Sinful Purity

I am grateful to the people who’ve helped me through this difficult, 2-month-long journey, among them: my parents for helping me navigate this country’s medical system, Noam who brought me food when I was sick, Miryam for lending me her father’s z”l walker, my parents again for driving me to Boston when I finally accepted I needed to see a doctor, and all the trans femmes who’ve shared their shitty HRT experiences online.

A suggestive flower grows in occupied Palestine.

This Jewish new year I was called to slow down. The voice began softly – exhaustion from 8 hours of farming is practically part of the job description. It grew louder – a couple fits of hysterical crying seem normal enough for a girl going through puberty, like me. Louder – a hot flash at work, then nearly fainting. 3 days of bedrest, then louder – nearly faint again. Blood tests all negative. I had to quit my job. Louder – can’t stand up for Rosh haShanah amidah. It deafens me – I need to use a walker at Yom Kippur services; I am forbidden from fasting. I can’t hear anything but the call now. Slow down. Slow down. You need to slow your transition down.

Maybe a crash was the only way to get me to listen. When I got the results of my hormonal blood work on July 28, it was literally a birthday present. I was so excited that I dropped everything and ran to tell my coworkers: “My testosterone levels are nearly zero!” They were all happy that I was happy. I even told one cis female friend, joyously, that I had less T than she did. I remember saying, “It’s like I’m not even human!” Two months later, I could barely stay standing without holding onto something.

Humans need certain levels of both classes of sex hormones, estrogens and androgens, even after puberty. BMC’s HRT guidelines recommend for trans women T levels from 30 – 100 ng/dl; mine was 7. There are a lot of guidelines for trans health out there, many contradict each other, and all of them are based on unreliable research – but I have to start somewhere. I was also suffering from 7 of the most common side effects of the anti-androgen drug my doctor had prescribed, spironolactone. (Not counting the listed side effects of erectile dysfunction, breast enlargement “in men”, and decreased libido. Spiro is a drug meant to treat high blood pressure; its testosterone suppressing effects are incidental.) Yet my doctor thought it was “unlikely” that my near-zero T levels were unhealthy or that my HRT regimen was the cause of my debilitating fatigue.

I should say, before taking my anti-spiro rage any further, that there are plenty of trans femmes who are perfectly happy using that drug as an anti-androgen. One of my friends has been on the same dosage as I was – 200mg/day – for years with none of the fatigue that shook my life. A body’s hormonal needs and reactions are incredibly difficult to predict, since “sex” hormones are in relationship with every bodily system. I wasn’t put on spironolactone, or on 200mg/day of it, maliciously. But even though what happened to me was not a guaranteed outcome, it was a predictable one. Many trans femmes have suffered similar effects from “macro-dosing” spiro; my doctor should have discussed those potential negative effects with me, and once I reported my symptoms, should have identified my HRT dosage as a likely cause much faster. Instead, I had to do my own research and advocate for my own health.

To tell the truth, I knew the day I almost fainted at work that it was because my testosterone was so low from spironolactone. I even told my friends I thought that was what was going on. But it took me over a month, until I couldn’t leave the house without a walker, to do anything about it. I was in denial. I couldn’t admit, in my heart, that I need testosterone.

I have come to hate so much of myself. It was easy to turn away from masculinity. And then with medical transition, I also began to uproot maleness from myself. I cultivated an urgency, a desperate need to crush and cast away everything in me with the curse of man written on it. I’m supposed to pray twice a day, “Let there be no hope for what speaks against us, and let all the evil vanish instantly, and let all the enemies of Your people be cut down swiftly, and let the arrogant be swiftly uprooted, crushed, cast away, and humbled quickly and in our days. Blessed are you, haShem, Who breaks enemies and humbles the arrogant.” Unknowingly I directed that prayer against the masculinized voice that speaks against me; I yearned for my facial hair and my testicles to vanish instantly as if they are the evil. I raced to cut down my testosterone, since I believed it was my LORD’s enemy. In my heart I made maleness into an idol of hardness and violence; my hands burned with fire to reduce it to ashes, and in the end I was the one brought down and humbled.

I understand why I’ve come to treat maleness as evil, as the evil. It has caused me the greatest pain of my life. It is the root of my dysphoria: the panic attacks after not shaving for one day, the whiplash of moving to touch my vagina and being met with a penis, the dissociative breaks in reality that come when I sense that my gender, the fabric of my individuality, is fake. Maleness is the reason I repressed my beauty, my compassion, and my love beyond the reach of consciousness for 24 years.

Of course, maleness is only the superficial reason for my repression. I could have grown up in a world that wanted me to know that I’m trans. And it is true, on a high spiritual level, that gender is fake and the world of our experience isn’t the deepest reality. The pain of dysphoria might be an irreducible fact of my life, and being born “male” may be the cause of it – but the sacred instinct to heal wounds is different from the sinful pursuit of purity.

I said in my heart that I would be pure, cleansed of maleness, perfectly feminine. I thought my problem was the maleness itself that lives in me, and my solution was to scorch the earth it grows in. On Rosh haShanah, I finally heard the call to slow down. I stopped pushing myself beyond my limits, to stand when I couldn’t, to be at services when I had no energy to serve. On Yom Kippur I gave all my lifeforce to haShem; in the emptiness that followed, I accepted what I’d always known I would have to do to return to life. I would need to let go of the urge to destroy, and turn my heart to balance. I would need to welcome testosterone back into my body.

Humans need a balance of estrogens and androgens to be fully alive. When I chose to double my spiro dosage, I might have been seeking life, but I was choosing death. I hated the androgens themselves instead of the imbalance of estradiol and testosterone – and now I believe the severity of my condition was caused not only by low T but too low E as well. (Trans women’s estrogen levels should be at least 100pg/ml; mine were never above 80.) HaShem does not want me to be forever devoid of any aspect of Hir Creation; Ze wants the dance of the partnered energies of life in me. HaShem does not want purity; HaShem wants balance.

I was called this year to slow down, because the work of balancing moves with patience and constant, minute adjustments, but the work of destruction is unhearing and unrelenting. I have tended the fire that transition has been to me for the past 2 years – a wild, bright, all-consuming rush into the world as my full, living self. Now is the year of water, of filling the vessel I have come so far in creating, of sensing the shifts in the waves and trusting the wisdom of the flow. 2 years ago I got on a motorboat to escape poisoned waters, and now with them behind me the time has come to get into a kayak.

This is a year of letting go. My dysphoria has already gotten worse since lowering my spiro dose 2 weeks ago; weeds flourish during the release. But I let them grow, so that when the time comes to cut them down, their decomposition will nourish the soil sevenfold. It’s painful to see what my body does when I leave it alone even a little. But this is the rest of my life, and I want to be alive for it. Fuck the purity. I choose the dance.

…בִּפְרֹחַ רְשָׁעִים כְּמוֹ עֵשֶׂב וַיָּצִיצוּ כָּל־פֹּעֲלֵי אָוֶן לְהִשָּׁמְדָם עֲדֵי־עַד׃ וְאַתָּה מָרוֹם לְעֹלָם יְהוָה׃
צַדִּיק כַּתָּמָר יִפְרָח כְּאֶרֶז בַּלְּבָנוֹן יִשְׂגֶּה׃ שְׁתוּלִים בְּבֵית יְהוָה בְּחַצְרוֹת אֱלֹהֵינוּ יַפְרִיחוּ׃ עוֹד יְנוּבוּן בְּשֵׂיבָה דְּשֵׁנִים וְרַעֲנַנִּים יִהְיוּ׃ לְהַגִּיד כִּי־יָשָׁר יְהוָה צוּרִי וְלֹא־עלתה [עַוְלָתָה] בּוֹ׃

Though the wicked sprout like grass, though all evildoers blossom, it is only so that they may be destroyed forever. But You, O haShem, will remain on high forever…. The righteous will flourish like the palm tree, ze will grow tall like a cedar in Lebanon; planted in the House of haShem, they will flourish in the courts of our God. They will still bear fruit in old age, they will remain full of sap and vigor in order to declare that haShem is upright, my Rock, in Whom there is no injustice.

Psalm 92:8-9, 13-16 (trans. based on Rashar Hirsch)

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