Not sure if you’re joking or being sarcastic, but here are a few examples where the mere absence / presence of a Y can’t determine sex & gender.
- Sometimes a person has XY chromosomes, but the body developed in a female manner because the fetal cells were resistant to testosterone. Such a person has good claim to being a woman (she developed that way) or a man (he has a Y chromosome; his brain could have been sensitive still to the testosterone to still develop male-coded)
- Sometimes a person has XX chromosomes, but the body developed in a male manner. Usually (though not always) this is caused by part of a Y chromosome ending up on an X. Such a person has good claim to being a man (he developed that way) or a woman (maybe she lacked enough testosterone to male-encode the brain).
- Other conditions such as XXY combinations, or chimeras (some cells XX, some cells XY), or other intersex conditions where some body parts develop male, some female.
To me personally, I view trans people as a type of intersex person. It seems entirely possible that you might have a person whose brain cells were more or less resistant to testosterone and/or exposed to testosterone and truly is a man/woman in a woman’s/man’s body. You don’t need to bring choice or culture into it - I think biology alone provides good evidence to believe trans people about what gender they claim to be.
Short answer to your precise question, for while you’re transitioning to a new treatment:
What triggers for you a strong, negative emotion, every time you’re exposed to it? I knew I was recovering when they stopped hitting the same way. In my case, I was extremely sensitive to my friendships and was ultra-tuned towards any suggestion they were growing distant from me. A late reply to a text (bad), or two friends hanging out without me (devastating) really hurt. I knew something was up once those stopped bothering me so much.
Longer ‘answer’ detailing my whole experience:
Since I was a young child I was always unhappy, worried, etc. Suicidal ideation started in my early teens. In my late 20s, at the start of the pandemic when I was unemployed, living alone, and friends I had made in grad school were all ditching town to quarantine with their families, I was in an emotional crisis and I had real doubts I’d survive. I sought out treatment again (attempts years earlier failed for BS non-medical reasons, not worth getting into). I was initially prescribed with bupropion, which while it tends to be a good first choice for many people, in my case it enhanced my negative emotions. That was very, very bad. I was quickly switched to venlafaxine (FYI while it has terrible side-effects when getting onto it they usually resolve after a couple of months).
Anyway, after a few months of being on it / some dose increases every few weeks from the initial low dose, I started to feel better. I stopped craving the endorphins I’d feel from the extreme emotions of suicidal ideation, and I stopped overreacting to negative events / perceived slights from friends (say friends A & B played golf together and didn’t invite me, even though they know I hate golf and maybe just wanted their own 1:1 hang). This is sounding like “he stopped feeling anything”, but once the stress & anxiety & rehashing of the bad parts of my childhood disappeared, there was finally room for me to become the person I had always wanted to be (goofy, care-free, smiling, relaxed). The depression & anxiety didn’t fade into numbness, it got replaced with happiness. I can honestly say I feel happy a majority of the time and I’m one of the happiest people I know; I recognize bad events but they just don’t affect my baseline all that much. It’s like - if depression is always feeling bad, and while good events momentarily help they don’t last, then I have “anti-depression”. This whole process probably took about a year.
With the supervision of my doctor I am in the process of getting off venlafaxine. There’s nothing wrong with staying on it forever if need be, but some of the newer theories of how these drugs work suggest that your brain grows new neural circuitry as it adapts to the drug, and it’s the new circuitry that actually helps. If that’s true, then once the new circuitry is grown the drug isn’t actually needed anymore. We’ve been slowly decreasing my dose, monitoring my mood, and so far I’m still feeling great. I’m now on the lowest dose, and if things continue as they have then I won’t need a refill in 2 months.
Every time I share my experience I want to clarify a few things: