Photo by Ryan Song

I do not think there needs to be a specific “endpoint” to transition nor a “beginning”. Of course, people define their transition in all manner of ways, each of which is almost entirely unique to the individual. A lot of people do feel there to have been a definitive turning point where they began to transition. But I am not one of these people. For me, it turns out, the whole thing is the middle.

How it began

When I first understood that I am trans I thought I needed to wait until I was comfortable asserting myself as a man to tell anyone outside of myself, or (eventually) my girlfriend. This idea is wrong. This is classic internalized transphobia, which was simply a self imposed continuation of the violent need to categorize and classify every person one meets or feeling one has. This white imperialist culture in which we find ourselves has always had a problem with people just existing the way they would like to exist.

Tuck: How do we stop deferring happiness to [the future] and start just figuring out how to exist in this weird middle time and like find joy in that?

River: When you kind of realize that like the whole thing is the middle time.

gender reveal podcast, Ep. 116 53:00

How it’s going

I have since come to regret delaying my medical transition because even this feels like the whole thing is the middle.

While I don’t think there was a definitive beginning to my transition, I do feel I should have pursued medical steps much earlier. This stems from thinking back to all of the reasons I had for delaying my appointment. And unfortunately, all of those worst case scenarios came true. Albeit, in not quite so permanent a fashion as I had initially feared.


I was most worried about getting deadnamed and misgendered, and my biggest fear was starting HRT, then being forced to stop because of a job loss or lack of health coverage. Well, you can probably put together what happened when I finally did get my prescription.

Even though my name had been changed legally, my health insurance was an absolute nightmare to get in contact with. I was only ever able to change it with my local county Medi-cal office; the contractor that actually provided my coverage still has yet to correct it. This caused a lot of confusion and multiple instances of misgendering and deadnaming at the local CVS pharmacy.

I no longer have this health insurance so it isn’t an issue anymore. Luckily, I was able to weather losing insurance without a financial interruption but I did have to reduce the amount of money I save each month to pay for my meds, appointments, and blood work.

An unexpected intermission

I did end up having to deal with an interruption to my HRT, as well. Not because of anything that was my fault, nor anything I could have prevented, or forseen. No, I went a week without a shot because my pharmacy at the time rarely had my syringes in stock. I couldn’t find another pharmacy in the area that had them.

After waiting a week, the pharmacy claimed they had filled the script. They technically did, but the gauge on the needle was way too small. This made using them very difficult to use because testosterone cypionate is a very viscous suspension.

When the script was due for refill, I transferred it to a Walgreens recommended by a friend that is a 15 minute drive from my house. Which doesn’t sound bad by U.S. standards until you know that I didn’t have a reliable vehicle at the time. This meant I was using Lyft to get around and I don’t think anybody wants to pay an extra $20+ just for the privilege of paying $40 for a prescription. Conveniently, I was able to purchase a vehicle before my prescription was due for pickup.

Photo by Luke van Zyl

Wrapping it all up

I was lucky and in a position of relative privilege; I’m definitely grateful for this fact. But, these legal and medical systems have so consumed my life these past few months that I have all but given up on everything else that gives my life pleasure, or would actually further the administrative side of my transition. I feel so stretched that taking the time to remember the fact that, sometimes, transition unfolds in its own way, on its own timeline helps me. It can be a comfort to know that your transition won’t necessarily end even if you lose your job, or health coverage, or your access to HRT, or if you are forced back in the closet. It only ends when you feel like it does, or it turns out the whole thing’s the middle.

Complement this with an exploration of trans survival in a cis world.