Navigating the Uncharted: HRT and the Panic of a Gestalt Language Processor

Recently, on my doctor's orders, I doubled my HRT dosage, and while this is an exciting step forward, it’s brought about some unexpected challenges. You see, the original dosages were based on a schedule that, rather amusingly, seems designed for people far smaller than my 6’7” frame. It’s like trying to fill a swimming pool with a teacup – no wonder I needed a larger dose.

However, as an autistic Gestalt Language Processor (GLP), this adjustment has triggered a cascade of responses I wasn’t entirely prepared for. My brain thrives on recognising familiar, whole patterns to process experiences, but the sudden surge in hormone-induced sensations has left me without the gestalts I need to make sense of what’s happening. Without these mental frameworks, panic quickly sets in, as my brain scrambles, unsuccessfully, to categorise this flood of new physical and emotional stimuli. It’s as if I’ve been handed a new book with missing pages, and my mind is left frantically trying to piece together a story that just won’t come together.

The Physical Sensitivity of Increased HRT

With the increased dosage of HRT, I knew I was in for a weekend of heightened sensitivity, both physically and emotionally. Having experienced subtle shifts when I first began my transition, I anticipated that this next step would turn the dial up several notches. That’s why I wisely scheduled the first larger dose for last Friday night, giving myself the entire weekend to navigate this new reality. And let me tell you, it didn’t disappoint.

The heightened sensitivity hit almost immediately. Everything from the texture of my clothes to the way I experienced touch felt more pronounced. My body, now finely tuned to even the smallest changes, was suddenly processing every sensation as if on high alert. It wasn’t just physical – my emotional responses were equally amplified. A fleeting moment of joy felt like an overwhelming surge, while a minor frustration could set my pulse racing. It was like living life with the volume cranked all the way up.

For a GLP like me, this amplified state creates a particular challenge. My brain needs familiar patterns to categorise experiences, but with so many new sensations flooding in all at once, there were no recognisable gestalts to ground me. Instead of finding comfort in known patterns, my mind was left trying to sort through a whirlwind of uncharted territory, leading to a sense of overload. Each new sensation demanded to be processed, but without the framework to do so, my brain scrambled to make sense of it all, triggering a constant state of heightened awareness and unease.

The Role of Gestalt Language Processing in This Experience

As an autistic GLP, my brain functions by processing experiences as complete, meaningful wholes rather than breaking them down into smaller parts. This way of thinking allows me to navigate familiar situations with ease, as I can rely on established gestalts—patterns my brain has already recognised and categorised. But when faced with new or unexpected experiences, especially ones as intense as those brought on by the increased HRT dosage, the lack of pre-existing gestalts leaves my mind scrambling to make sense of it all.

In this case, the sudden rush of heightened emotions and physical sensitivity triggered a profound dissonance. My brain, conditioned by a lifetime of masculine norms—where ‘boys don’t cry’ and emotional displays were discouraged—found itself grappling with an entirely new reality. Feeling emotions so intensely, and being so easily triggered by the smallest shifts, was like stepping into an unfamiliar world without a map. It was disorienting, even unsettling. The emotional vulnerability I had been taught to suppress now flooded to the surface, and my mind, trained in the rigidity of past conditioning, didn’t know how to categorise these overwhelming feelings.

In my previous article series on nocturnal panic attacks, I explored how the GLP mind can panic when it encounters situations it cannot process. This weekend’s HRT-induced emotional surge was no different. The absence of familiar gestalts to interpret these deeply emotional and sensory experiences threw my mind into a state of panic, struggling to reconcile the discontinuity between my previous masculine conditioning and this new, intensely emotional self. It felt like my brain was flipping through an empty catalogue, desperately searching for a pattern that no longer existed.

The Cascade of Panic: A Runaway System

When my brain is confronted with an onslaught of unfamiliar sensations, like those brought on by my increased HRT dosage, it’s not just a matter of sensory overload. What happens is a kind of cognitive cascade—a runaway system in overdrive, where my mind, as a Gestalt Language Processor GLP, scrambles to make sense of it all but lacks the necessary frameworks or “gestalts” to do so. My brain, conditioned over years of masculine socialisation, can’t find any familiar patterns to ground itself. It’s like being handed a script with all the key scenes missing.

This process of panic is eerily similar to the nocturnal panic attacks I’ve written about before, where the brain, in the absence of sufficient information, spirals into overdrive. In this case, the sheer intensity of new emotions—emotions I’ve been conditioned to suppress for so long—combined with heightened physical sensations, triggered a kind of mental shutdown. It felt as though my mind was running through every past experience, trying to reprocess and reinterpret them with these new scripts. But the more it tried, the more overwhelmed it became.

It’s not just the present that my brain is contending with—it’s the past as well. This is where the concept of retrocausality comes into play. My mind isn’t just dealing with new sensations; it’s dredging up old memories, forcing me to reconcile these with my current identity as an autistic trans woman. Events and emotions I had long buried now demand attention. In the blink of an eye, I was reliving years’ worth of experiences with an entirely new lens, and my brain, ever the analytical system, insisted on cataloguing them all at once.

But it’s not a neat, linear process. The dissonance between my former self—conditioned not to cry, not to feel—and my current state of emotional vulnerability created a kind of cognitive overload. My brain, desperately trying to integrate these new realities into a coherent narrative, struggled to keep up. Every new sensation or emotional trigger felt like another layer of complexity, further destabilising my ability to process anything in real-time.

This isn’t just about feeling overwhelmed by the present. It’s a retroactive rewriting of my entire life, where every memory, every suppressed emotion, comes rushing back, demanding to be reprocessed through my current lens. The result is a profound sense of vulnerability and loss of control, as my mind tries to make sense of who I am now, in light of who I was—or thought I was—for so many years.

It’s as if my brain is running a massive “update” on my entire cognitive system, but instead of installing new software smoothly, it’s experiencing crashes at every turn. The gestalt processor in me is scrambling to make sense of an overwhelming amount of data without the necessary frameworks to anchor it. This, more than anything, is what drives the cascade of panic—an internal system meltdown that leaves me feeling exposed and untethered.

Addressing the Challenge: Finding Grounding Strategies

Navigating the overwhelming sensations and emotions brought on by the increased HRT dosage requires more than just quick fixes—it demands grounding strategies that draw from years of experience. Over the decades, my practice in QiGong, Tai Chi, and Systema has proven invaluable, offering tools that help centre and steady the mind amidst chaos.

In QiGong, breath is the anchor. The focus on cultivating “Qi” through slow, controlled breathing helps regulate both mind and body. When I feel my brain spiraling in an attempt to process too many unfamiliar sensations at once, I return to this breathwork. Deep, rhythmic breathing, in alignment with QiGong’s principles, restores balance and creates a flow of energy that allows my mind to settle. It’s as if the practice trains my body to release the tension and anxiety built up by the cognitive overload.

Tai Chi offers a similar grounding approach, but with an added emphasis on movement. The slow, deliberate motions of Tai Chi not only calm my body but also bring my mind into a focused, meditative state. By syncing my breath with the flowing movements, I am able to move through the discomfort of new sensations, giving my brain the chance to integrate these experiences more gently. Tai Chi’s focus on balance and control provides a framework for navigating physical changes with grace.

Systema, on the other hand, emphasises breath control in the face of physical and emotional stress. Its techniques are designed to help manage stress responses, particularly when the body feels under threat. By applying Systema’s breathwork during moments of sensory overwhelm, I can release the tension in my muscles and focus on softening my body, letting go of the panic. It’s a method that encourages resilience, allowing me to process unfamiliar sensations with a calm, centred approach.

These practices, each in their own way, provide me with the tools to build new gestalts over time. As I repeatedly engage in these grounding techniques, my brain begins to form new cognitive frameworks, making it easier to process the unfamiliar without the same level of anxiety. Over time, these sensations become part of a new, stable pattern, enabling me to navigate my HRT journey with greater ease.

Final thoughts …

The increased HRT dosage has brought on a wave of physical and emotional sensations that, as a GLP, I’ve had to navigate without established frameworks. The overwhelming nature of this experience highlights the need to support and understand how GLPs process unfamiliar transitions like these. Through grounding techniques rooted in decades of practice, I’m slowly building new gestalts to make sense of it all. I’m not through it yet—this is just one part of the journey. Writing this down and sharing it is part of that process, helping me—and hopefully others—find clarity in the midst of change.