I know a girl who lives in Massachusetts, near Boston. She first slid into my Twitter DMs about a year and a half ago, asking for general life advice. The request was so sincere and charming and yet so utterly random. I immediately agreed, and that’s how this past year, I’ve become a mentor. She was 18 at the time, and had just decided to go on hormone replacement therapy to medically transition to a woman. Her name, the name she chose for herself, is Alice. (It’s not, but for the purposes of this essay, let’s pretend it is.) She’s been taking feminizing hormones for about a year.
Alice doesn’t come from privilege. She’s not wealthy. She didn’t go to college. Her parents are a mess so she lives with her uncle, who is always pressing her for money she doesn’t have. Up until recently, she was working in a gas station. She told me once that her manager told her, disapprovingly, that the customers think she’s a girl. She was absolutely giddy about it. On Twitter, she doesn’t identify herself as trans. Her profile picture is a snapshot of her made-up face; she has soft, round cheeks and wears a light pink eyeshadow. She doesn’t put “she/her” in her bio, nor does she list the trans flag emoji, often a dead giveaway that someone belongs to the community. She wants to just be a cis girl, she told me. She wants to be a normal, unremarkable, average cis girl, whatever that means.
Unfortunately for her, as I keep telling her, she’s anything but unremarkable. She’s hilarious, honestly. She’s curious, she’s gregarious, she’s kind and smart. She’s talented — she makes these avant garde, grotesque cartoons that display a native visual intelligence that other artists probably strive to approximate their whole careers. She’s a musician, and she’s finishing her first album, which she made in her bedroom.
She struggles, sometimes.
About six months ago, when Alice was 19, she told me that if one more person clocked her as a boy, she’d intentionally take an entire bottle of Tylenol. Alarmed, I told her that medical transition would take time. That she had to undergo a period of a few years at least before the estrogen-induced changes would make her feel how she wanted to feel. That if her first puberty — the male one she endured as a young teenager — was traumatic and hormonal and emotional, she could expect her second puberty — the female one she was now experiencing, via hormone replacement therapy — to be similarly turbulent. That it’s never fun to have your world roiled by becoming, whether it’s something you choose or something foisted upon you.
She was unmoved.
I don’t want to go through the awkward period, she told me. I want to be a woman right now. No ugly duckling phase.
In desperation, I asked around on Twitter for inpatient psychiatric facilities in her area, covered by Massachusetts Medicaid, that had a reputation for dealing with trans patients fairly. It was the central requirement, I felt. Transphobia, internalized and external, had her at the brink of self-imposed extermination. I couldn’t risk sending her to a facility that wouldn’t know what to do with someone who would suffer psychological harm if they called her by the name on her state-issued insurance card. One of the people who I spoke to for advice was my friend Noah, who transitioned about five years ago. I explained to him the stakes, how Alice threatened suicide at the prospect of facing any transphobia at all. The slightest misgendering would do her in, I told Noah, and that was too risky for someone in early transition.
Noah quickly helped me find a local treatment facility that had received positive reviews from other trans people, but seemed less shocked than I was at the intensity of Alice’s emotions.
That’s actually kind of normal for a trans teenager, he told me. The all or nothing, the big, big emotions. It’s par for the course.
I had known, of course I had known, what 41% meant, for trans people. It’s a number that trans people and their allies often meditate on, as it’s a reminder of the stakes we are up against, those of us who want to see trans people flourish. 41%, nearly half of all trans youth in this country, report having attempted suicide in their lives. I think, hearing Noah matter-of-factly tell me how normal Alice’s feelings were, brought it home for the first time. This is a known risk, this is something that happens often, he was telling me. I knew, of course, that transphobia takes its sacrificial offerings in the very flesh of transgender children, who are facing all the regular problems of adolescence but are doing so in a world that keeps telling them, over and over again, that the fundamental way they are is the way they are not supposed to be, and that the essence of their entire being is inaccurate, in some way. But for the first time a young trans girl I knew and cared about was facing down a premature death, come up against the inevitability that transition takes time and the lack of a care network to support her as she waited.
With my advice, Alice checked into an inpatient facility. It stabilized her, it got her out of a crisis but didn’t do much else. Six months later, she seems to be in a better place with her gender, but the unsupportive, cold uncle and the no place of her own and the lack of money remains the same. (She quit the gas station job, finding it to be an emotional and financial dead-end, but hasn’t replaced it with anything yet.) The being stuck in place while watching her peers move forward in their lives remains the same.
Recently, she’s expressed a desire to move to Missouri, to be with her friend whom she met online. This girl has become her best friend, she tells me, and she’ll do anything to be with her. Unfortunately, the friend has family members in her town who are dependent on her, so she can’t leave. Alice, if she wants to be with her friend, will have to leave the relative safety of Massachusetts, where state health insurance will pay for her hormones and her gender-affirming surgeries, for a state that just made it relatively impossible for most adults to receive any gender affirming care, even if they pay for it out of pocket. That means no doctors will treat her gender dysphoria, no doctors will legally be allowed to prescribe her any estrogen or progesterone.
She is so desperate to change her life, to feel something different than stuck-in-mud inertia, she will go from the safety of New England to the Bible Belt of the South, a region of the country transgender people are trying to flee from en masse.
You won’t be able to get healthcare, I told her.
I’ll get my surgeries here in Massachusetts, she said. I’ll go stealth (aka: pass as cis) and get my hormones illicitly.
If Alice was terrified of being misgendered socially, even unintentionally, in Massachusetts, where there was no real reason to fear any criminal repercussions for being trans in public, is she prepared for the stress of living stealth in the South, where being clocked could mean something much worse than feeling temporarily dysphoric?
I told her the way out of her uncle’s house wasn’t moving south, it was getting a slightly better job in town and a few roommates. It was going to community college, part-time if need be, and continuing to transition in relative safety and allowing that prefrontal cortex of hers to solidify into blessed firmness before making dangerous, life-endangering decisions.
A few hours later, she responded.
I’m not going to let the fascists stop me from doing what will make me happy, she said.
I had nothing to say to that. How do you say anything to that?
I am thirty-four. I am a full fourteen years older than Alice. I still remember what it was like, to be that young, to be so convinced in the superiority of my decision-making ability. More than a decade ago, my best friend Shae and I made similar plans — we were going to live together at my parents’ house in Connecticut, no matter what — and no amount of gentle, and then forceful dissuasion on the part of the elders in our lives made any impact.
Both of us were at the nadir of our lives, both having been felled by mental breakdowns that put us off from completing our college educations and made it impossible to obtain and maintain steady employment. We had no money, no prospects, no allies in our corner, or so we believed, based on how much we were fighting with our respective parents, with whom we had each been reduced to living with full-time. All I knew is that the only thing that made me feel alive was talking to Shae, late at night on Facebook Messenger, waiting for her reply to pop up in the corner of the browser. Only thing that made me feel any hope was chatting with her on my computer, on a chunky laptop when a decade earlier we had done the same thing via desktop and AIM.
Together we came up with a plan that — in retrospect — was idiotic.
Shae would leave the relative physical safety of her mother’s house, where she was fed, sheltered, and had obtained comprehensive Medicaid health insurance coverage after her father had unceremoniously booted her off his plan, and she would move to the emotional safety of my parent’s house with me in suburban Connecticut. Things had been catastrophic at her mother’s house, granted. The fights between Shae and her mother had become explosive and toxic. But the solution we decided upon — moving her to the inaccessible suburbs, far away from any institutional or emotional support network she had in Schenectady — was too extreme. With me, she would gain a fast and steady friend, but lose access to health care, access to any public transportation, and guaranteed room and board. But again, with me, she’d gain a friend. She, and I, would both gain a partner. We each would get someone who understood what we were going through, someone who wouldn’t react to our various mental illness-induced shortcomings with blame and desperation and voluminous anger. We knew, in a hand-wavy sort of way, that there would be difficulties in the future, but together, we thought we’d be able to overcome anything life threw at us.
So I am not going to pretend I don’t understand why Alice wants to move to be with her best friend in Missouri. When you feel so alone, so friendless and so badly understood where you are, even if you’re ensconced in something other people tell you is safety, you can’t help but wonder if you’d do better elsewhere, with people who love you, even if it’s in a part of the country that isn’t built to support you.
What ensued, for Shae and I, were a chaotic couple of years. The initial euphoria at having escaped daily fights with her mother soon devolved into the problem of how we, Jaya and Shae, would take care of each other.
Shae was sicker than she or I had known when I agreed to have her move in with me, and needed much more intensive care than I could provide. She had a sleep disorder that made it difficult for her to wake up unassisted, and she was working a job at Trader Joe’s that required my help getting her there for. But in turn, Shae was beginning to notice some things about me that led her to believe my problems were more extreme than simple depression. As my low mood began to recede with medication, I found myself getting swept away in passionate, sometimes dangerous love affairs, a few of which Shae had to extract me from by force. I went from minimally employed, taking per diem bartending jobs when I could, to taking on three or four jobs in a week, overcommitting myself in a way that always seemed to lead to a catastrophic collapse of my schedule, and then, my mood.
If I could do it again, I tell myself that I would have left Shae in Schenectady where she was. I tell myself that I should have instead concentrated on my own recovery, pushing my parents to put me in some kind of inpatient facility, where I could heal from what turned out to be bipolar disorder, on my own. Instead we endured what we now call the “rough period” — our cherished friendship turning into something that looked more like codependency as we helped each other keep the jobs we were too sick to work, as I drank too much and Shae smoked too much weed. We realized the hard way that public buses didn’t run as often in New England suburbs as they did in cities, which made it difficult to sustain employment in far-flung strip malls. We learned that when you had profound psychological needs, you needed ready access to good doctors, something Shae didn’t have, as we had turned our noses up at New York State Medicaid and all it offered — free, comprehensive psychiatric and medical care with no copays or premiums.
We learned that there was only so much a simple friendship between two imperfect kids could take.
I tell myself that if I had a do-over, we would have done our lives the right way, and that is why I feel comfortable advising Alice to listen to my brain and not her heart. It did work out for us, eventually. We fucked around for a few years before each of us finally decided to give the Schenectady region a real shot. Now, a decade later, we are both happily established in upstate New York, and we look back at the “rough period” with detached bemusement. Why wouldn’t we? We lived out our chaotic decision-making to an improbably lucky end. And now, as I advise another young person to not follow in my footsteps, I’m forced to ask what would Shae and I have lost if we had done things the right way? If I had decided in 2011 to leave things as they were, to not do something desperate and outrageous and fueled by love and hormones, would I be able to count Shae as my chosen family, the way I do now? Would I have continued in my recovery, alone and apart from Shae, and always wondered what it would have been like, had I taken the path of fellowship and friendship and camaraderie, rather than that of common sense?
I can tell that nothing I say will make much of an impact on Alice, who is overwhelmingly fueled by her inability to tolerate her present discomfort. I am writing this essay with a bit of a hidden agenda — I am sharing it with Alice before publishing, and part of me hopes she will take our story as a reason to reconsider her Missouri plans. But if she does proceed, which she probably will, I want her to know that I understand.
That’s what that those making these insane laws down south don’t understand. Legislate trans people out of existence? Well, girls and boys, teenagers and kids and adults, will still choose to transition to the gender of their choosing. Make laws to force trans and queer people to flee the Bible belt? A dedicated few will choose to remain, heads held high because fuck the fascists, they can’t stop us from doing what will make us happy. Tell young people to not follow their dreams, and they’ll laugh in your face, and just do what they were going to do anyway.
This new wave of Christian nationalist patriarchy is coming up against the most potent force that has ever existed, the determination of young people to live their lives governed by their own choices, morals, and desires. Missouri might crush Alice, the way Connecticut nearly crushed Shae and I. On the other hand, Alice might survive Missouri, the way Shae and I miraculously survived Connecticut. There are other Alices, other Shaes and other Jayas, who will be crushed, mercilessly, by the forces of reaction that exist elsewhere. They won’t be lucky, the way we were, the way I hope Alice is.
As long as young people like Alice exist, Missouri will have one hell of a hard time wiping them all out.