I've recently been fighting with my 15+ year psychological diagnosis of Gender Dysphoria. My sense of dysphoria feeling/being a man, but still having physical attributes of a female, escalated to a level that I hadn't experienced in more than a decade. It started with a low-level of physical pain in my groin. There's a 30-year-old, largely calcified cyst in a delicate (read genital) area of my anatomy. Unrelated to anything I can recall leading up to it, the cyst became inflamed, infected, and eventually burst open 2 separate times. The second time the pus that drained out was putrid, gritty, and contained shards of calcium. All of this led to a few medical appointments, a small procedure, and a soul racking anxiety about my gender identity. Or at least the physical manifestations of said identity.
The practical and pragmatic questions started immediately. Why did this flare-up occur now or at all? Did I do something that made it happen? Is it just a random flukish event? Is there an underlying medical reason? Is it a combination of multiple factors? And more importantly, is there anything I can do about it now?
But the broader philosophical questions arose moments later. Why has this caused such a massive flare-up in my mind? Why has this medically benign object in my groin, set off a cancerous spread of gender dysphoria in my head? Why am I questioning my male identity based on a cyst that could just have easily occurred in my armpit, my neck, or on my ass? Why am I struggling to come to terms with a more than 30-year-old part of my body, that I didn't believe mattered anymore?
It's because it has mattered all along and I have been unwilling and unable to acknowledge or accept that. I've been aware of this thing for as long as it's been there, both pre- and post-transition. It's been a daily reminder of where I am male and where I am not. And I hate that.
It is a literal encapsulation under my skin of a medical condition that has dictated more than 75% of my life. And it was a condition I didn't even know I had. The physician I saw had done her research and figured out that I have Hidradenitis Suppurativa also known as Acne inversa. It's a chronic skin disease of acne, boils, infections, and scarring of the skin, usually stemming from sweat glands and follicular [hair] blockages. It has many comorbidities (conditions that often occur with it) that include anxiety, depression, excessive sweating, obesity, high cholesterol, high blood pressure, diabetes, and Poly Cystic Ovary Syndrome. All of the above applied to me at one point or another in my life.
The disease itself isn't curable, and only the symptoms can be treated/managed. In a miraculous turn of events, my transition from female to male has helped, though that is certainly not the most common treatment. The removal of my ovaries and uterus, breast tissue, and a weekly injection of testosterone ended the ovarian cysts, the boils under the breasts, and seemingly most of the cysts in the groin. But, it didn't erase or eradicate the hardened cyst already there.
This new medical information didn't alter my sense of gender dysphoria. It was good to learn and access new resources, but it didn't change the dis-ease of not having the physical structures I want and think I need. That's the whole point of this for me. That no new diagnosis, or self-actualization, or psychological therapeutic intervention, or level of imagination will result in a physical change in my anatomy. I may one day be able to reconcile my gender dysphoria with my body, but it will never truly be that of a cisgender male. There may be an approximation that will meet my psychological needs, but it is not something that happens quickly, easily, or inexpensively. Surgical interventions are complicated processes.
But the surgery I can have done right now, a basic excision of the cyst, won't change anything about my anatomical or physical appearance. In the long run, it will likely alleviate some of my feelings of dysphoria, yet, it will likely exacerbate them as I focus more on that area. There will be pain, swelling, the potential for infection, issues maintaining blood glucose levels, and risks for scarring. It will serve as an acute reminder of my physical differences.
But will it be worth it? I think the answer for me is yes. I need to remove that which I can, even if it doesn't physically alter anything else. Freedom from something that has been painful and distressing for more than 30 years is worth the cost of a little bit of discomfort. Perhaps, it will serve as a motivating factor in creating more physical changes to my body. It may help me to refocus on what is most urgent for my health and wellbeing. And in the end, that might be more surgery. Or it might not. Who knows?
In the end, I have seen that gender is indeed something that comes from between the ears. It's a construct in our minds that stems largely from our culture, our religious traditions, and our personal experiences of G-d. But there is for me a physical component as well. And maybe that's the real difference between transgender and transsexual identifications. One's need for recognition as a man or a woman, or for specific body parts that signify recognition as a male or a female. Two or more forms of presentation and perception that create a slightly more holistic view of a human being. And which one is most important for the human being who is presenting and being perceived.Whatever the end result is, I am thankful for this time to experience it, even if it has been triggering in so many surprising ways. Even challenging things teach us to see what is and what might be possible.
Thank you for continuing with me on this journey of experiences.
Be well, love your neighbor as you love yourself, and remember to actually love yourself.
- Ari
My Beautiful Friend <3
ReplyDelete