When Kit and I sat down to record this latest episode, we knew we were treading into deeply personal territory. We open up about our own bouts with outfit-induced stress, a seemingly trivial matter that unveils the profound complexities of gender identity—a conversation that goes far beyond the clothes we wear. Our listeners will journey with us through the experiences of those living with gender dysphoria, the impactful contrast of gender euphoria, and the heartfelt moments when one's true identity shines through. We don't just talk about these concepts; we share the lived experiences and emotional depths they encompass.
This episode isn't just about definitions; it's an exploration of the human experience as we navigate the intricate feelings of disconnect for individuals whose gender identity doesn't match their assigned sex at birth. We contrast gender dysphoria with body dysmorphic disorder, dissecting the nuances and highlighting the emotional impact these conditions have on every facet of life. From the importance of using correct pronouns to the individual nature of transitioning treatments, we address the necessity for empathy, understanding, and support systems for those on this journey.
Wrapping up, we delve into the personal and medical aspects of transitioning, including hormone replacement therapy and gender-affirming surgeries. I share my own insights into the decisions that come with these life-changing steps, and together we underscore the critical importance of meeting treatment criteria to ensure the best outcomes for those with gender dysphoria. This isn't just a conversation; it's a celebration of identity and a call to stand with our friends navigating their path to self-actualization. Join us for this enlightening session—it promises to be as informative as it is uplifting.
Instagram
TikTok
Facebook
Want to see the video? Check us out on YouTube.
When Kit and I sat down to record this latest episode, we knew we were treading into deeply personal territory. We open up about our own bouts with outfit-induced stress, a seemingly trivial matter that unveils the profound complexities of gender identity—a conversation that goes far beyond the clothes we wear. Our listeners will journey with us through the experiences of those living with gender dysphoria, the impactful contrast of gender euphoria, and the heartfelt moments when one's true identity shines through. We don't just talk about these concepts; we share the lived experiences and emotional depths they encompass.
This episode isn't just about definitions; it's an exploration of the human experience as we navigate the intricate feelings of disconnect for individuals whose gender identity doesn't match their assigned sex at birth. We contrast gender dysphoria with body dysmorphic disorder, dissecting the nuances and highlighting the emotional impact these conditions have on every facet of life. From the importance of using correct pronouns to the individual nature of transitioning treatments, we address the necessity for empathy, understanding, and support systems for those on this journey.
Wrapping up, we delve into the personal and medical aspects of transitioning, including hormone replacement therapy and gender-affirming surgeries. I share my own insights into the decisions that come with these life-changing steps, and together we underscore the critical importance of meeting treatment criteria to ensure the best outcomes for those with gender dysphoria. This isn't just a conversation; it's a celebration of identity and a call to stand with our friends navigating their path to self-actualization. Join us for this enlightening session—it promises to be as informative as it is uplifting.
Instagram
TikTok
Facebook
Want to see the video? Check us out on YouTube.
It reminds me of every time I have to dress to go to something important, and then I have this internal meltdown over it. I call it my identity crisis, even though it's not technically a crisis with my identity and who I am and who I know I am. It's more of the feelings of I'm so stressed out, I'm having a meltdown. Today we're going to explore a psychological experience called gender dysphoria. We spoke on our last podcast episode about another psychological experience called dysmorphia. Dysmorphia, just to go into a little recap, is also known as BDD or body dysmorphic disorder. It consumes individuals with an obsession over perceived flaws. On the other hand, gender dysphoria, which we're going to dive into today, refers to the profound disconnect between assigned gender and inner identity. So we're going to have a discussion today and try to help everybody better understand these conditions and maybe we can develop a little bit more empathy toward people that are suffering through these things. I think both of us included, right, kit?
Speaker 2:Absolutely, I know. Even just today, picking out my outfit, I was like okay, what is happening with my brain? Can we just get it together and put on clothes, please? And thank you.
Speaker 1:I know this struggle is real.
Speaker 2:Yeah, and that's when I settled on glittery trash heap. So here we are.
Speaker 1:I think you look awesome, but I always think that you can literally pull off anything.
Speaker 2:Thank you so much. I appreciate that. Gender dysphoria are feelings of intense discomfort, distress, even anxiety, depression, just all these horrible feelings around your assigned sex at birth and the gender identity that resonates with you, that is psychologically matched up with more of who you are and that can come down to being born female and more identifying with the psychology of men, so becoming trans man, or being born male and identifying with the psychology of a female, becoming a trans woman, or they could just be not identifying with gender whatsoever, with your assigned sex at birth, with gender as a construct in general, being non-binary gender, fluid agender, bi-gender, demi-boy, demigirl, just the plethora of gender identities that fall under a feeling of disconnect between your gender identity and your assigned sex at birth. So it really is just this vast array of emotions that all boil down to that disconnect. But then there's also the flip of the coin, which is gender euphoria, which a lot of people talk about in coupling with gender dysphoria. So they'll talk about like their first dysphoria feeling, but then it's their first euphoria feeling.
Speaker 2:For example, for me one of my first memorable moments of gender euphoria was I think I was 12, and I was going with my mom and my grandmother to get insoles for my sneakers because my knees and my feet were so fucked up that they bent inward weird and I needed insoles to fix that. And afterward we went to a restaurant because I was really upset about needing insoles, so they got me something good to eat and I remember holding the door open for this older couple and they said thank you so much, young sir, and I was like oh, that happened to me just the other day.
Speaker 2:That whole feeling of the opposite side of the coin, of gender dysphoria, is your unbelievable joy around the feelings of your gender identity and even if they don't match up with your assigned sex at birth, that's okay. Like, sometimes, the strangest things will provide gender euphoria, and it's so cool because for every trans, non-binary trans man, trans woman, you will find different examples and experiences of gender euphoria, and I find them all beautiful and totally valid, even when they fall under gender stereotypes that we were all raised under, because that's kind of how that's going to work. We were all raised under them. Of course, they're going to provide euphoria for the people who were denied them.
Speaker 1:So let me jump back for a second, because I want to just sort of dive into dysphoria and just talk about how there's dysphoria, but then there's also gender dysphoria and they're two different things. And I think that a lot of times when people talk about dysphoria, it is related to the gender identity part of dysphoria. But there's this misconception that dysphoria is always related to gender identity. The truth is that dysphoria can cover a wide range of experiences beyond gender, so it can include things like mood disorders, depression, anxiety, etc. Dysphoria relates to that feeling of discomfort. So you can feel discomfort with any of those other conditions, but specific to gender dysphoria, that specifically pertains to the discomfort associated with the misalignment between assigned gender and gender identity. So, like you were saying before, kit, I think when people are referring to dysphoria or talking about dysphoria, they are referring to specifically gender dysphoria. They're not really referring to that broader term that can be used to encompass a lot of different forms of discomfort. I just thought it was important to delineate the differences between the two.
Speaker 2:That's so fair. I didn't even realize that dysphoria had an outer psychological meaning outside of just gender dysphoria. That's really fascinating.
Speaker 1:Yeah, gender dysphoria is actually recognized as a legit medical condition and because of that it oftentimes requires specialized support and interventions. Dysphoria I guess like the umbrella term of dysphoria in general might not necessitate medical treatment. I guess other types of dysphoria, whether they're related to eating disorders or depression or anxiety, could also necessitate medical treatment. Whether you decide to go the allopathy route or the holistic, naturopathic route, these symptoms are also related to something like the depression that's the condition. The anxiety that's the condition. The eating disorder that's the condition. So gender dysphoria is its own separate condition, but both involve these feelings of distress or dissatisfaction or just general overall discontentment. Both conditions can have a serious impact on someone's well-being and, like I said, they might need some kind of intervention. But there's definitely a difference between general dysphoria and then dysphoria specifically related to gender or related to other conditions. But today we're going to focus on specifically gender dysphoria.
Speaker 2:That is fascinating. Truly love that.
Speaker 1:The other thing I was going to say is that gender dysphoria actually puts the focus on the discomfort or the disconnect between a person from their assigned sex. So it's this disconnect between the person and their genitalia, it's not the gender identity itself. So when I was reading into this, I thought that was pretty fascinating, because I feel like the term gender dysphoria can be a little bit misleading or confusing. It actually does focus on the discomfort piece. The discomfort comes from the incongruence between the person's assigned sex at birth and their gender identity. It's the incongruence between the two. It's not seeing the identity itself as the problem.
Speaker 2:And now I totally understand what is being addressed when dysphoria is being brought to these teams of medical professionals is not the gender identity itself but the discomfort around that gender identity. It's trying to help the patient become more aligned physically with how they feel psychologically, whether that's just social transitioning so changing your name, changing your pronouns, changing your wardrobe, changing your hair, all of that or medical transitioning, which involves things like hormones and even puberty blockers for those of a younger age, and surgeries. But yeah, I totally see where you're coming from with that.
Speaker 1:Yeah, I think people can tend to get confused pretty easily. But when I was looking into it I was like, oh wow, it actually refers to the feelings of discontentment or discomfort. Like it refers to those feelings almost like the struggle is real, Like I'm on the struggle bus, you know, Like those feelings, those feelings of struggle. So it refers to that specifically, not your gender identity. There's nothing wrong with your identity or how you're identifying. That's not where the breakdown is.
Speaker 2:I see what you mean. Yeah, I do.
Speaker 1:So, and further to that, further to the feelings of disconnect or discomfort, there's also something called incongruence between the assigned sex at birth and the gender identity. That's actually referred to as gender incongruence. So when I was looking at things and the research and everything, I said, oh wow, that's really cool. There's actually a name for that. They call it gender identity incongruence, so that's the term they use for it. If somebody is not feeling right in their bodies, that would be referred to as gender incongruence.
Speaker 1:The incongruence refers to the mismatch. The dysphoria itself refers to the feelings of discomfort and that's it. It's more of the emotional distress. Gender dysphoria is the distress or the unease someone with gender incongruence may feel. So for some trans or gender diverse people, this specifically relates to their assumed gender, their body. Gender incongruence, which is referred to as GI, is defined as a condition in which the gender identity of a person does not align with the gender assigned at birth. People with GI who experience significant burdens are, in the DSM classification, described as gender dysphoria or GD. So they do overlap, they are related, they are intertwined, but there is a distinction between the two.
Speaker 2:I genuinely love that, especially as someone who I don't know about you, but I personally have a favorite spelling B big dictionary word style thing. I love the word incongruence. I love that word that word is such a vibe.
Speaker 1:Yeah, it's a great word. Yeah, I love the word mismatch too, because I feel like it does refer to that inner or that internal identity in conflict with external assignment.
Speaker 2:Yeah, it's very well done. I like how the terminology has evolved over time, especially clearly with the involvement of queer people, not just as people to be stared at, but people to be learned from.
Speaker 1:Yes, and that's what we're doing here. We're learning from each other, we're learning more about topics that are specifically related to our community, because we're studying to deliver the information. So in teaching we're learning. I want to add, too, and point out, that some of the distress and the discomfort that we've been talking about, some of the things that add to this burden, stem from, say, things in society like societal expectations and also limitations that society places on us, and it's basically based on their assigned sex. It's like going out to public. Sometimes you know how often does that cause you stress? Because I know a lot of times when I have to get dressed for an event and I'm in my bedroom and I'm picking out clothes, it causes me a lot of stress.
Speaker 2:Oh yeah, it's extraordinarily stressful because it's the whole idea of especially I mean me personally. I don't really like being perceived in general, in general. That's kind of a thing I'm working on, and especially with the act of being perceived, I don't know. A lot of times I equate it to a lyric from a song. That's one of my favorite lyrics. It's I'm quantum physics, my witness brings me to existence. I don't really feel real until I am being perceived. And then, very suddenly, in that moment is when I'm reminded that gender even exists as a construct. And then it's the oh God, what gender am I? And I start to panic about that.
Speaker 1:Yeah.
Speaker 2:And then in that moment in the morning it's like trying to prelude that by forcing that moment of panic and then being like, OK, what do I do about that? Where am I at mentally in that moment of panic. But it's so fucking difficult, it is.
Speaker 1:It reminds me of every time I have to dress to go to something important and then I have this internal meltdown over it. I call it my identity crisis, even though it's not technically a crisis with my identity and who I am and who I know I am. It's more of the feelings of I'm so stressed out, I'm having a meltdown.
Speaker 2:Yeah, it's the what do I do? And that's dysphoria, that distress that comes with gender. Dysphoria can affect every aspect of life, depending on who you are and how affected by gender dysphoria you are. It can affect your personal life, your professional life, your interpersonal connections or relationship, everything. It can affect the way you see yourself. It can affect your relationship with you. It does consistently affect your relationship with yourself. It's a constant sense of distress around who you are, which is something that I mean you hear it from people who don't come out until their 60s or their 50s and things like that. They hit the point where it was do this or die, because you can't keep living in that lie for the rest of your life.
Speaker 1:Exactly. I call that the clash. So one thing that is pretty consistent is this constant discomfort and distress revolved around the clash of gender identity versus assigned sex at birth, specifically how we present to the world. That, for me, is where that clash is. It's like the cognitive dissonance we spoke about in the last episode. The cognitive dissonance is manifested because there is this clash between one's assigned gender at birth and their strong desire to be another gender or live as another gender out in public, out in the world. So it's that cognitive dissonance in your head. But I also think a big part of that. What contributes to that, at least, is, like you said, what is that expectation? How are people perceiving us? It does play a factor.
Speaker 2:No, absolutely it really does. It plays a huge factor in it. I say again, I feel like, at least for me as someone who is autistic, at the very least it plays a huge factor in it for me, because being perceived in general as a fucking nightmare and it's just gender has always just kind of felt weird to me, even as a very, very little kid, when I was the one who wore the dresses and liked the shoes that clicked. I liked them because I could stim with them in a way where people allowed me to stim and I didn't get in trouble for stimming because I was stimming in a way that was appropriate to my gender, like twirling in a dress or clacking on shoes. I liked the sound itself was a stim for me as a kid, and it was either that or chew on my own hair which always got me in trouble.
Speaker 1:That's amazing.
Speaker 2:Like yeah, you're literally forced into a box of gender identity just to get the emotional relief that comes with stimming in a way that is societally accepted, and then you're not believed. When later in life you're like, oh shit, I'm autistic. And then people are like no, there's no way we would have known. Like no, you screamed at me for chewing on my hair too much when I was five, so I stopped.
Speaker 1:Even relationships I look at as being fluid. You know it's really hard to fit into a box.
Speaker 2:Yeah, it's all, it's all. I love it. Doctor who. They always say time is wibbly wobbly, timey, whimey stuff, and then a bunch of people started using that to describe gender Wibbly wobbly, gendery, wendery stuff. It's confusing and it's broad and it's vast and it spreads centuries Like it's ancient. We are only just now realizing and relearning how ancient it is and once you hit a certain point it does kind of just become a law. It's a law, it becomes very wibbly wobbly.
Speaker 1:It is very complex and layered. I just love how we're having conversations about it now more than ever, and I'm also waiting for us to start having the conversations about fluidity and relationships, because that's a topic that completely fascinates me that no one talks about.
Speaker 2:As someone who identifies as polyamorous, even though I'm not in a polyamorous relationship at this point. I'm in a monogamous relationship just because trauma and crappy living situations, not trying to yeah, but I totally understand what you mean by like the opening up discussions about the fluidity of relationships and the fluidity of love in general. We forget that love is an emotion. Love and happiness are the same thing. They're both feelings. So, just like happiness, love can grow, it can become something incredible, but it can also shrink, it can start to fade away, it can change, it can become something else and it can once again go back to being the love that it was before, with time, work and patience.
Speaker 1:Those emotions that come or live deeply within us.
Speaker 1:We can generate more of them by pulling them out of ourselves, and we do that by pouring into ourselves, if that makes sense.
Speaker 1:A lot of times I see other people relying on others to fill up their cup and I don't think it's their responsibility, and I think that leads to a lot of breakdown and unhealthy relationships when one person is relying on another to make them happy. So I've adopted this philosophy I'm responsible for my own happiness and my own joy, and if I don't feel those things, then it's my job to do the work to get there. And then, when I get into a relationship, I want to attract somebody who is also in that same place, and then we can magnify each other's happiness. But the point is that you can't magnify each other's happiness if your partner is depending on you to be happy in the first place. I think it's a danger to completely rely on another person, even though at certain points you know they may fill you with joy and happiness, like, for example, if somebody's having a bad day, okay, I know exactly what to do to make that person happy in the moment, but generally speaking, they are a happy person already. I'm not responsible solely for their happiness.
Speaker 2:Yeah, that's super important in order to not end up with things like codependency and stuff like that, where it's you know, the thought of being without the other person is not something that you can handle, and everyone needs to be able to handle being alone. Because if there's everything, we all got, one thing in common is that we came into this world alone and no matter what we're going to go out alone, it doesn't matter. If you're surrounded by everyone, you're the only one leaving Back to what you're saying about polyamorous relationships.
Speaker 1:I feel like more people would be capable of that if they would concentrate on filling up their own cup. Most people are not able to be alone. Most people jump from relationship to relationship. If you ask anybody how long they've been single, most people will tell you it's less than three months. So I now say, after picking up some important wisdom from people throughout my life you need to be alone for all the seasons. If you do all the seasons alone, then you're good, and that gets you back to self. It allows you to do the healing that you need to do. It allows you to get deep, to listen, to do the work, and so when you get to happiness, you get to joy. There's no room for jealousy, there's no room for envy, and so when you're okay with you, I think you can invite more out-of-the-box things into your life and you can do them in a healthy way, because there's no room for jealousy to exist.
Speaker 1:Those are those negative, vibrating emotions, right, there's fear and love. We come from two places in life fear and love. Everything that is born in life is born out of one of two places fear or love and love. States are happiness, joy, etc. Euphoria, as we've discussed and fear. States are envy, greed, jealousy, resentment, etc.
Speaker 1:And that's not to say that when we're fully grounded and committed to our inner work and doing it on a more regular basis, that we won't have times of feeling greed, jealousy, resentment, anger, etc. We are going to have moments of that. That's part of being human. It's to feel the palette of emotions. But we don't get stuck there and that's the difference. We don't make decisions from those places, those places of emotional charge. We can make decisions based on a ground that is with intention, that is not driven by emotions. People that are all anti-polyamorous I think first and foremost they are scared. There's a fear factor in that, that they don't really understand all the ins and outs surrounding what that relationship would look like. I think either they come from a different generation, which is one thing, or they just can't imagine themselves being in it because they don't fully understand it. One or, and or they just haven't done the work, they haven't done the inner work to arrive there.
Speaker 2:And that's totally fair. I also. I totally understand people are just like I'm just monogamous.
Speaker 1:Like I don't need more than one partner.
Speaker 2:I don't, yeah, like, like. I know people who are like that, where they're just, I'm just, they're just monogamous. They don't need or want more than one partner for themselves or want a partner who has, you know that other responsibility outside of them. And that's fair, all for you, as long as y'all are healed and healthy and good relationships. And I mean, these are some of the cutest fucking couples I know. I must say I ship that shit like FedEx, even though you're not supposed to ship real people. I don't care, my friends are fucking cute together and I love them. Um, but, yeah, like I. But I totally see where you're coming from. We're a lot of people who are anti-poly. It's not that they're just just like, I'm not poly, but good for you, you do you. But the people who are like straight no, that shouldn't be allowed. They need to go to therapy. You need to, for one, figure out why this makes you so fucking angry, because it doesn't involve you.
Speaker 1:I think it all boils down to where it stems from Like does it? Are you intentional with your decision, you know? Does it stem from a healthy place or does it stem from trauma? I think that's the defining factor in that Like. That's the silver lining. I think the most important thing is that people maintain the right to choose. I remember when New York State put through gay marriage back in 2011,. It was finally became legal and people were like so, anti-gay marriage? Well then, don't get gay married. Don't get gay married. You know, you, do, you, you, you let others do what they feel is right for them and keep the peace.
Speaker 2:There's bigger things that we could be doing besides outlawing polyamory.
Speaker 1:Totally so. I want to jump back to some of the presentations of gender dysphoria and, just as a disclaimer, I want to say that just because you experience some of these symptoms doesn't necessarily mean that you have gender dysphoria as a diagnosis. So it's a good thing to check with a health professional. I recommend a holistic one. That's again that's my lens. Go to a holistic team and get an assessment for that. But we're just going to share some things that are common, one of the things being a strong desire to be the opposite gender.
Speaker 1:In gender dysphoria, the primary thing is discomfort with your body, whether it's primary or secondary characteristics, sexual characteristics specifically, it could be body, hair, genitalia, the pitch of your voice, anything that is incongruent with your experienced gender. You can be very uncomfortable in social roles. You know under societal expectations, feeling like you are having to conform to certain societal gender norms or specific roles. You can be experiencing anxiety, depression, any kind of we'll call them burden of discontentment type feelings, with not being affirmed or accepted by others. Unfortunately, this can also lead to isolation, like that's a big thing.
Speaker 1:I just I really feel like we should meet people where they are, approach them by their pronouns. I thought it was awesome. On the news recently I was actually reading an article actually about next Benedict and how their mom was recorded and actually quoted referring to her daughter with she her pronouns, and then corrected herself because she said you know it's generational and I'm used to using she her pronouns with you know my kid, and she basically was like I screwed up, I take ownership for that. So let's give me grace, just as we should give others grace they're trying and just as we should give next grace, you know, she. I just have a lot of respect for her because she owned that and I just I love that.
Speaker 2:Yeah, I said I had seen that it would go fund me for next's funeral and for other kids. Any leftover money would be going to other children who are being bullied for similar reasons. Next, and in this, go fund me. Their mother had used their birth name and she her pronouns throughout like yeah, and that was one of the main reasons why Twitter, the cesspool of the Internet, got its hands on their dead name and on their old pronouns and unfortunately very quickly weaponized that and very quickly kind of spiral that out of control. But she handle that with incredible amounts of grace, more grace than I feel like I could have shown in a moment like that, having just lost my child and having people jump down my throat for misgendering them like listen, I get it. Like I said, twitter just assess pool of the internet was able to use that to weaponize against the entire queer community. It's not a good thing that it happened. That woman just lost her child. Give her some fucking grace exactly.
Speaker 1:It's amazing how fast they jumped on the opportunity to harass her and to judge her and to put her down in public, especially after having such a grave loss as losing a child. It's disgusting. I mean, not acting in kindness to others in general is just wrong and sucks and should never happen, but in the light of this tragedy it's extra fucking grimy and disgusting like let her have peace yeah no excuse absolutely not I say fuck, my mom would have done it.
Speaker 2:Guarantee you bet money on my life. My mom would have accidentally misgendered me if I were to, if I were to die in some like horrific anti trans whatever the fuck she would probably access because because she's a grieving mom like bro, what do you want? Yeah, they're trying to survive yeah, like I've seen mothers almost break their knees. They throw themselves to the ground so hard like bro yeah, you're there, they have.
Speaker 1:They have this new reality now that they're trying to process.
Speaker 2:I can't even imagine yeah, it's an entirely different world now. It's a whole different. Everything, every breath of that house and that life is going to remind her of them for a really long time, if not for forever yeah like. That is a kind of pain that, unless you've been through it, shut the fuck up yeah maybe just say I'm sorry for your loss and move on with your day. If you don't have anything nice to say, don't say don't say anything at all.
Speaker 1:I mean, didn't we learn that back in kindergarten really?
Speaker 2:I'll say it much meaner than they did back in kindergarten if you can't be nice, shut the fuck up shut the fuck up, yep.
Speaker 1:So back to some of the presentations and certain feelings and realities for people that may be going through some gender dysphoria. We talked about anxiety. We talked about depression. We talked about avoidance of certain activities or certain settings, especially in public.
Speaker 1:Some things that remind you of your assigned gender could also exacerbate these feelings of dysphoria.
Speaker 1:Having a strong desire for a gender-referring intervention so, whether it's hormone therapy or surgery or puberty blockers or whatever it may be, something to align your physical appearance more closely with your gender identity you can also experience heightened dysphoria during puberty, so these feelings of dysphoria may intensify during that time. There could be certain times where they tend to be magnified over others, especially with secondary sexual characteristics. So those are just some of the things that keep in mind. But, like I said earlier, just because you feel some of these things some of the time doesn't necessarily mean that you're diagnosed gd. It might mean that you're just, you know, you just kind of wax and wane in and out of these feelings. In and out of them.
Speaker 1:These symptoms are real and the severity can really vary, so just keep that in mind. I also want you to keep these presentations in mind, for if you have a child, or if you have children who have not hit puberty yet and they are starting to explore with their sexual identity and their sexual orientation. Also keep them in mind. If you know somebody who does have a child that hasn't hit puberty yet, just so that parents are better equipped to know what to look for, it's helpful absolutely.
Speaker 2:It's a very different experience for every single queer and trans person and that's why a lot of you know some people seek medical intervention, some people just socially transition, some people. It is different for everyone, so show everyone grace. We have some treatment options listed for those who do end up going to seek medical intervention. This is what would most likely be the course of action that your team would in some way, shape or form, take, depending on what you're looking for. These are right from the Mayo clinic, so these are just words from the experts relayed through the layman's mouth. You feel me?
Speaker 1:yes, wholeheartedly. I second that again. I am a chiropractor, I am a doctor of the nervous system and some of these things that we discuss on our episodes are not necessary a reflection of things that I would suggest that you do, especially considering that I have not had the opportunity to evaluate you as an individual. Some of these things are not under my purview to treat as a chiropractor and I don't even like the word treat, because I give my patients care from a very holistic lens and we first remove interference from your nervous system, we get your central nervous system functioning so that you can function at the highest level possible.
Speaker 1:I absolutely recommend chiropractic care for everyone in general, specifically the queer community, because I feel like our community has undergone so much stress that the things that we face are just so layered, not just with gender identity and sexual orientation that's different from the normal narrative but also traumas and relationships with other people, whether it's familial, romantic, etc. There's the different layers, like I was talking earlier about primary and secondary characteristics in your development as a human being. So it's very, very, very layered. But all to say that we are putting together these episodes to start a discussion, to make people more aware, to invite people to talk more about these topics and also to start thinking about their health and maybe to identify some of the things that you don't have answers for or you didn't have answers for previously. So now we can have a conversation, but, like I said, no matter how you decide to move forward, getting evaluated by somebody that you trust more specifically is very, very important, because treatment is very, very much individualized for you, or it should be anyway treatment is extremely individualized.
Speaker 2:It depends on the needs and levels of dysphoria for each person. So again, just go see a doctor. I was explaining socially transitioning earlier. I personally, at this point, am just considered socially transitioned. I've changed my name, I've changed my pronouns, I've changed my hairstyle, I've changed my wardrobe very much. So I've changed how I do my makeup often. Sometimes I do my makeup a little more masculine, sometimes I do it more feminine, sometimes I just kind of do it relatively androgynously, where it's just like dark around the eyes, kind of emo shit.
Speaker 2:Anyway, those who do decide to medically transition have mainly two options at this point, with how far we have come in the field of Medically intervening with gender dysphoria. You can do both of these options, only one of them, a combination of the two. You could do hormones for six to eight months or a year or whatever, and get a couple of the effects of it, like, for example, with non binary transitions. There are some Non binary, a fab people who will go on hormones for six to eight months and have a dip in their voice, have a slight Adams apple, have a slightly sharper jawline and a little bit of facial hair and then they'll. They'll get off of it and their period will return as normal. So long as they themselves have an average fertility and weren't experiencing any fertility issues prior to starting testosterone, everything should start back up normally and they have the maintained effects from being on that testosterone for six months.
Speaker 2:The slightly deeper voice that you know, those certain things tend to kind of just stick around for a while, even like with the three months I was on T. I noticed my voice drop about two octaves and it hasn't really gone back up, unless I like make it go back up. For, like customer service, I how are you style voice? So for hormones or transgender men, there's testosterone which can be taken in way more ways than I thought when I was offered tea. There's injections for those. There are two kinds subcutaneous and intermuscular. Subcutaneous is just kind of it goes in, I think, about an inch or so. Mind you, before you get on hormones. All of this will be explained to you by a medical professional, of which I am not, but yeah, subcutaneous, the needle just goes in a little bit. And with intermuscular, the needle goes in pretty deep and it has to be done in certain areas of the body to make sure it can go in deep enough. Subcutaneous is also only done in certain areas.
Speaker 1:The subcutaneous one that isn't applied directly on the skin, or am I thinking of the gel?
Speaker 2:Yeah, so usually subcutaneous is considered right under the skin, but the needle does have to go in a little bit. So like my stepdad used to do them for me and he would have, he would put in the needle like this much-ish, and then he would just kind of, so it basically went under the epidermal layer, so that thick epidermal layer of skin, so there's the epidermis on top and then there's other layers underneath. It has to go through all of those layers and then underneath that, whatever the fuck that's called. Like I said, I'm not a doctor.
Speaker 1:Well, I am, so I can help provide a little clarification here. So the subcutaneous layer is actually the most deep layer of dermis you have in the skin. You have three layers of dermis. You have the epidermis, the dermis and the hypothermus. The hypothermus is just another word or term for subcutaneous tissue or the subcutaneous layer, and basically its function is that it helps to connect the outer layers of the skin. So you have the dermis and epidermis to the underlying muscle. So that subcutaneous layer is actually the layer that's in between the two dermis layers on top and then what connects to the muscle tissue underneath. But yeah, the testosterone one that I heard of was the gel. It was the gel type.
Speaker 2:There is 100% testosterone gel. That does exist. There are also patches, which I thought was really cool. But yeah, subcutaneous and intermuscular are two different types of needles that are used to give testosterone. Intermuscular needles are just a lot bigger than subcutaneous. Because I did subcutaneous because I was already really nervous about injecting myself. In general I have a needle thing for some fucking reason I have a needle thing.
Speaker 2:So yeah, my ex was doing them for a while and then my stepdad started doing the shots for me and he had experience with subcutaneous needles from just being an EMT and stuff like that. I never even felt it. My mans was so good at doing my tee shots. Oh my God, if I ever thought about getting back on it again, I'd have to go.
Speaker 1:I didn't realize there were two different needle types. That's amazing.
Speaker 2:I have the needles downstairs. They're just shorter and a decent bit thinner and stuff like that, so you tend to have to go slower because the medication is kind of thick.
Speaker 1:That is pretty freaking awesome. I did not know there were two different needle types.
Speaker 2:And yeah, there's also gels and patches, which I thought was pretty cool. And yeah, the gel is applied daily at no need for needles. It is slower acting than testosterone injections like a lot slower acting. That's one of the things that I hear most common complaint from trans men, who are definitely afraid of needles and use the gel it is very slow acting. Or the patches same complaint very slow acting. But at the very least there's no needles and the needles are usually weekly or every other week, depending on your schedule, where the patches and the gel are daily. So that's another thing is having to remember to do it daily rather than only having to remember it once a week or once every other week, depending on your dosage.
Speaker 1:Yeah, and I think there's pros and cons to both. I would think that if I decided to do it, I would do the slower one, because the idea is that you're introducing something external into your internal environment, so your body needs time to process that. So if there's too much too quickly, it can have unknown effects or detrimental effects, or you could have reactions that you wouldn't be able to respond to fast enough if it were to be a slower drip. And also what you're saying about having to remember. Sometimes I feel like doing something every day might be better to get in the habit, to start a habit, because it takes 21 days to form a habit, rather than having to remember once a week or once every other week, like how out of sync with that habit would you be after seven days have passed or 14 days have passed. I would think that trying to implement something daily would actually stick better and be a little bit more structured.
Speaker 2:You're so valid. Even with me. With testosterone, usually the average dose that's given for injections is 0.5. So you fill the needle up to that little 0.5 mark. I, because of my size, was given only 0.25, which is about half that. So that's what they'll do for every transplant.
Speaker 2:Just because 0.5 is the average does not mean every single trans man is getting prescribed 0.5, because they also understand that introducing too much to people of different compositions could really fuck you up. And again, informed consent also really goes through that. Here's the emotional things that you'll start to expect, here's the physical things that you'll start to expect, and they do that for both the gel and the shots. So you'll know the time difference between the two and stuff like that very in-depthly before you step foot into it. I was aware that the biggest issue I was going to have was the anger spells that come from testosterone. I knew that years before setting myself up for tea. I was well, well aware of that, even just from having conversations with trans men. So there's a good amount of information that's given. There's a good amount of information that's available out there, and they are very careful with dosing each person in relation to their size, their composition, their other medications, fucking everything.
Speaker 1:And that's really, really important. It's good to hear too, because you never know. Everybody's different, they react differently. They respond differently, people have different tolerances, they have different allergies. You just you never know. It's better to err on the side of precaution, and from that, conservative lens operate that way more of the time. But sometimes I think people are just not, they're not at peace inside and they just want it to happen faster. So, but I think finding a balance between the two is probably the best route.
Speaker 2:That's entirely fair and, yeah, I feel like at this point, we have found a pretty decent balance with it, with making sure people are getting the results that they want in the time span they want, while also not doing things too quickly to the point where people are getting hurt, as long as, again, people are being honest with their doctors, people aren't getting their hormones in unsafe ways, people are properly storing their hormones, people are properly using them and you know, as long as you're doing it right, you're going to be okay.
Speaker 1:Yes. So follow the directions that your team gives you. It's for the best for your health and the results that you discuss with your team. So please, please, please, just follow the directions. For trans women, there's options, too with estrogen. There's the pill, there's the injection. There's also through the skin via gel, spray and patch, kind of similar to the hormone options for trans men.
Speaker 2:I will say what's very different is trans women, I do believe. I'm not 100% sure if this is still the case, but as of a couple of years ago, those injections are done in office. Unlike testosterone, estrogen injections can't be done at home. So testosterone injections are usually done by the trans person or by a friend or family member willing to assist them, whereas estrogen injections. I'm not entirely sure why those injections have to be done in office. Probably because the needle is much more advanced and in depth, probably something to do with the injection spot being a little more delicate. It could be any number of, but yeah, that has to be done in office.
Speaker 1:So I have a few thoughts on that. So when you have male hormones and you're undergoing feminizing hormone therapy, it basically starts by blocking male sex hormone receptors. So the first thing that happens is that the amount of testosterone entering into the body, or that the body is able to make, is significantly lowered. And this has to be the first step in that hormone therapy In order for the estrogen replacement to be added to that second phase of the hormone therapy. Now, just so that we're clear, this is hormone therapy that we're discussing in transgender women, but this can also be applicable to an inclusive of the non-binary individuals who were also assigned male at birth and considering feminizing hormone therapy.
Speaker 1:When you're undergoing this therapy, there's a lot of things that change there's physical, there's emotional, there's sexual and there's reproductive, and there's so many changes that happen in a short amount of time. People are coming from a place of they're ready. They're ready for the changes, and I get that and that's totally understandable. But we have to listen to our bodies. We have to do the replacement therapy to the extent of and at the rate that your body is currently able to make changes. So it depends on many factors and I know one of the things that's pretty common with the estrogen is the wide vagaries in mood changes and shifts, and that could be really dangerous. So maybe that's a reason why they do it in office now and I don't know previously if it had been done in the office or not but that could be one of the reasons why a doctor would want to take ownership of that and do it in the office.
Speaker 1:One last thing, too, to add is that the effects of the hormone therapy make the person feel like they're going through a second puberty, and puberty normally takes years for the full effects to be seen. So when you're taking hormones, taking higher doses of those hormones won't necessarily bring about faster changes and it could also endanger your health. So, as we were talking earlier about doing things slower versus doing them faster, I tend to feel like, like we said, everybody's different and from my lens, I think doing it properly should absolutely outweigh endangering your health. Even if you feel a little uncomfortable inside, I just hope that a person has the right team of people and the fact that you're making changes is amazing, and enjoy the journey of it, or at least try to as much as you can. It's there to help you. It's not there to cause you more pain. So, kit, do you want to jump into the surgeries that trans and non-binary people tend to look into and explore?
Speaker 2:Yeah, absolutely so. You see a surgery. There are numerous different kinds of masculinizing and feminizing surgeries available for trans and gender non-conforming people to help with their identities, matching their physical appearances. There are facial surgeries. There are jaw, again facial whole face, eyebrow, nose, whole face, I think collar bone even I've seen some people talk about collar bone. I'm not 100% sure about that. That one kind of confused me and scared me.
Speaker 1:I mean, yeah, that totally makes sense. But there's clavicle shortening and there's also clavicle lengthening. So the shortening or reduction, it's basically for width, so that when you shorten the clavicle it decreases the size of your shoulders. So for a trans woman it gives her a more feminine looking physique. And then the lengthening would broaden the shoulders in the same way, but opposite right, to give the trans man a more masculinizing physique.
Speaker 2:Fair. But yeah, I don't know. I heard something about that that would freak me out too much to look into as someone who has collar bone things.
Speaker 1:Yeah.
Speaker 2:There's top surgery for men or even for women. If you're a trans woman, you can get breast implants, while estrogen will help you grow breasts. Sometimes you know they're a little itty bitty-titty. Committee, you will be joining my club.
Speaker 1:Your club and mine.
Speaker 2:Yeah, if you would like to upgrade from our tier to another tier, that is an option. Is basically all we're saying.
Speaker 1:Yeah, and that probably gets a little deeper into the world of cosmetic surgery after that.
Speaker 2:Yeah, absolutely. And at the end of the day, all of these are considered cosmetic, right? What's the word? Not mandatory?
Speaker 1:The opposite of mandatory Elective.
Speaker 2:Thank you, elective procedures, yeah. And then there's bottom surgery. For trans women, bottom surgery is a much easier process at this point, technologically speaking, than for trans men. As my horrific ex so eloquently put it, it is easier to dig a hole than build a pipe, and they kind of weren't wrong about that. It's not the best way of saying it, but it's also not entirely wrong. Until we hit the point where we are able to see things like full transplants and things of that nature, it is going to be really difficult for bottom surgery to really be what we need it to be for the trans masculine community. But for trans women, I mean, I've been to a trans health conference and you know a lot of the times they'll show like before, during surgery, after it's bro, it's kind of weird because it's like oh God, a dick. And then it's like, oh, surgery, and then it's just like the most beautiful vagina you've ever seen and it's kind of incredible.
Speaker 1:Wow, that's mind blowing. That is mind blowing that they can even do that.
Speaker 2:Absolutely incredible shit. So, yeah, there are many different surgical options, all of which must be spoken through with your doctor. Always be honest about the things that you are ingesting, the things that you are doing in your life that could prevent you from getting surgery or make surgery a dangerous process, because we would rather you be here than anything else. Absolutely.
Speaker 1:You definitely want to be honest about everything, because you never know how withholding one little thing can affect the rest of your life.
Speaker 2:And then just real quick. The World Association for Transgender Health has the following criteria to follow for hormonal and surgical treatment with people who have been diagnosed with gender dysphoria. This is some but not all of the criteria, which is something we could do in an entire own episode about what criteria it takes in order to be eligible for hormones and surgeries, but this is just a couple of them. Persistent, well documented gender dysphoria. Capacity to make fully informed decisions and consent to treatment. Legal age for one's country or, if younger, they follow the standards of care for children and adolescents. If significant medical or mental concerns are present, they must be reasonably well controlled.
Speaker 1:I'd say those four things are a pretty good guide, baseline.
Speaker 2:Absolutely Now 100%. Because at the end of the day, even if they say there's someone who's experiencing severe suicidal ideation or some form of disconnect with reality and things like that, there has to be a handle on mental health conditions or even just physical conditions, life conditions outside of your gender dysphoria, in order to consider approaching things like hormones and surgeries, which do require stability in order to make happen I mean, even with surgery you need someone who's willing to take care of you.
Speaker 1:Exactly. And if you're already having symptoms, you don't want to exacerbate them, especially when you don't know how the hormones are going to affect you and mood swings and how your body is going to process the difference in what it knows as its current normal. You want to be able to function in daily life. You don't want to just survive through it. You want to be able to get to the point where you're actually thriving, you're actually feeling the feelings that you're striving for with making the decisions to get the surgery in the first place or do the hormone replacement therapy or someone, and so forth. So we just wanted to remind you gently because we know that it is a very, very layered and very complex place to be experience, and we just want you to know that you're not alone. So, kit, you want to jump to that fun fact?
Speaker 2:I absolutely want to jump to the fun fact. So the fun facts today is about porn. The oldest known pornography dates back over 3000 years, features male-male relationships, female-female relationships and female-male relationships.