Thursday I met with the psychiatrist who oversaw my transition and a few months of my re-transition. It was interesting–very brief, and anticlimactic; at this point, I’m not really in transition in either direction. She also clearly saw it as a one-time deal. She asked some questions about how I was, and what it had been like to come back. Her main focus was on why I thought I started transitioning in the first place (more on that later): what created a need to do something like it, and what made trans masculine transition so attractive in particular. And I do understand why she would be most focused on prevention as opposed to cure.
There was one aspect of re-transition that she didn’t ask about at all, although it didn’t occur to me until after the meeting. She didn’t ask me any questions about what it had been like to transition back under the auspices of my provider, or under her care. How I felt about the level of care or its direction, if I had any suggestions or complaints, if it seemed different from oversight during the first transition or maybe too much the same.
According to her, over the decades of her practice, she has only had one patient who transitioned more or less all the way and then transitioned back because they didn’t actually identify with their post-transition gender or feel comfortable in their post-transition body. Me. And this is what I hear over and over again: people like me are very, very rare. Close enough to nonexistent to not really exist.
But I do exist, and I think we exist. (When I quit, I was at most six months away from dropping my insurance and leaving the country; if I had made it a little further without turning back, she might never have heard different. It’s normal to use psych resources for as long as it takes to get approval for transition, and then to move on with your life. So I do wonder whether her count is higher than one.) If our physicians never see us–and if they consider us unheard-of or statistically negligible–they can’t possibly have a clinical model for helping us. There is no re-transition SOC.
I’m not sure, even now, what that would look like. And I don’t know if there’s any way to ameliorate the way I felt then or make the process any easier. I will say that my providers, this one included, didn’t seem to have any idea what to do with me. I can think of a few specific things that were wrong. In general, I don’t know if there was a clear picture of what my position was or what it might mean to me. For example, what’s the difference between transitioning to trans womanhood, and being able to transition to cis womanhood? How is it different to earn the female status you used to take completely for granted?
I get that a lot, actually–from different groups of people. Sometimes I’m not really transsexual; sometimes I’m partly transsexual; sometimes I’m transsexual twice over. I’ve used all three formulations myself. In session, I encountered all three ideas: that I was like a very lucky trans woman, or alternately like an adolescent cis girl, and then of course a rara avis.
Gender history isn’t like double-entry accounting; you can’t just tote up years spent in a particular place and count back to point zero. Going back–going forward a second time–wasn’t just like a first transition, wasn’t just like my first transition, wasn’t just like a trans female transition, wasn’t at all like staying where I initially had been. This process shared elements with all four ideas, but its refusal to map to any made it impossible to see as a simple combination. That’s the thing about gender: so much of what you are is based on what you’re not, a cross-border experience cannot be reduced to a sum of mutually exclusive parts.
I will say that I was made conscious of my total lack of cohort very early on–it’s a truism in the trans community in general that this almost never happens–and that this may have altered my perceptions of treatment. If I know going in that they’ve never seen this problem, how confident can I be in their ability to solve it? But if my first transition was a little too by the book, the second one was unmoored.
I said that there was no “re-transition SOC.” I think that…well, this is the thought process as I understand it. What about people who need to transition back, who aren’t really trans? (Trans-directed version: What if you aren’t really trans? What if you get all the way there and find out that it wasn’t for you?) Well, they aren’t statistically significant; in the aggregate, they’re barely visible. Therefore, this issue–mistakes, hindsight, evolving sense of self, immutability, physical and emotional dichotomies, ambiguity–is not a big one, but more properly a small problem to be folded into all the bigger, more important problems.
There is a tendency in the wider world to see trans as the place where gender fails, and trans people as failed or failures. Deviants if you’re hateful, casualties if you’re nice. But always and only a painful reflection of a larger system, not as a people in and of themselves. The crossed experience never assumes its own shape. I think that in some ways, the ex-transsexual, fake-transsexual, super-transsexual population is made to play that role in its own community. My care providers and acquaintances seemed to see my type, and my doctors seemed to see me, as the place where transgender fails: a solution we haven’t perfected yet, a practice that isn’t adjusted to all the right vectors, a useful net with one or two holes. Transitioning people, in turn, are forced to define themselves and their process in opposition to the fake transsexual.
I’m not that kind of ex-transsexual; my point is not that transition is not a solution or that my doctor did not provide solutions. But to see the margins as safely the margins seems like a bad way to move forward.