The Game Plan for when Transition Hasn’t Worked Out

This is a guide for after the moment when everything gets weird, when the background noise gets muffled, and the pace of the world slows way down. This is a guide for when you might be having a very bad dream, but that would suggest the last couple years of your life have been a bad dream, which is not comforting to consider. This is a guide for when the sunlight changes, starts to looks pretty fake really, and people seem to be passing by, walking and talking, in a suspiciously normal and low-key manner, despite the nature of the intensely dramatic revelation you have just been burdened by:

I got this wrong.

It’s quite the moment. It’s a cinematic moment. Seems like the kind of moment someone should put in a screenplay. This is because you’re dissociating. From both the stress of the realization, and that prominent dissociative habit you’ve been leaning on. I had this moment looking out over Lake Merritt, watching the birds, and serving extremely dejected, tearful trans-masculine realness.

(Something kind of nice about dissociation is even your most miserable moments have a romantic flair.)

Perhaps you detransitioned and you never had this moment. You came to the revelation slowly, cognitively, through reading a lot of blogs. Then you met a detransitioned person, felt a kindred spirit between you, and it wasn’t that dramatic, you just gave yourself permission to use some different words. This essay will be useless to you. This essay is for the people caught off guard. The people unsure of how badly, exactly, they screwed up their lives. The people who feel like they are seriously cracking up. The people who are being flooded- with shock, with shame, with horror at the sunk cost, with fear about what kind of life they could possibly live now, with cortisol out the ASS.

Honey pie. You stressed out kid. It’s time to get a grip, and yes, you can get a grip even while dissociating. Life may feel like a very sad movie right now. But it is not a movie, life is much longer and stranger. We’re going to tackle your problems one by one. A fair amount of these problems you will be working on for years, so there’s no reason to rush.

I’m not a big believer in the binary of “mentally ill” and “normal.” You put the healthiest person under a high amount of stress, the wrong substances, subject them to physical disease and discomfort, and their mental health will rapidly decline. You take a person who looks completely off their rocker, and give them a lot of safety, helpful substances, healing for their physical body, and most people’s mental health rapidly improves. (There are certainly exceptions on both ends, but my experience is they are rare enough to prove the rule.)

You may feel really scared that you’ve gone round the bend, and unsure when exactly you went round the bend, but I’m here to tell you: you’re just in a bad trip. Yes, I am appropriating drug culture and stealing it for detransition mental health. I think it works- because this gender shit is surreal, and it tends to pick up steam in people’s lives in very trippy ways, and often it feels like it’ll never come to an end. Have faith. You will get out of this bad trip. Not immediately- just like with hallucinogens there’s some time between when you want off the ride and when the ride lets you off. You’ll have to be patient. I think it took two years after detransitioning before I began to have windows of feeling like myself again. But in those two years, when I didn’t feel like myself at all and things still felt very surreal and scary, I was taking a lot of daily, self-loving actions that ended up paying off. That is the trick of a successful detransition. Feeling big, hard feelings, but behaving in a strategic and outcome-oriented manner.

Our map of addressing your problems is Maslow’s Hierarchy of Needs. There might be times when you have some higher order needs figured out (a partner, a creative path you love) without having lower order needs met (enough food, physical health, secure housing). That can be a lucky circumstance but it can also be unlucky. If you have a partner but not secure housing, ideally your partner can be a resource that helps you find secure housing. But the flip side is partnerships and even friendships in which one person is in danger of not having basic survival needs met often have weird power dynamics happening (ie. if you stop dating this person you don’t know where you’ll live.) In general I’d like you to put off tackling the higher order needs until you are in a good place with lower level needs.

Physiological Needs

Generally, the more your body is changed because of transition and the more money you spent on those changes the harder the moment of insight that transition was not the right move is. You might have a very strong desire to undo all the changes to the fullest extent you can, as quickly as you can. I hope one lesson you take from the experience is that the emotional intensity of a desire is not an indicator of whether the desire is the right move for you. If you want to go back to the hormones your body was running on before medical transition, you should make a plan with your doctor for stepping down. Depending on the surgeries you got your doctor might be the only way to access those hormones. I recently heard a story of a doctor refusing to provide testosterone HRT for a detransitioned man after an orchiectomy. You run into a sociopath like that, find another doctor. (Oh, and maybe post about it on so other detransitioners can avoid them?) Now, that’s easy for me to say, but in reality finding a new doctor or talking to your old doctor can be the most stressful pain in the ass. Detransition is full of stressful, pain in the ass experiences, so you can’t get precious about this stuff. You really will have to toughen up about the stress of anticipating people’s strange reactions, because yes, those strange reactions are coming.

I wish before I stopped T I’d gotten started with an antidepressant. Partly it was life stuff, but the fatigue that comes when you stop T didn’t help. If you’ve been depressed before it’s worth discussing an anti-depressant with your doctor, before you taper down.

As far as reversal surgeries- don’t think about this now. Even if you have the money. (How on earth do you have the money?) Rule of thumb- don’t plan surgeries when you’re freaked out. Especially if this moment is coming for you immediately after a surgery. Our physical health and our mental health are not separate systems, and when your body is recovering from a big physical trauma like surgery, your thoughts and emotions are going to be affected.

One thing detransitioners are in desperate need of is a directory of endocrinologists, primary care doctors, therapists, and even surgeons (I know, I’m not a fan of the profession either) who are competent in working with us. There’s a lot we don’t know about how our health is going to be impacted by the interventions we went through for medical transition, and that is an area of common ground with trans people.

Safety Needs

Are you around safe people? Sometimes being trans-identified involves living in communal situations with a cast of characters that strike you as progressively less benign the longer you know them. You’re not safe if there’s someone in the house you have to fuck to live there. You’re not safe if there’s someone in the house who has rages and breaks things. You’re not safe if it’s a combination punk house/tinderbox. For you to think clearly about how to put your life back together you need to be physically safe, and that could mean standards for safety that you haven’t ever insisted on before. I’m a big fan of moving in with family if they aren’t spontaneous ragers. My family perhaps isn’t entirely emotionally safe, because we’re all nuts, but they are physically safe. If your family is hard to take but not prone to rages, I say better to lean on them then stay in a sketchy situation.

How about how you’re earning money? The safety of your work is totally dependent on the specific people you’re working with. I started to detransition while at the informed consent clinic, which didn’t work because in a highly ideological environment like that people have to believe you are “gender-fluid” but in denial. Then I quit, lived on student loans for 6 months, grew my hair, and got another job where people generally didn’t know I’d been trans. Much less stressful than trying to convince people to not call me they! I know another detransitioned woman who had a sweetheart of a boss who she came out to and they hugged and cried. If you are going to try to come out as detransitioning at work, I’d think hard about who has been a real friend to you, who has a pattern of being a dick, who can advocate for you with other people, and try to disclose in a strategic way that maximizes your chance at people being chill.

Maybe this is me being too careful, but think about saving up for awhile before you come out at work. The projections people put on detransitioning people are wild, and I do think anytime you are disclosing you should be prepared for social interactions to go sideways. For instance, I made the mistake of telling a girl I worked with who was partnered to a trans guy, and she got flirty and then smacked my ass. Because in her mind when I said “detransitioned” she heard “part of my dating pool/relaxed about sexual boundaries.” (She probably also heard “top.” So many people assume this stuff boils down to what you want in the bedroom.) Even if you have a cool boss, a coworker who gets weird can make your workday very uncomfortable. Money in the bank=freedom to quit=not feeling trapped=mentally healthier you.

Social Needs

Oooof, I think this is a rough one. When I meet new people, I don’t mention this chapter of my life. Generally I like the way I’m treated by people who don’t know a lot more than the way I’m treated by people who do know. I find people who know tend to treat me like I’m pretty dumb, and people’s boundaries get strange. People will tell me really intimate stuff, disclose a lot of sexual stuff, and generally seem to think I’m more likely to be interested in sexual experimentation with them. (But actually, I’m a prude, and I get real vicious when people come at me like that. I’ve made people cry.) I don’t know how much you can extrapolate from my experience. I do think there are upsides to only telling people who need to know.

With your old friends- your trans-era friends, your lead up to the trans-era friends- you might end up re-evaluating a lot of those friendships. Transition and then detransition probably created opportunities for you to see how people come through for you during tough times, and maybe they didn’t come through. I know my standards for what “respect” meant became much higher in response to the experience, so a lot of what I was calling friendships didn’t make the cut. But also there were a lot of social patterns in the queer scene I wanted to be done with- I never wanted to see another narcissist dominate a room by lecturing at some poor soul about being “problematic.”

You might find the experience made you incredibly socially awkward. Rather than trying to get less awkward (which in vicious irony makes you more aware of how awkward you are) focus on getting very kind. Awkward, kind people are in high demand. The best mental hack I ever heard for social anxiety is when you enter a room, pick the person who looks most uncomfortable (besides you) and brainstorm if there’s anything you can do to make them comfortable. Sometimes all you can realistically do is send them good vibes. But using your brain to send them good vibes is much better than using your brain to obsess about how awkward you are.

I didn’t do this, but I think volunteering at a place where you’re helping people or animals might be good for both your awkwardness and sense of your own value. (I WAS BUSY.)

As far as dating people, unless you already have a partner cool it for awhile. Detransitioning people seem to get very anxious about our value in the dating pool and if you’re letting that anxiety run you around you will date garbage. Dating garbage is bad for the spirit and you should skip it. I promise you, you are much more attractive than your brain can believe right now and really nice, sexy people will be into you once your shit is together.

It can be helpful to meet other detransitioners. The caveat is: detransitioners often have strong personalities. I certainly do. When people with strong personalities go through tough stuff, they can have very intense responses to each other. So keep your expectations for what your relationships with other detransitioners are going to do for you low. A conversation might surprise you with some deep healing through recognition of shared struggle. A conversation might also surprise you in less pleasant ways, like “oh no I have to hear the word problematic again.” Other detransitioners aren’t your therapist, aren’t your mom, and aren’t going to be constantly supportive and validating. They’re people going through it themselves. It’s not worth it to put big relational expectations on people you know are going through it. Meet people, chat on reddit and twitter, join a facebook group- just make sure you’re not cocooning into an internet social life and neglecting your in-person social life.

Esteem Needs

Detransition will humble the shit out of you. You are officially a person who gets BIG SHIT WRONG! You are officially a person who can be massively overconfident about BAD IDEAS for a LONG TIME! You’re so far from alone in getting this one wrong. You have to find a way to forgive yourself for getting it wrong. I struggle with this- there’s no one I’m angrier at than me in 2012. But with what you knew, who you were surrounded by, and what you were trying to figure out, you made the best choices you had the capacity to.

A friend told me in recovery groups they have a saying, “Self-esteem is built by doing esteemable acts.” You have to figure out some shit to do you’re going to be proud of. Making stuff can go far here: write, paint, make a zine, learn an instrument, grow food, learn to fix bikes or computers, learn to can. Finished degrees feel better than unfinished ones. Being helpful to others, and especially being helpful in a context where if you don’t show up it screws people over, is good for your self-esteem. Humans need to be needed.

Self-Actualization Needs

Self-actualization is a drive within all of us to realize the potential of our talents and possibilities. I find the concept challenging. Is there more than one way for the same individual to experience self-actualization? How do you ever know if you’re moving towards the fullest expression of what you could be? Is it possible to both become self-actualized and pay off your student loans? (Is either option something anyone I know will accomplish?)

I don’t have any advice for you becoming self-actualized, because I’m certainly not there. But I do believe self-actualization is a future event in your life and that transition/detransition, rather than being a ruinous obstacle, will be part of what shapes you to the fullest expression of yourself. You know things now. You might know how another gender gets treated. You might know what a hormone feels like. You might know people can be a lot nastier than we like to think. You might know what it’s like to be treated very badly.

There’s a lot to be said for being a person who can survive a descent. I’m not going to go out of my way to experience more descents. I’m totally fine with no more descents, thank you very much. But a truly terrible experience can be mined for crucial knowledge, knowledge you can live by and knowledge you can try to share. (Descent knowledge is tricky to communicate.)

What I didn’t give you a game plan for is where you put all those big, hard feelings from the descent while you are strategically conquering Maslow’s hierarchy. That’s rough. I still get big, hard feelings on a daily basis. I write them out, I cry, I sing the Mountain Goats at top volume in my car, I pray a lot. I angry tweet. It was tougher at the start, the feelings were so big they’d just wear me out. I had maybe 5 hours a day of being functional and then I’d need to go home and just FEEL. (Cry.) I cried a lot during yoga classes and massages. Cried writing. Cried in the park watching sunsets. Cried holding my dog. You might not be a crying aficionado like me. Figuring out how you move through your feelings is a good thing to go to therapy for. (They won’t pressure you to cry, I promise.)

What’s neat, and terrifying, is you’re creating the future right now. Your choices today are building what your tomorrows are going to be like. That’s a lot of power and sometimes it can feel like a lot of pressure. You don’t have to be living your best life by next week. You don’t even have to have a five year plan. You just have to take it one day at a time, looking for the next right thing to do. If you get it wrong, you take the lesson, you get smarter at finding the next right thing. Moment to moment, the next right thing. I promise you, you got this.

Written by

LMFT/LPC, detransitioner, advocate for taking it easy

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