The bizarre world of body dysphoria

I have found it quite difficult explaining body dysphoria to people who have never had the misfortune of experiencing it firsthand. It often seems a bit like trying to explain colors to someone who has never been able to see. How do you really explain to someone that parts of your body feel foreign and wrong and that it feels like other parts are missing?

Ever since puberty, I spent at least some part of every single day in distress about my breasts. Over the years I tried various ways of making peace with them, trying to at least be okay with their presence even if I couldn’t get myself to like them. Nothing ever worked, and it seemed the harder I tried, the worse the dysphoria became. It was a constant anxiety. It was worst when out in public, but the anxiety was always present, even when I was alone. When I was around other people, the part of me that was constantly aware of my breasts was always trying to minimize or hide them. They felt like alien growths that didn’t belong to my body. While I did not come to the understanding of being trans until just a couple of years ago, I always felt like people would not be able to see me for who I was because of the breasts. This feeling finally made sense when I realized I am trans. I did get some sense of relief when making the decision to transition knowing that I would finally be able to get rid of the breasts once and for all. When I made that decision, I did not realize just what a profound impact it would have on my life.

It has been nine months since top surgery and the change that this has had on my quality of life has been nothing short of phenomenal. The constant anxiety over my chest is now gone.  I can finally wear shirts that actually fit instead of ones that are 1-2 sizes too big to hide the breasts. I even wore a tank top out in public last weekend for the first time in years and never once had anxiety about how my chest looked. My chest is not perfect. I have scars and will need at least one revision to fix the excess skin under my arms and to move my nipples down a bit. But those issues are minor in comparison to the feeling that my chest was alien to me.

Some people have tried to understand the trans experience of having a ‘wrong’ body by comparing it with typical complaints many of us have about things we don’t like or that we’d like to change about our bodies: things like being overweight or wanting the “perfect” <insert body part here>. But wanting the perfect body part is much, much different than believing the body part does not belong on your body at all. Because I now have a few things that need to be changed about my chest, I can better understand just how different these two experiences are. There is minor anxiety around wanting to fix the imperfections in my chest. But the internal experience is not at all like the experience of feeling like my breasts didn’t belong there. My chest is mine now, even as imperfect as it is. It’s the chest I was always supposed to have to be congruous with the internal image of myself. My outward experience has also shifted. If I were to go to the gym and change in the dressing room, I would have some discomfort about showing my bare chest because of the scarring, but I wouldn’t feel like I couldn’t be seen as myself. It would be the difference between feeling embarrassment and feeling invisible.

Every trans person has struggled to explain the experience of body dysphoria to those who are not trans.  The thought that a person would feel like part of their body did not belong to them is so foreign to most people that they have no frame of reference to even contemplate such an experience. Attempts to create a frame of reference by comparing it to the desire for some way to make an existing body part “better” don’t really get to the essence of what body dysphoria is. Medical science has come a long way in the past 10 years, and studies are starting to show how our brain has its own internal body map. For a trans person, the brain’s innate body map does not match the physical reality of the body, and this is where the dysphoria comes from. This is how a person can feel like a healthy part of their body does not belong to them or how they can feel like their body is missing parts that their brain says should be there. For cisgender people, the brain’s map of the body is congruous with the physicality of the body. Cis people may not always like everything about the body they have, but their brain isn’t telling them that parts of their body don’t match what it expects to be there. My experiences of my body before and after top surgery have given me some new insights into how different these frames of reference are from each other and why trying to use the frame of reference of “improving” a body part is so inadequate to explain body dysphoria.

Top surgery has not eliminated all of my body dysphora. To feel completely comfortable in my body I will eventually have to seek changes to my genitalia, but that discussion will require another post of its own.