There's something I'd like to talk about.... as a Butch identified person and gender non-conformist.
It's the idea of transitioning. Why is this subject taboo for Butches and/or other gender non-conformists? I have come to realize that much of my paralyzing ambivalence around 'transitioning' and my own health care options has been influenced by the stigma and myths around what it means to transition. This includes what meaning is placed on breast tissue removal and chest masculinization, as well as effects of testosterone on appearance, mood and personality.
I am not speaking about the idea of transitioning to manhood, which I fully support the ability of male identified people to do. I am speaking about the ability of non-male identified trans people, Butches, Bois and others to transition into our bodies in ways we feel comfortable - ways which fully respect our psychological, emotional, and physical needs. I believe many Butches are limited from openly discussing their desires to take steps to inhabit themselves more comfortably and fully because of this stigma, the judgments and conclusions people in our own communities make around these acts and options - as well as pervasive genderism in our healthcare systems.
Many Butches are suffering due to a lack of information on how access to trans related healthcare can benefit them. For example, it is not uncommon for Butches to experience hormonal irregularities, with the common solution being prescription of the pill. However, for Butches already suffering from bodily distress around feminization, going on the pill would increase an already unbearable discomfort in inhabiting our bodies. Developing fuller breasts, hips and softer bodies, for individuals already in distress and who feel at war with their bodies will only increase psychological, emotional, and gender dysphoria.
The simple fact is, testosterone has been prescribed to women-identified people for the past 40 years for health related issues with little negative impact. Female assigned and identified people are prescribed low doses of testosterone for increased libido, wellness, self image, muscle strength, endurance and recovery, increased bone density, mood imbalance, fatigue, muscle soreness, relief from anxiety and depression, sleep disturbance, increased metabolism, energy, focus, and memory, for example. Side effects include mild hair growth, muscle growth, lowered voice, increased genital size, decreased breast size, interruption/lack of periods (dose dependent) and slightly increased masculinization. For many Butches, side effects would actually be desired effects! Why testosterone therapy hasn't been presented more readily as an option for gender non-conforming people in health care is a disservice to all those who could benefit from it and is likely based in gendered notions of healthcare.
In terms of stigma within our own communities in using testosterone as hormone therapy, I have often heard of remarks of how testosterone will affect our personalities by making us more aggressive, hostile, chauvinistic, less sensitive, and more sexist in our behaviour towards our female id'd partners (for those of us who date women). While I'm sure that some individuals who use testosterone act like assholes, what I would tend to argue with is the idea that testosterone is the cause. For many of us who use this health option, the benefits make us happier, more self-confident people. We feel more right in ourselves because of our increased libidos and masculinization and may in many cases receive more appropriate gendering as a result - which also increases our sense of wellness. Differences in emotionality and affect may be very subtle or not noticeable, especially when taking low doses.
As for top surgery, there are similar pressures and stigmas preventing many Butches, Bois, Genderqueers, and others from exercising this option. The idea that top surgery must be preceded or accompanied by hormonal and conceptual transition to maleness has limited this option for many. I admire the bravery of those individuals who have gone ahead with tissue removal without hormone therapy and who feel greater relief and self esteem as a result of removing the feminizing and gendering aspect of "breasts." The thought of not having to bind and to be able to physically relax on a cellular level as a result of feeling right in one's body and passing more readily is liberating. To be able to finally wear shirts/clothing that do not signify femaleness by virtue of lumps on one's chest, without being read to have breasts or cleavage of any sort would be incredible. And for those who have the cash, it is an option. Some doctors do not require the degradation of having to submit to psychological or psychiatric testing in order to make the choice of what to do with one's body, and will honour the autonomy and selfhood of those who do not fit the gender binary.
The idea that gender non-conformists must suffer through their dysphoria as a right of passage or inherent aspect of their identities is grossly misinformed, transphobic, and archaic. Labelling access to appropriate healthcare options as a product of internalized misogyny is, in fact, a product of cisgender privilege.
For those who have been curious about trans health care and the benefits to them, I encourage you to do your own research, ask questions, talk to others, and advocate for your right to access what is already available for others. Conceptual limitations and stigma need not impair your ability to make informed health care decisions to fully inhabit yourself and your happiness.
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