Follow-up to Lost to Follow-up

by crashchaoscats

I have a lot of conflicted feelings about my piece “Lost to Follow-up/How Far Can You Follow Me?”. Writing it at the time was healing but when I reread it now, I no longer relate to a lot of it. It’s an illustration of me in the process of changing myself, getting out and articulating intense feelings so they could move through me and transform into something else. Writing it was powerful, I made myself very honest and open when I wrote that. Everything I wrote was true for me at the time but I think and feel differently now. Writing “Lost to Follow-up” changed me and that’s one reason I still appreciate it even though I no longer identify with it.

I was already thinking of writing a follow-up piece to “Lost to Follow-Up” before I learned that portions of it had been quoted in When Harry Became Sally, a book written by Heritage Foundation member Ryan T Anderson which argues that medical transitioning is harmful and criticizes the movement for trans rights. I’m not surprised he choose that piece to quote, others before him have quoted it as proof of the harms of transitioning, and I’m not pleased about it. It was upsetting to learn that yet another conservative Christian was trying to use my words to promote their political agenda. I haven’t read the book yet and I’ll likely have something to say about how it represents me once I get a chance to read it. This is not a response to being included in Anderson’s book, that will come later, but learning that “Lost to Follow-up” was quoted in the book inspired me to write the follow-up piece I was already considering. I decided to write it before I read the book, so I can describe my current thoughts and feelings from a less reactionary place. This is a clarification of the original intent of “Lost to Follow-up” and where I stand in regards to it now.

I wrote “Lost to Follow-Up” to describe how anxiety, fear and other intense feelings could get in the way of a detransitioned person contacting their old medical providers and informing them of their detransition. People often overlook how many detransitioned people don’t trust their old providers, feel shame about transitioning or otherwise experience strong emotions that could prevent them from coming forth and how this could lead providers into thinking that detransition is much less common than it is. How can you accurately gauge how many people detransition if many of us don’t want to talk about it for one reason or another?

Soon before I wrote “Lost to Follow-up”, I’d seen a gender therapist boast online that he’d seen very few people detransition over the years and I thought that he wasn’t considering that perhaps more of his patients had detransitioned but didn’t feel comfortable coming back and telling him. People in general, not just gender therapists, are largely ignorant of what life is like for detransitioned people. To many people, we’re abstractions, not real living people. Most of the detransitioned women I know never told the medical professionals who helped them transition that they had later detransitioned. We didn’t trust them or we felt ashamed or we didn’t think we’d get anything productive from doing so and so forth. I wanted to bring this fact to attention by talking about my own experience, talking about why I never went back and told my old providers that I’d detransitioned.

This meant dredging up a lot of feelings, anxiety, fear, humiliation, everything that could make it hard to talk about detransitioning with the providers who helped me transition. I called these feelings up into my mind and concentrated them to make them easier to articulate. I imagined myself in the presence of my old providers, imagined what I’d feel standing in front of them, trying to talk to them about detransitioning and how I thought my original transition was connected to trauma. I imagined my fear, shame and vulnerability. And I wrote, focusing on the most difficult feelings.

“Lost to Follow-Up” is not primarily about how transitioning hurt me but about my fears of being unable to connect or communicate with my old providers, my fears of them not being able to hear or understand me. If I open myself up and talk about my pain will they be able to hear me and respond with respect and compassion? Will they be able to acknowledge that they unintentionally contributed to my suffering? I make it clear I do not hold my providers wholly responsible for harm I incurred through transitioning. I don’t want them to take all the blame on themselves. Mainly, I’d want them to show concern for my well-being. If they made too big of show of being sorry for causing me harm I’d be just as uncomfortable as if they refused to acknowledge any part in my suffering. I wouldn’t want them to take on too much just as I wouldn’t want them to totally deny any responsibility.

A lot of that piece is about how there is no social script in place to help a detransitioned person and the providers who helped them transition deal with this new situation. As a transitioning person interacting with professionals helping me take testosterone, our roles were fairly well mapped out. There were social codes and routines to follow. I had some idea of what questions I’d be asked, they expected a certain range of answers, I had a good idea of how every appointment was going to go, whether I was seeing my therapist or the nurse practitioner who oversaw my hormone administration. I’m not sure how it would go if I told them about detransitioning. I would like to think they’d at least try to act right by me. Not having a social script in place would add to my anxiety.

When I wrote “Lost to Follow-up”, a lot of what made it seem so hard to go back and tell my old providers was that I felt ashamed about my transition. Deeply, painfully ashamed. It felt like talking to them about it would be admitting that I was fucked up and broken, that something was very wrong with me for having transitioned. One of the biggest changes between when I wrote the piece and now is that I no longer feel this way. Part of healing has been working through my shame, understanding why I felt it and overcoming it. I’ve learned that when you struggle with self-hatred it’s hard to give it up all at once. I look back now and see how hard I’ve been on myself in the past and how a need to have a perfect, ideal self had distorted my self-perceptions. It’s not true or fair to my younger self to see all of who I was when I transitioned as self-destructive and dysfunctional.

For a long time, I felt like my past transition was a brand that marked me as a crazy, broken person. Just being a person with a trauma history felt shameful. I felt like I should’ve been stronger, I shouldn’t have gotten hurt in the first place. Having been hurt by other people was bad enough, I couldn’t even face the full reality of that for years and blocked it out for as long as I could. But then, when I did start seeing how I’d been hurt, and what I’d done to cope, I was horrified. My survival strategies lead me to feel even more shame. I saw transitioning as evidence that other people’s treatment of me had fucked me up to a humiliating degree and I hated myself for it. I tried to separate from my past, I dissociated from my old trans self. That’s how I knew how to handle shit like that. Hate yourself for not being good enough, strong enough, split off the parts you can’t accept, create a different self out of what’s left, keeping running from what you are. I was a detransitioned woman whose ideal vision of womanhood was a butch dyke who’d never transitioned. I was still comparing my actual life and self to a fantasy self that wasn’t real for me, that I could never become. I had to learn to stop beating myself up for not fitting my ideal. I had to to learn to give up that imagined self, realize it was a figment in my mind and that my actual life, who I was in reality, was much more important and valuable.

I get nothing from seeing my transition as purely destructive or maladaptive or evidence of my imperfections. I get nothing from trying to shun my past trans self. I need to be able to accept all of me, all my parts, I need wholeness. I need to be as fully present as possible. Transitioning was as much driven by a will to survive, to exist and express my deepest self as it was a way of escaping myself. Just because parts of me were shaped by other’s mistreatment of me or by living in a sexist society doesn’t mean they weren’t real or that I have to reject them. Acknowledging how my trans self was authentic, not mere false consciousness is still disturbing because it means my self, my real self, is unfixed and subject to change over time. My self is also interconnected with the rest of the world, created through interactions with other people and the environment. Learning that who I am can change through contact with the reality I live in is unsettling but fascinating as well. It makes me feel both vulnerable and connected and gives me a sense of greater meaning when I map out my particular connections to the rest of the world.

I can long for a true self that never changes, that stays untouched by the rest of the world but I will never find one. That doesn’t mean I don’t have a strong personality or that I haven’t found reoccurring patterns in my life but it does mean I ought to prepare for movement and impermanence and stay aware of how my interactions with other people and the world I live in shapes me. Who I am can change and grow. How I understand my life and my actions can change dramatically. Knowing this sometimes makes me feel groundless but it can also be exhilarating to be aware of existing in open, shifting space.

Writing “Lost to Follow-up” was a huge release of thought and emotion. By concentrating on my feelings of shame and humiliation for getting hurt, my feelings of being fucked-up and broken and writing them out, I was able get them unstuck and moving, helping myself change and heal. I’m not surprised then that when I read it now I feel very different from who I was when I wrote it. It can be hard to reread now because doing so reminds me of how much I was suffering when I wrote it, how I was struggling with a lot of self-loathing and shame. One reason I know I’ve changed since I wrote “Lost to Follow-up” is that I feel compassion for who I was when I wrote it. I don’t need to reject that past self or disown her or feel ashamed of her. I can accept and appreciate who I was when I wrote it and how helpful it was to voice all those intense fucked-up feelings. Slowly I learn to accept having been hurt and the ways I’ve coped with being hurt without feeling shame about it.

“Lost to Follow-up” is the only piece I ever took down from my blog, though I only took it down temporarily, putting it back up after adding a disclaimer about how my feelings and views had changed since I wrote it. It can still be uncomfortable to reread now but I value how much writing it helped me heal and I know it accurately captures how I once felt. I don’t want to deny my past. I also know other detransitioned women have probably had similar thoughts and feelings and it could be helpful to them to read it. And I still think the original intention of the piece, describing what could get in the way of detransitioned people contacting and communicating with their old providers is very important. I still don’t trust that many medical providers working to help people transition would be able to accept and hold the complexities presented by detransitioned people’s realities. I still think that they have a lot to learn about us and I’m not sure how many of them are ready to listen.

What I would say to my old providers now would be different than what I’d say when I first wrote “Lost to Follow-up” but not totally different. I still would tell them about how my reasons for transitioning ended up being complicated, involving trauma and lesbophobia and how transitioning was harmful to me in some ways. I would tell them how ashamed and distraught I used to feel about transitioning. I would probably show them the original piece to let them know what kinds of feelings could prevent detransitioned people from coming forward. I would definitely make it clear that detransitioned women don’t all have the same experience with transitioning or detransitioning and that many of us are critical of how transition healthcare is currently administered. I’m still not ready to contact my old providers, though the thought of doing so doesn’t seem as overwhelming as it did in the past.

I reread through most of my blog recently and it was interesting to see what I still related to and what I felt more disconnected from now. I’ve certainly grown a lot since I started writing it five years ago. There’s a lot I want to write about still, including how some of my perspectives have shifted in the last year or so but a lot of my present thoughts and feelings still feel too raw and unfinished to share publicly. It’s hard to write openly about a lot of my life because I know some people will try to pick over it, looking for evidence to back up their arguments about transitioning or trans identity or whatever. It doesn’t matter if the argument they’re making is something I agree with or not, being treated like that feels terrible.

A lot of people who are against transitioning like to point to pieces I’ve written where I talk about suffering caused by transitioning, never considering that maybe in the meantime I’ve managed to heal from that suffering. I don’t like when people assume that people who were harmed by transitioning are doomed to suffer forever. It hasn’t been true in my case. I suffered longer than necessary because I saw my transition as being a more catastrophic decision than it really was. I spent far too long feeling ashamed. I was wrong to think that transitioning meant I was broken or that transitioning had ruined my life. I’ve been able to heal much of the wounds that lead me to transition and that were caused by transitioning. I want people to be able to see my power, not just my suffering.

At this point in my life, I’m not bothered so much by my past transition. Right now, most of the difficulties I face as a detransitioned woman involve how people misperceive me or try to use me. This isn’t limited to one group. I’ve been troubled by how all kinds of people across the political spectrum, including trans people, radical feminists and religious conservatives, view and treat detransitioned women. I hate when people disrespect, tokenize, objectify, or pity me or other detransitioned women, or belittle, deny or exploit our experiences. It’s frustrating as hell.

I am no longer horrified when I remember the time I spent transitioning. That doesn’t mean that time in my life is not heavy to hold. That doesn’t mean that I didn’t have much I needed to grieve. I look back now and my past behaviors make sense, they don’t seem so crazy. I understand why I acted as I did, why I developed that particular understanding of myself. I feel compassion and respect for my past self. I see how my transition and my trans self are part of my totality, part of the process of how I came to be the woman I am today. Taking all that in and holding it gives me a sense of peace.