Gender transition isn't what you think it is, Part 1: Psychological Transition

A series on psychological, social, legal, and medical transition & what it means to be trans

Those of you who are not transgender/nonbinary, what are (or were) your first associations with “transgender” or “gender transition”? Like, free association, what words or concepts pop into your head?

“Sex change”? Surgery? Genital surgery? Hormones? Pronouns?

Famous trans people like Laverne Cox or Caitlynn Jenner?

Various slurs that I won’t type here? Very popular p0rn categories?

When I was a little kid in the 80s, the closest association I had was Boy George (who is not trans at all; he just liked breaking rules of gender expression). Thankfully, transness and trans care have much more visibility, awareness, and accessibility (remember Laverne Cox on Time magazine and “the transgender tipping point”?) But now we have the backlash. In recent years, a hurricane has caught a lot of people up with misguided fears, unfounded rumors, misinformation, and disinformation. These have been leveraged into unnecessary bans and policies that are harming very real people.

So let’s break it down. What are we really talking about when we talk about gender transition and gender-affirming care? (I’ll get into the specifics of gender-affirming care for different age groups in later posts.)

I find it helpful to break down transition into several major categories: psychological, social, legal, and medical. This gives us a framework to organize things around, but it isn’t The Truth or The Way. Just a way. To keep things relatively bite-size, I’ll write one post per category.

Psychological Transition

Psychological transition is a person’s internal awareness and realization of being transgender or nonbinary (or gender fluid, Two-spirit, etc.). It’s recognizing that your gender differs from the gender assigned at birth. When I was born, the doctor looked at me and declared, “It’s a girl.” But once I had the words, I could begin to express my boyness. One label for that is gender incongruence.

Psychological transition itself can be broken down further into stages that are more-or-less linear: “awareness that your gender is different,” “realization that you are trans/nonbinary,” and “acceptance of your transness.” I had a 35-year gap between the first and the second.

For me, awareness of some incongruence between my internal sense of my gender and what my parents were telling me about my gender started around age 3. I declared I’d be a boy when I grew up. I thought I’d grow up with whiskers like Dad and join Boy Scouts and Little League like my brothers. Sure, I preferred blue to pink and liked Tonka trucks and catching lizards, but I also liked cooking, embroidery, Anne of Green Gables, and other typically “girl” things. Those are elements of gender roles and gender expression.

But when the kindergarten teacher said, “Boys line up to my left, girls to my right,” I deeply felt that I was supposed to go in the boys’ line. I always felt I was faking it with the girls. I had big brothers and a big sister, and I shared a room with my sister, admired her, etc., but my default was to think of myself in the same category as my brothers—not my sister. This describes my gender identity—who I am—not just what I like.

Because of social norms and my parents’ conservative religious approach, I was forced to push away that boyness. But it didn’t disappear. Instead, it gnawed at me. I couldn’t name it then, but that was gender dysphoria, the pain and discomfort that you may feel because of gender incongruence (but not inevitably).

Decades later, I was able to put the puzzle pieces together and realize I’m trans, but it took a good 18 months to embrace it and accept it fully.

Therapy or counseling can be beneficial here and can be considered a part of psychological transition. I started seeing a therapist who specializes in gender identity after I realized something was going on with my gender. Once I realized I was not a woman, I felt a keen urgency that threatened to burst out of me.

As any good therapist should, he supported me as I figured things out, but never pushed. In fact, it took me months of seeing him before I could say “I’m a guy,” and he admitted he saw the signs from the first session. But he waited for me to get there on my own. Then he listened while I spent an entire year trying to figure out what to do about this new knowledge of myself.

In my book, psychological transition is all it takes to be trans/nonbinary. Even if you never come out to anyone.

You know it. You feel it. So you are.