My November Beast of Bipolar Mental Illness

Hello My Dear One,

The writer T.S. Eliot said that April is the cruelest month, but for me, November is far worse. There is something about November that brings out or up the crazy that can normally be dealt with most other months of the year. It's a special holiday crazy if you like. Honestly, I don't like it one bit, but My Beast of Mental Illness seems to revel in it.

Maybe it's the creeping darkness here in the northern part of North America where I live. Maybe it's the cold, wet, and snowy winds paired with the final descents of the autumn leaves. Maybe it's the chemical hailstorm that occurs every 5 to 6 months regardless of the seasons. Or maybe it's the lead up to the Christmas Season, and its pressure to feel happy, overjoyed even, about the origin story of a 2000-year-old religion turned national holiday of gluttony and selfishness. And don't forget Thanksgiving, Black Friday, Chanukkah, Kwanzaa, Solstice, and a million other reasons to feel that material items will bring light into your darkness.  But most likely it is a combination of all of those things in largely unequal measures.

And here I am, sitting in a knee-deep pile of November wondering what I hope to accomplish with the rest of my life.

November is the harbinger of endings, and there is something deeply unsettling about that for me as a person with Bipolar Disorder 1. My sleeping Beast of Mental Illness is awoken by my nightmares of purposelessness and potentially futile endeavors. And he pounces on this with full force and full ferocity. He is nothing if not consistent in his attempts at convincing me of my worthlessness. Within this time of self-reflection/self-loathing, there is ample material for him to sculpt and manipulate me. Creativity, though limited to an almost singular subject, is my Beast's strong suit. There are always new and inventive ways for me to experience existential angst with a side of paranoia and mania at no extra charge. Trust me, this guy is a pro.

November 2001, a mere 18 years ago, was the first time my Beast took the reins and I couldn't take them back. I experienced rapid-cycling, meaning mania followed by severe depression, as often as 4 times per hour. Every 15 minutes I would swing from believing I would be the next solution to all of the world's problems, to holding a pillow over my face while attempting to suffocate myself. I would reach highs that would've made meth addicts jealous. Then the lows that followed would've made those same meth addicts' crashes feel like tiny tumbles onto a cushy floor covered with cashmere.

I was officially diagnosed with Bipolar Disorder that year, and perhaps that's why I see November as the ending of me. Or at least as the ending of who I thought I was. November is the anniversary of the loss of my prior identity. At 26 years old I was suddenly someone who needed massive amounts of psychiatric drugs to go grocery shopping. I was no longer "creative," "eccentric," or "unique," rather, I was "sick," "crazy," or "insane." My Beast was no longer a worry in the back of my mind, but a full-blown reality in my frontal lobe.

I was dis-eased in every way possible. And each day was a battle for even a gram of wellness. Some mornings it felt like I'd lost a kilo of sanity the night before. With each increase in one of the medication dosages, I would feel worse for a while, then better, and then back to worse as my mind and body would adjust and adapt to the neurochemical dance. Most often I would sleep for untold hours, ironically wearing athletic clothes while I laid on my couch for days on end. I gained more than 110 kilograms (50 lbs) and saw my not quite manageable diabetes become unmanageable in almost every way.  

Yet, I chose to keep going, fighting through my last semester of university, and even applying and being accepted into graduate school. I completed a 79 credit Master of Arts while taking 2000mg of Depakote and 60mg of Paxil every day for 5 years. I also became a parent of 2 sons and underwent Gender Identity Disorder therapy, medical treatments, and 2 surgeries. But that's another topic for another day.
    
So, where am I now, nearly 2 decades later? I'm not suffering through those original night terrors, but, yes it's often still a nightmare to try to exist in this space. My Beast and I have fallen all the way down since, and 7 years ago I finally received better treatment in an inpatient mental health facility. But, here's a small part of what my time now looks like:

Medications tweaked. Emotions addressed. Rollercoasters to ride and prayers that they end. Meltdowns that erupt. Apologies to be offered. Relationships to be repaired. Actions that attempt to make things better. Fear, anxiety, self-loathing, depression, and self-pity. Elation, exuberance, unrealistic expectations, mania, and unfounded superiority over others. And the never-ending battle for control between My Beast and myself. 

It's an arduous task to attempt every day. And in all likelihood, it's even more so for everyone around me. I am regimented yet unpredictable. I am a loose cannon yet afraid of confrontation. I am the monster in the closet and yet I too am hiding under the covers of the bed.

I am living with My Beast, and others live with both of us. And each November we all find ourselves frustrated, afraid, angry, disappointed, joyous, optimistic, and secretly worried that this might be the last November we all have together. And in the end, that is the darkest part of this cruelest month, the knowledge that the light may not return. But after 18 Novembers that have come and gone, I have faith that number 19 will pass the same way, and we'll all still be here for another try.

Thank you for choosing to live on and through this journey with me.

Be well, love your neighbor as you love yourself, and remember to actually love yourself.

-Ari

Legally Crazy; Walking the Tightrope of Mental Illness

Hello My Dear One,

It's funny, how we can pretend that enormous things are little, while we simultaneously create catastrophes out of details that will be forgotten by tomorrow. It's easier to focus on something we think we can control, rather than on a problem that is far beyond our reach. Think about when the grocery store is out of your specific brand of milk, versus climate change or gun violence.

That's the tightrope that we all walk, I think. And for me, visualizing it as a real tightrope helps me understand the issue better. When we imagine ourselves on the cord we only see the tiny sliver of path under our feet and ignore the large safety net below us. We can't even see the crowds in the stands, but we are acutely aware of their presence and the shame we will feel if they witness us fall off.

When one suffers from mental illness, like I do, that rope can seem to shrink to the width of a toothpick, and it feels like I'm wearing clown shoes. To extend the imagery, the tightrope also appears to rise higher and higher off the ground with every step. Before long, the height is dizzying and my anxiety has risen commensurately with the rope. I don't know if this is what it's like for others with mental illnesses, but it's been my experience over the years.

But as much as the mental illness, in my case Bipolar 1, sucks, there are ways to manage it. The largest one for me is the support net[work] of family, friends, religious community, and healthcare providers that I am surrounded by. Were it not for other people who are safely grounded on the floor I would be at risk for a ton of injuries, both psychological as well as physical.

There is another way that I deal with these things so that the fears and emotions don't send me flying. And that is being able to freely express the ins and outs of my illness in written form. Somehow, it makes it more manageable and less terrifying when I can get the words out of my head and into a more coherent form. I can read my thoughts out loud and hear if they make sense or not. I can see more of the picture, more of that balance beam I'm on.

But it's always in the back of my mind, that the disease can take over at any time, and the balancing act begins anew. And perhaps it's the balancing itself that is the issue, not the rope, or the net, or the crowds, or even my clown shoes. Maybe it's the ability to know how and when to lean into or out of a bobble or a potential fall. Maybe it's knowing how to steady yourself with something less instinctive, such as your feet, rather than grabbing out with both hands in a wild panic. Maybe, it's just being present to the situation and waiting for the feelings of fear to pass. Probably, it's a balance of all of those things.

Each day I'm confronted with the task of balancing the needs of my family with the needs of keeping my mental illness in check. Each day I hope that I have done a decent job and that both parties are satisfied with the end results. Each day I strive to be more balanced than I was the day before. But I am learning to forgive myself when I'm not.

The tightrope act.

I'm also learning to forgive others when their words or actions are delivered not with kindness but out of fear or a need for control. I'm learning to see others' panicky grabs for balance as a reflection of their fears instead of my own. I'm learning how to reach out to be a steadying force, rather than a reactive shove in the opposite direction where both of us are now flying off of the tightrope. And I'm learning to see the tightrope at the height it really is, usually no more than a few inches off of the ground, not 50 feet up in the air.

I will probably never master a smooth and steady walk across the tightrope of my life with mental illness. But perhaps, with the right supports and a steady group of people surrounding me, I'll make it to the other side in one piece.

Thank you for walking this tightrope of a journey with me.

Be well, love your neighbor as you love yourself, and remember to actually love yourself. 

Ari

Legally Crazy; Transgender Happiness

Hello My Dear One,

Recently, I gave a presentation about transgender healthcare issues as well as my personal story of transition. Largely, I keep things light with plenty of jokes, some slightly self-deprecating humor, and an upbeat attitude. Of course, I take a more serious tone when I talk about suicide attempts, losses, transphobia, harassment, and abuse. I balance the softness of the good with harsher realities of Gender Dysphoria and the process of becoming oneself.

This particular talk was especially fun and I engaged with the audience through comical descriptions of what my life has been and continues to be like. We all laughed quite a bit, and by the end it felt like we had collectively shared a special time together. It was truly fulfilling for me to be able to bring a group of people together and transform their understanding about transgender people through our conversation.

After I've done my storytelling portion of the presentation I open up the discussion to questions. Now, I've been asked every type of question, from biology, to psychology, to theology, and a host of other things I've never thought of. I find that there are certain constants, usually having to do with my children - what do they know/how do they feel/how has this affected them - or with surgical inquiries, or how do I reconcile my faith life with my gender identity? All of these topics have multiple answers, and I respond based on the composition of the audience, the setting, and my own personal level of vulnerability in the situation. Mostly, I stress the positive aspects of each of these and explain how transition has made me the man I am today, not just in presentation but in totality. 

This past time someone asked a question I'd never been asked before, or even consciously considered in recent memory. The preface to the question was particularly meaningful given the past year that I've lived through and my own doubts about my mental state of being.

"You seem like a really happy person. Do you think you would have been just as happy or happier if you had been born as the gender you identify as now?"

Wow. What an amazing thing to think about. And I know it took a few breaths before I answered. But, like me, it is was and is a dualistic response that I gave. "Yes and no," I replied.

Of course, my life would have been significantly easier if I had been born physically male. My sense of self was always as a male person, so it definitely would've helped to have a mind and a body that matched. I wouldn't have suffered from the deep seated sense of betrayal that I felt toward my body, and I might not have tried so hard to hide from the reality in an extra 100 pounds of fat. Dating would've been easier. Fitting in might also have been simpler, but then again, maybe not. I doubt that having a penis would've really increased my popularity, much. So yes, I suspect being happy would have been an easier emotion to access if I had not needed transition.

For the sake of full disclosure, I do have Bipolar 1 Disorder, and that plays with the neurochemistry that affects my emotional wellbeing. But, medications have controlled this for 15 years and my happiness now is dependent upon my outlook and how I respond to life circumstances.

But back to the no answer. Why would I say that needing to transition from female to male made me the "happy person" that I am? There are so many reasons, but the primary one is that I had to struggle through the truth that I could not live any other way than as myself, as a man, as the person I am in the world everyday, or I would have chosen not to live at all. It was the horror of finding myself with only 2 choices - transition or suicide - that built the foundation for the happiness that I have today. It was the process of finding that who I am is right and good. It was the risk of losing all that I loved, my wife, my children, my family, my faith community, everything and instead finding them all stronger and happier as I transformed into this body and this person.

My life now is based in the knowledge that I am a beloved child of G-d. I believe that my transition is a gift from G-d that helps me to have greater love and empathy for everyone else. I feel in my core that I am called to experience this transition as part of my journey to being more fully human, and to more fully knowing the Divine that guides my life. This is the basis for my deepest happiness and for how I live as myself each moment that I have. And I am thankful for each one.

Thank you for being part of the happiness that infuses this part of my journey.

Be well, love your neighbor as you love yourself, and remember to actually love yourself.

Ari

Legally Crazy; Medications and a Carrie Fisher Quote

Hello My Dear One,

Well, we've made it through the Chanukah and Christmas holidays, and it's almost a new year on the Western calendar. I never had a real meltdown, so that was nice, and I didn't curl up in the fetal position too many times, also nice. But I did suffer from the increased dosage of the medication I added in several months ago. Three months and three milligrams into it and I've successively gotten sleepier and more fatigued with each passing day. I've had a few "good" days here and there filled with energy and positive feelings, but mostly I've been flat. I haven't been depressed per se, or even remotely suicidal, just weighted down by the heaviness of medication.

Now, I don't want you to think that I've gone and changed things without consulting with my provider first, because I did consult with the appropriate people. I have chosen to switch when I take a medication from morning to night in an attempt to use the sleepiness to my advantage. You see, after about 10 to 12 hours of having taken the med I begin to feel happy, relaxed, and ready to get on with my day. Unfortunately, this is usually around 8:00 pm (20:00 hours) and that's not particularly conducive to my life. If I worked a late shift I suppose this would be okay, but since I don't it really doesn't help. And as an insulin dependent diabetic, sleeping all day and night doesn't really help my overall health either.

So, onto the experiment, and a hope for a little more energy during the day. I've skipped my AM dose today in order to try this, yes, it's the first day and I don't know what will happen, but I'll let you know in a week. But I wanted to share this more because I want to be proactive about what's going on in my life. I want to let you know that meds help, but they have side effects that can leave you wondering if the previous instability was better than the current stability. Which is exactly why people with Bipolar Disorder go off their meds. Either we feel better because of them and question why we need them in the first place or we feel rotten on them, read normal, and stop taking the chemical help we've been receiving. It's a perpetual loop of positive and negative feedback where it's almost impossible to know the truth. Sometimes it's best to look to family, friends, and other loved ones for perspective, and to trust them that they can see who we are even when we're not ourselves. So that they can see who I am even when I am not myself.

There is a marvelous quote from the late and amazing Carrie Fisher:
     ”One of the things that baffles me (and there are quite a few) is how there can be so much lingering stigma with regards to mental illness, specifically bipolar disorder. In my opinion, living with manic depression takes a tremendous amount of balls. ... At times, being bipolar can be an all-consuming challenge, requiring a lot of stamina and even more courage, so if you’re living with this illness and functioning at all, it’s something to be proud of, not ashamed of.” 

I miss her. I miss her because she was a voice for those of us with this fatal disease. Yes, Bipolar Disorder is fatal, but we can manage it for as long as possible with support from those around us and from those who are willing to speak out about it. 

We can live with it, medicate it, use therapy on it, use acupuncture, other healing options, and talk to it with our own voices even when it feels ridiculous to do so. We can live even as we are dying, and that takes a lot of courage and stamina. 

Thank you for bringing perspective on this journey.

Be well, love your neighbor as you love yourself, and remember to actually love yourself.

Ari

Legally Crazy; My First Transgender Suicide Attempt

Hello My Dear One,

Important Preface: I am in no way currently suicidal. I have no suicidal ideation, no plans, no causes, no reasons for wanting to kill myself. And therefore, I don't want to kill myself. I am under the care and supervision of medical professionals and am 100% safe. Trust me, you can hold me to this one.

All that said, I want to share what my first suicide attempt was like and what I've learned about myself from it.

It was 1985 and I was on the floor of my parents' bathroom in the house I grew up in. I was 10 years old.

I know that seems shocking, that I was so young, but that was the first time I realized that anyone could end their life if they had the right resources. I happened to have the right resources.
I had a bathtub full of water, a towel, a door with a lock, and a giant block of dry ice. I had been allowed to experiment with the dry ice, we had received a shipment of frozen steaks in the mail, and was warned that the the CO2 (carbon dioxide) from the melting compound could be deadly. Dry ice is made of CO2 and as it evaporates the gas sinks to the floor and will cause suffocation if breathed in exclusively. So, I filled the tub, locked the door, rolled up the towel to block the crack under the door, and laid down. I was waiting for the suffocation.

But how did I get to this point?

There are numerous reasons that someone decides that suicide is a valid option for them. At 10 I know I didn't understand the true finality of the act, but I did understand that it was an end to suffering. It was an end to feeling different. It was an end to the constant pain of my Beast of Mental Illness telling me that I was never going to be okay, and I knowing that much was enough at that point.

I was different. I was a boy stuck being a girl. I was transgender, and I didn't even have a word for it. In 1985 there were people who had sex changes, I had only heard of 1 man who became a woman, and I knew plenty of people who were gay. Since I didn't know of trans people I figured I had to be gay, despite knowing I was male, something I'd determined when I was three years old. But without vocabulary I was left in a no-man's-land both figuratively and literally. Gender dysphoria wasn't a thing yet, but I was, and that was exactly how I thought of myself. I was a thing, an it, caught between a mind and a body that wouldn't match. Death seemed like a good answer at the time.

Thankfully, after awhile I sat up, because the process was taking too long for my liking. I moved the towel. I opened the door. I left the bathroom. I pretended as though nothing had happened. And it would be a few more years before I would cognitively realize my Beast yelling out again for an end to the pain.

I would still attempt self-harm during those years, fantasize about fatal or at least violent and scarring accidents, and wonder what death would feel like. It was a time when I see that I was more than distracted by the darkness, I was living in the hell of mental illness, of Bipolar Disorder 1, as well as trying to be male in a female body.

I have to admit that writing these things down has been more difficult than I imagined it would be. I wrongly assumed that recalling the factual details of an event in my early life would be a straightforward task. But it turned out that it has been emotionally draining in unexpected ways. The greatest one is that of being a parent now with children in their tween/early teen years and how much my heart breaks when I think of them feeling something half as badly as what I've lived through. I truly can't make myself feel that pain. It stops me in my tracks every time.

So, what did I learn about myself way back then? How did I change after that moment? And what have I learned since?

For one, 1985 was the year I changed my name in my mind. Even though the rest of the world knew me by my given name, Arin became the name I called myself. Yes, when I write to you it is as Ari [are-ee] and not Arin, but I have other deeper reasons for that.

A spoonful of poison...

Secondly, I learned that no matter how hard I tried to be something/someone else I couldn't do it. Even a dead body was the wrong body.

And among other things, I now see that who I am is a product of those horrible conflicts within myself. I am exactly the man I am today because of the female role I had to play back then. I am a father, a husband, an uncle, a friend, and so much more for having chosen to walk away from suicide that time, and many more as the years went on.

Thank you for living alongside me on this journey.

Be well, love your neighbor as you love yourself, and remember to actually love yourself.

-Ari

Legally Crazy; Transgender in the Psych Ward, Disclosure

Hello My Dearest,

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

Legally Crazy, Transgender in a Psych Ward part 2

Hello My Dear One,

After the first night at the inpatient psychiatric facility, I woke up to the startling reality that I was still there, and that I couldn't leave. Owing to the fact that I was rapid cycling in a full blown Bipolar 1 episode, and I had gone off of FDA approved amphetamines (Ritalin and Vyvanse) with no plan and no medical assistance, I did the only reasonable thing I could do. I started writing.

Being a writer was beneficial at that moment, particularly because all technology was removed from patients, and I needed something to do. The electronic detox was at times as horrible as the medical one was. It was hard to not have my laptop, especially since I'm dyslexic, and writing by hand can be physically painful. Still, I kept going because I was driven by the therapeutic need to as well as the mania.

In order to justify, or make some sort of sense of my stay [to myself] in the psych ward, I had to create a different reason for being there. I decided that morning I was a writer, not a stretch, who was doing an undercover piece on what it was like in an inpatient mental health facility in rural Maine. On one level this was true, insofar as I was writing about said subject. The reality though was I was there because I needed to address my own mental snap, not an undercover journalist. I was not Nellie Bly reporting on the wretched conditions of an asylum 1887. I was the wretched conditions of myself and my family being treated for asylum worthy behaviors.

Anyway, by 4:00 pm I grabbed the composition book I'd brought, although I have no recollection of packing it, or for that matter packing at all, and sat at the dormitory style desk in my room. I have to think that my wife packed it and brought it for me, but I've never asked, perhaps because I haven't wanted to imagine what that must have been like for her. There are a lot of things I don't want to know about those early admission days, but I know I will ask when I can.

I got out the pen and started working. The writing is relatively clear, although it resembles a verbal cascade like a dictionary spilling itself down Niagara Falls. The words were pressured the same way that my speech was, a spigot of sensical and nonsensical language turned onto full blast. Given that I am an extrovert by nature, I can scarcely imagine how this must have appeared to others. I know my ability for talking, and I'm thankful for the amnesia that surrounds that section of time. I must have been far more obnoxious than usual.

As for the writing, I'll let the first sentence speak for itself:

"Today has been my first day inpatient at a psychiatric hospital, I have met w/nurses, recreational therapists, behavioral techs, student nurses, an NP, visitors, a therapy dog, my wife, and a cavalcade of characters who are on this journey with me - the other patients."

So, that was something. And it goes on like that for another 4 pages. Yep, four more long, accelerated, and at times unreadable pages. The script itself is obviously a barrier to understanding, but, like the person writing it at the time, it is addled and self-aggrandizing. It reminds me of the mania itself, and that has ramifications now all these years later.

Old school technology.

What now? I guess it's a matter of one sentence at a time. I'll keep you posted on the progress. And yes, the transgender identity does matter here, it will be addressed soon. Just a little more time is needed.

Thank you for unpacking this part of the journey with me.

Be well, love your neighbor as you love yourself, and remember to actually love yourself.

- Ari

Legally Crazy, Five Years Ago in the Psych Ward, Colors

Hello My Dear One,

Autumn, here in the North Woods of Maine, has arrived and the leaves are finally changing color. I remember how vivid the hues were, and how vibrant the scenes were five years ago. I was in the throws of a hypomanic rapid cycling event of Bipolar 1 Disorder. Everything was more delicious and over the top. The individual blades of grass were whispering their sadness over the upcoming deaths they would soon face. The cool breezes spoke of light and loss. And the darkness was the blackest that I had known.

Of course, the reality was that I was about to slip into a full break with reality itself.

After multiple violent and terrifying blackouts where I couldn't remember how the chaos around me had occurred, I made what could've been the final drive of my life. I don't remember much of that either, only the telephone pole that I swerved away from and the looks of compassion on the faces of the people at the crisis center. And I remember how my then therapist took my hands and said, "I am so sorry that you are feeling like this." It was a strange and comforting moment that I would look back on throughout the hours and days that were to come.

I know that I spent hours at the crisis center, hours in the emergency department, and took a ride in a fancy new ambulance down to the inpatient psychiatric facility at a hospital about an hour away. I remember screaming, crying, throwing things, and hurling insults at the woman I love. I remember wanting to die.

I have plenty of memories from within the pysch ward, too many really. Even five years later I remember the plastic mirrors, the lack of shoes, the open door with the night checks. I remember the therapy dog, the arts and crafts room, the terrible food, and the other patients. Even the one who needed the electro shock therapy to deaden her depression, and how she would need to return when the effects would wear off in 4 to 6 months. I remember the lockdown when an out of control patient had to be confined to one wing, thereby reducing by a third the length of hallways that could be paced. He refused to control his diabetes and so the rest of us lost the lounge with the second television.

The colors there were all beige and grey, food included. We were allowed to wear our own clothes, but even those looked pale and dead. Many people wore black, grungy shirts and ripped blue jeans. Some donned light blue hospital clothes because they had been transported without their own things, and there was no one on the outside to bring them items. The staff had scrubs, or shirts and ties, but any colors didn't pop out at me just as if we were all blending into the grey surroundings ourselves.

And the color of darkness was present too. I can't describe that very well, because it's different for everyone. At the time I would have called it an endless blackness where no light could be seen. But now I see the darkness through the glare of the florescent lights. A flickering grey that could only be altered by fresh sunshine during the days, yet still a place to stumble into a mire of beige and grey. I hope to illuminate that space in time.

There's more of course, but for now those are all the descriptors I have left. After five years, it's time to free the demons of the psych ward from my memories and back to the hell where they belong. It's an arduous task, but a necessary evil if you will.

More muted than before, but just as beautiful.

So, in the meantime, I plan on looking at the world outside of myself and seeing what the comparison is to the alternate universes that swirl around on the inside. So far it seems that out there it's not quite so busy, so frenetic, or so anguished. It's not quite as scary either. The world between my ears can be a dismal place to reside, and seeing the colors of fall, even if they are more muted than five years ago, gives me hope.

Thank you for being on this colorful journey with me.

Be well, love your neighbor as you love yourself, and remember to actually love yourself.

Ari

Legally Crazy, in Transgender Sickness and Health

Hello My Dear One,
     Nearly 19 years ago, at our wedding, my wife and I recited vows we had written that reflected our youthful beliefs about our future. We were after all, "baby dykes," lesbians in our very early 20's, with idealistic gay pride dreams and plans for an "Out Loud and Proud," kind of life. Well, as out loud and proud as one can get in a rural college town in the northern woods of Maine.
     So, the timeless "in sickness and in health," phrase wasn't necessarily a direct quote in our marital pledges to each other. It was certainly implied, but not explicitly stated, and sometimes I wonder if that was an intentional oversight on my part, or just wishful thinking on her part. Maybe, at 23 we knew that we were invincible, and no disease was going to strike down two young, healthy, and attractive kids just starting their lives together.
     Of course, our reality has been nearly nineteen years of a partner (me) who has battled bacterial infections, dislocated joints, broken bones, viral attacks, Legionnaire's Disease, cancer, insulin dependent diabetes, Late Onset Congenital Adrenal Hyperplasia, Bipolar 1 Disorder, and Gender Identity Disorder. And really, that's only a partial list. I've had at least a dozen surgeries, every test under the sun, treatments, therapies, medications, hospitalizations, and that infamous week in the psych ward. Currently, I am recovering from the flu. Sickness. A damn lot of sickness has been handed to my wife on the less than a silver platter of her spouse. Somehow, she manages, or exceeds at making it all work out, and I have absolutely no idea how she does it.
      But back to our wedding, to that rainbow pride flag filled day, with guests, and cake, and the promise of a fresh, new, and amazing start. Back to that moment when I saw the most beautiful woman in the entire world, floating down the aisle in pristine white and smiling at me with tears in her eyes. Eighty people disappeared from my sight as we met in the middle of our beginning. Time was standing still, and I remember little else from that afternoon, save the glitter that came exploding out of the air vents in my car as we drove away. Those responsible for this know who they are.
     What I am certain of, was my new wife hardly expected 14 years later she would be dealing with a female to male transgender husband who had been admitted to a psychiatric facility.
      Inpatient hospitalization happened that day for rapid cycling of extreme mania and immobilizing depression, withdrawal from FDA approved methamphetamine [medically prescribed stimulants for ADD], the refusal to take medications for Bipolar Disorder 1, and suicidal ideation and suicidality. There had been an attempt that morning as I drove myself to the crisis center, choosing at the last possible second not to plow into the telephone pole on my right. Only G-d could have been with me then, because I certainly wasn't.
     After the crisis center came the Emergency Department, then an ambulance ride, an elevator, and my delivery to the inpatient mental illness floor of the Catholic hospital an hour away. I was in a self-imposed and unsupervised detox, having mood swings of messianic proportions, and painfully suicidal. There was a team to keep me from falling apart. There were safety nets everywhere. And of course, there were bars on the windows.
      But what about my wife? Where was she in this chaos? Where were our children? And what could that woman possibly have been thinking? What was this sickness doing in her life?
     I don't have the answers about her emotional state, though I can guess, but what I do have are the memories of her presence each and every step of the way. I remember how she placed herself between my Beast and our boys. And how before I even arrived at the crisis center, she had reached out to family and friends to ensure that our children were safe, cared for, and loved. She was present for them as she reminded them their father still loved them, but he was sick. She was present when she told them that even though he'd stopped acting like the loving daddy they once knew, he was still there, somewhere. She protected them from the sickness, and from the Beast that was tearing his way through that man.
     And then, she was there at the crisis center, and then the ER. And when my Beast could no longer be contained she returned to our children, having faith that I would get the help that I needed. She was there at the psych ward, once even bringing those precious boys to visit the crazy man who had barely begun to accept the sickness and the Beast that were attempting to drag him into oblivion. A Beast and a sickness that were clawing at him from a hell that even he hadn't imagined, despite decades of mental illness.
      She was always present. Her love, support, and devotion were there every second that I was there, even though I couldn't recognize it at the time. The Beast tried to tell me otherwise, but pathological lying is a hallmark of that guy. And I know the Beast was wrong, because, almost five years later my wife is still present, still caring for, still worrying about, and still loving our sons, and me.
     And I believe that her ability to be present is a demonstration of love in action, the love that she has always known from and through her relationship with G-d. It is her faith that has been enough for both of us, has been enough for our family. It is her remarkably healthy faith that continues to combat and overcome the sickness in me and in our world, familial and otherwise. You should see her teach Sunday School sometime. So, the sickness and the health will always be present in our marriage, as will the faith that started with a hopelessly romantic fantasy, saw the births of two remarkable children, continued through years of immeasurable changes, and still persists in spite of all the reasons for it not to. And our family is blessed by a G-d who chooses to continue showing love through all of G-d's Beloved Children. 
      Thank you for living into the love in action along this journey.
Be well, love your neighbor as you love yourself, and remember to actually love yourself.

- Ari

Blessed by Love in Action

Legally Crazy, Transgender in a Psych Ward

Hello My Dear One,

Nearly four and a half years ago I had to choose between driving into a telephone pole or allowing myself to be taken to the psychiatric section of a hospital. Although this was far and away one of the most difficult decisions I have ever had to make, there have been many more that required far deeper introspection, risk, and personal loss. All of these times have involved life and death, gender identity, and the Beast of mental illness that coexists in my being. 

In an inpatient psychiatric hospital ward there is a total loss of autonomy. It is the relinquishing of one's freedoms, including the right to sleep without observation, or have shoes or shoelaces. Then watching those shoes get relegated to a locked closet until a supervised group walk. Sitting at a table, working on a large coloring page [many years before the "adult coloring books" became popular for stress relief] and going to the nurses' station to have your colored pencil sharpened. Why? Because electric pencil sharpeners might be hazardous to your health. And the loss of control of what you, what I, could eat, could wear, when and where conversations were allowed, and even when and what television programs could be watched. 

It was and still is soul crushing. And it was and still is sad. And when it was over, when I returned to my normal life, there were years that passed where I still wondered what happened. There are voids in my memory. There are gaps in my timeline. And I continue to consider how many different ways the story could've gone. In the end, my reality will always be altered by the madness of Bipolar Disorder One, Anxiety, Depression, Mania, and neurochemical wiring and firing that continues to blast holes through the memories within my mind.

Of course, there's that whole Gender Identity Disorder, transgender/transsexual piece of my life. The added complication of mind and matter, of a mental gender and a physical sex that do not align. A divide between who I am and how the world sees me, then and now. 

I am a man, but I am also a transman. I am a person who has lived in both genders. I have thirty years of life experience being treated as less than because of my biological sex and my gender presentation. I have another twelve of being seen for who I am, being treated as better than I am, yet always remembering what I was. It is never as simple as boy or girl, even when it is.

But why now, so many years after my committal into that place, is it in the forefront of my mind? Why I am ruminating on this time in my life? Is it a distance or a near proximity to the places and events of 2012? Or is it related to the current political reality show that has become the United States government? Certainly, the attitudes and legal battles that have been given new venomous lives, are causing anxiety within me, within all of us who know what it means to fear for our own safety because who we are.

But, I believe that it has to do with something far more subtle than a global ethos or a cultural zeitgeist. It is a more nuanced thing, more fluid, like gender itself, that has brought me to this place of contemplation.

It was gossip about a person who had battled some form of mental illness or addiction as having "been in the psych ward," rather than taking appropriate care of their children. A hand was raised to the side of the mouth when the words were uttered, signifying a tidbit of information too private to speak at full volume, but too juicy not to share. It was as if the damning nature of such a fate was like an accident scene that one doesn't stop for, but cannot help but gawk at as it's passed. 

Shh, don't tell, don't say the words that might make me sound crazy. Keep them hidden in the recesses of shame, stigma, and silence. Keep quiet, keep still, pretend that it doesn't happen to people "like us." Ignore the gut-wrenching pain of the unmerciful torturers, the beast of mental illness, and the judgement of a world that makes you the beast. 

The irony I suppose is that in all of this, the transgender part of me had little or nothing to do with the medical and psychiatric care I needed. It wasn't my gender that was the problem, it was untreated Bipolar Disorder One, a disease that doesn't distinguish or care who you are, or how you are viewed. Indeed, it really doesn't care about sex, gender, sexual orientation, race, ethnicity, religion, political affiliations, age, or anything else. If you are mentally ill, it is a sickness in your brain, not in any of the packaging. 

And for the week I was inpatient, my gender identity was disclosed by me to only one other person, who also happened to be transgender. Surprisingly enough, that person was there for neurochemical reasons too, and the transgender identity was as irrelevant to their treatment needs as mine. 

Of course, being transgender, when labeled with a psychiatric diagnosis of Gender Identity Disorder for treatment purposes, i.e. hormone therapy, surgical procedures, etc. is by definition a mental illness. And with that, many people are in psychiatric facilities for depression, anxiety, suicidal ideation, and suicide attempts because of that designation. Yes, being transgender can cause you to wind up in a psychiatric setting, but it doesn't mean that it will, or that it should.

And there's the crux of the issue. If and when I disclose my mental illness and my gender identity, they become inextricably linked for people who understand little or nothing about either one. I end up inhabiting the fear that my credibility, or that even my value as a human being is diminished by these coexisting forces in my life. 

Simply put, do people think I'm crazy because I'm trans, or I'm trans because I'm crazy?

I don't know, and I probably don't want to know.

What I do know though, is that right now, the juicy gossip, the truth, the lies, and the inaccuracies about all of us who are mentally ill, or are transgender, or are in any way different is affecting us daily. Anger/Fear at the "other," and at each other is nothing new, but the ability to spread it so fast and so far is. Words can be emissaries of love and hope, or violent harbingers of physical harm to come. With technology and media that travel at the speed of light, it is often difficult to know if the threats are real, or are merely the rantings of a scared and lonely person, suffering in their own state of depression. 

Either way, our anxiety rises, our rational selves erode, and our love for our neighbors is relegated to theory rather than practice. We cannot even see those we disagree with as our neighbors. It is safer to keep them as enemies, risking degradation of us all, rather than a little bit of humanity for just one person. That is crazy. 

The author in blue.

It's funny really, that when I was in a psych ward, transgender and all, the people around me, the other "crazy" ones treated me as a true neighbor. They applauded during a group therapy session when I said that I'd finally agreed to start taking medication. What a crazy way to experience unconditional love. 

Thank you for always being there on this legally crazy transgender, and sometimes psych ward filled journey with me.

Be well, love your neighbor as yourself, and remember to actually love yourself.

- Ari

Of the Roller Coaster Ride of Mental Illness

Hello My Dear One,

I apologize that I haven't written in nearly three months, and although I have had plenty of news to share, I have been in a self-imposed silence. I have been giving more attention to my work life than to my inner life. I have neglected parts of my soul so that I could nurture others. And I have paid the price.

My silence is not that of one who has nothing to say, rather it is the silence that comes as in a nightmare, as I stand frozen in horror, unable to make a sound. I have been so overwhelmed by the responsibilities I have, or have created, that I have ceased to even attempt to speak what is on my heart. And because of this, I have allowed my Beast a chance to pull me into his old familiar spaces. 

In my life I coexist with the physical illness of an auto-immune disorder, and the mental illnesses of Bipolar I Disorder and Anxiety. And of course, I am an openly intersex and transgender individual, navigating a world that is blatantly heteronormative. These facets of my life are both blessings and curses, as they afford me a unique perspective and understanding about what happens when mind, body, and soul are altered from within. 

Instead of the outside world changing me, it is my own body chipping away at itself, systematically attacking the very cells that I am composed of.  And instead of my mind being a place of rationality and control, it can become a wasteland of neuro-chemical storms that prevent impulse control, or allow reality to enter in. 

And when my rational mind has been attacked, my Beast of mental illness will begin to seep out. And often, when that first trickle begins, a massive flood is not far behind it. The reality of depression and mental illness, is that underneath the happier and safer thoughts, whether spoken or not, are painfully dark and frightening ones.  The comic genius and the haunting madness are inextricably fused together. The light and the dark emotions blurring as they spin faster and faster.

And so, I ride the roller coaster of mental illness.  Those of us who have been on the ride, never having willingly gotten in the queue, find ourselves unable to get off. Even when the cars have come to a complete stop and the amusement park closes for the day, we are still on the ride. If we are fortunate, we manage to get out onto the platform, yet, in all likelihood we will soon be strapped in again, ascending and dropping, twisting and turning, screaming from start to finish.  

Ultimately, 99.99% of the time, roller coasters are completely safe. Rarely does anyone get physically harmed, let alone killed on one. There are tragic exceptions, but for the most part getting on a roller coaster ride is safer than the car ride to and from the park itself. It's the tracks that the cars are affixed to, the seat belts that secure our bodies to the cars, and the technicians who maintain the rides that prevent accidents, that safely provide adrenaline filled thrills for us all.

But what happens when the tracks are not maintained, the cars rusted and gone unchecked, the seat belts tattered and failing to click appropriately into their buckles?  

It is the same as when our medications stop working, and when we ignore our bodily needs for rest, or food, or shelter. Or when we choose not to go and talk to our doctors, therapists, clergy, or even admit to ourselves that something is wrong in our lives. It is then, when we have no more strength to move forward, and the depression is greater than anything else, that we crash headlong into the barriers, derailing ourselves, and everyone around us. It is a terrifyingly violent end to an even more terrifyingly violent ride.  

But even when I am well, the ride fixed, maintained, and running smoothly, I wonder when the real terror will return.  I am waiting to look over at the seat next to mine and see my Beast, grinning his vicious smile at me. That's when the crazy comes back.  Suddenly, he and I are screaming through the rises and falls of our carnival ride from hell.

During November and December, the Beast, my Beast, finally did burst through the barriers and flailed into being, a total of four times, for a few gut wrenching hours that saw me cause pain, grief, and insanity to the ones I love most. No matter how hard I fought to keep my Beast in, I simultaneously threw the doors wide open for him, sat down, and buckled in for the ride to start. 

You see, that roller coaster ride isn't all bad. There are times when we all desire more excitement in our lives. There are times when we want the thrill of an adrenaline rush. There are times, when the darkness holds appeal, and I want to escape the rational life that I live.

I realize that this is not limited to people with mental illness, but to all of us who feel surrounded by the everyday, a mundane existence, a lack of purpose, and a hope for a more exciting tomorrow. Why else would there be theme parks, vacation packages, and shopping malls, but to draw us out of our everyday, and jettison us into an over exaggerated fantasy where everything can be fixed, for the right price?

In my real life, I actually detest roller coasters, much to the dismay of my family. I don't feel safe, I am trapped, and I am not in control of anything. The reckless abandon that others' revel in when on a thrill ride, leaves me shaken with a a high level of disregulation. I am queasy from the twists and turns. I am dizzy from the fear of the rises and falls. I want to go home.

So, all that begs the question, why do I give in to my Beast's ghastly ride, if I hate it so much? 

Sadly, I think it has to be that even though I hate the roller coaster of mental illness, I have the illusion of control when I am participating in it. My Beast and I are controlling everyone around us with our behavior. Maybe, if only for a few fleeting moments, I am the operator of the ride instead of the passenger. And worse still, if my Beast and I can manipulate my thoughts and actions, then we can manipulate others' as well.

In the end, as the ride comes to a stop, the last two months of the solar calendar over, and the beginning of another trip around the sun, I am finally able to get off the ride. I am free to explore the other rides, foods, and attractions that are all around me. I can enjoy experiences without the fear of an unwanted upside down loop the loop that can create dangerous situations for me and for those around me. I can see the joy in my family's successes, triumphs, hopes, and dreams. I am at last present. 

And by the grace of G-d, I can spend more time in this reality than in my Beast's sadistic one. And if I'm lucky, the next time I'm there, screaming through the highs and lows of the roller coaster ride of mental illness, I will know that it will end, that I will regain control, that my life is more than this. I will know that I am more than this. And I will cherish the gift of reclaiming the man I am called to be, holding fast to the man I have already become.


Thank you for choosing to come along on this ride with me.

Be well, love your neighbor as you love yourself, and remember to actually love yourself.

-Ari

Of At-One-Ment, of Being Enough

Hello My Dear One,
      Rosh Hashanah has come and gone, the new year [5775] ushered in, the shofar blown, and our sins sent out into the waters. Yom Kippur is over as well, and we have atoned for our wrongdoings and are sealed in the Book for another year. Sukkot, even if I do still have cabbages in the garden, with our celebrations of wandering, harvesting, and backyard huts is complete as well. There is a clean slate, an array of beautifully colored chalks, and an invitation to create anew. 
      But I do not feel it. I am uninspired. Instead I feel the weight of what is to come, burdened by the violence of the past year. I feel the fear. I taste it.  
      Why? Why do I choose to see the suffering, the sins, and the separations, especially after I have just atoned for all of them less than a month ago? Is there something more appealing about the negatives? Is it my Beast sniffing around, trying to prey on my weakness for a half empty glass? I don't know. 
      I do know that it happens every year. I know that I find the dark spots of myself almost delicious. It's as if I want to reveal how terrible I really am. Is it my doing or is it my Beast's? Is it a collaboration of the two of us? And how much of it will be shown to the rest of the world? How much do I actually want to be judged?
      I was just called to atone for my sins. Now, I personally define sin as: separation or the act of separating myself from G-d; to live outside of covenant; to choose an independent path, one that may or may not lead to a livable outcome. I performed a kind of spiritual surgery that dissects the comfortable, yet prickly habits of my mind, the downright dangerous grudges, and my failures to forgive. I broke apart the self-aggrandized acts of teshuvah that I congratulated myself for, from the real, and far less glamorous forgiveness I have experienced and have given.
      And I confessed all of the sins I committed this past year. I attempted to at-one-ment myself back into relationship, right-relatedness with G-d. I expelled the grudges. I offered forgiveness. I accepted that I had been forgiven by G-d. I moved out of the old year's agonies and into the new year's possibilities.
      But here I am, reveling in the evils that were, and making myself feel like a horrible person, not worthy of the forgiveness I've already been granted. And as I sit with this, I feel the realness of mental illness, the hardness of past abuses, and the deepest truth that I wrestle with each and every day.

I don't believe that I will ever be worthy enough. 

      In the face of therapy, medications, writing, praying, working, the assurances in Torah, and the tangible proof in my life, I still question my worthiness. 

In moments of true narcissism, I want to claim that I am the victim of some cosmic tragedy that has time and again left me with too few resources, be them financial, emotional, psychological, or spiritual. I want to believe that if something, anything had been different in my life, then I wouldn't be dealing with the perpetual disappointments of the everyday. I want to believe that my suffering entitles me to an extra helping of pity from the world. Most cruelly, I believe that others do not need to be forgiven, because of all the pain they have caused me.

      When I cannot see others, as my neighbors, I sin. When I fail to see the inherent worth of all of G-d's children, I fail to see my inherent worth as a child of G-d. If I am not worthy, then my neighbors are valueless as well, I whisper into the dark vastness I have placed between myself and G-d. 
      And I want G-d to whisper back, "Child. Why? Son, when will you accept My acceptance? When will you realize that you are truly worthy of love, respect, and safety? When will you finally let go of the pains of the past and come into the current? It is time child to accept forgiveness, and believe it. Trust Me. Every Child of G-d is forgiven. Every single one. And you are one. You are worthy. You are enough." 
      And when I listen with every fiber of my body, my mind, and my soul, right now, I can hear that whisper. I feel the sorrow, the compassion, and the release. I am present. And for a moment or two I am enough.
      Unlike G-d though, I am painfully human. I will take offense at perceived slights. I will feel insulted by offhanded remarks. I will lose my temper at my spouse, my children, the GPS on my smartphone, and probably many other people and inanimate objects. I will in all likelihood find a grudge, muckle onto it, and store it in the darkness of my own pettiness. I will forget that I am forgiven, that everyone is forgiven, and I will forget our collective worthiness as children of G-d.
     But for now, I can remember that I am whole, I am enough, I am more than I will ever know. Through this holy experience of welcoming a new year, seeking forgiveness and a page turn on the old year, I am assured that I am truly good enough for G-d.

Thank you for your forgiveness on my journey.

Be well, love your neighbor as you love yourself, and remember to actually love yourself.

Worthy

-Ari 

Of Being a Real [Intersex] Man

Hello My Dear One,

I recently wrote about my transgender realness, and what it currently means to be me in the world I live in.  But I knew I needed to address the other part of me, the intersex part that has driven the need for the transgender procedures, and that has been an underlying chemical truth of my life.  I need to explain the biology behind the mental illness of my own gender dysphoria.

As far as I know, I have Late Onset Congenital Adrenal Hyperplasia, an inherited condition that causes masculinization in XX individuals and hyper-masculinization in XY individuals.  In my life and family medical history this has presented as facial and body hair, fertility problems, anxiety, high libido, short stature, and masculinized features in the XX females on my mother's side for at least the last 5 generations.  On my father's side, there were hyper-masculinized XY males, very early onset puberty (age eight for my father himself), short stature, anxiety, anger management issues, high libidos, and massive amounts of facial and body hair.  In the XX females I know of in that lineage there were fertility issues, uterine and ovarian cancers, anxiety, some masculinization, and again, shortened stature.  These are all known characteristics of Late Onset CAH.

Personally, I knew myself to be male from the time I was three, but my body sent mixed messages about this.  I was physically strong, quite tall for my age, was developing some body hair, and mimicked only the males in my life.  But on the other side, my body was missing a penis, and I was in perpetual disbelief that somehow I had not been given one or worse yet, that I had lost it.  I began packing (using different materials to create an appearance of male genitalia under clothing) at a very early age, but stopped when I realized that it was something I just wasn't supposed to do.  

By the age of twelve I had gone through female puberty, and six months later I began male puberty, one however, that did not result in the expression of all male secondary sex characteristics.  This confusing, and ultimately horrifying experience of two bodies fighting within one to exist, left me in a state of shock.  I was troubled.  And turning to my family and even doctors proved just as lacking in answers.

I learned from my mother that this male part of myself was something to be horribly embarrassed about, shameful, disgusting, and should be hidden at all cost.  Stories of birth control pills gone wrong, useless electrolysis, and ways to be more womanly through wigs, makeup, clothing, and behaviors were standard topics of our discussions from as far back as I can remember.  Being who I was, what my body was expressing completely naturally, was a tragic error on the part of G-d.  It constituted a burden that I was supposed to bear, rather than a gift to embrace.  And I felt a deep and persistent hatred for my own body because it, and therefore I were mistakes.  Never female enough to be the woman my mother wanted me to be, never male enough to be the man I knew I was.

From my father, I learned masculine ways, traditionally male gendered activities, and that he had really wanted a son.  Never male enough to be the son he desired, never female enough to know what to do with.

I lived in my disparate selves for more than twenty five years and then something changed.  In a dichotomy of life and death my body decided to take over, the rest of the way, and allowed my true self to shine through.  It was possible only because of a life threatening illness, one that literally took my life multiple times, but for the grace of G-d and the dedication of the medical staff who saved me.  For me, it was through this physical death that my inner core was able to be born into corporeal existence.   

I was twenty eight years old, and in my second semester of seminary.  My mother-in-law had died of terminal lung cancer barely two months prior, and my now motherless wife and I had a five month old son.  I was taking nineteen, yes, 19, credits, and consequently chose to live on campus two nights a week in order to be physically able to attend all the classes.  I was camped out in a tiny bedroom doing as much schoolwork as possible and then rushing home to be a parent to our new son, be a loving partner to my wife, and to continue my ridiculously heavy graduate course work.  It was exhausting and I began unravelling quickly.

One Monday morning, six weeks into the semester, I was hurrying out of my home when I slipped and fell on the ice, sliding partially under my car.  I banged a few ribs, but shook it off, threw the rest of my stuff in my car, and drove the two hours to school.  That day I became very ill with a high fever, blurry vision, and extreme nausea.  I made it to the Emergency Department, was diagnosed with pneumonia, treated with antibiotics and promptly sent home.

A few hours later I returned to the Emergency Department, half-dead, and saw the panic in the physicians' eyes as I faded in and out of consciousness.  The following days were largely a blur, being taken to the ICU, seeing my wife, x-ray after x-ray, oxygen masks, and then nothing.  I would later learn that I consented to being put on a ventilator, and then a few days later my wife consented to having a temporary pacemaker inserted into my chest so that I wouldn't die every time my body was moved.  I spent more than two weeks in the ICU, was resuscitated multiple times, was drugged out of my mind, watched all of my skin peal off from the megadoses of antibiotics, and celebrated my 29th birthday in a hospital bed.  I can only imagine the fear my family must have experienced during this ordeal.  But for me, fear was not a part of it at all. 

During my hospital stay I was largely unconscious, though a few bits and pieces of events remain.  Once, I saw a great, warm, white light that I wanted to go toward.  It was inviting, and I felt a sense of calm as I approached it.  Then in an instant it was gone, and I was returned to a darkness filled with strange noises and visions.  More importantly though was a dream that involved a surgery of testicular implants, and I remember lay feeling elated by my great fortune.  But again my joy ended when I looked up (in the dream) and saw two doctors at my bedside discussing my case.  As one man flipped through my chart, the other looked down at the silent/sleeping me and said that they [the hospital, the doctors, the nurses?] "didn't take care of patients like that."  I was hurt, yet still happy that my body matched my mind.  Of course this was just a dream, no surgery was performed, at least not that particular one, and when I awoke from the medically induced coma I was heartbroken that the implants were not there.  And again in my mind, they were lost, just like my (imaginary) childhood penis.

The turning point in my life, to begin the transgender transition process, occurred not from the illness, the near death, or the dreams.  Rather, it came at the end of my month long stay, when I awoke to find my mother in my room.  She was distressed, physically upset, crying, and obviously concerned about the situation.  I, in my ever hopeful desire for a loving mother, wondered if she was thinking about nearly having to bury her only child.  But this is my mother, a woman with untreated Borderline Personality Disorder, and nothing could have been further from the truth.  No, she was devastated that during those weeks, one minuscule, meaningless, and pointless act of care had not been done.  My face had gone unshaven.  I had three and a half weeks of facial hair growth, and this was a fate worse than death itself for her.  I must point out that this terrible outcome of not being groomed had nothing to do with me, and everything to do with the hatred she had for her own body.  At the time of course, I didn't see that.    

Her words penetrated into my very soul, "For G-d's sake, why didn't they shave her?"  

She seemed to be reliving a conversation with someone, and it was as if I wasn't even there, despite the fact that she was speaking directly to me.  And once again, I felt like I was not a real woman, nor was I a real man.  I was a creature betwixt and between the two.  And I was left to hang in that dark place of despair, alone, afraid, and secretly thrilled to have my body trying to show its true self.  I had a beard.  It was all mine.  And even though I shaved it off that night, I knew for the first time that the world would not end if I let it grow.  I was given the gift of authenticity.  I could finally move forward on my journey.

A real intersex man.

As the years passed I went through all the necessary steps to becoming the real intersex and transgender man that I am today.  And it has been nine years since my body, my soul, my mind, and my heart finally came together to integrate into one whole being.  Even through the horrid Beast of Bipolar Disorder I, PTSD, and suicidal ideation, I have remained true to my male self and gripped fast to the real man I am inside.  I am a real man.

For now I am happy, content perhaps, with who and where I am in my life.  Yes, there is more to do.  Yes, there are hardships and hollow times I will endure.  And yes, I will have to navigate the devilish waters of puberty with my own sons, and how I will fully explain who I am at a biological level that will have positive meaning for them.  But in the meantime, I will continue to advocate for the realness that we all deserve.  I believe in the real purpose of that.  And I believe in the G-d that makes it so.

Thank you for staying on this sometimes all too real journey with me.

Be well, love your neighbor as you love yourself, and remember to actually love yourself.

-Ari