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Translating ADHD
When ADHD Meets Early Gender Transition: Managing Change, Identity, and Logistics
00:34:48
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- [00:01]
A
Hi, I'm Ash.
- [00:03]
B
And I'm Dusty.
- [00:04]
A
And this is Translating adhd. Dusty, this week I do want to talk about. Last week I kind of caught listeners up on my own journey to the best of my ability. That is something that I will be trying to put language to for the rest of my life, because it is, especially if you're doing the type of work that you and I do, right? That's curiosity led and interested in individual lived experience. It, it really is. It was a difficult experience, but it's really rich on the other side in terms of how fascinating it really is. But anyway, I've caught you all up to the best of my ability. I've put language to the experience for those of you who do not have that lived experience to better understand where I've been. And this week I want to turn my attention towards the interplay between ADHD and transness, particularly in early transition, where it is absolutely the most impactful. And what's really funny about this is a couple of years ago at the Chad conference, Brendan Mehan asked me to be on his podcast talking about ADHD and transness and was really enthusiastic about bringing that topic to his podcast. His podcast, by the way, listeners, is ADHD Essentials. I'm not sure that new episodes are coming out at this moment in time, but there's a huge back catalog of really interesting, interesting stuff. I've been on that podcast a couple of times. Dusty has been on that podcast a couple of times. Cam has been on that podcast a few times.
- [01:37]
B
Yeah, I spoke to Brendan, and it will be coming back.
- [01:39]
A
And it. And it will be coming back. So. So something to look forward to there. Anyway, for the purposes of the story, today earnestly asked me for. To bring some insight about the intersection of those two topics to his podcast. And I was very interested in working with him again, but I couldn't make meaning of that topic at the time because I wasn't far enough in my own journey, despite knowing all I know about adhd, to distinguish what was ADHD and what was not ADHD or other stuff. I just couldn't, couldn't make enough meaning of it to bring that topic to life. And so here we are two years later, and I'm. I'm ready to bring that topic to life. But before I start down this road, Dusty, I'm actually curious, as somebody who hasn't had this lived experience, but who knows a lot about it by way of your own queer community, by way of our friendship, what does this topic bring up for you? What questions might you have for me? What do you think some of the ADHD pitfalls might be? And you don't have to answer all of those questions. This is, this is a. Whatever this brings up for you and listeners. I did not preface listeners. I did not prepare Dusty for this, even though I knew I wanted to open this episode this way. So we are all going to hear whatever Dusty has to say together for the first time.
- [03:01]
B
Yeah, well, I, I think it, too, people should refer back to the episode that we did on, like, ADHD and like, Queer Frameworks, because certainly I think it's. I'm curious, you know, how that the. All the changes that happen when you're transitioning and all the changes that happen when you're, like, accepting that you have to do things differently with adhd. Like, just like how, like what it's like to handle so much change all at once, you know, like, and if your identity is in flux, like, how that impacts figuring out what ADHD structures are going to work for you. But then also something that a number of my clients have brought up that I really never thought about was the impact of, like, hormones and hormone therapy on ADHD and on executive function and mood and emotion. Yeah. So I, like, that's something that has just really kind of. I'm learning about it now, watching a lot of my clients go through it, and it just. I never, never thought about it.
- [03:54]
A
Dusty, I love that because you touched on a number of things that I want to cover today. And I'm actually going to start with something I said in my coming out episode, which was what was simple and easy and routine suddenly isn't anymore. So at the very start of a transition journey. And that looks different for everyone, by the way. Some, Some people sit with the knowledge of transness for a long time before acting on it. My story was almost the opposite of that, where I, I found that answer for myself, and it felt correct. And it was two months from the time that I had that realization for myself to the time that I came out publicly on the podcast and everywhere else and made the decisions along the way to do it in that way. But anyway, at the, at the very start of transition itself. Right. So you're. So you're starting to live your life differently. You're coming out to people. You're, you're, you're in this new place. It is really intense how hard everything gets and all of the things that you have to think about that you didn't have to think about before. And in my case, this is Particularly true because I was 38 years old, right? So something as simple as getting dressed in the morning. I went from having a wardrobe that suited every facet of my life at the time to having one pair of men's jeans and a couple of hoodies and T shirts from my old wardrobe that, that worked well enough. While knowing nothing about how I want to dress myself in this. I hate to use the language, new identity, but I guess newly discovered identity, right? Knowing nothing about how, what I actually want to wear, other than I do not want to wear women's clothes ever again. Like that, that part of my life is definitively over. And by, by the way, that's a statement that is true for me. I do know trans men who, who mess around with feminine attire and feminine accessories and that is absolutely valid. But for me, that was something that I pretty definitively knew. So much so that it was the question that I would go back to in those early panic moments of is this real or am I an imposter? Is okay, do you want to put the girl clothes back on? And there was a gut level response of nope, absolutely not. So going from having a complete wardrobe for, for any situation that would arise in my life to having nothing like completely different context, but not too dissimilar from like having a house fire, right? Like, okay, like everything that I own to dress myself and go be out in the world is useless to me now. And I don't really know yet what I'm looking for to start to rebuild that in some way.
- [07:15]
B
Yeah, like, and what a, what a mind bender for like, for executive function already, right? Like it's hard enough to manage laundry. And like, I know a lot of people with ADC will struggle, will have changing body size. Like we change meds and we struggle with binge eating and then we struggle with no appetite for our meds. And so on top of managing what clothes fit, what clothes are clean, where do I find my clean clothes now it's like, okay, which clothes can I like actually wear, right? Like you've just such on such a functional aspect. And then so many people with ADHD also, you know, there's like budgeting and finance issues sometimes for people, right? So if you're in a comfortable life situation or you're older, you're more subtle, that's one thing. But if you're like very low income and maybe you can't afford, you know, replacing these items or you can't afford some of the, the, you know, like haircuts, right, like you have to get haircuts so much more. Like, I mean, you should get haircuts pretty frequently, even if you have long hair anyway. But if you're, like, a man or you have a short haircut, like, you have to get haircuts all the time. And so even, like. And. And that's one thing, like, I feel. I feel quite badly for, like, trans women because there's so much more with, like, if you're going to do, like, makeup and jewelry and nails and all the accoutrement that goes along with, like, femininity, which I think, understandably, a lot of trans women are really excited about and looking forward to. Right. Because they, like, it might feel like I get to do this more than, like, I have to do this. But at the same time, there is also, like, that, like, I have to do this for, you know, stealth or for safety. And then there's so much cost associated with that. And there's so much more to manage. Like, makeup has expiry dates, and if you don't use that, if you don't sort of, like, keep in, you know, the expiry dates of your makeup in mind, you could end up with, like, a sty on your eye. Or there's so much more to manage there, just in appearance.
- [08:56]
A
Yeah. And dysphoria is in the mix, too, particularly an early transition. You talked about haircuts. My first haircut, and I still see the same barber. She's wonderful. She's queer herself. I went in and I. Like, I was in tears. I hadn't even started t yet. This was before I had come out publicly. And I told her I wasn't really sure what would look good with my hair. My hair is pretty difficult in terms of. There's a lot of texture and it grows in different directions. So I wasn't sure how to look at men's haircuts and look at myself in the mirror at the time and know what would look good on me. And I'm saying all of this to her, and I'm in tears. And she held space for me, which is something so beautiful in queer communities, by the way, is like, she knew where I was. She. She made it okay for me to not be okay. And then at the end of that haircut that I was feeling very good about by the time we were there, she turned me around, and I was disappointed because I saw. I saw a tired old woman in the mirror with a man's haircut. Right. And the same thing translates to fashion when. When you put on clothes and you don't feel good about your face or what you're seeing in the mirror. Otherwise, I think there can be an expectation that the clothes will. Will do something for you there that they're not doing right. So it, it can very much become about what you're projecting out. And I will say that early on, a lot of how I dressed was more about trying to be seen the way I wanted to be seen. And there's a full circle moment here where now I dress how I like to dress, and I'm still learning there, but now I know how to put a fit together and look in the mirror and be like, yeah, that's me. I feel good in that. So you're talking about executive function stuff. Here's another big whammy in early transition is logistics. I went from pretty much being able to go anywhere at any time for any reason as a cisgender heterosexual white woman, to being acutely aware of what's, what's the crowd like here. Because in early transition, people were not reading me as man, but they were certainly reading me as queer. Right? That was something that I couldn't hide. The only way to hide it would have been to. To put on the girl clothes in that moment, right? But. But with my physical being and the way that I looked at that time, the way that my voice sounded, people were honestly reading me mostly as lesbian, but certainly, like, queerness was suddenly very visible. Right? So going from sort of I can go wherever, whenever, for whatever reason to what's the crowd like? What's the safety situation? Where is this? What's the bathroom situation? My best friend from high school invited me to his 40th birthday party. And the location of the bar was such that I was concerned about those very things. And I sent him a text saying such right. Is. And I think the text was, I, I would like to be there. Is this a safe setting for me? And we'll, we'll talk about this more in the allyship episode next week. But it was such a great show of allyship that he had already thought of that. He's like, I thought of that. I checked out multiple places and rolled out a few others. But I, I went into this place, I talked to the owners, I checked out the bathroom situation. Both single stalls, both for both genders. So you are, you are all set there. But, like, you see the number of things I had to think through to show up for my best friend from high school, my brother from another mother, who, of course I'm going to be there for you. And of course I'm stoked to see your family and catch up with them. Like all of a sudden there are all these barriers and stressful consideration.
- [13:03]
B
It reminds me of a story that another friend of mine told me who is neurodivergent and she also has like Ehlers Danlos and some physical concerns and she was invited to a bar where there was nowhere to sit down and nobody considered it because nobody thought about, nobody was disabled, no one thought about disability. But like she can't go somewhere for long periods of time where she has to just stand, right? And so like, and that happens to a lot of people with ADHD too is like this creeping. Whether it's hypermobility or chronic fatigue or pots, right? This creeping added layer of like, is this space accessible for me? So kind of, it just kind of reminded me of that. But yeah, absolutely, that's, that's for sure, like a huge thing. And in terms of logistics, like I can't imagine like it's hard enough for me to like remember to just take my ADHD meds. Luckily like I don't have any other meds I need to take. But then you have to get like, you have to get your hormone stuff and like I know some clients who are transitioning have like a testosterone gel that when they put it on they have to like sit still for like 20 minutes and they can't do anything. And then like I feel like I would like probably lose it in my house somewhere, like not be able to find it. And I had a friend who you know, like was in here in British Columbia. You know, one thing I'll say bless the Canadian medical system, but we do always have that like shortage of doctors and it's hard to find a doctor, it's hard to get a good doctor and you kind of have to like take whatever doctor you can get if they have a space. So then finding a trans friendly doctor or care provider.
- [14:32]
A
Dusty, I think is this space accessible to me is actually really beautiful language to describe what I was going through because it was very, very true and, and still is when I am driving, when I'm road tripping. I live in the Midwest in the US so if I am driving from St Louis to any other major city by car, I am going to be on the road for at least four hours. There will need to be at least a bathroom break and I am still very uncomfortable in unknown men's bathroom situations, particularly in rural America. Right. And that's, that's kind of another like mind bending thing of transition is when people start to see you differently, then the game changes. Right. Because I can use a men's room and I can't use a women's room. Right. If the option is a, a men's room or a women's room that are both crowded, I do not belong in a women's room. And I would make women uncomfortable in a women's room at this point in time. And men do not tend to notice me if I go into a men's room. But there's still that like niggling. And this is where the political climate does have an impact. There's still that niggling fear that somebody who is psychotically transphobic would clock me or spot me because I am still clucky if you know what you're looking for.
- [16:14]
B
Yeah, I was actually here in. Well, and for. You said earlier you're like, I'm still uncomfortable going into men's bathrooms. And I'm like, yeah. And like based on your country, like as you should be. And it's only going to get worse. So. But I was here in Vancouver, we have like a two week fair that happens at the end of summer called the Pacific National Exhibition or the P and E. And I was with my kids at the Peony and something I saw that I thought was so nice is when we were in the lineup for the bathroom, there's a sign that says like women's bathroom. And then underneath it it says trans people welcome here. Like, and all the bathroom signs in all of the fairgrounds have that. It says like, it's clearly, it's explicit. Trans people are welcome in this bathroom. Right. So I thought I was like, that's really good. Because it also sends a signal to the people who are transphobic that like, hey, the rules of this bathroom are that trans people can go in it, so mind your own business.
- [17:04]
A
Absolutely. I love that. And that would make me feel a sense of comfort and security because that, that's signaling safety. So that tells me something about the community that I'm in right now. So more so than giving me permission, it it, there's a safety signal there that would be relieving, particularly at the moment in time. I'm talking about when bathrooms were terrifying. It was a terrifying issue for me. I do mourn the loss of the women's room. I, I just want to throw that in as a funny aside because there's so much cool women and femme people being cool to each other. Shit that happens in a women's room that's lovely and beautiful and men because of, well, they're gross, but they're also, they're terrified to interact with each other in the bathroom because of patriarchy and internalized homophobia. So like the, the thing that actually makes it a little bit easier for trans men than trans women is if you pass well enough, which I do like. The trick to the men's room from there is just to act like a man, right? Like go in, don't look, be a little embarrassed that you're there. Like, and, and that's, that's the whole mo. But it was a weird thing to get used to coming from a bathroom situation my whole life that is relatively social, right? Like if you're both washing your hands, we might chit chat. If you need something, you can ask for it.
- [18:36]
B
I want to say, it's so funny the direction you went because I. That is not the direction I thought you were going to go because I was going to say like, do you miss women's bathroom? Because it never. It doesn't smell constantly like poop because we don't like poop in front of each other for some weird reason. And then men's rooms are always. But that you went a different direction.
- [18:51]
A
Yeah, I did. Yeah, I know. The, the grossest factor I can deal with and that's the fish tour in me. Right? Like the, the men's room and the women's room on fish tour are equally vile. They just are because it's that type of environment. So I can cope with the vileness aspects. The smells, etc, the social elements were certainly something. A huge adjustment, honestly, because Again, I lived 38 years having one experience and now I'm having this new experience and carrying fear for my safety while also trying to kind of get over that hump, bridge that gap for myself where if I need to, I can walk into a men's room and use the bathroom. Which I can do these days, by the way, in almost any circumstance. But in certain circumstances it's still uncomfortable for me. I don't know if that'll ever go away or not. Tbd. The next thing I want to talk and I think it's so interesting that you. That you brought this up when I asked you what would have your attention is sense of self and identity. This is already hard with adhd. For years, the. One of the cornerstones of my coaching practice has been coaching people around identity. And why is this true? Right. Because we, we live this experience of otherness that the people around us don't understand and that we don't understand. So we Start building up mass. We start becoming these very reactive beings where we're trying to avoid conflict, we're trying to avoid those moments where the other shoe dropped. We're trying to put on a certain Persona and ADHD itself, because we have these searchable but not indexable brains, makes introspection, I don't want to say harder, but certainly makes it something that doesn't come to us naturally the way that it might come to other people. Because we can know things about ourselves, but not have that awareness in a way that's useful to us, right? So when I'm doing identity work with clients, we're not finding, like brand new crazy things, but we are finding little nuggets that they were previously unaware of, that were building on, right, so that they understand something more about themselves, who they are in this world, which helps inform, where are we going on this journey? And what is a life that fits for you? And so ADHD makes identity stuff hard. And then you throw in transness and a puberty, and everyone listening to this podcast has been through a puberty. So you can understand something about that liminal identity space. Middle schoolers and early high schoolers tend to be kind of quote unquote, cringe, as the kids say, because you're trying on different things and you're seeing what fits. You're figuring out who you are and who you aren't. And ADHD can make that really hard to attend to. It can make it all feel really messy. Some language that I sat with for quite a while in my transition because there was an extra element for me, and I talked about this last week where I was trying to make more meaning of the powerful work I was doing in my coaching practice, but so unable to separate the noise in my head in terms of what's adhd, what's transness, What's. What is this for me? How can I turn this inward to help me understand this differently? I was just not able to get there in a meaningful way until I was. I tell new trans people the only way out is through. So for trans folks with adhd, I think the road can be a lot more complicated. I also think we uniquely need community. For that reason. I think all queer people need queer community. We all need mutual understanding. We all need spaces where we feel like we can fully be ourselves. But ADHD people in particular, there's a coaching skill called normalizing, and we. We really need that. We need to hear our lived experiences coming out of other people's mouths. We need to relate. We need the Context, right. Our brains are wired for context. So when you have other trans people in your circles, they can help you better understand yourself just by way of talking about their own lives. And so one of the biggest supports for me in through the liminal space of identity, ah, nothing makes. It all makes sense, but none of it makes sense moment that I was in for so long and the I was talking about some language that I wanted to use and the useless frustration I was sitting in, in that place knowing there was meaning to be made and I couldn't make it, was the support of other trans folks. And not even necessarily in a way where that's why I was accessing that all the time at the time, but just having time and space to be with other trans people, to be able to comfortably talk about our trans experience in a shorthand way. Listeners, you can relate to this. It's really, really easy to talk to other ADHD folks about ADHD because they understand your lived experience. And even if it's not the same, they can relate to it. They can pull something from their own experience of adhd and shortcut those connections know something about your lived experience. So the same idea is true here where I, I love the cisgender heterosexual folks in my life. The, the cisgender heterosexual folks that are left in my life are absolutely the, the realest of the real ones. But those people who had previously been my support network couldn't be at this moment in my journey. And in fact, those relationships got back burnered for a little while. And not because they were doing anything wrong in how they were showing up for me, but because this is what I needed. And I needed to be far enough along in my own identity journey to feel comfortable being the one queer friend at the barbecue when my high school best friend invites me to the barbecue. And that took knowing something about who I am that I didn't know until I knew. So again, kind of a full circle moment where my world got really small for a while. It got small because I prefer to go to places where there are queer people and safe bathrooms, and also because it was helpful for me to be able to talk about my life and what I was going through in that moment with people who could relate and understand in a way that straight people cannot. But now, full circle, like, we're bringing those relationships back into the fold. And I'm recognizing that, yes, those relationships are always going to be different than they were before because we relate differently now. But now that I'm there, like, they're still lovely and Wonderful and valuable. Does that, does that make sense, Dusty?
- [26:08]
B
Yeah, absolutely. I mean, I think, like, this is kind of like moving us towards that allyship episode and some of the things we talked about last time. And I want to be conscious of time before we run out of time. Can you speak a little bit to the, like, the hormonal aspects and the connection between like, hormones and adhd? Because that's what was really interesting. That was of interest to me too. And I think maybe something you don't always like when you're about to transition, maybe it might not be something that you might consider, especially if you don't know the connection between like, ADC and hormones.
- [26:38]
A
Sure. So this was something that I did absolutely consider and was aware of because of my context, because I was already a working ADHD coach who had had conversations with clients about hormones. Actually, interestingly, not any trans folks, but clients in perimenopause or menopause or even clients who menstru. And that monthly hormone fluctuation that comes along with a menstruation cycle breaking down pms. I had a lot of context for the fact that hormones do absolutely impact ADHD symptoms. And I went searching for the impacts of testosterone in particular. And there wasn't a lot of information out there about trans men, but there is a lot of information saying that for men in general, everything else being equal, ADHD symptoms do tend to be worse. I do think that that is true. And so coupling that with all of this new executive function tax that we've been talking about this entire episode was really frustrating. I do feel like I had to relearn my own ADHD in a way, if that makes sense. That previously being something the only thing that I really fully and completely understood about myself. Another interesting thing, and this is true for trans men or trans women, although the way in which it happens is different is hormones change how emotions feel in your body. I. I took up kickboxing because I stopped being able to cry and it physically felt like I had pent up emotion. Like aggression isn't the quite the right word, but it felt like it could turn in that direction if I didn't find an outlet for it, if that makes sense. And that was that coupled with I was concerned about weight gain on T because puberty doesn't know that I'm already a grown adult and the growing part is done. Those are the two reasons that I took up kickboxing as a way to better deal with my emotions. And Dusty, I too am noticing our time, but I have a Little story to maybe take us out that I think kind of, kind of puts bow on, on the story I'm trying to tell today. Things change so fast. That's, that's the other crazy thing, right? Transition can feel really slow, but particularly with adhd, like you quit paying attention to something for a while and you're like, oh gosh, where did all that new body hair come from? Right? Like there is nothing there. The last time I was paying attention to my stomach and now, now there's a whole bunch of body hair there. But things don't just change internally. They change in terms of how you look. It's crazy to pictures of myself from those early transition days. It's crazy the journey I've been on in terms of people in people in non queer spaces and how they receive me just on a basic social level, right? We went from pretty, pretty, pretty all the time ma', ams, which hurt, but like we're fine and whatever to this funny liminal space where I would get people correcting themselves in both directions, which was terrifying at first because I was afraid of outing myself. But now in a new, more confident place in my trans identity, I find really hilarious when it happens. And it can be pretty entertained by it. And so it's like, it's like continual change in all directions in terms of your context. And that is such a crazy thing to deal with. And the story I want to tell about this is right before I started t, I came out publicly. In the very next week, Cam and I are in New York City doing an interview for a documentary that never came to fruition. But that's okay. That's not the moral of the story. And I have a client who's a photographer in New York City who is so generous. She, she rented this studio space. She charged me nothing. She rented this studio space to do new professional photos of me. Because the one quote unquote professional photo that I have I took in my driveway so that I had a photo with that more accurately reflected my identity for when I came out publicly to my audience. So we spend the whole day, multiple outfit changes, doing this photography session. And I never use those photos because by the time on the business front I was there to start using them that, that they don't look. They genuinely do. Not so much so actually later today I'm having new headshots taken because they just don't look like me. And similar to the haircut at the time that they were sent to me, there was also coupled with that disappointment of yeah, that's what I look like right now. But that doesn't, that doesn't feel like me yet, both in terms of physical transition changes and also in terms of the clothing I had at the time. Right. I hadn't yet figured out who I am from that point of view. So I worked with what I had at the time, but would choose and have chosen something very different for today. So, Jane, if you are listening, like, please know how much love in my heart I have for you for doing that photography session with me. And it's been on my mind to reach out to you and tell you why those photos never got used. But I also wanted to end on that story because the moral of the story is that the change in internal and external context is a constant until it's not. Right? Until you do finally get to a place of feeling more settled. Right? Feeling you feel less like a fractal being that's coding to all of these different contexts and more like a whole person who is choosing. Now I'm a choice about how I code myself or don't code myself.
- [32:22]
B
Yeah, I mean, it's, it sounds like a lot. I don't envy having to manage all those challenges and I wish all the people transitioning out there a good support system because you need it so 100%.
- [32:34]
A
And I will actually toss in that my coaching skills were a massive boon to me here. And I do think that coaching, and I've had a couple of experiences with trans clients that affirm this. I do think that coaching can be a great framework to work through some of this stuff, particularly if you also have adhd. So the same identity work that I was doing with clients and building on became useful tools and resources for me in my own journey. To sit in that discomfort and to, to the best of my ability to approach things with curiosity but detachment, right? Because again, that useless frustration that I was sitting in at times, right? There were times where the, the, the best question I could ask myself is, what can I do now? Right? Looking at all the things I can't do and looking at how far away I feel from understanding myself. Like, okay, let's back it up to like right now, today. Like, what can, what can you of improving your life from this place? Because my, my life in other ways had also crumbled around me during this time. So, like, what, what am I capable of right now? Like, what can I turn my attention towards? Because we're not there yet with this bigger stuff. The fog is not clearing on this stepping stone in those bigger ways yet. So, on this stepping stone in the middle of the foggy pond, where can I take some meaningful action? So, trans folks, if you're listening and coaching is something you are interested in exploring as a way to better understand yourself in your own journey with transition, please do reach out and give me a shout, because that is something I am interested in exploring with more intention. Because it's certainly something that was immensely useful for me to have those skills in my own toolbox along the way. Time to wrap.
- [34:30]
B
Yeah, let's wrap it.
- [34:31]
A
All right, so until next week, I'm Ash.
- [34:35]
B
And I'm Dusty.
- [34:36]
A
And this was the Translating ADHD podcast. Thanks for listening.