Bravery or Survival?

You’re so brave

You’re amazing*

You’re inspirational

Trans people get this a lot.

I’ve heard these things so many times already, and while normally I try to take a compliment graciously, these type of comments make me feel a little uncomfortable (only a little, so please don’t freak out if you’ve said this to me). I’ve seen other trans people saying they feel the same about being told they’re brave/inspiring, so I know I’m not alone in this. In this blog post I wanted to try and explain why it bothers me.

Disclaimer: I do understand that these sort of comments come from a place of support. I don’t want to sound churlish, or make anyone feel guilty for saying or thinking them. I’m just being honest about why they make me feel awkward, because I think it’s something that’s worth saying.

Imagine you’re in a burning building. A tall burning building—maybe a hotel—and the fire escapes are blocked. You run to the roof as the fire spreads, and the building is starting to creak ominously.

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You look down, and through the smoke you can see a swimming pool. You’re high enough up that jumping into the pool isn’t a guaranteed escape. You might risk injuring, or even killing yourself on the fall, but with the fire getting closer and the building about to collapse underneath you, you don’t have a choice anymore.

Stay and die in the fire, or jump and hope?

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Jumping is an act of survival, not one of bravery. And that (to me) is how it feels to come out as transgender.

Bravery implies a choice, and nobody chooses to be transgender. They just are. And coming out and transitioning is simply dealing with that reality. Personally, I don’t see it as an act of bravery. I’m just living my life in the best way I can.

*I am amazing, obviously. But that has nothing to do with me being transgender 😉

What’s in a name? Unexpected awkwardness.

As part of my social transition, I recently changed my name legally by deed poll. We’re lucky in the UK compared to some countries, because this is a relatively simple process.

Hats off to my dentist, my banks and my kids’ schools for all being very quick to get things updated and start using my correct name and title almost immediately. In fact, I got a text reminder for a dental appointment about half an hour after I’d updated my details over the phone. When I saw it said “Dear Mr <name>” I may have given a very unmanly shriek of excitement and done a little dance. But that’s just between me and my kitchen and a rather surprised cat.

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One of the things I hadn’t anticipated, though, is how weird and exposing it feels to be addressed as “Mr <name>” in public, when to the world I still look and sound mostly female. At the dentist recently they called loudly down the stairs “Mr <name>”, and I was very aware of the other people in the waiting room who might have thought that was rather odd if they were paying any attention.

When you’re living happily as the gender you’re assigned at birth, you go through life not really noticing how many times you give your name and title to people, how many forms you fill in, how often you have to give tick a box that says M or F. But as a trans person, the world suddenly becomes a minefield of opportunities for awkwardness and dysphoriaespecially when your physical appearance doesn’t match your identity, and your new name and pronouns.

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As another example, I had to go to the local chemist today to collect a prescription for one of my kids. The pharmacist asked to see some ID, so I showed him my driving license, which is still in my old name. He didn’t look too closely at the title (which is actually Ms but that’s a battle I won’t have to fight anymore), and as he wrote my name on the prescription he said, “So is that Mrs <name>?”

Cue awkward silence while I wonder whether it’s better to deal with this now than in a few months when my voice breaks and I start getting facial hair.

Decision made, I say, “Um… no. Actually it’s Mr.” I notice a woman standing at the counter looking slightly interested in our conversation. So I chicken out of using the word transgender, and add vaguely with a hand wave. “For complicated reasons.”

The pharmacist, to his credit, obviously gets it immediately and doesn’t bat an eyelid. I scribble the ‘s’ off the end of Mrs, which he’d already written, and sign on the dotted line.

Then he asks, “So, where it says ‘relationship to child’ should I put…?”

Another awkward silence.

“Parent,” I reply. I will always be the person who gave birth to them, but it seems weird to be asking people to call me Mr while still using words like ‘mother’ to describe myself on official forms. So that’s what he used.

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The other fun thing about changing my name to a male one while still being pre-testosterone has been dealing with telephone banking. I had to call my bank about a transaction the other day. Just as the call connected, I realised that the person speaking to me would be seeing Mr <name> on their screen. Then I spent the entire call trying to sound like Brian Blessed rather than a boy soprano and nearly broke my throat!

Bring on the testosterone please.

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Living with Gender Dysphoria

Every trans person experiences dysphoria differently. In this blog post I’m talking directly about my personal experience of dysphoria. So, as always, bear in mind that this doesn’t necessarily apply to anyone else.

So, what the heck is dysphoria anyway?

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For those of you who aren’t familiar with the concept…

The Oxford English Dictionary defines dysphoria as: a state of unease or generalized dissatisfaction with life. Gender dysphoria, specifically, is defined by the NHS as: “A condition where a person experiences discomfort or distress because there’s a mismatch between their biological sex and gender identity.” In the UK, in order to access treatment, a transgender person needs to be diagnosed with gender dysphoria.

NB: Dysphoria is not to be confused with body dysmorphia. They are totally different.

Dysphoria can be split into two categories.

Physical or body dysphoria: Discomfort centred on your physical appearance, and the fact that your body doesn’t align with your gender identity. For example I look in the mirror and dislike various bits of myself that I see as feminine.

Social dysphoria: Discomfort around how others perceive you, and how you feel when being misgendered by society. An example of this is how uncomfortable I feel when someone refers to me as ‘madam’ in a shop, or how angry and miserable I felt as a child when the girls and boys had to line up separately, and I couldn’t go with the boys like I wanted.

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What does dysphoria feel like?

Dysphoria for me is a constant state. A lot of the time it’s mild, like a buzz of static, or a rumble of thunder in the distance. It’s a feeling of unease, of things not being right, but it’s hard to pin down. I’ve lived with it all my life, but it’s only since I’ve had an understanding of my gender identity that I can recognise it for what it is.

When it strikes badly it’s more akin to a feeling of grief or profound loss. I experience it like a physical sensation, a punch to the chest that makes it hard to breathe. I feel hollowed out and empty, trapped and claustrophobic. Sometimes it comes close to a panic attack.

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I’ve spent a disproportionate amount of my life feeling anxious and depressed for no apparent reason. But it never felt like clinical depression in the way that others describe it. It came and went too quickly and rarely persisted for long periods, but would sometimes hit me out of the blue with no warning. Looking back, I suspect that much of this cycle of mild depression and anxiety was due to undiagnosed gender dysphoria.

A timeline of my gender dysphoria

As a child, my gender dysphoria was obvious and vocalised. I hated being a girl. I hated that I had the wrong body. It was a source of great shame, unhappiness and anger to me that I wasn’t how I wanted to be. I dressed as a boy when I could, and had my hair cut as short as I was allowed. I introduced myself with the male form of my name, and if strangers assumed I was a boy I never corrected them.

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As a teenager and young adult I could no longer ‘pass’ as a boy. Stuck in an all-girls boarding school, my life was difficult for reasons other than gender dysphoria. By that stage I’d buried my desire to be male and was deep in denial. I adopted all sorts of unhealthy coping strategies to numb the emotions I couldn’t name: binge drinking, smoking, drugs, self-harm, disordered eating. As I grew older, I learned ways of coping that were less damaging to my body: exercising (although still rigidly controlling my weight to make my body more androgynous), and losing myself in new obsessions like music, reading, and writing, but the all-pervasive sense of wrongness continued.

In adulthood I never felt like a woman. I hated the word being applied to me, and lady was even worse. Gendered titles like Miss/Mrs/Ms made me irrationally angry, and I was reluctant to get married because I didn’t feel comfortable with the idea of being a ‘wife’. Still unaware of what the problem was, I carried on. I went through some phases of overcompensating, and presented to the world in a very feminine way, but it never felt right. I remember joking about how I felt like a man in drag when I wore dresses and heels — If only I’d known how close I was to the truth! At other times I’d swing back the other way and cut all my hair off and dress in more gender neutral way.

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During pregnancy and while my kids were small was probably the only time I felt even slightly content as an adult woman. Whether it was the hormones or another bout of overcompensation, I don’t know. But while pregnant and breastfeeding, I finally felt as if the body I’d always hated had a purpose. I’ve often coped with my physical dysphoria by dissociating from my body, and I think perhaps pregnancy and breastfeeding was an extreme form of dissociation. My body no longer felt like my own, but I was okay with that. It was only when my youngest stopped breastfeeding that my mental health got worse again. All the feelings I’d been running from came creeping back, but I still didn’t know what was wrong with me.

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Five years ago I finally found the answer. I read a story that had a transgender (FTM) character in it, and immediately recognised myself. After that I went online and found transition videos on YouTube. They were fascinating, but the envy I felt for those guys was so intense it frightened me. I didn’t want it to be true. I didn’t want to be trans, and that’s why it took me so long to get to where I am today.

As I began to question my gender, my dysphoria got worse because I was beginning to understand why I felt the way I did. My mental health spiralled downward too, unsurprisingly, and that’s what finally pushed me to the point where I had to admit what was going on with me. My dysphoria peaked when I first started telling friends and family, and was the worst it’s ever been. Thankfully it’s settled down a little now I’ve started to move forward, but it’s still ever present. I doubt it will ever go away completely.

A Gender Glossary

When I first started doing my own research about all things gender related, it was like learning a new language. There were so many things I didn’t understand and I’m still learning all the time. This glossary is an attempt to explain some of the words/phrases you may see in my posts that are new to you.

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Disclaimer

This is by no means a comprehensive guide to all gender-related words and phrases. I’m explaining some of the ones I use regularly on this blog, and I may add to it as I go. I’m describing them as I understand them. But if you look them up, there is often variation of the exact meaning.

Also please be aware that when it comes to what words individual trans people use to describe themselves, it’s always down to personal choice. A word/phrase that one trans person is happy using, might be one that another trans person feels uncomfortable with. If in doubt, just ask what the individual prefers.

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Transgender: An inclusive term for anyone who does not identify with the sex they were assigned at birth. It should be used as an adjective, not as a noun. It’s okay to talk about “a transgender person.” But not, “a transgender.” Sometimes shortened to trans.

Transsexual: An older and less inclusive term, usually used for someone who has undergone medical transition. Many trans people prefer the word transgender (including me).

Cisgender: The opposite of transgender. A person who does identify with the sex they were assigned at birth. Sometimes shortened to cis.

Transman: A transgender man, so someone who was assigned female at birth but now identifies as male.

Transwoman: A transgender woman, so someone who was assigned male at birth but now identifies as female.

Nonbinary or genderqueer: A word used to describe someone who identifies somewhere more in the middle of the gender spectrum, or alternatively completely outside the gender spectrum. Agender is another word with a similar meaning.

Genderfluid: A descriptor for someone whose gender identity is fluid, sometimes feeling more male, other times more female. 

Dysphoria: A profound state of unease and dissatisfaction. Gender dysphoria describes the feelings that transgender people experience as a result of their internal gender not matching the sex they were assigned at birth. Dysphoria can be physical (centred on the body) or social (centred on social interactions and the perceptions of others).

Pronouns: For those who weren’t paying attention in English at school… pronouns are the words that we use to substitute a person’s name. They are usually gendered when we’re talking about people. He/him/his or She/hers. Nonbinary people may use they/them or ze/zir/zirs for example.

FTM: Acronym for female-to-male. 

MTF: The opposite of FTM, so male-to-female.

Transition: The process of moving away from the sex you were assigned at birth, in order to bring yourself in line with your internal gender identity. Transitioning has many (optional) steps, including social and legal ones (coming out, changing your name) as well as medical ones (hormones and surgery). It’s better to avoid the term sex change, which implies surgery is necessary for transition.

T: Testosterone.

For more detailed information, including words and phrases to actively avoid when talking about transgender issues, please visit:

http://www.glaad.org/reference/transgender

The Path Ahead

My last blog post was about how I got to where I am today. This blog post is all about what lies ahead for me. It’s less reflective and more factual, and is very much about the physical process of transition and what that involves. I tried to keep it fairly general and not too personal. I hope I got the balance right.

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What’s next for me?

I saw my GP in September and requested a referral to a Gender Identity Clinic (GIC). The nearest one to me is in Exeter, so I was referred there.

The NHS services for transgender people are massively overused, so the waiting lists are long. I would have had to wait over a year to even have a first appointment with the GIC in Exeter. After that, it would probably be at least two appointments and another six months before I’d even be able to get started with physical transition.

For this reason, I decided to seek private care in parallel to the NHS so I can get out of my current limbo more quickly. I’m fortunate that this is an option for me financially, and I’m happy to report that I have my first appointment at a London clinic in January.

Hormone Therapy

At that appointment I will hopefully be prescribed hormone therapy, specifically testosterone (usually referred to as T for short—I must do a transgender glossary post at some point) and will be able to start that fairly soon after the appointment. T is usually taken in the form of regular injections, although can also be administered as a gel that is rubbed into the skin.

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I don’t think T is actually green…

T will make me go through male puberty. You can google for the specifics of how T changes a female body into something approaching a male one, but the most obvious changes to people who know me will be my voice breaking, and just starting to look generally more masculine (hopefully). I find it totally bizarre and hilarious that I will be going through puberty again at the age of 45, but hey—it’s an original way to sidestep the menopause.

Just kidding.

Surgeries

People often ask trans people if they’re going to have ‘The Surgery’. When I get that question I just laugh and say, “Which one?” The process of total gender reassignment from female to male involves a number of surgeries. Also, FYI, most trans people aren’t too comfortable being asked this question—I’m sure you can imagine why if you think about it for a moment. If you’re a close friend or family member you might be able to get away with it, but caution is advised.

Top Surgery:

The most common surgery for transgender men is top surgery: the removal of the breasts and reconstruction of the nipples/chest to give male contours.

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This is the only surgery I know I definitely want, and I want it sooner rather than later, hopefully next year sometime.

Hysterectomy:

Another common surgery for transgender males is a hysterectomy (also referred to as hysto). Once the body is running on testosterone there is little benefit to keeping the female internal equipment. For this reason many transmen have a hysto a few years into transition, if not before.

I’m neutral on this one. I don’t need my uterus anymore. Its work here is done (literally—I have two wonderful humans as living proof). But having it still there isn’t currently a source of dysphoria for me so I will see how things go.

Genital Reassignment/Reconstruction Surgery:

(Also often referred to as ‘bottom surgery’ or ‘lower surgery’)

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This is the one that fascinates everyone. I can see why. I mean, how can you make something out of nothing? It’s easier for the uninformed to imagine how you might remove a penis and construct a vagina. Unfortunately the process of constructing male genitals is a lot more complicated, and usually takes not one, but several surgeries. There is more than one method. I won’t go into detail here but it’s a long and difficult process. If you would like to know about the options available the terms to search for are metoidioplasty and phalloplasty. But no surgery will ever create a fully functional penis. The technology doesn’t exist for that yet.

Being transgender involves compromises, but that’s true for life in general. I have to accept that I will never have the body of a natal male. It’s often hard for people to grasp that gender isn’t about what’s between your legs, it’s about what’s between your ears. Masculinity and femininity aren’t defined by body parts. Some transmen choose to have this type of surgery, but many others find peace with their body without the need for more intervention. So here again, I’m keeping my options open and will wait and see how I feel further down the line.

I’d like to finish by pointing out that some transgender people choose not to take hormones, or have any kind of surgery. It’s important to realise that this decision doesn’t make them any less trans than someone who does choose the medical route.

Thank you for reading if you made it this far. I’m glad you’re interested in my journey.