But Are You SURE You’re Trans?

In just the past few years, Western culture’s understanding of gender has changed significantly. It may not seem like much because of those pushing back, screaming, “There are only two genders!” are so loud. However, I know times have changed because when I correct strangers on my gender or pronouns, I get fewer disgusted looks and hesitant replies than when I came out in 2015. I haven’t started physically transitioning either, so that has no effect here.

One day I do plan on physically transitioning, but between college, only having a part-time job, and coming from a lower middle-class family, those plans are resting on the backer burner of a stove that’s turned off. Although I can’t pursue any medical assistance just yet, that doesn’t keep my hopeful transgender heart from dreaming. Recently I’ve come to realize that the best plan for me is to get top surgery, or chest masculinization surgery, before starting hormone treatment.

When I explained my idea to my psychologist, the person who needs to write me a referral letter to be able to receive either treatment, they told me it was a bad idea. I asked why they thought so, and they replied that it’s not the typical route trans men take. But why should I care about that? They quickly added that trans men usually take testosterone for at least two years before getting any trans-related surgery. Usually. The reason is so that trans men are sure they want to transition before altering themselves with surgery.

The Typical Process of Transition
The process is similar when trying to receive HRT as when trying to get trans-related surgery. However, many trans people are pushed to get HRT before surgery because it’s deemed “more reversible.”

Now, I don’t have room in a single blog post to unpack all of that, so I’ll focus on the concept of “being sure.” How am I sure I’m trans? That I want to start hormone replacement therapy one day? That top surgery is more important to me than testosterone? Each of those questions could be a post of its own, but the point I want to make is: Transgender people should not be punished because of a very small percentage that decides to detransition.

The gatekeeping of the transgender community is one aspect that I haven’t seen improve since the surge of transgender media attention. We still need to see a mental health professional in most (US) states before we can even see a doctor about the possibility of hormone replacement therapy, surgery, or any other medical transition options. All this letter needs to explain is that we have seen a therapist (usually cisgender) long enough to convince them that we’re sure we’re trans and won’t regret our decision to transition.

Even with all the precautions, some people decide after the fact that the transitioned life isn’t for them. Why is this? Well, because gender is fluid and one of the most abstract conceptions humans have created. Some people may start their life knowing they’re a girl then realize they’re a boy as a teen or adult and go back to identifying as a girl even later in life. The possibility that any transgender person might change their mind one day or that their gender flows back to something else scares so many people, and it keeps all of us from being able to transition when we know we’re ready.

I know these are infamous words, but let’s be honest, what’s the worst that could happen? I explore my gender and realize it’s not how I want to live after all? What’s to stop me from transitioning and detransitioning? Other than my bank account and social stigma, of course. Detransitioning itself isn’t even harmful and should not be treated as a horror story that we tell to scare trans people into not transitioning.

Now don’t get me wrong. I do believe there needs to be extensive education between a doctor and patient about what hormones and surgery will do to their body. These are serious choices that should be considered carefully, but once I’ve weighed the pros and cons myself and decided I want to do with my own body, I shouldn’t have to spend hundreds of dollars and months of my time convincing a therapist that I’m ready for the next step in my transition. The general attitude towards transgender people has changed positively, now the process of transitioning needs to as well.

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