Breaking the testosterone/dysphoria cycle

In Anne Vitale’s T-Note #15 entitled ”Testosterone Toxicity Implicated in Male-To-Female Transsexuals: Some Thoughts”, she speculates on the role of testosterone in causing gender dysphoria in natal males. She talks about how some MTF people try to detransition, and then attempt to take testosterone and their gender dysphoria returns. She presents two case studies where two post-op MTF people have detransitioned, but could not take testosterone without overwhelming feelings to retransition returning. One eventually retransitioned and the other did not go on testosterone.

Note that I generally agree with Anne Vitale only in her descriptions of phenomena, not in her descriptions of the reasons why they happen.

Also note that these people were both okay with presenting as male as long there was no testosterone present. Suggesting that there is not some essential identity involved. This is one of the things that I am critical about in our conceptualization of these issues. I can definitely find plausible the existence of a condition that makes one function better on cross-gender hormones. I also think cross-gender expression can be healthy. However, I cannot find plausible the idea of a medical condition that requires someone to have their cross-gender identity constantly validated by others in order to feel okay with themselves. It was noticing the difference between how hurtful it was when someone did not validate my gender identity, versus how little it hurt when people didn’t validate aspects of myself I was comfortable with that contributed to my questioning of the whole thing. In the first case it was because deep down I didn’t believe in my female identity myself, precisely why it was so threatening when it was challenged.

However, I still faced the challenge that Anne Vitale addresses in this article. As I talked about before when I escaped from this female identity and got off estrogen I felt more connected to my body and enjoyed the absence of social anxiety and better mental functioning. I still had issues with fatigue and apathy and so decided to try testosterone. I felt amazing in the first 2 months of testosterone, a very great euphoria. However this was only temporary. I soon felt there was a part of me that wanted to return to presenting as a woman as well as erotic fantasies. I felt this pressure within my psyche and resisted it. However after a couple more months I found I couldn’t resist it and so went off of testosterone and went back on estrogen. This relieved that pressure but again it was clear to me my mind wasn’t functioning properly and I felt dissociated. Now I was in real trouble because I felt like I couldn’t go forward and couldn’t go back. Then I tried T again and the same thing happened, then I went back off it again.

By this time I was aware of role of trauma in this process and had a good intellectual understanding of what was going on, but that was insufficient to solve the problem. I went to two different counselors that I had worked with in the past to do work on this issue. I discovered the root of my “female self” was in feelings of profound unsafety around being myself and presenting male. In other words there were vital aspects of myself that I couldn’t express as a male without being subject to violence, much like the violence I suffered in childhood. Through the use of EMDR and IFS I was able to work through this. When that happened it felt like this idea of a female self dissolved and I have since been able to be on testosterone without difficulty. It has been over 2 years now and the feelings have not come back, of course I can’t be 100% sure they won’t come back again, but it felt like something permanently shifted in that moment and there is no pressure in my psyche. It is important to note the fantasies still exist, but they only exist as fantasies and I understand them for what they are. I don’t think the existence of the fantasies itself is changeable, at least not with our current knowledge.

This is why I conceive of this as a psychological process in a feedback loop with an erotic imprint (at least for those in Anne Vitale’s “group 3”) This also fits what I observe in others. People can have the erotic imprint without the psychology (i.e. cross dressers). I think the difference between cross dreamers/crossdressers and those that go onto transition is that they have the same erotic imprinting (they like the same fantasies) but have different psychological responses to it. Also eliminating testosterone does not eliminate the psychology but does reduce the fantasy component. I disagree with her that the developmental process she describes is inevitable, but I do think it reaches a point where it is quite difficult to reverse.

So, the what can you do if you want to halt this cycle and do not want to transition? I have written about some of the psychological issues here, here and here. Intellectual understanding is insufficient for this psychological work, it is a visceral, experiential understanding that is required, and it is probably best done with supportive others.

However, this says nothing about the erotic component which I think behaves more or less like other erotic imprint issues. Unfortunately, most of the psychological treatments have high relapse rates and are not very effective. A couple of examples include aversion therapy, and orgasmic reconditioning. The use of porn exacerbates these problems as overtime it requires more and more stimulation for the same effect. Other things that have shown promise are the use of mindfulness to insert a gap between stimulus and response, and values-oriented living as this problem tends to exacerbated by loneliness, stress and anxiety (and people often transition in response to a life crisis of some kind).

One thing I have learned is that having shame about fantasies makes them worse, and you have to accept them. Lots of people have erotic fantasies that don’t correspond to what is healthy for them to do in their lives. No one would suggest that women with rape fantasies live them in the real world in order to be their “true selves”. It is not any different for people with feminization fantasies or other fantasies. Porn doesn’t tell you who you are! They are things one can perhaps act out with a consenting partner, but they aren’t life maps.

If the fantasies are too powerful and acquire a compulsive quality, there are pharmaceutical treatments that are known to be effective. Of course anti-androgens are helpful for testosterone driven behavior (and if anti-androgens or estrogen improves your well being I think that is great) , however transitioning is a separate decision. Anti-depressents, particularly at higher doses are known to be effective for stopping this compulsive sexual behavior, but the response is highly individualized and that is something that should be done working with a doctor.

Sometimes cross-dressing and other cross-gender behavior has been connected with OCD, and in that case working on the OCD itself may stop things. Treatments that have worked for OCD include cognitive-behavioral therapy, exposure-reponse prevention and again high-dose anti-depressants.

This stuff is very complicated, and I really wish more mental health people were really digging into these things instead of saying “oh you have gender issues, therefore you have gender dysphoria, here have some hormones” Not all gender therapists are doing this, but the ones who see people for one session and write letters for them definitely are, that’s not enough time to diagnose anything.

40 comments

  1. TWT fascinating post and, as a Anne Vitale fan myself and also part of her group 3 I can relate to much of what you are saying. I resolved my dysphoria problem and erotic imprinting issues thusly:

    First I realized that whatever caused my gender dysphoria was beyond my reasoning and beyond my control. I had tried absolutely everything to dissassciate myself from my interest in my “femaleness” by blocking it out and using repression. Things got unmanageable and had to go for treatment and after eliminating guilt and same issues I realized that this “desire” (for lack of a better term is part of me and can indulge in it without giving up who I am. If you want to call that crossdressing I don’t care but the essential point is that I did not initiate this desire and its why I have always termed it gender dysphoria to distinguish myself from people who start cross dressing as a sport or entertainment (I personally don’t know any such persons but assume they exist). As a student of Harry Benjamin I believe at least in part in a biological predisposition for my inclinations and he stated clearly that he believed in a common root etiology between transvestism and transsexualism.

    I have come to terms with my condition by realizing that I don’t need to reject my maleness in order to embrace the impetus behind my cross gender expression. It works for me and I go with it without reservation.

          1. glad that you have confirmed that its only about being sexually aroused for you and that you self identify as a fetishist. However I can see by what TWT writes here that he has had a different experience with this whole issue. Maybe the fact that you post here means you might not be so sure about your own views.
            That’s the great thing about humanity; we are all different.

            1. “glad that you have confirmed that its only about being sexually aroused for you and that you self identify as a fetishist.”

              What do you expect from a fetish other than to be sexually arousing?

              “Maybe the fact that you post here means you might not be so sure about your own views.”

              Maybe the fact that you post here and on “crossdreamer” spaces rather than general trans spaces, means that there is something about your “desires” that you feel may not quite be appropriate….

              “However I can see by what TWT writes here that he has had a different experience with this whole issue.”

              Actually I have yet to meet anyone else who shares my theoretical outlook regarding this phenomenon as much as TWT does. To which I wonder, what have you even been reading!

              https://thirdwaytrans.com/2014/07/23/erotic-imprinting-overview/

              1. erotic imprinting is not and should not be enough to drive people to develop doubts about their gender identity. If you are only driven by fetish then dress to your heart’s content and masturbate. That is a reality that you identify with and that works for you but there is more than meets the eye and all you need to do is read the established literature from Benjamin, Vitale and company to see that others are driven by more. You are a believer in fetish developed out of childhood trauma and I am not. We will have little chance convincing each other and I don’t need to waste my breath or time doing so and don’t have the interest. The only point I make is that reducing all to fetish is simplistic and maybe fits your particular life experience and not of others. It would seem that most of the established experts disagree with your concept including Blanchard who, although a proponent of AGP, still advocates gender role transition for his patients as a way to relieve their suffering. If their fetish is to transition and it works then call it what you like.
                I will stick to the work of a researcher that saw over 1000 patients in his lifetime rather than subscribing to your opinion but thanks.

                1. “erotic imprinting is not and should not be enough to drive people to develop doubts about their gender identity.”

                  yes, it is. I’m sure that if I don’t have the fetish I would never doubt my gender identity. I’m having hard time how the fetish is not and should not be enough to drive people to develop doubts about their gender identity. Its pretty obvious.

                  I think this is also the key to healing, the acknowledgement/acceptance to the uncomfortable reality.

                  1. I definitely agree that acceptance is the key, regardless if you transition or not. Ultimately you have to accept the male aspects of yourself even if you transition and go through the whole process, because there are always things that are unchangeable. So, better to start now.

                2. “erotic imprinting is not and should not be enough to drive people to develop doubts about their gender identity.”

                  lol of course it is and does. Again, do you even read what is posted here? In this very post TWT writes, “I think the difference between cross dreamers/crossdressers and those that go onto transition is that they have the same erotic imprinting (they like the same fantasies) but have different psychological responses to it.”

                  The terms for which an individual identifies, are the affiliations for they historically have come to relate themselves. As all but universal, perhaps necessarily so, an object of sexual stimulation will tend to develop accompanying psychological & emotional attachments, even “love” and it is no different in the case of this fetish which is sexual arousal by the associating of oneself to symbols of femininity (emasculation).


                  “If you are only driven by fetish then dress to your heart’s content and masturbate.”

                  Why must people go on as if “crossdressing” is in some way representative of this fetish. In the context of this fetish (masochistic emasculation), dressing is at most a particular fantasy theme or tool utilized on part of a theme.

                  “read the established literature from Benjamin, Vitale and company to see that others are driven by more.”

                  And what understanding do these people have in regards to the fetish? Nothing.

                  “We will have little chance convincing each other”…. “The only point I make is that reducing all to fetish is simplistic”

                  For the simple credulous reason you, like Molay, dislike what I and TWT propose. You have no argumentation to support yourself.

                  “It would seem that most of the established experts disagree with your concept including Blanchard who, although a proponent of AGP, still advocates gender role transition for his patients as a way to relieve their suffering.”

                  Established experts? Regarding this phenomenon, there are none. lol I have always maintained that transition is pragmatic, it all comes down to the individual’s well being.

                  “I will stick to the work of a researcher that saw over 1000 patients in his lifetime rather than subscribing to your opinion but thanks.”

                  Oh an appeal to authority, how cute. If you want to actually engage in theoretical discourse, I’m always happy to do so.

                  1. Believe what you like as neither of us has better proof than the other. I appeal to the experts because they have more credibility than your opinion which changes nothing for me and how I manage my dysphoria. There is a chicken and the egg scenario happening here in that for you the supposee fetish creates a false female identity. Conversely the possibility exists that there is a biological predisposition (perhaps due to insufficient androgen exposure) which creates a scenario where the child begins to exhibit signs of gender behaviour attributed to the other sex. The erotic imprinting then becomes a symptom and not the cause of the condition. Again nothing changes for me or you since the imprinting is now permanent but I won’t close the door to Benjamin’s or Vitale’s assertion that there might be a biological root to all this.
                    In the end believe what you like since its about living day to day and managing that really counts. Asserting that the experts do not acknowledge the eroticism is clearly disingenuous since they clearly do if you bother to read them. For Blanchard it’s the primary driver for transition in AGP transsexuals. Benjamin recognized it also but saw it as a symptom and not a driver which is why he still recommended transition for some patients who had a clear history of masturbation and dressing.

                    1. My position on this is that there is mutual causality going on. It is not that the erotic imprinting causes the psychology or the psychology causes the erotic imprinting but that they feedback into each other in a feedback loop. This is actually common in psychology, cognitions cause feelings and feelings cause cognitions.

                      Also, I don’t think the erotic imprinting is the sole input to the psychology. The psychology contains real and vital parts of self that need to be expressed in some form or another.

                      I think we all get trapped in this idea of “realness” where how the causality works depends on whether things are real or fake. I don’t think that some identities are more real than other identities, I don’t think identities are false or true. I do however think that some identities are more useful than others. One of the principles of ACT, one of my favorite therapies is to think of beliefs in this way in order to promote cognitive flexibility and preventing your own beliefs from getting in your way.

                      I also think the idea that some things are biological and real and other things are non-biological and fake is incorrect. This idea is pervasive and also makes it difficult to have discourse around this issue. Everything is biological in a sense.

                      I think there very well could be some pre-natal disposition and it could be hormonal, but maybe not. I definitely think childhood events play a role. In any case like you say it doesn’t matter much because once it happened it happened.

                      While, the erotic imprint seems to be unchangeable I think the psychology is changeable, although with difficulty. I wouldn’t believe it myself if it didn’t happen to me. I think it is difficult for the same reason that we have low success rates in changing any kind of pervasive identity issue, the canonical example being narcissistic personality disorder. If you add a sexual component as well, you are left with a very difficult thing to change psychologically. But still difficult is not impossible and maybe we can make it less difficult in the future.

                    2. “you the supposee fetish creates a false female identity.”

                      No, it is your misunderstanding, that a “dysphoric” psychology which derives from the fetish must inherently be inauthentic.

                      “The erotic imprinting then becomes a symptom and not the cause of the condition.”

                      The masochistic sexual imprinting of emasculation trauma, for which “trans” affiliations are adjunct etiological condition of emasculation anxieties.

                      “Believe what you like as neither of us has better proof than the other.”

                      This would require that you to actually have an intellectual grounding to your position, let alone to address the logic of what I actually propose.

                      “Asserting that the experts do not acknowledge the eroticism is clearly disingenuous since they clearly do if you bother to read them.”

                      Any “expert” that does not understand the phenomenological constitution of the fetish, effectively in terms of masochistic emasculation (thus what is psychologically and etiologically disclosed), will struggle to grasp anything beyond the superficial.

                  2. You are right that I do agree with you on many aspects of what you say. I certainly think the erotic drive is very powerful, especially when fueled by testosterone, we see all the time that men are willing to risk their entire careers for a one-time sexual encounter. I do think it requires something more for things to persist when testosterone is eliminated.

                    I am not convinced that masochistic emasculation is the sole theme of the fantasies, although it is certainly a very common one. AGP is also only a subset of the fantasies, they aren’t all AGP. Jamie Veale found that in one of her recent studies, citing a correlation with “themes in transgender fiction” and not necessarily AGP.

                    I think you have also shown awareness of the distinction between the psychology and the erotic drive itself, being that based on your description of yourself that you are someone with the fantasy but not the psychology.

                    I also agree that transition comes down to well-being, compared to other alternatives.

                    1. “I do think it requires something more for things to persist when testosterone is eliminated.”…… I think it is simply the difference between more directly sexually-mediated properties, as opposed to much more historically and emotionally engrained properties, as well as ideology/belief.

                      “I am not convinced that masochistic emasculation is the sole theme of the fantasies, although it is certainly a very common one.”……

                      I think in theorising this phenomenon, the phenomenology of the fantasies plays a fundamental role and there are some subtle but absolutely crucial dynamics at play, especially the relationship between the structure of the underlying imprint and theme. For which sexual arousal by the anxiety of one’s association to symbols of emasculation, is the horizon of meaning for the fantasies in general, where the fantasies can not be intelligible otherwise.

    1. It sounds like you have found a great resolution that works for you. The important thing is that the vital aspects of self be expressed somewhere, they don’t have to expressed everywhere.

      I am reminded of something from either Jung or a Jungian writer, I don’t remember who. One of the things they said was that we all have more life than we can express due to our mortality and that the aspects we don’t express in our life can find an outlet in fantasy or elsewhere. He described someone who worked in business but also had a drive to be a priest, and ended up living that out in a elaborate fantasy life.

      So whether it is through living them through a dual-role or integrating them or what as long as they are not repressed or allowed to become a total obsession it can help relieve the dysphoria.

  2. I also have a healthy skepticism for the so called gender professionals since they themselves don’t have the condition and cannot relate. They are often just as much in the dark as you are and some may prescribe hormones before you are ready or ever will be. Its good to read and reflect for yourself before embarking on a journey that may lead where you don’t want it to go.

    Oh and apologies for the typos in the first response!

  3. I guess my only point would be that if one fuels the other then one had to be there first and I have more problem with the idea that very small children develop fetishes than with some sort of condition/predisposition being there already. It might be part biology and part socialization. Some small boys put into dresses early on never develop any dysphoria later on and yet others do. Is this because one was predisposed and not the other? I was not one of those children who was somehow predisposed and my mother discouraged it strongly when she saw me doing it. I couldn’t have been older than 5 years old and started this on my own. Conversely, my younger brother who was a target of my sisters as a dress up model is a perfectly normal male today and has no interest whatsoever in dressing as a woman.

    Any sexual overtones to my behaviour showed up only at or just after puberty which is why I have tended to agree with Benjamin that there is biological predisposition present.

    Anyway thanks for the interesting post once again.

    1. The typical commonsensical supposition that sexuality begins in at puberty, therefore there is a “purity” beforehand. Rather we are all sexual from very very early in childhood, but it is simply around puberty or the discovery of masturbation, that there is the condition for sexuality to be conceptualized as such, and the condition for sexual properties to be recognised as sexual.

      1. As I have stated before, believe what you like since neither your reality nor mine changes. The way we define and respond to this difference is unique to each of us and so it should since we have different life experiences. The conclusive proof about how all this happens will have to wait until more is understood about the human brain and how we become sexualised beings and how our internal perception of gender develops. In the meantime lives must be lived which is what counts most for me.

        1. “In the meantime lives must be lived which is what counts most for me”…………..”believe what you like”

          How about addressing what I propose? I guess intellectual integrity isn’t important in how you live your life, that you just want to be told what you want to hear.

          “The conclusive proof about how all this happens will have to wait until more is understood about the human brain and how we become sexualised beings and how our internal perception of gender develops.”

          Deferring argumentation through an appeal to science, where actually the terms of this discourse are all but understood right here and now in psychological terms. But what do you want? Is it that you don’t like the idea of the fetish, or that you want to affirm the “inner woman”

          1. “I guess intellectual integrity isn’t important in how you live your life, that you just want to be told what you want to hear”

            How interesting in that I could say the same about you. But if you are going to address the issue of intellectual integrity, I would only say that not many intellectuals working in this field who agree with you so again believe what you like.

            1. “How interesting in that I could say the same about you.”

              Who of us is avoiding to engage with the other’s arguments?

              “But if you are going to address the issue of intellectual integrity, I would only say that not many intellectuals working in this field who agree with you so again believe what you like.”

              Do you know what an appeal to authority is? Otherwise it is interesting, seeing as my and TWT’s nuanced position aren’t even present in the field as of yet, for it to be possible for the supposed “intellectuals” you have in mind to feel any way about it.

          2. “But what do you want? Is it that you don’t like the idea of the fetish, or that you want to affirm the “inner woman”?”

            Nope I don’t believe in an “inner woman”. What I do believe is that there is a possibility that there is a basis for this propensity to lie in biology AND in psychology. The fact that you insist that the biology is not possible is not being intellectually honest. Absence of proof is not definitive proof as you can see from post-Neutonian physics or understanding the movements of the planets before Gallileo.

            However if the ultimate answer is a fetish then so be it. Even the definition of the term fetish is complex enough since we don’t know how they originate and why some people get them and others don’t.

            1. “Nope I don’t believe in an “inner woman”. What I do believe is that there is a possibility that there is a basis for this propensity to lie in biology AND in psychology.”

              Molay likes to fall back on this mantra. There is no given way which biology will figure within construction, in the same way that high testosterone (higher than average aggression for example), does not necessarily determine that an individual will be affiliated with aggressive “masculine” activities, for which properties associated as “masculine” are the conditions which an individual reflexively relates him/herself as male-like/being-male. Common thought on this issue is effectively the projection of “gender identity” onto a property like high(er than average) testosterone.

              “The fact that you insist that the biology is not possible is not being intellectually honest.”

              Rather it is simply the case that you need to understand psychology, in order to understand the terms for which biology can possibly figure within psychological construction.

              “However if the ultimate answer is a fetish then so be it. Even the definition of the term fetish is complex enough since we don’t know how they originate and why some people get them and others don’t.”

              It isn’t complex at all. Probably the one relevant scientific discovery I am looking forward to, would be the biological mechanism for which relatively overwhelming experiences are sexually imprinted, along with varying biological conditions for which individual’s may be particularly sensitive to such imprinting.

              1. “Rather it is simply the case that you need to understand psychology, in order to understand the terms for which biology can possibly figure within psychological construction”
                The root of all psychological construction is biological: its called the human brain and that particular organ is exceedingly complex. It is what allows this conversation to go on and which makes me go back to my original statement: believe what you like. We are still very far away from anything even remotely conclusive on this topic.

                Using childhood emasculation trauma to explain away the transgender condition is, to put it mildly, simplistic and although it may appeal to your childhood experience, it does not correlate with mine nor I suspect with many others, which is why we have sought for answers elsewhere. My situation no longer causes me any grief however and I live my life perfectly happy with only intellectual curiosity remaining. I leave all doors open but prefer to stick to published scholarly work by people who have studies numerous cases.

                1. “The root of all psychological construction is biological: its called the human brain and that particular organ is exceedingly complex.”…….. Ever heard of a psychologically constituted psychology? Now it gets more fun when it gets to the question of how could it possibly be that a psychology could be constituted in anything other than psychological terms? The psychological state is always necessarily psychologically predisposed.

                  “Using childhood emasculation trauma to explain away the transgender condition is, to put it mildly, simplistic”……. Actually childhood emasculation trauma explains masochistic emasculation fetishism, and a trans/dysphoric psychology on part of a masochistic emasculation fetishist will routinely be psychologically derived from the fetishism.

                  “it may appeal to your childhood experience, it does not correlate with mine”…….. If you are a masochistic emasculation fetishist, then etiological and psychological facets & possibilities are already disclosed in it.

                  “My situation no longer causes me any grief however and I live my life perfectly happy with only intellectual curiosity remaining. I leave all doors open but prefer to stick to published scholarly work by people who have studies numerous cases.”…….. Good for you, give me a heads up when you come across any such supposed “scholarly work” lol

                  1. “give me a heads up when you come across any such supposed “scholarly work”
                    You might want to start with Hirschfeld, Benjamin or Vitale for starters who might have just a little more experience in this field than you do. However I would be open to reading scholarly works that supports your theory.

                    1. Point me in the direction of where they actually show they have any understanding of the fantasies we get off to? (This is a trick question)

    2. There is some good evidence that childhood experiences play a role in erotic imprinting. Here is an example article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1691703/

      This phenomena has been observed in animal experiments as well. Generally the default is that people imprint on their opposite-sex parent, and then there is something called the Westermark effect which makes it so that you aren’t attracted to your actual parent (or siblings) but people that are like your parent. This process has been tied to a theory of fetishization as well: http://www.diva-portal.org/smash/record.jsf?pid=diva2%3A415134&dswid=-2447

      This is just the default and lots of things can happen to change to this. Further it is a chaotic process and like with trauma in general people are very different in how they respond. One person can develop PTSD for a relatively mild trauma, and another can go through severe trauma unscathed. There also may be a genetic or epigenetic predisposition that plays a role as well.

      In the end of the day though, I do think this discussion can be a bit of a distraction, because whether through genetics, epigenetics, or childhood experiences or a combination thereof, once this imprinting has happened it acquires a fixed and permanent character at least according to our current psychological knowledge, and that is what is most relevant for determining how we can respond to it.

      1. “once this imprinting has happened it acquires a fixed and permanent character at least according to our current psychological knowledge, and that is what is most relevant for determining how we can respond to it”

        A statement I wholeheartedly agree with but I prefer to think that there are a myriad of possible combinations or permutations of origin rather than to state unequivocally (without any solid evidence I might add) that this is all purely psychological construction. That is pure conjecture.

        1. One of those embarrassing situations where an individual doesn’t know that they don’t understand what it is for something to be psychological. Often along the lines, that if something is psychological, it means “it isn’t real”, a passing state of mind, or is a “delusion”.

          1. What should be more embarrassing for you is your presence on the web consists of highly sexually charged imagery and language which very clearly puts you in the fetishist camp. No one I know or correspond with and identifies with any sort of trans psychology engages in this sort of activity. I am having trouble understanding why someone who falls into this extreme group desires to explain away everyone else using the same brush.

  4. It is obvious that if you care about what people tell or think then you are probably not a woman !

    But I care about what other people think because if they think I am a man in a dress they would treat me badly because they think I am crazy or a perv and so I will suffer from their BEHAVIOR and not from what they JUST think.

    I love ho I look as man and as a woman. So hoers opinions do not care.

    But I know that i live in a society and that being a woman implied living as a woman and not as a freak, hence I need others to be a woman.

  5. I am the wife of a man who strongly believed for fifty years that he was a female trapped in a man’s body. He came out to me at age 56 because he could no longer handle the “dysphoria”. In less than a month he went from feeling he only needed to cross-dress once a week to he just wanted breasts to he had to fully transition, including SRS. This led to a complete breakdown and he had to be hospitalized. Leaving out many details I will say that he was treated for a chemical imbalance with an SSRI and therapy which included EMDR. I will also ad that he was sexually and physically abused by an adult male neighbor, almost everyday for a year and a half, from age seven. The next three months seen a peeling away of his TG desires. During that time his medication was slowly increased. I also read numerous transition regrets to him daily (and there are many that I’ve saved in a file). I also read him tons of information from this site and many others. Now he is baffled by what he was thinking and can’t relate to the feelings at all. He said that about a month after he got out of the hospital he put on one of his dresses and when he looked in the mirror he felt nothing. The euphoria was gone and all he felt was ridiculous. He said it was the first time he seen a man with a dress on and was not eroticized by the image in the mirror. That was a over a year ago. He is dumbfounded now about why he even thought he wanted to be a female. He says for the first time he can feel outside of his fantasy world. He’s able to sexually connect now, without escaping into his fantasies. He says that for the first time in his life he no longer feels guilt after sexual release. He says now everything feels so right, so peaceful, so satisfying after lovemaking. I believe him because he can”t stop kissing and hugging me. He constantly wants to cuddle. He’s acting like someone who is in love for the first time. I believe this is the first time he’s ever felt love for a female outside of his fantasy world. He no longer has dreams that he’s a female for the first time in his life. I will follow with more thoughts.

    1. Thanks for sharing your story and I am glad that your husband got the care that he needed and was able to find a way to work through things. I’m glad he was able to do some EMDR work for the trauma. Also, I think the use of SSRIs with respect to crossdressing and MTF issues should be explored more. I’ve read a couple of case studies and seen several people report that SSRIs helped them particularly with any obsessive thoughts and compulsions. Certainly many people’s dysphoria persists when taking SSRIs also.

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