(2021-04-22) Lim On Transgender Children And Medical Intervention

Liminal Warmth: On Transgender Children and Medical Intervention (Sex And Gender). I do think there's a very real tendency for many well-intentioned people to encourage a path that they themselves have not walked, and could not imagine walking, because they believe that it will reduce the suffering of the person they're encouraging.

But to cast transition as sunshine and rainbows, as a surefire release valve for intense dysphoria, as the person quoted describes, is a straight up lie, well-intentioned or not.

In my experience, and from what I have observed in others, there are often very complex emotions in play with dysphoria that address your body, your social role, your ideal desire, and what is permitted and encouraged by those around you

Transition may not resolve your feelings or issues with any of these four spheres, no matter how far you take it, because you're only partially dealing with external influences. You're also grappling with self-perception.

Culture has changed a lot in terms of permissiveness

this is, broadly speaking, a good thing

But also it allows for (and even encourages) medical interventions that may not be necessary or useful to address the root problem with dysphoria

These interventions may also be incredibly useful and in many cases life-saving, but you don't really know unless you've taken the time to unpack that wobbly ball of feelings and can leap confidently into irreversible changes

I have often wondered what my life would have been like if I had grown up today instead of 30 years ago

I most likely would have been someone who asked for puberty blockers

I can only guess at what AFAB people see when they look at men, especially as a teenager, but it can be very lonely and difficult to be a man in the world

Many of these dynamics are things you can't even appreciate or understand until you're an adult. What does a female teen know about male adult work politics and status?

When you're deeply unhappy with who you are and how you present, your idea of the alternative is not gritty nuance. It's all too often a shiny ideal.

Surgery is unlikely to ever live up to the ideal you imagine in your head, and regardless of happy talking points, it's not the same biologically (or experientially) as a cisgender body.

If you already have severe body image issues (and I've never met a TG person who doesn't), altering your body may lessen aspects of your dysphoria, but it's not a cure for a negative self-perception

When I went to have gender reassignment surgery, I had already been married. I had graduated from college. I had worked in the corporate world for a number of years. I had been through several years of therapy and thinking about these issues as an adult.

It was on the same trip that I heard FtM patients who were there for bottom surgery talk for the first time about what it was like, and the expected outcomes for even a "very successful" FtM bottom surgery. I do not envy those guys--there is a reason many TG men forego it.

at the last possible minute before they put me under, the doctor stepped in and asked me to rank three factors for the surgery he was about to perform: Depth, Aesthetics, and Function.

They hadn't prepared me for this. I don't know why not.

The thing that did make me feel different was when my mother handed me a mirror. I had decided on the last week to also have the surgeon do a tracheal shave while I was under, because it was cheaper than doing it later and I had a pronounced Adam's Apple.

GRS made my life easier as a woman in a myriad of ways, but the tracheal shave was probably 2-3x as psychologically impactful back then.

A month of in-house hospital care, excessive bleeding, and barely being able to walk.

roughly six years before I had another orgasm

*I went in with eyes open.

And even so I was so not prepared for the reality of it*

I can't imagine having to grapple with these decisions at 17, or 13, or younger. I could barely do it at 26. I'm honestly not sure if I would have preferred potentially guessing wrong to living with an extra decade of dysphoria.

you can't change your past decisions.

I mildly support drugs which delay puberty (with limited knowledge of the side effects) while you explore these questions and paint a realistic picture of outcomes.

It might be better than the alternative, but it's not going to be everything you wish it was. It can't be, because it's not the same

I don't know that I would feel comfortable letting my own child make this decision for themselves

This is me telling you, with as much empathy and love as possible, to put the irreversible steps off for as long as you possibly can.