Support – Page 3 – Purple and Green and the Life in Between

Inclusive Pregnancy and Birthing Terminology

NOT ALL PREGNANT PEOPLE ARE WOMEN

Not all pregnant people are women. Being pregnant as a person who does not identify as a cis woman can make my identity feel invisible. It often feels like all anyone sees about me is that I’m pregnant and therefore I must be a woman.

I know lots of cis women also feel like they lose their individuality while they are pregnant and especially once they are a parent. Some push back against it and some embrace it. I also know that pregnancy, birthing, and breastfeeding have been seen as traditional components of womanhood and there is a lot of push back against people who don’t identify as women claiming these experiences. There is also push back against people who identify as women not wanting to have these experiences and shame/stigma experienced by women who would like to have these experiences but are unable to for whatever reason.

I can’t fight against all these types of social marginalization, discrimination, and stigma in one post. I personally don’t see any of those judgments or identity based limitations as necessary, meaningful, or helpful. Everyone should be allowed to experience whatever aspects of childbearing, child caring, and child rearing they want and if they are unable to we should support them with community rather than shaming them. Regardless, I wanted to share my own personal experiences with this and some recommendations that might help others in the future.

PERSONAL EXPERIENCE

Being pregnant and preparing for a baby requires consuming a huge amount of information and resources, most of which is presented as female-centric. I constantly have to filter out the language in order to apply this information to myself which is exhausting.

It is often hard to tell why I am uncomfortable with the information I’m consuming. Is it because it is all new, different, and overwhelming as anyone preparing for their first child can attest? Is it because picturing myself in that scenario triggers dysphoria which may mean I will need/want to avoid that situation or have a dysphoria management strategy in place? Or is it because the information is presented using language that is triggering dysphoria as I read it?

This makes it extra difficult to know what aspects of birthing and baby care will be more or less difficult for me gender-wise and how to prepare without stressing myself out about things that will be completely fine in the moment.

In order to sort through these reactions, I have joined trans/nonbinary support groups so I can see if I am equally as uncomfortable, anxious, or dyphoric when discussing the same topics with people who share my experiences and use affirming language. I also talk to my therapist and will have appointments scheduled for postpartum as well (highly recommend this for anyone able to access this service). Lastly, I have found The Birth Partner by Penny Simkin to be an invaluable source of balanced information presented almost entirely using gender neutral language.

RECOMMENDATIONS AND RESOURCES

Below is a table of some of the terminology that I have come across and some gender neutral or inclusive alternatives. I hope this helps steer resources and practitioners in a more trans inclusive direction.

Traditional Language	Trans Inclusive Language
Pregnant women/woman	Pregnant people/person Gestating people/person
Mother, mom, mommy	Parent Gestational parent [Preferred parenting label]
Woman in labour	Person in labour Labouring person Birthing person
Father, dad, daddy	Parent, partner, co-parent Support person Non-gestational parent [Preferred parenting label]
Nursing	Lactating Feeding Bodyfeeding
Breastfeeding	Chestfeeding Breast/chestfeeding Bodyfeeding
Breast milk	Human milk Expressed milk

Please Note: I paired ‘Gestational parent’ with ‘Mother’ because traditionally, anyone gestating is labeled ‘Mother’ and resources that refer to the ‘Mother’ are often for gestating people in general. Some gestating people are men and will use the term ‘Father’ or other typically male parental term. Similarly, not all ‘Fathers’ are ‘Non-gestational parents’ – they might be the one who gestated the child! But traditional resources referring to the ‘Father’ often mean ‘Non-gestating parent’ or even just ‘Support person’.

The goal is to say what you mean. Do you mean ‘pregnant women’ specifically ie are you referring to a difference of experience between pregnant women and pregnant people of other gender identities? Or do you really mean ‘pregnant people’? Being inclusive isn’t difficult or mysterious. But it does require awareness of the breadth of identities and experiences and self awareness to say what you actually mean.

In addition to using trans-inclusive language, a basic understanding of what dysphoria is and how trans people who are pregnant, birthing, or postpartum may experience dysphoria is necessary for providing trans-inclusive care. Every trans person experiences dysphoria differently and will manage it differently. Knowing how to have those conversations with the gestating trans person in your life will make you a much better support person. As a support person, you are not responsible for identifying or managing their dysphoria for them. Simply knowing how to ask about it, being familiar with the language and experiences, will give them space to discuss it with someone who is showing care and support. Trust me, it makes a big difference.

If you are a birth worker (medically trained or not), here are some other resources that will help point you in the right direction:

Inclusive lactation style guide from International Lactation Consultant Association and why it matters
Gender Inclusive Language examples from Trans Care BC
Moss Froom: Trans & Queer Centered Doula & Childbirth Educator
Jenna Brown: Love Over Fear Wellness and Birth LLC
The Birth Partner, 5th Ed by Penny Simkin (also very good resource for gestating and birthing people and their supporters)

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The Power of a Non-Binary Perspective

THE WORLD IS NOT BLACK AND WHITE

I listen to a lot of podcasts and recently I listened to two different ones that seemed to be in conversation with each other. The first was an episode of Gender Stories by Alex Iantaffi released on April 12, 2020 called A non-binary approach in the COVID-19 pandemic: a conversation with Meg-John Barker. The second was an episode of Thoughts on Thoughts by Kristjana Reid, Jessica Miller, and Taylor Thomas released on June 8, 2020 called The Power of the Word “And”: Holding Conflicting Emotions Together. Both of these episodes were talking about how limiting, and potentially damaging, a black and white, either/or perspective can be.

There are many times in our lives when we are either personally experiencing a complex situation (such as parenting a difficult child) or are surrounded by one (such as a global pandemic). Often, we feel like there should be a right and wrong way to react to the situation, certain actions that we should take and others to avoid, ways we should feel that would, by the very nature of those feelings, prevent other ways of feeling. But if the situation is complex, why can’t our reaction to it also be complex?

THE NON-BINARY PERSPECTIVE

Here’s where the non-binary part comes in. Non-binary experiences and identities directly counteract the gender binary. Gender cannot possibly be composed of two boxes, male and female, that are seen as opposites of each other, if there are people who experience both of these genders, neither of these genders, or a third and completely different gender.

The non-binary perspective allows for a variety of experiences beyond the most obvious two (black and white, right and wrong) that we are usually presented with. It encourages us to consider both options as acceptable, or neither, or a third different option, or various options depending on the circumstances. It also encourages us to allow others to choose a different option, have a different reaction, or experience a situation differently from ourselves without judging that as incorrect, wrong, or harmful.

Now, the caveat is that, as I said, this helps us navigate complex situations with a more nuanced or open-minded approach. Some situations are not complex. Some situations clearly have a right and wrong reaction. So use your own judgement as to when this applies and when, perhaps, a stronger, more defined stance is required.

EXAMPLE 1: COVID-19 PANDEMIC

Here are a couple examples that came up in the podcast episodes (rephrased in my own words). The COVID-19 global pandemic has lead to many countries, local governments, and individuals reacting differently but very strongly based on very little information. It has lead to a lot of blaming and shaming, anxiety and isolation, but also creativity and ingenuity. This is one of those situations where, maybe, different reactions are acceptable depending on the situation at the time, in that place, or for that individual.

There are a lot of black-and-white seeming questions. Should we wear a mask or not? If we’re wearing masks, do we still need to stay 6 feet apart or not? Should we be disinfecting everything that comes into our houses or not? The scientific answers have been slow to keep up with the social necessity of answering these questions so everyone has had to decide for themselves what is best.

The non-binary perspective allows space for a variety of responses to these questions without shame, blame, or guilt. It allows for the freedom to change your response depending on the situation or what information you have.

Note: if you are looking for a source of scientific answers to these and other questions related to the COVID-19 pandemic, I recommend the podcast Science Vs from Gimlet. It is scientifically founded with a citation list for each episode and entertaining to listen to.

EXAMPLE 2: CONFLICTING EMOTIONS

The second example that stuck with me was dealing with conflicting emotions experienced during the postpartum period or with the death of a loved one. As I am into the third trimester of pregnancy at the time of writing this and my grandmother recently passed, I found these examples particularly relevant. I actually wrote a post along these lines about my experiences during pregnancy before I heard this podcast episode (Grief and Gratitude).

When we experience conflicting emotions we often put the word ‘but’ between them. ‘I love my baby but I’m so exhausted I can’t deal with this anymore’ or ‘I’m sad she’s gone but I’m glad she’s now at peace’. In the podcast episode of Thoughts on Thoughts, they talk about how the word but diminishes or negates everything that came before it. It suggests that we have to choose between those two experiences, that we can’t possibly experience them simultaneously or in equal amounts, and the one that we say after the but is taking precedence.

Instead, they suggest trying to use the word ‘and’. ‘I love my baby and I’m so exhausted that I can’t deal with this anymore’ or ‘I’m sad she’s gone and I’m glad she’s now at peace’. How does the change in these phrases sound to you? For me, this re-framing was powerful. It suggests that we are allowed to feel both of the emotions equally. It now sounds like the second part that before was negating the first, is now resulting from it, that they are tied together, intrinsically linked. This, for me, is a much more truthful presentation of how conflicting emotions feel.

So, next time you are expressing conflicting emotions, try to listen for that word ‘but’ and change it to ‘and’. Just like gender isn’t either/or, male or female, neither are emotions. You can be experiencing both at once, or even more than two, without any of them negating or diminishing the others.

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In My Body

Note: Although this post is specifically about my experience of being pregnant, you might find what I talk about relates closely with other major life events such as health challenges, injuries, and aspects of transitioning. I hope you find it interesting, if not relevant to your own experiences.

Being pregnant is a weird experience. Everyone who is or has been pregnant experiences it differently, both physically and emotionally.

There are both positive and negative aspects to the process that we have to navigate. Some of the positive aspects can help offset the negative ones, but sometimes our only ways to cope with the negative ones also diminish the positive.

I am currently trying to deal with physical body pain as well as physical and social dysphoria while trying to stay present and experience the wonder of being pregnant.

Generally, the easiest way to cope with both physical pain and dysphoria are to distract myself, decrease my focus on my body. But that also takes my focus away from the internal changes related to being pregnant. This can make me feel like I’m missing out on the experience of being pregnant and decreases my ability to convince myself that the negative aspects are worth it for the sake of growing a human. Regardless, if the pain and/or dysphoria are bad enough, distracting myself from my body becomes a necessary survival tactic.

Most of the time, some amount of focus on the specific parts of my body that relate to the positive aspects of being pregnant actually helps offset the pain and dysphoria by making them feel worth it or at least by giving me something positive to focus on. These aspects include the expansion of my belly, the sensation of the baby moving, and knowledge about the baby’s growth and the changes in my own body.

So focusing on my body in specific ways can heighten my awareness of the positive aspects of pregnancy and offset the negative ones to some extent but too much focus on my body can actually cause the negative aspects and my awareness of them to get worse. This balance point is different every day and in different situations. For me, finding this balance point is an instinctual process.

Lots of prenatal programs encourage meditation, yoga, stretching, and breathing techniques, all of which require or encourage a certain amount of focus on or awareness of your body. Depending on where I need that balance point to be, these activities might do more harm than good for me at any given time.

Everyone’s strategies for managing the positive and negative aspects of pregnancy will be different. Some people may not even be aware they are using a strategy similar to mine. I only recently became aware that I was using this strategy myself. Some people may not be able to understand how this strategy works for me or why it is necessary no matter how much I try to explain it.

Our connection between our mind, body, and emotions is strange and complex. The more you understand how it works for you, the better you will be able to navigate these types of complex, conflicting, and life-changing experiences.

So far, I feel like I’m doing ok.

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Grief and Gratitude

This is not the experience of pregnancy I had hoped for. Everyone hopes for an easy pregnancy with no complications for the baby and minimal difficulty for themselves. Very few people get to experience this but that doesn’t change the hope or the emotional response when it doesn’t happen.

More than anything, I want to enjoy being pregnant and be able to celebrate how my body is creating a new life. But it is hard to feel happy about the experience and excited for it to progress when my body is in constant pain as a result.

Having hopeful expectations that aren’t met causes a feeling of grief. Grief about the experience I wanted to have, grief about not being able to be present and connected to the experience the way I wanted to, and grief about not being able to engage in my everyday life the way I normally would due to being pregnant.

Grief is our way of processing and letting go of those inaccurate expectations. Ignoring grief makes it stronger, makes it have a more insidious effect on my emotional state that I cannot counteract. So I choose to acknowledge it, process it, accept it, and talk about it. Maybe there are others out there who also struggled with grief while pregnant.

But despite feelings of grief, there is not a single moment that I am not grateful to be pregnant. There is not a single moment that I regret all the time, money, and emotions we put into getting to this point. Grief and gratitude can exist at the same time and often do. One does not negate the other.

When I talk about the struggle that I am experiencing as a result of being pregnant, I often get a sympathetic reaction but I also get comments of ‘it could be worse’ or ‘just be grateful you were able to get pregnant’ or ‘just wait, it’ll be even harder once the kid is born’. These comments are often accompanied by stories of terrible pregnancy symptoms, struggles with infertility or miscarriage, and comparisons between pregnancy and life with a newborn. While these are likely true stories, they do not often relate directly to my experience in a way that will help me cope or prepare for the future, nor do they acknowledge or hold space for my grief.

So next time you ask someone how they are doing, whether because they are pregnant or because of other difficult situations (of which there are so very many in the world at the moment), try to hear the emotion embedded in their experience and connect with that rather than the situation on the surface. You may have experienced a similar situation but had a very different emotional experience with it that will not resonate or provide support for the person you are talking to. But if you can relate with a story that shares the same emotional experience even if it was a completely different set of circumstances, this will be much more supportive and powerful.

Emotions are complex. Many conflicting emotions can exist at once within each person. Just because I am grieving certain aspects of this pregnancy experience does not mean I am not grateful for every part of it at the same time. And that is perfectly fine.

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Non-binary and Pregnant (Again)

That’s right! I am in my second trimester of pregnancy!

HOW WE GOT HERE

After the miscarriage (see Pregnancy, Miscarriage, and Gender), we continued with IUI for two more cycles (taking a month off between each as before). When that didn’t work, we tried a medicated IUI cycle where I took a follicle stimulating drug. The goal was to force my body to produce and release multiple eggs.

The drugs gave me hot flashes, dizzy spells, racing heart, and decreased appetite. We decided that if this cycle didn’t work, we would take a longer break to build up some money and prepare for IVF. The two week wait was particularly intense and when it came back negative, it took extra time and energy to recover from.

IVF

We calculated that it would take about eight months to build up the money needed for IVF but with the help of both of our families, we were able to start much sooner.

The IVF process involved a lot of hormone injections, abdominal discomfort from enlarged ovaries, many internal ultrasounds, an egg harvesting procedure, daily embryo updates, and eventually an embryo implantation.

What with all the hormones in my system and the aching ovaries, I had no idea if I was pregnant or not until the blood test. Which came back positive!!

PREGNANT AGAIN

This time, we knew for sure that the egg had properly developing genetic material inside so we had already avoided the cause of my previous miscarriage. Over the next few weeks I slowly developed the typical first trimester symptoms – fatigue, nausea (luckily not too bad), and increased hunger and thirst. The aching in my ovaries slowly faded and resolved by about week six.

We had our first ultrasound at week 7. There it was, a little bean, floating in a pool in my womb. Better yet, there was a little fluttering spot in the bean that showed a heartbeat!

My pregnancy symptoms continued to worsen until week nine when the nausea suddenly disappeared. My appetite and thirst increased even more. Around week six I started to have increasing joint pain. I have chronic SI joint problems and low level body inflammation and often take naproxen to manage pain. It is a wonder drug for me but unfortunately, you can’t take naproxen or anything like it while pregnant. So, over time my SI pain has gotten worse and I have had to use a cane, wear an SI belt, and be careful what I do at work.

THE GENDERY STUFF

The IVF process had a lot of ups and downs with regards to gender. There were times when I felt like I fit right in and felt affirmed as a woman, in awe of what my body was doing. Then there were times when I felt very out of place, at odds and uncomfortable with being identified as a woman. At those times, using the women’s bathroom and signing many documents that identified me as a woman were particularly difficult.

I was forced to be aware of and interact with my ‘female parts’ in invasive and unavoidable ways. I had many transvaginal ultrasounds throughout the IVF process, one of which fell on a particularly dysphoric day, after which I immediately had to go to work, and took me hours to recover from. All procedures since then have been slightly more difficult regardless of dysphoria just because of the memory of that experience.

During the pregnancy so far I have been floating around the female side of neutral, much closer to the middle of my typical gender bandwidth than the last time I was pregnant (see Pregnancy, Miscarriage, and Gender). Is this because I have had more time to become comfortable and confident in my gender or because the hormone balance is different this time around? Who knows. Regardless, this means I have had more balance but slightly more dysphoria than last time.

LOOKING AHEAD

As I move into the second trimester and start to show more and tell people, I’m expecting my social dysphoria, and eventually my physical dysphoria, to get worse. Hopefully I’ll be able to manage this ok with the support that I have and a lessening of the first trimester fatigue.

I will try to post more frequent updates on how things are going and what being pregnant is like as a non-binary person.

If you or someone close to you is going through the IVF process and you would like more details on my experience or someone to talk to I am happy to share in a more private setting. Feel free to email me or leaving your contact info in the comments.

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

OVERVIEW

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

SHOW NOTES

Jake’s Top Surgery Experience

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

Partner Experience of Top Surgery

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

Jake’s Top Surgery Recovery

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

Partner Experience During Recovery

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

Looking Back On It

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

Next time: Legal Transition

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

OVERVIEW

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

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

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

SHOW NOTES

Jake’s process for coming out at work

Preparation

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

Tipping Point

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

Challenges

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

Bathrooms

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

Looking Back

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

Did People Adapt?

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

Other Interesting Situations

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

Partner Experience

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

Meaghan Ray’s experience of coming out at work

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

Jake’s experience as a partner

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

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

OVERVIEW

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

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

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

SHOW NOTES

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

Who to come out to first?

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

Partner Experience during closeted and early coming out phase

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

Coming out to family

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

Coming out to partner’s family/long distance family

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

Methods for coming out

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

Responses to coming out conversations

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

Partner experience during early stages of being out to family

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

Correcting others when you get misgendered

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

Emotions during coming out to family

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

Mental vs physical image and adjusting to new identity

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

Partner emotions during coming out to family

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

Burnout lasts a long time

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

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

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

Jake’s experience as Meaghan Ray’s partner

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

The coming out equation

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

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

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

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Prioritizing Together Time

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

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

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

TALKING TIME

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

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

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

ACTIVITY TIME

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

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

EXPLORATION TIME

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

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

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

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

SHARING SPACE

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

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

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

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

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Let’s Talk Gender S1E2: Transition Timelines

OVERVIEW

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

SHOW NOTES

General Thoughts on Transitioning

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

Jake’s transition process:

Personal Transition

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

Social Transition

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

Medical Transition

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

Legal Transition

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

Transition is never completely finished

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

Meaghan Ray’s Process:

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

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