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Author: Addison

Summer Skin

Summer Skin

As the dressings were removed, I felt the new life I’ve been leading had been validated. In reality, it was the same life. It just looked different to everyone else. I felt like it wasn’t me that radically changed, but the perception of me. Yet, we all changed in some ways; as we struggled to evolve and adapt to our conditions and environment. I desperately wanted everything, yet nothing to change. Likewise, while the unveiling was something that I took in with satisfaction and joy, not everyone shared that sentiment.

In any event, while grooves were being worn in the waiting room floor, cuts were made, stitches placed and the scalpels washed and put away. Just two days later I stood for the first time on wobbly knees, nurses on either side. She sat on the couch in front of me, watching on as the staff attempted to wrestle panties around the catheter bag and line while simultaneously keeping me from teetering over onto my face.

During this spectacle, I noticed a drop of blood hit the floor, followed by another. When I looked up, she had averted her eyes; her hand shielding her face as if to protect it from the sun. My concern immediately turned from my own predicament onto her, asking what was wrong.

“I can’t look,” came her reply.

My heart sank somewhere beyond the pit of my stomach. A rush of emotions fueled by hormones and Percocet convinced my brain that this was it. The moment where she could no longer look at my body or me. As the nurses finally wrestled my undergarments into compliance, tears crept from duct to cheek. As I waddled out of the room and down the long corridor, I considered how it had gotten to this place.  How I could be so blind, so stupid.

Once I had completed my victory lap of the 4th floor, I returned to my room. I mumbled through my emotions, asking if it was me, the vagina or the blood. She assured me that it was simply the blood and that she was squeamish. I felt somewhat relieved, but my confidence still shaken to the core.

Somehow, I feel a little more alone now. No matter the proximity. Nothing will ever be like it was before, not for anyone. Everything changes. Just somethings more drastic than others.

‘Cause the seasons change was a conduit

And we left our love in our summer skin

Euphoria

Euphoria

I tried to think of an appropriate title for this entry.. Like I’ve had this window open for about 30 minutes trying to come up with the a title. In the end, one word was all it took, and it fits perfectly.

So yesterday, I woke up at about 6am. Still partly wired for east coast time and also just being a whole ball of nerves, feels, and other emotions. The day that I have been dreaming of for years and decades and lifetimes had finally arrived. Overcoming all adversity in my way, I had arrived at the finish line and all that was left was to step through the ribbon.

I don’t know that a non-trans person can ever fully understand what this means for someone like me. I don’t know that I could ever articulate it in such a way that would convey the complete story.

Finally getting out of bed at around nine after dozing in and out of consciousness, I bathed for the last time with a special antibacterial soap that hospital had provided.  I shaved my penis, scrotum, and pubic area; forgoing my legs and armpits for once.  I brushed my hair and dressed in a light sundress. I decided that I no longer needed to tuck, for in a couple hours I would no longer have anything to tuck.

We arrived at the hospital just before 10:30am. I checked in at admission and she directed me to the surgical department on the main level. We waited about 10 minutes here, before we were led out of the waiting room. From here, I was weighed and moved into a post-op room and put on my surgical gown. I signed all my final releases and we waited. and waited. and waited. Surgery was originally scheduled for noon. We were notified about 11:55 that we were going to be moved back to 12:30 due to a delays. Dr. Bowers came by, as well as the OR nurse and the Anesthesiologist. My pre-op nurse told me that Dr. Bowers makes the prettiest vaginas and my wife was going to be jealous. I said, “I’m ok with that”.

At, 1:14PM pacific time, I was rolled into operating room #2 at Mills-Peninsula Hospital. The OR nurse, whose name was Megan, introduced me to a couple other people who would be assisting. They had me verify why I was there and what surgery I was having. Being caught off guard, I said GRS, Genital uhhh rea-re-uh-reconstructive surgery. Close enough, right?

They pushed my gurney up against the operating table and had me slide over. The table had a oval hole/indention in it and I was instructed to slide my butt down to the edge. The put arm boards out and then strapped me down to the table. At that point, the anesthesiologist started to run his IV line into my left hand, where it still remains at this time. He hung fluids and then proceeded to administer a sedative to relax me. He said “This is going to make you feel really good.” I closed my eyes for just a second…

And I woke up in the recovery room. It was just after 5PM. A brief panic rushed over me, and I couldn’t really get words out because my throat was so dry. But I managed to ask the nurse if the surgery happened. She confirmed that it had and everything was fine.

At that moment, the euphoria rushed over me. I smiled a huge smile, and some tears welled up in the corners of my eyes. It was as if every wrong in the universe had been righted, the stars had aligned and I was complete.  I pulled back the blanket and lifted my gown and peered down at my crotch and it was perfectly flat. I knew I had made the right decision and that this was what I needed to live my life fully.

innie

Deep in my own feels, I wanted Megan to be with me, but she wasn’t allowed in the recovery room.  Eventually, around 6PM they brought me to my room where I’ve been ever since. I’ve not been able to get up and walk. I’ve been playing on the internet and having ice packs on my crotch.

This afternoon, Dr. Bowers came to see me. She said that everything had gone well. Since I was not overly endowed, and due to some atrophy from lack of use, she had to be creative with the tissue in order to achieve adequate depth. She also said that the aesthetics are beautiful and that I’m going to be very happy with the end result.

So tomorrow, I will be able to unwrap my birthday present.  I’m pretty excited to see it, even in it’s swollen and bruised state. I’m hoping to get a shower in and maybe shuffle around the nurse’s station. While this bed is comfortable, I’m ready to be free of it’s pillowy bonds. Monday, I will head back to Dr. Bowers’ clinic for packing removal (the magic scarf trick) and instructions on how to dilate.  Provided no complications, I’ll be released from her care. Life goes on and I hope I to be part of it for a long time to come.

I apologize if this is rambling or incoherent. I think it’s time for me to take a nap.

Final Thoughts

Final Thoughts

The day has finally arrived. I can hardly believe it. Yesterday, Megan and I met with Dr. Bowers at her office in Burlingame. She was very friendly, asked questions, answered ours. She examined me and said that she didn’t think there would be any issues and that she expected the results to be very good. 

After that, we went down to the hospital and had my blood drawn one last time. From there, we picked up my bowel prep prescriptions as well as dropped off my post op prescriptions for antibiotics and pain killers. 

The rest of the afternoon I spent holed up in this hotel room, drinking a gallon of something called Go Lightly. I will tell you right now, that it is false advertising at best. A god-damn lie, I would proclaim. I’ll spare you the details, but food poisoning is about the same deal. 

Currently, it’s about 7:30 pacific time, and we check into the hospital in about 3 hours. I’m not nervous at all, not any more. I feel totally at ease with my decision and I’m comfortable with everything that’s about to happen. I suspect that as they’re starting the IV, I might get the jitters, but they have drugs for that. 

I don’t know when I’ll feel up to posting again, but I’ll try… 

Against all odds!

Against all odds!

We’ve finally made it. Today is the day that Megan and I fly to California. On Tuesday, I will have my GRS. A lot of people have asked how I feel. Excited? Nervous?

Honestly, this past week and a half have been a roller coaster of emotions. With Joey’s suicide and that fallout there, that has been the primary concern. I also had to stop all my hormones about 2 weeks ago, and so I’m sure my attitude and mood have been impacted. On top of all that, I’ve started on antidepressants. Basically, I tried to make things as complicated as possible. Holden fuckin’ McNeil.

But anyway, I’m almost to the finish line of this journey. There were times that I wasn’t sure that I could make it, or that I would. The story is fraught with harassment, discrimination, and hurdles. I’ve sat in my car many mornings and cried.

I have to finish packing, so I have to cut this short, but I hope to do a better entry once we’re in Cali and then one post op.

and the grapevines seemed left for dead…

and the grapevines seemed left for dead…

I’ve been meaning to update for some time. There’s so much happening right now, but it’s all running together at this point. The biggest thing going on right now is the worst thing also.

One of my very best friends committed suicide the other day. I’m finding myself left trying to pick up the pieces left in his wake. Once the initial shock passed, my first and most recurring thought is one of guilt. I think that I could have done more to have prevented this. I feel like we, his friends and I, saw the signs and we did nothing. Or not enough. Because that’s what we do. We act like nothing can ever happen and that everything will sort itself out.

Except it didn’t. My friend is dead. What’s there to sort out now? You can’t undo that. There’s no rewind. It’s all so surreal and odd. Just 30 minutes ago, on my way home from dinner with Megan, we passed his neighborhood…. and it’s just like “now what?”

My second feeling is one of anger. I’m upset with him for making such a drastic choice. While I’ve gathered that his problems were quite large and had snowballed into something with a life of it’s own, there was still a solution that wasn’t so final. A very permanent solution for a temporary problem. I’m mad that he didn’t reach out to anyone before ending his own life.

Of course, the other thing that’s happened is that I’ve been forced to do my own agonizing reappraisal of my own feelings towards depression and suicide. I mean, it’s no secret that I’ve been depressed, off and on, for years. Stressors at work and at home due to my transition have pushed me closer to the brink than ever before. Add in some hormonal mood swings and a couple of crushes and you’re dealing with a potentially lethal cocktail. When you sit in the car with the gun in your lap and just stare at it for 15 minutes and then put it away and go to work, things are not going as well as one might hope.

There’s always something that pulls me back from the edge. Usually my kids. I really can’t fathom intentionally leaving them behind. They’ve already lost their father, they shouldn’t have to lose a parent as well.  Also, who would clear my browser history and dispose of my sex toys? (Just kidding, I have a friend who agreed to take care of that for me. Just like Harvey Keitel’s character in Pulp Fiction.)

nsx
“That’s thirty minutes away. I’ll be there in ten.” (nine minutes, thirty-seven seconds later)

But most of all, what I’ve come up with in the last two days is that I don’t want to put anyone through what I’m feeling right now. I’m hurt, I’m sad, I’m betrayed, I’m just scrambled eggs. I couldn’t bare the thought of my wife finding me, or my children. I wouldn’t want them to have to deal with all the emotions and the heartache. I feel like since starting hormones, I cry so much more than I ever have in my life and the last few days has had the volume turned up past the point of distortion. My eyes are tired and my cheeks are dried out from the tears and the constant wiping.

That’s all I can come up with for now. 🙁

And besides that, Mrs. Lincoln, how was the show?

And besides that, Mrs. Lincoln, how was the show?

I have been working on an entry for a few weeks. I’ve just been struggling with depression and anxiety lately. It’s made me not really want to do anything. Going to work has been a major endeavor. I have to sit in my car and just kind of psyche myself up to it. So writing has taken a back burner to mostly lying on the couch and also hiding in the dark.

Despite all that, things have been progressing in other ways. First, I switched from oral estradiol via pills to intramuscular injection. Basically I’ve started stabbing myself with needles once a week and injecting lady juice right into my muscles. I’m a doper. I’ve officially moved from the gateway drugs to the really hard stuff. I never thought it could happen to me. I couldn’t help but think of my own kids and the “I learned it from watching you, dad!!!” commercials. Let’s hope it never comes to that. But if it does, so be it.

Since the switch, I’ve noticed that my boobs have been having periods where they hurt continuously. Sometimes they just ache off and on. However, at this point they’re pretty much tender all the time. This is usually a sign that they’re growing. At least I hope they’re growing. I’m probably a solid A cup currently and have been since back in August. Since then, they’ve largely remained the same. I’m hoping that this will jump start them into growing and providing something a little larger. I make due with fancy push up bras, but with my torso, I really need something a little bigger to kind of level things out.

The biggest news though is that on the evening of my last entry, I received a call from Dr. Bowers’ office saying that they had a cancellation and they wanted to offer me the appointment for surgery. Of course, I have accepted. My new date for surgery is May 3rd. My original date was 2/8/2017. So this is a big shift. Originally, I was hoping to have surgery with Dr. Schechter on 3/29, but you all know what happened there. My new date is still slightly tentative due to hospital scheduling and other things, but I should have a firm commitment in the next couple weeks. At that point, I can go ahead and start booking travel arrangements.

So, we’re about 58 days out and I’m alternating between a few different emotions, including but not limited to: “omg omg omg”, “it’s never going to come”, “oh shit, this is like next week” and “what the fuck did i get myself into?”

I’ve never had any major surgery. The most was having my wisdom teeth removed, all four of them being impacted and angry. I remember being loopy as hell from the general. I also remember going out to dinner that night, driving myself while on pain pills. Probably not the best idea. This is considerably more severe and invasive. Of course, the idea of correcting what most bothers me about my body is comforting. Being able to jettison some unwanted cargo, if you will. However, the reality of the situation is a bit more worrisome.  There’s a lot of complications that could happen. Lots of risk.  So you have to balance the eagerness to correct what’s wrong with the nagging concern that you could make things worse.  I don’t think any transwoman goes into the operating room excited about the actual procedure. They go in with the expectation and a hope for a better, more comfortable future. At least, that would be my guess.

Possibly TMI stuff beyond this point….

Because a lot of people have asked me about what all this actually entails, I thought I would give the broad strokes. The procedure itself is supposed to run about 3-5 hours. It will be performed by Dr. Marci Bowers in Burlingame, California. The actual surgery is referred to as single stage penile inversion vaginoplasty. It actually involves a number of different procedures like Orchiectomy (removal of the testicles), Vaginoplasty, Labiaplasty and Cliteroplasty. For the purposes of insurance, some surgeons bill for Penectomy, although almost the entirety of the penis is reconfigured. Despite what most people think, they don’t really cut anything off. Aside from the testicles. Those will go in the trash or maybe in a jar full of formaldehyde. Everything else is sort of a waste not, want not kind of situation, like the Native Americans did with the Bison.

The first part of the surgery is to remove the testicles. The penis is then dissected. The vaginal canal is fashioned from the skin of the penis.  The skin is turned inside out and the end sewn shut, hence the “inversion” part of the name. The clitoris is formed from the tip or glans of the penis maintaining the nerves and blood supply. Even a portion of the erectile tissue is retained, in order to engorge when aroused, causing the clitoris to become more exposed.  The urethra is shortened and the vulva and labia are fashioned from the scrotal skin and surrounding tissues. SCIENCE!  The vagina is packed with gauze and in some cases a stent, to maintain the structure. Surgical drains along the incision site and then a big fancy surgical dressing. All the stitches are dissolvable.

After surgery, I get to spend 4 days, 3 nights in a luxury, all-inclusive hospital bed. During this time, I’ll be fully packed and will have a catheter in place to give my newly shortened urethra time to start healing. Assuming no major complications I should be up and walking within a day or so. Discharge is on the 3rd day. I’ll still have the catheter at this point, still stuffed like a thanksgiving turkey. I’ll spent 3 or so more nights at local hotel.

Six days post-op, I should be back at the surgeon’s office to have the packing removed. I have nicknamed this experience the “magic scarf trick.” This is based on discussions with other post-op ladies who say they they start pulling and it just keeps coming out…. foot after foot. Heheh.  They’ll also remove the catheter at this time.

At this point, they’re going to teach me the finer points of zen and the art of vagina maintenance. Namely, dilation. Dilation is something I’m going to be doing a lot of. As in, three times a day for the first 3 months. It’s kind of like getting your ears pierced. You need to make sure the newly formed “neo” vagina doesn’t lose any of it’s depth or diameter. So for 15 minutes, thrice daily, I’ll insert a dilator and just kind of let it hang out for 15 minutes while I watch tv or something… Ponder world peace… Whatever girls do when they’re very full of Perspex. After 3 months, I can go down to twice daily until 9 months and then once per day. After the first year, most ladies will go down in frequency, especially if they’re sexually active with penetration. Intercourse is not a perfect replacement, but it serves it’s purpose in more ways than one. If everything goes well, I should be in California between 11-12 days. Flying home should be exciting. Remind me to make sure I have plenty of pain meds and the rubber donut for that flight.

My primary concerns are, and in no particular order:  infection, loss of depth or the vagina itself due to graft complications, nerve damage, loss of the ability to orgasm, and/or urinary problems. There’s also a small risk of death. Which I guess, you know, could happen. If they were to nick or penetrate the bowel, I could end up with a colostomy bag and a very botched set of genitals. Nothing to worry about, right?

Statistically, based on Dr. Bowers volume, major complications seem very unlikely. I’ve only read a few people who were displeased with her results. There’s a reason that she runs a waiting list that’s nearly 2 years long. She’s sought after. The only surgeon in the US that had a longer waiting list was Dr. Metzler. The two of them are pretty much the rock stars when it comes to store bought vaginas. The win out for Bowers is one, she’s a woman…. and two she’s a transgender woman. I think that ultimately, she probably knows what I want more than I do at this juncture in my life. Who better to help me? Plus she has a good sense of humor and her jokes are both somewhat crass and sarcastic.. which is kind of my thing.

Pausing To Say Thanks

Pausing To Say Thanks

EDIT: 2017.09.09 — Sometime last year, Premier changed their name to LightRx. This was to reflect that they offer more than just laser hair removal.

So, I know that I have a reputation for venting all of my frustrations online. I wanted to stop and give thanks for the lady that does my laser. SHE IS AWESOME. If you’re in or near Louisville and you want someone that’s competent and awesome and friendly and is ok with working on trans girl parts… She’s your lady.  So I took a minute to type a letter, print, sign and mail it to the corporate office in Michigan.  Here’s what I said:

PREMIER LASER SPA
(ADDRESS REDACTED)

To Whom It May Concern,

I am writing today to send praise for one of your employees in your Louisville KY location. Her name is Ashely Vonderheide. She is nothing short of fantastic and although she’s typically inflicting pain upon me, I actually look forward to seeing her.

I have been a customer of the branch since May of 2015, and with the exception of one visit, she has been my technician. Originally starting with the treatment of my face and neck area, I’ve since come back for a full Brazilian treatment. As a pre-operative transgender woman, I am not fully comfortable with my genitals and they cause me a great deal of dysphoria. However, as I needed to have hair removal done as preparation for gender confirmation surgery, I had no option but to “bare it all.”

Since I was already an existing client, I initially approached the branch manager via email to see if that’s even something that they would be comfortable doing. I was assured that it was no big deal. Even still, I was very apprehensive about the whole thing. However, having already built a rapport with Ashely, I tried to put my mind at ease. She had been nothing but professional and had always respected my pronouns and addressing me as she would any other woman.

I’m so happy to report that she has given me an experience that exceeded all my expectations and even my hopes in terms of treatment and respect. We’ve joked about the awkwardness of the whole thing and had a couple of good laughs and let the elephant in the room be a non-issue. She has taken all of my anxiety away.

I know in today’s society, we rarely stop to sing the praises, we only complain when things are wrong. I’m guilty of complaining often and never sending accolades. However, I wanted to take a moment to thank her. I was taught that for every customer you anger, they will tell 10 people. For every customer you impress, they might tell 1-2. With Ashely driving your customer service, I think any location she worked would see an improvement in customer satisfaction. You have one of the best you could hope for in your Kentucky office.

Sincerely,
Addison L Newton

So, if someone does good, let them know. Better yet, let a lot of people know.

Throwback to my first endocrinologist visit.

Throwback to my first endocrinologist visit.

So, about this time last year.. I was done with my first endo visit. Having started therapy and coming out in December, I had been waiting for this appointment for some time. When I started therapy, I wasn’t sure exactly how things worked. So by the end of my second appointment, I told my psychologist that I wanted to start hormones. The following week, we started working on the formal referral letter which took two more sessions to complete.

When we completed the letter, she suggested two different doctors. The first was Dr. Winters’ at University of Louisville Physicians. She said that they had the least amount of waiting time, but had heard that his bedside manner wasn’t the best. If I had questions, I should have them written down because he normally was in and out very quickly. As I’m the type of person that does her research on her own, I usually don’t have many questions… so this seemed ok. She also mentioned Dr. Pookay, who had the better rapport, but much longer wait time to get in.

With that in mind, and my history of not wanting to wait for anything once I’ve made a decision, I chose Winters. Thus sealing my fate! At the end of that session, she called over to Dr. Winters’ office and setup the appointment for me. This was January 13th, 2015. My appointment was for 8 AM on February 6th. She gave me a post-it note with the details on it, faxed over my referral letter and gave me a copy to keep.

This appointment was to be a defining point in my life. I was so excited that I might be able to get started on hormones. I tried to set expectations that I probably would not get a prescription on my first visit due to blood work and other factors, but IT WAS ALL HAPPENING!!! I was finally going to be myself after thinking about it for so many years.

As I was not out yet at work, or to many people other than family and friends, I was still presenting as male day to day. I had to work that day, so I was dressed fairly typical for myself at that time. That day it was skinny jeans, a woman’s t-shirt and Chuck Taylors.  The real reason that I didn’t look feminine didn’t have anything to do with my clothes. The real reason was the same reason I was sitting there. Testosterone.

After the barrage of paperwork and vital statistics, I was finally placed into an exam room. Even before I saw Winters, I saw another doctor that was doing her fellowship with Dr. Winters. Keep that in mind… He’s responsible for shaping the minds of other doctors.

So she comes in does the initial introduction, checks the data on the chart. She has me change into a gown. When she comes back, she checked my thyroid and glands and did an overall exam. She asked for permission to lift my gown and examine my genitals. I complied. She commented on my attire, the fact that I didn’t shave my pubic area, the hair on my arms and other things. The line of questioning was very presumptive that these things are what all women do. The CISnormative checklist. At one point, she asked if I had a primary care physician and I said no, giving some sort of “I should probably take better care of myself” admission. She replied that she understood, that her husband never wanted to go to the doctor either. So, apparently me and her husband are alike in one regard?

After that awkwardness was over, she left and came back with Dr. Winters. He went through most of the same things that she did, feeling my thyroid and general poking and prodding. Then he did something totally unexpected. He lifted my gown and started doing an examination of my testicles. With his bare hand. Without a glove. I was so frozen with shock, awe and equal measures of dysphoria that I couldn’t even voice a protest of what was happening.

Feeling fully sated that he had sexually assaulted someone that wouldn’t ever press charges, he moved into the line of inappropriate questions. He asked a lot of the same things that the fellow had asked. A lot of things that were in the referral letter. He asked if my family was on-board for “all this.” Just a lot of probing. He seemed more interested in playing psychologist than endocrinologist. Maybe trans people are his way of escaping the monotony of diabetes and underactive thyroids…. like a little vacation.

Interestingly, he seemed most interested in my childhood and more specifically my relationship with my father. I could tell that he was trying to come up with a causation theory. My first response was “Well, he’s dead, so we get along pretty good!” He didn’t really like this answer and probed deeper. He wanted to know what kind of activities that we did together when I was a child and other things. It was very bizarre. I kept thinking, “THIS IS NOT YOUR JOB, DUDE.” He went so far as to say that we could proceed with starting hormones (pending bloodwork), left the room… and then came back to ask more questions about my paternal relationship.

With that done, I had blood work drawn. Now my bloodwork came back the next day and he called me to let me know that I had extremely high triglycerides. I didn’t know how my lipids had impacts on hormones, but he said that he wanted me to come back for a glucose tollerence test. Honestly confused at this point, I asked him if there was a concern about diabetes.

“I wouldn’t do it if I didn’t think there was a concern”, he replied with a tone of righteous indignation.

Right there, I stopped him. I said, I’m not asking these questions to argue. I’m asking you because I’m totally ignorant of how diabetes and cholesterol impact each other. You could actually hear him relax and he explained that the concern was that estrogen can cause your triglycerides to increase, which can cause pancreatitis. He prescribed me Lipitor and told me to come back for the glucose test.

The glucose test came back as insulin resistant, but not diabetes. I thought this was a good thing. He disagreed. He wanted me to diet and take the Lipitor for a couple months before he would start me on hormones. I was so upset. I felt so hopeless. I countered with an argument that if a post menopausal woman on estrogen replacement presented with high triglycerides, he wouldn’t stop her hormone treatment until her cholesterol lowered itself. That both could be treated side-by-side. He actually agreed with me on the first part. He said he wouldn’t take hormones away in that situation. But he still wouldn’t give me hormones. Preferential treatment for cisgender versus transgender people.

I tried to impress upon him that he was messing with my mental health and that the here and now was more important than the possibility of diabetes or heart problems further down the line. Furthermore, that I wasn’t sure I could wait any longer and that I might be forced to go DIY. He refused to do anything to help me.

Devastated, I tried to find anywhere within a 3 hour driving radius that would prescribe on an informed consent basis. I had my letter. I knew the risks. The closest places that I could find were in Atlanta or Chicago. Nothing reasonably nearby. I considered ordering hormones over the internet, but dealing with customs and illegal prescriptions seemed risky, not to mention considerably more expensive without my insurance coverage. I sat in a parking lot in my truck crying. It was a fairly dark moment for me.

While all of this was happening, I was relaying it back to my psychologist. I went ahead and had her book me an appointment with Dr. Poorkay at Norton. However, he couldn’t get me in until April. So, I kept my appointment with Winters and double booked to ensure I got what I needed. I also changed my diet and tried to do what the doctor wanted, so he’d have less of a reason to say no.

By the time I went back for bloodwork on the 13th of March, my weight had dropped 14 lbs and my triglycerides had gone down by 138 points. I also had an office appointment with him that day. Honestly, I’m not sure why we were meeting, since the lab work wouldn’t be back until the next week.  In any event, since he had told me that I wasn’t feminine enough on my previous visit, I had gone out and bought my first proper girl outfit. So I showed up in a dress, leggings and boots. He walked into the room and looked me up and down, elevator eyes style and said “Good for you.”

On the 18th of March, He called me back again and said that he was going to send over a prescription for Estradiol. However it was a low dose and he refused to give me a testosterone blocker. This is typical, from what I’ve heard from others who’ve seen him. I pressed him on this issue and his claim was that if we added that now, my body would produce excess testosterone and it would be counter-productive. I cited the protocol recommended by University of California, San Francisco – Center of Excellence for Transgender Health and he said they were wrong. I decided it wasn’t a battle worth fighting, as I had my first appointment with Dr. Poorkay on April 6th.

When I called to cancel my follow-up appointments with Dr. Winters’ office, they asked if I would like to re-schedule. When I said no, they didn’t even ask why. The tone seemed to acknowledge that this was not an uncommon occurrence.

When I went to Poorkay and I explained the dosage that Winters had prescribed and his first reply was “Why would he do that? That won’t do anything.” Indeed. He doubled my dose of estrogen, added progesterone and the testosterone blocker. You know what didn’t happen? My testosterone spiking. In fact, 3 months later at my follow-up, my total free testosterone was 9. Normal female range for adults is 8-55. So there.

A Mother-Daughter Talk

A Mother-Daughter Talk

A year ago today, I told my mother the news. I came out to her as transgender. It wasn’t as easy as everyone else. For some reason, I just couldn’t seem to find my way to have this conversation. I had intended to tell her before Christmas…. and then before New Years… and well, it never happened. Not counting family events, I actually had to go to her house three times before I could get the words to come out.

She (and my step-father, via proxy) was the last of the family that I wanted to tell, face to face. I had worked my way through the other members, one-by-one, telling them the new reality of the boy/man/son they knew and loved. Thus far, it had gone pretty well. Everyone had been supportive. They even promised not to tell anyone else, until I had covered my bases. They couldn’t though…. because by the time I got to my mom, I think everyone on my dad’s side of the family knew. I started getting texts and FB messages from people who weren’t supposed to know.

I tried to prioritize the list of people I told, based on how I expected they’d react. I prepared for all of them to go poorly. The whole mantra of planning for the worst and hoping for the best. The majority were done in public places, like the mall or restaurants. All with a clear plan of how to get away if things did go poorly. I would make sure to have viable exit and a well thought out method of egress.

Throughout the process of working through this list, I would go to visit my mom and try to find my nerve. In the end, I’d sit and talk for a couple hours and then I would leave. Too scared to just say it. No longer afraid to be myself, but terrified of the reactions of those who I loved most. I had squarely placed my mom on the end of the spectrum of people that I couldn’t bare to lose.

As it so happened, I was to be off work on a Thursday. With all of the trans stuff and then the holidays compounded on top, I had become a little ball of stress. In December,  I had met a new friend, who happened to be a licensed massage technician. That Wednesday evening, I messaged her to see if she had any openings. She confirmed that she could get me in at 10:45. So, even though I was still presenting as male, I put on some yoga pants and a ladies t-shirt and I headed down to her office. For the next hours, I let her force out 34 years of pent up stress. I left there feeling very zen and centered. I decided that it was time to tell mom. Megan had said she would go with me to be my moral support, but she was at work and I was feeling like a million bucks.  I hopped in the truck and drove from the Highlands down to Bullitt County.

However, much like the other visits, this one pretty much played out like the others. I got nervous and I couldn’t get the conversation started. In fact, I had given up and was getting ready to leave. My mom had gone to her room to lay down and I got a brief moment of courage and I took a deep breath and decided I needed to tell her just one last thing.

I came in and I sat down on the bed and I told her that I needed to tell her something important. Immediately, she was sitting up and worried that I was dying of an incurable disease. Putting out that fire, I started in on the next. As was customary in my various coming out speeches, I led in with “So I’ve been seeing a therapist…. and I’ve been dealing with some issues, and well… I’m transgender” We talked for probably 30 or more minutes. I explained that this was something that I had always felt. I had never been truly comfortable in my own skin, etc, etc, etc…

Her response was that she had known since I was 3 or 4, but she always kind of just figured I would be gay. I said something like “Well if you had said something, maybe we could have saved a lot of time.” I explained to her the next steps. That I was seeing an endocrinologist in the coming weeks and hoping to start hormones as soon as possible. I told her about my upcoming laser hair removal. I answered all her questions, to the best of my ability.

Once we had come to a conclusion of the conversation, she went out to the living room with me and we sat down and had the same conversation with my step-father. Now, my step-father and I have always had a great relationship. They have been married for 30 years, and he’s been with me since I was 5. He’s as much my dad as my own biological father. In some ways, more so. So to say that his approval was important to me would be putting things extremely lightly.

If I had to explain his reaction in only one word, I would say that word would be “confused.” I had opened with the same bit about therapy, which I did to kind of offset the “are you sure” line of questioning. Even still, he asked “Did you get a second opinion?”

I considered how to answer that question and the best I could come up with was, “She was the second opinion.”

He thought about it some more and he said something along the lines of “It would be a lot easier if you were just gay.”  To which I agreed. However, I thought about that too and then I explained that I was a lesbian, so actually I was gay. I explained that I did not have any intentions of leaving Megan and that we were going to try and make this work.

At this point, I think his brain actually locked up and needed a reboot. He was having a really hard time separating gender from sexuality. He could comprehend a gay man, having them in the family. However, a guy who’s transitioning to a girl, who still likes girls? We might as well have been trying to divide by zero.

However, in the end he was accepting and we hugged and he kissed me on the cheek and I went on my way.

Once it was all said and done, my mom was upset with me. Not because I was trans. But because I had waited so long to tell her compared to other people. She was upset that my aunts and uncles knew before her, but to my credit…. they weren’t supposed to know.

With that out of the way, next came the letters and then the facebook dump. Which I refer to as the scorched earth approach. No one can turn around and tell someone else, I already told them. So there!

My Two Surgeons

My Two Surgeons

So let me tell you about what I’m dealing with these days….

I had planned to write this entry for the last few days. I even have a couple of drafts that will likely never see the light of day. I wanted this to be a happy entry, a fun entry. Something exciting. Much wow.

I was hoping to be able to say that I’ve finally got a real date for my surgery. That I can sit back and relax and just check off days on the calendar. However, this is not that entry. Oh no, of course not. One door opens, and then a Trump-like villian builds an electrified Jurassic Park style 10,000 volt fence.

So, as you may recall…. I originally had picked Dr. Bowers. Because reasons. A myriad of reasons. However, with that reputation comes droves of dysphoric transgender women looking for new hoo-haas. So the wait has been an issue. I’ve been on the cancellation list trying to get a leg up on the situation. It had not happened. I started to get nervous and began to look at other options.

In October, I found a surgeon in Chicago by the name of Dr. Schechter. He seemed very competent, amazing resume, etc. I set up a consultation with him in early November. Post consult, they had submitted a request for a pre-determination to my insurance company. That’s where things get weird.

I spoke with Dr. Bowers face-to-face later in November when she was in town for a banquet and I explained my unique situation. She seemed concerned and interested in helping me, so I immediately contacted her staff.  Things looked good and the office manager said we needed to start in on insurance approval immediately. I hurriedly sent over all the paperwork and crossed my fingers for the best.

Not long after, I received notice from Dr. Schechter’s staff that my claim had been denied. The reason was that I haven’t met certain requirements today. However, we were attempting to schedule for after those requirements had been met. They would not schedule me without this approval. Unless, of course, I want to pay out of pocket.

I contacted Dr. Bowers’ staff again and let them know of the situation. They advised me that I should attempt to appeal but that it would be 1-2 months… yes, MONTHS… before they could even get around to filing my insurance paper work. So I moved forward with the appeal.

I submitted the appeal on December 14th, assuming that Blue Cross Blue Shield would take the full 30 days to make a determination. So I sat on my hands and I waited. I didn’t email any of the doctor’s. I enjoyed the holidays and I tried not to think about it.

Last Monday, I got a letter in the mail saying that my appeal had been denied. From what I could tell, the insurance company totally ignored my letter altogether and doubled down on their original verbiage. That’s point where I lost my collective shit. Remember “Ferris Bueller’s Day Off?” That scene where Cameron looks down and sees the odometer on the Ferrari? Just like that, except without the hot tub later on.

As I have been known to do, I went to twitter and I started a (nearly) perfect (shit)storm.

From there, things got weird. The next day, I decided that work was not in my best interest, what with my heightened mental status. So, having finally blown off some of the steam, I was going to try and just let it go. Maybe I would have to wait until March. I had some other ideas. But then there was a knock on the door. Who could that be?

Ok, so I earned that. 140 characters doesn’t give me enough rope to truly hang myself. Wait, that’s not right either. Umm.. I was trying to say people denied care are more likely to commit suicide. Not that I was going to kill myself. Simple misunderstanding.

After having an awkward conversation with the very nice police officer, I went back to Twitter and some friends and I bantered back and forth about the denial, the police and the “man.”

But later that day, I got a phone call from Blue Cross. In a crazy turn of events, they reversed the denial. After a brief rush of euphoria, I emailed Dr. Bowers’ office and let them know that I was approved for surgery and politely asking what the next step would be.

Despite a number of emails exchanged, the most informative answer I’ve gotten from Dr. Bowers’ office is that that they’ll work on it this week or next. This is even with a representative at the insurance company willing to personally process the claim.  I have basically begged them for more information, but all I get are vague replies, days later.

So, I decided that maybe I just needed to give up on Bowers. Maybe it just wasn’t meant to be. Schechter’s office wanted a bunch of additional clarification from the insurance company, which the rep at BCBS agreed to do. She faxed them a special letter with the info they needed. I thought that at that point, I could get a date. So I emailed them on Monday and asked them what the status was. I waited until today (wednesday) to call them and see what was up. Now they’re wanting additional info. They still won’t schedule me. Well, she offered to schedule me if I would pay out of pocket.

I let the lady have it. I really just let it all go. I told her that I didn’t feel like they really wanted my business. I felt like they were not putting enough effort forward to obtain their required documents from the insurance company. That I had done all the heavy lifting because once again, no one will advocate for me except me.  She was unmoved by my plight.

  
I contacted the rep at BCBS again and asked if she could help hand hold Dr. Schechter’s office through whatever they needed. She said she would reach out and get back to me as soon as she had more info.
Meanwhile, by Christmas, I’m sure Bowers will find my file under the pile.

Edit: As my friends so eloquently explained, GRS/GCS is a seller’s market. There’s a ton of demand and only so many surgeons. I think this climate has led to the poor customer service that we’re seeing. We are put on endless wait lists and we’re meant to feel lucky when it’s our turn. It’s sad, because I don’t think that’s what the providers intended for when they started in this field.

In any event. for months, I’ve been walking on eggshells with both doctors. I know they don’t need me like I need them. Writing all this might make it worse. I might never get a surgery at this point.

Update, 10:16 2016.01.14 – email from my insurance regarding Dr. Schechter’s refusal to schedule me, still.