Dysphoria – A personal account

Content warning: This post includes pictures of a shirtless man and a topless woman, with the complication that they’re the same person.

Last Tuesday, Tilly Bridges posted her weekly blog article, Tilly’s Trans Tuesdays (Google Docs link). Her focus was dysphoria. Reading her article prompted me to write one of my own. As Tilly explains, there are many ways to feel dysphoria. Tilly’s dysphoria experience was quite different from how I felt–or didn’t feel. 

My egg cracked (1) when I was fifty-three years old. Before that, I was somehow completely clueless that all of the feminine aspects of my personality, all of the stereotypically feminine interests I suppressed, and my lifelong desire to be one of the girls were trying to tell me that I was trans. 

Trans people are fond of ironically saying, “There were no signs.” Despite the irony, it’s often the case that the signs are only visible to us in retrospect. When you’ve lived your entire life in a cave, when it’s the only thing you know, you don’t know it’s a cave. Only when you step out into the sun do you realize you’ve been living in the dark.

That was the case with me. I look back and see many signs. I mentally kick myself for not seeing them. But I can’t beat myself up for that because, clear as they are to me now, those signs were not visible from my perspective. They’re a kind of retroactive dysphoria. 

So what were some of those invisible signs?

Facial dysmorphia

I never liked my face. I hated almost every picture of myself. When I looked in the mirror, I didn’t usually look myself in the eyes. When I did, I didn’t see anything there. 

Over the years, people told me I was a good-looking man, but I never saw it. In the end, I kind of accepted the majority opinion, but I still didn’t really believe it. That’s what made my realization all the more dramatic. It was precipitated by a webcomic by Mae Dean shown on a blog post by Doc Impossible. The webcomic featured the following social media post:

Tweet by Kathryn a.k.a. TransSalamander:

If you're under the assumption that you're a cis guy but have always dreamed of being a girl, and the only reason you haven't transitioned is because you're afraid you'll be an "ugly" girl:

That's dysphoria. You're literally a trans girl already, hon. 

Tweeted December 31, 2017.

See My Awakening for more detail on how the next week went for me. 

As I started transitioning, my mental image of my face started to change. First it was my smile, which was new. I smiled quite often before transitioning, but the smile I developed last fall made it seem like nothing before was a real smile. The left side of my mouth was raised, occasionally joined by the right, but my eyes rarely joined the party. Since last August, my eyes have led my smile. The position of my lips doesn’t matter as much because my eyes are smiling.

Then came hormone replacement therapy: estradiol patches and a testosterone blocker. Before long, my face physically began to change, to soften. I started catching little glimpses of what I thought of as “her,” even if “he” still dominated my features. Then, on December 27, I looked in the mirror and saw myself. In my face. In my eyes. Since then, my facial dysphoria has faded. I still see little glimpses of “him,” but now, all I ever really see is me. 

I can feel it in my facial expression. I don’t have my old wooden, guarded face. I smile by default. 

In six months, I’ve taken more selfies than in my entire previous life.

It’s easy to see why.

A selfie of me taken a week after discovering who I was. My one-day stubble is noticeable. my smile doesn't involve my eyes.
August 12, 2023
A selfie of me taken about two weeks before publishing this article. My face is smooth. My purple eyeshadow is subtle. So is my smile, but it projects true happiness.
March 12, 2024

Hair dysphoria

Hold on, back up a bit. This section says dysphoria, but the previous section said dysmorphia. What’s the difference? Many other people said my face was attractive, but I didn’t see it. That suggests I had an unrealistic mental image of my looks. I saw ugly when everyone else saw kind of cute. If you have a flawed (dys-) perspective of your appearance or shape (morphos), that’s dysmorphia. If you see something about yourself realistically, but you hate it, that’s dysphoria (literally, you can’t bear it).

So what was wrong with my hair? 

When I was young, I didn’t think much about it. My parents told me when I needed a haircut and took me to get one. In university, I saw a lot of friends with longer hair, and decided I wanted that. But no matter what I did, with the help of the campus stylist, I couldn’t make it grow down. It would only grow up. Eventually, in my late twenties, I gave up and shaved it all off. 

Fast forward twenty years. I was on my own after separating from my second wife. I started getting in touch with my feminine side. Part of that was realizing that if I ever wanted my hair to grow out, I’d better hurry up before it was gone. I had been slowly thinning on top, and by this point I had a small bald spot. As I let it grow out, I still wasn’t happy with it. It was too thin. But I persevered. 

In the case of my hair, I experienced dysphoria that I never related to my desire to be more feminine. 

Wait a sec. If I always had a desire to be feminine, how could I not know I might be trans? The short answer is, when I was young, I didn‘t even know the word, let alone what it meant. As time went on, I simply maintained my image of who I was–which, despite putting on a happy face and projecting an air of confidence, wasn’t the person I wanted to be. Unfortunately, the only image of who I really wanted to be was so ridiculously impossible to me, I never let the idea enter the front of my mind. 

Body hair dysphoria

A shirtless mirror selfie of me taken in August 2017. Aside from the extreme farmer tan, the most noticeable aspect is my body hair. I'm not extremely hairy, but it's there.
Nothing NSFW in this pic, just male pecs

I was looking at an old picture of myself the other day. I took that picture in 2017, after I had lost quite a bit of weight. This was long before I started shaving my body hair. It had always bugged me, but it was a part of me, and I didn’t think of getting rid of it. After all, guys didn’t shave their body hair; only women did. Just over a year before I discovered myself, I had a medical device for a day that required shaving several patches on my chest. After removing the electrodes, I decided I didn’t want to be patchy, so I shaved the rest of my chest hair. As I looked at myself in the mirror, I wondered why I hadn’t done that years ago. I immediately thought of the reason: deeply ingrained gender expectations. The next day I shaved my legs, and I’ve been shaving my body hair every week since then. 

A topless mirror selfie I took last week. I'm in very similar shape to the 2017 pic, but now I have no body hair--and no farmer tan!
Oh no! Exposed female breasts!

As I started my transition, my body hair dysphoria increased. Every weekend, before my shaving ritual, I’d look at my body hair with revulsion, needing to get it off. If I saw a picture of a man with a hairy chest, I looked away. When I tentatively ventured onto dating apps, I swiped left on any profile with body hair or facial hair without reading further. 

But when I looked at that old selfie the other day, I didn’t look away. For one thing, I couldn’t stop looking at the differences between it and my recent topless selfies. But it was more than that. I thought my body hair in that picture was attractive. I still wouldn’t want it back, but if I met someone with that amount of coverage, I probably wouldn’t turn away like I used to. 

However, I do think I look much better clean-shaven. 

Facial hair dysphoria

Facial hair is another story. And right now, it’s a happy story. After three full-face and one middle-face laser treatment, my visible facial hair is practically gone. The white hair is still there. There’s nothing laser treatment can do about that. But it’s invisible for most of the next day after I shave–a far cry from my former 10 AM shadow! 

I always hated my beard. But I was a man, so it was part of me. I tried to grow a beard a few times, but each time I couldn’t stand it for more than a couple of weeks. Finally, in early 2007, I had had enough. I went for three laser treatments to try to get rid of it once and for all. I hated it. I wanted it gone. Unfortunately, laser technology at the time wasn’t very effective, and I couldn’t keep going back for more treatments. I resigned myself to having sandpaper on my face. But at least the laser sessions thinned it out enough that shaving wasn’t so painful anymore. 

Denial of my interests

Boys like blue; girls like pink. Boys are interested in sports, cars, and being manly in the outdoors. Girls are interested in fashion, makeup, and making a good home for the children they definitely have to have. 

Nowadays, we realize how ridiculous it is to have such strictly defined interests, separated by gender. Sort of. Well, some of us realize that. But if you go into a store, online or in the corporeal world, you’ll see clothes and toys separated by gender. These days, we like to think that we’re more enlightened than we were in past decades, but gender fortification (setting expectations for one’s perception of their gender) is still very strict.

So throughout my childhood, I played with cars, building toys, and other boyish interests, and made sure I didn’t even think about playing with dolls, brushing their hair, or even playing with the girls on my street. As a teenager, I was reluctant to join the choir because that was for girls. But I was glad that the choir teacher convinced me because singing was a lot of fun, even more so than playing in the band, and my vocal development paved the way for my voice transition four decades later.

In my adult life, I took on the role I was required to play, trying to be interested in team sports, but failing to gain any skill at playing them, continuing to wear “boy” colors, and never expressing my strong interest in hairstyles, which had become a kink–a term I only became aware of in my late thirties, and only embraced in my forties.

It wasn’t until my final marital separation that I finally allowed myself the luxury of exploring my interests, including shoes, fashion, makeup, and hair. I enjoyed exploring my interests in an atmosphere where it was accepted. That was probably the most significant factor that led me to the point where I was ready to accept my egg (1). 

Since starting my transition, not only do I enthusiastically explore my interests, I don’t feel like I need to hide them. Finally, they feel perfectly normal

The overall effect

Even though I never consciously experienced dysphoria, realizing and accepting my identity was the most significant emotional release in my life. It was as if I used to wear a heavy iron breastplate, but never realized it was there, or that I could simply unbuckle it and let it fall off. It’s like Plato’s cave allegory; I had only seen shadows of my personal reality–then suddenly I emerged and saw the real world. 

In my old life, I felt empty. I tried filling my reality with identities borrowed from others, especially my second wife, who I met after a series of events left me with a huge internal vacuum. I also tied my identity to my work. Of course, I never realized any of that, no matter how desperately I felt it. Since I began my transition, I’ve been filling in the blanks from inside myself. I feel like I’m good enough. Good enough to exist on my own without relying on someone else to make my life complete. Good enough to be happy with who I am without feeling like I have to strive to be someone better. Good enough to be there for my friends when they need me, and not feel like I’m burdening them by asking for support when I need it. Good enough to love, and be loved. 

Good enough to really believe that I deserve this wonderful new life. 


(1) Receiving an egg, cracking, and hatching form a common metaphor for trans people discovering themselves. 

An Unlikely Affirmation

One of the most affirming things I’ve done recently (aside from talking to my best friend; nothing beats that) is try FaceApp. 

I was feeling particularly boy-mode-ish the other day. Near the start of my transition, I used a locally installed AI app to feminize my appearance, but as someone told me recently, I’ve exceeded that caricature already. But, feeling particularly dysphoric about my face the other day, I had to know how FaceApp would initially identify me. I uploaded one of my favorite recent selfies. It identified me as male, of course. But the feminized pic wasn’t much different. 

A FaceApp comparison of me, on the left, with a feminized version on the right. The obvious differences are longer hair and a smoother, younger-looking complexion. Aside from that, it gave me a slightly wider jaw and more sharply defined eyebrows.

I tapped the option to make my pic more masculine. Once again, not much difference. 

A FaceApp comparison of me, on the left, and a masculinized version on the right. The only differences are a slightly taller skull, my jaw extended a couple of millimeters, and my orbits squared off a tiny bit.

Then I selected a pic with my wig and pantsuit. If the system identified this pic as male, that would confirm my facial dysphoria. But it identified me as female. I hit the option to make me more feminine. Hardly any difference.

A FaceApp comparison of me in my short purple wig and pantsuit with a further feminized version on the right. It widened my smile, lengthened my yhair a bit, and minimally increased my bustline.

I uploaded a dozen more photos, most of which I didn’t save. FaceApp identified me as female just less than half the time. Even a picture in which I thought the light made my face particularly angular, with makeup but no wig, was identified as female. 

My face is pretty much gender neutral. I’m the best of both worlds, baby!

While putting this article together, I looked at these pictures in my Google Photos album. Google Photos automatically detects pictures of you and prompts you to add other faces in the picture. If you save a collage of multiple pictures of you, it will only identify one, assuming that the others are different people. 

In the first picture in this post, it recognized the feminized version as me and prompted me to identify the face on the left. When I viewed the masculinized version of the same pic, it identified that version as me, and, once again, asked me to identify who the “other” person on the left might be. 

Even mighty Google, with all of its invasively collected image data, couldn’t tell the original from the modified version, getting it wrong four out of five times. The only comparison it identified correctly was the one below, and no kidding; I can’t even dream of having that hair! 

A FaceApp comparison of me with a strongly feminized version on the right. In addition to the changes in the first picture, my eyebrows are much more sharply defined and my hair is luxuriantly long and thick. It also rounded my glasses a bit.

I think I need to go wig shopping!

Me, but Not Me – Six Months Later

I was talking to my best friend on the weekend.(1) We were talking about smiling, and how it comes through when you really feel it. I sent her this picture, which was taken on April 16, 2023. 

A selfie taken in April 2023. I'm wearing the same glasses. My hair is the same color. My face is mostly the same. But somehow it's not me.

I took that picture shortly after dying my hair purple for the first time, three and a half months before my awakening.(2) That’s about as brightly as I ever smiled in my selfies before I transitioned. Just now I was looking for a selfie taken just before I transitioned, but I don’t have one. The closest one I have was taken in May. 

I never used to take a lot of pictures of myself. I created a folder for my selfies in late November because I had started taking a lot more. I went back two years to find old selfies. My new folder contained 19 selfies taken in the two years before I transitioned, and 91 taken in the four months since. As of today (January 29), that folder has 227 pictures in it.

This is a common pattern among transgender people. When you start loving yourself, you take more selfies. A lot more. This one is my favorite:

A picture of me taken on January 6, 2024, just after getting my ears pierced. You can't see my studs very clearly, but they're a gorgeous purple gemstone on titanium studs. I'm still wearing the same glasses. My hair is purple, like in the previous picture. But I'm smiling in a way I never did before. This picture is me.

This picture was taken on January 6 by the person who had just pierced my ears. In 54 years, this was the first time I had gotten a piercing. I was happy. My piercing artist was very affirming. She had just said something that made me smile, and she took three pictures in short succession. 

For days, I couldn’t stop looking at this picture. I had smiled before transitioning, of course. I had been happy once in a while. I had smiled specifically for pictures. I smiled when my son was born, and when I got married. But I had never smiled like I did in this picture. 

Immediately after leaving the studio, I sent this pic to a bunch of friends. I received replies throughout the day. Everyone said I looked great. I looked so happy. My sister said she had never seen that smile before. 

When I got home, I started changing the profile pictures on all of my online accounts to this selfie. I had never loved a picture of myself so much. Before transitioning, I had never loved a picture of myself at all.

This picture is me.  

So who was in the previous picture? I looked at the first picture again this morning, and I didn’t recognize myself. It’s me, but not me.

At the most fundamental level, of course I’m the same person. I’ve retained a lot of my thought processes and some of my behavior patterns. But I feel different. I express myself differently. I interact with others differently. And I look different. Part of that is three months of hormone treatment, but more of it results from how I feel about myself since I figured out who I am. Before transitioning, I didn’t look in the mirror much. When I did, I was looking at something specific, not at my face overall. Now I look into the mirror and I see myself. 

Look at both pictures again. They’re not the same person. The first picture is a shell I used to hide behind. Me, but not me. The second picture is me.


(1) With this friend, that’s like saying the sky is blue, water is wet, etc., but I have to set the scene for this paragraph.

(2) But there were no signs!

“It’s just biology”

Mastodon is my primary social media. It’s run independently, so it’s not subject to the whims of anonymous shareholders or a flaky owner. It consists of thousands of independent servers that talk to each other. A lot of scientists and tech people use it. 

I was scrolling through my feed the other day when I came across this thread. It’s written by a biologist who studies how certain gene sequences regulate the expression of other genes. He explains the complex process of how sex is determined in a very simple, accessible way. 

If you’ve wondered how biological processes can produce trans and gender diverse individuals, here’s a quick and easy explanation.


I want to rescue this from my account on the birdsite but I once got into arguing with TERFs (it happens, try not to judge me too harshly) and as a biologist I just wanted to push back a little on the “it’s just biology” line, so I wrote the following:

Okay, sex determination in humans.

This shit is COMPLICATED and this will probably be a longish thread. Sorry. But I’ve seen a lot of people claim that “biology says” that everyone is either male or female, full stop, and it’s just not true. 1/22

So human fertilized eggs develop into embryos with a pair of “indeterminate gonads” and TWO full sets of tubes. The Wolffian ducts can develop into the epididymis (omg spelled FROM MEMORY) & vas deferens, and the Müllerian ducts can develop into uterus and fallopian tubes. 2/22

Most embryos that get a Y chromosome will have a working copy of a gene called SRY (for Sex-determining Region on the Y). The product of the SRY gene is a protein that can control when other genes are turned on. If the cells of a gonad start making working SRY protein … 3/22

… then they start to develop into a testis. Some of those cells produce high levels of testosterone, and some make a protein called Müllerian-Inhibiting Substance. The Wolffian ducts need high testosterone to survive and develop; Müllerian ducts do by default UNLESS … 4/22

… MIS is around to stop them. So SRY can coordinate a program that shunts the default female development into male development.

Chromosomes can break and pieces can rearrange, so some people get a Y chromosome without an SRY gene, and are usually seen as female at birth. 5/22

Humans didn’t evolve to have Y chromosomes in the females, or only 1 X, so these people generally have abnormal sexual development and tend not to be fertile. Likewise, the rearrangement can mean that SRY winds up on another chromosome, so someone can be XX and “male.” 6/22

Without some other genes on the Y chromosome, and with 2 Xs, these people do not exactly develop the “normal” male program.

But it’s a LOT more complicated that that, even. 7/22

I was careful to say “a working copy” of SRY above, because genes mutate sometimes. A change of a single DNA “letter” (out of >800) can make a completely broken protein that’s like not having an SRY gene at all. OR, it can make a partially changed protein. 8/22

SRY controls a lot of things, so a partial change in the protein can mean activation of some crazy subset of the genetic program it normally activates. The result is an embryo not really developing as male, exactly, or as female, exactly. 9/22

Consider, too, that the enzymes that make testosterone are made from genes (controlled by SRY) different from the gene for MIS. One of those and not the other can be broken, and you can develop with unusual combinations of Wollfian/Müllerian duct products. 10/22

And just like SRY, the enzymes that make testosterone can be partially changed, and you can make intermediate levels, that don’t exactly direct male development but don’t exactly direct female development either. 11/22

For other parts of the body to become “male” or “female,” they have to respond to these signals. That early embryo has tissues that can either become a penis and scrotum or a clitoris and labia. Mostly the difference is in how much testosterone they see. 12/22

But responding to it requires another protein that controls other genes, this one called the Androgen Receptor. People with AR mutations can be XY with a working SRY gene, but will generally be viewed as female because their cells don’t know that testosterone is high. 13/22

At puberty, lots of other cells become responsive to these signals. Breasts and beards may develop. When different cells in an animal all turn on a gene, it’s often the case that different DNA sequences near that gene control that process in different cells. 14/22

(These sequences, called “enhancers” and “silencers,” are what I actually work on myself.) Just like the parts of genes that make proteins, these can be different between people, so the subprograms that make up the broader genetic program of sex can differ. 15/22

Most complex and controversial of all of this, it is *likely* the case that part of this program happens in the brain.

No one really knows what “masculinization” or “feminization” of a human brain means! (Though very smart people are earnestly trying to figure it out.) 16/22

In other animals, with simpler and more hard-wired brains, we have learned a lot. In fruit flies, for example, we know that there are separate (though obviously linked) genetic programs to determine sex in the body and in the brain. 17/22

So mutations exist that produce anatomically male flies with female behaviors, or vice versa.

People are VASTLY more complex than flies and our brains are much more flexible. It’s not clear, after decades of looking, that male and female brains are genuinely different. 18/22

Still, most male people become sexually attracted to female features at puberty, and vice versa. This is *suggestive* (though by no means proof) that some kind of “male program” and “female program” for brain development might be encoded in the genes. 19/22

And of course these are then under the control of still other DNA sequences. It’s really not hard to imagine a situation where “the body” develops as male and “the brain” as female, or vice versa. Or where parts of one program and parts of another overlap. 20/22

So there’s a system in place that has evolved to make male and female bodies in most cases, but it has a LOT of moving parts, and they all do different things. Every combination of differences imaginable will result in a different point on a high-dimensional spectrum. 21/22

And this is the most crucial part: Every one of those is a person. The lived experience of someone with a combination of genes that does not produce perfectly coordinated “male” or “female” development is no less valid than that of someone we see as “normal.” 22/22


Here’s a short bio of the author.

stevegis_ssg@mas.to

Steve Gisselbrecht @stevegis_ssg@mas.to

I never did an #Introduction, but I’m a 55-year-old gay biologist and music-lover living with my beloved husband in Boston, MA, USA. At work I’m a Research Specialist for Brigham and Women’s Hospital and study transcriptional regulation in Martha Bulyk’s lab. At home I love to cook and bake—I’m “The Chocolate Guy” to a lot of people—and when it’s safe to be in a crowded room breathing other people’s exhalations I love live music. We hope to retire to Paris et parler un peu de Français.