Sunday, 14 October 2007

Venting

It's disconcerting to realise that you've been just a tiny bit psychotic most of your life.

"Psychotic" defined as "denying reality", an irrational state of being unable to perceive obvious, incontrovertible evidence that is contrary to your world-view.

For most of my life, I believed I was a male with a small, harmless but persistent delusion that I should have been born female. I can't blame myself for that: my body, while mildly Intersexed, was not remotely female, just not quite fully male.

The medical diagnosis, by people far more knowledgeable than I, in 1985 was "undervirilised fertile male syndrome (PAIS-1)'. All I had to do was look in the mirror for the evidence. I had the body of a footballer, not a cheerleader, no matter how I felt. Maybe I should have been born female, but obviously I wasn't, so deal with it.

But... I had to go to extreme lengths to cater to my delusion. No, not the usual crossdressing, I could only wear white or blue shirts, anything pastel was too effeminate. Same with ties, nothing but dark colours or muted patterns.

I was so scared that someone would guess that I was a girl trying to be a boy. Yet I couldn't admit that to myself. I'd see a pretty girl walking down the street, think "I wish I looked like that!" then 15 minutes later, it would have been erased from my memory. Or rather, buried. I trusted the evidence of my senses, not my internal feelings (normally a pretty rational thing to do), but way beyond the point of rationality.

Had I looked up the data on Transsexuality, the situation would have been obvious. But I was just unable to perceive it, I had a blindspot there. I couldn't bring myself to do any research on the subject. Other areas of neurology and cognition, yes. I've been blogging about brains since 2003. But not that area.

Due to some metabolic weirdness, the official diagnosis in 2005, this time by people who were expert in Intersex conditions, and after many, many MRI, Blood chemistry, chromosome and Ultrasound tests, was changed to "severe androgenisation of a non-pregnant woman". Treatment commenced shortly thereafter.

Even now, even after the blood tests, the expert reports, the eyewitness accounts, even the photos, part of me is convinced I must be delusional, that this cannot possibly have happened.

There are three possibilities: psycho before, psycho after, or psycho before and after. The worst thing is that you don't realise you're irrational, the psychic mechanisms used to cope with the stress stop you from realising that.

People who are anorexic don't "believe" they are fat, they know it. Something happens between the optical processing of the image in the mirror, and its conscious evaluation. It's not that they're irrational in their conscious thoughts, it's that their perceptions get distorted long before that. Measurements and eyewitnesses who contradict the evidence of their senses cause cognitive dissonance, which can lead to a cure if they resolve it.

Well, now my research on other Intersex conditions such as 5ARD and 17BHD deficiency shows that indeed, such contrary-to-all-common-sense things as apparent spontaneous sex changes can happen. The eyewitness accounts of my colleagues and friends who witnessed the changes as they happened confirm it. There's objective evidence that my appearance changed so much that I became unrecognisable in just a few months to people who had known me for years. I've found about a dozen similar cases, 3 in Australia alone.

The medical results though are... insufficiently certain. Yes, my hormone levels were way out of normal tolerances, in the female not the male range. But that is nowhere near enough to explain the rapidity of the perceived change. It should have taken years, not weeks.

Just at the point where I have convinced myself that it was just an unusual hormonal glitch, that I'm actually standard TS who feels so guilty about that (and indeed, I'm repressed and very old-fashioned in many ways, that makes sense) that I'm searching for justification... I have more medical tests, and that comforting idea gets blown out of the water. Again.

My GP is convinced I'm a Freak (not unkindly, quite the contrary, we laughed together at the sheer incredibility of the long-term trends). My Endo, older than God, who's seen it all refuses to be drawn on the subject. My Psych had tentatively offered the hypothesis of the most spectacular conversion syndrome she's ever seen, even found some plausible mechanism why a totally repressed need could cause weird things to happen to my body. But everyone is flummoxed by the blood tests, taking female hormones may not cause much of an increase in oestrogen levels, but it's not supposed to lower them! Who ordered *that*???

Maybe I'm attention-seeking, some part of me wanting to be someone special, one in a few million. Munchausen syndrome. Well if so, I wish that part of me would go take a running jump, this has caused me no end of legal hassles, plus the medical bills. Let us not forget the social problems, I mean, I have a marriage of 27 years duration, and I have a son who is everything to me.

At this point, I'd just like a straight answer. If I'm delusional, good, we can work with that, maybe anti-psychotic medication, whatever. At least that would be safe, and I'd be able to take standard medications without the possibility that an atypical metabolism would react in a dangerous way.

Then there's the bit that I really don't want to think about. If it's got a genetic component, what about my son?

Oh yes, I'm also doing a PhD, changing sex, and my sexual orientation has changed too. Just that alone is a lot to cope with.

Reading what I've written - I would have to be crazy to think anyone with all this on their plate is sane. Seriously, if it had happened to someone else, I'd be saying "I couldn't possibly deal with that!". If someone else said they were a Rocket Scientist, had helped design several naval and submarine combat systems, and were doing a PhD in Computer Science, I'd be pretty impressed too. But to me it seems all show: I work with people who are very much brighter than I am, I know people who have coped with far worse problems, and I feel like an imposter. Looking good on paper, but in reality, nowhere near as impressive. That's not false modesty, and I'm not chopped liver, but it's all show, with little substance to back it up. Not no substance, just not enough.

Enough with the self-indulgent navel-gazing. I know it's my blog and I can write anything I like, but a blog that is not for its readers is just intellectual self-abuse.

If you want to read some more interesting and worthy stuff I've written, try looking at some of my posts recently at Salon.com.

4 comments:

Hildy said...

There's no real reational way to deal with transsexualism, I've figured. It's bound to make you go nuts one way or another.

For the better part of my life I felt like two people. One convinced he was a boy, because that's what the rest of the world saw and expected. One convinced she was a girl, just because. You can't imagine the rows I've had with myself, or the panic if my dress or manner of speaking went a bit too much to the feminine side. Occasionally switching between the two wasn't much fun either. If you think switching your sexual orientation over the period of about half a year is weird, consider switching it over the period of about an hour or so.

Basically I figured that either I was TS, or I was going nuts. But how could I be TS, it's not as if I could readily identify with women. I mean, there aren't much women my age (I'm 26) whose idea of an evening well spent is playing with argument-dependent lookup or template specialisation in C++, or figuring out how Van Wijngaarden grammars work. Thus the votes were in favour of going nuts.

So I went to a psychiatrist, who upon hearing my story said "well, it could be schizophrenia, or something else related". Not only do I fall right in the age bracket for developing schizophrenia, an uncle of mine developed it as well, so I could be genetically predisposed to it.

Well, long story short, talking to a sexologist specialised in gender identity disorders made me conclude that I was not going nuts, I was basically trying to rationalise something that cannot be rationalised.

The BSTc isn't part of the rational brain you know. Dealing with a cross-gendered brain is bound to make you go at least a little nuts. Hell, the gender clinic here in The Netherlands, the one at the Free (as in liberty) University were Prof. Louis Gooren used to work, even considers not having any psychological problems other than a cross-gender identification a contra-indication for being TS. "How can you lived in the wrong gender for all those years and not have developed any problems at all?" they reason.

Anyway, that's just my €0,02.

Hildy said...

... with apologies for the grammatical errors I made :)

mythusmage said...

I still say it was something you found in one of your dungeon delves. :)

(You ever notice how gay Brillo was?)

But seriously, you're ever in these parts you have an open invitation to seek me out for hugs and cuddling whenever you're feeling odd.

Dana said...

I dunno, Zoe. You certainly haven't been "psychotic" about it. More like mistaken or invested in the obvious-but-wrong conclusion. The whole thing is counter-intuitive and in opposition to the narrative we our fed for our entire lives, isn't it? In fact, I'm not sure language has the words, and lacking words, the concept suffers (especially expression of it).