TransLater

There are so many book recommendations, lol - just let me know if you want a list.

I wouldn't say suicidal ideation is the same as self-harm, and that was meant to just be one example of harm that comes from not transitioning - dissociation, depression & anhedonia, anxiety, drug abuse & other addictions are all examples of other harms that are commonly found in trans populations and which improve with gender-affirming care:

https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

I had no idea that I was depressed, anxious, or suicidal until I started HRT. Within a month or so I was having what felt like randomly happy moments throughout my day, and I noticed I no longer felt like it would be objectively better if I were dead. It turns out I had been passively suicidal since I was 13, and this was the first time since then that I had genuinely (irrationally!) felt happy to be alive - even when engaging in otherwise stressful events, like running errands. It is a bizarre experience.

All this to say, I completely understand if the benefits of HRT seem theoretical or unlikely, or that you don't really struggle that much or that it's not that important (and certainly not that important relative to your marriage and family, etc.).

I'm not sure there is much I could have said to myself pre-transition that would have made me take this seriously, and I had no kids and a spouse that wanted me to transition (because she wanted what was best for me). I felt transitioning was selfish and irresponsible, and I worried it would disrupt relationships with my in-laws. And it did! But looking back it seems absurd to me that I dismissed transitioning because of them (even knowing now that my fears came true and I lost those important relationships). I mostly feel immense grief and regret at having not transitioned a decade ago, of having dismissed my dysphoria as just a likely fetish or clothing preference (and not seeing or understanding it was much more than that).

I do think I want to begin HRT, but I also don’t want to just charge ahead in without her. I understand what you’re saying about not letting her hold me back for my own sanity and health, but I think I’m going to need to find the balance between keeping her trust and doing what I need to do for me.

Definitely need to find a balance (it would be worrying if you didn't care about your wife's needs), but that balance probably also shouldn't be not taking HRT because your wife is afraid of you becoming a woman.

This is part of why a couples counselor might be helpful, to mediate those conversations and ensure some fairness and proper perspective.

There is a lot working against you as a trans person. People don't understand trans folks, we are not well-liked and we are vilified as a political scapegoat. There is immense pressure against us socially, and this means it is hard to stay grounded in reality and what is evidenced. So from my perspective it's important to compensate for that anti-trans bias by being clear-sighted about the clinical significance of transition and its medical necessity, mostly because I know most trans people drag their feet to please others.

I have endless stories of people who don't transition or who delay or slow their transition for some reason or another, and the reasons are rarely legitimate and are often based on misinformation, anti-trans bias, or simply another person's preferences. For example, one trans woman I know can't get bottom surgery despite her dysphoria because her wife wants to continue having penetrative sex. Even more of us just never even consider social or medical transition because of what it would mean for our relationships.

So, I get it - it's hard, but it's also important, so working on finding a way forward is important.

I also fear what impact coming out more broadly might have on our son, especially at his age, and remembering how miserable middle school could be.

In the past people have pointed out that by not transitioning you also communicate something to your kid about what is or isn't acceptable, that it provides a poor role model and message. I understand the concern, though - I just think if you're like the rest of us, you're likely to be a much better human and thus a much better parent if you transition. Those are the clinical facts.