I remember learning about different groups of trans people in the 2000s, when I was a teenager. I learned about MTF and FTM trans people, who used to be called transsexuals. I also learned about transgender people, who did not medically transition, and genderqueer people, who also usually did not transition. Over the last two decades, however, many of the distinctions between the different groups of trans people seem to have melted away.
According to the new way of thinking, desire is the primary factor in determining the course of a person’s medical transition. If nonbinary people are given access to medical interventions, and if nonbinary identity is broadly defined, then anyone who wants access to all, or any, of the pieces of medical transition can now gain access. The “total package” of social transition, hormone replacement therapy, and surgery is now broken into pieces, so that a person can—at least in theory—choose any of the parts of medical and social transition separately from any of the other parts. If the old model of transition was a three course meal, the new model is more like a salad bar. The WPATH Standards of Care have changed to reflect this new way of thinking with Version 8 of the Standards of Care, and there is a lot of pressure on therapists, endocrinologists, surgeons, and other medical providers to change their practices to order to conform to the new standards.
When I started exploring the possibility of transition in my thirties, I was told: “Do what you want.” That wasn’t helpful for me, because I didn’t know what I wanted. I thought that I wanted to be seen as a woman, so I “came out” as a trans woman and injected myself with estrogen for ten months. I started to feel uncomfortable with being seen as a woman, so I “came out” a second time as nonbinary and took low-dose estrogen for a brief period of time. Then I decided to re-identify as a trans woman and take full dose estrogen again. I took full dose estrogen for another seven months before stopping once more. Eventually, I cut off my hair and asked people to refer to me as “he.” I consider myself to have detransitioned.
As I moved through the medical model of transition—in my own strange, nonlinear way—I had friends, therapists, and doctors cheering me on. When I expressed doubts, they would tell me: It’s all good! You’re doing great! Just keep going! It was very difficult and painful for me to finally recognize that no, I wasn’t doing great. I was going as fast as I could towards my transition goals, but I had no idea whether the destination was somewhere that I actually wanted to go. Before I stopped estrogen and socially detransitioned, I was in the consultation process for both vaginoplasty and facial feminization surgery. By then, my continued effort to transition was mostly driven by fear. I had lost the sense of wonder and excitement that I felt during the honeymoon phase of my transition. I consider myself lucky to have stopped the process when I did. My detransition was easy, when compared with people who re-identify with their birth sex after multiple surgeries and years of cross-sex hormones. Nonetheless, I feel that my story is a good example of the flaws in the WPATH standards.
The problem with the current framework for transition is that it misunderstands the nature of desire. Human desire is rarely what it seems to be on the surface. It doesn’t take a Sigmund Freud to understand that. Desire often points beyond itself, towards something deeper, something unseen. Just because I have a thought about eating three bars of chocolate, that doesn’t mean that is what I actually want, or need. And just because I have a thought about wearing a dress in public, that doesn’t mean being a woman—or being perceived as a woman—is what I actually want.
I pursued transition because I wanted validation in my androgyny. It didn’t feel like enough to be a feminine man—I felt the need for public recognition of my femininity. I wanted to be seen as beautiful, precious, and desirable. During my transition, I received the validation that I craved—only to find out that the validation that I craved wasn’t the validation that I actually wanted. That’s why the successes of my transition felt so empty.
As I became disillusioned with my transition, I felt like I needed something different, but I couldn’t see what that was because my thinking was so stuck in the “gender” paradigm. It was actually a FTM person who took me aside and told me, very gently, that perhaps I was drinking from the wrong well. He said that if I could step outside of Identity with a capital I and just be a person, then maybe the kind of person that I wanted to be would emerge. That was exactly the kind of advice that I needed. It helped me to realize that I was being too concrete, too literal in the way that I thought about gender.
Today I am working with a therapist who does Internal Family Systems therapy. Doing IFS work helped me to understand that identity is not a singular thing. Even apart from gender, every person’s identity is complex and layered. I think that it’s a product of our post-Tumblr era that we’ve become obsessed with “What pride flag should I put on my social media?” I’ve had friends tell me that they think of me as nonbinary, but I have stopped claiming the label for myself. I guess that the word “nonbinary” seemed to me like it just created new binaries in place of the binaries that it was meant to challenge—No longer male and female, but binary versus nonbinary, trans versus cis.
Today I am seen as my birth sex, and I consider that to be a privilege. When I make a new friend, I get to make a decision about whether or not to talk about my past, and I appreciate the privacy that that affords me. But I know that not all detransitioned people have that luxury. For that reason, I am sharing my story, because right now there is someone on Reddit.com—probably on r/detrans or r/actual_detrans—asking the question, “Good God, what am I going to do?” When that person asks, “What is gender, what is identity,” the answer to those questions might change the trajectory of their life. If that person somehow finds this essay and it helps them to come to a greater sense of clarity about their identity and their relationship with the medical model of transition, then I will have succeeded in my purpose as a writer.
Although desire is obviously critical in guiding the choices that we make in our lives, desire must be tempered by wisdom. Desire is not intrinsic—It is always formed in a social context. It takes a wise and discerning heart, governed by a clear-thinking mind, to make sound decisions regarding the body. The mentorship of wiser, more experienced people is critical. Medical transition is not a substitute for friendship, for community, for love, for everyday moments of human connection. And no amount of body modification can bring a person joy if they are not in alignment with their life’s purpose.
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Thank you for your insight into your trans experience. It is eye-opening and revealing. I am very grateful to you for making the effort to put your thoughts and experiences into words for me and others to read and learn from. You did a fantastic job. It’s very helpful. am wondering if you can explain how your relationship with, and perspective of, your parents was throughout your experience. And, how it was after your experience. Thank you.
I am saddened every time I read an account of someone being cheered on to hormones and surgeries when the nature and sources of their dysphoria have not been explored. When I worked therapeutically with men who had "gender issues," the overwhelming majority who focused over a period of time on who they were and what they wanted decided they were "not trans." During the Nineties and up to 2010 or so nobody came to see me saying "I know what my gender identity is." The most anyone "knew" was that they liked to wear women's clothes and had always had other feminine interests. The idea in a man's head that he is a woman is a complex process that evolves over time and can be influenced by other people, just as a person's idea of his "life purpose" can change when someone he respects says, "You would be really good at" a specific occupation.