Diary of a Pre-Trans Woman, Part 3: Intervention
Nov 14, 2016 — Wishing you were trans IS trans.
As described in the last installment, I’d reached a point where I needed some kind of medication. I just didn’t know what kind. I wanted hormones, but I was also incredibly scared, as I knew that would be an inflection point — the moment I began a gender transition, if indeed that’s what I was doing. I wasn’t convinced it was.
The last months of 2016 were some of the busiest and most stressful in recent memory. My world was turning upside down at the same time I was trying to plan holiday travel and deal with working long hours. I wasn’t sleeping well. I was arguing with my wife a lot. Still, something drove me forward.
The weekends before and after the US election were pivotal. I was still on the fence about whether to try hormone therapy or an anti-depressant, or so I thought. When I saw that my new gender counselor seemed hesitant about giving me a referral to a doctor for hormone therapy, I recognized the sudden fear I felt in that moment. I made a snap decision and found the resolve to actually tell him that was what I wanted.
11/5 — Got a haircut. I didn’t want to, was hoping longer hair would help dysphoria, but it just looks so bad. I felt out of place in the barbershop, even after going there for 12 years. It feels too masculine. — I was dysphoric already, then found out my GIC appointment was postponed. I felt like crying, then read an article [this one] and actually cried. I was depressed all afternoon and evening.
11/12 — Counseling session at GIC — Seeing caution from the counselor about giving a hormone referral made me realize I was afraid of not getting them. I Decided to attend the support group afterward since it’s more facilitated and less social. My first reaction was that everybody was obviously trans — nobody passed, and there were lots of deep voices. There was a lot of talk of suicide and lost families. My dysphoria just isn’t that bad. I left the group depressed, like this isn’t the answer I was looking for. I still feel like I don’t belong here — maybe the non-binary group, or cross-dressers?
11/13 — Didn’t sleep well last night, was awake at 3AM. I was very depressed and tired all day and cried in the evening. [Wife] thinks support groups are weird, but supports calling Dr for hormones — but she keeps saying “you’re not trans” and that I’ll back out before any real physical changes. — We talked about how divorce is not an option. She says she’s too dependent on me and wouldn’t know what to do. That hurt. It made me feel like I’m holding her back, being controlling. I want a partner, not a dependent.
11/14 — Called [LGBT patient advocate referral from GIC counselor] to set up an appointment w/Dr for HRT. I kind of freaked out when she said my gender was MtF and wanted to correct her, to say I’m not there yet. I had the same reaction when she said “when you present as female.” The more real this gets, the more I get scared and feel like it’s not true, like it’s wishful thinking, but then I worry lack of conviction will mean I can’t move forward, and that scares me. I want this to be the answer! Wishing you were trans IS trans. I keep telling myself that. I think my big fear is that this won’t make me happy, and that means I won’t ever be happy (stuck, no answers). Everyone is treating me like this is something I want or need, and that feels wrong. Is it wrong, or am I scared? Both counselor and [advocate] suggested Transitions support group, even though I’m not transitioning. Is this “try it and see” approach really so strange?
11/15 — Set appt for hormone therapy — [Doctor] 12/2 — I’m still feeling uneasy. There’s a lack of conviction that this is the right path, and fear that I’m not really trans.
11/17 — Read an interesting article about how searching for a “diagnosis” is really just trying to absolve myself of the responsibility of making a hard choice. I don’t like committing to choices, and still doubt/regret the big ones (moving away, buying a house, etc).
Everything about that week was terrifying, but especially the call to request an HRT appointment. My heart was pounding. I expected to only have to leave a voicemail message, but a real person answered on the second ring. It took all my courage to not immediately hang up. I am so grateful my local health system employs an LGBT patient advocate (a trans woman, no less) to help with this process. I highly doubt I would have been able to call a regular appointment line and ask for hormone therapy.
Speaking of terrifying, I had to walk through the door of an unfamiliar doctor’s office and tell the receptionist, out loud, why I was there. Then I had to tell the nurse why I was there. Then I had to talk to my new doctor about how I secretly want to be a woman but not really and maybe she could help me figure that out. Then I had to tell my wife about it afterwards, during my employer’s holiday party that just happened to be scheduled the same night.
12/2 — Appt for HRT — The meeting went well. [Doctor] is easy to talk to. She confirmed gender dysphoria, gave the ok for hormones. It feels weird, like there should be more barriers. I can get a Rx as soon as Tuesday. [Wife] says if changes kick in around 3–6 months, I should go 6 months to experience the effects. That’s longer than I was planning (3 months) but I was glad to hear it. More chance for breasts. We talked through the consent form, and the discussion of feminizing effects was surprisingly jokey. [Dr] says the social aspects are important. I told her with more confidence/assurance, I think I could address that aspect better.
My doctor is amazing. She moved my appointment to the end of the day so we could talk as long as I needed, and was as much a counselor as a physician. She told me the secret of how to circumvent the usual schedule backlog and get back in to see her a few days later after the blood work was done. Most importantly, she was knowledgeable, straightforward about the risks and likely outcomes, and gave me the prescriptions even after I told her about all my doubts and fears. She’s now my primary care doctor.
12/3 — Low dysphoria today. I wore women’s jeans and shaped my fingernails. My second counseling session at the GIC was not very helpful, since I mostly just voiced conclusions I came to already. I probably won’t go back. [I didn’t.]
12/7 — Got prescriptions for estradiol and spiro.
12/8 — Prescriptions delayed. I got depressed and crashed, fell asleep at 7:30.
12/9 — Got spiro, took half tab —I was anxious about starting. There was no immediate sense of relief. It was anti-climactic. I’m feeling some impatience and wanting to skip the ramp-up period.
12/13 — Got estradiol — I took the first dose in car immediately after picking it up, I was that eager/curious.
12/15 — No noticeable psychological effects from early usage. — Note from therapy: lack of a negative response to gender expression is just as important as having a positive response (null hypothesis).
12/27 — My nipples are sore.
1/5 — Dr appt — Just checking in. Depression score is slightly lower. She keeps talking about transition, but I don’t think of it that way. Sometimes I wish I could.
1/8 — Blood work came back. T and E are both in the female range. I didn’t have any strong emotional reaction to the results.
1 Month HRT Experience — There’s no obvious sense of calm, relief, or rightness like others often report, but also no distress or wrongness either. Shouldn’t cis people have that? Breast buds are the most noticeable change. That’s both exciting and worrisome, since early growth might mean they’ll get too big. My sex drive is lower, and cross-dressing seems less exciting. Is that due to the lower sex drive, meaning it really was a fetish? It could also be the lack of novelty or lowering of taboo/secrecy. A desire for female attributes still exists, but the thought of going through full transition is more scary/impractical/disruptive — not worth the effort. I don’t feel like I have a female identity, or a gender identity at all — I wish I did (on both counts).
I was really hoping that estrogen would provide an immediate sense of calm, as is reported by so many trans women, and that would be evidence I could use to prove that I had some sort of female brain chemistry. That didn’t happen. The fact that I never had a euphoric reaction to estrogen made me doubt whether I was really trans.
I forged ahead, determined to complete my experiment and come to a decision about whether to continue hormone therapy or stop and switch to an anti-depressant. It was a tumultuous 3 months, as you’ll see in the next installment, but I got through it.
3 Month HRT Experience — Physical changes continue, breasts are larger but not yet needing support. My hair is growing back! I’m not sure how much the receding hairline will recover, but the top and back is returning. I didn’t realize how much I hated it before. — There’s still no sense of identity, female or otherwise, and no conviction. The thought of stopping treatment is vaguely terrifying. I like the effects I’m seeing and don’t want to go back. But not forward either. — I really have no libido at all, which is kind of worrisome, and I’m also losing the desire for feminine presentation. Depression has stabilized, but not really decreased.
Despite my assertion, the depression was in fact decreasing. I know this because I was logging my daily mood, and when I charted that information (because I’m a data nerd, you see), there was a marked decrease in depression levels that began when I started hormone therapy.
That alone should have been enough to convince me that being on estrogen was the right thing to do, but no. I still resisted the idea that I might be transgender. I looked for anything I could find to prove I was different, that I didn’t need this. I still desperately wanted to be normal.
You might think the tail end of that graph suggests I had fewer mood swings in the first few months of the year, but as you’ll see in the next installment, that was definitely not the case.
(Continued in Part 4)