How I knew I needed Surgery

Content Warning: I’m going to talk explicitly about sex in this post.

How did I know I needed surgery? It is a question I get a lot in different forms and it’s a good question, particularly for other trans people to ask each other.

My earliest inklings were from when I first learned what vulvas were. I was immensely curious as a child so I secretively turned to my local library and sex education websites to find out what women had that made them so amazing and supposedly so different. That’s when I found out the beauty that was the human vulva, vagina, and especially, the magical clitoris.

What was initially curiosity quickly turned into an obsession. And I doubt it was the same kind of obsession that my cisgender peers were starting to have as their libidos awakened. It crept into my psyche and my dreams. It wasn’t long before I was having both sleeping dreams and daydreams that involved strong, powerful women with both penises and vaginas. Because to me, the peak of human achievement would be having the best of both worlds. This was before I even knew that trans or intersex people existed.

It took me years of suppressed queerness before I finally admitted those dreams in group therapy as an early adult. And in the meantime I went through phases of hyper-masculinity as I tried to reconcile these desires to experience a vagina that kept pestering my brain. When I first had oral sex with a woman, the obsession only grew.

Eventually I finally got enough exposure to trans people that I realized I was one too. Not out of peer pressure like the media tries to paint it, but from seeing examples of people like me. I started out slowly and it took me awhile of my social transition before I decided to take any medical steps. You can see a lot of that progression if you read the early posts on my blog.

I had a lot of hesitation about starting estrogen because I was worried it would change how my already anxious/depressed brain worked. But once I started, I knew I could never go back. After the initial adjustment period, my brain had never felt more “right” and like I finally had the right operating system installed. But it did fundamentally change how I experienced sex.

I have always been hesitant and anxious about using my penis. But after starting hormones, there was some significant rewiring of my nervous system that took place and changed how I felt sensations. Suddenly an appendage that felt like a blunt tool now felt like a fine tip brush. It honestly felt like I imagine an inverted vagina would feel with a clitoris on the tip. My sensitivity increased immensely and I also lost all desire to use it for penetrative sex.

I had already started to think about surgery but my initial explorations had all been about whether or not it was possible to have a vagina and a penis simultaneously. I thought for sure that’s what I wanted because that’s what all my dreams still involved. I scoured the internet and couldn’t find anyone except naysayers who claimed it was anatomically impossible.

Finally, the first surgeons started to do what they called “penile preservation vaginoplasty” and my dreams were vindicated! Except ironically, by the time I discovered that, I was beginning to realize that it wasn’t what I wanted. I came to understand after almost 2 decades of dreaming that that form was more about what I was attracted to, not about what I wanted for myself.

Once I finally accepted that I wanted a vaginoplasty, the rest was just about getting through the medical gatekeeping. Last year when I went for my consult, I was sure that it was what I wanted. Now I am 120% sure and for months now I have been counting down the days (12) until I could finally achieve what I’ve secretly desired for so long.

I’ve been trying to decide for a couple years now if I am asexual or if I just have a low libido and as I think about life post surgery and all the sex I can have uninhibited, I think I finally have my answer. I just needed the right parts!

I’m in the home stretch now and I’ve started taking the pre-surgical meds. The Gabapentin is making my brain a bit hazy and I’m rather scatterbrained so hopefully this blog post makes sense. But in 6 days I pack up the car with my partner who will be my caregiver and her partner who lives with us and we drive down the coast to San Francisco.

12 more days!

The queer dilemma

I feel like one of the constant queer dilemmas in figuring out your identity is whether you want to “do them or be them” (or the demisexual equivalent, date them or be them). When you get your first glimpse of queer representation or that gay awakening moment, it’s sometimes hard to tell if you are attracted to that asthetic or person because you want to become like them or whether you have pants feels for them. 

For me, that moment came in my teen years when I first heard in the sex ed books I covertly read in the public library about people with both/all kinds of genitals. Sadly at that time I wasn’t reading anything by actual intersex or trans people so the terms I learned initially were highly problematic but the idea still stuck with me. That it was possible to have both a vagina and a penis at the same time.

It wasn’t long before that idea had seeped into my imaginations and people with hybrid genitals dominated my teenage fantasies, both waking and dreaming. For a long time, even after I started transitioning, I thought that was my goal. Two years ago, I tried researching whether it was possible and at that time there wasn’t anything published about it yet so it was only theoretical. Last year, I discovered two surgeons who had started offering a penile preservation vaginoplasty which gave me the chance to think about it seriously.

Now I am planning for my “classic” vaginoplasty and I couldn’t be happier about it (other than that it’s not soon enough!). I don’t feel any confusion or serious doubts anymore. But as I have thought about it more and why I thought I wanted more nonbinary genital options for so long, I’ve realized that it’s because I’m very attracted to that kind of body. The people I find hottest in the world are the folks who have a penis and boobs on the same body. And I’m so glad that the many people I’ve met who want that body now have more options to achieve that.

Statues

Reinterpretation of the Tres In Una statue by Paul Richer

I need new genitals like, now

Content warning: I’m going to be talking explicitly about sex here so proceed at your own risk.

I can’t wait for bottom surgery. As in the idea of waiting another 11 months seems like torture. I need it so badly and while it feels good to finally have it planned and even some of the money raised, it still feels like forever away.

I tried for so long to feel comfortable with the body that I had, but I only had mild success. There were times where I was comfortable with partners who I felt truly saw me that I was able to have enjoyable sex, but for the most part it always felt awkward and performative. I wanted the connection and release so badly but the means I had of accessing that weren’t great.

The best sex I’ve ever had has always been with queer sex. The kind of sex where someone’s fingers or toy is inside of me and they are using their mouth in the ways that it seems only a queer person can. And the most comfortable I’ve been penetrating others is when I’ve worn a strap on. Otherwise being in that role feels weird for the most part.

This week I decided to try having sex “the old fashioned way” one more time to see if there was anything I’d miss about it. I took some generic Viagra because I can’t have those kinds of erections otherwise anymore and had some anniversary sex with my spouse. And while I love having sex with her, it just felt awkward and I was distracted the whole time by how uncomfortable I was. It felt like I was using body parts that didn’t belong to me but that somehow still transmitted sensation to my body. And not in the good way like I’ve managed to access a couple times. We eventually stopped and switched over to the ways we know we both like.

I feel like that was the moment that any last shreds of doubt I had were banished. I’ve proved to myself that my dysphoria really is “bad enough” to warrant the amount of money I’m spending and the amount of pain it will take to get my new vagina. Which is a terrible way to feel. Like you have to justify not wanting to be dysphoric all the time by degrees of severity.

So this week when I met with the PhD level psychiatrist to get my letter for the red tape of insurance approval, I was able to say with confidence that I know I’m making the right choice. And luckily I can also say that I have the right support in my life now to make that plunge. My work and my spouses work are both being very supportive in giving us the time off to go down to San Francisco for a month. And my community has been so generous in helping me raise $880 in less than a month already (plus a promise of airline miles) to put me well on my way.

If you are able to donate to support me as well, I would be very grateful. I can’t wait to finally get this surgery. https://www.gofundme.com/f/haven-gender-confirmation-treatments 

What is dysphoria?

So I’ve talked quite a bit here about my experiences with dysphoria but I’m not sure I’ve ever attempted to define it, partly because it is a tricky concept to convey to someone who has never experienced it. But I’ll take a stab at it with the disclaimer that trans people don’t all experience dysphoria in the same way and some trans people never experience it because contrary to what psychologists think, being trans doesn’t require dysphoria. Some people are lucky enough to discover their true self through the experience of gender euphoria which is when you have extreme joy in finding something about your body, presentation, or the way people perceive you that affirms your gender.

On most days, I have a low level of background dysphoria going on. Some of it has always been there and I was kinda successfully ignoring it and some of it may not have been and has developed or been revealed as I’ve gotten closer to bring other parts in alignment with my gender. It’s hard to look back and accurately know what I was thinking in the past because one of my experiences of gender dysphoria is that my brain blocks out a lot of memories that don’t align with who I really am. A lot of my past is fuzzy or completely blocked from my consciousness due to trauma as well.

What I do know is that there were times that do clearly stick in my head where I experienced bursts of gender euphoria as a kid such as when I would play dress up and walk around in heels, or when I would play imaginary fairies or mermaids with my sister, or when I felt accepted as “one of the girls” in my friend groups. A lot of that went away as I reached an age where gender roles were more strictly enforced and in particular, a lot of my puberty is blocked from my memory both due to how I was treated by society and because more of my dysphoria started becoming apparent as the wrong hormone was taking front seat. I am so jealous of kids who have affirming parents and figure it out early enough to use hormone blockers or transition early on before the wrong puberty goes too far. It makes a lot of things easier.

One of the things I do know is that early on, stubble gave me dysphoria similar to how it does now. That, and my dysphoria around my prominent chin, are the biggest reasons I grew a beard at 18. I was getting to the point that I would have to shave my chin twice a day to look clean shaven. At first it was just a goatee but by 21 I think I was able to grow a full beard. A positive for combating dysphoria at the time but unfortunately now I have to get rid of all that thick, dense hair very painfully.

On a daily basis, dysphoria is like having little pin pricks constantly poking your skin. Or like wearing shoes that are too tight. It’s annoying and eventually it brings you to a breaking point. Everyone’s tolerance of that breaking point is why some people don’t come out until later while others figure it out early on. That can also be helped along by someone effectively helping you find the right size shoe and suddenly you realize how they didn’t fit all along. And trying to push past that background pain every day is exhausting and means that you can’t bring your full self to what you are doing until it is dealt with. I sometimes wonder where I would be in life if I had been born cis and been able to just move along happily through life without having to stop and deal with the dysphoria or the self worth issues that go along with it.

On days when my dysphoria is more acute, that pain is brought more to the forefront of my mind. Sometimes it is bad enough that I will look into a mirror and I can see enough to style my hair or assess my outfit but my face will be completely blurred out – as in I physically cannot get my brain to see my facial features. Dysphoria, as far as I can tell, is the brain not being able to handle the cognitive dissonance between the reality of your brain’s self image of you and what is physically in front of you. It also means that even on less bad days, parts of my body are often distorted so that what other people see isn’t the same as what I see. For me that most often revolves around my chin, or shoulders, or body hair. I will look at myself and all I can see is what feels to me like a giant, cartoonishly distorted chin with a cleft so big that I feel like Gaston from Beauty and the Beast.

Another way that dysphoria plays out for me, especially lately, is that an area of my body may feel completely absent. Most days now my genital area essentially feels like a black hole. It doesn’t exactly feel like there’s nothing there but almost the opposite of nothing like antimatter or something. That’s probably the biggest reason I’ve been much more asexual lately, at least with my own body. It is hard to think about sex when your mind is actively avoiding thinking about what body parts you might use. I’ve had to be much more creative and luckily when you have queer partners, using your own genitals isn’t as essential.

I’ve found that what helps the most when I’m feeling actively dysphoric is to focus on the parts of my body that I do like. Often it doesn’t help to have people compliment the areas you are feeling dysphoria around because it just brings more attention to them. But focusing on things like how great my legs are or how soft my skin is gets my mind to see the positives and less of the negatives. Sometimes affirmations can be helpful though, even if in the moment you can’t hear them. Lately I’ve been feeling more dysphoric around my speaking voice but when I’ve told people that, many have told me that it isn’t particularly deep and is actually rather feminine. Those are the things that I come back to later and think about when I’m struggling.

The reason that it is so essential to have insurance that covers gender affirming treatments and low barriers to accessing them is because dysphoria is such an insidious beast. It often feels like you can’t be a whole human until these parts of yourself are aligned with who you really are. And ultimately, all most of us really want is to be fully seen as ourselves. So please, don’t put up barriers to keep trans folks from getting there.

PS – I just remembered another trick I found to help combat dysphoria. Find things that you can do with your body to make it feel like your own that you can focus on when the rest of it feels wrong. For me it really helped me to be able to see myself to get my ears pierced, get fun glasses, get visible tattoos, and dye my hair. These things remind me that I can make changes because it is my body and my rules.

Sex vs Gender: two sides of the same coin

So I know a lot of trainings, including many written by trans people, like to separate sex and gender into different concepts. But in my experience they aren’t all that different and are so integrally tied that you can’t actually separate the two. From an external perspective I think sex is what you are assigned at birth because doctors and parents make an assumption about a binary future for you based on your genitals (and sometimes force surgeries on intersex babies if they don’t match that vision because sexual characteristics aren’t binary either). Gender is what people assume about your genitals and often your behaviors and experiences based on visual cues later on. They are just two sides of the same coin. The only real difference is what external markers you are using. When I was born they assumed I was male based on my genitals and now people assume things about my genitals based on signs such as my beard and build.

Well this gets complicated of course when you are trans or nonbinary. You can do a lot to change your external appearance through clothing, hormones, and surgeries. And since sex isn’t actually based on chromosomes since most people have never been genotyped, I think those changes arguably change your sex tangibly as well. I don’t think I am a feminine person with a male sex. I now have breasts and an estrogen dominant body that is clearly and visibly nonbinary now. I would need to make major alterations at this point via surgery to go back to being a male.

So when I see forms that ask me what my sex is, I get annoyed. You can ask me what my sex assigned at birth was as a data point if you need. But my sex and my gender are the same thing viewed from different lenses.

Now internal gender is a lot harder to define but that’s a post for a future day.

Exploring surgery further

Content warning: I’m going to be talking about sex and genital surgery. Be forewarned.

Now that I have done some work in therapy to work through my fears about surgery, I am starting to explore my options in earnest.

For years I thought that I wouldn’t want to get surgery unless I found an option where they could add a vagina while keeping my penis intact. This was partly based on how I envisioned myself and those I was attracted to in my dreams as a teen. Before I knew that trans people existed, most of my imaginations centered around people who had both sets in tandem, sometimes with retractable phalluses and always with breasts. A year ago I tried to do some research to see if that was possible. At that time they had just successfully done the first neo-vagina made from peritoneum, the internal connective tissue in your abdomen. But everywhere I looked people either weren’t talking about that option or claimed that it was impossible to construct a vagina without damaging the penis.

So I had pretty much given up on that idea and gotten on board with a standard penile inversion vaginoplasty. But this time when I started doing research on surgeons I came across the website of Dr. Heidi Wittenberg who mentions that for gender nonconforming people she offers a penile preservation vaginoplasty. I can’t find many details online about the technique but apparently it involves using skin from another area such as doing a tummy tuck or a strip from the thigh. The scrotum is still used to build the labia and the phallus is left intact. And I hear from other trans people that she isn’t the only one. There are several surgeons who trained under Brownstein and Crane who can do this.

The odd thing is, now that I’ve finally found the thing that I always thought I wanted, I’m not sure that’s actually what I want. The more I think about it the happier I am with the idea of having a well constructed neo-vagina. I’ve seen the work that surgeons can do firsthand and it is incredible how hard it is to tell that it isn’t natal.

Luckily I don’t need to decide just yet. Next year is my jaw surgery (hopefully with some chin correction while I’m at it) and I know I can’t afford both in the same year so this will have to wait until at least late 2019 or probably 2020. My current plan is to go to both Gender Odyssey in Seattle and Philly Trans Wellness to learn more about the current techniques and hopefully catch Dr. Wittenberg’s presentation. I can get a consultation there and schedule something if I want. I do like the idea of having a surgery done with someone who recognizes transitions outside the binary and can talk me through the options. Not to mention that she specializes in Gynecologic urology exclusively for trans people and is considered an expert in neurology and minimally invasive surgery. Currently her waitlists appear to only be 3 months which is much better than most of the surgeons out there.

What I have noticed is that making up my mind that I do want surgery and giving myself permission to explore that in earnest has improved my sex life quite a bit. My libido has picked up and I find myself more ready to utilize my penis now that I know it is short term. It almost feels like I want to make good use of it while I have it as a way of wishing it goodbye. I have also noticed a difference in sensation as my brain rewires itself for estrogen. The head of the penis is more sensitive almost to the point that it already feels like I imagine a large clitoris must feel. And stimulation on the shaft somehow evokes the sensation of being penetrated. Not sure how to describe that and how much is me envisioning it in different ways but it does feel more and more like what I have right now is an inverted vagina, not the same penis I used to have.

That may be TMI but you can’t say I didn’t warn you.

Thoughts on surgery

My brain has been rather obsessed lately with thinking about if and what next steps I should take in my transition. So I’ve been trying to figure out what my options are around gender affirming treatments and beginning the very overwhelming task of delving into the surprisingly difficult question of what do I actually want.

Unfortunately I’ve found, with the help of therapy, that that question is very deeply tied to the related question of what do I actually believe I deserve. I didn’t realize I had so much around self worth entangled with my transition. While I 100% support my friends who pursue gender affirming surgeries, I have a hard time convincing myself that I am worth spending that much money on. I had the same issue with my upcoming jaw surgery to correct a crooked internal angle that prevents me from biting on one side. A lot of emotions came up as I went through the steps to book it and talked with my spouse about the money involved. I don’t know the full costs yet but so far we have shelled out $5,500 out of pocket for the braces and I have some significant guilt around needing her help to do that and taking away from money we could use on other things, especially in this political climate.

I firmly believe that while surgeries and treatments are definitely not required to be a valid trans person, they are medically necessary in various forms for many of us as important treatments for gender dysphoria. And I certainly have been having a lot of increased dysphoria lately. But when it comes to the next logical step of then believing that I deserve these treatments, I fall into the trap of hearing all the naysayers whispering in my ear about how trans people are too expensive and a burden and, and, and…

So I’m trying to work past that part of it. But there are also other fears to conquer. I realized I have a very deep fear that I will go through all these steps to try to get closer to the person I know I should be seeing in the mirror and still not feel like I can achieve it. I worry that being so close will just make the last little bits that I can’t change, things like not being able to be pregnant or have the kinds of sex I want, even more frustrating. That’s certainly the biggest thing holding me back from thinking about vaginoplasty.

I realized recently that vaginoplasty is covered by my insurance. Of course there are no surgeons in Western Washington and wait lists are a mile long but theoretically, this is one of the easier things to accomplish financially on my list of options. But that is also the one I was most unsure about. Mostly because I was afraid that I would have complications or worse, that I wouldn’t be able to orgasm afterwards. I don’t particularly like the equipment I have now but at least I know how it works and have figured out how to get it to do what I want, at least some of the time (though that is getting harder while my brain is undergoing estrogen rewiring projects). And is it worth the risk for the potential reward? And am I just caving to transmedicalists (aka truscum, people who think you need surgery to be trans) and societal pressure if I take a more linear transition path?

Arguably, the things that would make a much bigger impact on my dysphoria and certainly on my ability to function in the world are facial feminization surgery (FFS) and hair removal. Unfortunately those are the things that my insurance has classified as “cosmetic” and doesn’t cover. Hair removal is top of my priority list and as I discovered last time, is very expensive. So I am trying to call around and see if I can find a clinic that would work with me to fight insurance and advocate with my doctor for its medical necessity.

Facial feminization is a greater challenge. I’ve realized only recently that the main reason I keep my beard is because it hides my chin, which I can’t stand looking at in the mirror. I’ve obviously grown to love it as evidenced by the name of my blog and how much it has shaped my identity. But it’s also just a tool to reduce dysphoria which has the unfortunate side effect of making me hypervisible. And even in a city like Seattle, it’s no fun being able to be spotted as trans from 3 blocks away. Increasingly I’ve been realizing how much my beard shapes how exhausting daily life in public is for me. But I don’t think I can shave it off unless I at least have a plan for what to do about my chin.

My chin is rather prominent and cleft. In my head and when I look at photos of the few times I’ve shaved (only twice in 12 years), it looks like Gaston from the animated Beauty and the Beast – comically large and masculine. There is a possibility that with estrogen softening my facial features, I will end up liking my face without surgery. Or that after my jaw surgery I will like my look better. But I am honestly scared of having to shave next winter to do that.

Facial feminization is a very expensive proposition. I’ve heard estimates anywhere from $7k for just the chin to $30k. And the odds of me getting insurance to cover it seem pretty slim. I did take the step of emailing my jaw surgeon to see if there is any chance he can leave off the portion of my chin he was planning on rearranging in the surgery or if he would be willing to partner with a specialist to do the work while I am already in surgery. No word back yet though.

I have talked a lot with several trans women in my life over the past couple weeks as these thoughts have been distracting me which was very helpful. And the more I talk about it, the more I realize just how much I’ve been trying to ignore my dysphoria out of fear and shame. I desperately want to be the self confident, visible, bearded trans icon that people seem to think I am. But the reality is that I am having an increasingly hard time looking at and thinking about my face and genitals. When I shave my chest, stomach and legs, I can almost start to see something that looks attractive. And sometimes a good photo can make me feel ok about my face. But my crotch often feels like a black hole on my body, something that doesn’t exist. Or sometimes my genitals feels like a fake nose someone glued on my body when I look in the mirror. And it makes relationships a lot harder when you are moving farther along the asexuality spectrum.

I need more time to think about it but I wanted to get some of these thoughts down while they were still fresh. I don’t know what the answers are yet but I’m increasingly starting to think that the fact that I can’t stop thinking about these questions means that these are inevitable steps I have to figure out how to take.

On a lighter note, if I eventually get rid of my beard, what should I call my blog? The Artist Formerly Known as Genderbeard?

Increasing Dysphoria

Isn’t being on hormones supposed to help dysphoria? I mean it’s helping my confidence in my chest and overall shape but it’s definitely bringing up more feelings about my face in particular among other things. The biggest effect that estrogen has had so far other than breast growth is that it is making it harder to ignore things I’ve been burying and ignoring.

I often have days where I look in the mirror and literally see a blank where my face should be. My brain can’t handle the cognitive dissonance between my real appearance and my identity. And even more often I find myself avoiding mirrors or hyperfocusing on my hair to avoid looking at my facial features. And I can’t decide whether growing out my hair would help that or make it worse.

I’ve kept my beard thus far because it hides parts of my face that I can’t handle, especially my chin. But more and more I wonder if it is doing more harm than good. I get stares everywhere I go because people don’t know what to do with a bearded person in a dress. And it makes it so that I can be spotted blocks away as trans. I mean it’s not like I can hide easily with my height and tendency to wear bright colors, but maybe I don’t need to make myself that easy to spot. It also gives me a lot of “not queer enough” feels and makes me avoid spaces that are supposedly for femmes because I don’t think I would be accepted with my features.

But the thought of removing my beard and having to come to terms with the face underneath terrifies me even more. I am dreading what is going to happen when I’m forced to shave next winter for a long planned jaw surgery to correct my bite. But I also find myself wondering if there’s a way to capitalize on that to change my face. From what I remember of the consult, they are already going to need to make adjustments to my chin to make my face symmetrical and I wonder if I can talk the oral surgeon into taking some of it off permanently. Or if I could work with him to do a combo jaw surgery and facial feminization technique. The thought of cutting open my face twice doesn’t sound pleasant.

Then there’s the matter of my genitals. I’m feeling more disconnected from them recently which goes along with my feelings of asexuality. Most days I’d rather forget they are there and sometimes my brain does that for me. The other day I was on a date and I was trying to get myself in the mindset but everytime I thought about what was between my legs all I could picture was a black hole. I ended up not being able to do anything with my own body because I couldn’t reintegrate. Luckily queer sex doesn’t revolve around a penis or any specific kind of sex. But when I think about bottom surgery I’m still not sure whether having different genitals would help at all.

I’ve also realized that I only feel confident at all when my chest, stomach, and legs are shaved. Which even with the estrogen means trimming twice a week. I need to go back for more hair removal but I can’t decide between laser which requires $1,400 up front for 3 sessions (probably twice) or electrolysis which has more guarantee of permanency and I can break into smaller chunks but means more sessions.

Basically I’m feeling dysphoric most of the time now but I don’t know what to do about it and what interventions would help and how I would pay for those. So my brain gets overloaded with that background anxiety and I end up being less productive or mildly dissociating. I know I should try to do things that connect me with my body more instead of just escaping into video games. But I have a hard time figuring out how to do that in ways that a) don’t involve gendered locker rooms, b) don’t trigger my asthma (running is out of the question), and c) don’t make my back and neck pain worse.

There’s a little peek into what’s in the back of my brain most of the time these days. So when you ask how I’m doing and I say I’m fine, please know that there is a giant asterisk there.

Debunking “Biological Sex”

So this is probably an unpopular opinion but I think the term “biological sex” is meaningless, as is the distinction between sex and gender. While I continue to hear trans people use it and share it in various forms such as the problematic genderbread person, it is primarily used by cisgender people as a way of convincing themselves that the binary does exist in some form even if they support diverse gender identities. But as a biologist (by training) and a real life trans person™, I am here to tell you that it is just as much of a shared illusion as binary gender.

Hopefully by now you are aware of the existence of intersex people. According to the Intersex Society of North America, “intersex is a general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male.” Without going into excruciating detail because you should hear it from intersex people themselves , both chromosomal sex and reproductive organ configuration exist in more than two options. There are 6 different ways that chromosomes can combine (X, XX, XXY, XY, XYY, and XXXY) that create various different kinds of humans and most people never have their chromosomes tested so using this as the basis for your gender is ridiculous. And various other changes in development mean that regardless of genetics, genital variation is nearly infinite.

But even putting intersex people aside for a moment, let’s talk about how useless the term biological sex is when you are dealing with reality. Many trans people such as myself have known from an early age that our brains are different. Long before I ever knew the term transgender or nonbinary, I thought that I didn’t fit in because I didn’t have a boys brain. And more and more evidence suggests that the brain can develop in utero in ways that more closely match the gender identity that child eventually expresses than the gender they are assumed to be based on external signs (although even that research is hopelessly binary). Though huge disclaimer here because there is no one way to be trans. Not everyone knew they were different from birth and not all trans people experience things like dysphoria.

Ok, so say you put aside natural variation in genitals AND you ignore differences in brains. Well I hate to break it to you folks, but the differences continue to be useless. Trans people do not all experience socialization the same way or come out at the same age so there is no point at which you can make a valid argument that we are somehow “essentially male” or some such bullshit. And there are MANY different kinds of gender confirmation surgeries that make trans bodies infinitely variable and often indistinguishable from their gender.

So what’s the point of this? It means that you should stop using terms like “female bodied” or lumping people together based on binary genital arrangements. And you should stop saying things like “all women are” and reducing your research to binary sex results. Yes, statistically there are vast swatches of people who never have cause to question their gender or assumed sex. And you could do your research based on those people and ignore the tails of those statistical curves. But you are missing out on some of the most amazing parts of human experience when you do so. I am here to tell you that the conversations that happen among trans and nonbinary people behind closed doors that cis people rarely get to experience would blow your mind! And because of constructs like “biological sex”, many of these people intentionally avoid revealing that complexity to cis people and often rule out dating or interacting with you altogether.

So if you want to benefit from what we could bring to the conversation, think deeply about how you can be more inclusive and the assumptions you make on a daily basis. We are here and we are so much more queer than you could possibly imagine.

Getting creative with sex

Content warning: Description of sex and genitalia

This is a first for me. I don’t usually write so publicly about the actual details of how I have sex. But I had a moment I am really proud of this weekend that I thought other people mind find helpful.

So here goes.

Are you ready?

Lately I have been having difficulty having sex that involves my penis. Partly it is dysphoria but mostly with the estrogen and the low libido it is causing I am just having a difficult time getting and staying hard. I’ve used generic viagra for awhile now for ED because I had so many issues around sex anxiety that I was working through because of how my ex messed me up. But before I started E I was using less and less. Now I need to take any time I want to use that part of my body.

But this weekend I had a date with my spouse and I was feeling more sexy than usually and decided to take the viagra. Predictably as we were getting ready to have PIV intercourse my dysphoria kicked in which usually would have put a quick end to it. As I touched myself to put lube on, it literally felt like my penis wasn’t my own and wasn’t part of my body. But this time I found a way to work with that feeling.

Without even thinking too hard about it my brain decided to make that a part of the sex. I conceptualized my penis as the best strap-on dildo ever. It was both attached to me and not part of me at the same time in a really hot way instead of a disturbing one. I could feel what was happening but it felt like I was feeling that through something else instead of directly. The part that I’m most proud of is that I was able to make that switch so smoothly that it didn’t interrupt the flow and we had great sex and I told my partner about how I had done it afterwards.

I’m not sure if I can always do that but hopefully the memory and success of that moment is transferable. How do you find ways to use your body through dysphoria?