New post on Gender Blog by Darlene Tando, LCSW


by Darlene Tando, LCSW

If you are like most people, you haven’t had to think much about your lungs. You were born with fully functioning lungs that have delivered oxygen to your blood and brain, just as they are supposed to. You can’t imagine it any other way, simply because it’s never been any other way for you. You’ve also not given much thought to the role oxygen plays in your life, because it’s always been there, as much as you need, delivered to you on cue, no questions asked.  For anyone who’s briefly experienced a decrease in oxygen, or lack of oxygen, that person will likely never forget the feeling of panic and the intense, primal need to have oxygen fill the lungs once again.

Take a nice, deep breath. Let the air expand your lungs and your stomach.  Feels good, doesn’t it? Ah, oxygen. What would you do without it? Well, you’d die, is the obvious answer.  What if you had enough of it to survive, but just not quite enough to lead a “normal” life?

Picture this: You were born with something wrong with your lungs, so that they couldn’t fully absorb and process oxygen the way most people’s lungs can. You can take in just enough oxygen to live, but not fully engage in life. Since you were born with your lungs not doing precisely what they should do, you spend every day of your life not being able to do all the things you would otherwise like to do. You spend many of your days wishing your lungs were different, wishing you could breathe as fully and deeply as everyone around you. You watch everyone take those deep, life-sustaining breaths, and you can tell none of them realize how lucky they are; their lungs (and the resulting oxygen they get) is simply taken for granted.  You stand there, taking shallow, ragged breaths, feeling weak and somewhat listless.

Then one day, you stumble across something on the internet: ‘Sub-par Oxygenation Syndrome”. (Yes, I made that up.) You discover there is a name for what you’ve been experiencing, and other people have it too!  Sadly, some have taken their own lives from not being able to tolerate the feelings associated with having this syndrome.

You feel relieved, validated, excited. Then you read that there is a solution. While it may not give you new lungs, there is a machine that can deliver this life-enhancing oxygen straight to you: an oxygen tank. It’s expensive (insurance doesn’t cover it in this scenario), but you know you’ll do anything to get access to it. The day you get your tank feels like the most liberating, exciting day of your life. You strap that baby on (it comes in a nifty backpack) and put the tubes under your nose. To breathe so fully and so easily is something you’ve longed for your whole life, but never thought you’d experience. (At times, you feel sad and resentful you have to wear such a contraption to feel the way most others were born feeling, but continue to be grateful nonetheless.)

When you explain to those close to you what you’ve discovered and show them your new tank, they’re skeptical. “Really? Are you sure you’re not getting enough oxygen? I get plenty of oxygen every time I take a deep breath. Perhaps you’re not doing it right.”  Others don’t like your oxygen tank. “Hmmm, I liked you better before you wore that tank. I’m not used to seeing you with those tubes. Can you please take it off?”. You’re saddened and shaken by these responses, but you don’t take it off. The oxygen tank brings you too much relief and too much life to dare take it off.


I’ve been looking for some sort of concrete metaphor to use to help explain being transgender and transitioning. Concrete examples can help with understanding. However, I wanted to be careful not to compare being transgender with being disabled. I do not think it is a disability. I think it is something REAL, like not getting enough air. I hope this analogy does justice to those transgender individuals reading it and hits home with loved ones.

The irony of my example is that if someone had been born with something wrong with his or her lungs, it would likely have been caught right away by medical doctors, and offered a solution early on. Gender variance is a bit trickier; a person’s need for his or her gender identity to be validated develops much later than one’s need for adequate oxygen. While we still have a long way to go, intervening with children who display persistent gender-variant behaviors and a consistent desire for changing genders is much like offering the oxygen tank to the person in the above scenario as a child; “I know what you need; here you go.”

One last thought worth mentioning is that I do believe being transgender is a medical condition and belongs in the medical books, not the DSM (Diagnostic and Statistical Manual of Mental Disorders). This is why comparing it to another type of medical condition was appealing to me. I’ll save the rest of my thoughts on this topic for another blog. 🙂

To Oxygen!

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