I started, taken aback. What did my emotions have to do with my eczema? “What do you mean?” I asked.

She didn’t speak right away, but the kindness in her expression surprised me. She was asking out of genuine concern, as a sister or a friend might. I felt cared for. Seen. Somehow she could tell that underneath my raw and painful skin was a heart crying for help so quietly that even I hadn’t heard it. Before she could speak, I burst into tears.

Coming out as trans to my partner, Norman—showing the entirety of myself to him—had been a major step. But there were still so many people I was keeping in the dark, so much of myself that I was editing out anytime I opened my mouth to speak. My life had been one long transformative, transpacific, transcontinental, transgender journey, and by staying stealth—living as a woman without telling others I was trans—I was showing only one tiny sliver of it to everyone else.

The rash all over my skin was trying to tell me something. The message was etched all over my body; my insides were crying out to be heard.

“I need to honor my eczema!” I blurted out between sobs, right in the middle of the exam room. I knew what I needed to do; all I had to figure out was the timing and the method.

“Take care of yourself,” my dermatologist told me as I left her office that day, after giving me a prescription for steroids and some instructions for lowering my stress level while managing the pain.

Walking up Church Street after the appointment, I had a clear view of the Manhattan skyline, stretching all the way uptown. There was a skip in my step, as all the city’s possibilities spread out in front of me. Usually I hated being seen with my rash, but that afternoon I felt like the woman on the street in one of those Maybelline commercials: “Maybe she’s born with it, maybe it’s stress!”

When I got home to the Upper West Side apartment I shared with Norman, I was tempted to tell him everything I’d realized. But I wanted to keep it to myself for now. To let the idea marinate. This was a step in my journey I wanted to figure out myself first.

A few weeks later, Norman asked me how I wanted to celebrate my thirtieth birthday. “Tulum!” I told him a little too quickly. It was obvious I had been waiting for him to ask. The rash had subsided by then—not all the way, but enough to give me some relief—through a combination of medicine, yoga, and meditation, although the true healing was coming from deep within my soul. If stress had caused my eczema, I needed to get my feet in the sand and an umbrella in my drink, pronto.

The property we stayed at—Residencia Gorila—was gorgeously appointed. In the middle of the lush courtyard was a small, five-foot-deep dipping pool, and the shared outdoor kitchen was kitted out with a stove, a refrigerator, and a blender. Every morning I woke up at five to watch the sunrise on the beach, admiring the way the light arced over the ocean, painting the massive, billowing clouds in tropical shades of orange, purple, and pink.