Trans Enough...

2006-05-17T14:24:00.000-07:00

I have to write another brief post today, but wanted to share in the joy of my being able to shower regularly again! I no longer have to worry about the stream of water hitting my chest as it is no longer painful. This has made my life much easier and those around me much happier. At this time, it has been five weeks since surgery and it feels as though it’s been 6 months or so. Not to say that the pain is completely gone and doesn’t remind me it was only five weeks ago, but there are so many other things going on right now for M and I that it is hard to remember that I had surgery. It took almost no adjustment whatsoever. I have noticed that it is much easier for me to do things because I’m not constantly worried about hiding my breasts, thus my anxiety levels while out and about have decreased dramatically. What a wonderful experience it is to be in public without having to worry. I still feel anxiety around bathroom situations. I don’t think I’ve ever really discussed the stress I feel if I have to go the bathroom while out in public. I have never made it a habit to use men’s rooms as I feel the level of physical harm is greater to me within those rooms. However, some women are very territorial and are not always shy about expressing their opinions about me being “in the wrong bathroom”; at the very least, the glares I receive are enough to let me know that’s what they’re thinking. I had many more problems in Baltimore than I’ve had here. Partly because androgynous looking people are not as uncommon here as they were in Baltimore, but mostly because just living in Baltimore was stressful. While we were living there, M and I came up with non-verbal signals to get me out of the bathroom and we always make a point to be talking to one another when we go into bathrooms. I anticipate continuing to use women’s restrooms because they still feel less physically threatening, and I don’t really expect that there will be much difference in women’s reactions to me as my breasts were never really all that noticeable in the first place, but I have a heightened awareness about it now. I’m sure that will lessen in time, but bathrooms continue to provide a source of unique, everyday stress that some transgender or androgynous people experience.

2006-05-10T16:26:00.000-07:00

I thought I would write a post today as it is my four week post-surgery anniversary. I don't have much time, so it will be brief. I think it's been about 5 days since I've taken any tylenol for any pain associated with my chest. Sleeping, shower, and fuctioning throughout the day have all become 100% easier in the last week. I don't think I've fully recovered, but would estimate I'm about 95% of the way there. I am super stressed with my thesis (due in 9 days), but was just offered a job in Oregon, which helps with some of the stress. In the next month I will be graduating and moving-I would expect those things to take a physical toll even without recently having surgery, so we'll see how it goes. Most of the scabs have come off my incisions and grafts, which is nice. I'm still wearing the dressings over the grafts due to the remaining scabs. There is still swelling around the incisions, but I anticipate that will be the case for the next few months. The best thing is that I don't feel as though my pain is prohibiting me from doing normal daily activities anymore.

2006-05-03T10:35:00.000-07:00

Today marks my three week anniversary since having surgery. It is hard to believe that it has been three weeks, it seems as though it has been both forever ago and just yesterday. This Friday marks two weeks before my thesis is due and that has rapidly taken on a greater importance than trying to adjust to living without breasts (which has been surprisingly easy, aside from my still feeling slightly naked without having to wear a bra or the binder). Last week was hard as it was my first week back, but it got incrementally easier each day. This week is a bit easier in terms of having energy to do things-I no longer feel completely exhausted, just partially exhausted. I did manage to over extend myself both Monday and yesterday while teaching. It’s hard to write on a chalkboard, never mind having to erase from it. Being the third week after surgery, today also marks the last day I have to wear dressings over the grafts. This is the final thing that I’ve been instructed to do by Dr. Brownstein, so it’s nice to come to the “end” of his instructions. I have, however, begun using a topical “scar” cream on my incisions and have started taking vitamin E everyday. There are no guarantees with the scar cream or the vitamin E, which is fine, as scars aren’t something that I’m overly concerned about. I’m using these more to be proactive about my recovery than out of worry for my aesthetics. I still have a scab on one of the drain holes but noticed the scab had fallen off of the other drain hole. The grafts are mostly still covered with scabs, but those are falling off little by little. It will be interesting to see if they start to fall off more after I stop wearing the dressings.
Recent life experiences have reminded me about another way trans folk sometimes transition; for some trans individuals changes are made to the name they go by. Taylor is actually my last name, something I started being referred to when we moved here to San Francisco. My first and middle names are beautiful names, they go together very nicely and it is a very classy old-fashioned combination. I’ve never really felt comfortable with the names, however, and Taylor seems to be more fitting for me. It’s hard to write about this because it’s hard to try to verbalize how the name I was given before birth and have had for 25 years doesn’t feel right; in my family's mind, it is the right name and I know the importance behind the reason it was given to me. Deciding to go by Taylor was one of the hardest decisions I’ve made throughout this entire process. Most of the difficulties in that decision had to do with fear of disappointing my parents. I didn’t even tell them about the change until this past January when I came out to them as trans and told them I intended to have chest surgery (though I didn’t know at the time the surgery would be more immediate than not). I assume they already knew about my going by Taylor as both of my sisters have visited me here and heard friends refer to me as such (and because at least one of my sisters has difficulties keeping things secret even when asked to…though I don’t remembering asking them to keep this a secret). My parents actually seemed more upset about the name change than anything else during our conversation in January. Going by my last name without having made any legal changes to my name gets confusing at certain times, in certain contexts. I have gone for months here without experiencing this, aside from M having to remember who she’s talking to and by what name that person knows me as-but that’s more complicated for her than for me. Recently, however, there have been multiple times and contexts that have been complicated. In the past week, I have had two phone interviews for jobs and have been to the dentist. In these contexts, my full name is required and consequently, my first name has been used. While at the dentist’s office last week, the dentist came to the waiting room looking at my chart. Upon looking at my name, she stopped in the doorway and looked around the office as though she was very confused. She had hesitated for about 15 seconds (even though I was literally the ONLY person in the waiting room) before I finally told her that I was probably who she was looking for. These types of experiences were part of what prompted my decision to go by Taylor in the first place (did I mention that my first name is what M refers to as an 80-year old woman’s name?). It was more awkward to tell people I go by my last name right after I started doing so, it has certainly become easier to do so, but still presents unique situations that have to be negotiated. Again, this isn't a unique or common experience to being trans; but it is another layer that comprises some trans folks' transitions.

2006-04-26T13:57:00.000-07:00

Thus far, my time back at school and work has been somewhat stressful due to a general lack of energy on my part. I’d forgotten how physically exhausting surgeries can be-I haven’t been this tired since suffering from sleep apnea. I wish I had had the time to stay home a few more days, I think a full two week recovery would have been better; but this is certainly doable. I took the tape off of my incisions last night and have now seen everything. The incisions were not as scary as I had thought they might be, though they go further than I thought they would. I didn’t expect them to go almost all the way to my sides, but they do. I am feeling the results of the surgery more today than in recent days. I don’t know if it’s related to having taken the tape off, or if the activity of the last couple of days is catching up with me. I imagine it’s probably a combination of both. Today is my last day for wearing the binder. I look forward to being able to go without it, though found it easy to adjust to wearing. It pretty much feels the same as when I wore my sports bras-just over a larger area. I did start wearing a t-shirt underneath it, which I found to be more comfortable. I am also still wearing button-up shirts over the binder, though I’m sure I could wear over-the-head shirts, as I am able to put the t-shirts on without too much effort. I’m really very pleased with the entire outcome; it feels as though I have my “perfect” body back and while I know my breasts weren’t really visible when I wore my bras before, I certainly feel much more comfortable in my body, aside from the residual pain. As far as sleeping goes, I’m still mostly doing so on my back (with a pillow on my chest in case my cats decide to jump on me). I have been able to sleep slightly on my sides, but it does cause more discomfort than sleeping on my back. I look forward to being able to sleep in any position! Ok, enough about me...I have something I think is important to share.
The first day of my trans class, my professor read stories about different scenarios in which people face transphobia, one of those stories has stuck with me. I am still having trouble wrapping my head around all of the implications of the story and will probably be frustrated with my attempt to discuss them-but I’ll give it a shot anyway. The story was about a boy in high school. We’ll call him Tim; he identifies his sexual orientation as being straight and even has a girlfriend with whom he is very happy. He is involved in drama, enjoys wearing make-up, and has rather effeminate mannerisms. Tim often finds himself the target of jokes and other forms of harassment from many of his peers-they think he’s really gay. When he complains to the administration, they label his peers’ behavior as homophobic though it is in fact transphobic behavior. I recognize the importance of homophobia and being able to talk about it and fight it. Before hearing this story, however, I never recognized that many behaviors described as homophobic are actually transphobic because of our society’s tendency to assume gendered behavior translates to sexual orientation. I will be the first to admit that when I see men engaging in overtly effeminate behavior I make assumptions about their sexual orientation. The emphasis placed on “appropriate” gendered behavior by social norms and mores is hugely limiting to many individuals in our society, especially males. When males respond in “femmy” ways, we label them as deviant in terms of their sexual orientation; thus reinforcing the importance of both masculinity and heterosexuality. It has been eye-opening for me to think about this as a form of transphobia rather than homophobia because it has forced me to begin divorcing gender and sexual orientation. I’ve known intellectually for years that there is a split, but upon hearing this story I fully understood the impact of what that split means. Possibly, the most important meaning is that transphobic behavior such as this negatively affects more people than those identifying as transgender. You don’t have to be trans identified in order to experience instances of transphobia which makes transphobia a very common enemy.

2006-04-20T20:47:00.000-07:00

Yesterday was my postoperative suture visit with Dr. Brownstein. I was grateful that I had kept a final pain pill for the visit as I can’t imagine how much more it would have hurt had I not had the pill. The appointment lasted only ten minutes or so. Dr. Brownstein was very direct in removing the sutures, he certainly didn’t hold back for fear of hurting me. He removed each individual suture from one side and I was once again reminded that the pain had to be repeated by having it done on the other side. While he was removing the sutures I asked him how many there were and he says that he doesn’t count because there are just too many. When he was done removing the sutures he applied adhesive to the incisions and placed tape over the adhesive; the adhesive really stung as it was being applied but it didn’t last that long. He then applied Polysporin to the nipple grafts and covered them with 2 x 2 gauze. The binder was then put back on and I was done. Again I felt residual pain from the procedure but that only lasted for about an hour and after the pain pill wore off I took some more Tylenol and that was enough to help. Last night when M got home we took the binder off so that I could shower. It was very stressful and emotional for us both. I was worried that M would find me less attractive and M was apparently worried that I wouldn’t be pleased with the results. Both fears proved to be unfounded although M admits to being a little queasy at seeing the grafts not because of how they looked on me but rather just the general thought of the surgical process that created them. The tape covers the incisions, so we haven’t seen everything yet, but it was exciting to see the results. I know that it takes anywhere from six months to a year to fully heal which is somewhat frustrating, but so far it seems great. There are rules about removing the dressings from the grafts as well as about showering—so the prospect of removing the dressings and the actual shower was very stressful. I asked M to shower with me so that it would be less stressful, and it was. I stood in front of her as far away from the water as I could get and removed the showerhead from the holder so I could direct the flow of water without fear of too much water getting on my chest. I’m sure that I will take fewer precautions as I take more showers…luckily the tape only stays on for another week and the dressings only have to be applied for another two weeks. The grafts weren’t quite what I was expecting although it sounds silly they looked more stitched on than I expected, but Dr. Brownstein seemed very pleased with them, so I feel reassured that all is well in that regard. Since I live in the area he asked me to make a follow-up appointment in 4-6 weeks. I have the wear the binder for another week, but was told I can wear a t-shirt underneath it, if that is more comfortable. When I go back to campus on Monday, I will definitely take advantage of that. I’m apprehensive about my return. This semester, Mondays have been my long days on campus (13 hours); I’m not doing the full 13 hours this first Monday, but still have to be there for about 8 hours. I’m taking “half” days the rest of the week too, trying to ease myself back into the swing of things. I have been getting out each day since my drains were removed, and each time has been for longer periods of time, but I still tire easily and nap often. I am looking forward to feeling better and am feeling consistently better especially because I was offered a phone interview for a job that I really want. Wish me luck!

2006-04-17T20:55:00.000-07:00

I got my drains out today! After witnessing a fender bender in front of our apartment this morning, M and I took a cab over to Dr. Brownstein’s office for my appointment. It took about ten minutes in total to remove the drains and we were only in the office for about 15-20 minutes. It hurt to have the drains removed, very quick sharp pains and it was hard knowing that after the first one that there would be one more. M ended up staying home with me again today as she was concerned that the initial pain I experienced after the drains were removed was going to last longer than it actually did. She is so great! Dr. Brownstein also checked the grafts and said that they looked great; he changed my dressings and put the binder back on. The binder is a single piece of material similar to an ace bandage except wider, thicker, and more durable. It is held together with velcro and goes from my armpits to whatever the place where your ribs curve in is called. I also got the lab results from the pathology lab where my breasts ended up. No malignancies although I was surprised to read that I had a cyst. I go back Wednesday to get my sutures out and look forward to that, as it will allow me to be able to take a shower although there are still restrictions. I took my second to last prescription pill this morning before the appointment and plan on taking the last one before my suture appointment, just in case. I haven’t had to take anything stronger than extra strength Tylenol after the drains were removed. Which leads me to believe that much of my pain stemmed from the drains. I was able to go on an errand to the post office today to mail our niece’s birthday presents and was pleasantly surprised to receive two instead of the expected one package from friends wishing me well. The contents of the packages were wonderful and I feel very spoiled. I’ve been continually amazed by the support my friends and family have shown and appreciate each and every one of them.

2006-04-14T16:09:00.000-07:00

(This is guest blogger M again to avoid confusion all comments in parentheses and italics can be attributed to me and all other comments are from Taylor). Today is a much better day; I am feeling a lot better after getting some sleep and managing to keep some food down. The morning of surgery M and I took a cab to the surgery center and got there before 8:00 a.m. I checked in with the nice pregnant woman at the counter who had me sign some paperwork and collected our final two payments: $850.00 to the anesthesiologist in a cashier’s check and the remaining $1,700.00 on a credit card. The diagnosis for surgery on my paperwork was female to male transgenderism thus I was listed as male on all paperwork and on my wristband and was referred to as such by the staff. Although recognizing the importance of this for many other patients in these circumstances, it seemed to me another illustration of the idea that if you are trans identified you still have to pick male or female. I was very relieved to have gotten through the paperwork and made the final payments (me too!!!). I spent the time between completing that and being called back observing other people in the waiting room as it helped keep my mind off of the upcoming surgery. After I was called back (I had to wait in the waiting room while this was happening, you think that they would have more comfortable chairs although the staff was so nice that it made up for it) I was taken to a small room where the nurse gave me a consent form and went over my general medical history. She then gave me a gown and support stockings and foot booties, which is the closest I have gotten to a dress and pantyhose since high school! She also gave me specific instructions as to how Dr. Brownstein wanted me to wear them all. My clothes were place in a laundry basket and put under the bed that eventually was wheeled into and out of the operating room. I then went to the bathroom and when I returned I was asked to lie on the bed so the nurse could start my I.V. Before she placed the I.V. I had to take out my tongue ring and held on to it to give to M who came to visit me shortly. M was able to hang out with me in the pre-op area until Dr. Brownstein came to make markings on my check, I assume to assist him knowing where to cut. (I was starving at this point so had breakfast in the cute Mediterranean café in the building I also went over to the hospital during this time to buy Taylor a gift from the gift shop…the surgery center staff took my cell phone number in case they needed to get a hold of me.) Dr. Brownstein, the assisting nurse, and the anthesthesiologist all made separate visits prior to the time I was wheeled to surgery. The assisting nurse had given me a sedative before I was wheeled into the operating room and I only remember the trip down the hall and being in the room for about a minute. When I woke up I was in the recovery area and much of the details for a little while are hazy. What I do remember is being helped to get dressed and another nurse talking loudly to a man who had just been wheeled into recovery. M then was allowed to come back to see me. (Actually it was about an hour after Dr. Brownstein came out to tell me that the surgery was complete and had gone very well that I was allowed back in the recovery room. It was a long three hours and I highly recommend that if you are in a similar situation that you take a friend with you as I was somewhat of a nervous wreck). The nurse gave us instructions related to medication and the emptying of the drains. After observing her empty one, M was asked to try to empty the other. This went well and we were given some more instructions on aftercare before I went to the bathroom again and put my tongue ring back in. The staff called us a cab and waited with us until it came and wheeled me out. (I would just like to say that the drains were one of the things I was most afraid of although I had been assured by someone who had had the surgery that they weren’t that bad…thanks Ethan!…they look to me like clear tops to a turkey baster and are safety pinned to the binder that she is wearing around her chest. They have to be emptied into little cups every 6 hours and then the measurements of the fluid have to be recorded). Much of the rest of the day is a blur but as I was instructed to keep ahead of the pain and not play catch up to it, I haven’t been in pain although have experienced general discomfort. I’m off to take a Percocet induced nap but hope to be able to take a walk to a local restaurant for dinner tonight. More soon--Taylor

2006-04-13T18:46:00.000-07:00

This is guest blogger M filling in for Taylor while she recovers. She wanted to have me post a long dictated description of surgery but unfortunately is not feeling very well today. The surgery itself went just fine and Dr. Brownstein is very pleased but this morning she began experiencing a mild itching all over her body and he suggested she take some Benadryl in case it was a allergy. This helped a little but she has had an upset stomach and threw up this afternoon. Pain wise she is fine and the drugs are working well although she needs a little more sleep! We promise a longer more descriptive entry sometime this weekend as soon as she is feeling up to it. Thanks to all of you who have been so supportive, we very much appreciate it! :)

2006-04-11T16:38:00.000-07:00

I got a message from the nurses at the surgery center yesterday. It was left around 1:45 and simply stated that they wanted me to return the call. When I did so, around 3:30 I was asked whether it was a surgery or insurance related question-I told them I assumed surgery related as insurance won’t cover this procedure. I was then informed that all of the nurses had left for the day and that they would have someone call me the next day (today). When I hadn’t heard from someone by noon, I called back and asked to speak with a nurse. They were all busy, so I left another message. When I still hadn’t received a call by 2, I called back knowing that they might have left by the time I was done teaching lab (which started at 2:10). I was finally able to get a nurse on the line and spoke with her regarding what to wear (loose clothing and a button-up shirt), what not to do tomorrow (eat or drink anything aside from a sip of water to take the pills I take on a daily basis), whether someone would be picking me up and staying with me for the rest of the day and all of the night, and what allergies I have to medications. I asked her about whether I was expected to remove my piercings-I am expected to remove those that can easily be removed, those that can’t can be taped. I also checked with her that they had cab company numbers readily available-they do. So, that being taken care of, I am now focusing on surgery. My anxiety level is steadily increasing. I’m lucky enough not to be a generally anxious person. I grew up with, and am now partnered with people who worry a lot, which made/makes me not tend to worry-it’s being done for me. It seems a lot of energy is expended through worrying, so it’s generally not something I do until is absolutely necessary. I feel as though that time has come. That being said, I have worried throughout this process about various aspects of it (mostly about the logistical and financial part), but the worry about the surgery has not really begun until recently. I should say that I think it would have started sooner were this not to be my third somewhat serious surgery in a little less than six years. The two prior to this were both on an out-patient basis and involved anesthesia as well. Having had those experiences, I feel comforted in a lot of ways, because I feel prepared for the anesthesia and am familiar enough with the general routine of out-patient surgeries. For these reasons, I am not really worried about the actual procedure part; rather my focus is been on the recovery part. Hearing all of the talk about the binder and the drains, and the sutures, and the bandages, etc. has been the focus of my worry. This might be due to my not having to deal with anything of the sort for my previous surgeries (minus the nose packing which is just better forgotten for everyone involved), but I think it’s more to do with stress about keeping track of all of the instructions and worry that I’ll do something that I’m not supposed to which will compromise my recovery. I think that I’m blowing the likelihood of this happening out of proportion, but isn’t that what worrying is all about?

2006-04-10T10:04:00.000-07:00

The process of coming out is never the same for any person. There are general steps and claims that can be made, but it really is a different experience on an individualistic level. There are some big choices made by some people identifying as trans; the choice to pursue body modifications through surgeries or hormones, the choice of which pronouns to have used, and the choice of gender identity. For me, not feeling male or female or androgynous, makes genderqueer work. My professor for the trans class described a model of gender in terms of boxes. There is a male/masculine box and a female/feminine box. Some people blur the boundaries of the boxes, some people jump back and forth between the boxes, some people are resolutely outside of the boxes-I think that is where my gender lies. I have many masculine and feminine traits, but don’t really feel either box represents my gender. As mentioned earlier, pronouns are hugely important for lots of trans people. They are used to reinforce their gender choices and stand as others’ recognition of their choices. I was raised with female pronouns and attempts were made to socialize me as female. Thankfully, my parents never really cared much about gender appropriate behavior, so most of the sanctions I encountered when it was thought that I was transgressing gender were from peers or through school. That being said, while growing up strangers frequently thought I was a boy and referred to me with pronouns they thought to be appropriate in those situations. I enjoyed being thought of as a boy though the strangers’ “mistakes” were often corrected by my family. This created a sense of confusion for me. Though I liked being referred to as a boy (I hated all things having to do with girls, I thought/think we place too many gendered restrictions on children), because it was something that had to be corrected, I began to feel a sense of shame. This, along with general peer/society pressure to conform, led me into junior high and high school. This was the only time in my life where I chose to have long hair; the few times I attempted to dress in an overtly female sense were during this period too. I felt very awkward and self-conscious during this time. I realize that is the feeling most teenagers have and that it is a rite-of-passage of sorts, but I truly felt as though I was ugly. The few times since then, when I’ve put on a skirt (always as a joke) I’ve felt as though I’ve been in drag. Getting back to pronouns, I do not mind being referred to with female pronouns. That is with the exception of absolutely hating being referred to as “ma’am” or “miss” or anything in that general family of words. Female pronouns are what I’m used to, and they work for me. The same is true of male pronouns-I do not mind them and am getting rather used to them. Regarding testosterone (T), it seems as though many people who undergo chest surgery are also interested in using T. After deciding to have the surgery, I felt as though it was almost expected of me that I start taking T. This pressure stemmed from the hegemony of the female-to-male (FTM) community…taking T and having chest surgery go hand-in-hand. The trans enough concept comes into play again, here, because I wasn’t sure if I could have surgery if I didn’t identify as FTM, and if I did identify as FTM, shouldn’t that make it so that I would have to take T… In coming to an understanding about that, I thought about what my motivation would be in taking T. I concluded that taking T should be something that I want to do, not something I feel that I have to do. For me, because I don’t want to be a man, I don’t see the point of T. Again, there are no rules to coming out and it changes from person to person. It gets complicated because most discussions surrounding trans identities focus on transsexuals and/or FTM/MTFs; it’s hard to negotiate an identity when you don’t have a language to talk about it.
I have been beyond busy with school stuff the last week or so, which has been nice because it hasn’t given me time to stress about surgery. That’s beginning to change, though…

2006-04-05T13:08:00.000-07:00

As I reflect on the fact that my surgery is a week from today, I can’t help thinking about how amazing the entire process getting here has been. While the surgery will not stand as the end to a years-long struggle with my gender identity, I hope it does stand as the culminating experience of a general unhappiness with my body. I know I will continue to struggle with my gender identity because I know I still hold some internalized transphobia. The transphobia is mostly related to society’s general inability to accept any sort of difference as a positive thing, especially one seen by so many people as such an unnatural difference. Having been out, in terms of sexual orientation, for going on ten years, I am familiar with this type of personal struggle as related to internalized phobias. I don’t know how, or when, I got to the point of embracing my non-normative sexual orientation as an entirely positive thing, but I’m certain I have. I’m also certain that I will be able to embrace my non-normative gender identity as an entirely positive thing, but that it will take longer. Getting back to my hope that the surgery will help end my experiences of feeling disgust with my body and reflecting on the process it took to get to being only a week away from surgery, I can’t help but feel amazed at the support I’ve been given. I have a partner who is wholly supportive and loving and has provided a continuous safe place for me in this frightening journey. I recognize that I am lucky because of this-not everyone can say the same. My family loves me. I have no doubt about that. They might have questions, and never fully understand my need to do this, but regardless, I know they will always be supportive of me. That too is amazing. There are far too many stories about families disowning their children/siblings because of sexual orientation or gender differences. The other thing that I am reflecting upon is my access to this. This is not an inexpensive surgery, it costs $7,550. It is not covered by most insurance policies; it is certainly not covered by mine. While I don’t ever plan on taking testosterone or undergoing more surgeries to further masculinize myself, I recognize that all of that would come at great cost too. Living in the same city with my surgeon, one of the best in the country, is fortuitous as I have already discussed that it would be more costly to have the surgery done were we to wait until we moved. This discussion of cost is a very important one to have. I can not speak for those who aren’t fortunate enough to be able to afford this type of procedure, but it’s important to try to imagine how difficult it must be for them. My breasts aren’t overly large, that is not always the case for other people who wish to have this surgery. The lengths they go to in order to hide their breasts are probably even more extensive and painful than what I’ve had to do. I can’t even begin to imagine how much worse I would have felt were I not able to hide my breasts as easily as I’ve been able to do. Access is such an important issue-trans people are dying because they don't have access to safe medical procedures. I learned recently that while in the process of trying to feminize or masculinize themselves, some trans folk are injecting various body parts with foreign substances in order to enhance the body part(s). These “silicone” injections have less silicone (because of expense) than other substances such as mineral oil. These injections have a tendency to “migrate” over time and cause immeasurable damage to individuals including, in some instances, death. Again, this is an area in which I do not have nearly all of the facts; this topic can (and should) be researched elsewhere. I raise this issue because it has to do with access. I have access to this surgery and want to recognize the importance of that fact. I think it is also important to recognize those who don’t have access and the lengths they go to change their bodies.

2006-04-03T09:30:00.000-07:00

I had my pre-op appointment last week with Dr. Brownstein, though it lasted all of about 10 minutes, it was very informative. This was a necessary appointment, and could have been anytime within two weeks before surgery-mine was earlier in that time frame than most people’s, especially the people coming in from out of town. Sometimes their pre-op appointments aren’t until the morning of surgery, so it all depends. He wrote my prescription for the pain medicine to take after surgery, which I filled the following day. He told me what time to be at the surgery center, and what would happen before and after surgery. He showed me one of the drains and said I shouldn’t expect the same amount of discharge on each side. Apparently, after the surgery, someone at the surgery center will explain how to measure the amount of fluid and how to empty and reattach the drains. I think that is the part I’m least looking forward to-I know it’s the part that M is least looking forward to! Dr. Brownstein will call the night of surgery to check-in over the phone, and there are three post-operative appointments, though one (the day after surgery) is voluntary. Of the other two, one is about five days after surgery-that one is to get the drains removed, the other is a week after surgery, and that is to get the sutures removed. I will not be able to shower for at least a week after surgery (I believe this is due to the sutures). After the first week, I can shower but can’t stand facing the stream of water. I will have to wear a binder for the first two weeks after surgery (I don’t really know what it will look like, or how tightly it will bind my chest, a friend suggested it might be like a straight jacket without the arms-a lovely thought). I was also given a sheet with other post-op instructions but haven’t really spent much time looking at them. They will be gone over, in great detail, by the staff at the surgery center. The appointment ended with Dr. Brownstein looking at my chest to ensure that the procedure I told him was appropriate for my chest was in fact the appropriate procedure. There are two types of procedures that can be performed. One, called the key-hole procedure, is able to be done only on very small breasts. It is less invasive and doesn’t scar nearly as much as the other procedure-a double incision procedure which is the procedure for larger breasts, and by larger, I mean anything bigger than an “A” cup. The double incision procedure will be the one I have done. Much more information on the distinctions of these procedures can be found on Dr. Brownstein’s site, for which I have added a link on the right side of the page.

2006-03-30T17:14:00.000-08:00

I guess I should talk a little about the title of the blog (trans enough) and how that concept has had a huge impact on my gender identity. As I mentioned earlier, historically there have always been trans people but it wasn’t until sexual-reassignment-surgery (SRS) that the general population took notice. Initially, only those individuals who were thought to be able to “pass” well as the sex they were trying to become and those who would identify as straight after the SRS were allowed to go through the procedure (provided they could afford it). Because the general population began to take notice when surgeons started performing SRS, and because these people had to become “medicalized” in order to have the surgery in the first place, the distinction between transgender and transsexual was not made. Generally, transgender is an umbrella term within which over 100 gender identities exist, transsexual being one. Many people assume that if you physically change any part of your body via surgery or hormones that you are transsexual. I used to think that the only way I could pursue chest surgery was by identifying as transsexual, even though I knew that wasn’t the “right” identity for me. It seems as though many people feel there is a hierarchy within trans identities in which transsexual people are seen as the “most” serious about their identities. It is thought that all transsexual people know how they feel, know what they want, and will take any steps necessary to obtain it. As for the rest of the people under the umbrella, they are often seen as just playing around and not really serious about how they feel. I think that is where the concept of trans enough comes from. When I first started exploring my gender identity, it was complicated for many reasons, the lack of terminology and language for one. The other big one was my assumption that, because I didn’t want to be transsexual, I couldn’t be trans at all. Even after embracing my genderqueerness I still felt like I couldn’t have chest surgery (no matter how much I wanted it) because I wasn’t trans enough. Most of that feeling stems from my internalized transphobia. An entire blog topic in-and-of itself, I’ll just say now that while it wasn’t until I took this trans class (for which this blog is fulfilling a part of an assignment) that I even admitted I had any internalized transphobia. I think it stems from the concept of there only being one way to be trans and that is transsexual and always feeling inadequate as a result. It should be pointed out that the key to gender identity is the same as with any other type of identity…it is the person’s choice. No one can confer an identity on another person. In understanding this, it is imperative to understand that not all transsexual people undergo surgeries or hormone therapies. Conversely, not all people who undergo surgeries or hormone therapies are transsexual. You can claim a transsexual identity and never physically change your body through surgery or hormones. You can claim an identity other than transsexual and still change your body through surgery or hormones. I am physically changing my body because I have always felt uncomfortable with breasts and I think this will offer me the chance to feel at peace with my body. I am able to do this now because I finally understand that while some people might consider my gender identity as somehow lacking or as being frivolous, I am trans enough for me.

2006-03-28T13:57:00.000-08:00

After the initial euphoria of getting the surgery scheduled more practical concerns arose for me. Namely, the cost and how to work around the request Dr. Brownstein had for a letter from a mental health professional. Historically trans people have always existed, however, with the first sex reassignment surgeries in the 50s, doctors had to come up with standards to apply for trans people before any body modification was done. Along the same lines, a diagnosis was created for gender dysphoria in the DSM. Thus, for a long time, before a trans person was allowed to make any sort of change they had to be in either a doctor’s or psychologist’s care and be diagnosed with a mental disorder. Not wanting to be diagnosed with a mental disorder (or at least another one) I wanted to avoid the entire situation wherein I had to receive a letter from a therapist in order to have chest surgery. I should clarify that chest surgery is considered genital surgery, which falls under the past criteria of a surgery requiring a letter (there is a fair amount of published information about the history of all of this, and I’m sure it is better written, should anyone be interested in further exploring the topic). After speaking with Dr. Brownstein, he thankfully waived the letter requirement leaving only the hurdle of figuring out how we could afford to pay for the surgery.
Dr. Brownstein included a pamphlet for a surgery loan in the initial materials he sent us after we contacted his office for more information. M took charge of contacting the surgery loan people after we scheduled the surgery because she has a “real” job and would be a more appealing candidate to loan people. She worked with them over the phone for a few days until they came back with the offered interest rate. This rate was higher than any of the credit cards we have and also had a “service charge” that would have added up to be almost $2000 more than the surgery cost had we taken the full time to repay the loan. Upon hearing this news, we decided to pay using credit cards. We are very leery of credit cards and have only had them since we moved to San Francisco. The decision to put the surgery on credit cards was not made lightly, and then we found out all of the payment details-there are five separate payments to make to various people and places involved in the surgery. One of them, the first, could be made with personal check and was for a relatively small amount. The second and third payments, both due no later than three weeks before the surgery, had to be paid with cashier’s checks. The same is true of one of the two payments due the day of surgery. The final payment is the only payment that can be applied directly to a credit card. At this point, we weren’t sure what we could do, and asked people about their experiences in situations like this. M’s coworker said that there are things called access checks which are checks you can write from a credit card to whomever. The tricky thing about access checks is that they usually have phenomenally high interest rates. Knowing we would have to open another credit card account to help pay for the surgery, we researched and found one that has a 0% interest rate for a year on all transfer balances and access checks. We applied for that one, and were able to pay part of Dr. Brownstein’s fee by writing an access check to ourselves, depositing it into our bank account and then getting a cashier’s check from the bank.
Our experience in trying to deal with the stress of paying for this, and our ability to pay for part of it out-of-pocket has reinforced the idea that surgery or hormones are not accessible to those who can’t afford them. The ability for a trans person to modify their body, if that is their wish, comes at great cost.

2006-03-27T15:58:00.000-08:00

After deciding to go ahead and pursue the matter, I scheduled a consultation with Dr. Brownstein (which was free, by the way). I was nervous to meet with him, but it all went well and we scheduled the surgery. This, of course, prompted me to have to tell the important people in my life about the event. My partner, M, was super supportive of the idea from the beginning and accompanied me to the consultation. It made it much easier to have someone there for emotional support. When telling my parents they did not jump up and down with joy, nor did they react in an overtly negative way. They were not surprised in the least as I was very vocal about my disgust with the idea of puberty and continued to complain throughout. I think they are more worried than anything else, which is not surprising as it is something at which they excel. I was able to tell them in person, which was both easier and harder, I think.
I sent a somewhat formal email to my sisters as a way to distance myself from their possible rejection. They too, however, were fairly supportive and not at all surprised. I have brought up the possibility of this happening at various points over the past five years and I think they know that having thought about it for so long and being so dysphoric about my breasts, that this is the best thing for me and they are ultimately more supportive of my happiness than anything else. Telling my friends has been very easy and they have all been really understanding and excited about it (because I’m excited about it). Though all of the reactions have been overwhelmingly supportive, I still had reservations about whether I was doing the right thing. I was mostly concerned about being able to finance it, but I was also really worried about how the surgery would affect my relationship with M. M self-identifies as a lesbian and is very proud of that identity. I was concerned that she would feel differently about me if I were to have the surgery. I checked in with her about it many times and it wasn’t until around the fifth talk we had that she finally shared some new feelings. She maintains that while she will be sad, in some ways, she recognizes that my breasts don’t really play a serious role in our relationship, except as a cause of stress and shame on my part. What she shared with me was actually quite surprising as it was something I had never thought of. She said that when we’re out in public and mistaken for a straight couple, she feels as though she is lying to herself. That she has worked so hard to be comfortable with her sexual orientation that she is somehow cheating by being perceived as half of a straight couple. Paying attention to others’ reactions of me is not high on my list when I’m in public mostly because I try to remain invisible. I developed this coping mechanism many years ago and have become more and more oblivious to the strange looks that people often send my way. It is because of this that I didn’t realize we were mistaken as a straight couple and that it was upsetting to M. I don’t really know how to resolve this, and anticipate that more people will assume we’re a straight couple after the surgery, which might exacerbate M’s feelings. This isn’t necessarily a feeling you can “get over”. I think, though, that this is something you can adjust to, and given enough time-I hope that is the case.

2006-03-24T11:16:00.000-08:00

In about two and a half weeks I am having chest surgery, or more specifically, a bi-lateral mastectomy with areolar reconstruction. Never fully identifying as female I was mortified when I discovered what would happen to my body when I reached puberty. The development of breasts was deeply upsetting to me and I tried to hide them as much as possible through wearing baggy clothes, sports bras, and hunching over. Unfortunately, this last technique to hide them has led to me having awful posture and a weak lower back that often tires and hurts a great deal. For the last 4 years, or so, I’ve taken to wearing Frog Bras from Title 9 Sports, described on their website as “major mashers”. I can attest to this as they do a great job of minimizing my breasts, though the tightness of them leads to permanent bruising under my arms. Off and on for the last 6 years or so I have fantasized about having chest surgery, though it wasn’t until this past December that the “far-off possibility of what may be” dream I had solidified into a more concrete feeling. Again, I think this relates to my being in San Francisco and meeting so many other trans folk. Seeing the courage these people have to live their lives, as they feel most comfortable has given me a sense of strength that I previously didn’t have. I think I would have gotten this sense of strength had we not moved here, but it would have taken longer than it has. In deciding to have the surgery I feel that I was able to fully embrace a transgender identity and let go of some of the notion I had in my head that I wasn’t trans enough. I used to believe that if you had any type of surgery or took any hormones that that meant you were transsexual and as I have never identified as transsexual I didn’t think I was “allowed” to have this type of surgery.
When the concreteness of this decision sunk in my partner and I started discussing both who should perform the surgery and when it should be done. My partner loves to research things on the Internet and quickly took charge of finding who should perform the surgery. There are a couple of doctors in San Francisco and it was decided that among them, Dr. Brownstein had the best reputation so we got information from him regarding the surgery and went from there. As far as the timing of the surgery, I initially thought it would still be a year or two away because of the cost. But my partner and I are moving to Portland this summer after I graduate and it seemed like such bad luck that we found a good surgeon where we are currently living but are planning on moving from. It didn’t occur to me that I could do this before we left mostly because it is my last semester and I’m trying to get my thesis written. My partner, however, pointed out that if we wait a year or so we would have to pay even more because we would have to pay for a place to stay the week or so after the surgery. She also thought that there would never be a good time and that we are never really going to have the money unless we make it a priority. This summer marks the beginning of a 12 month period in which we are moving, buying a car, having a ceremony and maybe trying to get pregnant…as I said, we weren’t going to have the money unless we prioritized this. The initial thought of doing it before we moved was -“that’s really really really soon!” That feeling faded as I became more comfortable with the whole idea and realized that this really is the best time for the surgery. When we move to Portland I will be getting a “real” job and it would be easier for me if I started that “real” job in a body I feel comfortable and confident in. I have no idea if I will feel more comfortable and confident in a body without breasts, but I certainly did when I was younger and I don’t really know how I could feel less comfortable and confident than I do now.

2006-03-20T20:32:00.000-08:00

My name is Taylor and for the last year and a half I have been lucky enough to live in San Francisco while pursuing my Master’s degree. I chose San Francisco, in part, because of it’s widely known diversity regarding gender identity and sexual orientation. My partner and I moved here from Baltimore, definately a big change! I will be 26 in a couple of months and for as long as I can remember have never felt comfortable in my birth sex/gender designation of female. Being in SF has allowed me to explore my gender identity more-I identify as genderqueer and “came out” as transgender around 5 years ago, while still an undergraduate. It wasn’t until we moved to San Francisco that I was able to explore what being trans meant to me without feelings of shame or guilt. This is due, in part, to meeting so many other trans folk, but also due to a class that I am fortunate enough to have taken. As one of the only classes of its kind in the country, my experience taking the course, Intro. to transgender studies, has allowed me to talk about and think about gender through an academic lens-one I feel most comfortable with. This blog is being created as partial fulfillment of an assignment given in the afore mentioned class, but also as an informal platform wherein I can further explore my gender identity as I get ready to have (and recover from having) chest surgery.