Saturday, 31 August 2019

PTSD and mazes with only dead-ends

Admitting to something being wrong is the first step. Doing something about it is the second step. Both are essential. That's where PTSD therapy is essential. It's all very obvious and clear-cut. Admit the problem, get treatment. As neat and orderly as running unarmed into a war zone and getting gunned down. Nothing about it is clear-cut. It's just another phase in a war that seemingly won't ever end.

Though I have had psychotherapy for my PTSD at my current therapist for over a year now, it's only recently that my therapist deemed my current situation stable enough that we could start with the actual PTSD treatment, in the form of trauma (memory) integration therapy. This essentially involves digging out memories to create an ever more coherent timeline of memories, to ultimately approach and explore the traumatic memories.


I have forgotten so much. No, not forgotten, but tossed to the side, not thought about them, because they weren't important. Memories of being a child, of growing up, of looking at the future ahead of me. Of the person who I was, and who and what I thought I would become. This PTSD-induced narrative that my mind evolved over the years is however pervasive.

It's hard to put it into words. Probably mostly because the trauma-induced narrative that one's brain produces isn't rational. That's why one often feels so frustrated and angry with oneself, because what should be easy and clear just isn't working, or takes much longer than it should. Things that are easy for others seem complicated and take up a lot of energy. Thus one feels angry with oneself. Blames oneself.

Others will perceive this frustration and anger as being targeted at them, or interpret your internal struggles as you being slow or inattentive. The resulting external struggles in addition to one's internal struggles leads one to feel as though one is trapped inside a maze with the exit visible behind many doors, only to see them slammed close before they can get to them. Because they're too slow. Because they don't measure up. Because there's no reason for you to keep trying any more. Because it's better to give up.


This week's first trauma integration session already loosened up a lot of memories that I had thought gone or buried. Many impressions and sensations I haven't experienced in years. The flood of emotions that comes with this is overwhelming. And this is just the beginning.

I thought I knew who I was. The child back then thought it knew who it was. Now it's time to pull on all those loose threads and see what happens.


Maya

Vlog: Finding my self again


Friday, 9 August 2019

The brain of a childhood abuse victim

The realisation that we are our brain rarely feels more relevant than when considering the impact of childhood on an individual's development and the adult which they'll ultimately become. With half of the neuronal connections within the brain getting pruned between the age of 3 and adulthood, massive structural changes occurs occur within the brain during this period.

Little wonder, then, that essentially anything that a child experiences will impact which connections will get pruned or rewired and what the child's adult brain will end up look like. This is most apparent when it comes to victims of childhood abuse and neglect [1]. By exposing the young brain to a high-threat environment, it has been observed that this makes the amygdala (part of the emotional regulatory system and fight or flight mechanism) less responsive.

Along with the hippocampus (responsible for short-term memory handling), both regions thus become optimised for a high-threat, high-stress environment. While great for surviving such an environment, this adaptation makes it hard to impossible for those such affected to thrive in an environment where no such threats exist. Especially dealing with diverse, non-threatening emotions becomes exceedingly hard, with in the most extreme cases children being unable to distinguish between emotions such as sadness and anger.

Along with the hyper-vigilence and inability to regulate their emotional state, this can pose severe difficulties in the interaction with others. Since the child's brain is tuned for a high-threat environment, warnings by adults or certain actions by peers can be interpreted as a prelude to imminent danger, causing the child to display overly aggressive or aversive behaviour. In turn, this leads the former to issue sterner warnings and proceed with more aggressive forms of punishment and the like, continuing the cycle.

Abuse and symptoms

Not all types of childhood abuse are the same, obviously, and each will have a different set of common symptoms in the affected children [2]. In the case of sexual abuse victims: "Disclosure is the most obvious indication of sexual abuse. Age-inappropriate sexual behaviour or excessively sexualized behaviour might be an indicator of abuse. Indirect signs can include any of the following:"

  • acting out (with aggression or anger);
  • withdrawal;
  • regression;
  • fears, phobias, and anxiety;
  • sleep disturbance or nightmares;
  • changes in eating habits;
  • altered school performance;
  • mood disturbances;
  • enuresis or encopresis;
  • running away;
  • self-destructive behaviour; or
  • antisocial behaviour (eg, lying, stealing, cruelty to animals, fire-setting)
   
This combines with symptoms from Box 2 in the previous link, which includes an aversion to physical contact, even with caretakers and close family, as well as low self-esteem and the feeling that one deserves anything bad that happens and any form of punishment, since obviously one is a bad person.

Adulthood

For most victims of childhood abuse and neglect the consequences persist into adulthood, where their struggle with emotions and stress responses causes many issues [3][4][5][6]. Their views of the world and other people will be more negative than average, and the difficulty in recognising positive emotions causes significant friction in the interaction with others. Many will end up in abusive relationships that imitate the original environment in which they grew up, others will exhibit risky and/or extreme sexual or otherwise self-destructive behaviour as they find themselves struggling with a low-threat environment. A number will attempt suicide.

Other common issues include homelessness, substance abuse including alcohol and drugs, criminal and violent behaviour, as well as mental health issues. The latter includes depression, post-traumatic stress disorder and a range of related disorders. Finally, another major impact of childhood abuse appears to be medical, in that the affected individual will suffer more medical issues over time, likely caused both by the effects of the initial high-stress environment on the child's development immune system and the results of the later high-risk behaviour and unhealthy life style choices.

A personal note

Repressing memories of the traumatic events is apparently also quite common, even as the neurological effects do not change. This is how I was able to believe for many years that I had had a normal childhood and youth, with a caring family and a safe environment. Even as I was exhibiting many of the symptoms of child abuse during this time and well into adulthood. By being ever more confronted with my own behaviour and the reasoning behind it, it has forced me to quite literally dig into my oldest memories to put things together.

A few years ago this led to the resurfacing of a recollection of being physically or sexually abused. Likely the latter as I remember lying on this surface, with two or more adults present, touching my undressed child's body. I think I must have hurt one of them as I struggled to get away. Next I remember is me running and ending up in this dark room with no way out. Then this adult male standing in the doorway and yelling at me that it's 'all my fault' before slamming the door close. Leaving the child alone in that dark room.

If it was just that apparent recollection I might have dismissed it as just a dream or fantasy, but long before this my mother would tell me that around the age of 5 I suddenly went from this open, energetic and super-friendly child to a withdrawn child, who didn't even allow their own mother to touch them, instead flinching away from any form of physical contact. Over the following years one can then track a pattern of similar symptoms that are typical of abuse as discussed earlier.

I still do not know who might have abused me, how many times or for how long it happened. I do know that a cousin of mine committed suicide after growing into a young adult because she could not live with the memories and lack of support in the family where an uncle and grandfather sexually abused her along with a number of other young girls. Especially after a legal error set the two criminals free again. Things like that are too close for comfort, and it makes one wonder about other dark secrets. Maybe even ones involving one's 5-year old self.



I'm beginning to realise that what I'm struggling with for years now are essentially the results of childhood abuse, combined with years of social rejection and bullying at school, followed by years of rejection and ridicule by doctors and psychologists regarding my intersex condition. Oh, and getting raped, sexually and psychologically abused on multiple occasions because I too fell for the lure of high-risk, abusive environments like so many of child abuse victims.

In a sense it's comforting, I guess, that I appear to be such a textbook-style case of child abuse. By realising that what's 'wrong' with me is that my brain is simply tuned for an environment which hasn't really existed since I was a child. That the way to hopefully fix this is to correct for this behaviour by being more aware of it, hopefully forcing my brain to stop living life as though there's a child rapist and murderer behind every corner. In the midst of a war zone and zombie apocalypse.

The many years of doctors and kin mistreating me the way they did has done me no service, and they will likely never relent, but there are things which I can control and fix. Together with my therapist I can dive back into what really happened, finally release that child from the dark room and show it that there can be a life after such an event. To evaluate life and other people not as a potential source of threats, but as a potential source of interesting and fun interactions and experiences.


It sounds terribly easy when I write it like that. And that's sadly the thing with cases like mine. One can cover up the literal emotional damage to one's brain with intelligence and reasoning, but in the end one is still one's brain, and just like a broken leg one cannot just wish the physical damage away. It will take time and good care to make things heal and go back to the way things were. Just like a broken leg it will however never be quite the same again.


Here's to the long road to recovery.


Maya


[1] https://pediatrics.aappublications.org/content/122/3/667
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743691/
[3] https://www.psychologytoday.com/intl/blog/somatic-psychology/201104/the-lingering-trauma-child-abuse
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4117717/
[5] https://www.nap.edu/read/2117/chapter/8
[6] https://aifs.gov.au/cfca/publications/effects-child-abuse-and-neglect-adult-survivors

Tuesday, 6 August 2019

I'm completely alone as a hermaphrodite

Now that the immediate urgency of being homeless, various legal matters and health issues have subsided or vanished with me having moved into a new apartment, it seems only fair that other matters would suddenly push into the foreground. Such as this little matter of me being intersex. And not just a weird little genetic gotcha like (C)AIS or XXY, but in the form of a full-blown chimeric condition called a true hermaphrodite in medical terms.

Which is to say that in Western society I do not exist. Theoretically there should be more people like me around in the West, and thousands around the world. Yet I have never met anyone else like me. Among the dozens of doctors and other medical specialists none of them had ever encountered one either, or they had merely opted to ignore the details and just 'normalised' the babies or infants born with both male and female genitals.

I guess I am an oddity in that I managed to reach adulthood without getting tossed into the hellscape of 'intersex treatments' [1] first. Yet as an escapee I still will not learn answers to the many questions I have about my body. About this second puberty that I'm still in the midst of. In how far the abdominal pains that I suffer are normal for someone with a mostly female phenotype. Why old scars are suddenly vanishing and I seem to be getting younger in appearance over the past few years since this second puberty started.

With no answers forthcoming, I'm left to try and live my life. Even ignoring the childhood and other assorted traumas that I got handed, it's so incredibly lonely and frustrating to feel that one is the only person of one's kind in this world. Though I managed to at least improve the dissonance by having my official sex changed from male to female, it's not a fix. It's still not who and what I am.


Because of the many negative experiences I have had over the past decade, I feel both cursed and stuck with this body of mine. True, one is still a human being, but by not having my intersex and hermaphroditic nature acknowledged, it feels as though I'm only allowed to partially exist. As long as I pretend that I'm just a regular woman who has had a regular youth and regular female puberty, I can get along fine. Since I'm physically primarily female, suffer through the same joys of monthly periods and everything as every other woman, I can share in everything minus the part where I have to admit that I was born infertile, let alone that I bleed internally because my labia have merged.

It's as though I am two people: the part that society accepts, and the part which will not ever be acknowledged.


The same thing is true in any relationship. There's always the feeling that there's this cultural divide, with either side growing up in a different world. People will often tell me that they 'get it' what my life must be like as a hermaphroditic intersex person, but do they really? The many years of confusion and fear as one's body does things which do not make sense as puberty kicks in, along with an increasing dissonance as the image society tries to project on your body becomes more and more mismatched.

Naturally, the only way that I could have grown up as a 'girl', officially, would have been if it was discovered when I was born that I am a hermaphrodite and they had opted to chop off the penis and not rip out the vagina and other female bits, which would be roughly a 50/50 bet. That my current situation forces me to consider myself to be 'lucky' is possibly the saddest part of all. I made it without suffering genital mutilation.


There's the knowledge of what still has been done to me, as well as the questions which I will likely never have answered, not to mention the cold certainty of always feeling like a one of a kind, sort of freak of nature. All of this makes me seriously consider whether life has much to offer to me. Whether I'll ever be truly happy, or whether it'll always be this intense feeling of loneliness and sadness that fills my heart. It often hurts so much just to live through another day, let alone for me to consider my future.

Maybe if humanity decided that we could let go of this 'male' and 'female' distinction, and just treated everyone as a human being, without having to conform to unrealistic labels. As things stand, however, all I can do at this point is play along with society's game even as my heart yearns to finally be allowed to be myself, along with all others who are like me.


Maya


[1] http://mayaposch.com/intersex-controversy.php

Thursday, 18 July 2019

Who do you want to be when you grow up?

Identity is an interesting concept. We like to think of ourselves as individuals, as singular entities with identities (personalities) that are unique and unchangeable. This means that as a child, we only get asked what we would want to be when we grow up. Which mostly just means what kind of job you'd be most interested in. This changes over time as our personalities develop and change.

In the end one's identity is composed out of the memories one has collected over the years, combined with one's experiences. Having presumably learned from one's mistakes and successes, and having made note of what worked for others, one will have changed one's behaviour to become more efficient and presumably happier.

Yet the question that rarely gets asked of children is who they want to be when they grow up. What kind of person, do they favour kindness and empathy over a colder, more business-like approach to others? Some of this is in obviously covered in the kind of job they profess interest for, but I imagine it would be enlightening to address this more directly. Not just for children either.

Even as a child I'd be wrestling with lots of questions about life, and found a willing person to bounce such thoughts off in my mum. She had gone through plenty of less pleasant experiences in her life, starting off with physical abuse in her childhood years, and essentially surviving through a less than welcoming family. Those are the types of experiences which force one already as a child to take a few steps back and really look at people.


As for what person I wanted to be when I grow up, I always felt strongly that being fair to others was essential, and to demand in return that they would treat me and others fairly as well. This meaning that you'd not steal, lie, discriminate or otherwise act in a negative way towards others. Mostly because it does not make sense to act negatively towards others. In the end it just creates this self-perpetuating system of negativity and hatred that will hurt countless people.

Even the experience of getting sexually abused as a young child does not seem to have affected that conviction. Yes, it is necessary to accept and understand that oneself was not to blame for what happened, but to realise that it was the person or persons who did this to you deserve all the blame. That does not mean that you should hate those people, however. To carry hatred in one's heart only affects oneself.

I have always found a lot of inspiration in the saying that 'the best way to take revenge is by living a good life'. That to me summarises the breaking of the chain of negativity. By countering something negative with something positive, you both end up living a much better life by spending that energy on something productive, and the person responsible for the negativity that made you suffer is put off-balance by not getting the expected response, as well as having to watch you ignore them and living that good life.


In the end it's about light, air and joy. A self-perpetuating cycle of happiness, honesty and progress towards a better future for all. It's all about the person one wishes one to become, both as a child and as an adult. We can be that change.

Be optimistic, do give that compliment you thought would be awkward to say, don't be afraid to make a fool of yourself by helping out that person at the busy train station who is wrestling with a suitcase, dare to smile at a child and drop the mask of adulthood. It are the small things that make the world move.


Maya

Sunday, 14 July 2019

Why transsexuality hurts intersex people

It's been nearly fifteen years now since I first visited a gender team. This was in early 2005, when after an extremely confusing puberty I deduced from online references that I was most likely intersex. Part of the evidence involved my skeletal features and my general physique. I figured that I would get medical help with this matter soon. Yet as it turned out, I'd be forced to be my own physician for a lot longer than I had imagined.


My skeleton is absolutely that of a female human, with its wide, tilted pelvis, that causes the thigh bones to rotate inwards to effect the female way of walking. It also causes the inwards curve on the lower part of the 'S' that forms the spinal column. I also have the outwardly set lower arms, which presumably evolution engineered so as to allow lower arms to not hit the sides of the wider hips.

Add to this the lack of any masculine features in the skull, such as an eyebrow ridge, and it's obvious that my skeleton is devoid of any features that are masculine. The other features, however, are all secondary female characteristics that would have developed during puberty. This all seemed to point strongly towards the conclusion that despite the outwards appearance of my genitals, I was in fact not male, but had to be intersex.


At the gender team, however, my opinion wasn't shared. Though first seemingly accommodating, a blood test for testosterone levels and a urologist appointment were scheduled. The first would supposedly show that I had regular male hormone levels, and the second ended with me being told by this urologist after some unenthusiastic external prodding that no sign of me being intersex had been found by him.

Quickly this situation devolved into me being pushed into the transsexuality protocol, with numerous discussions with psychologists and kin revolving around why I'd not just simply accept that I was not intersex, but transsexual. After two years of this, the final drop was a fake-out where a previously extended offer - to start on hormone therapy towards a female hormone balance and skip the transsexual protocol - was brutally retracted and with me subjected to a ten-minute monologue of how I'd have to stop being so difficult and that following the transsexual protocol towards gender-reassignment surgery was the only option for me to get what I want.

Suffice it to say, that was the day when I decided to become my own doctor again. Getting hormone level tests via my GP was easy. Obtaining the hormones via the internet was too easy and even affordable. Calculating the right doses took a bit of effort, but was doable. That was the moment when I figured out that I had neither typical male, nor typical female hormone levels.


Testosterone was being produced at elevated levels for a female body, but not significantly so, while estradiol would be high for a male body, but on the low end for a female body. I also paid out of pocket for an MRI scan of my abdomen. That scan showed me to be a hermaphrodite, with both male and female genitals present, though with a closed-off vagina.

While initially thinking that this MRI scan in 2007 might change things, this quickly resulted again in my getting stonewalled in the Dutch medical system, with doctors there insisting that nothing could be seen on the scans, and that I was just male, and transsexual. After shifting gears in 2011, I would focus on getting my official gender changed from male to female using a Dutch law aimed at intersex people, to finally put an end to the mass-confusion in waiting rooms due to this official gender not matching my phenotype.

I managed to get the required orchiectomy ('castration') that the Dutch law required to prove that I could no longer be fertile as the old gender. The resulting biopsy of the removed testicles showed that they were underdeveloped, explaining why they had never produced significant amounts of testosterone. This just added to the body of evidence about me being intersex, along with the exploratory part of that orchiectomy surgery, where the surgeon opened the perineum and found the entrance of the vagina.

Fast-forward another eight years, and the same pattern repeats over and over. I can try my utmost to find solid evidence about me being intersex, but it will be denied and I will be pushed back into just giving up, admitting to being transsexual and playing that game. Giving up, getting my body cut up and my spirit broken. Never being allowed to just be myself.


When I say that I hate transsexuality [1], it is from the above described perspective. If transsexuality didn't exist, would I have had to spend fifteen years (and counting) suffering through this non-existence with a condition that is more than real to me? Will there ever be an end to this? Is giving into what feels like the tyranny of transsexuality the only option that's being provided other than to simply end one's life? I question this.

And I'm not the only intersex person to feel this way. A good (trans) friend of mine mentioned recently on Twitter how she had been told the same thing by other intersex people she knows: how the insistence of the medical system and society to force intersex people to be like transsexuals is harming them. It feels both positive (confirmation) to hear this from others, though it also makes me feel terribly sad that so many of us intersex people are affected by this.

I will never judge a person for something what they are. I will however judge anyone based on their actions and deeds. I will judge those medical professionals and kin who caused me and so many others like me such untold suffering and trauma. They made us feel disgusted and have our traumas triggered at the mere mentioning of 'transsexuality', and who made being confronted with transsexual people such an awkward and at times traumatic experience.

As mentioned in the linked post as well, I would love to be able to find a place for this trauma, but I cannot do so while the cause behind it hasn't ended. Transsexuality is still hurting us intersex people, and those hateful, ignorant doctors will keep inflicting that same blunt instrument of transsexuality on us intersex people until we finally all submit to it, giving up our own identity.

I cannot find medical help for my intersex condition, even as it changes, causes discomfort and pain, with possible harmful long-term implications from the closed-off vagina. All I can be to the medical world is either a regular woman/man or transsexual. As I'm neither, I do not exist.

Here's to being invisible and hurting in so many ways.


Maya


[1] http://mayaposch.blogspot.com/2019/06/torn-between-hate-love-and-hope.html

Friday, 12 July 2019

Where there should be happiness, there is just exhaustion

A new home has been secured, the necessary forms have been filled out and submitted, and financial obligations have been handled. Next week should see me moving into a new place. It's big and spacious, with a large conservatory, multiple terraces and a garden. It's located in a quiet area, with a nearly completely unobstructed view from the living room windows across the fields.

I notice that I do find comfort in the thought that I'll soon be living in this new place. Yet at the same time I find it hard to commit to any thought like that until it's become reality. And even then there's still this massive backlog of... things and feelings of the past years that have to be processed. Not just from when I first moved to Germany, but also so many years of living in the Netherlands, but not really living.

Earlier today my mom sent me more pictures of my youth she had found and wanted to show me. Pictures of me with my brothers on the farm, working on our projects in the mud, amongst the fields and wide open spaces. Looking at a picture like that brings memories flooding back and makes me realise just how much I miss all of that. The village where we grew up, our neighbours and friends, the school and everything else.

It made me realise strongly just how much I am not a city person. That's why this new place that I'll be moving into is the right choice, I think. Away from the city, back into a more rural environment, with more of the space and nature with which I grew up. It should provide a healthy environment for me to do all of this catching up, as well as to finally finish writing that first part of my autobiography.


Rationally I'm all onboard with this, and I can see myself plotting a course through all of this, finally leaving the misery of the past years behind me. Yet emotionally it will all take much longer. There's only so much one can take before burning through one's emotional reserves. After the brutality of the now finished legal eviction battle, it's clear that there were no victors there, with both sides incurring massive financial losses. Maybe if I had switched to that better lawyer sooner I'd have come out better, but that's all too late now.

It's also hard not to feel largely alone, either. Recent events have shown me that sadly the same kind of bullies who have harassed and terrorised me before will likely always keep popping up. The type who'll try to find whatever weakness they can find in you and exploit it for their own sick games. Like the bullies who'd harass me in 2011, both before and after my failed suicide attempt. It's often hard to tell whether they have a real goal, other than to live off the misery of others.

I'm at least grateful that such... people do not really get to me any more. They'll try to spread rumours and try to character assassinate you, but the people who really know you, and who aren't afraid of actually talking to you and ask questions will no fall for such tricks. It's just a matter of finding those decent human beings with whom it's actually a pleasure to interact.


At this point my faith in humans in general has quite obviously been diminished significantly, with me being hardly any further as far as my intersex condition and its treatment goes than when I moved to Germany in late 2013. It saddens me to think that perhaps I'll never know the answer to any of my questions, receive medical help and live out my life just as invisible as an intersex person as I do today.

My sincere hope that this raw, bleeding wound inside my very psyche can heal over time, with everything else that causes me grief resolving itself as well. Because I don't want to be always occupied with myself. There are far more interesting things out there, after all, and so many people to meet and sights to behold.

And maybe, just maybe, in the near future I'll feel that spark of happiness again.


Maya