Being diagnosed with Type 1 diabetes at 3 years old meant I never knew a life without the disease. I thought my experience was universal until one day in the third grade. As my best friend and I ran laps during recess, I was stunned by her effortless endurance. When I asked her how she could get past the trembling and cold sweats, she gave me a weird look and said, “I think that’s just you.” I was floored.
It had never occurred to me that hypoglycemia wasn’t something that everyone experienced and, by extension, that some things were more difficult for me because of my chronic illness. My newfound awareness made me wonder what else made me different from everyone else.
As I went through elementary school, my able-bodied classmates began expressing how much it must suck to be me, saying things like, “I would rather die than take shots every day,” and, “I would kill myself if I had to take insulin.” I never knew how to react, so I stopped bringing up my diabetes. I hid my daily visits to the school nurse’s office to complete my insulin injections and, by middle school, if my insulin pump’s alarm blared, I blamed it on my phone.
I took refuge in the school nurse’s office. I felt taken care of by nurses and, unlike the rest of the school, no one asked me intrusive questions about my condition. Behind the privacy curtain, I could pretend that my diabetes only existed in the space of a medical setting.
But it wasn’t just my diabetes that made me feel different. In 5th grade, I started developing crushes on my female friends. I forced myself to ignore my feelings even though hiding them was painful. “It’s not right,” I would tell myself, which really meant, “It’s not the way anybody around me is.”
Then, right on the cusp of puberty, I realized I was nonbinary. On top of watching my classmates breeze through activities that were trying to me because of my diabetes, now I watched my male peers grow taller and heard their voices drop, all while I went through an estrogen-induced puberty, instead.
I felt out of place, as if I were in between the girls and guys around me, just enough of one to not be the other. As bitter and isolated as I felt, I was so afraid of bringing negative attention to myself that I bottled up my feelings.
Accumulation of Angst
I did confide in a few friends that I was queer and nonbinary, but I wasn’t ready to come out at school because I didn’t feel welcome. However, my friends let others in on the secret and, gradually, more of my classmates found out. I knew my friends were just trying to prevent me from being misgendered, but I had hated how people reacted to learning about my diabetes—their pouting look of pity when they pointed out my insulin pump or blood glucose monitor made me feel humiliated—and now I grew to hate how they reacted to my queerness. Whenever I was outed, the reaction was the same scrunched eyebrows, the same sorry expression.
While I didn’t feel welcome at school, I did confide in a few friends that I was queer and nonbinary. Gradually, some of them let others in on the secret. I knew my friends were just trying to prevent me from being misgendered, but I wasn’t ready to come out at school because I didn’t feel welcome.
On top of the confusion of exploring my gender and sexual identities on my own, I felt isolated and overwhelmed by the physical and emotional demands of keeping my diabetes under control.
Diabetes care is a lot less cut and dried than some doctors try to make it seem; not only do I have to calculate my insulin doses at mealtimes up to four times a day, I also need to correct my blood sugar whenever it falls outside of a certain range. Combine that with the hormonal disaster known as puberty and I was scrambling to keep my blood sugar in range. At times, it felt like I could barely keep it together. It wasn’t uncommon for me to feel borderline feverish when my blood sugar would spike, or break out in a cold sweat when it would drop.
A Consummate Image of Strength
By high school, I asked my parents about therapy. They refused, saying that independently taking care of my diabetes made me strong enough to get through my burnout on my own, no psychotherapy needed. If they were so sure, I thought, then why couldn’t I handle it? Instead of reaffirming my mental strength, their words only taught me that weaker people went to therapy, and I must be weak for wanting to pursue it, too.
At a routine appointment during my junior year of high school, my endocrinologist casually asked me how I was feeling. Immediately, my eyes welled up and I shrugged, casting my gaze to the floor. I had always made an effort to be upbeat during our appointments, but this time I couldn’t.
It wasn’t just my diabetes weighing on my mind. For weeks, every morning I rolled over in bed and cried over how feminine my body looked. I couldn’t pin down why that was, but I knew that it had something to do with my identity shifting from nonbinary to something more masculine. Every minute I spent in a body that didn’t reflect how I identified was excruciating.
Seeing my tears, my doctor offered to bring in the clinic’s on-staff social worker, assuring me that this visit wouldn’t be reported back to my dad, who stayed in the waiting room.
I was relieved that my parents didn’t have to know that I went behind their back for help. Still, humiliation coiled in my stomach. I wasn’t upholding the consummate image of strength expected of me as a survivor. Instead, I felt beaten down and like I wanted to give up. I didn’t want to be seen like this by anybody. What if they decided I was a fraud?
Dealing in Fantasy
When the clinic social worker arrived, I fielded her matter-of-fact questions: “What’s wrong? Why do you feel that way? Do you have any support?” Feeling taken off guard and unprepared, I simply answered, “I don’t know.”
Even so, her questions helped me start to internally process and come to terms with my feelings, confirming for me that counseling was the right course of action.
I realized that I was longing for an easier life where I didn’t have to worry about hiding parts of myself. I often felt like I was in a dream, and that one day I would wake up and live a normal life where no one would blink twice when I injected my insulin, or maybe I wouldn’t take insulin at all. Maybe my pancreas would do the work it was supposed to.
I could date whoever I wanted, and there would be no hang-ups about what I was. Even better, maybe I would go through the right puberty, the one with testosterone. I would be taller than my younger brother and have the same strong build as my father.
I realized that I was upset that my body wasn’t doing what I wanted, which was for it to produce the hormones I needed to feel happy and healthy.
Counseling on My Own Terms
After the endocrinology appointment, I mustered the courage to email my local queer youth center and requested to speak with the social work intern. I had recently stumbled upon the center while on a walk in my neighborhood and learned that they offered free counseling.
In our very first appointment, my counselor Sarah established that she was an expert in what is called “queer-informed counseling,” meaning that she predominantly worked with queer youth. I was ecstatic.
Vitally, the counseling space was private. A long, white curtain separated it from the rest of the center and white noise played to keep others from hearing our conversations. A black office chair was parked by her desk along with a smaller chair that was designated for me. During our afternoon sessions, sunlight crept in through the window to the right of Sarah’s desk. I felt welcome, despite my anxieties about opening up.
During our first full session, I tried to keep myself from choking up as I confided in her about how I was less of an “in-betweener” than I had thought. Being neither male nor female wasn’t an adequate descriptor for me anymore. I’d begun considering hormonal transition, and it scared me how appealing it was. My desire to be more outwardly masculine represented a huge turn away from how I had thought of myself.
“I don’t know what to think looking back now,” I confessed. “I had an understanding of myself that isn’t true anymore but I really believed it.”
It was my way of telling her that I felt like a fraud again.
At this, Sarah tilted her head back and looked like she was thinking it over. The room suddenly felt a lot smaller, as if the air had gone still. What if she dismissed my fears?
“Maybe it’s not completely different… maybe it’s a reframing of yourself in a new way,” she pondered. Mulling it over, I pictured a video turning 180 degrees.
“Yeah, that feels right,” I responded. It was like flipping on a switch in my head; there was a new light to see myself in.
I had always felt strong in my identity as “definitely not a woman” and nonbinary, but another label fit better now: transmasculine. I felt my best in my Mary Janes, with my long bob and wearing a men’s flannel. Maybe that’s who I’d be: a mix of whatever elements of masculinity and femininity I liked best. The more I thought about it, the better it seemed. I wasn’t a fraud for not conforming to other people’s expectations. I was my own person.
Calm After the Storm
The walk home after this conversation was oddly calm. Instead of fending off tears and anxiety and fantasizing about being someone else, I pictured myself as I was. From a bird’s eye view, I watched myself walk down the street with sunshine washing over me, a sense of hope blooming with every step I took.
There was more to me than the pain I was feeling over the past few months. The future was as bright as the sun.
The more I attended counseling, the more expansive the world around me became. Depression had forced tunnel vision onto me; I was so convinced that I was on my own that I had inadvertently blocked out everything else. In the center, I realized that there were people like me: youth who were figuring themselves out and needed a safe space to help them. I was both stunned and reassured.
At Sarah’s encouragement, I decided to open up to my friends about my diabetes, offhandedly mentioning how crappy I felt because my blood sugar would keep me up all night or that I would be missing school because of an upcoming doctor’s appointment. My friends opened up to me in return, and I learned that I wasn’t the only one with a hormonal disorder, and I certainly wasn’t the only one that was on lifelong treatment.
After years of hiding, opening up about my chronic illness was hard. Looking back, I think it was the experience of being “found out” that had bothered me the most. I wasn’t able to control what people found out about me and couldn’t brace myself for the inevitable confrontation. So, I decided to start telling people on my own terms.
Inspired by c-punk trends, I began to paint my insulin pump in bold colors and dotted designs. Although I’m not a creative person, compliments on my painted pumps eased the all-too-familiar feeling of humiliation. Inadvertently, painting my pump helped me become accustomed to it.
Opening up about my diabetes also helped me to be more open about my gender identity. I started coming out to groups of friends and classmates with a quick, “I prefer he/they pronouns.” The more I did it, the better I began to feel about myself. After hiding for so long, I wanted to take up space.
There are still moments where I struggle to be vulnerable when it comes to my diabetes and identity. It’s not uncommon for me to feel burned out or emotionally drained after correcting people on my pronouns or scrambling to keep my blood sugar in range. But what’s most important to me is the emotional growth that I’ve undergone by opening up. Telling people about my identity feels like taking back some of my power.