This time around, I want to bring things a little closer to the quick, so to speak, and talk about some more personal things. I'll be talking more about me throughout this 'lesson,' and I want you to understand up front that because of this we very well may hit some very heavy emotional points. I'm not really going to trigger warning anything in here, but, just to spell things up front (and without any foreknowledge because, unlike other installments, I am completely doing this one on the wing with no semblance of an outline of what I want to say)...the road that follows may well be exceptionally fraught.
Viewer discretion is advised.
Here there be dragons.
And other things as well.
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One of the biggest stereotypes, I think, when it comes to trans people (and I think it may be possibly more prevalent among people talking about transwomen) is the idea of a 'woman trapped in a man's body.' It's something that I've heard said for decades, and it seems to be a resoundingly familiar narrative for a lot of people.
I don't want to deny there is some kind of artistic poetry to that. In fact, it does somewhat tie into the metaphor of butterflies...a concept that is very common in the community (as a side note, one of the larger known clinics, at least on the east coast of the United States, is named for butterfly in French). There is something mystic about bursting forth from a chrysalis...it's a beautiful image. I won't deny any of this.
I will say it's far from universal, and far from a truism.
I feel trapped by my body...but I do not feel trapped because it's a man's body and I am a woman. I feel trapped because other things...my arthritis, my crippling depression, my a-fib, my anxiety...are major impediments for me. My depression keeps me from even wanting to get out of bed many days. My arthritis keeps me from doing some of the activities I love...and yes, that's even with stretches and heat and anti-inflammatories and so on. My heart means I have to limit my caffeine intake (which I try but do fail at), and I have to be very careful about just how hard I push lest I do accidentally push myself into fib.
Those things trap me, or make me feel caged...my brain the worst offender of the mess. I can tell you that people have said that I've seemed like my brain has actively tried to work at every opportunity to hurt me and break me, and I don't deny this. I have a lot of damage, and I hurt myself more than anyone else ever will or ever has.
But it's not because I'm trans.
And it's not because I'm 'a woman trapped in a man's body.'
Allow me the opportunity to let you in on a little secret, OK? I have a woman's body. I was born with a woman's body. My woman's body just happened to come with a penis and testicles rather than a vagina, uterus, ovaries and labia. I don't have an issue saying this. I don't LIKE any of what I have. There is a massive amount of discomfort and disassociation with them. But I also don't run from the fact that they are there. Like any person, I just don't talk about them because who really talks about their plumbing in polite conversation (NB: the trans peoples I run with on Twitter definitely does, but that's different)...do you see posts from your male friends saying 'Boy, my penis feels really great today...no lumps on my balls either. Yee haw!'
If you do...I may actually be interested in who because honestly, that's pretty funny.
Realistically, in most polite conversation amongst strangers, however, you don't talk about your gonads. And neither do I. My plumbing defines me every bit as much as my hair...that is to say, not at all. I still want to modify my plumbing if at all possible, both to ease the discomfort I have mentally as well as to emotionally know that I am aligning with my internal knowledge of who I am, but who I am is not walled in by that part of my body.
And yes...I do see the irony in spending a lot of words talking about my genitals in a piece that starts off talking about how polite conversation doesn't center around the current weather conditions of a stranger's groinal regions, but...well...to paraphrase Wolfie in Amadeus:
“Forgive me, Majesty. I am a vulgar woman!”
This is one of those areas that really...if anyone ever decides they trust you enough to talk to you about such things, feel honoured. And treat that trust like it's the suitcase with the red button in it. Violating that trust is violating the deepest personal secrets or information a person can share with you...and it may well do more than just cost you a friendship. It could cost you a life.
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Another common misconception, I think, is that being trans causes depression.
A number of researchers, whose work has been widely discredited and moved out of the medical mainstream, have maintained that medical/surgical treatment for transmen and transwomen (i.e., contra-hormonal therapy, subcutaneous mastectomy, vaginoplasty, etc.) exacerbate existing mental health issues, and/or the desire on the part of the trans individual to have these procedures done is borne from their mental illness. Additionally, they claim that post-therapy/post-procedure self-harm/suicide rates are no different than pre-therapy, those proving that these treatments are not as important as intensive psychological and psychiatric treatment to find a 'cause' via psychiatric disorder.
Some of the info that follows is from some articles by Zinnia Jones, and I'll be annotating appropriately. I want to give you some exact points of reference so when I move forward, you have a basis on which my thoughts will be built.
First off, from Paul McHugh, formerly of Johns Hopkins University and now widely discredited, though he doesn't think he is:
“We at Johns Hopkins University — which in the 1960s was the first American medical center to venture into “sex-reassignment surgery” — launched a study in the 1970s comparing the outcomes of transgendered people who had the surgery with the outcomes of those who did not. Most of the surgically treated patients described themselves as “satisfied” by the results, but their subsequent psycho-social adjustments were no better than those who didn’t have the surgery. And so at Hopkins we stopped doing sex-reassignment surgery, since producing a “satisfied” but still troubled patient seemed an inadequate reason for surgically amputating normal organs.”
Well, I wonder why MuHugh said all this. He couldn't have an agenda, being a doctor and all, could he?
“…Johns Hopkins was one of the places in the United States where this practice was given its start. It was part of my intention, when I arrived in Baltimore in 1975, to help end it.”
OH.
Well then.
Here's some data ZJ has gathered:
“A study from Belgium in 2006 found that trans people’s rates of suicide attempts dropped from 29.3% before surgery to 5.1% after.
Another study of 50 trans women who received genital surgery found that their physical and mental health was not significantly different from samples of cis women.
A 2013 study of 433 trans people in Canada found that 27% of those who hadn’t begun transitioning had attempted suicide in the past year, but this dropped to 1% for those who were finished transitioning.
And a 2010 meta-analysis of 28 studies showed that 78% of trans people showed an improvement in psychiatric symptoms after transitioning, with a level of psychological functioning similar to the general population and greater than that of untreated trans people.
Several additional studies have since confirmed that hormone treatment for trans people is associated with reduced stress levels, a lower prevalence of depression, less anxiety, a reduction in functional impairments, and a higher quality of life. There is no excuse for using a study from 1979 and missing the entire body of evidence that’s accumulated since then.”
(Paul McHugh is wrong: transitioning is effective (Gender Analysis 10), 1 Sept 2015. http://genderanalysis.net/2015/09/paul-mchugh-is-wrong-transitioning-is-effective-gender-analysis-10/)
Those of you who have been been around me for a long time know that I have struggled with crippling depression for a very long time. I am not shy about admitting this; I am not stigmatised by this in any way. It does handicap me in so many ways, from affecting my work performance to my ability to enjoy regular day to day activities to my appetite to so many other things.
Do you know how my depression is associated with my identity?
We'll start by explaining that Gender Identity Disorder, as defined under the Diagnostic and Statistical Manual of Mental Disorders Volume 4, has been replaced by Gender Dysphoria in the DSM-5. The biggest difference may seem semantic, but it is incredibly major. Disorder implies...no...outright states that trans gender identity is an all encompassing mental disorder/illness, something that is wrong with a person psychologically and ergo must be treated in the same manner one would treat depression or schizophrenia or bipolar or what have you.
There is evidence suggesting that people who identify with a gender different from the one they were assigned at birth may do so not just due to psychological or behavioral causes, but also biological ones related to their genetics or exposure to hormones before birth. (Heylens, G; De Cuypere, G; Zucker, K; Schelfaut, C; Elaut, E; Vanden Bossche, H; De Baere, E; T'Sjoen, G (2012). "Gender Identity Disorder in Twins: A Review of the Case Report Literature". The Journal of Sexual Medicine. 8 (3): 751–757. doi:10.1111/j.1743-6109.2011.02567.x) This is to say, gender identity disassociation or discomfort are not simply caused by some underlying mental health issue, but may exist separate from that; therefore, depression/anxiety/etc are symptoms of the dysphoria, not the other way around.
My dysphoria manifests in a number of ways. There is great dissatisfaction with my body structure as a result of a lifetime of testosterone poisoning and its resultant modification of my secondary sex characteristics:
Body hair
Facial hair
Hair recession to the Caucasus
Male pattern genital hair
Broadening of chest/shoulders/neck
Squaring of chin
Fat distribution
Vocal range
and probably many more than I simply can't think of at the moment.
It sounds like I am describing a man's body when I type all of that, which seems to run counter to my assertion above that I do not have a man's body, but rather a woman's. The thing is...a wide range of these characteristics can be caused by a variety of conditions in AFAB woman, including polycystic ovary syndrome among other things. In at least the case of PcOS, these characteristics are caused by (gasp) elevated levels of androgens in the woman's system.
I'll let you mull that one over.
No, really.
I'll wait.
(pours some lemonade)
Moving back to the psychological...my depression does not cause my discomfort with my body. I am not trying to escape my problems by running from my old life and trying to create a new personality to hide in. My depression comes from the fact that society sees me one way (even, perhaps, when I am able to fully present femme) and that perception is at odds with my self-knowledge. Every time someone calls me sir, or he, or brother, or uncle, or by my deadname, it hammers in the fact that I am not seen as the person I really am, but rather as the person people want me to be.
It wears on you.
It grinds you down.
It becomes a huge millstone strapped to your back; unlike Sisyphus, however, there is no top of the hill to reach whereupon the stone will roll back down to have to be carried again. The hill is never ending.
My anxiety comes not from the discomfort of 'being trapped in the wrong body,' but instead from my inability to do daily things without judgmental looks and comments. Buying make up? Buying clothes? Trying on shoes? Walking around? Going to the bathroom? Going to the drug store? Do you know the number of places I actually feel safe going to by myself presenting in full? 2...my comic book store and my psychiatrist's office. I might be able to pull off my cardiologist...but I haven't asked if there would be an issue. I shouldn't feel I have to...but I do.
Otherwise, I won't go anywhere without someone. I can't. The fear gets far too great. I panic. I hyperventilate. I shake. I start crying.
My identity doesn't cause that.
Society causes that.
My depression comes from trying so hard for almost all of my life to try and be someone I was not. It comes from years of psychological and emotional abuse from someone I trusted, to the point that I started denying reality unless I was told something was real by my abuser. It comes from someone telling me I wasn't a 'real man' (well duh), that I'd never account for anything. It comes from being told 'you're too old, you'll never look like a girl.' It comes from so many places. It comes from places you wouldn't even expect, but perhaps you should.
To wit:
Every clique has a pecking order. You probably remember that from high school. While on the top your clique was all for one and one for all, the reality of things was generally far different from the intended theory. Someone always gravitated...or floated, rather...to the top. If you were lucky, that person didn't take advantage of that float. More often, they did. The same is true in the LGBTQIA+ community; there are decided cliques and power structures and power struggles even within that group of people being oppressed by a white cishet male power system, and there is a decided sense of 'once I get mine the rest of you can pound sand,' or 'I want mine because I deserve it, y'all have to wait.'
It's literally replacing one form of systemic dominance with another.
And quite frequently, the groups that get hardest...and I'm not even TRYING to factor in race or anything...are bisexuals and the trans community.
(Please don't ask me to try and put together a hierarchy of the community...I have feelings, and those feelings are that WOC and transwomen are at the absolute bottom, but I would think that, wouldn't I? I bet at least part of that is really true tho.)
And it gets crazier when you consider that even within the trans community there's a hierarchy based on how long one has been out, how young they transitioned, passing privilege, et cetera et cetera ad infinitum unlimited rice pudding. It's every bit as possible...and very often, more likely...that you'll get dragged and attacked as hard if not harder by someone in your 'community' as without. And as bad as it feels for some rando to tell you you're ugly, not a real woman, a freak, it hurts a billionty and eleven times more when it comes from someone who in theory is supposed to have your back. How easy is it to feel despair when you don't even feel you have a community of like-minded people to go to when you need support?
And people wonder why I won't be a part of the trans support community.
My depression comes from my dysphoria...my dysphoria does not come from my depression.
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There's one additional thing I considered for this essay, but it really fits better in a different one that's in the works, so I'll hold off on it for a bit. This one is pretty lengthy and, as usual, fairly heavy even by my standards, so before I drive the despairmobile off depression cliff, I'll close things up. As always, I encourage questions and interaction; part of the purpose of this is to create launching pads for conversation to start.
Share it around if you found this of any use or interest, or think your friends might find something in this that would be enlightening.
See you all in a week or so.
(NB: as always, this is posted under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) license with the intent that you may share it if you have found it informative, helpful, or enlightening. You may use extracts, properly attributed, as part of your work as long is it is openly shared under similar license.)
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