No, you do not have to live as a man; 

it is an act of moral choice. 

But you cannot live as anything else—

and the alternative is that state of living death 

which you now see within you and around you,

 the state of a thing unfit for existence, 

no longer human and less than animal, 

a thing that knows nothing but pain 

and drags itself through its span of years 

in the agony of unthinking self-destruction.