Looking back at the first six months: Mental and emotional changes

Content Warning: This post contains frequent mentions of mental health, gender dysphoria, anxiety, and depression.

This is a continuation of my last post: Looking back at the first six months: physical changes.

In comparison to physical changes, the emotional and mental effects of hormone replacement therapy are substantially more complicated. I can’t measure my emotional state now and compare it to measurements from before HRT. Instead, I have to rely on my memory and experiences. It is a completely subjective experience.

I often think of my own mental health as a piece of pottery that has been broken and put back together. The pottery may still function for its intended purposes but the cracks are still there, crisscrossing across the object. These rifts intersect and merge, creating new fractures from the intersection of two unrelated fault points. Much like the splits and fractures in such an object, mental and emotional issues are not discrete. These issues intersect and merge, creating new fractures from the intersection of two unrelated fault points. Issues of the mind and emotions lack clean boundaries, where does gender dysphoria end and depression begin? How much of my anxiety is due to dysphoria and how much is unrelated? And how does gender dysphoria interact with other traumas and experiences to create something entirely new? There are no simple answers.

In general HRT has had a positive effect on my mental and emotional state, but it has also made some things more difficult. Before starting HRT, I suffered from anxiety and bouts of depression along with gender dysphoria. During my time on HRT, my general anxiety has gone way down and my occasional periods of depression have decreased. My gender dysphoria has also decreased substantially. But, none of these have gone away completely, only diminished. And in their place have come “new” mental and emotional issues. Gender dysphoria was a constant burden and it took an immense amount of mental and emotional energy to carry it at all times. It was an ever-present blinder that concealed other traumas and burdens that I was carrying in my mind. Reducing my gender dysphoria was positive, but in doing so I exposed these traumas. I am no longer kept awake at night wishing that I was a woman but instead awoken by trauma nightmares. HRT has definitely improved my mental and emotional state, but in doing so has exposed other mental concerns.

The effect of HRT on my emotional and mental state is incredibly complicated. I think the complexity is unavoidable, the mind is incredibly complex. I consider myself a pretty introspective person, but I am still baffled by the workings of my own mind. I went into transition with an overly simplistic mindset. I thought that addressing my dysphoria would fix all my mental health issues, that dysphoria was at the root of everything. Instead, reducing my dysphoria exposed other issues to the light of day and revealed which of my mental health concerns were unrelated to my gender identity. This is still an improvement, less dysphoria is the entire point of HRT, and it has improved my general wellbeing. But it has also forced me to grapple with trauma and concerns that dysphoria had long overshadowed.

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