“T is the key that opens the gate holding back the flood”: When transition isn’t helping

Research online trans communities and you develop an ear for contradiction: 

Life got worse after transitioning, but not because I transitioned

I’m having those “what if they’re right” moments and it really sucks. Transitioning is the treatment for dysphoria, and that’s been the case with me. I seriously am so happy with how my transition is going!

But other circumstances in my life have gotten worse since I’ve transitioned and even my Mom is starting to notice. I’m unemployed, I’m not dating or outwardly interested in meeting new people, I don’t have many friends. I’m so silent when in social situations because I have nothing to talk about or say because there’s nothing going on in my life, and I don’t necessarily care for there to be.

I feel like I’m hurting “the cause” by being an example of “transitioning doesn’t fix everything” because not only did it not fix those issues above, but they’re worse than before.

Has anyone gone through this?

“I’m so happy with how my transition is going!” but also “life got worse after transitioning.” To protect transition from the damning judgment of one’s whole life getting worse around it, people like this will try to bracket transition, as though it had nothing to do with anything else, just as being trans has nothing to do with one’s personal biography, mental health struggles, need for meaning and belonging, etc.

Fellow Redditors relate:

Even though I know that version of “the cause” is just respectability politics, I’m also prone to feeling guilty that my life is not a PR brochure about the transformative power of transition.

I haven’t been able to work since shortly after transitioning– I was already very sick, but was forcing myself to function through it. A year or so into transition, it finally reached a breaking point and I started having anaphylactic reactions to my own stress hormones (so almost daily). Now I’m more medically stable, but being unable to work is hard and isolating. Like you, I find it tough to make conversation.

I also had a difficult time dealing with my extended family’s silently disappointed reaction to my transition. And at times I’ve sort of distanced myself from trans friends who are especially jazzed about their transness/queerness and their involvement in the community, because they feel like they found their purpose there, and I can’t really relate. My gender is an important part of who I am in the world, but it’s not The Answer for me. I’m not especially comfortable in large LGBT groups because I’ve had a number of bad experiences.

This all to say… I can relate. I also think many trans people exaggerate how perfect their life is post-transition. There’s a lot of pressure to make your personal story an argument in favor of trans medical care. There’s also a lot of social pressure to be Saved, in general. I feel like 90% of Instagram is just variations on “My life was bad, but then I found therapy/medication/yoga/transition/this organizational app/a Casper mattress, and now I’m productive, confident, and at peace with the universe.”

The replies are loaded with comorbidities of the type that very well might contribute to gender dysphoria and trans identification:

I didn’t have this, but not because that’s an invalid experience. A lot of my issues were caused by biochemical dysphoria which is now treated. I still have PTSD. I’m still bipolar. I’m still autistic. But my dysphoria is treated. The other things require other solutions.

Ive always had issues around self isolation and avoidance, but something about transition triggered these coping mechanisms for me. Ive been reaching out to people less frequently, finding socializing to be more and more overwhelming, and have nearly stopped trying to date or even hook up with people. Some of this is because being trans in social settings fucking sucks (i prob dont have to tell you this) it’s awkward in its uncertainty, people don’t understand what’s appropriate/inappropriate to say because the social scripts around transness are being written in real-time, and even the people i love treat me differently. If youre feeling some strain from socializing, it makes sense that itd fatigue you quicker. But theres another factor for me i think, when i stopped trying to make myself be something im not (i dont just mean my agab) i also stopped forcing myself to socialize in the ways i wasn’t comfortable with, unfortunately right now that happens to be all socializing lol. But what im trying to say is, maybe youre just taking the space you need? Even when transition itself is going great, being trans in this society can be uncertain or even traumatic. Hope im not projecting too much. Good luck with everything, youre not alone

You also hear the kinds of justifications for worsening mental and physical health that set gender clinicians’ hearts aflutter:

I mean expecting transistioning to fix your life is like expecting getting your asthma under control will fix your life. Would you stop your asthma medication just because other parts of your life are going to shit?

Yes, artificial sex-trait modification to treat distress over physical characteristics is just like—let me check my notes—treating a respiratory condition. No wonder clinicians like Annelou De Vries are keen to redefine such problematic concepts as “‘positive effects’ of treatment.”

Someone else chimes in that “second puberty” (not a thing) is hard. Another person says: “I remember my gender therapist warning me that transition wouldn’t fix all my problems and that sometimes issues that were overshadowed by dysphoria can surface once the dysphoria is lessened. That certainly happened to me…” In other words: everything else getting worse could be a sign that transition is working as intended. 

It’s possible for one part of your life to go well, while everything else is a struggle. But that’s not what seems to be happening here. Instead of clinical curiosity about why so many patients seem to deteriorate mentally and physically with each step they take toward gender ‘self-actualization,’ we get excuses. Just add ‘minority stress.’

Other posts are more explicit:

Dysphoria is destroying me, even as I medically transition

I’m 33, FTM. I was on low dose T from 2021-2022, stopped for a year, and recently started again at a normal dose. It wasn’t immediate, but in the past 3 months since re-starting T I feel better than I ever have in my whole life. It’s like I didn’t know I was living my whole life dissociating until I wasn’t anymore. There’s so many things I want to do and so many things I want to try, because if I can transition, then anything is possible.

The problem is that now, about 4 months in, I’m really struggling with dysphoria. If you asked me a year ago if I was dysphoric, I’d tell you “no” – what I didn’t realize was that I had created a disconnect between my body and my sense of self as a way to live with the fact I was unhappy with being a woman. Now it’s like 100 times worse. I’m short – 5′ tall. I have big hips. I’m pretty effeminate, but I’m gay so I let it slide a bit. I’m getting a top surgery consult soon but I don’t feel like it’s going to help. I feel like I’m the ugliest, most disgusting looking girl alive and I’ll never be the man I want to be. I’m angry that I’m stuck like this when other people have had opportunities to transition sooner. I’m upset that I built an entire life around trying to be a woman only to find it’s not working for me. I have never been gendered properly – I even get misgendered when I wear pronoun pins. If I use the men’s bathroom, people think they’re in the wrong bathroom.

I thought T was supposed to make me less dysphoric. I thought that the more I transition, the better I feel, but if anything I just feel worse. It’s like how I see myself and the person I want to be is wholly unattainable even with hormones and I should just give up.

I don’t know what to do. I’m between therapists right now, otherwise I’d ask. I’m closeted, and I can’t bring myself to come out looking like the way I do now. How the fuck do I deal with this? I’m tired of forcing myself to look in the mirror and tell myself this is what a real man looks like. It’s not about what a “real man” looks like, it’s about what I want to look like, and I’m never going to achieve that.

e: Please stop recommending me exercise. I’m in eating disorder recovery and used to be a powerlifter and then an olympic weightlifter for a good 5-7 years. I’m not going to lift weights. That part of my life is done and over with. It’s extremely triggering and I’m not going back.

There are those clashing statements again: “I feel better than I ever have in my whole life” and “Dysphoria is destroying me, even as I medically transition.” Both of these statements cannot be true (if your life was already at rock bottom before transition, there would be nothing for dysphoria to ‘destroy’). Since the first statement goes unsupported by any evidence whereas the second statement is followed up by an avalanche of painful specifics, I’m going to go with statement two: “Dysphoria is destroying me.” The poster expresses extreme self-disgust and self-doubt. She recognizes on some level that what she wants out of transition is “wholly unattainable.” She’s tired of “forcing [herself] to look in the mirror and tell [herself] this is what a real man looks like.”

“I feel better than I ever have in my whole life” is the frame members of online trans communities put around the most serious and wracking doubts. After a while, it starts to sound an awful lot like “He’s the love of my life but I wish I’d never met him.”

Again, the responses invite the obvious question of why transition so consistently makes dysphoria worse:

T is the key that opens the gate holding back the flood, but you need to go through that gate to get to your destination.

I was in a similar boat to you, not horribly dysphoric. I didn’t like my voice, that was about it. Before I realized I was trans, I actually had dysphoria about not looking feminine enough. Once I started T, though – which has been incredible for both my mental and physical health – it was like every bad feeling I didn’t know I had came rushing to the front. I want everything to be better right now. But, it can’t be. We can’t speedrun transition. I have to wait until surgeries are obtainable for me and then I have to wait for them to heal. I have to wait for the T to move my fat around. I have to wait to see any progress from working out.

It’s like. Once you start your medical steps, you realize all the things you could have but are just out of your reach. But they’re not out of your reach! Not permanently, anyway. The T is the little light of hope that is suddenly illuminating the fact that there are other things you want but you don’t have yet. Unfortunately it’s not a quick process to get those other things. But eventually, you’ll get there.

Read that again: “Once I started T, though – which has been incredible for both my mental and physical health – it was like every bad feeling I didn’t know I had came rushing to the front.”

Here’s another “success” story:

I feel for you man. Here’s the thing- you’ve only been on T for four months. That is not enough time for changes to happen. Transition is a slow process- think about how long puberty is for boys. They don’t look like men for a long time. I was on T 11 years before I could grow a beard. And it took at least 3-5 years for my fat to fully redistribute. It takes time.

Now regarding dysphoria- it often works like that. We are experts at dissociation and often don’t realize our issues with our bodies til we allow ourselves to see it. It’s hard and painful and I say this with experiential solidarity.

Top surgery did wonders for me. And then a decade later I realized I needed lower surgery and that improved my life too. Last year I had masculinizing lipo on my hips which definitely helped my dysphoria. None of this is an easy road, unfortunately. I had to save for years for each surgery.

Tell me this doesn’t sound like someone trying to treat body dysmorphia with cosmetic surgery. Tell me where the finish line is. Further down in the comments, someone writes that sometimes she looks at men she would like to resemble and “just feel[s] like we aren’t even the same species.” Contradiction trails in the wake of impossible dreams and the desperate attempt to smuggle an embodied human life into such a fantasy.