The journey of transitioning as a transgender woman is deeply personal, profound, and complex. It involves more than just physical changes brought about by hormone replacement therapy (HRT); it touches the very core of one’s identity. One of the most prevalent challenges in this process is the societal pressure to “pass”—to be perceived as a cisgender woman. This pressure can be overwhelming and, in some cases, detrimental to mental health, especially for those who feel that they fall short of these often unrealistic expectations.
As a 55-year-old transgender woman who began medical transition 18 months ago, this struggle is painfully familiar to me. My experience, like so many others, has been riddled with self-doubt, fear, and internalized transphobia, exacerbated by the hurtful reactions of those closest to me. Recently, when I came out to my wife, from whom I have been separated for two years, I was met with a crushing response. After explaining my truth, she said, “I married a hot guy, and I am going to be divorcing a hideous freak, or whatever you think you are.” That moment shattered me in ways I still can’t fully process. The pain and rejection will linger, and the fear of being seen as “less than” remains a constant companion.
In sharing this story, I hope to shed light on the damaging effects of the societal expectation to pass, and how it can impact transgender women who, like me, are grappling with severe gender dysphoria and the mental health toll that comes with it.
The Concept of “Passing” and Its Weight
The term “passing” describes a transgender person’s capacity to pass as their true gender to others. For transgender women, this typically means being seen as a cisgender woman—someone who was assigned female at birth. It’s a term loaded with both hope and despair. For many, passing can feel like the key to safety, acceptance, and self-confidence. It can lead to fewer instances of being misgendered or discriminated against, and the idea of moving through the world without drawing negative attention is undeniably appealing.
But the pressure to pass is a double-edged sword. When society sets this expectation that only those who can “successfully” blend into the cisgender world are valid or deserving of respect, it creates an environment where those who don’t pass—or feel they never will—experience deep shame and inadequacy. This burden is especially heavy for transgender women who struggle with their appearance, their voice, or other physical traits that may not align with what society views as “feminine.”
For me, looking in the mirror is often a painful experience. I see remnants of the person I was assigned to be, and though HRT has brought some changes, I can’t help but feel the disconnect between how I see myself in my mind and the image reflected back at me. Every time I go out in public, the fear of being seen as an imposter or ridiculed because I don’t fit into societal norms of femininity is paralyzing. This pressure to pass, to somehow meet expectations of beauty or womanhood, looms large over every interaction.
The Unrealistic Standards of Femininity
For many transgender women, the pursuit of passing can feel like an endless chase for something that may never be fully attainable. Society has cultivated a very narrow and often unattainable standard of femininity that includes ideals of beauty, body shape, voice, and even mannerisms. Cisgender women are often held to these standards as well, but for transgender women, the stakes feel even higher, as they are already subject to societal scrutiny simply for existing as their true selves.
It’s important to understand that hormones, surgeries, and other aspects of transition do not always result in the dramatic physical changes many of us hope for. HRT, in particular, is often seen as a miracle cure that will bring about rapid changes in fat distribution, breast development, and softening of facial features. While HRT can bring about incredible and affirming changes, it’s not a magic wand. The results can vary widely depending on factors such as age, genetics, and individual body characteristics.
At 55, my body doesn’t respond to HRT in the same way that a younger person’s might. The progress has been slow, and while I am grateful for every sign of change, the truth is that I may never fully meet the physical expectations that the world imposes on women. And that’s devastating—not because I want to conform to societal ideals of beauty, but because I want to feel comfortable in my own skin and be accepted for who I am.
The relentless pursuit of passing can also lead to harmful behaviors. Some transgender women may resort to extreme dieting, over-exercising, or engaging in risky procedures to try to achieve a more “feminine” appearance. The focus on passing can overshadow the actual goal of transitioning: to live authentically and find inner peace. Anxiety, depression, and a sense of failure can take the place of the joy of transition when the emphasis shifts from self-acceptance to meeting external standards.
The Mental Health Toll of Failing to “Pass”
The pressure to pass often makes gender dysphoria, the distress experienced when one’s gender identity does not match their assigned sex at birth, worse. For many transgender women, the disconnect between their internal sense of self and their physical appearance can be agonizing. The emotional toll can be significant when they believe they are not “doing womanhood right” or are not living up to expectations set by society.
Studies have shown that transgender individuals are at a higher risk for mental health issues, including depression, anxiety, and suicidal ideation. Much of this is linked to the discrimination, stigma, and rejection they face in society. But the pressure to pass adds another layer of strain. It creates a narrative that if you don’t pass, you are somehow less worthy or less valid in your identity. This can lead to a profound sense of inadequacy and isolation.
Personally, I’ve found that the moments when I feel I don’t pass are when my mental health is at its lowest. The weight of feeling like I’m failing at something so fundamental can be crushing. I find myself comparing my progress to that of other transgender women, especially those who seem to have transitioned more “successfully.” The endless comparisons and the feeling that I don’t measure up often leave me feeling hopeless. The idea that I will never be seen as the woman I know myself to be fills me with despair.
The cruel comment from my wife, calling me a “hideous freak”—only deepened my insecurities. It confirmed my worst fears: that I would be seen as something grotesque rather than as the woman I am. That rejection, coming from someone who once loved me, has left scars that will take time to heal. But it also highlighted the pervasive nature of these societal expectations, even among those closest to us.
Redefining What It Means to Transition
In the face of this overwhelming pressure, it’s essential that we, as a society, work to redefine what it means to transition. The idea that there is only one way to be a woman—or that “passing” is the ultimate goal—needs to be challenged. Transitioning is not about becoming someone you’re not; it’s about aligning your external self with your internal truth. And that truth is different for everyone.
For many transgender women, passing might be an important goal, and that’s valid. For others, it may be less of a priority, or it may simply not be achievable. But that doesn’t make them any less of a woman or any less deserving of respect and acceptance.
Self-acceptance is a crucial part of this process. For me, it has been difficult to come to terms with the idea that I may never look like the woman I envision in my head. But I am slowly learning that my worth as a woman is not defined by whether or not I pass. It’s defined by my authenticity, my courage, and my resilience in the face of adversity.
We need to create spaces where transgender women can feel safe and supported, regardless of where they are in their transition or how they present. This includes addressing the harmful narratives around passing and offering emotional support to those who are struggling. Mental health resources, peer support groups, and communities of understanding can make a world of difference for transgender women dealing with the pressures of passing.
The Importance of Compassion and Understanding
For those of us who are on this journey, compassion—both from ourselves and from others—is essential. The road to self-acceptance is not an easy one, especially in a world that often tells us we aren’t enough. But we are enough. Whether we pass or not, whether we meet society’s expectations or not, we are valid in our identities and worthy of love and respect.
My experience with my wife’s rejection was a harsh reminder of how deeply ingrained these expectations can be, even in the minds of those who once cared for us. It hurt more than words can express, but it also reinforced the importance of surrounding myself with people who see me for who I am, not for how well I fit into a prescribed mold of womanhood.
We all deserve to be seen, accepted, and loved for who we are—not for how well we conform to others’ standards. The pressure to pass may be an ever-present force in the lives of transgender women, but it does not define our worth. The journey to self-acceptance is long, but it’s one we don’t have to walk alone.
As I continue my own transition, I remind myself daily that I am more than the reflection in the mirror. I am not a “hideous freak.” I am a transgender woman, and that is enough.
