The “Under the Knife” Question

Of all the feedback and discussion from last week’s article, one issue very definitely got my attention, and I should not be surprised it had such an impact.  Surgery is serious business.

I am someone who can no longer recall what it may have been like to not experience dysmorphia, or waking up on any morning without pausing to ask God, “Why this again?”  This is a subject of infinite importance and baffling intensity for me.
I sigh, I lie, I wonder why, if every day I always cry, should I simply die?
No, this is not Dr. Seuss’ suicide note – it was more or less my default state of mind for years, before I put on the character of the day.  (I usually tried for a Cary Elwes-vibe, a la Princess Bride and Robin Hood, Men in Tights; Clearly being the pinnacle of representations of masculinity to my childhood mind)  It was a hell of a lot more fun that feeling like I should hurt myself every time I stepped in the bathroom.)
Now, I’m not suicidal – I pretended to be on two occasions because there was just no way I felt comfortable being honest about myself when my extreme misery was questioned.  (Just as a quick aside here, because the internet is a dark and scary place, there really is no shame in suicidal feelings, and check out help if you need it kids – There are chat rooms and 1-800-273-8255 for the USA.  Try not to think about the fact that this spells “ape talk” on a phone, that’s just a neurotic tangent.)
But the key point I’m meandering around here with sarky tangents is this – being uncomfortable in my own body was a horrible experience, and it isn’t over just yet.  Not all transgender people need, or want, surgery, and they most definitely should not have something imposed upon them in the form of present legal discrimination, let alone physical treatments.  For those of us who do need harsher methods, well, these sort of issues can make or break someone.  They almost broke me, and distraction is crucial.
I used to make up dreams when people asked about them so I wouldn’t have to share the truth about them, either.  Listening to people talk about their dreams is damn boring, I know, but long story short the highlight of my days for a good while was the occasional dream where I could just be a girl.  That was my great moment of subconscious wonder – not flight, not power, not sex with that one person from that show with the dreamy eyes and the great hair, very rarely unicorns, but just getting to go through the day with my parts all in a proper, synchronized order.  Also, rollerblading with the Gilmore Girls was pretty cool.
But it never happened enough.  I tried to barter with God for years just for the privilege of, if I could just dream that I was a girl every night, life would be something I could handle.  This was, incidentally, after I had lost hope in the idea of praying to just be a girl.  I had no idea that was an option.  But neither of those prayers made it very far in the short term.
There are better sources than I for the details – just throw “transgender resources” into your search engine if you want sordid details about high cost, limited availability, and the general awkwardness of this whole topic.  Ivy League Schools and Fortune 500 companies helping their own still relies on someone not only being capable of getting into one of those programs, but doing so, potentially, while terrified of taking showers (And not because they just saw Psycho).  
Just sitting down to write this flooded me with miserable memories, because that’s what dysmorphia is – misery.  Remember the worst movie you ever saw?  I’d watch it seven-million consecutive times if I could trade away this feeling.  My body has betrayed my mind with a dozen details I could tear myself apart over at any moment.  So distraction is crucial.
So my take on the subject is this – some of us want nothing to do with surgery, and others need it so badly we will try anything that seems to offer a sliver of hope at progress, at wholeness.  And some slide from one side to the other of the issue too often to know what to do with any of this.
Distraction is crucial, and asking somebody about surgery for something so awkward is just another reminder of the problem, of the misery, of the pain.  So unless you are willing and able to help do something about it, please don’t ask any actual transgender person you meet about surgery, just to be safe, of any kind.  It’s not the sort of thing that makes for casual banter.
Casual banter is supposed to be distracting.


  1. Hi Amy! I am the mother of an adult child who is transgendered. She came out when she was about 23. My best friend also has a daughter who is transgendered. I am trying to find a blog by parents of adult trans children. Do you know of any? I have had no luck with my own search efforts. I was so glad to find your blog via the Cracked article (great article!). Thank you for your voice.

    • Sadly, not really. The majority of resources on the internet are medical and therapist raw information (and resemble the sorts of hopeful, if vague, sorts of things that innumerable conditions have, but with less quantity), or young trans people blogging about their own feelings. I’ve seen a smattering of parents blogs (few and far between) that all seem to deal with minor children. This blog is by the parent of a 19 year old, if that at all helps.

  2. It’s terribly comforting to know someone else out there who has had pretty almost all the same thoughts as yourself. I could never have said it better myself. I suppose commiserating isn’t an ideal solution, but at least you aren’t alone.

    Thanks for sharing.

  3. Wow, that sounds like it really really sucks. So, if I may surmise from your self-description, it seems like dysmorphia, & perhaps transgenderism in general, is primarily physical. It’s not the ideals of grace & femininity that our culture has associated with womanhood to which you find yourself polarized. You don’t feel like a woman in the sense that you want to wear dresses & makeup &, I dunno, deal with the glass ceiling & awkward sexual advances thinly disguised as drink offers. You feel like you’re a woman stuffed into some a man meatsuit.

    This actually sounds a lot like phantom limb syndrome – the neural framework, the sensory homunculus, not matching up with reality, creating an internal feeling of brain-body dissonance. I’ve read on other transgender blogs (where, exactly, escapes me at the moment), about how aberrant input of estrogen or testosterone at the wrong point in development can profoundly alter the neural architecture of the fetus. The article cited guys having female arm structure (the forearm bent outward, away from the body, rather than straight, at the elbow when at the sides with palms facing forward) as evidence of this. It is known that men & women’s brains are wired differently. It could be that one of those differences is an internal map of how the body feels, & if something misfires in development, then the brain can wired with the female connections, despite growing in a male body.

    If this is the case, I would predict that the number of self-identifying male-to-female transsexuals would markedly outnumber female-to-males. The reason is simple: we all develop in females, & an aberrant surge of estrogen is more likely than an aberrant surge of testosterone. Now, I wonder if this is the case. Off to Google!

  4. There remains a lot of debate in the female-to-male transgender world because a significant concern has been that it is less likely to raise eyebrows if a “woman wants to be a man” due to the general theme of “masculinity is power.”

    But yes, the idea that I was trying to put out into the mind’s of the Cracked audience is that there is more to being transgender than dysmorphia, as there are a lot of people out there who are “one but not the other.” Or both, or neither.

    In my particular case, if I’m being honest with myself and I don’t feel threatened in that particular social context, I am also more female-cliche in my moods and behavior, and how I relate with friends. I’ve had multiple relationships develop with girls who figured I could be their best friend with the added bonus of boyfriend regardless of my own interest, and I felt guilty about saying no to anything (Because they were my friends – Obviously, this makes life awkward for everyone). I also happen to prefer more feminine clothing, but that is more of an after the fact consideration than a motivation for why I had to seek out treatment. The sensation I long was at a loss for words does sound similar to how I’ve heard phantom limb syndrome described, yes, but it would instead be like feeling like an arm should be where I’ve got an extra leg instead. (Bad pun, unintended, but I can’t unthink that.)

    But it’s also worth noting that surges in testosterone are often reported in pregnant women under significant stress. It correlates with left handedness, ambidexterity, and attention problems in children. Just more fuel for the thought fire, while we’re discussing CogSci.

    • Oh, believe me Ames. You have *nothing* on the manure pile composed (compost?) of my shitty puns.

      I’m not surprised that there are multiple psychological etiologies behind transgenderism. For instance, a lot of men like secretly like to cross-dress to feel more feminine, & contrary to Hollywood stereotypes, the vast majority of them are straight as an arrow. I don’t think, in general, that this has to do with dysmorphia. Rather, I think what we see in these instances is a sort of internalization of their own sexual desires. Teenage boy sees attractive girl. Teenage boy gets the hots for said girl. He goes home and whacks off thinking about her, thus acting as his own sexual partner while he mentally fixates on who he wants to be having sex with. Repeat roughly a 2-3 thousand times during the course of a teenager’s life, & the feminine ideal becomes merged with the mental act of masturbation. In short, the subject becomes so adjusted to self stimulation while fantasizing about a beautiful woman that his perception of his sexual self is altered, & he starts to feel like his own fantasy. That’s just a guess, though. There’s no hard data to back it up, but if we treat this model as an hypothesis, I would predict that men who cross-dress in adulthood were more often than not awkward with the ladies & did not date much in high school & early college. This, of course, probably covers over 70% of the male population, most of whom will never wear so much as a stocking, so I would further predict that cross-dressing tendencies would be much rarer per capita in guys who got all sorts of tail in their formative years.

      On the subject of brain sex, there is a test on the BBC’s website that provides a few simple diagnostic metrics on whether your wiring is more female or male. It gives you tasks like judging emotions from just pictures of eyes, or matching objects that have been rotated in 3D space, & places you based on which sex you perform the most like. If you’re interested, here is the link:

      If you do find the time to take it (~20 minutes, in my experience), I’d be very interested in hearing your results.

      Also, there’s nothing necessarily telling in syncing well with women. My wife & I are each other’s best friends, & I have a roughly equal number of male & female friends, though, following my wife, my three best friends all happen to be guys.

      Finally, regarding the testosterone surges in utero, if stress is the stimulus, then we would expect a higher incidence of ftm transgenderism in people who come from very low income backgrounds. This would likely be difficult to detect without self-reporting though, as a “hard-knock life” environment would naturally lend itself to making girls into tomboys, so masculine self-identities would not stand out as much, maybe not even to the individuals themselves.

  5. Well this is fascinating because I tend to consistently score as very feminine on this test with a few exceptions. I score way on the fringe of a lot of things, with the only exceedingly “masculine” result being rotating objects – but I’ve also worked with CAD programs before, really enjoy classical dance, et c.

    I got about halfway between the center and the average female overall.

    10 on Angles (Vs 13 for women, 15 for men on average)
    57 on the differences test (46 average women, 39 men)
    Empathizing 19 (10.6 women, 7.9 men)
    Systematizing 5 (8 women, 12.5 men)
    Words. I had a score of 17. (12.4 women, 11.4 men)
    And the money ultimatum I just went for an even 25 each. (25.5 women, 25.8 men) Not a big difference there.

    Left thumb on top

    The ‘eyes’ test confused me because it states the same average (6.6) for men AND women, and I was close to this number. So what is that test even supposed to actually measure?

    Strong masculine preferences in faces. But I already knew that. I’m attracted to masculine men and women, which just makes my sexual discomfort that much worse. :/

    Finger length ratio: I got .96 vs .98 for men, .99 for women
    Shapes. I had a score of 11 vs. 8.2 for men, 7.1 for women

    So these results just seem to suggest I’m pretty extreme, I guess. But in sometimes opposite directions?

  6. Interesting. Amy, when you hold down your arms at your side, with your palms facing forward, does your forearm bend away from your body at an angle, or does it remain mostly flush with your body?

  7. It’s something I read once. Women & men have slightly different arm structures. Men’s radii & ulnas are more or less aligned at a 180 degree angle with their humeri. This allows for a more powerful & accurate throwing arc. Women, on the other hand (, have forearms that bend away from the body at a slight angle. This helps them carry things more securely, like crops or babies.

    The logic goes that XY fetuses that are exposed to abnormal surges of estrogen during gestation manifest some of these tell-tale anatomical signatures. Since your test scores indicated a strongly female neuroanatomy, but your finger length proportions were those of a typical male, I wanted to see if your arms were more male or female.

  8. Huh. Well that might make sense then, I suppose. But it just raises further questions, in my mind, about what that may mean, and how, or when, or if, it may prove useful to have this information in the future.

    And I am still irritated at my own personal chaos. It’s all terrible awkward.

  9. Scientific inquiry always raises more questions than it answers. That’s one of the ways you know you’re on the right track. As for how this information may prove useful, the applications extend beyond your “own personal chaos”, & even beyond the issue of transgenderism itself.

    The interface between human neuroscience & psychology is a virtual black box. Almost nothing is known about how the concerted firing of neurons translates into thoughts, beliefs, & behavior. The field is so uncharted that in many cases we don’t even know what we don’t know. When something goes wrong, though, the issues become much more identifiable. In this way, the underlying causes of dysmorphia, if discovered, may be able to shed a lot of light on how our brains normally develop & how they interface with our bodies.

    Unfortunately, it’s very doubtful any of this insight will produce a “cure” within the lifetimes of people such as yourself who have to live with being literal misfits day in & day out. Fortunately, modern medicine isn’t entirely empty-handed. I hear HRT can go a long way towards making transgendered people feel more like themselves, & with advances in stem cell therapy, we may even be able to clone organs to modify or replace people’s sex organs. Scientists have already managed to clone hearts (, so penises or vaginas may be viable possibilities in a few decades. In the meantime, I think the most achievable gains (at least, theoretically) for alleviating the angst of living with transgenderism is raising awareness & fostering understanding, which ultimately ties into the greater goal of getting people to see other people as individuals, with their own personal hopes, fears, passions, & pain, rather than just unidimensional iterations of their own personal schemas – as “geeks” or “cops” or “men” or “blacks” or “transwomen”.

  10. Hey. Typing on a playstation vita, so I’ll make this quick since typing on it takes ages.
    You are incredibly articulate and have raised and adressed issues I have pondered about in the past. Any chance you are aware of ? I think you could help some people out on there.
    I’ve added your blog to my list of things worth reading. Thanks for sharing!

    • I was not aware of that specific site, no. (Or I’d forgotten.) I’m always skeptical of how much good can be done in such formats, but it’s worth a shot I do suppose.

    • Wow. Just, wow. I am very glad to have seen this. I’ve only read, admittedly, 4 of the entries and not dug further but – this sums up so many of the issues I always found hard to talk about.

      I hate porn videos. For all of the reasons that article pointed out seem to turn men on. And I have never deliberately watched sex – I had the misfortune of walking in on a male friend, not even touching himself, just watching it – and it freaked me out something awful and I couldn’t look him in the eye for a few weeks. Now, I don’t want to jump to conclusions, and I will state that I am irritated by several terms they brought up, but if this is accurate, my sexuality is most definitely female. I am going to tear through this and share some thoughts here.

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