Jaw feminization

I just talked to my oral surgeon about what can be done to feminize my chin, the biggest source of dysphoria for me at this point, when I go in to align my teeth this Winter. This is a major oral surgery I’ve been dreading for almost 10 years now as I waited for the right insurance and financial stability to make it possible. But now that there is the possibility it could make my face more tolerable, I’m actually excited.

I started the process 2 years ago when I first met with the surgeon before I was out and thinking about what the impact of my prominent, square, cleft chin was. I’ve been using my beard to cover it up for so long that I sometimes forget that this really ugly-feeling part of me is underneath. I found out just how much it would cost and realized I needed a new job to make this work. The next step was the braces I got installed in January which re-align my teeth back to where they will need to be after the surgery. Unfortunately, in the short term, the braces have made my dysphoria and confidence worse. The first day I had them I dissociated so badly that I felt like I was walking around viewing the world through a long, dark tunnel. It has gotten better since but I still can’t wait to get them off.

But the end of stage one is finally in sight so I got up the courage to reach out to the surgeons office to find out if there were parts of facial feminization that could be accomplished as part of this procedure. I was both excited and terrified as the appointment got close this month fearing that he would just dismiss my concerns and focus on function. But it went surprisingly well. For an old white cis dude he seemed to really get it. He talked about the various things that he can do to tilt the lower jaw back, shave off the harsher edges, and bring it more in line with the rest of my face. He even was aware enough of the gendered aspects that he is suggesting increasing how much of my upper teeth are visible when my lips part because apparently that is a feminine trait.

He was cautious about over-promising and he is limited with how much he can do because of the potential impacts on my breathing and sleep apnea and the amount of muscle I have on my chin. But I am hopeful that it can be enough better that I can actually face myself in the mirror without my beard. He promised to do some advanced prediction models and show me several options we can discuss at our pre-surgery appointment so I can have some say in how my new face will look.

I’m especially excited for this since my insurance doesn’t cover facial feminization. And overall that’s not really a primary concern of mine on the rest of my face since I have great cheekbones (even according to the surgeon) and a good nose that balances my face. So if I can get this all done in one surgery that I’ve been planning for so long, I will be very happy.

Now to see if I can actually live without the beard for the next few months before surgery. I haven’t gotten up the courage to go into the barber yet…

Shaving prep

So I’ve decided that I’m going to at least try shaving soon and see if I can get used to my chin. I was going to wait until just before my jaw surgery this winter but I’m growing increasingly uncomfortable with how people read me due to my beard. While I want to be confident and not care, I think it leads to even a lot of allies not realizing that I’m trans. And it gives me a lot of impostor feelings.

One of the many reasons, other than latent chin dysphoria I didn’t have a word for at the time, that I grew the beard in the first place is because my facial hair is very dense, thick, and curly and grows quickly. Because of that, I got a lot of ingrowns and my face didn’t tolerate shaving well. So I definitely need to step up my game. I talked to a friend who is an expert and I’m going to go into The Art of Shaving to get good supplies and tips. Other than a quality razor and exfoliating at night, what else can I do to keep my face smooth and soft?

It’s been 12 years since I’ve shaved regularly. This is going to take some getting used to.

Curves and Clothes

With the changing of the seasons and the rainy season beginning here in Seattle I’m pulling back out the clothes I haven’t really worn since before estrogen. And I’m amazed at how much better they feel on my body and how great I feel in even some of my older androgynous type clothing from the men’s section. Having curves underneath an otherwise straight cut pair of pants or shirt makes the whole outfit quite a bit more feminine and affirming.

I wish I could get a photo of how good my butt looks in these stretchy pants (including matching Chucks) but this will have to suffice for now.

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Queer Choir and name change

A few weeks ago a fellow enby told me that the former associate director of the gay men’s and women’s choruses in town was starting an all gender, queer-focused choir. This is literally a dream come true for me. Some of you may recall that a year and a half ago I tried to start my own choral group for trans voices because I was so frustrated with the lack of options in town that weren’t either too binary or too heteronormative. I forgot to do a follow up post here but basically while I found lots of people who were initially interested, I didn’t have enough musical talent to train them and not enough people auditioned to make it work.

So I’ve been waiting either for the right people/time to try again or for someone else to start something so I could join. And it finally happened! Someone else had the same vision and was much better connected than I am so she managed to not only get 80 people to audition but got a well known and very talented artistic director on board.

Last night was our first rehearsal and it felt so good to be singing again after a 3 year break. And what was even better was being part of a bass section with several other nonbinary people as well as trans people from both directions. The tenor section was half women too which was super fun to hear. I got several of my friends to join and I’ve already started making new friends.

I realized about halfway through the rehearsal that this is my opportunity to try out my new name in earnest. I switched my middle name to my chosen gender neutral/femme leaning name last year and I have been trying it out at home and among close friends tentatively the last couple weeks. But here I have a chance at a new start with a group where the only people who know me are fellow trans people and it is by design mostly (if not all) queer and very inclusive. I did have to do some explaining to some people who met me at auditions or when I first came in the door but people were very understanding.

So double excitement! A chance for a fresh start and new name context as well as the choir I’ve always dreamed of! The first rehearsal went so much better than I expected and we sound amazing. There’s about 70 people and everyone is equally enthusiastic. I can’t wait to hear how we sound by our concert in Dec.

Sex vs Gender: two sides of the same coin

So I know a lot of trainings, including many written by trans people, like to separate sex and gender into different concepts. But in my experience they aren’t all that different and are so integrally tied that you can’t actually separate the two. From an external perspective I think sex is what you are assigned at birth because doctors and parents make an assumption about a binary future for you based on your genitals (and sometimes force surgeries on intersex babies if they don’t match that vision because sexual characteristics aren’t binary either). Gender is what people assume about your genitals and often your behaviors and experiences based on visual cues later on. They are just two sides of the same coin. The only real difference is what external markers you are using. When I was born they assumed I was male based on my genitals and now people assume things about my genitals based on signs such as my beard and build.

Well this gets complicated of course when you are trans or nonbinary. You can do a lot to change your external appearance through clothing, hormones, and surgeries. And since sex isn’t actually based on chromosomes since most people have never been genotyped, I think those changes arguably change your sex tangibly as well. I don’t think I am a feminine person with a male sex. I now have breasts and an estrogen dominant body that is clearly and visibly nonbinary now. I would need to make major alterations at this point via surgery to go back to being a male.

So when I see forms that ask me what my sex is, I get annoyed. You can ask me what my sex assigned at birth was as a data point if you need. But my sex and my gender are the same thing viewed from different lenses.

Now internal gender is a lot harder to define but that’s a post for a future day.

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?

The path to coming out can be long and winding

It’s been 7 years since I finished college but I’ve been thinking recently about why I was so closeted there, even to myself. And I think a lot of it is because my sexuality is so tied up in gender and I didn’t have the words even then to see or describe myself. There were also some major barriers that got in my way.

When I first came to University, I was probably one of the most conservative people there, even at my conservative evangelical college. I was just coming out of my fundamentalist homeschooling experience and starting to actually see parts of the world on my own for the first time. And while I was starting to be a little more open to HEARING new ideas, I definitely wasn’t very open to the prospect of changing what I believed. My parents didn’t want me to attend because it was clearly a “liberal” school where they taught evolution. So I came armed with an entire box of books on how to refute evolutionist teachers and “prove” 7 day creationism.

At that point in my life I had never knowingly met an out gay person and I had never even heard of trans people, much less the concept of nonbinary identity. But I was admittedly a very sensitive and naive kid who in part because I wasn’t exposed to a traditional schooling system, hadn’t had much of my gender nonconformity questioned.

My first year I had many hilarious mishaps because I desperately wanted to be friends with the women around me but every time I tried to get close in what I considered to be platonic ways, people always mistook that for attempts to date. Admittedly asking someone to go sing love songs from musicals in a practice room probably would be a date for most people. And when they found out that I wasn’t interested in dating, most people put that together with my sensitive nature and assumed I was gay. There were apparently bets going on about how long it would be before I came out.

And in some ways they were right. I was very gay but they were assuming I was gay for guys and it turns out I was just very gay for women because I mostly am one. But I sadly didn’t figure that out there.

My second year, I screwed up the courage to attend a couple events at the campus’ controversial LGBT discussion club, mostly because I am insatiably curious. And one of those events was a panel with trans people which is where I met my first out trans person who I am still friends with to this day. My mind was blown by the idea that you could reject the gender you were assigned at birth but still my only exposure at that point was to AFAB transmasculine people and binary trans women. And I didn’t think I could ever get to the point where people would believe I was a woman so I dismissed the idea pretty quickly.

When I joined the club the next year as a regular member I started identifying myself as a gender nonconforming ally since I didn’t know where else I fit. I knew I wasn’t gay for guys and I didn’t really know much about bisexuality so I assumed me being interested in women settled the matter. I also made the very terrible choice to get married to a cis woman the summer before my Junior year, mostly so I could pay for school since my dad was trying to use money as a leverage to keep me from becoming too liberal. And at that point I assumed that your sexuality was defined by who you dated and that marriage made me straight. Being in a marriage that I thought put the questions about my sexuality to bed also helped my confidence in being part of such a controversial group.

The next couple years where very chaotic for me, both as a member of the queer club and for my marriage. This was a campus that banned all “homosexual activity” so the group was constantly at risk of being shut down. My junior year they tried to kick us off campus but we eventually rebelled and kept meeting anyway. My senior year I joined the leadership team and it ended up being a pretty crucial year. They tried to shut us down completely by telling us that we didn’t exist anymore and that we absolutely could not reserve rooms. So of course we met in the common areas which made the group less safe but definitely made our point. We weren’t going away. A 6 week intense struggle with the administration ensued where I became the de facto spokesperson for the group, even as a “ally”, and was on the front page of the school paper 4 weeks in a row and interviewed by several news outlets. Eventually the alumni organized a successful letter writing campaign and once the administration realized there was donor money on both sides they backed off and offered a private apology with the permission to not only meet on campus but advertise for the first time. The focus on our mere existence as a group definitely effected how much we could think about our own identities though.

All that time I was also going through a crisis in my marriage that forced me to put any exploration of my gender and sexuality on the back burner. Since I had come out of fundamentalism I had never dated or even kissed anyone before my ex wife. And while we had experimented with some sexual acts before marriage, that all went away about the time I got engaged. It turns out she was likely somewhere on the asexuality spectrum but didn’t have the self awareness or even willingness to confront that to figure it out. So me, a very allosexual (opposite of asexual) person at the time, was very confused when once we were married we never had sex. (The first time I had “traditional” PIV sex wasn’t until 5 years later).

She also was treating me very poorly during this time and increasingly being emotionally and verbally abusive and controlling. So I focused all my emotional energy onto trying to find the solution to fixing my marriage instead of figuring out who I actually was. After college that kept up for far too long until I eventually had the courage to leave her after 6 years of marriage. The straw that broke the camel’s back was when I did finally start to figure myself out and wanted to come out as genderqueer and pansexual and she didn’t want me to tell anyone because she didn’t want to have to answer questions about what that meant for her. She had some very deep set biphobia and it turns out her mom had been whispering in her ear the whole time that I was gay and was eventually going to leave her for a man.

The way I finally figured out my identity was through dating once I became polyamorous as a last ditch attempt to figure out how to make a sexless marriage work. I knew by that point I was not only attracted to women but also to nonbinary people and it was a fellow enby who pushed me to think about how to broaden the definitions of androgyny and think about myself in that context. And by realizing I was attracted to transmasculine people, it helped me unlock my queerness and realize that I was also attracted to a variety of body parts.

Anyway, the point of that story is that there are lots of barriers in life that can prevent you from discovering who you really are. And sometimes it requires addressing those barriers or figuring out the complex intertwining of gender and sex that unlocks that door. I really wish I had figured out who I was sooner but in the end it worked out for me.