Hormones Sold Separately

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I believe that overall quality of life is the most important thing to consider for people whatever their sex or gender, inward or outward. What things can we do to make another person’s life better? What things can we avoid doing?

We do not improve the quality of someone’s life by denying the validity of their lived experience as they tell it. Nor do we by validating the concept that one ‘earns’ their right to call themselves transgender only after seeking medical treatment.

I advocate inclusivity, embracing transgendered people at every step along their journey, accepting the various and unique ways they have chosen to handle their situations… without judging what they’ve done or haven’t done to their own bodies. That includes transgender people who don’t pass as the opposite sex.

Being transgender is not an act. It’s not a performance. Unlike doing drag, it’s more than just an activity because there are crucial qualities, emotional and psychological and experiential, which preclude any actions taken. The transgender experience is much less rooted in what you do — or how you look — than how you feel.

Gender dysphoria is described on Psychology Today’s website as “strong, persistent feelings of identification with the opposite gender and discomfort with one’s own assigned sex that results in significant distress or impairment.”

The term transgender is more of an umbrella term which encompasses more than just individuals with gender dysphoria but for the sake of brevity, I will refer to people with symptoms of gender dysphoria as transgender or simply trans.

Feelings are sometimes invisible, like loneliness or depression, especially when we fight to keep them hidden from others. Sometimes we choose to keep feelings private rather than public, but just because our feelings don’t show on the outside does not mean they are nonexistent. The same is true for trans people. What’s inside counts.

Science Daily reports that “Brain activity and structure in transgender adolescents more closely resembles the typical activation patterns of their desired gender, according to new research.

You cannot always know if a person is trans just by looking at them, because not all trans people express themselves in an identical way.

Some opt for hormone therapy and sex reassignment surgery, with the goal of eventually passing as the desired gender. For many trans people this process is beneficial because it enables them to feel more comfortable with their bodies and allows them to enjoy less risk of public scrutiny. This process, commonly referred to as ‘transitioning’, is sometimes not covered by health insurance and can cost thousands of dollars. It may not be offered in the country where an individual resides. There may be restrictions on how young a person can be to receive hormones or surgery, and usually psychological evaluations are required.

The aforementioned barriers in mind, some trans people choose not to transition for reasons other than the expense or their ability to access the care. They may live in a place where the treatment is readily available. They may be unburdened by financial concerns. Yet, though they struggle with the same painful mind-body discrepancy that other trans people endure, they have decided against altering their bodies or their outward appearance for the time being. Sometimes, they are criticized for this, or accused of not ‘really’ being trans. I disagree with that logic because I think it constitutes a different kind of transphobia, one which occasionally comes from within the LGBTQ community itself. It’s at least as bad as ‘misgendering’— because it’s actively denying another person’s lived experience, which is more than skin deep. The same logic could be used to tell pre-transition transgenders who want medical treatment that they are ‘not really transgender’.

A Q&A from Psychiatry.org describes it thus: “Some people make use of trans affirming social networks online and in local supportive communities to cope with gender dysphoria and claim a gender identity and forms of expression that do not require medical treatments. Some individuals choose to express their felt gender in private settings only because they are either uncomfortable or fearful of publicly expressing their felt gender.”

Whatever their reasons, they are still trans. Being trans doesn’t have a set expiration date. You don’t, for example, discover that you’re a girl who feels like a boy trapped in a girl’s body at age 10, and then have only until age 25 or the year 2020 to do something about it. Let’s say this person identifies, due to their emotional and lived experience, as a transman (FTM), but unfortunately due to mother nature, has large breasts. Maybe he doesn’t always want to squeeze into a super-tight sports bra and wear thick clothing just to pass more as a biological man. Maybe he doesn’t want surgery to remove his female breasts. Maybe he does want facial hair, but is not interested in taking male hormones, at least not now, maybe not ever.

When a person decides to postpone or avoid transition, is it laziness? Fertility concerns? Doubts about the medical industry? Is it massochistic self-denial for the sake of appeasing one’s parents or spouse ? I have the answer for what it most definitely is: nobody else’s business. They are still trans, and they likely need compassion and understanding for who they are in this very moment rather than who you think they ought to be.

Most progressive-minded folk agree that it’s innappropriate to police other people on what they do with their bodies, particularly chastising them regarding their appearance. To those who have paid their dues, so to speak, in order to transition medically, there need not be a sense of entitlement; they haven’t ‘earned’ their trans experience by paying for it. After all, they too were trans even before they transitioned.

Obviously, if a person feels like a woman but has mostly secondary sex characteristics of a man, i.e. a hairy face, it’s normal that people will default to masculine pronouns, it’s normal that strangers are unlikely to perceive her transgender feelings. Those honest preconceptions are fair enough. What’s not fair is someone seeking the support of transgender affirming communities and then being mocked or alienated by their own on the basis of their outward appearance. That’s gotta go.

We know how likely trans people are to experience depression and suicide attempts, sometimes in part due to the lack of a robust support system. For many of them, the first place they are going to turn to for compassion is the LGBTQ community — their peers, who, for the most part, can understand the emotional struggles they have lived through and the systems which have oppressed them. To look at the similarities, rather than the differences, makes a safer and better LGBTQ community for everyone.

1. Gender Dysphoria retrieved from https://www.psychologytoday.com/us/conditions/gender-dysphoria

2. Drescher, Jack, and Jack Pula. “Expert Q & A: Gender Dysphoria.” Psychiatry.org, retrieved from www.psychiatry.org/patients-families/gender-dysphoria/expert-q-and-a

3. European Society of Endocrinology. (2018, May 24). Transgender brains are more like their desired gender from an early age. ScienceDaily. Retrieved January 17, 2019 retrieved from www.sciencedaily.com/releases/2018/05/180524112351.htm

4. Hassanein , Rokia. “New Study Reveals Shocking Rates of Attempted Suicide Among Trans Adolescents.” HRC.org, retrieved from bit.ly/2NEK9bc.



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