Tag: Family

The Egocentricity of Dysphoria

Having dysphoria can be an all-consuming experience. Especially when it first starts, when you first identify it as dysphoria, or when it shifts. If the dysphoria is stable over a longer period of time, it is somewhat easier to ignore and manage but even then, there are days when it is all-consuming.

Dysphoria causes obsession about little things that no one else would care about. You might brush off their concern or minimize it but this doesn’t give them the validation they need and can result in more obsessing.

Dysphoria can make it difficult to communicate their identity, needs, and wishes to others in a way that will be understood. It is so all-consuming that it makes it difficult to step out of their current experience and see things from another person’s perspective. So they end up using language that other people don’t understand or skipping over basic concepts that others haven’t grasped yet. This leads to more confusion and frustration and leaves them with even less energy and motivation to try to communicate the next time.

Because of the level of obsession on new areas of their body and new behaviours, it can seem like there has been a big change in their personality with the onset of dysphoria. This isn’t necessarily true, it’s just that the dysphoria is taking up all the person’s attention and focus and they aren’t able to express the parts of themself that you are used to seeing or engage in the activities they used to enjoy with as much ease.

The dysphoria induced self-obsession can come across as lack of caring for others or a lack of awareness of others. This is something that should be communicated in a caring and understanding way that acknowledges the impact of dysphoria but looks for ways to help the person cope by focusing their attention outside their body and strengthening supportive relationships.

The onset of dysphoria can seem sudden to those around them. They have been obsessing about it internally for a long time and have a lot of internal pressure built up. Coming out gives them permission to talk about dysphoria and the obsessions that it causes for the first time. This can seem like a sudden onset of dysphoria and a sudden shift to being egocentric to the people around them.

Sometimes, people have a tendency to refer everything back to dysphoria or use dysphoria as an excuse – ‘if you only knew how it felt you wouldn’t say that’ or ‘oh I can’t do that because the dysphoria is so bad’. Dysphoria can be so all-consuming that it can be hard to tell when something else might actually be at fault – burnout from work, relationship stress, financial stress, fatigue from not enough sleep, changes in meds, having a cold, etc. Sometimes it takes an outside view from a supportive person that is close to them to help them differentiate what is dysphoria and what is something else that should be addressed differently.

You might have difficulty getting along with someone who experiences dysphoria because they may be more emotionally volatile or have unknown or shifting triggers. They may have a lack of interest in things they used to enjoy including things you used to do together because of the new focus on ‘solving’ the dysphoria. Try to be understanding and supportive but take care of your own needs and emotional well being too.

TIPS FOR DYSPHORIC PEOPLE

  • Use self talk to combat the skewed perspective that the hyper awareness creates.
  • Find activities to do that don’t trigger dysphoria that will help you get out of your head.
  • Remember that people who do not experience dysphoria will not remember that you do or understand how much it can effect you. Try to be understanding of their ignorance and explain gently. Getting angry with them when they do not automatically realize when you are feeling dysphoric will not help to keep your relationship with them as a source of support.
  • Make sure to express your appreciation and caring for the supportive people around you.
  • Find a therapist. Your support people cannot support you and be your therapist. They will get burned out and no longer be able to support you appropriately.
  • Find concrete ways to manage your dysphoria that require the least amount of time and effort so that you have more time to spend with those you care about.
  • If your dysphoria shifts, try tracking it to give you a better idea of what causes the shifts and help you predict when it will happen.

TIPS FOR SUPPORTING DYSPHORIC PEOPLE

  • Build a list of words, activities, and situations that trigger the trans person’s dysphoria so you are more likely to understand when they react negatively at those times.
  • Understand that getting the dysphoric person to explain their dysphoria to you, especially at times when they are dysphoric, will be hard and often makes their dysphoria worse. Look for other resources to learn what dysphoria can feel like and how to recognize it.
  • Help the trans person focus on something external that is less likely to trigger dysphoria or encourage them to engage in their self-care activities. They won’t always remember to use self-care strategies at times when they need them the most so external reminders can help.
  • Find sources of support for yourself other than the dysphoric person – a therapist, friends that might understand, community groups and support such as PFLaG, or online resources.

Living with dysphoria is an ongoing struggle and is different for everyone. Talk to each other, be as open and honest as you can, and find the support you need.

What is your experience of dysphoria or supporting someone with dysphoria? What other tips do you have that I should add to the list?

Let me know in the comments below!

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Pregnancy, Miscarriage, and Gender

IT WORKED!

We were pregnant! If you missed the story of how we got here, check out Getting Pregnant is Hard to do Without Sperm.

The first thing we felt was excitement. The second was anxiety. Not because suddenly such a big thing was happening, but because we had spent so long stopping ourselves from being excited in order to avoid the pain of disappointment that any excitement we felt triggered anxiety. This reaction slowly wore off and we allowed ourselves to be happy and excited but the more excited we got the more we wanted to share the news. Suddenly, we had a secret again.

I knew I was pregnant before we got the results. I know that’s a cliche but it’s true. My breasts were so sore that I couldn’t touch them, days in advance of when I normally have PMS symptoms. I was fatigued to the point of being in a daze. These symptoms continued and were joined by mild to moderate intermittent nausea. All the typical symptoms but nothing extreme. If you know me at all, you know I can’t keep anything to myself. Especially if it involves distress. I much prefer to complain – I mean, commiserate – about it with others. Luckily, a couple people at work were in their second trimester and gave me a small community for support with this new adventure.

GENDER WHILE PREGNANT

If you’ve read other posts on this blog, you may already know that I am gender fluid, shifting between moderately female and mildly male with the majority of time spent in the neutral space between. But, as I talk about in Menstruation and Gender, I consistently shift towards the female side during my period. The same thing happened when I was pregnant. Except that I wasn’t just pregnant for a few days, like when I’m on my period. So I shifted to female and stayed female for two and a half months.

After about three weeks of being consistently female I started to feel like the male part of myself, Ray, was imagined, a dream, a ghost. I was missing half of myself, unable to experience my full range of gender that I had only just recently struggled to understand and accept. This was a symptom of being pregnant that I couldn’t so easily explain to or commiserate about with others.

EARLY ULTRASOUNDS

Because we were followed by the fertility clinic, we were scheduled for early trans-vaginal ultrasounds. The first one was when I was 7 weeks pregnant. The image on the screen showed a slightly small gestational sack in my uterus but no yolk sack or fetal pole. This was mildly concerning but not conclusive since it was still early and the gestational sack was small. We went back the next week for another one. It showed the same result which was significantly more conclusive of a blighted ovum. With some googling, I learned that this happens when the egg that was fertilized happened to grow without any genetic material inside it. An ’empty egg’.

So, I had to come to terms with the fact that at some point in the next few weeks, when my body figured out something was wrong, I was going to have a miscarriage. I was waiting, and dreading, but not yet able to grief or process because if I did, I would be grieving until it happened, which could be days or weeks or a month. But I had to go to work as usual, travel to visit my family, and stand with my friend in her wedding. So instead, I became emotionally constipated, numb, and burnt out.

While visiting family, I had some spotting and cramping but then it stopped again. When we returned home, we had a final ultrasound that showed the same result and gave an official diagnosis of a non-viable pregnancy. This triggered a referral to the early pregnancy loss clinic. They called me four hours later and reviewed my options. I could let the miscarriage happen naturally (which my body didn’t seem to want to do), take a medication that would induce severe enough cramping to force my body to miscarry (sounds terrifying), or have a procedure (Dilation and Curettage or D&C) where they put me to sleep, dilate my cervix, go in, and scoop everything out. If the first two options didn’t expel everything I may end up needing the D&C anyway. Since I had known this was coming for what felt like an eternity already, I work in a hospital so medical stuff doesn’t bother me, and I had had a polyp removal six months prior via the same procedure, I opted for the D&C. It was scheduled for three days later.

RECOVERING FROM MISCARRIAGE

Both the physical recovery and the emotional recovery took longer than I expected, despite warnings from everyone I talked to who had also had a miscarriage (it is surprisingly common given how little it’s talked about). Physically, I had a few days of mild cramping and fatigue. When these initial symptoms faded out I felt like I was better and returned to work only to find that more than half an hour of being on my feet (I have a fairly active job) caused waves of moderate to severe fatigue, shakiness, dizziness, and hot and cold flashes. My body was in hormonal shock.

The most frustrating part physically was that knowing why it was happening and trying to connect with my body to calm it down did absolutely nothing to help. It felt like my body’s operating system had crashed and was taking forever to reboot. So I started doing really slow, gentle, breathing pace exercises. Anything from dynamic stretching to Qi Gong. Almost instantly, my mind-body connection began to repair itself. It was such a dramatic improvement at a time that I needed it most that I have kept up with these exercises ever since.

Emotionally, I expected to be a wreck as soon as the procedure was done and maybe the day after. But because I had not allowed myself to feel the grief for three weeks I was in an emotional holding pattern. I thought that maybe I had been processing my emotions this whole time and I didn’t need to have a strong, overt reaction. But the exhaustion after the second day back at work meant that I didn’t even have enough energy to hold my emotions back and once I got home I broke down and had a couple hours of intense crying and grieving with my lovely husband for support.

Overall it took just over a month for me to feel like I was back to my normal self.

GENDER WITH MISCARRIAGE

Going through the procedure itself and being in a ‘Women’s Hospital’ didn’t feel dysphoric since I was still feeling very female at the time. A week or so after miscarriage, my gender started shifting slowly back to the middle, then to the male side. And there it stayed for almost three weeks. This felt both good and bad. Good, because I was finally able to experience the other half of myself that had been missing for the last two and a half months. Bad, because all of a sudden I had dysphoria again. And I was out of practice with how to deal with it. While still being very emotionally raw.

Initially, it was very distracting and a constant irritation that sucked up a lot of mental and emotional energy. But I slowly remembered the strategies I had been using before and became acclimatized to the discomfort of dysphoria and it faded to a background buzz.

TALKING ABOUT MISCARRIAGE

Over the last few years both myself and my husband have been through some pretty major experiences that all have different levels of taboo and layperson knowledge/understanding. When I talk about our fertility struggles, very few people have negative reactions to discussing that and it doesn’t feel threatening for me to open up about it and though most people don’t know the variety of options, they have a general understanding that there are medical options and often know someone who has used them. When I talk about gender identity or transitioning, I don’t always know what reaction the other person will have and often have to deal with a negative or ignorant response. Most people have little to no understanding of nonbinary gender identities or the transitioning process to the point that they can’t even relate to whatever it is I’m telling them about unless I explicitly state what emotions are tied to this experience.

When talking about miscarriage, everyone instantly understands that that would be a difficult thing to go through, understands what emotional response is appropriate, and provides support. And yet, it’s still something that isn’t often discussed openly. I’m guessing this is partly because historically, it was viewed as the fault of the woman that it happened and was shameful. But nowadays, I think we’re mostly past that (based on the reactions I get when I talk about it) so I’m guessing it’s not discussed simply because it’s an emotionally difficult thing to talk about and considered a very private experience. I’d like to change the culture of silence around miscarriage and normalize talking about it and then eventually, normalize the idea that people of any gender identity could have a miscarriage.

THE JOURNEY CONTINUES!

At this point, we are still trying to get pregnant. There are a few more options we are willing to try and since the last one worked, I feel like it is likely to work again. But we have also discussed what our limit is in terms of how long we want to try for and how much money we are willing to put towards it. We are not tied to the idea of the child being genetically related to us (seeing as how it won’t be genetically related to Jake anyway) and open to considering adoption if we reach our personal fertility limit.

Subscribe to the blog or keep checking back to get future updates and find out what happens next!

Have you had pregnancy struggled or miscarriage? For those of you who are trans/non-binary, how did pregnancy and/or miscarriage affect your gender? Please leave a comment below. I’d love to hear your experiences.

Getting Pregnant is Hard To Do Without Sperm

When Jake and I first met we were unsure if we wanted kids. Once our lives stabilized it seemed a lot more feasible. Around the same time we spent some time with a couple small babies and had our parental instincts kick into high gear. Since both of us had a uterus and ovaries we had a choice of who would carry. Jake was more worried about being able to bond with the kid and I was more worried about the physical process of pregnancy so initially he was going to carry (this was pre-transition for him). This decision came with the caveats that if for some reason he couldn’t conceive or if gender ever became a question and he was no longer comfortable with it, I would carry.

Since neither of us produce sperm, our options were sperm banks, fertility clinics, or known donor. We were both less comfortable with the known donor path and there was a two year wait for our local fertility clinic. So the best option for us was to start with a home insemination program run by a sperm bank. We started saving money as each attempt through this program would cost between $1,500 and $2,000. When Jake’s gender questioning led him down the path of transitioning and he started to come out, we figured that was enough emotional stress on its own so we put the baby making on hold.

A year and a bit later, things had calmed down and we were ready to start trying. We started with home insemination from the sperm bank in Toronto. We signed up for the program, had a consult, and got blood tests done. We went through the online catalog and each month on day 1 of my cycle we would send in our top three choices to the sperm bank. On day 11 a 2.5 foot tall box would arrive which contained a large cryo container and a tiny vile of frozen sperm. It also contained specific instructions on how to thaw it and inject it. I tested for ovulation (LH surge) each morning and when it was positive we carried out the instructions. Then the dreaded two week wait (that anyone who has struggled to get pregnant will understand) began.

After four cycles and no success we decided to save the rest of the money we had put aside for future options. We quietly asked a few friends and family members if they would be interested in being a donor for us and ended up trying twice with two different donors (four more cycles). This involved a lot more social engagement and logistical planning but ultimately followed the same pattern of make plans, test for ovulation, do the thing, wait two weeks. Again, no success. We decided it was medical intervention time.

We went to our family doc to request a referral to the fertility clinic. Since we had only technically completed 8 tries (equivalent to 8 months of TTC – trying to conceive), he was reluctant since the typically referral criteria require 12 months of TTC. So instead, I got a referral to a women’s clinic where they ordered more specific blood work and other tests to make sre there was nothing structurally wrong. When this all came back normal, that doctor finally referred us to the fertility clinic.

The two fertility clinics in our city (one public and one private) had recently amalgamated which cut the wait time from 2 years to 6 months. When we finally got our appointment there was more blood work and tests. They started me on a low dose of Synthroid to get my thyroid levels from low normal to high normal. On the scan of my uterus they found a fairly large polyp that they decided should be removed prior to any insemination attempts so I was on a waitlist for that for another four months (which turned out to be 7 months). I had very little warning when my surgery date came up so, suddenly, I was having surgery (which went totally smoothly) and then we were told we could try on the next cycle.

Except with all the waiting I had slacked off and hadn’t gotten the mandatory counselling session booked, a requirement before ordering sperm. Within a week we had that done (a stupid, expensive hurdle that I could rant for a paragraph about but I will spare you), we ordered sperm (a fairly straightforward process since we had done it before), Jake got his final blood work done, I had my surgery follow up, and we were ready to try!

We decided that we would start with IUI (intra-uterine insemination) with a natural cycle (ovulation is not enhanced or induced with drugs) since I don’t have PCOS or endometriosis or other conditions that interfere with the menstruation and ovulation cycle. Again, I peed on sticks to detect ovulation, we phoned the clinic early in the morning when I got a positive result, and went in a few hours later. We received a mini report of the quality of the sperm and how well it had woken up from cryo. The insemination was completed by a nurse and off we went.

The two week wait was even worse than last time. Unfortunately our first attempt didn’t work. The month after we were out of town during my ovulation dates so we gave ourselves the month off to regain our emotional stability and tried again the month after. Somehow, this time felt different. A week after insemination my breasts became very sore and I had a few sharp pains in my uterus area. Since we were doing a blood test for pregnancy (HCG) two weeks after insemination we didn’t bother peeing on a stick. This time, the result came back positive. We were pregnant!!!

Read the next part of our journey in Pregnancy, Miscarriage, and Gender (coming soon).

If you relate to any part of the story above or have any questions, leave a comment below and I will respond!

What’s in a Name and How to Pick One

For many gender non-conforming and trans people, names are super important. Just like pronouns, names often have a specific gender attached to them. There are female names, male names, and gender neutral names.

Often one of the first things that a trans person will do, after coming out to themselves and before coming out to their broader community, is to pick a new name. This name is considered their chosen name. Their previous name is called their birth name. And once someone has socially transitioned and no longer uses their birth name, some trans people call their birth name their ‘dead name’.

So how does one go about finding a new name? I was lucky in that the masculine part of my identity came with a name that automatically felt right. However, this did lead to me having two names which I will discuss below. Jake, my husband, had a very different experience. He didn’t specifically dislike his birth name and if it had been an acceptable gender neutral or male name he probably would have kept it. He tried shortening it to a more masculine version but it didn’t feel right and ultimately chose the name Jake. I discuss more about his process below.

HAVING TWO NAMES

I have two parts to my gender identity, a female part and a male part, and I have a name that matches each. It has taken me a long time to figure out how I want to navigate the world and be identified and I am still figuring it out but here’s where I’m at so far:

  • In my head and when referring to myself as a whole (to people I am out to or in online spaces like this blog) I use both names as though they are one name ie Meaghan Ray
  • In my everyday life where I am not yet out as genderqueer or nonbinary, I use my birth name only
  • In queer spaces when I am feeling more neutral or masculine I use Ray only

Having two names means that when I am in spaces where I am out to people I have to specify how I would like to be referred to each time. Some people are better than others at asking and then using the name I specify. I am slowly getting better at remembering to specify and correcting people when they get it wrong. It’s an ongoing process.

So far, I don’t feel the need to change my name legally. At some point I may change my middle name to Ray but for now I am comfortable with where I’m at.

FINDING A NEW NAME

When Jake was looking for a new name we used a few different strategies. I have also heard some others mentioned by other trans people. Here are a few ideas:

  • Look up baby names from the years close to when you were born
  • Ask your parents what you would have been called if you had been born as your current/true gender
  • Make a list of names used in previous generations of your family
  • Make a list of names that start with the same letter as your birth name or middle name (if you like it) or other first letters that you like the sound of
  • Flip through a baby name book and make a list of names that feel right for you
  • Shorten or alter your birth name to version that matches your gender

There is no one way to find a name. Some names are more common in the trans community so connect with the community online if you can and see what other people with your identity have chosen. Maybe you want a common name, maybe you don’t. It’s your name and it is completely your decision.

TESTING YOUR NEW NAME

Choosing a new name can feel daunting and huge. This is the name that will represent you for the rest of your life! So, give yourself a trial period before you start telling everyone. Here are some suggestions of how to test your new name:

  • Use it as an alter ego online or as a character name in a video game
  • Ask a few close supportive friends or family to test it out for you (we learned that this doesn’t work very well with only you and one other person because you never use first names unless there are three or more in the group)
  • Try writing a journal entry about your day in the third person using that name
  • Participate in a queer social group that you have never met before and put your new name on the name tag
  • Pick one of the names on your shortlist and mentally use it as your name for a week, switching to a different name for the next week

Many of the above strategies will also work for testing out pronouns. Don’t be afraid to try out different names and change your mind. But be aware that it is often difficult for the people closest to you to adapt to a new name. So the more ways you can test it before telling the whole family or coming out at work the more confident you will feel that you are choosing the right name for you.

Remember that you also need time to get used to your new name. It will sound strange when someone refers to you by that name for a while. The longer you can give yourself to get used to it internally or with a small group before coming out publicly the more it will feel like your name when you hear people using it.

If you changed your name, what strategies did you use to pick a new name and test it out? If someone you know changed their name, how did you feel about the change? Leave me a comment below with your experiences!

Queer Wedding Ideas

When Jake and I got married, we both identified as women (this was pre gender exploration for both of us). We made some adjustments to the ceremony so it didn’t feel so heternonormative. Since then, I have participated in, and seen pictures and descriptions of, many different gay, queer, and gender non-conforming (GNC) weddings. Here are a few of the ideas I’ve collected:

  1. Switch Sides. If there is a more masculine presenting person and a more feminine presenting person, stand on the opposite side from the norm of man on the right and woman on the left (from the audience perspective).
  2. Who Enters First. Typically, the man starts the ceremony at the front or walks in first. So instead, have the more feminine person walk in first or have both of you walk in at the same time up parallel aisles instead of having one central aisle.
  3. Wear Whatever You Want! Don’t feel confined to one person wearing a dress and the other wearing a suit. Either person can wear whatever they want! Similarly, don’t confine your wedding party to a suit for the men and a dress for the women. Either allow them to choose or offer a midway option of a blouse and suit pants or a skirt with a shirt, vest, and tie.
  4. Mixed Wedding Parties. Don’t limit yourself to female assigned/identified/presenting people standing with the ‘bride’ and male assign/identified/presenting people standing with the ‘groom’. Pick the people that are most important in your life to stand with you regardless of gender or presentation. That’s why they’re there, isn’t it?
  5. Colours! Base your colour theme off a queer flag that has meaning to both of you. Include rainbows, or trans colours, or purple and green (as we did, kind of by accident). You can also use rainbows or meaningful colour combinations as highlights such as having a rainbow rose in the table centers.
  6. Include Your Community. Community is hugely important for queer people and often serves as a chosen family. Include your community in your special day with a ring warming, readings from different people either during the ceremony or at the reception, or a modified sand ceremony where everyone adds a pinch of sand on the way in and those jars are mixed together by the couple. There are so many options! You can pick one that someone else created or make your own!
  7. Location and Ceremony. If you and your partner are religious, you can absolutely have a queer wedding in your place of worship. But many queer people have had difficult experiences with organized religion and may feel uncomfortable within these spaces and with the religious basis of the ceremony. So consider choosing an outdoor location or a non-religious location that is meaningful to you. Likewise, there are some aspects of the ceremony that are required to be legally binding but some are optional. Definitely talk to your officiant about ways to make the ceremony personal and, of course, queer.
  8. Language. Weddings are full of heteronormative and binary language. Be open about what language each of you is comfortable with and make sure that your officiant and wedding parties are on board. Consider having a wedding website that includes an explanation of the terminology you will be using. This is also an easy way to specify pronouns and names of people in the wedding party or important family members.
  9. Identity Pins or Stickers. Have pronoun pins/stickers available for people to wear as a lapel pin if they wish. Weddings bring together family and friends, many of whom will never have met and may come from very different social backgrounds. This can be a way for the queer people participating in or attending the wedding to feel more comfortable.

That’s it for now! If you had a queer wedding or have attended a queer wedding, what strategies did you use? Leave them in the comments below and I will add them to the list!

Educating Others Without Compromising Your Boundaries

Sometimes those of us with experience and knowledge of trans related topics want to help educate those around us and sometimes we don’t. And that’s ok. You should never feel like you have to compromise your own mental health for the sake of addressing someone else’s ignorance. But how do you politely tell people to bugger off and educate themselves through other means? And when you are comfortable having some of those conversations, how do you know what you’re comfortable sharing and what you’re not? How do you make them aware of your boundaries without derailing the conversation or damaging your relationship with that person?

Throughout my husband’s transition and my own gender explorations I have had many different conversations with many different types of people about gender and trans related topics. Many times towards the beginning of this process I was already knee deep in a conversation before I realized that I was well past the line that this person shouldn’t have crossed. I am a very open person and I am often comfortable sharing much more personal information with others than most people are so I wasn’t personally uncomfortable with the content. What concerned me more, and often only in retrospect, was that the person I was talking to had no awareness of which questions were appropriate and which ones they should have asked special permission for (and respected my response if I said no). If you have people in your life that have a similar lack of understanding of what is appropriate to ask about or say, see my post How to Interact Respectfully with a Trans Person, or, better yet, send that person the link.

How far do you go before you recommend resources and leave the conversation? That is completely up to you. Everyone will have different boundaries relating to their privacy depending on the type of information, their relationship to the other person/people in the conversation, and the setting where the conversation is taking place. Boundaries are healthy. They are self-protective. The more experiences we have that are threatening, the more self-protective we are likely to become.

The problem comes when you don’t know where your own boundaries are until they have been crossed. This can make you vulnerable, defensive, antagonistic, and can even put your safety at risk. Often, the other person/people in the conversation don’t even know they have crossed a line. Your sudden change in manner can be a shock to them and even to yourself.

How do you avoid this? Think about your boundaries in advance. Below are some guiding questions to get you started. I recommend you add to it any time you get asked a question that triggers a warning bell in your head. Revisit this exercise every few months, when you are nearing a major transition related event, or when you’re going to be interacting with people you haven’t seen in a while (family gatherings). For each question, try to answer it for a variety of different people in your life – a co-worker, a friend, a parent, your doctor, another member of the trans community, etc.

General Info: Are you comfortable…

  • disclosing your birth name?
  • explaining why you prefer the pronouns you use?
  • talking about your experiences of dysphoria?
  • talking about specific strategies you use to change your appearance or presentation (binding, packing, tucking, padding, etc)?
  • talking about how supportive your family, significant other, or other people in your life are?
  • talking about what support groups you attend/are a part of?
  • talking about wait times, difficulties finding a trans friendly family doctor, and other systemic barriers?

Medical Info: Are you comfortable…

  • talking about medication you are on related to transitioning?
  • talking about changes you are experiencing as a result of those medications?
  • disclosing what surgeries/surgery you are interested in having/have had?

Legal Info: Are you comfortable…

  • talking about legal documentation changes?
  • discussing transphobic politics and policies?

This is by no means an exhaustive list of topics that might come up related to your own or your partner’s transition or gender identity. If your partner is the one who’s information you would be sharing, go through this list with them so they can tell you what they are comfortable with you sharing with people in your life. My husband is typically a fairly private person (at least compared to me), but often had much looser boundaries when it came to me sharing info with my coworkers or friends if they were people that he was unlikely to interact with.

Now that you know your boundaries, what do you do or say when someone asks something that you are not comfortable talking about? Try saying exactly that – “Sorry, that isn’t something I’m comfortable talking about with you.” Another phrase I use a lot (because there is rarely something I’m actually not comfortable talking about with someone) is “That is not actually something you should typically ask about a trans person.” They usually respond with “Oh, really? I had no idea.” You can also add phrases such as “Thank you for your concern” or “Thanks for trying to learn more about my experiences/trans issues” or “If you want to learn more about that I would recommend [appropriate resource].”

So whose responsibility is it to do the educating? I believe that no amount of reading on the internet can substitute for face to face conversation and personal anecdotes. But that doesn’t mean that it is always up to the minority to educate the majority. People from or connected to the trans community should not be responsible for providing all necessary information to everyone around them (especially medical professionals). That would be more than exhausting. But you will need to provide the people in your life with enough information to get them from unconsciously ignorant to consciously ignorant and explain how important it is that they educate themselves further. It will also help if you can provide them with specific resources that speak to you. They are much more likely to absorb the information they are getting from other sources if they are confident that it is relevant to your experience.

What other topics or questions would you add to the list? How do your boundaries change depending on your situation or the person you’re talking to? What phrases do you use to identify your boundaries to other people? Was there a situation where you shared something that you realized in retrospect had crossed your personal boundary? Tell me what happened in the comments below!

How to be Respectful Towards a Trans Person

Most of the people I talk to about my husband’s transition are open-minded and accepting but generally ignorant. They want to treat trans people respectfully but don’t know how. They want to learn more about my husband’s transition and my experience as his partner but don’t know how to ask the questions in a respectful way. So I thought I’d give you some suggestions or guidelines depending on your relationship with the trans person.

STRANGERS AND ACQUAINTANCES

Use the correct name and pronouns by which I mean use the name and pronouns that they ask you to use regardless of how they present at the time. If they don’t specify their pronouns you can ask or use the pronouns that is your best guess based on their presentation until they correct you. If they use other gendered terms to identify themselves then you should reflect their language back to them and use the corresponding pronouns unless they have specified otherwise.

You should not be asking anything about their transition including the name they were born with, whether they’ve had surgery (especially don’t ask if they’ve had ‘the’ surgery), whether their family is supportive, how old they were when they realized they were trans, or how long they’ve been on hormones.

Phrases to Avoid:

  • Are you a guy or a girl?
  • You look so good! I never would have known you were trans.
  • I have so many questions!

Phrases to Use:

  • My pronouns are ___. What pronouns do you use?
  • …blah blah blah… [incorrect pronoun]… sorry…. [correct pronoun]…. blah blah….

FRIENDS, COWORKERS, AND EXTENDED FAMILY

If this is the level of your relationship, the trans person may have shared more about their transition process with you. This may include frustrations and struggles, medical components such as starting hormone therapy or having surgery, and legal components such as completing their official name change on various documents.

The most important thing you can do remains using the correct name and pronouns. Even better, correct the people around you if you hear them get it wrong. Not only will this help you and others adjust more quickly but it will also show the trans person they have your support and establish an expectation for everyone that it is not acceptable to misgender someone. Correcting people’s pronouns is exhausting for the trans person especially when they have to correct the same person repeatedly. To help you adjust, change their name in your phone/contact info and put their pronouns in brackets next to it. Each time you think of that person, repeat their name and pronouns in your head five times. Don’t worry about sounding awkward and hesitating if that’s what it takes to use the correct name and pronouns. If you make a mistake, apologize and move on. Don’t derail the conversation and make it all about the trans person and their pronouns every time someone makes a mistake.

It is a long process with lots of barriers and frustrations. Drawing attention to how long the process is taking makes it harder for the trans person to deal with. Transition is not a step by step process or a recipe that people follow and does not always have a specific end point. Everyone’s transition process is different. Not everyone will be transitioning to male or female (they may identify as non-binary). Not everyone will take hormones. Not everyone will have top surgery or bottom surgery but some people might. The length of time between parts of their transition vary wildly. It is not your place to ask about this unless the trans person offers the information first. If they confide in you, it is not acceptable to share that information with anyone else without their permission.

Do not compare your frustrations with changing your last name after getting married to the trans person’s experience with changing their first name and gender. Forms that have categories for getting married do not have options for first name and gender changes. People that process name change paperwork are familiar with the process of last name change with marriage status but not first name change with gender. Talking about your name change with marriage does not put you at risk for discrimination or having people question your identity the way it does for a trans person. This example applies to almost any aspect of transition including hormone replacement, surgery, or other types of coming out experiences.

Try not to treat the person any differently once they transition or once you learn about their status as a trans person. Do not try to educate the trans person on ‘how to be’ their new gender. Do not second guess the trans person’s identity, even if their presentation or interests are not stereotypical of their stated gender. They have second guessed their identity enough, long before you became aware that they were trans.

Phrases to Avoid:

  • Why does your ID still have your old name?
  • When are you getting the surgery?
  • And your spouse/S.O. is ok with this?
  • I can get your name right but I just need a little more time to get your pronouns, you understand right?
  • You’re still not done yet? You’ve been working on this for a while!
  • I knew you as [birth name] for so long, it’s going to take a while to adjust
  • What bathroom are you using?

Phrases to Use:

  • I want to learn more about your experience. Do you have any resources I could look at?
  • Is there anything I can do to help support you?
  • …blah blah blah… [incorrect pronoun]… sorry…. [correct pronoun]…. blah blah….

CLOSE FRIENDS AND IMMEDIATE FAMILY

Everything from the previous section applies to you as well, especially the part about name and pronouns. In addition, you may be one of the first people the trans person is coming out to. Your support is the most important factor in helping the trans person get through their transition. Literally. The suicide rate for trans people is extremely high. The number one factor that prevents suicide among trans people is family support. So learn as much as you can about the transition process and let them know they have your support, even if you are struggling to accept or understand their new identity. Let them know that they should tell you if you do something or say something wrong or upsetting. Make sure you spend time with them doing things that you both enjoy that have nothing to do with their transition. It is a good way to stay in contact and get used to changes as they happen but not make everything about being trans.

If there are aspects of their transition that you are struggling with, let them know and tell them you are working on it. Find other people to talk to about it. Unless they have given you permission to tell other people, this will likely be a therapist. If they know that you are struggling and need to talk to someone and you ask if you can tell a specific friend or one other family member, they may be open to it. Never tell someone that this person is trans without their permission. Once they start telling people, you may become a conduit for information for the rest of the family or group of friends. Talk to the trans person about how they want you to answer typical questions and how much information they are comfortable with you disclosing. This type of conversation will happen repeatedly as the group of people they have come out to grows.

Offer to go with them to medical appointments and other difficult tasks even if they seem trivial to you. It often takes a lot of courage to get those steps done and having backup definitely can help. If they ask you to, try to be willing to attend therapy or support group sessions with them.

Phrases to Avoid:

  • You’re not going to get surgery though, are you?
  • These changes are permanent! What if you change your mind?
  • You really should tell [specific person]. They deserve to know.
  • You don’t really need to get the surgery, since you’re married. If you were single it would be a different story.
  • You can come over for dinner, as long as you don’t talk about your transition.

Phrases to Use:

  • Would you like some company when you’re going to… (eg: HR, passport office, fingerprinting, registry for name change)?
  • I support you and your decision to transition but it will take me some time to adjust. Is there anyone you would be comfortable with me talking to about this so I can work through my own feelings faster and not put them on you?
  • Let me know when you are ready to start telling other people and I will help you with that in whatever way I can.
  • What can I do to affirm your identity? You have told me what not to do, but are things I can do that feel positive for you?

MEDICAL AND HEALTH PROFESSIONALS

If a patient enters your practice seeking treatment from you and you are either aware of their trans status or become aware of their trans status during the interaction, the first thing to do is confirm that you are using the correct name and pronouns and then stick to those. Make sure your patient database on your computer system reflects the correct name and pronouns. If you are unable to change them in your system for legal/billing reasons until the person has completed their legal name and gender marker change, find a way to indicate in your system what name and pronouns the patient uses so that all the staff in your clinic identify the patient correctly.

As a health professional it is your job to know what aspects of the patient’s status as a trans person are relevant to your medical field and which are not. Learn how to ask questions about the relevant areas in a respectful, straightforward way that makes it clear why it is relevant.

You should not be asking any questions related to any aspect of their transition or experience as a trans person that is not relevant to your area of practice. If you want to learn more you can ask the patient for resources they would recommend, but, better than that, you can do your own research just like you are expected to do when a patient has a history of a medical condition you are not familiar with. It cannot always be up to the patient to educate the professionals. It is not only exhausting for the patient but unprofessional.

Keep in mind that trans people will have had many unpleasant, inappropriate, transphobic experiences with other health professionals before you. They are coming into this interaction with their walls up expecting a negative experience. It only takes one misstep to confirm their expectations that this interaction will be like all the rest. If you realize you have made a misstep, apologize for it taking full responsibility and move on. Stay focused on why they are there to see you and only what is relevant to that condition/concern/complaint.

Phrases to Avoid:

  • Oh! You’re trans? That’s so interesting! I’d love to talk to you more about that.
  • Have you had the surgery?
  • When will your transition be complete?
  • Anything irrelevant to your profession or the reason they are there.

Phrases to Use:

  • I admit I have very little experience with trans patients so if I say something inappropriate please tell me right away or if you think there is something relevant that I haven’t asked about, please feel free to mention it if you feel comfortable doing so.
  • I’ve been trying to find information on trans people’s experiences with this condition. Are there any resources you would recommend?
  • I understand from your history that you are trans. Have we been using the correct name and pronouns for you? If yes, let us know anytime if that changes. If no, what name and pronouns would you prefer?

I hope this information helps you feel more confident that you will be able to treat trans people in a way that conveys your respect for them. Did you find any of this surprising? If there are areas you want to know more about, take a look at the Resources Page or search for other similar posts under the Partner tab.

If you are trans and reading this, what other suggestions do you have? What is your reaction when someone uses one of the phrases that I recommend people avoid?

Help! My Partner Just Told Me They’re Trans!

If your partner just told you they are trans or wondering if they are trans it means they trusted you enough and value your place in their life to share this huge part of themselves with you. If you are not sure what to do next, how to be supportive, or what this means for you you’ve come to the right place. I hope this post will help answer some of those questions.

new relationship

Someone you’re dating who you are interested in and want to pursue a relationship with just told you they are trans.

They’re trans and ‘post’ transitioning

Ask them about their experience of being trans (if they are willing to share).

  • Do they use that label? Are they ‘out’ as trans?
  • When did they start to transition? How long have they been living authentically?
  • Do they have people who are supportive in their life? Are there people who have not been supportive?

Be honest about your level of knowledge and ask if they have any resources or things they feel you should look up.

  • Even if they say no, GO LOOK THINGS UP (which you likely are already doing if you have found this page so good for you! Keep going!). Learn some terminology, learn the basics of what dysphoria is and what the transition process entails for their area of the world.
  • Be honest about your level of comfort and confusion and that you will try not to do anything to offend them or make them uncomfortable and that if you do you want them to tell you right away so you can learn.
    • Sometimes giving someone feedback like this face to face is difficult which results in not getting the feedback you need to be aware of your actions and improve. Offer alternatives – they can write you emails or notes.
    • When is a good time for this type of feedback? It is much easier for people to offer intensely personal feedback if you ask for it directly. Once a week (or whatever time frame works for you), check in with them and ask for feedback.

Offensive questions/statements to avoid:

  • DO NOT blatantly ask about their genitals or if they have had ‘the surgery’ yet.
  • DO NOT say ‘wow! I’d never have known if you didn’t tell me!’ or ‘Wow you look really good for a [insert gender here],
  • DO NOT ask what their ‘real’ name is, or what their name used to be.

The fact that they told you means they feel strongly enough about the relationship that they wanted you to know and that they trusted you enough to tell you something that could potentially put them in an unsafe situation. This reflects well on how you have acted up to this point. Don’t mess it up with an ignorant if well-meaning response.

They are a person, same as they were before they told you they were trans. Nothing has changed. Continue with whatever topics of conversation you were enjoying and learn more about them the same way you would on any other date. Don’t make everything suddenly be about their trans identity.

They’re trans and ‘pre’/in the middle of transitioning

Ask them how they would like you to refer to them (pronouns and name) and try your best to respect that. It may change as they go through their transition so be open to that. If you mess it up say ‘sorry’, correct yourself, and move on. Don’t make a huge deal of it but don’t gloss over it either. If they would like you to use a different name/pronoun than they use in the rest of their life clarify when they would like you to use which set – will it change depending of where you are and who you are with? It is a good policy to have this check in each time you are entering a new environment/meeting new people.

Ask if they’re comfortable talking about it and if they’re willing to explain more about what they’re going through. Keep in mind that they may not want to if you’re out in public but might be ok with this in a more private setting. Or they may not want to right now but they might be able to in the future. This is not usually a reflection on you or how much they like you or how much they feel they can trust you. It is more likely related to whether they have found the words to express the confusion they feel inside.

Ask if they have any resources you should look at that will help you understand their identity or experience (see above).

Be open about your level of knowledge, confusion, and willingness to learn (see above).

Acknowledge that you might do or say something that offends them or makes them uncomfortable but that you don’t mean to and that you want them to tell you right away so you can learn (see above).

They are a person, same as they were before they told you they were trans. Nothing has changed. Continue with whatever topics of conversation you were enjoying and learn more about them the same way you would on any other date (see above).

Long term relationship

Your partner may have known for a long time and have been trying to suppress it, blend in, hide it from you but they can’t any longer. They may have been presenting very much in line with their gender assigned at birth to you and to the world so this can seem like a huge change.

Or, your partner may have been presenting as closely as possible to their true identity and when they reveal to you that they’re thinking of transitioning it may seem like it makes sense and won’t be much different or it might still seem like a surprise.

You may have feelings of shock, betrayal, anger, fear, regret, even disgust. Society teaches us that trans people are abnormal and many of your initial reactions may be a result of this conditioning. Do not beat yourself up for these reactions but try your best to figure out which emotions are specific to you and your situation and which ones are a result of your preconceptions and stereotypes from society.

Try to find some private space and time where you can talk to your partner for as long as you need to understand how they feel and what they want to do. Understanding who they see themselves as and who they want the world to see will help you get a better idea of how you might feel going forward.

Express your own feelings, both negative and positive, and decide whether you need some space apart to work things through or more conversations together to learn more about how/if things will work between you.

Make a list of the aspects of your lives this will affect – your relationship, children, business ventures, family relations, etc. Being able to categorize where the stress is and who is best suited to deal with it will help avoid situations where you are both frustrated and stressed and you don’t know why or what to do about it and end up taking it out on each other.

If these conversations continually break down, consider finding a therapist that is familiar with trans issues to help guide you through this process. You can see the therapist as a couple, by yourself, or recommend your partner see them. Support groups can also be very useful. We found a PFLaG group in our area and have been going as often as we can for over 2 years now. It is wonderful to be in a space where everyone understands what you’re going through without having to explain it in great detail first. It helps normalize the experience and can help you find the support you need.

If you’re up for it, suggest a trial period of them presenting how they feel comfortable. This can be an evening at home, or a weekend away somewhere. It can be done in stages with them slowly changing their appearance one piece at a time to give you time to adjust or all at once. However you decide to do it, I suggest you discuss it together first and make a plan so that no one is surprised or put on the spot.

At this point you likely have an idea of whether or not you are comfortable maintaining your relationship with them or not. This can look many different ways. Some examples are:

  • Yes! This makes so much more sense and I’m here to support them 100%!
  • Yes, I think I’ll be ok with this but it’s going to take some time and I’ll have to take it slowly.
  • No, I no longer see myself in a relationship with them but I’m all for supporting them as a friend.
  • No, I definitely am not ok with this and I don’t want to have any part in their transition.

All these reactions are valid no matter what other people will tell you. Your experience and your life is your own. Make sure your reaction is true for you and not a reflection of what others will think or what society has taught you. You have the right to change your mind at any time. If you think you might be ok with it but at some point realize the relationship is no longer working, be honest with yourself and your partner.

Moving Forward

Communication is key!! If your partner is not willing to sit down and have open conversations with you about who they are and listen to how you feel you may need to find a more formal venue for these conversations (ie couple’s therapy with a trans positive therapist).

Honesty with yourself and your partner is also key!! Be honest about how you feel and when you don’t know what you feel. Find ways to explore different scenarios with your partner to help each of you figure out how you feel. Your partner will be going through a lot of intense emotional things and you may not feel like you want to put all your doubts and confusion and frustration on them as well. Ask them if they are ok with you talking to one close friend about what you’re going through. For me, this was someone who lived somewhere else in the country which meant very low risk to my husband. It might help if it is someone who is somewhat familiar with the queer community, especially if you are not.

If you are happy staying with your partner, their transition will change how society views your sexuality (see my post about this here). I know, this makes no sense because you haven’t changed as a person, but it will happen anyway. Your sexual orientation and the labels you use can change if you feel like it has but it doesn’t have to. You are likely still attracted to the same types of people you were before your partner transitioned. Your partner may still fit within the label you use or you can see your attraction to your partner as an exception. Either way, it will help to find labels that work for you so you have a way to come out to people without outing your partner as trans (for those that didn’t know you beforehand).

 

I hope this helped. This is the type of information that would have been useful for me to have during my husband’s questioning phase and into the beginning of his transition. Giving support to other partners of trans people is one of the main reasons I started this blog.

 

How did you react when your partner told you they were trans? How has this affected you as you process this information? What types of support have you found? What is the outcome for you and your partner? Leave a comment below and tell me your story.

My Husband’s Transition – A Partner’s Perspective (Part 3: Medical and Legal Transition)

The story began in Part 1: Exploration.

The story continued in Part 2: Social Transition.

And now, the conclusion.

Where do we start?

As soon as Jake knew he needed to transition we searched for any information about the medical process where we live. There was nothing online. The most reliable source of information came from Jake’s psychologist who is very involved with the trans community, including moderating a PFLAG group that we had been attending for several months. At this community support group we heard from others that were further along in their transition process how they had accessed medical care and got their legal documents changed.

Jake started by going to our family doctor who was allowed to prescribe hormones following a very clear algorithm in the WPATH guidelines but, having been to a seminar about the transition process ten years ago, our doctor felt like he knew the appropriate process (all referrals had to go through the psychiatrist) and refused to overstep his bounds. As you may have guessed, the medical management process has changed somewhat in those 10 years but very few family doctors are aware or feel competent enough to provide the treatment that trans people require. And although he was ‘aware of the correct procedure’ he didn’t know that the wait to see the psychiatrist was over a year long or believe us when we informed him of this repeatedly after talking to other trans people who had just gotten their first appointment and phoning the psychiatrist’s clinic.

Luckily, through the community, we learned of a family doctor who had prescribed Testosterone for another member of our group. Jake booked an appointment with him asap and was able to start T a week later. At the time I’m writing this Jake has been on T for 14 months.

Testosterone

The first change was his voice. He was starting a second puberty at the age of 30, complete with the cracking voice which led to much hilarity and some mild embarrassment. Until his voice had dropped enough to be more consistently recognized as male, I was the designated representative when interacting with strangers – ordering food, making phone calls, giving my name for contact info.

As his voice dropped mine started sounding higher by comparison to the point of sounding nasal and squeaky at times. I naturally found myself lowering my voice which in the end made me more comfortable due to my own gender identity (more on this in the posts from the ‘Personal’ category).

Jake then started growing facial hair, a sleazy mustache at first, then very slowly sideburns and a goatee. He got stronger, especially in the arms and shoulders. The slow nature of these changes gave me plenty of time to get used to them as they happened. I never had a moment of hesitation or question about whether I still found him attractive. The more his body changed the more confident and comfortable he became. Confidence is very attractive. My mental image of him had included a lower voice and facial hair for quite some time so as his physical body changed it simply fit my mental image more closely rather than being more and more at odds.

As he was read more as male this in turn made us read as a straight couple and put me squarely in the female category. All of this took away our visibility as a queer couple, something which we both continue to struggle with. It was also a trigger for my personal gender exploration – more on this here.

The struggle of Changing his ID

When it came to getting his documents changed Jake encountered too many barriers to list here. Forms that did not include options for his situation, systems that couldn’t accommodate a change in this information, customer service people who were not familiar with the process, conflicting answers that often required backup from unrelated documents that he was also struggling to get changed, all of which required a fee to be processed.

My personal experience with this was when I had to change his information on my health insurance through work. You can’t do this over the phone, you have to email them, they will send you the form, you fill out the form and fax it in, they will email you when it’s completed. The form has a section for changing your  dependent’s information and reasons why you need it to be changed including information is incorrect, marriage, divorce/separation, etc. There was no ‘transitioning’ category (which I wasn’t expecting) but there also wasn’t an ‘other – fill in the blank’ category. So I ticked off the ‘information incorrect’ and wrote beside it ‘transitioning from female to male’. When I got the email saying it had been processed I checked my account and found his name had been changed but he was still listed as female and ‘Mrs.’ So I emailed them back. A while later it got updated to Mrs. Jake, male. Another email, another wait, and eventually they got it right.

This whole time we weren’t sure what would happen if Jake tried to claim health expenses using his updated Alberta ID if his info in my account didn’t match. So he had been holding off on a couple of things until this went through. This was a needlessly frustrating process but still was much safer than many of the interactions he would go through to get ID changed – for example justifying himself in front of a line of waiting people to a clerk who then had to go get their manager to whom he had to explain himself again.

Getting his national documents changed was the biggest ordeal because he was born in New Brunswick, the one province or territory that had not yet passed legislature for people to change their gender marker on their birth certificates. And until your birth certificate is changed you can’t change your passport. And until your passport is changed it’s not safe to travel to a variety of places including the United States. So we had to cancel our planned vacation to go to Arizona in February at a time when we really could have used it.

Frustration levels rising

All I could do was try to support him, provide a sounding board for his frustration and provide positive outlets and distractions. Very few people could understand what this process was like. When voicing our frustration to others we would usually get the response of ‘oh yah, when I got married it was such a pain to change all my documents, it takes forever, but it’ll be done eventually’. Oh yah? Did the forms you had to fill out not have the option you needed to check off? Did the clerk never know how to process your request or require medical documents as proof? Did it take a huge amount of emotional resilience to walk into each office and out yourself every time? Just like coming out as gay and coming out as trans are not the same thing, changing your last name on all your documents after getting married or divorced and changing your first name and gender marker because you are transitioning is not the same thing. I know people were just trying to be supportive but the amount of educating we had to do to get people to understand the differences was exhausting.

The overall the frustration level rose considerably while he was on waitlists for surgery and endocrine, waiting for paperwork, and even waiting for laws to change so he could change his birth certificate. Frustration is a stagnant emotion that I learned leads to considerable burnout. Eventually I had to start paying more attention to my own mental health and I started a bullet journal including habit tracking, weekly debriefs which eventually lessened to monthly, daily journalling which tapered off quickly, and making sure I had emotional outlets that provided some sense of progress and connection with the queer community – for me this is creative writing and music. It took me five months of consistent personal work but I improved significantly and was pretty much back to normal.

Top Surgery

Jake had waited 4 months for his consult for top surgery with a local surgeon which would be covered by health care. The consult was not particularly encouraging, suggesting that he would likely need a revision a couple years later which would not be covered. It would also be 1.5-2+ years wait before he would be having surgery (because of the waitlist). So he had booked a consult with a private clinic in Toronto which he waited another 4 months for.

In prep for this consult we had to take topless pictures for the surgeon and take measurements which was a very uncomfortable experience for both of us as neither of us pictured him with a female shaped chest at this point. Any time he saw himself in a mirror it would cause dysphoria. My image of him had a blurred out section at his chest. Since he overheats easily and has asthma he couldn’t really wear a binder comfortably so instead he had been wearing baggier clothes and adopted a slightly hunched and rounded posture which was causing upper back and neck pain.

This consult went very well and, as it turned out, they had a cancellation and could do the surgery a month later. We had a brief scramble to make sure we could both get time off from work, see how much flights would cost, make sure my parents didn’t have other visitors staying at that time, and then confirm everything.

Just before leaving for top surgery he received his final national documents in the mail – a huge milestone and a huge relief for both of us.

Getting him through surgery

The days leading up to surgery were filled with excitement and nervousness. After the pre-op appointment the day before surgery this went to a whole other level and all I could do was help him manage anxiety about surgery and self-doubt about whether this was right for him or not.

While he was in surgery I waited and waited and waited. I checked in with the clinic at the time when they said he’d likely be done, was sent away, returned an hour later to be told he was in recovery but that they wouldn’t let me in. I came back 45 minutes later to be told he was a little teary but was doing ok (What does a bit teary even mean? Why was he teary? Wouldn’t I be the best person to support him if he was upset?). Not having access to him in recovery to help with the immediate symptoms was even more frustrating because I work in a hospital and I’m very familiar with how to deal with people who are coming out of anesthetic and dealing with post-op pain.

Half an hour later I finally got to see him. He was super pale, sweaty, and shaky. But even with the post-op binder on his chest was flat! I asked him about the tears. Turns out it was just an endorphin response when coming out of the anesthetic, not an emotional response to the surgery or his chest like they had made it seem. I helped him change out of the gown into his clothes, grateful that we had been told by friends to wear a button up shirt. Eventually he was feeling good enough to go home but they insisted on escorting him to the car in a wheelchair. As far as I’m concerned they’re either ready to release him or not but whatever. This caused more hassle than necessary because I had to go get the car and figure out how to get back to where they were waiting. I tried to stay calm because Jake didn’t need any more stress than necessary but was ready to scream or burst into tears by the time we were finally in the car and driving away.

We spent the next few days resting in bed. I visited with my family while Jake was taking naps. I helped him manage the binder, adjust it as needed, and folded face cloths to wrap over the edges of it where it was digging in under his arms. I helped him stay cool or warm, got food and water, made sure he had entertainment when he was up for it so he didn’t get antsy, got him different meds when he got itchy or nauseous from the narcotics, and put arnica on the bruises (very gently). His energy slowly came back and the pain decreased enough to wean from narcotics but the binder was still digging in under his arms in the most painful bruised areas where they had done liposuction so he couldn’t use his arms much as a result. T-rex Jake.

Post-op reveal and return to normal life

We went back to the clinic about a week after surgery for removal of the bandages and to see how the nipple grafts were doing. I’ve seen incisions before so it didn’t make me queasy or concerned. His nipples looked really dark but this apparently is normal and the surgeon was pleased which was a good sign. It was a very interesting experience to see his chest flat for the first time. I was finally able to look at that part of his body and not have what I was seeing conflict with what he looked like in my head. Over time the blurry part where his chest was in my mental image cleared to match what his chest looks like now.

Once we were home he struggled with the binder for another few weeks but eventually gave up and stopped wearing it. He was instantly more comfortable using men’s washrooms which in turn decreased my own anxiety about him being at risk in public washrooms. He slowly started wearing the clothes that he hadn’t been able to for a while because they had been too fitted across the chest. Now they fit perfectly. I don’t think he had realized how much stress he had been dealing with whenever he was putting clothes on to go out until he was able to put on whatever he wanted and not worry about it getting him misgendered. It’s an amazing experience to see your person finally be at ease with themselves and gain the confidence they had been searching for for so long.

The end?

So in the span of about a month we went from huge amounts of frustration and burnout to all legal documents changed and top surgery complete. It took a while for the stress to dissipate and the relief to settle in but man, did it feel good. Not everyone has the opportunity to pay for private surgery and get it in a timely fashion. Not everyone has support from family when they’re going through these medical procedures or transition in general. We are extremely fortunate in both these areas. And yet, even with all that support and stability it was still a very difficult, stressful, emotional process that was very hard to explain to the people around us. Spending time with each other and other trans people and finding online resources that related to our experiences were the things that kept us going. It is not a surprise to me at all that approximately 50% of trans people attempt suicide at least once in their lifetime (reference).

There is no specific end point to transitioning. Jake may have other surgeries in the future and will continue to have slow changes from Testosterone. But in our experience, after being on T for year, having completed top surgery, and having all his documents changed he has been able to pass consistently as male and has considerably less daily struggle with being trans. When we go through future transition related experiences I will make separate posts about those so stay tuned.

I hope you found this account interesting and helpful. Leave a comment if you have had similar or different experiences or if you’d like to hear more about any particular aspect.

My Husband’s Transition – A Partner’s Perspective (Part 2 – Social Transition)

The story began in Part 1 – Exploration.

Coming out

We started Jake’s coming out process with some preparation and planning, as usual. We made a list of the people he wanted to tell first starting with who would be easiest to tell and would likely be the most accepting. Telling them would hopefully give Jake the confidence and support he needed to tell the ones who’s acceptance would have a bigger impact and therefore, would be a lot more stressful to come out to.

I helped Jake write an email that he sent to the first few people on the list. When that went well, he continued down the list at his own pace. We revamped that letter a number of times throughout the coming out process depending on who we were telling and what type of information they would respond to best.

Gender Gymnastics

I had my own sort of coming out process at the same time. For a long time I had been trying to refer to Jake using male pronouns and name in my own head and at home (which we discovered is hard to do because when it’s just the two of us we never use our proper names or third person pronouns). But until Jake was ready to come out I still had to refer to ‘my wife’ when I wanted to share personal stories with co-workers. This is something I had done a lot of in the past in an effort to be a visible example of a queer couple. Plus, I’m a talkative sort of person, what can I say. This became very uncomfortable, to the point where I began avoiding pronouns or using neutral pronouns when talking about Jake, and shortened his birth name to a gender neutral nickname. However, neither of those would fly around his family so I had to continue with the female pronouns and name with them.

Adjusting to someone’s new pronouns and name is extremely difficult for a lot of people but here I was switching back and forth between three sets of pronouns and names with minimal errors for about four months. We quickly realized this must be my super power. Even so, it took a lot of mental energy, caused a baseline level of burnout that would continue to escalate over the next two years, and caused me to develop a speech pattern that has random pauses in it from when I had to reorder the words in a sentence to avoid a pronoun midway through.

Telling My Co-workers

Around the time Jake started coming out to his friends and family, he gave me permission to ‘come out’ for him with my co-workers (whom he had minimal to no contact with). Finally, I would be able to use male pronouns and refer to my husband Jake. This happened to coincide with November 20th – Trans day of Remembrance. I work in health care in a department that is broken into smaller teams so I decided to make a short presentation at a the next team meeting.

I highlighted how difficult navigating the health care system can be for trans people and the disastrous consequences of that ignorance and transphobia can have, especially when it comes from a professional or happens at a time when the trans person is already in a vulnerable position. I explained that this issue is particularly important to me because my husband is transitioning. My voice only wavered a little bit at this point but I was extremely grateful that I could hide my shaking hands behind the lectern and lean on it for support when my legs went to jelly. I quickly followed this with an educational introduction video done by Jazz Jennings listing the 10 most important things to know about trans people. At the end of the meeting I received hugs from a couple of my closer friends on the team and someone even thanked me for helping them understand what a younger member of their family was also going through and how to support them better.

In my experience, there was plenty of gossip about co-worker’s private lives relating to other topics (deaths in the family, health issues, reasons for absences, personality conflicts, etc). I thought this would be a novelty item for gossip and would spread quickly through the department. Well, I was wrong. Either my partner transitioning is too far removed to be of interest (rather than me transitioning), or people didn’t know how to talk about it or were too uncomfortable to talk about it to want to gossip about it. Or they recognized that talking about it would constitute outing someone which is generally not acceptable, though in this case it would have been useful.

So this began about a year-long, slow coming out process with many repetitions of – blah blah my husband blah blah, oh yes, still the same person, yes, my wife is now my husband, no I haven’t gotten divorced and re-married in the span of a few months, my husband is transitioning, yes I’m ok with it, yes, I’m still gay, his name is Jake, no, it’s not actually polite to ask what his name was before, no, that’s alright, yes, I’m happy to explain it all to you sometime, just not right now in this room full of people, anyway, what I was saying was…. Each time my heart would pound, my palms would sweat, and I’d be glad I was sitting down or would find a chair quickly. This reaction lessened with each repetition but often the mini coming out sessions would take me by surprise because I was never sure who would have found out some other way or who I had told already (I am notorious for forgetting who I told what to).

Occasionally I would have longer more in-depth conversations with some of the co-workers I knew a bit better or some that were particularly curious. I say curious rather than nosy because for the most part their questions didn’t come from a place of wanting to know juicy details about my personal life or my husband’s. They were more curious about what the internal and external process was like in a general sense or in a health care related sense and what my reactions were to it. So even when their questions were targeted to me or Jake I would keep my answers broad such as ‘well often the trans person…’ or if I was ok being more specific or personal (which often I was) I would say ‘well I can’t speak for other people but for us…’ I had many conversations with Jake about what aspects of his transition he was comfortable with me sharing with people and lucky for me he usually said whatever I wanted to share was fine. This is partly because I was talking to people who he had little to no interaction with and partly because I work in health care and we want to educate as many health care workers about trans issues as possible.

Over time (via trial and error and educating myself via online resources) I learned what questions were appropriate for people to be asking and which ones they didn’t really need to know in order to expand their understanding of the trans experience. One example is when people would ask what his name used to be. They would remember that I had a wife but couldn’t remember my wife’s name so when I said I had a husband named Jake and yes, he was the same person as before, they wanted to fill in the missing information. In these instances I learned to tell people that this isn’t actually a question you should ask and provide an explanation why so they didn’t think it was just because I was uncomfortable answering and then go on to ask the same thing of the next trans person they met. For the above example I would explain that knowing his previous name wouldn’t help them understand his experience or who he was, it would likely only get in the way of them changing the image of him in their heads by giving them a female name to latch onto. Maybe at some point in the future I will be brave enough to challenge them by asking why they are curious about this in the first place and make them reflect on where that question is coming from.

Telling My Family

When Jake was ready to come out to my family we discussed who he needed to come out to directly and who I could act as a go-between for. I helped him rephrase his letter (again) and provided backup for the follow up questions. I had discussions with my immediate family about what this meant for me and how I was dealing with it all. By this time I had had plenty of practice with explaining this to people so though the conversation was slightly more intense because it was more personal, I managed it fine.

Since my family lives across the country from us they had to police themselves in order to reinforce correct name and pronouns. So we gave my immediate family some time to get used to the idea and more comfortable with the correct name and pronouns before telling my extended family. I hand wrote a personal letter and mailed it to my grandmother, hoping that the evident effort in writing it would show how important it was to me. I got a brief response from her that said she received it and that she loved us and she used male pronouns and ‘Jake’ throughout which was all we needed. We shortened this letter to just the necessary basics and sent it as an email to my extended family all at once. I got many responses of support, all of which I forwarded on to Jake so he would see them too. Overall, it went fairly smoothly.

Helping With His Family

Around Jake’s family I reinforced his name and pronouns just by using them. Since he never uses them for himself and they wouldn’t use them when talking to him it was only when I was also there that they would hear someone using them and we could see whether they were doing the same. This meant I had to get out of the habit of avoiding pronouns and start using them as much as possible – again, thankful for my super power. But their slow reaction time and constant misgendering of him took its toll on me. We discussed a number of times whether it was ok for me to correct them or not – was Jake not correcting them because he didn’t want to rush their acceptance process and he was trying to be respectful or because he didn’t have the energy but really wished I would? Jake preferred to correct them when he saw fit so when I felt my blood pressure rising I would bow out of a conversation or avoid social engagements with them for little while.

The turning point came when Jake’s step-brother got married. Jake hadn’t planned on telling his extended family yet but he knew he didn’t want to be introduced as the groom’s sister or be asked to wear a dress *shudder*. So about a month before the wedding Jake sent them an email (as per usual) and got a supportive reply suggesting they get together the next week when they were in town. We had a lovely open conversation with them and discussed how to handle this at the wedding. Jake decided he was going to jump in with both feet and correct people as needed but he would be ‘Jake’ and ‘he’, the groom’s brother from now on.

The majority of the guests at the wedding had never met Jake before, though a few would have known that the groom had a number of sisters but no brother. I assume some of that correction happened in the background on the groom’s part but for our part Jake and I made brief explanations and corrections for the people who actually knew him and his mom helped with that a bit too (yay!). Throughout the weekend everyone around us was referring to Jake as male like it was a non-issue. It was fantastic. More than that, it showed Jake’s immediate family that using Jake and he/him was ok, people wouldn’t treat him as a freak, and he was so much more relaxed. Because everyone else was calling him Jake and ‘he’, they looked weird when they didn’t. So his immediate family had a weekend of name and pronoun immersion which is just what they needed.

Coming out at work – more anxieties

We had been planning for Jake to come out at work for a while. He had contacted HR to make sure he had backup if he needed it, he had done bathroom reconnaissance to find a gender neutral bathroom in case the males were not supportive enough to feel safe using the men’s bathroom, and he had drafted a letter to his team lead and her boss. But after that weekend at the wedding where he got to be Jake for an entire weekend it was extremely difficult to go back to being a woman at work. So he bit the bullet and sent the emails and had the meetings.

When Jake was preparing to come out at work I had a resurgence of the anxieties about whether he’d be going to an antagonistic work environment that was unsafe but I knew that it would still be better than the constant overwhelming dysphoria. How would he deal with people that weren’t accepting? The first day when he was telling people was super stressful but in the end it went fairly well. They are still (more than a year later) messing up his pronouns on a daily basis which is taking a toll but overall everyone was supportive.

The next step was to start changing his ID. Not to mention that he was still waiting for the initial psychiatrist appointment who would refer him for hormones and surgery. This is where the real frustrations began.

The story concludes in Part 3: Medical and Legal Transition.