Surgery

Barely surviving

I’m going to say some things that might sound scary but let me be absolutely clear that I have no plans to commit suicide or anything drastic like that.

 

I’m sick and tired of barely holding on to life. I’m exhausted from just surviving and it’s hard to see a path to a place where I’m thriving.

Now I know part of that is my seasonal depression talking. I’m on three meds now to try and control it but the best I have at the moment is “not as bad as it was.” I’ve tried messing with them but it’s a dangerous proposition when I’m in the midst of it. The last dosage change I tried put me at too high a risk for suicide for me to continue.

And part of that is the mental and physical exhaustion of being disabled. My back and neck always hurt and that background pain is draining. And then there are periods like the weekend I just had where a seemingly simple task like assembling and hanging a medicine cabinet puts me in 24 hours of acute pain. And it’s demoralizing to know that you can’t even do basic things anymore.

Another part of it is trying to exist in a world that wasn’t built for me. Our westernized society still doesn’t know how to be inclusive of trans folks even on the most basic level. Even queer community makes it hard to be recognized if you are outside the binary gender construct we all take for granted. And when you can fight for decades for the most basic human rights and have those stripped away in just one politician’s term, it’s pretty demoralizing.

But the biggest part of it is the dysphoria I have around how my body is gendered. I have been on hormones for 2 years now and it has helped a lot, but I still can’t look in the mirror most days and see myself looking back. I see a face that looks hopelessly masculine to me, and I hear a testosterone shaped voice come out of my body that can be fun to perform with but still feels like a form of drag to me.

I want so badly to be ok with the body I was given, but that’s not how dysphoria works. I can do all the body positivity building I want and all that helps with is my weight. There is still a misalignment of who I know I am, and the body that others see. I walk around daily in a shell that causes people to make assumptions about who I am. And even when those assumptions are right, it usually means they are focusing on the wrong things.

At this point I feel like I am just barely clinging on to hope that bottom surgery will alleviate enough of this feeling that I can relax even the tiniest bit. I don’t know for sure if it will, but I also don’t know if I could keep going if I don’t try. So for now, I survive.

Reflecting back on my beard

Last night I came across this photo in my Instagram history and I had one of those rare moments where I thought “Wow! That beard really was great sometimes.”

Caleb board portrait

To be honest, when I look at this photo I see an absolutely gorgeous queer person that I would date in an instant. But the problem is that it doesn’t look like me and never really did. What I see in the older photos of me isn’t the same person that I actually am inside. I may as well be looking at an old friend that I’ve grown apart from.

For a long time I despaired of ever getting my appearance and identity to match which is why I didn’t take any steps towards medical transition. I think now that I’ve done a lot of hair follicle removal and my facial features are changing, it’s getting closer. But I still have a hard time focusing on my face in the mirror.

My final jaw surgery, which includes some feminization of my chin, is in 3 weeks. Hopefully once I heal from that and get my braces off next year, I will be closer to who I am.

The queer dilemma

I feel like one of the constant queer dilemmas in figuring out your identity is whether you want to “do them or be them” (or the demisexual equivalent, date them or be them). When you get your first glimpse of queer representation or that gay awakening moment, it’s sometimes hard to tell if you are attracted to that asthetic or person because you want to become like them or whether you have pants feels for them. 

For me, that moment came in my teen years when I first heard in the sex ed books I covertly read in the public library about people with both/all kinds of genitals. Sadly at that time I wasn’t reading anything by actual intersex or trans people so the terms I learned initially were highly problematic but the idea still stuck with me. That it was possible to have both a vagina and a penis at the same time.

It wasn’t long before that idea had seeped into my imaginations and people with hybrid genitals dominated my teenage fantasies, both waking and dreaming. For a long time, even after I started transitioning, I thought that was my goal. Two years ago, I tried researching whether it was possible and at that time there wasn’t anything published about it yet so it was only theoretical. Last year, I discovered two surgeons who had started offering a penile preservation vaginoplasty which gave me the chance to think about it seriously.

Now I am planning for my “classic” vaginoplasty and I couldn’t be happier about it (other than that it’s not soon enough!). I don’t feel any confusion or serious doubts anymore. But as I have thought about it more and why I thought I wanted more nonbinary genital options for so long, I’ve realized that it’s because I’m very attracted to that kind of body. The people I find hottest in the world are the folks who have a penis and boobs on the same body. And I’m so glad that the many people I’ve met who want that body now have more options to achieve that.

Statues

Reinterpretation of the Tres In Una statue by Paul Richer

I need new genitals like, now

Content warning: I’m going to be talking explicitly about sex here so proceed at your own risk.

I can’t wait for bottom surgery. As in the idea of waiting another 11 months seems like torture. I need it so badly and while it feels good to finally have it planned and even some of the money raised, it still feels like forever away.

I tried for so long to feel comfortable with the body that I had, but I only had mild success. There were times where I was comfortable with partners who I felt truly saw me that I was able to have enjoyable sex, but for the most part it always felt awkward and performative. I wanted the connection and release so badly but the means I had of accessing that weren’t great.

The best sex I’ve ever had has always been with queer sex. The kind of sex where someone’s fingers or toy is inside of me and they are using their mouth in the ways that it seems only a queer person can. And the most comfortable I’ve been penetrating others is when I’ve worn a strap on. Otherwise being in that role feels weird for the most part.

This week I decided to try having sex “the old fashioned way” one more time to see if there was anything I’d miss about it. I took some generic Viagra because I can’t have those kinds of erections otherwise anymore and had some anniversary sex with my spouse. And while I love having sex with her, it just felt awkward and I was distracted the whole time by how uncomfortable I was. It felt like I was using body parts that didn’t belong to me but that somehow still transmitted sensation to my body. And not in the good way like I’ve managed to access a couple times. We eventually stopped and switched over to the ways we know we both like.

I feel like that was the moment that any last shreds of doubt I had were banished. I’ve proved to myself that my dysphoria really is “bad enough” to warrant the amount of money I’m spending and the amount of pain it will take to get my new vagina. Which is a terrible way to feel. Like you have to justify not wanting to be dysphoric all the time by degrees of severity.

So this week when I met with the PhD level psychiatrist to get my letter for the red tape of insurance approval, I was able to say with confidence that I know I’m making the right choice. And luckily I can also say that I have the right support in my life now to make that plunge. My work and my spouses work are both being very supportive in giving us the time off to go down to San Francisco for a month. And my community has been so generous in helping me raise $880 in less than a month already (plus a promise of airline miles) to put me well on my way.

If you are able to donate to support me as well, I would be very grateful. I can’t wait to finally get this surgery. https://www.gofundme.com/f/haven-gender-confirmation-treatments 

A new life

It’s been a little over 10 months since I shaved my beard and almost a year since I started using my new name everywhere and already it feels like another lifetime and another person. I’m still getting photos from a year ago popping up in my Facebook memories and it is hard to even recognize them as myself. I can see that the person in (some) of the photos is beautiful but it isn’t me anymore. I have moved so far beyond who I was in that moment.

The first few months after shaving were definitely rough with having to face my dysphoria around my chin and stubble. But now there is so little hair left that I don’t have to think about it 90% of the time and I often forget to shave the few stubborn hairs around my lips. I feel so much more feminine now without the shadow on my face.

It also helps that I can really visibly see the changes that estrogen has made in my body. My facial structure has been changed by both rounding of the edges from hormones and from a pretty distinct cheek structure change created by the first jaw surgery. Many acquaintances I see think I have already had the feminization portion of the surgery which feels great. At this point I’m feeling more excitement than dread about the second surgery and the final results I’ll have. Especially since I can finally get this annoying metal out of my mouth and feel confident smiling again.

There are still a lot of hurdles to cross. I’m trying to get the letters from the psychiatrists that I need for surgery and the hair removal on my genitals to prep for that. I have appointments today and next week that should hopefully cover those barriers.

I also started vocal feminization lessons last week. While my voice has subconsciously raised a few degrees already, estrogen doesn’t automatically bring your voice back to where it was before testosterone (yet another reason to support hormone blockers for trans teens). I have to do a lot of conscious work to expand my upper range and retrain my muscles not to create the masculinized resonance my vocal cords are used to. Someday it will hopefully be second nature but for now it is exhausting work.

However, I do seem to have crossed some magical threshold now where many people in public recognize me pretty quickly as a trans woman. Whereas before with my beard I would get stares of befuddlement everywhere I went, now I mostly get recognition, at least in liberal Seattle.  Which has meant that I get a lot more “ma’am”s and “she” either automatically or from self correction.

I tried using she/her pronouns before just around my chosen family but it still felt grating at the time. Like I was too far away from that reality and the pronouns just reminded me that no one would automatically assume that. But now I have decided to use them again as another option in addition to they/them and it feels wonderful. Especially when it is coming from strangers who I am first meeting.

In the moment, progress can feel so slow but it is nice to have these moments where my head comes out of the water and I feel like I can breathe again.

Fundraising for surgeries

It makes me so sad that trans people have to beg for money from friends and strangers in order to have live saving treatments for gender dysphoria. And that we have to have our identities pathologized and our daily existence diagnosed in order to get access to insurance coverage. But this is the reality that we live in.

Transition is a very expensive process with exorbitant costs everywhere you turn. If you want to change your name, you have to pay $400 and spend most of a day in government offices getting a judge to approve it and other offices to accept it. If you want to treat dysphoria around body hair and have any hope of being seen as a trans woman, you need to spend thousands of dollars on hair removal that most people consider a luxury and insurance won’t pay for. And if you want surgery, you often have to travel out of state like I am doing to find someone trained in what you need which means the expenses snowball with housing, airfare, meals in a strange place, etc.

It is absolutely terrifying to be looking at my budget for surgery next summer and realize that I need to come up with $6,000-$9,000 for my out of pocket costs. And as much as I hate asking for money, that’s what I’m doing now. I’ve launched a GoFundMe campaign to start saving up.

So if you have ever benefited from my writing and how openly I share about my path to self actualization, please consider donating. Every little bit will make a difference in making this life saving surgery a reality. https://www.gofundme.com/f/haven-gender-confirmation-treatments

Surgical Consults

I have a date for gender confirmation surgery! August 3rd, 2020.

I’ve decided to go with Dr. Heidi Wittenberg for my vaginoplasty. She is who I have been researching for the past year and my consultation with her last week confirmed that she is everything I had been hoping for. Her staff were all wonderful and friendly. And she was very approachable with a great bedside manner and excellent at explaining the process and answering questions. She seems very factual and will be straightforward with the risks and complications. She also has the training in alternate techniques such as peritoneal pull through that would allow her to perform a revision surgery with the latest technology if that was needed. More importantly, she feels like someone I can trust completely and it makes sense to me to have a woman with a background in gynecology and urology doing my care.

I did do a second consultation while I was in San Francisco with Dr. Thomas Satterwhite who trained with Dr. Wittenberg at Brownstein and Crane. He comes highly recommended from friends but I didn’t have the greatest experience with him. In both his intro video and in person he was very fixated on BMI (Body Mass Index) and treated it as medical fact, despite the vast body of evidence that it is wildly inaccurate, scientifically useless, and never intended by the creator to be used on an individual basis. He brought it up multiple times in my 20 minute consult to warn me that if I gained 10 lbs before next summer, I would be ineligible for the surgery. And yes, I have what many people would consider excess fat around my belly, but I am not objectively that fat of a person. I am tall and large and I am built that way naturally. In fact, I am pretty average in build for a white American.

If I, who have quite a bit of relative privilege, am receiving this much fat phobia from him, how much more pronounced would that be for the many trans people who are larger than me? And if he puts stock in pseudoscience like the BMI, what other areas does he make inaccurate conclusions in? To me, this is the kind of thing I would expect from a plastic surgeon that makes money off of fatphobia. And maybe that’s his background, but I’m not giving him money to support that. Even if he was the best surgeon around. Luckily, I have choices.

Now I’m not saying other people haven’t had wonderful experiences with Satterwhite, but I loved Wittenberg and I’m excited to be having her do my surgery. Next up, I am submitting documentation to get laser hair removal done on my genitals to prepare the area for surgery. Then I need to get 3 letters from my physician, therapist, and a PhD level psychiatrist because my insurance still goes by the outdated WPATH standards of medical gatekeeping.

In the meantime, I’m starting my countdown now for surgery. 377 days!

If you would like to contribute to my transition fund, you can donate at: https://www.gofundme.com/f/haven-gender-confirmation-treatments

Dysphoric Bandaid Beard

There are times when I wish I still had my beard. In a lot of ways it was like a security blanket for me, allowing me to exist without having to constantly focus on my dysphoria around shaving and my chin shape. When I first grew it of course I had no idea what dysphoria was or why I hated my face so much, but I used it as a crutch for 12 years.

When I made the decision last fall to get rid of the beard, I knew that my dysphoria would get worse before it got better. And it most definitely has. It is starting to get better now that my growth rate and amount of active hair follicles have been reduced from laser therapy and electrolysis, but the first few months were hell.

Ultimately, the reason I chose to shave was because I chose to believe that it could be better eventually. That somewhere down the road I could be happier and less dysphoric than the low level that I was at with my beard. Sometimes it is hard to see through the high level of dysphoria I have now to that hope that I held for a better future. But I have to keep reminding myself that transition is just a stage in my life and the point of it is to pass through it to emerge from my cocoon as the beautiful butterfly I am.

I am lucky to be surrounded by wonderful people who constantly tell me how beautiful I am at every step along the way. But the thing is, attractiveness feels good but it doesn’t alleviate dysphoria. Dysphoria and dysmorphia aren’t the same thing. The only way to treat dysphoria is by addressing the medical and social needs around gender affirmation. Words alone can’t cut it. But luckily we live in an age where we have plastic surgeons who know what they are doing and are constantly refining the process to create and re-form the body parts that we need.

Thanks to a new trans friend for the title of this blog post and some of the thinking behind it. Maybe someday I’ll make the queer band to match.

Selfies are hard

Dysphoria is hard ya’ll. I took a selfie yesterday after my haircut that everyone agrees is objectively hot and at the time felt like a really good photo of myself. But today when I look at it I have a hard time not focusing in on how much more prominent my chin looks now that my upper cheeks are widened by my first jaw surgery. It gives the illusion that I’ve lost weight because my face comes more to a point but to my dysphoric brain, it seems like it REALLY comes to a point.

Luckily, I’m going to have my chin reduced slightly during my second jaw surgery, probably in December. It is nice to know that there is potentially an end in sight to this source of dysphoria. And I am chugging away on laser hair reduction which is slowly making that source easier to handle. But it is still frustrating to have my day derailed by those obsessive thoughts.

Next up on my to-do list – call my top two surgeon choices in San Francisco to set up a consult for my bottom surgery (vaginoplasty).

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Inheriting a fixer-upper

I just scheduled my jaw surgery to do the first part of correcting my bite for mid-May. It’s something I’ve been dreading for the last 10 years since my dentist identified the root problem. And I’ve been surprised at how many emotions around surgery are coming up for me now that it is an undeniable reality, not just about this procedure but about my plans for bottom surgery.

My original plan was to get my jaw surgery out of the way this year and then go in for vaginoplasty next year. And in the interim I was going to meet with the surgeons I was interested in when they were in town for Gender Odyssey. But now I feel like that plan has come crashing down around my ears (like most plans have in my life).

I found out a few weeks ago that my jaw surgery is so intensive that they need to split it into two separate procedures with a year of expanding my top palate in between. So now I have another surgery on my face to dread but at least I have jaw feminization included to look forward to. Unfortunately that means I have to rethink my whole plan around bottom surgery.

To complicate things further, I found out that Gender Odyssey isn’t in Seattle this year and they aren’t doing a conference for trans adults this year anyway. So now there’s no opportunity to meet with them that doesn’t involve investing in travel. I feel like I need to decide whether to try to attend Philly Trans Wellness where I might meet some potential providers (although not my top choice – Heidi Wittenberg), or whether to travel to San Francisco to meet with them directly.

And trying to figure this all out while I’m also undergoing intensive laser hair reduction on my face (I put electrolysis on hold for now because it was too slow) just feels like so much. I feel totally overwhelmed by how far I still have to go before I’m done with all these medical procedures and honestly I’m feeling pretty despondent and hopeless about it all.

I just want to fast forward to a point in time where I feel like my body is my own. But instead I feel like I inherited a fixer-upper house that needs major repairs to be livable and every time I fix one thing, another breaks. I know that all these surgeries and procedures aren’t going to fix everything but I still have to rest my hopes on life getting easier once I’m past it all. Because without that hope I don’t know how to keep going.

This is one of those points where I really wish I had been born with a brain and body that matched and I didn’t have to go through all this work just to be myself. And sometimes it feels like I should just throw in the towel on life and give up. Don’t worry, I don’t actually have plans to do so but I can’t say I haven’t thought about it.

Anyway, I don’t know where all this is going right now other than hopefully forward even if it takes a painstakingly long time to get there. I know I wouldn’t be able to keep wading into the fray if it wasn’t for my partners and friends so I am very thankful to all of them for keeping me going. I know things have to get worse before they get better but I really hope I turn that corner soon.