Let´s Talk Gynecomastia

gyno

Gynecomastia, a disorder of the endocrine system which causes an increase in male breast tissue, is usually attributed to cisguys. It is caused by an irregular amount of estrogen in the body, either due to a hormonal imbalance or the use of anabolic steroids (which will make the body produce estrogen in order to counteract testosterone).

I´m grateful for cisguys who speak up about this issue, because just like transmen, they deal with self-esteem issues, self-harm and even suicidal thoughts because of this. Many said they very much wanted to “shave off” their chest, and were too ashamed to take off their shirt or go swimming, some even having been ridiculed by women.

I´m glad that cisguys talk about this because they understand the ways in which even a benign condition, medically speaking, can destroy your confidence and turn your world upside down. Since my coming out, my experience is that there are people who tend to talk it down, even saying that “if they had breasts, they would not mind…”.

Obviously there are people with breasts who do not mind, and that´s fine. However it kind of bothers me when people who have no serious dysphoria tell me that if they were me, it would not be a big deal. You just have to love yourself, is what they say. Or it doesn´t matter if people judge you, as long as you cherish your own body.

Although such advice is probably well intended, I have a very hard time believing that these people have such superhuman levels of confidence that body-shaming and dysphoria would not faze them at all. I still to this day have to meet the person who is confident with everything while having dysphoria, trans or otherwise.

It´s encouraging to know that there´s cis folks out there who go through similar problems, that being trans isn´t about having unique problems that will just go away by upping your confidence. I say kudos to anyone who can love themselves despite it, and to the others; hang in there, this situation isn´t permanent.

The Dysphoria Trap III

dysphoriatrap

It´s been really warm today. I´ve spent most of it inside, waiting until the temperature drops, so I can escape my room and get some groceries. Since I don´t have a lot more to do and there are no more episodes of Last Week Tonight, I figured I might as well write the third part to the dysphoria trilogy.

In my first post, I explained how it´s possible to deal with dysphoria by distancing yourself from any mental associations your brain may create. Sort of observing yourself without judgement. This method requires that you either have or create a lot of mental fortitude, for example though meditation or working on your general awareness.

Testosterone lessened the dysphoria for me, before coming back with a vengeance and making it unbearable. With my body looking gradually more masculine, the zen-master approach no longer worked for me. The chesticles and genitals were a sore reminder of the fact that I was not born the way that I wanted to.

When the surgeon first declined my referral for top surgery, I flipped out and hurt myself quite a lot, wearing the KT tape way too long and also intentionally damaging those areas. Neither mindfulness nor being active, nor taking calming medication was helping anymore, so I resorted to the last option I had; going to the coffeeshop.

The coffeeshop here is a place where you can get not just coffee, but an array of weed and hashish. To any outsider it may seem strange that you can just wander around the block and buy some drugs, although in my opinion it is no different (even more benign) than buying alcohol or getting a prescription for antidepressant drugs.

I am not advocating that everybody with dysphoria just go to the dealer and buy soft drugs. After all everybody is different, and marijuana may or may not help you with anxiety. For some people, it makes anxiety worse. I personally am glad that I tried this last resort. It was the only thing that helped ease the extreme stress I was in.

The Dysphoria Trap II

dysphoriatrap

In The Dysphoria Trap (holy crap, it has been a year), I described the relationship I have to dysphoria and the ways in which I tried to keep it under control. It should be mentioned that back then, I was not on testosterone, and dypshoria does tend to shift while you are on HRT. It can become better and it can also become worse.

For me, the dysphoria lessened a lot (and I mean a lot) in the first six months of HRT. My body changed very fast, I soon had hair all over the place, a very different voice, and other much welcomes changes. Unfortunately, after that my dysphoria got way worse. Sometimes I´m not sure I can even survive it at all.

The advice I gave in the above post, is that one should try to dis-associate dysphoria from mental constructions. Whenever your mind attempts to make a connection between breast movement, for example, and your ideas of manhood, you simply observe that this is happening and then distance yourself from this mental process, by staying calm.

You become neutral territory, so to speak. The battle rages between your brain (dysphoria) and the signals that your brain receives (looking at your chest or nether regions). Instead of choosing sides (identifying with either your body or your brain), you realize that you are neither and merely observe any feelings that arise.

In all honesty, if you can do that, you are a zen master. What I´ve found is although I was able to dissociate from this body-brain exchange previously, I am not able to do so now. Any physical trigger encourages my brain to scream murder and persuade me that I should react either by panicking, self-harming or feeling suicidal.

Battling this trigger has been my biggest challenge so far. More about this in the third part of The Dysphoria Trap.

Being (Un)happy

sprinklers

I had not gone running in ages, due to my depression and due to the dysphoria. When I run, things shake (even when thoroughly packed in all kinds of wrap) and it takes a lot of willpower for me to ignore it. So usually I don´t run. However when on Saturday I went for a walk, I felt an urge to bust through the stagnation.

So the next day, all the time while hyperventilating and trying not to self-harm, I put on my running shoes and went. As usual when I go anywhere, I avoided the traffic and chose streets with lots of trees and shadows. It makes me feel better. Breathing in exhaust fumes isn´t my idea of a healthy workout.

I ran through streets bursting with bird song and spotted a sprinkler system with a reach too big for the tiny garden it was in. I ran towards it and waited for it to come my way. Big drops rained down on my head and my shirt. They brought back memories of running through my grandma´s garden as a kid.

They also brought back memories of enjoying sensations on my skin, the way I felt before extreme dysphoria. I imagined how wonderful it must be to have top surgery and run around in the rain. For a short moment I remembered that being alive can be great. Which is a feeling I haven´t had in a long time.

All this being unhappy is wearing me out. Though this year marks my thirtieth birthday, sometimes I feel as though I am aging much faster than time suggests. For example, last year feels like three years ago. It´s hard to fathom that back then, I wasn´t on testosterone yet. Time brought changes and a bunch of wrinkles.

I am hoping that I will slowly crawl out of the stagnation of mid-transition. I can´t wait to approach surgery and know that my body and my life will finally be changed for good. I have big plans for the future – when all this over, I want to go to wonderful places, where nature reigns wild, and enjoy the cr*p out of life.

Open Letter

mail

Sometimes, I write in a very detached and generalized way. I did so in a recent post called “Friendly & Uptight”, in which I described how awkward and uncomfortable I often feel around friends and family when I´m struck by a bout of dysphoria. I´ve decided to re-write that post in the format of an open letter to those people.

I love being around friends, after all they´re the greatest bunch of people on the face of the earth, scattered across it most of the time. With the exception of my folks, with whom I don´t get along so well, I seemed to luck out in the department of accepting grandparents, aunts, uncles and cousins as well. But let´s move past the sweet talk.

The trouble with dysphoria and being social is that dysphoria tends to make me so thoroughly uncomfortable that I´m no longer able to socialize with the next person, process what they are telling me, or even communicate with them on a genuine level. The only thing I will be thinking at that moment is about running away from my body.

When this is happening, I never know what to say. I usually put on a fake smile, nod in agreement, and just look altogether uncomfortable, like I want to flee the scene.  I am not entirely sure if people notice (I would like to think my friends and family are pretty astute), and I am never entirely sure if I should just tell them about the dysphoria.

Maybe if I do, they might start asking difficult questions, like what triggered it. Often when I´m triggered, I don´t want to specify the details – and if I did, it would probably sound like language from outer space to the ears of a cisgender person. Also, I just don´t want to burden them with awful stories about transitioning.

Nonetheless, acting like nothing happened makes me feel tense and guilty. I actually really enjoy the company of friends and family, and to think that my behavior or expression could suggest otherwise, makes me cringe. So next time I have a great big frown on my face and act all distant, don´t hesitate to ask why.

I don´t expect people to fix my problems or make me feel better. Maybe just expressing what´s going on will alleviate some of the tension for me, and if it doesn´t, I might go for a walk or take a break in the restroom. Depending on the situation we can just discuss what works best, and still enjoy the time together.

Vicious Circle

handcuffs

My bottom dysphoria has been impossible to manage in the last four days. I do all that I can to get my mind off it, go for long walks, go running, play games, mod games, watch the Simpsons, and write, which is why I´ve been so active posting. Even with all these distractions though, I still need all the benzodiazepines.

It started with a trigger, a confrontation with one of my worst phobias. Since, I haven´t been able to turn a blind eye to the area in the way that I usually try to. Instead, I now want bloody revenge, some kind of accountability on the part of the crotch for getting in my way and sabotaging my life. I have trouble thinking of it like an innocent body part.

Maybe to other people this sounds insane. To dissociate from a part of your body by portraying it as a villain, an evil saboteur, only out to get you and tackle you in your weakest moment, is to divide and victimize yourself. Both strategies that don´t contribute to feeling stronger and more in control. It´s nothing more than just another organ.

Why would people do this to themselves then, engage in relentless yet pointless conflict? Scratch at themselves literally (in the sense of cutting or other self-harm) or figuratively like a cat trying to get rid of that shiny new bell their owner bestowed on them? Maybe it´s instinct to get rid of something you feel is not inherently yours, is foreign on your body.

Whatever the reason is, it´s easy to lose yourself in a vicious circle, where the intense longing to be free and hyper-focus on the obstacle makes the obstacle that much bigger and almost impossible to surmount. I know this better than most and yet a trigger like the above mentioned will capture me, make me a hostage of my own brain yet again.

Maybe the only way to escape from this is to reverse your actions, to gradually reduce the amount of weapons you´re using in the fight and let body parts (or other aspects of your life) be what they are for the time being, knowing that you don´t have to accept it but that you don´t have to let them ruin your life.

Phobias & Dysphoria

germophobia-inside-image

I can usually only make inferences about things that are happening to me, and guess a rough estimate of trans people who might be suffering from the same thing. Sometimes, I´m pretty sure that I can´t be the only one and that maybe it is quite common, but at the same time my background makes it impossible to draw hasty conclusions.

Phobias are one of those things. There are a lot of definitions for phobias on the net, but they all boil down to pretty much the same, like this one from Oxford: “An extreme or irrational fear of or aversion to something“. Although the root cause of dysphoria might not be the same, in the end it feels very similar, and is often handled in similar ways.

In addition to suffering from your usual top and bottom dysphoria (even though back then I could never have guessed it was called that way), I also had an aversion to other things, such as long hair. Towards the time that I was coming out and was afraid of being seen as female by other people, my blonde long hair would make me cringe and sometimes panic.

Even though I had it all cut off, I still project this fear around me: when I see the long hair of other people lying around – and specifically when it´s touching me – I want to get as far away from it as possible and wash all the sites of my skin that came in contact with it. It´s in this way that dyphoria seems to cause specific phobias for me, and that´s just one.

I could give you an endless list of the small things that remind me of my body and the things I wish I could get rid of now. Some of them are symbolic, but frequently I see them in sounds and in textures as well. The result is that I (sometimes obsessively) try not to have any of those in my environment or try to avoid all confrontation with them.

Exposure is the best way to handle phobia, but the complicated connection with gender dysphoria makes me wonder about that. After all, is it good for a person with dysphoria to be confronted with the things they would rather deny? If exposure were the solution, there definitely would be fewer people with dysphoria, maybe there´d be no trans people at all.

I´m curious whether any thought has been given to this in other research. As with most transgender mental health topics, I don´t think most symptoms can be explained in isolation from each other. Contrarily, in some transgender individuals, the symptoms (phobias, anxiety) go away when they´ve physically transitioned.