Ask Matt: Nowhere to Live if I Transition

A reader writes: “I’m 17, a junior in high school, and FTM. I live at home currently with my mother and sister. I came out about a year ago.

“My mum’s response had been ‘I saw this coming. I’ll love you for whoever you are.’ The next day she clarified that whoever I am isn’t a man. Biggest bubble burst of a lifetime. If she had said she wasn’t okay with it from the beginning, I would have felt better than I did about the whole thing in the long run. The kicker is that she saw it coming and still doesn’t believe it.

“According to her I was a feminine child. I was actually very androgynous, but she doesn’t want to remember the Legos and remote control cars. She has this picture of me in her head as a women, and when saying I was feminine isn’t enough, she claims I’m just on a quest for perfection and the media has corrupted my mind with male supremacy. I don’t even know where she gets half of the ideas she spews at me.

“After a lot of struggle I confided in my doctor that I was trans and needed help because my mum was refusing to find me a therapist or let me go to the one I had found. The doctor helped me to get a therapist and I’ve been going for a few months. Secretly I purchased a binder and packer. Many fights arose from that. Now I’m able to wear them and everything is kind of okay.

“My problem is that I want to start hormones. I’ve been ready for a long time for this. My mother has shown no interest in any if the materials provided and has banned me from physically altering transition-related things while living under her roof.

“I realise that I won’t be able to do anything until I’m 18, but I’ll still be in high school then and living with her, so I still wouldn’t be able to start T even then. My only option is to move out. I haven’t been able to find a job as of yet but I’m still looking, although any job I can get at 17 won’t be enough to support me to get a home and hormones.

“I do have one alternative. My father is okay with my transition and willing to take me in, but he’s mentally unstable and sometimes abusive. On the other hand, I have my grandparents. They are very religious and don’t understand trans people. My grandma at least seems to want to understand. She helped me get my binder. But I don’t feel I could ask to live with them, and I don’t know if I could physically transition under their roof.

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Ask Matt: Binding Blues and Peeing Problems

A reader writes: “I’m in high school (Junior), but am very open about my gender identity (cross dress, bind, etc). At this point there isn’t a whole lot I can do about hormonal treatment or surgery. So instead I try to do what I can, at my age. I bind, as mentioned, and use a commercially available binder.

“It has been fine, but lately I’ve gotten a lot of pain, difficulty breathing, and nasty bruising on my rib-cage. I wear it too often as it is (about 12 to 14 hours a day, nearly every day), so I know the best thing to do would be to just stop wearing it so much.

“Unfortunately, this is a problem for me as my gender dysphoria has also gotten much more severe as of late (and includes thoughts of self-harm and things we don’t need to get into). It’s a difficult trade-off for me to consider – wear it less and hopefully not end up with a serious injury in the hospital and cause my dysphoria to be that much worse (which, when paired with my depression, anxiety, and raging teenage hormones can be a serious and kind of terrifying problem), or continue doing what I can to suppress (no pun intended) my dysphoria and likely end up in the hospital.

“My mother doesn’t take my depression or dysphoria seriously (it took her witnessing one of my most violent panic attacks to convince her to let me see the school therapist), so advice from her doesn’t help (especially when she doesn’t offer any).

“So that’s problem one. My other problem, which is much less serious, is standing to pee. I really would love to be able to stand to take a pee, but the price of commercially available STP devices that also function as packers is insane! Not to mention the harnesses! The cheapest set I found would still set me back by $50 that I do not have (a lot of money for a jobless teen who’s worried about affording college, a car, gas for that eventual car, animals, etc). Do you have any ideas in this regard?”

Last question first – have you tried a coffee can lid? I never got the hang of it, but a lot of guys use a plastic coffee can lid with the edge or lip part cut off so that it’s just a flat circle. Then they roll it into a kind of tube and pee through it. You can also buy a sheet of thin plastic at the hardware store and cut a coffee-lid-sized circle out of it. It’s explained here on TransGuys.com, along with other suggestions, tips, and links for the Stand to Pee situation.

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Ask Matt: Gender-Neutral Pronouns and ‘Non-Transition SRS’

I’m catching up, but still behind. Today we have two short letters that I have some thoughts about, but that I am unable to answer with much certainty, so I hope that readers can give these writers some additional information.

A reader writes: “I found your website while googling around on gender-neutral pronouns. My question, in brief, is this: Is it just me, or are gender-neutral pronouns mostly sought by people who were assumed to be cis women at birth?

“I love the idea of genderqueer and have happily appropriated the parts that work for me and read a fair amount of queer theory over the years. It occurred to me today that most of the third-way writing I have read is by people who no longer want to use girl-pronouns after being assigned she/her at birth, where as trans women tend to love getting access to (and perhaps ideally only using) the girl pronouns versus seeking some third way.

“I googled a bit hoping to find some evidence to the contrary, but didn’t find much. Perhaps I’m insufficiently thorough. Thanks in advance for your reply, and also for your patience with my question and any parts I may have phrased inelegantly or insensitively.”

I don’t know whether or not this is true, but it appears to me, as well, that the majority of people who prefer gender-neutral pronouns are those who were assumed to be female at birth. I do know some genderqueer-identified people who were designated male at birth who use “they,” and I know some who use “he” and “she” interchangeably. But again, the majority of people who I have found to use “they” or “ze” were designated female at birth.

I’m not aware of any statistics on this, or whether or not any surveys or studies have been done (if anyone knows, please fill us in), so my answer is coming from personal experience.

If my personal experience transfers to the larger culture (and I don’t know if it does or not), and I had to give my thoughts on why this might be, I would say that I think that the “gendered” life experience is different for those who are designated female at birth and those who are designated male at birth, and this causes potentially different responses to any feelings of gender incongruity.

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Ask Matt: Mood Swings and Moral Judgments

Below we have two letters having to do with transition issues. The first is about the effects of hormones on mood, and the second deals with changing names and gender markers on transcripts. Here we go:

A reader writes: “I started ‘T’ (testosterone cypionate) one week ago at 100 mg. every two weeks, then will go up to 200 in three months. I started feeling a bit more agitated and quick to anger two days ago. I also feel sort of flat emotionally and a tad depressed.

“The first two days after injecting I felt calm, more peaceful, and good (probably because I was starting the process). I’m older at 53. Do these feelings settle down after a while? It’s becoming sort of a drag.”

They should settle down. Hormones can cause rapid mood changes and other feelings that you are not used to. Testosterone and estrogen can both affect mood, emotion, and feelings of general well-being. Your body is not used to this hormone. It has to adjust.

Testosterone can make some people feel agitated and angry. Strong agitation and anger is what body builders who are on steroids mean when they refer to “roid rage.” Not every trans guy experiences this, but it is not uncommon, and it should either lessen over time or you will adjust over time. It also should fluctuate as your body cycles through each dose (if you are injecting).

I personally think that testosterone suppresses some emotions, which could be why you feel emotionally flat. I am not able to cry as easily on T, and it’s not because I think that guys shouldn’t cry. I know a few guys who have gone off of T just to have a good cry once in a while. I also know a trans women who became very confused about why she was bursting into tears at the smallest provocation, because she had never done that before in her life. She had recently started estrogen. Aha!

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Ask Matt: I Can’t Take Testosterone

We have two letters below regarding testosterone – first, from someone who can’t take it, and next, from someone who doesn’t want to. I hope readers will chime in with their suggestions and personal experiences.

A reader writes: “Though I have had top surgery, no doctor will prescribe me T because of my health problems, and I cannot find it through other channels. Add that to crippling bottom dysphoria, being five feet tall, and being universally misgendered, I am not a happy guy.

“I have a fantastic long-term boyfriend, a queer cis guy who sees me as I really am, but my own angst is magnified by the way the rest of the world treats us. Either I am treated as his ‘little lady,’ with waiters handing him the check when I give my credit card, gay men saying I’m a fag hag, being called a butch dyke, or being offered ‘makeovers’ to ‘look like the pretty girl stuck under the boy costume’ (oh, the irony).

“My boyfriend and I try to explain endlessly about me being a trans guy, and we get met with reactions ranging from puzzlement (‘I know a trans guy who really looks like a guy, but you don’t, and I can only think of you as a butch girl’) to laughter (‘You’re joking’) to hostility (‘You’re a crazy bitch and he’s a closeted fag’). I wish I could let all this misgendering go, because obviously our explanations aren’t making it better, but I just can’t.

“So, my question is twofold. Firstly, when I came out in 1999, we needed therapist letters (which I had for my surgery) to get treatment. Now, there are informed consent clinics to give you hormones even without letters, but they do require blood tests. Do you think in the future they will waive this requirement, too, or at least let people like me get hormones if we sign an affidavit indemnifying them from liability? There is no guarantee that hormones will worsen my physical issues, but my gender angst has gotten worse over the last 15 years to the point where I don’t know how much longer I can stand it.

“Secondly, do you have any tips to make going out in the public eye easier for the constantly misgendered trans man and his boyfriend, who himself is tired and hurt by the way his love for me, and also his own identity and motivations, are misconstrued? Am I being delusional in the first place to expect anyone to respect my gender identity when, despite my teenage goatee, big muscles, low voice, flat chest, and boyish style/haircut, I am still very short and not on T?”

In response to your first question, I think it is unlikely that even informed consent clinics will change their policy on blood tests, because there is just too much liability involved. Even if you sign a paper releasing them from all responsibility, that might not hold up in court. We have become a lawsuit-happy country.

We sue tobacco companies (and win), even though we choose to smoke. We sue McDonald’s (and win), even though we choose to eat junk food. So even though it is obvious that we are making our own choices, we can still assign blame and win in court. Doctors and clinics are aware of this. Even when a person’s blood tests come out fine, that person still has to sign something saying that he/she/ze understands the risks of hormones. If medical risks are obvious, as determined by blood tests, regardless of what you’ve signed, medical malpractice might be an issue.

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Ask Matt: Gender Identity/Sexual Orientation Confusions

In these two letters, we look at the confusion around, and intersections of, sexual orientation and gender identity. Here we go:

A reader writes: “I’m dating a trans man now and it’s been amazing. I’m still slightly confused as I have always considered myself as a straight female and have always seen him as male, but at the same time I’ve accepted that for the moment he is still female and am willing to do stuff with him (obviously, haha).

“I know labels are not the best way to go about things, but I’m not sure of how else I can understand what I am feeling? I hope this doesn’t come across as naive or stupid. I’m just a little bit confused.”

It’s not uncommon for those who are dating trans people to become confused about their own sexual orientation. For you, it seems pretty straight-forward – you’re a straight woman dating a trans guy, so you’re a straight woman … because he’s a guy.

I would argue that he is not “still female.” I think what you mean is that he has not had any type of genital surgery. Maybe you even mean that he is not taking hormones. But if he’s living as a man, then he’s not female. And if you see him as male, then he’s not female to you, either.

Just because he has a different body type from what you might be used to doesn’t negate any of that. If you’ve been with several men in your life, you know that their body types vary widely, even though they all might have come closer to the particular prototype or representation that we have of a “standard” male body than your current lover’s body does. No matter. He’s a man, you’re a woman, and the label for that type of relationship in Western culture is “straight.”

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Ask Matt: Small-Town Transition Blues

A reader writes: “I’m a 16-year-old trans guy, and I came out to my mom two months ago, and my dad one month ago. They haven’t rejected me (I knew they wouldn’t), but they’re not on board with thinking of me as their son, and probably won’t be in the near future. My mom e-mailed a gender therapist recently, so I’m looking forward to my parents getting a ‘professional opinion,’ and so I can finally talk to someone who speaks my language.

“Some problems are: I don’t know how (or when) to come out to my siblings. My brother is 13, and looks up to my 18-year-old sister. My sister has treated me like less than a human being for my entire life, probably from deep jealousy that started when I was born, and I’m finally letting go of the belief that if I tried hard enough, she would show any emotion resembling love toward me. She’s leaving in the spring, and if I came out to her before that, she would probably out me to our school, and subsequently our town.

“My town has a population of 400, with less than thirty people in my high school and with two other students in my grade. I’ve lived here my whole life, and have despised it for just as long. I need to transition as soon as possible, and the only way I can think of to do that is to move to a big city, and since I’m a minor, I can’t just go and get an apartment and a job in Portland and start testosterone on my own.

“I feel guilty about wanting to ask my family if we can move, since I only have a year and a half of high school left. I also don’t want to put them through a lot of stress if I ended up coming out in this town, which is what I would need to do if I had to spend my senior year here.

“So, do you have any advice for getting my brother on my side, without him getting thrown into the middle of differing opinions within my family?

“How can I convince my parents that living this female lie is so debilitating that I can’t keep it up for even another year, and if I had to stay in this town, I would probably sink into a very deep, deep depression?

“And this isn’t as important, but I’ll ask it anyway: do you think me acting masculine on some days and effeminate on others would confuse them, or that they would have a harder time believing I’m male?”

First I would like to say that I have never known a family that picked up and moved because their teenage child asked them to. Maybe it’s my generation, but my parents would not have even paid attention to such a request. Your parents are probably settled, with jobs, a house, and a life where they are, so I can’t imagine them moving because you ask them to. Again, times might be different now or your family might be different. But I wouldn’t count on them moving.

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Ask Matt: Support for Older Trans Men?

A reader writes: “I am a 59-year-old African American lesbian giving serious consideration to transitioning to a male. Are you aware of any females beginning their transition who are my age?

“I do realize there will be generational, cultural, and racial considerations. My questions largely have to do with being post menopausal and beginning T. Are there challenges that younger trans men don’t have to deal with? Will T be more effective since I am post menopausal? Are there any health considerations or concerns?

“As I begin my transition, I will bind my chest. I’ll see how it goes prior to deciding to (or not) having a double mastectomy. Is there an ‘older’ community of trans men support group? Any other suggestions would greatly be appreciated.”

There are definitely cultural and racial considerations that I am not qualified to address. I’ll have some suggestions with regard to those in a minute, and readers will have others, I’m sure.

As far as female-designated people who being transition later in life – yes, there are many, and some are older than you. Your age should not stop you from doing what you need to do. The oldest female-to-male transitioner that I am aware of was in his mid to late 60s. The oldest male-to-female transitioner that I am aware of was in her 80s. It can be – and has been – done.

An older trans guy named Jay, who has posted a video on YouTube, started T at age 65. And here is one from Dr. Jay, who started transition at 56, and here is a video from a guy who is transitioning at age 60. If you check out these videos, you will also find others from older trans guys who are transitioning (related videos appear down the right-hand side of the page). Dr. Jay has several videos, and he does talk about health issues related to starting T at an older age.

I’m not a doctor, and you should definitely talk to one, but testosterone in low doses is prescribed to some post-menopausal women to increase libido and to help maintain bone density and muscle mass. You would be taking a much higher dose, because you desire physical changes, but this just suggests that testosterone is not contraindicated for female-designated persons after menopause.

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Ask Matt: How Can I Believe That My Child Is Trans?

A reader writes: “I am a parent of a teenager who just last year, at the age of 17, shocked me with the announcement that she was transgender and would be starting the transition from FTM as soon as she turned 18.

“Up to that point, my husband and I had no idea her gender identity was in question. She was definitely a ‘tomboy’ (as was I most of my life), and never played with dolls, etc., but we never put two and two together. We did think she was a lesbian, however, but even that we were unsure about, because she had gone from one phase to another over the years (emo chick, athlete, etc.).

“So I am trying to find a place where I can be educated that will help me not only believe this, but accept it, embrace it, and eventually advocate for my child. I am having a very difficult time ‘transitioning’ my own mind to believe that my daughter of 17 years is not a female. I cannot get the word ‘him’ out of my mouth, and I cannot get myself to call her (him) by this new name.

“Does this make me a mean, closed-minded, unaccepting parent? I just tried to call my husband ‘babe’ or ‘honey’ the other day (something I’ve never done), and that felt so incredibly awkward coming out of my mouth. How in the world will I call my child ‘he’?

“I cannot seem to find good information on how to change myself, and my husband and my 12-year-old son’s mindset on the fact that ‘Jane’ is now ‘John.’ Not to mention, my husband is not at all willing to change the name. He does not even believe that this is happening. Knowing nothing at all about transgenderism and totally unwilling to educate himself at this, I am at a loss!”

Let’s get the most important thing out of the way right up front – you are not mean, closed-minded, or unaccepting. You wouldn’t be writing to me if you were. So stop beating yourself up about that, and let that one go.

Next, let’s put your husband on the back burner for a moment, because it’s not your job to make him accept his child. Don’t worry – we’ll come back to him later. Right now, we are going to focus on you, because how you deal with this will likely eventually influence how he does, and how your 12-year-old son does.

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Ask Matt: Recommendations for Transition

A reader writes: “I’m 17 years old and have been thinking about and researching FTM transitions since I was 13. I did the ‘wait a year to think about it,’ like you would for a permanent tattoo, for the past four years.

“I decided August of last year that I honestly want to go through with the process. I have friends and a girlfriend who will be there for me, even though I know my family might not be.

“I’m asking you about recommendations and for any advice you could spare. I have a few ideas on how to go about it, but I’m not sure what’s proper, or if there is even a proper way. Like, what kind of therapist(s) should I contact to get the ‘green light’ to start the process, and what kind of doctor should I talk to for treatments and surgery and such?

“That, and I’m not sure which surgery I would go with first, top or bottom. I was thinking bottom, because I heard they can do womb transplants, and I want to give a woman in need something that could make her world – I’m just not sure if I should get that surgery before even doing T so that it would be safer for transplantation. But I really do want to know your opinion on that, on everything!”

I’m going to assume that you’re in the United States, but I don’t know this for sure. I’m not that familiar with health care systems in other countries, so if you are not in the U.S., you would need to check with your (probably far superior) health care system to find out what you need to do. Some countries’ health care plans have very specific steps that must be taken in order to receive transition services that are covered by the health plan.

At 17, you might have a difficult time getting a doctor’s approval for hormones without parental consent. But you will soon be 18, so if this is a barrier, it will go away in twelve months or less.

The first thing that I would recommend is that you find a therapist. Depending on where you live, you might have gender specialists already there who are advertising as such. If not, I would look for a therapist who has something in his or her advertisement about self-discovery, moving past obstacles, living an authentic life, or other phrases that might ring true to you.

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