(This is part 11 of my observance of Transgender Awareness Month, my answers to the 30 Day Trans-Challenge.)
Yes, I realize I'm very behind schedule. Maybe it'll be Christmas before I finish; I dunno. Anyway, here's question 11:
11) How do you manage dysphoria?
Woooooo. This one is a little tricky, because I know it's so different for so many of us. So I'll preface this by saying these are just my strategies. They may not work for everyone, and a year from now they may not work very well for me either, because I evolve them as my needs change.
Presentation
As I've said previously, my agreement with DW is that I no longer present femme, even in the privacy of our home. That doesn't mean I'm stuck wearing frumpy, baggy lumberjack clothes, though. Over the last 18 months, I've built up a decent little collection of attractive, androgynously-cut clothes I absolutely love to wear: a couple of pairs of jeans, some dressy slacks, a few chinos, some button-up shirts and nice tees to layer with them. I don't really push the gender boundary too hard, though... I work in a pretty male-dominated field, and I'm not entirely sure if that wouldn't end up being a career-limiting move. But it's a blessing that my field also has a fairly relaxed dress code, so I don't have to go all "Mad Men" with a suit & tie (honestly, that would drive me bonkers really quickly).
I've also been acquiring a small collection of gender-neutral jewelry: bracelets and necklaces, mostly beads, shells, or natural fibers. It's a little touch, but sometimes it's just enough to remind me of my identity and help me to feel a little more confident about myself when I'm surrounded by testosterone.
I pay more attention to personal care than I used to. I try to keep my fingernails neatly trimmed, and occasionally treat myself to a pedicure (once on an anniversary date with DW, which was unexpected & fun). I try to shave my face every other day; I really ought to do it daily (or even twice daily, really), but I also have very sensitive skin, and over-shaving it makes it irritated. I've been using moisturizer morning & night, and that seems to be helping a bit. I've also been growing my hair out; it's long enough now to pull back in a little ponytail, which is a new experience for me. I'd like to go a little longer, but that's a conversation DW and I haven't had yet.
Chemical
In addition to all of the above, I've been on herbal supplements since this spring: Saw Palmetto as an anti-androgen, and Black Cohosh for its phytoestrogenic properties. They're both much milder than HRT, but they serve to take the edge off my dysphoria just a little bit. But really, I need to find an endocrinologist and get set up with something a little more official and professional, if for no other reason than to make sure I'm not messing up my liver. The herbals have been a nice stopgap while we were in transition from the East Coast, but now that we're more or less settled and back in good health, I think it's time to start doctor shopping.
I've also made a habit of eating more healthfully. I've almost completely eliminated soft drinks from my diet (the occasional Mountain Dew at a restaurant still happens from time to time), which has made a pretty big difference. I eat a lot of salad (I'm talking rabbit levels of salad consumption); it fills you up just as much as carbohydrate-heavy stuff, without the negative effects carb-loading can have. I otherwise haven't really cut anything out of my diet, I'm just smarter about portion control, and try to reach for fruits and veggies first if I need a snack.
Another chemical change that has been very helpful is regular exercise. At least a couple of days a week, I try to run (well, more like power-walking most of the time) during my lunch hour. It wakes me up when I might otherwise get a little sleepy after lunch, and it revs up my metabolism so that it's more efficient about burning calories (which feeds back into my diet). Since I started my exercise program in earnest, I've lost about 35 pounds! I'm not quite where I want to be yet (still have a bit of a "spare tire" to lose), but looking in the mirror isn't quite so distressing as it once was.
Social
I've talked before about how helpful it's been to have friends that know what I'm going through. I participate on a couple of email discussion groups for LDS transgender people, and it's been very rewarding. Sometimes I'm able to say an encouraging word or two when a friend is feeling down. Other times, someone will do the same for me. Often the discussions we get into will expand my understanding of some facet of the Gospel, or of what it means to be trans and stay a faithful member. Sometimes my friends and I get into off-list conversations over Google Chat or Facebook or whatever, and those conversations have also been really rewarding and enriching.
Just as importantly, I'm out to my wife, and lately we've had some really great conversations about faith and faithfulness. We have kids that don't yet know the fulness of my issues, and I don't have anyone else I can really talk to in person, but having DW to talk to has been a tremendous comfort, and I've very grateful for her and her attempts to understand me and support me in my challenges, even as I try to do the same for her.
Spiritual
Finally, last but not least, is the spiritual component to my coping. I have about a 45-minute commute to work most days, and although sometimes I spend it listening to NPR or music, I've been making an effort to plug in my audio scriptures and listen to at least a chapter or two every day from the Book of Mormon. It's been really interesting to me to study this way, because the lessons I'm gleaning from the long sweep of Nephite/Lamanite history are new to me, and I'm learning a lot about human nature, righteousness, wickedness, humility, pride, and what it means to have faith, even when I don't know the meaning of all things.
Disclaimer
Again, these are my coping strategies as of November 2013. I reserve the right to change them as my needs change, and I make no claim that they'll be a silver bullet that eliminates all traces of gender dysphoria. Doing these things haven't eliminated mine, either, but taken as a whole, they've certainly made it more manageable. And for right now, that's enough.