[Feel free to submit a question for this column, addressing it at massimo at howtobeastoic dot org. However, please consider that the column has become very popular and there is a backlog, it may take me some time to get to your question.]
G. writes: I have been suffering from obsessive-compulsive disorder for a long time (since I was 12-13, or so; I’m 23 now). The topics of my obsessive thoughts changed over time, but for the last two years, I’ve been dealing with the most challenging one. Suddenly I started to be afraid of the fact that I might not be comfortable with my gender. I’m a biological man, and I really never had any problem with that. In fact, I went through puberty without feeling distressed because of the changes in my body. I was fine with that. But since this obsession came in, I’ve been reconsidering my whole life, trying to find any clue in my past that can give me an answer to the question “Am I transgender or not?” I am analyzing many facts of my early childhood and adolescence, trying to find the answer. It’s torturing me. I barely can sleep, feel an incredible amount of anxiety and feel extremely depressed sometimes.
I think recently I realized that I never actually felt the urge to change my body at all, and that gave me a little peace of mind. However, I feel mentally or intellectually more similar to women, I guess (a fact I really can’t confirm since I can’t be inside a woman’s head) and it’s really confusing me. There are times when I somehow want to be a woman, not because of the physical part, but in order to be more in accordance with my mind, so to speak. I’m not sure of this, though, because I never felt that need. I was fine with how my body and my mind are. Further, I really don’t imagine myself transitioning from man to woman, I don’t want that in my life, actually. It’s more like sometimes I wish I could’ve been born female to be more at peace with myself. I tell you that because, from a Stoic point of view, the gender assigned at birth is obviously out of our control. The only option we have to change that is transitioning, through taking hormones and all that. But it’s really not what I want at all.
Actually, the nature vs nurture debate about gender is far from being settled, in part because we can’t (for ethical and logistical reasons) do the kind of experiments that would be necessary to settle it. (Here it’s the biologist in me talking, since gene-environment interactions is my field of research.) Consider that many transgender people describe their situation before transitioning as “being trapped in the wrong body,” which sounds like a strong endorsement of the idea that a biological component is affecting their gender. By contrast, a number of radical feminists vehemently reject that implication, because they subscribe to an equally strong notion of cultural construction of gender. (I would add a note of caution to the effect of keeping in mind the distinction among sex, gender, and sexual orientation, just not to further increase the level of confusion. Here is a good introduction.)
Luckily, from a Stoic point of view, we don’t need to settle that particular matter. Your situation, insofar as gender is concerned, seems to me to be fairly clear: you state explicitly that you do not want to transition, even though you imagine yourself being more at peace had you been born female.
Well, the way you were a born is clearly not under your control, so there is nothing to do there. Decide whether to transition (depending on the availability of medical and financial resources), by contrast, is something that is under your control, but, again, you stated clearly that you don’t want to do it. The upshot, then, is that you will remain a man, biologically and gender-wise. Internalizing this ought to give you some piece of mind.
Nevertheless, you are not happy with your situation, obsessing, as you put it, on alternative scenarios that you manifestly do not want to actually explore. Part of the problem, therefore, seems to lie into your inability to accept and thrive under your current predicament. Marcus has something to say about that:
“Such as are your habitual thoughts, such also will be the character of your mind; for the soul is dyed by the thoughts. Dye it then with a continuous series of such thoughts as these: for instance, that where a man can live, there he can also live well.” (Meditations V.16)
Or consider Seneca: “Why do you wonder that globe-trotting does not help you, seeing that you always take yourself with you? The reason which set you wandering is ever at your heels.” (Letter XXVIII. On Travel as a Cure for Discontent, 2)
While both Marcus and Seneca are talking about physical places where one lives or travels, I think the same applies to mental states. You wish you were a woman “not because of the physical part, but in order to be more in accordance with my mind.” Okay, but nothing is getting in the way of that, other then the fashion in which you “dye your thoughts,” so to speak. If you are good with the physical part of being a man, ask yourself what it is that you’d rather change, exactly: would you feel more comfortable dressing like a woman? Then do it. Yes, I know, there can be social consequences, but less so these days, at least in many Western countries; and at any rate, what other people think is outside of your control, and their opinions do not matter unless they are wise ones. Or perhaps you feel physical attraction for other men? You don’t mention anything about sexual preferences, but, again, if that’s the issue, then go for it, regardless of what others may think of your choice. Or, finally, it is simply a matter of thinking and feeling the way you imagine a woman would think and feel. But as you admitted, you don’t actually know what that is like, which means you should think and feel exactly the way you want to think and feel, without attaching a label (“manly!,” “womanly!”) to it. What good does that label do?
I suspect, though, that the real issue is the one you mention at the beginning of your letter: a tendency for obsessive compulsive thoughts. I surmise that you have actually been diagnosed with this, that it’s not just your way to describe the way you feel. You also say, interestingly, that the object of your obsession-compulsion changes over time. So one may reasonably infer that the man vs woman issue is actually just a temporary manifestation of your disorder, because you always need something to be obsessing about. It just happens to be gender at this particular moment.
Stoicism, of course, is a philosophy of life, not a therapy. But there are therapeutical approaches out there that are inspired or informed by Stoicism, particularly rational emotive behavior therapy and the family of cognitive behavioral therapies. So why not seek a professional who works within these frameworks (as opposed to, say, a Freudian psychoanalyst), and see what she advises you to do about it?
Obviously, you should not feel like a failure just because you have a medical condition, of course. As Seneca puts it: “You must not think that our human virtue transcends nature; the wise man will tremble, will feel pain, will turn pale, for all these are sensations of the body.” (LXXI. On the Supreme Good, 29)
The same goes for you: although you are a prokopton, i.e., you are striving to make progress with the theory and practice of Stoicism, you don’t have control over something like obsessive-compulsive disorder.
Consider Epictetus: “Impressions (which philosophers call), striking a person’s mind as soon as he perceives something within range of his senses, are not voluntary or subject to his will, they impose themselves on people’s attention almost with a will of their own. But the act of assent (which they call) which endorses these impressions is voluntary and a function of the human will.” (Fragments 9)
In your case the impression is the result of internal, rather than external, perception, but it amounts to the same thing.
You can, however, make the decision to seek professional help, in the meantime trying to calmly and rationally interrogate your own sensations, like Epictetus invites us to do:
“So make a practice at once of saying to every strong impression: ‘An impression is all you are, not the source of the impression.’ Then test and assess it with your criteria, but one primarily: ask, ‘Is this something that is, or is not, in my control?’” (Enchiridion 1.5)
Therapy, if successful, will bring your mind back to a level of more or less normal functionality. Philosophy will pick things up from there, guiding you through life in a way that increases your chances of living eudaimonically.