In Praise Of Lesbian Doctors

Getting healthcare as a trans person is goddamn difficult. I avoid doctors to my own detriment because it’s so unpleasant. I get caught in health insurance hell as various agencies attempt to determine my sex and thereby decide what healthcare I deserve. I’m one of the lucky ones–indignities aside, I always get the healthcare I need.

Through the ups and downs of appointments and procedures, a few dedicated people have gone out of their way to show me respect, advocate for my rights, and deliver the care I need. Where would I be without lesbian doctors?

  • My step-mom, who prescribes me antibiotics in a pinch, who referred me to the doctor who prescribes my testosterone, who is one of the few doctors in her city who treats trans patients.
  • My primary care doctor, who prescribes my testosterone, who takes a genuine interest in my wellbeing, who makes pelvic exams bearable, who uses the right words for my body, who goes out of her way to help queer patients.
  • The surgeon I’m consulting with for my hysterectomy, who is happy to see transsexual men in her gynecological practice, whose staff is highly informed and respectful.
  • The doctor who takes care of billing for the surgeon, who is also her partner, who personally called my insurance company and insisted they come up with a real solution for trans patients, who is arranging to give me a discount on my consultation so I can afford it without insurance.

All four of these professionals are lesbians who make a point of being allies to other queer people, a commitment they’ve discussed frankly with me. I’ve never a bad experience with a lesbian doctor–and as you can tell, I’ve seen quite a few–nor have I ever had a doctor of a different identity go above and beyond the call of duty like this. (Never had any other queer doctors, as far as I know.) I was referred to each doctor by another on the list, so it’s really my local lesbian doctor community that has done so much for me.

Thank you, thank you, lesbian doctors, for your life-saving solidarity.

Gender Dysphoria Is A Good Problem

I was depressed for 15 years. Today I am thriving, and I enjoy life every single day. What happened? I transitioned.

Transition doesn’t solve all your problems, but damn, it sure does help. For me, it solved my only real problem, the disease creating all my symptoms. Turns out that my depression, deep-seated anger, social and general anxiety, problematic substance use, and self-harm were all just different faces of the same monster–gender dysphoria.

Addressing dysphoria not only led me out of the misery of mental illness. It also led me into feminism, social justice politics, and radical consciousness. It led me into community with badass human beings who live authentically and strive to help others. It led me into my chosen field, mental health. It led me to God.

Gender dysphoria is a good problem to have. Gender dysphoria is a problem that, at least potentially, ends. It’s a problem with a solution. It’s a problem with a path to recovery, crooked though that road may be.

As I watch friends and family members struggle with depression and addiction, as I get the news of more and more classmates dead before 30 by suicide or overdose–goddamn am I glad to have been given gender dysphoria and the ability to address it. These people I knew, may they rest in peace, by and large had access to treatment… just not treatment that worked fast enough.

My problem was simpler than that. Sometimes I see a friend dealing with depression, and I honestly hope the real issue is that they are a gender or sexual minority. At least then I’d know how to help.

Gender dysphoria is a problem that creates friendships and community, artwork and poetry, awareness and solidarity. It’s a problem that can lead you down an incredible road of growth and self-discovery, maybe even to your destiny.

Perhaps gender dysphoria isn’t really a problem at all.

Loving Broken Things

Primordial tragedy. The vessels of light that shattered and scattered into everything.

Once again I found myself contemplating the brokenness of the world. Sometimes I get engulfed by that bottomless grief. The ruined body of a hummingbird smeared across the asphalt with the dead leaves, styrofoam cups, and condom wrappers. A man with dead eyes staggering down my street with a needle still in his arm. Headlines. Teenagers beat two homeless men to death. Parents kick nine-year-old boy to death. Photographs of children killed in Gaza. Why, why, why.

And our own lives, our own bodies, all that lesser brokenness. I read that the ancient rabbis said it would be better for humans to never have existed, there is so much pain in the world. But since we do exist, they concluded, we must try to do good.

Why, why, why? Once again I found myself contemplating brokenness. And realized: No brokenness equals the disavowal of all imperfection. Broken things would have to be forbidden, a ruthless test imposed on all forms in the universe.

What is the greatest act of love of something broken? To forbid it, deny it, destory it, uncreate it? No.

The greatest act of love is to allow it to be. To cradle it, honor it, let the light fall upon it. What we call broken is held in the infinite embrace of Reality, no less than what we call good.

Brokenness, too, is a testament of love.

Opposite Of Opposites

But there is a magic aspect in abnormality and so-called deformity. Maimed, mad, and sexually different people were believed to possess supernatural powers by primal cultures’ magico-religious thinking. For them, abnormality was the price a person had to pay for her or his inborn extraordinary gift.

There is something compelling about being both male and female, about having an entry into both worlds. Contrary to some psychiatric tenets, half and halfs are not suffering from a confusion of sexual identity, or even from a confusion of gender. What we are suffering from is an absolute despot duality that says we are able to be only one or the other. It claims that human nature is limited and cannot evolve into something better. But I, like other queer people, am two in one body, both male and female. I am the embodiment of the hieros gamos: the coming together of opposite qualities within.

– Gloria Anzaldúa, Borderlands/La Frontera

The enforced boundary between male and female is among the deepest cuts in the human soul. How did that ancient play of opposites twist from a dance into something much more sinister? The dividing wall has become an idol, and you and I, the sacrifice. They have forgotten that wall once was a bridge.

They have forgotten the most important truth, the secret underlying everything: all opposites are one. Opposite pairs are interconnected, not mutually exclusive; allies, not enemies. Opposites complement, transform into and create one other.

And what of us? We are questions, dreams, possibilities. We have healed the war between the genders within our own bodies. Like the poles of a magnet, male and female are opposites with one source, one body, one life, wholly interdependent.

We are the promise of a new paradigm. We are the example of healing.

We must be for ourselves, or who will be for us? Yet we cannot only be for ourselves, or what are we? We have also come for them, the others, our sisters and brothers. The delicate glow of our light will heal them, too, if they can bear to see it. We have come to bring a thousand years of peace between men and women, if only they will make a little room for the rest of us.

We are only messengers; they shot us. We are doves of peace; they gutted and ate us. We are born in every generation, bellwethers of their compassion. They crush us, and only crush themselves. They try to snuff us out and they snuff out their own souls.

But there is another way. There is another way, and we must be her champions. It is the way of open hearts and open borders. Someday they may yet see us in their mirrors, and remember we were sisters and brothers once. Someday they may listen. Our voices will wash over the desert, and if the acequias run with blood, do not be afraid. It is only all the blood already spilled these 500 years convulsed with violence. Those tiny rivers will clog with brine, the tears of the dead seeping at long last out of the soil.

The light of love will wash that away; water will flow again. We will eat piñon and cactus fruit, and let doves be.

Then we will know, and we will remember. They are us, we are them.

Paradise is ours when all of us want it.

7 Reasons To Use Preferred Gender Pronouns

Preferred gender pronouns (PGPs) are a perennial issue for transgender people. It’s confusing to friends and family when we ask for a new pronoun. Strangers misgender us and go for the wrong word. Well-meaning people struggle to use gender-neutral pronouns or keep slipping up and using the pronoun of our assigned sex. Those little syllables can make us cry, puke, or scream–or they can make our day. Here are a few reasons we should all take the time to get pronouns right.

1. The Golden Rule. Treat others as you would like to be treated. Would you like it if someone referred to you with the wrong gender pronouns? What if everybody referred to you with the wrong pronouns?

2. Set an example. Are you an awesome trans person or ally who knows your friends’ and colleagues’ PGPs? Be an example for those who don’t know the right words or are struggling with a pronoun change. If people hear you referring to someone as he/she/they/ze/etc., they’re likely to follow suit.

3. Give a gift. When I was early in my transition, the words he/him/his were music to my ears. It truly made my day when friends, classmates and strangers got my pronouns right. Do a good deed–use someone’s PGPs today.

4. Mental acuity. Do you value your ability to learn new things and remember important information? It is really tricky adjusting to a friend’s pronoun change or learning to use unfamiliar pronouns. Keep your mind limber and expand you vocabulary. As they say, you either use it or lose it.

5. Embrace change. It can be genuinely disorienting, even stressful, when a loved one comes out as transgender. It can also be confusing when you get to know a person who uses pronouns you haven’t heard before. By using PGPs, you commit to embracing the change life has thrown your way. This flexibility will serve you well in all endeavors. Plus, next time, you might be the one going through a major life change and hoping your community will rally around you.

6. Build relationships. I vividly remember how friends and relatives reacted when I started going by male pronouns. I remember those who cared about my wishes and made a good faith effort to change. And I remember those who griped, moaned, and generally appeared to care more about individual syllables than about me. This one thing didn’t make or break any relationships, but it’s no coincidence that none of the complainers are part of my life now.

7. It’s the right thing to do. Enough said.

Birthday Getaway

Today I am 25! I am extremely grateful and satisfied with what I have learned in my first hundred seasons under the sun. I hope I will be blessed with many more years like these.

As you read this, I am somewhere in the airspace over North America. My mom and her partner are taking Alma and me on vacation. I’ll be leaving the desert for the seaside this week.

I have a couple posts scheduled, so Today I Am A Man will go on as usual. I may be slow moderating comments.

Thanks for reading.

Where Will The Trans Movement Be In 10 Years?

A reader writes,

It seems like the trans movement is at a watershed moment right now. Where would you like to see the movement go in the next 10 years? What should our goals be, and what pitfalls should we try to avoid?

Thank you for these interesting and important questions! I appreciate the chance to explore the topic. This is an amazing moment for the trans community. We are reaching new levels of mainstream acceptance and visibility, and we are connected, organized, and engaged like never before. I’ll first discuss some benchmarks I’d love to see us reach in the next decade. Then, I’ll examine our priorities–including a few things I hope won’t become priorities.

It’s difficult to answer this question concisely, because trans equality is intimately connected to justice for all people. Trans people are of every race, religion, gender, nationality, ability, class, sexual orientation, etc. We will never be really free while there are violence and oppression in the world. However, I will focus this post on a few issues specific to the trans communities I know and inhabit.

Before I dive in, a caveat. This is just my take as one trans dude/blogger/small-time activist. My thoughts reflect my position as a middle class, light-skinned, Jewish transsexual man in the US. I would love to hear different ideas and different perspectives on this. I’d like to invite others to offer their own answers to the questions above.

The Trans Movement in 2025

How will things change for the trans movement over the next 10 years? I don’t know, but here are four things I’d love to see.

1. Safety

In 10 years, I would like it to be safe to walk down the street as a transgender person. Being visibly trans or gender-nonconforming should not put a person at risk of discrimination, harassment or violence. As a transsexual man who hasn’t been misgendered in years, I am quite safe. Many trans people do not have this basic freedom, and it’s no coincidence that trans women, people of color and poor folks are all at greater risk.

I am nauseated to admit I do not think we will get there in 10 years. But safety is, of course, an essential goal. I recognize there are many places and situations where people aren’t safe, period, regardless of gender identity, expression or history. Still, I feel I have to put this at the top of the list. This is what I would most like to see: that we can move through our own communities without fear.

How we’ll know we’re there. The TDOR list will stop getting longer.

2. Healthcare &  Transition

Many people are not able to access medically necessary, life-saving care because they happen to be transgender. In 10 years, I would like to see the disappearance of healthcare discrimination and much expanded access to transition.

It is unspeakably horrible that people are denied emergency attention or cancer treatment just because they are trans. In terms of transition, if we in the US still have our horrible health care system, I would at a minimum like to see transition care covered by insurance.

I would like to see policy changes that give trans people reasonable avenues to update their legal sex (some encouraging recent developments on this; when I changed my sex on my Social Security record just 4 years ago, I had to prove I’d had surgery, and that’s not the case now). I would love to see some kind of option for genderqueer people (and others who are neither male nor female) to reflect their gender on their records, if that is something nonbinary people want.

How we’ll know we’re there. People won’t die waiting for care that will never come just because they are transgender. People won’t have to get hormones on the street or forgo needed surgery because it’s too expensive. We won’t be walking around with mismatched identity documents (unless we want to be!).

3. Awareness & Acceptance

Transphobia and cissexism aren’t disappearing anytime soon. But I’d love to see us make huge gains in public opinion, and I think that’s possible.

In 10 years, I’d like “transgender” to be a concept that more or less all adults understand. I’d like the mainstream to have a basic sense of compassion and respect for trans people. There will undoubtedly be hold-outs who despise us. I hope they will, indeed, be hold-outs, left behind while the public learns to live alongside us. There are signs this is beginning to happen, but we have a really long way to go. This visibility ought to include nonbinary people as well as transsexual women and men, of course.

How we’ll know we’re there. There will be trans characters in popular books, movies and shows (this is starting to happen). Most people will have met at least one openly trans person (like the situation of gays & lesbians in the US now). There will be openly trans people in various occupations and roles. In many jurisdictions, it will be both illegal and unpopular to discriminate against us.

4. Mental Health

Being trans shouldn’t be a near-guarantee of depression and suicidal ideation. I would like to see greatly improved mental health within our community. If we’re safe, if we’re largely accepted, if we can access transition–that will go a long, long way towards alleviating our collective misery. I would also like to see mental health professionals improve and update their understanding of trans issues, so we can easily find professionals who know how to work with us (and, hopefully, actually afford mental health services–see number 2!).

How we’ll know we’re there. Suicide & suicide attempt rates for trans people will be close to the rates of the general population. Family members will by and large support transgender loved ones.


What about goals and potential pitfalls? I really see just one issue here. Our priority should always be improving conditions for our whole community. We should let the most dire issues and the needs of the most vulnerable among us set the agenda. I hope that in 10 years, the trans movement will continue to be a vibrant, diverse coalition. I hope we will continue to address urgent causes, to question systems of oppression, to offer intersectional interpretations of power. I hope we will not take on an assimilationist focus that mainly serves trans people who are already privileged by race, class, etc. That is the pitfall that worries me–that instead of conditions improving for trans people in general, there will be widening inequality within the trans community.

What do you think? Where would you like to see the trans community in 2025?

Ask me a question.

Testosterone: Gel vs Injections

I recently switched up my testosterone prescription. I am now using Androgel, after nearly 4 years of injections. I am really pleased with the change and thought I’d compare and contrast the two experiences.

I initially started with injections for two reasons. First, the cost–it’s generally much cheaper. (If you’re paying for testosterone cypionate out of pocket, you might want to look into Strohecker’s Pharmacy. Affordable and awesome.) Second, my doctor informed me that people usually see faster changes with injections, and fast changes were my no. 1 priority at the time.

I’m a rather anxious person, and over the last few years I developed a very negative relationship with my shots. In the beginning, I was highly motivated to get T into my system, so I didn’t really care. Once hormones changed from a matter of urgency to plain old health maintenance, I found it harder and harder to do the shots. I also found the shots got a lot more painful as I shed fat and gained muscle. Alma dutifully did every single one of my injections, despite my frequent complaining about them. (Thank you!!!) I kept thinking things would improve with time, but in fact, they got worse and worse. A couple months ago, I finally decided I’d had enough.

With some effort, I found an affordable way to get the gel. My insurance covers it at a great price if I get it through a special home delivery pharmacy, and it works out to be only slightly more expensive than the injections ($160/year vs $120/year). I’ll be aging off my dad’s insurance plan in a year; hopefully I will be able to continue to get the gel at a reasonable price after that. We’ll see.

Some things I love about switching to Androgel:

  • No needles!
  • No pain!
  • I can do everything myself (never worked up the nerve to do my own injections)
  • Levels feel more even (used to get breakouts & feel low-energy at the end of my shot cycle)

A few things I don’t like about Androgel:

  • Volume of gel I have to apply. I am on a lower dose (3 pumps/day, similar to 75mg/week in injection terms) and it’s still so. much. gel.
  • Worrying about accidentally exposing someone else to T (namely Alma)
  • Skin is a bit dry and itchy where I apply the gel

The few downsides are minor inconveniences. I’ve switched my showers from morning to night, so that takes care of the accidental exposure issue. Lotion is helping with the skin irritation. I will get my levels checked in a few months to make sure the gel is doing its job. All in all I’m really pleased with the switch.

Readers who take hormones–what method do you use?

New Look, About Page & Ask Me Anything

Today I Am A Man has a new look! And I finally got around to making an About page, where you can learn mundane facts about me and see a picture of my dogs. I also thought I’d take this opportunity to direct your attention to my Ask A Question page, where you can contact me anonymously. (You can also email me–see address in sidebar.) I really love getting questions and I welcome all queries asked in good faith. So if you happen to have a question, ask away!

We now return to our regularly scheduled blogging.

How Do Trans People Fit Into Gender? Trans Inclusion & Asking Good Questions, Part 2

In my last post on good questions and trans inclusion, I offered an answer to the question, “What is gender?” This time, I’d like to look at two more aspects of genderneutral’s question: How can we include all trans people in our understanding of gender? And, how can we view trans people as interconnected within the larger human story of gender?

If gender is part of being human, for better or for worse–so often for worse–and if we could think of it a bit like language or music, we have already entered radically new territory. We are no longer in the realm of rules, rigid categories, and so-called truth. Instead we have entered a realm of meaning, culture, communication and beauty. A melody may be especially pleasing (or not) to our own ears, and it may be of a certain style or format. In no sense, however, can a melody be “wrong” or “right.” Pay no mind to the few who try to say so out of snobbery. Those who claim some type of music is not music are always made wrong by history.

So we can let gender wax and wane, bend and change with the cultural seasons; whatever is good and real in it will endure. We can let people, ourselves included, be as they are. They are that way anyway, whether or not we see fit to grant our permission. I say, use your voice and try to sing, as best you can, the song that you were born singing. Or dwell deeply in silence, drinking in the rich space of your own quiet. To insult or drown out another’s song is an act of cruelty, which does nothing but introduce more hatred into the world. Such violence is a senseless and tragic misuse of your fleeting time on this earth.

In this logic, all trans people are always already included within the concept of gender. I will not spend any time justifying our dignity or legitimacy. Our existence is enough. I take this truth to be self-evident: that theory and ideology, if they are to contain any sense at all, must conform themselves to meet reality, and not the other way around. Any explanation of gender that does not include us contains a basic flaw, a broken promise–it does not describe the universe. Not this universe, any way.

In this universe, gender-variant people have always been part of human diversity. This includes those who, in this place and time, we call transgender, transsexual, intersex, genderqueer, agender, bigender, Two Spirit, and other terms. In other times and places, different words have been used, implying different subdivisions among gender and sexual minorities. It is wonderful to learn about the unique terms and traditions of various cultures, especially the more humane manifestations. But that’s somewhat beside the point here. The point is simply that we are real.

How, then, do diverse transgender people fit into the larger human story of gender? Like violin strings in an orchestra, like crickets in a summer night. What would springtime be with only one type of flower, or dawn with a chorus of identical birds? It is the imposition of a violent and unnatural monoculture that rejects our spice and nuance for the sake of its own bland, efficient machinery.

But human nature, like all nature, contains somewhere within itself the awesome intelligence of the ecosystem. The natural world is an interdependent wonderland containing order and chaos, harmony and discord, and dazzling uncountable myriad forms. So the genders need no more determine, dominate or detract from one another than the animals, vegetables and minerals sharing a bit of the earth.

All I have said so far confines itself to our understanding of gender–to internal shifts in our view of the world. How do we take such an understanding and shift the world? I think changing our understanding of gender, and living out that change, are necessary, but obviously not sufficient.

What is sufficient? I do not know.