Q&A With Emily

Age 21, Female

Virginia, USA

Interviewed February 2022

Hobbies, interests, and/or favorite school subjects:

art, comics, x files, bugs

Dream job / dream career:

Owning a tattoo shop with my friends

History with Transition and Detransition

Age when first identified as trans: 13

Age when first started puberty blockers: 14

Age when first started cross-sex hormones: 14

Age of first gender reassignment surgery: 18

First surgery was: Double mastectomy

Age when stopped identifying as trans: 20

Age when stopped taking cross-sex hormones: 20

Early Life, Gender Identity, and Transition

What were some messages about men and women, or about gender expression and sexuality, that you received in your early life, before identifying as transgender? What were your beliefs about those things?

My two older sisters were very feminine, loved makeup, clothes, etc and I had no interest in those things. I was very uncomfortable with the societal expectations put on me because I was female. I also couldn’t identify with any female characters I was seeing in media because they were always sexualized, or secondary, or just not as well designed or as complex as the male characters. The few masculine women I’d see were still very comfortable with being a woman, which I could not relate to.

How did you learn about transgender identity, gender dysphoria, and transition? What do you think drew you to those concepts?

Tumblr is where I learned about gender. I was drawn in because I’d never seen terms before that described how I felt in regards to my gender. I felt fundamentally different from other girls, so when I saw words like ‘demiboy’ and ‘genderfluid’ it was like an epiphany to finally find words that described how I felt. I thought that must be the answer to why I’ve always been so different.

What sources (friends, specific websites, specific social media sites, therapists, books, etc) did you rely on the most for information on how a person can figure out if they are transgender? What thoughts, feelings, or internal experiences did these sources say were evidence that a person is trans?

I used Tumblr and YouTube. The communities that I was a part of were accepting and affirming to an extreme degree. People commonly talked about how there’s no right way to be trans and how everyone is ‘trans enough’. There were essentially no requirements to being trans other than ‘feeling like a boy’, ‘not feeling like a girl’, feeling ‘gender euphoria’ while dressing a certain way, etc.

What thoughts, feelings, or internal experiences did you have that you believed were evidence that you were transgender? What do you believe now about the origins of those thoughts and feelings?

I was genuinely a very masculine girl with a lot of interests similar to boys my age. I now think it’s likely that I’m autistic, but that’s a whole other thing. My older sisters often excluded me, I didn’t feel like I really fit in with my female peers, and I didn’t like how people expected me to dress and behave because I was a girl. I’ve also had deep body-image and self-worth issues since I was very young which made it hard to feel pretty or likeable.

What advice would you give to someone who is starting to wonder whether they are transgender, or starting to wonder whether they should transition?

The decision you’re making is if you want to live the rest of your entire life as a trans man/woman or continue living as a cis person. You will never fully be the other gender, you can not fundamentally change something like that, it will always be something you have to disclose to intimate partners. Try every possible treatment for any/all mental health issues before transition. Consider how this will affect current and future relationships. Do not undergo surgery if it is not truly necessary.

Therapy Before and During Transition

Did you work with a therapist while considering transition, or during your transition? What are some things the therapist said or did that was helpful, and what was unhelpful? Do you think there is something that a therapist could have said or done that would have led to a better outcome for you?

I had a therapist for pre-existing mental health issues before I came out, so when I needed a letter for hormones, my therapist wrote one. I never saw a gender therapist, and I almost never talked about gender and transition with my multiple therapists I’ve had over the years. I think this is essentially medical malpractice. I was a mentally ill 13 year old and no one was going to question my sudden deep urge to become a boy? My therapist needed to delve deeper into why I ‘felt like a boy’.

Did you receive a diagnosis of gender dysphoria, and what was that process like? What beliefs did you have about what your diagnosis meant, and what did your therapist communicate to you about the diagnosis?

Yes, I am fairly sure I have the diagnosis. My psychiatrist at the time was writing a letter for me to get hormones, and I asked if she needed to diagnose me with gender dysphoria, and so she did. It was really as surface-level as that.

What advice would you give to someone with gender dysphoria who is working with a therapist?

Whether you are sure or unsure of being trans, it is beneficial either way to deeply discuss why you feel the way you do. Work on self-confidence, body issues, eating disorders, trauma, autism, depression, anxiety, because these all seem to be very common among people who have experienced gender dysphoria. The ideal scenario would be overcoming it and living as cis. If you feel compelled to jump right into transition and not attempt to cope with dysphoria as a cis person that is a red flag.

What advice would you give to a therapist who is working with a patient with gender dysphoria?

Do not listen to everyone online who says that affirmative care is the most ethical ‘woke’ form of care for trans people. It is dangerous. You’re dealing with mentally ill teenagers most of the time and you need to truly dig into the feelings of dysphoria and why the patient struggles to identify with their birth sex. I would advise you not to treat gender identity how we treat sexuality. The ramifications are extremely serious when it comes to medical transition. Be cautious.

Detransitioning

When did you first start to question your trans identity or consider detransitioning? What factors do you think led you to no longer identify as trans?

I came out at 13 and had no serious doubts about my transition until I was 20. I don’t know if it was the puberty blockers that slowed my psychological development or what but I think gaining more mental maturity was part of what led me to start questioning. I realized how flawed and illogical my thinking was as a teen. I realized how reckless and careless my decisions were. I also took shrooms for the first time when I was 20 and realized how worse my life really got since transitioning.

What advice would you give to someone who is starting to wonder whether they should detransition?

If you can live as cis, it’s my belief that you should because it’s the healthiest option both mentally and physically. It’s always better to stop now despite how far along you may be than to keep going just for the sale of it. If you have a shred of doubt, do not make any permanent decisions. Even that can’t save everyone though, I felt so sure for years before my double mastectomy, now I regret it. Don’t be so quick to throw away a part of yourself just because you don’t like it.

What are some challenges you faced as part of detransitioning, and how did you support yourself in overcoming those challenges? Did you have support from others?

I still haven’t fully detransitioned. I’m off hormones and have told my parents that I’m starting to question things, but in my day-to-day life I’m still read as male. My roommates still think I’m a cis gay man. This is obviously hard at times, but I want to take things slow, I have so many conflicting feelings about it all that I’m trying to sort out. I’m looking for a good therapist to work through all my pre-existing mental health issues that weren’t addressed before and during my transition.

What advice would you give to someone who is detransitioning?

I’ve been off hormones for about 6 months, but it’s all still very new to me. I don’t know that I have much advice. A support network is really important, I’m going through this basically alone and honestly I feel like I’m going insane half the time. Despite how awkward or intimidating it might be, find a friend, or someone you can talk to about it.

Is there anything especially challenging or rewarding about life as a detransitioned person? How do you support yourself through those challenges, and how do you take advantage of the rewarding aspects, if any?

The level of mental clarity I feel I have now does make me much more confident in myself and my decision making. It’s great to reconnect with the person I used to be that for so long felt so foreign and unreal to me. I loved who I was before transitioning and I’m starting to love myself again. I have not yet faced many or the struggles of being detransitioned, but I’m definitely dreading telling all my family members and friends, legally changing my name again, etc.

What advice would you give to someone who is working on building a good life after detransitioning?

I guess it really depends on the person. I can give general advice like exercise, eat healthily, make friends, have fun, etc.

Therapy Before, During, and After Detransition

Did you work with a therapist while considering detransition, or during your detransition? What are some things the therapist said or did that was helpful, and what was unhelpful? Do you think there is something that a therapist could have said or done that would have led to a better outcome for you?

I don’t currently have a therapist, but I have told my psychiatrist and endocrinologist that I’ve stopped hormones and that I think I’m headed towards detransition. My psychiatrist did not ask much about it other than strongly urging me to get a therapist.

What advice would you give to someone who is detransitioning, or considering detransitioning, who is working with a therapist?

Talk it through with a qualified therapist, one who is not gender-affirming.

What advice would you give to a therapist who is working with a patient who is detransitioning, or considering detransitioning?

n/a

Bonus Question: What is your spirit animal?

Bat