Lauren Black: “I am a butch lesbian. I live with gender dysphoria. I do not believe my deep discomfort with my female body means that I should take steps to change it.”

I am a butch lesbian. I live with gender dysphoria. This is the condition which, according to mental health professionals, means I am transgender. However, I do not define as transgender. I do not want to take hormones or have surgeries. I do not accept that it is possible to live “as a man”, without believing in old fashioned gender stereotypes. I do not believe my deep discomfort with my female body means that I should take steps to change it. This is my story.

In many respects, I live “as a man,” if you want to put it like that. I don’t want to put it like that, which is part of the problem I face. But I work in a warehouse. I shop in the men’s department. I have a wife and children, who I work to support. I am at ease in the company of men. My hobbies include turning wood, and fixing things. If I could click my fingers and be rid of my womb and my breasts, and not face lifelong medicalisation, I probably would. I have regularly felt, like Lady Macbeth, “unsex me here.” I am often “misgendered.” People call me “lad” or “sir,” until they hear my voice. It bothers me not at all.

I meet the criteria, set out in the DSM 5, for medical transition. That is, if I went to a gender clinic and told them how I feel, and about my experiences, they would prescribe me testosterone and a double mastectomy. I choose not to transition. Instead, I am learning to love the skin I’m in. I have my own struggles with that skin, with my female body. Those struggles are not because my female body is wrong, but because my negative thinking around my body and my sexuality, which started in childhood, was not explored through therapy soon enough. I do not think it is in my interest to treat a condition that is in my head by making changes to my body. Psychiatry does not have a good history in this regard.

I’m not hard line about transition. I support the right of adults to take what course of action they feel they need to take. However, I believe it is the responsibility of the medical establishment to explore options with individuals, before going ‘nuclear’. If counselling, feminism, learning to accept your sexuality shame free (which for me is butch femme dynamics), or even just growing into yourself can help you, why take life changing drugs and have life changing surgeries? It is not the job of clinicians to prescribe unthinkingly to satisfy another person’s desire to be validated; it is the job of clinicians to explore the reasons for an individual’s distress.

I choose not to transition. Instead, I am learning to love the skin I’m in. I have my own struggles with that skin, with my female body. Those struggles are not because my female body is wrong, but because my negative thinking around my body and my sexuality, which started in childhood, was not explored through therapy soon enough.

The affirmation model, the rush to the nuclear option first, is not good for individuals like me, who live with dysphoria. It closes down my options. I am less able, not more, to seek help for my distress, as the only help now widely available would, I believe, be damaging to my health and my life. The side effects of testosterone on women include, and may not be limited to – painful orgasm, vaginal atrophy, clitoromegaly, suicidal tendencies, violence, panic attacks, rage, jaundice, severe allergic reaction, nausea, vomiting, liver failure, cancer, kidney or urinary problems, infection of the injection site, stroke, or heart attack. Learning to love the skin I’m in sounds like a much better option to me. 

Affirmation also solidifies a trans identity. Dysphoria is a condition affecting individuals; transition is only one treatment for that condition. “Being” trans seems as though it attaches an identity to a condition, and I don’t think that’s a helpful way to think. Individuals live with a variety of conditions, without letting those condition define them.

It is particularly important not to “affirm” children in identities which may take them down unhelpful routes in their lives. Telling a child they “are” anxious, for example, is less helpful than giving them support and strategies to deal with their worries. 

How much more important is it, then, not to consolidate the identities of people in ways that will make them life long medical patients, reduce their choice of sexual partners, and may ruin their future fertility and sex life? If I had been “affirmed” as transgender as a child,  when I was a tomboy, if that option had been open to me, I would have taken it. It was not an option. I am glad it was not. I now have a life that I never thought was open to me.

My wife loves me, just how I am, with all my oddities. I’m very glad that I’m in a lesbian relationship. I would not want to be in a heterosexual relationship with a woman. That would wreck something important for me about who I am, and what I stand for and I could never have discovered that on my own if I had been transitioned young.

I still have difficulties with my sexed body. Periods are particularly difficult for me. But instead of seeking a hysterectomy, I tell myself, “Lauren, you’re a butch lesbian, are you really so afraid of a little blood?”, and then I get on with my day. My wife loves me, just how I am, with all my oddities. I’m very glad that I’m in a lesbian relationship. I would not want to be in a heterosexual relationship with a woman. That would wreck something important for me about who I am, and what I stand for and I could never have discovered that on my own if I had been transitioned young.

I stand for trashing the old fashioned, regressive stereotypes that say “if you can drive a forklift and operate a lathe, you must be a man.” No. I stand for a celebration of the amazing diversity that women are. I stand for smashing the nonsense that is the gender binary. I stand for loving the skin you’re in, and embracing who you really are, not for altering healthy bodies with drugs and surgeries in an endless quest to become someone that, in the end, you biologically can never be. 

And so, I will put on my high vis vest, and my steel toe caps, and go to work with the lads, and I will hug my wife a little tighter when I’m suffering. I will clad my female body with muscle, and my female voice with chivalry, and I will know that this is who I am. And that it is good enough.