Thursday, 12 December 2019

Confronting severe ascites

I have written a few times before about my suspicion of having ascites [1]. As the symptoms have progressed from a grade 2 (bulging flanks) to the most severe grade 3 (>2L of fluids in abdomen), I have finally convinced myself to go to a doctor with it. With a bit of help from a friend who made the appointment for me, I'll hopefully find out a bit more during tomorrow's appointment.

It's disturbing enough by itself to look at oneself in the mirror and see an abdomen that would befit a 9-month old pregnant woman, while tapping one side of the abdomen causes ripples to travel across the skin to the other side of the abdomen. My best guess is that around five liters of fluid has collected in the abdomen at this point, with it clearly causing intense discomfort inside my abdomen, along with symptoms such as shortness of breath.

Looking up information on ascites, it's not a cheerful picture that one gets, as most cases of ascites are due to a small number of causes: one's liver is dying, one's kidneys are failing or one has some type of cancer. Though I'm fairly certain that it's neither of these three options, it's nevertheless a sobering realisation of the potential severity one might be dealing with.

Depending on how quickly the underlying cause will be found, I could be looking at severe dietary restrictions (low-sodium), regular draining of the fluid from the abdomen and other assorted fun. Considering that the Holidays are right around the corner, getting quick help seems unlikely. All one can do is hope for the best.

Merry X-Mas, I guess.



Wednesday, 11 December 2019

Gender is a social contract, not a part of you

Societies are highly complex and interconnected structures. They involve having every member of a society essentially getting 'hired' into the society, upon which they accept an (unwritten) contract. This determines their basic rights and responsibilities. Most individuals start off like this when they are born, with their birth implicitly informing their consent.

A newborn gets the most basic of social contracts, which depending on the society usually at least includes the right to being fed and protected, with the parents or guardians being expected to ensure that this is all taken care of, and that no harm comes to the infant. Most societies codify this into their written laws as well.

As the infant grows up, this basic social contract keeps getting modified, with responsibilities and rights amended or removed. The specific society that the child grows up in determines a lot of the exact format, due to peculiarities of traditional culture and formal law. Whether a child is born into a rich, well-off or poor family also massively determines the exact contents of the social contract.

Within this framework, it is easy to answer a question of the type 'what is a typical male?', or 'what is a typical woman?'. It all depends on the exact societal framework that one works with. Depending on one's (perceived) biological sex, one's social contract is amended based on the (unwritten) social rules in that society. This so-called 'gender role' is a specific sub-type of a social contract, which tends to have its roots more often than not in social and cultural traditions.

The exact content of such a Gender Social Contract (GSC) differs strongly per society and per time period, with the exact set of requirements and rights differing wildly. A GSC also forms only one of the possible foundation contracts, with the 'social status' contract being decidedly more relevant.

To then answer the question of 'what is a typical male?', one would have to define within which society, which time period, with which social status, and also with the modifiers of marital status and whether or not the individual has offspring. Ditto for the question of 'what is a typical woman?'.

Essentially, all of us in a society are raised to be lawyers, recognising the subtleties of each individual social contract, trying to amend or circumvent them where possible, and sometimes changing them by force. An example of the latter is when the suffragette women were dissatisfied with the GSC for women in Western societies excluding the right to personhood, and with it the ability to vote in elections, sign their own legal contracts, and so on. Their intense protests resulted in the GSC for women to be modified to include roughly the same rights as in the 'male' GSC.

The assignment of a GSC is determined solely by one's biological sex, which leads to unfortunate consequences in the case of intersex children, whereby at birth it is clear that the child is neither strictly male nor female. Since no intersex GSC exists in most societies, the child is surgically modified to make it fit a GSC, instead of vice versa.

One way to change one's social contract, including the GSC, is by modifying one's physical appearance. This can result in a breach of contract, which results in society modifying and amending one's social contract until order is once again restored. This is usually also the way that new generations end up modifying a society, by invoking changes and alterations that ultimately begin to affect a society on a more fundamental level instead of just for one or more individuals.

As someone like myself, who switched from a male to a female GSC on account of being a hermaphrodite and a written law entry allowing for a GSC change in that case without physical alterations, it's interesting to look back on the past years, and see all of the above play out pretty much as I have just written. It's something that has made me think a lot about one's sense of identity and that of belonging in a society.

Obviously, there is no intersex or hermaphrodite GSC in Western society. The lot of us are essentially 'freaks of nature', with the basic option being to awkwardly conform to the system-as-is, or to provoke change. The latter being exceedingly difficult, as I have had the displeasure of noticing. When a new 'GSC' is being drafted up for intersex people by society, it attempts to either put us away as sub-humans with the definition of 'disorders of sex development' (DSD), or 'third gender', along with other unwanted non-conformists.

Ideally we'd just drop this 'GSC' thing, as it isn't based on any physical reality. Yet societies loathe change, which is why the lot of us will be stuck juggling GSCs and social contract amendments and alterations like the overworked, underpaid attorney lackeys we are.


Monday, 9 December 2019

Freeing the child: overcoming childhood trauma

My previous blog post was rather dramatic, being written while I was working my way through a pretty big shift in my psyche. Then I described it like 'waking up', and re-establishing direct contact with my body. Now, a few days later, the effect persists, and I have been able to examine what I think has changed.

Back when I was about five years old, I found myself running away from an adult male who had apparently tried to harm me in some way. I ran into a dark room where I tried to hide. The adult didn't enter the room after me, but just stood here in the door frame. He yelled at me that it was all my fault, before slamming the door close. I was left behind in that cold, dark room. All silent and abandoned by myself.

Regardless of whether my mind is able to recall exactly what happened to me as a child, the effect was the same: part of me never managed to leave that room. Never managed to stop crying, dry those tears, open the door and leave. That part of me would remain there, always tangible in the back of my mind as this persistent sensation of intense sadness and agony.

Anything that would happen to me would also happen to this child in the dark room. It felt as though as the years progressed, the differences between the child and me strained the link ever more, with me never really able to live in either the past or present. As I was being tortured by doctors, psychologists and others on account of my intersex condition it was basically a straight repetition of what the child could still remember vividly, as for the child - this traumatised part of me - it had only just happened.

I'm not exactly sure what allowed this situation to change, but the past days, every time I access this part of my mind where this dark room with the child used to be, the room is now sunny and empty, with the door ajar. The child has managed to leave, open the door and has become a part of me again. It's a curious feeling to describe, and it almost sounds like something what a mad person would say, only I never heard voices or the like.

It's more as though this traumatic event of decades past has now been given a place, finally allowing me as a person to become whole again. I really get it why they say that childhood trauma can literally steal one's life away, because that's how it feels to me. As though in some ways I am still that 5-year old child, albeit with the intellect and memories of someone much older and wiser.

Most of the conflict that I felt inside my head is now gone, and a strange calm has settled. I feel more capable of handling day to day things, and generally less terrified of the world around me. I guess that really was the child projecting its terrors on my mind.

It's interesting to look back over the past months, how I exposed myself to a number of anime series that managed to evoke very strong emotions inside of me, allowing me get into touch with my humanity, as I phrased it in recent blog posts. In a sense I think that it were those stories which really chipped away at the defences that my traumas had created inside of my psyche. Sometimes it's that kind of exposure therapy which is the only real way forward, even if it hurts a lot.

It feels like I am actually alive now, and actually here, right now, in this moment. Not like until a few days ago, when this strange split between the past and present persisted.

Although I'm sure that my therapist sessions also contributed to this step forward, I feel that discussions with friends and my binge-watching of this recent set of series (for full disclosure: Death Parade, Black Lagoon and Knights of Sidonia) were the final triggers needed to break down those last defences. It was while watching one of the last episodes of the second season of Knights of Sidonia when some things really clicked, also because of a certain character in that series who happens to be somewhat like me.

Here's to being human.


Friday, 6 December 2019

To finally wake up from a life-long nightmare

Those moments of hyper-awareness. When I am aware of this body of mine. Of what it is. Of what it is changing into. Of it growing into an adult woman's body. Of me being fully unprepared of dealing with this.

I was never prepared to grow up with an intersex body like this. For all of my life I have just been pretending it was either a male or a female body, even when the former was a lie, and the latter only a half-truth.

I can feel it now. My body. I can see the slender, feminine hands. I can feel my body respond exactly like a woman's body would. I'm a woman. Yet I'm also not. I can feel years of memories, of traumatic experiences fighting back against this notion. I can feel the pain of having to pretend that my body is that of a woman, even though I know that's not what I am. Even as it keeps transforming.

A puberty that takes decades, instead of a mere part of one. Nothing of this makes any sense. Yet it is the truth that I must accept. Somehow.

Even as I go through this, I must find ways to make money. Because I'm an adult. Because otherwise I'll likely die. I also must make myself see a doctor again. Because of the ascites. Because of the nausea and feeling sick. Because my body is transforming and changing in ways that may harm or kill me. Yet I cannot convince myself.

This is my body. This body is me. I can feel it so strongly. Soft and feminine. All of the masculine features I was told I had a lie.

Nobody around me can help me understand this body. I feel like a child in an adult's body. It's too soon, too early for me to be forced to grow up like this. Why did my body suddenly have to grow up like this? Why is everyone expecting me to be an adult?

On one hand this body of mine. This female body that's finally growing out of its teenage phase. On the other those fifteen... no, twenty-odd years of what surely must have been a nightmare, of me being trapped in a child's body, with adults telling me to grow up, to accept that I had to be a male, a teenage guy, no, a transsexual guy. The horrendous nightmare of endless physical examinations, of one medical judgement after another. Condemning me to be a guy. To be transsexual. To be something which I know I never was. Something which I now know that I could never have been.

My mind is tearing itself apart as it tries to make sense of what cannot possibly exist in reality. Of what cannot be held to be all of the truth in one's mind.

I'm an adult woman now. Yet I'm also a hermaphrodite. An adult hermaphrodite woman who was lied to for decades by doctors. By psychologists. By anyone who was supposed to have a clue about human physiology. About intersex. About stlarning transsexuality.

This must be what it feels like to finally wake up from a nightmare. One that has lasted for one's entire life.

Yet what to do next? I woke up to find myself alone, in a dark, cold room. In a world where my real identity doesn't exist and will likely not ever be acknowledged. Where I'm starting from scratch, it feels like. Outside it's dark and quiet. I must have a plan to deal with this outside world. Somehow I must find a way to exist in this world.

Can you help me?


Tuesday, 19 November 2019

Analysing my body's decades-long stumbling through puberty

In previous writings I have mentioned this 'second puberty' that I felt that I was experiencing, but after looking it more closely, it's more of an excessively drawn out puberty. When using the commonly used Tanner scale [1][2] and putting it alongside the symptoms which I have noticed since the age of 11, I can now clearly see the struggle my body went through over the decades.

Age 11 was when I noticed early breast development, along with my hips beginning to widen. Over time both this female and male secondary development slowed to where I was left in essentially in a Tanner III stage, with neither full breast development nor any of the typical male characteristics, aside from the development of penis. As the biopsy of the removed testicles in 2011 showed, they had never entered the spermagenesis stage of development.

At this point in time, the female side of my body appeared to be stuck in a Tanner II or III stage when it came to the breasts, but with no clear development of the vagina into the multi-layer structure yet [3], as judged by the near-dozen MRI scans that were made of that region between 2007 and 2014. These showed the vaginal structure in the lateral views, running from the perineum to the top of the bladder, but without the characteristic 'H'-shaped structure when looked at it in the top-down views.

The clear presence of a vagina indicates that the testicles while present did not produce sufficient Anti-Müllerian hormone (AMH) to have terminated development of the müllerian (paramesonephric) ducts that would go on to develop the upper part of the the vagina, the uterus and surrounding structures. Though the top one-third of the vagina appears to be present in those MRI scans, a uterus cannot be distinguished on them, nor ovaries.

Clearly, the interesting thing is that after puberty ground to a halt in my early teenage years, it seems to have resumed again in 2015, 3-4 years after the late 2011 orchiectomy that saw those undeveloped testicles removed. This may hold clues as to why the hormone replacement therapy (HRT) (with estradiol) seemed to have very little effect on my body, despite being on it from 2007 to 2014. Some triggers appear to have been missing.

This led to the sudden estradiol overdose effect when the estradiol sensitivity of my body apparently became significant, with female development akin to Tanner IV and V taking place over the course of the past four years. Most noticeable being the significant growth of the breasts, going from a small A cup to a regular B (so far), in the complete absence of HRT, with seemingly my body winding its way through the Tanner V stage towards full maturation as an adult female. It's also noticeable in my hips and overall body and skin tone.

The abdominal swelling and suspected ascites that started around 2015 appears to be linked with this as well. As part of female puberty involves the enlarging and development of the vagina, uterus and ovaries, this could provide hints as to why I am having these pains and sensations of discomfort in my abdomen and perineum. Considering my unusual physiology, any such changes to organs and randomly distributed tissues in my abdomen could easily lead to ascites as abdominal tissues respond to these changes in a negative way.

What would be interesting at this point is to have a new abdominal MRI scan made, as the first scan since before the resumption of puberty. Could one now see an adult vaginal structure, including the multi-layer mucosa, surrounded by a bright, white line? Is the uterus truly missing, or did some vestigial tissues there respond and grow? What would have happened to the ovarian tissue that's likely also present in my abdomen, as evidenced by my natural estradiol cycle (recorded in early 2018 by a gynaecologist)?

At this point I'm on a low-sodium diet in an attempt to keep the ascites-like symptoms under control, which seems to have a positive effect. Heading back into the fray of the medical system is not something which I am looking forward to, however. Though my body is very clear at this point about finishing up the development of these secondary female characteristics, the medical system and the people in it doesn't appear to have evolved to the point where a hermaphroditic intersex person doesn't simply get laughed away as 'yet another transsexual'.

That's a trauma which I'm absolutely not looking forward to facing again, and is essentially the reason why despite me feeling practically pregnant with these ascites symptoms I haven't bothered to see a doctor about it again this year.

As for my body, I do hope that it will follow a natural course here. Simply finish up this whole puberty thing after what feels like a lifetime and leave me with nothing more serious than the issue of the still closed-off vagina and the monthly discomfort and agony. Though I am on a contraception pill now to suppress most of those symptoms, I'm well aware of this not being a fix but instead merely treating the symptoms.



Wednesday, 6 November 2019

Why transhumanism is wrong and humans are terrible at being human

The essence of life and the human condition have been two things which have been on my mind since a young age. Not merely that of any meaning which one could ascribe to existence itself, or the state of being alive. No, the biggest question to me has always been what it means to be human. Over the years it's become painfully obvious to me that people conflate the fact of possessing a human (biological) body with actually being human. While the latter requires the former, the former does not imply the latter.

To be human is to have an awareness of one's feelings and emotions, along with the perception and empathy with other people's feelings. It means a purity of mind, of a desire to move away from the harshness of the natural world in which our species evolved, towards a world in which joy and happiness are paramount and eternal. Even if it is not achievable in our lifetime, we will nevertheless persevere, because that's what it means to be human.

The premise behind transhumanism is that we humans as a species are fundamentally limited by our bodies and minds, and that only by somehow transcending these limitations, we can become something more, something better. This dogmatic view ignores the fundamental truth that for thousands of years now there have been human beings around who have excelled or excel at being human. Because they have found and embraced their humanity. We don't need to change, we merely need to discover what we already have right now.

Similarly, humanity as a whole is confused, struggling with itself as it cannot seem to find its humanity. Even though society as a whole is gradually moving closer to this ideal humanistic world, it's not hard to find examples of those who make this transition harder than it should be. The most egregious example of this being the wanton cruelty inflicted upon others, especially the cruelty inflicted in the name of human-made rules, such as austerity programs, religions and other dogmatic systems.

To be human is to want more goodness and fewer worries for everyone. That's why we humans invented healthcare, discovered vaccines and antibiotics, as well as ways to repair a body damaged by disease or injury. Because fundamentally a human being does not believe in suffering. Not that of themselves, nor that of others.

Maybe I am wrong about every human having this capability to feel and empathise. Maybe it is indeed merely a fluke in a vanishingly small percentage of humanity which allows these individuals to only selflessly desire change for the good of humankind. Yet I do not see how changing our bodies or even achieving immortality of our bodies would make us more human. That's where I see that transhumanism is completely missing the point.

What we need to understand better is how humanism exists within a person. Whether it's indeed this fluke, in which case humanity as a whole would never achieve the level of understanding and empathy that is required for the humanist dream. Meanwhile, we will continue to take away worries for many, even if it's the unintended fallout from actions by the selfish and wealthy. Healthcare will improve, diseases will fade, life-threatening diseases and injuries will become routine operations. Death becoming a thing of the past.

But will it be part of the humanist dream, of humanity collectively realising its humanity and finding enlightenment that way? Or will it be the dystopian nightmare continuing well into this future, with the vanishingly small minority of the haves ruling over the have-nots, showing that humanity has not progressed a millimeter since the heydays of the Industrial Revolution or long before that?

I will keep the humanist's dream alive, even if it's just inside my heart. I hope many more people will do the same.


Wednesday, 30 October 2019

Moments when one truly is alive

Perhaps the most ironic thing about feeling alive is that it's something of which is only truly aware when the numbness of merely existing subsides. When one's thoughts during the day consist mostly out of reminders of one's duty and unpleasant recollections of previous failures, the world around you will keep turning a shade more grey and dull every moment. When one feels haunted by one's past, more rocks keep getting added to this weight that is slowly crushing one's soul and spirit.

To then be reminded of what it is like to feel alive is both a wondrously amazing and yet exceedingly excruciating experience. While feeling the lightness, colours and happiness flood one's system, it is impossible to not start crying. To release the pain, to celebrate the feeling of being alive and to embrace the warmth of hope and faith. That there is more to this world than duty and repressing past failures and traumas. That life can be a world filled with merry laughter and warmth.

Remembering those moments when one is only distantly aware of the fact that one's body is really, that this world in which this body exists and moves around in is real. What's real, after all?

Haunted by the pain of the past, of being lied to and deceived. One remembers being a boy, only one wasn't a boy. That was all a lie. One remembers being told things by doctors. By psychologists. By random people. One's mind briefly revisits childhood traumas. One tries to remember that although all of it was real once, it is now in the past. It all blends together into this frantic and unrelenting assault on one's sanity. Past. Present. Future. Which way is which again?

Some rare moments I can feel my spirit lifted up and the bleakness of merely existing lifted through unexpected means. Such as through a well-written love story, where the characters truly feel like they could exist and their struggles and relationship feels genuine. Or a bitter-sweet film, where self-sacrifice somehow offers hope to many others. Moments when one can feel the raw emotions welling up inside of one's chest, with nothing in between to deaden or hide it. Suddenly everything all seems so clear and the world so full of life.

It makes one feel that life is indeed worth living. Not out of duty or obligation, but because one is filled with the passion of life, and one is a human being who can experience all of those aspects of life, while sharing those experiences with others.

It's such a difference from living with the bleakness of merely existing and false hope. When the euphoria wears off again, it's all too easy to slip back into the shadows. Feel the warm glow of loving and being loved back slowly cool and fade until it feels fake and forced. Accept that it was all just a play of one's emotions, unrelated to reason and one's humanity. Or was it?

Maybe it are those moments when we truly allow our humanity to shine through, when we are no longer bound by the shackles our minds have created over the years. Accepting this would however highlight the tragedy of most 'social gatherings', which appear to be driven primarily out of duty and obligation, not because it is truly because we want it, or because it makes us feel alive.

Can you feel the pain inside? Can you feel the weight crushing your spirit, even as you lie to yourself? Again?

Are you happy? Do you feel alive? Do you want to cry in rage and pain?

Do you feel like sobbing uncontrollably in joy? Do you feel your heart overflowing with love?

Do you feel human?

Do you exist?

Are you alive?