Year: 2021

How Dysphoria Contributes to Burnout and What You Can Do About It

WHAT IS BURNOUT?

I have struggled with cycles of burnout for many years now. For a long time I felt like I was making it up, or being lazy, or finding an excuse to avoid the mundane but challenging parts of everyday life. Very little of what I was feeling matched the symptoms of depression but that was the closest I felt like I could come. Until I heard about burnout.

When I’m in a state of burnout, the thought that keeps going through my mind is ‘I just don’t care’. I know I should, and usually do, but I can’t muster up the emotional energy to engage with almost all aspects of life. This is not me. In this state, I don’t feel like myself. And because I don’t have the energy to care, it is very hard to make myself do the things that will help me get out of the state of burnout.

I feel numb, heavy, and drawn to escapism. It feels like the world is happening around me and I’m just going through the motions. I don’t keep up with house chores, I eat less and more poorly, I socialize less, I exercise less (usually not at all), I am often late, and my productivity at work decreases.

If this sounds like you or someone you know, I highly recommend the book ‘Burnout’ by Emily and Amelia Nagoski. Not all of it resonated with me but the parts that did have been very helpful by giving me language to discuss my experiences of burnout with others, different ways of thinking about and noticing how I’m functioning, and practical strategies to prevent and recover from burnout.

HOW DYSPHORIA CONTRIBUTES TO BURNOUT

I have found that dysphoria is a large contributor to my burnout. There are three reasons for this:

  1. It takes a lot of mental effort to ignore the buzz of dysphoria in order to focus on what I’m supposed to be doing. It takes mental effort to check in with myself, identify what aspects of dysphoria I’m feeling, and use appropriate management strategies. It takes mental effort to identify and avoid situations that trigger my dysphoria (as much as possible). And it takes mental effort to reframe the dysphoria or fight it’s effects by using positive self talk and affirmation. So yah, lots of mental effort.
  2. Dysphoria is constant. It goes up and down depending on the day, my emotional state, my physical state, who I’m around, and what situation I’m in, but even at it’s lowest it’s still there. So lots of constant mental effort.
  3. Generally, there is a lack of understanding from others about what dysphoria is and how it affects me (or how it can affect people). The situations where my dysphoria is triggered the most and which are unavoidable are also the situations where I’m surrounded by and interacting with people who do not understand dysphoria. So lots of constant mental effort that is invisible to or misunderstood by the people around me.

WHAT BURNOUT FROM DYSPHORIA FEELS LIKE

For me, certain symptoms of burnout are specific to dysphoria. Three main ones are:

  1. Decreased attention/focus. So much of my attention is taken up by ignoring, managing, avoiding, and fighting the effects of dysphoria that I have less mental space to spend on other things. It is harder to stay on task, perform multiple step activities without getting derailed, maintain momentum on a task, block out distractions, and remember details.
  2. Irritability/easily frustrated. Dysphoria is an internal irritant that is constant and unavoidable. No matter how good I am at managing it, it will never be zero. So I already have a baseline irritation that I am working to ignore. That means that I have less patience for other sources of irritation. Less patience leads to more frustration. The more dysphoria I have, the more easily frustrated and irritable I am.
  3. Physical, mental, and emotional fatigue. The constant mental effort I talked about above is exhausting. The feeling of being misunderstood and invisible and at odds with myself or how people see me is emotionally exhausting. We feel our emotions in our bodies so I end up with a feeling of heaviness and lethargy that means I don’t feel like I have the physical energy to exercise or do any extra tasks (even though that is what would often help me the most).

WHAT YOU CAN DO ABOUT IT

Over the last few years I have developed a number of different strategies to help manage my burnout. After reading the book I recommended above, I have some more language to explain it and some practical strategies to suggest.

Prevention

Identify the sources of dysphoria for you. Develop strategies to decrease as much of the dysphoria as you can (more posts on this in the Related Posts list below). Where possible, avoid situations that trigger high amounts of dysphoria or repetitive situations that trigger even small amounts of dysphoria (such as getting dressed in a room that doesn’t have a mirror).

As much as possible, make these dysphoria prevention, management, and avoidance strategies automatic. Restructure your environment, schedule, or routine so that you don’t have to spend mental energy on remembering to do things in a different way. The goal is to decrease your baseline mental workload, not increase it.

Protection

In psychology they talk about protective experiences that may be completely unrelated to the harmful experience but help build resilience and emotional capacity or offset or heal some of the negative effects. There are a few protective experiences that I have found to be important in decreasing the burnout caused by dysphoria.

  1. Euphoria. Notice moments of gender euphoria and seek them out. Avoiding dysphoria is helpful to tell you what doesn’t work for you but moving towards euphoria tells you what you should do. Moments of euphoria can pass us by or be overshadowed by dysphoria unless we notice them, focus on them, and celebrate them. In this way, they can be a beacon of light to look forward to and to remember when we feel overwhelmed by dysphoria.
  2. Support. Whether through therapy, social support groups, online groups, friends, or family, support from people who understand what you are experiencing and can give you a sounding board to process and strategize with is important. Your support person/people can also help bring your attention to the symptoms of burnout you are experiencing and provide some external motivation to socialize, exercise, or engage in whatever other activities are necessary for you to recover.
  3. Affirmation. Dysphoria is constantly telling us that something is wrong, that we don’t fit in our body or in society, that we don’t look the way we should, and that maybe we’re making this whole gender identity thing up. Finding sources of affirmation, whether from your support network, from positive social media influences, or a personal journaling, self-talk, or meditation practice can be extremely helpful in offsetting the negative thoughts and feelings associated with dysphoria. The more the affirmation comes from an outside source, the less mental work we have to do to provide the same level of protection and, often, the more likely we are to believe it.
  4. Activities and Interests. Part of burnout, for me anyway, is a lack of interest in things that I would usually enjoy. The frustrating thing is that engaging in things I enjoy makes me feel better. The trick is to find activities and interests that do not trigger any dysphoria. This allows you to engage in your activity or interest with less mental effort so that it doesn’t make the burnout worse which results in a net gain of positive emotion and energy.

Process the Stress

This concept is directly from the book I recommended earlier. The gist is that we experience our emotions in our bodies as a chemical and neurological process. When we are under constant stress (as with dysphoria), our bodies are constantly in ‘fight, flight, or freeze’ mode. Even if we get a burst of euphoria or a period of relief from dysphoria, our bodies still have to complete the chemical reaction or neurological pattern that was triggered by the stress. If we don’t engage in activities that encourage this completion to happen, our bodies remain in the stress state which only gets stronger the next time we experience stress (five minutes later).

So while we can’t necessarily get rid of the stressor (dysphoria) and stop it from triggering a stress response in our bodies, we can do various things to move through the stress response in our bodies, complete it, hit the reset button, so that the responses to this continual stress don’t compound as much. For me, the most useful activities are physical activity of any kind, breathing, affection, positive social engagement, and creativity (writing, painting, and crocheting). With so many options, it is easy to engage in at least one per day, usually more.

One of the tricks to making this as effective as possible for me is to do these activities mindfully. To focus on the calming effect it is having on my body, mind, and emotions. Or, if there was a specific situation that was stressful that I am ruminating on (because my body is still stuck in that stress cycle), I focus on that situation at the beginning of the activity, think through it, feel the emotions that I felt at the time (or didn’t allow myself to feel at the time), and continue the activity until the emotions and the associated physiological response dissipate. The amount of relief this brings in a very short span of time is pretty incredible.

Tl;dr

Burnout sucks and makes us feel numb, exhausted, and irritable. Dysphoria can lead to burnout due to the constant mental effort that is invisible to or misunderstood by the people around us. You can help yourself avoid repeated cycles of burnout by preventing as much dysphoria as possible, protecting yourself against the negative effects of dysphoria, and processing the physiological stress triggered by dysphoria (and any other sources of stress).

I hope this helps you. It is what I needed to hear five years ago. Leave a comment below or send me an email with your thoughts and experiences of burnout. Maybe your experiences are similar to mine and maybe they are very different. Either way, your experiences have value and I would love to hear about them.

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Reflections on Top Surgery, Part 3 : Post Surgery

Gender affirming chest masculinization “top surgery” is one of the major defining moments for trans men. But getting from your existing chest to the one you want to have can be overwhelming from both the information overload and emotional point of view. Having had surgery 3 years ago, I wanted to share my thoughts on surgery in case it may help someone else in the same position. I’ve created a 3 part series on surgery : Pre-surgery, surgery itself, and post- surgery.

This will be mainly from my personal experience as a mostly binary trans man, but could easily be applied to non-binary/GNC people.

If you haven’t read Part 1: Pre-surgery and Part 2: Surgery, start there. To recap: I had a phone consultation with a privately funded top surgeon in Ontario, who gave me a surgery date 6 weeks later. I had my surgery, had my bandages removed, but still had to wear a compressive binder for a couple more weeks.

Initial recovery

Right after the disaster of visiting the clinic for the last time, we went to a nearby mall for some fast food self care. I went into the food court bathroom which was the first public washroom since surgery and I automatically felt 100 times safer. I felt like I belonged. I didn’t feel like an imposter that everyone would automatically clock and tell me that I was in the wrong bathroom. This bathroom euphoria wouldn’t last (more on this in a future post and other bathroom shenanigans here) but for now it was an amazing experience and I couldn’t wait to use another public bathroom!

Our flight home was uneventful. I was nervously waiting for a security officer to ask why I was walking so stiffly, or wonder why I was covered in bandages but nothing happened.

Once home I had another week off before returning to work, but my energy levels did not bounce back as quickly as I had hoped. I ended up taking an additional week off.

In those couple of weeks after surgery I was mostly numb across my whole chest and down my sides. Showering was weird since I could feel the water near my neck and on my belly, but not in between. I was also getting weird prickly sensations across my chest and I would itch but it didn’t help at all. Meaghan Ray said it was my nerves starting to boot back up, so I rubbed a rough cloth across my chest to help my skin remember what sensation was all about and stop freaking out which seemed to help. This technique is called desensitization. Leave a comment or send us an email for more info.

I wore the binder all day and night, and applied polysporin to my incisions and nipples. Slowly they closed up and started healing with more normal skin tones. There was a point in healing where the scabs on my nipples started coming off in small pieces, and since the healed skin underneath was so much lighter, it looked like my nipples had fallen off entirely! It was terrifying until more of the scabs came off and I could see that my nipple was still intact.

Getting back to normal life

When I returned to work after being gone for 3 weeks, people were happy to see me, but for them not much had changed. It was like I had gone for a vacation and come back. It was very frustrating because I had spent a bunch of money to have body parts removed in order to “pass” and meet society’s expectations of what I should look like, but people still couldn’t use the proper pronouns. It felt like I had a big incision and T-rex arms for nothing. My euphoria and confidence slowly drained.

Once I stopped wearing the binder and started feeling the shirt directly against my skin, my confidence began to return. I didn’t care as much about being misgendered because I could feel how flat I was and it was awesome.

I wanted to minimize scarring so I massaged my scars with oil at least once a day for several months. I also didn’t raise my arms above shoulder height for 6+ months which made getting back to working out consistently a struggle. Everyone heals differently so it’s hard to tell if it made any difference but protecting my scars was the thing I had control over and it feels like I did the right thing for me.

Post op Depression

One experience specific to top surgery is having to keep your elbows at your sides for months which limits your use of your arms and therefore your independence. I was a bit angsty with how weak and dependent I was and I am prone to depression so the first couple weeks were a bit rough for me. But having the support of Meaghan Ray and seeing how excited they were for me helped me find that excitement for myself.

Many people experience post-op depression after top surgery. If you google “post op depression” the autofill option for “after top surgery” is only 4 options below. It happens after many surgeries due to some metabolic and physiological reasons as well as having time to yourself while you recover to ponder your life choices. It can especially happen after top surgery or other gender confirmation surgeries because there is usually a long buildup from when you are starting to wonder if you are trans, to finally getting a result in the mirror you are looking for, usually years later. You are looking forward to having the surgery completed, but then there is physical recovery, there is pain, maybe there are complications which feels like it robs you of the excitement you were expecting. And now that the surgery is completed, there is a sense of not having something to look forward to anymore.

Another aspect is that while your brain is telling you what you want, the actual experience of being unconscious for 2 hours and having something removed that you were carrying for 15+ years, makes part of your brain go haywire. Something is suddenly no longer there. And while you were mentally picturing what it would look and feel like, you didn’t know exactly what that would be like. So there is an adjustment period while your brain catches up. And having to wait while your brain straightens itself out makes you doubt that you have made the right decision.

While I definitely experienced all these types of thoughts, they didn’t cause a spiral into depression which I am grateful for.

Where I’m at now, 3 years later

I am still a little self conscious when taking off my shirt around others. 31 years of social training will take a little while to fight against. I have gone swimming in pools and the ocean with no shirt which was empowering. Looking down while showering is great. Doing skin to skin contact on my chest with my newborn kid was thrilling.

Once I did get back to working out and doing other activity, not having the wobble of my chest was amazing. One of the first things I noticed after that wobble was gone was the jiggle from my belly! It was a weird sensation but I quickly adjusted.

Every once in a while after I wake up in the morning my brain will remind me to grab a bra from my dresser, but then I laugh to myself when I go to open the drawer. T-shirts and button up shirts fit so much better now.

There was a point where I was wondering if I wanted a revision for what we affectionately call “the crinkle” in the middle of my chest between my scars. It would be free and the clinic was more than willing to set it up, but when it came time to booking the appointment I never followed through. I had started accepting what my chest looked like, and then grew to love it. It will never be a cis male chest since I am not a cis male, and that is ok.

Having a flat chest has greatly increased my general gender euphoria, and decreased my chest dysphoria down to nearly zero. My social dysphoria was also decreasing as my voice deepened and I grew a scraggly mustache. About 3 months after top surgery when I was healed a decent amount and not struggling with day to day activities I did notice a shift in dysphoria. The very blatant dysphoria of “you have breasts, everyone thinks you’re a girl” was pretty much gone, but my discomfort with my lower area (which I didn’t have much of before surgery) started ramping up to noticeable levels. This is also very common in trans guys – once the seemingly obvious problem gets dealt with, the focus moves to a more personal but just as glaring difference between what you were born with and what you should have.

As trans or GNC people, our dysphoria will likely never go completely away. There will be sudden surprising moments of “I wish my hands were a better size, they completely give me away as trans” or having to explain a different name on a credit application. But hopefully as time goes on, our gender euphoria and comfort with our bodies (surgically altered or not) will increase and those moments of dysphoria will be so much less devastating than they were at the beginning of transition. Having top surgery was life changing for me and provides so much gender euphoria armour against dysphoria frustrations, and I am grateful that I had the opportunity to pursue it.

I hope you found this 3 part series on top surgery helpful! If you are contemplating top surgery and have questions leave them in the comments below, or send an email to letstalkgenderpodcast@gmail.com.

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Reflections on Top Surgery, Part 2: Surgery

Gender affirming chest masculinization “top surgery” is one of the major defining moments for trans men. But getting from your existing chest to the one you want to have can be overwhelming from both the information overload and emotional point of view. Having had surgery 3 years ago, I wanted to share my thoughts on surgery in case it may help someone else in the same position. I’ve created a 3 part series on surgery : Pre-surgery, surgery itself, and post- surgery.

This will be mainly from my personal experience as a mostly binary trans man, but could easily be applied to non-binary/GNC people.

If you haven’t read Part 1: Pre-surgery, start there. To recap: I had a phone consultation with a privately funded top surgeon in Ontario, who gave me a surgery date 6 weeks later. I booked my time off from work as well as flights for me and my spouse, Meaghan Ray.

Last Minute Researching

While I had been looking at post-op trans guys for a while, and reading their stories of heading into surgery, suddenly it was going to be me in that position! I refocused my searches on what other people had found useful after surgery.

While there weren’t a lot of medical sites with information regarding top surgery for trans people, there was loads of information for people recovering from breast cancer surgery. Some of it was not quite relevant (what to do while waiting for breast reconstruction), but a lot of the advice on recovering from a long incision across your chest was useful.

The things I found most useful were button down pyjamas and shirts, as well as a neck pillow. Other items that seemed like they would be helpful but then I didn’t use were dry shampoo, body/baby wipes, and stool softeners (though I REALLY wish I had).

Arriving In Toronto

Since we were staying with family, we arrived a few days before surgery for a visit. Similar to when I was travelling for archery competitions, arriving and settling into a new location a little early allowed me to start mentally progressing towards acceptance and excitement.

I did some journaling at the time to help get rid of all the bees buzzing around in my head. I knew that I was super excited for the surgery, but there was now also the return of the anxiety of wondering if I had made the right choice. Everything I did was the last time before having a flat chest, and it felt important to remember those things, mundane as a lot of them were. “This is the last time I’ll be flying with a round chest” “This is the last time going to a cafe with a round chest”. So journaling helped with clearing my head a bit and helping me feel less chaotic.

Pre-op Appointment

The day before surgery I attended the clinic to see where it was, meet the surgeon face to face, and ask any last questions. The staff were great with pronouns, and the clinic seemed modern and clean. However, my appointment time was more than 2 hours behind schedule, and no one bothered to let me know. The only good thing about that is my anxiety completely burned itself out, and was only left with mild annoyance.

Meeting the surgeon was good, he was very respectful but clearly he had his method of doing the surgery and didn’t seem to be interested in what my desires were (similar to the surgeon back home). Despite those nagging worries, I was happy with the pictures I had seen of his results, and I was far too excited for a flat chest to let that slow me down. We drove the 90 minutes back home and settled in for a long evening of no sleep.

Day Of Surgery

Due to my sleep apnea they moved by appointment up to first thing in the morning. Once we arrived I changed into a gown and had the two clinic surgeons as well as a visiting surgeon draw the anatomical lines that would make sure everything ended up straight and proportional. It was a little awkward but clinical (“this is the last time a stranger will see my female chest”).

Everything happened fast after that. They got an IV started and I was off to the surgery suite, and next thing I knew I was waking up crying inconsolably with a pressure on my chest. I don’t know why I was crying, just that I couldn’t stop.

The surgeon came by briefly, but otherwise I felt very alone and disoriented. I was discharged fairly soon afterwards, but with fumbles from the staff leaving me unattended to have a panic attack in the bathroom, and while discharging me out a back door with minimum instructions. This left the experience feeling less than excellent.

Eventually we got back into the car and Meaghan Ray drove us home. According to them, I was frighteningly pale and very nauseous the whole way home but I don’t remember much of that. I do remember the neck pillow came in handy to keep the seatbelt off my new incisions.

First Couple Post-op Days

I was firmly ensconced in the bedroom for several days. The pain was manageable with medications, though I was fairly drowsy so I slept lots and watched lots of movies in bed.

My main complaint was the post-op compression binder used to keep the bandages tight to the incisions. My surgery included liposuction along my armpits and sides to prevent the dog ears that the Edmonton surgeon had mentioned. While that would allow for a more masculine appearance, those areas were not as numb as the incisions and were very tender against the binder. Meaghan Ray helped to modify the binder so that it would be more comfortable. I was told I would need to wear it for 4 weeks! Guess I would need to continue to deal with a binder even though I no longer had breasts. Argh.

Post-op Reveal

The day before flying home, I had a post-op appointment at the clinic where they would remove all the bandages and tapes. There are many videos on YouTube of transmen seeing their new chest for the first time where they elatedly collapse in happy tears and emotion.

My appointment was not like that. I mostly felt relieved to be free of the bandages, continued tiredness from recovery and pain medication, and a touch of feeling surreal. Luckily Meaghan Ray was there to capture the moment and feel excited for me, even if I couldn’t stir up those feelings very well.

Again we fell through the cracks while waiting to be fully discharged. We waited a respectable amount of time, and another 15 minutes on top of that. We finally had to sneak out into the hall where someone finally went “oh, I didn’t know you guys were still here!”

Everyone else who had surgery with this surgeon had nothing but good things to say about their experiences with this clinic, so it appears my experience was an anomaly. I believe most of their private pay clients stay at the hotel adjacent to the clinic so perhaps they were thrown off by me staying 90 minutes away?

I was (and still am) very happy with my results, though the experience itself was far from ideal.

Up Next

Now I got to take my new flat chest back home! I couldn’t wait to finally experience that gender euphoria around my friends, family and colleagues, when they would stop misgendering me since I now had a flat chest! Right?

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Reflections on Top Surgery, Part 1 : Pre-surgery

Gender affirming chest masculinization “top surgery” is one of the major defining moments for trans men. But getting from your existing chest to the one you want to have can be overwhelming from both the information overload and emotional point of view. Having had surgery 3 years ago, I wanted to share my thoughts on surgery in case it may help someone else in the same position. I’ve created a 3 part series on surgery : Pre-surgery, surgery itself, and post- surgery.

This will be mainly from my personal experience as a mostly binary trans man, but could easily be applied to non-binary/GNC people.

Deciding to pursue surgery

Wanting to pursue top surgery can come before wanting/deciding to transition and be a driving force towards wanting to transition. AKA your chest dysphoria is so strong that any other steps towards transition (hormones, coming out) are secondary.

Or like in my case, my social dysphoria was my driving force to transition, and once I had started the process for getting hormones and coming out, top surgery was my next urgent priority.

Applying for funding

In Canada there are two main paths to take in order to get top surgery – public and private.

The public funding model in Alberta involves being diagnosed with gender dysphoria by any psychiatrist who then submits for surgery funding on your behalf. When I was going through this process in 2017, there was one approved psychiatrist that had a long waiting list of his own. I was referred to the psychiatrist in September 2016, saw him in July of 2017, and I had a consultation with the surgeon in November 2017. At that time the waiting list for surgery was 1.5 – 2 years since dysphoria-eliminating surgery is not high on the list of priorities when those same surgeons are assisting cancer survivors.

In other provinces there are variations on how to go about getting funding, and the wait times vary.

Having to wait for surgery after coming out as male, attempting to “pass” as male with friends, family, colleagues, and strangers while still having a rounded chest was frustrating, tiring, and a safety risk. I decided to look into privately funded surgery.

In searching “top surgery in Canada” there was really only one option which was in Ontario, which was ok since my in-laws lived there. I submitted the documents the week after my consultation with the Alberta surgeon, and was set up for a phone consultation for March 2018.

Research while waiting

Part of my frustration with the Alberta surgeon besides the long wait time was that he didn’t seem interested in my goals for my chest. He asked me to take my shirt off, looked at me and told me what he would be doing. He told me that I would likely have a common complication called “dog-ears” where pockets of skin and fat remain along the sides, but also that Alberta wouldn’t cover the surgery to remove them, or the technique necessary to avoid creating them. So while I would have a drastically flatter chest, it would still be not quite ideal (in my eyes).

I started researching the different methods of masculinizing surgery and saw that the Ontario surgeon offered more than the one kind the Alberta surgeon offered me.

I spent lots of time on surgeon’s websites as well as different Facebook groups where I could see pre and post op chests and compare to what I thought I might want, and what my results were likely to be. In attending a PFLAG group in Edmonton I discovered that a couple other people had gone to the same Ontario surgeon and were happy with their decision. One person actually offered to show me their chest in person after the group which was great. I began to earnestly look forward to my consultation in March.

Private surgeon consultation

The consultation was similar to any other health professional, but since this surgeon was using the informed consent model as opposed to having mental health professionals vouch for me, I had to start at the beginning yet again and prove to another person that I was trans enough to get the surgery. Since this was a common occurrence at the beginning of my transition I had all the answers at the tip of my tongue, but it was still mentally exhausting. Its like the stress of a job interview every time, but instead of trying to land a job, you are trying to justify your ideas on why you are who you are. There are no certificates or diplomas, just defending the difference between your appearance and your thoughts.

While I had moderate chest dysphoria, I still felt like I had to exaggerate my feelings a bit in order to get the approval from the surgeon. What if he felt that I was a minor case and could wait? Maybe there were people out there who were suffering more than me.

I successfully “passed” that consultation and was given a surgery date for 6 weeks later! Suddenly I had to change from endlessly waiting to preparing for surgery.

Preparing for surgery

The physical components were easy to do and were a distraction from having to emotionally prepare for the surgery. I completed all the forms and bloodwork, submitted for time off from work and booked flights.

But when that was all completed, I had a relatively short amount of time to emotionally prepare. I had started questioning my identity in 2016 and had spent many hours in my own head up to that point, but admittedly I was fine with being stuck in the trans angst of “I have to wait so long, this sucks!”

Chest surgery was the next logical step for my happiness and safety, but I had a lot of conflicted feelings. My dysphoria was not overly bad. I enjoyed having nipple sensation. I was worried about surgery. I didn’t need to wear a binder very often. I was worried about what I was permanently doing to my body. In my anxiety I even started wondering if transitioning was the right thing to do. My therapist is highly regarded by many trans people in the city (read: long wait time) and I was not going to be able to see her before surgery.

To get through this mental hurdle I had to trick myself a little bit. I thought to myself “what would I say to someone in my exact circumstances?” “would I be jealous of someone else getting my 6 week date?” and “what would happen if I waited?”

The clinic did give me the option to postpone if I wanted, but after thinking about those questions, and endless talking about it with my spouse, I decided to go ahead with the surgery in 6 weeks.

Things I wish I had done differently to prepare

While I am happy with how things turned out, with the benefit of hindsight, I wish I had done a couple things differently.

I wish I had researched more surgeons – since I was paying out of pocket anyway, I could have chosen to go to a variety of surgeons.

I wish I had gone to see my therapist before going for surgery to try knock down some anxiety. Though I knew she had a long wait time, she always has space for emergencies. I didn’t even make a phone call to inquire, which I wish I had just mustered up some courage to ask for an appointment.

Up next

I’m getting on a plane heading to Ontario for surgery! The next post in this series is all about the few days prior, the surgery itself and the few days after.

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Baby Haircuts and Gender

My baby was born with lots of hair. That was always the first thing people commented on. It was dark and long and made them look a bit like a hobbit. At first I loved it. It was cute and made them look like a mini toddler. But when they started squirming and rolling, the hair at the back became matted on a daily basis. Combing it either took over an hour or led to a lot of screaming. So we decided it was time for our baby’s first haircut.

As it turned out, the hair underneath was a lot lighter. The before and after pictures look like completely different babies. It took some getting used to. But it wasn’t just that they looked different. My perception of their gender was also different.

They suddenly looked like a boy.

My general feeling on this is ‘Ugh. Why does my brain have to gender my baby based on their hair?’ But of course, just because I’m nonbinary does not mean I’m immune to the gendered programming I am surrounded by and grew up with.

For me, haircuts are one of the biggest sources of gender euphoria I can reliably get on a semi-regular basis. This is because having my hair short helps me express my masculinity and helps me see my masculine side when I look in the mirror. But just because short hair feels masculinizing for me does not mean that short hair indicates masculinity or male gender for everyone.

Especially babies! Most babies have no hair or very short hair. It was only because I was used to my baby’s longer hair that my brain registered the short hair as a gender indicator.

Then I began to wonder – does everyone automatically gender babies as male because of the short hair unless there is a female indicator such as pink clothes, frills, or a flower headband? Is this one of the reasons why baby clothes are so overly gendered?

In the two weeks since the haircut, with a steady stream of corrective self-talk, the gendering effect has worn off a bit. But regardless, I figure that if some people put flower headbands on their babies, I can too. Creating a genderful experience for my child means using clothing, accessories, toys, and language from all parts of the gender spectrum. It also means doing things to trick my brain out of gendering them based on their sex assigned at birth or their short hair.

What experiences have affected your perception of your baby’s gender? What things do you do to create a genderful experience for your child? Tell me in the comments below!

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Postpartum Update: 5 Months

We’ve all seen the representations of postpartum people in media who are frustrated with not being able to lose ‘those last five pounds’ when they’re five weeks postpartum. Let me tell you now, this is not reality. At least not for me.

My body did a whole lot more during pregnancy and birth than just put on a few pounds. Therefore, my body finding it’s way to a new, stable normal is not all about losing weight. Maybe I’ll get back to my pre-pregnancy weight, maybe I won’t. But more importantly, what is my body capable of doing and how does it feel?

PHYSICAL ENDURANCE AND MOBILITY

If you followed along with my pregnancy journey, you’ll know that I had severe pelvic and back pain that meant I was using a walker for mobility by week 14. Immediately postpartum I was able to start taking my regular medication and the pain improved quickly. But the impact of six months of limited mobility doesn’t go away over night.

I had a lot of joint stiffness and residual associated pain. I had significant muscle weakness in certain muscle groups (and still do to some extent). And I had extremely limited cardiovascular and muscular endurance.

I have been working on all of these as much as I can (giving the limited extra energy when caring for a baby). Initially I was mostly doing slow easy stretching and gentle movement and short walks. More recently I have done cardio exercise in the form of climbing the stairs while wearing the baby, using my rowing machine, and going for fast paced walks, strengthening exercise while playing with the baby on the floor or using the baby as a weight, and endurance exercise in the form of longer walks at normal pace. I even went skating for the first time today!

Each time I try another activity or try to push myself I come up against a very sudden limit in strength or endurance. I’m going along enjoying the feel of my body moving when suddenly I have no power. My muscles turn to water and my joints cease. I slow down or take a break to stretch, and try to continue. Often I can get a bit more out of my body but at much lower intensity or poorer quality. And that’s ok. That’s just where I’m at. Every bit counts.

Even if I wasn’t trying to improve my strength and endurance, just the act of moving my body and expending positive energy makes me feel less antsy, more patient, happier, and more connected with myself in a positive way.

HORMONE FLUCTUATIONS

At around two and half months postpartum I started having similar symptoms to when I was taking fertility drugs and when I was immediately postpartum. Wooziness, light headed, foggy, weepy, laughter easily becoming hysterics. Yes, apparently this is normal.

There is a hormone shift at 2.5-3.5 months postpartum and again somewhere between 6 and 9 months postpartum. My hormones were taking the next step in leveling out. Ugh. Not looking forward to going through that again but hopefully the next wave of this will be the last.

OTHER SYMPTOMS

  • All birthing trauma has healed (I had nothing severe and no C-section).
  • Despite having low milk supply initially and now decreasing lactation, my period has not yet returned (yay!).
  • I had some increase in hair loss around the time of the hormone shift but nothing extreme and it seems to have leveled out.
  • My belly is still round in a more pregnancy like shape than my typical body shape but is down to about my early second trimester size.
  • I had many many stretch marks that have somewhat faded into a soft, saggy, pouch of excess skin below my belly.

EMOTIONAL EFFECTS

As I am now trying to figure out what being a parent means and often exhausted from caring for my baby, I am definitely not in the same place emotionally as I was pre-pregnancy and never will be and that’s fine. Becoming a parent changes you and I am embracing and navigating that change.

But there are emotional effects from the experience of being pregnant and giving birth that stuck with me for a while. A few weeks postpartum, when the extreme fatigue had worn off a bit, I started having mild panic attacks when I was lying in my bed trying to go to sleep because I would be transported to the moments when I was waiting for another contraction to happen. That lasted for a few nights but, with the help of my husband talking me through it, wore off and hasn’t returned.

Looking back on being pregnant, remembering how it felt, is extremely surreal. Even when I see pictures of myself when I was pregnant. I know that it happened to me, I can remember that it happened, but I have a very hard time actually feeling what it felt like at the time. My body just felt so different than it ever had before and than it does now.

I can remember little things, like what it felt like when my baby had hiccups, what different stages of contractions felt like, and what my baby helping along my contractions felt like. But the overall experience of being pregnant? What it felt like to move around? It is very vague and very surreal. And maybe that’s ok.

So have I ‘recovered’ from being pregnant? No. I don’t even know what that means. Pregnancy doesn’t feel like something I need to recover from. I’m not trying to re-create my pre-pregnancy body. And as debilitating as my pregnancy was, it wasn’t a negative experience.

I am five months postpartum and very happy with what my body is capable of doing these days. I will continue to be curious and fascinated by all the changes just as I was during pregnancy. It is a continuation of the process that began with pregnancy. It did not end at my baby’s birth and will not have reached a conclusion for many months yet. So here’s to the journey.

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Discovering My Identity as a Parent

Recently, I’ve been thinking about my identity as a parent. Yes, as someone who has a child I am responsible for, I am automatically deemed a parent. But what does that actually mean for me as a person? What does it mean to identify as a parent? How does this new part of my identity mesh or clash with other components of who I am?

As a queer person, I have an understanding that identity is fluid, multifaceted, and individual. I have had the experience of exploring new aspects of my identity as a gay person and as a nonbinary person. In drawing parallels with my new experience as a parent, I had a bit of an ‘aha’ moment that I wanted to share with you.

STAGES OF QUEER IDENTITY DEVELOPMENT

For me, discovering and exploring aspects of my queer identity followed a similar process: from unaware/baseline, to awareness, resistance, exploration, acceptance, immersion, and finally, integration. My process of moving through these stages was different when I was discovering my sexuality vs my gender.

Before figuring out I was gay I was assumed to be straight but really I didn’t have much sense of my own sexuality. Figuring out I was gay involved very little resistance for me because of the liberal environment I was raised in. I went from awareness to exploration to acceptance very quickly. I was still in early high school at that point with little autonomy for accessing the queer community. But as soon as I went to university away from home, I entered the immersion stage and became involved in the queer club, went to all the queer events, hung out with primarily queer friends, and went to queer bars. I always had something rainbow on, hung my rainbow flag on my door, and talked about queerness every chance I got. Over a couple years, this faded to being just one component of my identity (integration).

Figuring out I was nonbinary went through the same stages but at a very different rate. Despite having a gendery experience in high school, I remained unaware of my non-cis gender identity for years after and probably would have said I was a woman. During my husband’s transition I became aware of nonbinary identities and developed an awareness of my own but did not feel like I had the energy to explore it or deal with the consequences that exploration might bring. I remained in the resistance stage for at least two years. By the time I finally got the space and courage to explore my gender, I already knew that I was nonbinary and had accepted it, I just didn’t know what to do about it. So I immersed myself in this part of my identity for six months to a year, figuring out all the different facets of my gender, how to explain it to people, and connecting with a gender diverse group of friends. This has slowly faded to a more integrated level but remains a larger part of my overall identity than being gay did.

The ‘coming out’ process started at different points for these two identities. I came out as gay immediately after the acceptance stage, before immersion. I am still working on coming out as nonbinary despite being somewhere between the immersion and integration stages.

HOW THIS RELATES TO MY IDENTITY AS A PARENT

Because of the external and concrete nature of being a parent, the first couple stages don’t apply as much. I wasn’t a parent, and then, suddenly, I was. However, the process of resistance through to integration is more about the emotional and personal relationship with this new aspect of my identity, so I think it still applies.

So where am I at in the process? At this stage of things, four and a half months in, I’m still not really sure what it means to be a parent. I’ve been resisting my new parental identity because I didn’t want to lose the rest of who I am. If I lose who I am, all my emotions will be tied up in how well I feel like I’m doing as a parent. And since there are many aspects of this parenting thing that I have no control over, that seemed like a dangerous game.

Then I realized that ‘losing who I am’ was part of the process – the immersion stage. I had been too scared of what that would feel like to allow myself to move through the stages of exploring this new identity. Since making this connection, I have quickly moved from exploration to acceptance and, a bit nervously, into immersion.

It definitely feels different to allow myself to become immersed in an aspect of my identity and existence that is so strongly dependent on something external to myself. I feel like I have less control over my exploration process (and therefore, how it will integrate with the rest of my identity in the long run) than I did with the queer aspects of my identity. Add to that the fact that we are in the middle of a global pandemic and therefore have limited access to the social activities and groups that I might engage in as part of the immersion stage.

Needless to say, exploring my identity of being a parent will be different from exploring my queer identities. Regardless, I can’t jump straight from acceptance to integration. But maybe, since the identity of being a parent is a more external one, so too is the immersion process. Who I am internally, all those pieces I have fought to understand and accept, can stay where they are. I’m not going to ignore my experience as a nonbinary person while figuring out what it means to be a parent. I’m going to figure out what it means to be a nonbinary, queer parent.

What stages did you go through in exploring your queer identity? How did you feel in your role as a new parent? Leave me a comment to share your experiences. I’d love to know how you navigated these transformational experiences.

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Gender in Isolation

In the time of the COVID 19 pandemic, many of us are living in physical isolation. We have significantly less social interaction, especially with strangers, and the majority of our social time is over the internet using video chat. Depending on your situation, this time of isolation may have been helpful or harmful as it relates to your gender. For me, it has been a bit of both.

My experience of isolation, in general, has been positive. I live with a supportive spouse, I have job and housing security, and I haven’t had any major medical incidents (other than giving birth to our baby). I know this is not the case for everyone, especially queer and trans people. Many are isolated with family members that are not supportive of their identity or even abusive. Many have lost their income. Many have had major mental or physical health crises. If your experience differs from mine, I would love to hear about it. Please share in the comments or send me an email. However, I will stick to my own experiences for the purposes of this post.

HELPFUL ASPECTS OF ISOLATION

Separating Physical and Social Dysphoria Triggers

When I am home alone, or with only my spouse, the majority of my dysphoria goes away. This has made it even more obvious to me how much of my dysphoria is triggered by social interactions and how important it is for me to build a life for myself where I am predominantly in supportive environments. The flip side of this is that it also has shown me what aspects of my dysphoria are present regardless of social interaction. These are physical and part of my experience even when I’m by myself.

For example, I always assumed my dysphoria related to my chest was triggered by having other people see me as female as a result of the shape of my chest. Turns out I have almost the same amount of dysphoria even when I’m by myself, it’s just easier to ignore because it’s not compounded by all the other socially triggered parts of dysphoria.

Decreased Social Dysphoria

About 75% of my dysphoria is triggered by social situations. This includes being misgendered, hearing female language used to refer to me, and being expected to look and act a certain way. Since being in isolation, I have had so much less exposure to these triggers that I have way more energy and emotional bandwidth to spend on other things, like taking care of my four month old!

Seeing how much of a difference this has made has given me incentive to try to be open about my gender when interacting with new people and even work on coming out to other people in my life. Hopefully over time this will shape my social environment into a more supportive one that has fewer triggers for dysphoria.

Space to Experiment in Safety

Though I haven’t felt the need to experiment in the last few months as I have done a fair amount of this already, I have found isolation necessary to experiment in the past. Trying something in private has always been the first step in seeing how I feel about it gender-wise. If it feels good, I’ll try it in a queer inclusive space next. If it doesn’t, I’m always glad I tried it on my own first.

The isolation isn’t just good for the experimentation but also for the process of building up courage and taking care of myself afterwards. Sometimes this means laying out what I want to try and just holding it up to myself or feeling it before trying it on. Sometimes it means having time to take pictures or look in the mirror. Sometimes it means changing into comfy clothes and working out or cleaning afterwards to get rid of excess energy and re-ground myself in my body. Almost always, it means having time to journal about the experience either immediately after or a day or two later. Having to interact with others while feeling vulnerable and confused about the experience is extremely taxing. So doing the experiments is always easier during a period of isolation.

DIFFICULT ASPECTS OF ISOLATION

Testing Public Reactions

Often when I make a change to my appearance or behaviour I am doing it in an attempt to influence how other people see me and interact with me. Seeing how the change influences others can’t be done without social interaction. This means that while I may find ways of being that I am very comfortable with for myself, it may not have the effect I’m hoping for when I’m out in public or at work. This stage of experimentation will have to wait for when the social isolation has ended.

Coming Out and Reinforcing the Change

Being in isolation may have given me the bandwidth to build up courage to come out to more people and shown me how necessary it is but it doesn’t allow me to reinforce the changes that others have to make as a result. Coming out as trans or nonbinary requires a bunch of work from the other party. For me, this usually includes changing the pronouns and language they use to refer to me. Most people can’t do this without significant practice. And most people need to be corrected when they get it wrong before they start to correct themselves or get it right on the first try.

Without the regular social interaction following coming out, I can’t do this repeated correcting and reinforcing. Sometimes this means the change in how they refer to me happens slower, and sometimes it stalls and doesn’t happen at all and I have to repeat the coming out process at a later date.

Separation from Queer and Trans Support

While the global pandemic has led to many support groups moving online and therefore becoming accessible to me even though I don’t live in the area, it has also led to not having access to my in person, local group of queer and trans friends. There’s something different about meeting in person that I don’t get from an online group. I miss it and I’m looking forward to the days when I can get it back.

How has isolation influenced your relationship with your gender, either recently or in the past? Leave me a comment or send me an email with your thoughts and experiences!

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Childhood Influences on Parenting Experiences

Note: This is the first guest post on the blog! If you listened to Season 1 of Let’s Talk Gender, you’ll have heard Jake talk about his transition. Now you get the first blog post from him. Enjoy!

As trans people, we know that a person’s sex doesn’t dictate their gender and upholding societal expectations of gender would be hurtful to our child’s existence. The gender of the child is especially irrelevant in the early stages of parenting because babies are mostly blobs. As they grow we will help them explore the vast world of gender. Regardless of how our child chooses to present and identify in the future, we will love and support them.

And yet, when we were trying to get pregnant, the question of “are we hoping for a boy or a girl?” still came up. I was hoping slightly more for a boy. I thought that raising a girl and trying to build up her confidence against a misogynistic world would be harder than teaching a boy about privilege.

I was beyond thrilled when our 10 week blood test came back with no abnormal chromosomal conditions and that we would be having a boy. I felt that I could vicariously live through his “male” childhood since I didn’t get to have one myself.

This is not fair to him. It is his childhood, not mine. Even by virtue of who his parents are, his childhood will be completely different from mine. However, this reaction, and the subsequent un-learning, has lead to a lot of reflection.

HOW MY PARENTS GENDERED ME

My mother had me at 19, and whether it was a function of her age, because it was the 80’s, or because of who she is as a person, she let us do what we wanted. My sister and I played with what we wanted, where we wanted, and wore what we wanted. My mom’s easy-going approach was a big reason why it took so long for me to realize I was trans (but more on that in a different post).

My father, however, was 8 years older and grew up in a military house. He always said that he wanted to make his love apparent to us since he didn’t feel it much from his parents when he was growing up, but he was much more strict about what was expected from us, including enforcing societal views on how we should be acting as girls.

RAISING ‘BOYS’

My parents divorced and remarried and my dad had another child who is now 7 years old. My dad has mellowed with age and perhaps a marriage that is more his style, and mentions frequently that he regrets how he raised us, that he was too strict, and wishes he let us express more of who we were.

In watching my dad interact with his young son, I am amazed at how lenient he is with him. Maybe my dad has become more easy-going, as he says, or maybe he is more willing to let his son do what he wants because “boys will be boys.” My dad has mentioned that his son is “all boy” in the way he interacts – he is rough and boisterous and doesn’t like to follow instructions. He has also said he wants to take good care of his health because “it is clear to him that my son will need a strong male role model” in his life. These are not phrases I would be comfortable using in reference to my own child.

My dad frequently sends me texts about his son and his bodily discoveries, saying “Just wait til your son gets older”, and “boys!! oi-vey!!”. I know he sends these in an attempt to commiserate and create a bond that is strangely based on our child’s genitals, but it leaves me feeling dysphoric and unsatisfied with my childhood. Of course I don’t know what it’s like to grow up with a penis and experience all those discoveries. Of course I don’t know what it’s like to experience the freedom that’s granted to boys and not girls, and seems to be perpetuated by my dad.

But will I let this dissatisfaction make me overcompensate with my own child? Will I let the influences my parents had on me dictate how I raise my own child? Not if I can help it.

MOVING FORWARD

While I initially fell victim to the same “do I want a boy or a girl” thinking that seems to predominantly afflict cis and heteronormative parents-to-be, what’s important is how to move forward. I vow to do better by my child. I challenge my assumptions when I think of my child as a grown up. I remind myself to not restrict myself (or my child) simply based on what genitals he was born with.

While we have chosen to use he/him pronouns for our child, we don’t believe that this dictates his gender. We avoid all other gendered language (son, little man, good boy, etc). We put him in clothes that we like and that fit him, regardless of design or colour. And we will be allowing him to play with any toys, where he wants, and to wear what he wants. We will be asking open questions about gender and presentation and be honest with him about our own identities.

While I initially wanted a boy, I now truly understand that it wouldn’t matter. My baby is my baby and will grow up into whatever human being they want to be.

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When Caring for your Child Triggers Dysphoria

When we picture having a child we think of sleepy cuddles, bonding while feeding, and being an expert at diaper changes. The reality is not always so rosy. Maybe our baby has health struggles, we struggle with mental health postpartum, or, in my case, dysphoria gets in the way.

There are multitude of ways dysphoria can be triggered when caring for your child, depending on how you experience the most dysphoria and what your child care roles are. Personally, I found nursing to cause the most dysphoria, then later, pumping was causing less but was still building up over time, as well as all the sensations in my chest associated with lactation.

I noticed it was getting in the way of being able to bond with my baby the way I wanted to and stopping me from being present in order to notice the small daily changes my baby was making. I couldn’t pay attention to my baby while nursing. I had a spike in dysphoria when holding my baby against my chest. And I was dreading the time I had to spend pumping which made me irritable and easily frustrated.

So I developed a number of strategies to use depending on the situation to decrease the interference of dysphoria. Even if the trigger for your dysphoria is different, I hope these strategies will help you navigate caring for your child in a way that minimizes your dysphoria and maximizes your ability to bond.

BE HONEST

Be honest with yourself, your social supports (partner, doulas, close family or friends), and your medical supports (midwife, doctors, mental health professionals, lactation consultants). As much as we are taught that it is, it is not shameful to feel dysphoria, even when it is triggered by something like caring for your baby or child. The only way to make the situation better for everyone is to be open and honest about it.

This will also help narrow down the trigger. Often, I would be feeling irritable, fatigued, or burnt out and not recognize it as dysphoria related. Then, once my husband and I realized it was likely dysphoria, it still took a bit of conscious awareness to figure out the trigger which for me was nursing. Upon further discussion, observation, and testing, we figured out what would need to be modified to decrease or eliminate the dysphoria. There is no way I would have been able to do all this on my own.

ASK FOR HELP

Sometimes you need someone to take over the dysphoria-triggering task, even if temporarily, to give you a break and build up some reserve. But this isn’t always an option. My husband couldn’t take over lactation for me. So instead of taking over that specific task, even having them offload other tasks can give you more energy to deal with the dysphoria and still have enough left over to bond with your child.

For example, my husband does as many feedings as he can each day as they typically coincide with pumping times. This allows me to pump without the stress of wondering when the baby will wake up and scream for food or delay pumping in order to feed the baby resulting in increased chest discomfort.

FIND OTHER BONDING TIME

If dysphoria gets in the way of bonding with your baby during typical bonding tasks, prioritize bonding at other times. Carve out some play time or snuggle time when it is less likely to trigger dysphoria. Find a snuggle strategy or style of play that is more comfortable for you. I look for the times when the baby is alert and playful and drop what I’m doing to play on the floor, read a book, sing and dance, or go for a walk. This takes time away from other things but getting extra housework or personal stuff done doesn’t make up for the lack of bonding time at the end of the day.

I also found I was missing little changes and new behaviours my baby was doing because I was too busy trying to ignore or deal with the dysphoria. So, on days when I felt particularly dysphoric and disconnected, I would use my journal to write down my own personal challenges and triumphs for that day (to disconnect it from the baby) and some of the new things the baby was doing or a fun moment we shared that day. Just taking the time to think back on the day in order to write it down helped bring those moments into focus through the haze of dysphoria.

ADJUST YOUR CHILD CARE STRATEGY

Sometimes, despite all your efforts to manage it, the dysphoria is too strong or is getting progressively worse. As much as you would like to care for your baby/child in the ‘optimal’ way, that is not always what’s best for you and therefore best for your child. Sometimes we have to compromise on our preferred style of care in order to take care of ourselves and minimize dysphoria.

This could mean using disposable diapers instead of cloth to make diaper changes faster. Or switching to bottle feeding instead of nursing. Or switching to formula and stopping lactation altogether. Or having the baby in the stroller for walks instead of the carrier. Or doing ‘skin-to-skin’ time with the baby lying on your lap instead of your chest. There are always other options.

For us, this meant switching from nursing to pumping and bottle feeding after two weeks. I had the goal of feeding my baby my milk for the first six months but once my supply increased to >75% of my baby’s intake, the amount of sensation from my chest started increasing my dysphoria much faster. So we decided to decrease lactation earlier and slowly switch to formula. This may increase my baby’s gas. This may not be my preferred method of feeding my baby, or what society tells me is best. But it’s what’s best for us.

What I’ve found is that, even though it’s not my preferred method of care, the next-best option that results in less dysphoria feels significantly better and allows me to engage in the care a lot more, resulting in a much better experience for my baby as well. There is no harm in trying different things. You should never rule out options based on preconceived ideas from society. If it’s the best option for you (and still meets your baby’s basic needs), it’s the best option for your baby as well.

What baby/child care tasks trigger your dysphoria? What strategies do you use to deal with it so it doesn’t interfere with bonding with your child? Leave me a comment below or send me an email! The more strategies we share with each other the better!

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