No Questions Asked
How therapy became my unexpected haven for gender euphoria
A year ago, I sat in my therapy session intentionally changing the subject away from the question, “I noticed a little facial hair in those pictures. How do you feel about that?” I had shared with my therapist two images. They showed my hair, my eyes and thin upper lip, my ears. They also showed the stubble she was asking me about. The photos were of men and at the time, I was not one. The question made me very uncomfortable because I don’t think I wanted to admit — to her or myself — how much I wanted that stubble on my face.
The images I’d shared were AI generated from an app that takes your basic selfies and turns them into “professional headshots.” When the app asked me to pick my gender, offering choices of male, female, and other, I chose other, expecting my resulting 100 images to all be androgynous or a weird AI mix of male and female facial structure and clothes. AI is not known for its ability to remain in the gray area.
I’d been identifying and out as nonbinary for a few years after learning on Twitter about the term and that it wasn’t just for young people to claim and for a while, that felt good enough. Both female and male, neither male nor female. I was undefined, file not found. This felt safe because I could detach from womanhood, from femaleness, without really committing to anything else that would surely result in rejection by my parents. I was not ready to let them go. (Is anyone ever really ready to accept that their parents don’t love them unconditionally?) But in the days after getting those images from the app, I found myself unable to stop looking at them. Not unlike my pre-teen bedroom plastered with images of teen heartthrobs from Bop magazine, not because I was smitten with them but because they were goals. I wanted to look like them. I held my phone in my hand and stared at Male Me with stubble, imagining what could be.
“It’s fine, I guess,” I finally responded to my therapist with my favorite non-committal answer and we moved on to a different topic.
The truth was that the stubble was everything. I both wanted it and was terrified of it in equal measure. I had long been subject to my mother’s mocking, insults, scrutiny, and non-acceptance for the most minor of things like preferring to wear my hair very short, or wearing masculine clothing. Innocent things that many women chose to do. The rejection I would face from her if I dared show myself with intentional facial hair would be unbearable. I’d seen her laugh at the anti-trans jokes her Facebook friends post and I had spent my life desperately trying to not be on the receiving end of her laughter. I didn’t need to come out to her to know how she would react.
But those images, looking at them and imagining myself as that guy, felt better than the pain of my mother’s cruelty. I was more drawn to that idea and image than I’d ever been drawn to anything before. Three weeks later, I sat in my living room holding my testosterone injection kit from Folx on my lap. After a 30 minute discussion with my new gender affirming care provider the week prior, I was all set to begin micro dosing — injecting very small amounts of testosterone to allow for very gradual changes. I would slowly ease into maleness. Hope my parents wouldn’t notice for quite a long time. Prolong my inevitable rejection.
How was I to know my body would accept the testosterone with such gusto that even on the most micro of micro doses, I would still reach testosterone levels equal to that of a cisgender male very quickly and my changes would be anything but gradual? I wrote last year about the realization these AI images brought me and how they ushered in my shift from they/them to he/him. In that piece, I spoke of my friend, the first person I told that I was leaning toward he/him, and his immediate acceptance of me with no questions asked.
My partner had a very similar reaction. I asked her one morning, hoping to seem very nonchalant, “How do you feel about trans men?”
“I feel fine about trans men. I want them to be happy and be who they feel best as,” she told me.
Feeling a little bolder, I followed up. “How would you feel if I was a trans man?”
“Well, I would want to explore that with you because I want you to be happy too. Are you trans?” She asked.
That question had always felt like an accusation when it came from others. People wanted to force a label onto me when there simply wasn’t one that felt welcoming. My partner’s inquiry though, it felt like an invitation, and one that I was eager to explore with her.
My parents have not (yet) rejected me but have instead decided to live in denial. My voice now matches that of my older brother and my body changes are far beyond muscle definition resulting from working out. One cannot have known me before and not notice that I have changed and continue to. But in their world I remain their daughter. Neither my name nor my pronouns have changed for them and I know better than to even try and insist on it.
Before taking my first shot of testosterone, I imagined being denied my truth, my identity, by people would upset me. I thought I would need my entire world to recognize and respect who I had become or my identity would fail to be real and valid.
While the world remains annoying at best regarding my gender, I have everything I need to believe and be reminded that I am valid and my gender is real.
Despite my reticence to have the facial hair conversation with my therapist, my time in therapy since starting testosterone has become a cornerstone in maintaining my mental health, though perhaps not for the most obvious of reasons.
Therapist relationships are strange. In those that work well, they know the best and worst things about you and your knowledge of them is minimal. The opposite of how relationships with people who know all about you usually work. Upon coming out of anesthesia from a recent surgery, as my partner, a therapist, entered my recovery room, I announced, “It’s my second favorite therapist!”
Slightly offended, she asked who number one was and I evidently explained to her that my therapist was, because she, “likes dogs and is a brain wizard.” This is the sum total of the personal information I know of her while she knows my fears, the best and worst things I’ve experienced, and the joy that being able to feel my voice in my chest brings me. With the knowledge of all your hidden bits and secrets, it’s a therapist’s job to dig around in the mess, poke and prod to help you explore and understand yourself in ways that friends and significant others can’t and shouldn’t.
Had I not conveniently waited until my therapist was away for a couple of weeks to make the decision to begin testosterone, it’s possible that I would have been questioned about my choice. Not in a negative or rejecting manner, but to explore and feel my feelings about it. I needed to avoid a longer version of the facial hair question. I did not want to explore my feelings about it. I just wanted to embrace this realization that I’d been on the precipice of for what felt like my entire life and soak in the joy that had, until that point, been a rarity for me.
Even the best intentioned people that I’m close to had questions for me about my newly-embraced identity. Some because it seemed as though I’d leapt into this with no planning or thought or that it came out of nowhere — which warranted the question from me, “Have you not been paying attention at all in the years you’ve known me?”
But others, like my partner, simply wanted to understand and share the joy with me. But any line of questioning felt to me like being questioned about my decision to use the bathroom after a long road trip. It was something that my body and mind needed that warranted no further discussion. Of course I was doing this, it made perfect sense.
That’s exactly what I got from my therapist. No questions, no needing to explain or defend my seemingly hasty choice. Just this part of me being accepted as ground truth. Unlike many others who noted that the time between realizing that I was transgender and beginning hormone therapy was quite brief–three weeks to be precise–she never questioned that either.
Throughout the year that I’ve been on testosterone, therapy has remained the one place my maleness can simply exist as a fact, even when I may not yet be able to pass in public as a man. Of course, we have discussed my very complicated feelings about masculinity as displayed by the men in my family, but not as something that diminishes my truth, my existence. We’ve discussed this solely as something that served as the biggest barrier to me accepting myself and the main reason it took me 40 years to arrive here.
For many supportive friends, my body has become a thing to comment on and frequently ask about. I’ve gone from being allowed to exist in a regular fashion to having to constantly reference my body to educate and inform those who ask. In therapy, I am free to simply be. Enjoy my body without the requirement of explaining it.
Aside from my gender affirming care provider and therapist, every other health-based relationship has become unpleasant since starting testosterone. My former primary care doctor — the only doctor I’ve found who will actually trust that I know my body and listen to me — upon learning that I started testosterone and wished to change my name and gender in my patient information said, “Oh. I’m sorry, I don’t treat…those.”
At a recent dental cleaning, my dentist felt the stubble on my chin when she put her hands in my mouth and instead of approaching this noticing with curiosity or compassion, joked about menopause and chin hair. I even miss my former veterinarian in Chicago where despite that relationship revolving entirely around my dog, they gave me space on forms to identify as nonbinary and offered “Mx.” as a choice. There is no such offering with my current vet and the changes they notice in my voice during each visit always result in me being asked if I’m sick. Even among accepting people, the lack of empathy and understanding is jarring.
In a life where I’m mistaken for a woman, inadvertently she/her-ed based on a glance, or thought of as a joke, someone confused or playing a role, and remaining stuck in a body with female features because of the barriers and bullshit on the path to top surgery — therapy has become my haven.
My voice has deepened, my muscles have become much more defined, facial hair has started growing, my hands and arms now have prominent veins, and the new span of my shoulders make shirts fit differently. My body is taking on a masculine form, bit-by-bit, and it brings me new joy every day. Despite every change I’ve experienced in my body and brain since beginning testosterone, getting to go sit in my chair with my therapist on the other side of the screen twice a week remains the most gender affirming part of my day. Because we don’t have to talk about it. My choice, my truth, has never been questioned, poked, or prodded, and I’m regularly reminded that I am, in fact, a white man now, for better and worse, even on the days where that doesn’t feel true in my mind.
In order to cover gender-affirming care, many insurance companies requires a gender dysphoria diagnosis from a mental health provider. I imagine the old white men making these decisions sitting in a conference room, smoking and drinking coffee out of styrofoam cups thinking that they’ll get therapists around the country to interrogate the trans-ness out of us. If we’re pressed on the issue enough, we’ll change our minds. It must be treated like a disease or a personality disorder first and only after will they cover some of the cost of gender-affirming care. I also imagine these men are free to take Viagra — also gender-affirming care — without having to seek years of therapy and out themselves publicly in their personal and professional lives as a man who has erectile dysfunction (“Hi, I’m Bob. I can’t get it up and I’m from Akron, Ohio.”)
I have my required diagnosis. It was put into my treatment plan despite my therapist thinking it’s as ridiculous as I do. Having the diagnosis to check all the proper boxes despite my gender never being treated like a pathology feels like a small victory. A double-fisted middle finger to the insurance decision makers and their Viagra. In my mind, having something diagnosed and recorded in your medical records indicates that it’s something you suffer from and is a problem to be worked through and eventually solved. I suffer from post-Grave’s Disease hypothyroidism. I suffer from 35+ years of joint damage from juvenile idiopathic arthritis. Both of these conditions are in my medical history and must be monitored and managed. Neither of them are any part of my identity.
My gender is not something that plagues me, nor is it something to manage. It’s something to enjoy, embrace, and celebrate. I wake every day and remember that I get to be a boy! Then I’m reminded that I suffer from joint pain and have no thyroid. They’re not the same. While much of the world prefers to see my gender in the same light as hypothyroidism and arthritis, my two hours every week in therapy remain the one constant place my gender is enjoyed, embraced, and celebrated.
