happy — neither their parents. And sometimes when we get pestered a lot about our coldness towards parenthood, we just point at their own lives and say: ‘why should we be more happy following your steps?’

There are still other arguments, like ‘who’s going to care for you when you’re old?’. This usually comes from people who have put their parents in a senior home and just see them for Christmas. In other words: there are a lot of myths and expectations put upon parenthood, but reality shows how tough it actually is, and how many pitfalls there are — for what? Satisfying a basic human urge?

In our case, yes, we’re rational about it. We simply cannot afford to give our children a proper education and set them up in life in a way that they deserve. It’s not about us. It’s about them. They ought not to suffer because we have been careless. So we decided, long ago, that we would not do that — it would be highly unfair to place children in this world due to selfish urges, while at the same time have no means to give them the proper care and education that they need.

Our arguments are rarely well accepted, but we are both in one mind about it: we couldn’t care less about what others think about our arguments. We still stick to our decision. And, of course, it might happen that in a decade we both get good, solid jobs as teachers, and we might consider adoption. But that’s in the future. We have no such illusions about what happens today, when we cannot even afford to pay an electrician to fix the cabling and the lights in our tiny home — we cannot even afford to paint the walls, and they sorely need it.

Similarly, when I approach the issue about my potential transition (and my wife backs me up in this), I also employ reason, and not merely emotions. It’s very fine to say that I have a depression mostly caused by repressing and supressing all my gender issues and try to live a normal life. As discussed with my psychologist, it seems clear to me that the more I dress as a woman, the more things I can do, including work, that are simply ‘blocked’ when I have to present as a male. If this goes on, it seems that the only way, or at least the best (and possibly fastest) way is simply to go ahead and become a woman full time.

In an ideal world, that would probably be my best choice.

But I’m fully aware that there are no jobs for transgender people, at least not in my country. And with the clamping down on immigration currently seen in the Western world, due to the upcoming war and so forth, this is perhaps not the best time to simply move away to a more LGBT-friendly country. In any case, this means going through a radical change of lifestyle — and lacking a means of financial support. It’s true that, right now, because I cannot work, I don’t have a source of income. But I still have the hope to be able to finish my studies and get a job, in the not-so-distant future. It might take a year, or three, or five, but eventually I’ll be able to do that.

As a transgender woman, however, all those doors would be locked for me. There would be no way to get a regular income. Sure, as a computer expert, there is a lot of work I can do remotely, but almost none of it can be done regularly, and doesn’t pay well anyway — we would be condemned to a very precarious situation, with a dark future ahead of us. In exchange for what?

Well, one might say, in exchange for getting rid of depression and living my life as I wish it, as opposed as how others want me to live it. But what pitiful life it would be! What would I do? Beg on the streets? There is always work as a transgender prostitute, but, seriously, that’s not a choice. In any case, I’m not young anymore, and the number of people with a fetish for old transgender people is definitely not big enough to generate a steady supply of money 🙂 In any case, I have zero interest in that. Even as a last choice. I’d rather beg on the streets than become a prostitute!

In any case, that potential scenario is way darker than the one I have right now.

In some European countries, there is a choice: people that are unable to get a job (especially if they are part of a discriminated minority, like being transgender) get a stipend from the welfare state, which usually is enough to barely allow them to survive. I know of a few people in the Netherlands and the UK that live that way. They are not only transgendered, but often chronically ill with depression and other afflictions. They get barely enough money to survive, living under the poverty line. But at least they don’t die from starvation and have a roof over their heads. Their lives might not be something to brag about, though.

Such a choice is not available in Portugal (at least not yet): because of my erratic work career, I somehow managed to get excluded from all kinds of support from eventual welfare, and there are no LGBT institutions that can financially help transgender people to survive.

So my best option is to swallow up the bile, and go ahead with my life, presenting myself as a male to get a job, work another two decades or so, and get a retirement with minimum wages. Only then, in my late sixties, I might be able to consider transition. But at that age it might be pointless; sure, I know that Caitlyn did just that, and she certainly is my role model, but I will never achieve the kind of figure she has — I will never be that rich (like the old sexist saying goes, there are no beautiful and ugly women; there are only rich and poor ones 😉 ).

Obviously I confided my worries to my psychologist. Yes, of course I’d love to transition. But I’m fully aware that this is not an option — in terms of survival. In my country, part of the evaluation to allow transition is the support of a close familiar (a parent, a partner) which can support the transgender person for the rest of their natural life (unless, of course, the person has some financial means to survive on their own without needing a job!). The doctors are fully aware of this issue. My psychologist’s answer was laconic: ‘Stop thinking so much about the future. Work with what you have now. Worrying about things that might never happen is pointless.’

She’s so right, and it was actually a relief hearing that!

So, for the time being, I will not worry at all about my future (the anxiolytics I take are awesome to deal with that!). There is some homework to do, and I have started with little things. I’ll dress as a woman more and more, go out in public, not only to have fun with my friends, but to do other chores, like shopping for food and so forth. I’ll get used to be pointed at and laughed at in those situations. In the mean time, I’ll try to expand the ‘coming out’ to some close friends and family, but do it in small steps. There is a lot I can do at this stage to slowly get better. As said, the marathon might not be my goal, but I might get better even if I’m just jogging or even running for a while.

Perhaps the ‘homework’ I got is enough to get rid of the depression. I shouldn’t worry much about what comes next. Or, rather, I should stick to my original plan — finish my studies, get a job as a teacher. My expectations are that once I get rid of the depression, I’ll be able to cope with my gender issues with a clear mind. Maybe, in that regard, my best choice is simply to crossdress part-time for the rest of my life, and be content with it. Maybe my gender dysphoria is light enough so that ‘merely crossdressing’ is more than enough to maintain my happiness levels at a sustainable level, and keep depression at bay. I seriously don’t know.

But at this stage, I’m really not worrying much about the future. Of course I get a lot of criticism about that. But I’m adamant: my psychologist told me not to worry about the future, and that’s exactly what I’m going to do, because I trust her.

Ironically enough, a few transgender friends (some of which are at the late stage of their transition) have struggled with the very same issues, and got the same ‘homework assignments’ as I did. At some point, however, they got bold enough to stop pretending to be someone they’re not, just because of the financial issues and their future lives, and went ahead with their transition, no matter what the consequences were. They did this not lightly. It took them months or even years of deep reflexion, together with their therapists. They hesitated a lot. But eventually they got the courage to take the plunge.

I’m not sure if this will ever be my case, but, in all honesty, after all the talks with my psychologist, I really don’t care. All I wish right now is to get rid of the depression and be able to work again.

That’s all that matters to me.