It is sort of impossible to talk about “regret” because it means too many different things. We are not good at differentiating between “I regret that this happened, because the circumstances were unfair and beyond my control,” vs “I regret that I made that choice, because a different choice probably would have turned out better,” vs “I regret that I did this, because my actions did not align with my conscience.” Whether regret comes from guilt, injustice, or ignorance, it all gets slushed into the same pile of “things that I wish had not happened,” where we load it down with the hope/hubris that we can avoid our problems in the future if only we ~make better choices.~
I think this concept of “regret” is sort of mucking up everyone’s ability to accurately judge what exactly we are responsible for, what we are capable of, and how we ought to feel about our limitations— specifically when it comes to deciding to medically transition, but also in the general landscape of life.
Unfortunately, I have some kind of sickness that makes me want to try and write things that feel impossible, so here we go again!!
My boyfriend and I recently went back to KC for a wedding, and of course, Kansas people like to ask me about my tattoos. I hear a lot from people in their 50s, here, going oh, I’ve thought about getting a couple of tattoos but I’ve never gone through with it, because I just don’t know if I’d regret it.
Which is fair, y’know— getting a tattoo carries a lot of uncertainty. The marks you make will take time to settle in. What looked fine in the tattooist’s mirror might look too big or too small or awkwardly-placed once you’re wearing a different outfit. Parts will fade, edges will blur, because even a very skilled and experienced tattooist can only do so much to mitigate the reality that skin is a liquid. You have no choice but to trust in the process, which a lot of people find so daunting that they’d just rather not.
When people tell me about their fear of tattoo regret, I like to show them my ugliest tattoo— a matchbox with a cupid baby on it, the match-heads shaped like little hearts. It looks bad for the exact same reasons I got it in the first place: it was tattooed by an inexperienced, self-taught artist doing scratchers out of their apartment. I knew this about them and asked them to ink me anyway, because I wanted to support them. I was an excuse to give them money, and also contribute in some small way to their skill-building. And, y’know, I wanted more tattoos, because tattoos are cool.
That’s not even my only “ugly” or “amateur” tattoo. I’m slowly building a ring of antique keys around my bicep, tattooed exclusively by apprentices, people I want to remember as fellow travelers. The circumstances that put these images on my body— the people who put them there and the people I was when I got them— are just more important to me than the way they look. Every tattoo is, if nothing else, a memorial to the moment of its own creation.
It’s very cute and sexy of me to be all sentimental and que sera sera about it like that, I know, but some people do get tattoos without even imagining the possibility that they won’t like it someday, and they wind up feeling all tacky and regretful about it.1 But ultimately, “protecting clients from regret” is just not part of the tattooist’s job description. A tattooist’s job is to tattoo.
THE TRUST FALL
Tattoos and gender transition elicit a lot of similar anxieties about regret. What if hormones don’t do what I want, or worse, do things I don’t like? What if I change my mind? What if I wind up worse instead of better? How will I ever get a job, and what will my family think, and what the fuck am I going to look like when I’m old!!?!?
In the year before I started testosterone, I was very concerned with these things. I was worried about whether I would hate having a beard or a fuzzy chest (i don’t) or if it would ruin my soprano singing voice (it did) or if “straight” men would keep finding me attractive (data inconclusive due to unclear parameters and small sample size). I had no idea ahead of time if HRT was “right for me,” or if my parents would be so angry with me that they would stop paying my tuition, or if anyone would ever love me again.
The trans people I “knew”— a handful of other twenty-somethings I’d met in my first two years of college, some YouTubers documenting their transitions, and many bloggers who treated Tumblr like a public diary— were very clear to me that they could make no promises. Hormones can only do what hormones do; “fixing you” is not on the list of side-effects. Even if we had fantastically well-documented research on what testosterone does (we don’t), it’s effectively impossible to know what it will do to you. Whether you’ll look like a beautiful anime twink or your uncle as a gay lumberjack is mostly determined by your genetics, whether you’ll like it in the long run is determined by your psychology and your circumstances, all of which you have very little control over.
With all of this uncertainty, they said, transitioning is a trust fall. It is a contract with your future self, asking whoever you might become in 2 or 10 or 50 years that they will not begrudge you for the decisions you made for them. I really only had two choices: face the “regret” of trying HRT and then stopping because I didn’t like it much, or the regret of hitting 40 and wondering what could have been hiding behind the door I had left unopened all these years. I decided that I would rather find out what fear would otherwise have robbed from me, for better or worse, and if it sucked, I would figure it out from there.
SAINT UNCERTAIN
Bully for me, taking testosterone wound up being one of the best decisions I have ever made for myself. In some ways, I feel luckier than a lottery winner that I made a long-term choice that would alter the rest of my life with so little certainty or control, and I have been so utterly satisfied by it. But I don’t think this is down to luck so much as its a credit to the philosophy that I soaked up from other trans people. In guiding me through my early transition, they impressed on me a broader wisdom about living in the world:
Life is filled with uncertainty. Part of making choices that are reasoned and informed is in the acceptance that there are some things we cannot know or predict. No matter how careful we are or how many acorns we stash away, there is a hard limit to how much control we can exert over the future. Most often, the choices we make do not save us from pain so much as they allow us to prioritize which problems we would prefer to face. When we ask ourselves, should I admit my crush or try to preserve the friendship? should I take this job or look for something better? where should I go to school, and what should I study? would i be safer if i leave the country? is now the right time to have children? etc, this is what we are doing— solving some hardships while creating new ones, and just crossing our fingers that we’ll be in the black once it’s all added up.
When making these uncertain choices, your job on this earth is to cultivate yourself as a person, not as a commodity. You are not here to optimize your existence or maximize your stats, but to pursue the experiences you want to have. This is the difference between people who exercise or play videogames because they want to cultivate endurance and skill, vs people who think that making a number go up will validate their worth as a human being. Ambition requires the risk of disappointment, but it is the experience of pursuing it that enriches you, not the heuristics we use to measure progress or an outcome you may never achieve.
So if our experiences aggregate to create the person that we are, and our choices are what determine our experiences, every choice is permanent, including doing nothing. Though you can decide to live differently every minute from now on, you cannot roll back the clock to erase the personal history which created the you that is here right now. And that you— the one that actually exists, not the fantasy ideal of who you could have been or might yet become— is already inherently valuable because it is the one that really exists. Even if the experiences that made you who you are were painful or unfortunate, even if you don’t even like the person that came out of them.

I don’t know if I’m doing a good job describing this worldview. It’s full of paradoxes— informed consent by accepting what we do not know, exerting control by relinquishing it, doing nothing as an active choice, condemning the unfairness of circumstances while still valuing the person that has resulted from them. It feels like it gets less clear the more I try to explain it.
But this is effectively the advice you would get from a therapist teaching “radical acceptance,” from trans people coaching one another through uncertain transition, and from regretful detransitioners. In certain parts of detrans reddit, you’ll find people advising one another to not “abandon their past selves” who were just doing their genuine best, and to not judge their current-day selves in comparison to an imagined ideal that could only have existed if everything had worked out perfectly (which of course, nothing ever does). There’s a a lovely sort of wisdom about regret shared between people thinking about transitioning and people who wish they hadn’t— in this light, regret becomes an impossibility, without losing our ability to self-improve, seek justice for past mistreatment, or avoid repeating past mistakes.
Maybe it would be easier to just say that choosing your path in life is like Everything Everywhere All At Once— maybe, in a different universe not too far from this one, you could have spent your later years in a beautiful and passionate lesbian marriage, sure, but also you would have weird hotdog fingers, so all told it’s sort of a net neutral. Maybe I will show uncertain trans people that Romano Tours sketch from SNL, where Adam Sandler disclaims that you will still be you on vacation— he can take you on a beautiful hike, but he cannot turn you into the kind of person who likes hiking. Maybe we have to handle our aspirational plan-making like that episode of Community about the giant hand, with a little of Socrates’ all I know is that I know nothing and a little of Doris Day’s whatever will be, will be.
CHAOS & CONTROL
This worldview is apparently something that conservatives consider not only completely unhinged, but dangerous to advise. (This is the part where I switch to talking about politics— if you don’t want to think about anti-trans conservatives, this is a good point to stop reading.)
It does not surprise me that there has been a wave of anti-trans lawmaking during a time when our culture is obsessed with wellness and optimizing. We track calories, moods, periods, miles walked, pounds lifted and blood sugar and heartbeats as if knowing as much as possible about ourselves will necessarily give us greater control over what happens to us. We judge the worth of a person on the heuristics of their progress— their resume, their weight, their high score, their follower count— rather than the experiences and proclivities those heuristics represent, and regardless of what we express about living through them. It is as if we believe that everything will be alright, as long as I make all the right decisions. If I fill up my calendar, keep a tight budget, eat only the right things, live and work and walk and fuck as much as possible, in the right place, in the right way, I will have stats that prove I have lived a good life.
And like, I don’t know, man, this seems like a recipe for neurosis and dissatisfaction. It is an attempt to foreclose regret by simply never doing anything that might lead to risk— including “doing nothing” by not ____maxxing every facet of our lives. It seems like an excellent way to feel like anything bad that happens to you is either your own fault for not trying harder, or the fault of some conniving enemy. It is no surprise that conservatives terrified of chaos would obsess over trying to mitigate it through control.
So this is how you get women like Abigail Shrier working from a patriarchal playbook: claiming that others— particularly children and “female” people like me— are too incompetent to be responsible for their own agency. You also get people like Chloe Cole, a 20-year-old detransitioner who testified before Congress that no child should ever be allowed to make the choices she regrets, because the holy spirit came to her during an LSD trip and told her she wasn’t a real boy. Wyoming’s law banning gender-affirming care for minors is named after her.
You also get trans advocates and clinicians who think of medical intervention not as a choice, but as a cure for what ails you, the sort that is poisonous when applied to a healthy body. We know that at least some people transition as a necessity for their wellbeing— a tiny handful of people who fit neatly and honestly into the medical model of transsexualism— but we still struggle to imagine any other legitimate justification for transition. When talking about trans identity, we act like we can protect ourselves by constantly evoking a True Self that must be rescued, as if such a thing really exists.2
It certainly doesn’t help that surgeries are prohibitively expensive, and proving medical necessity to an insurance company is effectively the only way to pay for it.3 In the capitalist model of medicine, honesty about uncertainty or complexity will always be luxuries reserved for the wealthy. In the politics of control, it fully just doesn’t matter how certain you feel if you are simply the wrong type of person.
Even those who think of themselves as “moderate” somehow take it for granted that it is a doctor’s job to not only know what hormones do, or how to avoid complications from surgery— and also explain these things in spite of dubious/absent evidence, to people who don’t really trust them— but also to make sure that you’re sure that you want what you want, and stop you from doing anything you might regret. This is a lot like asking a tattooist to judge the quality of a client’s relationship with his girlfriend before tattooing her name on his bicep. It is demanding a physician do the meaning-making work that only philosophers, artists, and communities are really equipped to do.
This is getting long, so Part 2 coming whenever I have time. !!Stay tuned for more!! on patriarchal politics of control, the conservative obsession with children, and the valuable advice of mystics and crazy people. Eventually.
Further reading:
Andrea Long Chu, My New Vagina Won’t Make Me Happy, NYT 2018. Around the same time that the NYT was getting roasted for platforming Jesse Singal’s “just asking questions” bullshit, a bunch of my trans friends took to twitter to chastise ALC for letting cis people in on the open secret that most of us don’t think of transition healthcare as a “cure” for anything. They weren’t mad at her because she wasn’t telling the truth, but rather because they thought the NYT was an inappropriate venue for the kind of honesty that cis people can’t handle. Her point was to say that our agency should be cherished and protected for its own sake, even if the choices we make do not meet some measure of ~improving our lives.~
Jules Gill-Peterson, Histories of the Transgender Child, 2018. Gill-Peterson is one of the only people I have ever seen staking their writing career on writing about trans healthcare as an issue of recognizing that children are more competent than we give them credit for, to the point that she lightly accuses Judith Butler of hand-wringing.
Leslie Feinberg, Stone Butch Blues, 1993 (link to free PDF). People love and hate this book for a lot of reasons, but the big thing I took away from it is that people transition for all kinds of reasons besides “being trapped in the wrong body,” and you can’t realistically stop those of us who would eagerly choose agency and risk over comfort or security. RIP Leslie.
Erin’s Informed Consent Map, an updating list of healthcare providors who offer HRT on an informed consent basis, & DIYHRT.wiki for avoiding doctors entirely.
Simone Weil, The Need For Roots, 1949/52. Read it! I am no longer asking!!!
I mean, it’s hard for me to envision this actually happening, considering that “but what will it look like when you’re old?” is perhaps the single most common statement ever spoken about tattoos, but I suppose anything can happen.
I don’t know how to tell these people that sometimes butch lesbians get top surgery and remain steadfastly women, or that not every femme queen on E at the local drag bar is a trans woman, or any of the other thousand complex realities you encounter if you actually hang out with trans people outside of a doctor’s office oh my god.
Right now, hormones are extremely easy to obtain through Planned Parenthood, who operate entirely on an informed consent basis. Who knows how much longer this will last, because guess who’s getting defunded if GOP’s “big beautiful bill” passes. Fucking hell, man.
Another banger. Can't wait for Part 2!
I think blame is a lot more toxic to bystanders than regret. I see that as the binary, that you can focus on preventing blame or focus on preventing regret, but you can't do both. I am the child of someone who had a lot of blame toward others for restricting his path in life in various ways. I would much rather be the child of someone who made a decision to pursue gender transition that they later regretted than be the child of someone who blames the authorities for stopping them from pursuing their interest in gender transition.