#why do i have to get expensive surgeries and go on hormones just to feel at home in my own body? i shouldn’t have to do that

[beebmo]

people online act like being trans is such a beautiful wonderful thing and that it’s soooo amazing that you get to become the person you want to be or whatever but i honestly can’t see it as anything but a curse for me in particular

[cheerfullycatholic]

Hey, this is totally random, and honestly I apologize for dumping this out on your blog. But I need to talk to someone and I don't know what to do.

Hi, I've been in a relationship for about 4 years now. I love him with all of my heart. But I've been thinking of leaving.

I need to know if I'm justified in this. If maybe this is a push from God, or something, to get out.

He's always been insecure, I've always had to reassure him. Constantly. It was fine at first, but it's exhausting sometimes. It feels like I have no privacy. When I am on my phone, he asks what I am doing, when I am talking to someone, he asks what we are talking about and makes sure that I'm "not talking about him". I have to tell him what I write in my journal, just in case it's about him. He says he doesn't read it, but I don't entirely believe him, or think he wouldn't.

He usually sits in the bathroom while I shower. If I have my phone to play music, it's suspicious to him. If I'm on the couch or anything and my phone is face down, it's suspicious to him.

He has gone through my phone before behind my back. He has told me about the one time, but I suspect there's others.

He doesn't want to go through RCIA or attend Catholic mass. Something I have been passionate about, or at least was, until he ruined it. We would fight every time I wanted to go to church. He would make me feel so selfish for dragging him along. So I stopped fighting it. I never asked him to be a member. I just asked him to learn with me, to explore. But he doesn't want to. Now, he wants to pick a different church. I said I would. Because I don't know what else to do. Mind you, it is non negotiable that we have to attend the same church, he will not compromise.

We talk to each other about our expenses which I don't mind, but often, when I want to buy things, he calls it a waste of money. But when he wants to buy things, it's not. I have spoke to him about this, it doesn't seem to change.

We have to eat the same foods for dinner. I can't eat things that are different from him. I don't know why.

I have an opportunity to get a college degree with a mild commute. He doesn't want me to take it because we won't work in the same town anymore. And he is worried I will meet someone more interesting and leave.

I have told him that I'm doing it no matter what. But when I bring it up, he shuts down, or gets angry.

Our intimate life has been lacking, as I have had issues with pain during and after, and hormonal imbalances, due to possible Endo. While I know it's been out of wack for the better part of two years, and that can be frustrating, it seems he really isn't understanding about it. After about 3 weeks going without intimacy, he gets depressed, and ends up either arguing with me, or making me feel bad because it must mean that "he's not attractive to me" or "I think he's gross". I can understand insecurities stemming from that. But it's a struggle for me too, and I'm literally scheduled for a surgery to fix things and diagnose. That doesn't seem to matter. I feel like I have to constantly prove myself loyal to him. Even though he says he trusts me, I constantly have to tell him I'm not cheating on him.

I can't talk to him about this, because I'm almost certain nothing will change, and it will just make him more insecure. I'll have to reassure him more. And I can't. I don't have any more to give. I can't talk to anyone about this through text or anything because I know he'll find out somehow. That's why I'm doing an anon ask, so that it will not be in my notifications.

Am I wrong for feeling suffocated? Is this unhealthy? I don't know what to do. I have no family where I live, they're halfway across the country. I feel so trapped.

Oh my gosh, Anon, that's awful. I can't imagine how hard being in that position must be and I'll be praying for you both 🖤

You are absolutely justified in leaving and I recommend you do so soon. I won't rant but, man, that is far from a healthy relationship and you deserve better. But please, be safe. I hate to assume, but do you think he'd be the type to lash out? Just from what you've told me, I personally wouldn't trust him to just let me leave. If you think it wouldn't be safe, maybe have a friend or even a police officer there with you, just in case. I wish I knew what else to say. Maybe someone else will have something to add?

I really hope you'll both be okay and that you'll be able to get through this safely. I wish there was more I could do

[mithliya]

Hi! Do you think you could explain how gender critical people can support body autonomy in cases like abortion but not transition? I know you believe that medical transition doesn't change someone's gender. But under the ideals of body autonomy, would you support a woman taking T if she still called herself a woman instead of a calling herself a trans man?

And in general, I know radfems are anti-plastic surgery, but wouldn't that too fall under one's body autonomy?

I'm just trying to figure out radfem and gc ideas but I'm running into some inconsistencies.

honestly i was a bit baffled by this ask and couldn't help but feel like its bait bc ... how is cosmetic surgery that is harming your body, incredibly expensive, and done as a result of self-hatred the same as not wanting to carry a baby & go thru the risks of pregnancy for 9 months? to me these are such blatantly, fundamentally different things. but let me assume this isn't bait and you're asking in good faith and address your points.

I know you believe that medical transition doesn't change someone's gender.

this shows a complete lack of understanding on what beliefs i even hold. i don't think medical transition "doesn't change someone's gender" i know it doesn't change a person's *SEX*. this difference is very crucial. gender = gender roles, gendered expectations, etc. it is a social construct. it has nothing to do with anything medical nor biological, its a social contruct that varies across time and cultures.

But under the ideals of body autonomy, would you support a woman taking T if she still called herself a woman instead of a calling herself a trans man?

why would i support the act of taking synthetic hormones which are actively harming your health just as long as you Identify a certain way? it doesn't matter to me what you call yourself. i'm critical of medical transition because it is costly, harmful, and rooted in questionable beliefs. i'm critical of how readily it is promoted. i am critical of how profitable it is to pharmaceutical and medical industries. i am critical of how little research is being put into ensuring the safety of it as well as research into other methods of dealing with sex dysphoria. whether you call yourself a man or a woman is the least of my concerns.

you use the term bodily autonomy, but you seem to be under the belief that bodily autonomy = a person gets to do whatever they want with their body and their choices are always above any criticism or analysis and it does not matter how much their choices are harming them or others. by that logic, if you don't support an anorexic woman starving herself or getting a liposuction, you are against her bodily autonomy because you are not allowing her full agency over her body. by that logic, if a woman tells you she wants to get a BBL or have implants put in, you need to validate and encourage that choice because to question harming your body is to oppose bodily autonomy. but that is not what bodily autonomy is. here is a definition:

Body autonomy is defined as the ability of one person to demonstrate power and agency over choices concerning their own bodies. These choices must be made without fear, threat, violence or coercion from others.

Body autonomy allows individuals the freedom to make their own choices about their bodies. This is significant to a person’s health and wellbeing.

now, if there is a group of people being told that they need to transition ASAP and being told constantly that without transition they will kill themselves, is that or is that not going to instill fear? because if i was told that i need to take an action as early as possible, lest my life be miserable and doomed, then im going to want to urgently take such an action out of fear. if parents are being told "do you prefer to have a dead daughter or a living son?" or w/e, is that not coercion and threats?

moreover, we know taking synthetic hormones for cosmetic purposes can be extremely harmful for one's health. women with high levels of testosterone naturally suffer from a lot of health consequences as a result, nevermind people who alter their body's hormones. this is fundamentally different from a woman choosing to get an abortion because a pregnancy is costly, risky, has health consequences, and will impact her entire life for at least the next 18 years of her life.

that said, i'm not blaming people who do pursue cosmetic procedures or artificial hormones and i'm not against them. i am against the industries promoting this and making it difficult to even have a conversation on this, even pushing against research that does not benefit their financial interests. i am against the promotion of cosmetic surgery as necessary, healthy, and somehow healthcare. i think that there NEEDS to be more research into medical transition, the impacts it has on health, its usefulness and helpfulness, and alternative treatments. the lack of such research and the lack of constructive conversation on this topic is where my concerns lie. not with identity politics like what someone calls themselves while harming their bodies.

so ultimately, i'm not understanding what you think is an inconsistency here. questioning profitable industries and cosmetic surgery which are modern inventions rooted in amplifying people's, namely women's, insecurities for the sake of profit is not at all the same as an abortion and it's worrying to me that you don't see the difference. providing blind affirmation to every choice an individual makes is not bodily autonomy, its individualism and liberalism to another degree. bodily autonomy is allowing individuals the right to make informed, healthy, decisions for themselves. a woman deciding she does not want to go through 9 months of pregnancy and 18 years of child-rearing is not the same as a woman deciding she hates her body and thus MUST get a boob job (which ultimately harms this person's health rather than helping), or someone deciding they hate their sex and thus MUST get surgeries to pass for a different sex (which also ultimately negatively impacts the person's health, even if it provides some psychological relief which potentially could've been gained via a different approach like therapy).

[detransition]

from dickevandyke The other day a friend of mine said they hardly even consider me detrans because I "didn't really do anything to detransition". I didn't ask what they meant by that, because they're not really the kind of person I can have that sort of conversation with. I didn't want to have to explain to them why I detransitioned. I didn't want to have to justify finally feeling okay with myself after spending my teenage years being miserable and stressed about being trans.

It's kind of a fascinating mindset, though. I think it gives really wonderful insight as to how their brain works. Like, I stopped taking testosterone. I stopped asking to be referred to by male pronouns. I "came out" as a woman, and I Came Out as a Lesbian after also spending most of my teenage years trying very hard to repress my attraction to women. This person doesn't view that as doing anything. Why?

I imagine it's because I dress fairly masculine - as Butches generally do. I wear still wear, mostly, "boyish clothes". I didn't start wearing make-up. I didn't let my hair grow out long. I haven't done any voice training, or really made an effort to make my voice higher pitched like it was before. I haven't gotten breast implants. I rarely correct people when they call me "sir". I don't need to do any of those things. A stranger calling me "sir" doesn't mean I am not a woman. Not having breasts anymore doesn't mean that I'm not a woman. The point of my detransition was not to turn myself into a stereotype or to dive head-first into femininity.

The point of my detransition was just that I am finally comfortable with myself, just as I am. That doesn't mean that I love my body, but I am okay with it. I am at peace with who I am.

Do I regret getting a mastectomy? Yes. There was no other reason to remove my breasts, they were perfectly fine, they were small and didn't cause me any back pain, I didn't have any medical issues related to them. Do I regret wearing a binder? Absolutely. It has screwed up my ribs and back so severely that I am probably going to be living with chronic pain for the rest of my life. Do I regret going on HRT? Sometimes, sometimes not. Honestly, it didn't really change much for me outside of my voice and making my body hair slightly thicker. Do I regret social transition? Absolutely. I dug myself into such a deep hole of self loathing and repression that it took me three years to finally crawl out of it. So after going through all of that - after putting myself, my body through all of that, why would I want to do it all over again in the opposite direction, when there is absolutely no need for it?

I "didn't do anything to detransition" because I don't need to do anything to be a woman, I just am one. Woman is my natural state. I "didn't do anything to detransition" because I already put my body through three years of cross-sex hormones, five-ish years of binding, and an unnecessary mastectomy which has left me unable to feel most of my chest more than a year post-op. I don't need more unnecessary surgeries or expensive treatments to make myself into a woman, I never really stopped being one. Getting breast implants wouldn't make me more of a woman because I don't need breasts to be a woman. Voice training to make my voice a higher pitch again won't make me more of a woman because a high pitched voice was never what made me a woman in the first place. Wearing make-up, growing out my hair, wearing "girly" clothes wouldn't make me more of a woman, because femininity does not make a woman.

I didn't argue with them when they said that because, to be honest, I don't want to hear what they think makes a woman. I don't want to hear them trying to justify why they barely consider me detrans because I have not tried to turn myself into a feminine stereotype. It just really struck a chord with me, because if I'm not really detrans to them, am I really a woman to them? Or do they see me as some kind of "failed" woman because despite explicitly and openly accepting my womanhood, I am not their picture of what a woman is suppose to be?

thinking of detransition? you are not alone

[blueraspberrycoke]

Best college research is in USA cost vs degree use which has a list of schools, this gives you the best loan for degree cost of the degree is the goal. Look at that and the subject then online at the best cross matches. Unless you want a social experience mostly then whatever vibes. Listen you know anti-trans bigotry like in your about has NO ethical point in feminism, it's just bigotry.

Thank you for the advice on college :)

I'm not a bigot. I'm not anti-trans. I don't think trans people are inherently evil. But I do not believe you can change your biological sex. I do not believe allowing trans women into women's sports, changing rooms, sexualities (lesbians being pressured to date trans women), etc. is good for women and girls. It's not just a belief I have, it's factually proven to be dangerous to put TW in women's prisons (1, 2, 3, 4, 5) and in bathrooms (1, 2, 3, 4, 5 [5 is written by a trans woman]).

I'm not saying I hate trans people or that I don't trust them or that teens/children who identify as transgender are "broken" or "wrong" like people have said I do. I think we have manipulated an entire generation of lesbians and homosexual boys (though not all trans-identified people are homosexual/bisexual) into believing they have to be the opposite sex. We've lied to dysphoric teens and told them they're going to die if they don't recieve gender-affirming care (see all the posts on the protecttranskids, transgenocide, transrights etc. hashtags).

This is also evident in that anytime you question someone who says trans people are experiencing a genocide, especially a younger person (like a teenager who gets all their information from Instagram and TikTok) they actually can't come up with a single example. Even when they bring up the so-called "anti-trans legislature" being passed in the United States, they can't name any specific bans, because that actually does not exist. What I linked for you is HB1276, which, if you read it, allows minors who underwent sexual reassignment surgery to sue their doctors up to 30 years after they turn 18 for malpractice if they regret surgery. Trans Legislation Tracker labels this an "anti-trans" bill.

They have reason to regret it, too. Lupron, the drug administered in FtM transition to dysphoric females, has painful and sometimes deadly side effects that gender-affirming medical clinics will not disclose with you in full. (1, 2, 3, 4, 5)

Also, a disproportionate amount of FtM females are autistic, homosexual, and depressed. I care especially about these women because I'm eighteen, autistic, and a lesbian, so I really resonate with their pain and struggle. I'm not disgusted by transgender individuals and I'm not angry with them. I feel terrible for them. And I want to help.

What I think we have in the world now is an extreme lack of education. It's harming girls and women my age, when there are more affordable and better options. We've known for a long time doctors will push medicines that don't work/shouldn't be as expensive as they are in order to make money (I'm talking about things like selling insulin for $500 a vial. I'm not talking about things like vaccines.).

If you want to change your name and use other pronouns, cool, fine, whatever. I don't care what you do with your life, your money, and your time. But don't call yourself male or female when you're not. See my pinned post for why doing so harms women and men.

Transgenderism is motivated by misogyny. Go to any of the subreddits created for TW (r/Egg_irl, r/MtF, r/transgender [though that one contains trans men also]) and you'll see in every "How I knew I was trans" post that these people consider being female synonymous with being feminine, and it isn't. I'm not feminine. Does that make me a man? No. It just makes me a nonfeminine woman.

I'm not denying the existence of gender dysphoria. Many of my mutuals are desisted females who still struggle with it. But hormone therapy/SRS (sexual reassignment surgery) are very clearly not the answer. I hope this helps you understand my position better. I also hope I've not come across as condescending or patronizing in any way.

[sirdeeziii]

I don't really have any followers but here goes.

College is hard. Because of how much it costs, as a society we put extreme pressure on kids to make a single final decision quickly. Oftentimes before they even know what they want to do for a living. College is a competition, where you have to prove to them why you're a worthy investment. For scholarships, too. All within only a few months. It's a lot of pressure. Making the adjustment to leaving home (as is usually the case) is jarring, and you no longer find yourself surrounded by the people you went to school with for most of your life. For trans people, however, it gets a lot more complicated. More under the cut.

Most college dorms are split by gender. When you're trans, where do you go? Will they let you into the opposite "gender" dorms? Are you comfortable with a cisgender roommate knowing you're trans? If you're a trans man, are you comfortable being with cisgender men? There's undoubtedly an underlying fear of being taken advantage of or exposed. If you're a trans woman, are you comfortable being with cisgender women? There's undoubtedly an underlying fear of being wrongly perceived as a predator. Will people be disgusted? Will they hurt you? Will they misgender you? Will they harass you?

Living in your affirming dorm means you are surrounded by cisgender people. Most trans college students are pre-op, meaning there is an incredible likelihood of feeling dysphoric because you don't feel as "real" as everyone around you. In the event that you have no choice and must stay in the dorms of your agab, you would be battered everyday by the dysphoria of invalidation. And this isn't even including the pain nonbinary people face. There is no gender neutral housing option. You're forced to pick. It's an even bigger losing situation because you will experience dysphoria no matter where you stay. (These examples are mainly considering trans people who experience dysphoria, because not all do) (Also I know not all nonbinary people strictly identify as agender, but I'm trying to make a point).

Some colleges offer coed or single person dorms, but these options are not universally available (as far as I know) and often more expensive. Trans people already deal with having to pay extra for basic comfort, so going into thousands of dollars in debt is not ideal (or always possible).

Although there is a clear effort, most spaces are still not trans safe or accessible, and until they are, students like me will continue to struggle and suffer--not just in college, but out in the world as well.

Some terminology for the 5 people on Tumblr who aren't queer:

Transgender - an umbrella term for someone who identifies as something other than the sex they were born as

Trans - shortened form of transgender

Cisgender - someone who identifies with the sex they were born as

Nonbinary - an umbrella term for someone who does not strictly identify as a man or a woman

Trans man - someone who was born with female sex characteristics but identifies as a man

Trans woman - someone who was born with male sex characteristics but identifies as a woman

Agender - the complete lack of a gender identity; not identifying as a man, woman, or anything else along the spectrum

AGAB - stands for "assigned gender at birth", referring to the social gender identity automatically associated with an individual's sex when born

Dysphoria - the extreme mental discomfort and pain experienced by trans people when they are reminded of how they are perceived by others, how they perceive themselves, and/or the disconnect between their gender identity and their physical body (e.g. when a trans person is misgendered, when a trans person remembers that their body does not align with their identity, etc)

Pre-op - shortened form of pre-operation, meaning a trans person who has yet to receive gender-affirming surgery or hormones

A big thank you to TransgenderFirst for this scholarship opportunity. Hopefully they accept Tumblr and also ignore my blog name and username.

[wanderinglotus7]

WAITING Season

Hello friends, it seems like forever since I actually posted something on here other than some photos and videos of a few trips I've taken. Your girl has been struggling, even drowning. Yet, I'm still standing! My physical health has been my greatest enemy lately. Without retelling my whole journey- because that gets exhausting- I have updates. So, back in 2022 I was diagnosed with PCOS and most of my symptoms stem from hormonal imbalances. From there I had many lab tests conducted and a few of them repeated which sucked. However, I'm happy that Dr. S was being cautious and doing everything she could before any major decisions would have to be made. At the beginning of 2024, I found out that my body is overproducing the stress hormone cortisol. Late March, a MRI scan revealed that I have a tiny noncancerous tumor located on my pituitary gland (located in the center of my brain). This tumor pressing on this gland is the root cause of my body overproducing the cortisol and throwing my body out of whack. The remedy is surgery. June 7th I met with a pituitary gland specialist doctor and surgeon. Along with PCOS, I was diagnosed with Cushings Disease which is related to the cortisol. They both said that if the surgery is successful all of my symptoms should go away for good. Thank you Jesus! Before I can schedule the actual surgery, I have to get a vision exam (June 27th) and a CT scan (July 1st). Each person is different but the recovery process should take about 3 months.

This is a sucky way of getting an extended vacation from work. A sucky way of escaping from Boston for awhile. I keep reminding myself and telling others that I'm bless to have health insurance to help with my medical expenses. I'm bless that all my specialty care (with the PCOS clinic & Pituitary Gland clinic) is under the same medical system-Beth Israel which I'm an employee at BIDMC. Nobody wants a tumor, but I'm bless that it's small & isn't cancer. I'm bless that I'm young because I can probably recover better compared to someone of an older age. I'm just BLESSED!!!!! Also, I've been receiving lots of support from the Adelante & CVPR team once I decided to share my story with some folks from work. My supervisor Cynthia has been really supportive, and I think I even made her cry one day when I was giving her updates on my appointments (sorry). On the other hand, I've had mixed reactions from family & friends that are aware of my situation. Another reminder that I'm really out here in Boston by myself. Not only that but this situation has shown me people's true colors. I don't need people in my life who disappear and go silent on me when I need them the most. Time to say Good-bye to those people. I don't need energy leeches in my life.

Going away to SC & VA gave me the space I needed to accept the fact I have PCOS & a tumor. Honestly, I've been numb about this whole reality and just coasting emotionally because I'm still trying to process my emotions and getting frustrated with people keep asking me how I'm feeling. I can't provide a answer if I don't have a answer for myself. The funny thing is about a week or two weeks before SC, I had a total mental breakdown over everything that's going on in my life. Caroline really came thru that day! I'm bless to have her as a friend. It was nice to have someone genuinely listen to me in that moment and didn't ask anything from me which is completely new and foreign to me. There is a reason why God places certain people into our lives at a particular time. I felt so much better after our conversation. That conversation has helped me have some tough conversations with some people and in combination with a writing prompt from my poetry class. I can identify those who make up my village and are truly my friends.

WHAT IS HOME? I'm still trying to figure out what home means to me and what home looks like. I mentioned this to my Grandmother, and what she shared with me finally clicked. Home is where you feel loved. Ding dong this is why Boston doesn't feel like home. Yes, I have a support system here, but it's not the type of love I'm searching for myself. Boston isn't conducive to the future I envision and pray for myself. Like Bobbie said to me this morning, "I'm trying to find where I belong". In my heart, I know I don't belong in Boston or even in MA. I belong somewhere else and that somewhere maybe in NC or somewhere else (who knows). I love my family, but I know Gloucester isn't my forever either though Gloucester, like Thailand, will always have a special place in my heart.

Boston has really tested my strength & patience. 8/7/24 will be 4 years since I moved here from Gloucester. I might be here for another two years because I'm determined to earn my LICSW which I can start preparing for the clinical exam next year. So, I should earn my license in 2026. From there, I can go anywhere! Boston has given me the opportunity to achieve my academic dreams/goals. Because of Boston College my first internship with Amirah open the door for me to be working with Adelante. Adelante has been my gateway into my involvement within the Anti-Human Trafficking movement. However working for BIDMC makes it feel like I'm working two jobs instead of one. I'm a social work advocate with Adelante. I'm a clinical social worker/advocate for the Center for Violence Prevention & Recovery. One side of my job shows me what I like about my job (Adelante). The other side of my job shows me what I don't like about my job (CVPR). Hopefully during my recovery time, God will provide me with the answers I'm looking for related to my career after I earn my LICSW. I still would like a hybrid work model, do counseling & advocacy, but not work in a medical center and not be On-call. In an ideal world, I would like to have a manageable work/life balance where I can work in a bookstore and on the side either be a counselor for those 13 to 25 years-old or be a supervisor/mentor for young professionals in the social work field.

In the bigger picture, I’m ready for a change in scenery. I’m ready to live in my own apartment or live in my first little starter home like a two bedroom. I’m sick of living with roommates. I’m tired of feeling like I’m living on top of other people. I’m tired of living in such a crowded space. I want my personal space back! I want to be able to either sit on my front porch or in my backyard without feeling like my space is being intruded on or cannot enjoy the peace & quiet. I want to be closer to nature without having to live in the middle of nowhere. I want a good combination between the city and country life but not live in the suburbs. At 27, I’m ready to settle down. I’m ready to enjoy a slower pace of life. The freedom to enjoy my cup of tea, reading & writing, maintain a career while enjoying being a wife & mother.

I told myself before 2023 ended, I’m going to invest more into myself from my physical health to my emotional health to my creative life. I slacked a bit between April and May, but I’ve been able to lose some weight. I’m 5lbs away from my summer goal. I had a few hiccups but I’ve found peace with my relationship/breakup with my ex and my mental health is at baseline (no panic attacks). These poetry workshops I’m attending have been therapeutic and are a nice distraction from my world. A healthy avenue to channel my art and release any stress in my life. Also, I’m learning and gaining so much skills to improve as a writer and a poet. It was a disguised blessing that Mariposa didn’t become a finalist in the Button Poetry chapbook contest, but it was for the best. I realized I wasn’t truly finished writing my story until I released that piece of myself that was holding on to Erik. I’m proud of myself for setting and being firm with my boundaries in all aspects of my life!

My path may look a little different now, but the destination remains and looks the same. I’m still going to Jamaica next July (2025). I’m looking forward to attending Caroline’s wedding. In honor of my Granddaddy, I’m getting a Bluejay tattoo because he has been my protector since he passed away. I’m looking forward to publishing Mariposa. I’m emotionally prepared to enter my next relationship. I’m still growing my relationship with God and doing my best to live like Christ. I’m taking control over my life!

[bisextrous]

The thing people don't understand about it being hard for trans people to live in the US isn't that the places where we're less likely to get hate-crimed are also the most expensive places to live, or that the rising tide of anti-trans legislation makes more people feel ok about acting on their transphobic beliefs, it's that even when we're doing everything right, it's still impossible to get good healthcare.

I live in New York-- not just the state, the city.

I go to a specifically LGBTQ-friendly medical center where I see doctors who are part of a specific LGBTQ program.

And even there, I am met with interns, nurses, residents, doctors and specialists who do not have the understanding of trans health that I need.

I have had to explain the different ways that testosterone can be dispensed, how it gets injected, low dose vs high dose, intramuscular vs subcutaneous injections, gel vs injections, why I use what I use at that dose and that frequency. I have been asked to advise doctors on where to order needles, syringes and my actual testosterone from. I have explained over and over and over about the relationship between testosterone and cardiovascular changes, my rising cholesterol and why I'm not particularly concerned about it.

And through all of this, I also have to deal with the laws that vary from state to state. Like how, in NY, testosterone is a Schedule II drug. I cannot be prescribed any more than I am intended to use-- so despite the fact that a perfect draw doesn't exist, that in order to get the testosterone into the syringe at my proper dose there needs to be more than my dose inside the bottle, if I am prescribed .5 ml injection every two weeks, I get one vial with 1ml in it. The doctor is not allowed to I'm not allowed to have refills. I can never possess more than a 30-day supply. Every prescription (because it's a new one every time when you don't get refills) requires a Prior Authorization confirming that my doctor spoke with me and made sure I still need this medicine.

This means that I have to lie about the dose that I'm taking so that I can get enough prescribed to me to actually take the dose I'm comfortable taking. If I want to take a .5ml dose every two weeks, I have to say that I take 1ml every two weeks, so that I'll get 2 vials instead of one and I'll actually have enough to draw .5 every time.

It also means that every month I have to play a game of requesting my prescription at the exact right time because if I request it too early and it gets sent over before the 30 day window is up, then the prescription gets rejected and I have to start the process all over which means now I'll get the prescription late.

It's worth mentioning that I'm at a point in my transition where I've had multiple surgeries and I no longer have the organs that produce hormones for me, so HRT is more of a need for me now than ever. And it's worth mentioning that I've been out and on T since 2016.

Now sure, you could say, "if the state laws are giving you so much trouble, why not move?" But where else am I going to find a trans health clinic? Where else am I this protected from hate? Do you think I want to live in the most expensive city just for kicks? As a queer person, I'm keenly aware of how my identity is only allowed to exist comfortably in certain places and even as I write this, that list grows shorter.

I'm tired. I'm tired of it being so hard for me to fucking stay alive. It shouldn't be this complicated.

[sydthetiel]

Update:

https://linktr.ee/helpsyd 

If you can donate, please consider doing so. If you can’t, please don’t, but please share this instead! Even $1 helps. If this post reached 10,000 people, and each person donated $1, there might be some hope of long-term survival. If this post reached 1,000 people, and each person donated $1, we could get Syd the care she needs.

Syd’s life: It’s an older video, but not much has changed, so posting it again to remind of what’s been going on.

We had some wonderful donations for Christmas, which got Syd to a specialist on New Years Eve. The current goal is to treat this as chlamydia, and administer a 6 week course of doxycycline (antibiotic) injections. However, her more recent health concerns were reproductive in nature, and they’ve given her a dose of Lupron, a hormone blocker.

This first visit came to nearly $300, and each future appointment will be nearly $200. The specialist still also wants to run more diagnostics, if her condition doesn’t clear up with these treatments.

So I could really use more donations to ensure I can get her this full course of treatments.

Dad’s life: However, I’ve also received news that my mom, who has been alternating between nursing home and hospital for the past two years, only has 35 days left of short term nursing stay coverage. That means once she goes from the hospital to a new nursing home (since the last one left her in worse conditions, to the extent that her bed sores required surgery just after Christmas) she has 35 days to recover and come home, or will be considered long term. Long term coverage means they will take her SSDI income, which is what we use to pay the bills. My SSI check is too small for that, so it goes to monthly expenses. The taxes still haven’t been paid, and that’s nearly $6,000. She was supposed to go to a nursing home today, but I got a call that she needs yet another blood transfusion today. It doesn’t appear that anyone is looking into why. They write it off as anemia. Great, fantastic. She’s had a history of anemia, but she’s never needed transfusions before. Now, she’s had three in the past month. WHY?!

I have no hope that she won’t be long term, at this point. So I have 35 days to figure out how I can swing over $1,200/month expenses on $900 a month. I pretty much can’t find any hope in affording bills, or taxes. There is nowhere else I can go. This is our family’s home. It was passed down from my grandparents. With my income, there isn’t anywhere in the entire country I could afford to live.

I am truly at such a loss on what to do anymore. I’m drowning in all of this. I have my own health issues that doctors don’t take seriously. I only just got a lead on what doctor to see for my pain and fatigue 3 days ago, and so far haven’t been able to secure an appointment.

I’m afraid that over the next few months, I’ll be living out of my van with Syd. That’s not sustainable for either of us, but certainly not for a sick bird, whose treatment I won’t be able to continue without help.

I feel hopeless.

[anauro]

it’s so confusing to me and i’m trying to educate myself but i get so much backlash when i ask and i get it no one owes someone to help educate them but then they ask why people aren’t educated on a subject it’s like no one will explain

how can you identify as a man and still want to be pregnant? does that not go against your gender identity? i understand some people can’t afford bottom surgery but wouldn’t getting pregnant as a trans male go against who you are considering giving birth is well a women or i guess nb thing?

im not trying to be hateful or rude i’m just curious and trying to learn

Hi anon,

I am not a trans man, so I may not be the best person to address this. I know there are trans men following me, but currently none has this information in their bio, so I will not be tagging them. They can interact with this post if they’d like to.

I will put the rest under the cut, because it's a sensitive topic and some people may not want to read it. I will also tag your ask with warnings, even though I understand you are just curious. Don't take it the wrong way, it is just to avoid dysphoria in people who'd rather not read this.

My advice would be to either google this (quora and reddit has plenty of threads like that) or ask a trans man directly.

I can provide my opinion as a person who isn't cis, but I don't see myself as a man either.

So.

In my opinion, genitals are not something that define you or your gender identity. A trans man may chose to undergo full surgical transition or may stay in the body they were born in and not even go on hormonal treatment. Trans men who aren't on T or who don't bind are just as much men and as valid as the rest of the male identifying community.

I believe this is the first thing you, anon, need to understand. Genitals do not equal gender. Not all trans people want to change their bodies and their genitals. Not only is this a painful, long and expensive process, it is also a risky one and sometimes it's just something that's not desired by the person in question.

I personally am not happy in my current body, I find it too feminine and gross, but it brings me great joy to think there are trans and nb folks out there who don't experience that. I don't identify with they/them pronouns, I go by she/he but am AFAB. For that reason, consuming trans men media (reading, writing, art, porn) feels very euphoric to me. I don't always relate to them, I wouldnt want to be viewed as strictly a man (I like both), but my anatomy relates closer to trans men than it does to trans women or cis women. It makes me feel happy to write trans male characters, simply put.

A man with a vagina or a woman with a penis is perfectly valid.

People who are born with a uterus can choose to use it and I don't think the desire to have biological children invalidates their gender identity. This mentality that pregnancy is a women-unique experience is a social construct and nothing more.

If you want to understand the trans and nb community, you must first understand that nothing in this world belong strictly to one gender only. Anyone can wear suits. Anyone can wear dresses and heels. Anyone can have a penis. Anyone can be pregnant.

Pregnancy for me is something extremely dysphoric. Even before I realised I am not cis, I have had extreme reservations about it. If I ever become pregnant, I would consider myself a pregnant man cause the mentality that I am a pregnant woman would be too damaging for me.

So to wrap it up, this is not a trans man talking, but a genderfluid person. You, anon, need to get rid of this 'x is a women's thing and y is a men' thing' mentality. Or that the state of one's body and their organs and genitals define them. Gender roles are a social construct and a very harmful one.

If anything in this post is factually incorrect or transphobic, please feel free to point it out to me. I too am still learning and always willing to be pointed out where my obnoxiousness or privilege is showing. Similarly, if I missed a tag - let me know asap!

Lastly, I'd like people to not comment on the personal things I described here. If you know me a bit better (aka if we talked one to one on discord), then feel free to message me, but otherwise I am sorry, but I don't care what people think of my personal experiences.

[intersex-support]

Umm. I’ve been doing some searching and understanding of myself. And thanks to your blog, I think I know what’s…”going on.” But like, can we just start identifying as intersex or is that something a physician diagnoses?

Here's a post we've made talking about self diagnosis.

Intersex self diagnosis is a complicated process. Most people are diagnosed through a physician. When self diagnosis does happen, it's something that requires a lot of research, and most people I know who have self diagnosed have some medical involvement. Intersex self diagnosis sort of feels like you have to be a detective about your own body, looking back through your childhood, maybe looking at medical records and seeing what tests you've gotten done. Usually, people who self diagnose as intersex do it because they've gotten hormone tests done but no diagnosis, or got a karyotype done and found out they have different chromosomes but they don't know why, or they got misdiagnosed with one intersex variation but realized it was another, or realized they had surgery at birth because of their scars. I am definitely not in charge of who is and isn't intersex, and who's diagnosis is valid, but I want people to understand that intersex self diagnosis usually takes a little more work than just reading a list of symptoms online. There are some intersex variations that the only way to confirm it is through genetic testing, and that's just not something you can do online. I want to make it very clear that dyadic people are not able to just identify as intersex because they think it's cool, or gender affirming, or because they read one post online.

However, I do want to make it clear that we do support self diagnosis. Doctors fucking suck, and a huge part of intersex oppression is the fact that we face so much medical abuse. I am never going to tell people that they have to put themselves through medical abuse just to get a diagnosis, and it is so expensive anyway. Doctors are not in charge of our bodies, and there are ways of finding out that you are intersex without professional diagnosis. Fuck doctors and fuck medicalization. I believe that people are allowed to figure out what is affirming to them, and I fully am here to support people when they do the research and figure out what is right for them. I will never shame intersex people who are self diagnosed, or demand proof from them. Intersex community can be a great resource in your diagnosis process and this blog is here to help point you in the right direction, share resources, and can help with discovery.

Anon, I don't know your situation and can't tell you if you are intersex or not. Know that this blog welcomes all intersex people, regardless of their diagnosis story. But that is ultimately something you will need to figure out yourself.

Other mods and intersex followers, please feel free to add on with your perspectives. we do not all share the same opinions and that is really valuable!

[talisidekick]

It shouldn't be this hard.

Warning: long post, surgery reference, talks about cock.

I've been struggling about my decision to get GCS/SRS and there's more than one complex reason why:

The first is that starting out on my journey [when I admitted I hated myself and my body so much in the past that I now felt numb, and the only real feeling I had was a want (not a need) to be a girl] I went to a transgender focused clinic in my area in the attempt to get on hormones. It was informed consent and one of the forms they gave me to choose to sign was admission to part of an optional study on transgender people and I can't go into much further detail. All my experiences have been documented thus far. And I said I was interested in getting SRS because at the start I thought I wanted everything, and there's nothing more I would love than to contribute to a study on trans healthcare in a positive way. In this world today, a study like this is paramount to countering transphobe conjecture, rhetoric, and ridicule, and especially important if it's used by local governments in the future to justify expanding trans heathcare services. And as I've continued my hormone regimen I learned my wants were needs. I needed to transition because it made me go from a numb sense of nothingness to having hopes, and wants, and desires, and feeling love, and joy, and even negative emotions like anger and envy. I'm ... alive again after so long. I feel again. So I come back to my initial statement of wanting SRS and do I actually want this? I'm part of a study, am I wanting SRS out of obligation? Or do I want SRS?

The second is ... a lack of dysphoria. I've always been ambivalent about everything. Numb. Being a girl was a want that only became a need because I realized I'd shut down all negative feeling to cope. I can now emotionally feel bad, but I still remain neutral on my own dick when it comes to my feelings. Am I just repressing again? I've never had to shower with the lights off, never felt disgusted looking down, never felt unnerved or hated masturbating, but is that because I've shut that off? Like growing boobs is probably the happiest thing in my life right now. Watching my hips fill out over this last year has been awesome. All things I wanted but never knew I needed. Is my dislike of the bulge in jeans because of societal pressure? Or do I dislike how that looks on a personal level? Am I fine with it, in reality? I've read peoples intimate recounts of sex from both non-op and post-op trans women and ... both are ... euphoric in that I could have that one day, maybe. But is that euphoria from being liked and treated as a woman in an intimate setting, or euphoria from being a non-op or post-op trans woman? Am I just looking to be accepted intimately? Loved for who I am now, or do I feel an intrinsic need to look a certain way for myself or is societal pressure, this obsession with what's in a trans womans pants making me want to change so I can have confidence in knowing bad actors could never tell if push came to sexual assault? Am I wanting SRS because the cock feels wrong on me, or because I'm looking at this hellscape before me and trying to find safety?

The third is ... well ... transitioning is expensive. Hair removal on my legs, ass, back, hands, and stomach (I got lumberjack genes apparently) costs a sizeable amount (face and chest were covered by local gov't), and so does face feminization surgery (ffs) if after a few years and the facial hair being removed I decide I need it to realize being me, and even just clothes which I don't have the money for right now. And it may come down to me needing to market myself in the porn industry to get what I need to feel normal. Just a reality of capitalism. Being a girl with a cock is a niche market and a potential source of income. So do I want to keep it because ... it'll potentially give me access to the means I need to change the things I do know I dislike about myself? Because it could improve my current quality of life? I mean ... I know my gov't pays for it but not travel expenses up front, so I don't even have the money to really even get to the clinic if I'm approved.

Fouth and lastly ... I've always loved the idea of being that girl that stands up and defends. Not to be a hero, just to know I'm justified in telling others to fuck off and help someone struggling out of the muck so they can shine. I don't ever want to really be famous or a celebrity, just someones personal inspiration that makes them a hero for others to look up to. I mean, it's in the name of the blog: sidekick. That's my goal. Someone else can be the hero. And keeping the dick and still proving to the world I am a woman regardless by just living every day in it ... that can really help others feel normal. Okay in expressing anyway they feel, shine as individuals because if I can do it so can they.

And so ... I'm stuck. SRS ... yes or no? Do I want it for my own personal reasons, out of obligation to science and peers, or safety in conforming? Do I want to keep it because I'm fine with it, because I'm trying to be an inspiration to those with greater potential than myself, or because it can help me get more of what I need if I keep it? The greater question I keep landing on, but I'm unable to answer is: if society didn't care, if there was no obligation for science or money, if I was just accepted as me and loved either way, what would I do? Only ... I can't compartmentalize. These are huge factors for who I am, who I want to be, and the impact I could be making.

It shouldn't be this hard, and it is, and before anyone jumps in saying I need to talk to a therapist or a psychologist ... there's no time. I'm sitting on the forms now. They need to go off and I have to make the choice ...

And yet ... I fear that choice is being made for me as well because even if I do ... I can't afford to go. Not just the flight ... it's 6 months recovery time and even if I qualified for disability payments during that period, it's only 60% of what I currently make ... which at my wage I already live paycheck to paycheck ... so am I fine not being able to get this proceedure? And I don't know.

This is why I haven't made a stream or video in over a month. It shouldn't be this hard. I'm struggling.

[juseki-taisen]

Ive watched the anime and that was some good shit right there. the mix of 3-D and 2-D animation is wonderful too! I would love to know how the 12 would treat their recently transitioned or in transition S/O because I hear “trans rights” coming from them

You bet your bottom dollar that they all scream TRANS RIGHTS!

Updated: Because I did Sharyu twice and forgot Nezumi. Sorry!

Inounoshishi

Dating Inounoshishi while transiting is actually ideal

Not only does she support you and whatever gender you want to be, but mama has money and is going to pay for it

You're her darling, why wouldn't she pay to keep you happy?

She's also going to take you shopping. She loves shopping and the idea of getting you a whole new wardrobe is to good.

Just be nice and say thank you, and show how much you appreciate her

Honestly? She never got to figure out who she really was/is as a person since she was always trying to please her parents. Seeing you figure out/announcing who you really are is really motivating for her.

Dotsuku

Doesn't have a problem with it.

May occasionally slip up on your pronouns, but always corrects himself immediately. After a week? Doesn't mess up again

Dog. Loyal. He's not about to let something like you being who you really are affect what he thinks of you.

Added bonus: His daughter just rolls with it. Kids aren't as stupid as people make them out to be. If you used to be a princess/prince, you're now the opposite. The real question is, what kind of super hero cape do you want?

Dostuku will help with your medical bills. If doctors give you shit for it, the man has connections. He will find a good doctor who respects you and get your surgery (if you so choose) taken care of

Niwatori

The whole idea of being trans is a little confusing at first for her, but it takes about 000.1 seconds for her to decide it doesn't really matter?

Her whole life she's been a tool for the family, with you she's a person. In the end, no matter how you identify, as long as you still love her that's what matters?

Does a TON of research. She gets books, medical journals, ect. She uses her contacts to find doctors for you, and don't worry. Cost isn't an issue.

Anyone who tries anything just...vanishes. You know from that weird smile she gets she 110% had something to do with it

If you ever feel ad or dysphoric about your body, she's very supportive.

Sharyu

She already knew. She's very perceptive, and was just waiting for you to be comfortable telling her.

The most supportive.

Does whatever she can to make you comfortable. If you want new cloths, she'll shop with you. If you're to embarrassed to go to a store, she'll order online.

Never uses the incorrect pronouns for you.

Will put one of those little trans flags in the window of her apartment.

If there's a pride event, will go with you.

Arranges a good doctor for your transition when you're ready, and will go to appointments if you're nervous

Hitsujii

He's old, and has seen it all. He may be older, but he's not going to question it.

One of those "Whatever makes you happy" people

Doesn't understand a lot of surgery details and hormone stuff. He'll try to research it, but you may have to help him learn terminology. He does catch on fast

The idea of surgery freaks him out because he has no control. He’d help you, but he is going to be silently panicking on the inside

Uuma

Actually really cool with it? Just tell him you still love him. The first thing he worries about is that you’re going to become this amazing you, and the you that loved him wont love him anymore

Really supportive? Doesn’t know a lot about trans issues, but he tries

He will probably buy you anything with the trans flag on it. 

If you have surgery, he’s going to make sure only the BEST doctors do it

Listens when you talk if you have feelings to get out. It just makes him really happy you’re confiding in him

Takeyasu

Trans? Cool. Fine. Help him pull off this heist

He really doesn’t care, if you’re happy he’s fine with it? 

Actually brings up frogs that can change their gender, and that there’s a species of lizards that reproduce without asexually. If reptiles do it, why can’t people?

Gives you money for surgery if you wanna get it. Worries through the entire thing, but only Nagayuki knows about his brother internal freak out

Also, shopping spree. Criminal shopping spree. grab and RUN

Has trouble using the correct pronouns, but tries really hard and corrects himself. 

Nagayuki

He already knew way before you told him. He’s perceptive, smart, and also finds your online content. Really, he was just waiting for you to tell him yourself

Probably gets you a tray of cupcakes with the frosting colored with the trans flag colors. He likes snacks, any excuse to get snacks and make you happy? Killing two birds with one stone

Master of your pronouns and possibly your new name

You know how hard it is to change your name? This dude hacks into the systems and does it in a night. 

Helps you get surgery if you want it. Not emotional about it, but will hold your hand if you want him to. 

Ushii

Help him. He doesn’t understand trans when you first bring it up, but when you explain it clicks

Now he is fully on board and ready

While he can’t keep up with a lot of LGBTQ+ terms, he supports you and what makes you happy. You want to be the gender you’ve always wanted? No problem. Just tell him what he needs to do

Has fought someone who purposely misgendered you before. 

Will take you shopping if you’d like

You want surgery? He knows people. Honestly? He’s so well known that the doctors are volunteering to make sure it gets done properly.

Never once messes up your pronouns.

Tora

She’s seen so much on the battlefield that when you tell her, she’s not that concerned. It’s great that you trust her, and she will support you but...You’re not going to leave her, right? 

Cuzz she loves you with all her heart and if someone like you can become every more yourself (and therefor more amazing) why would you stay with a screw up like her?

After she gets past her insecurities, Tore is very supportive of you

Has punched a guy in the face for being rude to you. Maye have started a street brawl over it, it’s fine. She won.

Surgery freaks her out no matter what is it, but she’s going to be there if you want it. She may just cry when you can’t see her. What if something goes wrong???

It wont and you’re fine but you wake up and she’s crying like a BABY

Usagi

This...is kind of a disaster? Not in the way you’re thinking

He gets all your pronouns right, and quickly is VERY excited to call you his new girl/boy friend. 

But uh...people may die...A lot of people

If he notices that people give you weird looks, they’re dead. He will FIGHT and MURDER people who are transphobic (but what’s the loss really?)

Loves to shop with you, and tries to pull things he thinks you’d like (probably kills people there too, RIP)

If you want the surgery, you have to do the research. Usagi doesn’t get it. HOWEVER he will help pay...sort of

“It’s expensive”

“Will this cover it?” Proceeds to pull out diamonds and gold bars, and...is that a rare species of monkey? WHERE DID HE GET A MONKEY?

How do you even exchange that for money?

Imagine going to pride with Usagi. 

Snuggling with Usagi if you have body dysphoria. Him not really understanding everything but 110% being willing to support you. 

Neuzmi

Already knew. Not a huge deal for him. 

Supportive, but really casual about it

He’s great with pronouns, and does use his ability a lot to try and make sure he doesn’t say something to make you uncomfortable

always quick to apologize if he does. 

[qqueenofhades]

Fedyor is just as afraid of somehow losing Ivan as Ivan is of losing him, but he's just better at hiding it. He's usually the optimistic one and he's known as the sunshine half of the Kaminskys, but he can also have depressive episodes and fearing that he's not going to fix anything and just going to endanger the life that they've managed to make.

This is such an interesting and great take on Fedyor and i have many feelings about 🥺🥺🥺 Reading this though made me realize that generally we see Fedyor in a good place throughout PEL and the fivan backstory fic — the one glaring exception being the proposal chapter ofc. I mean Fedyor gets kidnapped by Nazis and is still kicking without a missed beat. Which does make me wonder exactly the kind of dark episodes Ivan has had to pull Fedyor out of privately and I’d love to know more about Ivan being that rock and source of comfort for Fedyor the way we see Fedyor be there for Ivan (especially in the Drag Queen backstory!).

also i have many many feelings about the fact that one of Fedyor’s biggest fears is making things worse and ruining the life he has with Ivan and then…it kind of, sort of happens in PEL. Nobody obviously blames Fedyor, least of all Ivan, but I think Fedyor would feel a bit of guilt. I mean he tried to help Nina, instead got kidnapped by Nazis and then his husband almost got shot trying to find him (and Matthias was in a really bad place because he thankfully saved Ivan’s ass). And all of this shooting and almost dying is a very very scary thing for Fedyor to try to wrap his head around after the fact. And I don’t think by any means that Fedyor regrets helping Nina but there is this scary part of his brain that’s won’t shut up sometimes and is like “Did I just make everything worse???”

Welp. I do think that post-PEL, once Fedyor and Ivan get home to Brighton Beach and everything really hits, there will definitely be some trauma to work through on both their parts. Ivan will have to deal with his fear of almost losing Fedyor, Fedyor will have to deal with his guilt over supposedly causing that situation/almost getting so many people hurt as a result of rescuing him, and they'll definitely need some therapy, as another anon suggested. Because yeah, they both dealt with it like badasses the whole time, but that doesn't mean that they weren't both fucking terrified, and that will have to be reckoned with.

Ivan, of course, isn't all that good at talking about emotions, whether his or anyone's, but he shows his love through his actions. Whether it's turning up at protests that he personally thinks are stupid in order to physically protect Fedyor, or putting together that whole military-grade rescue plot to save him from goddamn Nazis, or doing anything that Fedyor wants even if he has to grumble first, Ivan has already demonstrated his devotion in countless different ways. Fedyor likes to talk about things and provide the verbal reassurances that Ivan needs, such as in the drag queen backstory, but there's no doubt that Ivan has done just as much for him. I mean, the man left Russia and agreed to head into exile in order to marry Fedyor and be with him, gave up his entire life and everything he had ever known, to go to a foreign country where he had never been before, didn't necessarily trust, and didn't particularly speak or read the language. Even though they're living in a very Russian neighborhood, there's still a serious culture shock to get over, the knowledge that he can't go home again soon or probably for years, and... yeah.

(This isn't to suggest that you were implying that Ivan hadn't supported Fedyor the same way Fedyor has supported him, lmao. I just have Many Feelings about Phantomverse Ivan and how VERY far he has come and everything he has done over the years.)

As for Fedyor's dark episodes, he certainly can give into the "our country is doomed why am I even wasting my time" activist ennui that he and all his friends feel, even though they keep working through it, and Ivan has to be there for him in his gruff Ivan way. Fedyor's organization is also occasionally contacted by desperate Russian parents who are trying to get treatment for their sick kids abroad. The way the medical system works in Russia is that if a drug isn't approved in the country, a patient can't be treated with it, and the approval process is complicated, lengthy, and subject to bureaucratic delays and runarounds. This is bad news for kids with very rare disorders for which the only effective (and expensive) medicine exists in the West. The parents have to apply to the regional medical authority for them to buy it/administer it at a federal hospital, which are almost all in Moscow. And if that doesn't work, they pretty much have no choice but to go abroad, and for working-class Russian people who have no way of getting that kind of money, they don't know what else to do aside from internet appeals and emailing everyone they can think of.

Anyway, Fedyor's organization takes these kinds of requests from time to time, from people who are not necessarily opponents of the Putin regime but are willing to ask Russian activists abroad for help getting treatment for their kids, even knowing that this will probably cause trouble for them when they return home. Fedyor and his colleagues can sometimes help, but sometimes they can't, and he feels intensely guilty about having to turn them down and know that he's basically sentencing that kid to a lifetime of not having the right treatment/dying young, because they can't get it in Russia. That fucks with his head almost more than anything else he does, and Ivan has to take special care of him when that happens.

Likewise, LGBTQ Russians are often in contact with Fedyor and company, and he has to help them emigrate or whatever other arrangements they need. Gender confirmation surgery/hormone replacement therapy for trans Russians is (for the moment) still available, but it's insanely hard to get approval from the government commission who has to okay it, and transgender people can't hold driver's licenses or other essential IDs. So Fedyor often has to help trans Russians find some way to get their treatment somewhere outside the country and then decide if it's safe for them to go back, and if he can't do that, he likewise takes it very hard.

In short, Ivan knows that Fedyor really wants to help everyone, regardless of the possibility or feasibility of doing so, and when there's a particular person that he just can't do anything for, it really eats at him. Fedyor is pretty good at getting over it after a few days and bulling onward, because he really is fearless and used to doing the things that he has to do, but sometimes he needs more help, and that's when Ivan is, as ever, 100% there for him.

[therapy101]

(1/2) With a rise in young children expressing gender nonconformity being sent to gender clinics, being taught about gender dysphoria and being ‘born in the wrong body’ in schools, being guided towards pubertal blockers and medical transition, I was wondering if I could ask for your more knowledgeable input please. When treating such children and adolescents, why is the underlying assumption that the dysphoric feelings are valid and the body is what needs fixing? Why is APA/psychologists

(”2/2) allowing medical decisions to be made based on outdated mind-body dualism? We don’t affirm anorexia and offer liposuction, or the delusions of schizophrenia for instance, so why is this the only mind-body incongruence that’s treated this way? Does GD in a developing child really warrant medicalizing them for the rest of their lives? Since we’ve scientifically concluded gender is a spectrum, shouldn’t we instead be promoting gender diversity no matter what sexed body we’re born in?”

There are a lot of things to unpack and understand here. 

1. The underlying assumption is not that “the body needs fixing.” Medical transition is not the first step for children, adolescents, or adults with gender dysphoria. From 2004-2016, only 92 total children and adolescents out of six million total patients younger than 19 seen in the sample received a hormone blocker for a transgender-related diagnosis. Even among adults, current estimates for the United States are that between 25-35% of trans and non-binary adults complete any kind of gender affirming surgery (this means, even enough those who have surgery, it may only be one type of surgery and may not impact all relevant body parts). Getting access to trans-affirming medical care is very difficult, and structural inequalities like racism impact access to care, leading some trans people, especially Black trans women, to have to buy hormones from non-medical sources. That’s one of the reasons why the APA has come out to support trans folks and gender affirming care: because otherwise, these folks don’t get any care, or they get mistreated. The point here is to ensure that everyone gets equitable access to high quality medical and mental health care. That includes hormones, hormone blockers, and/or surgery for some people, but not everyone. 

2. All feelings are valid- dysphoric or otherwise. Sometimes feelings don’t fit the facts, or acting upon them doesn’t make sense, but that doesn’t take away from their validity. The question is not whether the feelings are valid for kids with gender dysphoria, the question is how to understand that dysphoria better and how to identify what to do about it, both in terms of gender identity and in terms of coping, support and improving overall mental health. This is a great place for a therapist with expertise to step in and help the child and their family figure it out. 

Sometimes the child or adolescent has known literally or essentially their whole life, and that may mean no dysphoria (which is great!). From Katz-Wise et al., 2017: 

For some youth, primarily but not exclusively those ages 7–12 years, indication of transgender identification occurred early and was described as “immediate.” One father of an 18-year-old trans boy from the Northeast noted, “It was so immediate that it was just, you know, it wasn’t like he was seven and he said, ‘Oh my god he thinks of himself as a boy.’ It was just kinda always like that with him.”

For other youth, it is a more gradual process, and may take some time to sort out. Some youth also don’t have dysphoria while they are doing that so there may not be a reason to seek out therapy unless there is some other mental health issue they are facing. But if they do have dysphoria, or are otherwise experiencing mental health symptoms related to their gender identity, then seeing a therapist can help. 

3. Supporting a child to identify as trans or nonbinary or some other non-cis gender is not “medicalizing them for the rest of their lives.” Hormone blockers can be removed, and hormones can be stopped- but I disagree that these are “medicalizing” in any case. A person cannot be reduced down to the medications they take or the treatments they receive. Is a woman with cancer “medicalized” because she undergoes a hysterectomy? Are the children on puberty blockers for medical reasons “medicalized” (>2000 of them in the study I cited above, but no one seems concerned about them)? What about those people with delusions who are put on antipsychotics, which are known to have severe side effects including higher risk of diabetes and heart disease, seizures, tardive dyskinesia, overwhelming sleepiness impacting ability to work or drive, weight gain (I’ve seen clients gain >70 lbs in 3 months), and more? 

I would encourage you to read either of these great studies by Katz-Wise et al: 1 or 2 to understand this better. When you ask trans youth about themselves, the medical aspect is such a small part- they are talking about their whole selves, their hopes for the future, their families and friends, and their wishes to be able to be loved and accepted for who they really are. Some of it is about their bodies, sure, and that can mean that some decide to use hormones and/or hormone blockers or undergo surgery (although we’ve seen that those rates aren’t super higher ). But they’re also just talking about being called the right name and pronoun, getting to wear the clothes that make them feel authentic, getting to date and marry and have sex, and: getting to live. Not being ostracized and assaulted and killed. Like this 8 year old who identifies as a girlish boy worrying he’ll never be able to get married AND be his true self (from the second Katz-Wise et al):

An 8-year-old youth participant who identified as a “girlish boy” similarly worried about other people's reactions related to gender norms in the long-term future, as told by his mother,

He said [to me], ‘But I'm not going to get married, because if I married a boy I'd want to be the bride...I would want to wear a dress and people would laugh at me because I'm marrying a boy and I'd be wearing a dress.

He is 8 years old and these are his worries. As a mental health professional, my immediate thought is that he deserves any and all support that makes sense to him and his family so that he doesn’t have to worry like this. So that he can be 8. 

4. Finally, and probably most importantly: gender dysphoria is different because treating it with hormone blockers, hormones, and surgery is literally life saving. 

As high as 42% of trans people have attempted suicide at least once. For comparison, the lifetime prevalence of suicide attempts in the general population is 3%.  

Study after study has shown that there are three primary factors that reduce suicide risk: 1. Timely medical and legal transition for those who want it; 2. Family acceptance and general support from friends and loved ones; 3. Reduced transphobia and internalized transphobia. (1 2 3 4 5). 

Psychologists want to help people live, and live well. Living well means having a life you enjoy and find meaningful. If medical transition means someone’s suicide risk decreases and their mental health improves, then they can pursue the life they want. Being affirmed in their gender means they can have that part of the life they want. It might also help them get to other things they want (like having the marriage and wedding they envision, like that example). These are things we as psychologists prioritize. Period. 

It’s not the same as anorexia because providing a liposuction for two reasons. One: It would not resolve the dysphoria. People with anorexia who lose weight do not feel better about themselves and their bodies. That’s the dysphoria: people with anorexia (and other eating disorders, sometimes) often cannot see their bodies as they really are. Changing the body won’t help. Unlike in gender dysphoria, where changing the body- either in presentation or actually medically -actually does help. Two: Liposuction for an underweight person with anorexia could kill them. As we’ve discussed, gender affirming surgeries for trans people can save their lives. These are not comparable. 

The comparison to delusions doesn’t work very well because there isn’t really a “medical” intervention you would do to affirm someone’s delusion. But, since you may not know this: we sometimes do affirm people’s delusions, and it’s not necessarily psychologically helpful to try to change someone’s mind about a delusion. Delusions are not bad all on their own, and: sometimes things we think are delusional, actually aren’t, so it’s super important not to assume we know someone’s life and experiences better than they do. (Just recently a nurse assumed a patient was delusional, but actually they were quite rich and owned several expensive cars. People can be rich and have a significant mental illness.) So anyway- I don’t know how that applies. 

Overall: we as a field are still understanding the full spectrum of gender identities and how to do good treatment and good science in relationship with that. But what’s clear is that medical transition is sometimes a part of a good treatment plan for both youth and adults, and that it can save people’s lives. It can make their lives better. I am 100% about saving people’s lives, so I am 100% about a medical transition when appropriate and gender affirming care in general. 

References: 1 2 3 4 5 6 7 8 9 10

(email me at academic.consultant101 gmail.com if you need full texts)

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[fox-steward]

hi, not sure if this blog is active bc im on mobile but you seem v knowledgeable so i hope you are. i have a question if thats ok. ive been id'ing as ftm trans/nb for about 6 years now but havent rlly been able to come out to many ppl or transition at all so im still largely presenting as female. i wouldnt rlly call myself gender critical or anything like that, but i know transitioning is a long & difficult process and im wondering if there is a way to alleviate my dysphoria without going (1/2)

“thru all that. i dont want to transition only to realize that i dont feel better and there was an easier way. in other words, id like to rule out any possibility that im not trans before medically investing in being trans. any chance you have any advice for me? (2/2)”

hey there—still active, if sporadic.

when it comes to healing from dysphoria, there’s no cure-all, no hidden path to healing that you’ve simply yet to uncover. just as there’s no way to guarantee transition will make you happy, there’s no opposite guarantee either. i can only share some of the stuff that has worked for me and some of the hardships i uncovered about living as trans, which i hope you find helpful.

what helps me?

get clear with yourself about what you believe about gender, ideologically. i personally feel, if my beliefs do not stand up to critical thought, if they cannot be supported by rational arguments, then those beliefs are not worth holding on to and i need to let them go. this is what happened to me WRT transness, gender, and all that.

start small—what is gender? is gender innate? do we have gendered souls? how could we have gendered souls if gender is a social construct? okay, so we can’t have gendered souls, so what is gender, if not innate? is gender the social expectations and norms attached to the two sexes? is it possible to break those roles and expectations? does breaking those roles and expectations change anyone’s sex? no—males can behave in typically feminine ways and females in typically masculine ways and that does nothing to change their sex. so what would conceivably make someone (or myself) trans? inhabiting the social roles and expectations of the gender associated with the opposite sex. since we already established that gender isn’t innate and we don’t have gendered souls, there’s no merit in the “born in the wrong body” narrative; it is not possible to be born in the wrong body. we each get one body, no matter how we change it. but if i wasn’t born in the wrong body, why do i feel so uncomfortable with mine, especially with the sexed aspects of it? if you’re female, the likely culprit is misogyny. you don’t actually have to hate women on a conscious level to be suffering from internalized misogyny. we live in a misogynistic world, it saturates everything. if you’re female, it affects almost every factor of how you move through this world—how people treat you, what opportunities you’re given, which behaviors are encouraged for you and which are discouraged, etc. if you are inclined to prefer masculinity—for whatever reason—society will encourage this in males and discourage it in females. having your way of being subtly discouraged all the time can easily lead to feeling disconnected from your body, perhaps even hating it, especially since you know that your way of being would be ENCOURAGED if only your body were male. and that’s when many of us encounter trans ideology that tells us we CAN be male—in fact, we actually were all along! all we have to do is change our bodies drastically with lifelong medication and surgery, all we have to do is trade money and time and health to convincingly imitate the opposite sex—THEN society will finally recognize that our way of being is okay—because we were actually masculine MEN all along, it was simply our female bodies obscuring that. does this feel like a good or healthy trade to you? it doesn’t to me, but i can’t make these decisions for you.

there IS an important caveat, a shortcut that bypasses this bad trade entirely—and that’s realizing that your way of being is ALREADY okay. masculine females and feminine males are healthy and good. it’s not always easy to comfortably BE that way in a society that does not embrace masculinity in women and femininity in men, but the solution is not to change your self, it’s to change the society. and the only way you can do that is by carving out that path—BE a masculine female/woman and you’ll show little girls today that there’s a place for them in this world.

i did try out the trade for myself, however, and i learned a few things you might find useful—maybe these lessons i learned can save you the time and money and pain i’ve already spent.

1) you never actually change sex. you’re always chasing the aesthetic imitation of the opposite sex with transition, but never becoming the opposite sex. in this and so many other ways, transition never ends.

2) passing is conditional. when your sense of self is predicated upon others seeing you a certain way, it can be taken from you in a second. i could be treated like one of the guys for a year, until one of them finds out i was born female. now that he knows, he cannot unknow. now my experience is tied to how he sees me—does he see me as a woman now that he knows? is he comfortable with me in the locker room? it was stressful and uncomfortable for others to have this level of control over my experience of the world and of myself. it’s also out of my control whether he decides to lend manhood to me now—will he use male pronouns with me? will he call me a woman? will he out me to the others? will he sexualize me or sexually assault me based on my female body?

3) as stated above, transition never ends. no matter how well you pass, transition always requires maintenance. you’ll need bloodwork as long as you’re on hormones—that’s time and money you wouldn’t have otherwise spent. you’ll need supplies for your hormone shots—time and money you wouldn’t have spent. there will be instances where you need to disclose your trans status, thus repeating the coming out process infinitely—doctors or EMTs, new intimate partners, friends. this process is exhausting and othering, it’s an ever-present reminder of the fact that you’re trans.

4) medical transition is expensive in terms of money and heath. taking hormones is always a risk. there’s potential for: cardiovascular risk associated with testosterone, vaginal atrophy and sexual side effects, changes to mood (some for the better, some worse), not liking how hormones change your body. then there’s the financial aspect. in the USA at least, this costs money—money for doctor’s visits, money for the hormones themselves, money for the supplies to administer them. there’s risk in any surgery—risk of death or serious complication, loss of function and sensation, improper healing, chronic pain. and of course, the monetary cost associated with surgery. removing the uterus can have lifelong consequences—early onset dimentia, lifelong need for synthetic hormones, osteoporosis.

5) there is no “actually trans.” there’s no meaningful distinction between “true trans” people and others. trans people transition and identify as trans. their dysphoria isn’t any different than mine was. there’s no method for parsing “real dysphoria” from something else. transness is an ideology. i liken it to religion. there are no “real christians” and fake christians, there are only people who believe and those who don’t. that’s the salient difference between myself (detransitioner) and trans people—belief. and if something requires me to believe in it to be real...well that’s a good indication it probably isn’t.

good luck out there. these are heavy questions and weighty struggles. there’s no harm in focusing on other aspects of your life when you’re having trouble answering Big Gender Questions. rooting for you.