Edit: Just wanted to take a moment to say thank you to all of the kind and informative responses I am getting here, and for all of the constructive discussion I see going on in this thread. You all are amazing. 💜
I’m 34, came from a conservative home that was in a Christian nationalist cult. The idea of homosexuality was an ultimate taboo, I didn’t even learn what “transgender” was until well after puberty, well after I’d casually had the thought to myself that being a woman wouldn’t be so bad. Well after I’d been chastised for playing dress up with my mother’s clothes despite the fact my brother never did.
Even when I did learn of the T in LGBT, I had so many excuses as to why that didn’t apply to me. I’m just overly imaginative. I just get along with some more naturally than men. I just see women as people and feel strongly about their issues because I’m a progressive egalitarian man.
Even when those excuses failed me, I told myself I was genderfluid, or nonbinary. And in many ways those both definitely apply to me still. I do not experience dysphoria existing as a man all the time.
But today I cracked. I messed around in faceapp and touched up a photo of a time id shaven and had my wife put makeup on me and I cracked. I cried. I let myself feel that deep sense of longing I’d always instinctually suppressed.
And then I realized I was well and truly fucked. I live in Oklahoma. I have a child. And I live under some of the worst conditions to be beginning a journey that is being persecuted more than ever….
Wild to suggest as THE first thing for someone who experienced gender dysphoria for the first time to directly experiment with HRT. I don’t know, seems like that would be something like step 4. I get that it might help one to help with finding the truth but maybe start with something less invasive?
And no, I am not a gatekeeper. I supply trans people with HRT. People who came to terms with their transness and don’t want to wait for the bureaucracy to get it for them.
for a lot of us HRT is a terrifying step and we build it up as you say as invasive and risky - this is mostly due to social pressure not to transition. In reality, the risks are extremely low to non-existent, and the potential benefits are literally life saving. A lot of lives would be saved if HRT were the first step. It very often clears up depression, anxiety, and suicidal ideation without any other treatment, and for many it feels like the first time they were starting to be alive.
Clinically I think it’s unethical to play into false narratives that HRT is risky, irreversible, or severe - instead I think it should be part of the first steps someone takes when they come to realize they have dysphoria, since the risks are so low and the clinical benefits are so well demonstrated.
Not that I don’t acknowledge the psychological reality that it will continue to be perceived as risky and something people should wait to do and thus will be a scary and intimidating step, but then I feel that is all the more reason for those of us who know better to try to help compensate the social pressures against HRT by encouraging and reassuring early transitioners that HRT is low risk and life-saving.
One of the reasons I list it as the first step is because the depression that is so common in untreated trans people makes everything harder to deal with, egg cracking and looking at how to socially transition is stressful enough without depression, so by treating the debilitating anxiety and depression those challenges will be easier to take on. Simply put, addressing depression first helps address everything else.
Before estrogen, I could barely manage to go to the grocery store once a week. After estrogen I was able to clean and declutter my house, run errands multiple times a week, and generally became mentally normal for the first time in my life. So many of us experience this, and from a clinical perspective it seems more than worth it to encourage that treatment be started as soon as possible for others with similar symptoms. In the worst case scenario, if after a few weeks no mood changes happen and it’s not helping, they can stop HRT if they don’t feel like continuing at that moment.