There are several issues and some flaws in our communities' ways of working through our own very difficult and often confusing journeys. I've heard several respected therapists who work with transgender people suggest treating us for PTSD or severe grief reactions. I'm not sure that is called for with all of us but I do think we (trans folk) often minimize the challenges and losses we face.

We become so focused, for a time, on the mechanics and stages of transition that we neglect some of the important internal work we need to do. We are shocked, surprised, and outraged at how others respond to us. We suffer major losses in many important areas of our lives. During our awkward transition stages we are noticed. We must be very tough to get through all of the difficulties we face.

For some of us who lived more traditionally gendered lives we may fall back on behaviors we learned during that portion of our lives. We have a lifetime of behaviors to learn in a short period of time.

We will be relating to the world and the world will be responding to us in very different ways. We will be surprised and shocked almost daily by simple things we never considered. Our reality has been altered. Our relationships are seriously challenged. They don't understand our late adolescence even if they are accepting of our transitions. We loose friends, lovers, wives, partners, kids, parents, jobs, careers, homes, incomes, neighborhoods, communities, and even, to some degree, our history. To suggest this is disorienting is an understatement.

We expect miracles of ourselves and those around us. Many of us think we will be able to master this most complete transformation with much greater ease than is realistic. We tend to be pretty focused on ourselves for several years while we are going thorough all of these profound changes. For those of us in the MtF category, we may have a lot of the traditional masculine style of self reliance and pride that does not allow us to ask for or accept support easily. Many of us are pretty isolated.

With all of this, it is amazing any of us manage to get to some more comfortable place and identity. Surprisingly, a lot of us do. (When I was in a drug addled recovery from surgery in Bangkok I had a sense we were like the Northwest salmon I knew well from my years in Washington State. We are somewhat like those who reach the spawning grounds. We've swam up waterfalls, avoided bears, the nets of fishermen, and bald eagles swooping down on us to finally get home to ourselves). I knew only a small percentage of us get to have surgeries we need or want.

What we often neglect during this rigorous transformation is our feelings and our relationships. Those of us who have known our true selves from an early age realize that we may have never had a fully honest relationship. We never shared who we were. We have often protected and isolated who we are ˆ even from ourselves. It is no wonder folks often have difficulties. We are adolescents with a second puberty and not very many peers who can relate to our awkward efforts to form relationships or create community.

So... what to do? Well, we form some communities or try to. We have this online version and some of us actually get together with each other. That's a good step, I think. We may be able to learn a bit from each other. The folks who've been on this path a long time may have some wisdom to share. Certainly they (we) have made mistakes we would not wish on others. Hopefully the Crones and Elders in our community can offer a bit of perspective and support.

Of course, I'd love to see really good, affordable, accessible, skilled and knowledgeable counseling available for all of us. Not gatekeepers but wise and supportive allies who can ask the necessary and difficult questions we need to ponder; folks who, out of their experience, would be able to offer understanding and resources to ease the journey. Sadly, there are not enough of those folks and not all of those we value are affordable.

We are, like it or not, left with each other... and those folks in our lives and communities who have stood by us. So we need to learn how to ask for support and give it with care. We need to learn to build new relationships. The physical transformation many of us go through is not really a magical completion. It is a new beginning.