Trigger Warning: This post mentions castration and talks about self-medication.
Cradled in my hand are two little pills which represent a very desired, but equally uncertain future. They are the first step on a journey. They will be recognisable to many transgender people, at least those of the M2F variety. But these pills are also controversial.
They are Spironolactone and Finasteride. Both of them are androgen suppressors…they prevent testosterone from binding to the receptors it needs, and thereby deny its effects. They do not affect the levels, just the action. You might have heard of Finasteride as a treatment or preventative for male pattern baldness—a lucky side effect for a treatment whose origins was to prevent prostate cancer. It may or may not work. But as an androgen suppressor, it surely does.
I bought these pills on the black market over a year ago. I have been carrying them in my bag wherever I go, ever since. I was going to start a course of Hormone Therapy the day I first met ex-Mistress, and for some reason that day, put this course I was already on, on hold. I forget at times that I had already decided to come out before meeting her…I think what I found with her was more courage.
But I hesitated and hesitated because I was afraid of two things: hormones after a while create irreversible body changes that are noticeable, and what about my libido?
It may seem strange to you who have read previously that I hardly ever have orgasms. I don’t masturbate…at least not in the sense that I play with my whatsit. Never have, never will. I also haven’t had sex with my wife for 15 years. You would be forgiven for thinking that I have a low libido. But I don’t. I think I have a very high libido. Off the charts. I am totally and utterly sexual. I don’t want you to think that I am always thinking about sex, or always have a hard-on…but in a way, I am very, very often aroused. Its different than what I think about male arousal though…in my case, arousal is born from emotion.
It is impossible to know the lived physical experience of another human, let alone a class of humans. By the body I was born with, you would think I would know what it is like to be a man. But in so many ways, I don’t. At least not physically. When I am aroused, and I mean really, really aroused, so hard I think the skin on my cxxxk will rip, the idea of conquest is the last thing on mind. I believe that most men want to fxxk when they are in such a state. Me? I am paralysed. My skin is alive to touch. I just want to melt into somebody, to touch them and be touched by them everywhere at once.
Not once in my life, not once, have I ever leaned in for a kiss, taken a kiss. Never. Not without asking, or just saying how badly I wish to kiss. Recently, I experienced this. Her lips so close to mine the air was crackling between them. My mind was shrieking, “oh my Gxd, is she going to kiss me? And I was doing somersaults around the room, hooting like Daffy Duck, stars and purple explosions were going off in my mind, in my whole body. And yet, I was beyond still, not daring to move, not even to breathe, wanting to stay this way, as if in stasis, my new equilibrium.
So, I get aroused, especially at night or in the morning. I wake up in the middle of the night with a powerful arousal, and while it is felt most prominently in my loins, the truth is that I can take that feeling and spread out, and I do, and I can feel it washing over me, suffusing every part of me, my skin especially, and it feels so incredibly good and erotic. I love this feeling. It is so powerful that it can paralyse me in a state of desire and arousal for hours on end. Like permanent edging.
I have been afraid that I would lose this and that it would never come back. I have the good fortune of being a member of a number of transgender support groups, and we can talk about scary stuff like this…what happens with desire when you start taking hormones.
What I have been told by so many trans women is that desire and libido on estrogen is very much there, very powerful, better even, but that it is different. I can embrace that, especially since I have never enjoyed coitus—its just too much…[part of me is sorry for that, mainly for my partners, because on some level, I think that most women really want a good, hard you-know-what every now and again. While I have done that, it isn’t usually in me—though it has been with a very small number of women who have engaged with me in a more aggressive way—and when it was intensely emotional at the same time].
I don’t know what the percentages are, but the numbers are huge. I might even guess that a majority of transgender people self-medicate at some point on their journey. Why?
- Doctors are expensive.
- Not everyone has health insurance
- Not every health insurer covers HRT for trans people (finasteride is used to treat old men with prostate problems, but getting it as a transgender person is often quite tough—another example of medical gatekeeping)
- There is no consensus within the medical community about what the correct and best protocol is for a trans person to follow
- Gatekeeping is rampant: when people make it humiliating to ask for help, or who impose certain conditions…
For these and other reasons, often personal, people choose to take matters into their own hands. What is very clear, however, for almost every trans person? You need to become super informed, prepared, able to became your own advocate, and absolutely your own physician. What other “condition” could be so complicated to get treated for? Can you imagine how disempowering and degrading it is to go through this?
I recently applied to start HRT on the NHS, the British Health Service. Nothing doing. Even going private. Nothing doing. There is a four-and-a-half year waiting list. There are 165,000 people in front of me in the queue. Yes, there are that many of us who are that desperate and disoriented about our own bodies and gender to take this step. And you know what? Just to get on the list you need to get a letter from your GP (call that your family doctor) who in effect gives you permission to seek gender reassignment. And do you think that your GP knows much about this? Probably you will be the first, because your GP is determined by where you live. So you go to your local doctor. How many of them judge you, or put obstacles in your way?
What else? Well, once you get your first appointment, you have to demonstrate commitment to a full transition. Full transition. What does that do to people like me. Non-binary? What about people who consider themselves women, and might resemble one in every single way, and that is that last step of cutting off the whatsit…take Eva Robbins for example, an Italian transgender movie star. She is a beautiful woman. She also happens to have kept her anatomy intact. She would be denied care in the British system.
I am not here to rag on the NHS, because I sure wouldn’t trade it for the US system, I just point it out as an example of two things—that a government has the audacity to say what we do with our bodies, and might presume to know better than us…and that the binary is alive and well—that people like me, the in-between, have no place in most societies.
What’s My Goal
I am not a man. I love saying that. I say it over and over. They are strange words to feel in my mouth. If you are a man, I dare you to try. It will feel weird. Say it out loud. I’ve been saying it for years, and it feels something good.
I don’t want to be seen as a man either. I don’t like the way that women look at me when they see me as a man. If it is with desire, it scares me, as it puts a burden of expectation on me that makes me uncomfortable…and if it is with fear, my soul shrivels. If I could identify one thing that makes me want to disappear, it is a woman who reacts to me as if to say that I might be a predator.
Do I want to be a woman? I can’t be. At least not in the way that I would want to be. Not anymore. Was I non-binary from the outset? I don’t know. I knew I wasn’t comfortable being male; I knew that I wished to be female…all from such an early age that there was never any conscious happiness of being a boy. It was wrong from the outset. But my deepest fantasy in this regard was to be able to be able to change sex at the press of a button. That I could go back and forth. I guess those are non-binary fantasies. I can remember dreaming of those with an intensity that only children feel for things they want–like for Christmas presents—only this wish has never faded, only grown stronger. In fantasy stories, with the magic wand, the wish granting that all children dream of, my fairy godmother always turned me into a girl.
Today, what I have come to terms with is to be somewhere in the middle; visibly a little bit of both. I’d be dead if I wasn’t born with a body that was already predisposed to this. I feel so deeply for my sisters and brothers whose gender identity is so utterly different from the body type they have been given…oh, the pain. Such courage.
But being non-binary is not about having no libido. At least, I hope not. But androgen-blockers do exactly that. I am surprised that this would be “acceptable” to men who are given these drugs to deal with their prostates. Death or manhood. The game is quite different for me, but because it is death and manhood, so there are only positives—except the side effects.
It is a bit hard to describe just how quickly they work. Literally, within about two hours I felt completely dead between my legs. No stirrings. No nothing. And my libido? Completely gone. It was so dramatic and complete that I thought I should try to make something happen down there. I thought about every erotic thing that has ever excited me. Nothing. It was kind of weird, almost as if it wasn’t there anymore.
I don’t want to suggest that I haven’t read up on the topic. I have. Extensively. For years. But this was beyond what you can read. You have to feel it, or not, in this case. And I was puzzled, perhaps alarmed.
I love my libido. I don’t want to lose it. I love being aroused. I am told that on estrogen, it will come roaring back in new and beautiful ways…but having no feeling at all is kind of scary. I googled to find out. If I were to imagine what it is like, it is the same as castration. Indeed, it is effectively the same thing as a chemical castration.
No big deal, right? After all, that is what I am after. But at what cost? I read up more. I found my way to a superlative article in Slate.com that talked about the politics of androgen blockers, and it really spoke to me [if this issue is of real interest to you, it is a must read]. The argument ran that trans healthcare is born of a binary world by binary people who think that every transwoman wants to go all the way, that castration is effectively exactly what we are looking for. Never mind the concept of non-binary, which may wish to medicate to some in-between stasis point that leaves a mixed libido.
Both finasteride and spironolactone have plenty of other heavy side effects: liver damage, mental fog, depression. I can’t afford to have mental fog…not at least for the kind of work I do. I also picked a hell of a time to take a drug that depresses one, right during a divorce, which can’t be positive even in the best of times. Total stress.
Simultaneous to these I have been taking a cocktail of natural plant phytoestrogens—one of which has the side effect of bringing on lactation. I would love that. But what I do feel is an itching in my breast area, a sensitivity, and my nipples going bananas…sticking right out when I go for a run. There are times when my skin is so sensitive that my shirt stimulates them erect. I have lost my fear of breasts. I don’t want them, but am prepared to accept them as a consequence of being more female.
The other thing that was happening? I was crying all the time. Feeling really emotional. And it was happening at random times, from random thoughts. I felt out of control. And then I started forgetting things. All of this over a period of ten days…plus feeling like I had pain in my kidneys. It was too much. I freaked. I was just really, really scared.
I dropped the Spiro. I went to one of my trans support groups. They’d all been through it before. “Get used to it,” said one. “I cried for two years,” said another. “Puberty’s a bitch,” said another. “Why don’t you just get an orchiectomy [remove the balls]?” was one helpful suggestion. Only in a trans support group would this be such a natural question. I will, of that I am sure. One day. I know a domme who publicly fantasised about castrating her husband, preserving his testicles in resin, and wearing them as earrings. I could be down with that. [The irony? Her husband, uber straight, uber body building, has just come out as trans. And what happened? She kicked him out. I feel for you my trans sister!] The other irony? The idea of getting castrated actually appeals to me. This is an area of NSFW that I have written erotica about which would most certainly get me in trouble with the Thought Police. I don’t even sell that stuff on Amazon–world’s largest purveyor of literate smut. Nope. Literotica only–free.
Back to the meds. The good news? Once you start in earnest on “e”, you don’t need Spiro anymore. It has taken 2 weeks for my libido to come back, though I am still taking finasteride, which seems to affect me less. I am not depressed, not forgetful, and my happy self has returned. Libido is reduced in the sense that I don’t have the same frequency of arousal, but it is still there. Another noted side effect of Spiro which I don’t see anywhere else? Stiffness of the lower back, and. pain in the kidneys. This stuff is serious! I can’t wait to stop it, but it is an effective way to drive down Testosterone levels and make the body ready to receive “e”.
Of course, I shouldn’t really care about the physical-sexual effect, as it delivers results quickly…but I did. It was too much, too fast.
The Concept of Diet
I have been learning a new meaning of the word diet from shamanic circles I am moving in. This is a kind equilibrium state that you get in your body when you cut it down to eating only what you need, typically well, healthy ingredients, and your body gets into a kind of zen place. Then, when you take something, or eat something, and do it regularly, it is known as “to diet” a particular substance, herb, ingredient. It works. This is what I am doing with finasteride. This is what I am doing with phytoestrogens. It seems to be working. Even my brother-in-law commented on my hair.
Depression as a side effect of a little pill is most definitely not desirable. After all, life is plenty challenging…and given my life circumstances right now with divorce, untangling everything, my main therapist thinks that depression is a real risk (even if I have never been prone to such things)…and what I think about is how people with whom you had a bond…people you thought you could count on…people you. thought you knew, or at least hoped you knew…friends, lovers. My favourite therapist says to me, “there is only one person in this room who loves you unconditionally,” and she waits a long time for me to figure it out, because I’m like that, I need it totally clear, and then says, “you.” But I never wanted to be alone. But nothing drives it home more than losing people you thought you could count on. And my wife appears to have been married to someone else for all these years. I wonder what he’s like. I haven’t the faintest idea. Good riddance.
Sharing the burden
I need to tell more people about what I am going through. I can’t confide in just one friend. Thank goodness I have more than one therapist…sometimes you need to talk to more than one, and I sure hate to be boring and dwell on things, or keep coming back to the same issue, so the faster I can get it out of my system, the better…they don’t need to know that I had to talk about something four times before I was able to move on. Amiright?!
And thank goodness too for sex workers.
My need for physical intimacy and touch is going through the roof, and I can’t cuddle that much with my friends before they think something’s up…so thank goodness for the beautiful feeling of touch that comes in the orbit of a sex worker, be she a tantric therapist, a dominatrix, a good old-fashioned escort, or whatever. It’s enough that they are interesting, and I think in all likelihood most of them are. I don’t see it as good fortune that the SW’s I have had the pleasure of meeting have been fascinating and wonderfully deep and enriching people to be around…I suspect that most of them are like that, if you feel like listening and they feel like talking.
I’m scared. When it really gets down to it, that is exactly what I am. Scared. This is my jourey. Both good and bad.