Transition is hard enough as it is. Being an addict in recovery can make it both more difficult and more beautiful.

I didn’t get sober until I was 34 years old. I wish I had found the path sooner, but I am grateful that I found it at all. I didn’t begin hormone replacement therapy (HRT) until I was 39.

I also wish that I had come out younger. I didn’t grapple with my sexual orientation or my gender identity until my late twenties.

When I initially came out, it was as a gay male. This was before I got sober, and just after my mum died. I had never felt fully safe accepting who I was while she was alive, but that’s another story.

Only once I was sober for a couple of years did I finally realize that both my gay and my male identity didn’t fit. They never had. However, layers of cocaine, meth and alcohol had spun me into an identity rollercoaster moving with such speed and reckless abandon, that I accepted them without question. I chalked my doubts up to internalized homophobia - i.e. I just assumed I didn’t like myself because of society’s anti-gay/gay-marginalizing messaging.

When I discovered I was trans, and when everything made sense, I realized how glad I was that I had already been sober for a couple of years before I started contemplating the litany of changes and challenges ahead of me. What follows is a list of things I would want every trans person who is getting sober to know.

Coming Out As Trans

During the pandemic, in 2020, I discovered my trans-ness. By then I had been sober for almost two years.

Like many other trans folx’ stories I can pick from the shelf of childhood experiences which pointed to a girl living in a boy’s body. I ignored them. I look forward to delving into those experiences elsewhere, but that’s not what we’re here for today.

I was lucky and privileged enough to be financially afloat (kind of), living in California, and with a job when the gender reveal began in earnest. I was also lucky to have an emerging group of friends where I could play around with my pronouns to see what gave me a full-bodied yes.

First I began my identifying as they/them. Then I started expressing a desire to be identified as female, by close friends. Only later, in 2023, did I step fully into my femme identity.

During this time I mined the internet for stories of transition. I listened to podcasts. I read books. I looked at more pictures of before/after surgery than I can begin to explain. I researched the ins and outs (pun intended) of all gender affirming care.

By this time, now with closer to 5 years of continuous sobriety, I felt fully ready to move forward with everything that I wanted my trans journey to entail. I felt informed. I didn’t have a knowledge fueled by meth-y, 4am Reddit rabbit holes. I was able to research with a sense of calm and not feel like I had to fix everything now. I also wasn’t seeing gender identity as the ONE thing wrong with me, as if I could be fixed by one silver bullet.

With some retrospect, I can now reflect on why I am glad that I have some sobriety under my belt for this. As I embrace everything my trans identity wishes for me to fully align at both a spiritual and a physical level, my established sobriety is a key anchor to it all.

I get that dysphoria makes everything feel painful and urgent. However, everything felt urgent to me. That’s a by-product of my mental health diagnoses. I live in a constant state of hyper-vigilance and I have learned that when something feels urgent, a soft pause is the answer. That is, unless I am staring into the eyes of a bear and do actually need to run.

Getting Sober Is Hard

A pretty obvious statement, I know. That said, its truth bears repeating in insulting shorthand.

I managed to avoid going to treatment. I kind of wish that I had gone. Those concentrated 30, 60 or 90 days of respite from the world could have jumpstarted a lot of subsequent therapy. Sitting around with a bunch of other people in a similar boat would have been a great space to work through stuff, which could have included my trans and other LGBTQIA2+ identities.

I came into sobriety so raw. I hadn’t slept in more than a week. I had been on what could have easily turned into a fatal meth bender when an inexplicable moment of grace occurred.

The first 30 days were a mixture of difficult and impossible. I thought they would never end.

I couldn’t imagine myself not drinking or using ever again. I had to focus on just one thing, each day: not drinking or using. I had to keep my focus that narrow. Career plans, vacations, romance, sex, even transition - everything was put on hold. If I had focused on anything else and not gone to two AA meetings a day, I feel like I would have probably relapsed.

Most important, though, I got a taste of my existential crisis: I had no idea who I was without drugs and alcohol. My self-awareness was, at this point, more like a computer dismantled by an eager but useless engineer.

A New Identity

Once you get sober, so begins a process of peeling away the layers of the onion. If you’ve ever peeled an onion, you know the tears aren’t far behind.

This person I encountered, both in the mirror and in interaction with growing circles of new sober friends, was a fresh start. Parts of me I liked, other parts I didn’t. Sure, there was history to me, but it was a history whose impact and meaning was in for a change.

For so long, the world had been happening to me. I was both a piece of shit and that same piece of shit at the center of the universe. I had no real self-concept that hadn’t been shaped by self-centeredness and self-pity. Most important, I began to question almost every decision, perspective, and value I ever had in that first year of sobriety.

I cannot imagine having acted on my trans-ness and really done something about it while I was in active addiction. I feel like it would have been a realization caught up in a whirlwind of so much other madness that it would have been a reaction rather than a revelation. It might have presented itself to me as a solution to a problem - my terror at being alive and feeling feelings - that could be solved in softer, more spiritual ways.

In short, this frenzied, walking identity crisis followed me into sobriety. I had to find soft, gradual ways to discover who I was and not go rushing into anything.

Luckily, sobriety helped me begin to see what was and what was not me. I slowed down enough to recognize that presenting as a cis man attracted to other cis gay men didn’t make sense. Taking that time was critical.

Mental Health Chaos

Years of self-harm through drug and alcohol addiction did damage. Addiction to substances is always the solution to an underlying problem. That is, for a time my cocaine usage somewhat effectively addressed psychological and spiritual problems. At some point, that effectiveness waned.

When I got sober, I had to work out what the pain was that I was avoiding and numbing with substances. Getting to grips with my anxiety, depression, complex PTSD and childhood traumas was essential to the rebuilding process. Some of it was addressable through therapeutic modalities, while other parts were restored with medication.

I cannot imagine what it would have been like to be on gender-affirming hormones while sifting through the emotional and psychological jigsaw puzzle pieces, or getting used to new psych meds. I am not saying it’s impossible, but it’s something to consider for people who are grappling with their trans identity in early sobriety.

When I finally started estrogen and testosterone blockers in 2023, I experienced a bungee jump of emotions. I cried more often. I felt the ups and downs more profoundly. While I was trying to stabilize, hormones would have been difficult to deal with without a real danger of relapse entering the equation.

Fragile & Raw Nerves

Being newly sober is wild. I experienced a lot of joy in what is commonly referred to as the pink cloud. The pink cloud is the relieving sense of hope, possibility and lightness that comes with having a body drained of mind-altering substances.

I was also hyper-aware. Every decision. Every turn in the car. Every song I listened to. All my choices felt amplified and their risk/reward profiles highlighted. I wouldn’t lock the door to the bathroom at AA meetings for fear that people would assume I was snorting cocaine in there.

This level of hyper-awareness is kind of what it is like being trans most of the time. We’re constantly scanning the environment for haters, TERFs, misgendering moments. I think that, had I been transitioning in the first year of sobriety, this additional level of psychological weight would have been hard to handle. That said, maybe it would have been tolerable? All I can do is point out the things that come up for me.

Support System

I came into sobriety with no friends. Everyone I knew was some shade of codependent enabler whose idea of quality time with friends included staying up all night chained to a plate of cocaine or a pipe.

Alcoholics Anonymous furnished me with a support system. While it has changed considerably over the years, I still talk to people I met early on in my journey. Addicts in recovery get to know each other better in five minutes than most non-addicts do in ten years. There’s a shared experience and a dark realism which makes connection deep and rapid. There’s also a lack of judgment around a lot of crazy, weird, nasty, fucked up things we all did to get by.

A support system is integral to transitioning. It is also a part of the Standards of Care for the Health of Transgender and Gender Diverse People (SOC). Any therapist signing off on gender-affirming care will want to be assured of an individual’s robust access to supportive friends and family (biological or chosen).

Luckily, there are AA meetings which specifically cater to the trans community. Although some of these are in-person, many are available online for those living in states where being trans is less safe for social, religious and political reasons.

There are also a number of Reddit threads and Discord servers such as the Los Angeles LGBT Center’s Trans Lounge which offers both virtual groups and hang-outs as well a always on chat room options.

Electrolysis Without Caffeine

It’s a small point but an important one! Hair removal by electrolysis is painful AF. I use lidocaine injections for complete numbing of the area. You can also use lidocaine cream for more moderate numbing. However, whichever I choose I always make sure I am well rested, meditated, and without any caffeine when I go in.

All these factors contribute to the pain and to the healing process. Caffeine, which I was useless without in early sobriety, makes electrolysis much less pleasant. I am glad I am at a point in my sobriety where I take care of myself enough and don’t need to mainline coffee to be able to sit through hours of my hair being zapped out!

Integrity & Follow Through

If you’re anything like me, those morning and evening doses of gender affirming treatment feel like water in a desert. Although there’s no real immediate chemical shit happening, the feeling of euphoria and completeness they give me is no joke.

I have to make sure that I stay consistent with my meds. I am embarking on electrolysis to remove unwanted body hair and prepare for surgeries. All of these things I have to stay on top of.

When I first got sober, the idea of even setting up an auto-pay on my credit cards seemed impossible. I cannot count the number of times I would arrive at work only realizing I had forgotten to take my anti-depressants multiple days in a row because my hands were startling to tingle.

The transgender path can be a rocky road. Depending on how you define transition, I am still very early on in this journey. If you’re getting sober while trans, or you’re on the cusp or embracing your trans identity, I hope this article proved useful and don’t hesitate to reach out to say hey!

Family Acceptance

Healing within the family system takes time after we get sober. My family was disintegrated by choices all of us had made. My decisions, however, from a place of addiction put my fam through hell. I cannot begin to imagine what my dad must’ve felt like going to bed at night wondering whether his child would overdose or commit suicide by morning.

I have made conscious amends to my family, as best I can. My relationship with my dad, step-mom and siblings is better than ever. They accept me as I am. They call me by my name. I open Xmas cards with my name in the address. They struggle through mistakes with love and willingness to learn.

Had I transitioned before this healing began, I have no doubt that they would have seen my transition as yet another in a long line of phases and impulses I went through. I would have mistaken their confusion, sadness and at times anger towards my addictive lifestyle as anti-transness. Now we are on a different level and they can see how my transness is a consciously made decision that makes sense.

A Conscious Choice in Gratitude

All in all, the decision to transition within sobriety has been one of the most beautiful things I have ever done.

I have been able to understand how it makes sense for me. I haven’t rushed into it like I do everything else in my life (even sober I am impulsive).

I have a wonderful group of broad and deep relationships. I have people in my life who see me as I am.

I am sober and have a life beyond my wildest dreams. I have a job that I don’t call “work” because it doesn’t feel like it.

And I can wake up every morning and feel the estrogen dissolve beneath my tongue and swim elegantly through my veins knowing that my transition isn’t endangered, at least today, by the lure of a motel and a meth-pipe.