Being transgender is not a simple concept. Despite the instinct of the Left to present it as an effortless truth only the most hateful and ignorant disagree with, the experience is exceptionally complicated. In the same way, too many on the Right fall too comfortably into merely dismissing it all as attention-seeking, nonsense and/or mental illness. Unfortunately, the topic is so heavily politicized and the language surrounding it so heavily regulated, a true understanding becomes difficult. But I can empathize and relate, and not only due to my own experience with gender dysphoria and confusion surrounding gender identity.
A remarkably brave and insightful piece in the New York Times by transgender writer, Andrea Long Chu, titled, My New Vagina Won’t Make Me Happy, inspired me to consider how my own experience with the separation of self and the body and the interplay of emotion and physical response. About three weeks ago I was mindless eating pretzels in bed with my husband watching TV. Lounging back as I had done my entire life while eating, I shoved another handful of pretzels into my mouth and began thoughtlessly chewing. I went to take a casual and routine swallow when one sharp piece got stuck. I attempted another swallow and then slowly sat up as the realization came over me that I was potentially choking. A wave of fear rushed over me as I felt panic begin to bubble up and just as it reached a shrill scream in my head, the pretzel managed its way down my throat in a sudden, painful and relieved motion.
I sat there breathing in, grateful and overwhelmed with the thoughts of what might have just happened and how completely unprepared I was for the worst of the outcomes. Jacob hadn’t even noticed because it happened so quickly, but I found myself preoccupied with the ‘what if’ scenarios for several days. A few more times in the next week as I was eating I would have a similar experience of feeling a small piece of food hit the back of my throat in a way that triggered a panic response. Then, a week or so later, I was giving a presentation to a professional group on a project I was leading, routine and uneventful, when I found myself struggling to speak. My words were slurring, my vision was going in and out and I was having difficulty breathing. I began to notice the other people in the room looking at each other with concern and I did my very best to continue. But the symptoms grew more intense until I nearly collapsed.
I was taken to the ER with chest pains, difficulty breathing and the distinct belief that something was terribly wrong and after a round of testing was embarrassed to find I had simply experienced a panic attack. The symptoms are indistinguishable from a heart attack for men and have no real cause or trigger. This knowledge made me feel exceptionally vulnerable and helpless as I had been completely disabled by what amounted to a physical reaction to an imaginary threat. Worse, despite what felt to me at the time as a life-threatening emergency, most people simply replied with a relieved ‘oh…’ when I told them what the experience was called. Then, about a day or so after, I was eating, experienced the slight panic sensation from swallowing and found myself completely paralyzed with the fear of choking. Within a few hours I was nearly incapable of swallowing small amounts of water without my throat tightening up and a heat wave of fear consuming me.
Over the next few days I forgot entirely how to chew and swallow food properly as my focus became so intensely fixated on controlling every microsecond of the experience to protect myself from choking that the coordination of my reflex was disrupted. For nearly a week, every time I attempted even the smallest bite of the safest food options imaginable, my throat would tighten, I would begin to panic and the act of eating became nightmarish. I tried to overcome the fear, push myself to work through it and intellectually reasoned there was no actual threat, but my body simply refused to comply. I simply had no control.
My doctor prescribed an anxiety medication and promised it would help over time, but I found my optimism to be slipping. The notion of returning to normal with something so profoundly mundane as to be humiliating to describe seemed impossible and I found that absolutely no one beyond my husband really appreciated the concern. I tried to keep it to myself, but people notice when you don’t eat and asked questions. When I explained the symptoms their faces conveyed, at least to my perception, a confusion as to what on Earth was wrong with me. As they all ate normally in front of me, they simply could not imagine I was being anything other than irrational and dramatic. I can honestly say it was a deeply isolating experience and I don’t blame them for not understanding. Suddenly being so afraid to eat because you are absolutely convinced you will choke if you do not carefully manage every moment of the act is not a normal experience.
Just as suddenly as it appeared, it disappeared. I continued experimenting with different foods and despite a near constant sensation of fear, found that my swallow reflex was behaving more normally without the same spike in fear response as before. The physical symptoms had diminished, but the psychological aspect had not. It has only been a few days of eating almost normally, but I still hesitate with each bite and I still take a momentary mental note of calm and preparation before each swallow which, despite my heightened expectation, becomes more and more mundane. The lasting impact of this experience has brought out a better appreciation for the impact psychological conditions have in relation to the experience of the body in tandem. It has also made me appreciate how difficult it is to share the experience with other people who have never experienced it themselves.
Chu states, “But in my experience, at least: Dysphoria feels like being unable to get warm, no matter how many layers you put on. It feels like hunger without appetite. It feels like getting on an airplane to fly home, only to realize mid-flight that this is it: You’re going to spend the rest of your life on an airplane. It feels like grieving. It feels like having nothing to grieve.” She goes on to argue, “People transition because they think it will make them feel better. The thing is, this is wrong.” Her argument, essentially, is that current treatment for gender dysphoria, hormones and surgery, are believed to relieve the sense of dysphoria itself but simply do not. In fact, in her own words she faced more significant psychological and physical challenges once beginning treatment than she had prior.
She reveals, “I feel demonstrably worse since I started on hormones. One reason is that, absent the levies of the closet, years of repressed longing for the girlhood I never had have flooded my consciousness. I am a marshland of regret. Another reason is that I take estrogen — effectively, delayed-release sadness, a little aquamarine pill that more or less guarantees a good weep within six to eight hours.” She goes on, “Like many of my trans friends, I’ve watched my dysphoria balloon since I began transition. I now feel very strongly about the length of my index fingers — enough that I will sometimes shyly unthread my hand from my girlfriend’s as we walk down the street. When she tells me I’m beautiful, I resent it. I’ve been outside. I know what beautiful looks like. Don’t patronize me. I was not suicidal before hormones. Now I often am.”
Profoundly, she completes her essay with, “Nothing, not even surgery, will grant me the mute simplicity of having always been a woman. I will live with this, or I won’t. That’s fine. The negative passions — grief, self-loathing, shame, regret — are as much a human right as universal health care, or food. There are no good outcomes in transition. There are only people, begging to be taken seriously.” In this I agree with her. For nearly two weeks I felt strongly that all I wanted was for other people to take seriously the overwhelming experience I was going through. I resented the idea that it was just all in my head because despite my full awareness and dedication to intellectually tackling the issue, my body responded in ways I could not control. I simply could not will myself to stop being afraid and it felt to me as though I was responding to a real physical sensation as opposed to an imagined concern.
But where she and I disagree is on the notion of embracing the fear itself. Although my experience, temporary but impactful, is not directly comparable to the lifelong experience of gender dysphoria, I do believe there is understanding here. Those suffering, and they indeed suffer, with this experience are not just making it up or exaggerating for attention. Their feeling of detachment from their physical self, compiled with the growing anxiety, stress and awareness of transition inevitably creates a powerfully intense emotional experience. It makes more sense to me today why they often react with such hostility towards discussion of their psychological experiences exclusively, and apart, from their physical experience and perception.
For me the anxiety is multifaceted. There is a brain chemistry component, a lifestyle component and a situational component. Medication to regulate the chemistry allows me more authority to manage my lifestyle and address the situation. But the medication did not convince me I was right that something was wrong with my ability to properly swallow food. It merely alleviated the physical symptoms long enough for me to begin convincing myself I was irrationally afraid. Where Chu’s argument leaves me concerned is in her admission that medical transition does not appear to provide the foundation to allow a person to steady themselves and address the core of their dysphoria. And if hormones do not help, or aggravate the symptoms, and surgery does little more than introduce new physical concerns to manage, is transition truly the solution to dysphoria? She is correct that it should be a choice one makes without the condition of a doctor concluding it is the only way to ease their suffering, but to what end?
The Left is wrong in championing transition as the only true option for transgender people to be their authentic selves. They are wrong to dismiss concerns by indignantly demanding ‘science’ overrides all criticism. They are wrong to bully and silence debate by threatening such dissent is harmful and even life-threatening to transgender people. But the Right is wrong in dismissing it all as mere mental illness or attention-seeking as well. It remains unclear what the best path is for a person suffering from gender dysphoria and I am inclined to assign responsibility for that decision to transgender people themselves. But I also believe we are doing more harm than good with our current way of approaching the issue on both sides. At the very least we can agree gender dysphoria is a serious concern and the associated suffering deserves sympathy and recognition.