As requested, the letter
May. 5th, 2009 03:18 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
recursiveparadoxSome people on WiG requested the letter I sent be put up because some of them were wondering if my inclination to speak very scientifically about things had a poor impact on how he took the information. There's a good chunk science speak in the center, but on either end I definitely spoke from the emotional standpoint and tried to reassure him.
Still, any criticism that can be offered on how this letter was structured would be welcome so that I can avoid similar mistakes in the future, with other people or if he resumes contact:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Dear Dad,
I decided to tell you in a letter because it seems more personally connected than email. Email feels impersonal to me. I would have preferred to discuss this with you in person but the events of Christmas week prevented that. With ________’s stroke or seizure and all of us being sick, I felt that this needed to wait. But I also recognize that the longer I wait, the longer you worry about what it could be that I’m dealing with and whether or not my health is threatened. So I’m doing the next best thing to telling you directly and that’s writing an informal letter.
The general situation is that I have a psychological disorder and a serious one. It fits under the same set of bodily integrity disorders like, as an example (not what I have) BIID (bodily integrity identity disorder) which involves the patient’s mind rejecting the presence of one or more limbs as being foreign and wrong or deformed. Bodily integrity disorders involve a rejection of bodily structure as wrong or foreign, usually accompanied by an instinctual need for a different bodily structure to replace it (although they don’t require that second part) Disorders like this are untreatable by therapy or medication. In that, you can use therapy and medication to treat the issues and possible disorders that arise from the crippling psychological harm of bodily dysphoria (the feeling that a part or all of one’s body is foreign, wrong or deformed to the point of serious distress) but medication and therapy don’t really have an effect on the dysphoria itself. Generally the only way to fully handle the dysphoria is to modify the body accordingly, removing the offending characteristics or replacing them with the characteristics that the brain believes belongs. These disorders are not delusional disorders nor do they involve psychosis, because individuals who have them recognize that the feeling of wrongness and foreign deformity isn’t rational and is an issue. These disorders can cause delusional disorders and psychosis if left untreated as the mind tries to cope with the constant flood of foreign invasion or deformity signals from the dysphoria inducing parts.
Which brings me to my particular disorder. I have been diagnosed with GID (gender identity disorder). It isn’t aptly named (just an artifact from the last Diagnostic Manual before they really understood this disorder) for a bodily integrity disorder but that is what it is. Specifically GID is a disorder wherein the secondary and primary sexual characteristics of the individual and the lack of another sex’s characteristics are the bodily dysphoria inducing characteristics. There are variants where the individual with GID simply rejects the characteristics and wants nothing to replace them (agendered variants would require nullification of the secondarily sexual characteristics). Other variants (mixed or bigendered) require a mixture of traits similar to an intersexed condition. Fortunately my instance is a bit simpler than those. It (male to female GID) is also the most common type of GID for a male-bodied person with the disorder to experience so it actually has established bodily modification treatment and validity in the medical field.
This primary form of GID for male bodied folk involves my mind rejecting the male parts (the volume of body hair, the shape of my hips and waist, my flat chest, my facial hair, facial shape and my genitals) and expecting female parts instead (lower volume of body hair, wider curved hips and curvature along the waist, breast development, no facial hair, more rounded facial shape and a vagina instead of a penis). The dysphoria levels I face are, unfortunately, somewhat severe. I, at first, went the same route that ________ did in dealing with his problems. I drank. A lot. And often. I kept it a secret pretty well but things were getting bad in those regards and the risks of alcoholism were pretty bad back then for me. I had a few wake up calls and actually paid attention to them. So I stopped drinking and started doing research. Having found that GID fit pretty well, I involved myself in support groups and went about getting therapy.
The diagnosis was pretty immediate. It was clear from the psychiatrist that my symptoms fit GID very well. During this time I proceeded to purchase a permanent laser hair removal package for my facial hair and began undergoing those treatments. The removal of that facial hair has been very beneficial so far and has definitely helped but not quite enough to fully handle my dysphoria regarding the other elements of my body.
For a person in my position the normal procedure is to do as many bodily modifications as is necessary to remove the bodily dysphoria. The full set of bodily modification applied to the most severe of cases of Male to Female GID would include laser/electrolysis/IPL hair removal on the face and body, hormone replacement therapy (which resculpts the body fat and muscle and causes breast development), genital reconstructive surgery (which uses the materials of the penis to construct a functional neovagina), breast augmentation, facial feminization surgery and vocal surgery (a tracheal shave is included with that, but I lack an adam’s apple of any real size). I do not believe that all of that would be necessary for me. At this time, I would hazard a guess that the furthest I would need to go is laser hair removal on the face, hormone replacement therapy to restructure my shape and perhaps GRS (genital reconstructive surgery). I don’t believe breast augmentation would be necessary and my face is sufficiently androgynous that HRT (hormone replacement therapy) would likely do everything I needed there. I sincerely doubt I would need vocal surgery, as I know how to modulate and adjust my voice sufficiently (from all the impressions and voice throwing I used to do in high school.)
I’m aware that the social impact of pretty much everything but the hair removal is somewhat extreme. It isn’t terribly practical to walk around with male pronouns and a male name when you have breasts and a female looking face and especially a vagina (if I go that far). If I were to move forward with this treatment (and it is looking more and more necessary every day) it would become necessary for me to adopt female pronouns and a female name out of social practicality and social necessity. Changing my presentation like that, along with the physical changes has a risk of alienating some people and there is a strong level of social dislike scattered throughout our culture for individuals in my position. There are a lot of risks but I am also aware of how to account for them. I have inquired into how my field treats individuals like myself and the response has been mostly positive. I’m in a good college community where individuals in my situation are well treated, both by the school and by the people. I have confirmed this through several friends who are going through the same thing but are further along in treatment than I am. I already am very self aware and conscious of social situations, including dangerous ones and have a healthy level of distrust for people I don’t know and even people I do know. Most of these habits I learned before I was even aware what my situation was, simply because of how I was treated in high school. I learned social distrust and judging a situation, as well as safety in numbers at my community college, as I was often in the bad parts of the three cities when visiting my friends. So I am not unarmed and unable to stave off these risks. I am more than prepared for them.
Unfortunately, despite the social impact and the risks it exposes me to, those risks still aren’t as dire as the risks I am exposed to should I not treat my dysphoria. Were it the other way around, I wouldn’t even consider such a change as I myself am not fond of change and transition in my life. I have been on and off suicidal and prone to urges of self harm for a very large portion of my life, holding myself back only because of my strong moral objection to killing and self injury (one of the reasons I’m glad I grew up with a Christian background where those things are morally unacceptable). There were times when things got bad enough that I seriously considered castrating myself or even killing myself. It’s part of the reason I resorted to alcohol as it deadened the feelings of the dysphoria. Unfortunately, alcohol is, in and of itself, a form of self harm and I barely managed to escape the trap of addiction that comes with it. Were I to strip myself of treatment for this disorder, I would have little else to use to cope with it. Another serious risk I faced and still face while this goes untreated comes from my overuse of the disassociation coping method to deal with my dysphoria.
To give some background, disassociation is a mental coping method wherein a person pulls himself or herself away from reality. The mind literally perceives reality less, either through blurring things conceptually or literally pulling away from it and no longer perceiving all of it. Individuals exposed to traumatic stress often use disassociation. Soldiers, rape and abuse victims, children who are brutally beaten or teased in schools, gang members, victims of torture or people exposed to constant damaging levels of stress. Disassociation is often the cause of desensitization as the mind pulls far and frequently enough away from that segment of reality to not feel the impact any longer. Disassociation comes in two forms, depersonalization and derealization. Derealization is the most common for externally sourced trauma. Disturbing images or horrible experiences that a soldier might see or experience would cause him or her to pull away from external reality, to the point that it feels unreal, dreamlike, strange, and foreign or illusion like. That is derealization. Depersonalization is the most common for internally sourced or direct trauma. Severe and constant pain, direct trauma like rape and abuse tend to cause the person to pull away from their own body, feeling as though their body is someone else’s, or feeling like they’re having an out of body experience, often feeling like they’re watching the traumatic event occur to their body from afar. Both of these forms have the potential to be used too much and cause serious disorders like Disassociative Identity Disorder (commonly thought of as Multiple Personality Disorder) or General Disassociative Disorder (which I believe causes catatonic and fugue states in which the person is essentially “not home” in their mind, even while doing things).
I myself use depersonalization the most, as my dysphoria is constant pain relating to my body itself. My brain uses this coping method to such a degree that I often don’t realize when I’m in physical pain (like from the IBS) or notice what I’m wearing because I’m so pulled away from my body. The very real risk of me developing a disassociative disorder is one my therapist has mentioned numerous times and those are even more difficult to treat than GID.
I know this probably doesn’t help you worry any less and will probably be a lot to take in but I am adamant that I am in good hands and am working on getting the treatments I need. As scary and awful as they may seem, there are solutions and they are obtainable. I am dealing with this slowly, carefully and with the help of trained and experienced professionals. I am avoiding the harmful and dangerous methods of coping from my past and attempting to work within the therapy and treatment to fix this, instead of going down the self destructive route like __________ did for his own (presumably) unrelated issues. I also know that considering the strong possibility that your son could very well become your daughter is pretty harshly difficult all by itself. I get this and I will do everything in my power to try to make any future transition that occurs slow and careful so that you and mom and my brothers aren’t overwhelmed. My family is important to me and I want you guys to be a part of my life, even if I go forward with the full transition. So I want to do my best to help you come to terms with the disorder I have and what will likely be necessary to fix it.
If you have questions I can answer them. No matter how silly, ridiculous, strange, outlandish, foolish or even offensive you think a question is, still please ask it. One of the best ways to come to terms with something is to understand it as best as you can. And that means finding out everything you can of it, especially from the one who’s going through it. You can ask over email, over the phone, or even through letters you send on your own to me. Mom has already been made aware but she’s been afraid of looking into this stuff and researching it for fear of revealing this situation to you before you were ready to hear it. Which is sort of silly because no one is ever ready to hear this and there’s never a good time to tell it. But yes, she’ll need your help to do research online and such to find out more. That’s only if you guys want to do that stuff on your own. I have a good number of resources I can pass along and things I can find to help give more information on my situation and gender identity disorder and now that you know, there’s no risk to sending them to you guys. I have not told _________ or ___________ yet and I would appreciate it if this was kept from them for now. __________ especially. I’m sorry for any stress or worry this has caused you. I’ll do my best to help in this situation but in the end, it will be difficult and there’s nothing I can do to change that.
With Love,
__________________
Still, any criticism that can be offered on how this letter was structured would be welcome so that I can avoid similar mistakes in the future, with other people or if he resumes contact:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Dear Dad,
I decided to tell you in a letter because it seems more personally connected than email. Email feels impersonal to me. I would have preferred to discuss this with you in person but the events of Christmas week prevented that. With ________’s stroke or seizure and all of us being sick, I felt that this needed to wait. But I also recognize that the longer I wait, the longer you worry about what it could be that I’m dealing with and whether or not my health is threatened. So I’m doing the next best thing to telling you directly and that’s writing an informal letter.
The general situation is that I have a psychological disorder and a serious one. It fits under the same set of bodily integrity disorders like, as an example (not what I have) BIID (bodily integrity identity disorder) which involves the patient’s mind rejecting the presence of one or more limbs as being foreign and wrong or deformed. Bodily integrity disorders involve a rejection of bodily structure as wrong or foreign, usually accompanied by an instinctual need for a different bodily structure to replace it (although they don’t require that second part) Disorders like this are untreatable by therapy or medication. In that, you can use therapy and medication to treat the issues and possible disorders that arise from the crippling psychological harm of bodily dysphoria (the feeling that a part or all of one’s body is foreign, wrong or deformed to the point of serious distress) but medication and therapy don’t really have an effect on the dysphoria itself. Generally the only way to fully handle the dysphoria is to modify the body accordingly, removing the offending characteristics or replacing them with the characteristics that the brain believes belongs. These disorders are not delusional disorders nor do they involve psychosis, because individuals who have them recognize that the feeling of wrongness and foreign deformity isn’t rational and is an issue. These disorders can cause delusional disorders and psychosis if left untreated as the mind tries to cope with the constant flood of foreign invasion or deformity signals from the dysphoria inducing parts.
Which brings me to my particular disorder. I have been diagnosed with GID (gender identity disorder). It isn’t aptly named (just an artifact from the last Diagnostic Manual before they really understood this disorder) for a bodily integrity disorder but that is what it is. Specifically GID is a disorder wherein the secondary and primary sexual characteristics of the individual and the lack of another sex’s characteristics are the bodily dysphoria inducing characteristics. There are variants where the individual with GID simply rejects the characteristics and wants nothing to replace them (agendered variants would require nullification of the secondarily sexual characteristics). Other variants (mixed or bigendered) require a mixture of traits similar to an intersexed condition. Fortunately my instance is a bit simpler than those. It (male to female GID) is also the most common type of GID for a male-bodied person with the disorder to experience so it actually has established bodily modification treatment and validity in the medical field.
This primary form of GID for male bodied folk involves my mind rejecting the male parts (the volume of body hair, the shape of my hips and waist, my flat chest, my facial hair, facial shape and my genitals) and expecting female parts instead (lower volume of body hair, wider curved hips and curvature along the waist, breast development, no facial hair, more rounded facial shape and a vagina instead of a penis). The dysphoria levels I face are, unfortunately, somewhat severe. I, at first, went the same route that ________ did in dealing with his problems. I drank. A lot. And often. I kept it a secret pretty well but things were getting bad in those regards and the risks of alcoholism were pretty bad back then for me. I had a few wake up calls and actually paid attention to them. So I stopped drinking and started doing research. Having found that GID fit pretty well, I involved myself in support groups and went about getting therapy.
The diagnosis was pretty immediate. It was clear from the psychiatrist that my symptoms fit GID very well. During this time I proceeded to purchase a permanent laser hair removal package for my facial hair and began undergoing those treatments. The removal of that facial hair has been very beneficial so far and has definitely helped but not quite enough to fully handle my dysphoria regarding the other elements of my body.
For a person in my position the normal procedure is to do as many bodily modifications as is necessary to remove the bodily dysphoria. The full set of bodily modification applied to the most severe of cases of Male to Female GID would include laser/electrolysis/IPL hair removal on the face and body, hormone replacement therapy (which resculpts the body fat and muscle and causes breast development), genital reconstructive surgery (which uses the materials of the penis to construct a functional neovagina), breast augmentation, facial feminization surgery and vocal surgery (a tracheal shave is included with that, but I lack an adam’s apple of any real size). I do not believe that all of that would be necessary for me. At this time, I would hazard a guess that the furthest I would need to go is laser hair removal on the face, hormone replacement therapy to restructure my shape and perhaps GRS (genital reconstructive surgery). I don’t believe breast augmentation would be necessary and my face is sufficiently androgynous that HRT (hormone replacement therapy) would likely do everything I needed there. I sincerely doubt I would need vocal surgery, as I know how to modulate and adjust my voice sufficiently (from all the impressions and voice throwing I used to do in high school.)
I’m aware that the social impact of pretty much everything but the hair removal is somewhat extreme. It isn’t terribly practical to walk around with male pronouns and a male name when you have breasts and a female looking face and especially a vagina (if I go that far). If I were to move forward with this treatment (and it is looking more and more necessary every day) it would become necessary for me to adopt female pronouns and a female name out of social practicality and social necessity. Changing my presentation like that, along with the physical changes has a risk of alienating some people and there is a strong level of social dislike scattered throughout our culture for individuals in my position. There are a lot of risks but I am also aware of how to account for them. I have inquired into how my field treats individuals like myself and the response has been mostly positive. I’m in a good college community where individuals in my situation are well treated, both by the school and by the people. I have confirmed this through several friends who are going through the same thing but are further along in treatment than I am. I already am very self aware and conscious of social situations, including dangerous ones and have a healthy level of distrust for people I don’t know and even people I do know. Most of these habits I learned before I was even aware what my situation was, simply because of how I was treated in high school. I learned social distrust and judging a situation, as well as safety in numbers at my community college, as I was often in the bad parts of the three cities when visiting my friends. So I am not unarmed and unable to stave off these risks. I am more than prepared for them.
Unfortunately, despite the social impact and the risks it exposes me to, those risks still aren’t as dire as the risks I am exposed to should I not treat my dysphoria. Were it the other way around, I wouldn’t even consider such a change as I myself am not fond of change and transition in my life. I have been on and off suicidal and prone to urges of self harm for a very large portion of my life, holding myself back only because of my strong moral objection to killing and self injury (one of the reasons I’m glad I grew up with a Christian background where those things are morally unacceptable). There were times when things got bad enough that I seriously considered castrating myself or even killing myself. It’s part of the reason I resorted to alcohol as it deadened the feelings of the dysphoria. Unfortunately, alcohol is, in and of itself, a form of self harm and I barely managed to escape the trap of addiction that comes with it. Were I to strip myself of treatment for this disorder, I would have little else to use to cope with it. Another serious risk I faced and still face while this goes untreated comes from my overuse of the disassociation coping method to deal with my dysphoria.
To give some background, disassociation is a mental coping method wherein a person pulls himself or herself away from reality. The mind literally perceives reality less, either through blurring things conceptually or literally pulling away from it and no longer perceiving all of it. Individuals exposed to traumatic stress often use disassociation. Soldiers, rape and abuse victims, children who are brutally beaten or teased in schools, gang members, victims of torture or people exposed to constant damaging levels of stress. Disassociation is often the cause of desensitization as the mind pulls far and frequently enough away from that segment of reality to not feel the impact any longer. Disassociation comes in two forms, depersonalization and derealization. Derealization is the most common for externally sourced trauma. Disturbing images or horrible experiences that a soldier might see or experience would cause him or her to pull away from external reality, to the point that it feels unreal, dreamlike, strange, and foreign or illusion like. That is derealization. Depersonalization is the most common for internally sourced or direct trauma. Severe and constant pain, direct trauma like rape and abuse tend to cause the person to pull away from their own body, feeling as though their body is someone else’s, or feeling like they’re having an out of body experience, often feeling like they’re watching the traumatic event occur to their body from afar. Both of these forms have the potential to be used too much and cause serious disorders like Disassociative Identity Disorder (commonly thought of as Multiple Personality Disorder) or General Disassociative Disorder (which I believe causes catatonic and fugue states in which the person is essentially “not home” in their mind, even while doing things).
I myself use depersonalization the most, as my dysphoria is constant pain relating to my body itself. My brain uses this coping method to such a degree that I often don’t realize when I’m in physical pain (like from the IBS) or notice what I’m wearing because I’m so pulled away from my body. The very real risk of me developing a disassociative disorder is one my therapist has mentioned numerous times and those are even more difficult to treat than GID.
I know this probably doesn’t help you worry any less and will probably be a lot to take in but I am adamant that I am in good hands and am working on getting the treatments I need. As scary and awful as they may seem, there are solutions and they are obtainable. I am dealing with this slowly, carefully and with the help of trained and experienced professionals. I am avoiding the harmful and dangerous methods of coping from my past and attempting to work within the therapy and treatment to fix this, instead of going down the self destructive route like __________ did for his own (presumably) unrelated issues. I also know that considering the strong possibility that your son could very well become your daughter is pretty harshly difficult all by itself. I get this and I will do everything in my power to try to make any future transition that occurs slow and careful so that you and mom and my brothers aren’t overwhelmed. My family is important to me and I want you guys to be a part of my life, even if I go forward with the full transition. So I want to do my best to help you come to terms with the disorder I have and what will likely be necessary to fix it.
If you have questions I can answer them. No matter how silly, ridiculous, strange, outlandish, foolish or even offensive you think a question is, still please ask it. One of the best ways to come to terms with something is to understand it as best as you can. And that means finding out everything you can of it, especially from the one who’s going through it. You can ask over email, over the phone, or even through letters you send on your own to me. Mom has already been made aware but she’s been afraid of looking into this stuff and researching it for fear of revealing this situation to you before you were ready to hear it. Which is sort of silly because no one is ever ready to hear this and there’s never a good time to tell it. But yes, she’ll need your help to do research online and such to find out more. That’s only if you guys want to do that stuff on your own. I have a good number of resources I can pass along and things I can find to help give more information on my situation and gender identity disorder and now that you know, there’s no risk to sending them to you guys. I have not told _________ or ___________ yet and I would appreciate it if this was kept from them for now. __________ especially. I’m sorry for any stress or worry this has caused you. I’ll do my best to help in this situation but in the end, it will be difficult and there’s nothing I can do to change that.
With Love,
__________________