I know it’s a bit of a cliché, but for as long as I can remember, I have felt very different. As a child, I didn’t have many friends, and could not really relate very well to others around me. Aside from this, I was a happy child who grew up in a loving and stable family. However, from a very young age, I felt very feminine. I could not really understand it at that age though, and was acutely aware of what was expected of my behaviour, so for the most part suppressed any overtly female characteristics. I would always play as a female character in video games, and would admire strong female characters in movies and tv shows. I felt very embarrassed when asked about why I did these things, which just made me try and push these desires and behaviours further down. As I reached the age of puberty, I felt something very bad looming, almost predicting the torment that was about to arrive. And as expected, my journey through puberty was highly traumatic, to the point where my parents barely knew what to do with me. I was withdrawn, depressed, angry and apathetic towards all areas of my life – including my studies. Nothing gave me any sort of relief, I just felt (and still do) like a freak who doesn’t belong anywhere. I started anti-depressants at the age of 14. My doctor initially was reluctant to prescribe them to someone under 16, but saw how desperately I needed help and agreed to begin a low dosage. I began to realise at around 16 that I was experiencing thoughts of being transgender, and at that point many things in my life began to make more sense. Despite this revelation, I didn’t feel any better or sure of what I wanted to do with this information. I am now 19 and am still struggling with my life, and have effectively become a hermit – too nervous to even step out of my front door most of the time. I do not know how to go about regaining my life, as every direction I could take feels hopeless. The reality is that I don’t want to have to change anything, I want to be happy as and where I am – but I can’t see that happening any time soon. Any advice would be greatly appreciated, as I am at my wit’s end here.
A: Thank you for writing in with your question. I wish I could ask you more questions to clarify your situation but hope that I can still offer some help. I’d like to know if you have sought out any support regarding the transgender realization and if you feel your depression and tendency toward becoming a “hermit” seem related to your gender identity or feel like separate issues altogether. My best guess is that both might be true. Depression and anxiety is common with gender identity issues and is quite understandable. Surviving all the typical struggles of adolescence can be difficult enough, but it can be exponentially more complicated when your physical body doesn’t match what you feel inside.
I would first suggest that you reach out to others in similar situations for some support. No one else can understand better than someone also going through it. There are online forums and support groups and there may even be one in your local community. There are lots of resources online to help educate you and get you connected with the appropriate resources. Here are just a few examples:
http://www.nhs.uk/Livewell/Transhealth/Pages/Transoverview.aspx
#/a-primer-on-transgender-care/005870.html
http://www.apa.org/monitor/2013/04/transgender.aspx
I recommend therapy for addressing the depression, anxiety and isolation. The safety and confidentiality of psychotherapy is also an excellent place to explore deeper levels of your identity, sexuality and plans for the future. In the United States you have to participate in therapy before you can begin hormone treatment or gender reassignment surgery, although you did not mention these in your letter.
Finally, it is important to find a family doctor who has experience with gender identity issues. You need to feel comfortable when you go to the doctor, whether it is because of an illness or because you decide to pursue medical interventions in the future.
You are not a freak, your situation is not hopeless, and I think that once you surround yourself with support, happiness will be just around the corner.
All the best,
Dr. Holly Counts
