Five years ago I was in an inpatient psychiatric facility. Those are still not easy words to write. It means that my mental illness, my Beast of mental illness, was so far out of control that I was no longer safe with myself or others and had to be placed in a facility where I could be monitored. In fact, it meant that my room door was open and nurses walked by and checked in regularly. Unlike a regular hospital room though, there was no curtain to give an illusion of privacy, and the bed wasn't adjustable. Plus, the furniture was bolted to the walls, and there were bars on the windows.
But what was it like to be trans in the psych ward? It was definitely a mixed bag, especially because I was having a complete Bipolar 1 breakdown. I was suicidal. I was manic. I was delusional. In one way I was not myself, but in another I was completely myself.
I have dual diagnoses of Bipolar Disorder 1 and Gender Dysphoria, along with 4 or more other psychiatric disorders, and insulin dependent diabetes. The DSM 5 psychiatric diagnosis of Gender Dysphoria, despite all of the work I've done, and had done, indicates that my body and my mind don't entirely match up. I suppose being bipolar probably doesn't really help that in the end.
Being transgender and having Bipolar 1 Disorder possesses an intrinsic sameness for me.
It means simultaneous existences in 2 disparate worlds.
It means that even when I'm here, I'm there too.
That first night I probably wasn't thinking too much about the trans part of my life. I suspect I was more focussed on the sheer insanity of detox. Then again, I wanted to appear as fully male as possible. I didn't want anyone to know I was transgender. Even though every staff member knew my gender identity. Sanity wasn't on my side to start with, so thinking clearly wasn't there either.
Being transgender in a psych ward was terrifying for me in a way that was completely separate from the Bipolar 1. I was afraid for my own safety at the hands of the other patients. I was afraid that if the men there knew, they would physically or sexually assault me. Consequently, I never told them.
Looking back now, I think this put a huge damper on my recovery. I believed that I could be well even if my whole self wasn't present. I thought that I could heal the wounds without exposing the deeper cuts. I held myself back. In so doing, I delayed my progress and stayed stuck. I kept myself from moving forward in meaningful ways.
The anxiety of disclosure is still with me of course, even though I share my story easily and readily. I bring my whole self whenever possible, but there are times when I check 30 years of life treatment as a female at the door. I leave behind the person I was and pretend that I've always been the male who's standing there.
Perhaps this is an act of self-preservation. Maybe it is the physical fear of attack, but I believe it is an emotional, psychological, and spiritual fear of degradation and loss of dignity. Exposing oneself to other people's ignorance, bias, fear, distrust, and hate is risky. And yes, I am fully aware that I have a choice, my white skin color is a privilege, and I don't have to disclose my gender identity if I don't want to.
But sometimes I want to disclose for the sake of others. For my trans brothers and sisters who did disclose themselves and lost it all. For trans youth who are terrified of coming out to the safe people in their lives. For nontrans folk who have family members who are trans. And for the bigots who believe I am not who I say I am, who devalue my existence through denial and hate. For all of them to help normalize and accept that we are real live people who choose to be ourselves.
And back in the psych ward, I wish I'd done just that those first few days. I wish I'd had the courage to be that man. But maybe just being a man at that moment was enough. Maybe standing there in my Bipolar meltdown as the man I am was exactly what I needed to do, because a few days later I would have the opportunity to open up when the time was right.Thank you for being on my journey of disclosure.
Be well, love your neighbor as you love yourself, and remember to actually love yourself.
-Ari
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