Don't Neglect the Internal Integration of the Self!

Dr. Z discusses signs you may be lacking internal integration after gender transition. Transition isn't only external work—hormones, surgeries, voice training, hair removal. There's critical internal work that absolutely cannot be neglected. Unfortunately, many people hyper-focus on physical aspects, which makes sense because secondary sex characteristics cause tremendous dysphoria. But when internal integration is neglected, people complete transition yet continue struggling.

The first sign: you've achieved physical congruency but still struggle accepting yourself. The external shift happened, but the internal shift hasn't. You've become who you want to be externally but internally still struggle to embrace who you are.

The second sign: you feel congruent but continue experiencing dysphoria—especially social dysphoria. You're hyper-focused on being read as your gender in public, terrified people will discover you're trans. This indicates internal work hasn't fully happened.

Internal integration means forming a deep relationship with yourself beyond external representation—understanding what your gender means to you beyond stereotypes, exploring the complexity, and navigating authenticity. People who take time for internal work during transition tend to be more cohesive and wholesome afterward.

Watch to find out how to cultivate internal integration through journaling and self-exploration.