I had a check-in with my doctor yesterday so she could get a sense of where I’m at with regards to HRT and follow-on care after my chest pain scare a couple of months ago. The cardiology discussion was interesting timing, as my mother had just been diagnosed with coronary heart disease that very morning after an angiogram and is likely looking at a triple bypass in the coming week. In another bit of odd synchronicity, my scheduled stress test is for today, so heart matters were top of mind and we spent a long time talking about that and she was wonderful in explaining what was likely going on with my mom and how heart bypass surgery is performed.
We then spent a long time talking about my risk factors and lifestyle, reviewed my recent lipid panel (still very good) and then chatted a bit about things like where I’m at on transition and if I had a concrete plan, facial feminization surgery and electrolysis. Long story short, my doctor asked me if I wanted to increase my HRT dose to 4mg/day.
I thought about it a bit, and had her write the prescription for it. I’m not sure that I’m ready to up my dose yet, but I can stay at 3mg/day until I decide if it’s the right thing or not for me to do. I inquired about adding an anti-androgen and a liver function test, but with my response to estrogen without an anti-androgen, she felt it wasn’t needed, and given the healthy blood panel from before, she wasn’t concerned about any liver issues. I’m really not that concerned either, but I’ll push for one in my follow-up appointment in a couple of months just to err on the side of caution and get a new baseline.
Driving downtown later, I started to think more about her question around transition and planning, and I had an insight as to why I often struggle to tell others about all this. Transition is pretty much defined as a “from” to a “to” process. That’s definitely part of what I’m experiencing now, but there’s a larger sense that’s been building inside that I’m finally becoming the real, authentic me and that transition is one part of the larger process.
This becoming is much, much bigger than transition. Transition is the external stuff that other people see for the period of time they’re around me and eventually it will be over. Becoming is internal, and with me every moment of my life and is about my personality, sense of being, external expression of myself and place in the world, and it hopefully never ends.
The deeper insight is that I’ve been becoming for much, much longer than I’ve been transitioning, because it’s really a lifelong journey, and that somewhere in the past few months I’ve crossed some sort of threshold where I’ve finally started to grow into a vision of myself which is outside of who I used to be, and a part (albeit a large part) of that growth is externally expressed as transition.
At the moment, the transition part of moving “from” male “to” female is less important to me than becoming the next instance of me, a happier person. Transition is simply a side-effect of the larger process of becoming.
The other difference I’ve noticed is that transition is, from a process standpoint, a pretty clear-cut decision flowchart. You can pick from a smorgasbord of options to pursue and each has relatively well-known linkages, steps and outcomes.
Becoming, on the other hand, is much more about heading towards something that calls to you in life. It’s more organic, non-linear and unpredictable.
Metaphorically speaking, transition is about a seed becoming a tree, while becoming is about the tree growing in harmony with and reacting to its environment and turning into its own ecosystem for insects, animals and other plants while being a part of the larger ecosystem of the forest.
I think I’m finally figuring out my place in the forest of humanity, and it’s a good feeling.