ADVICE: Treating without transition

Cynthia Breheny is a woman who has struggled with gender dysphoria since early childhood and used unconventional therapeutic treatment methods to manage it without transition. Genspect thanks her for her raw and honest account of her lived experiences as well as for her advice.

“No, silly! You’re a girl! Only guys have to shave their faces!” This was my mother’s response when she caught me pretending to shave in the mirror. It seems like an innocent enough statement, but it struck me like a ton of bricks.

I couldn’t have been older than six at the time, and up until that moment, I was quite certain I’d grow up to be a man. It wasn’t something that I wanted, but rather something that I knew was going to happen. I looked around at the adults in my life, and I just knew I’d be one of the men. It never crossed my mind that I’d be one of the women. So, this statement from my mother not only shattered that innate knowledge, but it also slapped me in the face with the concept of permanence.

What did it mean that I was a girl? Was there really no way that I’d grow up to be a “guy”? What did it mean to grow up as a woman? Was there some way I could go back and start again?

My mother and grandmother were not gentle with their answers to these questions. Being a girl meant that I would have to become a vigilant guardian of my body. Men and boys would constantly be out to touch me or harm me, and I was to save myself for my husband. Being a girl meant that I would have to (as far as my grandmother was concerned) dress like I was a Victorian doll – perfumed, powdered, and presentable. That in particular didn’t bother me for the most part before puberty hit. My mother allowed me to wear jeans and do some “boy things” like climb trees, and I hadn’t come to associate gender with clothing yet. Being a girl sounded scary and difficult. And no, there was no way I’d be a man. None at all and I was apparently ridiculous for asking.

It was around this age that I started precocious puberty. I started developing breasts, body hair, and body odor. My mother and grandmother were fairly vague in explaining what this meant and only really told me that I had to wear even more layers and be even more guarded around boys. Boys were my main social group. I’d had difficulty interacting with girls, so this wasn’t something I was happy about.

I also had a very strange sensation occurring intermittently that I can only describe as a “phantom phallus.” It was a sensation on the pubic mound that I still experience as an adult – although less severely after therapy. I panicked whenever I felt it because there was nothing there. Given how I’d been raised, I knew I’d probably be treated like a lunatic by my family if I told anyone. It felt like it moved and reacted to stimulus, and whenever my pants would tent at school, I furiously pulled them straight, worrying it was that strange feeling manifesting in some physical form.

A few years down the line, I decided to finally take a look at my actual genitals. I hadn’t been allowed to wash them myself, so I’d never really felt them or had the idea to look. I was horrified. I screamed in disgust, I cried, I felt like a hideous monster. My grandmother laughed and took that moment to explain periods to me while my mom tried to calm me down. Oddly enough, I’d never felt this way about any other women’s genitals and still don’t. I’m bisexual and quite attracted to every part of other women. I am, however, still repulsed by mine to a degree.

When I got my first period, I went through another extreme bout of body dysmorphia. I wanted to cut it all out of me and replace it with a penis. I knew I couldn’t, but I wanted to. I hated it. Add severe PMDD and endometriosis to that, and I wanted nothing more than to crawl out of my body. My femaleness was literally a detriment to my health. This is what it meant for me to grow into a woman. This and inevitably getting married and being a baby factory.

But, over time, the hate died down. I started making female friends and getting interested in dating. I think I might’ve grown out of it eventually, but everything came crashing down again after my first boyfriend – another child at the time – raped me. I was sexually abused for years after that and self harmed through sexual encounters. At the time, I saw my “voluntary” sexual encounters as some therapeutic means of regaining some semblance of control, but I know now that that wasn’t the case.

Adulthood brought with it much needed peace. I was able to get far away from my abuse, far away from my family’s expectations, and although it wasn’t stress free, I was able to process everything. By this time, I knew I hadn’t wanted to transition. I’d wanted to go into medical school (but couldn’t because of a neurological disorder that caused paralysis and pain), and I’d seen lots of SRS videos. I knew the downside of HRT and that it would never really give me what I wanted. I could never go back and start over. I could never be the man I wanted to be, and being a hairier, boyish version of myself wasn’t going to solve my problems. I’m 4’11” and sound like a cartoon character. It’s painfully obvious that I’m female and there would be a slim chance that I’d pass as anything other than a 12-year-old boy.

I was afraid of therapists because I still couldn’t talk about my abuse, and I’d had so many negative experiences talking about my dysphoria/dysmorphia. I decided not to do anything about it for a while, until I recalled a daytime talk show I’d seen in the mid 1990s. In an episode about body dysmorphia and eating disorders, they’d talked about photo therapy, where a photographer took artistic nudes of the patients and the results were relatively positive. The patients were able to see reality through the photos and thereby associate with their bodies.

You can call it luck or fate, but I just so happened to have been following a photographer who did this type of thing. I didn’t really know that was the purpose of his photos – I just thought he took beautiful underwater pictures. But after meeting with him, he explained everything, and it all felt like it had been meant to be. I showed him a photo he’d taken of another woman who was very masculine looking, hoping he’d be able to bring that out in me. He didn’t mince his words: “I can’t make you look like that, but I can show you what you do look like.” Part of me was admittedly disheartened, but the other part was relieved and excited. I worked with him for years and came to not only associate with my body, but for the most part, I was no longer repulsed by it. I cannot recommend this approach enough. It was so healing, it was
almost addictive! I hope to see more people do this in the future.

After that, I worked with a hypnotherapist to help heal the trauma I’d experienced. Since doing both of those things, my gender dysphoria and sex dysmorphia became extremely negligible. That’s not to say I still don’t have days where it creeps in. It can come with guilt over not being happy enough that I’m relatively healthy, it can send me into a depressive spiral that’s hard to stop, but it’s very rare now. It doesn’t interrupt my life the way it used to, and I can have healthier relationships now, after working out all my trauma and issues surrounding my sex.

My advice to anyone in my position is this – think. Think for a long time. Think about every step of the way and ground yourself in reality. Do therapy, unravel your trauma, see if you can find a way forward.

Transition is just one option. Your journey with gender dysphoria is yours to work out and take your time with, however you see fit.

Photo provided by the author and slightly cropped for privacy, used with photographer’s permission

Image credit above: Cynthia Breheny