Obsessions about Sexual Orientation and Gender Identity

PLEASE NOTE. This post will be very long and probably confusing. English is not my native language, so there may be some grammatical errors. I intend to post elsewhere, so I would consider this post as multi themed. I will divide the text into parts for readability. I apologize for the excessive details, I believe that everything exposed here has some relevance. I beg you to read everything.

INTRODUCTION I - ANXIETY AND FIRST THOUGHTS
Hello. I am an 18 year old man, currently in college. My life, from August 18th until now, has been a complete hell. In early 2019, I began to have anxiety attacks every time I went to the movies or went out with friends. These seizures made it impossible for me to eat and caused constant nausea and dizziness. When I started college in March, anxiety became random. Some days it happened before and during classes. In others, just before.
However, I did not know that anxiety was until then the least of my problems. As I began my second semester enrollment in late July, I began to have depressing thoughts. These thoughts encouraged my death, mocked me. As someone radically opposed to suicide, that situation bothered me, but not enough to wreak havoc. Within a week, there were no more thoughts.
The first week of August, I went to a urologist. I was worried about the angle of curvature of my penis, and how it would impact sex. I'm a virgin, and never had a girlfriend. It may seem like irrelevant information, but it is not.

INTRODUCTION II - THE PORN
When I was 13, I discovered the concept of sex. Before that, I knew nothing about the workings of the sexual act. From this I discovered masturbation, eroticism and, of course, pornography. I masturbated and watched porn whenever and as long as I wanted without any worries. But as the years went by, I turned these two activities into relief valves for any kind of stress. I masturbated at least once a day. As for porn, I watched 1 or 2 hours. Between December 2018 and early 2019, I expanded pornography to approximately 4 hours. 2 hours in the late afternoon and 1 or 2 hours before bed. As for the porn categories, I started with light videos, until stopping at hentai and hardcore videos. I never watched gay porn.

PART I: THE BEGINNING OF THE RUIN OF A MIND
Back in August 2019. After the urologist, I began to worry about my likely porn addiction. I was afraid the videos would prevent me from having pleasure with a woman in real life, or cause Erectile Dysfunction or Early Ejaculation. I decided to limit porn and masturbation to twice a week, with a maximum of one hour in each of these sessions. I was able to respect this self imposed rule. But on August 18, everything changed. At night, two hours after watching porn, I was watching the movie Alien Covenant, and seeing Michael Fassbender, I immediately remembered the movie Shame. At that moment, bizarre thoughts invaded my mind [spoiler] Compliments of sexual connotation, comments about the actor's appearance and penis, images of myself ****ing him Obviously, I was terrified. I have never in my life thought such things. Even surprised, I associated such thoughts with the suicidal incentives of early July and thought, ****. This is going to end.
I was wrong. The next morning that **** went on. Every man I saw stirred these same thoughts, even my father. There was a distortion in my feelings, thoughts and perceptions. In a way, I saw every man as handsome, simply because he was a man. In just two days in that nightmare prototype, I thought something risky: Well, I like women, but these thoughts want to impose an attraction on men. If I bring the two together, I can neutralize that ****. Then I fantasized about myself having relationships with hermaphrodite beings - something like futanari -. I had fantasized about such things before, but only once, in 2016. Also, such a fantasy could be controlled.
That was not enough to stop gay thoughts. So every day boiled down to an infinite mental debate. On August 29th, in one of these innumerable internal discussions, I thought, In all my sexual fantasies, I always projected myself on man. At that moment, a damn thought came up: No, you projected on the woman. You want to be a woman. You should cut your penis. So from that day, besides the gay mind filter, there was a trans mind filter. Looking at me in the mirror came the image of a woman, looking at my penis, the image of a vagina. When I came across pronouns, thoughts changed their gender automatically. Seeing a couple, I couldn't tell if I thought the girl was pretty or envious of her.
In September, tired of those thoughts, I returned to my psychologist. I have been consulting with him since 2015, but he has known me since I was 9 or 10 years old. He said I was a straight man, but that wasn't enough to reassure me. Between September and October, other bizarre thoughts arose. After reading about Capgras syndrome, I began to fear the possibility that it was real. I feared the world was a simulation like the Matrix. I was afraid of being betrayed by my future girlfriend, or of being a cuckold. I didn't believe 100 per cent in the thoughts, just feared the possibility.

PART II - IDENTITY CRISIS AND THE INTERNET MESSING WITH MY HEAD
As I said before, my psychologist could not fully help me. So I decided, stupidly, to turn to the internet. I saw dozens of texts and posts about HOCD and TOCD. At first it helped me, but over time my mental state got worse. I read trans testimonials saying they thought they were cis until 18, or late onset gender dysphoria. Reading that, my head exploded. How to prove that I wasn't really feeling dysphoria? From then on, I lost hope. I felt in denial, even though I had never idealized myself as a woman in 18 years of life. That sense of certainty was unreachable for me. I read that **** until November, when the frequency goes down. In October, I watched the movie Joker. Honestly, Arthur Fleck saved my life. Seeing a guy at rock bottom become happy gave me a little hope. Interestingly, I didn't feel any anxiety during the movie. In fact, I had not been anxious since September. Probably because I was debating like crazy 24h.
Needless to say, my happy days were few. In 5 months of this hell, I can count only 1 month of joy. This month consists of several weeks spread out. Two in October, one in November, one in December. Even at these breaks, the symptoms did not fully subside.

PART III - MEDICATIONS AND THE ROCK BOTTOM
Since October, I have had blood tests and a psychiatrist. Examinations pointed to a lack of vitamin D, probably because of my sedentary behavior. On November 15, I started taking meds. Paroxetine. Side effects were complicated at first. I started with a small dose of 12,5 milligrams. When I say complicated, I mean COMPLICATED. I felt like a zombie, I didn't want to get out of bed, I missed college all week. This state lasted about one to two weeks. In the end, the medication did no **** against the thoughts. It just made me calmer and to some extent functional. In fact, even crying almost every day, and wanting to drop out of college, I was able to get high marks in all subjects this semester. Great irony, no?
In my opinion, the worst part of all this is WAITING. In August I was just an unhappy guy with gay thoughts, today I have no idea what I am. I talk 40 minutes with my psychologist every week, not counting discussions with my parents. In the early months, they understood. Today they seem to be tired of me. As for my psychologist, I feel his good intentions, but I see no progress. At the same time, I don't want to change professionals because I value the experience of my current psychologist.

CONCLUSION: WHO AM I ?
In the past. I was a confident guy. I wanted to live alone after finishing college. I dreamed of having a girlfriend. With luck, I'd marry her and we'd have a daughter. I prefer a daughter because I wanted to play the role of protector. Today my identity is in pieces. When I look in the mirror, I see someone else. My name sounds weird, just like the pronouns. Sometimes I feel like I'm just a pilot of someone else's body even though I know it's my body. I never had problems with my penis or my body hair before. I even grew a big beard in 2016 . Now I'm afraid every time I look at them. I don't feel authentic about anything I do.
Honestly, I never cared about gender. I was not a boy or girl. I WAS ME. A male individual. In fact, I had some feminine traits, but I saw such judgment as a stereotype. I cross my legs, I am very emotional and synesthetic regarding love or sexual issues. I wear long clothes that show little of my body. In this respect, I identified a lot again with Arthur Fleck. I like to dance alone and often have daydreams about my future girlfriend. At the same time, when I talk about things beyond love, I feel like a man. In discussions, I see everything from a strictly rational standpoint, I consider myself competitive and cold in certain respects.
The only time of the day I have peace is when I sleep. When I wake up, I feel good for a few seconds, until all hell begins again. Interestingly, I had dreams in which, as a man, I had sex with a woman. In my dreams thoughts had no power at all. Bathing has been a terrifying experience, because I can't tell if I like my body or not. During the day I feel my penis all the time and I have anxiety. The only time I feel good about my penis is when I masturbate and yet there is insecurity. The sensation is similar to that felt when you hurt a part of the body. This part seems to be independent of the rest, you feel it all the time.
If I didn't have friends, computer games, or family / medical support, I'd probably be dead already. I have tried to stop pornography, but I never quite get it. I've stopped watching videos for 1 month, but still saw erotic images or masturbated. I believe I developed an attraction to the penis, not necessarily to the men themselves . When I watch a video, I feel a sensation in my throat. Never felt this way before. I am afraid that when performing oral sex on a woman, I want a penis. I fear losing my sexual attraction to girls.
Even though I've never wanted the transition, I feel like a liar every time I think about it. I have no confidence in my memories and thoughts. My dreams at times seem distant. My only desire is to have peace, to feel like a straight man again, to make sure that I love my own body, to make sure that I love and desire women without ever envying their appearance. I imagine hugging my girlfriend and listening to her say she loves me, I imagine us having sex for love, not just for sexual pleasure. I imagine taking my daughter to school, watching her graduate, haunting her boyfriend's dreams . I am an unhappy being who has lost her identity, wants her back, and needs help.

Hello TheLostOneBeing: I see this is your first post here on PC. So... welcome to Psych Central.

I'm sorry I don't think there is going to be much I can offer with regard to your concerns. You mentioned you see a psychologist (who has known you since you were 9 or 10 years old) & said you feel his good intentions but see no progress. Still you don't want to change because you value his experience. You also mentioned both your parents, as well as your psychologist, now seem tired of you. You didn't mention if you've tried any other therapies such as CBT, DBT, ERP, etc.

I do think there can sometimes come a point where talking about stuff like this over-&-over perhaps begins to do as much or more harm than good. In fact there was another thread, here on PC, on that very subject just a few days ago. Maybe you've just reached a point where continuing to talk about this is no longer beneficial & you need to consider trying some other type of therapy? I don't know... it's just a thought. (I myself am an old man now. But I've waged a life-long struggle with my gender identity. So I'm not unfamiliar with what you're going through.)

Here's a link to an article, from Psych Central's archives, on the subject of exposure and response prevention therapy that may be of some interest:

ERP Therapy – Where are you?

I hope you find PC to be of benefit.

Thank you, Skeezyks. No, I haven't tried other therapies yet, and I don't know what type of therapy my psychologist utilises. I have a question for you:
Since when did you start to have gender dysphoria? In 18 years of life, I have never had any problems with my body or gender. Of course, I considered myself effeminate in some ways, but nothing too extreme - wearing women's clothes, imagining myself as a woman when masturbating, wanting to be a woman, for example - to the point of annulling myself as a man. In fact, I believe that we all have both genders within us, and I was happy with my "feminine side". I really hope I don't have gender dysphoria , as I've always liked my genitals. We have a fraternal relationship, so to speak

@TheLostOneBeing Thanks for your reply. Actually, my own gender-identity-related issues go back so far that some of my earliest childhood memories involve them. Yet I've always lived an outwardly more-or-less male life. (For most of my life it never occurred to me I had any choice.)

This all begins to get very complicated very quickly. But there was a period of time, around a dozen years ago or so when I first became aware of the "transgender community" so to speak, that I became convinced I must have been transgender all my life. But, as I have gotten further away from that "watershed" period, I've come to believe I was, perhaps, not really transgender; but that my gender-identity issues were just one aspect of a broader mental illness. Of course the reality is I'll never really know what came first for sure. There is a sense in which it is sort-of a "chicken & egg" kind of question.

I'm not a mental health professional myself. But, based on what I read in your post, it doesn't sound to me as though you have gender dysphoria. This all sounds more like, perhaps, an anxiety or OCD kind of thing. That is just a personal opinion though. I presume you've received some sort of diagnosis from your psychologist.

@Skeezyks, as far as I know, I haven't received any definitive diagnosis yet. But my psychologist disagrees with the gender dysphoria hypothesis. Both psychologist and psychiatrist suspect that I have some anxiety disorder.

Hello. I was away for several days because my symptoms fluctuated positively. However, I suspect that they are heavy influenced by stress. I really hope that positive fluctuation last longer, because,in fact, that variation was the longest: one month.

Since January 15th, I have stopped viewing porn or masturbating.

My interest for reading came back.
Even under medication, my libido and sexual desire for women remains. I have no problem with erections.
The feeling of "being out of the body" and the strangeness of seeing me in the mirror have greatly diminished. Practically such feelings no longer exist.
My relationship with my male characteristics - hair, voice, genitals, etc. - has improved.


Now, let's talk about the bad part:

The Intrusive thoughts remain. Of course, during this last month, there has been a reduction, but the frequency of thoughts is unpredictable. In my personal opinion, the "transgender thoughts" are the worst.
Sometimes, I experience false attraction to men. "False" because there are not any erection or love.

I experience a strange sensation when I hear my pronouns. In fact, the pronouns generate intrusive thoughts that replace them with the oposite sex pronouns.

The strange physical sensation in my genitals and throat remains. During this last month, the sensation disappeared in some moments. However, in the last days, this came back violently. The sensation in the genitals remains for much of the day, but the throat does not.
Occasionally, I feel hopeless to feel like a heterosexual man again, or rather, to be sure that I am one. When I see a beautiful woman on Instagram, for example, there is, of course, an erection. But then the intrusive thoughts appear and I begin to doubt. "What if I want her beauty? What if I don't like having sex with her? How can I, for sure, differentiate between love and envy?" Sometimes I feel like I'm in denial, like the 18 years I lived happily meant nothing - even though, deep down, I know they do -.