Decision time, and it’s anything but easy…

If you’re a frequent reader of my blog, you know that usually describe myself as a ‘failed transexual’ in the sense that, years ago, I simply gave up on any dreams of transition because it would make my life hopelessly more complicated (it’s already complicated by itself, I don’t really need more!). So I’m content to be called ‘transgender’ or even ‘merely a non-fetishist crossdresser’ and spend as much time as possible in the gender I identify with (in this case, female) and enjoy myself as much as I can during that time (and I cannot really complain).

For the past three years, I’ve been a victim of a severe case of clinical depression. While there are many different causes for it, some of which I have simply to accept and deal with it, as soon as I knew that something was wrong, I suspected that struggling with my gender identity and suppressing it for so many decades could have something to do with it. The worst part of the depression was being completely unable to do any work; that, fortunately, disappeared as mysteriously as it appeared five weeks ago! Technically, therefore, at least for any practical purposes, I’m not ‘depressed’ any more — I can work again and earn some money instead of depleting my bank account (goodbye, money for surgeries!) — so I’m happy again 🙂

But the story doesn’t end here. Because I always suspected that my gender identity issues were affecting the depression, I went to several specialists in the field, finally settling on one who possibly lead me out of the depression (or at least pointing the way out). He’s currently still diagnosing my ‘condition’ and has confessed to be hesitating between ‘gender dysphoria’ and ‘transvestic fetishism’. Remember, those are just clinical terms — they are not meant to be political ones! — which allow trained psychologists to know exactly how to act and what to recommend (all other cases of gender identity, from their perspective, do not require ‘treatment’ in the psychological term; gender dysphoria and transvestic fetishism, by contrast, can render you nonfunctional and give rise to a lot of other mental issues like depression and anxiety, so they need to be taken care of — in the first case, of course, through transition). During the long period of my diagnosis, I’ve been through several tests, some merely verbal, one with 531 or so yes/no questions I had to answer in an hour, and so forth. The doctors are still undecided. And they most certainly don’t wish to recommend anything that will make me regret my decision!

So, my doctors suggested doing some differential diagnosis, that is, a clinical test to distinguish between two conditions with almost the same symptoms: they proposed to put me on HRT. As my psychologist put it so bluntly: ‘if you don’t suffer from gender dysphoria, we’ll know immediately’.

As you might guess, I have obviously some doubts about that. On one hand, there is nothing more I’d wish for myself — finally getting to feminize my body a little (I don’t expect the dramatic changes I’ve seen on so many cases here in this group! — I’m sure I haven’t got the wonderful set of genes you all seem to have!). On the other hand, this will surely also lead to complications — social and familiar for sure — and I also fear the mental changes (mood swings and so forth) because I have no idea if my own Buddhist training is strong enough to be able to deal with the emotional changes and keep them from showing and ‘betraying’ me. I understand that people get used to them quite quickly, but I always wonder how quickly that might be — will it be quickly enough so as not to be overall noticeable?

Finally, of course, there is the ultimate issue to deal with. Suppose that the result of the differential diagnosis is that, yes, I suffer from gender dysphoria, and nothing besides a full transition will help me. Ok, I have read literally about thousands of success stories. Unfortunately for me, the vast majority of them have a very similar setting: get a divorce, lose your friends, lose your current job, move to a different city, start your life from scratch, be happy forever and never look back to regret the decision. There are a few variants: acceptance from a handful of friends and familiars, sometimes getting the dream job that would have been impossible to get without transition, finding the love of one’s life. And there is a handful of those thousands of success stories where people have for all purposes retired from their jobs, living off their savings, in the middle of their happy family, being fully accepted by all (except the odd idiot, who gets easily discarded). I would place, say, Caitlyn Jenner in that last group — she’s an example of how things can really work out to the best.

But I’m a very pragmatic kind of person. While I haven’t as yet slept on streets begging for money, I can say with some degree of confidence that I have passed through most of the stages in-between — from living a few years as a carefree millionaire to barely struggling to get enough money for the next meal and keep the house warm during winter. When we’re young, reckless, and dreamers, we are open to Big Changes in our lives, because we have the energy and the courage to start everything from scratch. As we get older, it’s not so easy. In my country, age is a handicap if you wish to work — employers care little about ‘experience’ and ‘knowledge’, they just want to pay as little as they are legally able to, and that means hiring kids barely out of college. Being a MtF transgender person is also a huge barrier: my country is very tolerant to trans people in general except when it comes to giving them a job (FtM transgender people rarely have problems, since almost all will pass to a degree that nobody will know) — among the hundreds who have fully transitioned there are just one or two who managed to get a job outside the sex industry; all the rest are currently unemployed, and will very likely remain so for the rest of their natural lives.

So when one defines ‘happiness’ in general, one has to take into account where one’s decisions will take us. There are plenty of people around the world who have carelessly entered married life, got a handful of divorces, fathered a handful of children, and now bear the burden of having to financially support all of that and lead miserable lives (no matter if they are cis or trans). Almost all of my MtF trans friends are divorced, and they struggle with money and time issues because of their ex-wives and their children — they hardly ever have the time to establish new relationships, much less deal with a loss of job which would render them hopeless, with all their legal burdens. My wife and I have long ago made the decision of never taking steps bigger than we can handle — and that meant no children because we cannot afford them — but we still are victims of all sorts of personal tragedies which left us struggling to survive, even if we don’t show that to the outside world: although we live way below the poverty limit, with no help from welfare (we’re not entitled to it), in modern contemporary societies that still means having a roof over our heads, an Internet connection, mobile phones, and driving a 20-year-old car formerly belonging to my father (who is too demented to be able to drive). And yes, we have enough to eat and a heated home (needing repairs for over a decade) to live in. Clothes are cheap, and we get lots of it from friends and family anyway. So… sure, we survive. But we cannot handle many more dramatic changes. My three-year-long depression was the last catastrophe hitting us, and we just barely survived that — a few more months, and it would be begging on the streets for us. We still had to borrow money, of course, which will take us a long time to repay. And it meant no more savings for the next catastrophe: all emergency money is now gone. In other words: no, there is no chance in the immediate future, and possibly not even in the far future, to put our lives in jeopardy with another ‘big’ change.

When I read all those reports and success stories of people transitioning, especially when I see people on YouTube talking about their choices and their current lives, it’s clear that they never had to go through dramatic financial troubles to survive transition. They just had a ‘bad’ period, when they possibly lost more money than what they earned. I have seen videos of people undergoing ‘just the smallest of cosmetic surgery procedures’ because ‘they could not afford more than a few thousands of dollars’ to do them — the amount of money which would last us a whole year, and possibly take several years to save, in our present condition. Many people had financial help from parents and friends; sometimes they had to break up with their partners and go back to live with a close familiar, or another friend also undergoing transition; in some cases, of course, they managed to get a new partner who not only accepted them but also took care of them during transition. There are also few ‘negative’ stories — at least on YouTube — except for the personal changes (i.e. suffering from anxiety, depression, even physical pain during and after surgeries and so forth), which eventually were dealt with. But I happen to personally know a handful of cases in my country where things are not rosy and shiny like that. Those people, like me — like all of you — have read all about the success stories, and they eagerly went ahead with their transition, hoping to become happy that way. And what they found was that they had basically excluded themselves from a life of financial independence. Now, alone and jobless, many had no other choice but to move back to the home of their elderly parents and survive on their charity. They still post messages on Facebook yearning for any kind soul to give them a job — but it’s obvious that they will never get one. Unlike the wonderful and beautiful pictures that have been posted all over the net, these people I know are personally unattractive (they had not much to begin with, and HRT didn’t really improve what they had), they have little or no education, they were already struggling while presenting themselves under the wrong gender role, they suffered from deep depression and anxiety because of that, and now that they have gone through transition, they suffer from deep depression and anxiety because they are alone and jobless, and have to rely on parents (or sometimes siblings) to survive. For them, it was a lose-lose situation: if you’re poor, uneducated, and unattractive, your chances are not going to improve with transition. But if you’re poor, educated but old, and not exactly unattractive but still not ‘normal’ enough to pass under the gender role you identify with, then your chances are just going to get worse over time, not better; being ‘happy about yourself’ is just a very small consolation compared to being condemned to a life of misery.

So you see my dilemma. I really don’t need ‘encouragement words’ from people who have successfully transitioned, and have never regretted it, living now their immensely successful lives — because they had started with all the possible advantages (again, like Caitlyn Jenner, for instance). I don’t even need to hear stories from people who have struggled, sure, but now are ‘back on track’ thanks to a complex, but positive, chain of circumstances that put them in a new life with the same kind of opportunities they had before. Obviously enough, if you have transitioned before puberty, or so very closely afterwards that you managed to develop your body according to the gender you identify with, you have entered your adult life pretty much as the gender you identify with, and you won’t have any difficulties in ‘starting’ your life that way — even if that means discarding some so-called ‘friends’. Get used to it: most people will discard their childhood friends in one way or another, and transition has little or nothing to do with that. And, of course, I have no interest in any stories of people who have transitioned so that they could get married to the ‘right’ partner and start their lives basically by attaching themselves to someone who is already financially solid and can fully support them. Unfortunately, the more I research such stories, the more they fall into the above groups.

Instead, what I’m looking for are stories of MtF transgender people who transitioned somewhere around their midlife crisis (between, say, 45-60 years of age), who are not especially beautiful and would never really ‘pass’, who have nevertheless managed to survive and kept their lifelong partners in a stable relationship, who have learned how to ‘bring over’ family and friends to accept them and cope with the ones who have utterly rejected them, who have figured out a way of still earning enough to survive even in spite of their handicaps — age and being transgender — and who did never regret the decision. I don’t personally know of any such case.

However, there is a TV movie which caught my attention: Normal from 2003 — it shows exactly such a story, and how it ended with a happy ending. Sure, it’s a movie, not a documentary, but it’s the kind of thing that always gave me some hope. There surely must be a few cases of success somewhere. I have just not come across them in ‘real life’, just in fiction.

I’m also not interested in listening to suggestions and opinions like ‘forget everybody else, forget the world, forget society, think about yourself and your own happiness, the rest will fall in place in one way or another’. Thanks, but I get that from my shrinks all the time. Sure, they may be right; and they even may be giving the best advice according to their experience and knowledge; but each case is different, and I don’t have the kind of personality that is ‘happy alone’ while telling the whole world to go and f**k themselves. I rather prefer to ‘f**k myself’ (I’ve been doing that for decades anyway) and still have some probability of being ‘happy among my peers’ (family, friends, colleagues, etc.), even it means not transitioning.

By contrast, there abound stories about happy couples where the husband has ‘come out’ as ‘merely a crossdresser’ and got accepted by at least their wives, often by their children as well, and in some extreme cases, even by other family members and friends. So long as they present themselves as male to the majority of the world, they are still able to present themselves as female in many circumstances — private and even social — and lead a ‘double life’ which gives them satisfaction. Of course I’m aware that such people do not suffer from gender dysphoria, or, if they do, it’s at such a low level of dysphoria that they can easily deal with it with some psychological training, possibly some meditation, and, of course, regular crossdressing.

In an ideal world, one would be able to transition even during one’s midlife years and have no troubles whatsoever — ‘transitioning’ would be just as accepted and tolerated as someone who has one leg amputated but gets a prosthetic replacement that works so well that they can continue to perform all their functions exactly as before (and yes, fortunately, medical science has advanced to that stage — at least in many, many cases). That means that everybody might be aware that this person is an amputee, but because it doesn’t impair their social and professional relationships, they are fully accepted (there will always be some idiots who won’t accept them, but that’s a fact of life: we cannot please everybody). ‘Transition’ is not the same thing because invariably it means crossing the artificial barrier of social gender roles — and that will have an impact. As a crossdresser (in the sense that this is how people see me, not how I feel deep inside), I get social acceptance in my relatively tolerant country (we are too polite to insult people in their faces; we insult them on their backs instead, when they’re not listening). When I present as a woman, I’m treated in a completely different way — one that is immensely pleasing to me, and which even pushes me to states of euphoria. Obviously I would be keen to make that kind of feeling permanent. But I’m also aware that I’m doing so-called ‘neutral’ interactions — with shop owners, or restaurant owners, or all kind of people providing services. I do not depend on those people to accept me all the time and give me a job! I just see them occasionally, or perhaps just once or twice, and interactions are minimal (even if frequent in some cases). It’s easy to ‘get accepted’ that way. It’s also easy to get overwhelmed (like so many of my personal acquaintances have been) and mistakenly believe that such occasional positive interactions mean that one can lead a successful life presenting themselves as the gender they identify to be. Unfortunately, I know so many examples where this was exactly the case, and I can see now what terrible lives these people must now bear, once reality caught up with them.

No wonder I hesitate a lot. This is a wonderful opportunity that my doctors are giving me. But I really fear my own decisions and my own judgement. After all, everything that went bad in my life was due to my wrong decisions. I’m not really good at evaluating circumstances and draw good conclusions from potential changes to deal with such circumstances. While I can do that reasonably well at the professional level — I’m not a genius in my own job, but I’m not an idiot either, I’m most definitely far above the so-called ‘average’ — I completely suck at the personal level. My psychologist tells me that this is due to a certain lack of self-confidence. No wonder! If you spent half of your life having to deal with the consequences of your wrong choices, then it’s almost natural, at least for someone sufficiently intelligent and able to do some introspective self-analysis, to come to the conclusion that one’s not that good at making choices at the personal level, and yes, that means losing some confidence in one’s ability to make good personal choices.

I’m afraid that I like HRT too much — the idea is really very appealing to me! I don’t even know what changes I can expect, but I have such low expectations about any potential changes, that merely getting smaller pores on the skin would be fantastic, and I would be ecstatic just to get that. Maybe I would also be incredibly happy about knowing that I won’t suffer from prostate problems, and that I probably won’t lose all my hair — such tiny things are almost guaranteed by HRT. More estrogen in the organism also means reducing the risk of cardiovascular problems — so long as high blood pressure is ruled out (I’m medicated against that) or the risk of blood clumping (which I might be subject to, due to genetic inheritance from my father who suffers from that) — and it also affords some degree of neurological protection (it means that your brain is slightly less probable of developing dementia). All such small changes would be wonderful for me! Sure, the doctors are always keen to point out that the libido will go down, but since it has been at zero for so many years, I couldn’t care less about it; it’s the only ‘negative side-effect’ that doesn’t worry me in the least. Getting smaller testicles and less erections? Oh cool — it will be so much easier to ‘pack’ my dangly bits, so I see it as an advantage, not a handicap! And sure, I can deal with mood changes and so forth; I’m just afraid that I’m not good enough at disguising them, but I will just need to learn that. So… all these are minimal changes which I will almost certainly get and look forward to them. Anything else is a plus. Getting boobs would be a dream come true, but I probably lack the genetics for it — almost all females from both parts of my family are flat as ironing boards — I have already ‘moobs’ (‘male boobs’, caused by accumulation of fat on the belly, which in turn produces estradiol, which will make boobs grow and accumulate even more fat on the belly) as big or almost as big as some of my close family members. They also lack curvy, voluptuous bodies, but are rather of the skinny and flat kind (again, on both sides), so I simply don’t have the genes to get a more feminine body; perhaps not even in the face, since my closest female relatives are horse-faced and not especially attractive, perhaps with the single exception of one aunt of mine (who got all the lucky genes of the family) — but her own daughter, my direct cousin, didn’t inherit anything from the mother. So I don’t expect miracles on that side. In fact, I don’t even expect anyone to notice any difference — not even my wife — and that would fit exactly my own personal plans.

There is a catch, of course — the doctors might see how much I love doing hormone therapy, and recommend taking the next step. And that’s what I’m scared about. Sure, I know that lots of people struggled with the same issue, and eventually it worked out — it usually does work out in 99% of the cases, or perhaps even more (my own doctors tell me that they have 0% regret cases, but that’s the kind of statistic that is only possible if you really have very few cases to deal with, and all of them are crystal-clear!). Sure, over 90% of people who have attempted transition in my country eventually figured out that it was not what they thought it would be, and aborted it quickly enough. Many have not even been able to go out in public and present themselves as the gender they allegedly thought they identified with, even if they were already taking hormones. I know of uncountable cases like that, where people officially start taking hormones and entering transition without having had a single experience of ‘going out’ as the gender they identify with — they have been either closet crossdressers, or often not even that. By contrast, I can certainly claim to be quite familiar and comfortable presenting myself in public — and that doesn’t mean going to LGBT-friendly bars in the middle of the night, but standing in queues in supermarkets or to pay my water and gas bills, in broad daylight, where makeup will not disguise your biggest flaws, and where everybody is staring at you (because I’m tall, large-framed, and naturally catch attention). I’ll go anywhere, and not even just to far-away places where nobody knows me, but I’m fine to walk to places in my immediate neighbourhood — I just avoid those places where I go with my wife (which are very few anyway) because she asked me to do so. Even so, once or twice I had no other choice but to go to supermarkets where I go with her, because I couldn’t find what we needed elsewhere (of course, nobody ‘recognised’ me — they work so many different shifts that the probability would be tiny). So… is that ‘training’ enough for a Real Life Test? No, not really — because such activities are secondary to my life. I have not ‘come out’ to many people, mostly because my wife doesn’t want me to do that. I did come out to my best friend from the university days; and very, very recently to my eldest cousin, with whom I enjoy a very special relationship, and it was only fair to give her a clue of what was going on, since she was so worried about me. I’ve not been dressed in front of either of them, though. And I’ve not even given an inkling of what’s going on to my colleagues at work or to my PhD supervisors. So I’m excluding ‘real life’ from my ‘interaction experiences’, and that pretty much makes the difference.

In other words: it seems that, once again, circumstances in my life are pushing me to ‘decision time’. A good Buddhist (which I’m not) would just say that these constant repetition of event chains leading to a point where a decision has to be made — and inevitably it will be the wrong one, no matter how much thought I give to it — is just the result of accumulated karma; in other words, I have a habitual tendency to get myself into such circumstances, over and over again, and it’s up to me to ‘break’ the cycles or loops, by seeing things as they are, and somehow learn to deal with them. It sounds simple enough when it’s put that way; reality, however, is incredibly more hard to deal with, and that’s why people require decades of practice in order to be able to do what Buddhist teachers suggest. It’s something that can be learned, and, better, it can be put into practice, and, most importantly, it works, but it’s not easy.

It also doesn’t get any easier if you’re already suffering from serious doubts about your own perceptions. Sure enough, Buddhists tell us quite clearly that we all suffer because we have wrong perceptions (and not even bother to doubt them). Depression brought to me the acute awareness that things are really not what my brain believes they are — it stopped being a philosophy or an intellectual endeavour to become a reality that I had to struggle with every day. I certainly learned a lot about myself, but not enough. For instance, I have not the slightest idea if I’m still depressed or not: atypical depression is hard to diagnosis in any case, and my own psychologist thinks that I might suffer from narcissistic depression anyway. This is a slightly different condition which, however, fits several of my symptoms. Usually, people suffering from narcissistic depression have spent a large part of their lives building up a mental infrastructure to support their fragile egos. While this infrastructure is in place, things are working out fine. But suddenly something external interferes with one or two pillars of that infrastructure — in my case, for instance, it might have started with the death of my mother and the discovery that my father had gone way ahead in his dementia (he had been shielded by my mother to the extent that we didn’t notice anything); at the same time, I got ‘blocked’ at work. So two (or three) of my pillars collapsed, and I ran like crazy from one pillar to the other, trying to keep the infrastructure in place, but it was too late — it just crumbled away to dust, leaving my inner self exposed. This is what apparently triggers the depression; the ‘running around’, crazily trying to put the infrastructure back into place, is possibly linked to anxiety; and the narcissistic aspect of it is the need I require for others to tell me that I’m doing well — I need their approval, not their criticism, and that makes me especially fragile when events conspire against my best laid-out plans.

To make matters worse, there is something inherently ‘wrong’ with my gender identity (in the sense that most people — those who are cisgender! — have no issues with their gender identities). As a consequence, I became a workaholic mostly to avoid thinking about my inner female self — the more it fought to ‘come out’ and dominate my wishes and needs, the harder I worked. The depression, however, affected my ability to work; as a consequence, the last refuge I had to escape from my gender identity issues was gone. Another pillar collapsed in my mental infrastructure; now it was all upside down, and it was by presenting myself as a woman that I gained a degree of self-confidence again. I’ve just explained how important for me is to feel the way people treat me when I present myself as a woman; I never got that kind of treatment as a male, and it has nothing to do with ‘politeness’. It’s just that women are treated differently. Trans woman are not frequently seen in my country, but everybody has heard about them, from TV and other sources; so people are especially nice to me. While as a male, I’m just another random, gray person, part of the mob — one of many, without an identity. See, all this comes from the narcissistic part of the depression. And it all makes sense: I used to get validation through my work, and, once that failed, I got it through my presentation as a woman. There is some kind of transfer mechanism at work here — my crossdressing (let’s stick to that word for a while) became my escape from a work that I cannot perform any longer; the acceptance I got from crossdressing replaced the acceptance I got from the work I did.

Things, fortunately, changed in the past five weeks: as said, I have been able to work as I did before. This is a good sign! I would therefore expect that the ‘need’ to crossdress would slowly recede; it would be the ‘normal’ reaction, after all, since the ability to work for extended periods, day after day (including weekends), simply meant that I had recovered my escape from my gender identity issues. But… that didn’t happen. In fact, in some cases it just got ‘worse’, if I can use that word in this context. Last week, for instance, because I’m so well ahead in my work — which I continue to perform — I dressed as Sandra almost every day, and went out in broad daylight all of those days, except for one (because I was on the phone with my cousin for over four hours). I have insane plans for things to do as Sandra in the upcoming weeks. But, in the intervals of going out as Sandra, I’m able to work as before. Or perhaps I can even work better, more intensely — it’s hard to say, it just feels like that.

For the past three years, doctors have tried to get rid of my depression and anxiety. They might have succeeded in that, or at least coming very close to it, since for me a ‘cure’ is basically recovering the ability to work again; I’m ‘cured’ in that regard. I don’t know if it will last forever or not; I’ve learned a few tricks in how to deal with it, how to recognise some of the signs, how to avoid the deadly trap of getting stuck again. I’m even confident that I’ll be able to overcome all of that, if it happens again; even if I’m just deluding myself, I have recaptured at least a degree of optimism and self-confidence, which will help me in the future (in other words: my brain has to do better and try harder to prevent me from working; I have figured out how to ‘trick’ it, to identify its strategies and push through and get back to work again by sheer willpower). But… now it’s time to tackle what’s left. According to the Standards of Care set by WPATH, once doctors ‘cure’ the associated mental issues (in my case, depression and anxiety), it’s time to tackle gender dysphoria — if it didn’t ‘go away’ after depression and anxiety have been ‘cured’.

At this stage I’m actually very confused. I have described elsewhere that there was no visible ‘transition’ between the moment I was still unable to work and the moment I started to work again. It didn’t feel like, say, a Zen satori moment, when all becomes clear for a brief instant and you recognise the nature of your own mind. Instead, there were just two moments in time, one when I was unable to work, and the next one, when I regained that ability. There wasn’t really anything between those two moments. I didn’t feel different at all, even though later, when the psychosomatic symptoms started, then I started feeling some difference. But after five weeks, those symptoms have simply disappeared. And, again, I don’t feel ‘different’. I’m writing these lines in what seems to me the exact frame of mind that I had two months ago. There is a difference, of course — I now have much less time to write on my blog (or on Facebook… or even uploading pictures and videos of myself!), but I don’t even regret that, I’m still slightly euphoric for having regained the ability to work, and I even have received the good news that the first money transfer to pay for that work has gone through (it’s not enough for us to survive, even considering that we live under the poverty line, but it’s almost enough — which is also good enough for me at this stage!).

But… well, seriously, I was expecting that more things changed. I was really hoping that the sense of dysphoria would disappear, or at least fade away, or something like that. Instead, I’m getting more and more confused about myself; my next article (still being written!) will be on my thoughts about what it means when a MtF transgender person, who has lived for decades in the male gender role, says ‘I am a woman’. In my case, what I have told my doctors is that I definitely do not identify as a male, because I have been forced to do so for decades, and have always rejected my ‘maleness’ (which always got me into trouble anyway). So, I’m not-a-man. Does that make me female? No, not really; gender, after all, is not binary. I don’t know what I am, or, more specifically, I have no idea what gender identity I have. What I can say is that I do not identify as a male; and I can also say that it gives me great pleasure to present myself as a woman — and that feeling remains, depression or no depression. It would be way simpler if I ‘believed’ in binary gender: I could just say, great, I’m not a man, I like to present as a woman, therefore I have to be a woman. But I know things are not that simple. Sure, I’m somewhere on the transgender spectrum, that goes without question. What should be questioned is if it will help me in any way to push myself into the other end of the spectrum and look back to my present situation and ask myself what is better.

And that’s pretty much what my doctors are asking me to do. Of course they are not pressing me to do it; they just want to know what my reaction is to the whole idea of starting HRT. They also know what it entails and how it proceeds: one of my doctors is the current top specialist in gender dysphoria in my country, from the perspective of the psychiatric and psychological point of view; because he’s also an endocrinologist, and got his PhD in the US in transgender studies, he’s in a privileged position to make good, solid judgments about myself and my reactions.

Dealing with them is actually quite tough 🙂 I mean that in a good way; I have always loved people who challenged me intellectually (that’s why I’m married to one; that’s why my best friends all have twice my IQ or so; I love the way they push me ahead and above myself, by forcing me to keep up with their enhanced cognitive abilities — which, in turn, also force my brain to work smarter!). My psychologist, in particular — after all, he’s the one who spends the most time with me — is always making me think a lot with his comments. He’s constantly giving me ‘homework’ — things to think about. They are tough for me. He wants me to abandon my own way of thinking; to stop overreacting in a rational, logical way, especially on issues that are mostly emotional; he wants to have an inkling about what I really think, once I peel all those onion layers away and expose my naked core to him.

Well, it’s not easy for me. If you’re reading this and are somewhere on the transgender spectrum, no matter where you are (or if you don’t even feel the tiniest bit of dysphoria), you know that you have to ‘keep a mask’ all the time to hide your transgender status. Even if you label yourself ‘just a crossdresser’, as I’ve been doing for decades, there is still something to hide. So what am I hiding — from myself?

My own definition of ‘transgender’ is taken from Jamie Young, who writes self-help books for crossdressers and transgender people:

If you question your own gender identity, then you are transgender.

This is what I’ve said before: cisgender people never question their own gender identity. Therefore, according to that very simple definition, there is absolutely no doubt in my head that I must be transgender.

After questioning one’s gender identity, the next step is asking yourself if you accept the gender identity that you have been assigned at birth. And here things immediately become tricky. What does ‘accept’ mean in my context? I mean, you can fully reject your assigned gender identity, and that means rebelling against it, committing suicide, or, well, go ahead with transition without regrets. It also means being quite sure about one’s own gender identity. This is clearly seen in those classic transexual cases: they are such strong believers in binary gender that they know for sure that they have been assigned the wrong gender at birth. In other words, unlike those who overthink the issue, such classic transexuals simply formulate the syllogism I’ve mentioned above — ‘if I have been assigned male at birth, have a male body, but do not identify as male, then I must be a woman, and I need a woman’s body to keep my sanity’. Such cases are crystal clear to deal with — it’s not even worth (from the perspective of a doctor or researcher) to ‘confuse’ the person with a complex explanation about gender being a spectrum and not binary.

People like me, if they are honest about their emotions, feelings, thoughts, and so forth, will simply state that they are not comfortable with the gender that has been assigned to them at birth. ‘Uncomfortable’ is what doctors would call ‘dysphoria’ — it’s a constant, nagging feeling that something is terribly wrong, and that one’s mind and identity are at odds with one’s body and social presentation. However, the solution might not always be to change the body and the social presentation — dysphoria can persist even then, especially in those cases where people are not only outside a binary gender classification, but their identity is absolutely genderless. Or, as it is so much more common, people might be simply bi-gender or, better, gender oscillating (which means that they may adopt different genders according to their state of mind, and such genders can be more than two). For such people, so-called ‘transition’ is pretty much useless, because they might, after all, need to embrace the gender they have been assigned at birth from time to time. Nevertheless, they might wish to make physical changes to their bodies in order to be easier to move across gender identities and presentations.

So… getting back to myself… sure, I would wish to present much better as a woman, and that also means going through hormone replacement therapy and surgery. I’m still undecided if that means that ‘I am a woman’. I’m sure it’s not so simple as that. Doctors tend to believe that people who are willing to change their bodies (switching sexes in the process) in order to stop their suffering must be transexual at some point, or at least transgender suffering from a certain degree of gender dysphoria. I’m personally not so sure, because I’m not totally convinced that the ‘solution’ to gender dysphoria — simply put, being uncomfortable in one’s own body and gender role, to the point that it renders that person non-functional — is to switch to a different gender identity (which means a different body — even if there are limits to what medical science can do — and implies a different gender presentation). There might be alternatives; and, conversely, that kind of change might not reduce gender dysphoria, it might just make it… different.

Now, I know I’m rationalising the whole issue to the utmost degree, in a very frustrated attempt to come up with an answer that satisfies myself. Deep in my mind, I still think that the human species is mostly gender binary, or statistically close to what we would call gender binary, since that’s the way we humans can reproduce better. This is not the whole story — not by far! — as you will learn on the upcoming article to excruciating detail. But to simplify the issue, we can simply say that we humans are mostly binary. Even if 10% of the human population is not gender binary, that still means that the vast majority — 90% — is.

So, as said, very deep in my mind, buried under layers and layers, there is a small ‘switch’ in my mind which says ‘male/non-male’ and it’s currently set to ‘non-male’. Because in 90% of the cases that means ‘female’, it’s a huge temptation to believe that — after all, in the same way I have been coerced to resign myself to a male gender role and a male presentation, I have also been conditioned to believe that gender identity is ‘mostly binary’. This makes me immediately think that ‘non-male = female’. I also think that my doctors can see right through all these layers of confusion and/or ‘hiding’ and can somehow see what I deeply believe in. In other words: at my intellectual level, where I employ logic and rationalising about things and issues, I know that ‘non-male’ does not imply ‘female’ at all, but rather just shows that there are many different ways of expressing a gender identity and nothing more. ‘Female’ is just one of many possible choices. But it looks like deep inside myself I actually believe (and note the difference between rational argument and belief!) that I ought to be female since I’m sure I’m not male.

Unfortunately for my sanity, I don’t work — yet — at those deep, subconscious levels. I cannot ‘see’ what it ‘down there’. I can only reason at the level I’m conscious about; my awareness is at a quite sophisticated level, even though I’m supposed to be training to be able to be aware at several levels — right now, however, I can only work at the level of the higher mental faculties, where cognition, logic, rationalisation, knowledge acquisition, etc. reside. It’s also the same level where I have my prejudices, my stereotypes, my ideas of what is wrong, what makes sense, what is functional, and so forth. And it’s also at that level where I question all my ideas, thoughts, emotions, feelings, desires, wishes, dreams, and so forth — and wonder how many of those are ‘truly me’ or merely a product of decades of coercion, then suppression, and finally even resignation, to what eventually I will have to ‘accept’ — that I ought to have started transition when I was first questioning my own gender identity, i.e. roughly around 11 years of age. At that time, things were so much simpler! But by the time I was 15, I was confused enough to wonder how someone who has been born with a male body, conditioned to adopt the male role, and having a strong attraction towards women, could be anything but a ‘man’? On the other hand, if that was the case, why couldn’t I be ‘a man’ inside my mind? That confused me tremendously, and it didn’t make any sense to me, until a decade later I was able to read about the subject on the Internet.

Anyway… as said, the more I watch other people’s success stories, the more I worry about them. They all feel ‘too perfect’ to be true — at least for a majority of people. Of course I also know about a few success stories, but they all seem to have it so much easier than me: in one case, for instance, a friend expressed the wish to transition because she was attracted to men, but found out that she wasn’t attracted to gay men — just to heterosexual ones. That meant, of course, getting a woman’s body, and that’s what she did. Since I learned about that case, I found out about many, many more — where the person ‘came out’ as homosexual (not being sure of their gender identity), started dating other homosexual men, and somehow it didn’t ‘feel right’ — because they figured out that what they really, really wanted was to date heterosexual men. Such a scenario doesn’t seem to be as rare as I thought before.

Others simply know since their earliest memories that they have been born in the wrong body, and while they may concede that there are more than two genders, they are also among the first to say that they strictly believe in a binary gender model — they have just been assigned the ‘wrong’ gender at birth. Therefore they wish to correct the ‘mistake’.

Many, many cases I know about have started with some sort of childhood trauma. Unfortunately, most of those cases had to do with being raped by a much elder man (usually a relative or a close neighbour or friend of the family). Such traumatic cases do not really ‘switch’ one’s gender to a different one; however, they might trigger something that has been deeply hidden but always known, and which finally surfaces to the conscious thought — namely, that their gender has been wrongly assigned at birth. Not all traumatic experiences are linked to rape, though; there are many more possibilities; and, again, it doesn’t mean that all transexuals somehow were victims of childhood trauma of some sort. Still, it’s a prevalent condition, and not so unusual as it might seem to be for an outsider.

To summarise: I have this feeling that every transgender person I have met, with very few exceptions, have been ‘sure’ of their gender identity, often for a long time; and they are sure that it’s not the gender identity they have been assigned at birth. They might come to realize that early on, or just at a much later stage — this depends of a ton of reasons, which are different for each person. They might have suppressed their gender dysphoria for decades and attempted to live a ‘normal’ social life according to a gender role they hate, but they have resigned themselves to survive that way, until something happens that makes it impossible to ‘hide’ any longer.

In my case, I would probably find myself somewhere in this second group. It takes now a conscious effort not to run at the first opportunity to raid the closet, wear something appropriate, and be Sandra, both mentally but also physically (at least, from the perspective of an outsider). But in the past, making that effort was easy, since I could suppress that wish/desire merely by working harder. During depression, however, I lacked that form of ‘control’, and I deeply wish to ‘be Sandra’ all the time.

But if I do not trust myself to make a decision based on my feelings and wishes, how do I know that this wish to ‘be Sandra’ is reasonable or not? The people I know that went through transition (or are still taking their first steps) did obviously hesitate for a while — even a long while! — but never as long as me. What causes that lack of self-confidence? What makes me hesitate? What are my fears?

I need to answer all of the above, truthfully, and I’m pressed t0 do it now. It’s not something I really enjoy or look forward to — but ultimately, the decision to go ahead with at least some form of transition is mine and mine only — I can just draw upon strength and support from those who have travelled this path as well.