How I knew I needed Surgery

Content Warning: I’m going to talk explicitly about sex in this post.

How did I know I needed surgery? It is a question I get a lot in different forms and it’s a good question, particularly for other trans people to ask each other.

My earliest inklings were from when I first learned what vulvas were. I was immensely curious as a child so I secretively turned to my local library and sex education websites to find out what women had that made them so amazing and supposedly so different. That’s when I found out the beauty that was the human vulva, vagina, and especially, the magical clitoris.

What was initially curiosity quickly turned into an obsession. And I doubt it was the same kind of obsession that my cisgender peers were starting to have as their libidos awakened. It crept into my psyche and my dreams. It wasn’t long before I was having both sleeping dreams and daydreams that involved strong, powerful women with both penises and vaginas. Because to me, the peak of human achievement would be having the best of both worlds. This was before I even knew that trans or intersex people existed.

It took me years of suppressed queerness before I finally admitted those dreams in group therapy as an early adult. And in the meantime I went through phases of hyper-masculinity as I tried to reconcile these desires to experience a vagina that kept pestering my brain. When I first had oral sex with a woman, the obsession only grew.

Eventually I finally got enough exposure to trans people that I realized I was one too. Not out of peer pressure like the media tries to paint it, but from seeing examples of people like me. I started out slowly and it took me awhile of my social transition before I decided to take any medical steps. You can see a lot of that progression if you read the early posts on my blog.

I had a lot of hesitation about starting estrogen because I was worried it would change how my already anxious/depressed brain worked. But once I started, I knew I could never go back. After the initial adjustment period, my brain had never felt more “right” and like I finally had the right operating system installed. But it did fundamentally change how I experienced sex.

I have always been hesitant and anxious about using my penis. But after starting hormones, there was some significant rewiring of my nervous system that took place and changed how I felt sensations. Suddenly an appendage that felt like a blunt tool now felt like a fine tip brush. It honestly felt like I imagine an inverted vagina would feel with a clitoris on the tip. My sensitivity increased immensely and I also lost all desire to use it for penetrative sex.

I had already started to think about surgery but my initial explorations had all been about whether or not it was possible to have a vagina and a penis simultaneously. I thought for sure that’s what I wanted because that’s what all my dreams still involved. I scoured the internet and couldn’t find anyone except naysayers who claimed it was anatomically impossible.

Finally, the first surgeons started to do what they called “penile preservation vaginoplasty” and my dreams were vindicated! Except ironically, by the time I discovered that, I was beginning to realize that it wasn’t what I wanted. I came to understand after almost 2 decades of dreaming that that form was more about what I was attracted to, not about what I wanted for myself.

Once I finally accepted that I wanted a vaginoplasty, the rest was just about getting through the medical gatekeeping. Last year when I went for my consult, I was sure that it was what I wanted. Now I am 120% sure and for months now I have been counting down the days (12) until I could finally achieve what I’ve secretly desired for so long.

I’ve been trying to decide for a couple years now if I am asexual or if I just have a low libido and as I think about life post surgery and all the sex I can have uninhibited, I think I finally have my answer. I just needed the right parts!

I’m in the home stretch now and I’ve started taking the pre-surgical meds. The Gabapentin is making my brain a bit hazy and I’m rather scatterbrained so hopefully this blog post makes sense. But in 6 days I pack up the car with my partner who will be my caregiver and her partner who lives with us and we drive down the coast to San Francisco.

12 more days!

Trans is More than Transition

I know that I’ve spent the last 4 years here writing mostly about my transition. And lately I’ve been very focused on surgery. But I want to take a moment here and remind you that being Trans is about so much more than Transition.

I started my social transition around the time I started this blog 4 years ago, but eventually that period of my life will end and my life will go on. Because ultimately this period is going to hopefully be a blip in the grand scheme of my life. And while I talk a lot about the challenges of transition and life as a trans person, I hope you’ve also taken away how rewarding my life is now that I am able to be my most authentic self.

My life is about so much more than transition and the world is filled with thousands of trans people living their lives, creating art, building relationships, and doing so many more amazing things than just transitioning.

The reason I share my (very privileged) story here is in the hope that by baring my soul and opening myself up to you readers, other trans people don’t have to do that education work. I live my life as an open book because that’s who I am. But for so many people, the stories I share are painful memories and open wounds.

So please, do not take away from my blog that it is ok to ask Trans people about their bodies, their journey, their medical details, and especially not “the surgery.” There are a million reasons why including that a LOT of trans people never want surgery. But the most important reason is simply that it’s none of your fucking business!

Our lives are not a performance for your benefit. Our stories are not open to your analysis unless we choose to make them open like I am here.

I write my story first and foremost for myself. Because I’ve found immense therapeutic benefit to writing out the burning thoughts in my head here. It really helps me crystallize what my brain is ruminating on and gives me an outlet for my emotions that benefits more people than just myself.

When I first came here, I honestly never thought that people would ready my work. I wrote this blog so that I, with my terrible memory shaped by trauma, could remember what I was thinking at each step along the way. And that’s still the primary reason I write. I never expected over 14,000 readers to visit my blog more than 27,000 times.

And while I’m very honored that you take the time to read my thoughts and sometimes rantings, I want to be very clear that this should not be your expectation of what being trans is like for everyone. Each person has a different path and honestly if there’s anything I could impress on you about the Trans Community it is that each of us is far more different than we are similar.

Insurance approval

I know to most cisgender people this doesn’t sound significant but I just got word from my surgeon’s office today that I got insurance approval for gender confirmation surgery!

This is one of those things that should be a normal occurrence. But for trans people, we have had to fight so hard for generations to get these surgeries covered by insurance that it is still a big deal for us to have these basic rights. I remember not that long ago when my friends were going to Thailand because that’s the only way most people could afford to get surgery out of pocket. And because of that legacy, there are still so few surgeons in the US that even those of us in major cities like Seattle have to travel out of state and incur huge expenses to get these surgeries.

It’s also significant because of the amount of medical gatekeeping we have to endure to get there. I can’t think of a single procedure where a cis person has to get more than one letter of support. But most trans people require 3 letters from MDs, therapists, and PhD level psychiatrists to get this insurance approval.

For me, I got these letter last fall because I was told the surgeon was going to ask for insurance approval in late winter. But they waited too long to submit paperwork so I had to go get the letter updated because they needed to be within 6 months. Which meant that the first time around I got an insurance denial which was scary even though I knew why.

The point of this story is, if you have the authority to be a medical gatekeeper for a trans person, PLEASE make it as smooth as possible for them. There are a variety of reasons that trans people don’t want surgeries and shouldn’t need them to transition. But for those of us who do, we are usually overwhelmingly sure that this is what we want. So don’t make it harder for us than it needs to be. Trust us to be the experts on our own experiences. And if you get asked for a perfunctory piece of paper, just sign it.

Remembering Childhood

I’m thinking a lot today about how much better life was before puberty and I started being aggressively gendered by society. I was so carefree and I miss that feeling.

I wish I knew that trans people existed, I wish I had been able to talk about my gender feelings, and I wish I had access to puberty hormone blockers.

Please take this as a reminder to protect and trust trans kids when they vocalize their needs.

41 days until surgery!

I’m down to less than 6 weeks before gender confirmation surgery and I’m so nervous! I’m not anxious about the surgery itself other than a natural concern about the rare complications. I’m nervous that something will happen between now and then to prevent me from getting the surgery. Because the idea of delaying it sounds like torture. When I did my consult a year ago, I was ready. And now I am wishing I had started the process sooner.

I’ve done literally everything I can do. I’ve bought medical supplies, collected comfortable clothing for the recovery, changed our original flight plans to a roadtrip, booked an accessible AirBnb, and even scheduled my pre-op bloodwork. But my brain can’t stop focusing on all the things that could go wrong.

What if there’s a new wave of COVID-19 cases now that we are re-opening businesses prematurely? What if I get sick right before surgery? What if I get down there and find out that the hair removal wasn’t sufficient because I missed 2 months due to COVID shutdowns? What if the doctor says that my weight is too much of a problem since I’ve put on 20 pounds in the last year?

The last one is the one I hate the most. I’m a very fat positive person and generally I don’t care about my weight. But last year I had a bad experience with Dr. Satterwhite when I consulted with him and he was hyper-focused on my high BMI. He claimed that if I gained any more weight it would be “unsafe” to do the procedure. Thankfully Dr. Wittenberg, the surgeon I ended up choosing, told me that they are more like guidelines for optimal results which I absolutely agree with, but my brain is still anxious about it. Fatphobia is one of the few remaining socially acceptable forms of overt discrimination.

In the end, there’s not much I can do about it. I know all the data about how fad diets don’t work and can cause more medical issues than they solve. And luckily the nutritionist/therapist I’m working with agrees and is helping me balance my food in a way that feels appropriate to me. But the voice of that fatphobic doctor still haunts me. I also wonder how many fat trans people he’s turned away and made believe that they can’t get surgery.

On a more positive note though, my job is being super supportive. They have hired new permanent and temporary staff to take on my workload while I’m gone with enough time to train them before I go. So now I know I can leave even in the midst of a busy period of running COVID research studies and know my work is in good hands.

Currently I am hoping to be able to return to at least part-time work after 6 weeks which is the minimum time my surgeon recommends. Since we are completely online now it should be more accessible. But there is a potential that I may need the full 12 weeks before I’m lucid and off pain meds.

For housing I was lucky enough to find a basement apartment owned by a gay couple to rent that not only is ground floor but has a kitchen and even AC! It was very expensive at $3,400 but it’s centrally located in San Francisco so I can easily make it from the hospital and to my follow up appointments without sitting in traffic. I’ll be staying for a full month since I need to arrive 5 days prior to surgery for my pre-op and stay for 3 weeks after for post-op check ins before I’m cleared to travel. I’m really hoping that I can handle the 800 mile drive home without too much pain since I don’t feel very safe about airports right now.

I’m in the final countdown period and I am so excited! Thank you to all my friends who donated over $2,500 to make this happen. And I couldn’t do this without the support of my wonderful spouse who will be my caretaker after surgery. I guess you could say it takes a village to make a vagina.

Lets talk about Intersections of Privilege

As a white writer, I don’t spend a lot of time writing about race which is a major flaw. I have the privilege of living in a world where my experience are considered to be the default for whatever other identities I have so I get to choose whether or not to think about my race. But a lot of people don’t have that privilege.

So let’s take a few minutes and talk about race. I think one of the first steps is examining and acknowledging which privileges and blind spots I have. This is literally the bare minimum I can do and I want to be clear I don’t deserve accolades for basic steps that all of humanity should be doing on a daily basis.

My privileges

  • I am white and I have the option to not think about race whenever I want. I’m also not discriminated against or at risk of police violence based on my race.
  • I am a citizen and I was born in a country with global power so I rarely have to worry about a war at home.
  • I grew up solidly middle class and never lived in poverty. I never had to worry about where my basic necessities would come from or whether my housing was secure. And I had ample luxuries in life to make me comfortable.
  • I am big and tall and rarely have to worry about my physical safety or invasions of my personal space.
  • I am relatively able bodied and don’t need accessibility devices for my disabilities most of the time.
  • I live in a state where cannabis is legal and easily accessible to self medicate my disabilities without barriers.
  • I grew up without disabilities and experienced most of my early life without physical barriers.
  • I am neurotypical for the most part and even with my ADD I grew up in a schooling environment where my difference was never pathologized with ADD relatives who normalized that experience.
  • I have a job where my ADD is an asset and have never been discriminated against due to my disabilities.
  • I had a good primary education and a private college degree that prepared me well for the economy and society we live in.
  • I have a full time job and have never been under-employed or laid off. I make enough money to be able to afford to live in an expensive city where I can find community.
  • I have a supportive spouse (even if it took a divorce to achieve that) and have never had a lack of dating partners.
  • I can easily find communities of people who look like me.
  • Even though I am fat, I still have size privilege by being able to shop off the rack.
  • I come from a religion that has always been the majority in my country and culture and never experienced discrimination because of my beliefs.

My intersections of marginalization

  • I am transgender in a country that is actively hostile towards me.
  • I will never “pass” as cisgender and will always be visibly trans.
  • I have large feet and cannot find feminine shoes my size in stores.
  • I am queer and have to be wary of people who want to date me because they either view me as a feminine straight man or a gay man in a biphobic, transphobic culture.
  • I am disabled and cannot do a lot of activities that I would like due to my asthma and the condition of my back.

Notice how short that list of marginalization is compared to my privileges? I may spend a lot of time writing about those intersections but what I don’t do is acknowledge my privilege and blind spots enough. There are dozens of reasons that my life could be harder due to things completely out of my control. And my life has never been made harder because of the color of my skin.

That is why we say Black Lives Matter. That is why we need to be conscious of what areas we don’t struggle with. Because otherwise those things are blind spots to us and can lead us to subconsciously discriminate against people who do have those issues. Because in our culture we are always taught to view life as a zero sum game which requires haves and have nots to function. So if I am not fighting for people of color, disabled people, immigrants, religious minorities, and people without class privilege, my work is for naught.

What are you doing to become more aware of your privileges and unconscious biases?

What if I had come out as a child?

I just woke up from a nightmare about coming out as trans as a child. In my dream I was going to a private Christian school and having to fight for basic human decency among classmates and school administrators who didn’t believe me. Who didn’t believe that trans people were real.

But as scary as that dream was, it is probably nothing compared to what would have happened if I had come out as trans in my actual childhood.

Let me be clear. My parents have grown a lot in the intervening years since I left home and they genuinely seem to be trying to understanding my experience right now. But I shudder to think what would have happened if I had come out as trans or even queer as a child while they were still in the grasp of the cult. I am fairly confident that I would have been sent to life-threatening conversion therapy that would have made my depression a lot worse and possibly led to suicide.

It was bad enough growing up as a child, confused and afraid because I didn’t know why I was different. Knowing that I had a girl’s brain but not knowing what that meant. Feeling like I was alone in my experience because I didn’t know that transgender people even existed until college.

But it would have been so much worse if I had voiced those feelings as a child and not been believed. If I had been placed into “therapy” to “cure” me from this sin. If I had been told on a daily basis that my lived experience wasn’t real and spiritually beaten over the head because I felt that way.

My heart goes out to all the kids who are still in that situation. Who live among parents, educators, and peers who don’t believe them. Who have to hide who they are because of the explicitly transphobic messages they hear on a daily basis.

When we say “protect trans kids,” we say that because even in a day and age where awareness of transgender people is at an all time high, trans kids have a one in three chance of attempting suicide.

We live in a country where hard won trans rights that we fought for decades to achieve are being taken away from us on a daily basis. Just this week, the protections that we gained in the Affordable Care Act were stripped away. And that wears on trans people mentally and kills us daily through denials of care and service. That permeates our culture and compounds with racism to make trans women of color the most marginalized and murdered group in America. Already this year, 14 trans people have been brutally murdered; the majority of them women of color.

As a white trans adult, my nightmare was largely just that. My life is rarely at risk of anything other than my own depression and suicidal thoughts. But I am one of the lucky ones. I have a supportive spouse and partners, I have a large community of trans people and advocates who stand with me, and I have a low risk of murder because of the color of my skin and where I live.

So when you fight for Black Lives, when you fight for queer lives, when you fight for trans youth, please make sure that your fight is intersectional and intentionally includes the lives of those who bear the burden of all of our collective societal sins. Fight for Black Trans Lives because they matter. And until we stop these murders, we can’t truly mean that Black Lives Matter.

Bottom Surgery is still a Go!

I’ve been on edge ever since this pandemic started because I have been so worried that my bottom surgery this summer would be postponed. But today I got confirmation that I can re-start laser hair removal to prep the area this weekend. And based on what the surgeon’s office has said, I think I should still be able to get enough of it in by July 29th to head down to San Francisco for my August 3rd gender confirmation surgery.

I’ve changed my plans and instead of staying with a friend-of-a-friend, I will be staying in an Airbnb so that we can maintain social isolation. My spouse and I will also be driving down instead of flying because as asthmatics, airports are a pretty big risk. And I don’t know what the visitors policies will be like at the hospital during my 3 days there after surgery. But damn am I glad that it is still happening.

Lately all the little things have been bothering me because my body just can’t wait to get this finally resolved. I am grumpy about having to use my hands to pee. And I hate everything about my balls. But it is only 68 days away now! I am almost there.

Selfie of the day

I didn’t expect how good it would feel to put on jewelry. Also, my hair is finally at my goal length!

Giving up Control

Today I realized an important component in my coming out journey that I haven’t talked about a lot here – giving up control.

Growing up I was very much a control freak. I liked to be the most knowledgeable person in the room. I was obsessively clean about my own space to the point that my mom could come into my room and move one object and I would know the moment I walked in. I abused my authority as the oldest child to control my siblings unfortunately. I also had my entire life planned out, both long term and short term.

I know where that behavior came from. It was a way to reclaim a sense of my own control in a life that was controlled by others and was also pretty chaotic. My parents were very controlling of us in many ways with lots of rules and that was made worse by being in a fundamentalist cult that taught that as a moral imperative. They were also low-key hoarders and our house was always messy even if that was often hidden behind closed doors.

My first attempt to stop being controlling as an adult went horribly wrong. I tried to give up control by giving it to my ex-spouse who abused that authority and emotionally abused me. But in that relationship I learned pretty quickly that the only way to survive was to give up the idea that I could control anything in my life.

The only sure thing in life is that there will always be unexpected things that you can’t plan for. And oftentimes those can be good things if you are open to them. Like a casual dating partner turning into a wonderfully supportive spouse once you get the courage to leave your abuser.

But that mindset about giving up control was also key to being able to come out as trans. Especially as a trans woman, it can be a shock to go from a position where you are subtly and sometimes overtly given societal power to a situation where you are suddenly one of the most marginalized and powerless. And if I hadn’t primed myself to be powerless, it would have been pretty freaky.

I think a lot of us are finding ourselves feeling powerless right now during this pandemic. Everything is chaotic and out of control and very few people (in the US) have planned for something like this. And that vulnerability and constant vigilance can bring out a lot of trauma responses from people who have been abused.

Being treated as a man when you know deep down that you aren’t is absolutely a form of trauma. Especially in a culture where toxic masculinity runs rampant. And that abuse becomes more clear when you come out and aren’t supported, whether by the people close to you or by society at large.

So if you are finding yourself in some very dark emotional places right now, please have patience with yourself. We can’t control this but that’s ok. It is only in giving up control that we can find peace and acceptance of the world around us. That is a journey that I am still on but telling myself that on a regular basis definitely helps so I hope it helps you too.