Beyond the Binaries
Five+ years ago, I remember sitting in a cafe near North Miami Beach about to enjoy a celebratory meal. I had just come from my “reveal” appointment with Dr. Garramone, and I was so excited because I got to see the results of my top surgery. For the first time, I saw my ACTUAL chest, whereas before, it had been hidden under “other tissue.”
It still amazes me how difficult it can be to be well-informed. I'm a mental health professional. I have been a member of the LGBT community my entire adult life. I have close friends who are transgender and have had gender-affirming surgeries. I have access to the vast stores of knowledge on the internet. And yet, up until that point, I didn't know that a person didn't have to identify as transgender to access hormones and/or surgery. Believe me, the question, “Am I transgender?” Is one I have asked myself many times over, for many years. But I was still assuming a gender binary.
These questions and the desire to “make changes” would hit me in waves repeatedly over many years. All along, I imagined what I thought the transition experience would be like or what I assumed it required, but I didn't feel any more “male” than I felt “female.” And so, I would assume that meant “I’m not transgender,” and I would table the thoughts until the next time they presented themselves. Another factor was that I had great coping skills and felt very "at peace" with myself, so the degree of distress I experienced was very low. As a result, non-action was easy for me to live with.
Then, after an abnormal mammogram set off a new round of “if I don’t want to have breasts, am I transgender?” I happened across a video or an article about non-binary people getting top surgery, and a whole new world opened up to me! Once I realized I could pick and choose what I wanted to change and shape my identity and appearance without feeling constrained to the binary extremes, I got excited! For the first time in years, I could stick to diet and exercise goals and lost 15 pounds in 4 months. I had an image in my mind of how I wanted to shape my appearance, and it was all achievable!
I know that one of my fears as I began working with a therapist to get a letter that would allow me access to top surgery was that I would not be seen as “trans enough” to get approval. I was also concerned that my strong coping skills would mean I wasn’t “distressed enough” to qualify for surgical intervention.
What I’ve learned is that adults don’t have to “prove” anything to “qualify” for surgical interventions or hormones except the following:
They are mentally and emotionally prepared for these interventions.
They demonstrate having realistic expectations about the results.
They understand the changes are permanent and have considered their reproductive options if they are of reproductive age.
The role of the therapist is not to be a gatekeeper and deny people access to medical interventions. Psychotherapy is best used for exploring those combinations, reducing internalized transphobia, processing social/familial adjustment, and increasing individual resilience.
During my recovery, I was thinking about how I can use my experience to help other gender expansive (gender non-conforming, non-binary, genderqueer, gender fluid, bigender, etc.) people and transgender people to shape their appearance and their lives the way they want.
I know how confusing it is to figure out what one wants. Looking back, if I had a clear male identity from the beginning and had I known I would have access to surgery, I might have followed through with the procedure a lot sooner. Or maybe later was the perfect time? Who knows, I certainly have no regrets!
So, how do you know if you are non-binary (or genderqueer, or two-spirit, gender expansive, or gender fluid) so you can make decisions about what actions you might want to take? Essentially, you don’t have to! There are many guides on the internet to all the terms and what they mean but I recommend checking out Genderqueer. me. This page has more links to more articles at the bottom of the page that I think you’ll find helpful.
What might be more accessible is to decide what gender traits feel most authentic to you, from clothes to hair, to names, to pronouns, to behaviors, to social expectations, to body parts and body appearances. Once you’ve worked that out, if *you* fit pretty close to one of the binary extremes, then you might be most comfortable identifying as a man or a woman. But remember, it’s okay if you don’t, and you don’t have to!
If it aligns with the gender assigned to you at birth, then you might choose to identify as a cis-gendered man or woman. If it aligns with what is typically considered the “opposite” gender to the one assigned to you at birth, then you might choose to identify as transgendered man or woman. And if the combination of gender traits that feels the most authentically *you*, doesn’t fit well into either of the male or female binaries, or changes from day to day or month to month, or just because you want to, then you might choose one of the many word options available to describe the gender expansive experience!
I refer to myself as queer because I no longer identify as a man or a woman. That makes it a little difficult to say that I’m gay or lesbian. I came out as lesbian as a teenager. And I have been a member of the LGBTQ+ community my entire adult life. As for the traits that feel authentically *me,* I wear very masculine clothes and had a very masculine hairstyle until recently. I don’t wear make-up. I kept a feminine name for a long time, then last year changed it to a more masculine sounding name. I’ve kept the F on my driver’s license, but I decided to get an X on my passport. I feel I am a form of “female” and I identify with the struggles of women, but I transgress just about everything considered traditionally female, so I am "female" and “not female.”
I took testosterone for a couple of years. My voice changed and I got a little facial hair. The thing is, my gender continues to evolve. There is no “end goal.” I’m simply open to finding my joy from one month to the next, and this includes my gender expression.