When I think of my mental and physical health, I rarely consider being transgender as relevant.
Physically it doesn’t really matter. Of course, were I to break my ankle my biggest (and shallowest) concern would be whether or not I would ever be able to wear stilettos agan. But my mental health is a different story. Throughout my life I have met with therapists for various reasons. My father was… horrible and it took some time in my early twenties to deal with that trauma and therapy was an enormous help when it came to resolving that. At the time, I identified as a crossdresser and felt no need to share with my therapist that I was wearing panties. I thought that *this* was all about clothes (and to be fair, from a certain perspective it is), and what I wore (and wanted to wear) had nothing to do with anything else. On some levels that is, and will always be true.
When I was in my early thirties I started seeing a therapist again. I had a new job that created a ton of stress and anxiety and I needed help coping with it. My therapist helped A LOT. As we neared the end of our visits I shared with her that I was a crossdresser. I didn’t tell her because I was… confused about who I was or what this meant. I have always been secure with my gender and my wardrobe preferences. I wanted to make sure that I wasn’t in denial. Was there something about this side of me that I hadn’t considered? Was I being honest with myself? She asked the normal questions that someone asks when you come out to them. She also asked a few more nuanced questions. I was honest with her (that’s what a therapist is for, after all) and after a little more discussion she shrugged and said “it is what it is”. It felt like she and I were on the same page, meaning that this side of me didn’t stress me out, it didn’t cause anxiety, it didn’t torment me the way one’s gender identity can.
It took about a year of seeing her before we had this discussion. It took some time to unpack and process the things I was going through and I felt that was the priority. As our sessions wound down (and we were running out of things to talk about, if I am being honest) we discussed gender and identity and, well, clothes. I waited until we dealt with the bigger, more pressing concerns because I didn’t think my crossdressing was… relevant. I’ve never felt like I was born in the wrong body or that being male felt wrong. Nothing about this side of me or what I was wearing caused any sort of… well, anything. If anything, it provided me with comfort and happiness. BUT! not at the level where I felt that wearing femme clothes was “the real me”.
After our sessions were concluded I felt more confident than ever that I was being honest with myself and I wasn’t in denial about who I was. In terms of my “journey” it was around this time I had started to wear “real” clothes beyond just lingerie. At this point I wasn’t Hannah, if you know what I mean.
The stressful job that drove me to therapy is in the same field that I am in today. Yes, you shouldn’t be in a career that causes an insane amount of stress, but I truly enjoy my job. A few years ago I was tired of the anxiety that my job caused. I knew the level of anxiety I lived with wasn’t normal, and it certainly wasn’t healthy. None of my colleagues could relate to the level of stress I felt. I realized I needed help. I went back into therapy and discussed different medications that might help. I was diagnosed with depression and was prescribed a form of Prozac. Depression didn’t quite feel right, if you know what I mean, but the therapy and the medication helped tremendously so I went with it. I didn’t, and do not discuss Hannah with my therapist.
A few months ago I thought it might be a good idea to revisit my diagnosis and my medication. I tend to overthink and I wondered if there was something more to my mental health that I hadn’t considered. Although the medication and therapy were helping, I thought that perhaps if I was being treated for anxiety (if that is what I am facing) as opposed to depression, then perhaps my medication and my coping methods could be changed and therefore be made more effective. I spoke with my doctor who referred me to another doctor and after a few phone calls and Zoom meetings I had started to explore other diagnoses such as ADHD. I filled out a lot of paperwork and was asked a lot of questions. Some of the things that I was asked are helpful when it comes to identifying different treatments and coping methods. The questions are designed to help pinpoint and even eliminate certain diagnoses. Did I have anxiety? Is it ADHD? Could I possibly be on the autism spectrum?
One of the things I was asked to consider was related to my interpreting social norms. Since I tend to overthink, I wondered about my perspective about my crossdressing when I was growing up. When I talk to other t-girls or read about their own journeys and experiences, this side of us is almost always acknowledged or realized when we are very young. We often talk about the clothes we wore (and wanted to wear) but we also talk about the feelings and thoughts we had at the time. It’s not uncommon we felt shame, guilt, fear, and confusion about this side of us. After all, we have always been told that boys don’t wear pink or dresses or nail polish or makeup. If that was true, then why were we trying on dresses whenever we had the chance? Almost all of us kept this side of us private and lived in fear of being caught. Most of the time this was because we were afraid something was “wrong” with us. This was, after all, against societal norms.
Although I lived in fear of being caught, I never, ever felt that it was wrong for boys to wear dresses. I felt a longing when I saw mannequins at department stores wearing pretty lingerie. I felt jealous when my sisters would paint their nails. I knew (because it is hammered into us when we are growing up) that boys didn’t wear pretty things, but I was confused as to why I wasn’t “allowed” to wear what I wanted to. Was this related to me not “correctly” interpreting societal norms (even if the norms were outdated and wrong)?
Let me make it clear that I do not think any diagnoses “causes” me to be transgender. Rather I wonder if my gender identity, specifically being so secure in it for my entire life, might be relevant when it comes to diagnosing something related to my mental health. Does that make sense? I am not saying that because I am transgender (or essentially anything other than cis gender) is related to a mental condition. What I am saying is that my comfort, my acceptance, and my embracing of who I am (and who I have always been) is… well, it’s not typical. Many t-girls and crossdressers felt confusion or stress or fear when it came to their own journey. But I never did. I loved, and still do, who I am. That’s not to say I came out to everyone I’ve ever met. My reluctance with coming out had more to do with not wanting to potentially rock the boat with anyone in my life. But these days it has more to do with not having the emotional or mental bandwidth to have those conversations.
To be clear, I am not more self-aware than anyone else. BUT I do think it’s a little atypical that I never felt that it was wrong to wear what I wore and wanted to wear. If this “enlightenment” is related to how I interpret social cues and norms, then disclosing my gender identity becomes relevant in therapy. Of course, I don’t feel I need therapy when it comes to my gender identity, but perhaps my gender identity, specifically never being vexed by it, would be useful when it comes to any sort of treatment or medication for my mental state. BUT please don’t misunderstand. I am not saying that me being trans NEEDS treatment. That’s not what I am saying at all. I love who I am and I won’t change even if I could. What I mean is that I never went through the typical stage of “wearing dresses is wrong and there’s something wrong with me” when it came to who I am.
It’s important to be honest with who you are, and it’s important to be honest with therapists and doctors… when you feel that certain information is relevant. With my medical doctor I don’t think my gender identity is relevant AT ALL. But with therapists it might be. I identify as bi-gender. I literally have a second gender identity. Although most of the world doesn’t see it, I am pink as much as I am blue. My gender identities are separate and overlap. Things can impact and influence both sides of me. I am often both Hannah and a boy at the same time, at least when it comes to how I think and feel. You can’t untangle the two sides of who I am. We are forever entwined.
That being said, I am thinking a lot about how much I need to share as I am about to get started with an upcoming round of testing and therapist appointments. Last week I had my first real appointment to determine what I am going to be evaluated for. In the back of my mind I considered whether or not I should come out to my doctor but in the end I didn’t. I didn’t feel it was super relevant (at least for now) and I also didn’t have the energy to go down that road just yet. I may or may not bring Hannah up, so I guess we will see how it goes. The point to allllll of this is that our identity (gender or otherwise) is WHO WE ARE. And who we are is EVERYTHING. Sometimes I don’t think my gender identity is relevant (and to be fair, sometimes it’s not), other times I think it’s absolutely important. The tricky thing is determining when it is relevant. It’s not important that my colleagues know about Hannah, but it is crucial our significant others know about our gender identity and about what is in our closets. Like walking in stilettos, it’s not always easy to achieve that perfect balance of knowing WHO to come out to when it comes to our mental health.
P.S. Of course there are some mental health “professionals” that may tell you that there’s something wrong with your gender identity, so if you are being told that you might want to see a different therapist.