Nonbinary Menstruation

Content warning: discussion of menstruation and gender dysphoria.

I struggle with sleep apnea and insomnia, including but not limited to disturbing and intense dreams which cause restless sleep. A reoccurring dream over the past seven and a half years has been me going to the bathroom and discovering that my period has returned in full force. As it is an extremely heavy flow it’s not something that can be ignored or denied, and the rest of the dream is either me losing my head entirely or accepting my miserable lot in life before I wake up in a panic. Sometimes I can’t fall back asleep and the following day passes in a sleep-deprived state of low-level anxiety and/or dysphoria. Sometimes I can reassure myself that it was just a dream and will never happen again.

Last weekend I experienced my period again for the first time in seven and a half years, almost to the date. I had experienced some discharge issues within the previous few months but thought (perhaps hoped) that it was just a yeast infection. That, while uncomfortable, would still explain the symptoms while keeping my fears at bay. But last Sunday I was in the bathroom trying my hardest to not have a total meltdown in front of my partner and friends, and even almost a week later I still can’t fully process what happened. At this juncture I’m happily telling myself, “Well, it was the best period I ever had! Just part of a day with minimal bleeding; if only they’d all been like that!”

It was partially, if not entirely, my fault. I’ve been on a low dose of testosterone cypionate for many months, even years, now. I thought I was on a quarter dose, but when I changed to 1mL instead of 3mL syringes I lost track of how much I was injecting and, to make matters worse, I’d been slacking off and injecting every other week. It turns out instead of the roughly 25mg of hormones I should’ve been injecting weekly I was averaging about 20mg every other week. On average that would cause my monthly hormone levels to drop from around 100mg to 80mg if I was lucky, but more realistically to 40mg for at least the past couple of months.

This gradual drop in hormones explained more than it didn’t and confirmed my hypothesis that my insomnia and vaguely hypomanic episodes, which since 2016 have been about one week out of every month, might be caused by my menstrual cycle. I suspected that in lieu of actual bleeding I instead was experiencing chemical shifts every time my period would have started, with the interim weeks building up to, and tapering off of, the episodes themselves. They involved cyclical thoughts, often involved having one song stuck in my head, and internal anxiety/hypomanic symptoms which could turn behavioral if I didn’t check myself on an hourly basis. I would have at least one night of absolutely no sleep, with my sleep otherwise being patchy at best and restless at worst, including waking up early and not being able to fall back asleep and/or struggling to fall asleep in the first place. The trazodone I’m prescribed as a PRN is only moderately effective and is my last-ditch resort as I find the side effects almost worse than the insomnia itself.

The fact that I got my period in the middle of all of this, when my symptoms were already coming to a head, confirms my suspicions that, indeed, all of this has in fact been menstruation in disguise. I’m now taking 25mg every Tuesday like clockwork, even when I don’t want to (which is every time) so that I don’t drop to 40mg per month. The positive angle to view this from is that I now know that I need to stay between 50mg-100mg every month in order to not experience menstruation as I once knew it to be. The downside is that so long as I am on hormone therapy I experience other side effects (e.g. hair thinning/male pattern hair changes, body hair growth increased likelihood of high cholesterol and heart problems, increased appetite, and increased libido) which are, in my mind, nearly if not as bad as actual periods.

I have no words of wisdom to impart, no takeaway message to share with my readership. I try very hard to share knowledge and experience in the hope of educating and supporting others who stumble across Genderweird. When gender dysphoria hits, it hits hard, and I’m not at a point where I can calmly assess the situation and provide compassionate understanding to someone who might ask me a question. As always I do appreciate comments and feedback, in particular as it relates to others’ shared experiences.

Auto Shop Gender Talk

It was one of those moments when you realize that the reality of a situation is almost stranger than fiction.  Id est, I could not have made this scenario up even if I’d tried.

I had arrived at an auto repair shop, and while waiting for them to find my keys I was eyeing up the various magazines they had to offer: Handyman or Women’s Health.  Being neither of the two, I instead chose to read about the looming “nuclear option” method of electing a conservative US Supreme Court nominee.  It didn’t make me feel any better.

They could not find my keys.  The owner’s wife, who has many times chauffeured my partner to and from work when the car’s been in for repairs, offered to drive me home to pick up the spare set of keys while they continued the search for the set we’d left there this morning.  En route I mentioned I wasn’t in any hurry, just so long as I could vote in the local elections today.  So the owner’s wife stopped at the polling place so I could vote, and I got back in her car feeling like, in my own vindictive way, I had done my civic duty to chip away at the conservative choke-hold seizing the country.  We drove a few blocks down to my place, I grabbed my keys, and we took off for the auto repair store once more.

In true Midwestern fashion, we started chatting about the weather.  I mentioned the weather down in Colorado, as my private contracting employer had recently had a snow day.  So then talk turned to my private contracting job, which is to essentially catalog correspondences to her mental health practice, all of which deal with gender questions, transitioning, finding transgender resources, or else an upcoming gender identity workbook.

The auto shop owner’s wife went off on the subject, pontificating on what wonderful and necessary work it must be, to be a mental health professional in the business of helping transgender folk fully express themselves, “to make that difficult transition and become happy,” as she put it.  I gauged the situation, then mentioned how, since I’ve been through that process myself, I knew how needed such services were, which is why I’d offered to do contract work for this therapist.

I’m not sure she believed me at first.  After many no way! or seriously? sorts of remarks, she clarified that I must have been born female but transitioned to male.  I stopped, breathed, and mentioned that this was sort of correct, but I didn’t identify that way.  She stopped, then said that she obviously was no expert on me, but since I was, could I explain how I did identify?  So I did.  I explained what it means to identify as non-binary, in a very general sense.  She seemed to understand, because when I started talking about the current requirements for transition in the US she didn’t ask for any further information.  We spent the rest of the ride talking about one of her former colleague’s daughters, who also happened to be transgender, and that having proper support was the real reason I wanted to go into providing therapy for transgender clients myself; in short, so I could provide trans folk with at least one means of support as they transition, even if they have no one else supporting them.

After I’d claimed my car I sped off, and felt a sense of unease about the whole conversation.  Not because of how it went per se, but specifically because of how it ended: the shop owner’s wife, upon my departure, said “You work so well with other people, I know you’ll make a great therapist someday.”  I don’t doubt I’ll make a decent therapist, but to say I “work well” with people seemed like a stretch to me.  No I don’t, I thought as I stopped at a red light, I’m terrible with people, I focus too much on what to say, or what not to say, and whether I expressed myself correctly, and whether or not I’m stimming too much or acting “neurotypical” enough for people….

And then, just before the light turned green, I had the most incredible epiphany.  For at least ten years, I’d thought of myself as socially inept.  Those were the words I’d used to describe not having many friends, or being desperately introverted, or not wishing to engage in small talk, or being told after the fact that I said something “rude,” or not knowing when it was socially acceptable to touch or embrace someone…or any number of other social issues I’d experienced since kindergarten onward, but had only become a real problem in the past nine years or so.  No, I wasn’t socially inept, I thought, I’m just autistic — which I’d only been diagnosed with on April 10, 2016 (for those of you counting, one year in six days).  I wasn’t socially inept, just autistic but undiagnosed.  Not socially inept, just neurodivergent, and therefore with a different way of communicating with people.

And really, it was more than that.  I’m autistic, communicating with a neurodiverse — but probably predominantly neurotypical — audience.  I’m transgender, communicating with a mostly cisgender audience; I’m more specifically gender neutral and non-binary, communicating with a binary, cisgender society.  And I’m asexual, communicating with a sex-saturated, non-asexual audience.  On a daily basis, I am forced to interact with a society that, on so many levels, is unprepared to understand the differences I bring to the proverbial table.  And on a daily basis others must interact with me, and I’m so far gone down the intersectional rabbit hole that I can barely comprehend others’ unique way of being and socializing.

And even though it was a daunting thought, I finished the rest of my drive home feeling so much more at peace with the world.  Because, for the first time in nearly ten years, I understood why I struggled so much socially.  It’s not because I’m socially inept — it’s just because I’m adrift in a society that, at least for the moment, has not taken the necessary steps to meet me halfway.  So I’ll keep making my steps forward, and I can only hope that maybe someday, society will meet me in the middle ground.

Autism Revisited

As promised, I did indeed go underground until after graduation.  And although graduating with an MSW provided a good excuse, this has very little to do with why I’ve been absent from the blogosphere for so long.  In truth I had received news which took a considerable amount of time — and angst — to process.  This is going to be one of the (hopefully rare) posts where I talk in depth about myself, or at least as much as I’m comfortable doing.

Almost one month ago I concluded a series of appointments with a local psychiatrist and team of clinicians.  I had sought them out on my own, and mostly due to two major concerns.  The first was significant auditory sensitivities, which I understood to be not at all medical in nature, but rather more psychologically based.  This had been ongoing for three years at the least, and I was determined to get to the bottom of their cause.

The second reason had more to do with the social end of things.  For years I’d told myself that I was socially inept, that I had no friends due to some sort of personal failing or shortcoming, and that I was far too much of an introvert than was good for my well-being.  As time (and therapy) went on I started teaching myself a new narrative: I’m not giving myself enough credit for the friends I do have, and I’m not at all a social failure.  But despite this I was still experiencing severe interpersonal impairments, which had not happened since I last had roommates in college, and had picked up again once I gained roommates for the past year and a half.

As the title of this post suggests, I had a good idea of what to ask about at the initial meeting.  I had long had my suspicions about my neurodevelopmental state, and given that my brother also has a neurodevelopmental disorder I was prepared to see a similar diagnosis.  What I wasn’t prepared for was one and a half months of testing, discussions, and agonizing until I officially received a diagnosis of Autism Spectrum Disorder.  More specifically, I wasn’t at all prepared for the extent of my results, which in graph form looks like this:

What’s important about these results are the percentile rankings.  So for example, my processing speed is through the roof; if I were in a room with one hundred people, only one person would process information faster than I do.  On the flip side, my social skills are (apparently) so poor that in that same room, only two or so people would have poorer social skills than mine.  What was further explained to me is that my conceptual and practical skills* were dragged down by my social skills, since for this particular test they each had a social component to them.

In short, the psychiatrist explained that my results are a prototypical result for someone who would have been diagnosed with Asperger’s Disorder.  Given the nature of the tests performed — and the limited options I had to choose between for answers — the psychiatrist also wrote in the report that I could be considered to have a social disability.  While I agree with almost everything about my results, this last point is not one of them.  For now I will concede to the fact that my struggle with social skills has led me to have differing social conflicts and struggles, but my overall ability to function socially does not seem disabled per se.

At this point I’m mostly struggling with the identity piece that comes along with this diagnosis.  While I’m absolutely not surprised at being given an ASD diagnosis, what I’m conflicted on is my place within the neurodiverse community.  I’ve spent twenty-six years on the periphery of this community, but never once did anyone indicate that I might also belong to this community.  Now that I find myself eligible for membership, as it were, I haven’t the foggiest of what I’m supposed to do.

 

*The conceptual and practical skills max out around the fiftieth percentile, though, so I’m not really all that fussed about those results.

Asperger’s and ASD

A topic I’m sincerely and wholeheartedly passionate about is Autism Spectrum Disorder (ASD).  This isn’t merely a hobby for me, this isn’t something where I sat here and said, “Welp, Brannen, you have to find your niche as a Social Worker once you start practicing for realz…go with ASD!”  No, like a lot of things in my life — Harry Potter, cats, trivia, gender studies, Buddhism, the DSM, and other random things — it’s something that I will spend literally hours researching on my own, checking out a library’s worth of books on to learn more, and even recently found a job where I can get paid to assist in a study examining family dynamics in the context of ASD.  Totally applying to that to support my broke grad student butt, by the way.

But I digress.

In the general theme of my blog, I’ve been thinking a lot about my identity.  You know, that thing that I sometimes do.  And in another related general theme of my blog, I’ve also been experiencing symptoms of anxiety.  This is not new for me, and it should not be surprising considering I’m switching my anti-anxiety medication.  But what really gets me, and has been a problem I’ve started pegging as an annoying, anxiety-inducing habit, is that when I get symptomatic in terms of anxiety my thought process looks a little bit like this:

Here’s a thing.  I like this thing.  I’m gonna do it.  Oh wait, hold on, another thing I like to do! [sets aside random thing for another random thing, continues in this vein all day]
Wait, people.  Oh, hi people!  Oh crap, it’s a thing.  A Social Thing.  Did I do it right?  I’m not sure…did I not make enough eye contact?  Too much?  Damn, I messed that up again, I just know it.
[Anxiety symptoms crank up a notch]
Oh look, another Thing.  Think about the Thing think about the Thing think about the–
Shit, this is horrible.  Why can’t I stop thinking about the Thing?  Or that other Thing?  What’s wrong with me?

Ad infinitum, ad nauseum.  And the anxiety gets worse and worse, and my symptoms follow suit.  I can’t decide if the behaviors precipitate the anxiety, or the anxiety the behaviors.  I start struggling with eye contact.  It’s harder for me to verbalize myself, and I find myself concentrating extra hard on forming and stringing words together coherently.  I get twitchy–very twitchy.  Loud noises, in particular high pitched ones, start making me jump.  And don’t get me started on physical contact.  Can you see where I’m going with this?

In short: even though I know I shouldn’t self-diagnose, even though I know it’s something I struggle not to do, especially when I’m anxious, it’s precisely when I’m anxious that I start thinking that yes, Virginia, this one has ASD.  Specifically Asperger’s, before they combined it with Pervasive Developmental Disorder NOS (not otherwise specified), Autism, Rett Syndrome, otherwise known as the Pervasive Developmental Disorders for the ASD diagnosis.  Told you I love the DSM.

Here’s the thing, though, because it’s a Really Important Thing…I’ve never been diagnosed with this, not clinically, which is my definition of truly being considered to have one disorder or illness or whatever it may be.  Because for me, that’s how I have to frame it so that I won’t walk around a hypochondriac.  I’ve been there, it sucks, and I really don’t want to do it.  And no matter how bad I get, no matter how anxious I am, no matter how symptomatic I become, I have never — and will never — appropriate a label that others have for legitimate reasons for the sole reason that I suspect it might be true for me.  This is something I struggle with regarding my dysthymia and potential anxiety diagnosis…I don’t even know how to identify as having a mental illness, because it’s so integrated into my personality that I feel as though it’s less an illness, and more of a character trait (or flaw, depending on the day).

So who’s to say I don’t have ASD?  For now, probably my therapist…unless she agrees with me.  But because I have this tendency to make up rules in my head that somehow equate to law in my book, like the not-being-a-hypochondriac rule mentioned above, I have this rule that tells me “Don’t self-diagnose, and don’t tell your therapist.  It’s not good to self-diagnose, and she won’t like it.”  I’ve brought it up briefly, and we moved onto other topics.  But like I’ve said, ASD is really, really important to me.  My brain latches on and won’t let go.

And here I am, writing this post.  Not just because I can’t let go, but because I’m making a serious and honest attempt to be transparent about this issue.  I can’t be the only one who’s ever thought they had some sort of sickness, mental illness, or neurodevelopmental disorder (as is the case with ASD).  However, that absolutely does not make it okay to appropriate a term that, by rights, isn’t yours to take.  At best it’s just rude; at worst you’re being uninformed and not considering people who truly need this diagnosis for treatment purposes.