My transgender life: ‘Social transition is scarier than jabbing a needle in your thigh every fortnight’

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The weirdest aspect of being in the early stages of transitioning from female to male is the unavoidably public “social transition”. I never had to come to terms with how I felt since I’d always felt trans – see my previous post. What scared me was telling everyone else. But if I wanted to get the medical ball rolling, on the NHS in my case, I had to be living fully ‘in a male role’ first, including being out at work and having official documents to prove it. Re-reading that sentence makes terms like ‘male role’ and ‘prove it’ sound absurd, but that’s a whole different can of worms. In the meantime, I’ll explain why social transition is infinitely scarier than jabbing a needle in your thigh every fortnight.

For me, transition is all about physicality and achieving the male body I’ve always felt I should have. Of course the outside world would notice, but that didn’t matter half as much as my own sense of congruence in mind and body. I didn’t really consider the social implications, or rather I didn’t think through how I would confront the fiery, many-headed behemoth known as society.

To make matter worse, I neglected to research the NHS timeline and criteria for prescribing the male androgens that would bring about the male secondary sex characteristics I craved. Firstly, I didn’t want to acknowledge the partial medicalisation of my life. Secondly, I assumed the prescription would come first, so I could transition socially once my voice was beginning to drop, or hips starting to shrink. In other words, when the world could see the mistake it had been making about my identity all these years and didn’t have to be told. The burden of proof would be on others if they misgendered me, not on me to prove my maleness.

Then, just as I was day-dreaming about disappearing for a year into the Australian outback, before coming back a bristling alpha male, my clinician main-lined a dose of reality. In the UK, transmen have to live successfully in a male role for several months before receiving androgens. I’m sure there’s sound medical reasoning for this but it sounded like a cruel contradiction in terms.

Sure, I’ve lived as a male for years in my own head. When I’m mistaken for a 15-year-old boy and admonished for using a petrol pump, it’s an odd victory but I have no responsibility to pursue the issue (“you’re right, I am a guy but totally not in the way you think…”). By socially transitioning pre-testosterone, I am essentially embracing awkward boyhood and agreeing to come out as trans to many more random strangers on a daily basis. I don’t want to come out as trans, I thought. I want to be read as male.

The specialist I saw probably did not know how much of a life-belt she was throwing me when she suggested a mindfulness technique to deal with the social anxiety of social transition. First, let me preface this by explaining why I’ve always loved going to the cinema. There, I can sit in the secluded, womb-like environment and escape for 120-odd minutes into the life of whichever on-screen guy I chose to adopt as my avatar. So, when the specialist suggested I practise visualising myself as an impossibly strong and resilient comic-book hero, she was, in a sense, legitimising and endorsing a survival tactic I’d maintained privately for many years.

At the end of last year, imagining myself as James Bond (Daniel Craig proves Bond can be short), I began the process of changing my name, official documents. I let everyone know, as quickly and efficiently as possible, that I would now be going by male pronouns. Let’s just say that I should never again bemoan the existence of Facebook.

I had to trust that my physical goals were part of the same process as outing myself to the world, and that it would all be worth the fear and unwanted attention. To a great extent, this is the same plunge a person must take when quitting a job they hate, leaving a long-term partner or making any other significant life change. Only a fool or a liar would claim to know exactly what to expect and that pure, unadulterated bliss is guaranteed.

Nearly three months later, anxiety and bliss maintain a lively détente, but overall, life as a grown-up teenage boy is going rather well. Admittedly, the knowledge that I’m, hopefully, weeks away from an androgen prescription is hugely important.

Socially-speaking, I’ve learnt that the idea of something can be much scarier than the reality, and that sharing a new name and pronoun dosn’t rattle many cages, not even those of 85-year-old grandpas.

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• nevercisgendered

  yes, pedophiles also show the same patterns, i believe….

• nevercisgendered

  i have spoken to the side effects of the treatments with dr ehrensaft and her attitude is that children are prepared to take the risks. unfortunately , in our definition of legal responsibility and age, children are not capable of making these types of permanent decisions. we don’t let them get married, or buy a car. they are not mature enough. my sister has been paralysed for 27 years and cannot speak, or move more than her hand to change a tv station. she cannot eat solid food and has not been out of bed for 27 years. this is all because of the hormones that have been prescribed for her gender dysphoria. the operation left her with a urinary tract that cannot handle normal urination and every now and then she develops a life threatening urinary tract infection…or extreme delirium which has put her in the psych emergency room.
  people have told me that now endocrinologists are more vigilant…how do they know who will suffer a stroke? they can’t monitor regular patients for strokes and certainly cannot predict it.
  now dr ehrensaft says that these kids want to go ahead knowing these risks. what a cavalier attitude. kids cannot realise what it is like to live for 27 years with 24/7 caregivers and only being able to watch television…
  other meds cause less damage or risk and we pull them off the shelves. why do we pander to a medical industry which is profiting off the confusion and misery of others.
  4 out 5 people who seek help at gender clinics do not go through with the treatment. surely that means the therapy is effective.
  surely, you have read that most gender confused kids turn out ot be homosexuals when they grow up.
  good luck with your child and accept him/her as they are now. but do not allow her/him to butcher their body.

• crash2parties

  Actually you are misrepresenting that a bit. It’s the law in the US that to not provide care deemed necessary by a doctor is considered being cruel to prisoners. Doesn’t matter if it’s hormone therapy for being transgender or diabetic.

• crash2parties

  You obviously care deeply for your sister. I’m sorry both of you have had to go through what you have.

  I too have spoken with Dr. E., in her office & at some length regarding our daughter’s care. Diane struck me far more as someone who correctly assumes that many kids do not fit into a gender binary and should not be forced to do so. For those very, very few who do need hormone treatments, however, they can be lifesaving. Sadly, just like most medical treatments, some known percentage will have side effects, some life-threatening as you point out. This is especially true for trans adults who have smoked &/or who have other conditions or medications that indicate any risk of clots. Especially smoking. And yes, endocrinologists are a *lot* better at monitoring a whole host of blood factors that predict and precede strokes and other maladies. That is why regular blood tests are so incredibly important for trans people and why it’s a standard part of the current treatment.

  Yes, 4 out of 5 do not go through with treatment and that is wonderful. That they think they might need to speaks more to the stigma in our culture around gender gray areas, as they often don’t have enough information taught to them beforehand – or don’t feel confident in not being binary – to self assess. I’m glad the profession has progressed to the point of being able to help them.

  But then, there are the fraction of the fraction that *do* need to transition, and *do* need hormones just to make their body work right, to say nothing of feeling right. And the even smaller number who need surgery. To withhold treatment from them would be extremely cruel.

  Insofar as allowing my daughter to “butcher” her body, I have no intent to do so. She will see a qualified endocrinologists when the time comes to manage her puberty if and when that is needed (she has never wavered in her identity nor her relationship to her body). And when she is an adult and can have surgery, if she chooses to do so we will assist her in any way possible, as at that point she could do so with our without our blessings. But she’ll always know she has them if she needs or wants them. Because by then she’ll know that statistically there is a small chance of blood clots, just like we know of the 40% suicide attempt rate for those who need treatment but cannot get them for whatever reason, that drops to a normal percentage for those who do get them.

• nevercisgendered

  the chance of blood clots is not small. in fact, there is a 49% higher risk factor of stroke and heart attacks in the transsexual female. this is not a risk that anyone should take, and the endos cannot evaluate who will succumb to it and at what level hormones are safe. you are imagining a foolproof system of medicine which does not exist. alarm bells should be going off. vioxx was pulled for less. women are routinely told not to take hormones for longer periods due to lower risks. i only was allowed on them because i was also on blood-thinners and then i was off them as soon as possible. there is no way of testing for the clots. my sister never ever smoked even one ciggie.

  you may want to hide your head in the sand, just like dr e., but i will still beg you to reconsider for your daughter’s sake. we do not know how many transsexuals die from treatment because there is no requirement to amass the statistics and the clinics will only promote their successes. besides there is no governing body to keep contact with post-operatives.

  your remarks about suicides is also misinformed because suicide is a complex and very personal issue. we do not know if these suiciders were suicidal before they discovered the transsexual narrative. may be they attach themselves to the transsexual narrative as a way of erasing themselves from their lives, at least superficially. certainly, i felt my brother’s transition as a death in the family. maybe my brother did too. the erasure of the male body was a safe alternative to the total death of the person by suicide. he reinvented himself, but still had all of the same mental health issues and emotional frailties that she had before transition. it doesn’t go away and she cannot hide from her essential self. they may very well have been on the tragic path anyway.

  i have heard the figures on how many transsexuals are suicidal before they have found treatment and how many suicide after they receive treatment. what needs to be teased out is what portion of these suicides were inevitable as part of their mental illness. it appears that they will suicide regardless of what happens to them.

  feminine and masculine are socially arranged constructs and in our society they are formed under the tutelage of a patriarchy. essentialism is a very reactionary concept….very conservative in its goal of placing men in blue boxes and girls in pink ones. the apa determines that a boy is gender non-conforming if they like to play with dolls or dress in pink. give us a break. these are so last century. let boys play with what they want.

• nevercisgendered

  also, the use of these hormones is what is considered off-label and there is no requirement to report adverse effects. the pharma companies are not interested in reporting negative results and many doctors are not familiar with transsexual health. i know from our experience. they are truly ignorant. so a transsexual who has had a stroke is not connected to the hormones they are taking. in fact, many hospitals have taken my sister off of her hormones due to blood clots. she is now on a low dose. endos cannot test for clot risk…..they assume they can guess which levels will provoke a stroke. if they could, please share with the cardiology community. i am sorry for being so adamant. it has been a suffering worse than death with my sister. if i can educate one person, then i have success. the doctors will never tell you this because they are in the business of “treating” a symptom…and they only report their “success.” what would they do if nobody came for transsexual surgeries.

• crash2parties

  Again, I’m so sorry both of you had this happen to you.

• nevercisgendered

  i hope you will investigate the topic on your own and realise that you are being sold a lie about the treatment and diagnosis. the idea of a woman trapped in a man’s body is the narrative used by dr steinach to justify his experiments of testicle transplant in homosexuals to cure them of their “illness’. and now it has been transfered to gender dysphorics by harry benjamin, who was a psychologist, not a medical doctor…look up the story.

• crash2parties

  Finally found an original copy of his book to add to our home library. Benjamin was a geriatric endocrinologist who was ready to retire when he saw his first trans patient. He didn’t believe much in the condition either but couldn’t argue with the empirical results. And that’s they key, isn’t it? I respectfully disagree about the treatment and diagnosis as within medicine as the success rate is truly enviable. That’s without delving into the why of it & things like serotonin regulation pathways being in hysteresis with sex hormones (& therefore depending on the in utero development of the ‘correct’ receptors, which is not at all guaranteed). As well as all those studies mentioned previously regarding the actual developmental steps, etc..

  Steinach was an early hormone researcher, but apart from theorizing & proving that some unknown-at-the-time chemical agents existed…is sort of a footnote in the history, nothing more. I’m not sure what connection you are trying to make between gays and trans people regarding hormones, sorry.