PTSD And The Act Of Transitioning

In Transition, Female-To-Male, Mind + SpiritZane Tyler
photo by Trent Lanz 

photo by Trent Lanz 

We had just moved to a new town in North Carolina. I was 11 years old. Our new home was a lush, green, country hill town—and for an entire week I lived freely in this new paradise. In fact, I remember our arrival there as a cherished moment in my childhood. Since I was 4 years old, I had been actively fighting with my mom about my boyhood. Her argument of course, was that I was supposed to be having a girlhood.

But when you move somewhere new, you get a second chance. Immediately, I made a friend, and without any hesitation, he knew I was a boy. We had a glorious week together. Playing the way I always wanted to, outside in the southern heat, exactly the way I knew best in my true boyish masculinity – until my mom called my name in front of him. Immediately he was angry, feeling deceived that I hadn’t told him I was a girl. But I’m not a girl, I thought.

I would liken this feeling of being separated from oneself—society’s refusal to acknowledge who we really are—to a baby who does not get held. We know what happens without touch. I would suggest that a person who can’t hold themselves up, and who instead lives in a split, and forced performance, is experiencing a slow accumulation of real and pronounced trauma.

If you’re wondering, “What happens if/when you actually transition?” Well, the answer isn’t so simple, as it’s different for everyone. Many trans folks feel like it is the greatest thing we’ve ever done. But it is also a road fraught with its own difficulties—namely because our culture has yet to truly embrace transitioning and trans people. Resources are scarce, information is underground and our friends and families lack the necessary context to support us along the way with open minds and hearts.

When I came out, it was standard to live as trans full-time for one year before gaining access to hormones. Thankfully, this “proving year” is no longer required, but instead has been revealed as an antiquated piece of our less-understanding, less-evolved history. The World Professional Association for Transgender Health (WPATH) changed their standards very shortly after I lived full-time for a year without hormones.

And at the time of my transition, I drove 500 miles to see a trans-competent doctor willing to work with me as a broke, uninsured trans youth. I urgently needed this care. I had been calling every doctor within a 50-mile radius and repeatedly heard the refrain, “We’re sorry, we don’t do that here.” My mom began calling for me because the rejections were influencing my already suicidal thoughts. (Since my childhood, my mother has become a wonderfully supportive parent and trans ally.)

My physical transition turned out to be lifesaving (quite literally). However, the extreme, singular focus on my body is a part of my transition that continues to haunt me, and as a result, I continue to lose touch with my mind, and I sometimes feel that sense of separation again. Wasn’t I to finally become whole?

Recently, I was diagnosed with PTSD—post traumatic stress disorder. I’m a textbook case: flashbacks, hyper-awareness, an inability to trust people. I believe my PTSD went unacknowledged, unchecked for years, because of the lack of understanding of what it means to be trans, the core separation from self that is experienced when you are forbidden by society to be who you really are. I’m still re-experiencing what I went through in order to get here, which has impacted my ability to enjoy what I now have.

Surgery doesn’t erase the trauma of not getting to live as myself for most of my life thus far. Let’s be clear, it’s not that I wanted to go through a surgical process, it’s simply that I wanted the results of top surgery; it was necessary to create the union between how I’m perceived and who I am inside. Too often it is considered to be only liberating, instead of what it also is: acute pain, bed rest, the dressing of wounds, scarring.

There is a wealth of information about PTSD focusing on people who have survived combat. The Mayo Clinic describes it as a state that occurs after experiencing or witnessing a traumatic event. It is marked by flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event. These things are normally experienced immediately after trauma, but when they do not subside with time, that is what is known as PTSD. Its impact on the mind and moods is tremendous; it’s also marked by distorted, negative worldviews and thoughts, irritability and aggression, and sometimes an erasure of memory about the very trauma causing the symptoms.

The suffering from PTSD can be mitigated with several therapies, medications, and other healing modalities like mindfulness and meditation. For me, mindful breathing has been particularly helpful for moments of severe anxiety, along with finding calming sensations, like music or visualizations. Exercise too, has been very grounding for me and it has allowed me to come back into my body. I use exercise as a ritual, asking my body what it needs of me and what I can do to strengthen and heal it.

PTSD is a larger community issue—invisible even to us—and fueled by discrimination and isolation. PTSD feeds on these experiences. We develop protective armor that is not who we are, which so often influences our worldviews negatively.

I don’t speak for the entire community through my experience. But my wish is to bring awareness to the traumas that are often unspoken, and to lend my own story to our history.  

If these symptoms sound familiar, know that you are not alone. We are a community that is only growing stronger and more visible. My greatest hope is that we can shift the focus of our cultural conversation about transitioning more to the mind, not solely our bodies. Ultimately, what we’re all seeking is a home and peace within.

To learn more about PTSD, check out the following websites:

National Institutes of Health

Mental Health America

National Center for PTSD




Zane Tyler’s pronouns are he/him/his. He is a student majoring in psychology at Ohio State University. He has always been interested in the mind and emotions. Currently, he tutors students in psychology and American Sign Language. In his spare time, Zane enjoys reading, playing video games, and staying active. He occasionally likes to post jokes on the internet.