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Posts tagged ‘Transgender Health’

On Regret of Gender Transition

There are some people who undergo a gender transition (either fully or to some extent) and then regret having done so and “de-transition”.  This post attempts to explore this phenomenon.

Some reasons why this might occur include:

  •  The person is not transsexual.  The person may have found by going through their transition that they are not in fact comfortable living in the other gender and that they feel either gender queer or more closely aligned with the natal gender.  Certainly instances of transitions involving surgery might have been prevented if there were a greater attempt to determine this beforehand; however, just like with non-trans issues, we often go ahead with things we think are right for us only to discover that they aren’t.  Sometimes the discovery just isn’t possible without trying it out.  The ‘real life experience’ (see WPATH’s standards of care) is an attempt to systematize this discovery process before any major surgeries.
  • Regardless of whether the person is truly transsexual or not, it’s possible that because of having lived so long with gender dysphoria and accompanying social and physical dissatisfaction, one may think of a full gender transition as a magical ticket to happiness.  I have seen this (sometimes unconscious) wish accompanied by other unrealistic expectations such as:  the idea that one will have a social community, better social skills, be more popular, etc.  When this turns out not to be true, there can be confusion and uncertainty that tends to focus on one’s gender transition.  It may be that the gender transition was in the person’s best interest, yet other causes of unhappiness and personal problems had not been sufficiently explored and worked through.  Sometimes with gender variant people, work on other problems are delayed because the gender issues tend to take precedence.
  • The person encountered too many problems with transition (i.e. dissatisfaction with their post-transition life).  These problems could include lack of family support, loss of partner, problems with transition in the workplace, disappointment with the outcome of surgery and problems “passing” as the new gender.  Additionally, transitioning is hard.  There are many hoops to jump through and one enters into a group of discriminated against people.  This can be exceedingly disconcerting for some.

Levels of regret

Certainly a person who has made a gender transition can have certain regrets that are not extreme enough to cause them to wish to de-transition.  The WPATH Standards of Care notes that “cases are known of persons who have received hormone therapy and sex reassignment surgery who later regretted their inability to parent genetically related children”.  Other less extreme regrets can involve loss of certain benefits of privileges commonly associated with one gender or another.

Some research on regret:

Pfafflin F., Junge A. (1992) Sex Reassignment: 30 Years of International Follow-up Studies after SRS: A Comprehensive Review, 1961-1991 [publication online]. Translated from German  into American English by Roberta B. Jacobson and Alf B. Meier. IJT Electronic Books.

This study looked at 70 previous studies and reviews on outcomes following sex reassignment surgery.  These included 2000 individuals from 1961 to 1991.  This doesn’t take into account individuals who transition without surgery.  About 70% of MTF individuals were satisfied and 90% of FTM individuals.

Krege S., Bex A., Lummen G., et al. (2001). Male-to-female transsexualism: a technique, results and long-term follow-up in 66 patients. BJU International. 88:396-402.

 This study shows little or no regrets possibly due to surgical advances.

Find out about Psychotherapy when dealing with Gender variance in yourself or someone close to you. email: info@amikaplan.net

Internalized Trans-Phobia

I recently wrote a short section on “internalized trans-phobia” for a forthcoming book.  So I thought I’d share it here.  (Note it’s aimed at a somewhat young audience).

What is it and how do you get it?

Internalized trans-phobia refers to feelings some people have inside about their being trans that they might not even be aware of.  It refers to how some people hate that part of themselves and are ashamed of it.  The phrase comes from the similar experiences of gay folk who sometimes have “internalized homo-phobia”.

How does this happen?  This happens because of discrimination, ignorance and stigma in society against people who display gender non-conforming behavior.  In other words against men and boys who appear feminine or girls and woman who appear masculine or “butch” or people who are more gender-queer and don’t appear to be completely male or female.

Historically, trans-folk have been the butt of jokes, been made fun of, laughed at, been misunderstood and have been the object of derision and violence.  Transgendered people have been seen as “less than”.

This attitude has been widespread and so to finally arrive at the idea that this could be you; that you could be a member of this hated group can be very scary.  Not only that, but by growing up in a culture and society where this attitude is common, you take it in and part of you believes it whether you want to or not. This can happen because we often learn the attitudes and beliefs of those around us before we become self-aware enough or wise enough to start questioning them.  We often learn these things from trusted people around us – parents, teachers, church leaders, etc.  so that we tend not to question them.  We learn that a certain group of people can be mocked before we know that we are in that group – and then we are stuck in the position of hating something about ourselves.

Sometimes the messages or feedback we get from parents and teachers when we are very young contribute to feeling bad about being gender variant.  Like a parent disapproving of acting too “boyish” or “girlish”.  These messages can be very quick and subtle, like a Mother telling her young son not to “stand like a ballerina”.

This is what causes internalized trans-phobia.

What are the effects of Internalized Trans-Phobia?

Feelings of hate and shame for yourself which you might not even be aware of can result in low self-esteem and depression.  They can cause you to feel uncomfortable, embarrassed and inferior, even unlovable.  They can make you feel like hiding a big part of yourself or pretend to be someone else.  They can make you to not want to be around people, to withdraw or be a loner.  These feelings can certainly make you feel very unhappy and angry.  Some people take a long time to come out as trans because they have so much internalized trans-phobia.  It can hold you back in life, not only in terms of finding a way to be the gender you are, but in many areas of your life such as forming deep and satisfying connections to others.

Sometimes internalized trans-phobia can keep you from connecting with other trans-folk.  When one has a deep hatred of the gender-queer inside it can get confusing to be around other trans-folk.  You may see them in the way you learned early on – as freaky, or not good-enough in some way.  The negative feelings can get pushed outward in this way.

What can you do about it?

The first thing to do is to try be aware of it.  Try and acknowledge it if you have it. This is hard to do because we usually automatically try to avoid things about ourselves that we are embarrassed about.  One can feel ashamed of being ashamed!  It gets complicated so it really helps to have a therapist who is knowledgeable about gender issues to do this work with, but a supportive friend or a support group can work too.  It helps to have lots of people in your life who are supportive and positive about your being trans.  It takes time to “undo” deep down beliefs about gender-variant people, just like it took time to get them.

Find out about Psychotherapy when dealing with Gender variance in yourself or someone close to you.

How to Close the LGBT Health Disparities Gap (by the Center for American Progess)

How to Close the LGBT Health Disparities Gap. by the Center for American Progess

This is an excellent summary of findings on LGBT health.  One item of note from the article:  50% of Transgendered adults report suicidal ideation. You can download the full study in pdf form from the Center for American Progess website (link above).

impact of docietal biases on mental health and well-being

 

Other points made:

  • Transgender individuals are often unable to access even basic preventative and primary care due to insurance exclusions.”
  • statistics show drastically high rates of HIV/AIDS among transgender women.”

Find out about Psychotherapy when dealing with Gender variance in yourself or someone close to you.


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