Transgender London

A Choice of Consequence

Transitioning seems to be on everyone's mind both within and without the transgender community. Outside the TG community, the perception is that everyone from the crossdresser on up the "scale" wants to transition. What the world sees of course is the transitioned M2F and she is dressed appropriately for her gender role. This tends to categorize and as such, it is easy to draw this natural conclusion. Of course that is simply misinformation, ignorance born out of the media's failure to grasp this whole concept of gender. It is far easier to sensationalize by holding up the transitioned person for the world to see than to dig much deeper to find the majority of transsexuals who will not transition. Yes, clothing and expression is part of this for all transgendered people but surprisingly, less so for the transsexual.

The transsexual lives with gender dysphoria from the first awakening of their gender condition. The article Sex vs. Gender outlines the reality of the need to hide and to erect barriers for self protection. In this regard, the real issue for the transsexual is to hide the true person and substitute him or her with a fabrication.

The crossdresser on the other hand may suffer some mild dysphoria (most do not suffer it at all) but their real concern is focused on keeping their secret. There is no need for transition here, only a need to emulate that gender they most admire. The crossdresser is for all intents and purposes in a recreational situation although that is an over simplification.

The emergence of gender issues can occur at any time in a person's life. There really is no trigger for this nor is it particularly predictable since many crossdressers start as young children. It is equally important to note that many transsexuals also recognize this as children. Where the real separation comes is at puberty. The child with gender dysphoria who carries it into his or her teen years is far more likely to identify as transsexual.

So it is fair to state that many if not most transgendered people suffer with some form of mental "disorder" associated with their gender issues. The truth of the situation is that it is not gender that is an issue, it is the anxiety, depression, PTSD, grief etc that are the real issues. Once these maladies are dealt with, gender is not an issue but it was the reason for their existence. The problem here is that most mental health professionals do not see this and place their focus on gender. This approach does nothing for the client. Similarly, the mental health professional has to understand how gender figures into these conditions in order to properly assist the patient.

All of this leads to decision making and circumstance. When the TS "hits the wall" or has "the awakening" s/he is driven beyond reason to transition. This period of gender dysphoria is horrific because of this singular focus. It is also the time when the transsexual is most at risk to themselves and others.

The risks can range from substance abuse to suicide. These often incorporate familial and social breakdown. The real problem is that the TS is often at a loss to explain any of it other than a need to transition. If the person is lucky enough and receptive then counselling with a good therapist experienced in gender dysphoria is a positive step. This avenue can lead to one of two future directions; transition or not. The consequences of these decisions are life long and life altering.

In either event the approach taken by the therapist should be to treat the person, not the dysphoria. The dysphoria is usually a manifestation of other conditions that are rooted in gender. Regardless of the choices made, addressing these issues is of paramount concern to everyone. Whether the TS chooses to transition or not, getting mentally healthy should be the first order of business. In fact transition within the boundaries of the Harry Benjamin Standards of Care require the TS to be mentally healthy; healthy enough to recognize that they have Gender Identity Disorder. This is the Catch-22 because it minimalizes the person to a disorder that really doesn't exist. The primary focus of this period of treatment is to get the TS to self acceptance. That is recognition of their gender for who they are and to accept that they can do nothing about it. They must learn to live with it because regardless of whether they transition or not, it will always be with them to greater or lesser degrees. When this point is reached it is like walking into the sunshine from darkness.

The transsexual is now able to make informed and relevant decisions about his or her future.

The choice to transition is sure to alienate the transsexual from many if not all friends as well as family, both immediate and extended. This is another reason being mentally healthy is a necessity. The transsexual can find him/herself alone AND lonely. It is a tough life until it can be rebuilt. For this very reason continued counselling is essential.

Spouses usually leave and take any children with them as well as most of the assets. The TS is often too willing to give it all up for the freedom they need. The real problem with this is that in transitioning, careers are also lost. High wage levels are gone and survival becomes a major problem. This only complicates the ability of the TS to pursue the transition. All too often the TS turns to the sex trade to survive.

The other side of the coin is for the transsexual to maintain the status quo of family and career. This too has its downside in that the pressures for the need to transition never leave and coping becomes a problem. Continued therapy is essential in this case.

One must remember though that even if the second choice is made, the partner of the transsexual is still cisgendered and in no way interested in a homosexual relationship whether literal or virtual. The danger of marital breakdown is always around the corner. So while the TS is still in a "committed" relationship, it becomes questionable as to its validity over the long term.

It may seem to be a no win situation but that is not always the case. Lives and careers can be rebuilt, new relationships established and happiness achieved. Staying in the committed relationship can also lead to a stronger one but it really does take a very special partner to accept this. It is not easy for someone who is cisgendered to live with a partner who is of the same gender. The real problem here is gender itself in that it becomes the barrier to shared happiness. Occasionally a partner can overlook this and really see the person but it is rare.

So to transition or not is a choice of consequences. If all barriers were removed and the playing field leveled, every transsexual would choose to transition. The fact that most choose not to do so only indicates a conscious decision of priorities; no more and no less.

It is, and always will be, a personal decision made made by the transsexual when the time is right.

This site was last updated 02/14/11