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. 

Transition Costs Revisited (unspecified amounts)

I wanted to go back a few years in this blog to the beginning of my transition and revisit a list I made.

From April 15, 2010 (italics) current updates (bold)

Figured I'd breakdown the basic expenses a trans guy faces.

binder- for the purpose of hiding one's chest: I have several. I use both T-Kingdom and Underworks. I like them both. But Underworks is much more affordable. I only use underworks these days. It sucks to have been binding for over 6 years.

soft packer- for the purpose of creating the bulge: again, I have more than one. Not expensive, but they do wear out over time. I forgot to include the packer harness. Again, not expensive, but the elastic doesn't last so long.

STP (stand-to-pee)- I use a modified medicine spoon. It was very cheep indeed. However, I also purchased an STP packer. It was not really worth the cost. I'm pretty sure I'm only on my second medicine spoon ever. I also don't use it much at all unless I'm in a public restroom and occasionally in the woods.

Strap-on- for the purpose of intercourse. I've no experience in this area. I now have experience in this area. Not particularly cheap.

Therapist- for the purpose of getting a letter for the the following. I actually enjoy therapy and I didn't just go so that I could get the official diagnosis to proceed with medical transition. However, I did get that letter written. And I have also not ditched my therapist. I no longer go to a therapist regularly.

Physician- for the purpose of getting a prescription. I've yet to find out if my health insurance pays for my doctor visits and blood-work. I go to my physician once or twice a year for a physical and bloodwork. My insurance covers the physicals and the general visits.

Testosterone- for the purpose of making one hormonally male. I use AndroGel. I rub it onto my upper arms once daily. Many other guys opt for the injection because it is much (much) cheaper. My insurance fails me in this regard. I have been on injections since September of 2010. The cost is low, especially with a pharmacy coupon. I am on a fairly low dose so my vial lasts many months.

Top Surgery- negates the need for a binder. I do not at this time wish to have a double mastectomy, though I do wish I had a flat chest. My surgery date is March 30 in Boulder. I will not need the double incision technique that is most common among trans guys. My surgeon said periareolar was the best option. This means I get minimal scarring and the retention of the nerve stalk for the nipples. However, it is two surgeries, and thus half again as much money as I was anticipating. This will be my largest expense in the whole process. It will be well worth it.

Bottom Surgery- yeah... I don't want this. Some do. I still have no intention of getting any sort of genital reconstructive surgery. Perhaps someday hysterectomy/oophorecotmy but that's way out of budget now. It'll save on testosterone cost though!

So yeah, I have a chest surgery date. I'm still worried about money, but I'll get it worked out. I will likely have to use the surgery office's line of credit, but it is no interest for a year, so I think I can handle that. I will be out of work on paid time off for two weeks. I will unfortunately have to spend most of that time in bed or at least minimally active. Send me your TV show, movie and book recommendations. Also, come visit me. I'm going to be super bored, but hopefully not too much in pain.