People who have identity issues, think about identity issues. Questioning doesn’t mean a person made the wrong decision. It doesn’t mean a person will make the right decision, either.
Wherever you are, you very likely will have days that you doubt or question yourself and any of the decisions you have made or are considering making. Gender is not seamless for anyone unless they are entirely gender conforming in every way or have a consolidated gender identity and even then it still may come up. This is especially true for people who question authority or have feminist political analyses. Questions are good. Doubt is important.
How do you know if you are really transgender? How will a therapist or a doctor? What is transgender, anyhow? That’s gotten very blurry. A person can be gender non-conforming and not be transgender. Other people might call them transgender and throw the person under the transgender umbrella. They could be transsexual, believing in the body brain mismatch, they could be someone who identifies as mostly male or mostly female or neither, they could be genderqueer, they could be a woman who prefers to do things associated with masculinity. Simply not feeling male or not feeling female doesn’t necessarily mean that a person should transition. Simply preferring to wear clothing that is associated with a sex different from one’s body doesn’t make a person trans. Fantasizing about yourself as the other sex doesn’t make you trans. We have a lot of blurriness around gender.
There is no lab test to see if a person is transgender nor is there a personality test. A therapist cannot tell you. A doctor cannot tell you. Only you can know. If someone else says they know this about you, they are likely not a safe person in some respect. A person knows themselves better than anyone else does. Many people would be more comfortable if it was not a subjective experience. There are risks and benefits and all change involves loss. It’s important to be as prepared for the loss as possible, but much of it cannot be anticipated. The losses people face are significant and for the right people, the gains are life-saving. Often people begin this process thinking they are transitioning to male, not transmale or female and not transfemale or genderqueer and not whatever the corollary would be. There is an image people have and it may not be the reality they reach.
There are people who transition and it is the best decision they ever made. There are people who are trans, but the emotional, social and identity costs of transitioning are simply too great. Perhaps, hormones didn’t fix what a person thought it was going to fix. Some people transition for reasons other than gender dysphoria and gender identity. Some people genuinely regret the decision they made to take hormones or have surgery and need to be supported in detransitioning. Detransitioning is also transition.
Some people start and stop their transition. They aren’t sure and need to go off hormones to learn something else about themselves. Or socially they can’t live as themselves and so they stop until they have the chance to start again in a manner that will work for them. They will lose too much at the moment so they stop. Some people detransition and it is not about regret, but rather they got where they wanted to get to physically or they discovered that it wasn’t where they wanted to go. Transition is not linear and is personal to each individual.
Transition is not a single event. How do one know what type of transition is right for them, if they decide that it is? (expression, community, social, legal, hormonal, surgical, etc.) Are they even thinking that way or are they headed straight for medical interventions?
In medicine and mental health we want to do what is least invasive first. When talking about gender non-conforming behaviors, we should not not immediately jump to surgery or hormones. For some clients or patients, they have been thinking about this for so long, and know it to their very core, any slow down is a barrier to getting their medical needs met. Other people are coming in with transitioning as just a first or second pass as an answer to their questions. Providers have to work with the person in front of us not what we expect. Sometimes, providers want to be experts and tell patients who they are before the patient or client decides who they are. It’s easy to fall into that trap. Providers want to help and in marginalized populations, people can reactively swing to being proactive rather than empowering.
We can draw a line between any two points—meaning that we have two facts that may or may not be connected. For instance, person A was sexually abused and person A is sexually attracted to people of the same sex. We can run with that and say sexual abuse causes same-sex attraction. People used to say that all the time. All we have are two points of information. These points are only <em>correlated</em> for <em>that</em> person, they are not necessarily causative or representational. Not much more can really be said about this.
We have two bits of information we are trying to make sense of. People are trying to make sense of their lives and their choices and make meaning from their experiences. Back to the sexual abuse and gay question. I imagine there are very few people who were sexually abused and then later came out as gay or lesbian or bisexual who have not wondered about the influence of that violation on their sexual orientation or sexual preference.
One of the political issues that arose from the fact that there were a disproportionate number of gay and lesbian people who had histories of abuse or sexual interactions with people who were older is that anti-gay people used it to say homosexuality was caused by abuse. In reaction, we had GLBQ folks begin to deny or not admit that they were abused because it would be used against the community.
In truth, there is a disproportionate amount of abuse, but the alternate explanation is that gender non-conforming children are different and may be isolated and predators choose kids who are different or isolated. Then there are the disturbed people who believe sexually assaulting an individual will teach them to be heterosexual. It is more likely that kids were targeted for gender non-conforming behaviors and we going to grow up to be GLBTQ rather than the outcome being homosexuality as the result of the assault. Another myth from the old days was about distant fathers of boys. Which came first? Having a gender non-conforming child that a 50’s father was ashamed of or disappointed in or disgusted by or the distance between the father and the child? Chances are insecure fathers created the distance because of the perceived gender non-conformity rather than the distance causing some sort of longing in the son that got sexualized.
We need to be careful about cause and effect, causation and correlation. We need to be careful about our explanations for behaviors and feelings. Person B says they hate their breasts and want to have them removed. For Person B it could be because they are trans, because they hate being sexualized, because they have neck and shoulder pain, because breasts are inconvenient, or because they interfere with activity. It could be all of the above. The real issue might be none of the above. Each person is a person and not on the same path as the next person over. There is no one true path and it’s not cookie-cutter. Many providers and patients would like for it to be. Patients want relief from suffering and clinicians want to help and provide answers. We’d all like to take the guesswork out of this.
Many people look back at their lives from whatever point they are standing at and try to find proof that they are who they feel they are now. Remember you can connect any two points. Lots of gender non-conforming kids behaved in gender non-conforming ways. So it’s easy to create a narrative of a long-standing transgender identity. Recently I was asked to give a gender history of person from childhood. It reaffirmed the ridiculousness of that question. I needed to talk about trucks and swim suits and other bricks in the narrative wall the client has constructed and make that palatable for the reviewer who is looking for binary expressions. It very much was “prove to me this person is actually a man or a woman.” I can’t do that. I can report what is said but I understand the context that narrative developed within.
We have so little research and much of what we have now and what we will have in the future will be biased anyhow. We have stories and narratives and anecdotes that we should take seriously and share.
Mostly what we have are people taking their best guess at why they don’t feel okay in their bodies or souls or hearts. Two people can have the same experience for different reasons and need to walk different paths. (I hate being a woman and woman is not me. 1) I hate being a woman because I am actually a man. Nothing about me feels right and certainly not feminine to me. 2) I hate being a woman because I hate the weakness, the self-deprecation, the vulnerability, the passivity of women. That’s not me and not the life I want.
These two people, one is transsexual and the other is expressing internalized and experienced misogyny. If transitioning the answer for them both, I would expect the second person to still not be comfortable in themselves and in the world. I have no research to prove this. Women are socialized to hate their bodies in America. Media influence is inescapable where beautiful women are airbrushed and photoshopped to be perfect and not exist in reality. We stereotype men and women. People who are moving from one side to the other in search of the stereotype will not likely find it in their transitioned body and mind. We are all socialized to be dissatisfied with ourselves and what we have in some way.
If you watch YouTube videos, you see a lot of newbies. People who have not yet lived in their transitioned gender for years yet. Read about people who transitioned ten or twenty years ago to get a sense of what life has been like for them. Be careful of writing people’s experiences off because they are older or a different generation. They are forefathers and foremothers and foregenderqueers.
Read blogs by people who have detransitioned or regret transitioning. You may not hear stories like these from your circle of friends or your providers. Remember, they exist in a context. Some people are very angry or feel harmed. They have important stories even if they say things that may feel invalidating or offensive. Listen for what is important and discard what doesn’t fit. We have to listen to everyone.
Understand that transitioning now exists in the context of now. Transgender people have been harmed and stigmatized and are are trying to prove that they are healthy and well-functioning and that transitioning should be accepted. Often you will hear so much positive that it drowns out the questions, the concerns, the negatives. Look for the questions, look for the downside, the things people wish they would have known. Go into this with your eyes open. People are looking for role models and heroes. Listening to people criticize or laud Chaz Bono should be instructive. He’s just a guy and makes decisions and mistakes like any other guy, but it’s in a community desperate for adequate representation.
If you have mental health issues like depression, a mood disorder like bipolar disorder, emotional reactivity related to a trauma history, get help for those issues. For a few people, those issues are connected to their gender identity. For most people they are not. They may be connected to gender discrimination or stigma but that is different.