Please join me in welcoming Harper back onto the show.
Vieno: So, topic of today is non-medical transitioning. So to start off with, let’s kind of go over what does that mean.
Harper: Yeah, I was about to ask you: Do you mean non-medical transitioning as in not taking HRT? Or do you mean non-medical transitioning as in no HRT no surgery? ‘Cause sometimes when people say non-medical transitioning they’re meaning just no hormones.
Vieno: I mean, we could talk about both, since there’s multiple definitions for it. ‘Cause for me, I would consider surgical transitioning to be medical transitioning.
Harper: But some people don’t. Maybe a better title for this would be “Alternate Transition Routes?” ‘Cause, I mean, everyone’s transition is different, right? The usual route is like: go see a therapist for three months, then you go get the HRT, then you do the HRT for however long, then if you got bottom dysphoria then you go get the whole magilla down there, and top dysphoria the same thing, and yay you’re transitioned! But, like, for non-binary people, or for people who don’t have bottom dysphoria, or who are not exactly in between the lines, some medical transition is needed, some isn’t.
Vieno: My hypothesis, and my, albeit limited, understanding, is that there would be less people who would get surgery without HRT than people who would get HRT without surgery.
Harper: Yeah, I think you’re right. And there are reasons for that. A lot of times HRT is all people need and they don’t have the kind of dysphoria that requires them to have surgery. But some people struggle with HRT, mentally and emotionally. I definitely knew somebody personally who was like that. They were assigned male at birth, tried hormones, liked the physical effects, but mentally it was just too much. The hormone changing and all that, and then the emotional baggage that comes along with transitioning, was just too much all at once. Not to say that they won’t try it ever again in the future, but they are pretty firmly on the surgical only, if anything, route right now.
Vieno: For your personal experience, ‘cause you’re not interested in doing really any HRT at the moment.
Harper: Yeah. And I’m 99.9% sure that in the future I will not pursue HRT at all.
Vieno: But are you intending on doing any top surgeries or anything like that?
Harper: Yeah. Personally, definitely want to have top surgery, but what I consider top surgery and what the “normal” top surgery is, is different. I’m non-binary, so, right now I have very large “assets”, I shall say. Breasts, I guess if we’re using medical terms here.
Vieno: Large tracts of land.
Haper: Yes, large tracts of land! And I don’t necessarily think I would feel right without breasts, but I definitely want them to be kind of androgynous breasts, if that makes any sense. So I want them to be almost mistaken, “are those breasts? I’m not sure.”
Vieno: So just like a considerable reduction, and not necessarily a mastectomy.
Harper: Yes. Because, I mean, I’m not afraid to share this, but before I stopped wearing bras I wore like an I cup. That is...yeah. That’s a lot of chest dysphoria to deal with. So anything less than that would be great. And the reason that I wanted to do it that was is because - it’s not because I’m too afraid to get top surgery and I’m just going to get a reduction because I’m too afraid- it’s more I’m just 90% sure I don’t want top surgery, and reduction will allow me to in the future if I want full on top surgery to be like “Yup this is not working for me we need to fix this into something that’s more workable for me.” I enjoy them, and I want my partners to enjoy them, but I do not want to see them when I have clothes on. It’s almost like they’re part of my gender identity but not my gender expression, if that makes any sense.
Harper (cont.): Methods of transitioning without use of medical transition. So I had a really good question the other day from somebody - it was actually a trans person, a more binary trans person - they were asking - ‘cause I’m non-binary - “how can you be trans, if you’re not transitioning?” And I go “well I have transitioned in certain areas of my life.” “Well what are you talking about?” I’ve transitioned in that I’ve changed my name. I’ve transitioned in that I’ve changed the way I sit. The way I walk. The way I talk, the cadence.
Vieno: Which is in general the social transition.
Harper: Social transition, yeah. A lot of people don’t consider that aspect. They’re just like “Yup you take hormones, then you have “the surgery,” then POOF you’re the other gender.” No. No. That’s not how that works. And this is a big topic of debate, but personally, in my own opinion, I feel like gender is - ‘cause there’s a lot of gender essentialists out there who are just like “No I was born this gender” - but I think gender is a mix of nature, nurture, and culture. So part of transition for me is just, I’m doing some of the culture aspects of being raised female to better fit my presentation of who I actually feel like. Which would be the nature side of that.
Vieno: It is kind of one of those interesting things that people don’t really want to separate the social transitioning from the medical transitioning, which I find fascinating, because not too long ago it used to be a requirement that you socially transition one year before you could get approved to medically transition. You had to essentially try the gender on for size.
Harper: Yeah. Without any help of hormones, if that is for you.
Vieno: Yeah. And so the fact that it’s kind of become almost this opposite perception on the social level, where it’s like “Oh if you’re going to be socially transitioning you also need to be medically transitioning.” Which is why it’s kind of a shock when you meet somebody who is kind of an older trans person who is socially transitioned for a very long time, and then you find out that they’ve never started HRT or anything. Like “Oh my god, I had no idea! I could never tell! I thought you had been on HRT!” and it’s just that she socially transitioned to such an extent that she knew how to dress herself and she-
Harper: Knew how to present herself to seem female.
Vieno: Yeah. And a lot of that can be done without having to do the hormones or any of that sort of stuff.
Harper: There’s almost a sort of pressure when you’re not medically transitioning. Because I was assigned female at birth, there have been a lot of people who are also AFAB who approach me and will be like “well if you’re going to try testosterone you should really try it now and see if you like it.” But the thing is after a certain point you can’t reduce the effects of the testosterone, and I’m just like “Yeah, I don’t really feel like that’s for me.” And there’s been a couple of times where people have just been like “Oh well you’re just too afraid.” or “You don’t know what you want.” And this is coming from trans people.
Vieno: And that’s really an unnecessary amount of pressure to put on someone who’s already going through what is something that is emotionally and psychologically...not the easiest thing to go through. And a lot of trans people do consider HRT to be this wonder drug. It’s because of the fact that it’s like “Well, my personal experience is that when I started HRT it made me feel a lot more like me and it made me feel great and dadadadadadadadada.”
Harper: But it doesn’t work for everyone.
Vieno: Yeah. It’s like “Because it worked for me therefore it has to work for you.” And that’s not necessarily true.
Harper: I’m going to reference the person that I said earlier, the friend who wanted to medically transition, found out that HRT was not for them, just emotionally and mentally. They had done informed consent so they actually got access to HRT very early on in their transition and they hadn’t had a whole lot of time to really discover and find out who it was they were, what their presentation was going to be like, ‘cause there does need to be some exploring in the beginning. And that doesn’t say that some people don’t just know, and that works for them. But I think a lot of people are afraid to say these things, just because there’s so many gate keepers out there who are like, “Oh well you don’t know any better. You don’t know what’s right for you.” But I think that if people want to have access to HRT they should have access to it, but it’s not the end-all-be-all of transitioning.
Vieno: It should be available but not forced. And it is also that, like you were saying earlier, especially with testosterone. Testosterone is very much a hard drug. For me and for a number of other trans men who I’ve talked to, their voices started changing within the first month. They started getting downstairs growth within the first few weeks. Those two things never go back. Testosterone’s a commitment.
Harper: Yeah. You don’t just try testosterone. It’s the same thing for estrogen. My friend who I was talking about earlier: some girls take a while to show breast growth. They had breast growth pretty soon after starting, and they were only on it for nine months. And those breasts are not going away. They are developed, and they are breasts. And if that’s not something that appeals to you, that’s not part of your presentation, that can be really dysphoric in the other direction.