Saturday, June 18, 2011

Medicating Our Identities

Starting at a young age, I was taught to seek strictly medical explanations for individual problems. My father had worked for a time counseling alcoholics and addicts, and he placed full reliance upon a combination of prescription medication and time spent on the therapist’s couch. However, my life challenges have been structured in ways that defied this logic. It is true that bipolar disorder can be treated successfully with medication. However what I was not told in the beginning is that it would take most of ten years and slightly over twenty drugs to find a sufficient combination. My recent case of abnormally low levels of testosterone and excessively high levels of estrogen is still nowhere near solved.

What causes both of these conditions? I hope someday that maybe someone reading this can develop the latest breakthrough. Simple genetics is one answer. One would think that the means of treatment might be easily explainable. Bipolar medications do not work like penicillin. Everyone who has been given penicillin to clear up an infection knows roughly how it works and also how long it generally takes to get well. With mental illness of any sort, bipolar being only one permutation, psychiatrists and researchers both have to concede that they really don’t know how psychotropic medications work. Lithium is a drug I take to stabilize my moods at a desired state somewhere between depression and mania. It works well for many, has been used for over a century to treat manic-depressive illness, but still no one truly can say for sure how it works. If only our knowledge of the brain was as adequately understood as that of basic infectious disease.

In seeking to find the proper combination of testosterone and estrogen within my body, I inject a designated amount of testosterone into the muscle of either my left or right thigh. My body then believes that a healthy amount of testosterone is excess, so it converts the remainder into estrogen. This is why I then take a pill, Anastrozole, designed originally for women undergoing treatment for breast cancer. Finding the optimum balance has required trial and error. At first, the dosage I was taking was far too strong and I nearly had to go to the Emergency Room to be treated. After that, I had to experiment with amount of dosage and the frequency taken. Now I take half my originally prescribed amount once every other day, as opposed to every day as was the original plan. In time, this may have to be tweaked slightly again.

When I made the conscious decision to talk about and even consider my feelings of gender dysphoria, I applied the same old logic as before. Yet again, what stared me in the face was another aspect of myself that could not be easily understood. Today, the phrase Gender Identity Disorder persists, though like homosexuality itself, it may soon no longer be considered a mental disorder or disorder of any kind. It was easy for me to accept this definition at first, since medical science has always managed to hang one label after another on me. And it was very convenient to convince my family that I was really just ill, but in a different way this time. I played along mostly to tell them what they wanted to hear and also to avoid conflict in the process.

No one’s ever done the requisite scan of my brain or analyzed how it functions, but I’d like to know what could be revealed. Behavioral aspects, social conditioning, or incidents of childhood trauma were, for a time, unquestioned qualifiers to explain transgender identity or genderqueer identity. Now they persist as controversial and largely dismissed. But one crucial word is present in each of these, acceptable or not: theory. Before I knew any of the terminology, I assumed that my thinking was just evidence of another eccentricity. I knew I was strange, and this reinforced my belief in my own eccentricity. And it was a secret eccentricity to never be shared with anyone, since obviously no one else could ever understand.

To this day, I wonder why on earth I romanticize womanhood the way that I do, as though it’s my private escape. The practical part of me recognizes how much of a challenge it would be to transition, pass, and live. And I shouldn’t build my entire self-esteem on what would be a very stressful and likely isolating process. Stressful and isolating are two words I’ve had quite enough of for one lifetime. The process is not an abstract one for me. I have observed it myself and seen its complexities and unforeseen complications. And if I felt as though it would provide me total wholeness, I’d do it. But instead I feel like a gender mutt, desperate for some degree of accepted purity and certitude, even though gender purity is a complete myth. For me, at least, knowing for sure what one is or is not falls into the category of wishful thinking. But still I want it! I want that clarity enough that I would give up much of myself to achieve it.

The aspects of myself that are masculine I concede, but rarely value. The aspects of myself that are feminine, I embrace and internally celebrate. As has been true with other significant problem areas, perhaps I assume modern medicine has a gender pill for me. What is the optimum balance between male and female that would give me the peace of mind I desire so strongly? Would I need to take one, two, or fifty? I take so many medications already on a daily basis, a few more wouldn’t hurt. I’ve already been manipulating my hormone level for months as it stands. Female-to-male transgender folks and I can already swap stories (and have).

My fear is, as always, that no one has any answers for me. Genderqueer is a very succinct way to describe the odd blend of masculinity and femininity I have always observed in myself. But I feel myself moving up and down the continuum on a daily basis, like a scale at the doctor’s office, and I am uncomfortable always with the realization. Some of my fear is defensive and some of it is adaptive. All of it unnerves me. Women are objects of both desire and jealousy. The thought of switching genders is an attractive one, and sometimes even an erotic one.

But in truth, in others who identify as queer, I’ve seen them seek to strike the same balance. It’s much more observable there because their presentation clashes with our expectation of gender and thus really stands out. In my current form, those who casually observe me note only a few superficial differences, but those who really know me pick up on many more. We modify our outsides to reflect the way we are on the inside. I will always remember the day that a girlfriend noted that I was genderqueer, without my even having to state it. I felt such joy and contentment. She validated me. Others may have picked up on it and simply not had the words to express it, but she knew and she said it.

As I think about what I'm seeking, maybe widespread understanding is what I’m looking for most of all. Sometimes in the outside world, I feel like someone who speaks a very rare language, in a place where native speakers are few and far between. The misunderstanding is simply an error in translation. Fluency would prevent problems with comprehension. Without it, I am taken out of context or misquoted. But should I find a native speaker, I delight in the conversation. How do we ensure that others understand? Self-realization should be adequate for me, but I want more than that. It is only then that gender might fall into place for me, assuming, after that point, that it even matters anymore.

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