Picture: Coco Wu
I wrote this piece before starting my medical transition, at the start of last year when gender dysphoria was still a classified disorder in the ICD. Now there is only the sexual health condition of gender incongruence - a complete and correct representation of all trans people, binary and non-binary. A dysphoria diagnosis will no longer be required for transition. It is a huge step forward, recognising that there is no disorder or pathological state that is attached to being trans. When allowed to transition, trans people suffer none of the additional anxiety or depression that combined to make gender dysphoria (only displaying these disorders at similar rates to their cisgender - non trans - peers). Despite the reversal in circumstances surrounding this issue, I would like to put this forward as the embodiment of why allowing trans children to transition at the very onset of puberty is the correct path to normalise and the damage caused when this basic request is withheld.
I would like to keep this introduction short, but firstly I want to warn that this contains intense emotional writing and covers some body image issues that some people may find distressing so please put your wellbeing first when deciding whether to read this piece. Secondly I want to clear up that being trans is just who you are. Some trans people have gender dysphoria. This is not a measure of their trans-ness, it is by no means a requirement for any identity. Generally most trans people will experience some level of dysphoria when they reach puberty, but it really is an individualised experience. I also want to emphasise that dysphoria varies in intensity and below I've described it at a point when it's fairly full-on. It's not like this all the time but it is ever present pre-transition and, even when you feel self worth and confidence in your body there is still dysphoria hanging in the background. It is also dysphoria that hormone replacement therapy aims to treat but that will be covered separately. Transition generally heals all...
~~~ (Circa January 2017)
This body isn't my own. Without a body of your own what are you? I'm nothing. I have nothing. I'm words spoken by a voice that is someone else's. I'm a stream of consciousness, a collection of imagined thoughts. There is nothing I can physically touch. Nothing I can see in the mirror. None of these memories feel like my own. I'm watching someone else grow up. Someone I lived inside but didn't know. My body makes me physically sick. I want to scream and rip my skin off. I want to escape from this prison. I want to feel something. I want to feel comfortable. Everything loses meaning because I'm nothing that can be touched or proven. I don't exist. Because this mass of cells isn't me. It's a body. It's the wrong shape. It doesn't fit. I can't feel through it. I can't recognise it. I don't know it. I've grown to hate it. Physical touch has minimal effect. Nothing can touch me. I can be hugged but this body stops it reaching me. I'm stuck inside. I've been stuck inside my whole life. I know exactly what my body is supposed to look like. I can see it without hesitation. I know every inch. But I can't have it. Dysphoria pains you. It envelopes everything you do. All that you are. I can not recognise my own existence. I'm hiding in a body that isn't my own. It's like swimming in a dark ocean, looking for the surface so you can breath. Every direction you swim in is enclosed inside. You can exhale and the bubbles escape. But you can never get to where. And just like being underwater, slowly it drowns you. Dysphoria is hell but a thousand times worse. Everything about your body is wrong. Nothing is right. All the features are in the place where they're supposed to be. But some of them aren't even the right ones. Every slight angle, the feel of your skin, the size of every little thing, the connection between everything is all wrong. Almost as if you were drawing from memory centuries later. Everything is almost right yet incorrect somehow, creating a whole that is so far from the true version it doesn't bear thinking about. You can't escape dysphoria. It makes you feel ugly. Not that feeling of oh people think I'm unattractive but actually makes you feel ugly. Everything that you are is ugly. It's wrong, disgusting. How can you run away from the thing you're trapped inside? It scares you. Most of all it hurts. Everything aches. Not the kind of ache that can be cured by medicine but if you've never experienced it I don't know how to explain it. You've never had your hips ache to be even millimetres wider, never had your face ache to just be a fraction softer, never had your body ache because it's been put together wrong. You can feel what it's supposed to be like. You can feel what it actually is. You can feel the right thing being forced against the edges of the wrong container. You withdraw inside. You can watch more safely from in here. Further away from the walls that imprison you. Everything becomes dulled. Every experience, every emotion is experienced at a fraction of the intensity it should be. Any emotion that arises from your interactions with the world. This includes all the emotions you get that are just generic, day to day happiness, sadness, excitement etc. Unfortunately, the emotions which arise from interactions with yourself emanate from the conscious thought inside: you. Those are strong. So encompassing they suffocate you. Those emotions come from you. The real you. And they are also trapped inside your flesh prison. Disgust at the body you're in surrounds you. It's rancid but you can't get away from it. Sadness weighs down on you, pressing from all directions. It's so heavy. Like the weight of your entire existence crushing every experience you've ever had. You can't move away. There's no where to go. Anxiety pulls taut, you're hanging from a thread that's going to snap at any second. Where can you fall to? Still the idea of that thread being severed tears you apart. These emotions surround you but beyond them you still feel empty. Nothing can fill the body you were given. It's the wrong size. The wrong shape. There's emptiness underlying every aspect of all your feelings and experiences. Just nothingness.
I can't describe your entire face feeling wrong from the inside, even when you aren't looking in the mirror. Other people think their face looks bad, people with dysphoria have faces that feel like a horrible mask that feels disgusting but is also welded to the rest of your body. Everything is wrong, from your very bones to the pores of your skin. There's nothing you can do. Clothes can provide some mild relief... sometimes. Most of the time there is nothing. You just withdraw further inside. Further and further in until you feel so compressed that you're going to explode. You live in constant fear of further changes to your body. Every day carries you further from where you need to be. Every day is another irreversible change that you're stuck with forever. Every day is a struggle. What happens next? Do you explode from the pressure? What happens if you do? I don't know. I haven't got there yet. If I do and it's still physically possible, I'll be sure to write about it but for now this is all I can manage. Dysphoria makes you so very tired, not the tired cured by sleeping. A tiredness of existence, a tiredness of being tired. Exhaustion that isn't physical or mental. Just exhaustion that comes from every second of living with dysphoria. Although it isn't really living, it's survival.
Well done for making it to the end! Look out for a follow up piece on why transitioning is pure bliss, challenging, and somehow the most and least important thing simultaneously!