Committing to Physical Integrity: Healthy Coping Part 1

Don’t let the mind bully the body-June Tomaso Wood

Healthy coping techniques are essential to any introspective journey. Wherever you are in working to understand your past and how you got to where you are now, it is important to take the time to be honest with yourself about your self-care and your habits. Taking steps, however small at first, towards healthy routines regardless of how you feel about yourself, your body or your gender from day to day or moment to moment is of highest priority. Your gender-dysphoria might be in the past or it may still come and go, but the first step is learning to take care of yourself despite whatever you may be feeling.

Establishing Physical Integrity

The body can take a lot of abuse, whether consciously or unconsciously. We cut ourselves, we surgically remove or change parts, we drink, we smoke, we binge, we starve, we ignore, we say mean things, and sometimes we allow others to mistreat us.  I hear so many detransitioners lamenting about what they were allowed to do to their bodies and feeling intense regret or rage over vocal changes, body hair, loss of limbs, not passing as their biological sex anymore etc. It can be easy to fall into despair and self-hatred.

Your biggest task in beginning recovery is establishing physical integrity. You will challenge yourself to take care of your body, despite how it looks or how you feel about it.

I would like you to write this down on a piece of paper and keep it with you where you can access it multiple times a day. This is a mantra that will help get you in the practice of connecting to your self-care. If you want to amend it or make it more personal to you, then go ahead:

“I am committed to the integrity of my body, no matter how I feel about it from moment to moment. I will do what it takes to restore health and healing to my mind and my body.”

Steps to Restoring Integrity to Your Body

For the following exercise, take some time to reflect on these different aspects of your physical health and set yourself a task list of steps that you can work on.

Medical Care

This can be potentially a painful area for desisters and detransitioners who have had many experiences and procedures with medical professionals throughout the course of their initial transition and subsequent detransition.  Many are left with complications, scars, and ongoing side effects from their surgeries and other interventions.  Some have simply stopped taking hormones, or stopped going to appointments. Some have had horrific experiences and feel scared and mistrustful of doctors.  

There is no easy solution to this problem, depending on where you live, and how willing your insurance is to help with your detransition, or how accepting/knowledgeable the doctors in your area are.

Despite this, it is important to try to find a way to get any medical worries or concerns seen to. This means making long overdue appointments, going to follow up appointments or paying attention to scars and complications.

Psychiatric Care

If you are experiencing any extreme mental health issues medication may be an important temporary or necessary intervention for you.  If you have questions you can set up an appointment with a psychiatrist who is a trained medical doctor with a thorough knowledge of medication.

Likewise, if you are currently taking any medications for co-morbid disorders like depression, anxiety, bi-polar etc. then it is essential that you talk to a psychiatrist and regularly assess and work on your needs. 

Sometimes it can take time to find medications that are right for you and this can be frustrating. Nonetheless it is an important step in finding what works for you. 

For others medication is not the right route. You can always explore this with a therapist and/or psychiatrist to make sure that you make an informed decision that is right for you.  If you want to stop taking medication it is important to do this with your doctor so that you can taper off of any existing medication and be supported in living medication free.

Nutrition

It’s no surprise that when you have spent years hating your body your nutritional health might have taken a back seat. Now is the best time to change this and focus on good nutrition. Making a plan for long-term healthy nutrition will support your recovery and help you to feel better. When you feel better, you will have a better chance of handling any feelings that may arise due to a relapse in your dysphoria, your detransition, or just life in general. Try to aim for 3 balanced meals a day. It may sound simple, but when disordered eating, comfort eating or restrictive eating have taken hold it can be a huge challenge.  Three meals a day is about creating balance and accountability. For example, even if you binge in the evening, don’t skip breakfast tomorrow, no matter what, be accountable to your three meals per day.

It can be very useful to talk to a nutritionist or physician to work on a meal plan that may be right for you and help you analyze your unhealthy habits and start to form new ones. There are also many sufficient online support groups to help with this.

Exercise

Relearn an approach to exercise which centers the integrity of the body

Your relationship to exercise may be complicated, especially if during your transition you used exercise to achieve the body type of the gender that you wanted to transition to. For some this was hours spent in the gym to develop a more muscular appearance and for others, it was a fear of bulking or developing muscle.

Relearning an approach to exercise, which centers the integrity of the body, is an important step towards developing a healthier relationship to self. 

This is about developing a mindset that challenges the obsessive focus on what is wrong and uncomfortable about the body. For some who have used exercise negatively it might be a process to discover a physical activity that is more focused on balance, flexibility, and patience rather than pure aesthetics. A good place to start might be just walking. Increasingly evidence shows us that exercise is effective against depression, stress and anxiety and essential for mental and physical health.

Sleep

Sleep should be one of the first lines of enquiry for any person wanting to improve their health. Without good sleep, every other aspect of our lives suffer. There are things that you can do to improve your sleep and they often include changing some pretty simple but stubborn habits. The Harvard Medical School Division of Sleep Medicine has a good website (www.understandingsleep.org) where you can learn about changes that will improve your sleep i.e.

Avoiding chemicals that interfere with sleep

Create a stable sleep schedule

Creating a calm and safe bedroom

Keeping laptops and screen out of the bedroom

Exercise

Addictions to Drugs or Alcohol

Are you prepared to analyze your relationship to drugs and alcohol? For many this is the first step towards health.  You can’t be healthy while you are abusing your body with alcohol and drugs. Ask yourself if you are willing to take a 30-day sobriety challenge. If not you may have a problem with substance abuse. 30 days provides an opportunity to discover what life is like without drugs or alcohol. If you can’t stick to this challenge, or you make up excuses why you don’t need to try it, you may have a good indicator of a deeper problem, which ultimately may require focused addiction treatment intervention. If you can stick to the challenge you will learn a huge amount about yourself, from the feelings that arise without self-medicating to new and healthier coping strategies for your ongoing life. 

Please keep in mind that if you have any doubts about drink or drugs being an issue for you, please see a qualified addictions counselor and get a professional opinion as soon as possible before attempting any self-treatment.

Sexual health

Sexuality can be overlooked in gender questioning people. Many detransitioners come to realize that what they took for gender confusion was actually a deeply complex and confusing relationship to their sexuality. Learning how to live as a same sex attracted person can be an important part of the recovery journey for many detransitioners. Are you sexually active? How do you feel about sex and whom you have sex with? Are you having safe sex? These are all really important questions to think about as you determine a healthier way of being in your body. Taking steps to avoid unwanted pregnancies or stds is a basic aspect of caring for yourself.  Taking stock of yourself might mean asking yourself: how do I assert my needs, wants and boundaries? It may also provoke you to think about what kind of relationship you want and what role sex plays in your life. Asserting ourselves sexually, whether saying no, or being able to discern with whom we want to be sexual with is an important component of our self-esteem. This can take years and is often best suited with a non-ideological therapist who can help you work through these questions without judgement and address any abuse or assaults that you may have experienced. Sex is the place where many of us express our intimacy needs and this can be fraught with shame and denial. Taking back control of our sexuality is a beautifully liberating experience and very important to living a life free from shame.

In the next blog post please find some reflective prompt questions to get you started on your way to developing a caring and proactive approach to your physical integrity.

Please feel free to comment if you have any other ideas and suggestions.