Creating body dysphoria

Some people believe that there are two kinds of dysphoria: social dysphoria, meaning a discomfort with the social expectations associated with a gender role, and body dysphoria, meaning a discomfort with the awareness of physical sex characteristics.

In this worldview (sometimes called “truscum”; the word is adopted as a badge of pride by many people who espouse it), the feeling of body dysphoria separates the true transsexuals from the wannabe “transtrenders.” It is a “medical condition,” resulting from a mismatch between brain sex and the shape of the body, and the only cure is full hormonal and surgical transition. Social dysphoria, by contrast, is a malaise resulting from society’s restrictive gender roles, and affects everyone who’s paying attention. The only cure for this is reforming society to equalize the sexes, and any other response is a waste of time.

In the truscum worldview, resources available for trans people are scarce, and the true transsexuals with their medical condition deserve priority over the transtrenders who only experience social dysphoria. Transtrenders also monopolize media time and attention, and trivialize transgender problems in people’s minds.

This argument rests on two claims: (a) that body dysphoria is qualitatively different from other kinds of gender dysphoria and much more intense, and (b) that body dysphoria is innate – either you have it or you don’t.

When I first heard this argument I was skeptical of the first claim. Does body dysphoria even exist, I wondered? I couldn’t think of a way it could arise psychologically, so I didn’t really think too much about the claim that it was innate. Now I’ve not only seen that body dysphoria does exist, but I’ve also seen how it can develop, in fully grown adults who never experienced it before.

My friend Claire said she had never felt any dissatisfaction with her body until she transitioned. But after a significant period of being accepted as a woman, and then a single incident focused on her genitals, she began to experience intense, traumatic body dysphoria. And she’s not the only one.

I’ve heard similar stories from other trans women, and they all have the same pattern: feeling accepted as a woman, thinking of themselves as a woman (with no “trans” qualifier), and having to confront the fact of having male anatomy at a time when it was inconvenient (or worse) to have it.

The fact that all of these women were fully grown adults when they first experienced body dysphoria means that there is no way to neatly divide the world into “true transsexuals” and “wannabe transtrenders.” It doesn’t show that body dysphoria is never innate, but it does prove that it isn’t always innate. We’re not all born this way.

Claire’s story

DSC00261My friend Claire is a trans woman who graciously agreed to share her story for this blog.

For most of her life she had no body dysphoria. “The funny thing is in the very beginning, I didn’t care,” she told me of her male anatomy. But then things changed. “I transition and the only thing I want is it gone.”

Claire began her transition in 2013, and by most measures she was wildly successful. For a trans woman of color, even more so. Her family and friends did not reject her and got her new name and pronouns right most of the time. Her small business continued to prosper, and her customers all took her transition in stride. “Everything came easy to me in transition and coming out, so I lived in a world where no one knew unless I told them.”

Even after transition, she didn’t mind her genitals at first, but she began to grow dissatisfied with them. And then something happened that brought about a drastic change in her feelings.

Earlier this year, Claire went on a vacation with her new boyfriend. They had a great time, and everyone treated Claire as a woman. “I forget that I’m actually trans at times,” she told me. Then when it came time to board the plane home, the TSA was performing pat-downs on all the women at that checkpoint. She thought nothing of it until the screener discovered a bulge.

The TSA screener had apparently never patted down a trans woman, and was unsure of the protocol, but Claire reassured her that she was indeed a woman and belonged there with all the other women. Eventually the screener let Claire fetch her driver’s license from her purse, completed the search and allowed her into the boarding area.

“She did everything right,” Claire says. And yet, Claire was traumatized by the incident. She started crying, and despite her boyfriend’s best efforts to comfort her, she couldn’t stop. She locked herself in a bathroom stall until the last minute, and then boarded the plane home. On the plane she sobbed into a pillow to avoid disturbing other passengers, and cried until she fell asleep.

That was just the beginning. “Months of depression and suicidal tendencies from just one experience,” Claire says. Significantly, she developed intense body dysphoria, focused on her genitals, which she still feels months later. “I really despise that thing but I know I have to live with that. For the mean time.” She says that she is currently feeling better, but she doesn’t know if the depression will return.

Claire’s story, and similar ones I’ve heard from other people, have important implications for all trans people, and I will discuss it further in future posts, but for this post I want to let it stand by itself.

I tried to be cured

There have been several times in my life when my transgender desire – my desire to be a woman, even though I was raised to be a man, with a man’s body – has gotten less intense, less frequent, to the point that I thought it might be gone for good.

I was tremendously relieved. I didn’t want to be a transvestite. I didn’t want a closetful of clothes that could get me mocked and rejected. I didn’t want to look into my mom’s eyes and see nothing but worry and pity. I didn’t want to harbor a secret that could get me blackmailed.

Twice I purged. I threw away all the women’s clothes I had collected, painstakingly, sometimes illegally, over the course of years. I put my past out of my mind. I no longer had anything to hide. That part of my life was over.

But that part of my life was not over. What I eventually discovered was that my transgender desires come and go with my gender dysphoria – my discomfort with my life as a man. When I feel satisfied with my life as a man, my desire to be a woman diminishes. I will not feel completely satisfied with my life, every day until I die. And when I am feeling particularly dissatisfied, life as a woman will seem like a great escape.

Life as a woman certainly seemed like a great escape when I was twelve. Of course it isn’t, I know that now. I learned from listening to women, and a few fleeting, incomplete experiences of living as a woman were enough to drive the point home. But when I’m feeling trapped and hopeless, the dysphoria returns.

As I’ve said before, I don’t think the dysphoria always gets worse. But it does come back, and with it comes the desire to be a woman, to look like a woman, to dress like a woman. That’s what happened to me after the two times I purged.

That, in turn, is why I don’t purge any more, and why I don’t ever believe I’ll be “cured.” If I did purge, I might enjoy some extra closet space for a while, but soon enough I would wind up paying again for expensive clothes and makeup.

I actually wouldn’t mind a cure for the trans feelings. None of them are very pleasant, even the euphoric post-event gratification. I’m not one of those people who think being trans is a gift. But I just don’t see it happening. Some day we may figure out how to prevent it, but I doubt we’ll be able to cure it.

Anticipation and gratification

I’ve gone out in public presenting as a woman a few times this summer, which gave me the opportunity to examine my feelings around those types of experiences. One observation is that what I’ve been calling “gender fog” has at least three distinct phases to it: the anticipation of a significant gender event, the event itself and the reaction to the event. I’ve never experienced one phase without the others, but the feelings I feel in each phase are somewhat different.

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The anticipation phase is the most uncomfortable for me. I experience intense excitement, insomnia and difficulty concentrating on anything other than the upcoming event. I find myself planning and rehearsing and rehashing all the details: what I’ll wear, where I’ll go, who I’ll see, and so forth. On the day of the event, I may have shaky hands and low appetite.

The excitement may taper off as the event begins, particularly if what I’m doing is not all that exciting in itself. But the feelings of satisfaction and gratification may grow, even if my feet are hurting or strange men are making me uncomfortable.

After the event, I tend to feel a certain satisfaction. I feel particularly gratified if the event goes well, but usually I feel some gratification even if the event wasn’t particularly satisfying. I often replay the event in my mind, focusing on the most gratifying details: who said what, who did what, what looked good on me in the mirror.

In this gratification period I also find myself thinking about future events: what else would be fun to do? If I see a pretty woman on the street, I may compare myself with her, and feel a desire to be out there on the street looking just as pretty as her. If I bought new clothes, I usually try them on at home and think about when I could wear them in the future.

The gratification period is also when I think most about how “easy” the event was (often because I’ve filtered out the difficult parts in my memory) and how much fun (often because I’ve filtered out any unpleasant parts). I find myself thinking about the possibility of spending longer periods as a woman, or doing it more often. If it begins while I’m still presenting as a woman, that’s the time when I may do something unwise, like the time I went home to the South Bronx without changing first.

I’ve toyed with the idea of separating the notion of “gender fog” into two feelings: anticipation and gratification. At this point I’m leaning towards simply talking about them as two distinct phases in the gender fog process, but I might change my mind about this.

Bigender dysphoria

Gender dysphoria, a feeling of discomfort with life in a particular gender, is the usual psychological justification given for transition: hormones, surgery, name changes, gender marker changes and gender presentation changes. In the standard transgender narrative, this feeling is presented as evidence of a mismatch between the gender that a person is currently living in and their gender identity, meaning the gender they believe themselves to be.

Trans dogma typically goes further, asserting that gender identity beliefs are indications of a person’s “true gender,” or the gender of their “authentic self.” This is usually supported with scientific studies claiming to show innate “brain sex” differences. Transition is presented as the only way to relieve gender dysphoria, and dysphoria as evidence that a transition will be successful and satisfactory.

There are a number of problems with this line of reasoning. The scientific studies are often cherry-picked from preliminary, inconclusive or overreaching research. Many people feel dysphoria without having any gender identity belief, mismatched or not. Many people with dysphoria are not satisfied with transition, and many people who are quite happy with transition show no dysphoria beforehand.

One of the biggest difficulties with the idea that dysphoria means transition is that many people are dysphoric to both (or all) genders. They’re not happy being men or women, and sometimes they’re unhappy with other genders, whether they’re non-Western ones like kathoey or recent creations like neutrois. I personally feel at least as uncomfortable with my experiences a woman as I do with my experiences as a man.

Some people react to this bigender dysphoria with more of the same essentialism: people who are dysphoric to both genders must have an authentic self with a dual gender identity, they say. If the prescription for dysphoria to one gender is transition to the other, then the prescription for bigender dysphoria must be to transition away from both, to an agender presentation. Others say that we should transition to an androgynous presentation incorporating both genders, or a fluid one where we live day to day in whichever gender bothers us the least.

The difficulty with these transition-based approaches is that frequently people need to experience a life in a gender before they know for sure how it will make them feel. That means that someone (like myself, for example) may know for years that we are dysphoric to masculinity before we discover that we are also dysphoric to femininity. A significant number of people have gotten major body modifications before they figured it out.

If we are uncomfortable with all genders, though, it raises the possibility that what we are uncomfortable with is not gender at all, but something else in life, like the pressure to conform, or some constant in our own lives, like a bad economy or an oppressive family. There may be other ways to deal with these problems, or they may be things that we have to accept. For some, there is even the possibility that they are trapped with no good options.

The bottom line is that any approach that offers only one solution, transition, is going to fail anyone with bigender dysphoria, and that anyone who feels dysphoria to one gender should give careful and thorough consideration to the possibility that they are dysphoric toward other genders as well.

How I deal with gender fog

A friend of mine showed a friend of hers my previous post on gender fog, and it got me thinking that it’s time to write a blog post about dealing with gender fog. As you can see from my previous post, it’s not like I’ve mastered the thing: it still can give me insomnia for days. But I have developed some coping mechanisms that I find useful, and maybe they’ll help you too.

To recap: Gender fog is a feeling that some transgender people get leading up to, during and sometimes shortly after, a significant gender event. What makes an event significant is highly subjective and personal, and dependent on the situation. Between the time when the event is planned and when it happens, I experience an intense excitement, often so intense that it interferes with my sleep. During that time I find myself planning and visualizing and rehashing every minute detail of the event, no matter how mundane, and often have difficulty concentrating on anything else (like work, friends or family). If I share my focus with friends or family, no matter how tolerant, they tend to complain that I show little interest in them or their needs. I sometimes lose my perspective on my own life and make decisions that I later regret. So what do I do to keep this from getting out of control?

  • I give myself breaks. Gender fog is very stressful, and in my experience it impairs my judgment. I need time when I’m not going through it, to relax and clear my head. In my experience it gradually subsides over the following week. After ten days it’s completely gone. I want at least ten gender-fog-free days, so I try to have these significant gender events at least a month apart.

  • I try not to do anything too special. I get so excited doing the same thing every month or so – going out for a walk and a little shopping, generally – that meeting up with a friend is a big deal. As I said above, what makes something a big deal is going to be different for every person and every circumstance. But compounding new things (“This is the first time I’ve gone out in three months, and I’ve got a new coat, and I’m meeting a friend, and we’re doing karaoke”) seems to make the gender fog worse.
  • I set goals and limits ahead of time. These may not be set in stone forever, but if I can say, “I’m going to go to the bar and have two drinks and then go home,” or “I’m going to spend no more than a hundred dollars on clothes,” it helps to keep things in perspective.
  • I try not to deny myself. Setting limits is good, but in my experience, one of the worst things for gender fog is the feeling that I’ve been restraining myself and keeping myself from doing whatever it might be. When I finally get a chance to do that thing, it releases my inner toddler, who does the thing as long and hard as she can. So I try to find a way to keep that kid happy.
  • I try not to plan too far in advance. The longer the time between the decision and the event, the longer the fog lasts. A major mistake this past time was deciding on Saturday that I would be going out the following Thursday. In the past, if I decided just a day in advance that meant only one sleepless night. If I can swing it, a spontaneous same-day decision is ideal.
  • I warn my loved ones. When I tell my wife I’m planning to go out, she knows that there will be a while when I’ll be distracted, and a time when I will be self-centered. She knows not to take anything too seriously at that point. It’s only fair.
  • I’m prepared to back out. In the past I’ve changed my plans because I realized that things were getting too intense. I went out by myself instead of with friends, or I wore something a bit less sexy and revealing, or lower heels. Sometimes I just cancelled the thing altogether, or went in guy mode, and went out later when I could do it at shorter notice. My friends have always been cool with it.
  • I’m aware of the gender fog. I’ve been through this before, and I know that my judgment is not at its best. As Slartibartfast said, “Do not agree to buy anything at this point.” I do, in fact, buy things, but I try to stay within my preset spending limit, and I generally succeed. I try to never, ever, take major risks, or make any major irreversible life decisions while in the fog. Sometimes I just tell myself, “Oh, I’ll decide that next week,” and then I usually wind up saying, “What was I thinking?”

So those are some of the things I do to deal with gender fog. I’d be interested to hear what your experiences with gender fog are, and if you’ve come up with any strategies that I didn’t mention here!

Gender fog feeds dysphoria

I had a really tough bout of gender fog this past week, and I have two thoughts from it. One quick thought is that it really makes a difference how far in advance I plan an event. In this case I decided to go out to the Queens Pride House transgender support group presenting as a woman. I decided almost a week in advance, which meant a week of insomnia and distraction.

Photo: Pauline Park
Photo: Pauline Park
The second thought is more complex: it’s that gender fog leads to gender dysphoria. Over the past week I spent a significant chunk of my waking hours, and a lot of the time I was supposed to be sleeping, thinking over and over again about what I was going to wear, what I wasn’t going to where, what the weather would be, when I was going to change, who I might run into, who might be at the support group, what they might say, what they might not say, trying on outfits, practicing my voice, and so on.

I don’t want to suggest I was worried about any of those things. I mean, you always want to think about safety, but it was care, not worry. The rest of it was excitement, the way I feel the night before a trip to Europe.

As I was having those thoughts, getting dressed and putting on my makeup, I had a lot of opportunities to think about the obstacles and challenges. If I had a smaller belly I could wear this dress. If I had narrower shoulders I could wear that dress. If I had spent more time wearing pumps or sandals in the sun I wouldn’t have those tan lines. If I didn’t have so much facial hair I wouldn’t have to wear all this makeup. If I got my ears pierced I could wear a wider variety of earrings.

I also felt a bit annoyed about all the time and energy I put into one night. If I went out again I would have to do the makeup and clothes, but I wouldn’t have to shave. I would be able to get more of my time and money’s worth for all the clothes and makeup and voice practice I’ve done.

And every once in a while I got annoyed with my facial hair, with my big arms, my crotch bulge, my deep voice, my tan lines, my belly, my narrow hips. I thought how much easier it would be if I had real breasts, and years of socialization as a woman.

In other words, I had gender dysphoria – discomfort with the masculine gender role that I live in most of the time, and body dysphoria – discomfort with the male aspects of my body – caused by the gender fog. Caused by my feelings and thoughts about this outing. Caused by my decision to take this outing, by my own plans. I increased my dysphoria through my own actions.

Of course, I think about all the people I know who have transitioned. They’ve told me that even though some obstacles (shaving, bulges, tan lines) go away, others remain, and new ones appear. Family problems, job problems, discrimination, safety. In the light of transition, things that had never bothered them before take on new significance.

All things that I took into account nineteen years ago when I decided not to transition. It was a good decision and I don’t see myself changing it.

But if I did this more often, I’m not so sure I would hold to my decision. If I never let the gender fog subside: if as soon as one event was over I had another one planned a week or so later, if as soon as I got used to one trans activity I pushed the envelope, if I spent every day and night thinking about trans stuff and how much more I could do, I think it would get too much.

I could see my dysphoria increasing, and my desire to be a woman growing with it. I could see myself getting my ears pierced, getting my hair removed, insisting on changing at home. And then I could see myself going out more often, pushing the envelope harder. The fog itself was pretty unpleasant; combine it with enough dysphoria and transition looks like a big improvement.

And that’s why, when some of my friends from the support group asked, “Will we see Andrea again soon?” I had to tell them they probably wouldn’t. They’ll definitely see me (they’re a great group of people, and their support is a huge help to me) but probably not in a dress. That was way too much gender fog – and too much dysphoria. I made my decision nineteen years ago, and I’m not going to put myself in a position to revisit it.

What gender fog is and is not

Gender fog is a state of mind experienced by many people in response to a significant gender event. It is characterized by intense excitement and a focus on the gender event.

Last September I couldn't hold the phone straight long enough to take this selfie.
Last September I couldn’t hold the phone straight long enough to take this selfie.
The event that brings about the gender fog can be anything; its significance is entirely personal and specific to the moment. It can be something that happened in the recent past, like being referred to with a particular pronoun, or something in the present, like wearing a particular outfit, or even something in the future. like a planned party. It can even be just thinking about something that happened in the past, or planning something for the future. What produces gender fog one day in one person may be totally uninteresting to another person, or even to the same person a month later.

Some indications of gender fog include shallow breathing, sweating, butterflies in the stomach, and a lack of interest in anyone or anything outside of the context of the event. In extreme cases, people (okay, I) have reported insomnia, buzzing in the ears and nervous tremors. The most common feature is that the person will simply not shut up about that event and how wonderful they feel.

Here are some things that gender fog is not:

  • Gender fog is not a sign of your gender identity, authentic self, inner woman, masculine side or any other part of your essence.
  • Gender fog is not specific to people who transition. From what I can tell, it is found throughout the “transgender umbrella,” among transsexuals, transvestites, drag queens, butch lesbians and others.
  • Gender fog is not happiness. I hope some day you’ll experience enough happiness to be able to tell the difference.
  • Gender fog is not relief from dysphoria. It is not sustainable. It will fade soon enough, unless another significant gender event happens. And if the same event happens too often, its significance will fade and you’ll have to do something more significant, and so on.
  • Gender fog is not safe. The intensity with which we focus on the event and our gender issues when we’re in the fog make it hard for us to maintain perspective and to keep our safety.
  • Gender fog is not pleasant for those around you. Just ask them.

Be careful out there, folks…

See also: How I deal with gender fog.

The times when you don’t want gender fog

Tomorrow I have a chance to wear a great dress I picked up at a thrift store last year, but I’m not going to do it. The problem is that my students need me to have a clear head tomorrow, and just thinking about wearing the dress makes it hard for me to think clearly about anything else.

10332972_10203549535520539_897630833_oThe dress is really pretty: a black cotton-silk wrap with a full mid-calf skirt and flower prints along the hem. When I bought it I didn’t expect to have many occasions to wear it, but the price couldn’t be beat. Then my friend Alice invited me to go see “Casa Valentina,” and I can’t think of a more appropriate place to wear it.

Unfortunately, my final exam is scheduled for tomorrow afternoon. Even though this was the first class I’ve come out to and they’ve been cool about it, I don’t think it’s the time for me to wear something so dramatic. They need to concentrate.

I wasn’t seriously thinking of wearing the dress to class; my actual plan was to go to my office downtown and change there, but that would mean carrying a lot of bulky clothes and shoes around with me in addition to the exam papers and my tablet. So I had thought of bringing the clothes to my office today.

The thing is that I need to concentrate too. Supervising an exam is not that demanding, but I do need to pick up the exams, be on the lookout for any foul play, and answer student questions. I also need to be able to think clearly afterwards, so that I grade the exams fairly and speedily. And for all that I need to not be gender-fogged and I need to be reasonably well rested.

As I started to think about packing a bag, I felt the rush of gender fog hit me. I was excited and a bit jittery, and I had a hard time thinking about anything else I had planned for the day. I decided that if I did wear a dress to the play, I wouldn’t plan it out over two days. And still, my thoughts kept coming back to the play, and every time I felt the same rush. I’m feeling it now as I write this.

This is just not a good week to have gender fog. Hopefully I’ll have a chance for a less exciting outing soon. Maybe I’ll even get a chance to wear that dress some time, and maybe I’ll be able to manage it so that the gender fog isn’t overwhelming. But this week I need to get work done, so I’ve decided not to wear it tomorrow. And that’s okay.

Feelings, beliefs and actions III

Recently I wrote that most of us under the “transgender umbrella” – transvestites, transsexuals, genderqueer, non-binary, drag queens, butch lesbians and all the others – all feel either gender dysphoria or transgender desire, or both. Our interpretations of these feelings may be different. But more importantly, there are a wide variety of possible actions in response to those feelings, and none of those actions are more automatic or necessary than any other.

A lot of us feel a desire to be a particular gender. Whether we see the goal as changing our gender or others’ perceptions of it, the feeling is similar. We also feel a desire to escape a gender, whether or not we see it as our true gender. Not all of us feel both feelings, we don’t all feel them to the same degree, and the feelings are not constant for any of us. Most of us, to one degree or another, feel conflicting desires to remain in or return to another gender, or discomfort with our target gender.

There is also a difference in beliefs, and how these beliefs inform our interpretations of our trans feelings. Some trans people believe that they are and have always been, innately and invisibly, the “other” gender. Others believe that they are simply “expressing their feminine side,” or “performing female masculinity.” Some believe they are and have always been genderfluid or bigender. Some believe that “true trans people” exist, but that they are not among them, despite their feelings. Some are skeptical of all these claims about invisible essences.

The biggest differences lie in what we do about those feelings. Some transgender actions are public: being visibly trans or talking about being trans in public spaces or in the media. Some involve interacting with the public, but more quietly: social or legal transition, public crossdressing, ambiguous gender presentation.

Some trans actions are more personal, although they can affect our presentation in public: hormones, surgery and soft body mods. Some can be private, like private crossdressing, underdressing, secret fantasies or even doing nothing.

Some of these actions are irreversible and involve a permanent commitment. Some are reversible with difficulty. Some are reversible with time, and some are easily reversible. In many ways, doing nothing has consequences over time.

I’ve seen a lot of people on Tumblr and Reddit asking, “Am I trans?” Someone half-jokingly responded that if you ask the question, you’re trans. And I responded that the real question is what you do about it. As Jamison Green said, “there is NOT one way to be trans.” There is no one set of actions that all FTM trans people take, and no one set for all MTF people.

Transgender actions, after all, are a means to an end. That end is making us more comfortable with our transgender feelings, relieving our discomfort with the gender that we live in and our longing to be another gender. Of course one way of doing that is to live, as much as we can, as the gender we long to be. But it is not the only way.

Which is the right path, the right set of transgender actions? Nobody really knows for sure. The decision is easiest if you know you’re either in the “transition or die” group or the “transition and die” group – where you would commit suicide if you transitioned, or if you didn’t. Those in the “transition or be miserable” or the “transition and be miserable” group can be fairly sure of themselves – to the extent they know whether they’re in one of those groups!

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Those of us in the “transition optional” group will just have to muddle along, trying one thing or another, seeing what seems to work for other people and what doesn’t seem to work. But it’s important to keep in mind that our choices, our transgender actions, don’t necessarily say anything about what we Really Are Inside, or what our True Destiny Is.