(Re)starting Transition

Nov 10, 2023 | About 3 min reading time

I've been putting this off for a long time now, but I think I'm going to finally talk to my family doctor this week about resuming transition.

As in, gender-affirming care. I want to go back on testosterone. It's been way too long now.

Quick recap for those who don't know: I came out as transgender at thirteen, started testosterone at fourteen, and then went off it at seventeen because I was constantly getting exposed to TERF (trans-exclusionary radical feminist) propaganda and there was... a lot going on in my life at the time, and I really desperately wanted to believe that the issues in my life could all be pinned on one convenient reason to blame, regardless of whether it made any sense. I haven't gone back on it since, because it turns out my gender was more complicated than I initially thought (I'm nonbinary and do still identify with womanhood), but I think I've also just been scared. I think the self-doubt from that period of time really got to me.

I am currently twenty-two years old, and my therapist who has been treating me for DID and PTSD wrote me a referral letter for top surgery almost a year ago now, so I've also been waiting for a response on that as well from the surgeon. I'll need to have more money saved up for that, though. My government covers the surgery, technically, but they don't cover liposuction because they see it as "nonessential" and this surgeon in particular will not do the surgery without liposuction because he believes it is essential to having a half-decent result. I have no clue if that's actually true or not (I'm betting on not), but this is the only surgeon in my region who does top surgery, and because of that my government won't cover top surgery if I travel to get it done somewhere else. It's a weird situation.

I'm glad my therapist wrote me the referral, though. They're also transgender, and they helped me get to a point in my ability to communicate with the rest of my system where we could confidently say we wanted top surgery. DID has also, honestly, given me a lot of anxiety about moving forward with transition; because if I might be a different part of me tomorrow, who knows what that part might want? Hell, I could even split new parts who want completely different things from me. Looking back, this may have been a factor in me going off testosterone as a teenager, as one specific part, Phoenix, was the host for most of that time period. Phoenix has much stronger dysphoria than the rest of us (which, it turns out, doesn't mean the rest of us don't have dysphoria), so when the situation he split to protect us from stopped, the rest of us suddenly felt much less strongly about testosterone than we were used to feeling, and we mistakenly assumed this meant we actually didn't want to be on testosterone anymore.

I don't think I feel comfortable fully explaining the situation with DID to my family doctor (I'm not formally diagnosed, because an evaluation costs about $4000 out of pocket and I have so many other things I need to save up for - but my therapist is treating me under the assumption that I do have it, and it's been more helpful than any other therapy I've ever had, so that says a lot), but I am going to try and talk about my discussions with my therapist to him and, you know, give him as much information as necessary so that he has a better idea of what's going on exactly. Hopefully he'll be okay with prescribing me testosterone himself, since he is able to do that here, and I'll try to bring along resources, my past prescriptions for testosterone, bloodwork, my surgery referral letter from my therapist, stuff like that so that he feels comfortable doing so, but if not, waiting a year or two to be referred to an endocrinologist is better than nothing, I guess.

Also, the current political climate is scaring me, quite honestly. When I first came out as transgender, I was out to pretty much my entire high school, and while there was definitely a lot of ignorance and some transphobia, it was nowhere near the level it's at now. I don't want to keep putting off transition out of fear and risk not being able to restart it as easily in the future.