Meaghan Ray

Let’s Talk Gender S1E7: Medical Transition: Top Surgery

OVERVIEW

In this episode we talk about Jake’s path to top surgery and his experiences of the procedure and the recovery process. We also discuss the role of the partner and Meaghan Ray’s experience during each stage of this process.

SHOW NOTES

Jake’s Top Surgery Experience

Referral to gender psychiatrist September 2016
Saw gender psychiatrist July 2017
- Referral to top surgery – likely a two month wait
- No word, called back, finally heard from the surgeon two months later
Two surgeons in our area that rotate so one is taking consults then start working on the surgeries while the other one takes consults
- Trans people are at the bottom of the list in terms of priority
- A friend got in for a breast reduction after a year, Jake has been waiting two years and still hasn’t heard back from them
Initial consult was a fast twenty minute run through with minimal information
- Didn’t know what questions to ask yet
- Learned that he would likely end up with dog ears
- Revision to get rid of dog ears is not covered by provincial health care
- Liposuction to prevent dog ears was not covered or even discussed as an adjunct out of pocket
- Offered double-incision method only
- Left Jake feeling uncomfortable and frustrated
Started googling where else he could get surgery
- Found McClean Clinic in Toronto where they do ‘Mascuplasty’ to create appearance of a male chest instead of just double mastectomy
  - Includes liposuction and revision
- Called the clinic, filled out the application, and was put on the list for a phone consultation which happened 4 months later (8 months after original referral)
- Likely wait was listed as 3-6 months after consultation
Phone consult in March 2018
- Surgery is done under informed consent – don’t need a referral from psychologists or psychiatrists but instead have to pay out of pocket
- Similar vetting process to the gender psychiatrist – what are your expectations for surgery, why do you feel you need this surgery, describe your dysphoria…
- Feel like you have to explain how you feel in stereotypical ways in order to ‘qualify’ and get access to the medical treatment you need
Offered a date 6 weeks later!
- Took a day to consider if this was what he wanted
- Much less time to logistically and emotionally prepare
  - Good support from community, even people who had personal experience with the McClean Clinic who all had great experiences
  - One friend showed his results and provided a list that he had made of tips and tricks after his surgery
  - Did lots of research on facebook groups for trans guys and breast cancer survivors
Trip to Toronto for surgery!
- Willing to pay for better results and less wait time
- Able to stay with family
- Second guessing at the last minute
  - Not a ton of physical dysphoria but lots of social dysphoria that was severely anxiety inducing especially in public washrooms
In-person consult the day before
- Surgeon was 2 hrs late
- Jake burned through all his anxiety during the long wait
- Brief but thorough description of the surgery plan, results, and follow up
Day of surgery
- Measurements and markings based on ratios
- Awkward but done in a medical way
- IV started
- Went into surgery and came out crying for no reason
- Very sore across the chest
  - Wearing a compression band over the bandages
- Got up to the bathroom and was dropped off with no supervision, felt very panicky, light-headed and gross
- Was rescued by a nurse who then asked about any history of anxiety
  - Maybe they should ask about this before surgery?
- Eventually met up with MR and was escorted out to the back door in a wheelchair
  - Lots of difficulty finding the car, figuring out where they wanted him to be picked up, etc

Partner Experience of Top Surgery

Included in all the pre-op appointments
- Helping remember information and nice to know what was going on
Day of surgery
- Stayed for pre-op measurements etc
- Kicked out when he went in for surgery
  - Told it would take about 2 hrs and they would phone when he was done
- No word after 2 hrs so I checked in with the desk and was shooed away with no actual updated estimate
- Waited another 45-60 mins with no word so I checked back in
  - They went to check with the nurses and this time gave me a spot to sit around the corner
    - Had all our winter gear and personal belongings and my entertainment to keep me occupied during the surgery piled around me
  - Eventually came back and told me he was just crying a bit and I could go back in a few minutes when he was feeling better
  - Would NOT let me go back to help him calm down/recover
    - Tried really hard not to get in the way but also mentioned that I am familiar with medical things and could probably help him
- Eventually got to see him once he was back in the pre-op room (after the whole anxious bathroom experience)
  - Very pale, shaky, sweaty, nauseous and in pain
  - Got a wet cloth for his neck
  - Helped him eat crackers
Generally poor communication with me
Fiasco with getting him to the car was very frustrating
Drove home very carefully
- He was already in lots of pain and getting very nauseous
- Had to pull over a couple times to make sure he was doing ok
Got home, got him settled and took it easy for a few days

Jake’s Top Surgery Recovery

Returned to the clinic the next day to ensure everything was going ok
- 15 minute appointment with lots of driving to get there and back
First few days were mostly sleeping, resting, watching movies, sleeping propped up
Became very itchy from the pain meds
Pain from the compression vest under his armpits where they had done liposuction
- Sensation in areas of liposuction came back very quickly with lots of bruising
- Tucked some towels over the edge to make it feel less sharp
- Moved the vest down a bit and loosened it a bit
Went back for a follow up after 7 days where they took off all the bandages
- Could already tell his chest was flatter but with no bandages or vest it felt very flat
- Subdued reaction due to pain meds and that it matched his expectation so it didn’t feel surprising
- Partner reaction was much stronger
  - Had spent so many months picturing him with a flat chest because that’s how he pictured himself that his chest area had blurred out and had become uncomfortable to really pay attention to
  - With the bandages off it was the first time that I could comfortably look at that part of him and have it look right
  - Also knew how awesome he would feel about it once his head was clear of the meds and he was feeling better
  - Took some pictures and video including the side view which was the greatest
Flew back to Alberta
Took an extra week off work in order to recover enough stamina
Was supposed to keep the compression vest on for 4 weeks but ended up taking it off after 3 because it was so uncomfortable to wear under work shirts
Kept nipple covers on to keep nipples moist
- Nipples scabbed as they healed (normal)
  - Looked like two black nipples and felt like something was wrong (also very common)
- Scabs started coming off and the nipple was so light that it looked like it wasn’t there but everything was fine
Sensation returned slowly
- Lots of areas across the top of his chest that started to itch as sensation came back
- Then down into armpit and across towards the nipples
- Played games where we would test where his sensation had gotten to
- Nipple sensation has returned part way, somewhat hypersensitive
- One spot in the left incision where a nerve ending was exposed and caused serious stabbing pain each time it was touched
Traumatized by liposuction video
- Makes sense why those areas were so numb
Scar care
- Bio-oil
- Scar massage
- Really careful to not raise his arms
  - Found other ways to exercise by modifying activities to deal with the feeling of being cooped up
Mostly frustrated with the irritating symptoms as the sensation returned and changed constantly
- Had to use numbing gel at times

Partner Experience During Recovery

Listen to what they are experiencing
Look up extra info such as scar care and desensitization strategies if needed
- Your person is so irritated by those sensations and burntout from the whole experience
Had fun figuring out where the sensation had returned to
Helping out others in the community since

Looking Back On It

If you’re considering private options, take the time to look around, including international options
- Worth pricing them out regardless of distance
- Consider amount of post-op support from family/friends
- Consider whether you will get the results you want and what medical follow up is offered
Most people have had positive experiences with McClean Clinic
- Jake found a big difference between the high quality customer service at a distance vs less awesome experience in person

Next time: Legal Transition

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Thinking Ahead to Parenting as a Non-binary Person

If you have read any of the other posts in the Pregnancy and Parenting category, you’ll know that Jake and I have been trying to get pregnant for a while now. So naturally, we think ahead to what it will be like to parent as a trans man and a non-binary person.

Below are some of the things we’ve discussed in relation to my identity as a non-binary person. Note: other non-binary parents may have different responses to these situations and my responses may very well change in the future. And that is totally fine! Think of this as a time capsule of what we’re thinking at the moment.

WHAT WILL THE KID CALL ME?

For the most part, I am comfortable with mom or mother. Mommy is a bit less comfy. I have seen various terms that other non-binary parents use such as Baba, Mapa, Maddy, Mappy, etc. None of these feel like they really fit for me but maybe I will just have to pick one that feels the closest and I’ll get used to it.

Another common one is Ren or Renny from parent. I quite like this one but it would not be as intuitive to others what it meant so it would take more explanation on our part or our child’s part. Maybe this is ok and wouldn’t be as difficult or frustrating as I’m picturing.

The other one I’ve thought of is Mur which is a sounded-out version of M.R. for Meaghan Ray. It also sounds like a shortened or slurred form of mother. So maybe I’ll use that.

I’m sure the kid will have their own opinions about what fits so I guess we’ll see what happens.

EXPLAINING MY IDENTITY TO MY KID

Initially, I won’t be telling my kid anything specific about my own gender identity because they won’t necessarily understand and they definitely won’t understand the safety concerns of who to tell and who not to tell. But we will have lots of kids stories about gender diversity and have lots of conversations about gender and gender presentation and preferences geared towards whatever stage they’re at.

When my kid is more preteen age I will likely tell them about my own gender identity. If my kid ever asks outright what my gender is I will be open and honest and deal with whatever personal consequences come from that.

NAVIGATING SYSTEMS

Whether it’s school systems or pediatric medical care, I will likely be identified as the mother on all the paperwork and to all the professionals. I will likely take that one situation at a time and if I come across an inclusive professional or an inclusive form, I will likely be open about my identity (as long as my kid was also aware of it at that time).

We will look for spaces where our kid, and us as parents, can hang out with other queer families so we don’t feel isolated in these various experiences.

PREPARING THE KID TO FIELD QUESTIONS

Depending on what we have told our kid about my identity and how they are referring to me, this may generate questions from other kids or teachers and other parents. We will not be able to control how our child responds but we can have conversations both before and after these questions come up about what they might say, how they felt about being asked the question, and if they feel like they want to ask any questions of us.

All we can do is instill an open minded and positive view of gender in our child and hope that that is what they represent in their answers to others. If they encounter a negative response as a result of my identity, we will debrief with our child and address it with the most responsible adult directly. This is probably the thing I am the most apprehensive about so we’ll see how it goes.

WILL WE RAISE OUR CHILD GENDER NEUTRAL?

Socially, emotionally, and physically – yes, as much as possible. This means playing sports and rough housing with them while teaching them how to be gentle. Modeling and teaching them emotional intelligence and emotional coping skills. Giving them access to a variety of toys, clothing, and accessory options.

However, we will not be using they/them pronouns for our child. We will be using the pronouns that align with their sex. Though neither of us are cisgender, statistically speaking, our child will be. As someone who prefers they/them pronouns, I understand how difficult it is to get people to use them and understand why I am asking them to. It can be quite upsetting for me when I have explicitly asked them to and they don’t. So having to fight for the same thing for my child would be way too much of a struggle and way too emotionally taxing for me when they are likely to be cisgendered.

As I said above, we will frequently be asking our child about their gender using whatever terms they understand. If they ever display a preference for other pronouns, we will adjust accordingly and immediately. For me, being flexible and open is more important than being strictly neutral from the start.

Do you have a child or are you planning on it in the future? What terms do you use? How have you discussed gender with your child? Leave me a message below!

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Let’s Talk Gender S1E6: Medical Transition: HRT

OVERVIEW

The changes with HRT are some of the most positive and euphoric aspects of transition. We talk about Jake’s experience with Testosterone and going through his second puberty. He talks about all the different physical changes and the emotional changes as well. We also discuss what it was like as his partner adapting to those changes.

SHOW NOTES

Jake’s Experience Taking Testosterone

Typical trans narrative is based on changes with HRT
- External, obvious changes
- Most socially acceptable aspect of transition to ask about
- Lots of YouTube videos and picture timelines
  - Can be fascinating to show what the body does on HRT but also gives you an idea what to expect (though everyone is different)
So much variability
- Will loosely end up similar to cis men that you are related to
- Also depends on age, dosage, etc

Accessing Hormones

Referral from psychologist to gender psychiatrist
Previously required psychiatrist referral to endocrinology but very recently could get a referral from family doctor (most family docs were not aware or comfortable doing this)
Wanted to start HRT right away but had to wait to see gender psychiatrist
- Came out to family doc who then refused to refer to endocrinolgy
  - Wasn’t up to date and wasn’t willing to trust our word enough to seek out more information
- Found another family doctor who was recommended through the community who was prescribing hormones using informed consent
Started Testosterone!
- Regular family doctor followed up with blood work and adjustments to dose
Waited another 6 months to see endocrinology (supposed to see them max 3 months after starting)

Physical Changes

Voice
- Started a few weeks after starting T
- Voice got a bit husky, thick, then started cracking, then eventually settled into the lower range
- Voice recordings were helpful to hear the changes that happened really slowly
- Vocal chords thicken but don’t change as much after you’re done growing
- Made a big difference to being misgendered, especially over the phone
- Generally done changing by about 18 months
- Partner experience
  - Had a fun time with the voice change
  - Making fun of the cracking, drawing attention to something that was affirming
  - My voice started sounding higher in comparison (caused voice dysphoria for myself)
    - Worked on lowering my own range
Facial Hair
- Very slow – mustache and side burns and under-chin hair first, very slowly filled in
- Helps with passing from afar
- Lots of euphoria
- Lots of time spent staring up close in a mirror
- Partner Experience
  - Enjoyed scruffing his beard, trying to encourage it to grow
  - Eventually had to encourage him to shave which he had a big resistance to
Body Hair
- Lots more on thighs, forearm hair thickened, more on tummy
- More fascinating than facial hair growth because it was less expected
- Grew a lot at the beginning, then slowed down a lot but has continued
- Partner Experience
  - Not much need to adapt to this as it wasn’t a huge change and has been fairly slow
Increased Temperature
- Lots of overheating initially on T but has since improved
- Especially when exercising which was very frustrating
  - Better after top surgery which meant he was comfortable exercising without a shirt on
- Partner Experience
  - Used him as a heating pad
  - Wildly different environmental temperature requirements
  - Unable to exercise together for a while
Menstruation and Lower Changes
- Periods stopped almost right away
  - Might be related to already having an IUD in
- Other changes in downstairs anatomy that we did not discuss (go look them up if you’re interested/need to know)
Strength
- Baseline strength increased without trying
  - Could suddenly lift tires more easily which felt weird
  - Didn’t need to workout to increase strength
- Noticeable only when doing things, not all the time (like facial hair) so often took him by surprise
- Partner Experience
  - Felt so much weaker by comparison!
  - Jealous of his strength and easy muscle gain when he was working out
  - Fun to see his confidence increase with his awareness of his strength
Body Shape
- Very delayed and slow
- Fat distribution changes – less on hips and thighs, more on belly
- Changes within face – less in cheeks, more to jaw
  - Gives appearance of wider jaw even though bone structure isn’t changing

Emotional Changes

Concerns before taking hormones about becoming angry and raging
- We were told that it augments emotions that are already present – if you’re an angry person, you might feel more angry but if you’re not, you won’t just suddenly become angry
Hormonal fluctuations definitely makes people generally more emotional just like typical puberty
- As an adult there are adult expectations and responsibilities you have to manage while having mood swings
- Hopefully have more coping skills as an adult
Less sadness, more channeled into frustration
Initially quire irritable but calmed down within a few months
Less emotional range and less nuance
- Doesn’t feel wrong or repressed or stunted
- Feels normal, the way his emotions should have been from the beginning
Less emotionally triggered, less emotionally invested
- Maybe due to increased confidence
- Seems more aloof but as a guy, people don’t particularly care (aloofness is somewhat expected)
Confidence increased which is difficult to measure as the person going through it
- As a partner, this was easiest to see as compared to the rest of the emotional experience
  - Less social anxiety
  - More comfort in masculine clothes
  - Was very cool to see and very much offset any mild discomfort I had with the physical or emotional changes
Partner Role
- Being a sounding board
- Encouraging him to express the huge emotions when he wasn’t used to having them or having so much of them
- Suggested a variety of positive outlets for emotions

Looking Back 2.5 Years on T

Lots of euphoria from HRT but at the time was painfully slow
- Celebrated every little change we saw and made a big deal out of them
- This was the good stuff during all the frustrations of accessing medical care and getting legal documents changed
Looking forward to more facial hair, body hair, and body shape changes
What will happened during the age of menopause/andropause? We have no idea!

Nonbinary Identities and HRT

Can take low dose to have fewer and slower changes
- ‘Micro-dosing’
- Can stop after the voice change but before much hair growth
I have minimal consistent physical dysphoria, no particular desire for facial or body hair changes, minimal voice dysphoria which I dealt with by working on my range
- Also trying to get pregnant so would not be able to be on T currently
Open to it in the future if I ever felt like I needed it

Next episode: Top surgery!

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Let’s Talk Gender S1E5: Social Transition: Coming Out At Work

OVERVIEW

Jake has now been out at work for nearly two years. We discuss his process for coming out at work from the preparation, through coming out, and all the frustrations that happened afterwards including HR struggles, bathrooms, mysogeny, and misgendering.

Meaghan Ray talks about what it was like to be in the role of the partner during this part of the transition process including having to come out to their co-workers about Jake’s transition.

We discuss Meaghan Ray’s process for coming out at work as non-binary so far and Jake’s experience of having a non-binary spouse when he’s talking to co-workers.

SHOW NOTES

Jake’s process for coming out at work

Preparation

Talking to community, online friends to learn from other people’s experiences
Talking to team lead and other coworkers in a hypothetical context
- They didn’t really apply the conversation to real life or think about it practically
Should have gone to HR in advance though he wouldn’t have necessarily known what to bring up as a potential concern until he encountered them

Tipping Point

Eventually dysphoria was bad enough that he could not do his job so it was either come out or quit
Told team lead in advance
Had written an email
Pulled aside immediate co-workers to tell individually
- Generally supportive
Sent email to whole department
- Much more generic than discussion with immediate co-workers
Told other higher-ups
- One person in particular had immediately helpful comments such as “Which bathroom are you going to be using” and “How do we get your name changed in the computer system” ie considering the practical aspects
- Some were confused as to why Jake’s transition would be affecting anyone and why he needed to tell everyone when it’s a personal/private issue (ie thinking of it as the same thing as coming out as gay)

Challenges

Old name on emails and inter-office messaging until his name change document came in
Then was told he had to get his birth certificate changed first as well as a new SIN card (even though others who are changing their name due to marriage etc do not require all of this extra documentation and there was no good explanation as to why he did)
Eventually discovered that HR had a diversity and inclusion rep that helped a lot
- Met with her in person and discussed all the concerns with things that had been happening and unnecessary hoops that he was being forced to jump through
- She was super feisty and got things changed really fast which was amazing

Bathrooms

Started out by going to the farther away women’s washroom
Then used the men’s washroom in the same farther away area but was terrifying, especially prior to top surgery
Found a single use bathroom a couple floors up in an abandoned area that was under renovation
- Felt safe but isolating and cumbersome
Found out later that some of the management had been talking behind his back about what bathroom he should be using in order to decrease the discomfort of others
Decided he wasn’t going to hide anymore and went back to using the men’s washroom closer to the work area
Had emailed facilities management to ask about bathrooms and they connected him to the diversity rep at HR

Looking Back

Felt like it took forever, in reality was about a year
Fighting on all fronts
Exhausting and circular and convoluted

Did People Adapt?

Took a really long time, no trigger event like we had with the family (see Episode 4)
An ally helped by correcting others on Jake’s behalf
Still getting misgendered 5-10 times per shift by immediate co-workers one year later
- Now, another year later, still getting misgendered 1-2 times per shift
People now know him longer as Jake than anything else and he still has a hard time correcting people
Newer co-workers don’t know he’s trans and never knew him prior to transition
- Others who misgender him get a completely confused reaction rather than people realizing he’s trans – people just don’t think of that
- Now that he passes, being misgendered doesn’t bother him as much because they end up looking like idiots

Other Interesting Situations

Suddenly being included in mysogenistic ‘bro’ language and conversation in an attempt to show acceptance
- Difficult to counteract the mysogeny without losing the acceptance
People tried to teach him how to be a guy as though he had never been exposed to masculinity

Partner Experience

Could only be a cheerleader
Wasn’t able to help with any of it in the ways I was able to help during other phases
Having to come out to MY coworkers for Jake so I could talk about my husband instead of my wife
- Made a little presentation which my immediate team responded to really well
- Hoped that it would get around via gossip but it really didn’t so I had to tell everyone separately, often more than once
- Lots of disjointed conversations where I had to stop mid conversation to explain why I was referring to my husband
- Most common question was “Does that make you straight?”
Had a hard time getting support from co-workers because no one had enough context for how the process was affecting me, what type of support to give me, and why I was getting burned out
- Tried to explain but ended up spending more energy than I got back in support
- More recently I have had more co-workers who have trans experiences
Educating co-workers was still important to me because I work in a health care setting and I want as many people who work with patients to understand how to be respectful towards trans people
Once I was no longer talking about my wife, I lost my ability to come out as queer off-handedly in a conversation
- Made my own identity feel a lot more invisible
Had a few difficult situations in my workplace where I witnessed transphobia or had co-workers misgender trans patients which were very triggering for me (and still are though I deal with them slightly better now)

Meaghan Ray’s experience of coming out at work

Most dysphoria at work, mostly social dysphoria
Half the people I interact with are strangers
Rather than a goal of not getting misgendered (not feasible), set the goal of minimizing discomfort
- Most uncomfortable with other female language (ma’am, ladies, girl)
Instead of “I’m non-binary, use they/them pronouns, call me Meaghan Ray,” I’ve chosen to instead say “I’m non-binary, this is what that feels like, please avoid these types of gendered terms and instead use these neutral ones”
Very choosy with who I have these conversations with
I still have a hard time correcting people when they use female terms but I tend to groan, squint, flinch, go silent, or say “Nope!” and they eventually get the idea and self-correct

Jake’s experience as a partner

Couple of co-workers that know about Meaghan Ray’s non-binary identity and are generally good at using they/them pronouns
Refers to Meaghan Ray as his partner or spouse
Generally less gossipy/social work environment so it comes up less

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Let’s Talk Gender S1E4: Social Transition: Coming Out To Family

OVERVIEW

Coming out to friends and family is a long process that involves lots of uncertainty, strategy, and a bit of luck. We discuss Jake’s process of coming out as a trans man and Meaghan Ray’s experience of that process as his partner, including how this process went for us, what methods we used to come out to people, what emotions we experienced, and what responses we got.

We also discuss Meaghan Ray’s experiences of coming out as non-binary so far (still early on in the process), Jake’s experience of being their partner, and how their two experiences are similar or different.

You can find the audio for the episode at the bottom of the page or subscribe to Let’s Talk Gender in your favourite podcast app.

SHOW NOTES

The following is Jake’s coming out process and Meaghan Ray’s experience as his partner.

Who to come out to first?

Friends, then close family, then work, then extended /more questionable family, then strangers
Everyone’s process will be different
- Start with the people that will be most likely to be supportive and work your way up to the least supportive people

Partner Experience during closeted and early coming out phase

Various pronouns depending on the situation and who was present – female, male, neutral, avoiding pronouns altogether
Still trying to get used to his new identity so using female pronouns made that harder
Lasted about 4 months
Didn’t realize the toll that this took until about 8 months later (caused fairly severe burnout)
Got used to doing a quick check in before each social situation of who’s going to be there, who are you out to, is it worth going out, which name and pronouns are we using?

Coming out to family

Thought it would be similar to coming out as gay but it really wasn’t
- Being trans is about who you are and requires them to do a lot more work – change how they think of you and how they refer to you
Started with the first few people who were most likely to have a positive to neutral response and who had less direct impact
- Didn’t judge all of those correctly but overall it went ok
- Be open to any response they have
- Keep safety in mind
First part felt like it went really slow
- Few people know and if they’re hanging out with people who don’t know it gets very stressful
- Asking people to hold back on gendering you correctly which slows down their process of coming to terms with it
Eventually there is a tipping point where it’s easier just to have everyone know

Coming out to partner’s family/long distance family

Multiple conversations
Expecting close family to come out to other members of the family for you does not work – you end up having to do it yourself
Mostly done through email with generally positive, supportive responses
Follow up conversations at face-to-face gatherings
Took them longer to adjust but generally had less impact on us
Partner can do more of the work, especially with the follow up conversations

Methods for coming out

Face-to-face is the hardest, tended to avoid that if possible
Sent lots of emails in the early stages
Wrote a letter and read it out face-to-face
Sent lots of shorter emails to the more extended family
Facebook/social media for general public, past friends, far extended family

Responses to coming out conversations

Told close family early on that he was thinking about it/working on it as a warning that transition might be coming
Told them a while later that he for sure was trans but they didn’t seem to understand that there was much difference from the first convo
No change in pronouns or name
Had a family wedding coming up that necessitated telling Jake’s brother
- First person to appropriately change pronouns, name, and referents (brother) and introduced him that way at the wedding
His family realized that they were the only ones referring to him with female name and pronouns and suddenly was making it more unsafe for him
- Kick started their use of proper name and pronouns in an unexpected way
- Positive effect of strangers getting name/pronouns correct around family that is getting it incorrect
Was a high risk, high reward situation
Realized afterwards that family had been reluctant to change likely out of fear for his safety (when he wasn’t passing yet)
- What they didn’t realize (and what we didn’t understand early enough to explain to them) was that the toll on his psychological safety was worse than the physical safety risk that they perceived

Partner experience during early stages of being out to family

At the beginning, tried to hang out with them and refer to Jake in third person as much as possible to set a good example
- Complete opposite from previous stage where we tried to use second person or no pronouns as much as possible
Really enjoyed being able to refer to Jake correctly, felt good about setting a good example and trying to help
When they were not getting it at all, it got very difficult to hang out with them
- Jake wanted them to figure it out at their own pace and didn’t want to correct them
- Started getting angry with them too easily and had to not hang out with them as much (until they suddenly figured it out at the wedding)
Once they figured it out, it was much easier to hang out with them again
- Started correcting themselves, correcting each other

Correcting others when you get misgendered

Often happens in larger groups or in the middle of a conversation
Don’t want to derail a conversation or become the center of attention
Will remind them via text message later if they do it repeatedly without correcting themselves
Much better if someone else corrects them for you because you automatically have an ally and don’t have to make yourself vulnerable in order to stand up for yourself
Always takes emotional energy so it’s a balance of how much pain it’s causing you vs how much energy you have to spend to correct them

Emotions during coming out to family

Transition from questioning stage to coming out stage was the hardest
Fear, nervousness, what if someone becomes vengeful, actively negative
Questions about which family would chose to never talk to me again
Can’t base people’s reactions to you being trans on how they reacted to you being gay
Eventually reached a tipping point of it is more difficult to live in the closet than the fear of how people would react
Realization of how many people you actually have in your family
- Exhaustion, frustration, unending
False urgency to tell everyone as soon as he started hormones because changes would be happening and people would notice
- Didn’t happen nearly as fast as he felt like it would
- Wanted changes to happen faster to help people have an external reference for changing name and pronouns

Mental vs physical image and adjusting to new identity

Lots of detailed conversations between us where Jake explained how he saw himself and would feel most comfortable which helped Meaghan Ray change their mental image of him earlier than anyone else would be able to
- Made it easy for me to use correct pronouns well before any physical changes
Other people don’t get to have those detailed conversations and therefore can’t change their mental image because they don’t know what to change it to
- Often do much better after physical changes start happening
Family have known you longest and will have the strongest mental image of you pre-transition
5% rule: people will take up to 5% of the time they have known you to get used to new name and pronouns

Partner emotions during coming out to family

Fear, mostly for psychological well-being as he was having lots of difficult conversations
- Kept my phone on me at all times
Tried to provide lots of validation and support so he had at least one positive influence
Offered to go with him when he would be having those conversations
Still didn’t really understand how hard those conversations were and how things were going
- Had to ask really specific questions in order to find out because he didn’t want to make it harder for me and did not have any more energy to spend on another gender based conversation

Burnout lasts a long time

Still nervous about talking about gender and transition because there is a conditioned response that those conversations will lead to something huge and exhausting
Reviewing past experiences is much easier than talking about current ones
If you are the second person to transition in your immediate family or even within your relationship, those around you might have a hard time as a result of the residual burnout from past experiences with it

Meaghan Ray’s experience of coming out as non-binary

Even harder than coming out as binary trans
- The person you are coming out to already has an idea of what you mean by ‘male’ or ‘female’
- Most people do not have that reference for ‘nonbinary’
- Requires a lot more sex and gender 101 education to work up to getting them to understand which puts them in information overload
Really, all I’d be asking is for them to use they/them pronouns and maybe a different name and even that seems to be extremely hard for people to do
- We use they/them automatically all the time but when people are asked to do it consciously, apparently it messes with their brain and they can’t do it
Takes so much energy that I haven’t done a lot of coming out to family yet
- Something else always seems more important to talk about when visiting with family
- Sent an email with an explanation but haven’t talked about it since
- Good sibling support, will likely help my family come around but want to have those conversations with my parents first
Will likely have those conversations with close family once I’m pregnant/having a kid and have more extended visits with them and potentially more gender-based discomfort

Jake’s experience as Meaghan Ray’s partner

Trying to avoid pronouns at all costs
- Awkward pauses, reorganizing sentences
Being supportive while Meaghan Ray is slowly working up to coming out
- Spending a long time in limbo
Can’t be fully invested because limbo causes burnout and limbo will last much longer

The coming out equation

Deciding when you’re ready to come out will be different for everyone
How uncomfortable it is to be misgendered vs how hard it will be to come out and how much benefit you will get
- Very different answers to this equation for each of us

Every coming out process is different and personal but inevitably affects and involves the people around you.

Join us next week when we talk about coming out at work.

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Gay vs Trans

There are lots of ways that being gay and trans are similar but there are also a lot of differences. I have found that when I initially start talking about gender with someone new who has minimal queer literacy, they often get confused between sexuality and gender and conflate being trans with being gay.

Below are a lists of similarities and differences between being gay and being trans based on my experiences of being gay and non-binary and my husband’s experiences of being gay and trans. We both identified as gay first, and later discovered and expressed our non-cis gender identities.

SIMILARITIES

Incorrectly assumed to be the default (cis or straight)
Living with confusion and feeling like you don’t fit in before you know why
Have to figure out your identity
Have to ‘come out of the closet’ ie tell other people
Dealing with fear of rejection, prejudice, loss of housing or work as a result of coming out
Excitement and comfort of finding people that have the same/similar identity/experiences as you
Culture, experiences, and history specific to queer community
Lots of different terminology, language, and labels
Different interaction with people in your community than people outside of it
Risk to physical and psychological safety by living authentically
Pride parades, pride month, pride flags and symbols
Being labeled by strangers (often incorrectly) based on how you look or who you’re with
Often become parents via alternative fertility methods, surrogacy, or adoption
Prejudice in health care and legal systems (significantly worse for trans identities but present for both)
Lack of appropriate/relevant sex education

DIFFERENCES

Who you like vs who you are ie sexuality vs gender
Gender based experiences and identities are much less understood and accepted by the general public than sexuality based ones (though this wasn’t always the case and we hope to get to the same place with acceptance of gender identities)
- Significant energy has to be put towards educating the people around you when you come out as trans that isn’t necessary when coming out as gay
Coming out as gay requires the other person to change how they refer to your partner (if you have one) whereas coming out as trans requires them to change how they refer to you (which takes a lot more work on their part)
Dysphoria with trans identities that doesn’t relate to gay identities
Possibility of medical intervention and changes to legal documents with transition
Difficulty accessing appropriate/competent medical care as a trans person when it wasn’t a problem as a gay person
Gay community is readily available and easy to find while trans community is much smaller and harder to find
Extreme shift in privilege with transition that is much less pronounced with coming out as gay
Most trans people pick a new name, gay people don’t

If you have anything you’d like to add to these lists, leave me a comment below!

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Let’s Talk Gender S1E3: Personal Transition: Gender Exploration

OVERVIEW

The first stage of transition is the personal exploration of your gender. We discuss what the process of exploring your gender feels like, how each of us figured it out in different ways, and what it’s like to be the partner of someone going through the gender exploration process.

Sorry for the variable sound quality. We are still trying out different set ups to find something that works for us.

SHOW NOTES

Exposure to a concept or identity that resonated with us
- Looking up other people’s experiences on YouTube
- Being fascinated by people’s experiences without knowing why until later
Finding language to express ourselves and define our identities
- Other people’s labels don’t necessary feel right for you
- The labels that feel right shift throughout the exploration process
- The trans label comes with a lot of weight
- Takes a while to find your own meanings for labels that fit
Exploration is often driven by the feeling of not fitting with the gender you were assigned at birth and how people relate to you as a result (dysphoria)
- Trying to minimize it guides us in a direction towards our actual gender
- Often have been experiencing dysphoria for a while but didn’t know what it was called and once we have the word for it it feels huge and way more painful than it did before
- Physical dysphoria, social dysphoria, mental dysphoria
- Fairly easy to tell what you are dyphoric about
Sometimes we encounter gender euphoria and exploration is driven by finding that experience again
- Trying on different clothes when playing dress-up or secretly raiding a family member’s closet

Jake’s Experience

Minimal physical dysphoria, mostly social dysphoria
Voice causing people to gender him as female
Explorations
- Cutting hair short
- Wearing a binder
- Trying a packer
- More masculine style
Very nervous that people would notice immediately
Very scared of what the implications were of this feeling good, progressed very slowly
Looking for a new name
- Flipping through baby books
- Making a short list
- Ordering different things online with a different name each time
- Kept coming back to Jake and eventually it stuck
Eventually decided that he definitely did not feel comfortable being female
- Even if he didn’t do any medical transition, he still felt more male than anything else
Exploration doesn’t end
- Now that he is more comfortable in his maleness he is exploring some of the female things that he would never have done before
  - Longer hair
  - Nail polish
  - Earings back in

Meaghan Ray’s Experience

Exploration was a lot easier because they already new their identity but needed strategies to manage dysphoria, especially at work
- Similar strategies as Jake
Had a very clear gender related experience in Grade 10 where they were a boy named Ray for a few days, then back to Meaghan, then back to Ray
- Kept up for 2-3 months
- Was very confusing and frustrating and destabilizing
- Ended up making a list of personality traits for Meaghan and a list of personality traits for Ray, drew lines between the ones that matched, and from then on lived as that person
- Buried the whole experience very deep until Jake started talking about gender and they found language and space to explore it in a positive way
Needed something more concrete to follow for exploration than Jake
- You and Your Gender Identity: A Guide to Discovery by Dara Hoffman-Fox
- Created a gender tracker to see how much their gender fluctuated between male and female for both physical and social sense of gender
- Learned that their period affects their gender and that their physical and social sense of gender can shift separately which they will use different strategies to manage
Trying on a dress privately
- Thought it would feel wrong but it felt like a non-binary person wearing a dress
- It did not erase their sense of identity which was encouraging
At the end of exploration, they now have many more strategies that help and a much better understanding of who they are and how to express it to people

Partner Experience

Seeing Jake with a flat chest in a binder helped change Meaghan Ray’s mental image of him
If the partner is cis it can be very difficult to understand what’s happening
- Some trans people are not willing to include the partner in their exploration process and just show up as their new self which is very threatening and sudden for the partner
- Instead, Jake included Meaghan Ray in the process and they helped look stuff up, break things down into smaller steps so it was less scary, tested things out during a camping trip, provide encouragement and support
Your experience is your own
Need to find your own sources of support as a partner
Don’t know how to talk about it yet because everyone is still just figuring it out
The more open we are with each other the easier it is to keep our relationship strong
We happen to both be AFAB and heading in the male direction
- Some strategies worked very well for both of us
- Some things worked very differently for each of us
- Some things worked for one of us but not at all for the other

Resources

FTM
- YouTube Channels: Chase Ross at uppercasechase1, Ty Turner, Jammiedodger
- Books: This One Looks Like a Boy
NB
- Podcasts: Gender Rebels, They/Them/Theirs
- YouTube Channels: Ashley Wilde, Ash Hardell
- Instagram hashtags to create a community for yourself

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Prioritizing Together Time

Whether you are in a relationship or have a close friend or family member that you rely on for support, prioritizing time with them is especially important if you are questioning your gender or transitioning.

Any exploration or change in our gender identity and presentation is a big change that very much affects the people around us. Close relationships only remain close if we keep communicating to understand how each person is changing and growing so we can support or adjust as needed.

From my experience during my husband’s transition and my own gender exploration, I discovered there are a few different types of quality time that serve different purposes. We were not always good at using out together time to the best advantage but we definitely got better at it over time out of necessity. Hopefully, by sharing our experience, I can help you skip the muddling through process and keep your relationships strong right from the start.

TALKING TIME

Setting aside time to share how each of you is doing or discuss new thoughts and emotions is the most important. These conversations can take a lot of energy but they are the core of what will maintain your mutual understanding and support.

These conversations can be intense, draining, and difficult. Here are some ideas you can try that might make them easier:

Schedule a regular check-in time that includes self care strategies before and/or after (journaling, exercise, creative expression, time in nature, etc).
Have these talks in a safe and isolated environment such as the bedroom (ie pillow talk), the car, or when you’re out for a walk together.
Write down some notes in advance if you get easily emotionally overwhelmed and have difficulty expressing yourself or staying present in the conversation.
Request a conversation to give the other person some warning. If this is helpful but also makes them anxious with wondering what it’s about, you can use a shorthand to define the parameters – Is it a you thing, me thing, or us thing? What is the general topic? Is it a big thing, a medium thing, or a small thing?
Try NOT to think of these conversations as a one-off for any topic. It’s important that you have a chance to come back to anything you have discussed previously to delve deeper, clarify or adjust how you explained yourself or how you understood each other, or to have another opportunity to explore, express, or process the same emotions or situation.

ACTIVITY TIME

Spending time doing something that you mutually enjoy is also really important. This is a way to take a break from the gender based conversations and maintain your bond based on previous activities. You can choose activities that are not inherently gender based or dysphoria inducing or agree to not discuss gender based topics during the course of a particular activity or day.

These activities may need to be adjusted somewhat if they trigger dysphoria. Be self-aware and honest about this. Sacrificing your well-being and hiding your discomfort defeats the purpose of doing something you both enjoy to strengthen the relationship. Finding new ways to enjoy the things you bonded over will initially take a bit of effort, communication, and time, but the pay-off is well worth it.

EXPLORATION TIME

Maybe you are exploring your gender and need a sounding board, someone to go shopping with, or someone to be your safety buddy when trying out a new presentation in public for the first time. Maybe you have started hormones or are having surgery and your body and emotions are changing and your partner or close support person needs time to explore these changes with you so they can get used to them.

These moments of exploration can happen spontaneously or be part of a planned activity. They are particularly important for intimate relationships but are also helpful for other close relationships.

Some examples of this are when I would feel my husband’s facial hair as it grew in or ran my hands down his chest when he was wearing a binder or post top surgery to get used to the change, or when we took a vacation trip where we explored different names and pronouns for him.

The exploration time is mutually beneficial. It can help the transitioning person be more confident in exploring something new or doing something scary. It can also be euphoric for the transitioning person and help them see their partner/support person being curious and making the effort to adjust. And of course, it includes the partner/support person in the transition process, helps them adjust their mental image of the transitioning person, and adjust to new changes.

SHARING SPACE

Sometimes all you need is to be in the same space together. You can be doing completely different things and not talking to each other at all, but just feeling the other person’s presence can be a balm against the irritation, frustration, and exhaustion from interacting with the rest of the world and navigating transition.

Acknowledging each other’s presence in small ways helps strengthen the value of this time. Whether it’s staying within view, checking in with each other with a look, a touch, or a few words, or sharing some aspect of the space while you’re doing different things (ie listening to the same music or watching the same TV show), this helps turn two people doing separate activities into quality time.

I hope these descriptions of different types and purposes of together time help you be more purposeful and effective with maintaining strong relationships during transition or other big life changes.

If you have other suggestions for together time, please leave a comment below! I’d love to hear from you.

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Let’s Talk Gender S1E2: Transition Timelines

OVERVIEW

Transitioning is a slow, often frustrating, ongoing process. It can roughly be broken down into four phases: personal, social, medical, and legal. We discuss the general timeline of each phase and how they overlapped for Jake’s transition from female to male. At the end, Meaghan Ray shares what their transition has included so far.

SHOW NOTES

General Thoughts on Transitioning

Typical FTM trans narrative
- Binary transition from one to the other
- Medical system sees it as a treatment to change from one to the other
In reality, it’s a slow frustrating process
- No sudden tipping point or specific end point
Non-binary transition is even more vague
- Often have to fake a binary identity to get the medical care you need
- Wide variety of social, medical, and legal changes
Generally made up of four stages
- Personal transition: an exploration of your own identity
- Social transition: the coming out process
- Medical transition: any medical interventions that help ease dysphoria or increase gender euphoria (HRT, surgery, electrolysis, voice therapy)
- Legal transition: changing name and gender marker on legal documents and with various institutions
Stages can overlap or blend into each other
Trans people do not need to go through all of these stages in order to transition or be considered trans.

Jake’s transition process:

Personal Transition

Longest stage
Began in 2015 until late 2016
Self-questioning, self-doubt, internal conflict
Talking to friends, looking things up on youtube
Found a therapist that was trans friendly that was familiar with the referral process
- Referral to gender psychiatrist
Felt like the therapist and Meaghan Ray were much more convinced that it made sense and he would be going through with it than he was
Finally determined that he would be more comfortable living as a man
Personal exploration continues throughout transition
- Getting used to body changes
- Learning how to communicate your identity
- Learning how to navigate new social status and changes in privilege

Social Transition

Came out to parents with a message of ‘I’ve been thinking about this, I’m exploring this’
Different approaches to coming out
- Emails, letters, face to face
You realize how many people you have in your life
- Very overwhelming and exhausting
Started with the people who would be most likely to be supportive
- Didn’t always work out as planned but generally helped build support
We were hoping that some people we told would pass on the information to others but it never actually worked out
- Ended up having to tell them ourselves
Reactions
- Some people changed name and pronouns right away
- Some people needed to be told multiple times and are still misgendering Jake (in late 2019)

Medical Transition

Lots of gatekeepers
Gender psychologist – referral to gender psychiatrist in summer 2016
Gender psychiatrist in summer 2017 on a cancellation
- Referrals for endocrine and surgery consult
Family doctor who was willing to write prescriptions for HRT – started Testosterone in May 2017
- Turned out to be an easy process once he built up the courage to ask the affirming doctor
Top surgery consult in fall 2017, didn’t feel good about the two year wait or the type of surgery offered
Had top surgery done at a private clinic (paying out of pocket) in April 2018
Hysterectomy in October 2018
Potential for bottom surgery in future – would require another visit to gender psychiatrist to get referrals to surgery and separate referral for funding
Got most of the information about who is allowed to make referrals, who is willing to make referrals, who is accepting referrals, and what the wait times are through the trans community
- Connections to community are very important

Legal Transition

Different process in each province or local area
First item was a piece of paper stating that [previous legal name] is transitioning from F to M that officially explains why you don’t look like the picture on your ID
- Important during the stage when you’re already on hormones and presenting differently but haven’t yet changed any ID
Name and gender marker change document that requires fingerprinting
- Submitted in Aug 2017, received it in October 2017
Immediately got driver’s license changed
- Felt safer in general but now had conflicting documentation with national documents
So many different documents that needed changing
- SIN card
- Banking information, loans, mortgages, credit score
- Marriage certificate
- School records, work ID, email addresses
National documents were the hardest
- Birth certificate took the longest due to waiting for laws to change – finally done in summer 2018
Took over a year
- No international travel
- Lots of stress, confusion, frustration

Transition is never completely finished

Will always be people to come out to or correct, medical history to explain, and documents that pop up that don’t match

Meaghan Ray’s Process:

No medical or legal transition yet
Personal transition started with a genderqueer experience back in grade 10
- Ignored it, put it away until Jake’s transition provided more language, strategies, and community to give myself space to explore it
Tracked my gender and explored it for a bit
Have just started coming out to friends and family and coworkers one at a time, very carefully
- Limited understanding of what non-binary means so coming out requires a lot of educating
Will be an even longer, slower, more careful process than Jake’s
May be interested in some form of top surgery or legal gender marker or name change in the future

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New Year, New Goals

Happy New Year!

Though not specifically gender related, I thought I’d talk about my current goal setting process. This is something that has helped me maintain a sense of progress and control which is especially important during unpredictable fluctuations in my gender, frustrating stages of transition, or other stressful life events.

Step 1: WHAT is your goal?

During the second half of December and first half of January, I think about the different areas of my life that I want to set goals for. Mine are typically health, creative projects, and housework. I pick 1-3 goals per category but no more than five total. For example, last year in the health category I had a weight goal and a cardio goal. This year I have a general fitness goal.

Goals should always be something that is important to you, not something you think you should do. They should be something you can easily state in a few words and something that you will feel motivated to work on for a whole year. If there is something you are working towards that will be completed halfway through the year (a competition or event), think about what you might want to work on for the rest of the year once that is done (whether or not you achieve the result you wanted).

Step 2: WHY is the goal important?

For each of your goals, write down as many reasons you can think of as to why this goal is important to you. How will it enrich your life? Will it improve your mood, help you connect with someone, decrease your stress, give you a sense of purpose, help you achieve an even larger goal, decrease dysphoria, build community, or increase your energy level?

Take some time with this step. Be holistic. I usually have 3-5 per goal. The things you write in this section will keep you motivated to achieve your goal when it gets hard or get back on track if you get derailed.

Step 3: HOW will you achieve your goal?

This is where you come up with strategies to achieve your goal. Trying to achieve a goal through sheer willpower is ineffective and exhausting. When forming a new habit or trying to make steady progress towards a goal, there are internal and external factors that will make it harder. This is called friction. For example, not having your exercise clothes with you when you could go to the gym or having snack food around that you constantly have to resist in order to eat healthier.

The strategies you are looking for are ones that decrease the friction for you and make the goal easier and as automatic as possible to achieve. These should be as concrete and personalized as possible. They might take some trial and error to figure out but don’t take too long to settle into a routine.

One habit forming hack is to connect the new behaviour to something you’re already doing. If you have an established morning routine and you want to meditate ten minutes a day, get up ten minutes earlier and fit it into your morning routine. If you have a weekly planning routine, plan out which days you are going to exercise instead of leaving it to chance.

Another good strategy is accountability. Find a buddy to exercise with. Find a friend with a similar goal and set up a regular time to meet up and review both of your progress and help each other solve roadblocks. If you’re even more brave, you can post your goals on social media with regular updates.

And lastly, rewards. If you respond well to rewards, include these in your strategies. Try to find rewards that won’t make another goal harder to achieve – for example, rewarding yourself for completing ten workouts by going out for dinner when you’re trying to decrease spending or change your eating habits. The best rewards are ones that support the same goal – rewarding yourself for a fitness goal by getting new workout equipment, new workout clothes, or new headphones (again, not a good plan if you’re trying to decrease spending but you get the idea). Another option for rewards is to have someone else decide on rewards for you which they will provide when you achieve a milestone (adds some anticipation, randomization, and excitement). This is a nice combination of the rewards and accountability strategies.

Step 4: WHEN is your goal complete?

How will you know when you have achieved your goal? This is the stage where you decide how you will measure your progress and end point. Every goal is measurable, you just have to figure out how. Different types of goals can be measured in different ways.

A specific process or habit based goal can be measured by doing the habit a certain number of times per week. If you multiply this by 52 weeks in the year, you will get your goal for the whole year. Or you can keep it as a weekly target and measure it by how many weeks of the year you met the target. This also works for daily or monthly goals.

A more general process or habit based goal that doesn’t have a weekly target can be measured in percentages. You might have to set up a tracking system for various parts of the goal to do this. The one that I do this with is my housekeeping schedule. My goal is to ‘maintain a clean house’. Doesn’t seem measurable, right? I set up a cleaning schedule that includes some weekly tasks, some monthly tasks, and some seasonal tasks. I have a grid of 52 weeks for each weekly task, a grid of 12 for each monthly task, and so on. I colour in the corresponding square when I complete the task. I then calculate how many I completed out of how many I was expected to complete and multiply by 100 to get a percentage. In the ‘when’ section for this goal, I have determined three targets for weekly tasks and three for monthly tasks – a minimum, good, and awesome percentage as a benchmark.

For an outcome based goal you will likely already have a measurable end point in mind – finish a project, run a marathon, achieve a certain weight. The difficulty with these is that the target is so far away that it’s hard to tell if you’re making any progress. So you’ll have to break it down into smaller pieces. Set as many measurable milestones as makes sense for your goal. Attach a timeline to each of these milestones so that you know if you’re still on track to reach the outcome.

Step 5: REVIEW PERIOD

How often will you revisit your goals and review your progress? Waiting until the end of the year doesn’t give you the opportunity to adjust your effort, strategies, measurement, or expectations. For some goals I have a weekly tracker or a monthly tracker built in but I will be reviewing all my goals and assessing my progress quarterly. This is a nice frequency because it roughly matches up with the seasonal changes and isn’t too far apart to forget why it’s important or get too far off track if my strategies aren’t working.

You know that burst of motivation that you get at the beginning of the year when everyone is talking about goals? Revisiting your goals and assessing your progress a few times a year gives you another smaller burst of the same motivation.

What are your goal setting and planning strategies? Leave a comment below if you have something different that works for you! I’m always looking for new ways to set, maintain motivation, and achieve my goals.

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