Cold sweat

When I asked Jeff for a prompt, he asked me to write about the exact moment I decided to go back – and what that decision felt like. There was no one moment, and I’m not sure I can identify a decision.

Transition in clinical process and popular imagination is about the proving of determination. Even the cliché, “I always knew, ever since I was a child, I always wanted to be a girl, I never felt like a boy,” is not an affirmative identification but an argument from evidence. Our early – earliest – memories allow our certainty – they prove that our condition is chronic, that we will never change, and so we have to live as ourselves. And under the demand I know and the declaration I knew is the appeal I tried, I did try.

In making this claim, we reject the dignity of medicine and law; we dispute the common sense of our audience and argue against every premise they have. By insisting that we are transsexual, we define ourselves as unreliable: biased for our wants, unbalanced by our needs, loony in our painted faces, histrionic in our repellent flesh.

So much of that testimony depends on an internal sense of self – and its subjective nature makes the demand for uncompromising assurance that much stronger. We cannot waver or we lose all credibility. Our desire must be pure.

I was confessing that I had become uncertain.

And as I stopped and began to change back, what I remember is not any decision. I remember going to these authorities in turn – my physician, my psychiatrist, my family, my friends – and asking them what I should do – what they thought I could be. I was not looking for advice so much as reaction.

When I understood that I could not go on, I believed that I could not go back. I believed that I was ruined – I wouldn’t exorcise this basic sense of calamity for years. I thought that I would never look normal – conventionally, unambiguously female, never visibly transsexual – again. I thought that I would always be marred by the changes my body had undergone in transition. I also believed, although I never articulated this idea, that my sanity had been irreparably disfigured. I hadn’t just made myself ugly. I had rendered myself unsound.

In retrospect, none of this was realistic – nor responsive to the explicit rationale of transition, nor related to the shape of my face or body or my physical response to hormones. If transition is reasonable, then retransition must be even more feasible. If I had been a normal woman, I could be one again. But I wasn’t thinking about transition in logistical terms – my feelings about this departure and return were almost spiritual. On a soul level, I felt compromised.  No, contaminated.  

So I reached out to everyone around me.  I may have been seeking reassurance, but I think I was also alerted to unease.  If they were as despairing as I was, then my prospects were low.

Regret, Part One

My first prompt is to describe the moment I decided to go back.  

There was no one moment when I gave up.  The decision I grappled with was whether or not to tell any of my care providers – and my friends, family, my audience.  I spent several months debating whether the feelings I had were strong enough to bring to their attention.  I believe I told myself I didn’t want to alarm them unnecessarily, but it was at least as much down to shame.  As I contemplated turning around and going back, what I felt was terror and shame.  

I was afraid that I would never recover from transition – that I would never look like I had before I transitioned, that I would never look normal, that I had lost claim to normalcy and beauty.  

I was ashamed to have failed my transition – to have offered up a false positive.  I felt as though I was disappointing my care providers, almost as though I was dropping out.  And so when I considered telling people, it wasn’t so much a decision to go back as a decision to confess my desire to go back.  

I’m not sure I made an independent decision – when I met with my doctor and therapist in turn, and when I spoke with my sister and parents, and when I took my friends out to coffee to explain, I was seeking guidance on what to do next.  I needed to see their reaction before I made my decision.

But to talk about those feelings – I can’t remember when I started to have misgivings.  Or, not misgivings.  Periodic depression.  Low feelings.  Exhaustion.  Inchoate sadness, unattached grief.  I remember being startled when I caught myself in the mirror.  

In retrospect, these were consistent, if intermittent feelings.  I should have considered them, and I should have alerted my caretakers.  At the time, I saw them largely as a problem to be dealt with, or hidden until they could be sent away.  I worried that I might be depressed, but I did not consider that I might be depressed as a result of transition.  I did not consider stopping transition.

I don’t remember when I reached a crisis point, or when I realized – or decided, or admitted – that these feelings indicated a serious problem, that they might mean I wasn’t really transsexual.  I know that it was some months after surgery.  I also know that these feelings predated surgery.

But I didn’t want to acknowledge them.  

Disordered, Part One

So as with gender identity, I go back and forth on whether I can apply labels like “mental illness” to eating disorders.  

On the one hand, it can help to use this framing to explain that people with anorexia and bulimia are legitimately crazy – that their conceptions of their bodies and diets are not based on any kind of logic, that they really do hold irrational beliefs about food, eating, thinness, and starvation, and that they can’t simply be argued out of their disordered behavior.  

But on the other hand, people with anorexia and bulimia are not psychotic.  They’re not usually institutionalized.  They can talk about having eating disorders without being stigmatized as dangerous – or irrational in general, incapable of making sense or telling the truth.  People with anorexia and bulimia are not generally deprived of their freedom or treated as though they should not be in control of their own lives.  Confessing to an eating disorder, current or past, does not make people anxious that you might relapse.  

Eating disorders are sometimes praised, or at least conflated with extreme dieting practices that themselves are praised; women whose bodies are too thin are beautiful, and women who eat too little food are strong and tenacious.  

And on the other hand, one gets into these thickets of really crazy, should you call yourself really crazy, do you have the right to refer to yourself as crazy, is it really as bad as being crazy, what if someone sees you referring to yourself as crazy?  And maybe it counts as a mental illness if you are afraid to name it; maybe it counts as a mental illness if it is shameful.  

Habituated, Part Six

I’m back in Michigan, and I can’t sleep because it’s five in the evening in South Korea and three in the afternoon in Cambodia.  

While I was living abroad, I had especial difficulty with time zones – when I first arrived in South Korea, I had a world clock on my desktop, and all it did was make me forget whether it was the middle of the day or the middle of the night where I was.  I thought this was just the consequence of living in so very many countries.  A feeling of dislocation.

And to be fair, I have lived in quite a few places – and moved back and forth across hemispheres between foreign gigs.  So it would make sense that my sense of place would loosen, and that I would eventually forget whether I was meant to be in daylight or not.  

To be fair, my life has been extremely stressful.  To be fair, I didn’t earn a living wage until last year.  To be fair, I have been exhausted.  To be fair.  

When I was in Argentina, and I first found out that I might have a thyroid problem, I was relieved.  It meant that I had an excuse for all my exhaustion.  I didn’t feel terrible because my life was terrible.  I felt terrible because my body was ruining my life.  And when I found out that my levels were apparently normal – depending on the standard you use – I was demoralized all over again: I couldn’t sustain my own life.  And when I found out that ameliorating stress did not take away my symptoms, I was ashamed: I couldn’t sustain normal life.  

And when I found out that I was hypothyroid after all, I was relieved all over again.  It meant that I wasn’t crazy, that I didn’t have a mental illness, that I wasn’t mentally ill.  I had a physical problem, one as easy to correct as anemia.  One supplement, once a day – your body will never resist it or fail to respond to it, and your symptoms will disappear.

And when I found out that I may have had a thyroid problem for a lot longer than I thought, I was extremely relieved.  Like I’ve said here, this means that a great many personality traits – a large portion of the negative ones – are symptoms.  They’re not me.  They’re my thyroid, little endocrine earthquakes.  

Having a physiological rather than a mental illness doesn’t only mean less stigma.  It means more control.  As I’ve talked about this with friends, I’ve said again and again that it is so wonderful to be spared the constant titration and re-titration of doses, the new medications when the older ones cease to be effective, balancing medications and side effects and supplementary medications.  Thyroid deficiency is easy to correct.  My health is under my control again, and I never have to worry about a lapsing brain again.  

And this too is a huge relief.  

I’m writing this because my body and brain are being disobedient, and because they’re obeying their marching orders to South Korea.  This diagnosis has allowed me to stop feeling so ashamed of my own brain, but it’s also allowed me to continue treating exhaustion like a pathology.  Not a trait, not a response, a symptom.  

Habituated, Part Five

My yoga instructor turns out to have had a thyroid condition – he has Hashimoto’s, and says that he was symptomatic for twenty years before he got treatment. His thyroid has been removed – he told me that it was springing nodules all over the place; I picture his thyroid gland looking like runny cheese or a wormy plank, riddled with complex holes, worn down on its surfaces – and swollen so much that it distended his throat.

He describes the removal as strategic in part: having had his thyroid removed, he could now demand thyroid hormone, since he was demonstrably incapable of any condition but hypothyroid.

He also mentioned that he experienced “brain fog” – that it caused him to “question his sanity” – and he recognized my own experience of not being able to think very well.

This is the common thread of thyroid problems, so far as I can tell: a bunch of minor deficiencies and lapses, blurring around the edges, an inability to keep track, sluggish processing. For me, it felt like a computer virus – or the advent of a biological one – a subtle yet constant problem.

I decided it must be an inherent problem. I developed a sense of myself as slow, prone to failure. I was flaky, absentminded, unreliable, sloppy. I had no sense of direction, no memory for names, no skill with numbers. I – and who knows, maybe this was common to expats? – wasn’t very good at keeping track of time zones.

And now I’m forced to reevaluate my whole personality in light of my clarified memory. It turns out that I am not overwhelmed by simple tasks. I can manage multiple deadlines. I can keep track of errands and papers. I can finish long-term projects. I can remember where I am and what time it is. I can clean my own house more or less as a matter of routine.

It went deeper than competency, too. I thought I was a failure in a global sense – I thought that the dirty laundry heaped on my floor meant that I couldn’t have a household; I thought the difficulty I had getting up in the morning meant that I would never have a career. And it was worse for being so subtle, so ambiguous: it wasn’t that I had sudden amnesia or fainting spells. I felt a little dim, a little stupid.

Habituated, Part Four

When I arrived in Korea, I had my two months of the lowest dose of synthroid.  I had already started to feel a bit better – my menstrual cycle normalized, my energy levels picked back up, I stopped feeling quite as dull-headed, and I started sleeping through the night and staying awake all day.  When I got low, I went to the doctor at the local hospital and explained my situation – at the pharmacy, they gave me a year refill, and I assumed I should simply keep taking that dose.  I figured I would return near the end of the year for another prescription. 

I settled into my narrow efficiency apartment and my lackadaisical teaching schedule, and I thought I was doing all right.  I was dependent on canned coffee – there are an infinite number of canned-coffee brands in Korea, and I found the most potent, cheap, and virulent brand – maize yellow and black in six-ounce cans.  

Several months later, as my contract year was heading into its last heat, I started to feel lousy again.  Tired all the time, slow all the time, unable to concentrate or muster any energy.  And my lovely, supportive group of friends in Korea noted the mild deterioration and told me I should see a doctor.  

(I had been second-guessing myself: What if I’m not sleeping well because I’m not sleeping well?  What if I feel sluggish because I drink coffee all the time so I can stay awake?  What if I just want more thyroid hormone so I can lose weight or something, and not because I seem to be having a recurrence of thyroid symptoms?)  

I went back to the local hospital, explained that I had started to feel cruddy again, that I was tired and subtly unhappy all the time.  They took a blood test, and then my doctor explained in his halting English – with frequent recourse to a pad of paper, on which he would write the same sentences he had just spoken – that I had thyroiditis.  He prescribed me a higher dose of synthetic thyroid hormone, which I duly started taking.

And within a week or so I felt like a whole new person.  It was the difference between being better and being well.  I could remember things!  I had energy!  I didn’t have to swill coffee drinks all day!

I also started doing some elementary research into “thyroiditis,” which the doctor hadn’t explained in depth.  

Glory

I’ve been thinking about cutting off my hair.  All of it.  To be honest, I think about it whenever I get drunk, but lately I’ve been toying with the idea even sober.  It might be because I’m here in Cambodia, letting everything go – I wear sweaty clothes and wrinkled skirts and pull my hair back in the same headband I took to the gym.  My shoes have begun rotting off my feet after a few trips through the rotten mud in Stung Mean Chey.  My hair is snarled and frazzled, dry in the heat and greasy from the weak water pressure of my guesthouse shower.  It’s easier to think about chopping off a tangled mess.  

But it’s still not easy. 

 

I go back and forth a lot in this dance of…call it employability, the dance of employability.  I have my hair because I want a job, I have my hair because my hair is acceptable, I have my hair because a woman with a shaved head might have a harder time finding a job.  There are the straight exclusion zones – the Emirates, say, where you can earn fifty thousand tax-free dollars a year if you have long hair – or Korea, say, where you can earn thirty thousand tax free dollars a year (plus a shoebox apartment) if you have long hair – or the United States, where having long hair won’t decide whether you get a job, but it may help you seem professional.  

Being attractive is professional.  Being normal is professional.  

These are the acceptable thoughts.  But under that thought is this one: If I cut off my hair, I will look like a fat ugly dyke.  

And there are other, concurrent bargains: you can cut off your hair if you are very careful with everything else.  You can cut off your hair if you lose weight.  You can carry off short hair if you are perfectly stylish otherwise – perfectly professional.  If you pay especial attention to your image, you can ward off fat ugly dyke.  

But otherwise, you have to keep your hair.

I have had a passive-aggressive relationship with my hair for quite a long time.  I hate caring for it and styling it – I tend to wear it simply if not sloppily, I don’t like dealing with it, I have no skill at styling or controlling it.  And I don’t seem to want to develop that skill.

But if I cut if off, I’ll be unprofessional.  Women with short hair are unprofessional.  Women who look like lesbians are unprofessional.  Women who look like lesbians have to work very hard to merit professional acceptance.  Women who look like lesbians have a harder time.  

If I cut off my hair, I will face consequences.  

And at the end of the day, these are my thoughts.  Not that I want to have long hair, or that I enjoy having long hair, or that I myself think my hair is lovely, but that I think that I will suffer if I cut off my hair, that I will be less worthwhile.  

I suppose it’s a pretty shocking level of fear and self-loathing around something as supposedly bland (these days) as a short haircut, but there it is.  I keep and cultivate my hair out of a sense of obligation.