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It's all in our hands

For me, no one has defined gender dysphoria better than Anne Vitale. Describing it as "gender expression deprivation anxiety" is brilliant because that is exactly what it feels like. But in its definition also lies the solution; ie the reducing or eliminating of its power which, according to the WPATH standards, can take on a variety of forms up to and including a full medical gender role transition.

I feel that our aim should be to attack that discomfort by whatever methods work using a measured approach. This means that less is better at the outset until we have figured out what we really need. If a medical transition is what we require then that is exactly what we should do. However, many of us are already embroiled in lives we have built and, treating our dysphoria the way we would ultimately want to, may not be possible. This is where deft baby steps are called for.

Some wait until a dear spouse is deceased or children are grown while others find ways within the context of their existing lives to deal with their feelings. If any of this were easy there would be a handbook, but unfortunately none exists. The only thing I know for certain does not work is ignoring your dysphoria; don't do what I did.

It is also very true that dysphoria is not of the same intensity for everyone and I am all but certain that Harry Benjamin was absolutely correct in this. It means that at its highest levels, it is virtually intolerable and must be addressed with transition lest mental health be severely impacted.

Expressing gender differently causes no one else any harm and we can confuse our desire to do this with a clarion call to transition. This is where we need to be extremely careful because there is no shame in lying somewhere between male and female on the gender spectrum. All that matters is that it works for you and society be damned.

For those looking for flexible solutions within a marriage, some spouses are understanding but if not, it may come down to a choice between your mental health and staying with them. You can explain this by asking them what it would feel like to suddenly be prohibited from expressing their gender identity. For this is what it feels like for us.

When you find a balance point you will know it because your happiness will return. No, things won't be perfect because real life isn't, but at least that awful disconnect will be partly or fully curbed.

I am not against getting professional help but in the end we are the ultimate deciders of our path here and no therapist, priest or doctor can tell you what is right for you. Thus, after many years of reading and personal reflection, it turns out that medical transition is not for me although for a time that wasn't an obvious decision.

This is why that soul searching is so pivotal especially since, the further along the spectrum one is from their birth sex, the more challenging that decision becomes.


  1. The best explanation I have ever read. Thank you.

  2. Thank you so much, This has explained so much for me, I've been transitioning for sebveral years HRT also, and holding back due to souse and children. And I can feel it building up everyday, my anxiety and anger. Alesha

    1. Take a deep breath and reflect Alesha. There are lots of options


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