Anniversaries

The end of March and beginning of April is when all of my transition anniversaries fall. I started testosterone 14 years ago. Chest surgery 9 (and 8) years. Hysto 2 years.  

It's surreal to continue keeping track of something like this. Something that helps make me who I am.  Something that is increasingly difficult to reckon with in current society.  

Back in 2008 or so when I was first learning about myself and transness in general, it was tough societally. There was general confusion and an general lack of rights. For instance, insurance didn't cover any treatments related to gender dysphoria. I paid for all of that out of pocket on a non-profit salary for many years. These days insurance helps with that, but the public perception of trans people is daunting.  I enjoy the rights that have come (in my state at least), but sometimes I think it was better when people didn't know about us. The hate is overwhelming at times. The misunderstanding. I'm just tired.   

At the animal shelter, I was mostly out, since I began transition while working there. At my "new" job, I'm very much not out. I don't necessarily hide myself, but I definitely don't share many personal details. I think this is fine, I'm not at this job to make friends. And I certainly feel more vulnerable here than before. At the shelter there was a very high percentage of queer folks, but now, I'm one of very few (that I know of). It's just a strange change.  I'm glad that I can be more or less stealth. Safe. But I also hate that I feel it's necessary.  

I've joined a HEMA club. That's Historical European Martial Arts. I'm learning to sword fight! This particular club is very intentional about being inclusive. It is really nice to be in a space fully of queer folks and to feel safe there. Even with steel flying around! In general, it's been a great new thing to learn and work on. I've been physically stagnant for several years with injuries, surgeries and general depression. I'm happy to be moving my body intentionally again. 

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. 

8 years

It’s been eight years since I took the plunge to start my medical transition to male. Eight years ago, I started testosterone. First as a gel I rubbed on my skin, then a cream that was less expensive, and finally, before the year was out, injections because my body needed a better dosing system in order to do the thing. It is also my de facto chest surgery anniversary. Three years since the original surgery and 2 since the revision.

A lot has changed since 2010. I’m myself more than I have ever been prior. I have accepted that my beard will not likely fill in any more and that my hairline will only keep receding. Some things have remained the same though: I am still working at the animal shelter. I am in a different role recently, though. This job has been a blessing in regards to my transition. Way back when I started in 2009, I asked for my name (my current legal name) to be on my nametag. Only a few months in, I requested a change in pronouns. With very few exceptions, people were amazing about it. Now that I’ve been there for so long, many of the people I originally worked with are no longer there. The people who have replaced them have only known me as male. In most ways, that’s amazing and wonderful to me. But I am not stealth, so in other ways, it can be a bit exhausting to ‘come out’ to people more or less constantly (generally not in person, but if you add me on facebook and look around, you’ll know!)

I’ve had some rough patches. Dealing with family at times. Old friends. But my community, my job, the friends I’ve retained from university. All of these have been stellar and I wouldn’t trade my experience.

Anyhow, all this to say that 8 years ago my life began to change for the better. Here’s to more years.

7 years on testosterone comparison

Seven years. It's a bit weird to think of really. Mostly it's just maintenance now; the majority of the changes have fully occurred. That said, I am getting more hair gradually. Beard continues to fill in. More body hairs in random places. That may be more of an age thing than puberty though. These last two years without a chest binder have done wonders for my back acne. I am still prone to pimples on my upper back, but not nearly so bad as before. I am still planning to meet with my surgeon again to determine if I should get another revision. I am mostly content, but it could be a little better, though likely never perfect. I am still working on my muscle-building and fat-losing. That, of course, is an ongoing process. I just need to stay on target and try to break my sugar habit.

Chest update

It has been a year since my second chest surgery. There's not a whole lot to report. It has healed up well, though I think I may need a revision at some point. The areolas aren't quite right. One is a bit too big, the other is not round. My right side seems to have some fatty tissue remaining. Overall, I'm quite pleased. I am much more self-conscious of my gut than my chest if I'm ever shirtless.

One thing I'm a bit disappointed about is that my nipples don't have much feeling. One reason this variant of surgery was so preferable for me was that the nipples were not grafted on, so they tend to retain (or regain) feeling. So far that is not the case with me. It certainly doesn't make me regret the decision in any way, but it is sort of disappointing. Though, there is always the possibility that I'll regain feeling. It is a process.

transition never ends.

Even after six years I can still note some changes. My mustache is finally connecting to my beard. And is generally still just filling in. It's very exciting. I always wanted Aragorn stubble. But I figured it may be out of my reach just due to the denseness. But I'm on my way! Too bad I can never stand my hair being longer than a couple of inches.

Also I realized today that though I'd like to lose some pudge from my middle, I really like the look and feel of my chest in a t-shirt. It's a novel thing. A very right thing. I loved having a flat chest for the first time (since I was 12) when I started binding, but this is better. The contours. I can actually see that I have muscle. I don't have to feel self-conscious about my binder showing through light colors or thin shirts. After the first surgery I stopped binding, but I never felt very comfortable simply because there was still some strange shapes going on. So while the feeling was good, I didn't approve of the look. But I do now. My next step is fitness and a final nipple revision so perhaps I can have this same feeling with a bare chest.

Anyhow, as the title suggests, there is no end to transition. It is always progressing. I am always becoming more me.

6 years on Testosterone

Today marks the sixth anniversary of my medical transition. Not a lot has changed hormonally in the last few years.

I got had my first chest surgery about a year ago and it has been a great year without a binder. I have noticed that my back acne has cleared up amazingly since not having that constriction. After my surgery about a month ago, it's amazing to be able to run and move without any bouncing of my chest besides some muscle. I now feel very comfortable wearing tighter and thinner shirts. I am not completely healed up yet: not quite comfortable enough to go without a shirt, but close. Just a bit more healing up and some working out, haha.



This journey is expensive and difficult, but so very worth it.

I have had amazing friends who have supported me in all ways; emotionally, financially, physically. This process really could not have been any smoother.

So as far as my mental transition checklist goes, it seems I've crossed nearly everything off.

Testosterone
Chest surgery (besides one more possible tiny revision)
Gender and name on ID
Gender and name on Passport
Name changed on all accounts and documents

The only minor things I haven't done and probably won't do are to change my birth certificate in any way and to change my gender on health insurance (who knows if/when I may need that to match my physical body).

At this time I have no plans for any further surgeries, which my bank account greatly approves.

Thanks for joining me on my journey.

This insurance thing is taking some time. The first inquiry was denied because my doctor's office hadn't sent the referral correctly. Now that I've officially been referred to the surgeon, they had to appeal the decision. I should probably have had my doctor write another letter of medical necessity, I have a feeling they're going to deny it again due to it being "cosmetic". Worse come to worse, I'll pay for it. It isn't much comparatively.

I asked my boss when a good time to take a week and a half off would be and she said not til early January because we're still slammed and short staffed. Hopefully by then there will be a lower animal population and we'll have new people all (or mostly) trained up.

Setting things in motion for my second surgery. There a a couple of really exciting things about it. One is that I can probably get it covered by insurance so long as my doctor writes a letter stating that it's not a cosmetic surgery. The other good thing is that it can be done as an outpatient surgery, so even if I do have to pay out of pocket it will be well under a thousand dollars.

The recovery time will supposedly be a bit shorter than the first one. I am trying to store up enough PTO for about a week and a half, which, with weekends added will be adequate. Work is really rough right now as we're very short staffed and the population is very high, so I don't know if they will even approve a long absence as I'm one of very few staff who have been around long enough to train new people properly. So with that and insurance, I may have to wait until January. I was hoping for early December.

I want to get it done in the winter so everything will be healed up for next summer. Hiking, swimming, running. I am excited to work out and be comfortable without a shirt.

I need to start paying more attention to my diet and exercise again. The change of seasons really messed it up for me.

chest update

Well, I had an appointment with my surgeon today. He said that the swelling is gone, but there is still tissue left. He said he will do liposuction with the next surgery. He can make there be almost no tissue between the skin and the muscle. It will still not be flat due to the pectus excavatum, but at least there will be no more of this daft bouncing flesh. He also mentioned that because it healed up so well, I could do the surgery anytime. I still want to wait until fall so I can make the most of summer for camping and hiking. The second surgery is supposed to have less downtime, so hopefully I won't have to take a whole lot of time off work. I am glad to hear that I did heal up just fine and that the size is not just in my head and that there is a solution. I just have to wait. I think I can handle that. I just need to decide if I should get another binder for running and long hikes. The one I have left is really stretched and gross, and I gave the others away to those in need.

A week and change.

I got those horrible drains removed. I feel like a real person now. The flat-chested sort! There is still a lot of swelling, but it's gone down quite a bit. It may swell a bit more as my body switches from draining the fluid to absorbing it. The process for removing the drain tubes hurt rather a lot on the right side, but after it was all done, it felt amazing. No more itchiness and discomfort. I only have to deal with the compression vest/wraps for a few more days and then I'm basically back to normal. I cannot wait until I can start being active again. I feel so fat and lazy. I know I'm supposed to be lazy for a time, but it sure feels horrible, and notice my gut seems to be expanding. I need to rein in my eating. But since Easter's just past, I cannot pass up half price candies. Ugh.

Anyhow, I feel much better and it's amazing to sit around in a t-shirt. What a feeling to not have to deal with layers. This summer is going to be great.

5 years

Today is the fifth anniversary of starting hormone replacement therapy. I took the last photo a few days before surgery because I knew there was no way I was getting into that shirt only a week after surgery. I messed up because I took it landscape instead of vertical. Oh well.

These five years have been some of the best I've ever had. It's really great to comfortable in my presentation. I am super excited to no longer have to bind. Next year the comparisons will be fantastic.

Have I mentioned that I hate the drains? I am so ready for them to be gone. I'm also going crazy with inactivity. I want to hike. I want to run. I want to do push ups. Ah well. Soon, I'm sure.

Post Op day 6

Not a whole lot new to report today. Drains are really bothering me. Itchy and painful. But I can last another two and a half days until Tuesday afternoon. I think the swelling has gone down a bit. I took off the bandage for awhile around the house. It's so odd to only wear one layer. And it's awesome to be visibly flat.

Post Op day 4

Tomorrow is the big reveal. I am so excited to get this tight and itchy bandage off, as well as the very uncomfortable drains. I am excited to see my chest. It will obviously need to heal more. And in a few months, I will be getting a revision to remove any skin that doesn't shrink up and to resize the nipples. But for the first time since I was 12, I'll see myself with a flat chest. Well, as flat as possible with my pectus excavatum. I hold 12 as my magical age. It was that age before menstruation. The age before breasts. It was the last age I was happy with my body. Testosterone has done wonders for my self confidence. I love the added body hair and the muscles. But I have never liked my chest. I have never felt my naked body was really mine. I have never had the debilitating revulsion that some trans people feel for their bodies, and for that I am grateful, but I have always disliked it. This is a huge step into really owning my body. I cannot wait to see the results.

Post Op Day 3

I'm restless. I hate being cooped up lying on my back all day. Got a nice sponge bath, and felt human again for a bit. I cannot wait to get these itchy drains out on Friday and have a proper shower. I've pretty much phased out the norco. I took only half of one today and I haven't been in any pain. I will likely only be taking it at night now.

I had a memory of waking up from anesthesia. My entire body was shaking like it does when I used to drink too much. I remember trying to explain to them that it's not an unusual thing to happen to me.

People are being really awesome. I've had some friends come visit and hang out. Everyone has been texting me and sending nice messages on facebook and tumblr. It's nice to have support and love and well-wishes.

I have a nagging fear of my mother. I really just think that things will be best if she never knows of this. I have no intention of telling her, and I certainly hope no one else does, as it is my business and mine alone.

Post Op day 2

Drains are pretty blech. Still no real pain, but I can feel where they go into the sides and it’s just odd and uncomfortable. I got my hopes up a tad at my pre op appointment when I was told that for this procedure, drains weren’t always necessary. Welp, they were for me. 

So far so good. Bit more tender today than yesterday but not as bad as I’d feared.

A loss for words (but actually only spoken ones, I can write a decent amount...)

So I was sort of despairing of getting enough money scraped together for surgery by March 30. I would have easily had enough, but I was counting on the FSA. Since that will only work as a claim after the surgery, I was seriously worried about it. I considered rescheduling. I was so loathe to borrow more money on top of my current student loans and car loan. But a couple people suggested I do a gofundme. I was reluctant. I always sort of scoffed at people who had those. I figured they could just be slightly smarter with their money. Or wait a bit longer or work a bit harder and whatnot. But I set one up anyhow, explaining the FSA and assuring everyone reading that I would repay them as soon as my claim went through and I got my money back.

I was surprised by the outpouring. Likes, shares, comments, and of course contributions. I had no idea all those people cared enough to actually help me out. I am so humbled and grateful. I met my goal in a single day. A day. I was expecting that I may still have to take another loan. Or that I'd annoy everyone on my feed by reposting the campaign every few days. But I don't have to worry. And I don't have to bother anyone.

Now all I have to worry about is the surgery itself. Being bored and immobile for a couple of weeks. And submitting that blasted FSA claim.

I really love my friends.

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.

Chest surgery updates

Dr. Hartley says I'm a go for the periareolar procedure. This means I won't have the long double incision scars. However, it does mean that I will need two separate surgeries.

He said that my pectus excavatum would not pose a problem. He will not remove as much breast tissue, instead sculpting it a bit more naturally to "fill in" the hole in my chest.

Now I'm just worried about money. I have enough for the initial surgery- the same amount it would cost if I did do the double incision. I do not however have the extra ~$4 grand. The second surgery would be a few months after the first one, so I can probably get about half of it, but I'll likely have to borrow some. I have a couple of options there.

I have a date scheduled for the end of March. I have to decide if I will go ahead with it, or postpone until later in the year instead of taking out loans.

I thought I'd been pretty good at saving money, but I'm realizing that's not really true. I will be better for the next few months. I will have to be very deliberate on what I spend my money on.

I also need to talk to my job about taking time off and easing back into work. The doctor said I need to take two full weeks off to recover. I have the PTO for that, but if I can talk to my supervisors about doing some desk work for some of the second week, I think I would like to save some of the PTO. It's made quite a bit more difficult by not having a manager currently. Ours recently left and they've yet to hire a new one. Also, the head of HR is brand new, so I feel a bit strange with the whole situation.

Mostly I'm just freaking out in my head that it's actually coming so close to happening. I certainly prefer this method to the double incisions; I just don't prefer that it costs half again as much. I like knowing that the scarring will be minimal. I like knowing that I'll still have nipple sensation, as the nerves will not be severed and nothing will be grafted.

I had a hard time deciding whether or not to inform my parents of this procedure. I finally called my dad because he reads this blog anyway. Through that conversation, I realized that I don't need to tell my mom. There is almost no way for her to find out anyhow, even if she sees me. My relationship with her is pretty good lately, and I'd really hate to ruin that.