Plans, Trans, and Autogynephilia- The newest chapter in the story of humanity. #TransJenner #GenderCisphoria

Plans, Trans, and Autogynephilia

April 20-27, 2015

The only guarantee that I can make to you, before you die, is that everything will change.

There are so many things to come, and most will be unexpected.

Consider the imminent bad drivers, graduations, awkward meetings, congratulations, missed appointments, hockey games, misunderstandings, and cavities.

Not to mention intimacy, births, affairs, health scares, separations, funerals, reunions, and new people.

Around you there will be Stanleybowls, leaders and corruption, wars, poverty, success and kryptonite, more will get Caught-In-The-Netflix, while some of earth’s species will ‘become’ extinct.

And there will be breakthroughs;  illnesses will be cured, devices will be implanted, iphones will become personal drones, automated transportation will create naps or angry birds, android butlers will assist in smart homes, desktop quantum computers will interface with holographic watches to monitor your body with ICU precision (Apple will keep the doctor away), vending machines will dispense genetic engineering necessities for virtual living, and we will explore the solar system and peer deeper into the universe with exponentially more microprocessor strength.

And you will get old.

Along the way, 0.008% fellow humans, living on this rock with you, will decide they want to live their life, as the other gender.

When one puts it that way, it doesn’t seem like such a big deal.

But the first time I met someone with ‘Transgender Disorder’, I half didn’t want to believe it myself.

Once you sit and listen, it gets easier to understand.

There are 2 parts to everyone, the part that everyone sees, and the part that everyone doesn’t.

For those of us, who wear the emperor’s cloak of privilege in a binary cis-hetero-normative society, we just don’t get it.  We don’t understand why someone would go to all the trouble, just to change THAT thing about them.

We tolerate changing your group of friends, taste in music, bad tattoos, university plans, romantic partners, sexuality, career, hairstyle, hobbies, mood, mind (or when you beat us, or become addicted), and just about anything else, when we say we really love you, and wish to do you no harm.  But for some reason, when you say you want to change your gender, it seems to fundamentally alter our worldview’s master plan, and we just don’t get it.

But for many, the gender dysphoria can cause so such suffering, it can breed desperation and hopelessness.

Especially if you are also born into poverty or addiction in the US, without health insurance. Those individuals suffer repeatedly, sometimes using prostitution as a way to obtain money for cross sex hormones.

They make that impossible ‘choice’, to get as close as they can, to life as the opposite gender. Is there anything in this world that you feel THAT strongly about, at all?

Difficulties due to the mismatch between your outer physical gender markings, and how you feel on the inside, used to be called Gender Identity Disorder.

The change happened after the smart doctors realized that being brave enough to risk happiness was not a disorder.

So for doctors in North America, at least, the DSM5 calls it Gender Dysphoria.

To be transgender, one has an inner experience of self and gender that transcends one’s physical shell.

This would not be the first time a human has done this for the better of everyone around them.  There is no longer much gawking around Hawking.

If you are reading this, which is a non sequitur, and you are a parent, consider the following.  With children come tears you can’t forget, messy diapers, loose teeth, growth marks on the wall, flying food, stitches in the night, Picasso on the fridge, toys underfoot, green eggs and ham, babysitting scrambling, the free cookie at the bakery, and a hand that perfectly fits into yours.

And that list above, of tender parent moments, when you realized you really do love your offspring, were gender neutral.

This person, that you met in your mind before birth, needs you more than ever, when they decide to really be themselves.

All 3 dimensional living breathing loving people are real, and we ALL desperately want to be ourselves.

We look at Jenner now, and are inspired by her bravery.  My hope is that soon, we won’t need a celebrity’s story to move us to compassion.

Most of us stared at the MTF on the bus a year ago, and Jenner’s changing face in the tabloid, unable to will ourselves to accept it.  It is good that things are finally changing.

I do hope we realize however, that we are all celebrities, to the people that love us.

I would recommend learning more about Cox, and if you have Time, check out June 9, 2014.

After that, it may be hard to ask the following.  How can someone feel like a boy in a girl’s body, or vice versa, or both, or neither?

We don’t understand, because we may have only caught glimpses, through the keyhole of the media.

A vast majority of people presenting as gender dysphoric children go on to be predominantly gay, lesbian, or bisexual, but not transgender.

Most trans teens go on to be trans adults.

People with Gender Dysphoria feel so strongly about living their life as the other gender (or both or neither), more than half, in some studies, contemplate suicide as a viable solution to the societal problem of them.

For many FTM men, menstrual moments are monthly murders of the mind.

The goal is to achieve body satisfaction, usually in the eye of the beholder, so going to the mall or just down the street doesn’t make one feel like the star of a hazing ritual.

They achieve satisfactory transition socially in what pronouns, legal names or language is used, how they dress, talk, walk, the use of make up or breast binders or augmenters, and other utilitarian utensils.

Even the wrong pronoun can feel like a public stoning.

Medical transition occurs through the use of cross gender hormones.

Top Surgeries (above 16), and bottom surgeries (over 18) depend on informed consent, and the skill and technique of the surgeon, and not all procedures save adequate sensory function.

Health guidelines have been established by the entity WPATH.

Some individuals do not seek support as they can live as gender queer (on a spectrum of all of the above), or agendered (no sense of either gender), with little or no ‘help’.

And there is recent biological evidence arising that it is your gender identity, not your biologic sex, which determines your attraction to the smell of a man’s armpit.

Isn’t that a stinker?

Amid the temporal collage of real images and messages from the web, all attempting to capture one’s attention (the most precious gift), the butterfly of the mind, with rainbow wings, flits around, trying its best not to get confused.

It must beware of the trap of thinking, that gives one no way to make sense, of the surrounding jungle.

Trans people we meet may challenge our ability to download their avatar, because we live in a much more binary world, compared to those who experience gender fluidity.

And when we see something that doesn’t match our expectations, we may become curious, or feel internal resistance, and perhaps become offended.

The mixed messages do not compute.

Cis society teaches us that to start understanding someone, one should start with biological sex.  Once that prong in the road is taken, the friction of interaction, one is taught, should lessen.

But the problem arises in binary-gender-world, when one doesn’t have the label for the other categories of human.

In the big picture, there might be a spoon, but gender categories are a blurred spectrum in our Matrix.  The once extras are now the Neo-gender-stars.  Their phans parade, primed in pretty pink polo pants, posh piercings paired with phallic phones, perhaps pirouetting post PVP, proud of Pat parenting.

Maybe we all insecurely stroll down the highway of life trying to pass as who we want others to think we are, or as who we want to be.

We rely on our mirrors, and windows and selfies, to reflect back to us, the face that we hope is still there.

And just maybe, we can make the smile even more perfect, the next chance.

It becomes even harder, when you know, that they can see through the disguise they think you are wearing.  And it seems impossible to explain to them that skin can be a mask too, and ones disguise can be the real identity.

The bystander doesn’t realize what they think they hate in you, they actually hate in themselves.

And nowadays, isn’t almost all human behaviour attention seeking?

It is all about those plans you make, and the labels you create for other people, as your fantasy guides them down the road of your life.

There is the opportunity to notice, along the way, that humans are not necessarily bound to their chromosomes.

We are special, equipped with a complex mind, able to integrate many signals.

Gender Dysphoria is the sign, of something much more testing, than a mere detour in the road.  The dysphoria creates an uncomfortable anticipation, that peaks in panic and relived fatality, when one fails to pass.  There is a danger that when the ‘the public’ looks in the rear view mirror, they may only want to see themselves.  Without shoulder checking, the societal blind spots only become more dangerous, and fear of gender benders worsens.

All roads do lead to Rome, but many of us live in a disconnected suburb.

Those brave enough to release the tension, and come out, often face an eruption of anger.  This represents the lava of rage burning through their parent’s and friend’s (not to mention stranger’s) vicarious future plans.

Those plans were written by society Pre-birth, and those blueprints may seem impossible to rewrite.

But that is the challenge for every great parent, friend, and stranger, to face that other version of themselves, and love it; despite it not being like them, in every way.

And now we confront Transphobia.

People seem to be capable of being afraid of anything, at least for a while.  Luckily, most of our fears never come true, and the ones that do, usually require your hand to author the plot.

Remember the scary mysteries of the sun, darkness, loud noises, small spaces, animals, treating non pinkish colored humans as equals, women voting, Y2K, or homosexual people.

Now we only seem to be afraid of the IRS, ISIS/L, transgendered people, and not being noticed.

Luckily, we have been brave enough to forgive Ellen, and now laugh whether she grinds against a female guest, or her table, by her chair, on her show.

She taught many of us that ‘her people’ are just like ‘our people’, looking for love, friends, and laughter.

So we forgave homosexuals for no crime, and we may even all agree that they should be allowed to marry wherever they want some day.

Aren’t we wonderful, and haven’t we done enough to have any compassion left over for those gender dysphoric?

Wikipedia defines Autogynephilia as love of oneself as a woman.

This is revolting to anyone who has been railroaded by its label.

It essentially states that biological males, seeking transition, are doing so to gratify a sexual fetish, where they attain arousal fanaticizing they have a female body.

The railroading comes in where the transfemale is nauseatingly confused for this (intensely homophobic) gay man whom sometimes kinkifies himself as a female sexual object so he can get off (without having his climax succeeded by overwhelming guilt, shame, or horror at what got him off).

It in no way describes the overwhelming majority of MTF’s central experience of reasons for living as women, which lie much closer to wanting to have dinner ready when their partner comes home, than anything sexual.

The diagnosis of autogynephilia is rarely made, but one should always be made aware of those passing out the kool aid.

The concept was created in 1989, the same year Apartheid started to be dismantled, the Berlin wall collapsed, and Tiananmen Square occurred.  Maybe that was what M. Manson was up to, the autogynephilia I mean, not those other things.

This particular railroading delivers a devastating cargo of emotion sickness.

We do not get to decide how other people should live their life, provided they don’t ask us, harass us, or hurt us.

There is nobody that you know well enough to convince them that they are not transgender.

Besides, conversion therapy has been found to be dangerous in all forms when used with LGBTQ humans.

Vomiting our expectations makes a mess.

Just because our version of gender is different than theirs, does not make love or kindness an optional style of friendship or parenting.

We need to find out who our children, teenagers, and neighbors are, and even if they change, support their growth.

They support us through our relationships, financial problems, bad luck, substance abuse, and other normal life adventures, because they are trying to teach us what love feels like.

Especially our children and teens, who are trying to teach us how unconditional love feels.  It is awesome how they raise families.

Every one of us is a snowflake.

We are all completely unique, fragile, and only a few short moments away from thawing into the ocean.

But, we are also the most complicated and curious bipeds on the planet, perhaps anywhere.

We are the Swiss Army Knives of the universe, who seem to be capable of ANYTHING we set our minds too.

What other species do you know that is manipulating its own genetics, recreating the Big Bang, and starting preparations to colonize another planet?

Since any one of us can possibly change everything, we need to ask ourselves, before we force other people to be pirates or fairies, why they can’t be both, neither, or something even more unique?

Let other people worry about their own gender.  We all have enough on our divided plates.

To create one more hierarchy seems like a waste of humanity.

And the paradox of here and now is that while we are all unique, we desire the same things.

So, since we are all different, let us all stretch in our own way, and share in all the patterns of human life that are possible.

It would make the moral of our collective story deeper, with a much happier ending.

Simon Trepel, MD, with Consultation from Jamie James

Simon Trepel, MD FRCPC, is a practicing Child and Adolescent Psychiatrist, in Winnipeg, Canada.  He is an Assistant Professor, at the University Of Manitoba, in the Faculty of Medicine, and the Co-founder of the GDAAY Clinic.  He is, more importantly, the proud Father of 2 beautiful Daughters.  He writes in his spare time about things he knows something about, and occasionally about things he doesn’t; like Yoga, and Italian flavored coffees.  He was not referring to coffee that tastes like an Italian person.

Check out his Blog, called Simon Says Psych Stuff, at



3 thoughts on “Plans, Trans, and Autogynephilia- The newest chapter in the story of humanity. #TransJenner #GenderCisphoria

  1. AWESOME CAT says:

    Dr. Trepel, I hope you will consider learning about autogynephilia from a source more reliable than Wikipedia. The very notion of autogynephilia is hugely embarrassing to the vast majority of MtF transgender people, those who are sexually interested in women. They have manage to stifle all discourse on the topic.

    I invite you to read some important papers (and a book) on the topic. The book and two of the papers were written by Dr. Anne Lawrence, herself an MtF transsexual. The PDF copies are linked below the citations.


    Lawrence AA. Autogynephilia: An underappreciated paraphilia. Adv Psychosom
    Med. 2011;31:135-48.

    Lawrence AA. Do some men who desire sex reassignment have a mental disorder?
    Comment on Meyer-Bahlburg (2010). Arch Sex Behav. 2011 Aug;40(4):651-4

    Bailey JM, Triea K. What many transgender activists don’t want you to know: and why you should know it anyway. Perspect Biol Med. 2007 Autumn;50(4):521-34.

    A.A. Lawrence, Men Trapped in Men’s Bodies: Narratives of Autogynephilic Transsexualism. © Springer Science+Business Media, New York, 2013. DOI 10.1007/978-1-4614-5182-2_1

    Liked by 1 person

    1. 5imon5ez says:

      Thank you Awesome Cat for your reply. After co-founding the GDAAY clinic, working with Transgender Youth for the past 4 years, advocating for changes at the provincial government level that culminated in changes to gender identity designations on vital statistics forms, contributing to the establishment of the first Canadian national Transgender Research working group, attending international conferences, communicating in an advocacy role with media, and working with health to ensure Transgender teens have access to publicly funded surgery, I feel I do have some experience to talk about issues affecting Transgender people. I also sought consultation from those in the Transgender community specifically in the ideas presented around autogynephilia. I called it a railroading, and indicated that it has created incredible shame for transgender people. My use of Wikipedia’s definition was merely to paint the picture of how simplified these concepts become to those not educated in the potentially devastating implications. I will however concede that I am not an expert on autogynephilia, and I will read all the references you have provided and make edits that are appropriate. I appreciate your comments, and welcome your feedback in the future. If we don’t agree on this aspect of my piece, I hope you enjoyed other parts of it. Simon Trepel, MD

      Liked by 1 person

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