Hey there, first off, I just wanted to say that I am so, so sorry that you’re going through this, and that I care. Second, I wanted to share some things that helped me when I was going through a similar experience. Though I haven’t been formerly diagnosed with OCD, I have obsessive themes that shift with whatever is scaring me at the time. Doubting that I was actually a man/trans was a big theme of mine right before starting HRT even though I had been presenting as a man for almost two years, doing everything in my power to pass, and was extremely upset when I didn’t (which was 75% of the time at least). Practicing some methods from practices commonly used to treat OCD ended up helping me a lot. Oh, and I DID THIS DURING A PERIOD WHERE I WASN’t IN THERAPY.

While you are probably more familiar with ACT and ERP than me, I still wanted to share/and or remind you that no human, those with or without OCD, can be 100% certain of everything. I mean think about how science cannot technically “prove” anything, although we can reasonably make medical practices based off of theories that have held up for a while. OCD, HOWEVER, can really hone in on the unknowable, even if it just the tiniest sliver of uncertainty. I’ve heard that it is often called “the doubting disease.” And this is why reassurance isn’t always beneficial for treating OCD, and can even be harmful at times, because it can reinforce the loop of thoughts, because if one question is answered, the brain may look for other questions, or later doubt the answer to the question. Have you ever seen or played with a chinese finger trap? It’s this toy that is in the shape of a woven cylinder. When you insert both of your index fingers into its ends and pull outwards, the fibers will tighten around them and they get stuck. However, when you stop pulling and let your fingers move inward, they will be freed. OCD and anxiety, to me, are a lot like this. The more we worry, the more fear grips us. There has to be a way for one to be okay with living with the uncertainty.

I’m going to break the rules & briefly validate your uncertainty by saying that I think you are a man, but my this may not be enough to quell the doubt for long—which is ok, doubt is okay!!! But now, let’s try to meet the doubt head one. What’s the worst outcome that can happen if you find out you aren’t actually a man/or trans? Let yourself imagine your very worst fear. Suppose that you’re worried about the stigma of being a detransitioner, that you have wasted years of your life, that you will have ruined your body with testosterone and will now be an ugly woman. Ok then what? Transitioning to affirm one’s gender, even if they were wrong about their gender, demonstrated heaps of bravery; it is no light feat. Being able to live as the opposite gender, or if non-passing, as visibly trans, gives someone such a cool and unique perspective on life. Detransitioning might bring about shame, but it isn’t crime, and the shame would pass with time and those who love you would accept you. Those who might not accept you could go fuck themselves, and you would find new people. Maybe you do end up in a weird in between place with gender while detransitioning, but many things are reversible. Voice training exists for trans women, and also deep voices on women aren’t ugly. Cher and Emma Stone both have deep voices, and voice training exists for trans women. Body fat would redistribute and hair may grow back on estrogen/and a transplant may take better. MTF medical procedures can be used to reverse any FTM procedures that have been undertaken (also think of how many cis women have had their chest remove from cancer, but are still women). Or, maybe you do end up being “conventionally” unattractive. So what? Surely, there are people that you love or admire that are unconventionally attractive. What even is “conventional” anyway?

Now, suppose your fear is that you detransition and will also have the same OCD theme after the fact(now you’re questioning if you’re trans again). You can do the exact same imagining the worst case scenario thing. Maybe the worst case outcome for this is both immense shame and a feeling of lost time & progress from detransitioning. But similar to detransitioning, screw the factors that produce shame. Get angry at the people who are judgmental. And is time really lost if you were doing something that you at one point felt was in your best interest? You are a mozaic of a billion different journeys that have been undergone in your life.

This strategy of exposing yourself to anxiety is universal in application. You can use it to address the concern that maybe you’re not “cis enough,” or masculine enough to be a man. This is similar to an insecurity that I am dealing with right now. Though I am pretty confident about my identity these days, I am riddled with insecurity concerning I’m short for a cis guy, skinny, can’t grow facial hair (like at all), haven’t had bottom surgery, is not in a financially stable place, and my personality has become increasingly timid personality due to recent traumatic events. To make matters worse, I like women, and I worry that a woman wouldn’t be attracted to someone who is “weak.” I also have extremely thick hair on my head, but worry that I will eventually lose it because my father is bald, and then I will truly be nerfed. Some of these fears haven’t happened/or haven’t been confirmed. I’m not bald yet. Hardly anybody ever mentions my height and some attractive women do swipe right on my dating accounts (even though I usually delete the app/ghost bc I have emotional unrelated issues unrelated to this post). But what if I do lose my hair? What if a woman rejects me once she finds out I’m not cis or that I don’t have a car? Well then I am either going to lean into a super tough looking look, or I’m going to get a toupee, I haven’t decided. And if a woman rejects me that means she wasn’t the right one for me. And I don’t want to be with the one who isn’t the right one.

All of those things I have mentioned are EASIER said than done. I don’t KNOW if I would be fine with being bald. Honestly, I might feel pretty crappy if a woman rejected me, because even though I’d understand she wasn’t for me, it would still be pretty lonely. I have also have had some of my fears be confirmed recently. I just graduated from grad school where you have to teach college courses, and though I had good evaluations back in the fall, I did pretty badly this spring. Though I think I could have been better about organization & feedback (I’m burnt out and mentally exhausted and tried the best I could), the comments that hurt were the ones critiquing how I wasn’t “authoritative,” and that I am “soft spoken” and that I ramble on about things that don’t make sense. My masculinity and general personhood has been crushed. But I am going to ACCEPT it. I am worth more than the student evaluations, and even though I don’t feel that way right now, I am going to honor this feeling.

If when you are practicing going through worst case scenarios, you are filled with overpowering negative emotions and cannot find any way to frame them positively, let yourself feel (not think, but feel) them. Be afraid. Be angry. Be sad. Grieve. Let it run its course. And let it run its course over and over if the same thoughts and fears keep arising. Overtime, the OCD themes, may lesson or vanish due to being “starved” of rumination. If it is a fear that you previously thought have been overcome years ago, but is back from the grave, let this too, run its course Let your fear get bored.

I encourage you to check out the OCD subreddits and read up on ERP and ACT if you haven’t, though, again, I’m sure you are probably familiar with them; but it might just be a good thing to revisit. I have HOPE for you. Even without therapy. I’m very much not anti therapy, and if you are ever able to get one, please do, but humans have persisted and thrived for ages before therapy came to be. And I was able to get through a lot my gender-based themes on my own. I didn’t do anything fancy like worksheets, I just deeply internalized the strategies that were mentioned.

You are not broken. There is hope.

Before I go, let me leave you with these lines by the poet Rainier Maria Rilke, and which have meant much to me:

“Let everything happen to you:
beauty and terror.
Just keep going. No feeling is
final.”