Tag: Dysphoria

Reflections on Top Surgery, Part 2: Surgery

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

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

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

Last Minute Researching

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

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

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

Arriving In Toronto

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

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

Pre-op Appointment

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

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

Day Of Surgery

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

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

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

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

First Couple Post-op Days

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

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

Post-op Reveal

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

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

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

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

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

Up Next

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

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Reflections on Top Surgery, Part 1 : Pre-surgery

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

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

Deciding to pursue surgery

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

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

Applying for funding

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

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

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

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

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

Research while waiting

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

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

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

Private surgeon consultation

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

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

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

Preparing for surgery

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

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

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

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

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

Things I wish I had done differently to prepare

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

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

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

Up next

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

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Gender in Isolation

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

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

HELPFUL ASPECTS OF ISOLATION

Separating Physical and Social Dysphoria Triggers

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

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

Decreased Social Dysphoria

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

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

Space to Experiment in Safety

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

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

DIFFICULT ASPECTS OF ISOLATION

Testing Public Reactions

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

Coming Out and Reinforcing the Change

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

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

Separation from Queer and Trans Support

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

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

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Childhood Influences on Parenting Experiences

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

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

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

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

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

HOW MY PARENTS GENDERED ME

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

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

RAISING ‘BOYS’

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

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

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

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

MOVING FORWARD

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

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

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

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When Caring for your Child Triggers Dysphoria

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

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

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

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

BE HONEST

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

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

ASK FOR HELP

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

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

FIND OTHER BONDING TIME

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

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

ADJUST YOUR CHILD CARE STRATEGY

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

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

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

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

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

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Feeding My Baby as a Nonbinary Person

PLANNING

When I was pregnant and looking ahead to having a newborn, it was very hard for me to tell how I would feel about nursing. I have dysphoria around my chest that fluctuates and when I read information on or listened to people talk about ‘breastfeeding’, my dysphoria would get worse. I didn’t always know if that was because I was feeling more masculine at the time I was absorbing the information, because the language used was dysphoria inducing, or because the act itself would cause dysphoria.

So we planned for all options. I learned what I could about nursing (which turned out to be just the basics because it would inevitably make my dysphoria worse). We purchased a set of bottles, nipples, a sterilizer, and formula. And I looked up information on pumping and bought a basic manual pump to try. No matter how I felt about nursing or how our baby did with it, we had a way to feed them.

NURSING

The first time I tried nursing was nothing special. There was no feeling of euphoria or ecstasy, no overwhelming feeling of connection with my baby. But it went well and within the first few days both of us had figured out the mechanics. During this initial phase, it was all about learning a new skill and as long as I focused on that, the dysphoria was secondary.

By the fourth day we had pretty much gotten the hang of it but my baby was still looking a bit jaundiced and was showing signs of dehydration. It turned out that although my milk was coming in, my let-down was nearly non-existent. My midwives explained that this is common after receiving an epidural. So they showed me how to hand express during nursing to increase the flow.

This worked well and my baby quickly improved. However, hand expression meant I had to be constantly engaged with my chest during nursing every few hours. My let down didn’t seem to improve a whole lot and after a week of doing this my dysphoria had increased to the point where I needed to keep myself, and therefore the baby, covered during feeding. I would express by feel and be able to watch tv as a distraction without the view of my chest in my peripheral vision.

The juxtaposition of the baby that I had a lot of love and connection to and my chest that I was increasingly uncomfortable with was very emotionally taxing. But due to the intense fatigue that comes from recovering from a four day labour and sleep deprivation from having a newborn that needs feeding every 2-3 hours, I was in survival mode and didn’t recognize how emotionally drained this experience of nursing was making me.

In addition, nursing sessions were lasting longer and longer, often an hour or more. According to everything I had read and been told, once my milk came in and the baby learned how to suck and swallow efficiently, nursing would get faster and faster, eventually down to about twenty minutes. I didn’t know why this wasn’t the case for us but I knew it likely wasn’t good. Not to mention the longer sessions were increasing my dysphoria significantly faster.

At our two week follow up with the midwife we found out that the baby wasn’t gaining weight like they should. Despite all the physical and emotional energy I had been putting into nursing, it wasn’t working. Without warning, I broke down into tears. I felt like we had been doing well. The midwife explained that between the baby’s lower body weight and the long nursing sessions, it sounded like I didn’t have enough milk supply. The baby was burning more calories than they were getting. So we decided to start supplementing with formula.

BOTTLE FEEDING

The plan was to nurse at each feeding time for 15-20 minutes per side, then offer formula in a bottle until the baby decided they were full. We discussed other supplementing options like a supplemental nursing system or SNS but since we already had bottles and it would mean that my husband would get a chance to be involved in feeding (which he was excited to try) we decided bottles were the way to go. Besides, an SNS would likely only increase my dysphoria further.

Luckily our baby took to bottle feeding very easily. Maybe it was because it was a clear source of the nutrition they had been struggling to get from me but without all the effort. My husband did the first bottle feeding session using a paced feeding technique. At the second meal, I tried it. The emotional experience of feeding my baby from a bottle as compared to nursing was significant.

I was able to stay engaged, watching my baby figure out how to coordinate sucking, swallowing, and breathing. I could enjoy the cuddles without experiencing dysphoria at the same time. Since both my husband and I were feeding the baby this way, it was a completely gender neutral or gender irrelevant experience. It was lovely.

Once I discovered how much better feeding my baby from a bottle was, I was reluctant to keep nursing. But I wanted to feed my body as much human milk as I could because of the health benefits and the ease of digestion for their still developing gut. So in order to keep increasing my supply without nursing, I had to start pumping.

PUMPING

I started using the manual pump I had purchased while pregnant. It was fairly easy to figure out. I still didn’t have much let-down due to low supply and therefore had to continue to hand express while pumping which meant the dysphoria was just as bad with pumping as with nursing, but it wasn’t competing or overshadowing the positive emotions I had for the baby. I could experience my love and bond with my baby separately.

I also had a feeling of altruism because I was doing the hard work of extracting the milk so my baby didn’t have to. Unfortunately, pumping 4-6 times per day with a manual pump while hand expressing takes a toll on your hands pretty quickly. My hands started getting too sore to express and too sore to pump more than 3 times a day. So I had to be satisfied with whatever milk I got from those sessions (one eighth to one fifth of what my baby was eating) and say that it was better than nothing.

Luckily, my midwives were connected with a publicly funded, trans inclusive lactation clinic in my area and put in a referral.

LACTATION SUPPORT

As soon as we discovered that I had low supply, I started taking supplements to help increase my supply slowly. I was reluctant to take the stronger, recommended medication in case it increased my supply more than I could handle in terms of dysphoria. I really disliked the few times I experienced the feeling of being engorged while my milk was first coming in. The supplements or the pumping seemed to be working because my supply was increasing. By the time the initial visit with the lactation consultant came up, I was consistently producing a fifth to a quarter of what my baby was eating.

Despite knowing that the lactation clinic was trans inclusive, I had significant anxiety and dysphoria leading up to the initial appointment. But they turned out to be great. The intake form that I filled out online in advance didn’t ask explicitly about identity and pronouns but it used inclusive language for the most part and had a fill-in-the-blank box at the end where we could put anything else we thought would be relevant.

They clarified my pronouns right off the bat and asked about my goals. They made it clear that their role was to support me in achieving whatever goals I had, whether it was to increase supply, maintain current levels, or stop lactation altogether. They were understanding and respectful of my experience of dysphoria and my need to balance that with the desire to feed my baby as much using my milk as possible.

Ultimately, I started taking the standard medication to increase supply and rented a hospital grade, double electric pump. I was nervous about how this style of pump would feel and it definitely took some getting used to but it allowed me to set it and forget it while still getting as much milk as possible. I adapted a sports bra to hold the flanges in place and was able to watch tv or play on my phone while pumping. Best of all, I didn’t have to wear out my hands to get milk. Sure, the altruism factor related to the hard work was less but being able to stay covered up and ignore it was great.

WHERE WE ARE NOW

Now, at three months postpartum, I am producing three quarters to 100% of what my baby eats. We have noticed a big improvement in our baby’s amount of gas and therefore their ability to sleep through the night. Even that, without any other benefit, is enough encouragement to keep me going. I am still taking the medication and my supply is still increasing slowly but with minimal feelings of engorgement and only pumping three times per day.

My plan is to continue what I’m doing for another three months. I will stop taking the medication after about eight weeks on it or once my supply is to the level I want, whichever comes first. Once my baby is six months old and starts eating solids, the lactation clinic will help me decrease and ultimately stop lactation.

I am happy with how this journey has turned out, despite the struggle at the beginning. I have had phenomenal support from my midwives, the lactation clinic, and especially my husband. Regardless, I am definitely looking forward to the day when I can wear my binder again.

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When Your Name or Pronouns Fluctuate

Many people that have a fluid gender identity use different names and/or pronouns at different times. Figuring out how to make this work for you can be a challenge, and then following through and making it happen is even harder.

I’m still learning how to do this but I thought I’d share what I’ve learned so far.

KNOW YOURSELF

The first step to knowing what pronouns or name you prefer at a given time or in a given context is to figure out how your gender fluctuates. I did this by tracking my gender daily on a scale of 5 female to 0 neutral to 5 male for the span of a month and a half. You can make up whatever scale works for you.

I also made note of my other activities, habits, emotional state, and menstrual cycle. Correlating the shifts in my gender with these other factors gave me a much better sense of what influenced my gender and how the shifts in my gender influenced my mood and behaviour.

Tracking my gender daily forced me to check in with myself. I learned what to pay attention to within myself to indicate where my gender was sitting and what strategies would be useful to minimize dysphoria and maximize euphoria. This is a hugely important skill for anyone who’s gender fluctuates. Even now, a couple years after the gender tracking that I did, I am much more in tune with where my gender is sitting, when dysphoria is affecting me, and what I can do about it.

Once you know how much your gender fluctuates and what influences it, you can have a better idea of when you’d be more comfortable with one name or pronoun over another. This still takes real world testing to be sure. So finding an online community who will refer to you however you wish on a given day (or a platform that allows you to change your username at each log in) or an in person group of at least two friends who will help you trial names and pronouns.

Now you know how your gender fluctuates and what name and pronoun you want people to use with each state of your gender. Next you have to decide how to find a balance between the different states of your gender and how to go about asking other to refer to you.

STRUCTURED APPROACH

My gender doesn’t fluctuate a whole lot and usually sits close to an equal balance between my male and female components. So I’m almost always most comfortable with they/them pronouns. But in my case, I don’t have a single name that is gender neutral, I have one name for my female side and a different name for my male side.

My job is such that it doesn’t feel feasible to have people refer to me by anything other than my female name and she/her pronouns. So in order to find an overall balance, I decided to use my male name and they/them pronouns almost exclusively in queer spaces.

Maybe you have a supportive work environment but you’re not out to your family yet. You may chose to use your ‘trans’ identity at work because you are always referred to by the name and pronouns you were assigned at birth when you’re at home.

Whatever the case, if there is one area of your life where you feel restricted in your ability to come out or advocate for yourself, this approach may be the best option to still allow you a sense of balance and a chance to experience all aspects of your identity.

GO WITH THE FLOW APPROACH

For some people, their gender fluctuates too often or on too wide a spectrum for the structured approach to feel comfortable. So the other option, if your life circumstances allow, is to go with the flow. This means that however you feel at a given moment, you indicate or request to be referred to by the corresponding name and pronouns.

This approach give you a lot more flexibility and perhaps a stronger sense of authenticity but it requires more clear signaling and more frequent self-advocacy.

GLOBAL APPROACH

Another option is to find a middle ground of where the different components of your gender overlap and use that as your default with the option to request a different name or pronoun if needed.

Or perhaps your gender is in one state the majority of the time and only occasionally fluctuates to a different state. You could use the most common state as your default and only specify when it differs.

Or, like me, perhaps you have a way to refer to yourself that encompasses your entire identity. I am 100% of the time comfortable with they/them pronouns and prefer to be referred to by both my names as though they are hyphenated. I can still specify differently if I need to but this gives me a lot of safety and authenticity.

Whichever system works for you, or if you come up with a completely different one, you will need a way to indicate or express to others how you wish to be referred to.

SIGNALING

One way to indicate to others which name and pronoun to use is via non-verbal indicators or signals. This can be anything from clothing to jewelry to behaviours to pins or name tags.

If you feel most comfortable presenting in a distinct way with each different state of your gender, you can use your general presentation to indicate to others how they should refer to you. This will still take a bit of explanation initially and maybe a few reminders but, in general, would be pretty straighforward.

If you present fairly similarly regardless of your gender or your presentation doesn’t relate to your gender in that way at all, you can use other means to signal your gender. I have a necklace that has Meaghan on one side and Ray on the other. Most of the time I wear it inside my shirt but if I’m in an environment where it is safe to do so, I will wear it outside my shirt with the Ray side facing out as a reminder to others of how to refer to me. You can do something similar with a bracelet, name tag, pronoun or name pin, or more subtle means such as a certain piece of jewelry indicating a certain name/pronoun combo.

Keep in mind that the more subtle the signal is, the more explanation and reminders it will take for people around you to pick up on it and get it right. But if you’re in a potentially unsafe environment, subtle might be necessary for safety.

ADVOCATING

No matter what signals (if any) you choose to use, you will always have to have some sort of conversation with those around you to explain that your gender fluctuates and you wish to be referred to by a different name and/or pronoun depending on the situation or the day and how they will know which one to use. This initial coming out conversation is difficult for any trans person but especially for those with a fluid gender that doesn’t fit binary notions of gender. See Related Posts at the bottom of the page for ideas on how to have this conversation.

As with any trans person, you will also have to correct people when they get your name and/or pronouns wrong. When your gender fluctuates and the name/pronoun you use changes, it takes even longer for those around you to get used to it and inevitably causes even more slip-ups. So decide how often you want to correct people and how best to do it. This will likely depend on your relationship with that person and the context you’re in at the time.

One good practice to get into the habit of is introducing yourself using your name and pronouns every time you meet someone. Not just someone new, even people who know you and already understand your gender. Something like ‘Hi [friend], I’m Ray and using they/them pronouns today’ works well.

Also let the friends and family you interact with regularly and who you’re out to that if you forget to inform them of your name and pronoun at the beginning of an interaction, it is helpful for them to ask about it or cue you to indicate if it isn’t clear from your signaling. How they ask is up to you and again, will likely depend on your relationship with them and the context.

Sometimes, all it takes is having one ally in the room who you have informed ahead of time what name and pronoun to use. Their role is to find an opportunity to refer to you using that name and pronoun within the first minute of you arriving and as often as necessary throughout the event.

IMPORTANCE OF GLOBAL IDENTITY

When you have a fluid gender identity with multiple components it can be easy to get caught up in the parts and forget about the whole. For me, it important to take a step back to make sure I am achieving an overall balance that works for me, even if I can’t get people to refer to me the way I’d prefer in every situation.

The goal of all this work and advocacy is to be able to experience and be comfortable with all parts or aspects of your gender. To get to express yourself in the most authentic way no matter what your gender is. So try not to get caught up too much in the details of every interaction and instead aim for an overall more authentic and gender-filled existence.

I hope this helps give you some ideas of how to navigate the world when your gender and therefore name and/or pronouns fluctuate. Comment with your own experiences, send me an email, or reach out on social media. You can find me on instagram @meaghan.ray.peters.

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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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How to be a Trans Ally

ALLYSHIP 101

Being an ally for any minority takes more than being accepting of a friend or acquaintance from that identity. Not being a biggot is not the same thing as being an ally. Being an ally isn’t a perspective, a state of mind, or even a level of understanding. It requires ongoing action that at first can be a challenge but eventually becomes automatic.

As someone who is part of a majority group, it is not for you to say that you are an ally. If you take actions that show to members of the minority group that you are safe to be around, understanding, supportive, affirming, and uplifting, they will label you as an ally.

Being an ally takes work, requires an open mind, and most of all, a willingness to feel uncomfortable. At some point, someone from a minority group will tell you that what you’re doing isn’t helping or may actually be causing more harm than good. Being an ally means listening to this perspective, asking questions to understand it further and what you can do differently, then acting on what you’ve learned.

Being an ally for one minority does not mean you are an ally for all minorities or even all the identities encompassed by that minority. Being an ally at one time does not guarantee you are an ally forever or in all circumstances.

But don’t let this discourage you! We need more allies!! Below are a number of ideas for what it means to be an ally to trans people. Please leave a comment below or get in touch with me if you have questions or other things to add to this list!

PRONOUNS

Put your pronouns in your email signature, your social media profiles, your video chat name, and on name tags. As a cis person, you likely have never had your pronouns questioned, never felt uncomfortable with the pronoun people assume you use, and never had to justify your use of that pronoun. Trans people have to do this every day or deal with the discomfort of being misgendered. So please, normalize the expression of pronouns by including yours.

Along the same lines, when you are introducing yourself to someone (anyone, not just someone you guess or know to be trans), introduce yourself with your pronouns. “Hi, my name is _____ and I use ______ pronouns.” You may get some funny looks or confusion from cis people who are not trans aware and you may feel awkward the first few times but just like anything else, it gets easier with practice. If you give up the first time it is uncomfortable, you really aren’t understanding how uncomfortable, scary, and often painful it is for trans people to be in a similar situation. And they don’t have the choice to just walk away, pretend it doesn’t exist, or avoid the discomfort.

Learn how to use a variety of pronouns. No, she/her and he/him are not the only singular pronouns out there. They/them is fairly common. There are also neopronouns such as per, xir or zir, and aer. Learn how these pronouns sound, how to use them in a sentence, how to switch between different pronouns, how to use pronouns that seem counter to your perception of someone’s gender, and how to avoid using pronouns altogether. Often, in English anyway, it is easy enough to rearrange a sentence to remove pronouns or substitute the person’s name.

KNOWLEDGE

Understand what it means to be trans. Understand the difference between sex, gender, sexual orientation, and gender presentation. Learn about some of the various identities that fall under the trans umbrella. Learn about the different steps someone might take to transition. You don’t need to know all the ins and outs of all the medical procedures or medication options (unless you are a healthcare worker and this is relevant to your field) but a general understanding is required.

Understand some of the challenges faced by the trans community in your area. This may be systemic barriers such as access to medications and medical procedures, cost of changing ID, wait times for medical procedures and documentation changes, lack of inclusive forms at medical clinics, banks, and workplaces, and difficulty accessing employment and housing. Or it could be interpersonal barriers due to transphobia that increase the risk of physical and emotional harm. Or personal challenges such as dysphoria, lack of social support, or struggles with mental health or addictions.

Some of this knowledge can be gained through online resources (such as this blog) but you will also have to engage with your local trans support networks and advocacy organizations. You may be tempted to simply ask your trans friend a slew of questions to learn about all these things. DO NOT do this. Trans people have to educate almost everyone they come in contact with. As an ally, you do not want to be another one of those people. If you have looked up everything you can online and joined the mail lists of your local organizations to learn more and still have some specific or personal questions to clarify a couple things, ask your friend if it’s okay with them if you ask them and when a good time would be. They are not obligated to answer. If you see this refusal as a lack of their friendship you really don’t understand what it means to be trans.

CHECK YOUR ASSUMPTIONS

Avoid making assumptions about someone’s gender based on their sex, presentation, physical characteristics, or mannerisms. Keep your language neutral by referring to everyone using they/them pronouns and neutral language until they have disclosed their gender to you. Yes, everyone. Not just people who fall outside the ‘norm’ of gender presentation or someone you think might be trans. You can’t tell someone’s gender from the outside. Being an ally means creating a safe place for trans people that you haven’t met yet. The only way to do that is to consider that anyone could be trans and act accordingly.

Once you learn someone’s gender, don’t make an assumption about what pronouns they use, what steps they have taken or plan to take in terms of transitioning, or what their experiences are with dysphoria. Every trans person’s identity, journey, and experience is different. You don’t have to understand all the different possible experiences to be an ally but you do have to keep an open mind and understand that there is no one way to be trans.

KNOW HOW TO ASK QUESTIONS

You may not be able to learn everything you want to without asking a trans person some questions. And if you’re not supposed to make assumptions about anyone’s gender, you may have to ask someone questions to learn more about their experiences. Knowing what questions to ask, how to ask them, and when/where it is appropriate to ask them is part of being an ally. This, too, takes practice.

The knowledge you have gained about terminology will help you with appropriate wording. Knowing what challenges trans people face will help you be aware of the context and choose an appropriate time and place. Beyond that, honesty is the best policy. If you’re not sure if the question is appropriate, or you’re not sure how to word it, make sure you’re in a safe and private environment before asking and then be honest about your lack of knowledge. Ask for feedback and be open to it when it’s given, solicited or not.

Keep in mind that just because one trans person was comfortable answering a particular question does not mean every trans person will be. Some people are open, some people are private. This is true for trans people as well.

ADVOCATE AND AUGMENT!

As an ally, your main roles are to set a good example for other cis people and to create a safe environment for trans people. This means correcting yourself when you make a mistake with pronouns or other gender references and correcting those around you if they misgender someone (regardless of whether the person is present or not). If you’re not sure whether the trans person wants you to correct other people on their behalf, ask them!

If someone asks you to speak about trans experiences and issues or asks you to review a policy or resource to ensure it is trans inclusive, defer to a trans person, especially if it is a paying opportunity. It is not your job to speak for trans people but to give trans people the support, space, and opportunity they need to speak for themselves. You can also share social media posts from trans accounts and spread news stories that talk about trans people in positive ways.

On a smaller scale, you can offer to be a buddy for a trans person in your life, especially if they have limited social supports. Whether it’s going to the public washroom with them for safety, going with them to medical appointments or registry offices for document changes, or being a caregiver after surgery, there are lots of ways you can help support a trans friend when other people who aren’t allies wouldn’t realize they would need extra support or when the trans person wouldn’t feel comfortable asking for support from non-allies.

I hope this helps give you some ideas of how to be a trans ally. If you are a trans person, feel free to share this with people in your life. We need more allies! Please leave a comment below if you have any questions or if you have suggestions for other ways to be a good ally.

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Let’s Talk Gender S2E8: Nonbinary Pregnancy and Parenting

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

This episode is 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.

FERTILITY AND TRYING TO CONCEIVE

Over the course of four years, my husband and I tried as many methods of getting pregnant as we could access. This included home insemination, known donor, IUI, and eventually IVF. I have heard many stories from folks who have gotten pregnant after only a couple tries of these earlier methods but, for no discernible medical reason, this was not the case for us. 

The IUI (intrauterine insemination) trials were done at a fertility clinic. Their language was generally inclusive of gay couples (referring to the partner as ‘partner’ instead of husband) but all the references to patient were female. We also ran into a few situations where, once my partner was identified as a man, people were confused as to why we were using donor sperm. Most notably, the psychologist we had to see to get the go-ahead to use donor sperm (which seemed strange to begin with) wanted to talk about if there was any guilt or shame on my husband’s part about not being able to provide viable sperm and when he stated he was trans she became very interested and curious, wanting to ask a bunch of irrelevant questions about his transness, and nearly derailed the appointment multiple times. You can bet I provided feedback about that encounter. 

The fertility clinic itself also did not have a gender neutral bathroom option and I had to empty my bladder immediately before each procedure. So that was fun. I did end up finding a single use bathroom in one of the medical areas during the IVF but it required a staff member to use a swipe card to get there so not actually for public use. 

I never came out to the fertility clinic, doctor, or nurses as nonbinary. With all the emotional ups and downs of trying to conceive, I didn’t have enough energy to educate or correct any misgendering that would happen afterwards. It was easier to let them assume I was female and deal with the dysphoria as best I could. 

Honestly, I didn’t find the IUI attempts to be that difficult. The procedures were fast with just me and Jake and a nurse in the suite, no high tech stuff. And it was only one procedure every two months. We decided early on that we needed to take a month off between trials to reset and breathe emotionally. Otherwise we would be required to order the next round of donor sperm before finding out if the previous trial had worked which felt a bit like having bad karma by assuming it wouldn’t. 

The IVF process was much more invasive and dysphoria inducing at times. They had to do an internal ultrasound as a baseline, after one week, and then every other day or every day thereafter for about five more visits before the actual procedure was scheduled. The ultrasound wand is much bigger than an insemination catheter and they had to move it around and dig it in to get good images of both ovaries. If my gender happened to be more female aligned on that day, this was mostly just physically uncomfortable. But there were a couple times when my gender was particularly male aligned and let me tell you, the dysphoria during the procedures on those days was a hell of a lot more uncomfortable than the physical part. I think I death gripped my husband’s hand to keep from crying at one point. Oh, and did I mention that these all had to take place first thing in the morning before I went to work? Where I’m also not out to most people and have a decent amount of dysphoria? Those were not good days. But hey, at the time of this recording I am 37 weeks pregnant and by the time this airs we will hopefully have been parents for a couple months so as far as I’m concerned, it was all worth it. 

PREGNANCY, MISCARRIAGE, AND GENDER

Being pregnant comes with its own slew of gendery things. One of those IUI attempts actually did work though it turned out that the egg that was inseminated was empty. I didn’t know this was something that could happen but apparently it’s very common. Usually these types of pregnancies end in miscarriage before the person even knows they’re pregnant. But my body was so ready to be pregnant it did a really good job of implantation and building a gestational sac despite the fact that nothing was growing inside it. So I experienced all the symptoms of early pregnancy until 10 weeks. 

During this first pregnancy, my gender shifted early on to the far end of my female range (which is still only about halfway from neutral) and stayed there. At first I was grateful. I had so much less dysphoria, both social and physical, and without the gender shifts I didn’t have to pay attention to my gender as much or worry about dysphoria taking me by surprise. But after a few weeks I started to feel like a part of myself, that I had only recently gotten to know, was missing. The male half of me that I knew was still there felt like a ghost, something I couldn’t quite touch, feel, or embody. The times I was interacting with queer friends who knew me as Ray felt dysphoric in a way they hadn’t before. I didn’t feel like Ray at all. It was very strange and disconcerting. 

After the miscarriage I was worried that my gender would suddenly shift to the male side and I would be swamped with dysphoria. But the hormonal confusion that I went through either masked that or overrode it completely. By the time my hormones stabilized and I felt more like myself, my gender was back to normal, feeling mostly neutral with a gentle fluctuation to either side. Still, it took some conscious work to re-learn how to use my dysphoria management strategies that I had developed before this weird female pregnancy experience. 

PREGNANCY (AGAIN)

Then I got pregnant again, after the IVF procedure. I was expecting a similar experience and had tried to think of strategies I could use to help with that ghostly feeling of losing contact with my male side for nine months. But as it turned out, my gender has stayed pretty consistently neutral. If anything, the only change is that it fluctuates less, if at all. 

This means that I have experienced dysphoria with this pregnancy. In the first trimester, before many people knew I was pregnant, it was mostly chest dysphoria as my breasts increased by multiple cup sizes. My chest was too sore to be able to wear a binder right from the beginning. I did use tape a couple times but even that was uncomfortable.

In the second trimester, the breast growth slowed down but my binder no longer fit. Once we announced the pregnancy I was slammed with social dysphoria as everyone started using more female language for me and asking about the gender of the baby. I continued to struggle with chest dysphoria until my belly started to grow. As my belly got bigger, my chest looked and felt smaller and smaller in comparison. In the third trimester, my belly was big enough that most regular t-shirts created a tenting effect that nearly completely hid my chest. I’m sure it looks funny to other people but it feels great to me. 

Throughout the pregnancy process I have been trying to consume as much information as I can about pregnancy, birth, and baby care though apps, websites, books, podcasts, and medical care providers. The majority of this information is female centric. The pregnant person is always referred to as mom or mom-to-be, is always assumed to be a woman, and dysphoria is never mentioned as one of the potential symptoms of being pregnant. 

We were lucky enough to find a midwife team in our area that is LGBT inclusive who we were upfront with about both my husband being trans and me being nonbinary from the start. This was hugely helpful for me. I don’t have to brace myself to go to every pregnancy related appointment like I had to during the fertility/trying to conceive process. If you are trans or nonbinary and trying to get pregnant, I highly recommend finding a trans inclusive care provider if you can. If none exist in your area or you don’t have a choice of who you go to, I recommend finding a trans inclusive doula to add to your support team who will advocate on your behalf throughout the process. You will have enough to deal with without having to do all the advocacy and education related to your gender identity on your own. 

At some point mid-pregnancy, I had an aha moment based on something someone posted on one of the facebook groups I’m in. They explained how they had re–framed their pregnancy as a nonbinary experience in a nonbinary body because they identify as nonbinary. When it was put like that, it seemed so simple. Of course if I identify as nonbinary, my body is a nonbinary body, and anything it can do, including getting pregnant and growing a baby, is a nonbinary experience. This mantra has helped a lot on days when my social dysphoria is getting the better of me or when I am trying to consume information that is highly gendered. 

INCLUSIVE TERMINOLOGY MATTERS

I have been able to find some resources that are trans inclusive. The Birth Partner, 5th edition is the best one. I included links to trans doula practices that also provide inclusive resources in Related Posts and Resources at the end of the show notes. 

The prenatal classes we attended were advertised as being LGBT inclusive and did a good job of being LGB inclusive, referring to partners instead of husbands, but they didn’t have much awareness of the trans component. They didn’t introduce themselves with their pronouns, so naturally I didn’t either. They almost exclusively referred to the birthing person as a woman or mom using female language. And when they were talking about feeding the baby they only ever talked about breastfeeding and used that terminology.

Particularly during the class on feeding, I had so much dysphoria that I became claustrophobic and had to pace in order to be able to stay in the room to get the information I needed. One of the perks of being in a pandemic was that these classes were all run over Zoom so I was able to be off screen and still listen in. Otherwise I probably would have had to speak up or leave the class entirely. I also provided the instructors of this class feedback (a couple weeks later once my dysphoria had calmed down) which was well received. 

When I’m trying to absorb information that will likely be helpful in navigating pregnancy, birth, or postpartum and caring for the baby and the information is presented in a gendered way that triggers my dysphoria, it’s very hard to tell if I am dysphoric because I just happen to be feeling more male and have more dysphoria that day, if the language used in the resource is triggering dysphoria that otherwise wouldn’t be there, or if the situation I am learning about will be dysphoria inducing when I’m experiencing it and I should prepare for that. This is why inclusive language is so important. 

If I feel dysphoric when picturing myself in a situation as I read an inclusive resource, it seems much more likely that I might struggle with that experience when the time comes. Since that very uncomfortable prenatal class, I have re-read the section on chestfeeding in The Birth Partner and watched videos by trans doulas on chest and body feeding and the dysphoria I feel when picturing myself doing this has decreased significantly. After this episode airs I will write an update on my blog and let you know how it’s going in real life. 

After the experience with the prenatal class and comparing it to reading The Birth Partner, I wrote a blog post with a list of inclusive pregnancy, birthing, and feeding terminology. This includes using gestating or pregnant person instead of mom, birthing person instead of woman, and chest or body feeding in addition to breastfeeding.

NONBINARY PARENTING

Of course the pregnancy journey doesn’t just stop relating to gender after the baby is born. It turns into a parenting journey. As I am not quite yet a parent, I can only speak to what I have been wondering about and talking to others about in preparation for this next step. 

First of all, there’s what the baby will call me. There are lots of nonbinary parental terms that people use and lots of nonbinary parents that are comfortable with either mom or dad. I honestly don’t know where I will go with this yet. I feel ok with mom but less ok with mommy or momma. I’m considering the name Mur based on my initials M.R. Or there’s something different like Ren or Renny from paRENt, or Mapa which seems highly accurate to my experience but doesn’t have any particular emotional connection for me. I guess we’ll see what sticks once we test them out. 

Then there’s deciding whether to gender your child based on their assumed sex or whether to raise them as gender neutral until or unless they specify otherwise. We have decided to gender our child but raise them in a gender inclusive, gender expansive way. For me, fighting for our child to be recognized as nonbinary when it is likely that they will identify as cis is not worth the effort and would be extremely dysphoria inducing for myself. We will of course be open about our own identities with our child and ask them often about their identity and adjust our use of language as often as they wish. 

This brings up another point. If we are open about our identities with our child, that necessitates being open with anyone the child interacts with – family, medical systems, school systems, playgroups. My husband is fairly open about being trans so this won’t be a huge shift for him. But I have only just started coming out to co-workers and family so this will likely be a steep coming out curve for me. I guess that is a pretty solid way of shifting the ‘need’ factor up in the coming out equation I talked about in Episode 5. 

And lastly, I have heard from many nonbinary parents that the world of parenting is, if possible, even more forcibly gendered than the world of fertility and pregnancy. I’m sure that is something you learn to deal with as it happens. But it’s probably good to have low expectations in order to be prepared and maybe occasionally pleasantly surprised instead of constantly irritated and defensive. 

REACH OUT!

If you are struggling through the process of trying to conceive, currently pregnant, or a nonbinary parent and want to reach out, please email me at letstalkgenderpodcast@gmail.com. You are not alone. 

That’s it for 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. 

As this season is airing, I will hopefully be at home with my husband and newborn baby, learning what it means to be a parent. If you subscribe to my blog, you will continue to get regular updates on our parenting journey and how it relates to gender as well as any other gender related thoughts and experiences such as updates on coming out as nonbinary or any medical or legal transition steps I take in the future. 

I hope you have found this podcast helpful. Please reach out by commenting below or emailing me at letstalkgenderpodcast@gmail.com. I’d love to hear your reactions, thoughts, experiences, and suggestions for future seasons.

Bye for now. 

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