This week, I'm sharing something a bit different from my usual reporting. What follows is a deeply personal reported essay about my own journey through diet culture, weight stigma, and the long path to understanding my gender dysphoria. It may not be my usual fare, but these stories matter, especially when they illuminate the complex ways that fatphobia and transphobia intersect in healthcare settings.
The essay explores how "feeling fat" was my only language for gender dysphoria for decades, and how weight-based gatekeeping of gender-affirming care compounded that confusion. For those who work with trans patients, understanding these intersections is essential to providing truly affirming care.
Next week, I'll return to our regular programming with more insights from the sources interviewed for this piece: a deep dive into the clinical distinctions, similarities, and overlaps between gender dysphoria and body dysmorphia. For now, though, I invite you to sit with this story and consider how diet culture might be shaping the experiences of the trans people in your care, and the ways you provide it.
I used to feel fat.
She is so proud. I hate myself. We stand in the kitchen, looking out over the sunken garage-turned-living-room half a floor below where my father sits in front of the television. He must feel as awkward as I do. This is so awkward! I want to scream. This isn't normal! But what do I know about normal? I don't. She's the one always telling me how not-normal I am, so she must know, right? She must.
I'm wearing my first training bra. She is so proud. I hate myself. The moment extends for an entire age in my memory, frozen in time. He must feel as awkward as I do. Please gods let him feel as awkward as I do, before the memory turns malignant, grows claws and teeth. What do I know about normal?
I don’t know normal. So when I’m told that this feeling is “fat” I believe them.
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