Good timing for this thread, just last night I had a bit of a dysphoric moment when I was getting ready for bed. I was deciding whether to wear my soft packer to sleep (which I have done since I got it), and I felt kind of ridiculous for "needing" a piece of plastic in my pants just to feel comfortable. I got down on myself like "it's not real anyways" and crap like that, but while still feeling like "but I want to have it there all the time", and thus feeling ashamed and guilty that I needed some fake, security-blanket-like thing. Long story short, my partner was very reassuring and helped me to see that it's not "real" in the sense of flesh and blood, but it's not fake either. What it's symbolic of, or a "placeholder" for, is real to me - and will be real flesh and blood someday, and that's what counts in the long run.
It seems that whether I was aware of it or not, the lack of a penis is more disturbing to me than the presence of that "gaping maw" ever was (although, obviously, I'm not a fan of "it" either...). With the parts I biologically have, I know that my "clit" is my penis, my "vulva" is my scrotum, etc., and so even without the packer I can "rename" things and not be as bothered by the presence of what's physically there, but it still doesn't add up to the *rightness* of having something more substantial there that feels like what I *should* have. And now that I'm used to having the packer there, it feels that much more *wrong* when it isn't there...
As for bleeding every month, it is my biggest area of dysphoria of all. Not only does it grab me and shake me and scream in my face "see! female body!", but the flood of estrogen pretty near destroys my self worth and pushes me right back into that female persona that I'd affected for so long in order to be accepted, and now have finally shed - for three weeks a month at least. It also robs me of using my packer and/or STP (because I can't use tampons), and it's impossible for me to mentally reassure myself of my male identity when all of my coping tools have been taken away, and all of these physical feminine traits are thrown in my face. It's the worst week of every month. It always was, even before I realized why, but now it seems worse because I had climbed out of my cave of despair, and this puts me right back down there every time.