I didn’t know I had OCD. Here’s why the stereotypes are so harmful.

May 12, 20188 Comments

Eight years ago, I was misdiagnosed with bipolar disorder.

I didn’t completely fill those shoes, but after spending so many years struggling, I was just relieved to have a label — any label — to help me make sense of things. And when none of the medications seemed to work, they told me I was borderline. While I had a nagging feeling that wasn’t exactly right, either, I didn’t know what else it could be.

I was passed around the mental health system, with clinicians throwing their hands up, unsure of why I wasn’t responsive to any of the therapy or medication they offered me.

At one time, I was on seven different psychiatric medications, and yet I was still reporting that I felt deeply hopeless and anxious.

When I was hospitalized a second time, included among my discharge papers was a handout about personality disorders, emphasizing that if I wanted to get better and would just work hard at it, I could “recover.” The suggestion that I was being difficult and simply not trying hard enough made me nauseous.

Through it all, not once did I consider that I might have obsessive-compulsive disorder.

Why would I? My clinicians were so focused on how moody and unhappy I was, they were totally unable to see the forest through the trees. But that’s a harsh reality for people with OCD — one study showed that half of people with obsessive-compulsive disorder cases were misdiagnosed.

Half. Imagine going to the doctor for a serious illness and the odds of your doctor diagnosing you correctly is the equivalent of flipping a coin.

I still consider myself lucky comparatively. Someone who would later become one of my closest friends stubbornly believed that my clinicians were wrong. This friend had OCD, too, and immediately noticed the similarities between us.

At their urging, I started doing research, and I realized two things: (1) Everything I thought I knew about OCD was wrong, and (2) I definitely, definitely had obsessive-compulsive disorder.

Photo by Catt Liu on Unsplash

This turned out to be a critical realization. Because I’d been misdiagnosed for so long, my clinicians had yet to try prescribing antidepressants for fear it would “make me manic.” The one classification of drug I needed most was denied to me for six years.

The type of therapy that was most effective, too, was the complete opposite of what I’d been receiving.

While reassuring someone with anxiety and challenging their assumptions can be helpful, reassuring someone with OCD about their obsessions can actually make them worse. Reassurance-seeking can be a compulsion for many people struggling with the disorder, and enabling those compulsions will fuel the obsession behind them.

In other words? This diagnosis was the difference between me getting better, and me getting much, much worse.

Unlike my previous misdiagnoses of bipolar and borderline, receiving my OCD diagnosis was a huge relief.

It fit in ways nothing else had before. At the same time, it was disturbing to think about how many years it took and how much emotional pain I had endured along the way.

But I don’t think it was just my clinicians’ faults, either. It’s not a disorder that’s well-understood by the vast majority of people.

I’m still amazed that I didn’t catch on sooner; it wasn’t a disorder that was completely unfamiliar to me. In fact, my paternal grandfather had struggled with OCD for most of his life. It got me thinking about how I could’ve missed something that now seems so obvious.

I’d already heard the stories — his need to have his home impeccably, impossibly, even irrationally clean; his repeated, time-consuming hand-washing; his counting every step as he paced back and forth and his insistence on walking a particular number of steps. I’d once heard that because of his extreme phobia of germs, he’d tear up and flush his junk mail down the toilet so that he didn’t have to touch the trashcan (how he preferred the toilet to the trashcan, I’ll never understand).

Photo by Vadim Sherbakov on Unsplash

I couldn’t have OCD, I thought. I wasn’t washing my hands over and over again. My room was a mess. I didn’t count my steps. Case closed.

But what most people don’t understand is that obsessive-compulsive disorder isn’t defined by a set list of obsessions or compulsions, but rather, the mechanism that keeps people stuck in that cycle.

The simplified version is something like this: A person with OCD has a doubt that provokes anxiety (“What if I get sick from touching the trash can?” “Does having this thought mean that I’m secretly evil?” “What if I lose my mind and push this person onto the train tracks?”), and to alleviate that anxiety, they engage in a specific behavior to help alleviate the anxiety.

And it might help with the anxiety at first, which our brains really, really like. If something helps us, our brains are inclined to repeat it. But over time, for people with OCD, it takes more and more compulsive behavior to achieve the same effect, which fuels a harmful cycle.

Because we can never know anything with complete certainty, we keep returning to the compulsions to try to alleviate the anxiety.

I can’t know that I won’t get sick, for example, if I touch a trash can, but I can wash my hands to make myself feel better. I don’t know that my partner loves me right in this moment, but I can ask them.

For someone with OCD, this might result in washing their hands more and more, and asking their partner the same annoying questions time and time again to get reassurance.

Certainty is just a feeling. It requires a basic level of trust that most of us have and develop based on experience (I don’t know there isn’t a unicorn in the other room, but I’m pretty sure, based on the number of times I haven’t seen one).

But people with OCD lack that trust around certain issues (because brains are that way, sometimes), which causes us to obsess. We try to conjure up that feeling of safety and certainty with compulsions.

When someone spends a lot of time spiraling in and out of obsessions like this, that’s OCD — and often times, that person might not even realize it.

The tricky thing is that compulsions might not even be perceivable by other people. Some compulsions are entirely mental. Examples of mental compulsions can include repeatedly reassuring oneself, repeating special words or numbers, counting and re-counting, making mental lists, or reviewing thoughts or conversations.

Photo by Glenn Carstens-Peters on Unsplash

I’ve heard OCD referred to as the “doubting disease,” and that’s really the best way I can think to describe it.

It’s the runaway train of “what if,” and then the absurd amount of time spent trying to resolve that doubt (fun fact: the doubt is never resolved). OCD just isn’t satisfied with 99.9% certainty, though, and will become consumed with the tiniest fraction of doubt, even directly in the face of logic or reason.

At times, I’d become obsessed with the idea that I might harm people, that my cat might die if I left a window open or that I might poison him by accident, that I wasn’t really transgender, that I’d made up my mental illness, that I’d fallen in love with my psychiatrist, that I might lose control and blurt out slurs or offensive statements, that I was secretly violent, that I might stab myself with a knife if I held one, and on and on and on (seriously, the list doesn’t end).

My brain would latch onto any terrible fear or anxiety I had, and then spend an inordinate amount of time obsessing about it, trying to convince or prove to myself that my doubt was or wasn’t unfounded (sometimes I imagine that my brain is like a courtroom, trying to sort out if a crime has been committed or not).

Thoughts are just thoughts, of course, but people with OCD tend to assign a lot more significance to some thoughts than most people do. It’s the way our brains are wired.

The reality is, then, that it’s not the content of the obsessions that matters. It’s the pattern of obsessing and then seeking to resolve the doubt — mentally or behaviorally — that defines OCD, and the extent to which it interferes with our lives.

Limited representation around just how many ways you can have OCD leads to a lot of confusion around what it actually looks like.

The truth is, OCD isn’t as obvious as people think it is.

There are as many obsessions and compulsions as there are people with OCD; no two people with the disorder will have it in exactly the same way. As a society, though, we’re still stuck on this idea that it’s a disorder that’s easily recognized by being quirky, frequently washing your hands, and organizing your bookshelf by color.

I had no idea I had this disorder. So when my clinicians told me I had a mood disorder, I figured it made enough sense. Not perfect sense… but enough.

While my brain ran on this hamster wheel of “what if,” my clinicians saw someone who was moody and agitated. And rather than asking about the content of my thoughts and how I was coping (or in this case, not at all coping), they focused on how those thoughts made me feel.

Of course, that exhausting mental hamster wheel made me feel like shit. Mood disorder it is! Oh, the mood stabilizers aren’t helping? Right. Personality disorder.

But underneath those moods, my brain was tormenting me. And until we addressed the obsessions, I was never going to get better.

It’s not exactly surprising, then, that clinicians are only accurately diagnosing half of us.

Because I’d heard of OCD in everyday conversation so many times, I’d just assumed it was a disorder that must be easy to understand and recognize. That couldn’t be further from the truth, though. It’s a complex, highly individual disorder, and it requires specialized care that many of us just aren’t receiving.

I was hospitalized twice, put on countless medications that would never help, misdiagnosed multiple times, and shamed by medical professionals who believed that my struggles were, in part, a lack of willpower.

And horrifyingly, I was given treatments that made me worse, and were never designed for someone with my particular struggles.

My cat, Pancake, really enjoys this book (and so do I!).

I’m extremely fortunate to now have a (totally amazing) therapist that is very familiar with my set of challenges, a psychiatrist who has prescribed medications that have made my life infinitely better, and most importantly, a framework to understand why my brain does the things that it does.

I can’t explain the level of relief that I feel now, no longer viewing my brain as an enemy but, instead, a complicated organ that’s just doing its best to handle the doubt that we all experience to an extent.

We all have obsessions and compulsions from time to time, and OCD is really a disorder of degree, not difference — and knowing this has helped me become a lot more compassionate towards myself.

In that way, I realize that OCD isn’t necessarily an “illness,” as it is a particular difference that we see in brains like mine. And we’re lucky enough to have some great tools to work with to alleviate some of the distressing stuff that comes along with it — for me, antidepressants, exposure therapy, and trauma work have helped immensely.

I had always assumed that I knew what OCD was. But I really had no idea.

It’s not just the hand-washing, stove-checking, lining-up-your-shoes disorder. It’s not quirky or fun — it’s difficult and it can be scary. The more we push this stereotypical narrative, the less likely it is that the majority of people living with OCD will get the care and support that they deserve.

It took me eight years to get the answers I needed. And too many of us are out there, still waiting.

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10 Ways to ‘Reach Out’ When You’re Struggling With Your Mental Health

March 3, 2018March 3, 201837 Comments

I’m a mental health writer and advocate, and a suicide attempt survivor. I’ve told people on this blog many times, “Keep reaching out.” I’ve written multiple articles preaching the importance of vulnerability, defying stigma, and owning your struggles.

This is my whole thing, okay? This is what I do.

So when one of my closest friends died by suicide a few weeks ago, I wasn’t just shocked — I was completely gutted.

I thought there was never a question of whether or not my loved ones could reach out to me. But the very person who I’d talked to so often about mental health… didn’t call me.

Not even to say goodbye.

The last night I spent with them.

In the weeks following their suicide, my grief took me to dark places. I soon began having my own suicidal thoughts. And even then, when it was my turn to “reach out”? Even after losing my friend? I began to withdraw, too.

I watched, with painful awareness, as I did much of what my friend seemed to do leading up to their suicide. I wrote myself off as a burden. I isolated myself. I got lost in my own head. And despite knowing the danger of where I found myself, I said nothing.

After an especially scary night, I realized something: No one ever explained to me how to ask for help. No one told me what “reaching out” even meant.

As my grief began to snowball, I hesitated to tell anyone I was struggling, largely because I didn’t know how. I didn’t know what to ask for, and without knowing what to ask for, it felt too complicated and futile to ask.

“Why didn’t they tell me?” is such a common refrain when we talk about suicide or mental health challenges in general. It’s easy to make this remark, because “tell someone” seems like a simple request. But in truth, it’s vague at best.

“Reaching out” is this skill we’re somehow expected to know, yet it’s never taught and rarely modeled for us.

It’s this vague, hopeful sentiment that people throw around, without ever really defining it. What are we asking people to do or say? It’s not exactly clear.

So I want to get more specific. We need to be more specific.

I don’t know if an article like this could’ve saved my friend. But what I do know is that we need to normalize asking for help and talk about what that might look like, rather than pretending it’s a simple and intuitive thing to do.

Maybe then, we can reach people sooner. We can meet them more compassionately. And we can find better ways to support them.

So if you’re struggling but you don’t know what to say? I get it.

Let’s talk about it.

1. “I’m (depressed/anxious/suicidal). I’m not sure what to ask for, but I don’t want to be alone right now.”

Sometimes we don’t know exactly what we need, or we’re unsure of what someone can offer. That’s okay; that shouldn’t discourage us from reaching out. It’s perfectly fine if you have no idea what you need or want — especially when all you can think about is how much you’re hurting.

Let someone know how you’re feeling. You might be surprised by the ways they offer to support you. And if they aren’t helpful? Keep asking until you find someone who is, or seek out a hotline (I know it can be weird to talk to a stranger, but there are some awesome hotlines out there).

2. “I’m struggling with my mental health and what I’ve been trying isn’t working. Can we (meet up/Skype/etc) on (date) and come up with a better plan?”

Feeling helpless or exhausted is part and parcel for dealing with a broken mental health system. But a team approach can make it a little more manageable. Sometimes we need a cheerleader/researcher that helps us explore our options, especially when we’re having trouble believing that we have any.

One thing you’ll also notice is that, for almost everything on this list, I suggest setting a time.

This is important for a couple reasons. The first being that it helps the person you’re talking to understand the urgency behind your ask. It can also be helpful to know that there’s an event in the near future when you can expect to receive some support. This can help us hang in there when things get bleak.

3. “I don’t feel safe by myself right now. Can you stay on the phone with me/come over until I calm down?”

I know this is a hard one to say. Because we often fear telling someone just how much we’re struggling, and admitting that we don’t feel safe? That’s a biggie. Obviously you can replace the word “safe” if it’s not working for you, but I always encourage people to be direct, because it’s the surest route to getting exactly what we need.

Asking someone to be present might feel especially vulnerable. It might not even feel like, in the moment, it’ll make that much of a difference. But you’re more likely to feel better with support than without any.

And remember, from everything we know about mental illness, depression is more likely to be a liar than a truth-teller (I talk about that a bunch in this blog post).

4. “I’m in a bad place, but I’m not ready to talk about it. Can you help me distract myself?”

You do not have to talk about what’s bothering you if you’re not ready.

Opening up a whole can of worms might not be the safest or best thing for you in that particular moment. And guess what? You can still reach out for help.

Sometimes we just need someone to shoot the shit with, so we aren’t stuck in our heads, making ourselves a little crazy. This is a valid and healthy thing to ask for! And it’s a subtle way of making folks aware that you’re having a rough time, without needing to go into detail.

The sooner the folks around you are aware that you’re having a hard time, the quicker they can show up to help you through it.

Early interventions are so critical for our mental health. In other words: Don’t wait for your whole basement to flood before you fix a leaky pipe — fix the pipe when you notice the problem has started.

5. “Can you check in with me (on date/every day), just to make sure I’m alright?”

I cannot say it enough — do not underestimate the value of asking for a check-in. I am such a huge fan of this as a coping skill, especially because it can be super helpful for everyone involved.

If you take nothing else away from this article, it should be this: Please ask people to check in with you. It’s such a small thing to ask for in the age of texting, but it can help us stay connected, which is freaking critical for our mental health.

(If you’ve played The Sims before, remember the social bar? That’s you. You need to fill it. Humans need to connect with other humans. It’s not just about wanting to, it’s that we actually require it to survive.)

And this can happen in so many smart ways. A few of my favorites:

“I haven’t been doing well. Can you text me every morning to make sure I’m okay? It would really help me.”
“Hey friend. I’ve been kind of sad lately — do you maybe want to Snapchat/send selfies to each other before bed every night, just to check in? It’d be nice to see your face.”
“I’m in a funk right now. Do you want to be self-care buddies? Like text each other once a day something that we did to care for ourselves?”
“I’ve been isolating myself a little lately. Can you check in with me every so often, just to make sure I didn’t fall off the face of the earth?”

Add emojis wherever fitting if you want it to feel more casual (but really, you don’t need to, there’s nothing wrong with asking for what you need!).

Asking for people to check in with you when you’re struggling is just like buckling your seatbelt when you get in a car. It’s just one extra safety measure in case things get rough.

Both can actually save lives, too. Consider this a PSA.

6. “I’m having a hard time taking care of myself. I need extra support right now around (task). Can you help?”

Maybe you need help getting to an appointment or the grocery store. Maybe you need a cheerleader to make sure you took your meds, or someone to send a selfie to to prove you got out of bed that morning. Are your dishes piling up in the sink? Do you need a study buddy? It doesn’t hurt to ask for support around tasks like these.

Sometimes these things add up when we’re struggling with our mental health. But we forget that it’s okay to ask for a hand, especially at those times when it could really make a difference.

Being an adult is already challenging. If you’re going through a rough time? It’s even harder. We all hit a point when we need some extra support. Don’t be afraid to let folks know directly how they could support you.

7. “I’ve been feeling so low. Can you remind me about what I mean to you or share a favorite memory? It would really help me.”

I used to think that asking for something like this meant I was “fishing for compliments.” And what a lousy way of looking at it…

Sometimes we need reminders that we matter! Sometimes we can’t recall the good times, and need someone to help us remember them. This is true of every single human being on the planet.

It’s such a simple request, too. If you’re the kind of person that feels nervous about making a big ask (again, I’d encourage you to challenge that assumption — it’s okay to ask for help!), this can be a small step in the right direction.

8. “I’m struggling right now and I’m afraid I’m reaching my limit. Can I give you a call tonight?”

To be honest, it wasn’t until my friend died that I finally found these words in particular.

Up until that point, I’d never been sure exactly how to raise the alarm. You know, that moment when you’re not at the end of your rope, but you’re getting there? It’s a crucial moment.

Yes, you can and you absolutely should reach out then, even if you aren’t sure if it might make a difference (spoiler alert, people might actually surprise you). I think about how much pain I could’ve avoided if I’d saw that moment for the opportunity it really was.

Listen to that little voice in the back of your mind, the one that’s trying to tell you that you’re a little too close to the edge for comfort. Listen to that nagging feeling that tells you you’re in over your head. That’s your survival instinct — and it’s an instinct you should trust.

9. “I know we don’t talk much, but I’m going through a tough time and I feel like you’re someone I can trust. Are you free to talk (day/time)?”

I wanted to include this because I realize that not all of us have people we’re close to that we confide in.

When I was a teenager, everything changed for me when I reached out to a teacher at my high school that I barely knew. She had always been incredibly kind to me, and I had a gut feeling that she would “get it.” And she did!

To this day, I still believe that she saved my life at a time when I had no one else to turn to. She connected me with a social worker, who was then able to help me access the resources I needed to recover.

While it’s important to be respectful of people’s capacities and boundaries (and be prepared, of course, if someone can’t be there for you or isn’t helpful — it’s not personal!), you might be surprised by the responses that you get.

10. “I’m suicidal. I need help right now.”

Raise the alarm.

Raise the damn alarm, friends, and be as direct as you need to be. An emergency is an emergency, whether it’s a heart attack or a self-harm risk. Harm to you in any form is reason enough to ask for help.

I promise you, there’s someone in this world — an old friend or a future one, a family member, a therapist, even a volunteer on a hotline — who wants you to stay.

Find that person (or people), even if it takes time. Even if you have to keep asking.

Give people the chance to help you. It’s a chance that my friend deserved, and it’s a chance that you deserve.

(And if all else fails, I have this resource about going to the emergency room when you’re suicidal. I’ve personally been hospitalized twice, and while it’s not a ritzy vacation, it’s the reason I’m here today.)

Pick something from this list. Write it down, even if it’s on your hand or a sticky note. Reach out — because now you know how.

Hell, bookmark this article while you’re at it. I know I’m going to, because there are times when I need this advice, too.

If you’re struggling with your mental health, let me remind you that it’s never too soon or too late to let someone know.

And it’s never, ever too heavy, too messy, or too much to ask — even if you asked fifty times the day before.

I’d have rather had my friend “bother me” every day for the rest of my life than have to lose them forever. Their life was that precious.

And yes, so is yours.

Hey there, friend. Before you go, I want to share some resources with you.

If you’re suicidal, call the National Suicide Prevention Lifeline at 1-800-273-8255, the Trevor Project at 1-866-488-7386, or reach the Crisis Text Line by texting “START” to 741741.

You can also go to the emergency room. If you’re not sure if you should or how to prepare for something like that, I’ve got an article for that, too.

This isn’t just a generic “here are some numbers” plug, this is a “I want you to stay, we need you here, please don’t go just yet” plea.

And lastly…

There’s a memorial fundraiser in honor of my dear friend, Cris Alvaro. The funds raised will go to organizations that support trans mental health and racial justice.

This article is, of course, dedicated to them.

Topher, you’re still the brightest star in my galaxy. We couldn’t keep you safe. But I will never stop fighting for a world that could have.

Feature photo by Matthew Henry on Unsplash.

I’m Transgender. But Trust Me, I’m Just As Surprised As You Are.

February 11, 201811 Comments

I’m glad that there are transgender people who knew who they were from the time they were very young. I’m just… not one of them.

As a kid, I honestly didn’t give much thought to gender. I did find myself confused from time to time as to why gender roles existed — in my mind, I didn’t perceive myself as being any different from my older brother, so there were moments when imposed expectations felt grating.

But gender wasn’t something I gave a lot of thought to. It didn’t feel especially present in my early life.

As someone who struggles with mental illness, my teen years were largely defined by my difficulties with complex trauma and obsessive-compulsive disorder. I didn’t have the luxury of contemplating who I really was. Gender seemed to be an avenue to desirability and outside approval. It was a role that I was cast for, rather than an identity I could consider. So I played the part, reluctantly. What else was I supposed to do?

My first conscious questioning of gender was when I was watching television as a freshman in college. I saw an androgynous person on television, and I remember thinking to myself, “That seems like it would be so much better… no expectations, just being.” It planted a seed for me. I didn’t know what “transgender” meant at that time. I just knew that I was drawn to this idea of gender ambiguity, for reasons I couldn’t quite place.

I remember going to my boyfriend at the time, telling him that I was thinking about cutting my hair off and maybe changing up the clothes I wore. This possibility excited me, but it repulsed him. “I don’t think I’d be attracted to you anymore,” he explained. “I think your femininity is what makes you attractive.” Fearful that I would be rejected by those close to me, I pushed my gender questioning to the very darkest corner of my mind.

I grew up very sheltered. My world was tiny, all things considered. And while some transgender folks know immediately and intuitively who they are, I spent many years living the life I was told I should be living. My way of coping with trauma and mental illness was to mirror the expectations people had of me, with the hopes of avoiding further harm. The more I could blend in, the more protected I felt.

In a world that deliberately pushes us into very restrictive gender roles, questioning those roles can feel deeply unsafe. A delayed timeline doesn’t make us impostors; it’s an expected consequence of living in such a cisnormative world.

It shouldn’t surprise us that so many people more readily repress their gender questioning before embracing it. For trans folks who already feel unsafe, we often can’t access the questions we need to in order to become who we’re meant to be. Many of us still lack possibility models, information, and safety, all of which can delay those important realizations that push us forward.

Repressing the desire to question or explore gender can be a very important and valid form of self-protection. That was definitely true for me.

My life ultimately changed when I met another transgender person in university. They were living the life that I had imagined when I first saw that androgynous character on television — they were completely gender-ambiguous, occupying an in-between space that I’d only pictured in my mind. I immediately felt drawn to them, and as I got to know them, I found the courage to begin exploring my own gender, too.

Family and friends that had known me for a long time were shocked. I didn’t really know what to say, other than to reply, “Hey, I’m surprised, too.”

Because in many ways, I was. With every step of my transition, I worried that I was making some kind of mistake. Shouldn’t I have realized this sooner? Could this really be a weird phase? Why now? Why this?

But with each change — clothes, pronouns, hormones, and most recently, surgery — I became a happier, more confident and self-assured person. The knots that had been in my stomach for as long as I could remember came undone; my social anxiety and agoraphobia started to melt away. I found an inner peace that I never knew was possible for myself.

I came alive. And… well, it really did surprise me.

And while I can look back at my history and see how this path makes sense (the video game characters I identified most strongly with are… pretty telling, honestly), that realization only comes in hindsight. While I never enthusiastically or even explicitly identified as a girl or woman, I didn’t exactly imagine an alternative until I was much older.

I’m not alone. In my time as a public figure in the community, I’ve found this to be a totally normal experience for many of the transgender folks that I’ve talked with.

I know plenty of trans people who are similarly surprised to be transgender. And why shouldn’t we be? Society tells us in a thousand different ways that trans people are rare oddities, terrible mistakes, or worse, simply don’t exist at all.

When I got surgery a couple weeks ago, I remember being wheeled into the operating room and thinking, “Am I seriously doing this?” I knew that this was what I needed, and yet I was still floored that this was something I had to endure. Yet when I woke up, the relief I felt was immediate and palpable. My first thought was, “Why didn’t I do this ten years ago?”

Being a particularly effeminate trans man, I think my process took much longer because society is so limited still in its understanding of gender. It took a lot to reconcile the fact that I could be especially feminine but still need transition and move through the world being perceived as a man.

Being seen as a feminine woman made me profoundly uncomfortable, and yet somehow, being seen as a queer, feminine man feels authentic and empowering. This is something I’ve simply learned about myself with time, kind of in the same way I’ve learned anything else about who I am. Trying new things, seeing what feels right, and going with my gut.

One thing I continually hear from loved ones of trans people is some iteration of, “I had no idea. Why didn’t I see it?” What these folks fail to realize is that, chances are, their transgender loved one didn’t necessarily see it right away, either.

Some of us take years, even decades to arrive at a safe place to explore our gender. I try to imagine telling teenage Sam that he was, in fact, a boy — and that he’d eventually transition medically to live his most authentic life — and it’s laughable to me. It would’ve been as foreign to me then as it was to most of my loved ones when I came out.

“Trans… gender?” I likely would’ve asked. “What the heck do you mean?”

I do wonder what my process would’ve looked like in a society that is more encouraging of questioning and exploring gender. I like to think that the realization would’ve happened for me much sooner, though I can’t know for sure.

For now, though, I find some comfort in creating space for trans people to be surprised. We absolutely deserve the space to be shocked, particularly in a society that often interrogates trans people’s identities before accepting them. Of course we’re surprised. When cis is presented as the only option, it can be shocking to realize we could be anything else.

Our genders are valid, even if our process has shocked us, confused us, or evaded us.

I’m transgender, and most days, it still surprises me. But being surprised doesn’t change who I am. In fact, it’s one of the best surprises my life has given me.

Appreciate the blog? Please consider becoming a patron! A dollar a month might seem small, but it helps keep this labor of love going.

Need a therapist? If you follow this nifty link, you can get $50 off your first month of therapy with Talkspace. Not a bad deal! ¯\_(ツ)_/¯ Read more about online therapy with Talkspace here.

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In 2018, let’s stop pretending cis women are the only ones having periods. Seriously.

December 30, 2017December 30, 20179 Comments

Recently on Twitter I saw, yet again, claims being made that trans people who menstruate will eventually no longer have a menstrual cycle because of testosterone… and therefore, trans inclusivity when we’re talking about periods is a moot point.

Holy cisnormativity, batman.

This irks me. Because not only have I been on testosterone for two freakin’ years and am still #blessed with a monthly, but it’s also a wildly incorrect assumption that every trans person with a uterus is going to end up on testosterone in the first place.

There are transgender people who menstruate. Let me say it again to make sure we’re all on the same page here: THERE ARE TRANS PEOPLE WHO HAVE PERIODS.

And whether they identify as non-binary, as trans men, or anything else in the gender universe, one thing is clear to me: We need gender inclusivity when we’re talking about menstruation.

For me, that week or so of bleeding is when my gender dysphoria is at its peak. It is a continual reminder of body parts that are alien to me. It’s a reminder of all the barriers in front of me as I try to medically transition. I panic about being outed as trans whenever I get supplies at the drugstore. And not only that, but I am forced to directly interact with a part of my body that horrifies me — multiple times throughout the day.

Don’t get me wrong, periods suck for everyone. But when you’re transgender, it can be a particularly miserable experience.

So when the world is trying to tell you that this difficult thing you go through every month isn’t actually happening, it’s infuriating. It’s worse, too, when every product is stereotypically marketed to women, a continual reminder that you apparently don’t exist.

Spaces for cis women to commiserate about menstruation are valuable spaces that I have no interest in interfering with. But just the same, we could be doing so much better to make sure that trans folks aren’t erased in the process — and that there are products, spaces, and conversations that trans folks can have access to as well.

Where to begin? It starts with busting the myths.

No, testosterone doesn’t always stop someone’s period. No, not every trans person who has a menstrual cycle will opt for medical interventions that stop it. No, menstrual products are not “feminine hygiene” products. And for the love of all that is good, periods are not just a “woman’s issue” (and not all women have periods, either!).

Which means that when we’re talking about issues that affect people who menstruate, we need to be thoughtful about how we talk about it. People of any gender can have a period, because periods have to do with anatomy, not gender.

Is your mind blown yet? (Hopefully not, actually, it’d be cool if this were common knowledge by now.)

Beyond how we talk about it, we need to design products that are more inclusive. And it’s happening, slowly but surely!

One thing that has given me a lot of hope recently are the new products I’m seeing that actually are gender-inclusive. My favorite example of this, which yes, is totally worth the plug, is the Keela Cup.

It’s brilliant because it’s created with disabled folks in mind, and it’s founded by a disabled person who keeps the marketing gender neutral — a gal after my own heart, really. It’s a menstrual cup that has a pull string (why didn’t someone think of this sooner?!), so it’s more user-friendly for marginalized folks for whom traditional products just aren’t cutting it.

Its potential to decrease gender dysphoria because of the ease with which it could be used makes it personally appealing to me. But beyond that, smarts products like these matter for disabled folks, trans folks, and survivors of sexual violence — or really, anyone who struggles with their period and the demands it places on us.

For anyone who struggles to interact with their bodies during their period, especially in ways they might not be physically able to or find it triggering to do so, having products like these out in the world is seriously important.

The fact that it’s only now coming into existence means we have a long, long way to go.

If we keep pretending that menstruation is just a nondisabled cis woman’s experience, we’re going to keep getting commercials with ladies in long skirts twirling around like periods are one big funfest, and products that, frankly, suck for everyone and especially for marginalized people.

Trans people can have periods. And everyone, regardless of gender or ability, deserves access to conversations, products, and spaces that make that experience as painless as possible.

So in 2018? Let’s make a resolution to be more inclusive when we talk about periods, demand better for the folks who are often neglected in these conversations, and yes, applaud and back the folks who are working hard to create better products that serve us.

Because seriously, it’s about damn time.

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A note about the Kickstarter mentioned in this post: I wasn’t paid in any way to plug it; I just believe in boosting the signal on stuff that I think has immense value for the communities I write for! If you want to support Keela Cup, there’s no pressure to do so, but I hope you’ll check it out regardless. And as always, if there’s a project I should know about, feel free to tweet me!

15 Mental Health Resolutions For The New Year

December 29, 2017December 29, 20176 Comments

2017 was pretty momentous, as far as mental health and recovery goes.

I was finally diagnosed with obsessive-compulsive disorder (OCD), which was one of the most important realizations I’ve ever had. It’s also the year I finally said goodbye to alcohol and hello to online therapy (both A+ decisions). As far as personal growth goes, it was kind of a banner year for me.

It wasn’t easy, though. 2017 was also an important reminder that healing takes hard work. The combination of political and personal turmoil landed me in the hospital last January, and a series of unchecked compulsions finally led me to seek professional help for my OCD after it tore through my life like a relentless tornado.

That’s because, my dear internet pals, healing isn’t linear. When you think you’ve got a plan in place, the universe often laughs in response.

So why make resolutions at all? Well, I believe it’s powerful to begin a new year by saying, “I’m choosing me.”

Every year for the past few years, I’ve shared my resolutions with the internet with the hopes of inspiring folks to choose themselves, and to be thoughtful about how they’ll care for themselves in the new year.

These resolutions are affirming our right to commit to and prioritize our wholeness; they’re the map that reminds us that to give to others, we have to first nourish ourselves.

These are fifteen resolutions that I have for 2018. I hope that you’ll steal them, throw them up on your vision board, tattoo them on your body, whatever — if you feel inspired, I hope you’ll carry them with you as you navigate the new year.

1. I will stop looking for permission to be happy.

I’ve noticed that I shy away from things that make me happy in favor of the things that make… literally everyone but me happy. I’m a people-pleaser by nature, but in 2018, I want to start unapologetically seeking out things that bring me joy, even if I’m the only one enjoying it.

2. I’ll think twice before I do something out of a sense of obligation.

I have a very difficult time saying “no,” especially as someone with a strong sense of empathy and loyalty. In the new year, though, I want to reconsider just how often I’m doing things because I feel obligated to — especially from people who could be taking advantage of my generosity.

3. I’ll focus less on what my life “should” look like.

Instead of living a life that looks good on paper, 2018 is going to be the year that I focus on self-reflection and building a life that makes me happy, regardless of how it compares to anybody else. Because sure, there are people in their late twenties that are traveling the world or working themselves to the point of exhaustion. But neither of those things actually appeal to me — so why should I measure myself against them?

4. I’ll commit five minutes to doing things that make me anxious.

I’m a chronic procrastinator. One of the antidotes I’ve read about is setting aside five minutes to Do The Thing, and giving yourself permission to stop after that if you don’t want to continue. Why? Because getting started is the difficult part, and it’s easier to commit to doing something for five minutes than trying to tackle the entire task. So this coming year? I’m going to do my best to commit five minutes to the stuff I’m dreading.

5. I’ll embrace being “too much.”

I’ve worried a lot about loving too hard or having too many feelings, or otherwise being “too much” for people. But what I’m realizing is that my intensity and depth of emotion are an intrinsic part of who I am. It’s a part of me that doesn’t need to change.

6. I’ll set boundaries even if it’s difficult for me or the other person involved.

I’m a pushover. I’ll admit it. When people demand my time or energy, I often cave immediately. And when I try to set limits, the faintest sign of disappointment or resentment will send me into a tailspin. But this next year, I’m setting boundaries and sticking to them. My heart is worthy of protection.

7. I’ll savor the time I spend alone.

This past year, I talked about how difficult I found it to be alone. But more recently, I’ve started to really enjoy it. In the new year, I want to take myself on more dates, embrace long walks for daydreaming, and give myself the space and time to reflect without interruption.

8. I’ll try to ruminate less on what I could be doing and enjoy what I’m actually doing.

How often do I worry about what I could or should be doing instead of just being present? Easier said than done, but rather than feeling guilty for how many hours of Netflix I’ve watched, I want to get in the habit of simply asking myself, “Is there something wrong with what I’m doing now?” And if there isn’t, maybe I can just freaking enjoy it for once.

9. I’ll let myself tap out if I feel like I can’t support someone emotionally.

There are people I’d literally fall onto a sword for. That doesn’t mean that I should, though. And if I find myself depleted, I want to make sure I’m taking care of myself instead of burning out.

10. I’ll give myself permission to ask “ridiculous” questions.

I’m a little embarrassed to admit how often I don’t understand something or pretend to know what people are talking about, just because I’m afraid of looking uncool or clueless. But what would happen if I just asked more questions? In 2018, I guess I’m going to find out.

11. I’ll practice naming exactly what I need from the people that I love.

I’m pretty sure this has been a resolution for me three years in a row now. But that’s because it’s so, so important. I want to keep practicing being direct when I need support. It’s the best way for folks to know what to offer me when I’m struggling.

12. I’ll curate my social media more intentionally.

I’ve started spending most of my online time on Instagram now. Why? Because I (purposefully) follow accounts that are positive and affirming, so it’s basically my only safe haven at this point. I highly recommend being thoughtful about who you follow and what you expose yourself to. It’s important to be informed, but it’s also important to take care of your mental health, too. (I talk a bit more about this in this blog.) Next year, I want to continue curating all of my social media accounts to be more balanced.

13. I’ll pause sometimes and make sure I’m doing what I actually want to be doing.

How often did I go along with someone else’s plan just because they were more assertive than me? How frequently did I default just because it was easier to? While it’s totally fine to go with the flow, every so often, I want to check in with myself and make sure I’m spending my time in ways that feel fulfilling for me, too.

14. I’ll ask the folks I care about what makes them feel loved.

I want to get in the habit of asking the people that I love what makes them feel appreciated. It’s different for everyone, right? Some people want to be showered with encouraging words. Some folks want physical touch or a thoughtful gift. So why not ask the people that are meaningful to me what makes them feel cared for?

15. I’ll resist letting shame control me.

Remember when I mentioned being diagnosed with OCD earlier? It took this long because I was so ashamed of my intrusive thoughts and bizarre rituals that I kept it to myself. Not anymore, though. This next year, I’m not going to let shame discourage me from getting the support I need. Often times, the things that make us feel like monsters or weirdos are actually common and very human experiences. No more shame.

So, readers, here’s to a brand new year.

After what was a difficult year for many of us, I hope these resolutions inspire you to invest more deeply in your own mental health and happiness. A year of honesty, authenticity, and self-care — in other words, the year that each and every one of us deserves.

You’ve got this!

Appreciate the blog? Please consider becoming a patron! A dollar a month might seem small, but it helps keep this labor of love going.

Need a therapist? If you follow this nifty link, you can get $50 off your first month of therapy with Talkspace. Not a bad deal! ¯\_(ツ)_/¯ Read more about online therapy with Talkspace here.

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Looking for some extra resources to make 2018 a better year?

I’ve got a few to recommend!

If you need to get organized: ADHD Survival Guide: How I Stopped Procrastinating and Got My Sh!t Together

If you’re thinking of getting some extra support: 7 Signs That Online Therapy Might Be Right For You

If you’re looking to incorporate more self-care into your life: 5 Awesome, Immediate Self-Care Resources For When You Feel Like Actual Garbage

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Happy New Year!

Photo by Inna Lesyk on Unsplash

For The Mentally Ill Folks Who Didn’t Think They’d Make It This Year

November 30, 2017December 2, 201719 Comments

The year had only just begun when I heard my psychiatrist, his voice quiet on the other end of the phone, telling me to go to the emergency room. “Will you go?” he asked me.

And I remember in that moment feeling like my cells were crawling and clawing in my body. The mere state of “being” was painful. I wanted to ask that doctor if he knew what he was asking me to do. How could he ask me to stay when everything hurt this much?

Last January, I couldn’t think of one good reason not to jump in front of the next train.

It’s December.

There were a million reasons not to.

Here’s what I would have missed: Trying my first veggie burger at Burger King. Learning I had obsessive-compulsive disorder. Eating sushi for the first time. Getting the first job that I’ve ever loved. Finding the best therapist I’ve ever had. Adopting a cat named Pancake that makes my heart so much fuller. Discovering how much I love yoga and learning more about astrology.

Buying the best pair of boots I’ve ever owned. Listening to Lorde’s best album and witnessing Kesha’s… everything.

Holding a dear friend’s hand while they waited for an ambulance. Crying with my partner when their father died. Learning a best friend’s new name. Trying out the word “no” for the first time. Looking in the mirror at my body and feeling gender euphoria for the first time. Figuring out (finally) that I actually am an introvert. Remembering what it feels like to believe in magic (and making a little magic of my own).

All the times I picked up the phone when someone needed me. All the times I said the right thing to someone that needed to hear it. All the times my being here made someone else feel like they should stay. All the times I said “I love you” and had the honor of hearing back, “I love you, too.”

All of the many, many moments this year when I woke up and thought, “I’m so glad I’m still here.”

It wasn’t easy. I relapsed spectacularly. I had to leave (what I thought was) my dream job. I almost lost my apartment along with it, and came within inch of losing everything else. I had to watch Trump celebrate his inauguration on a flickering screen in a psych ward, next to a poster from 1995 with “stress-busting” tips like, “Stop worrying so much.”

I was in that hospital for a week. In the last two days, it rained so hard that my ceiling leaked, drenching my group therapy handouts on the shelf below. You know, the handouts that were supposed to teach me how to be well again. And for a moment, I remember being flustered, thinking that maybe I should just throw them away.

I laid them out carefully to dry.

When I was discharged, I brought them home with me. And I started to rebuild, day by day.

If you’re reading this, it’s probably safe to say it wasn’t easy for you this year, either. I won’t presume to know why and I won’t tell you how to feel. But from one survivor to another, there were a couple things I wanted to shout out into the big internet void, hoping maybe the right person will read them.

Because you and I? We got through it. And the mere act of being here is a tremendous thing.

1. You are remarkably strong.

How do I know that? I guess I don’t exactly. But I have a hunch. Because it takes real strength to keep yourself alive, especially when your brain isn’t cooperating. You’ve had years now to throw in the towel, and yet, here we both are.

And yes, I suspect there were setbacks and close calls and tantrums, even, and all of that is valid. There was rage and grief, because if life is anything, it’s definitely not fair. I don’t doubt that it took everything in you, maybe even things you aren’t proud of, to keep going. And looking at where you are now, you may feel scared that you don’t have what it takes to rebuild.

Via Frizz Kid Art

But you’re here. Holy shit. You’re still here. And of all the jobs you have, staying alive is the most important one. You had the guts and resilience it took to survive this year. That was you.

Sometimes it was recklessly running into battle because, fuck it, what do I have to lose? Sometimes it was having an impulse, and choosing the less destructive one instead. And sometimes it was swallowing the pills you didn’t want to take, dragging yourself out of the bed you didn’t want to leave, or slowly sipping that nutritional shake to make sure your body had something, anything to sustain itself.

Whatever you had to do, you did it. And you should be so, so proud of that.

2. You belong here.

There have been more moments than I can count when I wondered if I ever should’ve been born. If there was really a place for me in this world. If someone like me could exist someplace like this.

That’s been an open wound from the moment I realized I wasn’t like most people (though, to be truthful, I have to wonder if there was ever a time I didn’t feel that way). I was queer, I was transgender, I was traumatized, I was sensitive, and by most accounts, I was crazy.

I certainly wasn’t the kid my parents were expecting. And I was never going to be the kind of person this world was built for.

I was lucky to find people, though, who taught me that while this world wasn’t built for us, it doesn’t mean there isn’t a place for us here.

And we might be a little rough around the edges. We might be a little wild, a little unsteady, and a little weird. But we find ways to grow no matter where we’re planted. Some of us make art, create zines, speak in poems. Some of us throw our bodies on the line for shit that matters. We speak truth to power, we stare down our fears and our demons, we exist despite everything that tells us we should not.

We show up for one another. We take up space. And we keep trying, knowing that there are kids like us growing up in the world that are going to need us to look up to.

We keep trying for them, the way we wished someone had been there for us.

…one of them was probably born, just now. (Let’s hope they find themselves a little faster than it took for us to find ourselves.)

This is the legacy we’re here to build, the legacy we’ll someday hand down to them.

3. Please be gentle with yourself.

Be gentle. Be soft.

There is an inner child within all of us, I think. Someone who’s doing their best in a scary world they were never prepared to enter. Someone who, every day, is hanging on tight as life does what it does best — changes.

And just when we think it’s settled, it changes some more. Sometimes for the best, but often for the hell of it, and almost never in the ways that we expect.

You are allowed to make mistakes. You are allowed to be messy, emotional, unsure. You are allowed to be afraid (in fact, I’d be surprised if you weren’t). And being human in all of these ways? That doesn’t make you “too much,” no matter what anyone else says.

You deserve compassion. You deserve patience, understanding. You deserve all the space and support you require to grow.

It’s easy to ruminate on what you wish you’d done, or the ways in which you disappointed yourself or someone else. That’s a feeling I know all too well; I think everyone, especially folks with mental health struggles, knows how that feels (which isn’t exactly comforting, but hey, at least you’re in good company).

I hope that when you find yourself going there, you remember what I’m telling you now: You are worthy of kindness and care. And whenever you can, I hope you’ll give yourself permission to receive it.

4. You aren’t alone.

I don’t say this to you as an empty platitude or promise. I say this because it’s the truth.

Mental illness and trauma can so easily cut us off from our connection to the outside world, making everything and everyone feel like it’s a million miles away.

But feeling lonely is not the same as being alone. And I can almost guarantee you that someone out there has walked in those same shoes before — or at least wears the same size.

This year, I was finally diagnosed with “pure obsessional,” a very difficult form of obsessive-compulsive disorder. I spent a lot of years with painful and confusing obsessions that I couldn’t control — and it convinced me that I was some kind of monster, the sort of monster that no one could ever understand.

When I got my diagnosis, a whole new world slowly opened up to me. I started to learn just how many people in the world were a lot like me, even people that I knew and talked to every day.

Shame and stigma are like a fog sometimes. We can see ourselves and our struggles so clearly, but it’s difficult to see anybody else. But that doesn’t mean other folks aren’t out there.

And if you keep searching, keep reaching out, the figures in the distance will become clearer. There is someone that’s been waiting for your story.

I know it’s terrifying to venture out into that fog, not knowing who’s out there. I know it’s scary to be vulnerable, to ask for help, or to share a piece of yourself with someone else. More than once, I’ve wished I could gather up the words I just said and shove them all back into my mouth.

But then someone says those words — “I thought I was the only one,” “You feel that way, too?” or my personal favorite, “YES!” with a bunch of frantic hand motions or snapping — and it suddenly feels worth it. Or at the very least, it gives us just enough courage to keep venturing out.

So here’s to this year and everything it took for us to survive it.

And the next one, too, whatever it may bring. Here’s to another year of stumbling through the fog. Here’s to all the people who waved their flashlights, giving us something to follow; here’s to all the shoulders we cried on, and the right words that came at the right time.

For what it’s worth — and I really hope it’s worth something — some very tender boy in California (hello, that’s me!) sends his love. You survived. And I, for one, am so glad that you did.

Appreciate the blog? Please consider becoming a patron! A dollar a month might seem small, but it’s helps keep this labor of love going.

Need a therapist? If you follow this nifty link, you can get $50 off your first month of therapy with Talkspace. Not a bad deal! ¯\_(ツ)_/¯ Read more about online therapy with Talkspace here.

Maybe being transgender wasn’t a mistake.

November 30, 20174 Comments

This article previously appeared at Ravishly, republished here.

I’ve been on testosterone for two months now. And while I do not believe in fate or in some kind of intelligent design, nothing in my life has felt closer to fate than this.

I find myself saying, “This was supposed to happen to me.” When I meet myself in the mirror, and I feel this electric and palpable ecstasy that travels across my body, I am convinced that this is the truth – my truth.

I have never savored something, loved something quite so deeply as this: The hairs on my hands, the contours of my face, the shapes and the smells and the erotic energy that swirl around in my brain.

“This is right,” I find myself saying, and my friends look at me, bewildered and happy, as if I’ve said the most obvious thing that could ever be said, and they tell me each and every time, “We know, Sam. We know.”

Two months on testosterone – while it may not have been fate, I’m exactly where I’m supposed to be.

Do you know the feeling of falling in love?

Where suddenly your world is bigger, brighter, beautiful in a way that it never was before?

Transition has been a slow, steady fall. Every day I see myself more clearly and I feel love in ways I haven’t loved before; I find flowers growing where they never grew before.

When I was a college student, I wrote a research paper on the idea of “lucid dying” in Tibetan Buddhism – the notion that, if we were enlightened enough, we could be aware as we came undone and transitioned from life to death.

My transition, not of death but of gender, has given me a kind of clarity of mind. I feel aware of every inch of my body. I swear, sometimes I can feel the choreography of my cells as they shift and grow and divide.

And I start to wonder if my body was never wrong. Maybe this transition is somehow a gift. The gift of lucidity, maybe. A kind of connection between body and mind that is so rare that some of us go our entire lives without feeling it.

Maybe the pain of being transgender is not random chaos in the universe, not my shame nor my mistake, but instead, the pangs of a deeper awareness.

I wouldn’t go so far as to say I’m enlightened, but I am wide awake.

A hairdresser mistook me for a woman the other day and I laughed.

I laughed.

I’d never laughed about being misgendered before. But somehow, when she made the mistake, I found it funny because I thought, does she not see that I’m glowing? Does she not feel what I feel?

Because I could’ve sworn that this light that I’m carrying inside of me could be seen from outer space.

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Need a therapist? If you follow this nifty link, you can get $50 off your first month of therapy with Talkspace. ¯\_(ツ)_/¯ Read more about online therapy with Talkspace here, where I offer my unbiased review.