12 years on Testosterone

I wanted to write about sort of the entirety of my transition on this anniversary. Content warning: surgery and recovery. 

Here is a list of all my important transition related dates: 

4/5/10 started testosterone (transdermal) 

9/21/10 started testosterie injections 

11/29/10 name change court date 

3/30/15 first chest surgery 

3/2/16 second chest surgery 

3/21/22 hysterectomy salpingo-oophorectomy 

In 2015, I got my main chest surgery. It really was crucial to my well-being. I had another surgery that was planned to revise the first one. I am still not entirely happy with my results and I may seek another revision to remove the rest of the breast and fat tissue and to make the nipples look more normal. 

This year I had a "full" hysterectomy. I have been pleasantly surprised with my recovery. I've had no fewer than 4 surgeries in the last two years, but the time in the recovery room for this last one was the worst. I generally don't have a lot of nausea, but I did this time. They also needed to keep me until I urinated, which took some time. Meanwhile, everytime I'd drift off to sleep the blood oxygen alarm would blare and wake me back up. But after peeing the blue dye out and heading home, the recovery has been great! Besides the significant cramping feeling in the recovery room, I've had no pain. In fact, getting an IUD (which I did in 2015) was much more painful for much longer. I've had no need of narcotics, just ibuprofen and acetamenafen alternating for a few days. I did have some pain in my shoulder for a day or two from the gasses they use for the surgery. A heating pad helped immensely.  My eyes were also a bit off for a couple of days. Hard to focus. Likely a side effect of anethesia, but not one I've encountered before. After a week, I have to consitently remind myself that I am still recovering and will be on restrictions for 6 weeks total. 

I admit I was more nervous about this surgery than the others due to the possible (however remote) ill effects it could have on my enjoyment of sexual activity. I will not know the extent of this until after the 6 weeks, but I am not terribly worried at this point.

It proved to be quite hard to find any sort adeqaute information for this surgery as it relates to transgender men (or non-cis AFAB folks). The majority of the information was for and about older women. I saw recovery times ranging from 6-12 weeks (including no sex of any kind!) I am cleared to retrun to work with some restrictions after 2 weeks. Restrictions should be lifted by 6 weeks. There was no ban on external stimulation, only penetration, and of course lifting and other pysical exertion. 

I think the biggest loss from this surgery was my shaved belly hair. Due to my age and duration on testosterone, my head hair has been thinning a whole lot these past few years and I take pride in the other hair I can still successfully grow. It will grow back of course, but it was sort of a surprise how much disphoria can be caused by a smooth abdomen. 

Though my surgeon works through the "Women's Clinic" I did not have any negative conversations about this surgery. Insurance required that I submit 2 (two!) letters from different therapists stating that I was in fact trans and could make this sort of medical decision. That was a bit ridiculous, but worked out in the end. My pre-op nurse did ask if my family knew I was there, getting surgery. I scoffed and said no, but pleny of supportive people knew. 

At this point I just don't want to rock the boat with my parents. I am confident in my identity and what needs to happen to my body. I don't want to risk getting into debates or anything with my parents about these things. It is possible that they'd want to know, just so they can pray for my recovery or whatever, but that's not necessary for me. 

As for effects of 12 years of testosterone: my hair is very thin these days and I have been taking finasteride to try to hang onto it. I'm hoping that on account of my most recent surgery, I'll be able to lower my T dose a bit. It's been on the high end to keep menses away. Perhaps with a lower dose, I'll be able to keep or regain some hair. It's also possible I just need to embrace the fact that I'm a guy of a certain age and give up the fight. 

I'm Alive and Continuing to Change

I have not posted here in a very long time. That's mostly because my transition has been in a sort of stasis. I'm aging and dealing with things that come along with that. My body aching, etc. 

My hair has been thinning increasingly these past few years. I began taking finasteride last July in attempts to curb that and retain what I have left. I don't have a bald spot or even a drastically receding hairline, just very thin, fine hair which I now just keep very short out of necessity. 

I am not super happy with the overal asthetic results of my chest surgery. It definitely did the trick of flattening my chest, but the nipples are strange shapes and misaligned. I've gained roughtly 20 pounds since surgery, and while I can be okay with the excess fat in other areas, it makes my chest look wonky. Especially since there is more on one side than the other. Because of these things, I'm considering a revision. Possibly a double incision or anchor type to be sure to properly remove all the offending tissue and resize my nipples. I'm sure my pectus excavatum will be a hinderance, but I just want something that looks a bit more normal. I have had the thought over the years that the double incision scars are such a trans masculine standard that I'm sort of sad to not be a part of. 

Other news: I'm scheduled for a full hysterectomy (full = ovaries, fallopians, uterus and cervix removal). This is something I never really considered as a thing I'd go through with, as the organs themselves don't really bother me. I have an IUD and it certainly serves its purpose, but I do gets some unpleasant cramping after sex in certain positions. I should be (and have been) on a lower dose of testosterone. When I was, years ago, I ended up getting a menstrual cycle back a couple of times and that was horrifying. Especially because it was unexpected. I'd like to go back to the lower T dose for a couple of reasons. One, it might affect my hair loss in a positive way. I also might be able to finally leave the acne behind. I am not certain the origin, but I have never been without acne. It was very bad for my fist puberty in my teens and again for a couple years after starting testosterone, but it has never gone away. Perhaps a lower T dose will help. 

There are a couple of worries I have with this surgery. I have heard wildly different recovery times. From back to work in 4 days to 6 weeks off in bed. I know it varies by individual. I will abide my my surgeon's suggestions. I tend to heal up quickly with minimal pain. I've had 2 rounds of chest surgery, a rotator cuff repair, an appendectomy, and a toe surgery within the last 5 years. I've been back to work (without heavy lifting) in 2 weeks or less for every one of them. 

Another worry is sex. Abstinence post op. Lubrication. Sensation. I won't detail everything, but it's definitely a concern. Again, one that has so meny varied experiences.

Lastly, I will not ever have the option of stopping testosterone. I have vague worries of societal collapse or being stranded on a desert island or some such. I mean, I guess in those scenarios, I'd have a lot of other things to worry about and can expect a shorter lifespan to result from a variety of causes. 

Summary: pros of the operation are lowering my T dose to possibly help with hairloss and acne. Stopping internal cramping and potential menstruation and pregnancy. No chance of a couple kinds of cancers. Cons are post op healing and abstinence. Possible adjustments in regards to sex. Potential catastophic affects of being hormone-less longterm. 

I'll try to update this as I'm healing up.