Tag: Bodies

How to be a Trans Inclusive Health Care Professional

THIS IS IMPORTANT AND YOU CAN HELP!

Trans people experience a wide range of barriers to health care including overt discrimination, uninformed health care professionals, systemic discrimination, and personal biases. As a result, trans people frequently have negative experiences in health care settings and often avoid accessing health care services even when it is necessary. Ultimately, this leads to significant health disparity. This is compounded by having intersectional identities and experiences that also experience health care bias (fatness, racial minorities, disabilities, neurodivergence, sex workers, previous incarceration, current or past drug use, etc.)

Trans people have a significantly higher risk of suicide, especially youth. The single biggest protective factor against this increased risk is having supportive people in their life that respect their name and pronouns. That’s all it takes (though the more support the better of course).

So as a health care professional, what can you do to help? Here are some suggestions.

DON’T ASSUME

Don’t assume you know someone’s gender. Not based on their legal gender marker, their presentation, their body shape, their voice, their experiences, or the clinical service they are accessing. Trans men can be pregnant, birth, and body feed their children. Trans women can have a low voice. Nonbinary people come in all shapes, sizes, and presentations. Not every trans person is able to or cares to change their gender marker.

Don’t assume someone’s pronouns or the language they prefer based on their gender (or any of the other above information). People can use any pronoun regardless of their global gender identity. Pronoun preference can shift day to day, depending on context, or depending on the people they’re with. Other gendered terms are separate from pronouns. People can prefer seemingly conflicting terms (such as preferring Mx., sir, guy, sister, and Mom) and this is perfectly fine.

Don’t assume a trans person’s transition trajectory. Don’t assume every trans person wants to transition in any way, what components they will want to include in their transition, or what order or length of time they will take to access and engage with the options available to them. There are not only two pathways for transitioning. There is no set end point to transitioning. It is a highly variable and individual process that spans many many years if not the rest of their life.

So if you’re not supposed to assume any of these things, how do you find them out so you can interact respectfully and provide the appropriate care? You use neutral language for everyone (not just the people you suspect of being trans) until they specify or until you confirm by asking specific questions. Knowing what questions to ask and how to ask them in a specific and respectful way comes with practice. It is your choice whether you want to practice on your own time (via accessing formal training opportunities or informally interacting with trans people on a personal level) or over the course of your professional career.

RESPECT NAMES, PRONOUNS, AND GENDER IDENTITIES

You don’t have to understand every gender identity in order to respect them.

When you get someone’s name or pronouns wrong (which you will, we all slip up sometimes), correct yourself and move on. Do not apologize, especially not repeatedly or profusely. By apologizing, you are putting the focus on you and the mistake you made and forcing the trans person into the socially conventional role of either thanking you for the apology or excusing the original mistake, neither of which is acceptable.

Repeating what you said with the correct pronouns, name, or other language is necessary to cement the correct version in your brain. The more you de-emphasize the mistake and emphasize the correct version, the faster your brain will adapt and stop making mistakes in the first place.

If someone else corrects you, say ‘thank you’ (not ‘sorry’), repeat it correctly, and move on.

If people around you are making mistakes, make sure to correct them if you feel it is safe to do so. It is often easier to hear when other people make mistakes than when we do it ourselves. The more you correct someone else, the more you are emphasizing the correct version to yourself and others. You can correct others by interrupting them and stating the correct pronoun/name/language, by repeating what they said but using the correct pronoun/name/language, or by continuing on with the conversation, ensuring to use the correct pronoun/name/language with added emphasis.

This goes for documentation and patient records as well. Find a way to include preferred names, pronouns, and other important language in your patient demographics tracking system. Document using the patient’s preferred name and pronouns. If these don’t match their legal information, start with a note that states that you will be referring to [legal name] as [preferred name] and using [preferred pronouns] for the remainder of the patient’s chart. If you have to do this at the beginning of every chart note, then do it. It’s important.

IT IS YOUR JOB AS A PROFESSIONAL TO BE OR BECOME INFORMED

It is not your patient’s job to educate you on the basics of trans identities, trans health care, trans bodies, or how to respectfully interact with them.

It is your job to know what aspects of trans experiences and medical care relate to your scope of practice. If you are a medical doctor and do not understand that trans men do not need prostate exams and trans women do not need pap smears, you have a significant amount of learning to do to be considered a competent medical professional (for anyone, not just trans people).

‘I was never taught that in school’ is never a good reason not to know something. All regulated medical professions have an expectation of continued learning and keeping up with medical advances and new research. Would you prescribe someone the same medication now that you did twenty years ago even if it was no longer recommended and newer medications that are cheaper, more effective, and with fewer side effects had since been developed? No? Then don’t treat a trans person according to twenty year old ‘best practice’ guidelines. Those are no longer best practice. The world of trans care is changing rapidly. It is your job as a professional to stay up to date.

YOU DON’T NEED TO KNOW EVERYTHING TO BE A GOOD HEALTH CARE PROFESSIONAL

Even if you are doing your best to stay informed, there will be times when you’re not sure whether you’re missing something or whether their experiences as a trans person simply aren’t relevant. You don’t need to know everything. But…

You need to be willing to admit when you don’t know something.

You need to do the work to learn what you need to know when you identify a gap in your understanding or knowledge.

And you need to be able to find the information you need and assess whether the source is reputable, scientifically based, and whether it holds bias (hint: there is always some bias if it is a scientific source so it’s important to be aware of it).

TRUST THE PATIENT

Trans people’s experiences are incredibly nuanced, intersectional, and often very internal. You cannot judge what a trans person (or anyone, really) is struggling with internally by looking at them. Therefore, you cannot judge what care would be best without first understanding and accepting what they are telling you about their experiences, struggles, joys, and desires.

It is your patient’s job to be as honest with you as they think is safe and necessary in order access the care they need. Sometimes this involves misrepresenting their identity or hiding parts of their medical history. The more informed you are and the more respectful you are, the more likely your patient will trust you, the more honest they are likely to be with you, and the better the care you can provide.

Don’t question their lived experience because it is outside your area of experience or expectation. Trans people are not exaggerating when they describe the systemic barriers they face such as long wait times, repetitive updates and submissions of forms, lack of appropriate processes for changing legal documentation, etc. You can be shocked and disgusted that that is the way the system is but unless you have your own lived experience of navigating these barriers with a trans person and have found a way around or through them, you have no right to argue against them, suggest that they are doing something wrong, or simply haven’t tried hard enough.

TRANS PATIENTS ARE STILL PATIENTS

At the end of the day, trans patients are still patients. If you’re not sure how to proceed, draw on your clinical knowledge and treat the patient in front of you, not the trans patient you are assuming they are.

Don’t know whether the testosterone that a trans patient is taking may be relevant to the reason you are seeing them? Go back to the basics. What affects does testosterone have on a human body? What body systems might it affect? Are these relevant to your patient’s current concerns? You can follow a similar thought process for any component of trans experience or medical care.

If you think something might be relevant, explain your reasoning to the patient in terms they would understand and ask some clarifying questions. If you’re still not sure, make a note of it and move on to the next part of your assessment. Then, before you see the patient for their next visit, learn more about it.

As with any patient, consider the whole health of the patient, mental health included. If there is a component of their trans identity or trans specific medical care that you are worried is causing concern for other aspects of their health, consider ALL the consequences of interrupting that behaviour or medical care before making a recommendation.

Often, trans people have to compromise their physical health and wellbeing in order to protect or maintain their mental health and wellbeing enough to function in society. If you then suggest that they change their behaviour in order to protect or improve their physical health, that change could cause significant damage to their mental and emotional health (which is much harder to get help with and recover from). So, before making any recommendations, ensure that you understand the patient’s reasons for engaging in that behaviour or pursuing that avenue of medical care. You may not be seeing the big picture, or your version of the big picture might be different from your patient’s.

WHERE TO GO FROM HERE

I hope this has helped clarify a few things and point you in the right direction. Simply by reading this, you are already showing you are a better health professional to trans people than the majority. That is how low the bar is. Please help raise it.

Below you will find recommended resources. These are a place to start, not a sum total of what you need to know. If these links are outdated or broken, please let me know. I will try to keep it up to date. But again, if you are a health professional, you have the skills to find these resources on your own.

Beyond these links, how are you supposed to learn more about trans people (or other minority groups that differ from your experience)? Here are a few options:

  • Talk to a trusted friend or family member who is trans (or other minority) outside of a professional-patient relationship
  • Read descriptions of trans experiences written by trans people (such as this blog)
  • Attend a lecture or other learning opportunity presented by a trans person
  • Pay a trans person to provide education to you and your staff or assess your clinic/practice on the basis of trans inclusion

Reach out if you are struggling to find specific resources. If you are a trans person and would like to add suggestions to this post for how health professionals can be trans inclusive, please leave a comment!! The more experiences and voices the better.

REFERENCES AND RECOMMENDED RESOURCES

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Diastasis Recti, Body Image, and Gender

Postpartum recovery is typically portrayed as a rapid return to pre-pregnancy weight and shape. For many people, this is not an accurate representation. Many people never return to pre-pregnancy weight or shape. Some do but have to put in a lot of work to make that happen.

I have a short torso so when I was pregnant, I carried my baby out in front. I started showing early and was very round. I had many stretch marks from early on and still have them. At halfway through my pregnancy people were surprised I still had a while to go. I was asked many times if I was having twins.

At six months postpartum my belly had shrunk somewhat but I still looked about the same size as when I was halfway through my pregnancy. While I knew that the media portrays postpartum recovery inaccurately, this seemed particularly slow. So I tested myself for diastasis recti and found a 3-4 finger gap between my abdominals. This was soon after diagnosed by a physiotherapist.

I started doing specific core exercises and regained my core strength fairly quickly. But at just over nine months postpartum, I still look the same as I did halfway through my pregnancy. While out for a walk with my nine month old baby in the stroller, a stranger congratulated me on the second baby I have on the way.

Having a round, pregnant shaped belly is a difficult experience for me for a number of reasons.

  • No one should ever comment on another person’s body shape, size, or presentation without being invited to do so and yet pregnancy seems to be a socially accepted time to do this. Being perceived as pregnant invites these sorts of comments.
  • In most people’s minds, being seen as someone who is potentially pregnant puts me in the category of ‘female’ or ‘woman’ and negates any other aspects of my presentation that might suggest otherwise. I dealt with this while pregnant for the sake of having my child but was really looking forward to not dealing with this anymore. And here I am, still being perceived as pregnant.
  • While pregnant, having a large belly helped minimize my perception of the size of my chest by comparison. Now that I am no longer pregnant and would like to flatten the appearance of my chest, doing so would only accentuate the size of my belly.
  • In order to heal diastasis recti, I have to avoid slouching. Standing up straight makes my chest look and feel bigger, increasing my dysphoria for the sake of healing my abdominals.

I know that recovery from or healing of diastasis recti is slow and takes diligent work. Being constantly aware of my posture, movement, and muscle activation takes mental effort. Making myself do core exercises daily takes will power. I am trying but I’m not always successful on all fronts. And without noticeable change in my function or shape, it is hard to stay motivated.

In search of answers and community, I recently turned to the internet and social media. I found lots of good information but every single resource used female terms and pronouns throughout. Finding community and support for part of my experience that actively excluded and invalidated other parts was painful, exhausting, and overwhelming.

Here is yet another topic where gender neutral terminology would not exclude or invalidate anyone and yet at every opportunity professionals refer to ‘ladies’ and ‘mama’.

Throughout this whole internal struggle with post partum body image, I have tried to be aware of where my thoughts and feelings are coming from. I avoid and reframe any thoughts I have about my weight. I try not to judge my body in negative ways due it’s size or shape. However, I can’t escape how my shape triggers my dysphoria or interferes with my preferred strategies for managing my dysphoria. And I can’t ignore how others perceive me when they assume I am pregnant.

No two people recover from pregnancy the same way. Don’t make assumptions about other people’s bodies based on their shape, size, or function. Don’t make assumptions about other people based on their bodies. If you are a professional supporting a community, question your use of gendered language. Substitute gender neutral terms and use language referring to a specific experience wherever possible. If this is something you would like help with, please contact me.

Did you struggle with body image after pregnancy? Did you or do you currently have diastasis recti? Leave me a comment below! I’d love to hear from you.

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Trans Wisdom: Our Bodies Don’t Define Us

YOUR BODY DOESN’T DETERMINE YOUR GENDER. YOU DO.

Trans people learn very quickly that their body and all the assumptions that go along with it don’t define their gender. Whether the body they were born into feels wrong or not, their identity is separate.

If this is true for trans people, it is also true for cis people. Maybe you feel at home in your body and the gender you were assigned at birth. But is your experience of your gender based on your genitals? Is it solely made up of your secondary sex characteristics? Or is it more than that? Do you have an innate sense of being the gender you are? What aspects of your personality, behaviours, and presentation are related to your gender?

Once you learn how to think of your gender as more than various parts of your body, you also learn that you can choose how to express your gender. Do you wear the clothes you wear because they align with your gender and make you feel good or because it’s what society expects you to wear? Have you ever tried wearing clothes or jewelry that you think will make you uncomfortable? You never know! You might discover something you like even better than your original presentation.

YOUR BODY DOESN’T DETERMINE YOUR WORTH.

It goes beyond gender. Our bodies also don’t determine our worth. Regardless of your body type, ability, size, colour, or sex, we are all worthy of love and care. Society may not treat us that way, but we have to treat ourselves that way.

Trans people learn this throughout the difficult journey to self-acceptance. As we learn who we are and take steps to communicate it to others, we are faced with uncertainty, confusion, anger, fear, and even violence which are really easy to internalize. If we take steps to change our bodies to align more with our sense of who we are, we learn that though the change may alleviate some dysphoria and make it more comfortable to go about our daily lives, it does not automatically result in an increased sense of self-worth. This is something we have to consciously work on at every stage of our journey (and throughout life).

YOUR ABILITY TO REPRODUCE DOESN’T DEFINE YOUR GENDER.

The reproductive organs you possess and whether or not you are able to reproduce has no bearing on your gender. It may be a component of yourself and your experience that you choose to include as part of your gender identity but this does not mean that is true for everyone with a similar experience.

Trans men and nonbinary people who have uteruses can get pregnant and successfully birth a baby. Cis women who have had hysterectomies are no less women. Trans women who produce sperm are no less women. Cis men who do not produce sperm are no less men.

Your gender (and your worth) is not defined by the ways in which you can or cannot reproduce.

SOCIETY’S PERCEPTIONS DON’T HAVE TO BE YOUR PERCEPTIONS.

Trans people are assigned a gender by almost everyone they encounter. Often, this assumption is either entirely or partially incorrect. Having a trans identity is also perceived as wrong, unheard of, a burden, or inappropriately fascinating. It takes work to unlearn these perceptions and hold onto our own self-concept, even when we feel like no one else around us sees us for who we are.

Are you judged by society in a particular way because of an aspect of your body or appearance? How society perceives you does not have to dictate how you perceive yourself. It’s often hard to identify which perceptions we have internalized and constant work to fight against that perception internally but it is worth it.

SURGERY IS PART OF A PROCESS, NOT AN END GOAL.

Many trans people undergo one or more surgeries in their effort to align their body with their identity. Often, when they are looking forward to the upcoming surgery, they have the perception that once they have the surgery, everything will be better. They fall into a mode of waiting for the surgery and build high expectations of the positive impact of the results.

No matter what the surgery is, it is always a difficult experience. There is pain and healing. There are often activity restrictions and limitations, sometimes for months afterwards. Sometimes there are complications. And regardless of the outcome, it does not automatically change their self worth or self confidence. If they are lucky, there is a decrease in dysphoria but often, over time, the dysphoria will shift to another area of their body, or they will become more aware of the dysphoria once the other source has been relieved.

Trans people learn the hard way that surgery is part of the process, not an end goal. Whether you are undergoing surgery for cancer treatment, weight loss, pain relief, or transition, it is never the only component of the process and often isn’t even the component that makes the biggest difference. If there is something going on in your life that is big enough to require surgery, it is definitely big enough to have emotional components and other milestones that come before and after surgery. Try to keep it all in perspective while you work towards or recover from surgery. Don’t leave ‘the rest’, whatever that is, until after surgery. Work on everything else while you wait for surgery. You’ll be glad you did.

What are your experiences around how your body does or does not inform your gender or other aspects of your identity? What societal perceptions have you worked hard to unlearn? Leave a comment below with your story!

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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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How to Ask About Someone’s Gender

We always say that if you don’t know someone’s gender or pronouns, just ask. But how do you do that in a respectful way? As a stranger, we can use they/them pronouns and avoid gendered language for everyone we meet until they specify. But what if this is a new colleague or a friend of a friend? Or what if your partner or child just told you they are questioning their gender?

The closer you are to someone, the more impact your questions are going to have. You can ask questions to find out the basic information such as how they identify and what pronouns and name to use. Or you can ask deeper questions to get a better understanding of what their identity means to them, how they picture themself, and what their experience of gender is day to day. These deeper questions can help you form a more accurate mental image of the person as they see themself so that you are more likely to gender them correctly. They can also help the other person sort out some of their confusion around their gender (if need be).

THE BASICS

When asking questions about gender (or any other sensitive topic), I follow the principle of not asking any question I wouldn’t also be willing to answer. I also use the caveat that they never have to answer a question I ask, though I do appreciate knowing why they don’t want to answer so I avoid asking other questions that they don’t want to answer.

If you are ever uncomfortable about asking something, it’s a good bet the other person will have some discomfort in answering as well. Be honest about your discomfort but don’t let that stop you. Be aware of your surroundings and choose a place where both of you feel the most safe (likely a private space).

If you’re not sure how to phrase a question or what language to use, be honest about that too. Try to avoid saying ‘I don’t mean any disrespect, but…’. Instead, use a phrase like ‘I’m not sure how to word this question. Is it okay if I ask it anyway and you can tell me how I’m supposed to say it?’ Usually, there is a reason why a certain question is inappropriate. Either the word you chose is seen as offensive, how you used it was incorrect, or the subject matter isn’t appropriate to ask about. It is helpful if you can find out why the question was wrong so you avoid making the same mistake with other questions or in other circumstances.

Asking about basic information such as gender identity, pronouns, or name is pretty straightforward. Offer yours first, then ask. ‘Hi, I’m Wendy. I’m a cis woman and I use she/her pronouns. How do you identify and what pronouns do you use?’ Keep in mind that knowing how someone identifies isn’t usually necessary. Pronouns and name are enough to interact with them respectfully.

Always question yourself about why you want to know the information and what purpose it will serve for you. If you’re just curious, generally you should refrain from asking unless you have a close relationship with that person and you’re in a private space. But, if you feel that you do need to know more information, you’re going to need to know what questions to ask.

DEEPER QUESTIONS

As I said above, you can ask these more intense, specific, personal, and invasive questions to learn more about someone’s gender for your own understanding or to help them figure out their own gender. I have grouped these questions into categories to make it easier to follow. These are just examples – feel free to pick and choose from each list as needed rather than using every question. This list is by no means exhaustive.

Gender Identity

  • How do you identify with regards to gender at the moment?
  • Has your gender identity changed over time?
  • What labels do you use for your gender and how do you define them?
  • Does your gender always feel the same or does it fluctuate?
  • Does your gender influence your sexual orientation in any way?
  • Are you comfortable with your gender identity or is it a source of frustration?
  • Are you confident in your gender identity or do you still have some confusion?

Language

  • What pronouns feel best for you?
  • Do you always prefer those pronouns?
  • What name do you want me to use?
  • What other language feels best for you (guys, ladies, girl, ma’am, sir, bro, dude, etc)?
  • What familial terms feel best for you (sister/brother/sibling, son/daughter/child/offspring etc)?
  • Is there any way I can help you test out various names/pronouns/language?

Body Dysphoria and Euphoria

  • Are there parts of your body that feel wrong or bring discomfort?
  • Are there parts of your body that feel good?
  • How do you picture your body should look?
  • Do you do anything to make your body feel more authentic for yourself?
  • Do you do anything to modify how your body appears to others?
  • Are there specific ways you would like me to refer to or interact with certain parts of your body?
  • Is there any way I can help you test out various presentations?

Medical Transition

  • Are you planning to/have you already started hormones?
  • How do you feel about the idea of/changes from taking hormones?
  • Are there any challenges you are facing with accessing hormones?
  • Are you planning to/have you already have any gender affirming procedures/surgeries?
  • How do you feel about the idea of/changes from [procedure/surgery]?
  • Are there any challenges you are facing with getting [procedure/surgery] done?
  • Have you ever encountered transphobia in a medical setting?
  • Is there anything I can do to support you with accessing basic or trans-specific medical care?

Legal Transition

  • Are you planning to/have you already changed your legal name?
  • Are you planning to/have you already changed your gender marker?
  • What documents have you changed so far?
  • What institutions have you informed of this change?
  • What documents/institutions do you still need to change/inform?
  • Is there any way I can help you with making these changes or support you during this process?
  • If we are in a situation where I need to disclose your legal name/gender, what would you like me to say? (hospital, banking, insurance, police, etc)

Practical Concerns

  • Who are you out to?
  • How would you like me to refer to you around people you are out to?
  • How would you like me to refer to you around people you are not out to but who know you and who you also interact with?
  • How would you like me to refer to you around people you are not out to but who you have no interaction with?
  • Have you encountered any transphobia?
  • Is there anything I can do to provide support?
  • Is there anything I have been doing or saying that is uncomfortable? What would you like me to do/say instead?

I hope this list of suggested questions helps guide your discussions of gender with anyone you interact with. Remember to think about how you would answer these questions before asking them of someone else. These questions are designed to guide a discussion that would be a follow up to the basic learning I talked about in How to Be a Trans Ally so don’t forget to start there.

Let me know how your discussions about gender are going! Or, let me know if you have other questions that you have found helpful in your discussions and I will add them to the list above. Leave a comment on this post or send me an email! Looking forward to hearing from you.

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Let’s Talk Gender S2E7: Living in the World as a Nonbinary Person

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Hi everyone. Welcome back to Let’s Talk Gender.

This episode is about living in the world as a nonbinary person including what ‘passing’ means for nonbinary people, navigating public washrooms, going to the gym, and how a nonbinary perspective can influence how you interpret other aspects of society. 

PASSING AS NONBINARY

Passing typically refers to the idea of ‘blending in’ with one of the binary genders, or being consistently recognized as the gender you identify as (assuming it’s one of the binary options). In Western society, we are trained to categorize everyone as male or female as quickly as possible because we learn from a young age that this is a vital piece of information that we need in order to interact with people. Since ‘nonbinary’ isn’t a gender that people assign to strangers, passing doesn’t exist in the same way for nonbinary people. 

Some varieties of passing that might apply to nonbinary people are being read as female in one situation and male in the next, or causing confusion and hesitation when the cues they typically use to gender you are conflicting.

I have found that some of these cues are stronger than others. Voice is one of the strongest. Luckily it doesn’t come into play until you interact with someone but this can be very frustrating over the phone, radio, or at a drive through. Another strong one is whether you have a curved or flat chest. There is some variability to this one depending on body size and structure but a chest that is curved or rounded, as when pushed up by a bra, is, in my experience, exclusively read as female where a flatter chest does not signal male nearly as strongly. On the flip side, having facial hair strongly signifies male, especially if it is darker, thicker, and more widespread, whereas having no facial hair does not necessarily signify female. A slightly less strong cue is bone structure, particularly of the face, presence of an Adam’s apple, a person’s stature, and shoulder to hip ratio. And lastly, clothing and hairstyle can have a significant effect from farther away but are easily overridden by the other cues above. 

I don’t mean to list these as a way to trigger dysphoria in anyone. It’s more a way of expressing my frustration that society is so hung up on these aspects of how we look and present that they can completely hijack a stranger’s brain into categorizing us a certain way regardless of our efforts to flag our gender. 

I also think about the list of cues above as a guideline of how to mess with the gendering system in other people’s brains. If I avoid the cues that have a stronger effect in either direction by flattening my chest, speaking in the lower range of my voice, wearing clothes that look boxier, and keep my hair short, maybe I will have a stronger effect. Or for someone else, this may look like having facial hair, wearing more feminine clothes, and maybe even a padded bra or breast forms. 

Unfortunately, if you can’t be easily categorized into male or female, you tend to stand out and draw attention to yourself. Always feeling like you stand out just for being who you are can be exhausting and often we end up compromising our personal comfort in order to blend in, even if just temporarily. This can be for safety reasons or to have one day where we don’t get second glances, stares, and looks of confusion. Some days I’m able to reframe the double takes as a positive thing, that who I am is showing through and challenging their binary views of gender, but most of the time it just feels like unwanted negative attention. 

ASSUMED CIS

Passing is usually referred to in a way that makes it sound like trans people are attempting to hide i.e. be ‘stealth’, trying to trick cis people, or frames passing as the goal of transitioning. These perspectives can be very toxic to lots of people, but especially nonbinary people. 

Instead of using the term ‘passing’ to mean ‘being identified by stranges in alignment with my identity’, which doesn’t feel like it will ever apply to me, I prefer to use the term ‘assumed’. Most of the time, I am assumed to be female by strangers, acquaintances, co-workers, really anyone I’m not out to. There has been the occasional time when I was assumed male and got called sir. One of these times they ‘corrected’ themself and changed it to ma’am when I turned around and spoke. The other time I was so surprised, in a good way, that I couldn’t remember my breakfast order and my husband ordered for me while trying not to laugh at my deer-in-the-headlights reaction. 

Anyway, I much prefer the term ‘assumed’ to ‘passing’. Not only does it relate much more strongly to my experience as a nonbinary person, but it also assigns the action to the stranger rather than to me. This is also much more accurate to my experience. I am living my life, presenting and interacting however is most comfortable for me and it is the people around me who are assuming that I am a cis woman. 

PUBLIC GENDERED BATHROOMS

There are some specific situations where not blending in with either binary gender can make life a lot more difficult. Namely, public gendered bathrooms and gym changing rooms. Let’s start with bathrooms.

When it comes to using a binary gendered public washroom, I have a few different options. Choosing either binary gendered washroom comes with the psychological impact of having to misgender myself in order to use the bathroom. I can use the bathroom I’m guessing that most people are assuming is in alignment with my gender regardless of how I’m feeling (usually the women’s which is lucky because it has a lower safety risk). I can use the bathroom that most closely aligns with my gender at that time to minimize the psychological cost (but if this happens to be the male bathroom I am trading the psychological cost for a much higher safety risk). Or I can avoid going to the bathroom until I have access to a gender neutral, all-gender, or non-gendered washroom with the increased risk of getting a UTI if this becomes a regular occurrence. When I’m out, having a friend to go to the washroom with can help protect against the safety risk posed by strangers but it doesn’t take away the impact of having to misgender myself in order to use the bathroom. 

As you can see, none of these options is great. But it has led to me making note of every business I come across that has non-gendered washrooms. 

GOING TO THE GYM AND OTHER PHYSICAL ACTIVITY

Going to the gym includes a few different things I want to talk about. The first is the changeroom situation. This closely mirrors the things I talked about related to public washrooms but with a few extra points. We aren’t just using a stall at the gym, we’re actually getting changed, often in view of strangers. This can be terrifying for anyone who’s body doesn’t fit the gendered expectations associated with the space they’re in. Getting changed is also often a trigger of dysphoria for lots of trans and nonbinary people. So overall, this experience sucks. 

On the plus side, most change rooms include bathroom stalls or changing stalls. This added privacy can definitely help with the safety risk. There are also often family change rooms that are single use. I know it feels weird to use those as a single person (maybe this is one of the random benefits of being a parent as a nonbinary or trans person?). I’ve done it when my dysphoria was too bad to feel comfortable using the women’s change room (and there’s no way I look like I belong in the men’s). It feels like everyone is watching you and judging you for using the one family change room as a single person but I know it’s what I need to do sometimes so I change as fast as I can and try to ignore the feelings of guilt. 

Then there’s the working out part of going to the gym. Let’s ignore for a minute that there’s a global pandemic and lots of areas have gyms closed or many of us are choosing to work out at home instead. Some of this will still apply. 

Gyms often have at least one wall made of mirrors. This sucks for a lot of people with dysphoria. Though I have found that sometimes, if my dysphoria is mostly social in nature rather than physical, seeing my body do something strong and personal and gender-affirming can actually help mitigate dysphoria or increase euphoria. 

The physical activity involved in working out can have lots of positive effects on our bodies in terms of endorphins, health, mood, energy level, and a sense of control over our physical being that we often feel so at odds with. All of these things can help improve our resilience and resistance to the negative effects of dysphoria. Unfortunately, with the nature of lots of types of physical activity, we can’t use some of our dysphoria management strategies such as binding, tucking, or packing. And feeling parts of our body move around that we don’t feel should be there in the first place can make certain types of physical activity a strong trigger of dysphoria.

Luckily there are lots of different types of physical activity to choose from. And that’s the last part of going to the gym, or in this case, even working out at home, that I wanted to talk about. For me, different types of physical activity feel more or less affirming depending on how my gender feels at the time. Whether it’s social conditioning or something inherent in the types of movement and how they feel in my body, stretching, Pilates, and low impact or endurance cardio feel more feminine to me, kickboxing and Thai chi feel more neutral, and weight lifting and higher intensity cardio feel more masculine. I can choose the type of activity that feels most in alignment with my gender at the time or I can choose a type of activity that will temporarily make me feel a different aspect of my gender to increase my sense of balance. 

THE POWER OF A NONBINARY PERSPECTIVE

Discovering you are nonbinary starts with questioning the gender binary. But living as a nonbinary person and challenging the gender binary on a daily basis also gives you the skills and awareness to recognize other binary situations and systems that you are uniquely equipped to navigate in a new way. 

For example, we have the saying ‘there are two sides to every story’. But what about a third or fourth interpretation? What about recognizing that those two sides overlap? What if neither side is wholly correct or wholly incorrect? 

In divisive politics and crisis situations, there is often a rhetoric of ‘you are either for us or against us’ or there being a ‘right way’ and a ‘wrong way’ to react to a situation. A perspective derived from a nonbinary view of gender teaches us that there is lots of space for middle ground, other options, and nuance. 

And lastly, when it comes to emotions, we often struggle with so called ‘conflicting’ emotions – grief and gratitude, love and anger, excitement and frustration, relief and shame. We often express these emotions by saying something like ‘I’m so excited to get my new ID but it’s taking forever!’ or ‘I will really miss my grandmother but I’m glad she’s in a better place’. We use the word ‘but’ between concepts that feel like they conflict because the two can’t possibly exist in the same space at the same time. This would be equivalent to me describing my gender by saying ‘I’m female but I’m also male.’ Instead, what I say and what feels true for me is ‘I’m both female and male.’ Applying a nonbinary perspective to conflicting emotions teaches us that just because these emotions are different from each other does not mean they are in opposition, in conflict, or are mutually exclusive. Just as various experiences of gender can exist in the same person at the same time, so can various emotions. Try listening for the times when you use the word ‘but’ and switch it out for the word ‘and’. You might be surprised by how this little change in phrasing makes the experience you are describing feel more whole and valid. 

REACH OUT!

If you have other thoughts on how being nonbinary has influenced your perspective on the world or you’re struggling with the day to day experience of living as a nonbinary person, send me an email at letstalkgenderpodcast@gmail.com. I’d love to hear from you and help if I can, or connect you to other resources. You are not alone. 

That’s it for Episode 7 of Season 2 of Let’s Talk Gender.

The music for this podcast is by Jamie Price. You can find them at Must Be Tuesday or on iTunes.

Coming up in Episode 8 I will be talking about pregnancy and parenting as a nonbinary person including navigating the incredibly gendered world of fertility and pregnancy, the physical experience of being pregnant, and my thoughts as I look ahead to parenting.

Talk to you soon.

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Let’s Talk Gender S2E3: Nonbinary Gender Presentation and Expression

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Hi Everyone. Welcome back to Let’s Talk Gender. 

This episode is about nonbinary gender presentation and expression and how to figure out what works for you. 

EXPLORING MY GENDER PRESENTATION AND EXPRESSION

I think of presentation as things people would see in a picture – clothes, hair style, makeup, facial hair, accessories. Expression is everything else – behaviours, voice, how you walk, gesture, and move, conversation style, word choice.

As I was raised female and I am generally identified as a woman by strangers, I started by adopting a more masculine clothing style. I did this before I even knew it was a gender thing. This was a fairly low risk change in presentation because it is acceptable for women to dress more masculine in my social culture. However, the same is not true for someone who is typically identified as a man by strangers who wants to dress more femininely. For that person, a change in clothing might come much later in the process of exploring presentation and expression.

Body hair was another aspect of my appearance that I figured out fairly early on. I was never comfortable with shaving my legs and intermittently comfortable with shaving under my arms. So I followed my instincts with those, again, well before knowing it was even a gender thing. 

I have never had facial hair and haven’t experimented with it since I never felt like I wanted any though I have been thinking more about it lately and might try some experiments with makeup in the future. 

My hairstyle was next. I had always had longer hair but kept it tied back. I cut it shorter for cuts for cancer one year and loved it. I never went back to having full long hair but didn’t have the guts to keep it short either. Then the undercut style came into fashion which was prefect for me – the one time I actually wanted to follow along with a fashion trend! I slowly went from an undercut to a side cut, to just cutting the whole thing short. This was the single most euphoric thing I have done in terms of presentation. Even now, about two years later, every time I get a haircut it feels great. 

As someone who has breasts, I also wanted to try a binder. Having experienced my husband using a binder during his transition, I already knew that I would love how this looked and felt. Unfortunately due to a medical condition, I can’t wear it for very long or for more than two days in a row but this usually suits me fine as my gender fluctuates somewhat and usually doesn’t stay in the ‘male’ range for very long. I have since experimented with Trans Tape as well which definitely has a learning curve but on the third try I got a good result that I was comfortable with and will definitely keep it as an option in the future.

I have also experimented with wearing a small packer. This is something that was especially terrifying in public but I have come to realize that it is much more noticeable to me than to anyone else. So I mostly do it for the feel rather than the look. I find it particularly useful when I can’t wear my binder due to pain or length of time before I’ll have a chance to change, but I’m feeling more male and have moderate physical dysphoria. 

In terms of expression, I always naturally had a more neutral or masculine interaction style and didn’t have to work particularly hard to get rid of the more feminine mannerisms. However, I have noticed this to be more of a struggle for some nonbinary people, especially those who were socialized male. Often we are unaware of which of our mannerisms are being read as masculine or feminine by those around us until it is pointed out so if changing your expression is important to you, I recommend finding a trusted friend who is typically read by strangers the way you want to be read and have them give you feedback on your behvaiours, mannerisms, and conversation style. 

One aspect of expression I did specifically work on (and am still conscious of) is the pitch of my voice. As I’ve mentioned before on this podcast, when my husband’s voice lowered when he started taking testosterone, my voice sounded high in comparison. I worked at lowering the range of my voice and speaking in the lower part of my range until it became natural. Luckily I did have some singing training so I had lots of exercises that I knew how to do to strengthen or change the range of my voice. But if you don’t have this type of training you can definitely look up apps that will take you through these exercises.

I also became more conscious of how much I was apologizing and how often I would move over on a sidewalk or in a hallway, especially if a man was walking towards me and tried to avoid doing these things if they were unnecessary and simply a programmed reaction from being socialized female. 

THERE ARE NO RULES

The practical aspects of what you want to change about your gender presentation and expression and how you explore that are going to be different for everyone.

When I was looking for ideas of what to try that might feel good for me, I found Instagram to be very helpful. I followed nonbinary hashtags and found people to follow who had a look that I wanted to emulate. 

Remember there are no rules when it comes to nonbinary presentation and identity, despite what the media tells us. Nonbinary does not equal young, thin, white, assigned female at birth. Nonbinary presentation does not have to equal androgyny.

There is no such thing as ‘presenting as nonbinary’. Presentation and identity are two separate things. Do what feels right for you. 

HOW TO EXPLORE YOUR PRESENTATION AND EXPRESSION

But how do you figure out what feels right for you when the options are limitless? I’ll talk you through a step-by-step approach that we used during my husband’s transition and I used to experiment with some aspects for myself. 

Start by making a list of everything you can think of that you want to try. The questionnaire from Dara’s book that I talked about in Episode 2 helped me out with this a lot. Try to break it down as much as possible into small pieces. For example, say you want to try wearing nail polish. Clear nail polish is much more subtle than a brightly coloured one and black nail polish generally signals something different again. So if wearing a bright colour seems too scary or obvious, maybe add ‘wear clear nail polish’ to the list and start there. 

Next, make a hierarchical list of environments including a variety of places and the people you would be around from most safe to least safe or most scary for you. This can include at home by yourself, at home with your partner or family, at a trusted friend’s house, out in public with a trusted friend or your partner, at work, around extended family, etc. 

For each thing on the list, match it up with an environment that you would feel ok trying it in first off. Some of the more covert things might feel fine to do in public right from the start where some of the things on your list you might need to start by trying it in your most secure environment on the list. 

As you’ve probably guessed, the next step is to start trying things. Start with something that doesn’t feel too scary to you and slowly work your way through your list. 

First, I recommend trying each thing separately and later you can try combining parts of your presentation to see if that changes how you feel about a particular aspect. So for example, if you didn’t like wearing a skirt, that didn’t feel very good to you, later on, try wearing a skirt but with a more masculine top, or after you’ve cut your hair short, or while you have facial hair. Maybe the skirt will feel different in that context.

Once you’ve tried a few things in safe environments and figured out what you like, start trying them in the next environment down the list. 

This type of practical experimentation can feel exhilarating. It is scary but also euphoric. Sometimes it’s uncomfortable and exhausting. Whichever way each experiment goes, it is definitely emotionally draining. So make sure you have a good self-care strategy in place for before, during, or after if needed. This can be a phone call check in scheduled with a trusted friend, meditation or journaling about the experience, making yourself your favourite meal afterwards, whatever works for you. 

As you figure out what you like, what feels authentic, and what is comfortable even if it’s too scary to do in public just yet, keep adjusting and adding to your list. Start looking for interesting combinations to try or something you had rejected a long time ago, before even becoming aware of your gender identity. 

For me, this was trying on a dress for the first time since high school prom.

PERSONAL EXAMPLE: WEARING A DRESS

I had this dress in my closet that my sister had given me that I really liked.

I was expecting to feel very uncomfortable and dysphoric when I put it on so I collected a bunch of my more masculine jewelry and a leather bomber jacket to wear over top. I also made sure I was home alone and would have some personal time afterwards if I needed it. 

I brought everything to a room of the house that didn’t have any mirrors. And then I tried on the dress. At first it did feel uncomfortable. So I put on my jacket over top. That felt enough better that I wanted to take a picture of myself to see what I looked like. To my surprise and encouragement, I looked like my nonbinary self in a dress. I didn’t look like a woman I didn’t recognize. I had this irrational image in my mind that as soon as I put on the dress I would all of a sudden have long hair again, I would maybe have makeup on… Obviously, none of that happened. I still had short hair. I still looked like myself.

So I stepped out into the hall to see myself in a mirror. I spun in a circle and played with the skirt of the dress. I took off my jacket and looked at myself again. Yup, still nonbinary. 

While this experiment was a success in terms of turning out to be affirming and decreasing my fear of trying something, I still wouldn’t choose to wear a dress in public because of what it would signal to others. While I still saw myself and felt like my typical nonbinary self, it’s unlikely that strangers would when they read me as female when I’m wearing my most masculine clothes. 

But maybe, some day, I will feel comfortable going out in public wearing a long flowy skirt and a button up shirt with a binder or tape on and my leather bomber jacket on top. 

MANY REASONS FOR CHANGING YOUR PRESENTATION

There are lots of different reasons for presenting in different ways. Making yourself feel as comfortable in your own skin as possible is one of them. 

Safety is another one. Maybe it’s not safe for you to outwardly present in the way that would be most comfortable due to the threat of physical violence or the risk of losing your job, housing, or other forms of support and stability. In this case, you may choose to present in a way that blends in and find subtle or covert ways to present differently such as having your legs shaved or unshaved and wearing long pants most of the time, or wearing a more gender affirming style of underwear. Cutting or growing out your hair can also be less of a flag for people as it is much less tied to gender than many other aspects of presentation. 

Another reason to alter your presentation may be for social attention or visibility, or so we can be more easily identified as queer to others in the community. 

And sometimes we want to influence how people perceive us so they interact with us differently. I’ve noticed that people are less likely to interact with me in a feminine way or expect me to interact in a feminine way if I’m presenting more masculinely. This can help a lot with social dysphoria. I have definitely had days where I didn’t have a lot of physical dysphoria around my chest but I wanted to get people to interact with me as though I was male as much as possible so I wore a binder anyway. 

NONBINARY PRESENTATION IS LIMITLESS

Unfortunately, in the binary society we live in, strangers will always try to categorize us as either male or female. For this reason, there really isn’t such a thing as ‘passing’ as nonbinary. The closest thing I have seen would be making people confused or hesitate, or passing as male in one situation and female the next. 

Some people may find this inability to be recognized as who they are frustrating. Sometimes I do too. But I also find it liberating. If the goal isn’t to ‘pass’ as either male or female, you can do what you want. There are so many varieties of nonbinary presentations that I have seen. 

There’s something like me which is kind of androgynous, kind of masculine some days. I like wearing more fitted tank tops with more baggy bottoms, that type of thing.

There’s having a flat chest (either due to not having grown breasts, having had top surgery, or wearing a binder or tape) and wearing more feminine clothes and makeup.

There’s having a full beard (either due to having a body that naturally produces testosterone, taking testosterone as HRT, or wearing a fake beard or makeup) and then also wearing a dress at the same time.

You can present differently day to day or find something that is fairly consistent. 

You can take hormones to alter your presentation and expression in certain ways and then counteract some of the effects if they’re not for you such as wearing a binder or getting top surgery after taking estrogen or getting electrolysis to remove facial hair after taking testosterone. 

If you’re afraid of what a more permanent change might mean, look at both types of typical binary transition as well as nonbinary presentations. Maybe following a more typical binary transition will actually work for you. That doesn’t mean you are any less nonbinary (unless you decide for yourself that that label no longer fits). 

There are no rules. Don’t let anyone tell you differently. If you’re feeling lost, send me an email at letstalkgenderpodcast@gmail.com. I will try to help you connect with others that share your experiences or just be a sounding board if you need someone to listen. You are not alone. 

That’s it for Episode 3 of season 2 of Let’s talk gender. Among the resources for this episode are two blog posts I did on wearing a binder – the first one on physiological effects and the second on recommendations and exercises you can do to minimize these effects so check those out if you or someone you know wears a binder.

The music for this podcast is by Jamie Price. You can find them at Must Be Tuesday or on iTunes.

Coming up in Episode 4 I will be talking about how to navigate names, pronouns, and other language as a nonbinary person. As other nonbinary people will attest, there is way more gendered language out there than you realize! Talk to you soon.

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Third Trimester and Weird Pregnancy Symptoms

I’m so close to the end of pregnancy! And the very sudden transition to parenthood. That’s not terrifying at all.

THIRD TRIMESTER

Third trimester has been all about coping as best as I can and preparing for life ahead. I have continued to have pelvic and back pain what has slowly gotten worse. I have a lot of difficulty rolling over in bed, getting out of bed in the morning, and moving around first thing (including getting to the bathroom). On the plus side, all the stiffness and pain I had in my neck, upper back, and ribs has resolved due to the increase in relaxin. If I wake up with a stiff neck it is gone within a couple hours.

And stiff necks are common since I have to sleep on an incline in order to avoid heartburn. I have to eat smaller meals, drink lots of water, often have something creamy like milk or ice cream after a more acidic meal, and occasionally take tums in order to keep heartburn away. I know lots of people have worse cases of heartburn than this so in this regard I feel pretty lucky.

As it is currently mid August, I do struggle with overheating (which happens to make heartburn worse as well). Pain also increases my body temperature. And when I overheat, I get woozy, dehydrated, nauseous, and very fatigued. So staying cool is important. I have taken to wearing a damp headband hanging around my neck (like having a damp towel on the back of your neck but it doesn’t fall off) and hanging out in the basement or air conditioned spaces as much as I need to on hot days. As the area I was working in had no air conditioning and routinely got up to 26 degrees C, I ended up going off work a couple weeks earlier than planned.

Mostly, my body feels heavy and painful and every movement or activity takes twice as much effort. I’m still trying to enjoy the aspects of pregnancy that I can while I still get to experience them but more and more I am looking forward to the end of this phase (at which point I am able to start taking naproxen again!).

Other than the physical aspects of the third trimester, this part of my pregnancy has been characterized by looking ahead and preparing for what’s to come. This started with learning about labour and birth and moved on to learning about feeding, baby care, and postpartum experiences. I created a birth plan (descriptions of each stage of labour and reminders of what might be helpful to me during each phase) and a to-do list to prepare for labour and postpartum. My husband and I have used our planned time off in advance of baby to get as much of this list done as we can.

People call this ‘nesting’. I think of it more as responsible urgency. You never know when the baby will make their appearance so getting useful preparations done early makes sense. It’s not that I feel the need to clean the whole house and sterilize every surface. In fact, that was nowhere on the list and I likely won’t have time or energy for it. But I do want to have the nursery ready, some frozen meals prepared, and a hospital to-go bag packed in advance.

I will give you an update of how our postpartum experience compared to what I expect and whether these preparations were helpful once life with a little one feels manageable. And of course, whatever gendery things are going on during that phase as well.

WEIRD PREGNANCY SYMPTOMS

Most of these have nothing to do with gender but I wanted to share some of the more strange symptoms I have experienced that I hadn’t heard about until I asked if others had similar experiences.

I have way more freckles, moles, and other little dark spots than I did before. They are mostly on my chest, shoulders, upper back, and arms. I had lots of these before being pregnant but I have way more now. Will they go away afterwards? I guess we’ll find out!

In the last few weeks I have found my skin to be hypersensitive, especially with repeated stimuli like while having a shower. I can tolerate the water hitting me for 5-8 minutes but then it starts to feel like pins and needles. Stiffer clothes or anything with a label in it is extremely irritating. Even the waistband of my underwear can make my skin itch or sting.

The outside surface of my belly feels almost numb. I have lots of stretch marks which might be related but I figure if I started out with a certain number of nerve endings and then my surface area expanded, I likely have fewer nerves per area of skin. My husband can touch me on the belly and if I don’t see it I won’t even know. One of the more common symptoms is an itchy belly (which I also have sometimes). I wonder if this is due to stretching, muscles getting ready for labour, or my brain’s way of filling in the sensation that I’m missing from that area being mostly numb. Either way, it’s definitely weird.

And lastly, I have grown a thin layer of dark hair all over my belly, a little bit on my chest, and I have long thick peach fuzz below my ears and down my neck and jaw a bit. While most people who are pregnant are disappointed, embarrassed, or weirded out by this, I love it. Unless I take testosterone in the future, this is likely the only time I will have belly, chest, and (kind of) facial hair. Unfortunately, people have said it goes away soon after pregnancy is done. This is one pregnancy symptom I wouldn’t mind keeping.

Are there any other weird pregnancy symptoms you’ve heard of or experienced? Did they interact with your gender at all? Leave a comment below and share your experiences!

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Why Using AMAB and AFAB is Problematic

I have used AMAB (assigned male at birth) and AFAB (assigned female at birth) many times since I started this blog. But I recently heard an argument against using these terms that I think is worth sharing.

Though the terminology of ‘assigned at birth’ is better than ‘biological sex’ or simply ‘sex’, it doesn’t change the fact that these are still broad categories based on sex-at-birth characteristics. I often use these terms as a general reference to ‘people who grew up being read as female due to an estrogen-based puberty’ and ‘people who grew up being read as male due to a testosterone-based puberty’. But this still makes the assumption that someone’s sex assigned at birth will determine the type of puberty they have, the characteristics and functions of their body, how they are socialized, and how they are read by society. Boiling all of that down to someones’s sex assignment is limiting, unhelpfully broad, and extremely exclusionary to intersex people.

I am trying to replace my use of these terms with more specific references. Here are some examples.

  • People who were raised female/male
  • People who menstruate/don’t menstruate
  • People with uteruses and/or vaginas
  • People who produce sperm
  • People with penises
  • People who lactate
  • People with facial hair
  • People with dysphoria due to a rounded chest
  • People who are assumed to be female/male
  • People with a low voice (bass/baritone range)
  • People with a high voice (soprano range)
  • People who are trying to masculinize their appearance/presentation
  • People who are trying to feminize their appearance/presentation

In almost any instance where I would normally use the shorthand of AFAB or AMAB there is a better phrase that is more specific to the context that I am referring to and therefore the people who might share this experience. It may use more words to say it but it ends up being more inclusive, more specific, and much more easily understood by a wider range of people.

Using more descriptive phrases relates our gender to our experiences, not to our sex assignment at birth or the gender that society assigns to our body. You avoid the constant reminder that society got it wrong (and often continues to get it wrong). Many people who would be turned off by that reminder would have no problem engaging in discussion when they are referred to using one of the alternative phrases above.

These descriptive phrases are also more inclusive of nonbinary people who may not share all the same desires, types of dysphoria, and presentation preferences as binary trans folks. If referring to AMAB trans people with the assumption that they share the experience of attempting to feminize their appearance in various ways, this could be frustrating and exclusionary of intersex and nonbinary people.

So next time you go to use the acronym AMAB or AFAB, try replacing it with a more specific and descriptive phrase. I know I will. Since I started trying to do this, there haven’t been any instances where I felt like the acronyms worked better.

What is your experience with these acronyms? Do they rub you the wrong way or not bother you at all? Leave a comment below and share your thoughts!

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Staying Positive

The last few weeks of pregnancy are hard no matter what your experience is. You want it to be over but you’re nervous about the birthing process and having to care for the little being on the outside. It’s easy to get overwhelmed by frustration, discomfort, and anxiety, especially when dysphoria is thrown into the mix. So I’ve been asking myself a couple questions to keep myself focused on the positive and excited for the future. The answers to these questions will be different for everyone. Here are a few of my responses.

What am I going to miss about being pregnant (that I want to be fully present for while it’s still happening)?

  • Feeling the baby move
  • Feeling baby hiccups
  • Having a strong, visceral, automatic bond with this being
  • Being able to keep the baby fed, clean, and protected with my body
  • The extra fuzz around my face and hair on my belly and chest
  • The tenting effect of a shirt stretched out over my belly that hides my chest
    • Also my chest feeling smaller in comparison to my much larger belly

What am I looking forward to once I’m not pregnant (not related to the baby because who knows what that will be like, just for myself)?

  • Wearing my wedding ring
  • Sleeping in any position
  • Less pain, allowing me to walk without a cane or walker
    • Especially going for walks in nature with my husband and dog
  • Wearing my favourite clothes, especially underwear
  • Wearing a binder (eventually)
  • No more heartburn!

The other way to stay positive that works well for me is having a few key phrases that help me stay engaged and motivated despite constantly feeling uncomfortable. Again, these are very individual. What is helpful to me may not be to someone else but here are a few of the ones I’ve been using.

  • I am nonbinary, therefore my body is nonbinary, therefore my experience of pregnancy, birthing, and parenting is a nonbinary experience.
  • Stay cool and hydrated.
  • Rest when you need to but don’t give up on getting things done. Try again later or find a different way to do it.
  • Give the pets lots of attention and enjoy their cuddles.
  • Take it one day, one week at a time.
  • Every move the baby makes, no matter how uncomfortable, heavy, or nauseating, is a sign that they’re doing well.
  • Your body is capable of amazing things. Listen to what it’s telling you and believe in the wisdom it holds.

I hope this focus on positivity, excitement, and empowerment helps you find ways to strengthen those emotions for yourself as well. Hang in there. The world is a crazy place whether there are big changes in your near future or not.

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