skylar taylor-barrick

Institutional Capitulation

2026-03-02T00:00:00Z

I woke up, grabbed my phone, and opened Bluesky, as I often do. I'm not very good at ignoring the horrors despite fleeing the country to get away from them.

I see the headline: "Vanderbilt Will Stop Providing Gender-Affirming Surgeries to Trans Adults" and my stomach drops; I start to dissociate.

I had two surgeries there. My wife had two surgeries there. Countless friends have had surgery there. Now that's just gone?

Vanderbilt University Medical Center was where I experienced some of the best healthcare I've ever had – their VIVID Health program for Queer folks helped me find an excellent primary care physician and psychiatrist. When I did a full-time mental health program there, the staff were excellent and clearly cared about our well-being. Accidental misgenderings happened, of course, but there was never a sense of not belonging.

It's why I'm so disappointed to see this decision, especially with such a cop-out excuse as "operational limitations." The actual healthcare professionals on the ground doing day-to-day work do care about their patients, and I guarantee the surgeons who've been doing this work for ages (Dr. Kassis, you're an angel) want to continue, and will likely do so at other hospitals.

Unfortunately, this is almost certainly the beginning of a trend where public and university hospitals drop transgender surgery (I am not a fan of the term "gender-affirming") and drive these procedures to private clinics that are more expensive, covered by fewer insurers, and significantly less accessible for people on government-provided healthcare.

I wish they were at least honest that they were capitulating to fascists.

Uncomfortable Quiet

2025-09-15T00:00:00Z

Discovering our system has happened at the worst possible time in our life — I'm moving internationally in a few days, have very little interpersonal support, and have been in-between therapists. The last couple of weeks have really reinforced that.

Safety in Silence #

About a week ago, we made a tough decision. We felt like our attempts at untangling what parts of us came from where, and what they needed was holding us back, occupying too much brain time when other things were more important. Working with our new therapist felt like it was opening up more wounds and bringing up more questions than it was providing answers for.

We sat down for an internal conversation with all of us, and made the decision that everyone but Zari would take a break from fronting, let them lead us through this transitional period, and revisit plurality once we're settled some. It seemed like a good idea, and initially the peace and quiet felt really nice and refreshing. We wrote on our personal blog "I'm Skylar. A person with a lot of complexity in my head, but a single person, nonetheless." which was certainly optimistic.

Grieving a Quiet Brain #

We weren't prepared for what that quiet would look like or what the pressure of fronting 24/7 would feel like. There was an enormous sense of loss for the parts of ourselves we were starting to embrace — Ethan's masculine presentation, Aimee's coloring and cartoons, Christopher's protectiveness and insight.

The loss felt so great that we became paranoid that our plurality wouldn't return when we wanted it to and we had done permanent damage our system. Worse, we became increasingly convinced that this was more about other people's comfort than our own. This all felt like a step backward.

Back to Normal #

On September 12th, we were laying in bed trying to nap when suddenly Aimee came to front, crying and confused about what had happened. You see, she wasn't particularly involved in the decision, and was scared about being gone for so long. That opened the floodgates, and our fronting patterns went back to how they were before all of this.

This shift came with a lot of confusion and doubt, sending us spiraling and debating if this meant we were making up our DID all along, which is silly given we're formally diagnosed and have been in therapy for it. The covert nature of DID is really frustrating in this way.

Moving Forward #

I haven't really processed what this actually means for us, or what we need going forward. Did we temporarily fuse, and it came apart? Did we force the others into dormancy? Was it just a stress response that was largely involuntary? We don't know.

One thing that seems a bit clearer is that we really value the individuality of our headmates — we mourned the loss of that complexity like losing a best friend or family member. Their return felt like family coming home.

We really dislike uncertainty and it feels like a large part of healing from trauma and getting to a healthier place with our plurality is embracing it. Healing is never linear, and plural identity doesn't follow clean timelines or rely on therapeutic milestones.

We're still figuring so much out — that's been the case since March when we discovered our plurality. This will be a multi-year journey, as much as we'd like to rush things along for stability's sake doing so just makes things worse. We're working on sitting in the uncertainty and becoming comfortable with it.

Our headmates have returned, headspace is slowly becoming more active and present. That feels correct and good, for now. We worry we'll be this unstable forever, but know there's a lot of work to be done and much room for growth. Being honest about how we're doing is a good step.

Plural Again

2025-09-15T00:00:00Z

September 12th, 4:15pm.

Aimee showed up and took front after nearly a week with no switches and silence in headspace.

That seemingly opened the floodgates – our normal switching patterns immediately resumed, with 15 switches yesterday, and 9 so far today. It's mostly relieving, as I'd really begun missing the others and regretting what we'd done to ourselves.

It's also super confusing? I don't really have a read on what caused things to slip back to 'normal' really. I've been sick for a week and a half so I've had a lot of time to process things and try to figure out what happened, and I'm lost.

I keep thinking that this is a sign I'm making up my DID – which is dumb given that I'm clinically diagnosed and have a therapist who's been treating it who has seen us switch in session a ton, so I know it's real. Something about the covert nature of DID causes me to constantly doubt it.

I hope we're not doomed to this level of instability and ambiguity forever. I don't know what our access to therapy will look like after we move, which is troublesome.

This is certainly not the most coherent post I've ever written, but I wanted to update y'all on things.

A Quiet Brain

2025-09-09T00:00:00Z

It’s been a bit over three days since I’ve had an alter front. I (Zari) have always felt the closest to what I’d describe Skylar as anyway, so honestly it’s been not been a huge shift as far as my day-to day goes. The biggest shift?

My head is so quiet.

Headspace, once a clearly visible and busy place with the others trudging around, chiming in with commentary about what I’m up to, is silent and feels more distant than ever.

I’ve had headspace as long as I can remember.

For so long I would’ve given anything for my brain to be this peaceful and focused on what I need to do in the short term. But now? It feels like loss. grief. mourning.

Like I’ve lost enormous parts of myself I was just getting to know and embrace.

Comfort objects, hobbies, coping mechanisms, dysphorias and euphorias, suddenly absent.

I worry I made a bad decision, that I won’t be able to reverse this when I decide I’m ready – I’ve always believed that our brains surface things when we’re ready for them and I overrode that.

Was this all about prioritizing the comfort of others to the detriment of my well-being?

I don’t think that’s a question I’ll be able to answer any time soon. I just have to move forward.

On Being Multiple

2025-09-08T00:00:00Z

I've spent the last few months attempting to embrace my DID as a 'normal' part of my life – something benign and worth keeping and working on. I'm fully aware it's a trauma response to all the awful things I experienced in my childhood – sexual assault, parental alienation, undiagnosed disability, physical and verbal bullying at school, emotional incest, constant rejection – but it felt like there was a way to heal and remain multiple and enjoy the potential benefits of a life with complexity of personality most don't have.

I don't think that's the path forward for me now. Attempting to untangle what parts of me come from where has been more distressing than healing, and it's isolated me from friends and loved ones in a way that has been deeply destabilizing. I also only have two sessions with my brand new DID therapist before I move somewhere with worse mental healthcare access than where I am now, which is saying a lot.

So I'm reframing how I look at it – DID is, to me, a mental illness that once protected me, but is now holding me back. In my OCD therapy we talked a lot about how compulsive behaviors often once served a purpose to keep us legitimately safe or comfortable, but we've grown past them to a point they're harmful. Increasingly, I take this view of my plurality.

I had a tough conversation with some of the alters this past weekend, where we acknowledged that their fronting and having distinctly different needs about interaction with our loved ones, presentation, and expressing their varying ages is holding us back and causing active harm in our daily life. They agreed largely, and decided to step back. I haven't switched since that I can tell. Headspace is empty and quiet. I am back to only dissociating occasionally into nothing, rather than it being the precursor to someone else fronting.

Realistically, I don't know how long this will last, how long suppressing things will work. I pretty firmly feel like it's the correct path right now, until this move is settled, until I have a more concrete understanding of what my life will look. I'll likely have to confront this work again – but hopefully I'll be safer, more stable, and have the space to actually explore things without losing everyone around me.

So, let me reintroduce myself again: I'm Skylar. A person with a lot of complexity in my head, but a single person, nonetheless.

I hope it stays that way.

On Finishing Outpatient Care

2025-08-25T00:00:00Z

I just finished a Partial Hospitalization Program at Vanderbilt Psychiatric Hospital in Nashville, TN. It was three weeks of group therapy and skills classes from 9am to 3pm, Monday through Friday. It was an incredible but intense experience, with a lot of growth, reframing, trauma processing, and learning about myself.

Upon completing the program, you do something called Rock Ceremony, in which you are presented a painted rock with a kind message and it's passed around the room and everyone says kind words for you. After everyone else speaks – it's your turn. I pre-wrote my remarks because I knew I'd struggle with what to say in the moment. I decided to publish them here:

The first couple rock ceremonies I sat through I really thought to myself "This is sort of cringe, and I don't know if I believe these people have had such transformative change in their time here" I'm sort of a jaded person, I've tried a lot of things for my mental health over the years and never seen the progress I wanted. I wasn't sure I belonged here, that group therapy would help me.

So I don't have some wildly impassioned speech about how I've overcome a ton of obsticles, and how amazing this has been. But I have what I think I am beginning to realize is a much more inspiring and practical message:

This program has given me many tools, and the space and structure to learn to care for myself such that every day, I work to be a slightly better version of myself than the day before. And the next day I'll do the same.

I always wanted some big, dramatic change and then poof I'd be healed and fully-idealized and happy. Seeking those sorts of solutions held me back from doing the hard, nitty-gritty, day-to-day reframing it takes to change the momentum of your thoughts and feelings.

You have to show up, every day. You have to speak up, every day. You have to be vulnerable with yourself and others, every day. That's the real work of this program, not sitting and listening and taking notes, which is all really great. So many therapy skills feel like they're not that impactful on paper – and that's true. A lot of these things are things we've read elsewhere, or heard a million times. The difference is in learning how to apply them in your real life. That's the test.

So that's what it's time for me to go do – take all of the lessons I've learned from the phenomenal social workers here who put in extremely hard work every day to care for us and teach us things, the lessons from you all – my peers – who've offered more than just support, but practical help in figuring out what my values and goals are for my future – and apply it. Integrate them and figure out a new way of living that works better for me and provides a more authentic and healthy life.

If you're new here, you probably feel like I did at the beginning of my speech – unsure if you'll be able to sit here and confidently state you're in a better place. I want you to know that I personally have full faith in you, as long as you do the work. Engage. Listen actively. Offer feedback based on your life experiences. Talk through your struggles – you'll be surprised how often you realize you think about things differently in the middle of telling a story.

This entirely-too-longwinded speech has been a huge thank you, but let me say it clearly: Thank You to the staff of this program, to Vanderbilt for funding and believing in it, and for my peers for engaging critically with me – it's all meant so much more than I could say in the last 527 words.

I really am so thankful for this program. Tomorrow I see my new DID therapist, and I am beyond excited. Forward I go.

A New Start

2025-08-22T00:00:00Z

So I decided to bring my blog back – my life is about to get really busy and complicated, and I want to be able to write about it in a longform fashion. In reading my old posts, I was debating whether to republish them and decided it was how I felt at the time and that's worth something. But I wanted to provide context for what's happened in the meantime, how I'm doing, and how my feelings on some of those things have developed.

The biggest medical update is that I did in fact have Facial Feminization Surgery in April 2024, and Gender Nullification Surgery in August 2024. Both went very smoothly, and I'm really happy with the results – I have plans to write more about my experiences with nullification soon.

I was diagnosed with Dissociative Identity Disorder in March of this year and have been doing lots of work and research to learn and explore this part of myself. If you want to learn more about this, I actually made an entire website about it. My DID has really complicated and muddied my feelings about gender, style, and my body itself.

I've spent the last three weeks in a full-time outpatient mental healthcare program after a serious dissociative event left me unsure of my ability to care for myself and remain safe. Unfortunately, I experienced sexual assault in my free time outside of the program that has been re-traumatizing and undone much of the progress the program provided.

The political situation has also dramatically affected my life. Existing as a transsexual person in the U.S. has gotten much more difficult than when I vented about it here last, and my wife and I are moving out of the country this fall to get away from it all. This also means I'm giving up my dream of being a therapist, at least for now. There's not a super concrete path to it right now, and other things have taken priority.

I think that's all of the big updates about me? As always, I am terminally online on Bluesky if you want to know more about my day-to-day shenanigans. I want to write actual things now, but it felt weird to just show back up without context of what's going on in my life?

two = 'more than one'

2025-07-05T00:00:00Z

This is the first in a series of posts on our misconceptions about plurality. We let these hold us back from accepting ourselves and starting to do system work sooner, and hope sharing our experiences may help normalize the uncertainty of early system discovery.

Most of this post is written from the general consensus of the system's perspective, but a few statements are prefaced with emoji from a specific headmate's perspective that popped up during writing and editing.

Most of our day-to-day experience of plurality is experienced through Zari or Ethan's lenses, and about a third of the time we're co-fronting. In the early days of our system discovery we thought this meant we weren't plural, because we'd only really seen the stereotypical experience of "hard switches, full amnesia, many personalities" and that didn't align with our experiences.

It's often said that dissociative disorders hide themselves, because if you start exploring the system you'll inevitably uncover the traumas that caused the splits in the first place. I know that's absolutely been the case for us, we had extremely little recollection of our childhood and that's started to change the more system-aware we've become.

⚫️ I mean yeah, we've discovered two child alters, so clearly there's many damaged parts of us from that part of our life that need healing.

✨ We hadn't mentioned the other child alter, but yes, we do have a child alter that's younger than Aimee. She's pretty nonverbal and emotionally-driven so we don't speak about her too much.

As we've done research, we've discovered that it's actually extremely common to only have 2-3 headmates, and felt more secure. A note on language: academic literature will often say "1-2 alters" because they don't include the "host" or "main personality". We generally conceptualize ourselves as equals, and call ourselves headmates for this reason.

Further, dissociation and plurality can present in a wide variety of ways, such as fragments. We know folks who don't have fully distinct headmates, but do have fragments (or as one friend described them, lenses) and that's an entirely plural experience! This was just our journey to exploring what the literature says about how our system is structured.

✨ For a long time, we questioned if we were "plural enough" because we don't have really harsh switches or complete blackouts between us.

⚫️ Yeah, it's more like... sliding between perspectives? Sometimes I'm more present, sometimes Zari is, sometimes we're both here watching things happen together.

Co-fronting (or co-consciousness) is actually incredibly common. The amnesiac barriers between headmates can be partial rather than complete, and many systems have varying levels of memory sharing.

Learning about OSDD (Other Specified Dissociative Disorder) was really helpful, which explicitly includes systems with less distinct parts or distinct parts without amnesia. The line between DID and OSDD is actually pretty arbitrary - it's all part of the same spectrum of dissociative experiences.

If you're questioning whether you're "really" plural because you only have 2-3 headmates or because you don't match the stereotypical presentation - please know that your experience is valid. The clinical research backs this up, community wisdom supports it, and most importantly, your lived experience matters.

A New Path

2024-03-26T00:00:00Z

It's been a little bit since I've written here, not for lack of trying. My usual workflow involves writing in my personal journal, then realizing something I have written can be generalized a bit and published. Lately, my personal writings have been very specific to people and situations that I don't care to share online. Things have gotten a bit exciting recently, so I have general life updates that are worth sharing.

I have an Orchiectomy in a week, which is so exciting and nerve-wracking. The original surgeon I was hoping to see (which scheduled a consultation in March, when I called in August 2023) ended up pushing the appointment even further, to August, and that despair motivated me to look elsewhere. I found a surgeon who is slightly closer, was able to get me in for a consultation basically immediately, and I think is a better fit overall.

Even better, I've gotten connected into a system of providers who can help me access other procedures. Things I've long refused to indulge thinking about, presuming them to be unrealistic, are likely possibilities now. I have a consultation for Facial Feminization Surgery this week, which I am looking forward to. My face reads a bit masculine at times, and I have to supplement that with more feminine style to help. I'm increasingly realizing my style leans a little more butch than that, but I've been afraid to try more masculine things (I really want to do shorter hair than I have currently) because I don't want to get misgendered any more than I do. I'm hoping FFS can help with that.

Long-term, I'm hoping I can get Gender Nullification Surgery. I've spent years debating whether vaginoplasty would make me have less bottom dysphoria than I do now or not, and I believe it would feel just as incongruent as a penis does now. Nullification actually feels extremely correct to me mentally, both from a physical and sexual perspective. We'll see if my Orchiectomy helps my bottom dysphoria significantly, but I think I'll want this procedure either way. It's not incredibly common yet, with a dozen or so surgeons advertising it around the country. I'm hoping that the surgical team I'll work with for the procedures I have planned may have experience with it or be willing to learn, however.

In other news, I have a boyfriend now which is exciting! He is monogamous though, so there's been some interesting complexities there, but I think we're managing it well. Dating Apps are an exhausting experience, and I don't otherwise get out of the house enough to organically meet people, so I keep coming back. It feels really nice that my wife and I both have partners now, like we're actually doing polyamory instead of trying to do so. There's been lots of learning and communication along the way, but things are good.

There was an interesting couple of months where my wife and I actually decided we were going to move to a larger city not too far away, so she could pursue a new career path. We were pretty serious about this, we started meeting with a Realtor to sell our home. She ended up deciding to stay where she is a bit longer, since our health insurance is really excellent and we're planning surgeries and things.

Since that decision, I've actually discovered what I want to be doing as a career long-term! I'm going back to university this fall to study Social Work, then graduate school for Counseling. After 5-6 years of school I'm hoping I can get licensed to practice therapy, or do counseling for a community organization that works with vulnerable populations. I've also thought there could be interesting research opportunities about what therapeutic methods work best with queer and trans patients. It'll be a long path, but I feel confident about it being the right one. I'm excited to get started.

The rest of 2024 is looking to be extremely eventful, but extremely good.

The Dissonance of Trans Existence

2024-01-06T00:00:00Z

It's a weird time to be trans in the United States, particularly in the South.

On the legislative front, I'm not sure there's been a more worrying time. Our rights are being stripped from us at a pace I hadn't considered possible. Most of these bills are targeting trans kids, but increasingly trans adults are in the crosshair as well. Somehow conservatives have extended the definition of 'children' as old as 26 years old. I was already married and well into transition by this point, I most certainly was not a child.

At the same time as all of this, my life goes on as normal. I experience very little judgment or harassment for being trans in the relatively small city I live in. I go shopping for women's clothes and makeup without stress, go out to restaurants and bars with my wife and our friends, and don't often think about my gender. Hell, my wife went to a gun range with her girlfriend, and they were both gendered appropriately in a place with a Trump flag and a "stop the steal" pistol for sale.

I've had a hard time managing my relationship with social media, because constant awareness of all the awful things happening to trans people throughout the country makes it harder for me to exist in my life, despite knowing things are fine.

Most of the misgendering I experience is on the phone, because my voice reads as a flamboyant man. I want to do voice training, but multiple attempts at doing it myself haven't gone anywhere because I have a hard time understanding it. I need to look into hiring a coach but that is more work that my depressed brain doesn't have the energy for.

More than once I've seen people say that the average person doesn't really give a shit about trans folks and I'm inclined to agree. They may not understand us, and may have some internalized transphobia, but at least where I live they generally know well enough to keep that to themselves. I can work with that.

postscript:

I'm using "trans" here for a reason. I've started to use the label transsexual to describe myself lately, as I feel like the idea of sex and gender being separate can have some harmful outcomes for people like me. I know it's at times a controversial term, and most people use the more common transgender at this point, so i'll just use the shortened form.

On Getting Better

2023-10-22T00:00:00Z

It has been a whirlwind of a month for me.

I started anxiety medication two months ago, and an antidepressant two weeks ago. The reduction in anxiety has been extremely noticeable, it's been wonderful. The antidepressant has been a bit tough - it's an SSRI which I've historically struggled to onboard to, but I have ondansetron this time to help get rid of nausea, which is helping some.

I also decided to stop using cannabis after an intense discussion with my therapist - I hadn't told her of my daily use for the last 5 years or so. Finally coming clean and having to confront the negative impacts it's had on me was tough! I'm a month (and change) sober and I'm feeling pretty good about it. I definitely miss it on a daily basis, but the improvements make it fairly easy to not go back.

These serious changes have enabled the following this month:

A trip to my in-laws where my partner came out as transgender
Date night with my wife for the first time in literal years
Getting manicures with my wife (her first ever!)
Going to the gym every day
Making a new resume and applying to multiple jobs
Finished reading 2 books I've wanted to read for years
Volunteering to set up my city's pride festival
Attending the pride festival, a drag show, and after party at a bar
Started group therapy with a group of trans women

This is more social interaction than I've had in literal years, and I honestly don't feel all that overwhelmed by it? I woke up this morning after being out all night and even managed to make it to the gym for a good workout!

There's a small part of me, however, that misses the depression, the sitting around stoned all day, the lack of drama and emotions. It's really easy to romanticize the ease of doing poorly. Building a life from scratch is a challenge, having to figure out what you want as you go along.

Getting better isn't a linear process, and I really struggle with any small downturn. My instinct is to embrace that failure, internalize it as a fundamental part of myself, and sink back into depression and isolation.

I deserve better than that. I can do better than that.

Acquiring a Comfort Object

2023-09-27T00:00:00Z

A large part of my work in therapy lately has been to identify a way I judge others, then considering if it should impact how I view someone and deconstructing why I have that judgment.

During a YouTube video about managing anxiety I was watching recently, someone showed all their Squishmallows and shared how helpful having a cozy object could be when they felt overwhelmed. I wanted to be receptive to the idea, but just couldn't.

I've always judged people who have interests I consider childish. I mentioned this aversion in therapy as something I'd like to work on, so we spent a couple of sessions talking about it. I've since written privately about it, many of these insights are pulled from those writings.

As a child, when I began to show my naturally feminine expression and interests, most of it was immediately shut down. What I was able to sneak past was layered with judgment and condescension from my family, church congregation, peers at school, and sometimes teachers as well.

I couldn't get the toys or games I wanted, or go see the friends I wanted. I couldn't read the books I wanted. I couldn't listen to the music I wanted. I couldn't wear the clothes I wanted. I couldn't love who I wanted.

As a result, I pursued computers, software development, and isolation instead of toys, games, and going outside. I stopped watching animated media, and I still can't manage to enjoy it most of the time. I spent most of my time (outside of school and church) online chatting with adults. I chose not having a childhood over having the wrong childhood.

In an attempt to change my judgment, I decided to take a leap of faith and order a Squishmallow for myself. I felt embarrassed.

Some friends in Discord have many plushes, so I posted my order there, anxious that they'd judge me. Of course, they were excited for me! When it finally arrived and I held it for the first time, nearly all of the shame I felt was gone.

I really get it now! There's something to the softness of the fabric, the density of the filling, and the cute designs that comforts you. I immediately ordered two more - one of which was the comically-large 24-inch size, which turns out to be an excellent floor pillow. I sleep with one every night now, and I feel holding onto it during therapy has helped me discuss difficult topics.

I'm increasingly learning that having good sensory input on hand is helpful for making it though bad sensory input. Carrying my fidget toys, headphones, and a plush around can make things a lot more bearable.

That isn't to say there isn't any judgment in my brain still, I can't yet change that quickly. I'm working to truly convince myself that reclaiming these parts of childhood isn't a cringe excuse for age regression as a coping mechanism, but actually a tool to re-contextualize my trauma and find healing.

I also struggle to get past this "suck it up and desensitize yourself to the world" mentality. I know some amount of that is healthy, and I need to push myself, but too much is how I ended up so burnt out. It doesn't help that we're all feeling some of these anti-social tendencies because of COVID and having to isolate for so long. I need to figure out new ways to do things that are sustainable for me over the long-term. If that means wearing headphones while I cook, well, I can handle that!

Right now, I've only really spoken of this to a couple friends and my partner. I'll need to do some more deconstruction of that judgment before doing something like taking a plush on a flight or to my in-laws. I know I'm capable of doing it, I just have to.

I wonder what other preconceived notions I have that are wildly wrong? What other 'childish' things would I love? It's an area of exploration that I'm not comfortable with, but one I think will ultimately bring me comfort.

postscript:

I'm about to go to my in-laws this weekend, actually. I wrote this in early September, and now I'm realizing I didn't do that deconstruction work I was supposed to. Shit.

A Journey to Medication

2023-09-05T00:00:00Z

Anxiety is really frustrating. Things that I know are good for me - socializing, cooking at home, going on dates - feel impossible for reasons I can't really define. It's painfully irrational, causing spirals of self-loathing that can take days to get out of.

I've been in therapy two or three times now, and while each time has been helpful in various ways (my work with my current therapist being the most so) I haven't been able to overcome anxiety in every aspect of my life that I'd like. I have to spend a lot of time working myself up to daily tasks that most don't struggle with, and I'd like to reduce that activation energy so I can do more.

Over the years, I have tried a lot of psychiatric medication and never had a good experience. The downsides always overweighed and completely clouded any benefits. Here's some of the issues I've encountered while trying at least five medications over the years:

SSRI Onboarding caused severe nausea/vomiting
Multiple medications had no effect at all
Wellbutrin caused severe panic attacks every day
Suicidal/Self-harming Thoughts Increased in Severity/Frequency
Severe mood swings / anger outbursts that persist to this day

These experiences caused an aversion for medication in general, to the point I even stopped taking HRT for many years. I really regret that, as I've basically had to start my 'medical transition' over at an older age.

My new therapist introduced me to something called GeneSight testing, which is a genetic test that can provide indicators on what medications may work best for you. It took me a few sessions of being reminded about it, but eventually I talked to my doctor about it, and got the swab done. I didn't know it, but that was the easy part! Waiting for the results was tough.

I'd like to briefly detour for a rant about healthcare (and ultimately web design, somehow) now. It took five weeks from when the lab received my sample to getting my results. I called my doctor plenty asking for updates, and they assured me GeneSight can take this long - nothing was wrong. Eventually I got a bit desperate and decided to call GeneSight directly. I got an automated message: "The entire company is currently in an all-hands meeting and will be back later. Goodbye."

How bizarre! It took me a few days to work up the energy to call again, but this time I got through to someone. They informed me that they received the sample, but the paperwork was incomplete - no one had me sign the consent form needed, and the lab order form was completely missing. So many times I called and asked a nurse to look into why it was taking so long, and each time they assured me it was "in progress" and everything was normal.

I was able to do the consent form directly with GeneSight through DocuSign, which was great. The other form had to come from my doctor, so I called them to ask them to send it over. I couldn't help myself though - and had to ask why they had insisted it was just normal processing delay when it was explicitly on-hold with the lab. Surely they were notified?

When I mentioned earlier they said the order was "in progress", that information was coming from a web portal GeneSight provides to healthcare providers to follow up on samples and retrieve results when complete. That text was shown on an overview screen for all of the samples they had submitted, with no context or state indicated - no bold text or status light. When they clicked into the detail view? It showed the test was on hold, and the documents needed to release it. It was there the whole time.

I could've started medication an entire month sooner. I wouldn't have had to survive one of my darkest weeks ever. I lacked hope.

Because of some shitty UI?

Honestly, it was difficult for me not to be angry at my clinic's staff for not having paid more attention. But I think it's reasonable to assume "in progress" means that things are moving along normally. GeneSight probably should've reached out directly to the provider for the needed paperwork anyway, instead of relying on someone checking a portal. I got a SMS when they recieved the sample, why not tell me?

I guess it doesn't really matter, after all. I'm still here, thankfully, and it seems the worst has passed, for now at least. Starting medication was difficult, but with the help of Ondansetron to remove nausea, I'm feeling decent. Better than any other attempt at starting medication.

My partner and I can't help but keep saying that it seems that this should be the default course of treatment when a doctor thinks psychiatric medication is needed. Do the test, prescribe something it suggests. I've tried so many medications. Every drug I have tried was listed in either the 'Moderate Gene-Drug Interaction' or 'Severe Gene-Drug Interaction' column in the report. It's hard for me to understand how I hadn't heard of this sooner. How is it not immensely popular?

If I had gotten GeneSight five years ago when I first sought out mental healthcare in San Francisco, how different would my life have been? I was still working, maybe I wouldn't have burnt out? Maybe I could've kept us afloat financially and we wouldn't have had to leave. That would've been nice.

What if I had known anything at all about mental health in college, and hadn't been propagandized by my family and friends into believing it wasn't real? What if I had gotten treatment then? Dropping out of college is something I deeply regret. I was suffering through an un-diagnosed mental health condition, an un-diagnosed developmental disability, and such severely repressed trauma that I am only now starting to actually realize it even exists. I can't even blame myself. Can I blame anyone? Would it help?

It's so fucking hard thinking about what could've been. I feel like at so many points I did my part by seeking care, and was let down by this country's shit healthcare system. Even now, I'm having to put in administrative and research effort toward guiding my doctors. I'm nearly thirty years old and only really now figuring out basic things about who I am, how my brain functions, and ways to build a healthy life for myself and those I care for.

And yet, I have to try to shove all these feelings down and look forward, because ruminating is what got me here in the first place. I'm feeling pretty okay right now, all things considered! I've been doing more around the house, feeling more motivated. This is real progress, and it is better to make it now than never. That should be my focus.

It's only been a few weeks so far, but compared to the month before that? What a difference.

postscript:

I wrote the first half of this toward the end of July, before my mental health took a nosedive I hadn't experienced in a long time. I had no idea that my results would take so long, and that waiting would affect so severely. The entirety of August was a blur.

Feeling so close to some sort of answer and potential relief was miserable. I slipped into serious depression and stopped caring for myself or my home. I was counting on getting medication to get me out of it, which is not often successful. I really don't like taking pills (not that you could tell, as I take 10/day now) so this felt counter-intuitive to acknowledge.

I wasn't prepared to be in a place where I was begging for any amount of relief, even from something I don't like. It was humbling, in a way. That's a topic I'll write more about soon.

Dysphoria Whack-a-Mole

2023-08-02T00:00:00Z

An interesting part of being non-binary for me is that I feel fairly comfortable in a variety of gender presentations. Unfortunately, I've only used this to try to assuage my anxiety by living in 'boymode' full-time. Even though I've enjoyed that presentation at times, It's never been my most authentic self. It'd gotten to the point where I wasn't dressing feminine at all anymore - even stopping hormone replacement therapy.

Compounding this was my move from California back to Kentucky. I naively thought moving back wouldn't change me, that all the growth I'd done in those years would stick; I couldn't have been more wrong.

Despite coming out to my family years prior, they had never gotten any practice gendering me properly because I didn't visit. Some of them didn't have any interest in trying. Because I'm so conflict-avoidant, I'd dress extra boymode-y and avoid talking about anything even remotely feminine. As it would turn out, that excludes many of my interests and activities! The realization they never knew the real me (and never showed an interest in changing that!) was a factor in ending contact.

All of the friends I still had in Kentucky had moved away by the time I got back and settled, and then COVID happened. Getting here and staying inside constantly made me more reclusive than I've ever been. Trying to push yourself back out of the house and push yourself into new gender expression is asking a lot!

In April I started going to a LGBTQ+ clinic that opened in town, and it was really the starting point for a turnaround. I restarted hormones after four long years! Unsurprisingly, that has brought major changes, many of them mental. It quickly became clear that the 'indifferent androgyny' I had been doing could not continue any longer.

It turns out I had been weaponizing my identity against myself! It can feel so convenient to minimize certain aspects of yourself to avoid hard questions. Why be a woman, when it's easier to be androgynous? Why deal with other people's transphobia, when I can just blend in? These small deceptions added up over time, building a sense of dissonance between who I am and how I was presenting myself.

It often feels like I'm starting transition all over again which is discouraging - but it's going a lot better this time. I'm doing things I had always been afraid of - drastic hair changes (I have short blonde hair! I curl it! Innovative!) and wardrobe changes (rompers! dresses! not sweatpants!) that I always talked myself out of now felt necessary to survive.

This has been really good for me. I look in a mirror and actually like what I see for the first time. I am pushing myself out of my comfort zone and tackling long-held anxieties.

Through all of this, new dysphoria triggers I'd never expected keep popping up. My favorite baggy sweatpants (which I loved for being gender-neutral) now cause me dysphoria, and my new women's joggers that are more fitted make me feel good. My staunch disinterest in surgeries became incredulity at a six-month wait for orchiectomy from my insurer. Arm hair that I was fairly neutral toward now has to be waxed regularly.

I even changed my pronouns back to she/her after using they/them for so long! I go by sky (intentionally lowercase) instead of Skylar because it started feeling weird to hear people say my name. That I chose?

Why are all of these things changing? I haven't been able to figure it out, and it is so frustrating. I feel so little control, like my brain is dragging me toward self-actualization whether I want it or not.

This shift in identity, I worry, might be caused by hormones or societal pressure, rather than seeking out my 'true self' if such a thing exists. This worry is just internalized transphobia; I've known who I am for so long, and this was just my latest attempt to suppress it.

I doubt we'll ever to figure out why someone feels like the gender they do. Gender may just be fundamentally irrational. Can I live with that?

Standing Up For Yourself is Good, Actually

2023-08-01T00:00:00Z

I've always been a people-pleaser. My natural inclination is going along with the flow to avoid conflict - especially when my family is concerned. In other contexts, I'm pretty opinionated and willing to stand up for myself or others. Why is this such a blind spot for me?

This is something I've been working on in therapy - trying to convince my brain what lies on the other side is better than the indecision and abuse I currently endure takes a lot, as much as writing that sentence makes it glaringly obvious that it shouldn't be.

I've made progress, recently setting some hard boundaries with people in my life that I should have six years ago. It was such a difficult and uncomfortable conversation, but I feel so much better for pushing through and having it.

It really is better to not have someone in your life than to have them in a fake second life you create for their comfort.

I got to say things I've been thinking for over a decade, let out (reasonable and deserved) anger, and answered so many 'what-if' questions stuck in my head. So far, my time without them has been peaceful.

There are still moments where I think I made a mistake, don't get me wrong. I'm a lot more lonely now, something that's already been heavy for me lately. However, the space that they took up in my life (and all the emotional energy I spent) is now available for people who love me, the real me.

I'm excited to meet those people.

A Personal Blog, in 2023? Groundbreaking.

2023-07-29T00:00:00Z

I've decided to make a blog! Admittedly, this has become a little cliche. I've become painfully jaded and disillusioned with big tech over the last few years. COVID made us all dependent on these companies who took advantage of that by driving political division and worsening mental health crises, but most importantly increasing their profits.

It's hard to feel like there's anything you can do in the face of such large companies that are so entrenched in how we communicate and keep up with the world. So what have I done to try to feel better?

Device & Service Changes #

I'm running Linux full-time on both of my computers, using free and open-source software where I can, and only using federated social media. I have a NAS for (completely legally acquired) media, and a cloud cluster running Matrix and Lemmy - the latter of which I have become particularly enamored with and want to write more about soon.

The compromises you have to make for privacy and control over your own devices and content are too much for the average person. I can't play either of my favorite games (Fortnite and Valorant) because of their Windows only anti-cheat software. I'm not going to explicitly say I want their invasive, kernel-level spyware on my linux machines, but I do hate having to reboot into a small Windows partition to play games with friends.

I've been increasingly tempted by the idea of running postmarketOS on a OnePlus 6T, a really wonderful phone I had many years ago. I have my concerns about how the hardware's aged going into 2024 though, especially compared to my iPhone 14 Pro. I'm spoiled.

If you thought Linux on a desktop was bad, try a mobile phone! Reading people's stories of missing phone calls from family members because of software issues makes me worry, and I'm not that good with Linux. There are many applications on Linux I've come to love through using it daily (AudioTube and Nheko come to mind) that I'd adore getting to use on my phone.

I'd go with a dumbphone or something like the Light Phone, but I drive a Tesla so my phone is my key. I could buy a fob, but I'd lose features like preconditioning (I could totally use Tesla's API and Twilio to send commands via SMS, but I am lazy) and remote lock/unlock.

I think a de-Googled Pixel running GrapheneOS may be the ultimate solution, as weird as buying a Google phone for privacy feels to me. I am still unhappy with my smartphone's role in my life, and my lack of ability to do as I please with it.

A Word About the Blog Itself #

It's very possible I end up rewriting this blog from scratch in the future - It's built using Gatsby and React, and I've found myself longing for the 'old days' of web development. I almost deployed WordPress, so I'm going through some sort of crisis here clearly.

These feelings are coming from a real annoyance with what web development looks like these days, however dramatic. I have spent weeks trying to decide on a tech stack instead of actually writing the things that made me want a blog in the first place.

Hosted platforms are bloated, and shockingly expensive in a world where Netlify and other static-first hosting providers with a free tier exist. I already have a paid Netlify account for cros.tech, so I'd prefer to stay here - I just really don't want to code.

So, I yoinked a Gatsby blog starter and tweaked the CSS until it looked suitable enough. I'm not attached to this design in the slightest, you shouldn't be either.

What to Expect #

I have a couple of posts I'm already working on! In the future, I want to write about my thoughts about mental health, queer and transgender identity, and technology and its impact on us as people.

When reading a personal blog, I get a picture of who that person is and how they've changed over time. I have always wanted a place to do the same for myself.