Who are we, what are we?

One of the more difficult parts of this gathering stage is the definition of regret, which is amorphous–more described in its absence.  Re-transitioners are a tiny group–a tiny minority within a tiny minority.  They’re also a misunderstood minority within a misunderstood minority.    

Rationales for transition–and the threshold motivation for transition–have an evolving definition within the gatekeeper community.  When Harry Benjamin wrote his treatise on transition, his threshold was essentially a terminal case: someone who could not function within society, someone who might well commit suicide without access to treatment.  That definition has softened over the years, in part because the original proofs of that desperation can only be found through clinical inhumanity.  Deep and intractable need continues to be a property of transsexuality as a clinical and community definition and a proof of the validity of transsexuality as a human condition.  

The definition of transsexuality operates within a sense of assigned gender as profound: losing gender is almost like losing a part of your body or brain.  Gender is a social language; the amorphous refuse to speak to the rest of us, the transgender tell us lies, and the transsexual mutilate their own apparati.  Whatever your reasons for that willful self-destruction, they had better be good.  Activists and community members have challenged this assumption, but it is still current.  To the extent that transsexuality is regarded as gender instability, it is regarded as frivolous, unserious, irresponsible when it is not insane.  It must be both justified as necessary and dignified as sensible.  

Still, what is that need based on?  When a patient describes that need, what psychological referents do they rely on?  How deep does it go?  

The varying answers to these questions mean that there are varying wrong answers: just as people disagree on the properties of transsexuality, so do they disagree about the properties of regret.  

My therapist believed that she had only seen one other patient who had ‘gone back,’ transitioning back to a male identity and ceasing or reversing the transition process.  She believed that her patient was in fact a transsexual woman–at least, experienced significant dysphoria as a man and significant comfort as a woman–and that her patient had transitioned back due to family and social pressure.  She named conservatism, especially religious conservatism, as a factor.  

In other words, I am alone among her patients: the only one who really made a mistake when I claimed to be transsexual and embarked on the long process that would turn me into a man on the outside.  My need was not desperate or profound or intractable.  It was not even there.  

(I’m going to have to start drafting the “So, what the hell were you thinking?” section right away.  Put a pin in it.)  

That makes me a rarity.  In her experience, which is much more extensive than mine, it makes me unique.  

I could challenge her methodology.  The gatekeeping model, wherein the therapist scrutinizes the patient’s case for transition from multiple angles, introduces certain complications into the relationship.  Patients may feel pressured to hide parts they feel don’t fit, and may feel a more generalized sense of vulnerability and mistrust.  She may have encountered regret–not decisive but present, even in a patient who made the right decision–that she could not see.  The gatekeeping position also means that the relationship is not normally therapeutic: patients see therapists because they want to solve emotional problems; trans patients see therapists in the context of transition because they want permission to transition.  Even when emotional complication is not a barrier to that access, it is beside the point.  The therapist may not even be particularly interested in exploring deeper or parallel emotional issues.  I have to say that mine did not seem terribly concerned, although she may have seen me as well-adjusted and generally happy.  

There are valid reasons for this partial relationship.  Trans patients may not want or need therapy per se, and may feel this attention to be intrusive.  Given that there are few ways to go forward without approval from a counselor, you could argue that it would be unethical for a therapist to act as a therapist towards a patient whose participation is coerced.  Moreover, the overwhelming majority trans people report zero regret: it is a factor to guard against, not a factor that trans people hold in common.  Based on what trans people say about their process, most trans people do not need therapy for emotional problems resulting from transition, because most trans people do not experience emotional problems in transition.  

This conflict between traditional therapeutic motivation and the role of the doctor in transition exists in the original.  Harry Benjamin’s thesis was a reversal of the idea that transsexuality was sick and that transition could only be a deepening of the sickness.  He argued that a transsexual person–someone “trapped in the wrong body”–only required transition to bloom into emotional and mental health.  A patient in transition wouldn’t need counseling to deal with difficulty or stress because there would be no difficulty or stress, only joy forevermore.  There is plenty of space in his model for supervision, for interference.  Apart from the open-hearted charity he tried to attach to his humane advance, curing a grateful patient of a consuming disease, there isn’t much space for emotional support.  

There was thus no space for regret.  Any dubious or complicated feelings were grounds for disqualification.  Doctors were encouraged to root them out and fix them before the patient was allowed to transition; patients were encouraged to be absolutely sure prior to transition.  Each stage of transition involved a delay while the patient became accustomed to the preceding change.  Regret was defining: you either wanted it completely, or you didn’t need it at all.  

This definition does not match my experience.  I believe that complication is common, and only natural.  The overwhelming majority of trans people are right to transition: transition is necessary for them and has a strong positive effect on their wellbeing.  But no matter how necessary, no matter how supported, transition is difficult.  Even someone who never feels regret will deal with a significant amount of stress and emotional turmoil when assuming a new identity and a new body.  The trans people I know, none of whom regret transitioning, none of whom feel alienated from their new identities, all report that transition was a traumatic and overwhelming process at times.  

I encountered only a few people who believed that they should not have transitioned.  I’m the only one whose cross-gender identity was apparently mistaken.  One was transgender: androgynous or butch, very invested in feeling masculine.  That person believed that they had gone too far by transitioning into a male identity and body: they missed the sense of themselves as queerly gendered.  The other person transitioned and had complicated feelings about their new body, but did not feel mistaken in claiming a male identity.  I was the only one who fled, the only one whose rejection of my male identity and body was decisive.  

Three people, three regrets.  


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