Transitions

My patient thinks everything is changing. For the worse. They are gender-transitioning from female to male and aren’t certain they want to complete the transformation. They state fear is the main reason for this uncertainty. Today was supposed to be the first day they began using the pronoun “he,” but they have balked at its adoption. 

“What chances does a woman who wants to be a man have of surviving if civilization goes to shit?” is what they ask before they are even laying on the couch that most of my patients use when undergoing therapy. “If American society collapses as a result of the pressures and instability created by overpopulation and overconsumption, chaos will reign, as will the laws of savagery, red in tooth and nail,” they say. 

They have taken to reading dystopian fiction, and the habit simply stokes their concerns about societal collapse. “In the latest book I read set in the post-apocalyptic, former United States, where women have become chattel, and most men belong to brutish militias, the female protagonist was totally unbelievable. She is twelve years old and has miraculous healing knowledge, going as far as executing limb amputations. Even more far-fetched is her physical prowess. She has the strength and combat instincts to match an Achilles. And she doesn’t even want to be a man. If the new order of things is going to be neo-barbarism, how will any woman be able to live and die with dignity? How will I, as a woman turned man, fare against barbarians who were born male, who are physically stronger than me, more emotionally hardened than me, more suited to a life of street skirmishes and fighting to survive?”

Although I know what day and time it is—this patient’s regular appointment is on Wednesdays at 3:00 pm—I look at the date and hour on my timepiece. Whenever I’m faced with a difficult therapy session, I’ve taken to glancing at my watch. I’ve been in this profession for twenty-five years. Perhaps this peculiar habit tells me it’s time I head to other pastures such as teaching in human services or, even more tantalizing, opening up a second-hand bookstore. Although I don’t much believe in literary censorship, if I did open a bargain book business, I always thought I’d have to think twice about stocking pop romances, with their addictive, dopamine-circuit satisfying plots. Now, given this patient’s troubles, I might have to consider a bookstore that bans fictional dystopias as well as formulaic romance. 

My patient takes their place on the couch, facing away from me. We follow one of the unofficial rules of psychoanalysis that discourages the analysand from making visual contact with the analyst while in therapy. Most patients find it makes their responses less inhibited. This arrangement allows me to observe body language, while remaining myself unobserved by the clients while we tease Oedipus, Electra and a hundred other tragic and comic archetypes from the content of their spoken words. 

Today my patient is angrier than they were last session. Although I prefer to explore unconscious motivations for my patients’ behavior and usually delve deep into personal histories and how social context affects desire, there is an urgency in my patient’s voice today that I feel the need to disarm. I want to ask them what unconscious need or hankering their fear of the coming dystopia is satisfying. Given that they mentioned a heroine with unnaturally masculine qualities when our session started, I want to unravel the sense of inadequacy they may feel not being able to measure up to popular images of masculinity as a transgender male. Instead of taking this route, however, I cannot resist utilizing a standard tactic of cognitive behavioral therapy, a form of positivistic therapeutic intervention I usually frown upon. I don’t think effective psychological healing entails anything as straightforward and scientific as identifying thoughts and their concomitant feelings, then developing countervailing thoughts if the ones a patient is having is leading to existential misery as they are in this patient. I need to bring their level of passion down a notch if I expect them to listen to anything I have to say, so I ask, “Justin, what evidence have you that these changes you’re so fearful of are immanent? I mean, I filled up my gas tank and picked up my dry cleaning yesterday, bought a macchiato this morning, had a delightful avocado sandwich for lunch at the local bakery café. I spoke to my husband before you arrived to your appointment and although conditions at the Veteran’s Administration where he works aren’t ideal, they are stable. Government still exists, is more controlling than ever and although there are bumps on the road, as there always are, claims of the world devolving into chaos seem to be exaggerated.” 

Although my patient now expresses reservations about becoming a “he,” they choose to use, and demand that I use their preferred male name. Before deciding to become transgender, my patient’s name was Justine. Justine Chase.

Justin is taking testosterone and as a result has sprouted facial hair, and developed a vocal timbre that can pass as male. As a teenager, they followed the career of Ellen Page and initially they were elated when the actress became an actor and changed her name to Elliot. Now, they regard Page’s transitioning with ambivalence.

After I try to assuage them with examples of the quotidian from my life, Justin changes the course of the conversation. I find this unusual. They are usually focused.  

“According to my physical anthropology professor,” they say, “what most female simians look for in a reproductive mate are the qualities of an alpha male. As a former woman who is attracted to women, how am I ever going to embody the attributes of an alpha male? Not all the testosterone supplements and drunken courage I can afford will ever match the potency of primevally macho male horniness.”

“Justin!” I exclaim, finally, and unprofessionally, losing my patience. Perhaps I’m closer than I thought to finding a new career, but exclaiming their name has captured their attention. They break with procedure and look back at me from their supine place on the couch.

I regain my composure and continue, “I have a therapeutic request I need to make. Two therapeutic suggestions, if you will. The first is you must stop reading books about the end of times. Time never ends. Even if there were to be the worst possible cataclysm that decimated humanity, we would still survive. Change. Recover.”

They continue to look at me and listen. I’m about to utilize a principle of community mental health practice that I attempt with particularly recalcitrant patients. Justin isn’t one of these, but if they don’t steer off their manic and plaintive course soon, they might be setting themselves up for a debilitating depressive downswing.

I still have Justin’s attention. I proceed, “Second, every Friday afternoon the library in this neighborhood hosts volunteer readings for children with learning disabilities. Today is Wednesday, how about you go to the library after session and see if you can sign up for a place as a volunteer reader?” 

The aim of the intervention I’m suggesting for Justin is to use reading to create community, rather than foment alienation and dis-ease. 

They agree to visit the library, our session ends, and I go home and look online for commercial property that can be remodeled to suit the requirements of a bookstore dedicated to mindful and responsible reading, perhaps I’d call it Maxine’s Healthy Reads.     

*

At the end of Wednesday’s therapy session, Maxine, my psychoanalyst, lost her patience with me. She yelled out my name as I was rambling on about the sex lives of monkeys, and after I had gone on at length about how I wouldn’t survive the apocalypse as a man, or as a woman, or as a non-binary person, or as whatever it is I am.  

What I really wanted to address during session today, what I really wanted Maxine to answer, although she never gives me answers, is basically why I feel so damn lonely and why I’m finding it so hard to meet a girl to form a loving relationship with. 

Maybe it’s because I’m thirty something and I still live at home with Mother Marbles. Where would I be without her unflagging support and her grilled cheese sandwiches? Maybe it’s because I don’t get out enough or live in San Francisco. Maybe it’s because I’m not having success exhibiting my paintings, or perhaps it’s just because I’m batshit crazy and no one wants to get into a relationship, lustful, loving, or otherwise, with a person diagnosed with bipolar disorder. People are having a difficult enough time as it is in relationships when both partners are neurotypical. Who in their right mind wants the added baggage of meeting a person with a wrong mind, a derailed person, when they’re looking for love?

Maxine didn’t answer any of my questions today. She didn’t solve anything for me. I know it’s not her job to find solutions for me or to resolve my myriad complaints. If she had known, or even thought it was possible, she would’ve given me advice on how to be a transgender male who’s tougher than a person born male. Instead, after she interrupted my diatribe, she suggested I do two things. The first was to stop reading dystopian novels, which is going to be hard to do, because since I’m what used to be called manic-depressive, I’ve developed a routine where I paint to ride my dopamine fueled manias, which I find pleasurable and enjoy, and then, to come down and balance out the pleasure with a dose of simultaneously anxious and depressive pain, I binge read end-of-times literature. I think anyone would agree that’s a pretty messed up circuit, but I’ve been doing it for over a year now, so it’s not going to be easy to give up my daily dystopian fiction habit. But I didn’t do any reading yesterday, which was Thursday, so that’s a start. However, I also didn’t have anything to counterbalance the manic mood my painting put me in. As a result, I didn’t get much sleep last night.

That brings me to Maxine’s second suggestion: that I volunteer read to children with learning disabilities at the library in the neighborhood where her office is. And that’s what I’m about to do. When I went to the library on Wednesday to see if there was an opening, the librarian I talked to said a person had just happened to call in to cancel their appointment to read to the children. She placed me on the confirmed readers list for Friday, which is today.

I’m currently at the library, and there are little rambunctious brats everywhere. Kids romping about and laughing in rooms meant for studious quiet time. Kids stamping the library floor with their small feet and crying. Happy snot-nosed kids and grumpy kids wrinkling up their noses. There must be more than thirty children between the ages of three and six who are impatient to hear the three readers tonight. One of them is an elderly Hispanic-American gentleman who wears a Panama hat. One of them is a girl in her twenties who looks like she’s free of the weight of the world, and to whom, possibly for that very reason, I feel drawn toward. The last one is me and I will be the last to read.          

Each one of the readers has been given a Dr. Seuss book to present. Even though I’m an avid reader, my Cuban parents whose last name is Chavez, never read to me when I was young. To get back at my dad, Hector, for divorcing my mom when I was 21, I legally changed my last name to Chase, and although I’ve always been curious and it seems almost impossible given their popularity, I’ve never so much as glanced through the pages of a Dr. Seuss book.

A male librarian announces the beginning of the event and gets everyone present to find a seat and quiet down. He introduces the three readers by their first names. Most of the parents either stand or sit in chairs. The children are either on their seated parents’ laps or sitting cross-legged in a semicircle around the chairs where the man in the Panama hat, the world-weariless girl, and I sit.

The hatted Hispanic-American begins reading. His English has a Spanish accent, and although from the accent I can tell he’s not Cuban, the man nevertheless reminds me of my father. He is somewhat gruff, and for some reason, perhaps because he reminds me of Hector Chavez, I assume he is using his reading time to satisfy court-mandated community service hours. When he reads English r’s he rolls them, and he pronounces all vowels as if her were speaking Spanish. During his read some kids begin crying. Other kids yawn. Others leave the circle of seated children and find their parents. About halfway through the book, the hatted man says, in his accented English, “I’m sorry, I’m so, so sorry,” gets up and walks away from the reading circle. The children look surprised. The parents murmur in astonishment, but not disappointment. I’m glad to see him go, as I’m sure many at the event are, but at the same time I feel sorry for the hatted man. I’ve no real reason to dislike him. His name isn’t Hector. It was Franklin. 

The girl who takes the weight of the world for that of a feather, and whose name is Rachel, reads next, and compared to Franklin’s reading, her own does feel light, perhaps a little weightless, even. Her enunciation his flawless and free of interruptions, but she reads with very little emotion, I guess the reason I was initially drawn to her is that opposites attract. Unlike me, I don’t think Tabitha is a wrecking ball of highs and lows. I wonder what it must be like to go through life on cruise control set at a law-abiding 55, and not in a flurry of gut clenching accelerations and tire screeching reverses. She gets smiles and giggles while she presents, and when she is done, she receives a cordial round of clapping from the audience.

When it’s my turn, I introduce myself again, even though neither of the other two readers bothered to and the librarian introduced me to the audience earlier. I feel self-conscious and think the kids are putting two and two together: I have the slight build of a female and feminine features such as long eyelashes and full lips, but I have sparse facial hair and a baritenor’s voice. Is this a boy, or is this a girl, I imagine them think. The truth is, even though I was supposed to officially adopt “he” as a pronoun on Wednesday, today, before beginning to read to a bunch of kids I assume are confused, I am neither he nor she, and am feeling equally befuddled.

I manage to get a hold of myself, open to the first page of the Cat in the Hat and commence reading. I feel neither manic nor depressed, I feel even-keeled, but not flat like Rachel. Everyone in the library is listening.

When I read aloud about the bump that made Sally and her brother jump, I use my back and feet to lift the front two legs of my chair off the library floor, then bring the legs back to the earth with a resounding “crack!” and slightly jump out of my seat. 

While I continue reading, I show the rapt kids the book’s illustrations, and extemporaneously comment on them. They smile, they laugh, they make reciprocal comments and youthful exclamations.

When I reach the end, the audience and the parents in particular, erupt in thunderous applause. One of the librarians asks me to please come back for another reading soon.

In my car outside the library, I use my phone to text my psychoanalyst.

I was a hit.

‘Twas truly a healthy read. 

Thank you for that, Maxine.