Nonbinary Femme and other Biases

Coming out, even to myself ,as a nonbinary femme has been harder than I expected. I keep waiting for someone to tell me I somehow dont “qualify.” Hell, I question my self on a regular basis, why would I expect less from anyone else?

Many years ago, in the late 90s in Toronto my soon to be best friend Aimée and I would meet for “femme coffee” once a week and talk about the politics, nuances, and intersections of femme identity. I was somewhere between 21-25 and this was all new to me. Pieces fell into place in my psyche connecting me to the this queer community. I was becoming a part of.

Fast forward at least 20 years. Words like genderqueer, nonbinary and ace have flourished in an ever expanding garden of sexual and gender personal affiliations. They/them pronouns are discussed on NPR and the spectrum of trans identity is in media, politics, elementary school and everywhere else. I am in medical school at 45 years old, advancing my personal and professional education in sex and gender health. I am married to an androgynous millennial and she says one night “Femme is not a gender. You have no gender identity.” I was so hurt and angry and erased. I fumbled through my 90s gender books trying to find some proof that I existed; i had no name for who I was.

I folded in on myself at that moment. I knew that I had a complex gender and I knew I existed but I didnt have the words to speak up with.

Current time, or 2020. I was in relationship with another millennial, spending time with their all-trans friend group many of who were GenZ. I am jealous that these humans were able to grow up in a less gendered era than I was and had the freedom to know at 15, or 19, that their internal understanding of their personal gender *as well as their visible identity* could be whatever they wanted it to be. I know in my heart that if I were 17, or 27 instead of 47 I would certainly identify as nonbinary. And maybe I would have pushed my visible boundaries further than I will now.

One friend in particular was classically femme-presenting and identified as nonbinary trans. I repeatedly used she pronouns , probably 50% of the time, as their image in my mind was so deeply ingrained as one pronoun. It felt terrible every time – for everyone involved. I changed to using they/them pronouns for everyone for about 6 weeks until I got used to it as a habit in my mouth and brain. Uncoupling the phenotypical appearance of face/hair/clothing presentation from associated pronouns was very hard work for me. I could not figure out why I was struggling so much: How could i not get this right? What Was Wrong With Me. (spoiler alert: I was struggling with my own gender identity and associated femme biases.)

I wish this friend group and I had been able to have safe gender discussions. I wanted to learn from their growing up experiences as they were obviously very different than mine. I was in a deep struggle with myself as an older AFAB person allowing myself to invoke a nonbinary truth while still presenting as the lesbian femme I have always been. Eventually the words slid into place: I finally had language for a gender that fit my folded up erased insides. I harmed this friend by not seeing their gender in the same way I was unseen. I perpetrated that bias. I am truly sorry for that.

I dont consider myself trans. Cis does not fit comfortably either. For me, nonbinary means that – actually off the binary. That includes cis and trans, masculine and feminine, as well as good/bad, right/wrong, in/out, victim/perpetrator, love/hate. Unpacking the binary has been an enormous relief on multiple levels. I have a gender euphoria at deeply knowing that I am more than people assume I am from my face. I also still struggle with the words and explanations around what gives me the right to feel like I have a different gender than, for example, my also pierced and tattooed, also radical, also queer femme friends that dont identify as nonbinary.

I have had an image of gender as a 3D nebula with us all bouncing around inside moving through our beautiful multifaceted lives as our original and authentic selves. A few people stick to one pole or another; most of us are all over and in between at any one time. I am grateful for evolving language that imperfectly and accurately outlines a frame for my complex gender despite how you may read my face, my clothes/hair and my genitals. I still feel pretty unsure of the language and philosophy to discuss this evolution though. I have no critical theory or objective framework to reference when it comes to being a nonbinary femme or themme.

I welcome communication from nonbinary femmes out there of any age. Lets have coffee and talk (missmasina@gmail.com).

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Women need Testosterone

When I say Testosterone, what do you think?

Most people think: men, male. Some people think trans,*  transgender, or FTM. Very few people will think “the most abundant sex hormone across a women’s lifespan and an important sex hormone for all genders.”

All of the above is the correct answer.

Estrogen and Testosterone have been sequestered into gendered boxes, but both are equally important sex hormones for human health. Functional and biologically active androgenic receptors are located throughout the body in both sexes. Testosterone receptors are found in the breasts, heart, blood vessels, digestive tract, lung, brain, spinal cord, nerves, bladder, uterus, ovaries, skin, bone, bone marrow, muscles and fat cells of all women. This wide diversity of receptor locations illustrates the panorama of body systems that rely on adequate levels of testosterone for optimal female  function.

And yet, this important hormone is routinely ignored in women of all ages and especially those in their 30’s and 40’s who are exhibiting signs of testosterone deficiency including: dysphoric mood, muscle loss, cognitive decline, insomnia, breast pain, rheumatic and other pain, incontinence and sexual dysfunction.

Think you might be T deficient? Take our Eve test now! http://www.agemanagementcenter.com/eve-scale/

Around menopause, testosterone and other pro-androgens like DHEA, DHEA-S, and androstenedione become the primary hormones available as estrogen and progesterone levels decline. The ovaries stop becoming the major source of hormonal production, and the adrenal glands take over. As early as 1937, testosterone was used as a successful and important bioidentical hormone replacement option for menopausal women.  Seventy-seven years later, doctors still do not routinely address testosterone deficiency in this population, nor do they even test for it!

Symptoms are not enough to assess hormonal balance. Accurate bloodwork including Total Testosterone, Free Testosterone, Sex Hormone Binding Globulin, Estradiol, Total Estrogen, Progesterone and DHEA-S must be assessed to have a clear picture of hormone health for all genders.

Many endogenous hormones can be converted into other hormones, like Testosterone being aromatized to Estradiol and DHEA-S into Testosterone or Estrogen. Understanding these pathways and monitoring the blood levels over time is the best way to achieve optimized hormone status. No hormone should be ignored based on presenting gender or sex, as it is the delicate interplay of hormones that creates vibrant wellness.

For more information on women and testosterone make an appointment to consult with Dr. Wright now. To schedule bloodwork to assess your testosterone and other hormone levels, call Kristen at 207 774-1356. Free initial consults are available.  www.agemanagementcenter.com

References:

Transdermal testosterone therapy improves wellbeing, mood, and sexual function in premenopausal women. Goldstat, Rebecca MPH1; Briganti, Esther MD2; Tran, Jane MD1;
Wolfe, Rory PhD2; Davis, Susan R. MD, PhD1 Menopause. September 2003 – Volume 10 – Issue 5 – pp 390-398

Testosterone therapy in women: Myths and misconceptions Rebecca Glasera,b,∗, Constantine Dimitrakakisc, Maturitas 74 (2013) 230– 234

Current perspectives on testosterone therapy for women. Susan Davis MB, Bs, FRAC-P, PhD., Sonia Davidson MB, Bs, FRAC-P, PhD.  Menopausal Medicine. Volume 2 0 , No. 2 — Ma y 2 0 1 2

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