Like any story, it’s best to start at the beginning.
Before understanding the word “transgender,” Elijah Palles knew one thing – he felt different. But being able to express exactly what that meant would still be many years into the future.
“When you’re younger and not around the community you don’t really have words for it, you just know that you feel different,” Palles said, explaining his first recognition of how he felt was around 6-years-old.
When little girls were wearing bikinis, Palles preferred board shorts, often taking off his top when his mother wasn’t looking.
“I knew that it felt comfortable, but at the same time I knew it was shameful. I knew I had to be really quiet about it, and really secretive about it,” Palles said.
Palles went on to live life as he believed he should, making small modifications to his hair or clothing as he became older and more independent.
Then, in 2010 Palles had an epiphany, and he decided he was no longer going to conform to the norm society expected of him. He began embracing the side of himself he always felt more comfortable with. In 2013, Palles decided to come out to friends and family as transgender, and in 2014, he began the process of medically transitioning.
“I helped my family through it in slow steps,” Palles said, understanding the change was going to be difficult for his family and wife to adjust to.
Knowing the change would affect him just as much as it would his family, Palles decided to meet with a therapist, filling his family in on the steps he was about to take, and seeking out a doctor to begin hormone replacement therapy.
It was difficult to find a doctor due to his insurance plan, but eventually Palles found a doctor that was extremely knowledgeable, and made him feel comfortable with the journey he was about to embark on.
“After my first shot I immediately felt an overwhelming sense of calm,” Palles said. “It might have been a placebo effect, I’ll never know, but right away I felt a psychological shift.”
In an informative document given to patients who are about to start hormone replacement therapy, Dimensions Clinic in San Francisco, California, states for those taking testosterone one emotional side effect that can occur is feeling more calm once starting the hormone. Perhaps it wasn’t a placebo effect after all.
But one thing hormones can’t replace are the memories of what was.
“There is a part of you that is gone, and when people mention your old name it feels like a dream. It’s like your former self is dead, and it’s a rebirth of someone new. It’s beautiful, but it’s bitter-sweet to realize you don’t essentially have a history,” Palles said.
And one part of his history that remains in the present is a small letter with a big meaning.
“I have not changed my gender marker, it still says female, and that’s for a few reasons. One, if I get arrested I prefer to go to the female side,” Palles said with a laugh, “and also for insurance reasons.”
And his reason pertaining to insurance is no joke.
The Diagnostic and Statistical Manuel of Mental Disorders (DSM) use to classify Gender Dysphoria as Gender Identity Disorder, a change that was made in 2012. The term “disorder” labeled trans individuals as having a mental illness, where the term “dysphoria” now acknowledges the emotional distress individuals have because they are not connected to their assigned gender.
According to the Association of Gay and Lesbian Psychiatrists, in 1952, homosexuality was viewed as a “sociopathic personality disturbance.” Then, in 1986, the American Psychiatric Association removed homosexuality from the DSM. A revolutionary change forged by psychologists and activists, homosexuality was finally recognized as not being a diagnosis, or a mental illness. The removal was one that reflected social and cultural change, and the understanding that who someone is attracted to is not a reflection of one’s mental stability.
However, one of the major stigmas the trans community is trying to break away from is the same stigma the gay community fought against so many years ago.
“The fact is we’re dealing with a part of our population that people view as sexual deviancy and a mental illness. We are the only thing on the LGBT spectrum that’s considered a mental illness,” Palles said.
So, what does the DSM’s diagnosis and insurance have in common? They both can hinder trans individuals from receiving the proper care they deserve.
“There was a trans man that had cervical cancer and he passed away because he couldn’t get health coverage. The insurance said they wouldn’t cover it because men don’t have ovaries and a cervix,” Palles explained, “that’s the biggest barrier when dealing with healthcare.”
Some argue the diagnosis helps primarily in legal cases, but even that can work for or against the individual depending on the issue that has been brought before the judge.
For many trans individuals, the question of how far are they willing to go with their transition poses even more questions when attempting to get surgeries covered. Palles explains many medical professionals and health care providers don’t see the difference between a trans individual wanting to add or remove body parts from an individual who has Body Integrity Identity Disorder, and desires to remove a healthy limb they don’t feel connected to.
As the transgender community continues to grow, the support of people in and outside of the community is more important than ever. But as Palles explains, “People are afraid of things they don’t know. People like to put things in boxes, and the transgender community explodes that notion.”
However, exploding social norms is the epitome of forging change, and with change comes acceptance and understanding.
And that’s all anyone could ask for.