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Severe anxiety & coming out (lemmy.blahaj.zone)

cross-posted from: https://lemmy.blahaj.zone/post/13974203

Hey, so I [17 MTF] have now known I'm trans for a bit over 1.5 years. Still, I have only come out to precisely 2 friends and my parents, even though I am a member of several groups that are trans-supportive. I have extreme anxiety when it comes to that.

Some reasons that I believe are part of why: (CW transphobia included)

  • My parents didn't take it super well and are kind of on the edge between transphobic and supportive. (They have a lot of transphobic views but are generally not malicious about it and try to use gender neutral terms for me most of the time.)
  • One of the friends turned out to be quite transmed despite being trans herself, and has invalidated me on several occasions for not having enough dysphoria at the time.
  • I'm scared other people won't take it super well and I have no functioning support network.
  • I'm scared I'll be seen as some kind of abomination
  • I don't really feel like I "deserve" to come out since I haven't started HRT yet (and my parents do not support me starting, so I have to do this in secret) and don't feel like I pass well enough. I know I don't need to, but telling my anxiety any of that has no effect

This anxiety is absolutely crippling my progress. It extends not only to coming out but also leaves me too scared to even make an attempt to pass. I look pretty fem already and have sufficient voice training for most situations, but I don't even attempt to use that voice in public just in case it might slip. For this reason, everyone assumes I'm male very quickly upon me saying anything, which also leads to the anxiety worsening because now I'm also scared it was the looks and not the voice.

Additionally, I am non-confrontational to the point of fawning a LOT, which means I end up trying to appease anyone I have a conversation with even when there is no reason to. If someone criticizes the way my walls are painted for example, I will always agree with them to at least some extent, even if I actually like the way the walls are. This also makes coming out super hard because there is absolutely no way I will stand up for myself if someone reacts negatively. And that'll of course validate them in their negativity.

As I've said, I have multiple groups that I know to be trans-supportive. But there, I am afraid coming out might still lead to disapproval due to me "not passing enough". (Once again, I know this is a harmful way to think, but that's what I'm here to fix.)

I'm on a waiting list for a therapist, although I don't know how trans-supportive they are. I'm primarily there to help fix the anxiety and possibly get the autism I suspect to have diagnosed. I do hope they're good with trans stuff too, but it's not a requirement as I've already sorted the medical things out with slightly less-than-legal options.

So, my question is: Do you have any tips on how to reduce this anxiety and expand my support network by coming out in more places?

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[-] dandelion@lemmy.blahaj.zone 4 points 1 month ago

I live in a dangerous transphobic place (in the southern U.S.) and I socially transitioned months before starting HRT later in life (I'm only 7 months into medical transition, and almost a year since socially transitioning). You definitely don't have to take HRT to transition socially, some people never take HRT and only socially transition (I would work with your therapist on why you feel you don't deserve to socially transition). When I socially transitioned I did not remotely pass in the way I looked or the way I sounded, and I still don't pass most of the time. (I think sometimes I pass now when just walking around in public, but even at a distance lots of people can tell I'm trans. I think I just went from "man in a dress" to "that person looks trans / gender-ambiguous".)

All the anxiety you talked about was present for me, and you are right, it is crippling. I remember at one point googling like "how to deal with feeling so vulnerable and scared" and things like that. It was truly overwhelming. I thought I was going to be assaulted the first time I wore a dress out of my house (which was mostly in a car driving and then in the waiting room at therapy to talk about my gender dysphoria^1^). But what I found was that almost nobody cared. The worst of it was just intense stares in places like grocery stores or restaurants, almost always from hyper-masculine looking men. It is rude, but it's not the impending death my anxiety tells me it is. The reality of being seen as an "abomination," as you call it, in public is radically different than how you think it will be, and tbh most people just don't care if you are trans.

What I can say is that with exposure to situations like that, over time the anxiety lessens significantly. I felt panicky the first time I started to change my voice at work. I felt panicky the first time I wore a dress in public. I felt panicky the first time I came out to people at work or in my family, etc. But now, six months later, I get mild to moderate almost performance anxiety before speaking at work. It is mostly in the anticipation where the anxiety presents still, the waiting when I know I need to speak and the feeling that I won't be able to produce a natural sounding feminine voice. You just get used to it, you get used to looking trans and not passing and sometimes people looking at you. (You probably won't have nearly as much of a hard time as me, being so much younger, especially if you start HRT soon.)

What helped me was to recognize that because I couldn't perfectly pass, I should relax while I'm in-between and still early in transitioning, so I can actually more effectively train my voice and feel comfortable in social situations. Perfectionism, the demand that you never slip and let anyone know you are trans, is unrealistic and counter-productive to transition. The tension and anxiety caused by that perfectionism get in the way of actually using a passing voice, for example. I get why we all feel that perfectionism, but at least for me passing is so far away that it was helpful to let that go as a strict requirement. Instead it's a goal that I intend to orient towards, but which I recognize I will continue to fail at. Focusing on the failure doesn't help me reach the goal, so instead I focus on what I can do to help get closer to the goal without getting so attached to the outcome that I undermine progress.

It's hard to give advice, I don't know you or your situation. I think if I hadn't socially transitioned when the iron was hot (i.e. right after my egg-cracking), I am sure I would be having a lot of difficulty deciding to socially transition later. So I guess my tip to deal with the anxiety is to "just do it" and keep doing it and know it gets better. It is important to stay within "threshold" (i.e. not push yourself so much that you completely break down), but you might be able to handle more than the anxiety makes you think you can handle.

A part of my envies you, transitioning at 17 would have been much more ideal for me in terms of being able to pass. A lot of masculine features didn't appear until my 20s, and it kills me that I didn't transition younger. I think about the whole life I missed, not just as a woman but due to the depression and problems the testosterone caused me. Remember that you are doing something really kind to yourself, it is a gift to your future self. And remember you are not alone - lots of us are going through the same thing you are.

Oh, and I guess that does bring me to a certain point: starting estrogen can be destabilizing in some ways, but for me it massively helped my mental health, especially after a couple months of injections. I didn't find bicalutamide (an anti-androgen) helpful for my mental health symptoms, and spironolactone has lots of reported negative side effects including creating mood issues so I refused to take it. I use estrogen monotherapy as my "anti-androgen", i.e. sufficiently high levels of estrogen will block testosterone from being produced by the body. Estrogen is pretty safe when injected (oral & sublingual routes are less safe, though maybe most people are fine taking them; I just don't think oral would be safe or reasonable for monotherapy, it's too much).

You may or may not be like me, estrogen may or may not help your mental health. But before HRT I had regular horrific nightmares, anxiety, depression, constant passive suicidal ideation which at times became more acute and became intrusive active suicidal ideation, and a general unhappiness / grumpiness all the time. Estrogen literally reversed all of it. Estrogen most immediately solved my suicidal ideation, my unhappiness, and my depression - within a week or two of injecting, my motivation and energy were unusually high and I was getting things done that I had been putting off for literally years. I felt naturally happy for the first time since I was a child, and I realized I felt happy to be alive and no longer felt passively suicidal which hadn't been true since I started puberty. The anxiety continued to be a problem for me but after a few months even that subsided dramatically. I think it takes a while for the body to adjust to new sex hormones, or at least it did for me. I still think it is adjusting and I have off-days sometimes, so it is not a silver bullet - it just made a big difference for me, made me a much more functioning person.

Not all trans people experience this, and estrogen doesn't fix all mental health issues. It just really helped mine, and who knows - hopefully it helps you too.

^1^ By the way, I found the therapist by searching online for therapists that are trans-friendly or deal with gender issues, I would advise the same since you may need the therapist to write letters for you if you elect for surgery (which is something I didn't think I wanted when I started transition, but which changed pretty dramatically over the months, so keep your options open), and they may need to refer you if you decide to get an endo once you are 18 and no longer subject to your parents. I also recommend looking for a therapist with a PhD in psychology in particular, not all therapists are equal. Also, having a therapist that isn't trans-friendly just seems like a bad idea. Transition will be a big part of your life and a therapist that isn't accepting is not going to be a good therapist for you. At the very least having the conversation early about what they know about trans people and whether they are supportive or not will help you evaluate whether it is a good fit. You should also know, in places like Missouri, an autism diagnosis is used to deny HRT, so consider the cost / benefits of getting a formal autism diagnosis depending on where you live and what kind of legislation may be enacted. Trans panic is in full swing, so I just encourage being strategic (which is contextual, again - I don't know your situation).

I wish you well - good luck in your transition!

[-] TudbuT@lemmy.blahaj.zone 4 points 1 month ago

(i read all of this but do not have any comments except for on one part)

I am also doing monotherapy as that is the only option I have. I do DIY-HRT and none of the sellers i have access to sell anything but estradiol anyway, so this is an easy choice.

FYI, I will be going on Estradiol Enanthate. I'm still not 100% sure when it comes to how I'll be dosing things, and I cannot start yet because I have a parent-controlled blood test scheduled for a month from now (the last one before I turn 18). I do already have all the injection supplies and the estradiol itself though!

[-] dandelion@lemmy.blahaj.zone 2 points 1 month ago* (last edited 1 month ago)

I suggest using this injection simulator: https://transfemscience.org/misc/injectable-e2-simulator/

Enanthate will take longer to peak and longer to eliminate from your system, so you can inject less frequently which is nice. I sorta wish I had legal access to enanthate, my only realistic option through a doctor is estradiol valerate.

Once you turn 18, going to a Planned Parenthood should get you access to a Rx and blood labs if that's something you would like. You can also get a referral to an endocrinologist if you can find one that works with trans folks.

I hate to say it, but DIY seems like a good choice.

It's insane that your parents test your blood for estrogen, that feels abusive and like something that should be illegal. What doctor is providing those blood tests? It is against medical guidance and a whole lotta science to not treat gender dysphoria, and even worse than going against medical advice, it seems like a form of abuse to intentionally withhold treatment and to use blood labs to ensure you aren't getting treatment.

Have your doctors / parents / whoever actually engage with the medical and scientific literature, e.g. here's a jumping off point: https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

EDIT: I'm not a lawyer, but searching around I found that at your age you can probably legally reject the blood test, see: https://en.wikipedia.org/wiki/Mature_minor_doctrine

If the doctors try to force you anyway, they are probably taking on legal liability.

[-] TudbuT@lemmy.blahaj.zone 3 points 1 month ago* (last edited 1 month ago)

It’s insane that your parents test your blood for estrogen, that feels abusive and like something that should be illegal.

its a part of the blood test that i do for vitamin d regularly so i dont get a severe deficiency. T and E were both tested last time on request of my parents to know if maybe something was wrong with my hormone levels to cause my transness. turned out to be false of course. no idea if it will be tested again but i consider it a 50/50 chance.

EDIT: I’m not a lawyer, but searching around I found that at your age you can probably legally reject the blood test, see: https://en.wikipedia.org/wiki/Mature_minor_doctrine

this is only a thing in the US and i am in germany also it would be super suspicious to my parents

[-] dandelion@lemmy.blahaj.zone 3 points 1 month ago

oof, sorry for my U.S.-centrism 😳 I usually try to be better than that.

Usually T & E tests are a bit expensive, would be surprising to me if they tested again, but I see why you wouldn't take the risk.

[-] TudbuT@lemmy.blahaj.zone 2 points 1 month ago* (last edited 1 month ago)

Usually T & E tests are a bit expensive

US-centrism again. It costs nothing for my family here. :P

[-] dandelion@lemmy.blahaj.zone 2 points 4 weeks ago

I assume in Germany the tests are still expensive, the burden just falls on the state. I'm not sure whether that would translate to the state not wanting to keep the tests, or if they really would cover it.

Either way you are right that it is U.S.-centrism, as providers are more concerned about costs for patients here and care is often not provided for financial reasons.

I wanted to check in and see how you are doing and see if there are any updates. Hope you are doing well. <3

[-] TudbuT@lemmy.blahaj.zone 2 points 3 weeks ago

I'm doing okay in general but not great right now. Tests really are free for me and I can pretty much do as many as I want. But I exist with transphobic parents so that's not happening for a year or more.

I've come out in some places now and lost some of the fear. But now I have a different problem, namely that my voice still sucks because it turns out doing all voice training quietly in my room to avoid being heard, means I can only do the new voice quietly -_-. So now I have to somehow translate that to a more usable voice and make it less dependent on confidence (right now it collapses whenever I'm not confident enough).

[-] dandelion@lemmy.blahaj.zone 2 points 3 weeks ago

Voice training can be really challenging, even with a supportive environment. Have you listened to Selene's clips on size?

https://selenearchive.github.io/

That's a good place to start, as resonance is probably the most important factor in changing how your voice's gender is perceived.

You are going through a difficult time now, but it won't always be like this - I wish you the best as you get through these challenges!

[-] TudbuT@lemmy.blahaj.zone 2 points 1 week ago

I'm already very far in voice training actually, it's just really hard to do it right when either speaking loudly, or being nervous.

[-] dandelion@lemmy.blahaj.zone 1 points 1 week ago

I find it helps to raise pitch to be heard more easily when trying to increase volume, it goes against my habit which is to lower pitch and increase vocal weight to be heard.

Being nervous certainly doesn't help, though.

I'm seven-ish months into voice training, any advice you would give?

this post was submitted on 05 Jul 2024
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