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Written by Ashley-Devon W. .

Art by Alex Mckelly.

“Gender dysphoria” is used to describe a person’s discomfort or dissatisfaction with how their gender is physically manifested or expressed. On this issue, popular media prefers to give the mic to trans women who can recount growing up feeling extreme discomfort in male-presenting bodies, and how various combinations of surgeries, makeup tutorials, and wig purchases have made their physical bodies truly reflective of their gender identity. Given less media attention, but still discussed in queer communities, are the stories of trans men who have their genders affirmed through mastectomies, masculine clothing, testosterone therapy, and various other outlets.

These bodies and their stories are ever valid and necessary, but they only reveal limited versions of the journeys that non-cis people embark on to have physical forms that match intangible identities. Within and beyond the polarities of “man” and “woman” lie countless genders, and those who hold them often struggle with expressing them; for it is difficult to express that which has no predetermined models or standards, and because many people refuse to acknowledge the existence of non-binary and agender identities altogether. For these reasons, dysphoria among genderqueer individuals is a silent but dangerously pervasive issue.

Following puberty, I felt that I never “blossomed” and was instead a stunted bud that fell, prematurely, to the ground to be trampled.

My awareness of my genderqueer status started when I was about 6 years old. I remember my mom once trying to make me wear a dress, and me telling her that I didn’t want to because I didn’t “feel like a girl today.” It was a dress that had worn many times before and wore many times afterwards. I’m sure that my mom understood me as saying that I didn’t feel “girly” that day, and brushed it off as she helped me choose a new outfit. Still, I said what I meant and meant what I said. There were many more instances where I felt detached from girlhood, and temporarily changed my wardrobe or mannerisms in attempts to accommodate those sentiments, but was still unable to completely understand what I was feeling.

What I now recognize as dysphoria continued in small, fleeting waves until I met the large and formidable demon, menstruation, at age 11. Prior to starting my period, a friend and I read Judy Blume’s Are You There God? It’s Me, Margaret, and were excited about officially becoming women. I was secretly hoping for an even more drastic change — that those urges to estrange myself from girlhood would cease completely as I blossomed into womanhood. My prayers went unanswered and puberty greeted me with fists instead of open arms. Each month, PMS would leave me with feelings of intense self-disgust, and deeply painful periods made me want to rip out my uterus. Following puberty, I felt that I never “blossomed” and was instead a stunted bud that fell, prematurely, to the ground to be trampled.

By my early twenties I was confident in my pansexual identity. Still, I felt incomplete as if I was yet to uncover my truest self. Of course, I had heard of being non-binary, but I assumed the concept wasn’t relevant to me because I’m not the beige, androgynous figure with indeterminate facial features and a haircut featuring both a side-shave and bangs that the internet pines for. No, I am petite but still curvy, dark-brown with clearly feminine facial features and a curly afro that I refuse to cut, but sometimes pin down under wigs or weaves. With so much external femininity, I assumed gender couldn’t be the root of my discomfort.

For most in the medical community, hysterectomies with regards to gender affirmation are reserved only for those who have a clearly delineated gender. “Male,” not simply “Other.”

That all changed in 2015 when, convinced that the source of my bodily dissatisfaction was that I was fed up with painful periods, I received an IUD implant. This was promoted as a treatment for uterine pain during menses, so I decided that this was my best bet for finally feeling at ease with my body. My body betrayed me again, and my periods became even worse, making me miss several days of work and school due to the pain. In the midst of these monthly battles, I happened to be reading more about gender identity and stumbled upon r/genderqueer on Reddit. There, I found a thread where AFAB genderqueers were openly commiserating about menstruation-induced dysphoria, and discussing hysterectomies as a gender-affirming procedure. I revisited that thread several times for about a year, and after engaging with a number of other materials and conversations with other genderqueer individuals, I finally, at age 25, admitted to myself that I, too, am genderqueer.

With this newfound self-awareness, I asked my gyno to discuss the possibility of a hysterectomy. I was nervous though, and didn’t feel confident telling her about my newly realized identity. I told her that I wanted a hysterectomy because of the exacerbated pain I was enduring with the IUD. She refused, citing a number of reasons, mainly that I would hit menopause too early and would regret not having children. I tried three more times to discuss the issue, and received the same response. Offended, I decided not to see her anymore. More research affirmed my suspicion that this was common, and also that those who were brave enough to tell their gynos that they wanted a hysterectomy as affirmation of a genderqueer identity were told that they weren’t strictly “trans,” so the surgery couldn’t be deemed a medical necessity. For most in the medical community, hysterectomies with regards to gender affirmation are reserved only for those who have a clearly delineated gender. “Male,” not simply “Other.”

Three years later, I still battle each month with menstruation-induced dysphoria and am still seeking a healthcare provider who will take my invisible pain seriously, and deem a hysterectomy as medically necessary for gender affirmation. I still rely heavily on threads to affirm the realness of my concerns because genderqueer dysphoria has yet to become a topic of interest for serious public discourse.

The world must recognize that non-binary and agender individuals also often want to transition in some way, and we need caring doctors and counselors to guide us through those processes. Our lives depend on it.

About the Author

Ashley-Devon W. is an enby femme artist from the 513. A cultural anthropologist by trade, they turn to the arts to express things that are not best stated in APA format, like the delights of being surprised with homemade pies or perfectly symmetrical leaves. 

Follow on IG: @onerarecreature