Transition and its aftermath

How coming to terms with reality has shaken my confidence and maybe that's a good thing

Photo by Elin Tabitha on Unsplash

One of the most difficult aspects of realizing that my medical transition was built on untruths is that it has shattered my confidence in my own judgement. If I allowed myself to be duped to the point where I believed that medical transition from female to male was possible, what else have I been wrong about? How can I ever trust myself again? And how can I learn to trust again the institutions that allowed this to happen?

To know that I betrayed myself so profoundly is a shame that is hard to shake. I remind myself that at the time when I embarked on this medical experiment, my mental health was poor. Also, I did not make this decision in isolation. A whole infrastructure existed around me that nudged me forward, including a cultural movement that said that gender transition was not only possible but beneficial to socially awkward and gender non-conforming young people like me.

I remind myself that I am not the only one; that lots of intelligent people bought into the lie — many still do — that people can be born in the wrong body, and that altering the body to match the mind is a reasonable thing to do. People believe all sorts of wild ideas, because ultimately humans are not all that rational. One has only to look at the evolution of spelling in the English language to know that (though, through, and cough all end the same but sound different, for example).

We believe things, not necessarily because they’re true, but because believing them gives us a sense of agency, meaning, and purpose. Even a false belief can generate positive change. The placebo literature bears that out. My transition did — at least temporarily — propel me forward, out of a clinical depression for long enough that I was able to build a career. But when the lie starts to crumble, what happens then?

Coming to terms with a medical lie

With time, my fragile certainty about my so-called maleness waned. I had to face that I had embarked on this gender ‘journey’ not because of some innate male soul but because I was working through some pretty serious life events, which I’ve written about elsewhere. I was a masculinized female, and no amount of hormone injections, organ removal, and appendage construction would ever turn me into a male. It’s not possible.

What I don’t want is for this whole experience to harden me in ways that cut me off from the humanity of others, including those who still believe in gender transition as good medical care. I do not want to carry bitterness towards activists, advocates, and ideologically captured clinicians. I don’t want to forget how to love, how to keep my heart open and curious. In those moments where I wonder: why me? I remind myself that a more salient question is: why not me? What makes me so special that this shouldn’t have happened to me?

When I take a step back and look at how my life started and where I am now, I recognize how surreal a life I have lived. I have existed as two different genders across two different continents — a woman until my early 20s, and a man (socially) ever since. From tomboy to transman; from suicidally depressed to reasonably stable despite it all. By so many measures, my story is one of resilience, recovery, and growth. And yet, even for me, some days the grief over what I have done to myself, to my body, to the people around me, is hard to bear. What I would like to do is get to a place of forgiveness, including self-forgiveness, but the feelings of inadequacy and self-doubt make that difficult.

The shame is a weight that bears down on me with suffocating force at times. I will bear that shame because, well, I have no other choice. I will continue on because that is the commitment that I have made to myself and to my loved ones. But nothing about this has been easy.

I remind myself that we grow from our mistakes more so than from our successes. In the words of Enlightenment-era poet Alexander Pope: ‘To err is human; to forgive divine’. But what exactly was my error? Was I wrong for wanting to feel better, for seeking out help from the professionals that society had anointed as experts? Was my mistake that I wanted an easy fix to my feelings of loneliness and alienation? For wanting to be safe in a hostile world? Yet, how could I have known better?

Was my failure that I should have had the internal fortitude to know who — and what — I was? Yet for so much of my early life my family packed up and moved to a new house, town, or country, where we started all over again. How could I establish a secure foundation when I had no solid ground to build on?

Perhaps I was not skilled enough at critical thinking, given the multiplicity of internal contradictions built into gender medicine. For example, gender is sometimes described as fixed and innate, on one hand, and fluid and dynamic on the other. Children supposedly know who they were (i.e. trans) yet if left alone, those dysphoric children often grow up to be gay, not trans. Gender incongruence is framed as a natural variation not a pathology but also requiring ‘medically necessary care’. Gender dysphoria is the thing clinicians are supposedly treating yet some clinicians claim you don’t need gender dysphoria at all to meet the requirements for this ‘medically necessary care’.

The contradictions are dizzying if you take a moment to think about it. Yet there rarely seems to be time to think. The goal is to move as quickly as possible, with as little reflection as possible. No matter that the research points to higher rates of suicide post-medical transition, compared to the general population. Transition, it turns out, is not a panacea. But who needs caution when you can have surgery?

Was I too trusting? Too gullible? Stupid, perhaps? Yet, wasn’t it reasonable for me to trust the professionals? Surely, we have experts, people who have devoted themselves to study these issues, precisely because most of us can’t know everything about everything. Was it so unreasonable to expect that the researchers and early clinicians in the field would have done follow-up and outcome studies?

Of course, I now know that very few researchers and clinicians followed up with their patients, especially over the long term. Worse than that: the organizations tasked with creating guidelines for clinicians actively suppressed studies that undermined their claims.

I can forgive mistakes, but deception? That is harder to stomach. How do you heal and move on when leaders in the field of gender medicine continue to deny and mislead the public about the risks and harms?

Perhaps my mistake was that I should have known better. The reality is, I didn’t. So here I am, having already sacrificed my organs and my identity to a medical gender experiment gone awry. I am stuck a masculinized female and with no clear path back to womanhood and no desire for any further involvement with the medical establishment who did this to me.

I will bear the consequences of my decisions as best I can. I have no interest in living a life of resentment or rage, though at times it is tempting. Instead, I will do what I can, in my own quiet way, to make positive change. Slowly, with time, I may even learn to trust myself again. Not because I know all the answers, but because I’m more comfortable asking questions. Even questions about my own (litany of) flaws.