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M I C A H
neutrois.me
N O N - B I N A RY T R A N S I T I O N
F O R M E D I C A L A N D S E R V I C E P R O V I D E R S
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W H O A M I ?
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transgender advocate
blogger
writer
conference speaker
5’0 tall
wears bright shirts
M I C A H : Yo u r H o s t
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O V E R V I E W
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W H AT I S G E N D E R ?
Transgender
Non-Binary
W H AT I S T R A N S I T I O N ?
Parts and Process
Transition Goals
T R A N S I T I O N
Social
Medical
Legal
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W H AT I S G E N D E R ?
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W H AT I S G E N D E R ?
G E N D E R
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M A L E
F E M A L E
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P H Y S I C A L
• height
• hair
• skin
• facial structure
• muscle mass
• voice
S E C O N D A RY
P R I M A RY
• chromosomes
• genitals
• reproductive organs
• hormones
G E N D E R 7
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S O C I A L
• name
• pronouns
• clothing
• mannerisms
• personality
• hobbies
C U E S
P E R C E P T I O N
• gender expression
• gender roles
• expectations
• relationships
G E N D E R 8
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L E G A L
• marriage
• parenting
• employment
• athletics
• insurance
• safety
R I G H T S
D O C U M E N T S
• birth certificate
• marriage certificate
• death certificate
• social security
• insurance
• ID cards
• driver’s license
• school records
• library card
• gym membership
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HOW DO YOU KNOW YOUR GENDER?
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W H AT I S T R A N S G E N D E R ?
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A PA ( A m e r i c a n P s y c h o l o g i c a l A s s o c i a t i o n )
“Transgender is an umbrella term for
anyone whose gender identity, gender
expression or behavior does not conform
to that typically associated with the sex to
which they were assigned at birth”
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T I T L E
I D E N T I T I E S
T R A N S G E N D E R
T R A N S W O M A N
T R A N S M A N
identifies with gender assigned at birth
does not identify with gender assigned at birth
assigned male, identifies as a woman
assigned female, identifies as a man
G E N D E R
C I S G E N D E R
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W H AT D O E S T R A N S G E N D E R
L O O K L I K E ?
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RYA N S A L L A N S
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J E N N A TA L A C K O VA
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K Y E A L L U M S
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L AV E R N E C O X
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B A L I A N B U S C H B A U M
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J A N E T M O C K
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A PA ( A m e r i c a n P s y c h o l o g i c a l A s s o c i a t i o n )
“Transgender is an umbrella term for
anyone whose gender identity, gender
expression or behavior does not conform
to that typically associated with the sex to
which they were assigned at birth”
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W H AT I S N O N - B I N A RY ?
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n o t t h e A PA ( A m e r i c a n P s y c h o l o g i c a l A s s o c i a t i o n )
“Anyone whose gender identity is outside
of male or female”
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No content
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N O N - B I N A RY I D E N T I T I E S
• bullet 1
• bullet 2
T I T L E 2
N O G E N D E R
B O T H G E N D E R S
N E I T H E R G E N D E R
C O M B I N AT I O N
T H I R D G E N D E R
E T C …
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LABELS just a few of the options
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YAYGENDER.NET …and a few more
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H O W D O Y O U D E S C R I B E
Y O U R G E N D E R ?
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NEUTRAL AGENDER
Non-binary boy
Transmasculine. Not a dude.
Male
Gender-fluid
Feminine trans guy
Androgynous
Genderqueer girl
A kaleidoscope
of all genders
Genderpunk
Can’t describe what I don’t have.
Limitless
Maverique
Kinda like an old, beaten-in sneaker.
Green! Yellow for
‘other’ and blue for
male, mixed together!
With a “meh” sound and a wavy hand gesture.
If a color spectrum, gray.
Boy, if I can get away with it
Non-Binary. Not
really sure if I
can go beyond
that umbrella.
“masculine-neutral” - that’s an adjective for
my gender, not its name. I don’t have a word
for its name.
Online, genderqueer male or agender.
IRL, transman without getting into it.
non binary dmab non fem spectrum leaning,
demiboy to true neutral to questionmark fluid
Genderqueer, though
I’m not sure if it’s
totally correct. It’s
the closest.
404
As rarely as possible.
Downright
confusing.
Depends on the day.
I just don’t have a gender.
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G E N D E R I D E N T I T I E S
G E N D E R
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A S VA R I E D A S P E O P L E
cannot “tell” just from looking
cannot know identity unless you ask
N O T E M P L AT E
complicated to figure out
complicated to explain
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W H AT D O E S N O N - B I N A RY
L O O K L I K E ?
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“ G E N D E R Q U E E R ” B Y C H L O E A F T E L
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“ G E N D E R Q U E E R ” B Y C H L O E A F T E L
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“ G E N D E R Q U E E R ” B Y C H L O E A F T E L
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“ G E N D E R Q U E E R ” B Y C H L O E A F T E L
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“ G E N D E R Q U E E R ” B Y C H L O E A F T E L
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“ G E N D E R Q U E E R ” B Y C H L O E A F T E L
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W H AT I S G E N D E R ?
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F E M A L E
P I N K
B L U E
R A I N B O W
M A L E
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W H AT I S T R A N S I T I O N ?
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T I T L E
T R A N S I T I O N I S …
A L I G N M E N T
C O N F I R M AT I O N
T R A N S F O R M AT I O N
I N T E G R AT I O N
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T R A N S I T I O N
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O U R M A N Y S E LV E S
P U B L I C G E N D E R
How you are perceived by others
P R I VAT E G E N D E R
Inner identity, abstract feeling
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T R A N S I T I O N
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“Type a quote here.”
D Y S P H O R I A
D I S C O M F O RT
M I S M AT C H
between what others see and what you feel
feelings of anxiety, depression
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T R A N S I T I O N
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T I T L E
T R A N S I T I O N I S …
A L I G N M E N T
T R A N S I T I O N
I N T E G R AT I O N
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process of finding comfort in one’s self
aligning public gender with private gender
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What is unique about
N O N - B I N A RY
T R A N S I T I O N ?
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F → M A L E
M → F E M A L E
F / M → ? ? ?
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What happens when your public gender…
… D O E S N O T E X I S T ?
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T I T L E
N O N - B I N A RY T R A N S I T I O N
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… b u t w e c a n t r y t o g e t
C L O S E R T O C O M F O RTA B L E
P U B L I C G E N D E R
is undefined
may never match private gender
invisible in society
T R A N S I T I O N
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W H AT ’ S T H E F I R S T S T E P ?
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PA RT S
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M U LT I P L E C O M P O N E N T S
physical, social, legal
can happen in any order
M U LT I - FA C E T E D
emotional, mental
personal, family, community
B A L A N C E
all facets influence each other
individualized importance
T R A N S I T I O N
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G R A D U A L
exploration, discovery
lots of tiny decisions
trial and error
G R O W T H
learn new information
each step informs the next
how it fits into present, future self
P R O C E S S
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T R A N S I T I O N
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N O “ 1 0 E A S Y S T E P S ”
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L O T S O F C O M B I N AT I O N S
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L O T S O F O P T I O N S
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N O T A L L O R N O T H I N G
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I T TA K E S T I M E
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A R E Y O U S U R E Y O U WA N T C O O K I E S ?
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W H AT D O Y O U WA N T
T O A C H I E V E ?
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U N I Q U E
as varied as gender
U N C E RTA I N
unclear destination
choose among unideal options
indecision ≠ confusion
N O T S TAT I C
goals change
T R A N S I T I O N G O A L S
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T R A N S I T I O N
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“I’m not necessarily going from point A to
point B. All I know is I left point A.”
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STEPPING STONE OR DESTINATION?
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SAME OUTCOME, DIFFERENT PATHS
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NO RIGHT OR WRONG WAY
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P R O V I D E R G O A L S
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U N D E R S TA N D C L I E N T G O A L S
how it fits into unique gender puzzle
U N D E R S TA N D C O M P R O M I S E S
unique to non-binary transition
W O R K W I T H U N C E RTA I N T Y
reasons behind fears and anxieties
T R A N S I T I O N
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S O C I A L T R A N S I T I O N
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age, race, ethnicity, religion, community, personality,
interests, hobbies, likes, dislikes, identity, and...
GENDER
S O C I A L P E R C E P T I O N
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S O C I A L
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HOW DO YOU KNOW WHETHER SOMEONE IS
A M A N O R A W O M A N ?
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Markers others use to categorize you into
“male” or “female”
G E N D E R C U E S
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S O C I A L
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G E N D E R E X P R E S S I O N
clothes, hair, accessories, mannerisms
N A M E
shortened, nickname
ambiguously gendered
P R O N O U N S
gender-neutral (they/them)
don’t care / mix of both
G E N D E R C U E S
S O C I A L
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What happens when your public gender…
… D O E S N O T E X I S T ?
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N O N - B I N A RY G O A L S
S O C I A L 70
T O B E P E R C E I V E D A S
neither
mix of both
ambiguous
more of one than the other
the point is not to confuse, rather…
T O AV O I D B E I N G C AT E G O R I Z E D I N C O R R E C T LY
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S O C I A L I S T H E N E W S O C I A L
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S O C I A L G E N D E R C U E S
easy to change, hard to change
change can be outside of our control
S O C I A L = P E O P L E
… O T H E R P E O P L E !
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G E N D E R - N E U T R A L C U E S
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C O M I N G O U T
S O C I A L 73
S O C I A L T R A N S I T I O N R E Q U I R E S D I S C L O S U R E
depends on other people to follow along
C O M M O N C O N F L I C T S
hard to explain non-binary gender
not taken seriously
rejection
safety
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C O M I N G O U T
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D I S C L O S U R E I S A S P E C T R U M
Who
What
Why
When
Ongoing, Individualized
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TO PEE OR NOT TO PEE…
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CHOICES MAY BE LIMITED
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B AT H R O O M S
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F O R C E D T O G E N D E R Y O U R S E L F
… I N P U B L I C !
S A F E T Y
Fear. Anxiety. Danger.
E V E RY T I M E , A L L T H E T I M E
choosing a bathroom = choosing a gender
exhausting continuous anxiety
S O C I A L
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PROVIDE GENDER-NEUTRAL OPTIONS
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NEVER ASSUME
A LWAY S A S K
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M E D I C A L T R A N S I T I O N
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W PAT H S TA N D A R D S O F C A R E
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M E D I C A L
L E A D I N G M E D I C A L D O C U M E N T
informs other areas of transition (legal, social)
S O C , V 7 , 2 0 1 1
“Support through safe, accessible, healthy transition”
N O N - B I N A RY I N C L U S I V E
target gender
less linear
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H E L P, D O N ’ T H I N D E R
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G U I D E L I N E S , N O T R E Q U I R E M E N T S
framework, but focus on individual
I N F O R M E D C O N S E N T
adults making informed decisions
R E A L L I F E E X P E R I E N C E
what does “RLE” mean for a non-binary person?
antiquated hogwash
M E D I C A L
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I N F O R M E D C O N S E N T
M E D I C A L
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Y E O L D E N D AY S
providers as gatekeepers
E N L I G H T E N E D M O D E L
literally, ask for consent
therapy not a requirement for “approval”
hormones not a requirement for surgery
P R E S C R I B E , D O N ’ T
P R O S C R I B E
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R O L E O F M E N TA L H E A LT H
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S U P P O RT
cope with social, financial, physical consequences
how medical transition fits into identity
surgery, post-op depression
M E D I C A L
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Medical transition does not legitimize or
de-legitimize anyone’s gender
N O T A G E N D E R L I T M U S T E S T
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M E D I C A L
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H O R M O N E S
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O V E R V I E W O F H O R M O N E S
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“ M A S C U L I N I Z E ”
Testosterone
“ F E M I N I Z E ”
Anti-androgens, Estrogen, Progesterone
N O “ G E N D E R N E U T R A L ” O P T I O N
cannot lose characteristics without gaining new ones
M E D I C A L
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P H Y S I C A L
diminish existing gendered characteristics
combination of both
S O C I A L
appearances influence perception
E M O T I O N A L / M E N TA L
inner well-being
N O N - B I N A RY G O A L S
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M E D I C A L
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PA C K A G E D E A L
can’t pick and choose changes
U N P R E D I C TA B L E
extent of change depends on genetics
R E V E R S I B L E V S
P E R M A N E N T
two categories of changes
B I N A RY E F F E C T S
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M E D I C A L
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A C H I E V I N G T H E I M P O S S I B L E
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G R A D U A L
NOT all-or-nothing
C O N T R O L : D O S E & T I M E
low dose
on & off
short term vs long term
I N D I V I D U A L C H O I C E
M E D I C A L
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W H AT I F…
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C O M M O N C O N C E R N S
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… I S T I L L D O N ’ T PA S S ?
“pass” as what?
… I PA S S T O O M U C H ?
opposite gender is uncomfortable too
… I H AT E T H E M ?
can’t cope with undesired effects
M E D I C A L
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W H AT I F…
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C O M M O N C O N C E R N S
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… I E N D U P G O I N G A L L T H E WAY ?
how much compromise is too much?
F E A R O F C H A N G I N G I D E N T I T Y
today’s truth might not be tomorrow’s
M E D I C A L
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B A L A N C I N G
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P r i v a t e v s P u b l i c
S o c i a l v s P h y s i c a l
D e s i re d v s U n d e s i re d
R e v e r s i b l e v s P e r m a n e n t
D e a l B re a k e r s v s R i s k Ta k e r s
M E D I C A L
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S U R G E RY
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M A G I C A L “ S E X C H A N G E ”
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O V E R V I E W O F S U R G E RY
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T O P S U R G E RY
removal of breasts
H Y S T E R E C T O M Y
remove uterus, (optionally) ovaries
M E T O I D I O P L A S T Y,
P H A L L O P L A S T Y
construction of penis
M E D I C A L
O R C H I E C T O M Y
removal of testes
P E N E C T O M Y
removal of penis
VA G I N O P L A S T Y
construction of vagina
E L E C T R O LY S I S , F F S , E T C
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I D E N T I T Y
not taken seriously
“who will love me?”
medically impossible options
D O C T O R S
uninformed, hesitant
outdated guidelines
unfamiliar with alternatives
C O S T
binary requirements for insurance
B I N A RY B A R R I E R S
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M E D I C A L
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P H Y S I C A L D Y S P H O R I A
extreme discomfort with body parts
hormonal or internal effects
not always visible
S O C I A L
depends on gender goals
I N D I V I D U A L C H O I C E
personal reasons for opting in/out
N O N - B I N A RY G O A L S
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M E D I C A L
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B E N E F I T S O F S U R G E RY
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A F F I R M I N G
being at peace with body
C A N B E F I R S T S T E P I N T R A N S I T I O N
therapy not a requirement
hormones not a requirement (usually)
H I D D E N O P T I O N S
a handful of doctors not afraid to be pioneers
M E D I C A L
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L E G A L T R A N S I T I O N
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“Type a quote here.”
L E G A L G E N D E R
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R E L AT I V E
as good as the document it’s on
N O N - B I N A RY O P T I O N S ?
not really
personal reasons to change or keep it
R E Q U I R E M E N T S
vary by state, document, country
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“Type a quote here.”
B U T I ’ M N O T A L AW Y E R !
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P R O V I D E R S H AV E P O W E R
to sign off on paperwork (very glamorous)
M E D I C A L R E Q U I R E M E N T S
sometimes vague, open to interpretation
L E G A L N A M E C H A N G E
sufficiently satisfying
easy in the US with court order
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I N C O N C L U S I O N
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T R A N S I T I O N
F R A M E W O R K
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PA RT S A N D P R O C E S S
lots of options, each one is separate
gradual, takes time
G O A L S
unique, unideal, changing
J O U R N E Y
destination may be unknown
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T I T L E
N O N - B I N A RY T R A N S I T I O N
C O N C L U S I O N 107
PA RT S O F T R A N S I T I O N
social, medical, legal
N O N - B I N A RY G E N D E R
how the parts relate to non-binary identity
specific challenges for non-binary transition
O P T I O N S
lots of alternatives and combinations
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T I T L E
3 TA K E AWAY S
C O N C L U S I O N 108
I N D I V I D U A L I Z E D C A R E
path as unique as the person
G E T I N F O R M E D
research alternative options
make educated guesses
L I S T E N
never assume, always ask
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W H AT D I D Y O U L E A R N ?
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M I C A H
neutrois.me
N O N - B I N A RY T R A N S I T I O N
F O R M E D I C A L A N D S E R V I C E P R O V I D E R S