To speak frankly, depression is a serious condition, particularly for those in the transgender community. The pressures on a transgender individuals are very real and can be scary. For me, being male has always been painful. This is a concept that is difficult to explain to those who are secure in their gender identity. Despite trying to bury the the feelings of wanting to be female, the desire was always there as the background noise of my life. As much as I tried to ignore the feelings and desires, they surfaced consistently. Sense of identity underlies one's health and well-being, and a transgender person can live with an uncertain identity for decades. More than just a feeling, I felt a true desire to live as a female.
On top of the drive, there are a unique set of pressures that begin to pile up. I lived in fear of being discovered. Religion, family values, and peer pressure are common examples of stimuli that can contribute, but a transgender person will have a unique set of pressures as individual as they are. The combination of a strong drive for something forbidden, pain fear, and stress easily add up to depression. If the attempted suicide rate identified transgender individuals is 45%, THE RATE OF DEPRESSION MUST BE MUCH HIGHER.
I am 41, and hold a PhD. in physics. I work at a national lab, designing specialized x-ray detectors for a synchrotron light source. I've been struggling with depression for approximately 1 year. When the depression got strong enough that I felt like taking my life, I have always had the presence to find help. I have a history of self harm, but I have always stopped short of a serious suicide attempt. I count myself as one of the fortunate ones.
Having said that, I have missed 14 weeks of work over the past year. I have been hospitalized for six weeks, and spent another 6 weeks in outpatient hospitalization programs. There is a cost to my lab in lost productivity, and approximate insurance costs for hospitalization have been in the ballpark of $100,000. Out of pocket, we have personally spent in excess of $6,000 for individual therapy with psychologists. The dollar numbers do not reflect the costs to myself and family.
So, why do I want to write about simple pleasures? Simply put, I am thankful to be alive right now. I was discharged from the inpatient program 10 days ago. I have not yet been cleared to return to work, but am participating in a "partial hospitalization program," an intensive outpatient therapy program. I currently spent 6 hours at the hospital daily, 5 days each week. The day is comprised of 5 hours of group therapy, with an hour break for lunch.
The good part of this arrangement? My depression has abated somewhat, and I have been able to attend my therapy sessions as a female. I initially attended outpatient therapy as a male, but switched to female clothing after a few days. I came out as transgender to the therapy group late last week. The response has been positive.
It's hard to express how relieved I feel as a female. The depression abates, and the extra stresses disappear. There are simple pleasures. People who use my female name (Rebecca), or gender appropriate pronouns (she/her). I was using the lady's room yesterday when an elderly woman entered and complemented me on my blouse.
I've become friends with some of the female patients in the program. Today one of the other women braided my hair. Luckily, my hair is naturally curly, and I've been growing it out for about 7 months. I normally just wear it curly, but was flattered to learn it was long enough to braid.
Simple pleasures....
Tuesday, June 28, 2016
Wednesday, June 22, 2016
Ups and downs: Transgender mental health
It's been a month since I've made a posting. I was unable to write because of a major relapse; I've been fighting depression since last spring. My previous posting was about returning home from a business trip to New York state. I was a little nervous about returning home. Let me explain why.
Just before going to New York, I had been approved for hormone replacement therapy; I was going to start taking estrogen in hopes of feminizing my body. While my wife had told me she didn't want hormones in our home, I figured it would be okay. It takes several moths of estrogen before significant effects take place; I just had to explain that to my wife, right?
Was I ever wrong about that. When I tried to explain things, she went crazy. She became instantly angry and suddenly my explanation became irrelevant. She told me she was going to take the kids on a vacation, and she wanted me to move out before she returned. Not only did I not have a valid explanation, I no longer had any rights. Suddenly, my wife was ready to tear me out of the family.
At first, I didn't know what to do. I hadn't expected such response from my wife. I returned home late to spend the night on the floor.
The next day was very difficult. My wife gave me an earful as I prepared to go to work. My initial plan was to simply keep the hormones in my office until the time was right. I didn't know what I would do about housing or other matters. On the way to work, a sister began texting me about possible disciplinary actions that the Church could take. That was my tipping point. I took the day off work and tried to make things right. I gave the hormones to my wife as a peace offering. I told her I would try things her way in order to save the family. I took a large portion of my female wardrobe and donated it to a local thrift shop.
That was just the beginning of a very miserable week. I later learned that I would also lose the services of a therapist that I had come to rely on.
The following week, I went to New York. I was in a terrible state. I spent three days somewhere stuck between two genders - the one I have but do not love, and the one I desperately want but cannot have. I finally cracked mid-week and bought women's clothing while in New York. I spent the last two days of the trip as a woman, and felt better about everything.
I came home from that trip late on the Friday of Memorial Day weekend. I relapsed into a full depression, and spent the next three days unable to get out of bed. Ironically, home was the one place where I had the least liberty to be myself. I just couldn't take it.
On Monday, my wife finally told me I could either voluntarily return to the hospital to have my depression treated, or she would call 911.
I went willingly. She dropped me off at the hospital, and then took the kids swimming at the local pool. I was admitted to the acute inpatient program at the hospital's behavioral health unit that afternoon for three weeks treatment. I came home late on May 20th. I'm continuing treatment in a intensive outpatient program. I will probably miss 4-5 weeks of work.
So, there are a few important take-aways. First, being transgender itself is not a mental illness. However, transgender people do have a high rate of depression for a variety of reasons. Being stuck in the wrong body has a lot to do with it. You know something is very wrong, but transitioning to the right gender can be very difficult. It is very common to feel stuck in a bad situation with no options.
Second, it's often the people we are closest to who are the most difficult. In order for me to transition, my wife wants a divorce, which I think is understandable. However, she has laid out a list of separation terms that are not very favorable. She wants full custody of the kids, and only wants me to have limited visitation rights. Any visits to the kids would require her supervision, and I would have to appear as a man. She does not want me to interact with the kids as a female. This one is hurtful. I think it's best for the kids to know openly why Mom and Dad might be separating.
Finally, I decided while in the hospital that I would transition. I don't know how things will work out, but this is something I need to do. Being male is not something I can take for much longer.
Just before going to New York, I had been approved for hormone replacement therapy; I was going to start taking estrogen in hopes of feminizing my body. While my wife had told me she didn't want hormones in our home, I figured it would be okay. It takes several moths of estrogen before significant effects take place; I just had to explain that to my wife, right?
Was I ever wrong about that. When I tried to explain things, she went crazy. She became instantly angry and suddenly my explanation became irrelevant. She told me she was going to take the kids on a vacation, and she wanted me to move out before she returned. Not only did I not have a valid explanation, I no longer had any rights. Suddenly, my wife was ready to tear me out of the family.
At first, I didn't know what to do. I hadn't expected such response from my wife. I returned home late to spend the night on the floor.
The next day was very difficult. My wife gave me an earful as I prepared to go to work. My initial plan was to simply keep the hormones in my office until the time was right. I didn't know what I would do about housing or other matters. On the way to work, a sister began texting me about possible disciplinary actions that the Church could take. That was my tipping point. I took the day off work and tried to make things right. I gave the hormones to my wife as a peace offering. I told her I would try things her way in order to save the family. I took a large portion of my female wardrobe and donated it to a local thrift shop.
That was just the beginning of a very miserable week. I later learned that I would also lose the services of a therapist that I had come to rely on.
The following week, I went to New York. I was in a terrible state. I spent three days somewhere stuck between two genders - the one I have but do not love, and the one I desperately want but cannot have. I finally cracked mid-week and bought women's clothing while in New York. I spent the last two days of the trip as a woman, and felt better about everything.
I came home from that trip late on the Friday of Memorial Day weekend. I relapsed into a full depression, and spent the next three days unable to get out of bed. Ironically, home was the one place where I had the least liberty to be myself. I just couldn't take it.
On Monday, my wife finally told me I could either voluntarily return to the hospital to have my depression treated, or she would call 911.
I went willingly. She dropped me off at the hospital, and then took the kids swimming at the local pool. I was admitted to the acute inpatient program at the hospital's behavioral health unit that afternoon for three weeks treatment. I came home late on May 20th. I'm continuing treatment in a intensive outpatient program. I will probably miss 4-5 weeks of work.
So, there are a few important take-aways. First, being transgender itself is not a mental illness. However, transgender people do have a high rate of depression for a variety of reasons. Being stuck in the wrong body has a lot to do with it. You know something is very wrong, but transitioning to the right gender can be very difficult. It is very common to feel stuck in a bad situation with no options.
Second, it's often the people we are closest to who are the most difficult. In order for me to transition, my wife wants a divorce, which I think is understandable. However, she has laid out a list of separation terms that are not very favorable. She wants full custody of the kids, and only wants me to have limited visitation rights. Any visits to the kids would require her supervision, and I would have to appear as a man. She does not want me to interact with the kids as a female. This one is hurtful. I think it's best for the kids to know openly why Mom and Dad might be separating.
Finally, I decided while in the hospital that I would transition. I don't know how things will work out, but this is something I need to do. Being male is not something I can take for much longer.
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