This article comes from an Ask the Expert conversation with Dr. Jill Corey, N.D. (they/them). For Them sourced questions from the community to ask to a trans healthcare professional.

For Them: Could you talk through different ways herbal medicine and manual therapy can help to ease anxiety? Whether that's gender dysphoria, anxiety, or just, you know, being queer in this world is pretty anxiety producing.

Dr. Jill Corey: Yeah, stepping out of your house, anything right now, pandemic? Yeah, for sure. There's so much. So as far as herbal remedies for anxiety, there's different approaches we can do. There are approaches like daily preventative measures, things that can calm you down couple notches throughout the day.

There are some interesting studies on encapsulating lavender. It's not like essential oils and do not ever, ingest essential oils- they are really strong, powerful, and to only be used topically or in the diffuser in the room. But there's special forms of encapsulated lavender that have been researched. This certain form of lavender has been shown to be as effective in helping with anxiety as Prozac. The brand name that was used in the study is called Lavella.

There's L-theanine that is an amino acid that can be taken daily or as a rescue for anxiety. That can also be used to combat too much caffeine. There's also a glycine, which is an amino acid that's also very calming to the nervous system. A lot of people like to take it at night, because it kind of helps with that monkey brain at bedtime. Glycine, it's a precursor to the neurotransmitter, GABA, which is and gamma is the opposite of epinephrine. So when we're anxious and amped up, our body makes epinephrine and GABA does the opposite, so it's more calming. They make supplements of GABA as well. So those are those are very helpful for the day to day. I know they can be used as a rescue if you start feeling like a panic attack is coming on.

I find that if there's a panic situation going on, there's an herb called kava. It also is very good at calming down anxiety. It's from South America originally. So if you're feeling panicky and stuff, you want something to work quickly, sometimes a liquid form of kava could be more helpful, but this or you want to be careful because it can, you know, talk to your doctor first because it can interact with certain medications and it can be a little taxing on the liver as well. And there are also herbs, like the California poppy that could help as well.

For Them: We have a question about chest dysphoria and binding. "Do you have any tips on dealing with paralyzing chest dysphoria? Even when alone at home I can’t seem to do anything except when I distract myself very much. Binder helps for a short time, then not at all. Looking at myself with a flat chest in the mirror helps for short moments. It seems I can’t think and am moving through thick liquid. Every time I distract myself enough I feel fine again."

Dr. Jill Corey: Gender dysphoria sucks. I can relate to what this person is saying. People don't understand gender dysphoria unless they experience it. It is real. It is kinda like quantitative to chronic pain- where you have it all the time, it's there, you experience it everyday all day- some days are better than others, others are harder to ignore.

I understand it is really difficult when you're waiting for your top surgery or your insurance won't pay for it or even if you don't want top surgery that's ok too. But it can be a life saving surgical intervention.

Regarding chest dysphoria, binders are a lifesaver. It's very important to use a safe binder rather than ACE bandages or tape because that can cause a lot of problems with anatomy and your ribs. Also, to help mitigate it, some of my patients say having a night bra, a comfy bra they can wear to bed, something to keep the breast tissue contained is helpful.

Be gentle with yourself. Remind yourself that this is a chronic thing and day to day it can change. Try to not talk negatively to yourself, accept the process and that it's common and normal to have these feelings. Wear your binder whenever you can.

Bath time can be hard, a lot of my patients wear a swim top in the bath/shower.

It's a day to day thing, try to be as gentle with yourself as you can.