Originally published November 30, 2017.
UnnHappy, sad, mad, Unnspeakable blue red Unnsunshining and hot and cool and red hot and ice cold
— Nicole Maines, age seven
Detransitioning — undergoing a social or medical gender transition, and later choosing to reverse this — is a subject of perennial media attention and widespread public fascination. Although systematic studies have found that regret over transitioning occurs at a rate of 2% or less (Dhejne et al., 2014; Johansson et al., 2010), individual stories hold greater emotional resonance than abstract statistics, particularly at a time when many still do not accept the basic validity of cross-gender identity and are itching to find anything that can be leveraged as ammunition against recognizing and affirming trans people.
Some individuals choose to misrepresent the phenomenon of detransitioning as an argument against anyone transitioning, and in doing so they erase the complex nuances of those who’ve detransitioned: the ones who came to realize they didn’t need to transition but do not regret their cross-gender experience; the ones who detransitioned due to pressures from their family or community but maintain a cross-gender identity; the ones forced to detransition for their safety in institutional settings or to access services such as homeless shelters; the ones who transition once again.
All of these personal and systemic factors are wiped away in service of the myth that detransitioners are universally misdiagnosed cis people, that they all regret their transition, and that trans people are almost certainly mistaken about who we are and we might as well skip a step and just never transition.
But suppose, as a trans woman, I were to entertain this idea — that transitioning is always and forever a terrible mistake, I’ve obviously been dead wrong for the past five years about the clear improvement I’ve seen in my life, and I’d be much happier “accepting reality” (I simply cannot put enough quotes around that). What if, contrary to all available evidence and professional diagnoses, I really would be better off ceasing transition and doing something else?
Unluckily for me, I was recently handed this opportunity by a confluence of hurricanes, poor planning, and pharmacy incompetence which resulted in being deprived of my prescription testosterone blockers and estrogen for nearly a month. This meant having to ration what little medication I had remaining, doing my best to stretch it out over about three weeks. In the face of this wholly unwanted and decidedly frustrating circumstance, I decided a natural experiment of sorts was in order, and aimed to see what would happen if I were to taper off my hormones entirely.
This is about the last thing I would ever choose to do voluntarily — transitioning didn’t just give me back my life; it gave me what I consider a real life for the very first time. Being deprived of the medication that made this possible is my personal vision of hell. But, after all, I somehow managed to survive without it for 23 years.
How bad could a few weeks really be?
The first week meant reducing my estrogen dose by a third while staying on the same dose of testosterone blockers, without noticing much of a difference other than anxiety about how long I’d be able to hold out once I stepped down the dose again. By the second week, I’d reduced my estrogen by two thirds, and this is when the changes really became apparent.
Depersonalization had always been a prominent feature of my psyche before transitioning — the sense that I was always an observer in my own life and never truly involved in the world, the constant out-loud narration in my head of every waking moment, the utter lack of spontaneity as if the “you are now breathing manually” meme had swallowed my entire existence. Starting hormones wiped all that away within a week or two, to my utter surprise; I had really come to believe that was just what it felt like to be me.
This night-and-day difference helped me become highly attuned to the moment-to-moment textures of my consciousness — that directly verbal inner monologue was finally quiet, replaced by a sense of thoughts and concepts as abstract and unverbalized shapes floating past my consciousness in succession, logically and uneventfully progressing from one predictable permutation to the next. My mind could finally fall silent, and it was a relief like no other. It had stayed like that for five blissful years.
Now, full thoughts and phrases were once again starting to come to mind unbidden, though not conspicuously — less like a bullhorn, and more like a simmering pool beneath my immediate consciousness, easy to dip in and out of. I wrote several articles as if on autopilot. I began to notice that any sexual thoughts would lead to much more rapidly responsive erections, something I’d been so glad to be rid of on HRT. While my genitals aren’t a site of any especially significant dysphoria, my previous sex drive certainly was. I couldn’t stand the way it operated on its own schedule, distractingly and demandingly pushing its way into my consciousness when I just wanted to focus on anything else. HRT had made this entirely voluntary, something that could be effortlessly disregarded for weeks or months. I didn’t like feeling it doing things once again — both physically and mentally.
By the final few days, I was out of testosterone blockers and estrogen entirely. At this point, it was very clear that the remission of depersonalization symptoms I’d experienced when starting hormones was not at all imaginary. I’m forced to become aware of something else I was glad to be rid of: that nonstop, out-loud inner monologue. I become explicitly aware of it in the shower, where I used to come up with four or five ideas for blog posts on current events every day. Evangelical Christianity really gives certain politicians a ready-made base of people who are primed to be credulous. Now I’m picking up the shampoo. Most of them have been raised to distrust their moral instincts in favor of whoever they’re told to accept as representing some higher authority. Now I’m squeezing the shampoo. Scrub. Scrub. Scrub.
It’s not so much that it’s there — it’s that it never stops, and knowing that it’ll just keep going like that.
Penny and I sleep together. I try to explain to her a hypothesis I’ve been working on about how hormone therapy could be affecting the glutamatergic system to reduce depersonalization symptoms in trans people, but I can’t stop saying “like”. What is wrong with me? I realize that I’ve become immersed in the same suffocating separation from myself that had afflicted me before transition every time I tried to have sex — even when I wanted it, I just couldn’t get out of my own head to stop overthinking things and lose myself in the moment. Move your hand. Do I kiss her now? Kiss her. Should I keep kissing her?
I am a malfunctioning robot.
I am now breathing manually.
Everything I hear begins to echo in my head over and over until fading away — the last line of a song, the last few words of someone’s sentence, repeating into nothingness. In the worst depths of my depression as a teenager, my inner monologue had taken on a compulsively self-critical tone, always pointing out everything I did as if it were invariably wrong, constantly finding cause to mock me. Now, on Lexapro, it seems to be dipping into a completely different source entirely. Movie quotes and song snippets flit through my head in rapid succession with no apparent rhyme or reason. In the absence of anything else, my depersonalization seems to have become some kind of jukebox. How did I survive this for so many years?
Heather takes me out to the food court and I can’t stop quoting movies at her. What the hell is going on? The entirety of my sensory input is like flat noise, everything amped up to the maximum power spectrum value, becoming a constant static in the foreground of my brain. None of it feels like it should — the people around us, the books at the store, the taste of my coffee, all of it is like the partially eclipsed sun, beating down on my face, blinding, utterly devoid of heat.
I go to my hormone doctor the next day. I know I should be a tad miffed at what I’ve been put through because of their medication snafu, but I find that I don’t feel like expressing much of anything at all. My blood pressure has always read high at their office and nowhere else — something about having my endocrinological womanhood in their hands seems to set me on edge no matter how hard I try to relax. It wasn’t unusual to get a reading of 135/98. They’re putting the cuff around my arm. I’m having a conversation with the nurse about migraines and the face I’m putting up just feels so artificial and fake. The cuff deflates.
It’s a cool 113/93.
We fill my prescription and I’m finally back on my regular dose. It can’t work fast enough — I need this to end. And, finally, it does. Over the next week I’m on an upswing beyond any recollection. Everything suddenly comes easily to me — I realize within a few days that I’ve stopped thinking, and once again I can just be. I am integrated.
I consult a production company on trans health research for their television show. I participate in my first debate and win effortlessly. I stand in front of the mushrooms in the produce section and I’ve never felt more present in myself, more seamlessly woven into my body and into the world around me. I’ve seen the other side, and I’ve seen more than enough of it.
There is no question in my mind that this is the way of being alive that I want. I know now why detransitioning is so uncommon: because it is the worst.
Some may correctly point out that my case bears little similarity to most individuals who choose to detransition — I’m someone who’s found transition to be very suitable in my life, and I have no actual reason to change this. But then, those who do find detransition to be most appropriate don’t represent the experiences of the vast majority of trans people, either. ■
More on depersonalization and transitioning:
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