The intersection of gender and anxiety

Written by Emory Oakley

I was diagnosed with generalized anxiety disorder several years before I began to explore my gender identity but as time passed, and as I began my transition, I realized how interconnected these things are in my life. I am a queer transgender man and I used he/him or they/them pronouns and I think it’s important to talk about mental health.


My Experience with Anxiety

I am anxious about a lot of things but after years of therapy, I’ve developed a number of skills that help me to manage it and most days I feel like I do manage it fairly well. The part of my anxiety I find most challenging to manage is in relationships with other people. Despite my best efforts, I care what people think of me. I think this is a direct result of my desperate need to be liked (who doesn’t want to be liked?).

A few people in my life over the years have said something to the effect of “I like being transgender until I have to interact with other people”. This feels like the most real thing when I think about gender and anxiety.

I spend a not insignificant amount of time worrying about what people think of me and whether or not something I do, or have done, is going to make them change their mind about me. My ‘anxiety brain’ convinces me everyone is going to leave and it’s just a matter of when. So, it feels like I am in a constant state of alert when it comes to my interactions with people and doing the best I can to impress them in order to convince them to stay friends with me. This way of thinking persists even with friends I have had for a number of years and have talked about this exact issue with. Even though they have directly said there is almost nothing I could do to push them away and that they love me, there are times I still have a hard time believing it. I often feel like a burden.  


How Gender Impacts my Anxiety

I have been transitioning for more than four years and have been on testosterone for three. Making the choice to transition has changed my life and I couldn’t be happier but it is a complicated and lengthy process. 

In the years since starting testosterone, my voice has dropped significantly, my shoulders have broadened, I’ve gained muscle and filled out in many ways, my jaw has become more square and overall I do look more masculine. Despite this, and the fact that I often get ‘sir’ or ‘young man’ from strangers, some days I still have a hard time believing that anyone actually sees me as a man. 

When I look in the mirror I can’t help but see the person I used to try so desperately to be. I see every bit of those feminine features and even though I don’t personally dislike them, I feel like they ‘give me away’. I don’t necessarily try to hide the fact that I am transgender but wondering how people see me and considering whether or not they are going to treat me with respect or even common decency makes me very anxious.


How Does This Impact How I Live

When I first started to transition I forced myself to be as masculine as possible. Every time I left the house I thought extensively about what I was going to wear and I always spent a significant amount of time overthinking my behaviour in social situations. I refused to wear anything pink or with floral patterns and to be completely honest I even tried to smile less because I felt like it made me look more feminine. Not only did this take a lot of mental effort but it didn’t feel authentic to me which added to my stress. 

Now that I reflect on my teenage years and early twenties leading into the beginning of my transition, it seems as though it took me so long to come to terms with my gender identity for two reasons. One, I am still mostly attracted to men so for a time I figured I must be a girl (I am technically bisexual). Two, there are feminine parts of my personality that I love. The thing that really made me continue to question my gender was the fact that once I learned more about the LGBTQ+ community and had a number of queer friends, I felt like I was really gay. And since I was more attracted to men than women I was confused. But then it clicked. 

I am a feminine gay boy. You know those boys you see out at pride in crop tops and short shorts and covered in glitter? That’s the kind of boy I want to be. Of course not every day, but I sure do love crop tops. Unfortunately, I don’t have as much freedom to dress the way I want to because I worry that rather than making me look like a cute gay boy, some clothing just makes me look like a girl. In reality this is the case, I am far more likely to be misgendered when I do go out in a crop top or put on a bit of eyeliner. Do I still do it? Yes! But I have to be in the right place mentally and emotionally knowing that I am likely to get misgendered. 

So, even though I know who I am and I am comfortable in my body, I still have a significant amount of anxiety when it comes to interacting with people in public because of my gender identity. 


How Can We Make the World Better

As I write this and reflect on what this story means to those reading I would say it comes down to this. 

Our mental health is often tied to our outward appearance in more ways that we think and those who are anxious or sensitive can be greatly impacted by the views of those around them. So, take a moment to consider how your actions can influence those around you. When it comes to gender this could mean working toward a practice of not assuming anyone’s gender. This also means not assuming that any clothing is gendered. 


Image credit: Gerd Altmann


Emory Oakley is a writer and LGBTQ+ educator who regularly discusses the intersections of queer identities and mental health. Emory is committed to education through his work and wants to help end the stigma of mental health. Check out his website or follow him on social media

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