This is what I wish people who identify as ‘truscum’ would try to understand.

This is an open letter to transmedicalists.

I’m being direct this time, because I don’t want to talk about you as if you are some faraway, distant other. I don’t think that helps anything. You’re real people, and no matter where we differ, I don’t want to forget your humanity.

I’ve talked in the past about harassment that I’d experienced years ago from trans folks who identify as “truscum” (so, for outsiders, transgender people who believe gender dysphoria and medical transition are necessary to identify as trans — otherwise known as transmedicalists).

Most recently, I took to Twitter to vent about it. And, not surprisingly, a lot of you weren’t super happy with me about it.

Your responses got me wondering if I could’ve done things a little differently. Because I’ll be honest — I don’t know that it ever occurred to me before then to speak to you directly.

I’m not going to pretend that I’m not angry or hurt. But I don’t hate you, as some of you suggested. I just really, really want you to stop hurting other trans people.

Based on your responses, though, I wonder if you even realize that you’re harming anyone. I think you’re caught up in some of your own pain, too, and that doesn’t make this conversation easy for anyone.

So I’m taking a deep breath and doing what I should’ve done in the first place — unpacking, very carefully, exactly what I’m struggling with. I’m going to explain as best I can why this “truscum” thing is upsetting for me as a trans person.

And I want to give you the benefit of the doubt, because even if you don’t see me as part of your community, I still believe that you’re part of mine.

Relentless optimist that I am, I like to think that someday trans folks might join hands around a campfire singing “Landslide” by Fleetwood Mac (I swear this song is a transgender anthem — just a personal, unrelated opinion of mine).

But I’d be pleased if we were just nicer to each other as a whole.

This is the longest blog I’ve ever written by far (sorry in advance). But if you’re wondering if I’m coming from a genuine place? Rest assured, I wouldn’t expend this much energy if I didn’t care about this very deeply.

If you’re rolling your eyes about how exhaustingly long it is, you can also bookmark it at any point and come back to it. It’ll still be here. And I’m breaking it up with headers, so hopefully it’ll be easy to find your place again.

So why am I even talking to you in the first place? That’s a valid question.

To understand why, you’ll need to know a little bit of my history.

The first thing you need to know is that I work in digital media. It’s important to mention this upfront, because it’s my public work as a transgender writer that got the attention of transmedicalists in the first place.

Back in 2015, I started receiving emails and tweets from self-identified “truscum” for a blog that I wrote about how much I hated the word “transtrender.”

I didn’t believe that the stance I took was especially controversial — but it drew a lot of attention to me as a trans person, and led to some targeted harassment, which continued for a while throughout my career.

The fact that I hadn’t yet medically transitioned led these folks to start asking invasive questions about my body. They were barging into unrelated conversations on social media to tell folks I was an imposter, contacting my followers with conspiracy theories about my transition (I’d made it all up apparently), and otherwise trying to discredit my work.

And of course, I was misgendered. Just to add a little salt to the wound, I guess.

The reality is, at that point, I’d never said I didn’t want to medically transition. It was that I couldn’t.

Initially, in 2014, I’d had issues with my insurance because I’d moved across the country. After that, it was my mental health status that led clinicians to deny me access to transition-related care (if you’re curious about how this nightmare happens, I interviewed other trans folks with similar experiences, and I wrote about it here).

So while this harassment campaign was happening, I was privately struggling with dysphoria that I could do literally nothing about. You’d hope that other trans people would see this as a rallying cry to demand better access to care. But these folks didn’t.

Instead, transmedicalists told me my lack of medical interventions made me invalid.

In a word? It was traumatic. I felt betrayed by my own community; I thought if anyone was going to understand my struggle, it would be other trans people.

It didn’t stop when I finally accessed hormones, either. Instead, transmedicalists had decided I was lying about that. When I posted a photo of me holding my testosterone gel, they suggested it wasn’t my prescription, and then they decided that because I hadn’t had surgery, I still couldn’t be believed either way.

Never mind the fact that I was desperately trying to access care the entire time.

These were my very first experiences with “truscum.”

I’ll be honest — never in my wildest dreams did I think that the folks harassing me would be other transgender people.

And it wasn’t just me, either. I watched this happen many times to others as well, including some of the advocates that I deeply respect and young trans folks who had only recently come out.

So I’ll just be upfront and say… you all didn’t exactly make the best first impression.

And I know, I know. You might be thinking, “But that wasn’t ME! I didn’t harass you! What has this got to do with me?”

I understand why the generalization might bug you.

But when you tell someone that they have the ability to determine who is and isn’t transgender, some people will use that mentality to justify some really abhorrent behavior. Whether you’re passively advocating for that or actively doing so, the ultimate result is that people then feel emboldened to play “gender police.”

They feel emboldened to decide who is and isn’t “trans enough.” And that means people get hurt.

That’s the crux of the issue for me. Regardless of what you’re intending, people are getting hurt.

And I have yet to see folks who identify as transmedicalists acknowledge that this is happening, and that there are valid concerns here.

If you’re still with me here — and if you are, I appreciate it — I want to explain to you exactly why transmedicalism as a concept is so troubling to me, with the hopes you can better understand the pain that I’m talking about.

Not because I want to lecture you or that I think you’re incapable of googling this. It’s just that I recognize it’s possible that folks just didn’t take the time to unpack it in a way you could hear it, and instead they became reactive in a way that felt dehumanizing to you.

So let’s establish my starting place (or bias, whatever) here: It’s true that I don’t believe the presence of dysphoria is necessary to identify as transgender.

I understand that from the get-go, that can touch a few nerves. But I want to explain why I think that’s an important place to start from, regardless of how it makes either of us feel.

I stand by those points in part because I don’t think dysphoria is a helpful measure in the first place — which I’ll explain in a moment.

I don’t say this because I don’t understand the knee-jerk reaction that can happen when someone says they haven’t been dysphoric. Because yeah, dysphoria is painful. It sucks. When I got my first rejection while trying to access top surgery, I began abusing alcohol to cope — it was not a fun time for me. The pain nearly killed me.

I know it’s hard to imagine someone as trans when they don’t understand that kind of pain, especially when it’s a pain you’ve known acutely for a very long time. I’m with you there.

I’ve reacted that way before, too. I’m human. Sometimes my first reaction to something isn’t always my kindest one.

In a perfect world, we would have some reliable indicator or litmus test for helping folks to figure out if they were trans or not — some singular measurement that erases all doubt. As a fan of simplicity myself, I get the appeal.

But the reality isn’t so simple — many trans people suppress those feelings of dysphoria, or they misinterpret them and struggle to connect them to their gender.

This can make it impossible to discern — especially as an outsider — if dysphoria is present. Requiring dysphoria to identify as transgender, for that reason alone, has way too much room for error.

A personal example: I’ve actually experienced some level of dysphoria for my entire life… I just didn’t know initially what it was.

I don’t want to do a deep dive into my history here, but suffice to say, the background that I came from made it very difficult to question my own gender safely.

So I experienced dysphoria, instead, as feeling profoundly self-hating and “ugly” (I wrote about this previously in this article, if you’re wondering). No one else saw me as ugly or ever said I was, but it was a feeling I couldn’t shake. I felt like, no matter what I did, nothing made that feeling go away.

I just thought it was a stupid teenager thing. Except that “stupid teenager thing” didn’t go away and I became a self-hating, uncomfortable, gross-feeling adult.

If you had met me when I came out in 2012, you would’ve said that there was no freaking way I was transgender. I knew I was miserable and I knew I hated how I looked, but “dysphoria” wasn’t a part of my vocabulary yet. While it had always been there on some level, I didn’t have any way to interpret what it meant.

And this isn’t an uncommon experience, trust me. Plenty of trans people come out and are still learning how to describe their experiences. For those folks, it’s sometimes much, much later on that they realize there was some dysphoria happening for them. Sometimes the label comes first — and that’s valid.

I didn’t grasp how severe it was for me until after surgery. Only when my dysphoria was considerably diminished did I understand just how heavy it was to begin with.

It was a kind of misery I was accustomed to, to the point where I was the fish in the bowl that couldn’t really see the water. You know what I mean? But now that I’m post-op, it’s like I’ve experienced a kind of joy and ease that I didn’t know was possible.

There’s also folks for whom their feelings of dysphoria progressively appear or worsen overtime.

I think of this as a kind of “hibernation.” People suppress all kinds of emotions, and dysphoric ones aren’t some magical exception. But as they start to experiment with language, and explore their identity and expression, those feelings start to surface. As the outside world begins to reject them, that can trigger those feelings they’ve managed to push down as well.

Some people also experience dysphoria only in the form of dissociation, or a state of unreality, numbness, or disconnection. They might not connect this to their gender at all, because it’s not an emotional state they can necessarily identify so quickly in the first place.

For trans people with other mental health challenges, trauma and mental illness might interfere with their understanding of their gender, and dysphoria becomes attributed to other causes (I also wrote about that here).

In other words, our brains work extra hard to try to protect us, which can make self-perception as a trans person a little wonky.

That’s what brains do with any kind of trauma. And this can show up as a total break from our own sense of dysphoric feelings, or misunderstanding the source or nature of those feelings. It’s more common than you’d think.

So when a trans person says they don’t experience dysphoria? It might be their truth at that particular stage in transition. But that doesn’t mean it always will be. Those feelings could surface in the future, become better understood and recognized overtime, or progressively appear as it becomes safer to process them.

But if we accuse trans folks of being imposters from the start, we might closet them before they ever figure any of that out.

So for me? One of the big problems with transmedicalism as a concept is its potential for “friendly fire.” When you use dysphoria as this “infallible” meter stick, you actually end up excluding a lot of trans people who are traumatized or vulnerable, and arguably most in need of support, especially if they’re emerging from denial or dissociation.

Transmedicalists are more likely to harm someone who is trans than successfully cast out an “imposter.” Because in actuality, more of us are traumatized than faking it.

When I first came out, I said that I didn’t want hormones and I wasn’t sure I wanted surgery. I am definitely the kind of “transtrender” that you would’ve rallied against (and, well, you did for a while).

Looking back, I have to laugh out loud. I can’t imagine not having medically transitioned.

With proper mental health care and, yes, incredible community support, I was able to get to a place where I could identify this resistance as a fear of rejection by society and my family especially. I was in deep denial because I was afraid of what would happen if I transitioned.

I didn’t want to lose my family. So instead, I lost myself. It took a long time (and a lot of support) to really come to terms with that.

That’s the thing, though: I needed space, support, time, and compassion to be able to figure out my path.

As of 2018, I’ve been on testosterone for a few years now, which drastically improved my life and my mental health. And I’ve had top surgery, which was the single best decision I’ve ever made. I am so much healthier and happier now.

But when you use a singular measure like dysphoria to decide if someone is worthy of those things, you run the risk of doing a lot of harm to folks who aren’t “faking” anything — folks like me who needed to process things before they could make the right choice.

And there are plenty of reasons why medical transition isn’t an easy decision, too.

Some people can’t access it for financial reasons or are denied access by clinicians. Some folks have chronic illnesses that would make medical transition risky or undesirable. Some folks might consider it safer to remain closeted. Some folks are in abusive environments where they can’t even begin to contemplate something like this.

And for some folks, right here and right now? They just don’t want to or aren’t ready to.

Maybe they’re questioning, maybe they’re afraid, maybe they’re overwhelmed, or maybe they’re just fucking tired. That could change and that may not… but it’s not up to us.

It’s not our business why and it’s definitely not our place to interrogate them, especially because we run the risk of doing serious harm for folks who might be going through some shit — shit that maybe they don’t even understand yet and can’t articulate.

You just. Never. Know.

It’s kind of like that quote, about how everyone is fighting their own battle. Even if it’s a battle you can’t see — because with trans folks especially, it’s the battles we can’t see that most often define our experiences.

So listen, I’ll give you this: Some disagreement over how we define “transgender” is bound to happen. It’s not the disagreement part that I necessarily take issue with.

It’s miraculous (and incredibly rare) that anyone agrees unanimously about anything. There are some people, for example, who don’t like Nutella, and that I will literally never understand. The difference here is that when someone tells me they don’t like Nutella, no one is actually being harmed in the process.

I acknowledge that there are going to be growing pains for our community, and I think this is part of that. These aren’t the first pains, and they won’t be the last. Historically, in every community ever, there have been divisions and disputes.

What I’m questioning here isn’t the definition of transgender. It’s what actually happens in the real world when we rely on your definition specifically.

Using dysphoria or medical transition as the way to define transness results in gatekeeping — and gatekeeping doesn’t work, because it’s too easy to get it wrong. And when we get it wrong? Trans people get hurt. Period.

The people who end up hurt most often (like, overwhelmingly so) aren’t actually faking anything and just wouldn’t benefit from doing so.

I was one of those trans people when transmedicalists harassed me in 2015. I was struggling to identify and understand my own dysphoria. I was being denied access to gender-affirming care by clinicians. I was struggling with PTSD and mental illness.

It was a battle you couldn’t see, and instead of offering empathy, I was harmed by folks who should’ve stood by me.

Are there trans people who haven’t experienced dysphoria and never, ever will? There could be.

Regardless of what you think, I’m not convinced that the existence of trans folks who don’t presently experience dysphoria is justification for disbelieving people who come out of the closet.

Those folks might want to access transition-related care in the future anyway, because it could make them happier or healthier. They might uncover that they have been dysphoric as they learn more and gain more hindsight.

Which means that either way you slice it, you can’t know for sure if someone is transgender or isn’t, even by your own definition — because people change and grow all the time.

Otherwise, I apparently wasn’t transgender in 2012 but I was in 2014. I wasn’t transgender when I was too traumatized to grasp it, but I was when I was able to access and process my emotions. Which… doesn’t make any sense.

Personally? I think gender identity is a diverse and complex thing — which to me is pretty exciting — but we might never agree there, I realize.

But you don’t have to understand their experience to respect their process.

Folks need to be able to explore their gender identity without hostility, because we simply don’t know their internal reality and we never will. The paradoxical reality is that the more fiercely you try to keep “outsiders” out of the trans community, the more likely you are to hurt trans people.

It’s not effective. It’s not helpful. It serves no other purpose than to hurt people.

So if someone says they’re transgender? You should believe them (or at least leave them alone, okay?), no matter how you choose to define “transgender” at the end of the day. The risk of driving a trans person deeper into the closet is simply too great.

It’s far more important to make sure that anyone who is questioning their gender has options and support, and that those options are protected no matter what, than trying to suss out who does or doesn’t “belong.”

So the moment they say “I’m transgender,” I congratulate them and I move on. What the hell do I know? That’s between them, their support network, their therapist, and whoever else they choose to involve.

Otherwise, there’s too good a chance that a transgender person who needs support will be denied it, just because of a misguided assumption about how they’re presenting in a particular moment.

We already get that from cis people constantly. Let’s not be like them, okay?

That’s why, when I define transgender as “identifying as a gender other than the one you were assigned at birth,” I do so with very intentional openness.

I want to be inclusive of folks who are questioning, and I want to give folks permission to evolve or change their minds, because that’s the only way to ensure that trans people can make the choices that are best for them.

The reality is, very few trans people emerge from the womb with an immediate and full understanding of their identity.

But people don’t make awesome choices when they’re being shouted at or put on the defense. Or in my case, harassed. Transitioning within a community that feels like a pressure cooker, demanding a particular kind of conformity, is never going to lead to the best possible outcomes.

And honestly? Asking trans people to put the horse before the cart — to know what they need and who they are before they can entertain a label — isn’t how a lot of folks actually operate.

The label is often what connects folks to more information, support, and self-discovery. It helps them uncover what they’ve suppressed and who they might become. So being possessive over the label actually winds up failing a lot of folks in the community, because they need the language before they can find a framework to operate from.

I want to say, too, that I understand it might be hard to let go of that impulse to judge.

When we identify with our struggles, it can feel insulting when someone who hasn’t struggled in the same exact way takes on a label that has so much meaning to us — a label that you feel you’ve earned, while others seem to just be sauntering right up and grabbing it.

Even so, I think we need to all agree — at the very, very least — that this is much more complicated than simply walking up to a label and dropping it into your identity shopping cart.

We’re talking about psychology, culture, language, trauma, biology, intimacy, sexuality, even spirituality — what aspect of the human experience is gender NOT touching on? And that’s ultimately why I think reductionist definitions fail us as a community.

Gender is messy and abstract. If it weren’t, we wouldn’t be debating it literally all the damn time. The very fact that we don’t agree on this is simply proof that this is a complex thing we’re dealing with here.

And for that reason alone, I recognize that we will probably never agree 100% on what it means to be transgender. But I don’t think we have to — we just need to agree on how to treat one another.

You know, with respect.

So what do we do, then? For me, I’m just trying to do the least amount of harm. I’m asking you to consider doing the same.

There are so many different paths that people take to arrive at an understanding of themselves.

But if we close the door too swiftly on people who aren’t exactly like us, we run the risk of shutting the door on someone who needs us — someone with whom we might share a lot more in common with than we’d expect.

Personally, I don’t think people choose to be trans in a world that isn’t terribly kind towards trans people. And even if they did put on some kind of weird act, I’ve accepted that I can never know that for sure, nor can I really do anything about it.

But I can be kind and gracious with the hopes that, wherever folks end up, they find the path that’s right for them. Extending that kindness to them doesn’t harm me in any way, shape, or form.

At the end of the day, it’s more important (to me, anyway) to create a community that allows trans folks to thrive. Gatekeeping doesn’t allow for that — it makes us suspicious of each other, callous, and combative.

If we want trans people to be able to come out, we have to make our community a safe enough place for them to do so.

When I came out in 2012, I had so many incredible trans folks to look to, and I owe so much of my happiness and health to them now. If I hadn’t had their support, I would still be closeted, if I’d even be alive today.

Every person deserves the chance to question their gender and explore it freely, without pressure, harassment, or gaslighting. This isn’t just a “be nice” issue — this is about the mental health and resilience of this community.

And I so badly want to believe that the majority of transmedicalists don’t actually approve of the harassment that folks like me have experienced, and don’t want to see what happened to me happen to anyone else.

I want to believe that if they knew the full story and really thought it through, they would’ve been there for me, as a trans person who knows how hard it is to be trans.

But the only way to guarantee that we aren’t caught in the snares of gatekeeping, and harming one another, is if we end this culture of interrogation altogether.

When in doubt, we need to do the kind thing instead, and let people live. You may not understand where they are in their journey right now, but they deserve the freedom and dignity to walk that path and see where it leads them. They deserve all the time and space they need to figure it out.

They may or may not continue on that path — but it’s not for us to decide.

I’ve given you all the benefit of the doubt here, because I believe every one of us deserves it.

Will you please extend the same to other folks in this community?

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Transgender people shouldn’t have to lie about their mental health. But many do.

Until this last year, accessing top surgery was a losing battle for me. But it’s not because of where I live, my health insurance, or any of the other typical barriers you might imagine when trans people are looking for care.

It’s because I’m mentally ill.

I live with obsessive-compulsive disorder (OCD) and complex trauma; I’m also transgender. And I’ve found that, at this particular intersection, accessing the health care I need has been an uphill battle.

I’ve been denied care numerous times over the years, under the premise that I was too mentally ill to undergo a major surgery — ignoring that gender dysphoria, an acutely painful experience for many trans people, was contributing to my poor mental health.

It took two years to be placed on a waitlist for surgery, when a therapist finally decided that I was “stable” enough (without any explanation of what that actually means).

And it wasn’t just surgery that was made difficult. Psychiatrists in the past have encouraged me to stop taking testosterone, convinced it was making me “worse.” While hospitalized for depression, I had nurses trying to withhold my hormones because they didn’t feel it was “necessary.”

This last January, I finally got top surgery and I now have consistent access to hormone replacement therapy. But I still live in fear that, should my mental health decline again, I won’t have access to the gender-affirming care that has vastly improved my life and wellbeing.

Frustrated by my own experiences, I started reaching out to other trans people with mental illness to see if they’d encountered similar challenges — and I was horrified by what I found.

“A lot of doctors I saw questioned my ability to handle hormones as someone with a history of depression and self-harm,” Luke, a non-binary trans man in Ontario shared with me.

Could that history really justify someone being denied hormones altogether? I was wondering that, too. So I did a little research on the literature we have. And… it’s not exactly helpful, to say the least.

The World Professional Association for Transgender Health (WPATH) created their Standards of Care. The SOC are, more or less, the most recognized clinical guidelines for treating transgender patients. They advocate for an “informed consent” model: allowing for trans people, once fully informed of the risks and benefits of treatment, to choose for themselves the right path forward.

The standards also advocate for competent treatment of co-existing mental health conditions with the use of therapy and medications, where appropriate.

But if you look closer, you’ll find that they are limited in how they discuss treatment of mentally ill trans people. “Clients should be assessed for their ability to provide educated and informed consent for medical treatments,” it reads, without actually offering adequate guidelines for what this looks like in practice.

It also states that, before surgery is considered for someone with severe psychiatric disorders and impaired reality testing (so delusions or hallucinations, really), “an effort must be made to improve these conditions with psychotropic medications and/or psychotherapy before surgery is contemplated.”

This raises a really important question: How, exactly, do we measure “improvement” in mentally ill trans people?

And if there isn’t significant enough improvement, is a trans person simply in limbo, unable to access transition-related care?

Mentally ill trans people, then, are ultimately left to the whims of whatever mental health clinician they happen to be seeing — with very little recourse if they disagree with that clinician’s assessment of their readiness for care.

The SOC directly list conditions like psychosis, bipolar disorder, dissociative identity disorder, and borderline personality disorder as mental illnesses that could impact “readiness for surgery.”

But in a document of 120 pages, the SOC actually say very little on how, exactly, to assess at what point a mentally ill trans person might be “ready” to access surgery. Until this is made clearer, transgender people are put in an impossible position of deciding whether or not it’s safe to disclose their mental health status.

Interestingly, WPATH — and the overwhelming majority of care providers who work with transgender people — agrees that gender-affirming care is medically necessary. What’s puzzling is that, in almost any other context, mental health status would not preclude someone from medically-necessary care for any other condition.

Gender-affirming care somehow seems to be an exception, reinforcing the notion that trans-related care is “optional.”

The most direct mention of denying access to surgery in the Standards of Care reads, “No surgery should be performed while a patient is actively psychotic.”

This seems to be the only statement that a trans person can point to when they encounter obstacles, but given the other mentions of “readiness” and “improvement,” there are still too many ambiguities— and too many clinicians who aren’t at all familiar with the SOC to begin with.

Not to mention, none of this helps trans people with more severe mental health challenges who still need to access care.

It’s worth noting, too, that disorders like borderline personality disorder — which is flagged as a potential issue in the SOC — include an “unstable sense of self” as a diagnostic criteria, as well as difficulty trusting others and recurrent suicidality.

Coincidentally, these sound an awful lot like issues any trans person could struggle with simply because they are transgender.

In other words? Any trans person could  be denied care if a clinician who’s unfamiliar with this population misdiagnoses them. In fact, at the time at which I was denied surgery, I myself was misdiagnosed as borderline. When that diagnosis no longer applied, I finally found myself on the waitlist.

While some boundaries surely need to exist, the utter lack of clarity in these guidelines means that trans people with any mental health struggle are at risk.

I spoke to Traci Lowenthal, a licensed psychologist that has worked closely with the transgender community. Most of the time, she shared, “mental illness should not be a barrier to getting necessary trans health care.”

The keyword here being, of course, “should.”

When assessing the readiness of a mentally ill trans person to pursue surgery, the most important factors, she says, are safety and the ability to consent.

So long as they can provide informed consent and keep themselves safe (the example she gives is proper hygiene and medication compliance post-surgery), there should be no barrier in accessing gender-affirming care.

“If a person has delusions,” she continued, “it would be ideal if their mental health provider could help them prepare for how those delusions may impact them while they receive medical care and during recovery.”

Compare this to my two-year battle to access surgery. It wasn’t because I was delusional — I was told, in essence, that I was too depressed to undergo surgery. There was no effort made to determine if surgery might improve that depression, and if there could be ways to better prepare for surgery in that state of mind.

The end result? Transgender people are scared to be honest about their mental health. And this has serious consequences.

I spoke with Ghost (a pseudonym), a trans person in Detroit, Michigan, who experiences schizoaffective disorder, delusions, and anxiety. For them, this has meant a constant fear of interference and mistrust in clinicians. “I am absolutely terrified that my mental health status will be used against me [in transitioning],” they explained.

“I’ve already experienced ‘the look’ from a medical professional,” they went on. “The one they use when you tell them [your mental health status], and they’re suddenly very skeptical of you.”

And with disorders like schizophrenia and borderline disorder especially, all of the trans folks I spoke to said they encountered disbelief when disclosing they were transgender, simply because they had one of these illnesses.

Some trans people have resorted to hiding their mental health history, or outright lying about their mental health status to providers. Others postponed psychiatric treatment altogether to ensure they could first transition without interference, which included forgoing psychotropic medications they desperately needed.

The unfortunate reality is, clinicians can’t adequately prepare someone for the specific challenges of medical transition if they don’t know about their client’s mental health status. And of course, when trans people have greater reluctance to seek out psychiatric care during their transition, they’re unlikely to get the support they need for the best possible outcome.

The fact that trans people should have to choose between gender-affirming care OR mental health care is unjust. Access to both is critical, especially for such a vulnerable population.

Trans people face an extraordinary risk for suicide — but if they fear disclosing their mental health struggles, they are likely to suffer in silence. This puts their lives in danger.

And when a trans person with mental illness is, indeed, denied access to care, the path forward is equally unclear.

Florence Ashley, transfeminine activist and LL.M. candidate at McGill University — with a special focus on bioethics and transgender health care policy — highlights just how much of a grey area this is.

Pointing again to the WPATH Standards of Care, she notes, “The only case that WPATH describes as precluding surgery is while the patient is ‘actively psychotic.’”

The rest, she agrees, is murky at best. “As with many issues faced by trans people, the best we can do is extrapolate from sources of law that have yet to be applied to the specific issue,” Ashley said, noting that a case might be made on the grounds of medical liability and professional ethics.

However, there appears to be no legal precedent for trans people specifically to look to when making such a case.

“This really ties back to a core problem in trans law,” she continues. “At some point, policymaking bodies will have to take up responsibility and pass enforceable policies and laws on trans-specific problems in collaboration with trans communities. Otherwise, we’re always going to be left behind.”

It’s evident, then, that more research and attention is needed to properly support trans people with mental health struggles. We need clearer guidelines, direct policies, and competent clinicians who are prepared to work with trans people regardless of mental health status.

For the transgender people who fear that they will not be able to access gender-affirming care, however, this offers very little comfort.

“I’m constantly worrying that someone will look more deeply into my history and see attempts, hospitalizations, a history of self-harm, and take it all away,” Tamsin, trans woman in Vancouver confessed.

While she finally has access to hormones, she fears it isn’t guaranteed. “[It will] cause me at least some anxiety for life.”

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

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.

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Maybe being transgender wasn’t a mistake.

This article previously appeared at Ravishly, republished here.

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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.

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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.

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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.

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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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No, Cis People, Being Trans Is Not a Self-Esteem Issue

“I have a lot of sympathy for transgender people,” someone once told me. “I know a little something about what it’s like to hate yourself, to hate your body.”

I can appreciate when cis folks (who haven’t lived the trans experience) try to create bridges of understanding and empathy with trans people. I think flexing those muscles and building on your compassion is an important part of solidarity.

However, when those attempts miss the point – and ultimately uphold stereotypes that harm trans people – it warrants a serious discussion about how exactly cis people have come to understand trans people.

The “self-hating trans person” trope is widely used as a point of reference for cis people and fuels a lot of misunderstanding around the trans experience. In a nutshell, it’s assumed that what makes a person transgender is that they hate themselves, hate the bodies they inhabit, and thus transition because they don’t like themselves.

Simply put, the idea that being transgender is a “self-esteem” problem just isn’t true.

Which isn’t to say that self-hatred isn’t an experience for some trans people.

Struggles with mental health are a staggering reality for us. But this narrative around the “self-hating trans person” is a false one. It oversimplifies and misrepresents the experiences of most trans people.

I want to unpack, in more detail, exactly why this trope is so harmful.

Here are four reasons why this myth needs to be put to rest – and the real harm it does when we perpetuate it.

1. It Ignores the Impact of Systemic Oppression

A lot of the pain that trans folks suffer is at the hands of an oppressive system, and it has nothing to do with the feelings we have about ourselves personally.

When we diminish the struggles of trans people as a personal problem, we completely neglect the systemic forces that cause immense suffering.

The state of transgender folks’ mental health is dire, but it’s not necessarily because we’re transgender.

When we’re hated by the culture at large, have our rights routinely denied, face the looming threat of violence and even death, struggle to access adequate healthcare, and are ostracized by our communities, how can we be expected to feel positively about our transitions and ourselves?

The transgender struggle is not just one of self-hatred – it’s one of trans-antagonism, and existing in a world that doesn’t recognize our humanity. Too often, that dehumanization becomes an internalized struggle, and we begin to hate ourselves not because we’re transgender, but because we’re taught from a young age to relate to ourselves in a violent way.

However, if you equate being transgender with being self-hating, as if it’s a natural condition of our lives, you overwrite the systemic origins of our suffering.

And in doing so, there is no accountability to create a world that is safe and affirming for trans people. It’s reduced to a personal issue with us, rather than a systemic issue that cisgender people must take responsibility for.

Instead of assuming that all trans people are self-hating, the better question to consider is what kind of world we’ve created in which this kind of suffering is permitted and even expected.

2. It Imposes One Narrative onto All Trans People

This trope is a fallacy because there are plenty of trans people who don’t hate themselves. Full stop.

Our community is layered, complex. We have a variety of feelings about our identities, our bodies, and our transitions. To condense those experiences into a singular narrative and emotion does us a huge disservice: It completely erases the diverse experiences that exist within our community.

Some trans people hate their bodies, and some don’t. Some trans people hate being trans, and some take pride in it. Some trans people wish they’d been born cis, but others are glad to be trans.

There is no right or wrong way to be trans – but it’s problematic to assume all trans people share the same narrative and experience.

For me, personally, I don’t feel self-hatred in the way that cis people assume I do. I hate the ways that society has forced me to pretend to be something I’m not, and sometimes I even hate the body that obscures my truth. But I never hate myself as trans or otherwise.

I have a deep compassion and appreciation for myself and everything I’ve survived. Many trans people do.

The best way to build empathy for a trans person is to tune in when they share their experiences, and believe them when they do. Instead of relying on tropes and looking for misguided shortcuts to understand us, seek out trans people (plural!) who are willing to give you the benefit of their lived experience.

3. It Fundamentally Misunderstands Gender

Being transgender is not a self-esteem issue.

This implies that if trans people saw a therapist and worked out their feelings, their gender would somehow change, and they would magically become cis.

This just isn’t true.

When you say that transgender people just hate themselves, you overlook how truly complex gender is – and you assume that cisgender people are “right” and neutral, while transgender people are “wrong” and broken.

The trope of the “self-hating trans person” relies on one huge (and very wrong) assumption: namely, that being cis is the natural state of being that we reject out of disdain, instead of cis and trans folks’ genders being equally valid and authentic.

This completely undermines the sincerity and legitimacy of transgender experiences.

Claiming a transgender identity isn’t about rejecting the gender we were somehow meant to have because our self-esteem is too low. It’s about rejecting who we were wrongly said to be.

Being transgender is about embracing and manifesting who we actually are in a society that invalidates us, marginalizes us, and rejects us as trans. We can hate the (often violent) imposition of gender upon us without actually hating ourselves.

Gender is a deeply personal identity that we come to know throughout our lives. It’s who we are and how we relate to the world, to our bodies, to our culture, and to ourselves. The way that trans people arrive at that understanding is often very different from cis people, but it’s not inherently better or worse, and it’s certainly not flawed.

Asking to be recognized as we actually are is not an act of hatred – in fact, it’s one of the purest gestures of self-love that I know.

4. It Creates a False Parallel Between Cis and Trans Experiences

You don’t actually have to put yourselves in our shoes to have compassion for trans people.

In fact, you may never arrive at a point when you fully understand what it means to be transgender. And the sooner you can acknowledge this, the better your relationship with trans people will be.

What I dislike most about the “self-hating trans person” trope is that it assumes cis people who have struggled with their self-esteem or their bodies can understand what it feels like to be transgender. But I disagree vehemently with that conclusion.

The particular experience of being (wrongly) assigned a gender in a cisnormative, trans-hating society just isn’t the same as a cis person struggling to like certain things about themselves.

I’ve disliked my body. I’ve struggled with my self-esteem. I’ve dealt with a whole slew of negative emotions around who I am and what I look like. But those experiences, while they were difficult and raw and real, had very few (if any) similarities with my experience moving through this world as transgender.

For one, they were transient experiences that I could work through and even hide if needed. But being transgender is immutable. It doesn’t just affect how I feel on a day-to-day basis, but it impacts my access to power, safety, and resources.

It’s an inherent and complex thing about myself that extends beyond my self-esteem – it’s steeped in biological, sociological, psychological, and even spiritual understandings of myself.

When something is so deeply rooted and significant, a surface-level analysis will not suffice if you’re trying to find ways to relate and understand. The reality here is that when cisgender people are distracted by halfhearted attempts at empathy, they fail to see that being able to relate isn’t a prerequisite for solidarity, but listening is.

Cisgender people who diminish the trans experience by naming it as a simple emotion (self-hatred) – rather than acknowledging that embodied experiences of gender are much more complex – are participating in the erasure and oversimplification of the trans experience.

This trope, when employed by cisgender people, is trans-antagonistic – and perhaps in the most selfish way – because it’s about satisfying the curiosities of cis people with an easy-to-digest answer, rather than letting trans people speak their own truth, even if that truth might be more nuanced and require more effort to understand.

This article, then, is a deeper calling – demanding that cis people do the work and believe trans people when we share who we are and what we feel. Our emotional realities and lived experiences are diverse, painful, complicated, and even beautiful.

Cis people need to hold the space for all of this and more. And that starts with tuning in.

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This piece that I wrote originally appeared at Everyday Feminism.

Trans People Too Often Harm Their Own. So Can We Talk About How to Do Better?

A lot of the time, we talk about the ways that cisgender people harm us. And yes, those are critical conversations. But right now, I want to talk about trans people harming other trans people.

Because at the moment, I’m seeing an awful lot of it.

I think it’s time we had a heart-to-heart about the ways that we treat each other.

Whether it’s telling other trans people how they should or shouldn’t transition, criticizing the language folks use to self-describe, centering ourselves and stepping out of our lane, or simply not believing each other when we come out, we can be our own worst enemies.

But we can do something about this.

We can renew our commitment to this community and to each other. We can be mindful of the ways that we’re upholding one another’s oppression, we can self-reflect, and we can call each other in.

Because in this moment, in a world that is so hostile towards and dangerous for trans people, the last thing I want to see is us hurting one another.

We need to show up for each other. We need to protect each other. In so many ways, we’re all we’ve got.

So where do we start? Here are five ways we can better support one another.

1. Believe Trans People

I remember when I found a slew of tweets in my inbox from other trans people, accusing me of lying about being transgender.

They misgendered me, hurled unfair accusations towards me, and they began a concentrated online campaign to discredit me in this movement.

They reached out to a number of my Twitter followers, calling me a cis woman and saying that I was only pretending to be trans in order to get “Internet famous.”

Why? Because I hadn’t yet started testosterone, and in their minds, the only valid transgender people were those who were medically transitioning.

There is a lot of gatekeeping in the trans community, and it’s really heartbreaking to see. There are countless trans folks who feel that they can decide who is and isn’t transgender, and they exclude other trans people based on their own assumptions.

Sometimes, like in my case, this escalates into harassment and even violence.

I’ve experienced it firsthand many, many times. And it has hurt more than I could possibly express.

When that online campaign to discredit me began to take hold on Twitter, the timing couldn’t have been worse. As someone who had been struggling to come out to my family and was unable to access hormones, it was a painful time in my life.

Being bullied because I wasn’t on testosterone – something I desperately wanted, but couldn’t access – made an already difficult time in my life even more agonizing.

Why were hormones even relevant in the first place? Since when do they know my gender better than I do?

I often wonder: If we want to convey to the world that misgendering someone is an act of violence and that gender is a deeply personal thing that belongs to each individual, why do we do this to each other?

Why are we such hypocrites when it comes to others in our own community? Why do we ask for our gender identities to be respected, and then completely disrespect the identities of others in our community?

Rather than attacking each other and attempting to ostracize one another, we should be investing that energy into advocacy and supporting one another – not tearing each other down.

2. Don’t Place Judgments on How Other Trans People Choose to Transition (Or Not)

The reality is that transgender people are incredibly diverse and no two journeys will look exactly alike. We all have to decide, as individuals who know ourselves and our genders, what decisions are best for us and our happiness.

We also get to decide the timeline in which we make those decisions.

Some of us will pursue hormones. Some of us will not. Some of us will socially transition. Others won’t. Some of us need surgery or multiple surgeries. Others do not.

It isn’t anyone’s business but our own what we do with our bodies. And we are not more or less transgender because of our choices – because being transgender is not about the bodies that we inhabit, but rather, our sense of self and our identities.

It took five years of identifying as transgender before I finally pursued hormones. Five years. This was largely due to a lot of internalized self-hatred that made it difficult to accept that I needed to medically transition.

With everything I was going through, I still endured a lot of judgment from other trans people who questioned my authenticity because I didn’t make the same choices that they did within the expected time frame.

Can we just let other trans people make decisions about their bodies without judgment?

3. Hold Space for Trans People Who Are Non-Binary, Non-Conforming, or Questioning

Alternatively, this could be called “not being an asshole,” but I want to dive a little deeper than that for a moment.

Not all transgender people are binary. Some of us have carved out our own unique identities and our own expressions. It doesn’t make our oppression less painful. It doesn’t make our dysphoria (if we have it) any less real. It doesn’t make our gender any less valid.

Please don’t exclude us or ostracize us from the community because we don’t conform to your arbitrary rules. Instead, support us, include us, and celebrate us.

Not all transgender people are even sure of what their gender really looks like or how it manifests in the world. Some of us are still exploring this. Some of us aren’t sure what we need. Some of us have more questions than we do answers.

Please don’t push us to the margins because we aren’t so sure. Hold us in compassion, support us, and give us the room to figure out who we are without judgment.

Sometimes trans people can be very protective over the idea of what it means to be transgender. But this needs to be said: It is oppressive to deny people the right to self-identify. It is oppressive to exclude people because they do not fit your idea of what transness should be.

And it is a real waste of energy and effort to marginalize other trans people when we could, instead, collectively endeavor towards our liberation.

4. Be Mindful of Centering Yourself and Advocate for All Trans People

Trans folks of privilege – those who are white, able-bodied, or have class privilege, for example – may feel tempted to place their experiences and needs at the center of this movement. But in doing so, they fail to uplift all trans people.

This often happens when transgender people who have privilege assume that their narratives are representative of all trans people, or they fail to include diverse voices in their organizing.

Trans women of color, for example, feel the compounded effects of transphobia, misogyny, and racism. They face higher rates of violence, harassment, poverty, incarceration, suicide, and endure countless obstacles in their transitions.

Ignoring this reality and prioritizing the voices and experiences of white trans people only serves to further marginalize trans people of color, whose needs are arguably most urgent and life-threatening.

Giving more visibility and resources to trans folks of privilege does not liberate all trans people – it only upholds other systems of power that already benefit those with more privilege, and it serves only a small part of our larger community.

This is why it is crucial that trans folks who have privilege be constantly mindful of the ways that their privilege operates both within the community and outside of it.

I know in the work that I’m doing, I’m constantly assessing and reassessing where my lane is and how to stay in it. And truthfully, I don’t always get it right.

But self-reflection and self-criticism need to be an intrinsic part of the work. We keep working at it, because we care about one another and we want to liberate everyone, and not just ourselves.

We must acknowledge difference rather than assuming that our community is a monolith in which we are all the same. We must work collectively to ensure that the voices of all trans people – especially those who are most marginalized – can be amplified and given a platform in our movement.

A movement that only aims to benefit those who already have privilege simply replicates existing oppressions. And that? That’s not justice.

5. Call Other Trans People In

This is one of the most important pieces of the puzzle. When we see other people in our community engaging in problematic or oppressive behaviors, it is important to call them in.

When I was being attacked by other trans folks for not being “trans enough,” there was a shocking amount of silence from others in the community who would privately console me, but make no attempt to stand up for me.

The harassment continued for some time because very few people stepped in and made it clear that this kind of behavior wasn’t tolerated in our community.

I’ve seen trans people engage in vicious gatekeeping, followed by radio silence from the folks around them because they’re afraid to call in one of their own.

I’ve seen trans people find out that someone in the community is an abuser, followed by complete inaction because they aren’t willing to show up for survivors.

I’ve seen white trans people observe racist behavior, followed by complacency because they didn’t want to make things “awkward.”

I’ve seen trans people speculating about the authenticity of other trans people’s identities (“but are they really trans?”), followed by, you guessed it, no willingness to challenge that kind of behavior.

When someone in our own community is doing harm, we are arguably in the best position to engage. Our ties to one another and shared struggles mean that we can call each other in skillfully, if we’re willing to step up.

I know this is difficult work, because we share very intimate spaces with one another, spaces in which we can’t avoid each other. And obviously, when our safety is at stake, it can get more complicated.

But how many opportunities have we missed to make this community safer and more affirming because we were unwilling to make ourselves uncomfortable?

And I’m not exempt from this, by the way. I’ve missed a lot of opportunities, too, when I reflect back.

Our connections and ties to one another position us to do really transformative, healing work with each other. I think it’s worthwhile work to be doing. And I want to see our community embrace that, especially those of us that already have access to power and have the least at stake when they engage.

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If we don’t believe each other, support each other, uplift each other, how can we begin to create a world in which transgender people are thriving?

If we continue to hurt each other in these ways, where will trans people go to find a safe space? If we don’t have each other in this struggle, who can we count on?

The transgender community has shown up for me in so many ways, ways I will never forget.

It was a small community of trans people in Lansing, Michigan that embraced and affirmed me when I first used the word “transgender” to describe myself. That’s a moment I will never forget — that room was filled to the brim with validation and care.

It was a trans man that opened up his home to me when I first moved to the Bay Area, when I knew literally no one here. Total strangers helped me get my bearings, find housing, find community, and find my way thousands of miles away from the life I’d left behind, only knowing that I was trans and believing that this made us family.

Hell, when I was psychiatrically hospitalized and at the end of my rope, who visited me in the hospital? Who sent me books? Who wrote me? (A lot of you did, trans readers, and while hospital staff misgendered me and while I came undone, your emails reminded me that my life had real value and importance, that I always had a community to come back to, a community that truly saw me.)

I would not be who I am today without the love and support of transgender people.

That’s why I’m so passionate about trans people supporting other trans people – not because I want to pick apart our community, but because I see the difference that this support makes in each of our lives.

I believe in the power of our community. And that’s exactly why I believe it’s important that we are accountable to each other and that we strive to be a safe and supportive space for all trans people.

It’s my hope that we can and will do better. It starts with each and every one of us. And it must begin now.

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I Thought I Was Ugly. I Didn’t Realize It Was Gender Dysphoria.

For a long time, I couldn’t place why — I just felt ugly.

And not just in the insecure way, but in the something-is-so-wrong-but-I-can’t-place-what way.

No matter what I did, or how often my friends reassured me, nothing seemed to change the fact that something didn’t feel right when I looked in the mirror. And no one seemed to see it but me.

As someone assumed to be a girl, I figured that hating how I looked was a rite of passage. I could never articulate what I didn’t like, though. It wasn’t my nose, or my lips, or my teeth.

When people asked, I helplessly explained, “I don’t know, I’m just ugly.”

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When I look at old pictures of myself, though, I start to understand. For one, it doesn’t even look like me.

It wasn’t that I was ugly, so much as I didn’t look like myself. But not even knowing what “transgender” meant, I didn’t have a point of reference to understand my feelings at the time.

It wasn’t that I was ugly by some objective measure, or even that someone had told me I was and the comment stayed with me. It was that I was dysphoric — the body I was in didn’t feel like mine, and I could only react to it with discomfort and, at times, disgust.

There’s this narrative around transness, that we all knew immediately that we were meant to transition, meant to live in a different body, that the gender we were assigned is not the gender we actually are. For many of us, however, that’s simply not our story.

For me, none of that occurred to me consciously for a long time. I just knew that I didn’t like how I looked — that I was deeply uncomfortable with myself — and at times I felt that very strongly. It took much longer to understand why.

Transitioning happened for me a little haphazardly, and maybe a little organically, too. I was drawn to short hair, and after cutting it, I felt euphoric in a way I couldn’t deny. I loved androgyny as a style, and after experimenting a little, started to find new ways to express myself. I followed my intuition, not entirely sure where it would lead me, trying not to overthink what it said about me or my gender.

And then I noticed something: The further I moved away from the gendered expectations that came with being perceived as a woman, the happier I felt.

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Ugliness is such a profound, raw, and vulnerable emotional experience for some trans people. For me, it was the driving force in my transition.

“Ugly” was the only word I had to describe my dysphoria, which meant it flew under the radar for a long time.

It didn’t raise any alarms for the people around me. It just confirmed the sexist notion that women are supposed to be insecure, and therefore my discontent was an acceptable, albeit sad experience that came with the territory of my assigned gender.

But something intuitively pushed me forward. Part of that was finally meeting other transgender and non-binary people, who gave me the language I didn’t have, and filled in the gaps of knowledge I desperately needed.

I became acquainted with the feeling of gender euphoria — the sense of affirmation and even joy that comes with being “seen” as the gender you truly identify with. For me, I had waves of euphoria as I started hearing my new name, my new pronouns, and my new reflection staring back at me, being shaped before my eyes by testosterone.

Dysphoria is a complicated experience, and I think it’s very misunderstood, even by some folks in the trans community.

It’s not like I looked down at my body and saw a vision laid before me, immediately understanding that I wasn’t a girl. It was, more often than that, the sense of lingering discomfort, confusion, and profound emotional rejection that unsettled me, often on a deeply unconscious level.

Dysphoria, for me, has always been the battle between my conscious desire to take the easiest and safest route in life — one that cis people repeatedly told me would be living as a cis woman — and my unconscious and, at times, desperate need to transform my body so that I could live authentically and comfortably.

At first, it was easy to reject my dysphoria as feeling “ugly” and nothing more, because it felt safer to consider myself a cisgender person who felt ugly, rather than stepping into my life as a transgender person, considering the many risks and struggles that came with it.

Dysphoria never provided me an answer or a clear path forward, as it sometimes does for other trans people. For me, it created a problem, and it was one that I didn’t initially know how to solve.

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But as it turns out, transition was the right thing for me, even if it took years to understand that.

The profound anxiety that I had when I looked at myself has been replaced with a kind of joy — a joy I’d never had before transition, in which I can see myself and not only do I look good, but it looks right.

My friend Jes Baker, a fat activist and incredible blogger/human, said to me before that a lot of our unhappiness with our bodies happens when we look at the mirror expecting to see someone else (paraphrasing, but you get the idea).

In some cases, coming to terms with our bodies as they are can be our greatest act of self-love. There’s abundant messaging in this world that tells us to reject our bodies, and unlearning that shit takes time. But for others, change is how we make peace with our reflection.

I think it all begins with the question, “Who am I expecting to see looking back at me?”

Every day, I think the person I was waiting for is finally coming back to me. And I can’t even begin to describe how beautiful that feels.

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