The Marketing of Dysphoria

I’m starting to think my struggle may be more related to my body than I wanted to believe.  My childhood is mostly a blur, but one of my earliest memories is of the relief I would feel when I tucked my penis behind my legs and imagined the image of myself in the mirror to be that of a girl.  When I was seven I performed “surgery” on my baby doll Charles Cherry Cherry Coquette by cutting out nir penis with a pair of scissors.  To this day, when my nail polish is looking good, I want to chop a finger off and put it in a jar of formaldehyde so it can be preserved in all its girlyness without the shame of being attached to me.  When I have sex sometimes having my chest touched feels wrong and awkward.  The other day I went against my own advice and wore a dress because it looked pretty good combined with pants and and a cardigan and a wide belt to give the illusion of a waist, and I definitely experienced having phantom breasts, which was strange.

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If I were to drink the Trans-Aid, I would conclude that I have a female “subconscious sex.”  That my brain is wired in a “female” pattern and my suffering results from a “map” in the brain that does not match my body.  I haven’t ruled this out, but I think it’s much more likely that these bodily sensations are the result of psychogenic pain and misattribution of arousal. I propose that the indignities experienced by a gender-variant person in our society are so great that anger at society and anger at oneself is turned toward the body as a protective distraction to keep dangerous repressed emotions from being consciously experienced.  And I believe the anxiety brought on by the cognitive dissonance of gender-non-conforming presentations leads to perceptions such as phantom breasts because maintaining the conflicting beliefs “I am male” and “I am wearing women’s clothes in broad daylight” is so distressing.

I’ve definitely been convinced that there is some fundamental difference in the brains of transgender persons which manifests before birth.  But I reject the idea that the pain that results from this difference could possibly be best treated by modifying the body with surgery and hormones.

Excessive Humanity Disorder

Part of the reason I am so reluctant to try hormones is that I have an intense distrust of the medical industry.  I’m not sure how much that distrust is rational and how much is borne from being raised by an abusive psychiatrist who diagnosed me with Oppositional Defiant Disorder, physically abused me, and subjected me to cold showers and scorn to punish me every time I would engage in “anal expulsive” behavior when I failed (or refused, according to my father) to be potty trained at the age of four.  In any case I believe most doctors have their pocketbooks more than my well-being at heart.

Psychiatry especially has no idea what the fuck it is doing.  I mean, sure it has improved somewhat from last century’s shock therapies and lobotomies, but the change in its barbarism is not in quality and only in degree.

The reason psychiatry adopted a pharmaceutical model is not that it would cure mental “illness” but because of an embarrassing business problem.  Overcrowding in mental hospitals cages was reaching the proportions of an untenable crisis.  Meanwhile, Smith, Kline & French were using a shotgun approach to finding a market for the serendipitously “tranquilizing” Thorazine, which was discovered when trying to find a cure for malaria.  The pharmaceutical company marketed the powerful drug for a wide range of conditions from asthma to menopause before discovering that it was the perfect solution to the contemporary crisis in the business model of psychiatry.  Of course, the drug didn’t cure the patients.  It just disabled their brains to such an extent that they were no longer able to experience psychosis.  While the marketing said one thing, all the experts agreed it was just a “chemical lobotomy.”

The growth in the psychiatric drug industry since this watershed of deinstitutionalization is unfathomable.  The APA, FDA, and pharmaceutical companies formed an incestuous relationship with the intent of pathologizing humanity to the extent that over twenty percent of Amerikans now take psychiatric drugs.  Does one in five people really require psychiatric drugging?

Below are two advertisements for psychiatric drugs, one for Serentil from the 1960s, and one for Paxil from the 1990s.  Both of them position the drugs as solutions to wholly ordinary problems, whether “for the newcomer in town who can’t make friends,” or for the person who “would love to find someone special, only can’t.

serentil
Excessive Humanity Disorder: Then and Now

“Serene-til” was a potent “antipsychotic” with a high risk of permanent side effects such as tardive dyskenesia, cardiac arrhythmia, and sudden death.  It was finally withdrawn from the market more than forty years after release in 2004.  “Peace-il” is a supposedly safe “antidepressant” that allegedly functions by selectively inhibiting the reuptake of serotonin in the brain.  However, the evidence shows that SSRIs produce dependence and withdrawal just like an addictive drug, only the psychiatrists call this addiction “antidepressant discontinuation syndrome.” Cocaine happens to be another serotonin reuptake inhibitor.  I wonder if history’s greatest proponent Sigmund Freud had “cocaine discontinuation syndrome.”

SSRIs can also induce mania and akathisia, and have been implicated in many violent episodes including murder and suicide.  Of course, if an SSRI causes someone to have a manic episode, the psychiatrists say the “medication” “uncovered” the “patient’s” “underlying” “bipolar” “disorder.”  Not “Oops we poisoned this guy with powerfully toxic psychoactive chemicals and it caused nem to gun down forty people in a movie theater.  Sorry.”  How long will it be until Paxil is taken off the market just like Serentil?

Most psychological “disorders” and “syndromes” are just regurgitations and collations of the subjective experiences reported by patients themselves–fabricated pathologizations of natural human experience subjected to the inhumanity of modern society.  No one would prescribe Paxil for “major depressive disorder” because Prozac was generic and cost one-tenth as much.  Therefore Glaxo Smith Kline took ordinary shyness and invented a new illness “Social Anxiety Disorder” and got it into the DSM-IV.  Paxil became the only drug approved for use in this disorder, and so GSK could then market its patented drug and rake in the revenue.

Gender Dysphoria seems to be the one case where the psychiatric community has finally admitted that it is unable to diagnose someone with a disorder.  If you go to a psychiatrist and say “I think I have depression, what do you think?”the psychiatrist will conduct an interview and make an official diagnosis that you have “major depressive disorder” or not.  If you go to a psychiatrist and say “I think I have gender dysphoria, what do you think?” the psychiatrist will say no one can determine that but yourself.  So the sole diagnostic criterion for whether you have gender dysphoria is that you decide you have gender dysphoria.  I would call that simply no longer being blind to how gender is traumatizing to everyone.

The fact that transgender identities are no longer seen as pathological by psychiatry does not change the fact that the medical industry is still over-medicating the condition.  The psychiatrists are just passing on the business and referring it to more lucrative specialists in endocrinology and plastic surgery.  When all you have is a hammer, it’s irrelevant that every individual is a uniquely shaped peg and society contains only round and square holes.  You’re going to pound on the problem the only way you know how just the same.

About now is when the psychiatrists start to wonder whether I have “paranoid personality disorder.”  I guess it’s possible I am excessively distrustful.  I’ve never taken an SSRI.  If I were going to buy into the medical model of treating the individual traumas of a dysfunctional society, it would be crazy not to try an SSRI before I leaped to estrogen, don’t you think?  Unfortunately I believe an SSRI or estrogen have about as much potential to make me happy as a fuller head of hair or a new car for that matter.  My happiness is only going to come from within.

Dysphoria or Dissociation?

The author of ThirdWayTrans wrote an insightful post about how “dysphoria is very ordinary.”  On one level I agree.  The experience of a flat-chested person wanting breasts is not fundamentally different in a qualitative way from the experience of a bald-headed person wanting hair.  The problems only differ in the narratives that are used to understand the problems and the intensity with which the dissatisfaction is felt.  If society were arranged so that bald people shopped in different clothing departments, or were expected to paint their scalps to be beautiful, someone might very well feel like a full-haired person trapped in a bald-haired body.

On another level, I do think gender dysphoria is unique.  The ordinary parts of gender dysphoria discussed by ThirdWayTrans are its conscious manifestations, like the desire to wear different clothes, or be treated differently and be recognized as a different gender, or have different morphological characteristics.  To me the extraordinary parts of dysphoria are its unconscious manifestations.

It may be that, as an early transitioner, the author of ThirdWayTrans did not have the experience trans people who did not transition at an early age report, where gender dysphoria manifests as unconscious malaise, repression, and dissociation as described accurately by Anne Vitale and Jamie Veale.  I believe this experience is fundamentally different from ordinary dissatisfaction (or dukkha as the Buddha would call it).

To this day, the joy and sense of rightness that the idea of being female arouses within me occurs in fleeting moments before it is exiled from my consciousness by my psychological defenses.  It feels like a faint echo from another galaxy that somehow managed to reach me through the vacuum of space.  It feels like my life is a film in black and white, but someone who wants me to know I am more spliced in a disorienting frame of technicolor.  It feels like I’m in touch with a ghost from a past life.  It feels like I’ve yet to be born.  It feels like feeling it for more than a split second would warp the fabric of space-time and catapult me into another dimension I could never possibly have comprehended before.  It feels like everything else is just this strange nightmare that I’m too afraid to accept is not real.  I guess derealization and depersonalization such as this might be “ordinary,” and occur on a spectrum, and I’m just more dissociated than the average person, but it’s still terrifying.

The psychotherapist Daniel Mackler produced a film called the Four Stages of Emotional Healing where ne outlines a path of 1) dissociation, 2) depression, 3) grieving, and 4) enlightenment.  In the film, ne astutely identifies that the modus operandi of most psychological practitioners is to bring clients backward from depression into the inferior state of dissociation.  It’s pretty obvious that the function of “transition” is to bring clients back from suffering into a dissociated state.  Anyone with a penis who says ne is a woman is in pretty much the epitome of a dissociated, or perhaps even delusional state.

As ThirdWayTrans wrote in October, “I think people really are letting go of a false self in the process of transition, the trick is not to just adopt a second one.”  I hope to master this trick.  However, if I know one thing it’s that I have to reunite myself with that fleeting joy.  I hope that reunion does not require me to pretend to be a woman, but if it does, so be it.  I can no longer stand feeling so utterly disconnected from myself.

Not to be Reproduced (La reproduction interdite), René Magritte, oil on canvas, 1937.

Sissy Cries About Haircut, Gets Refund

This is the third post in a three-part series on hair.  Part one focused on a whether the hair loss drug Propecia is a transsexual phenomenon.  Part two focused on how posing that question is helping me in deconstructing the monolithic concept of “transition.”  This part focuses on the history of my personal relationship with my hair.

My hair and I have had a troubled relationship.  In elementary school there was a misunderstanding with the barber about what I wanted and I was devastated with what I got.  I cried so much Supercuts gave my mom a refund and a coupon for another free haircut when my hair grew out.  I made the mistake of telling a boy at school about this, and ne wrote about it in the school newspaper.  Basically the headline was something to the effect of “Sissy Cries About Haircut, Gets Refund: Pathetic or Clever?”

I detest getting my hair cut to this day.  I usually just let the hairstylist do whatever ne wants.  When I made the now unthinkable mistake of trying to man up and enter the corporate world by applying for actuarial jobs after completing my masters degree in mathematics, I actually had to refer to an online guide to men’s hairstyles for FTMs in order to feel comfortable going to a barber shop.  No joke.  I didn’t know what FTM meant at the time.  I was just relieved to find a resource that had so much information on how to fit in as a man.

In middle school I had fantastic hair.  It was thick, and shiny, and reached my shoulders, and for a while I dyed it a deep purple.  I was sort of chubby and wore baggy sweatshirts and strangers sometimes thought I was a girl.  My mom tried to use these occasions to shame me into cutting my hair but I wasn’t buying it.  Lots of “boys” had long hair at this time, Kurt Cobain having had just died.  But somehow the other boys who had long hair themselves would tease me for looking and acting like a girl–a specific girl, in my class.  Honestly, while I hated being teased, I was flattered by their suggestion.  I actually felt guilty that this girl had to suffer being compared to the likes of me.

A portrait of the author as a young tran
A portrait of the author as a young tran

In ninth grade my parents sent me to a posh preparatory school in the hills near the San Fernando Valley, an hour’s drive away from the strawberry fields I called home.  Now I was the only one with long hair.  And the dress code was so restrictive I’d taken to tie-dyeing polo shirts to express myself.  The prep school kids didn’t so much make fun of me for looking like a girl, but instead for looking like Mitch Kramer, the freshman played by Wiley Wiggins in Dazed and Confused.  The kids on the football team (which I joined based on some god forsaken reasoning of mine) actually wouldn’t call me anything but Mitch.  Around half of the signatures in my freshman yearbook read something like “You were definitely a weird guy.  You sang songs for no reason and talked to yourself, but your [sic] down Mitch.”  It didn’t help that I had been skipped a grade and was nearly two years younger than everyone else.  One of them started a rumor that I had no pubic hair.  I think I much preferred just being compared to a girl.

In that environment it wasn’t long before I cut my hair.  And then within a couple weeks the strangest thing happened.  I heard tell that one of the girls liked me.  You know, like, liked me liked me.  Nothing came of it, except I spent nearly every waking moment for the next two years silently observing her and parlaying my own identity development into little factoids and mental images of her.  The fact that we both had a pair of mackerel tabby cats was taken to be evidence of our predestined cosmic reunion.  (I guess I’m breaking form and abandoning my usual use of gender neutral pronouns for everyone, but a part of me just won’t let me call her nem.)

When I talk about this, I imagine it sounds normal for a thirteen-year-old boy, but I assure you it was really pathological.  I mean, if you had asked me back then what she had for lunch three Tuesdays ago, sitting with whom, and at what seat, and at which table, I probably would have been able to tell you.  All the while I was writing songs about how I would mutilate my body to have her.  Here’s a gem from the vault: “Just to walk with you with my hand in your pocket / I’d tear my eye right out of it’s socket.”  Eventually I wrote her a letter wherein I proclaimed that I would cut off my “finger” for her.  I suppose it doesn’t take a Viennese psychoanalyst to read through that one.

It was actually seeing her again at our ten-year high school reunion that unlocked my repressed cross-gender longing.  Unfortunately, the ensuing emotional turmoil led me to royally fuck up my marriage as I concluded that I didn’t love my wife like I loved my fantasy of this fourteen year old girl.  It took me a while to realize I didn’t want her.  I wanted to be her.

Deconstructing the Monolith of “Transition”

It’s become undeniable that I need to take some significant steps toward breaking down the psychological fortress I’ve established around my cross-gender identification somehow.  I’m starting to cross-dress with a queer look most of the time now.  And I’m working with an Internal Family Systems (IFS) therapist to unburden my exiled gender-variant inner child.  These steps are helping, but as Rimonim insightfully commented on a previous post about role models, I need to give myself permission to transition medically in addition to socially before I can actually answer the question of whether or not that’s what I want to do.

Writing my last post about whether the hair loss drug Propecia is a transsexual phenomenon has helped me begin to deconstruct the monolithic question “do I want to undertake the medical treatment for transsexualism?” into smaller questions like “do the benefits of taking a systemic medication to prevent hair loss outweigh the risks?”  Propecia (finasteride), one of the common drugs taken by MTF transsexuals, is essentially an anti-androgen, despite being taken by many “men” to prevent and reverse hair loss.  Thinking that way has a paradoxical effect.  While it makes transsexuality seem less extreme, and less frightening to contemplate, it also makes the usual treatment of it seem sort of silly and the need to make a decision about it less dire.

Using a regret minimization framework, I’ve been thinking it might make sense to take finasteride while I figure this trans shit out.  If I end up transitioning, but not for a while because of fear and indecision, I’ll certainly be glad I had taken the finasteride and preserved my hair.  If I don’t end up transitioning and I’d taken finasteride for a while, there’s only a small risk of permanent side effects.  So there’s not a lot of chance for regret there.  Likewise, if I don’t take the finasteride and don’t end up transitioning, there’s not much of a chance for regret.  However, if I don’t take the finasteride and do end up transitioning after a long period of reconciliation, I sure might regret being bald.

Furthermore, taking finasteride would allow me to test the waters about how I feel about hormonal adjustment therapy.  If I take finasteride and have a sense of confirmation that I am on the right track, then that might indicate that doing more would be good.  If I take finasteride and have a sense that I don’t like the path I’m on, that might indicate that I should turn back.

Different aspects of transition fare differently when considered using a regret minimization framework.  Am I likely to regret showing up at my child’s school wearing tasteful, appropriate “women’s” clothes?  Slightly, but I’m more likely to regret not penetrating the veil of secrecy and shame I will live under if I don’t.  (I’ve already done this, actually.)

Am I likely to regret taking spiro and estrogen?  I am scared of losing sexual function, but I’m not super functional already anyway.  I’m a bit afraid of sex, and often have erectile dysfunction or anorgasmia with basically everyone except fat girls anyway.  Go figure.  And now that I’ve quit porn I usually need anal penetration to cum when I’m masturbating.  Maybe estrogen is exactly what I need for good sex after all.

Am I likely to regret telling everyone “I’m a woman” and dealing with the effects this will have on my child’s development?  Certainly.  But I’m also very likely to regret not doing it, so I don’t have a decision there yet.

In the meantime, my hair loss is accelerating and the finasteride is looking pretty attractive…

A Full-Haired Person Trapped in A Bald-Haired Body

Nearly everyone agrees humans can be divided into two distinct sexes: full-haired and bald-haired.  Sure, there’s a loony fringe which challenges this concept.  They say that other sexual characteristics such as chromosomes, reproductive organs, and hormones don’t always correspond with people’s hairlines.  They challenge the widely-held belief that the inter-haired (people who have ambiguous hairlines) are defective and grotesque, and argue for the acceptance of a wide array of sexual diversity.  Some even say that the essential sexual categories can be better delineated according to the genitalia.  Imagine the fate at the onset of phaliarche of a poor baldie who’d been raised for several decades as a fullie just because nothing was dangling between nir legs at birth!  But I digress, these viewpoints are really too outlandish to address here.

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Crossdressing and The Untransy Valley

The “uncanny valley” or bukimi no tani  (不気味の谷) is a concept in the field of human aesthetics first articulated by Japanese robotics professor Masahiro Mori in 1970 that explains the relationship between a human’s subjective response to a rendering of something corporeal and the degree to which the rendering imitates the original.  As a pioneer in robotics developing nir craft, Mori attempted to make nir creations look more and more human over time.  Initially, people responded more and more favorably to this effort, but eventually Mori found that if a robot came too close to appearing human, people felt disturbed and repulsed by it instead.

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Genderqueer Role Models

In trying to guide myself through my transition, I find role models to be indispensable. Learning about success stories keeps me going when I get discouraged and think what I want to achieve is impossible. Unfortunately, I can count the number of genderqueer persons with a male history who can serve as a role model on one hand. Kate Bornstein, Riki Wilchins, and the anonymous author of ThirdWayTrans are inspiring, but I’d ideally like to find and connect with people who were able to end up with an integrated transgender identity without taking the transsexual path.  Here are a few of my role models.

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The Need for a Cisgender-Transgender Rating Scale

I’ve been thinking a lot lately about the cis-trans binary and I think it would be helpful to create a scale which expressed gradations of intensity of transgender feelings between the two poles.

When I was a teenager I struggled to reconcile my lemming-like crushes on girls with my furtive desire to wear lipstick and look in the bathroom mirror while I shoved a shampoo bottle up my ass through a pair of frilly panties I found from god knows where.  After mixing a pint of booze with a joint and my mom’s ambien to dissociate from it all I have a hard time remembering the details.  I also struggled to reconcile my dislike of kissing a boy with the satisfaction of craning my neck and extending my tongue out to lap up the cum that had dribbled out of my mouth onto the ash-covered upholstery of the same boy’s car.  I was desperately grasping around for a rope that would lead me out of the quicksand of anxiety lining the bottom of the hetero-homo canyon.  Instead of a rope, I found a compass: the Kinsey scale.

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