I am very frank in this blog and if it helps someone to cope with their gender dysphoria, then it will have been worth it. I am not trying to be sensationalist and no longer need to hide from who I am. I also view my existence much more dispassionately than when I was dealing with the paralysis of shame and guilt over being transgender.
In this light, Anne Vitale’s 2003 article titled “The Gender Variant Phenomenon--A Developmental Review” contains a reference to one of her patients that I can relate to. You might recall that she is the one who coined the excellent term "Gender Expression Deprivation Anxiety" to describe what many of us experience.
In the text she describes this patient thusly:
“John, a 50 year-old genetic male, medical research scientist, married (23 years), father of three children aged 20, 17 and 7, phoned me after experiencing a panic attack severe enough to require emergency attention from paramedics at the airport on his way to give a presentation at a conference. John gave me only his first name and informed me that I was the first to be told what he was about to tell me. He said he was "gender dysphoric" and that he was "desperate." Feelings that were once "controllable through sheer force of will," had increased to where he now was having protracted periods where he would close his office door, lie on the floor and weep quietly while curled up in the fetal position, holding his genitals in pain. Other than intrusive and repeated fantasies of being female, he had refused to allow himself any overt form of female gender expression. He reported feeling that if he was to cross-dress and be caught, he would dishonor his wife and family. Having attained international recognition for his work, he was also concerned about his professional reputation. The only other form of temporary relief came through masturbating, often up to five times a day.
Our work together over the last three years has been slow. However, with the help of extensive individual, group, and family psychotherapy, augmented by estrogen replacement therapy, with the full permission of his family, John has recently taken on a female name and is living full time in the female gender role. She is in the process of renewing and redefining her relationship with her family, and has successfully returned to work after an extended leave of absence”.
For the last few years I have been using masturbation to help control my dysphoria and put the feelings “back in the box” even if only temporarily. This means that when I come home from an outing I will try and put away thoughts of wanting to be Joanna by perhaps trying to reconnect with the guilt that an orgasm in women’s clothes once held for me. The orgasm no longer happens without some effort but it is nevertheless a tool in my arsenal to cope with my dysphoria.
With age, the relief periods have become quite short and I find being Joanna to be easy and comfortable such that without the crossdressing that I engage in on a daily basis the pressure would be too much for me to endure.
Anne's patient permitted herself no such outlet so the pressure built and built until panic attacks inevitably ensued.