The What

Exploring surgery further

Content warning: I’m going to be talking about sex and genital surgery. Be forewarned.

Now that I have done some work in therapy to work through my fears about surgery, I am starting to explore my options in earnest.

For years I thought that I wouldn’t want to get surgery unless I found an option where they could add a vagina while keeping my penis intact. This was partly based on how I envisioned myself and those I was attracted to in my dreams as a teen. Before I knew that trans people existed, most of my imaginations centered around people who had both sets in tandem, sometimes with retractable phalluses and always with breasts. A year ago I tried to do some research to see if that was possible. At that time they had just successfully done the first neo-vagina made from peritoneum, the internal connective tissue in your abdomen. But everywhere I looked people either weren’t talking about that option or claimed that it was impossible to construct a vagina without damaging the penis.

So I had pretty much given up on that idea and gotten on board with a standard penile inversion vaginoplasty. But this time when I started doing research on surgeons I came across the website of Dr. Heidi Wittenberg who mentions that for gender nonconforming people she offers a penile preservation vaginoplasty. I can’t find many details online about the technique but apparently it involves using skin from another area such as doing a tummy tuck or a strip from the thigh. The scrotum is still used to build the labia and the phallus is left intact. And I hear from other trans people that she isn’t the only one. There are several surgeons who trained under Brownstein and Crane who can do this.

The odd thing is, now that I’ve finally found the thing that I always thought I wanted, I’m not sure that’s actually what I want. The more I think about it the happier I am with the idea of having a well constructed neo-vagina. I’ve seen the work that surgeons can do firsthand and it is incredible how hard it is to tell that it isn’t natal.

Luckily I don’t need to decide just yet. Next year is my jaw surgery (hopefully with some chin correction while I’m at it) and I know I can’t afford both in the same year so this will have to wait until at least late 2019 or probably 2020. My current plan is to go to both Gender Odyssey in Seattle and Philly Trans Wellness to learn more about the current techniques and hopefully catch Dr. Wittenberg’s presentation. I can get a consultation there and schedule something if I want. I do like the idea of having a surgery done with someone who recognizes transitions outside the binary and can talk me through the options. Not to mention that she specializes in Gynecologic urology exclusively for trans people and is considered an expert in neurology and minimally invasive surgery. Currently her waitlists appear to only be 3 months which is much better than most of the surgeons out there.

What I have noticed is that making up my mind that I do want surgery and giving myself permission to explore that in earnest has improved my sex life quite a bit. My libido has picked up and I find myself more ready to utilize my penis now that I know it is short term. It almost feels like I want to make good use of it while I have it as a way of wishing it goodbye. I have also noticed a difference in sensation as my brain rewires itself for estrogen. The head of the penis is more sensitive almost to the point that it already feels like I imagine a large clitoris must feel. And stimulation on the shaft somehow evokes the sensation of being penetrated. Not sure how to describe that and how much is me envisioning it in different ways but it does feel more and more like what I have right now is an inverted vagina, not the same penis I used to have.

That may be TMI but you can’t say I didn’t warn you.

2 year blog-iversary

Today marks my 80th post and 2 years since I first launched this blog with the intention of creating more representation of the joys and struggles of being an AMAB feminine nonbinary person. It is also the 2 year anniversary of when I first started presenting as feminine full time thanks to a new job with a supportive team. However my journey towards being conscious of my gender first started almost 10 years ago when I began discussing gender with a college support group. It has been 4 years since I went on my first date with another nonbinary person who helped me realize that the definition of genderqueer was broad enough to contain my complexity. And over 3 years since I came out publicly.

The experience of writing a blog has been surprisingly wonderful. Before this I never considered myself much of a writer and certainly didn’t do so for fun. I did it mostly for myself as a way of documenting where I was at in my thinking along the way. But also in the hopes that some young baby-trans person might stumble across it and find it helpful in framing their own thoughts and seeing themselves represented. I never imagined that more than a few close friends would be regular readers. And I certainly didn’t in my wildest dreams guess that 2 years later I would have gained over 50 followers and had 13,000 views by 6,700 visitors.

Now, thanks to my writing here, I will soon be a published author with a chapter in a nonbinary anthology. It has also helped me become a stronger and more self aware person and started many conversations that I hope have pushed people to think about things in new ways. Thank you to all of you who have supported me in this journey so far, especially my spouse and chosen family. I couldn’t do this without your continued encouragement.

My gender

After further thought I think I can say as clearly as life will allow right now that I am definitely nonbinary but I would much rather be assumed to be a woman at casual glance than assumed male. I’m not sure exactly what my transition will look like yet but I will likely be doing what looks more like a binary path from the outside but rest assured, even when the beard disappears I’ll still be your lovable genderqueer tomboy. That’s all for now.

Thoughts on surgery

My brain has been rather obsessed lately with thinking about if and what next steps I should take in my transition. So I’ve been trying to figure out what my options are around gender affirming treatments and beginning the very overwhelming task of delving into the surprisingly difficult question of what do I actually want.

Unfortunately I’ve found, with the help of therapy, that that question is very deeply tied to the related question of what do I actually believe I deserve. I didn’t realize I had so much around self worth entangled with my transition. While I 100% support my friends who pursue gender affirming surgeries, I have a hard time convincing myself that I am worth spending that much money on. I had the same issue with my upcoming jaw surgery to correct a crooked internal angle that prevents me from biting on one side. A lot of emotions came up as I went through the steps to book it and talked with my spouse about the money involved. I don’t know the full costs yet but so far we have shelled out $5,500 out of pocket for the braces and I have some significant guilt around needing her help to do that and taking away from money we could use on other things, especially in this political climate.

I firmly believe that while surgeries and treatments are definitely not required to be a valid trans person, they are medically necessary in various forms for many of us as important treatments for gender dysphoria. And I certainly have been having a lot of increased dysphoria lately. But when it comes to the next logical step of then believing that I deserve these treatments, I fall into the trap of hearing all the naysayers whispering in my ear about how trans people are too expensive and a burden and, and, and…

So I’m trying to work past that part of it. But there are also other fears to conquer. I realized I have a very deep fear that I will go through all these steps to try to get closer to the person I know I should be seeing in the mirror and still not feel like I can achieve it. I worry that being so close will just make the last little bits that I can’t change, things like not being able to be pregnant or have the kinds of sex I want, even more frustrating. That’s certainly the biggest thing holding me back from thinking about vaginoplasty.

I realized recently that vaginoplasty is covered by my insurance. Of course there are no surgeons in Western Washington and wait lists are a mile long but theoretically, this is one of the easier things to accomplish financially on my list of options. But that is also the one I was most unsure about. Mostly because I was afraid that I would have complications or worse, that I wouldn’t be able to orgasm afterwards. I don’t particularly like the equipment I have now but at least I know how it works and have figured out how to get it to do what I want, at least some of the time (though that is getting harder while my brain is undergoing estrogen rewiring projects). And is it worth the risk for the potential reward? And am I just caving to transmedicalists (aka truscum, people who think you need surgery to be trans) and societal pressure if I take a more linear transition path?

Arguably, the things that would make a much bigger impact on my dysphoria and certainly on my ability to function in the world are facial feminization surgery (FFS) and hair removal. Unfortunately those are the things that my insurance has classified as “cosmetic” and doesn’t cover. Hair removal is top of my priority list and as I discovered last time, is very expensive. So I am trying to call around and see if I can find a clinic that would work with me to fight insurance and advocate with my doctor for its medical necessity.

Facial feminization is a greater challenge. I’ve realized only recently that the main reason I keep my beard is because it hides my chin, which I can’t stand looking at in the mirror. I’ve obviously grown to love it as evidenced by the name of my blog and how much it has shaped my identity. But it’s also just a tool to reduce dysphoria which has the unfortunate side effect of making me hypervisible. And even in a city like Seattle, it’s no fun being able to be spotted as trans from 3 blocks away. Increasingly I’ve been realizing how much my beard shapes how exhausting daily life in public is for me. But I don’t think I can shave it off unless I at least have a plan for what to do about my chin.

My chin is rather prominent and cleft. In my head and when I look at photos of the few times I’ve shaved (only twice in 12 years), it looks like Gaston from the animated Beauty and the Beast – comically large and masculine. There is a possibility that with estrogen softening my facial features, I will end up liking my face without surgery. Or that after my jaw surgery I will like my look better. But I am honestly scared of having to shave next winter to do that.

Facial feminization is a very expensive proposition. I’ve heard estimates anywhere from $7k for just the chin to $30k. And the odds of me getting insurance to cover it seem pretty slim. I did take the step of emailing my jaw surgeon to see if there is any chance he can leave off the portion of my chin he was planning on rearranging in the surgery or if he would be willing to partner with a specialist to do the work while I am already in surgery. No word back yet though.

I have talked a lot with several trans women in my life over the past couple weeks as these thoughts have been distracting me which was very helpful. And the more I talk about it, the more I realize just how much I’ve been trying to ignore my dysphoria out of fear and shame. I desperately want to be the self confident, visible, bearded trans icon that people seem to think I am. But the reality is that I am having an increasingly hard time looking at and thinking about my face and genitals. When I shave my chest, stomach and legs, I can almost start to see something that looks attractive. And sometimes a good photo can make me feel ok about my face. But my crotch often feels like a black hole on my body, something that doesn’t exist. Or sometimes my genitals feels like a fake nose someone glued on my body when I look in the mirror. And it makes relationships a lot harder when you are moving farther along the asexuality spectrum.

I need more time to think about it but I wanted to get some of these thoughts down while they were still fresh. I don’t know what the answers are yet but I’m increasingly starting to think that the fact that I can’t stop thinking about these questions means that these are inevitable steps I have to figure out how to take.

On a lighter note, if I eventually get rid of my beard, what should I call my blog? The Artist Formerly Known as Genderbeard?

Bra shopping adventures

After a month of searching I finally have some bras that fit! And it feels so right to have it on now that it’s the appropriate size.

I started out with a trip to my local Lane Bryant where I’m usually treated really well. Unfortunately the sales associate I got this time seemed taken aback that I would ask for bra measurements and rushed through it and then disappeared and wasn’t helpful in finding options. And it appears she measured me wrong too. She said I was either a 42B or 40C (anyone can look at me and tell I’m definitely not a C yet). But I tried on the few options they had for 42B and they didn’t fit well, especially since they were all underwire which I don’t need at this point. And the bralettes they carried had a flattening effect which is the opposite of what I want right now.

So I went home disappointed and decided to try online since my size is rare to find in stores. I first tried an order of 42B wire-free bras from HerRoom. And I managed to find a couple that looked good if I used my silicone breast forms. But the jump from having very little to suddenly being in a padded and stuffed B cup didn’t feel right. And the silicone against my chest made me sweat like a pig in the summer heat. Every time I looked down or caught it out of my periphery, it felt like I was an impostor for being so large so suddenly.

So this time I tried ordering some 42A bras from Bare Necessities. They just arrived last night and today I’m wearing the Coobie Comfort Bralette with molded cup inserts which lives up to its name. I also got the padded Leading Lady Smooth Wire-Free Bra which fit well with a little bit of room to grow. This time it really feels like the right size and shape for where I’m at. And especially with the bralette I like the comforting feel of the gentle pressure around my chest.

I still don’t have many options for shopping in stores with a large band size and small cup but at least I know what to look for online now. And I’m still growing of course so eventually I should properly fit those B cup bras. I’m at the 4 month mark after HRT now and while the growth has slowed down, they are still tender which means they are still growing. Hopefully I’ll have another growth spurt soon and my right side will catch up with the left.

IMG_1159

Bra feels

Today is my first time wearing a bra for a functional purpose. And I’m honestly not sure how I feel about it. Every time I look down it doesn’t quite feel right, probably because I’m not use to that being in my peripheral vision. It’s not that it’s physically uncomfortable because I found a good Bali bra from HerRoom without an underwire but it’s just a new self-image adjustment. And in a way I feel a bit like I’m being deceptive.

When I was measured at Lane Bryant they told me I was a 42B but I really don’t quite have a B cup yet so I’m supplementing with my silicone breast forms and using a padded bra. It’s hard enough to find them in that size with the large band and small cup – Lane Bryant only had a couple for me to try on that didn’t fit well so I ended up going online. And yet bralettes don’t feel good because they end up flattening and acting more like a binder than emphasizing what I have.

Don’t get me wrong, this is how I eventually want to look. It just feels weird to go from very little one day to a full chest the next. I wonder what my coworkers think because I’m sure they’ve noticed.

IMG_1120

The dress is a custom design made by my partner for when we went to see Hamilton made with a vinyl iron on from her Cricut. Also, I’m trying out a new hair color that was supposed to be a bit more purple but ended up Rose Gold.

Increasing Dysphoria

Isn’t being on hormones supposed to help dysphoria? I mean it’s helping my confidence in my chest and overall shape but it’s definitely bringing up more feelings about my face in particular among other things. The biggest effect that estrogen has had so far other than breast growth is that it is making it harder to ignore things I’ve been burying and ignoring.

I often have days where I look in the mirror and literally see a blank where my face should be. My brain can’t handle the cognitive dissonance between my real appearance and my identity. And even more often I find myself avoiding mirrors or hyperfocusing on my hair to avoid looking at my facial features. And I can’t decide whether growing out my hair would help that or make it worse.

I’ve kept my beard thus far because it hides parts of my face that I can’t handle, especially my chin. But more and more I wonder if it is doing more harm than good. I get stares everywhere I go because people don’t know what to do with a bearded person in a dress. And it makes it so that I can be spotted blocks away as trans. I mean it’s not like I can hide easily with my height and tendency to wear bright colors, but maybe I don’t need to make myself that easy to spot. It also gives me a lot of “not queer enough” feels and makes me avoid spaces that are supposedly for femmes because I don’t think I would be accepted with my features.

But the thought of removing my beard and having to come to terms with the face underneath terrifies me even more. I am dreading what is going to happen when I’m forced to shave next winter for a long planned jaw surgery to correct my bite. But I also find myself wondering if there’s a way to capitalize on that to change my face. From what I remember of the consult, they are already going to need to make adjustments to my chin to make my face symmetrical and I wonder if I can talk the oral surgeon into taking some of it off permanently. Or if I could work with him to do a combo jaw surgery and facial feminization technique. The thought of cutting open my face twice doesn’t sound pleasant.

Then there’s the matter of my genitals. I’m feeling more disconnected from them recently which goes along with my feelings of asexuality. Most days I’d rather forget they are there and sometimes my brain does that for me. The other day I was on a date and I was trying to get myself in the mindset but everytime I thought about what was between my legs all I could picture was a black hole. I ended up not being able to do anything with my own body because I couldn’t reintegrate. Luckily queer sex doesn’t revolve around a penis or any specific kind of sex. But when I think about bottom surgery I’m still not sure whether having different genitals would help at all.

I’ve also realized that I only feel confident at all when my chest, stomach, and legs are shaved. Which even with the estrogen means trimming twice a week. I need to go back for more hair removal but I can’t decide between laser which requires $1,400 up front for 3 sessions (probably twice) or electrolysis which has more guarantee of permanency and I can break into smaller chunks but means more sessions.

Basically I’m feeling dysphoric most of the time now but I don’t know what to do about it and what interventions would help and how I would pay for those. So my brain gets overloaded with that background anxiety and I end up being less productive or mildly dissociating. I know I should try to do things that connect me with my body more instead of just escaping into video games. But I have a hard time figuring out how to do that in ways that a) don’t involve gendered locker rooms, b) don’t trigger my asthma (running is out of the question), and c) don’t make my back and neck pain worse.

There’s a little peek into what’s in the back of my brain most of the time these days. So when you ask how I’m doing and I say I’m fine, please know that there is a giant asterisk there.

Debunking “Biological Sex”

So this is probably an unpopular opinion but I think the term “biological sex” is meaningless, as is the distinction between sex and gender. While I continue to hear trans people use it and share it in various forms such as the problematic genderbread person, it is primarily used by cisgender people as a way of convincing themselves that the binary does exist in some form even if they support diverse gender identities. But as a biologist (by training) and a real life trans person™, I am here to tell you that it is just as much of a shared illusion as binary gender.

Hopefully by now you are aware of the existence of intersex people. According to the Intersex Society of North America, “intersex is a general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male.” Without going into excruciating detail because you should hear it from intersex people themselves , both chromosomal sex and reproductive organ configuration exist in more than two options. There are 6 different ways that chromosomes can combine (X, XX, XXY, XY, XYY, and XXXY) that create various different kinds of humans and most people never have their chromosomes tested so using this as the basis for your gender is ridiculous. And various other changes in development mean that regardless of genetics, genital variation is nearly infinite.

But even putting intersex people aside for a moment, let’s talk about how useless the term biological sex is when you are dealing with reality. Many trans people such as myself have known from an early age that our brains are different. Long before I ever knew the term transgender or nonbinary, I thought that I didn’t fit in because I didn’t have a boys brain. And more and more evidence suggests that the brain can develop in utero in ways that more closely match the gender identity that child eventually expresses than the gender they are assumed to be based on external signs (although even that research is hopelessly binary). Though huge disclaimer here because there is no one way to be trans. Not everyone knew they were different from birth and not all trans people experience things like dysphoria.

Ok, so say you put aside natural variation in genitals AND you ignore differences in brains. Well I hate to break it to you folks, but the differences continue to be useless. Trans people do not all experience socialization the same way or come out at the same age so there is no point at which you can make a valid argument that we are somehow “essentially male” or some such bullshit. And there are MANY different kinds of gender confirmation surgeries that make trans bodies infinitely variable and often indistinguishable from their gender.

So what’s the point of this? It means that you should stop using terms like “female bodied” or lumping people together based on binary genital arrangements. And you should stop saying things like “all women are” and reducing your research to binary sex results. Yes, statistically there are vast swatches of people who never have cause to question their gender or assumed sex. And you could do your research based on those people and ignore the tails of those statistical curves. But you are missing out on some of the most amazing parts of human experience when you do so. I am here to tell you that the conversations that happen among trans and nonbinary people behind closed doors that cis people rarely get to experience would blow your mind! And because of constructs like “biological sex”, many of these people intentionally avoid revealing that complexity to cis people and often rule out dating or interacting with you altogether.

So if you want to benefit from what we could bring to the conversation, think deeply about how you can be more inclusive and the assumptions you make on a daily basis. We are here and we are so much more queer than you could possibly imagine.

Religious but not Spiritual

As open as I am about most things, one of the most challenging things for me to admit both to myself and to those close to me is that I am really struggling with how I engage with religion and spirituality lately. This isn’t necessarily a post about gender but I think it is important to show how everything in your life can be interrelated and this is (or was?) a significant part of my life so I want to take a moment to talk about it honestly here.

In the past I was skeptical of people who said they were spiritual but not religious because that seemed like an artificial divide to me. But more and more I am coming to see how that distinction is meaningful and how I have been essentially practicing the reverse for the past decade. I’ve been religious but not spiritual.

I honestly don’t know what I believe. I guess that makes me an agnostic. I don’t think you can ever rule out or disprove a god or deity or metaphysical property because by their very nature they are outside of science and tangibly observable facts. But the way I’ve been justifying my continued involvement in Christianity and the Episcopal Church is because humanity has been searching for the divine and building religious structures as ways of doing that communally since before the dawn of agriculture and civilization as we know it. And I figured that if so much of human history has been devoted to that, it is pretty foolish of me to think I am outside of that pursuit. I use Christianity as my lens mainly because that is my culture and the context in which I grew up and I don’t want to appropriate someone else’s religion and culture, especially when I am not ready to lean into it as a whole but approach any religion as a skeptic.

As I’ve mentioned before, I grew up in a Fundamentalist Evangelical Christian community. And built into that culture is a lot of spiritual abuse, patriarchy, and denial of the real world in many forms such as rejection of scientific discoveries, gender variance, and sexualities. I am sad to say that their techniques worked on me and for a long time I was a good Fundamentalist bible-thumper who had successfully pushed my questions and doubts to my subconscious and at least ostensibly bought into the propaganda hook, line, and sinker. So part of the reason I stayed in the church is because I thought it was important to heal from that past by reclaiming “good” Christianity or at least fully understanding how it didn’t need to be practiced that way. If I had just run away I don’t think I would be the same person I am today.

But my doubts have never gone away and the harder I try to lean into the discomfort, the more resistant I grow. It’s been a long time since I’ve believed in miracles, divine intervention, the heaven/hell divide, or “the power of prayer” to do anything other than change (or more often confirm) how the person praying thinks. Does the afterlife exist? Maybe. But I don’t know how it has any relevance to my life if I don’t believe in a god who would send people to hell and wouldn’t want to spend eternity with one who does.

And my doubt isn’t exclusive to Christianity either. In queer community there is an abundant amount of “woo” in the form of astrology, tarot cards, reiki, meditation, pagan rituals, witchcraft, etc. And while I’m slowly learning to just accept that other people find meaning in it I don’t think I could ever dive into that with an open mind myself.

For years I’ve been going through the motions of going to church partly for the reasons above about reclaiming and retraining myself, partly because I want to change the church and make it a more welcoming place for people who want it, and partly because I think intergenerational community focused on doing social justice work together is valuable. But recently I’ve realized that the only thing that keeps me coming back is the people. I am lucky enough to have spent the last few years in a very affirming and supportive small community where I have made many friends. And because of that I’m tied into various commitments like childcare, hospitality, and policy changes.

Lately I’ve noticed an increase in my anxiety every time I try to engage in anything related to church. It started out slowly with more and more resistance to attending on days I didn’t have commitments, but lately I have started having near anxiety attacks just sitting through services and last week when I tried to go, I couldn’t even get up the courage to walk through the doors. Part of it is that I feel like an impostor but there is definitely something deeper going on. And I suspect the reason it is really surfacing now is because the estrogen is really shaking out any emotions I haven’t dealt with yet.

I spoke to my very wise, queer femme priest who said this about what might be going on: “I think Christianity (all Christianity, not just bad Christianity) is wired into you entangled with the kinds of ways you were taught to shove yourself down and hate yourself. I think this is true biologically, even, that the neural pathways that are marked “Jesus” are also marked with the awful things you were told about how to be and how to behave, and that any encounter with Christianity, whether in line with your values and politics or not, sends an alert down that pathway. That’s a lot. It may or may not be reclaimable. But to repeat a pattern of forcing (the way you forced yourself to conform, and forced yourself within your marriage) with Christianity will likely only do you harm.”

I think she’s really onto something there. Christianity may not be something I can reclaim, at least not right now, and I need to listen to the wisdom of my body instead of fighting it. Christianity was integrally tied to painful and abusive parts of my past both through my upbringing and with my ex wife who wanted to be a priest and felt threatened anytime I had doubts. So as much as it hurts me to say, I need to step back from church for the time being. I need to find the things in life that give me hope and meaning and right now that isn’t religion or spirituality. But hopefully I can learn to open myself up to what is next.

PMS sucks – HRT week 10

I know this isn’t news to anyone who’s had an estrogen-dominant system but PMS really sucks. Apparently I’ve already settled into a monthly cycle because I am SO grumpy today and ready to burst into tears over little things. When I look back at my messages this happened almost exactly a month ago. And surprise surprise, it matches my spouses cycle. Also my boobs hurt way more than usual. Maybe the bra shopping trip I was planning for tonight will have to wait…