By Malik, 30 | Philadelphia, Pennsylvania
I’m a Black trans man living with schizophrenia. I take medication, have people who show up for me, and live a life that doesn’t resemble the version of my diagnosis you see on television. I’m tired of people acting surprised by that.
The first time somebody made a schizophrenia joke in front of me after finding out about my diagnosis, I laughed.
Not because it was funny.
I laughed because I didn’t know what else to do.
We were sitting around talking, and somebody said something about being “a little schizophrenic” because they’d changed their mind three times about where to eat. Everybody laughed. I did too. I even added something stupid to keep the conversation moving.
I went home that night and thought about it for hours.
That’s the thing about being the person everybody is joking about without realizing it. You learn to make yourself comfortable in rooms that weren’t built with your comfort in mind.
You learn when to laugh. When to change the subject. When to pretend you didn’t hear something.
And when you live with more than one identity that people misunderstand, you get a whole lot of practice.
I’m Malik. I’m 30 years old. I’m Black. I’m a trans man. I live in Philadelphia, and I have schizophrenia.
I’m also somebody’s son, somebody’s friend, a guy who loves a good cheesesteak, and the person in my group chat who sends too many memes when everybody else is trying to have a serious conversation.
I take medication. I go to appointments. I have bad days and good days.
Most importantly, I have a life.
Apparently, that last part surprises people.
The Diagnosis Didn’t Erase Who I Was
I don’t remember the exact moment I realized something was wrong.
I wish I could give you a dramatic story. Something that would make sense as the beginning of a movie. But the truth is, it happened gradually enough that I kept finding explanations for things that didn’t feel right.
I wasn’t sleeping well. I was having trouble concentrating. I started feeling suspicious of people who had never given me a reason not to trust them.
There were experiences I couldn’t explain, and the harder I tried to make sense of them, the more frightened I became.
At first, I thought it was stress.
Then I thought maybe I was just exhausted.
Then I started wondering whether I could trust my own understanding of what was happening around me.
That was the scariest part.
Not some dramatic scene where I suddenly became a completely different person. It was the slow realization that my brain was giving me information I couldn’t always rely on.
Getting diagnosed didn’t immediately make things better.
It gave a name to what I was experiencing, but a name isn’t the same thing as knowing what to do next.
I had questions nobody could answer with certainty. Would medication work? Would I be able to keep a job? Would people treat me differently? Was I going to spend the rest of my life waiting for things to get worse?
And underneath all of those questions was one I was embarrassed to admit.
Would I ever feel like myself again?
I wish somebody had told me that I hadn’t stopped being myself in the first place.
I was still Malik.
I was Malik going through something difficult, confusing, and frightening.
That distinction took me a long time to understand.
Being Black Changes How People See My Symptoms
There’s something I need people to understand about being a Black man with a serious mental health diagnosis.
You don’t get to experience your symptoms in a vacuum.
People already have ideas about you before you open your mouth.
They have ideas about whether you’re dangerous, whether you’re aggressive, whether you’re telling the truth, and whether your emotions are reasonable.
Add schizophrenia to that, and suddenly you’re fighting stereotypes from multiple directions.
I remember being frustrated during an appointment and immediately becoming conscious of my voice. Was I speaking too loudly? Did I look angry? Was I making too much eye contact? Not enough?
I wasn’t threatening anybody. I was scared and trying to explain what was happening to me.
But I was thinking about how my fear might look to somebody who didn’t know me.
That’s exhausting.
I shouldn’t have to calculate how to appear harmless while asking for help.
And yet, I know I’m not the only Black man who has done exactly that.
Sometimes I wonder how differently my early experiences with treatment might have gone if I hadn’t felt like I needed to manage everybody else’s perception of me while I was struggling to manage my own symptoms.
I don’t have an answer.
I just know that when people talk about mental health access, I want them to talk about what happens after somebody finally gets through the door.
Because being able to make an appointment doesn’t automatically mean you’re going to feel safe, heard, or understood once you’re there.
Being Trans Didn’t Cause My Schizophrenia
I need to say that clearly because some people seem determined to connect everything about my life to the fact that I’m transgender.
I knew I was a man before I had a schizophrenia diagnosis.
My gender identity didn’t disappear when I became ill, and it didn’t suddenly become a symptom because a doctor gave my experiences a clinical name.
Yet I’ve had people question whether I could really understand my own gender because I have a psychiatric condition.
Think about how insulting that is.
A person can have schizophrenia and still know who they are.
A person can experience psychosis and still have a history, preferences, relationships, values, and an identity that exists beyond those experiences.
I’m not saying psychiatric symptoms never complicate how somebody understands themselves or communicates what they’re experiencing.
I’m saying my diagnosis doesn’t give strangers permission to dismiss my entire life.
I spent years learning how to be comfortable with myself as a man.
I worked through the complicated feelings that came with transitioning, the relationships that changed, and the fear of how people would respond.
None of that was imaginary.
None of it became less meaningful because I eventually needed psychiatric treatment.
And frankly, I’m tired of having to explain that my masculinity isn’t something a medical diagnosis can take away.
Medication Gave Me Room to Live
I know medication is a complicated subject.
People have different experiences, different side effects, and different reasons for feeling the way they do about psychiatric treatment.
I’m not here to tell anybody that my experience is going to be theirs.
But I am going to tell you mine.
Medication helped me.
Not instantly. Not perfectly. And not without some frustrating trial and error.
There were adjustments. There were conversations about side effects. There were times when I wanted to throw my hands up because I was tired of thinking about my brain every single day.
But eventually, with treatment that worked for me, life became more manageable.
I could concentrate better. I could sleep more consistently. I could recognize when something wasn’t right and communicate that before things got out of hand.
I started trusting myself again.
That doesn’t mean I never experience symptoms.
It means I have tools, support, and a treatment plan that help me manage them.
People sometimes talk about taking psychiatric medication like it’s a personal defeat.
Like needing it means you didn’t work hard enough to heal yourself naturally, or you haven’t discovered the right mindset, or you’re somehow less capable of living a meaningful life.
I don’t have patience for that anymore.
I take medication because it helps me function.
I don’t owe anybody a more inspirational explanation.
If somebody needs glasses to see, nobody tells them they should work harder at believing in their eyesight.
My medication is part of how I take care of myself.
That’s it.
The Trans Men’s Group That Helped Me Feel Human Again
I found my trans men’s group at a time when I was getting pretty good at isolating myself.
I wasn’t necessarily avoiding people because I disliked them.
I was tired.
Tired of explaining myself. Tired of deciding how much of my medical history somebody needed to know. Tired of feeling like I had to choose which parts of myself were acceptable to bring into a room.
I wanted somewhere I could just be Malik.
Not a diagnosis.
Not a debate about gender.
Not somebody’s opportunity to prove how accepting they were.
Just a guy sitting with other guys, talking about life.
The first few meetings, I didn’t say much.
I listened.
We talked about transitioning, relationships, jobs, family, testosterone, body image, and all the ordinary things that become complicated when you’re trans.
Sometimes we talked about absolutely nothing important.
Those were some of my favorite conversations.
Eventually, I told a few of the guys about my schizophrenia.
I was nervous. I had already imagined how the conversation might go.
Maybe somebody would start treating me like I was fragile. Maybe they’d become uncomfortable. Maybe they’d start looking at everything I said through the lens of my diagnosis.
Instead, one of them asked me how I’d been doing.
Not in that overly careful voice people use when they think you’re about to fall apart.
Just a normal question.
How you been doing, man?
I can’t explain how much that meant.
He didn’t make my diagnosis the most interesting thing about me.
He didn’t pretend it didn’t exist, either.
He just made room for it.
Over time, those guys became an important part of my support system.
They aren’t my therapists. I don’t expect them to manage my symptoms or take responsibility for my treatment.
They’re my friends.
They check in. They invite me places. They tell me when I’m being stubborn. They remind me that I can ask for help without turning every conversation into an apology.
And I show up for them, too.
That’s something people forget when they talk about supporting somebody with a serious mental illness.
We’re not just recipients of care.
We have things to give.
I Am Not Your Inspirational Success Story
Sometimes people find out that I live independently, manage my treatment, and have a supportive social circle, and they react like I’ve performed a miracle.
I understand that they probably mean well.
But it can feel like they’re congratulating me for not becoming the person they assumed I would be.
The expectations are so low that simply having an ordinary life becomes extraordinary.
I don’t want that.
I don’t want somebody looking at me and thinking, Wow, he has schizophrenia and he can still hold a conversation.
I want them to think about what I’m actually saying.
I want people to disagree with me when I’m wrong, laugh when I tell a joke, and complain when I’m late.
I want to be allowed to be annoying, imperfect, and occasionally full of myself without somebody wondering whether it’s a symptom.
And I want to be allowed to struggle without people treating it as proof that my entire life is falling apart.
Some days are difficult.
Sometimes I need more support. Sometimes I have to adjust my plans. Sometimes I recognize warning signs and contact my treatment team.
That’s not failure.
That’s me taking responsibility for my health.
Living well with schizophrenia doesn’t mean pretending it isn’t there.
It means building a life where the diagnosis is something I manage instead of the only thing people see.
Stop Using My Diagnosis as an Insult
Here’s what I wish people understood.
Schizophrenia isn’t a synonym for being unpredictable.
It isn’t a clever way to describe somebody who changes their mind.
It isn’t shorthand for violence, stupidity, or being disconnected from reality in every aspect of life.
And it definitely isn’t a punchline.
I know some people are going to read that and say I’m being too sensitive.
Maybe they’ll tell me everybody gets joked about, or that comedy is supposed to be offensive, or that I should learn to laugh at myself.
I can laugh at myself.
Ask anybody in my group.
But there’s a difference between laughing with somebody and reducing an entire group of people to the most frightening stereotype you can imagine.
When the only version of schizophrenia people encounter is the dangerous stranger in a horror movie, that affects how they respond when somebody in their actual life needs help.
It affects whether people disclose their diagnosis.
It affects whether somebody feels comfortable seeking treatment.
It affects whether a person believes they can have a future after hearing those words from a psychiatrist.
I know because I had to work through some of those same assumptions myself.
I was afraid of what schizophrenia meant partly because I’d spent my life hearing people use the word as something terrible.
And now I’m living proof that the story is more complicated than that.
Not because I’m special.
Because people with schizophrenia are people.
I Have a Future, and It Belongs to Me
I’m 30.
I still have things I want to do.
I want to travel more. I want to keep building friendships that don’t require me to explain every part of myself. I want to get better at cooking something other than the same five meals.
I want to grow older.
That’s a big one.
There was a time when imagining the future felt overwhelming. Now I can think about being 40 or 50 without immediately wondering what my diagnosis will take from me.
I don’t know exactly what those years will look like.
Nobody does.
But I’m allowed to look forward to them.
I’m allowed to have ambitions that aren’t centered on overcoming schizophrenia.
I’m allowed to be a Black man, a trans man, a friend, a partner someday if that’s where life takes me, and a person whose biggest problem on a particular Tuesday is that SEPTA is running late again.
I’m allowed to have an ordinary life.
And if there’s one thing I want somebody newly diagnosed to hear, it’s this:
Your life isn’t over because you have a name for what you’re experiencing.
You may need treatment. You may need support. You may have to learn things about yourself that you never expected to learn.
Some days might be hard in ways other people don’t understand.
But you are still a person with a future.
You still deserve friendship, respect, autonomy, and the opportunity to build a life that feels like yours.
You don’t have to become an inspirational story to deserve those things.
You don’t have to prove that you’re one of the “good ones.”
You don’t have to make yourself smaller so other people feel comfortable around your diagnosis.
My name is Malik.
I’m Black. I’m trans. I have schizophrenia.
I take my medication. I love my people. I laugh too loudly sometimes. I’m still figuring things out.
And none of that is a punchline.
It’s just my life.
