Birth Control and Trans

I recently received a question, via email, from a young person about birth control.

“I am a 17 year old closeted trans guy who is looking for ways to mitigate dysphoria. I have access to binders, but I am physically unable to use one for health reasons. I have moderate to severe acne and have been recommended that I start estrogen-based patch birth control to mitigate it. However, my friend told me that the hormones included in patch birth control could have “feminizing” effects, such as breast growth. I looked on the internet to see if this was true, and there seems to be a lot of conflicting information. Some sites even said that taking birth control could lessen the effects of female-to-male hormone replacement therapy (FtM HRT) later down the road. I plan to start testosterone later in life. It’s not safe for me to come out to my doctor, so I can’t ask for help from a medical professional. Is there anywhere I can find reliable information about potential “feminizing” effects of birth control originally designed for cis women?”

So I asked a trans friend who is an RN, and who gave me this amazing resource and information:

Lots of great clinically sound information in this document: Birth control is appropriate and people taking or planning to take testosterone can use most any method. The methods that typically help stop bleeding would be the progestin pill, implant, IUD or the depo shot. Sometimes these methods are specifically used to stop bleeding, even if the patient does not desire it for birth control properties. Progestin does not interact with testosterone. Sometimes patients choose to avoid the methods that contain estrogen such as the pill, patch, or ring, due to the lack of clarity if estrogen interacts with testosterone, which sounds like it would be something important for this individual. I would say we have a fairly large handful of patients on T that get the Depo-Provera shot every 3 months. For some, it is to help control any potential bleeding that testosterone has not stopped, for others it is for birth control and for some it is for both reasons. The copper IUD might also be an option as it does not contain any hormones but could potentially have some light bleeding associated with it prior to starting testosterone. A final note, testosterone is a very potent hormone and has very little, mostly no issue, overpowering estrogen.

Trans TX Orgs

Trans Education Network of Texas:

Equality Texas:

ACLU Texas:

TX Trans Health:

TX Trans Kids:

Organización Latina Trans Texas

Trans Pride Initiative:

OutYouth (Austin):


20 Years.

I wrote a new (free) piece for Patreon today and then started wondering about all the things I’ve written over the years about the Towers and that Tuesday.

So, in order of their appearance, this one from 2005, and a peaceful image that did my heart good when I first saw it, and that I still call Wish.

Then, in 2008, this kind of throwaway piece that still packs a wallop because it was true; from the first time I flew in a plane after that day.

Two pieces from the 10th anniversary, one of which I wrote in 2007 for a grant application, and the other – about the dogs.

A few years later, when fostering kittens – one of whom would become our Greta Bean – I would write about how having our two gray boys leave footprints in the dust of our Brooklyn apartment that day.

I first started hating the term “never forget” I don’t know when but I first said something about it in 2014. That’s also when I posted this beautiful view from the top of the Towers.

By 2017 I had a fellow New Yorker here in Appleton with me, and I wrote this for her, and for me, and for all of us who were there but who left NYC, but moreso for all the people who weren’t there who think they’ve got something to say.

In 2018 a smattering of memories about the beautiful place it was and the hints of what was lost immediately after, soon after, and much after. (This is still something I need to write a hell of a lot more about, personally. I lost my life in no small part that day and have only insinuated about it but never really dug in.)

In 2019 this piece about being a post traumatic, when I was convinced that would be the center of my next book, an idea I abandoned once I started trying to write it because it was too fucking painful and I did not have the mental health resources – or the time off – to really do it. Sometimes you lose too much blood trying to get a thing down, and that was the case with this. Sometimes projects are abandoned because they have to be.

Last year, this piece a week ahead of time about a song, and a band, and a concert that happened afterwards, and the pathos and drunkenness and community.

But 2020 was filled with so much other grief, as is 2021. My rage is always the first thing that I can express, and I’m glad I get to, because I’m so continually disgusted at the misuse of this day for patriotism instead of memory, perspective, grief. What strikes me most this year is how much I still haven’t said or written about, my nightmares, how much of my life and my self I lost as a result. I’ve never written about Mychal Judge but I read about him a lot and hope he does become a saint.

So the rage is often what you get, the pushback to how we do this as a country. I’m sad not to be in NYC and relieved not to be in NYC, too: just one show on “what ‘never forget’ means to you” had me weeping in my BK apt, so maybe it is for the best that I’m not soaking in a whole town’s grief and anger today.

Or not. For now, I compile and cry and play with cats and order groceries and go back to reading N. K. Jemisin’s The City We Became.


For our 20th anniversary, I had this plate and artwork commissioned because queer artists are the best. Kaffers Illustration on Insta and FB.

(And yes, of course I have more to say about what it means/what it takes to make it to a 20th wedding anniversary as a trans couple, but not today…. )

Trans 101

The Fox Cities Book Festival recently chose the book George by Alex Gina as a community read, and as a result they asked me to do a Trans 101. It’s been up on Facebook but they were nice enough to get me a copy to be shared, so here you go:

PTSD: What It’s Like

I wrote a longer post about having a panic attack as someone with PTSD today. It’s not something I write or talk about often, but after this year, I’m realizing I probably need to share more of what it’s like, what it’s been like, how you learn the shape of your own trauma, how you negotiate with it.

Here’s an excerpt:

“Today’s panic started around 2:30. It’s just past 6:30 now and I’m coming down which is why I’m able to write about it. I’ve always wanted to and I honestly don’t know (also don’t care) if this explains how it works. This is just my version of PTSD; everyone experiences it differently.

In this case, too, there was resolution to the thing that caused the panic within an hour of the stimulus that set it off.

So: panic stimulus – stop breathing – stomach goes weird – fingers go cold – head comes off.

That all happens in about a minute.

I had a reason, an actual direct cause, to stop panicking maybe a half an hour after that.

Yet here I am, four hours later, typing this because I can’t get back to my work because I can’t focus. Because once it starts, you’re kind of just a passenger while the whole of you goes off the rails for a while. You wait. You watch symptoms once you’ve learned them – and that takes years – and you do the things that help a little, whatever they are, but mostly it’s just about passing the time until the brain can wrest control back, once telling yourself “you’re okay” actually starts to sink in.

So yeah. That’s what PTSD is like. I’ll be a little weird the rest of the day, a little queasy, a little angry, a little jittery. Eventually I will tell myself it’s okay to go to bed and I’ll take a pill for it, the kind I have an “as needed” prescription for, and mostly I’ll wake up feeling like myself tomorrow.”

You can read the whole thing here.

Trans People and Sports

As many of you know, I am not a sports person.

What I am very enthusiastic about, however, is girls doing sports. I was a tomboy, remember, and had to compete with boys a grade older in order to lose some races. I dropped out of sports for a variety of reasons, but that’s a different story for a different day.

But I’m even more enthusiastic about trans inclusion in sports, because it makes sense. And with this rash of bills making their way around the country – one is supposed to be introduced here in Wisconsin – I thought I might gather a reading list on the issue for those who want to know more.

First, this great article by the ACLU about the common myths surround trans inclusion in sports.

This piece by the ACLU about why we’re seeing this rash of state bills right now and what’s behind it. (And this additional one on the same topic by Dawn Ennis for Forbes, too.)

Completing the ACLU trifecta, Chase Strangio’s annual tracker of trans bills on Twitter.

My friend Quince Mountain on trans inclusion in sports and on being able to play sports doesn’t necessarily have to do with winning at sports., a project of Chris Mosier’s, which has a ton of information, from the basics on trans and sports, and an action center.

Dr. Veronica Ivy on Twitter regularly writes about sports and champions trans inclusion.

Here’s a great piece about how, if you want to protect girls in sports, you should probably worry a lot more about sexually predatory coaches (and not about trans people).

To close, I’m going to say a few things. When someone you know contacts yourself, ask yourself a couple of questions: (1) has this person ever cared about women and girls in sports before? (2) has this person ever expressed any interest whatsoever in feminism and “leveling the playing field” ever before? and (3) where is this person getting this information?

Because if the answers are (1) no, and (2) no, and (3) who the hell knows, you might want to send them this list so they can do some research and get back to you.

I’ve got 20 years of experience doing this work and no, I can’t boil it down to a meme or 5 basic issues. This rash of bills is an attack on trans people, plain and simple, and it is hateful and unwarranted and a waste of time.

But while they’re out there trying to pass these state by state by state, trans people you know are suffering, scared, and already dealing with so much prejudice and discrimination. Be kind to them, and argue with your friends for them as often as you can.

(I’ll keep adding to this list, so feel free to send me more resources.)

added: Utah op-ed by Max Chang which makes great arguments.

added: This Nancy podcast called “When They Win“.

added: this NYT article about Rachel McKinnon.

added: Vice article on the physical changes transition brings.

added 3/19: American Progress article on the importance of trans participation in sports.

Trans Day of Remembrance 2020 #TDoR2020

It feels so different this year with Monica gone.

It feels so much the same this year, seeing all the photos of the beautiful people taken by violence because they were trans.

It feels so different this year with 250,000 families mourning a loved one who died from Covid.

It feels the same to realize that there are still people who think a person’s gender identity is a good reason to hate them.

It feels so different this year because President Elect Joe Biden not only marked today as Transgender Day of Remembrance, but he made trans and non binary people a promise to respect their dignity and human rights.

I was talking to a fellow partner of a trans person recently about how terrifying it can be to negotiate other people’s attraction to your partner. On the one hand, it’s nice to see someone realize that they find a trans person attractive for the first time. On the other: really? I mean, there are a million billion examples of beautiful trans people. But the dynamic for someone who is surprised by that attraction is so, so complicated. I’ve had people walk up and tell me how hot my wife is, and sometimes they are so proud of themselves for validating her gender and beauty. Other times it’s just creepy and weird.

But partners always live with that fear that exactly the wrong person will find your person attractive, or find their gender an affront, and so we live with that fear all the time of the person we love being hurt because of who they are, but moreso, because the wrong person’s dick got hard.

It sickens me over and over again to see the beautiful people who were killed maybe because they slept with the wrong person or just because they were walking home from work late at night. Maybe they were doing sex work. Maybe they were in the wrong place at the wrong time. But it’s still a reality that a trans person can be targeted for doing absolutely nothing at all but existing.

So when we have these “theoretical” conversations about what gender is I never hear a conversation about gender. What I hear instead is a conversation about whether my beautiful wife deserves to be treated with respect, her life and autonomy protected.

And honestly my heart hurts these days, hurts with the piles of grief. It hurts because I miss Monica and still can’t quite believe she’s done. And it hurts with the fear I have for others’ safety, the frustration when I realize how little I feel like I can do, have done.

So this year I’m inviting you to celebrate or thank a trans person you know, to send them a card or a gift or pay a bill that needs paying.

If you’ve got suggestions for organizations that specifically help trans people, let me know.

Here in Wisconsin there’s FORGE and Diverse & Resilient. Today, consider a donation.

Do more. Read a book. Watch Disclosure. Support trans candidates for office.

Sometimes what bothers me most about TDOR is that I am reminded that a bunch of my friends are trans because their being trans isn’t the important thing about any of them and never fucking has been.

But we mark the day to respect the dead, to say their names, to say: violence is not okay.

I just really hope, someday, there is no need for TDOR because there is no violence against trans people.