In recent years, dysphoric people are not told that there are treatment options other than (what are by all means still experimental) surgeries and hormone therapies. As I’ve gotten older I’ve found tremendous relief from learning not to let dysphoria in or indulge it as a means of validating my gender identity. I’ve also found tremendous relief from processing all of the lesbophobia and misogyny I’d internalized. Mindfulness and exercise have also been a help. I’ve grown. I’ve learned to live in this body. I’ve learned to love myself as a lesbian. But fifteen year old me, sitting trembling and scared in my gender therapist’s office for the first time, didn’t know that that was possible. My therapist certainly didn’t ever tell me it was. Once she’d determined that my dysphoria was real (and, god, was it real,) there was one path. It involved turning my life upside down to go “stealth,” taking testosterone and eventually surgical intervention. I made it through the first two steps before I started to figure out there was another way.
Even if that one path had been right for me, I still would have deserved to know there were others. Everyone who is transitioning deserves to know that some people are able to manage their dysphoria with less invasive treatment. They deserve to know that some people with genuine dysphoria find transition unhelpful, counterproductive or just altogether useless. They deserve to know that some people find transition traumatizing, retraumatizing or to be at least a reaction to trauma. Everyone deserves informed consent. But that’s not what we’re getting. We’re being lied to. We’re being told, “spend the rest of your life taking hormones; have irreversible, major surgery; it’s the only possible way.”
So they position this treatment as the One And Only and, shove us away and onto it and then don’t even research the affects of what they’re giving us. A quick glance over the Society of General Internal Medicine’s 2014 Cancer Risk and Prevention in Transgender Patients makes it clear, repeatedly, how little we know (or at least how little we knew just two years ago:) “MTF individuals receiving feminizing hormones experience breast cancer, yet the degree of risk relative to natal females is uncertain.” “There are no long-term studies on endometrial cancer incidence among FTM individuals.” “No long-term studies have investigated ovarian cancer incidence among FTM individuals.” We don’t know. We don’t know. We don’t know. Or maybe, we don’t care. We don’t care. We don’t care.
Dysphoric people deserve better. We deserve to know every single one of our options. We deserve doctors who will look at our mental health holistically. We deserve medical practitioners and researchers who care if the medication we’re being given is going to maybe kill us someday. If you’re dysphoric and you feel that medical transition is the best option, you should still be angry about this. Your siblings- fellow dysphoric people- are experiencing medical neglect and abuse. You’re being prescribed or hoping to be prescribed something where your doctors don’t/won’t know what could happen or how to help you if something does happen.
We are all hurting and we are all living outside the lines in one way or another and we all deserve better from the medical world.