To read previous posts in this blog series, click here.
This time, on #otokonoko_radio, we'll go through a transgender 101 given by the perspective of someone who identifies as transgender. Save your questions/comments for the end, please~!
In your opinion, what is "transgender"?
"Transgender" is a label for an identity that can be many different things for different people. If you ask different people, they may respond in different ways depending on how they view themselves and their identity.What is gender dysphoria?
However, one thing to be aware about is that there is in fact a clinical definition for "transgender" in psychiatry. I like using the definition in psychiatry because realistically, in order for a person to receive medical treatment for being transgender (ex: hormone therapy, surgery), they must have fulfilled the DSM-V criteria for a certain disorder called gender dysphoria.
I wanted to make this point first because it's not like any random person or "special-feeling rainbow unicorn" can say, "I want to be a man/woman!" and the next day, your doctor will be willing to prescribe you medications. In fact, the process is very long and arduous, and most transgender people have to see a lot of psychologists, endocrinologists, and gender therapists for months to years before anything happens, and depending on where you are, it can be very expensive/not covered by insurance. This definitely isn't a pleasant process that people go through trivially, just like most normal people wouldn't be willing to go through the drug detox program whimsically unless they definitely already had a problem of some kind in the first place.
What is the problem for transgender people? I'd like to encourage most people to think of it this following way, because practically this is how it is in the United States and United Kingdom:
Currently, almost all transgender people (being treated medically by a doctor) experience or have experienced some form of gender dysphoria.
"Gender Dysphoria" is a psychological disorder described in the DSM-5, which is the primary manual that psychiatrists in the United States utilize in clinical practice. I would encourage people to look at it analogously to other disorders such as: anorexia, bulimia, anxiety (w/ panic attacks), etc.
While it can manifest in many different ways, symptoms can include: disgust at their own genitalia, social isolation from their peers, anxiety, loneliness and depression in relation to their gender or sex.
In order to make a diagnosis, a person must have experienced debilitating symptoms for six months or more. "Debilitating" means that it interferes with their life, it causes them significant distress, and they are unable to function because of it. If a person does not experience distress about it (e.g. a young tomboy who is happily gender non-conforming), this is not gender dysphoria.
Gender dysphoria can be different for different people, but I'll briefly describe what my experience was like in order to help you gain a better picture.
My gender dysphoria was strongest from 2012-2015, which I experienced on a cyclical basis in college. It was so bad during some weeks that I didn't want to get out bed and skipped all my classes/responsibilities. I would look at myself in the mirror, and I would hate myself and how I looked. In particular, I would be distressed by the body hair and secondary male sexual characteristics, and I'd want my penis to disappear. All I could think about then was about my gender. The only thing that made it feel better was if I shaved and removed the body hair, but when it started growing back, I'd feel upset again.
I knew that this was messed up. No ordinary person gets distressed by their own body hair and genitals, and I was perfectly aware at the time that I must have been crazy. I had no reason to be depressed -- I was a high-performing, physically fit, straight A student at a nice university, president of an intramural sport club with a social life, had no money problems, and I had a girlfriend too. In theory, I knew I should have been happy. So many ordinary guys would have been extremely happy to have what I had. It's hard to imagine what may have triggered this.
If I had to pinpoint one thing that may have triggered it for me, it might have been the relationship I had with my girlfriend. Most transgender people begin to experience gender dysphoria when they go through puberty, because obviously it can be very distressing to suddenly begin growing facial hair or bleed out of your crotch.
For me, around 2012, I had just begun dating in my first real relationship with a girl... and well... I had done the physical things with her, but I was beginning to question whether I was "gay". Intercourse didn't feel right for me. In fact, it felt very very very very wrong to me. I mean, yes, I really had crushed for her as a person in a romantic sense, she was attractive and a very very precious friend of mine, but... it just wasn't right. I think that gives sufficient context for what it was like for me? I thought I was straight my entire life. In a single year, I started questioning both my sexuality and my gender identity.
I'm sorry if I'm unable to convey the image properly.
Transgender isn't always about "wanting" to be the other gender.
Something I want to point out is that nowhere have I mentioned that "I thought I was a girl" or "I want to be a girl".
This is a common misunderstanding that people have about transgender people and gender dysphoria. People think that pre-transgender walk around thinking: "I wanna be a girl!"
In reality, it's more accurate to portray it as: "I hate being a man."
It is much more of a negative feeling than a positive feeling. Of course, it doesn't take much more than a five-year-old brain to conclude: "If it feels wrong being a man... does that mean I'll feel better as a woman?"
However, a lot of that is based on the assumption that there are two genders, and there's a lot of guesswork/imagination that people have about how maybe the grass is greener on the other side of the hill.
The entire gender-questioning process takes so long precisely because it takes a long time to figure out what makes us feel better. Each of us grew up with our own baggage, and none of us have seen what it actually looks like on the other side of the hill. We have to spend time experimenting so we figure out what might be the right answer for us.
For example, do I feel better or worse if I shave my legs?
Do I feel better or worse if I wear this particular scarf outside instead of this one?
Unfortunately, we live in a mostly gender binary world. Whenever you walk into a room, you are either treated as a man or you are treated as a woman. Perhaps you might figure out over time that you feel slightly better if you do X instead of Y. However, if I act like a woman or feel better as a woman, does that make me a woman?
I don't know. I don't know.
What if I don't feel better as either...?
There are no easy answers, but if you're thinking that way, you've already transcended the gender binary. However, when you walk outside in the real world, you still have to choose whether you look like (A) or (B), and people still treat you whether you are (A) or (B).
Can you get fixed from being transgender?
I once had a discussion with someone who said: "If gender dysphoria is like an eating disorder (after all, they are very similar with the messed up body image and stuff), can't you get therapy/counseling to get it to go away?"
The short answer is that it's already been tried.
In fact, it's been tried for over seventy years. If it were the 1930's and you went to the psychiatrist because you hate your genitals, they would have started you on psychotherapy and keep talking to you until you didn't hate your genitals/secondary sex characteristics anymore.
The psychiatrist also would have done the same thing if you went to them and said: "I'm a man and I like men." The first-line treatment for homosexuality back then was to start something called "gay conversion therapy". Homosexuality was viewed as a mental disorder, as a mental disorder, it had to be fixed.
Unfortunately, the psychotherapy for gay people and transgender people was notoriously unsuccessful. Psychiatrists attempting to talk people out of being gay/transgender with "conversion therapy" dramatically increased the rate of suicide among their patients, and this befuddled doctors. Why can't we make these... people who are messed up in the head become "normal" without them killing themselves?
The outcomes were so poor, and the evidence from the clinical research is so poor, that in the modern day the view among the clinical establishment has changed. Rather than trying to "convert" transgender people back to being normal, in the 70's and 80's, doctors experimented with giving these people medication and allowing them to live as the gender that most closely aligned with their identity.
Gender dysphoria, if untreated, has a suicide attempt rate of 41%.
Attempting to psychotherapy and "convert" them increases the suicide rate.
Giving them medication (hormone therapy) and helping them transition with the right social support dramatically decreases the suicide rate. Clinical trials results coming out from 2010 and onward have overwhelming shown that the most important determinant of mental health outcome is family support. Transgender people who transition with support of their family have incidences of depression/anxiety no different than the general population. Transgender people who are estranged from their families (ex: kicked out, disowned), are extremely high at risk.
As of 2018, the standard of care in the United States and other Western countries among established doctors, is to treat people with gender dysphoria with counseling and hormone therapy. The number of transgender people who are making their way into everyday life (and living normally) is increasing every year, and this trend is likely to only increase in the future.
Are you taking medications/living as the other gender?
No, I am not. After spending a lot of time questioning, what I learned about myself is that how I view myself is important than how other people treat me. Additionally, my gender dysphoria is not as severe are some other people's.
While I currently live as a man, I am able to manage my gender dysphoria with multiple non-medical strategies that I figured out when I was questioning (shaving, waxing, etc.). I realized that what was distressing me the most was internalized homophobia and the huge discrepancy between how I feel and how i was acting.
What is internalized homophobia? In my case, I actively tried exaggerating my masculinity while I was growing up because I was sub-conscious denial for a long time. I kept everything that I wanted and my true feelings bottled up inside. By the time that everything exploded, the person I was on the surface almost felt like a stranger that I was controlling like a puppet, and I didn't know who this stranger with a mask was.
Over the past 2-3 years, I've been spending a lot of effort to reconcile my "inside" self and my "outside" self. My online (female) identity used to be very different from my offline (male) identity. More recently, I've been trying to merge them more so that my offline identity more closely reflects how I feel on the inside.
And it can be hard, for sure! It can be difficult to get used to going to a store and thinking: "Which one do I really want?" vs. "Which one am I supposed to want?"
I do visibly act more like a feminine guy in real life than I used to, and I'm happier because of it. I care less about what other people think of me, and I embrace the fact that maybe my gender expression may seem #weird to other people. However, ever since I've accepted myself, I've been so much more at peace with myself.
I am lucky though. Not all transgender people are able to find an easy solution like I was able to, and lots of people are in really unstable places. I have one plea for you as a reader: if you find out a friend or loved one whom you care about is transgender, remember that the suicide attempt rate is 41%, do whatever you can to make sure they are in a safe place.
Even if that person isn't your friend, my appeal to you is to have a conscience -- and know that a particularly mean comment literally has the chance the kill them -- so at least try to be nice.
Thank you for reading!
@otokonoko is accepting anonymous submissions from LGBT people, traps/G.I.R.Ls, and ordinary people who have experiences with this demographic. If there is something you would like published/shared, please PM @otokonoko.
An otokonoko wonders about stuff #3
Author
ohko
【LGBTQ+ association】 【ohko is ohko!】
- Messages:
- 201
- Likes:
- 507
- Points:
- 181
- Blog Posts:
- 14
Bad Storm, AliceShiki, iampsyx and 2 others like this.