Gender dysphoria and health issues

[Ihatemyusername]

I'm in therapy right now for various issues, mostly stemming from issues that have arisen from my being a female. I had tokophobia ever since I was a kid and never saw myself wanting to be a parent. I resented that women were forced to suffer with periods, then pregnancy and the agony of childbirth as soon as I learned about it. Nature just seemed cruel. As luck would have it, I had my first period when I was only in 4th grade and developed breasts around that time too. I felt like I was cheated out of a childhood because I was interested in stuff kids my age enjoy but people gave me strange looks because I had the body of someone much older and got teased for being immature even though I was just acting my age. I actually was the last of my friends to even become interested in a relationship.

When I finally was in a serious relationship I went on BC and developed severe vulvodynia. Going off BC helped but I never got completely better. I convinced myself I was asexual to keep myself from the severe depression I got about not being able to have "regular sex" because without birth control and condoms together, I just don't feel comfortable having intercourse and much of the time it would be too painful anyway. I tried antidepressants but they actually made my pain AND depression much worse. After being in therapy for awhile I realized I'm not ace, and it has been a coping mechanism. A few times on my low pain days I tried masturbating. Ironically despite the super sensitive nerves in my genitalia, sexual stimulation doesn't feel like much of anything unless I use a heavy duty vibrator and even then orgasm aren't guaranteed. I know they shouldn't be the be all and end all of sex but I'd like to have some enjoyment from my body for once, but I feel in general like women have the short end of the stick when it comes to sex. It's harder for us to orgasm, but we can get pregnant even if we don't get enjoyment from sex.We have to deal with changing bodies and sacrifice ourselves happily if we do decide to have children and if we don't like the concept or don't want it, we get called selfish. I'm also frustrated as it seems most cis men can orgasm with minimal effort, they don't have to deal with periods and they don't have to deal with pregnancy. I realize not every woman feels negatively about pregnancy as I do, but as I've stated even before I had all these other problems, I found the whole idea terrifying. I have no idea why as I wasn't brought up in a house where sexuality was shamed and my mom loved being pregnant with me and was depressed that she could only have one child (she had several miscarriages).

I identify as non-binary as some days I truly do not feel very female at all. Other days I feel extremely so. I feel kind of guilty though when I envy people who don't have a uterus or a vulva, like I'm misogynistic somehow even though in all other aspects of my life I consider myself a feminist. I feel embittered that I have experienced a lot of negative (and even rare) problems from being having these body parts but have not gotten any benefits from them. I don't know how to feel about myself or cope with it.

Sorry for such a long, rambling post, but does anyone have any suggestions as to how I can feel better about my body, my gender, and my seeming inability to have any sort of sexual identity?

[Alice M]

Hi there!

While I am not someone who feels qualified to give advice on these questions, I wanted to leave you a note to let you know that we see you and that other staff will be around to weigh in with some thoughts and have this discussion with you soon.

[Ihatemyusername]

Thanks for letting me know. I realize this is not an easy question to answer. Thus my intense frustration.

[Amanda F]

Hey Ihatemyusername,

(I'll try to touch on a few of the things you mentioned - the staff will have more to add, I'm sure!)

I sympathize with your feelings about growing up in and living in a female body. At times it's been a struggle to see myself positively at times in the context of my body and gender identity, in part because of all the negative (and often inaccurate) messaging we receive about female bodies. You've already mentioned some, and I'll add a couple more: "female arousal is more complicated," "pain during sex is normal," "REAL sex = penis-in-vagina intercourse" - all toxic myths that, nonetheless, can have damaging effects on our sexuality and how we perceive ourselves.

Would you say that the feelings you have about your body and your gender identity are innate, or do some/all of them have any influence from our culture/media? Which ones?

You've already visited Scarleteen, so you're ahead of my first suggestion, which is: more/better education! Looking for sex-positive, affirming, supportive education and resources can help you learn more about your body in a really positive way. I don't mean to suggest that you don't already know your body; rather, I mean ways of relating more positively to your body, and ways that you can learn how to experience pleasure. O.school is one example; OMGyes is another (and Scarleteen, of course!). There are also some awesome books about female sexuality, including: "Come As You Are" by Emily Nagoski, and "Becoming Cliterate" by Laurie Mintz.

It's awesome that you've been going to therapy. Many therapists don't have much or even any training in how to help clients with issues around sexuality. Does your therapist happen to be a certified sex therapist? A sex therapist might be able to provide additional support.

Mind-body awareness is another thing to consider. If you're distracted mentally, that can really affect what you feel in your body. When you masturbate and you don't feel much, where would you say your head is? What thoughts are going through your brain?

Another suggestion (since you are over 18) is to consider visiting a sexological bodyworker. This is a bit more unconventional, and only something I recommend if you feel comfortable with the idea. A sexological bodyworker can provide therapeutic touch but for sexual issues. They remain completely clothed and it's not a reciprocal sexual scenario; instead, they will work with you to help you learn more about your body, how different kinds of touch feel to you, and whatever other things you feel would be helpful - including feeling more positive and empowered in your body. (Scarleteen staff, if this is an inappropriate suggestion for the boards, please remove.)

I realize I haven't addressed everything you mentioned, but I hope this is helpful to start! You're not alone, and you can definitely get to a place where you're feeling better about your identity and your body. It will take some work (which I recognize is also unfair ) but it is possible. <3

[Ihatemyusername]

[quote="birds_chirping"]Hey Ihatemyusername,


"Would you say that the feelings you have about your body and your gender identity are innate, or do some/all of them have any influence from our culture/media? Which ones?"

Bear with me, as this is turning into a novel.
I think it's innate but culture and media just made it worse. I remember when I was in 3rd grade or so, my female friend and a male classmate were arguing about why girls or boys were better. The boy made arguments such as
-Boys are more logical/less emotional
-Boys are stronger
-Boys are better at sports
-Boys are better at math and science and technology.

I realized of course, most of these things simply aren't true for most people. (with the exception of physical strength in many cases), but my female friend had very little to counter to these points with. We were only 8 after all and all she could say, was "women are able to give birth" which I remember feeling depressed about then because I wanted to play a sport or learn science not have a baby. I mean,I was 8 but I still knew from a young age I didn't want to be a parent. (Yes, people can change their mind, but I just knew that I wouldn't. As sure enough the older I got the more I knew it.) And it didn't stop me from pursuing my interests but it always stuck with me that the arguments about women's strengths were never anything that resonated with me as a person. And despite the other stereotype for women I don't have a higher tolerance for pain (yet I was given not only a pain condition that effects what clothes I can wear (I have to wear skirts and dresses a lot, long ones without underwear even though I've always been a jeans and T-shirts kind of person). I'm not much a nurturer etc. My (male) doctor told me that if men were expected to carry a baby for 9 months and then give birth to it, the population of humans would be significantly smaller and considering how I feel about the whole thing I'm inclined to see their perspective. He also told me about a male birth control pill that was never placed the market because of its side effect profile which was only a third of the side effect profile for women's BC. My partner told me that he'd be willing to take it but a lot of men have said things to the effect that it should be the woman's responsibility. One male friend even told me after I confided in him when I was dealing with "well isn't pain just part of being a woman?" Many men realize this is often case and simply don't care or think that women should just suck it up an get used to it. Even more own partner gets frustrated with me for missing work or not wanting to go out with friends like I used to, but who would when you feel like you're sitting on and sandpaper even if you're wearing nothing all. And it's depleting. I'm tired all the time. Having a chronic pain condition doesn't make you (at least not me) stronger. It makes me weaker and weaker to the point I simply don't have the energy to try to fake it anymore.

Women's bodies are under so much more scrutiny as well. I mentioned having precocious puberty but I also very skinny. I was 5'4 and 105 lbs (without any effort on my part) and somehow managed to have a size C or even a D cup and an hour glass figure, so once everyone finally got over the fact that I developed earlier, they started commenting on the fact that I must be anorexic (which isn't even close to being true.) I never hear people discuss men in such a way. Then in high school once everyone caught up to me in their adult body types they'd make fun of me for looking like a kid because I was skinny and had a young face. Or because I still had breasts for someone so small people would ask me if they were real.(Like that is anyone's business regardless)

When I was 12 or so my parents' friends (including but not limited to men) would come over and (trying to be nice I assume) would comment on how I becoming such a beautiful young woman which being that I was super uncomfortable because I wish they could talk to me like a regular kid. Others my age did get told this, though they did get more positive attention in school. I remember telling my parents I hated my curves and I was told that eventually I'd grow to love them because men like curves. Um..okay, but I'm not interested in what men like right now, I'm interested in living my life as junior high kid. I wan my body to reflect me, not the male fantasy. At any rate, I got sick of hearing this after every single encounter and eventually would walk away from them. When I was told by my parents and their friends that I was being rude, I responded that commenting on my looks every time someone saw me was also rude as it made me self conscious and that I was still 12 and wasn't ready to be called a young woman constantly like that was my entire identity. In order to combat this, I think I started acting MORE immature to distance myself from this despite the fact that made people think I was weird and caused the teasing and bullying to get worse.

I'm not sure any sort of "sexual bodyworkers" would help me as I already know what feels good and what doesn't and most of what doesn't is the results of a pain condition that makes my genitals feel intense agony and sometimes even radiates to my feet and legs

[Sam W]

Hi Ihatemyusername,

It sounds like your body has been under some deeply unwanted (and as you point out, in many cases inappropriate) commentary. You're far from the first person we've spoken to who's found such comments leading them to have negative or complex feelings about their body. Too, as much as you can, try not to feel guilty or like a bad feminist on the days when you find yourself envying people who don't have a vulva or uterus to deal with. There's nothing inherently wrong with wishing you could be without a body part that intensifies your gender dysphoria (or your anxiety, given your fears around pregnancy).

Have you had the chance to process this big wave of body feelings with your therapist? If so, how has that gone?

You mention wanting to feel better about your gender. Are there things you can think of that make you feel particularly connected to your non-binary identity? Or modes of gender expression that tend to make you feel happy, or at least comfortable, in your own skin?

I want to make sure I'm answering the right question, so with those issues around ability to have a sexual identity, are you thinking in terms of a sexual orientation? In terms of being a sexual being who engages in different types of sexual activities, either with yourself or another person? Both? Neither?

[Ihatemyusername]

"Have you had the chance to process this big wave of body feelings with your therapist? If so, how has that gone?"
I talk about not feeling comfortable being female and having the body parts that I do, but honestly I don't know if my feelings of being non-binary are just me trying to distance myself from the parts of my gender/sex that made me so unhappy growing up, and currently. I like some aspects of being female, and some days I enjoy dressing and looking very feminine. Other days I do not. (Usually those are the worst pain flare up days, but not always) .

I'm not concerned about my sexual orientation. I've always been attracted to males or masculine people and am in a committed relationship with a cis male who for the most part is patient with me and my issues. (He doesn't understand the emotional toll it's taken on me and he's not always the empathetic but he also respects my limitations and never tries to pressure me to do anything I'm not comfortable with and tries his best to do better about being empathetic which is all I ask) HOWEVER I'm not happy with how things are because of my health issues. He's attracted to me, and I don't feel attractive because usually I just feel pain.I have a hard time disassociating intimacy with pain. The only time I can do it at all is with a vibrator which I use by myself, because I want to get comfortable with my body before I let my partner get involved (he is aware of this and supportive) but any time I start to feel like I'm making progress, my health gets bad again sometimes for weeks or months at a time, and then I'm back to square one.

Before all of this happened, and before I could (or was ready) do anything about my urges/desires I had a pretty high sex drive and had a lot of "adventurous" ideas that I was looking forward to trying. Now I'm stuck with doing one thing and then possibly suffering from it if I do. (It's hard to pin point if it is the direct cause or not. Sometimes I have done things that have made me hurt immediately afterwards and other times I have felt fine for days after. There is no rhyme or reason to my flare ups and they last for as little as a few hours or as long as a few months and often nothing triggers it, though certain things such as certain fabrics seem to, and certain medications....)

I guess my question is, am I just supposed to accept that sex is not for me. I've talked to a doctor about a pain block and they told me it's possible that if it works it could cause permanent numbness. I've heard different things about this and I can't seem to get a straight answer. Some say it's temporary and some say it's permanent. I've even heard it has the potential to make you worse, which the way my life goes, seems most likely.) So, how do I accept that I won't be able to have sex or be intimate because if I have intimacy, I'm going to want to have sex, I've tried, and that's how it goes. I still have a drive, I just seem to get "punished" for it. My therapist keeps trying to look back into my past to see if there is some trauma or something in my upbringing causing this, but so far we have not found anything. Like I said, my parents were pretty open and positive about those things so I don't think that's the reason.

[Heather]

I think what I'd suggest is that you try and accept the way things are for right now. Who knows what the future will hold, and obviously it's a LOT more loaded to try and accept this is how it will always be, not to mention potentially unnecessary because it may not always be that way.

So, I'd say you focus on accepting all of the things that, for now, are not things you have the ability or the capacity to change. From what I can gather, what that is is that for right now, genital sexual activity (I don't see you saying that other ways of being sexual cause pain or fear, but please correct me if I've got it wrong) both with a partner or alone isn't working out for you, and seems to be causing you far more physical pain or emotional distress than pleasure. My best advice in that acceptance would be to just stop trying for a while: to accept that's not working for you no matter what you try right now, and to put your time, energy and focus into other parts of your life that do not create pain and distress. It might help to even give yourself a time period to start with, like, "For the rest of the summer, I'm just not even going to focus on or try with this: I'm going to focus on other things and try other things in other parts of my life."

One suggestion I have for trying other things would be to explore or focus on other parts of/things in life that bring you pleasure. Ultimately, sex is primarily about pleasure for most people, and just like with intimacy, sex is only one way of so very many ways for us to experience pleasure. What else brings you pleasure? If you don't really know yet, what might you try exploring that you haven't before? That could be something sensory, like learning to cook, something physical, like learning a new kind of movement, something social, etc.

Intimacy really, really isn't just sexual. That's one kind of intimacy of so many others. You say if you are intimate with someone you will want to have sex with them: is that true of your friends? Or family? Or even, say, with a therapist? How about when you're sharing things here, as another example? I'm asking because if so, that's a different kind of conversation to have -- if literally all kinds of intimacy result in sexual feelings for you -- than it would be if you can be intimate with people and not develop sexual feelings for them.

[Ihatemyusername]

When I refer to intimacy I mean sexual activity with my partner. Yes, I do want to be intimate with my partner and have sex with him. Cooking or the doing other activities I'm interested won't take fill that void. I do have several hobbies that I try to fill my time with when I'm not in too much pain to function (which sometimes happens, as sometimes it can be so bad that I'm bed ridden) Nor will my friendships that I have of a platonic nature, though I of course do value them, though even seeing them is something I do less than I'd like because having this health issue is so depleting sometimes I can't leave my house. (This has made work hard as well.) Those activities and friends won't make me feel better about my dysfunctional sex organs and the pain they cause me. I'm asking primarily how to feel okay in my own skin and my own body and to deal with being a female when it's caused me so much grief. Am I understanding correctly that you say I should give up for now, any sexual activity and to just continue to try to think of myself as an asexual being (with painful sexual parts?) I may be misunderstanding you, but the idea of giving up and living that way causes me much anxiety and depression. (Again, when I've tried antidepressants, it even made me worse). However that's the way I lived for about 5 years. I only recently tried sexually stimulating myself after being encouraged by my therapist to try when I was feeling better. Therapy has helped me explore more, but just like every other doctor I've tried, it hasn't cured me, of course.

I have enjoyed orgasm with a vibrator (quite a lot, the few times it has worked) The only time I have had an orgasm was by myself with one. Which made me feel relief at the time. But I can't do it very often because most of the time my body simply won't allow it (The pain, I want to clarify, if I haven't already, is NOT usually not touch activated, it's just starts hurting randomly at certain times until it decides to stop, and it does not seem to be aggravated by touch when it decides to remit) So I have had just a tiny bit of good experience, that teases me with what I could be missing. And I do in fact miss that. And I don't know how to stop resenting my body, my sex, gender and my body parts and my ability to get have periods, quite possibly get pregnant if I tried, but not get any of the enjoyment that I long for.

[Heather]

People can not be having/seeking sex and still not be asexual. What I'm suggesting isn't that you change your identity, but that instead of trying so hard to make all this happen when it just isn't, you accept that it's just not happening right now (for the most part, more on that in a sec), and give yourself a break from trying and from focusing on it.

I don't see what's going to change if you don't do that, save that it seems like you're only likely to get more frustrated and more upset, both ways of feeling that we know very much stand in the way of sexual pleasure and response for people. I feel like one thing you probably need to do that will stand a chance of changing some of this is basically unplug a bit from all that frustration -- again, I'm not saying forever, I'm saying you start with a specific period of time, like a month, for example -- so you can get a bit of a reset. Make sense?

In terms of masturbation that does work for you, by all means, when that DOES feel like the right thing, go ahead and do that.

If it helps, I'm recently on the other side of very long-term chronic pain which absolutely posed a barrier to my sexual life (and I literally have to talk about sex every single day for my job, so as you can imagine, I certainly understand how frustrating this can feel). In my case, too -- long story short, my back was effectively broken and my nervous system was on constant pain response -- the vast amount of the time, most kinds of sexual activity caused me incredible pain. But you know, that wasn't something I could change: the things that caused me pain just did, and in order to change that, in my case, I had to have a major surgery and then also give my body time to reset itself. In other words, the solution was only found via finding the way to change my health: there wouldn't have been much of anything I could do to change how my body was responding to sex through the sex, if you follow me. I think the case is the same for you here.

I also know -- and I knew already because of my job before it was my personal experience -- that the frustration of trying to change things sexually usually only makes pain conditions worse/increases pain: that kind of stress and strain generally is only going to keep you in pain.

Can I also ask if you are seeing a pain specialist, ideally someone who also is very well educated about sexual pain?