I am post-transition. It now seems rather impossible that I was once viewed as a girl. In the steady rhythm of a daily life in which dysphoria casts no shadow, things start to seem very solid, real, definitive, sensible. Of course I am a man.
And now I feel a strange, subtle weight upon my shoulders, something most unfamiliar: legitimacy. I am the legitimate transsexual, if you’ll permit such a paradox. Here I am: thoroughly, obviously male, confusing no one; comfortably masculine and heterosexual; expert-tested and little old lady-approved. I am the kind of transsexual you can take home for dinner: invisible.
Now that I have arrived on the far shore, shapeshifted once and ceased shifting, it all seems obvious, credible, inevitable. My transition, because it appears so complete, so, dare I say, natural, colors my whole life, past/present/future. The strangest bit is the way transition rewrites the past.
Two levels here. One, I appreciate: my secret truth, the burden I carried, is no longer my silent curse. Instead it is an open fact, and my retelling of my childhood now reflects that. As it should be. I didn’t grow up a girl; I grew up a masculine, gender-nonconforming kid deeply confused by the world’s insistence that I was a girl. The secret subjective has been brought forward.
The other level: very strange: the “true transsexual” narrative has been bequeathed to me, an inheritance, like a consolation prize from society. Now it appears that I always knew I was a trans man, that the signs were indisputable, that it was all very straightforward. I appear to fit the all-important narrative, the only story they’ve allowed us.
I first realized this was happening when my counselor wrote me a letter for top surgery. She helpfully explained that I had a stable male identity from the age of 3. True trans narrative jackpot! I laughed out loud when I read it, because it is, well…not false, but not exactly true, either.
What I told her was that I lived under a strange fog of unhappiness from the time I was in preschool; that I had a deep, foreboding sense that I was not like other people; that I had a vague awareness that I was somehow a failure of a girl; and that, in retrospect, I can trace my many years of childhood unhappiness to gender dysphoria. But that’s a bit fuzzy and hard to explain. She cleaned my life up for me.
Missing were my desperate bids for girlhood, my deeply meaningful experience of living as a butch, my stubborn suspicion of the gender system, the subtle, spiritual quality of my masculinity, the dance, the very dance itself, the essence of all of it. Poof, gone. Replaced with a reassuring and convenient story. No more mystery. Like it was all obvious from the start. Nothing to see here, folks.
I am grateful–she knew the letter was a bullshit requirement for surgery, and she wanted to ensure I got what I needed. But how strange, how damn strange, to see the narrative reproduced and imposed in real time.
The narrative is not for our benefit. It helps the cis majority sleep at night. If I could have once appeared to be a girl, and today be so clearly a man, what the fuck does that say about the reality of gender? What does–what might–that say about other people’s genders? This is a terrifying prospect for those who’ve lived their whole lives in the security of the gated city. Better to smooth things over, keep it simple, say it was always clear, like anyone could’ve taken one look at me and spotted one of those people. That way, no one else has to worry about themselves, their loved ones, their children; no one need contemplate that horror of horrors, one of us in their own midst. Perhaps under their own roof, sleeping in their bed, in their own skin.
Sometimes the narrative divides us. I now experience the weight of legitimacy in my interactions with other trans people, in person and online. People early in transition, people questioning their genders, people who don’t seem to fit the narrow narrative for whatever reason, sometimes seem to regard me with wonderment or adopt a slight crouch of defensiveness. Sometimes it seems like I am the real deal, a card-carrying certified transsexual, and other people might be amazed (“How do I get that?”) or irritated (“Conformist.”) or afraid (“Am I real enough?”).
It’s a surreal experience, because I have been to all those places. I have been completely certain that I could never fit the narrow transsexual mold. I have believed that I would never change my body because of my feminist principles, and felt a strange mix of envy and betrayal towards those who do. I have felt awkward, ambiguous and afraid in the presence of post-transition men, as if witnessing some grand achievement. I have been sure I would never be one of them, and wanted to be one them, and not wanted to be. I have jumped through the gatekeeping hoops to get the care I needed. I have lied and oversimplified my story to professionals to ensure access. I have said, “I can’t be transsexual because…” I have said I would always identify as queer, stopped considering myself queer at all, and starting calling myself queer again. I have lived in the badlands between the sexes. I have transitioned. I have moved through the world in the form of a man. I have been the same person all along.
So let it be said: I am a card-carrying true transsexual, and I don’t fit the narrative, either. I played with Legos and I played with baby dolls; I dressed up in my father’s clothing and I dressed up as a princess; I kissed girls and I kissed boys; I struggled mightily with my gender identity; I never thought I would actually transition, or that it would all fit together so perfectly. I tried to express what I was feeling, but it took me many, many years to find the words say it.
I always knew I was trans, and I had no idea at all. The narrative can only be true after the fact.
Legitimacy doesn’t love you, respect you, or make you whole. Legitimacy provides a minimum of safety. Legitimacy is a raincoat. If you’re getting soaked, cover yourself up, if you can. Don’t mistake access to rain-gear for your own essential worthiness, for your right to live, for who you are.
And when the weather changes, take the raincoat off again.
If the question of whether to take T inspires a lot of indecision and angst, the choice to have top surgery seems more straightforward. I rarely hear transmasculine folks agonizing about top surgery. It seems that many people just know they need to get something off their chests (or not). To that end, here are a few suggestions for those contemplating, planning and recovering from top surgery.
1. Pick a procedure. You are probably already looking into the available options. There are a few different procedures under the umbrella of top surgery for trans guys/transmasculine people. I had the double-incision with nipple grafts, a great option for people with a medium-to-large chest. I am very happy with the results. Smaller guys often opt for the periareolar procedure, which results in less scaring. There are also a few other options and a number of possible variations on these. This site has detailed info on procedures and other topics. A few things to consider when selecting a procedure:
- What’s suggested for your chest size/shape?
- Is nipple sensation important to you?
- How do you feel about scarring?
Surgeons often specialize in one or two procedures, so you might want to choose your doctor based on specialty (if you know what you want) or choose your procedure based on the surgeon’s strengths (if you are seeing a specific doctor due to location, insurance coverage or preference). When comparing photos of procedure results, it’s important to look for folks who look like you. In addition to the size of your chest, your overall body shape and size, skin tone and other factors come into play.
2. Select a surgeon. Here again, you’re probably already doing research. If you’re not sure where to start, try browsing photos on transbucket and asking other trans people. Before moving forward with any surgeon, you should see photographs of their work and make sure other trans people have hade a good experience with them. If you are looking to change your gender marker to M, ask whether the surgeon will write you a letter stating you have had irreverisble gender confirmation surgery (or whatever language is required in your area). Another important factor is location–if there are any qualified surgeons in your area, you can save a lot of money by recovering at home.
I got my surgery from Dr. Daniel Medalie. This took me far from home, but it was a great choice for me. There are no surgeons specializing in chest reconstruction in my area, and Dr. Medalie is highly skilled, relatively affordable, and great with trans patients. He told me he does top surgery several times a week!
3. How the hell do I pay for this? Cost is a major concern when it comes to top surgery. If you live in the US (can’t speak to other countries), you will probably find yourself paying out of pocket. The surgery itself usually costs somewhere in the range of $6000-$8000. That number can skyrocket if you need to travel, pay for a place to stay while recovering, etc.
Many doctors offer payment plans or accept credit cards. I covered most of my surgery costs using a CareCredit card (a credit card just for medical expenses). I was lucky to get extensive help from my parents, and we paid it off within a few years. Many trans people raise money through donations or a benefit event. This is usually the hardest part, and of course it really depends on your situation. Don’t lose hope–you can find a way to make this happen.
4. Waiting is the hardest part. You’ve worked your ass off, come up with some serious cash, scheduled your surgery, requested time off work…. Now it’s time to sit back and wait six months til the surgery date. Ahhhh! This phase of the process nearly drove me insane. Every day I had to put my binder back on, I cursed time itself. I tormented Alma with an incessant countdown updated several times a day.
I made myself totally miserable. Don’t be like me! Come up with some things you can do to make waiting easier. You might allow yourself a special indulgence during this limbo period or find a way to mark the time that’s actually enjoyable.
5. Get help while healing. In general, you can expect to be thoroughly laid up for about a week, and then functional, but still tender and healing, for a month or two. If at all possible, have somebody available to care for you during that first week. You are going to feel like shit, and it is really helpful if someone can feed you, take you to your follow-up appointments, and so on. Huge thanks to Alma and my mom for taking excellent care of me during my recovery.
The worst part of the recovery for me actually came from the presciption painkillers. I really needed them for the first day or two. By about day three, I started to feel horrible–a miserable nausea and weakness like nothing else. My mom suggested I ditch the percoset and start taking ibuprofen. Once the hard stuff was out of my system, I felt amazing. I was practically skipping when I went in for my follow-up a week after surgery.
6. Scars–a conversation piece? How will you navigate being a person with surgical scars? Some people opt to cover their chests at the beach and the gym to avoid revealing their scars. Personally, I take my shirt off at the slightest excuse. I’ve found that people very rarely say anything about my scars or even seem to notice them. I’ve occasionally had someone ask if I had a collapsed lung or heart surgery. As far as I know, I’ve never had anyone guess that I am trans based on my scars. So I wouldn’t stress too much about people seeing the scars or commenting on them.
That said, it’s a good idea to have a game plan. If someone asks, what will you tell them, and how much? I usually just say something about how I had surgery a few years ago and leave it at that. People are too polite to pry further.
7. Enjoy yourself. The most important part of getting top surgery–enjoying the results! Throwing on a t-shirt without having to scrutinize your chest in the mirror. The feeling of a summer breeze on your skin. Swimming bare-chested. Never wearing a
suffocating torture device binder ever again. Freedom is so sweet.
Readers–what tips do you have for someone preparing for top surgery? If you are considering or planning surgery, what questions do you have?
Is transition some kind of cop-out? I’ve tackled this topic before, but it always seems to come up again. A commenter recently described transition as “caving into oppression.” On the one hand, I find this to be quite a disrespectful and transphobic view. On the other hand, I know that I really struggled with this idea myself at one time. Because this idea is out there–especially in certain feminist and queer circles–many trans folks have to reckon with it. I thought I’d lay out a few of the ways this idea misses the mark. I’ve split this into two posts cuz I have a lot to say.
This is not a response to pasunhomme, who was talking about their own experience (not sure what pronouns you use, pasunhomme; let me know & I will edit). If transition is not right for them, to do so might well be a kind of “caving”–only pasunhomme can answer that. I hope this goes without saying, but just for the record, I happily support the efforts of all gender-diverse people to make our lives livable, whatever form that takes. This post is a collection of thoughts on the idea that transition generally, for those of us who choose it, is succumbing to social pressure/selling out/giving in to the binary/etc.
When a person needs to transition, it’s not selling out. Quite the opposite: it’s a radical declaration of self-worth and autonomy in the face of a system that denies, denigrates and kills us. This claim rests on a flawed premise: that we are under pressure to transition.
What social pressure to transition? I’ve heard that in some places, such as Iran in recent years, gender-diverse and LGB people are pressured to transition to fit more easily into strict gender norms. So I’m not going to say it never happens. But, in my observation, this is an exceedingly rare exception to the rule, which is that trans people are pressured not to transition.
This pressure can be overwhelming. It includes the incredible discrimination leveled at visibly trans people, encouraging us to hide in our assigned genders; the considerable barriers to transition in most countries, requiring extensive and costly psychological evaluation before medical transition is allowed; the threat of losing friends and family, which happens to huge numbers of people during transition; the stress of coming out on the job or at school, lack of legal protections for trans people, and complications created by, e.g., work history under more than one name; the lack of financial, social and emotional resources to help people in transition; denial of insurance coverage for transition related procedures; a culture of intense silence and shame around gender-nonconformity, leaving people with no words and the sense that they are broken and alone; narratives of trans people as freaks and a total lack of openly trans people in most communities… The list goes on and on and on.
Trans people encounter extremely strong objections to their transitions from family, friends, employers, bureaucracies, religious communities, and nearly every other sphere of life. For those of us who transition, it’s often the most taboo, out-there, flouting-all-social-norms action of our entire lives. To describe this as succumbing to social pressure is just bizarre. Bottom line, it can’t be selling out if The Man isn’t buying.
This is not to deny that gender-variant people experience intense social stigma. This is not to deny that some people are more gender-conforming after transition and thus may experience less stigma (or rather, different stigma). It is to say that 1) this stigma does not manifest in the form of pressure to transition, but rather pressure to conform to one’s assigned gender, and 2) the fact that people may face less stigma after transition doesn’t make it selling out. First, many people are just as or even more visibly variant post-transition. Second, it’s just plain cruel to say that because a choice improves our lives, it’s therefore a cop-out. We didn’t create this bullshit system, and we are among those most persecuted by it. It’s profoundly lacking in compassion to criticize us for attempting to survive it.
Caveat: I know that many people find that once they begin transition, they are under pressure to follow a conventional transsexual path and end up a more-or-less normative man or woman. This is a serious problem that undercuts out agency and harms our community. However, pressure to transition in a specific way, after transition has already begun, is different from a general pressure to transition.
More to come.
If women could be as manly as a Harlan Coben hero or John Wayne character, without everyday sexism and micro-aggressions claiming she is “bossy and aggressive” rather than “commanding and assertive”; and if men could be as feminine as Marianne Dashwood- if you have not read Jane Austen, pick another character, you know what I mean; would any of us need physically to transition?
This questions crops up, in one form or another, in so many places. So I thought I’d give it a proper treatment. This post is not a response to Clare specifically–she is simply the most recent person to voice the question in my presence. Short answer: I think people would still transition in utopia. Onto the longer answer.
First, gender expression is not gender identity. I do not believe that people transition primarily because their gender expression is devalued. This is born out by the many gender-nonconforming people who have no wish to transition and by the many trans people who are visibly gender-nonconforming after transition. Rather, people transition primarily because their gender identity and deepest sense of self are incompatible with their gender role and physical sex traits.
Being the manliest woman is different from being a man, and being the most ladylike dude is a different from being a woman. Cisgender readers may find it helpful to imagine whether living as a feminine man (if you are a woman) or a masculine woman (if you are a man) would be a trivial change, assuming you were shown respect and acceptance, or whether anything important would be lost.
I think something very important indeed is lost, and I would know, because I tried living as a masculine woman for as long as possible. This experience would undoubtedly have been nicer if I were in a society that truly valued gender-variant people. But it’s worth noting that I was in a tolerant environment and had the full support of family and friends. Yet I could not manage it. Even with the enthusiastic support of the wider world, I don’t think I could have managed it. I find it intolerable to live as some special type of woman. I still felt intense alienation from my body, and I still saw myself as “one of the guys” and wanted to be recognized as such. In fact, the more I allowed myself to expressed my masculinity, the more it became clear that I saw myself as a guy and wanted others to see me that way, too. No amount of support had any perceptible effect on that.
The body issues are important. Dysphoria caused by a subconscious sex/apparent sex mismatch is real and acutely painful. Wherever the technology is available, there will probably always be some people who seek out medical treatment to alleviate this pain.
The question also contains the implication that by transitioning, we are somehow attempting to be more socially acceptable or fit into gender norms. Stigma may be a factor motivating transition for some people. But it’s important to note that transitioning people are not spared by the gender system–far from it. Rather, in going from visibly nonconforming people to more conforming people post-transition–if that does indeed happen for a given person, as it did for me–we merely swap one type of marginalization for another. For example, I no longer get harassed on the street, but now I have to deal with a healthcare system that ignores the existence of bodies like mine. At the same time, a huge portion of trans people don’t look gender normative after transition; they may appear just as non-normative as before, or may trade the appearance of conformity in their assigned sex for visible variance in their congruent sex. Either way, transsexual people are among the most marginalized members of our society. I don’t believe large numbers of people are fleeing into that category to escape stigma.
The aspect of the question I find most troubling is the value judgment against transition. Not only does the question misjudge the motivations for transition, it implies that transition is somehow undesirable. If some way of living is perfectly fine, would one raise the question of whether it would exist in a perfect world? I don’t think so. For example, people often wonder whether we can achieve a society in which there is no poverty, child abuse or war. I never hear people wonder whether we can achieve a society in which there is, say, no friendship. To ask the question–would people transition in a better world–implies that there is something wrong with transition itself, like it’s a symptom of a sick society. It suggests that we should be working towards a world in which transition disappears.
I am not on board with that. I suggest, instead, that we work towards a world in which injustice disappears.
Creating space and acceptance for masculine women and feminine men is an essential project. But it is no substitute for transition and for engendering respect and safety for transitioning people. In any gender egalitarian world worthy of the name, trans people must be respected, including transsexual and other transitioning people.
None of this is to say that transition might not look very different in an egalitarian world. Here are a few ways that gender equality and acceptance of diversity might change transition.
- More diversity in transition paths. With widespread acceptance of gender variance, it would be a lot more feasible and safe for a person to have a mix of male and female traits. We would probably see more nonbinary transitions as well as more people taking unique paths in their transition to male or female.
- Different people might transition. There may be some folks who have transitioned today, who would prefer to live as a gender-variant member of their assigned sex if given the option. On the other hand, there are probably also some people who are too scared to transition today, who would do so in a more open-minded world. So the group of people who pursue transition might be different.
- Fewer people would be “stealth.” Many people are private about their trans status. This includes me. Most transsexual folks I’ve encountered are open with a small circle of people, but don’t discuss being trans at work, in certain social groups, etc. In a more accepting world, people could be more open about their transition history.
What do you think? Would people transition in a perfect world? Would you?
[This post includes frank discussion of my body.]
Growing up trans created a catastrophic rift between my mind and my body. Years into transition, I can recognize myself in the mirror, but I’m still healing the split. Little bridge over a great chasm, I cross it slowly, slowly, over and over. Someday I will actually trust it to hold.
An important and intimate part of this reconnection is my relationship with my junk. As I’ve written before, I have no plans for bottom surgery. I have a dick and I am quite content with it.
For years, I was told that I didn’t have a penis, never would or could have a penis, except maybe through (expensive, painful) surgery, and even then, I was told, it wouldn’t really count. I still encounter content on a routine basis that states that trans men who have not had bottom surgery don’t have dicks, which really bugs me. I’m realizing how deeply this psychological castration has affected me. And I’m learning about how my miraculous reverse castration (if you will) changes the way I inhabit the world.
It’s weird to have atypical genitals, a body that doesn’t fit perfectly in either box. I’m not thrilled about sitting down to pee. But I really don’t care that much, because what I’ve got now is such an improvement in terms of my comfort, identity, ability to be naked without vomiting, etc. And I am able to recognize and experience my body as male.
It occurred to me recently that, were I a woman, my body would create intense dysphoria. I’ve been aware that my voice, face, body shape, etc. are clearly male. But I’d held out on acknowledging how clearly male my junk is. My junk is a bit surprising for a man, sure. But, cissexism being what it is, my junk would be way more surprising for a woman. This was a weirdly comforting realization, a confirmation of how far I’ve come.
My doctor remarked on the changes in my genitals after a recent physical. Several years ago, while I was in a storm of changes from testosterone, she asked me how much my “clitoris” had grown. I felt pretty irked by the language–that’s my penis, thanks–but I answered, holding my fingers a couple inches apart. This recent check-up was the first time she’d seen me naked since I started hormones, and afterwards she made a rather confused comment, “There’s been a lot of growth in your, uh. Whatever you call it.” She couldn’t bring herself to describe my junk with female words any longer; it just doesn’t fit. I felt pretty delighted by this. Doctors are so often the arbiters of what words “really” describe our bodies, and mine had just acknowledged that it’s impossible to examine my groin and use female terms with a straight face. I felt like my dick was finally official.
People make a lot of noise about size, but personally, I just don’t give a shit. I’m happy with myself, and I have a partner who loves me and is attracted to me the way I am. So my dick is more like a baby carrot than a regular carrot, more like a baby zucchini than a large zucchini, more like a baby dill pickle than one of those giant pickles they sell at the movie theater…you get the idea.
Edible metaphors aside, the growth I’ve experienced surprised me. It’s tough to find reliable information on this sort of thing, but I had the impression I would grow a lot less. I don’t know if I’m bigger than the typical trans guy, or if I just got the wrong idea, or if I didn’t want to get my hopes up. Probably nobody knows; again, lack of information. For any trans guys who are wondering what to expect: I noticed growth in the first month or two, and it continued through the first two years. Today, my dick is similar in size and shape to my thumb; it ranges between about 1″ and 3″ (I haven’t actually measured, ha) depending on the temperature, whether I have a hard-on, etc. Most importantly for me, my dick is the most, er, prominent feature of that part of my body.
What’s really surprised me is how much the growth has shifted my sense of my body. I lived for more than 20 years with the constant pain of a phantom limb I didn’t know I had. I really feel like I’m slowly healing some deep wound as I relate to my penis. It’s not so much through sexual stuff–though I very much enjoy that–but more through ordinary experiences of my body. Changing clothes, taking a shower, crossing my legs–just seeing and experiencing myself. It’s important to me on personal, emotional, and sexual levels. But what strikes me most is this other, primal level, which feels like it’s rooted very deeply in a subconscious level of my mind. Beyond my wishes, transition goals, sexual desires, etc., is a preverbal part of me that knew what my body was supposed to look and feel like. A part of me that wanted to be whole.
If a dandelion makes its home in a crack in the sidewalk, who can tell its leaves not to stretch toward the sunlight? All beings possess a will to thrive and the intuitive wisdom to seek what they require. You are also turning towards the sun. But you have something the dandelion does not: shame.
As gender diverse people, we get a lot of shit from all sides. Some people love to judge us. They love to put us outside the bounds of what is real, permissible, legitimate, even possible. I suppose it serves to make themselves superior, briefly, in the distorted mirror of their own minds. Whether the naysayers are radical feminists, religious fundamentalists, or our own parents, the message is the same. Don’t be the way you are.
That’s not option, for us or for anyone. We are that we are. We have two choices: we can be in agony, resisting our own life-impulse, or we can be whole.
The incessant demand that we not exist is the root of a lot of our misery. It takes so many forms. There is the demand, on the one hand, that we conform to the countless dictates of our assigned gender. And on the other hand, the demand that all gender diverse people be “true transsexuals,” which is just an idea made up by a bunch of ignorant old white guys. We get crushed between these absurd requirements.
This dilemma is impossible. We’re trans: we will never fit our assigned gender. We’re human beings: we will never match up to a description in a textbook. If we need to transition to live well, we don’t deserve to live; if we do our best to live our own truth, we don’t deserve to transition.
This is a set up. We will never win this game. Let’s stop trying.
Don’t believe the propaganda. You do, in fact, exist. Go ahead and check. You are a being of unspeakable value. There is no reason, no test, no cause that should supersede your will to life. You are entitled to live and to do whatever you can to be healthy and whole. That includes an endless variety of actions and things: food, water, experiences, relationships, clothing, medicine. Whatever it is, do it, as much as you’re able. There is nothing special about the cluster of choices we call transition.
Let no one put arbitrary limitations on your quest to live–not even yourself. You must care for yourself, or no one will. This is our one glorious shot at life. We can’t settle for misery if joy is possible.
The paralysis that comes from the question of “trans enough” is exactly the point. They’ve set the bar for trans so high up, almost no one can reach it. That way they can let a few through, leave the rest for dead, and claim the system is just and legitimate. That’s a bunch of bullshit. When we beat ourselves and each other up like this, we’re singing their same old cissexist tune.
There is no such thing as not being trans enough. There is such a thing as being trans, and not being trans. That’s a question you have to answer for yourself. It may take some time to answer, but the question itself is a simple one.
“Simple” probably isn’t that first word that comes to mind when you think about being trans. Being trans is challenging, confusing, misunderstood, and so many heavy things. But it’s also quite straightforward, a single datum about a human being, one point on one axis of our lives. Because of our social context, that little fact has vast, reverberating consequences for every area of life. But the ripples are not the skipped stone.
Does your gender identity and/or expression fall outside the bounds prescribed by your society? You are transgender. That is plenty trans enough.
Now do what you need to do.
To T or not to T? It’s a tough question. Testosterone is a powerful hormone that can radically alter your body and your internal landscape. For many trans guys and some nonbinary people, testosterone is a ticket to a new world in which body, mind, spirit, and social perception finally align. But how can you know in advance whether that new world is really right for you? And what if the ticket is one-way?
I have been on testosterone for 4 years, and I’ll probably continue for the rest of my life. I spent several years desperately agonizing about whether to take T, and today I can say it was one of the best decisions I have ever made. Here is the advice I wish someone had given me back when I was wrestling with this question.
1. Do your research. In my experience, trans people turn into veritable internet librarians when it comes to our transitions. If you’re reading this post, chances are you’ve read dozens of articles on the physical effects of testosterone, plus sought out hundreds of blogs, videos and photo timelines documenting others’ experiences on T. But if you haven’t done all that yet, do it.
2. Talk to a doctor. A lot of people–including me–make talking to a doctor the last step of this quest. In retrospect, talking to my doctor early on would have greatly simplified the whole process. Ask whether it would be safe for you to take T based on your other medical conditions, what the process would be to get a prescription, and whether you’ll need any referrals. This gives you a timeline and clear series of steps if/when you decide to move forward with testosterone. If your country uses a structured clinic system, find out what is required to qualify for treatment and how long it takes to access hormones. This info will clear up a lot of the stressful questions that make this process such a challenge, such as, Will I be able to get a prescription? What tests will I need? How long will it take? How much will it cost? Do I need a new doctor? With that out of the way, you can focus on figuring out what you want and need.
3. What will you regret? Suppose you start testosterone tomorrow. Imagine yourself in 10 years. What might that person regret? Now, suppose you never take testosterone. Again, 10 years down the line, what might you regret? Nobody knows the future, but I found this a very helpful exercise. I realized that my greatest fear was never taking this opportunity, looking back and wishing I’d started T as a young guy. On the other hand, I couldn’t muster any real fear about, say, being perceived as a boring straight guy or not trying harder to live as a butch. (I tried as hard as I could.) Look into your heart; there may be helpful answers waiting there for you.
4. Do you want the whole package? Testosterone is a gamble. Each person responds differently based on dosage, genetics, length of treatment, and possibly magic. Think carefully about the effects of T, and ask yourself whether you are open to the whole range of possibilities or really only want some of the outcomes. The changes can happen to varying degrees and in different combinations. You might go in imagining yourself with a deep voice, toned muscles, and smooth skin, and wind up a chubby tenor covered in hair from head to toe–or vise versa. A lower dose will cause subtler and slower shifts, maybe no visible changes at all. But basically there are no guarantees, except that you’ll generally move towards more male-typical traits. Are you looking for the whole experience, external and internal? Or are there just a few specific changes that you want? If, for example, you want a more masculine physique and voice, and are wary of any other changes, you might want to experiment with diet, exercise and voice coaching before you try hormone therapy.
5. Seek guidance from a higher power. With a decision this big, it’s a good idea to turn to whatever sources of wisdom you find meaningful. Does your culture have traditions for gaining insight, beginning a journey or making a hard decision? Do you find meaning in prayer or meditation? Some places you might turn include scripture, religious leaders, faith healers, wise friends or family members, mentors and mental health professionals. This could take many forms depending on your beliefs and culture. A few ideas to get you thinking: get your Tarot cards read, set aside a day to meditate on the question, ask God for help, ask for the answer to come in a dream, create visual art exploring your feelings, go hiking or camping alone. The point is, you probably need to get outside of your mind to find a real answer. Find a way to access higher wisdom or deeper insight that works for you. Whatever resources you have, call on them now.
6. Whatever you do, do it for you. You’re probably facing opinions and pressure everywhere you look. Transitioning is taboo, so you’re probably feeling some pressure not to modify your body, to make it work in your assigned gender (possibly for the sake of feminism, the children, or something), and/or not to do something “artificial” or “unnatural.” On the flip-side, there’s also a strong norm that if you’re going to transition, you better transition to be a normative man or woman, including hormones and surgery. So you’re probably also feeling some pressure to follow a certain path through transition, including a dose of testosterone that will put you in the typical male range. It’s almost impossible to think clearly in this hurricane of social sanction. But, as much as you’re able, try to sort out your own needs and preferences, and make your choices from a place of self-love. Whether you decide to take testosterone or not, do it for you.
7. Go for it. At some point, you have to take a leap of faith and go with your best guess. You may find that you’ve taken plenty of time to think, done thorough research, and reflected deeply on the question, and you’re still not sure what you want. Make an educated guess and move forward, knowing you can change course if needed. If you’ve spent a year or five reflecting and you just can’t stop thinking about testosterone, you’re probably going to have to try it yourself to be satisfied. Let your fears slow you down and make you careful. But don’t let your fears paralyze or stifle you. It’s okay to venture into the unknown. In fact, it’s wonderful.
What questions do you have about testosterone therapy? For those who have been on T, how did you make your decision? What do you know now that you wish you had known then?
I couldn’t have gotten through transition without my dog. When the world looked at me with bafflement and disgust, she looked at me with pure attention and love. No judgment can pass through her gaze. She doesn’t give a shit about gender. A dog is an indispensable friend on this river.
I remember one day, back when I was desperately questioning my gender. It had been a horrible week of misperceptions by strangers and misunderstandings by family and friends. I was exhausted, almost heartbroken. I found my dog taking an afternoon nap in a patch of sun on my bed. I laid down and wrapped my arms around her and cried. She nuzzled my tears. I thanked her over and over for loving me with no thoughts at all of my haircut or my hormones.
She showed me that, whether people call me “he” or “she”,” I am myself. She showed me an acceptance that can be hard to find in human beings. Her love convinced me of my basic worth, my realness, the universe lovingly allowing me to be. Her soul shines through her eyes, and that soul is all souls.
A beautiful rescue with a scar on her face, she is intensely loyal. She seems to know that I took her in and keep her safe. She looks at me with gratitude and a little bit of awe. She has no idea that she saved me, too.
Over at Alas, A Blog, Ampersand raises the topic of being better-liked after weight loss:
When I think about losing weight – and like nearly all fat people, my mind sometimes strays there even though I’m against trying to lose weight myself – this thought always bothers me. I’ve read enough studies – and seen enough life – to be convinced that I would probably be better liked, and treated better – not by my close friends, but by acquaintances and strangers and business associates – if I lost a lot of weight.
But I think that would in turn make me paranoid. How could I make new friends, for instance, if at the back of my head I’m wondering if they’ll drop me if I regain the weight (as most weight losers do)? Would I take every instance of nice treatment as an opportunity to think “if you saw me two years ago, you wouldn’t be being this nice?”
This is a depressing reality, and as a thin person, I’ve never had to deal with it. It did get me thinking, though, about the ways transition has simultaneously improved and imploded my social life. People are just so much nicer to me now that I fit neatly into the male box. Cashiers and waiters meet my eyes; guys slap my back and call me brother; children don’t gawk at me in the street.
It was damn stressful being visibly gender-nonconforming. Every new interaction was laced with anxiety. People disrespected me in subtle ways every day. But more than that, people just kept their distance. A subtle chill seemed to follow me everywhere. People kept their eyes and bodies averted, stood a few feet away from me. Some may have been disgusted; most, I think, were just confused, overwhelmed with the awkwardness of meeting a person who might be a “he” or might be a “she.” Maybe they were even trying not to stare to be polite. It felt like shit, though.
Now, I’m some kind of golden boy of the system, and people are nice wherever I go. Women flirt with me, men get buddy-buddy fast. From bus rides to job interviews to bars, people seems easy around me. The few people who are rude or cold are probably treating everybody that way. A slew of single-syllable terms of familiarity, all of them gendered, follow me around the city, little olive branches extended everywhere I go. Bro, dude, man, bud, kid, sir.
I really enjoy the warmth and ease that have emerged in the last few years. It’s nice to have friendly chats with strangers, to be on a first-name basis with everyone in my classes.
But I take it all in with a more than a bit of suspicion. How conditional is this kindness? Will it drop if they find out I’m trans? In my limited experience of coming out, no–apparently, you’re good once you get through the door. More insidiously, then, the nagging suspicion that these nice-seeming people would’ve been completely different if we met when I still looked like a butch/he-she/dyke/freak (to use some frank terms).
Since transition, I’ve gained dozens of friendly acquaintances, but no close friends. The kindness is cruel; my general social trust has disintegrated. How can I open up to people now that I see just how two-faced they really are? It’s part outrage, part fear, part disgust, part loyalty to my past self, part internalized transphobia. I enjoy the superficial niceness for what it’s worth, but I am extremely hesitant to get close to anyone. How can I accept such gifts, now I see on what basis they’re given?
Sometimes, things really do get worse before they get better. I read a lot of blogs by people who are currently in transition, and I wish I could do more to help people survive that crazy time. This includes the process of self-recognition, questioning, and charting a course, as well as the process of physical, social and legal transformation. For now, let me just say this.
Transition is at once exhilarating, stressful, magical, devastating, terrifying, overwhelming and beautiful. Research suggests that during transition, we are at special risk for suicide attempts, even moreso than usual. Take care of yourself now. I personally guarantee that someday, you will see that this is one of the hardest things you’ve ever done, indeed one of the hardest things that anyone will ever do.
You went out on a journey, looking for a new life–one worth living this time. This is truly a mythic quest. You’ve met friends and enemies, overcome challenges, solved riddles. And now, you have descended to the underworld. If you feel like you’re in a living hell, well, my friend, you are. There is no way up, out or around; you can only go through. You will be a new person when you reach the other side. And you will–you must–reach the other side. Do it for all of us.
As Churchill said, “If you’re going through hell, keep going.”
Stay strong, comrades. You are not alone.