First of all, in a sense it shouldn't matter how we got here. If it did matter, it would provide an excuse for sorting the sheep from the goats, in other words deciding there are first- and second-class trans citizens, which is not fair. People are already outsiders and creating another outsider group outside the outsiders is not on. Also, although there are things to consider regarding causes, that way lies madness. The phenomenology of the condition is the real point for me, and this is just about me, although I'm pretty sure it reflects at least some others' experiences.
I am very much at peace with the realisation that other people really don't understand. So much so that I find that very peace remarkable. Nonetheless, they don't, and maybe an explanation is neither necessary nor possible. However, I do feel moved to comment on a recent conversation which seemed quite similar to some others I've had.
I could be seen as simply a person who wants to have less persistent body and facial hair, larger breasts and different genitals and generative system, and of course I am that, and it's true that they represent something I dislike personally about myself. It would also be entirely OK for someone with those issues to seek to change those physical features about themselves. Clearly this goes beyond physical features too and someone might want to alter their psychological outlook and the way they're perceived and relate to and are related to by other people. This is not the point though.
This can be illustrated by the discussion I had last night. Someone asked me why I wanted my penis removed. I found this question interesting for a number of reasons. Firstly, that's not what would happen. In fact the glans would be left and most of the erectile tissue removed before the sheath would be everted. I very much doubt this will ever happen to mine incidentally, for several reasons. Secondly, the desirability or otherwise of that modification is not the main point. It's a symbolic act which, among other things, gives a surprisingly unappreciated ironic finger to rape culture, and I've wanted that to happen for a very long time but that wasn't the catastrophe.
More important are the "two veg" - the gonads. Now, I cannot possibly say that organs essential to the existence of the two wonderful human beings which have dominated my life for the past two decades are entirely benighted, but once they'd fulfilled that function, they could have been said to be living on borrowed time. It also has to be said that the whole assemblage is important for another person and that is of course a major consideration. However, the gonads are constantly producing androgens, and it's the androgens along with their insufficient oestrogen production which was responsible for making me ill in the first place. When part of your body produces hormones inappropriately, it usually needs to be addressed, and the approach can be physical rather than pharmacological.
The fact is that before I unknowingly started taking oestrogenics, something was clearly making me - well, you know the familiar list but here it is anyway - depressive, irritable, anxious, phobic, obsessive-compulsive and the like - and I had never imagined that that could be alleviated by a combination of boosting the oestrogen and lowering the androgens, but that is what happened.
So my situation is not that of someone who simply wants the offending features of my body to be modified. It's that of someone whose current hormonal environment, left untreated, would give me a series of mental health problems through a physical aetiology with no psychosomatic or placebo effects, and who would therefore benefit directly from the removal of the organs making the biggest contribution to the askew hormonal environment. Moreover, the shift in my opinion is based exactly on that realisation. This is a physical condition, validated by that experience. Mad it may be, but this madness is not just a psychological process.