'D' is for Dysphoria

Hmmm - this is a big one to write, and will hopefully be more useful to my cis friends - as my trans friends will have their own (mostly) experiences of Gender Dysphoria which will be different (with perhaps some similarities) to my own.

Hard one to choose a song to accompany, but I'll go with a favourite tune, purely on the basis that it carries the line 'I hate this mirror, it makes me feel so worthless' - which is a pretty good intro. (It also has a great bassline)

What is Gender Dysphoria then? - In my coming out conversations over the last 4 months, I have tended to explain that I have not been doing well (including the hairy moments on the precipice of Robertville Dam) and that the root cause is that I have suffered with Gender Dysphoria for some 35 years - most people hear the terms and realise that I am basically saying, 'I am transgender' but without understanding how it feels or what it really means. For this I am profoundly grateful - it's horrible.

Our old friends at Wikipedia state that Dysphoria is:

Gender dysphoria (GD) is the distress a person feels due to a mismatch between their gender identity and their sex assigned at birth. People who experience gender dysphoria are typically transgender. The diagnostic label gender identity disorder (GID) was used by the DSM until it was renamed gender dysphoria in 2013 with the release of the DSM-5. The diagnosis was renamed to remove the stigma associated with the term disorder

That's pretty succinct, and is a good description, but doesn't really say how it feels to suffer with it - so I'll have a go.

Imagine you are sitting in a park, minding your own business and a person of the same assigned gender as you walks past - you may objectively (and this has nothing to do with sexuality or sexual attraction) consider that that person has enviable characteristics - you may feel some jealousy or admiration for them. It may even cause you pain or angst about your own body - being overweight, or having a prominent nose or ears in contrast. That angst is possibly Dysmorphia - which is a sense of dissatisfaction with the body - without crossing the gender line (which isn't exactly a line - but that's for another day).

Gender Dysphoria takes that admiration and jealousy, crosses the gender divide and leaves me feeling empty, sick, disgusted with myself and worthless that I am seen to be a man, with all the expectations and implications of it. It goes beyond clothes and fashions [I spot those too] it's about body, gait, deportment, hair and crucially; that the woman I have seen is accepted and observed as exactly that - a woman.

Another example is my aversion to mirrors - rather like Count Dracula I despise them; not because I see them as a 'foul bauble of man's vanity' like Prince Tepes, but because I cannot bear to see the face staring back at me. I notice every masculine feature - the beard stubble; which feels alien and disgusting, the thick eyebrows, the receding hairline, my Adam's apple, the hair which in the last 5 years has started to grow from my ears and nose. It feels like looking at someone else - some alien being that just isn't me and it hurts - so much that sometimes I want to cry. I have to look in the mirror to shave because I tried curing my dysphoria with a truly epic beard (didn't work), but I've learned to avoid them for things like contact lens insertion and removal. I hate mirrors in lifts and public bathrooms, as I never know when I'll be hit with the wave of despair and disgust.

It's not just my face, and not always when I am presenting male (which is 95% of the time right now) - I recently had a night out - my coming out party at which my lovely brother got to meet his big sis for the first time. I started the evening feeling pretty good, I felt like 'me' - I looked like me, and my lovely friends treated me like me, one of the girls as we got ready and loaded up on gin at our hotel. But then... I saw my face in the mirror in the toilet as I washed my hands and just saw a guy - looking back now it was utter madness, but right then a lovely evening crashed down around my ears - I felt a wave of depression and pain wash over me; I felt that nobody was fooled - they'd never realise that inside this body there is just a regular woman in her early 40s having a night out. I wanted to run away, to be away from my brother and friends, away from the other people at the club. It was sudden and debilitating and totally irrational - but that's my testosterone ridden brain for you. Here's a picture of me a couple of hours before disaster struck -

I guess the point I'm making is that dysphoria doesn't (for me) just go away by 'dressing up' or applying makeup - as many cis people tend to assume - it's deep rooted and about more than a costume - for me boy clothes feel like the costume - or as I've sometimes called them, a prison uniform.

Other triggers for dysphoria in me are my voice and hair (both thinning and too much). I'm terrified about opening my voice to speak when presented as me, as I have a VERY deep voice - it's physically sickening, and makes me want to rip my vocal cords out. I even start to fantasise about having some sort of illness of the vocal chords which results in my needing surgery or to communicate electronically. Not to minimise the horror of such a thing, but dysphoria takes your mind in strange directions. From a perspective of body hair - a horror show brought directly from the presence of testosterone in the system, I find myself being revolted at the sight of hairy arms (which are the most visible parts of my body)

Driving to work one day last year I had a crazy urge to put my arm from the window of the car and drive into an object to remove the arm totally - absolute madness, and of course I don't *really* want to be an amputee; but the revulsion is horrific, visceral and disabling.

It's really hard to describe this to people who are not transgender, and to separate it from the notion that being trans is all about dressing up and looking 'nice' - all too often I've had the well meaning response from cis women friends when I bemoan a masculine feature, or how a particular dress 'sits' on my body that 'women come in all shapes and sizes' or that they also hate 'this feature' or 'that feature' about their appearance - it isn't the same - it isn't something we can fix with a different outfit, or more practice with makeup - it's lurking beneath the surface - a fundamental horror that the world will not see us for who we actually are - at a most fundamental level.

As a teenager, I looked at the girls around me, going through their own puberty and felt a sense of profound jealousy - they were struggling (some of them) but it was a better [in my view] struggle than I was going through, it was the right struggle. I don't minimise the pain and misery of menstruation - but at a very deep level I regret deeply not experiencing it - it's another reminder that I didn't get the right physiology. Telling a trans woman that she should be grateful for not bleeding is a big 'no-no'.

So, how do I deal with my dysphoria - in a word, not brilliantly. It can, at a stroke disable my thinking and functioning - sometimes for a short while, sometimes for a day or more. I can end up in my car crying; I think at the unfairness of it all and if unchecked I can end up back in a very bad place. On of the things that entering transition and coming out has enabled me to do is identify the things that cause dysphoria, prioritise them and work out what I can deal with medically, surgically and aesthetically - and what I can't - I put them into my patented 'dysphoria pyramid' - with priority things at the top, an imposter from the dysmorphia club in the middle and the 'too late to do anything' stuff at the bottom in red.

It's not a particularly unique list, but the order of things is different for all trans people - and the extent varies too.

The first two are right now issues - I have VERY high testosterone, so my body and face are super hairy; the answer to this is laser/electrolysis - both of which are painful, expensive and take a lot of time. I'm heading off for an assessment over the next few weeks.

Boobs: (I have a colleague who will be cringing at that word) - These are the most obvious missing part of my body and not a source of sniggering and sex (as some would have it) - it's simply a matter of absence - wearing breastforms, even under a baggy hoodie makes me feel better immediately, a feeling of normality and completeness; even if nobody else can see them; Hormones should help me there, and eventually, if required surgery can also help - in the interim silicone breastforms will have to do.

My voice; - I've always hated to hear my voice (surprising to many!) - this isn't an unusual thing, but the depth of my voice is horrible and a constant reminder of what puberty did to me. It's also the first sure fire flag for transphobes to clock me and treat me like dirt. I've started some app based training exercises - but they're hard and it's dispiriting as you have to listen back to yourself. The effect of this? - Silence, a fear of engaging with people, isolation...

Genitals: Hmmmm - a big no-no to ask a trans person about. All I'll say is what I said to a therapist who once asked me out of the blue; 'what about your penis?' - Well, what about it? - I'm a woman and therefore don't want it. It's a major surgery, and one I'll deal with in due course.

Head hair - I've been receding for years, and the solar panel on the top of my head is starting to open up a lot more. I hate it from the same perspective a woman would - I want to have a head of hair, I want to be able to style it, tie it back, comb it, look pretty as I wish - and now, I can't - Testosterone is the villain here again. Options are, HRT - this may bring back some of the more recently lost hair, around the top of my head - but no promises. A hair transplant - privately acquired will see little change from £6k - which I just don't have. Wigs are the current and for the foreseeable future answer, and good ones aren't cheap, and cheap ones aren't good. On full time transition I will have to spring £800+ for a real hair wig, and then manage having more than one. More cost, more angst, more danger from going out in windy weather and another reminder of what I lost from years of T-Poisoning.

Hips and bum - hormones govern where fat is deposited in the body - men get the 'beer belly' and women have fat on their hips and bums - I'm a big girl (not as big as I was) - I lost 6st last year, with three more to go, but it doesn't make me 'curvy' - clothes fit poorly and like having no boobs (but to a lesser extent) it means that my body just doesn't conform to what it should be. HRT I hope will help redistribute, some gym work will do more - but short of wearing padding - which is a bit 'widow twanky' for me, I'll pray that estrogen does its' work.

In terms of the rest - there's little I can do - my feet are massive, but HRT may shrink me a couple of shoe sizes - which won't help much, but will open a very few other options - no Jimmy Choo's for me. And my height - 6'7" is there forever - some Trans Women report dropping a couple of inches - which I'd welcome, but it's still 'amazonian' to say the least - my plan once I've dealt with the rest is to simply embrace it (or move to Holland)

I hope I've given a flavour of what dysphoria means to me - there's more I could probably say, but honestly, I lack the vocabulary. A lot has to do with perception (of others to me) - validating my gender by outward appearance but by far the most is just that sense of incongruity with my brain and my body. The goal of 'passing' - or being seen as female in public is one I fear I may never attain - but I am a Trans Woman - and proud to be so, the operative word is 'Woman' - so if society can get over it's fears and prejudices 'passing' becomes a nice to have; so yes - dealing with my dysphoria is my issue - but my cis friends and society at large have a part to play too. Trans women are beautiful, Trans men are handsome - fundamentally we are human beings wanting to live our lives in peace. Dysphoria - the liar in our heads gets in the way - please try not to make it any worse for us.