The "Only transitions if you HAVE too" paradox

[Kate T]

This is the pretty much universally acknowledged advice given to anyone considering transition. Justifiably so. Yet there is an inherent paradox that never seems to be talked about. Along with this universal advice comes the almost equally universal "I wish I had transitioned sooner". It seems on a cursory interpretation that whilst an individual should not transition "until they have too" it would seem from experience here that the only regret experienced is that they should have transitioned presumably before they had too (i.e. I wish I had done it earlier).

The converse paradox is that of early intervention vs do no harm. As a veterinarian I am a strong advocate for early intervention. Generally the earlier treatment is initiated in treatment of a problem then the higher likelihood of a successful outcome, the easier is the resolution and the interventions are generally cheaper. It is arguable that by leaving intervention "until they have too" that there is a higher risk of significant pararelated illness occurring complicating initiation of appropriate intervention for the true underlying concern. Unfortunately though there is no real definitive test or even general agreement on when is the ideal time to initiate interventions. In the absence of clear evidence then it is arguable that a non interventional "do no harm" approach is preferable. there is certainly significant medical effects associated with medication or surgical interventions associated with gender transition therapy.

What do others think of this apparent conundrum?

[Karolyn]

I am 33 and starting HRT in less than two weeks. A lot of the past issues I have had were related to my dysphoria (such as stress and high blood pressure, not feeling well in general, still being single, etc.). Now that I know I am transitioning, I am feeling incredibly better, but I have had that feeling, multiple times, of "I wish I had transitioned sooner". I did not happen mostly because I did not know about it until 5 years ago, and the information I had in the past (internet and TV documentaries) were focusing mostly on bottom surgery, and how extreme the changes were. So I was not considering it. Now that I am ready, I am at an age where I will become a woman rather than a girl. I have early signs of aging, like wrinkles, and those will not allow me to be a gorgeous 20 years old girl. I am compensating currently by wearing clothes that are not for "my age range", at home only. Outside, I am more "mature" looking.

But when thinking about what happened in the last 10 years (since I started crossdressing daily), I realize that the transition would have been way more difficult. I read a lot online about people that transition while being student, or looking for jobs (either the first time or after being fired for being a TG). For them, the transition is incredibly hard, because they have to handle their own transformation, the costs that come with it, and external worries such as job seeking. On my side, I am settled now. I have a job that I like after doing studies until I was 27, and I now live in my own house since a few months. That will make me worry only about the transition itself, and nothing else.

To summarize, I have regrets to not be able to come back as a younger girl, but at the same time I realize the transition would have been much harder, resulting in less happiness overall. So that reduces my regrets to almost none, and I just live life in the present, rather than thinking about a possible past.

To answer your question, I would advise people to transition if they really feel like they need to, but think first about the external factors that would make the transition harder, and gauge which issue has to be dealt with first.

[KellyJameson]

I learned that phrase on this forum and it was from reading the postings on this forum that I learned it made sense for some but not something I would ever subscribe to for myself.

The idea that for some not only is the middle path possible but also probably safer never occured to me "coming out my experience with GD." For me it was always "all or nothing" and I tried the "nothing path" as long as possible other than wearing my hair down to the middle of my back and laser/electrolysis.

I had no illusions about how dangerous hormones can be or being transsexual in a country with rampant transphobia.

I pushed down my subconscious gender identity with everything I had but to do that I had to keep very tight control over every aspect of my life. I had to lace myself up into a type of psychological straightjacket so my subconscious could not take over.

I was constantly fighting myself and living relentlessly with the fear that I would lose control over my female identity that kept asserting itself. It was a conscious battle to control my unconscious mind.

For me anything remotely feminine was extremely dangerous. Crossdressing would be like letting a wild beast out of its cage.

I cared F..k all about shame and never experienced shame because I never had a male identity "to experience shame with"

You only experience identity conflict when you identify with that group but there was no male identity for me to threaten with by "unmasculine behavior" (crossdressing) so hence no shame or self loathing that you see crossdressers go through. People give away their actual gender identity all the time by how they experience shame.

Consciously I used masculinity to hide the truth. I played at being a man to hide the truth that "I was not" to avoid the danger if anyone found out that I was not, but I certainly was not emotionally invested "In masculinity" because I did not identify as male subconsciously. Your subconscious beliefs always give you away eventually.

Crossdressing was threatening to me not because of what others think "as to their acceptance" but because I would lose control over suppressing my female identity. I lived in a constant state of suppression of self as my gender identity because I instinctively knew once I lost control I would or could be placing myself in extreme danger.

I desperately wanted to be born but I also desperately did not want to be killed. I was simply fighting for two different types of survival. My gender identity was fighting for survival subconsciously and I was consciously fighting for survival as to not doing something that could get me killed or make me sick. Thats all it was. Very simple...... SURVIVAL

For me transitioning is all about survival and how you go about it.

But there is this whole other world related to transitioning that I did not know existed. Made out of fantasy and wanting to be a woman for whatever reasons people want to be a woman. It appears from their words that they are not women but maybe not men but some type of mixture of both and that they can live as both. This is so far removed form my own experience that it seems best to recommend the advice "only transition if you have to and or as far as you have to"

I definitely subscribe to the idea of only if you have to and I did everything for years to NOT TRANSITION, not because I was not a woman but because I knew "I WAS" and what the implications were because of that.

The paradox is I now know it was always a fixed game and I was always destined to lose it but how can you know this while you are still fighting against it? You can't.

The best you can do is look at how GD is trashing your life. It caused me PTSD but the problem is when you are suffering from any kind of mental illness than it is natural to think that this deep conviction that has always been with you is just another expression of this mental illness and truth be told sometimes it is.

Mental illness may be why some people want to be the opposite gender (identify with) but not being your "actual gender" causes mental illness so what came first, the chicken or the egg?

I finally reached a point where if this is mental illness and the only way to cure it is by transitioning than thats what I must do. Of course you never tell the therapist this but I was completely exhausted from a lifetime of fighting against myself.

Everyone is left ultimately trying to find balance and if you can walk the middle path lucky for you.

At some point maybe the best thing to do is to stop trying to define what is a man or woman according to everyone and figure it out for yourself.

I do get apprehensive often for some who are transitioning because it seems like they really do not identify as a woman so much as they identify with women but from a males point of view. This seems a dangerous path to walk when HRT or surgery is involved or worse they are doing it purely for sexual reasons to find a partner but without that deeply held lifelong conviction of being female.

Not WANTING to be a girl but BEING a girl. Being a girl who recognizes something is seriously wrong is very different from wanting to be a girl. You are coming from a completely different gender identity between the two.

I personally would never recommend any type of transitioning unless you have been seriously fighting against a long held subconscious conviction that you are female.

To transition without that deeply held core identity (subconscious) you are placing your life in serious danger in my opinion. You would be creating the very thing transsexuals are trying to escape from.

For me the paradox is it seems an awful lot of men want to be a woman (physical ) when all I wanted was to stop being a woman (subconscious gender identity)

I tried for years to force my brain to match my body but it knew better and kept fighting back.

[Zooey]

I'm always torn on how to feel about the "only transition if you have to" statement, because I'm not sure how it applies to me.

I've started to formally transition because, well, I realized I was already doing it. Once I realized it had been months since I'd left the house as a man for anything other than work, and that what used to feel like crossdressing felt like life and work was the new crossdressing, it felt right to me.

Honestly, the "only if you have to" rhetoric is tough for me, because I guess clearly I had to, but I never had the "traditional story". I was never severely depressed, I've never contemplated suicide. My dysphoria has gotten worse since transitioning socially. because I'm experiencing the low of going back to my male costume every day now. Before, it was my normal state, and while it was low I never felt the high necessary to provide the context.

In my weaker moments, I sometimes actually have imposter syndrome about it - I seriously wonder whether or not I'm sad enough to be allowed to pursue happiness in some people's eyes. How screwed up is that?

So "only do it if you have to", but - at least in my opinion - that doesn't have to mean a lot of the really negative things that everybody talks about.

[PaulaQ]

In an ideal world, those of us who noticed these feelings as children would've been given puberty delaying drugs, allowed time to figure out if transition was right for us, and then given medical treatment. We'd have lived most of our lives as cis women do.

And while more trans children today receive such treatment early on, most of the rest of us have to wait until our bodies have been poisoned and disfigured by T, sometimes quite severely.

So realistically, nearly everyone in this forum received treatment "too late."

The reason we have the paradox you stated is that by and large, the world doesn't accept us, and so transition can bring massive personal loss, and great hardship in the trans person's life. It's understandable that we often try to avoid this as long as possible.

The downside is that some of us hit the wall "transition or die." Apparently 41% of us hit this wall. You don't want to reach such a point of misery and desperation, it's quite dangerous.

[Rianna Humble]

The oft repeated, and very valid advice "don't transition unless you need to and if you do need to then don't let anything stand in your way" is not about whether someone has attempted suicide, it is very much about quality of life and perhaps to a lesser degree about determination.

We see some people posting here about transition, but who value their relationship with a non-accepting wife more than they value being congruent. Or who value being seen to be the father of their children more than they feel the need to be whole. Or who value something else more than the need to be seen for who they really are. For those people, transition would be a mistake because it is not a priority for them and they would lose whatever the other thing is that they prize more.

We also see some people coming here in a pink fog with fantasies of being treated like a Hollywood starlet or a princess or something. In many cases, these posters (if they even are transsexual) would regret the outcome because reality would not come anywhere near to their fantasy.

I regret not transitioning earlier, but that is tied to the fact that I fought against my need to transition for such a long time it is not tied to not needing to transition previously. To quote one friend who knew me during that time of internalised struggles against my identity

You never were a man, Rianna

[PaulaQ]

The oft repeated, and very valid advice "don't transition unless you need to and if you do need to then don't let anything stand in your way" is not about whether someone has attempted suicide, it is very much about quality of life and perhaps to a lesser degree about determination.

True - it isn't about desperation. And that is why this advice is often dead wrong in my opinion. I certainly received a ton of well intended but in fact quite horrible advice here based on this idea of "only transition if you have to."

There is a point to the advice - unfortunately you have to choose between an uncertain future, and certain misery from living as a man. And while we like to talk about transition horror stories (which are all too real), in fact some transitions are easier than others.

A great deal of the energy behind this idea seems to be fear of "Oh. My. God. They. Aren't. Really. Transsexual. And. They. Regret. Transition!!!!!!"

Look - before you do anything too awfully permanent to your body, you need to be quite sure that transition is for you, which unfortunately means living through some of the worst parts of transition - the early part. This is horrendously unfair, but it lets one see if the misery from GD that's eliminated is > than the misery of being trans and visible in our society, or for that matter, if transition is even right for that person.

Unfortunately, there really are no guarantees nor perfect predictors of success. Some of us will have extraordinarily hard lives during and post transition. Some of us will be murdered because we are trans.

I guess some of this notion is regionally based too. I seem to hear this attitude more from people where trans medical care is more readily available. Hey, maybe some medical systems push people to transition who shouldn't, or push people too quickly, before they really know. In many places though, the barriers to entry are pretty high - your experience transitioning in Texas is apt to be very different from someone who transitions in Canada.

[STACY B]

Right,,, Right,, An Right ,, Paula hit it ,, Rianna hit ,, An Kelly just lives in my head an reads my mind ,,lol,,

But the ol saying I should have earlier is kinda of Crazy for us older chix . Because of the lack of Medical care or advice . Even Now where I live there is very limited services ,, No General Doctors nor Endo's ,, Just a few therapist . With that being said who could afford to just pick up an move ? It's bad enough to have this an have a family or just the cost alone of going to local Doctors an having to pay out of pocket for all the different services you need much less throwing in Travel .
As far as the Education about Trans medicine an services they change month to month it seems there always evolving .

You have to wait until it's your own best time to do it ,, You can't use someone else's time line ,, It might be kinda close to your timeline but not exact . Everyone's different in there own way an this is no different . You could have picked a better job or house or car or on an on ,,, So this is one ride you got to step up an take control of . An just hope for the best .

An as far as children are concerned now a days my point exactly ,,, Blockers are more main stream an getting treatment much earlier just like lots of things before ,, Hell back in the day there were all kinds of small things that would or could Kill you that there are simple treatments for today . So this in my opinion is just like anything else ,, They will find a treatment an make it better an better by trail an error an move on to something else . I am sure there are lots of New things happening right now we would not even understand about . We understand Trans issues because we are Trans ,, What about all the other issues we neglect while consintrating on our own problems ?

[PretzelGirl]

I probably feel more like Zooey. As each of our paths are individual experiences, I find mine to certainly qualify. "Have to" can have a overbearing feeling to it. Don't define it as "if I don't, I am dead" as that is too far. I think I actually hit a sweet spot and it worked in my favor as it occurred on my terms. I did feel wrong all my life, but it didn't become something to address until the point I did. Because the environment was right, I was able to transition without a lot of the accompanying stressors and my mind was able to deal with it. So I believe that there is a component to a healthy transition to where you do it at the right time and not wait too long, not just from the depression side but also from the side of being able to cope with the transition itself.

Now a lot of people have probably delayed their transition due to the environment of that time. People have only been gaining acceptance on a broader scale recently and insurance just didn't happen. So it could be argued that the definition of "have to" is sliding a little because the level of family/social repercussions will drop over the years making it less of a personal issue. So I am hopeful that we will see more healthy transitions as I would like all to experience it.

[Kaitlyn Michele]

Paula,

Advice is always sometimes wrong.

You mention that you felt it was bad advice for you but then you put down a lot of words that kind of contradict what you said...and then you go on to talk about maybe getting murdered!!!
So basically i would argue that if i am about to do something that is permanent, that is a totally blind alley, there is no guarantee of success, that is horrendous to experience, and that might get me murdered, i probably shouldn't go down that path unless i have to..

I have no trouble with the statement or rianna's more robust and complete version of it.
It simply represents a shorthand way of saying something that is difficult to put in words without writing a book of sorrows..
It's not like people say or type "dont transition unless you have too" and just leave it at that anyway..

I have to admit that if you drill down on the simplicity of the statement you are faced with the followup question of "how do i know??" and all i have for that is you will "just know"...if you can't answer the question and say "i just know i have too", you are going to face a lot of roadblocks and potentially many losses and disappointments...regardless of the idea of "its getting better out there", you will still be marginalized especially if you don't pass ...you will still be a target for ignorance and hatred and potentially violence...

Another shorthand thing that ts people often say is "don't overthink it"...another is "do what you need to do".... there are lots of them that need alot more follow up if they are to mean something and be constructive..

[STACY B]

I agree with Kaitlyn's statements ,, You can read an read all you want about other peoples lives an there hardships or successes but we all have different lives . Live in much different places with different kinds of people in our area . An most certainly different services are available for each one . An one thing most of all is being in a good place with your job an money to pay for it all . So transitioning earlier without help from family is almost unheard of .

[Dianne S]

Honestly, the "only if you have to" rhetoric is tough for me, because I guess clearly I had to, but I never had the "traditional story". I was never severely depressed, I've never contemplated suicide.

Wow, Zooey! You could be me talking! That's exactly how I feel. And in my weaker moments, I also think "WTF am I doing? Am I really needing to do this?"

But then I remember how much happier I am presenting as a woman and I realize "Yes. This is right."

[flatlander_48]

The natural arc of Life is childhood, adolescence, young adulthood, middle age and old age. Owing to how the circumstances of ones life changes over time, it would seem that transition is easier (obviously relatively!) earlier or later.

At an earlier time, ones life is probably not well established and rooted. Great change can be accomodated better because there is less to keep you stationary. I'm assuming that a career wouldn't be established, or at least well established. Perhaps there is no family or perhaps only a spouse. At a later time, maybe it almost becomes a WTF deal because there is less concern about the reactions you will get. If you have a family situation, kids will be older and possibly full grown. There will likely be more career security or even retirement.

It would seem that in the middle is a more difficult situation to work with as you could have a lot invested in career, home and family. There's a lot more in play, many things to deal with and a myriad of things to go wrong.

DeeAnn

[LeaP]

Like most that delve into meaning, the OP paradox revolves (and resolves) around semantic ambiguity. That damage may have occurred doesn't obviate the meaning of need or transition or even damage. It's usefulness is in exploring one's premises

Watch out for the hidden assumptions in such formulations! An important one here is that damage caused by earlier transition would either not have occurred or be irrelevant.

[becky77]

I wish I had transitioned earlier, but I obviously wasn't ready.
You can only regret not starting sooner when you have actually started, and you can only start when you are ready. Better to regret not doing it sooner, than to regret doing it.

[PaulaQ]

My problem with the statement "Only transition if you HAVE to", is that I got a very strong sense that really, what was being said to me was:

" Don't transition."
" You are just a CD lost in the pink fog!"
"Your feelings about this aren't real!"

Married CDs seem to get this sort of advice a lot, despite the other really obvious symptoms they describe that peg them as a transsexual badly in need of transition.

I feel pretty certain that some here on CD.com have an agenda of keeping such people from considering transition. I can think of several reasons that might be, and I'm sure the reasons such people might feel that way vary from person to person. And I am not implying that this attitude is universal.

But I am saying that the idea "don't do it unless you have to" is inherently dangerous - because the entire rest of the world so often tells us - "you don't need to do this, no one does!" Reinforcing that, however unintentionally, seems like a bad thing to me.

It's not that there aren't people who are being totally unrealistic about their need to transition. I have seen that before, although I have to say that at least here, the barriers to entry are pretty high. It's just that I continue to see people who pretty obviously need professional help being told, basically, "stop huffing the pink fog."

I am finding the intention of this idea to be quite different from it's actual implementation here.

[MsVal]

The advice not to transition unless you have to is one of those wise old pieces of advice that seem to be bandied about without much supporting evidence. I say 'seems to' because I haven't (yet) paid it a great deal of attention. Please pardon my ignorance. I wonder, though, in the spirit of my oft asked question: "What bad thing would happen if you didn't?"

I already view transitioning as a scary, expensive, lonely, painful, and alienating venture.

What bad things happens to those who don't follow the advice and transition when they don't have to?

Best wishes
MsVal

[Kaitlyn Michele]

So val your idea is
"go for it, what can go wrong"??...

You also said.
"I already view transitioning as a scary, expensive, lonely, painful, and alienating venture."
Really?? No kidding.

How is saying that to a possible transitioner any better than saying "don't transition unless have to"..

Both you and Paula have now critiqued the statement and then came up with nastier scarier ways to say the same thing
...at least you didn't add you might get murdered..dont transition unless you have to pales to what you folks are saying.

I disagree that the idea is dangerous unless you take the position that sharing any difficult information with a troubled person is dangerous.
And i'd also add its unfair to ignore the fact that pretty much every troubled person that comes here is encouraged to seek out professional therapy.
Leaving that out really moves the argument away from what is really happening here.

And purely semantically Paula saying "don't transition unless you have to" actually PRESUMES that transition can be needed... it is the opposite of saying no one needs it...

++++++


The real story is that people that transition have a strong bias to counsel extreme caution. It's just a fact. Why is that??

Is it because they are a cabal of people that want their club to be exclusive? That hate crossdressers? We don't want people to know how awesome it is??
That is such a crock

or is that because they know what its really like and what the risks and rewards are? how expensive it is? how marginalizing it can be? what its like to look into your wifes eyes as she realizes you are transitioning..your kids eyes?

I actually don't think any rational person could conclude transition is anything but a last resort. Concluding its a last resort does not invalidate anybody. It doesn't stop anybody. You can go from 0-60 in a flash if you conclude you need to transition. Being a last resort means its an actual option to consider. It's not something to ignore.

Most of us know lots of transitioners...i do. they generally encouraged professional help and counsel to me and told me transition is a last resort to curing my gender dysphoria and to explore all alternatives to transition...and if i did transition they counseled me to be prepared for lots of really difficult times and they were right on all counts...

Who would know better than transitioned transsexuals and therapists?

btw..as an aside..I was told many times Paula that i was "just a cd" ...i know what its like...but i got over it, and so did you..


Does it make anybody feel that there should be a much more positive and encouraging viewpoint whereby all people are encouraged to pursue it as a primary alternative?

[arbon]

Val - just my observation but I know quite a few TS women who are broken and have a lot of problems, who are not very happy. Most I would think, from knowing them, had to transition, but some maybe not. One of my friends who transitioned a long time ago has said to me a few times if she knew how it was really going to be she would not have done it - she lost a lot and maybe what she got in return was not what she had expected.

I tend to want to dissuade most people and wish they could figure out how to make their lives work as men. Its just transitioning can be very hard and the other side of the fence is not always so much better when you get there. I don't feel that way for everyone though. Some come across as very certain and even graceful about transition and it almost seems easy for them without a lot of ordeal (like Sue!), maybe she did not seem like she had to but is a happy awesome woman so better for her. I was not like that! For me it was more a last ditch effort before killing myself, I was really coming apart from the inside out. My transition was not the hardest but definitely not real smooth going either. I felt like I had to though and things are better, but still I have issues and not everything is resolved, I'm still not all together. People here did give simular advice to me about not transitioning if I did not have to, and even implying I was a guy who crossdressed - back then it did irritate me a few times but really it just made me ask myself some deeper questions.

Transition if you have to - there are a lot that come on here and from what they write I think it is totally wrong for them (like if they are more focused on clothing and other external things, rather than on what is going on inside them) or even if it seems right you can tell from the their circumstances and how they are feeling that its going to be a long brutal experience.


Should we say it or not? I don't know.

Younger people are in a different circumstance though, they don't have all those years invested into a male life.

Just my thoughts and feelings on it with no real answers.

[Angela Campbell]

First let me say that I would not advise transition simply because I wouldn't wish this on anyone. Not my worst enemy....and I had a fairly smooth and easy time of it.

And yes I do wish I could have done it sooner but that was not a real possibility.

It is good advice to warn of the possibilities for those who are not necessarily needing it. You know.....where fools tread......

It is a serious life altering, thing which cannot be fully undone. No I wouldn't recommend it unless you have to.

Paradox...yeah it is. But nothing to play with.

[LeaP]

My problem with the statement "Only transition if you HAVE to", is that I got a very strong sense that really, what was being said to me was:

" Don't transition."
" You are just a CD lost in the pink fog!"
"Your feelings about this aren't real!"

Married CDs seem to get this sort of advice a lot, despite the other really obvious symptoms they describe that peg them as a transsexual badly in need of transition.

...
But I am saying that the idea "don't do it unless you have to" is inherently dangerous - because the entire rest of the world so often tells us - "you don't need to do this, no one does!" Reinforcing that, however unintentionally, seems like a bad thing to me.

It's not that there aren't people who are being totally unrealistic about their need to transition. I have seen that before, although I have to say that at least here, the barriers to entry are pretty high. It's just that I continue to see people who pretty obviously need professional help being told, basically, "stop huffing the pink fog."

Let me start with the last – people who "pretty obviously" need help. I don't know if I'm recalling this correctly or not, but I believe you are a mental health professional? Even so, it is by no means obvious to all mental health professionals who is transsexual and who is not, who might benefit from transition or not. If you are, do you typically diagnose people in such summary fashion?

But assume that one of these folks who pop in to the forum is transsexual, would benefit. Is there some protocol, some well-understood path for starting them down the transition route other than what we have today? Which is, not to transition until one is certain about one's identity, until they are ready from any number of perspectives? No, of course not.

One has to wonder what it is you are really objecting to. These people are not ready to transition, usually by their own words! They don't know who they are and they have no idea what it means to transition. Yet you are upset with advice on the forum that would warn them away from it if they don't need to transition or if they aren't ready. This doesn't come out of thin air, but in response to questions about transition. Moreover, I have never seen the bald statements that you attribute to members in your post. There are always caveats and conditions surrounding the statements similar to the ones you say are being delivered.

But let's ignore that, too! Let's assume the transsexuality, the benefit of transition, and the upfront advice to transition. Unfortunately, readiness cannot be assumed. Still, it's the ultimate "you go, girl"!

What now? Is there a therapeutic relationship in place to help with the transition? Whoops, turns out "no" most of the time. If the person is married (in a category where you really don't like the advice), is the spouse ready? Does the spouse even know? Whoops again. Does the person know anyone who has transitioned? Not usually. If they do, is that person prepared to take on the level of support this person is going to need? God only knows. Are they financially ready? Ummmm, mostly not.

It seems almost comical to have to point out the reason why these sorts of questions are important. And that is because someone transitions is highly likely going to be blowing up a significant portion of their life and relationships, exceptions noted. The sidebar plea that some mysterious negative is being reinforced, along with the implication that we are complicit in manufacturing transition issues is the purest of BS.

Transition is both constructive and destructive by definition. Chances are there is going to be fallout from the destructive portion of it. That doesn't require anybody manufacturing problems. Those will come up quite nicely on their own, whether or not there is cultural reinforcement from our teeny community.

Perhaps the objection is form rather than substance. That is that we should talk nicely about transition instead of coming off as harpies ... something like that. Even if we have to resort to much nicer, politer, Q&A on inconveniences like risks and reactions. That might have some merit were we being importuned by the masses desperate to transition who are actually transsexual, or were we unduly discouraging the few who are. You suppose the former. I reject the latter!

I suppose instead that there are actually very few cross-sex identified individuals indeed. And not all of them need to, want to, or would benefit from transition. Those who would tend not to be ruffled in the least by the Q&A. As Misty might put it (and where has she been lately anyway?) "if they think this place is tough… "

[Kate T]

Watch out for the hidden assumptions in such formulations! An important one here is that damage caused by earlier transition would either not have occurred or be irrelevant.

My apologies Lea, I did not express myself well enough in the OP. This was certainly the concern I was trying to raise with the "do no harm" discussion in the second paragraph of the OP. I really only hinted at the medical consequences of inappropriate intervention and should also have talked about the probably far more concerning psychological and social consequences that can also occur with inappropriate intervention as many members here have already pointed out.

[LeaP]

Don't apologize! I loved the OP! It is so seldom a thing to be able to consider something new here, and I have not seen those two things put up against one another before. As you can see, it prompted a lot of discussion.

I just don't like the paradox formulation here. It raises too many side issues (e.g., the meaning of need) around the real question. Which is, is there any realistic way to identify earlier who should transition and how to get them there? Approaching this as a retrospective on a life already lived doesn't help, beyond providing context for the question.

[PaulaQ]

@LeaP - I don't diagnose anyone - how could I? My observation is simply that people who express profound emotional distress regarding their gender, and in particular who mention suicidal ideation probably need some support, and encouragement to seek competent professional help in their area with gender identity experience to help them figure out what is going on with them. The constant negativity here is unhelpful, or at least I found it to be so, to someone who was ready to simply end their life to end their suffering. Telling them "pink fog - you are just a CD - this path is too awful for what you suffer from" is a bad idea, in my opinion.

In my case, I realized I could lose everything, and that I didn't care. I still don't.

The only thing I did care about was whether or not there was any conceivable relief possible from the horrendous feelings that gender dysphoria caused me to have. Because if no such relief were possible, I didn't want to wait around in misery for much longer. I'd simply had all I could take.

There are some awful things that happen to some of us - but I would point out not all of us. I have friends who have transitioned, and really, they lost nothing but misery. They kept their jobs. They kept their homes. Their friends and family stuck with them. There are, amazingly enough, good outcomes sometimes. I know though, from personal experience, that loss is common, and I see this with many others I have worked with, many of whom have endured far more than I ever have. (I've been quite lucky.) Some lose it all. But most don't. Most do lose a lot though. I have no problem with telling people that - it is the truth.

It is the subtle undercurrent of "just don't do it." That I have a problem with. I think people need to have hope that their lives can be better in some measure.

[LeaP]

@LeaP - I don't diagnose anyone - how could I? My observation is simply that people who express profound emotional distress regarding their gender, and in particular who mention suicidal ideation probably need some support, and encouragement to seek competent professional help in their area with gender identity experience to help them figure out what is going on with them. The constant negativity here is unhelpful, or at least I found it to be so, to someone who was ready to simply end their life to end their suffering. Telling them "pink fog - you are just a CD - this path is too awful for what you suffer from" is a bad idea, in my opinion.

...

It is the subtle undercurrent of "just don't do it." That I have a problem with. I think people need to have hope that their lives can be better in some measure.

No diagnosis? What is: "... really obvious symptoms they describe that peg them as a transsexual badly in need of transition. "

People get constant counsel to seek help here. It is THE most common response.

I don't see negativity, really, I don't. The "unless you have to" relates to TS transitioning, and knowing you are such. Helping people get to that realization is always the first order of business. People who are not cross-sex identified should not transition, with rare exceptions. Wrong solution.