Top Surgery: Four Weeks Later

It’s four weeks today since I had my top surgery.

I meant to post more, but I moved house and lost internet in those four weeks, so now I’m back! And four weeks to the day seems a pretty good place to give an update.

So: the surgeon removed 1.5kg of breast tissue. Pick up that in sugar bags next time you’re in the supermarket and imagine how much my poor skin was holding together. I wore a compression binder for a week, which canes on the ribs. It’s seriously quite painful because it’s 24/7. But there was no pain on the surgery site — just my poor shoulders and ribs, unable to move and being squished. The idea is to basically get the nipples to ‘stick’ back on, and it worked beautifully. One of my nipples has lost its scab now so it looks like it will for the rest of my life, more or less, and the otherone is nearly finished.

I have complete mobility again after four weeks: I can hold things above my head, I can drive, I can run for a bus, I can cook and lift boxes and all that nice stuff. I had pretty heavy bruises on the left (I’m left-handed, so likely caused by needing to use that arm more than the other one) and being driven home was not fun at all. However, they discharged me with paracetamol for mild pain and codeine for heavy pain, and in the following week I only took the codeine once, on the second night. After that, it was all uphill.

I’m still a fortnight away from being allowed to soak in the bath, swim or sunbathe, but it’s the middle of winter, so I’m not bothered. Putting heavy jackets on is still a bit sore. Sensation-wise, I have a tingling sometimes around the nipple areas, and the skin under each arm is totally and completely numb. I nearly fainted when the surgeon took the staples out, it felt so weird. Didn’t hurt at all, but my brain had no clue why the hell my muscles and ribs could feel pressure but my skin couldn’t, and my brain always wigs out a bit when things like that happen. My skin on my upper chest also has the oddest feeling like it’s been burned a while ago when I’m wearing cotton work shirts — for those of you who’ve had tattoos, it’s almost exactly that same burning feeling left behind when you’ve had some intense colouring or shading done on a small patch of skin. There’s a couple of pinches in the stitching under my right arm that may need tidying up in a few months, but I’m waiting to see what more healing, hormones and weightlifting do. It may sort it out, it may not. I’m rubbing bio-oil into the scarring twice a day to help it heal nicely and without leaving a big mess, and it seems to be working fine so far.

Most importantly: I am fucking flat. I am totally flat. I put a t-shirt on and I look like a guy. I’m wearing a man’s shirt at work, and I look the part. I don’t feel horrible buttoning it up. I was lying in bed with the laptop on my stomach the other day, looking down my chest towards it, and the contours of it even now — when four weeks of inactivity have taken their toll on my muscles, and the scars are still raised and red — I feel amazing. It’s going to be a while before I can get back to weightlifting and working out again, and when I do, I’m going to feel even better…but right now is pretty fucking awesome as is.

More updates will come as time passes. If I don’t get back to y’all beforehand — Merry Christmas!

Matt x

Top Surgery: 7 Days Later

Okay so it’s six and a half, shut up.

Basically, I feel fucking awesome.

This is a little selfie shot to show you what I had to lose. A pair of very big and heavy boobs. My surgeon told me afterwards that each breast alone weighed 700-800 grams. That’s 1.5kg I just lost in four hours — fastest diet ever. And I only weighed 54kg to start with.

They knocked me out at about 12pm, and the next thing I knew, I was back in my room sans breasts. Fine by me, not remembering being intubated is an excellent thing.

I felt pretty rough initially. My reactions to drugs is to feel sick, and the normal blood loss of surgery drops my already perfectly normal blood pressure down into the dizziness and fainting category. I nearly fainted just lying down and had to have a fan on all night. The night nurse kept annoying me too. At the 2am observations, she said ‘you’re not very responsive.’ No shit, lady! Trying to sleep here!

I basically slept, only punctuated by nurses coming to check on me, from that 4pm realisation I’d been returned to the ward until 7am the next morning. At once I woke up at 7am and had breakfast, I felt surprisingly good.

This is the state of play at 9am when the surgeon came back and they cracked open my chest binder to check for bleeding or oozing. There was a bit of gunkiness on the left, so that had to be changed, but not before I snapped a fuzzy selfie. I felt pretty human, albeit sitting up was a big no-no. Sharp, burning pain where I presume the incisions had run under the breasts. Not comfortable at all.

But it was mostly discomfort, not pain, exactly. I needed the drugs more to get my chest muscles to relax and allow me to move around. I was sick only once, ironically half an hour before I was discharged and in response to my body’s chronically poor ability to swallow chalky tablets.

Then at 11am, we were outta there! The drive home was similarly uncomfortable, but still didn’t really hurt. I was given paracetamol for normal times, and codeine for if it got really bad. Six days on from the surgery, I’ve only taken codeine four times, and two of those still in the hospital. (And my tattooist will tell you I’m a pussy when it comes to pain.)

That said, it’s not all awesomesauce. Lying down to go to sleep wasn’t happening even four days later, though honestly that was more the compression binder I had to wear 24/7. It felt like it was squashing my ribs. Typing this, I have a vague throbbing in my left breast not unlike what can happen when you run without a decent bra, or when your period is fast approaching. I struggle opening the heavy doors at Boots, but it’s discomfort rather than ‘ohshitthathurts!’ and I get a stinging sensation around my nipples occasionally.

This was the situation at 10.30am when I was up and moving and getting ready to go home, and it’s pretty much the situation now. I’ve been wearing a compression binder ever since. My surgeon crudely put it as ‘getting everything to stick back on’ (mostly the nipple grafts) and by god do you know about it when you’ve been wearing a tight binder 24/7, asleep and awake, for a week. Plus I can’t shower because the dressing absolutely much stay dry, so it’s been baby wipe sponge baths for indecently long. Tomorrow, the dressing comes off. And hopefully, stays off. And I can go home and shower.

I went home Friday, and spent most of Saturday just lying in the armchair in the living room watching TV. But Sunday evening, I managed to put a t-shirt on over my head, and went to the theatre for a mate’s birthday. (I slept for eleven hours afterwards, but hey, still counts.) On Monday, I went for a mile-long wander round the shops and had lunch in a cafe. Getting back to normal daily life was pretty quick and easy, and aside from push/pull patheticness and a tendency to hunch over like an old man to protect my chest, things were pretty good.

I also had a bit of an emotional moment when I put that t-shirt on. My frame looks so much more masculine, in one fell swoop. I’m too flat to be female. It’s so obvious that there’s nothing left, even with the dressing and the binder, and I couldn’t be more pleased about it.

Bring on tomorrow and the banishment of this itchy binder!

 

 

Surgery Day

It’s the day!

It’s 6.30am in Brighton and in 45 minutes I have to be at the hospital. My surgery window is anywhere between 8am and 11.30am. (And honestly, I’m so tired they may not need anaesthetic! Who invented 6.30am?)

Basically they will knock me out, do the deed, wake me up in the afternoon to check I’m sound, then leave me to sleep it off until Friday morning when they kick me out. So this is it!

My bra is in the bin, which I am obscenely happy about. But I am a bit grumpy this morning, thanks to the rule of nil by mouth since midnight, not even fluids since 5am. I want an OJ, damnit.

My hospital bag is finally ready, as of last night, and I go armed with things to do. I won’t however have my laptop as it’s too heavy to pick up afterwards, so this is the last you’ll hear from me until probably Friday.

Wish me luck, guys!

#boobwar is over

Top Surgery: Pre-Op

Yesterday was my pre-operative assessment for top surgery.

Effectively, I had to go to the hospital a week before the surgery to make sure I am fit for surgery, and have the consultation with the surgeon.

The fit for surgery part is pretty basic, and usual to most surgeries: blood tests, swabs to test for MRSA, take your medical history, all that nice stuff.

The consultation was short and sweet, really. The surgeon actually had some social skills (shocking for those high up in the medical field!) and explained what was going to be done.

Given I have a large rack, the technique that will be used is the double incision technique. Effectively the surgeon cuts under the breast and removes the nipple and lower half of the breast tissue. This leaves a curved scar under each one. The nipple is trimmed and reattached, then soluble stitches close the scars as thinly as possible.

The idea is to get the chest as flat as possible, though sometimes with large-chested people the skin between the breasts can dimple once the weight is removed and create a shadow. That shadow can look a bit like cleavage, but in my case, I’m going to see how it goes. I don’t get shirtless often, so how flat it looks is primarily important to me. That can always be corrected later.

After surgery, I have to wear a long binder, so I’ve been warned I may wake up feeling a bit like my chest is being squashed. I then have to continue to wear normal binders for a while. The idea is to get the scars and nipples to ‘stick’ in their places and not rip open or reject the graft. (I swear to you, the surgeon said stick.)

After two to three weeks, I can be back at work and driving around like normal.

So that is basically a flash update on where I am right now. On the 18th, I will be going back to Brighton, and in for surgery at 8am on the 19th.

Bring it on!

 

 

 

 

(Also apologies for not updating sooner, I’ve just moved house and haven’t got my tinterwebs set up yet.)

A Short Story About Allies

Once upon a time, there was a big open-plan office in Bristol, with big shiny lights, uncomfortable seats, and dual screen computers that never had the screens in line with one another. It was filled with people who spent all day clicking on keyboards, drinking copious amounts of tea, and going Excel-blind after manually cross-checking another fifteen thousand rows of data because the network server was down again.

And in this magical place of tea and passive-aggressive emails about the communal fridge, worked a transguy. He was the only transguy in the office, and had still been an undercover one when he joined the company. He even wore dresses back then, imagine!

Then in April, the transguy came out of the  closet and began to transition. He asked his colleagues to call him by a new name, and use ‘he’ and ‘him’ pronouns. He had to have a meeting with HR so that the company could pretend to be inclusive and diverse, when in reality everybody knew that the magical office preferred its employees to show no signs of having any sort of life whatsoever.

But, because the magical office was fuelled by unreasonable work demands and overseen by a tyrannical, three-headed beast known as ‘the senior leadership team’, none of the transguy’s colleagues could care less that one of their kind was changing. “Alright then,” they chorused, and the clicking of keyboards continued in peace.

For six months, nothing more was said on the matter. The servers continued to fail. The multi-headed beast continued to issue demands for constant status reports. The IT desk continued to insist that the solution would be to switch it off and on again, despite the problem being that the device would not switch on in the first place. It was not a happy place, but it was content, for tea supplies were plentiful, and — on the rare occasion that the beast had been cornered in its dark and dreary cave by the paranormal power of Meetings — office banter was happy.

Now in this office, there were three line managers. One ran around all day looking frazzled and feeling sorry for his stressed staff, and shall be known as The Fluffy One. One spent all day shouting at the people on the phone, and tormenting her junior staff with excerpts from Fifty Shades of Grey (the horror!), and shall be known as  The Kinky One. The other…

The other was simply known by his name. For what was there to say about Bob that could be agreed on? Bob did not like being a manager. He despised meetings and staff welfare. Bob liked to manage projects, not people, and the tedium of listening to employees’ problems bored poor Bob. And because Bob was tall and rarely smiled, people did not want to bother Bob. If he could be a One, Bob would have been The Stern One.

But ah! the transman knew better. For you see, he and Bob had worked together before. And he knew Bob to be the kind of man to trade insults as names, and enjoy the more relaxed banter that was always to be uttered out of earshot of the three-headed monster. In the transguy’s previous life, Bob had called her ‘shorty’ and ‘midget’, and said that the day did not begin before she put on her high heels ‘and grew three inches in three seconds.’

Now, the transguy found this attitude refreshing. What is working, after all, if there’s not some fun to be had? So the transguy and Bob mocked each other occasionally, and all was well.

But then one day, six months after the transguy shed his heels for the last time, a rogue manager strayed into the magical office of tea and banter. He had come to see the transguy about an assignment, but — for the rogue had not called the transguy to check he would be there — he found the desk empty, the cup of tea half-drunk and cold, and the employee sinfully absent from their desk.

So the rogue swooped down upon the only manager, our hero Bob, for answers. “Where is she!” the rogue demanded in a loud voice. “I have to discuss the loss reduction report with her!”

“Ah,” said Bob. “It’s ‘he’, actually. And he’s just–”

“No, no, no,” the rogue trumpeted. “The woman who sits there! We spoke last week! She’s doing a loss reduction report for me!”

“No, you don’t understand,” Bob tried. “It’s not she. He–”

“I think I know a woman when I see one,” the rogue guffawed.

And so Bob had little choice, and — in front of all the employees of the magical office — said, “He is transgender and uses the pronouns ‘he’ and ‘him.’ I’m aware you may not have been told before, but I’ve just tried to tell you. Please use the right ones in future.”

As the transguy could not be found, Bob sent the rogue away and pondered on what had just happened. For Bob was a private person, and did not like discussing an employee’s personal business out of their presence. So when the transman returned from his dangerous foray into The World Beyond The Office, Bob called him aside into the hall.

“I have to apologise to you,” he said, and the transguy was quite bewildered. What had Bob done to apologise for? “Fred was looking for you earlier and kept saying she. I tried to correct him subtly but ended up having to tell him the situation in the open office, in front of all the staff.”

“Oh,” the transguy said. “Well, everybody knows. And you know me, it’s not the kind of thing I’m bothered about.”

“I didn’t think you would be,” said Bob, “but I still didn’t feel it was appropriate to have to do it like that without you at least present.”

“Well, I’m not worried,” the transguy said. “Everybody in there already knows anyway.”

And so they returned to the office, refilled their cups of tea, and worked apathetically ever after.

****

Moral of the story: being an ally isn’t about being a boring shit who never says bad words, never makes fun, and never cracks a joke. You can call people every name under the sun and still be a good ally. You can play Cards Against Humanity at your desk during lunch, hooting like a group of monkeys, and still be a good ally.

Because being a good ally is about knowing where the lines exist in the circumstances you are in, with the people you are with, and upholding those lines where they are at that very moment in space and time.

Is it harder than blanket statements like ‘never use this word, never say that thing’? Yes. But it’s also more genuine. It doesn’t make a big deal out of things, it allows humour space to breathe, and it treats us all like the adults that we are.

So go Bob. For being the best ally, whilst simultaneously being the manager who can make you shit yourself with fear when he loses his temper.

Surgery Countdown

So tomorrow is exactly one month until my top surgery.

There’s a lot of stuff happened I could have talked about this week: mental health, what it’s like to not fit in to a community that likes to brag about how much it includes the LGBT, having a sense of humour about who you are, and so on and so forth. But they’re all pretty thorny issues, I’ve had a bad day, so I’m not going to talk about anything that’s going to piss me off or upset me.

So, surgery!

On 19th November, I will having top surgery. In layman’s terms, a surgeon is going to remove my breasts, put my nipples back where they would be if I were biologically male, sew me up, and send me on my way. Several pounds lighter, given that I have a massive rack.

I will be posting quite a bit around surgery day itself to keep you guys posted with a real blow-by-blow of what it’s like to undergo that procedure, but let’s start here with some background.

1) I am having to undergo this privately. For those of you in the US, that’s like ‘duhhhh.’ But in the UK, typically medical care is via the NHS, which is free at the point of use. The problem is that the NHS has serious financial problems right now and, even if it didn’t, frankly doesn’t much care about transgender patients and tailoring their treatment to the individual. In short, the NHS will pretty much refuse to give anyone any surgery before hormone treatment. As that isn’t what I needed, I went private.

2) So basically, I’ve been saving up £6,000 for this surgery. My bank balance is going to be a paralysed heap on the floor next month.

3) On 10th November, I will be heading to hospital for my pre-operative consultation. This is basically the bit in the medical dramas where the doctor draws on you with a sharpie. See, top surgery is done a whole bunch of ways, depending on the size of the breasts and the aims of the patient. Some people really want to keep as much sensation in the nipples as possible, so the surgeon will have to find a way of doing it to avoid as much as of the nipple resize and regrafting as possible. Others, like me, have looking naturally male top of the list and to hell with nipple sensation. So for me, the surgeon can use techniques that would render my nipples literally senseless and it wouldn’t bother me at all, as long as I can go topless at the beach and nobody looks twice.

4) On the same day, the hospital want to run a whole bunch of tests. Basically to make sure I’m fit to undergo surgery. I have to fill in a questionnaire the size of a stottie cake to bring to them, then they get to make me look like a heroin junkie with all the blood samples they’re going to take.

5) If all is well, I come back on the 19th. It’s nil by mouth for the evening and night of the 18th, then I have to show up first thing in the morning and get checked in. At some point, an anaesthetist will attack me with a mask, and then I will (ideally) wake up some time later sans boobs.

6) I will leave the following morning (20th). I know some American surgeons are all ‘you have to demonstrate you can eat and put a t-shirt on over your shirt’ but this surgeon hasn’t specified anything I have to do in order to be signed out.

7) I lounge around generally feeling knackered for a week.

8) On the 26th, I return to hospital for a post-operative check-up. By this point, swelling should have gone down and the early results should be obvious.

After that, I can get on with my normal life, albeit given that I currently wear 30F or 28G bras, my equilibrium will be a bit off for a couple of days, the car seatbelts are going to be shady as fuck for weeks, especially going over speedbumps where currently it’s like “Ma’am, please remain in your assigned seat,” in my shirt, and I will probably be mega confused the first few times I shower and reach to put on a bra again afterwards that I no longer need.

A few things will be different for a while, such as:

1) No driving for a week or three. It’s difficult to lift the arms afterwards, and nobody’s power steering is that good.

2) I’ll be taking pain medication and arnica to counteract bruising and swelling for a while.

3) I’ll have to wear a binder for a while afterwards too, to help healing and minimise scarring.

4) No swimming or working out for ages. Which is going to be a bummer, as I’ve worked super hard bulking out for this surgery to give the guy something to work with.

But that’s the boiled down version of what’s happening in like…four weeks. I’m also moving house in that time, so I’m going to have to pack a hospital bag super early, move, hope I lose nothing, arrange the new house in time to be useable when I’m released, and — of course — take entertainment.

Because lying around unable to work out, go to my day job, or roam is going to be fucking dull.

National Coming Out Day

I have mixed feelings about National Coming Out Day.

On the one hand, I agree with the idea of having a big celebration for those people who have come out of the closet, and have to come to terms with who they are, and are living ‘out’ as their true selves. Secrets can be bad for both those around the secret-keeper, and the secret-keeper themselves.

On the other hand…it’s kind of cruel to people who can’t come out.

Let me draw a comparison here. A friend of mine lost his father about five years ago now. Ever since, Father’s Day is a huge struggle for him. For me — I lost my mother in 2013 — the same doesn’t apply. I wasn’t close to her, we had a horrible relationship, and the family didn’t celebrate Mother’s Day anyway. I genuinely am bewildered every year when someone out of nowhere goes, “Oh, thinking of you and yours today,” with a sad face on. I need prompting, as I’ve probably missed what day it is!

Similarly, National Coming Out Day never bothered me, before or after I came out. Before I came out, I didn’t much feel like I was burdened with some horrible secret or anything. If anything, I came out because more people in my author world were driving me nuts about smack-talking my gender identity and orientation than people in my real world.

But one thing does bother me.

Every time National Coming Out Day rolls around, there’s a slew of posts on the forums (‘the’ being transgender and asexuality forums, respectively) from people worrying about how to do it, when to do it, who to do it with, and the consequences. And that’s totally normal. But there’s a significant number of them who openly admit, in the same post, that they don’t want to do it.

So don’t!

My God, does this still need saying?

Nobody — and I mean nobody — has any right to make you, or even pressurise you into coming out. If they do, they’re a fucking cunt. And I really mean that.

Not coming out does not make you a coward. It does not make you a liar. It does not make you homophobic or transphobic or any other phobic. It does not mean you are not ‘really’ the orientation or gender identity that you are. It simply means you have not come out. That is all.

Many people cannot or do not want to come out. I never wanted to tell my family, and I regret doing so. A friend at university never told anyone he was gay unless he wanted to have a relationship with them. Both of us had the perfect right to feel the way we did. In his case, he ran no real tangible risk of being ostracised by his friends and family, because they were all gay-friendly. In mine, I did run a risk of being turned away by my own blood, and it happened. I regret coming out. He doesn’t regret not coming out.

If you want to come out — if everything else aside, you want your family and friends to know, you want to tell the world — then congratulations, have some cake, and kick ass doing it. But if you don’t, that is fine too.

For everyone else — gay and straight, cis and trans, because sadly this exists on both sides of the fence — remember that there is no requirement to come out to count. People are what they are, whether they tell you or not, and you do not earn a ‘gay legitimacy card’ by coming out of the closet.

When I say I am asexual, I am telling you something about my sex life. When I say I am transgender, I am telling you something about the contents of my clothes. That is deeply personal information. It could get me murdered. It could lose me my family and friends. It could destroy my marriage (if I had one). It could get me fired. And it could simply be something I don’t feel like telling other people all about.

Every choice is valid — being in or out of the closet.

To everyone out or coming out today: congratulations, good luck, and make sure you’re safe and supported doing it.

To everyone in the closet: don’t let anyone tell you that you’re wrong or you don’t count for being there.

The Smear Test

This one may be a bit TMI for some people.

But it needs to be done, so here we go.

On Friday, I had a smear test.

Yup, that delightful ‘let’s stick a toothbrush up your vagina’ experience that, in the UK, ladies are auto-invited to have regularly after you turn 24 or 25. Seriously, the NHS sends  you letters about it.

(They even sent me one right after I changed my name and title. Apparently changing your title from Miss to Mr gets you an invite to have a stick shoved somewhere sensitive in the NHS.)

Now don’t get me wrong, I get the idea. Preventative screening is  important, especially when the various cancers that can affect the plumbing department for women are generally not caught early, and lead to lots of unnecessary deaths. And I would generally encourage people to go if they’re due, or if they’re told to go thanks to abnormal symptoms.

And transmen – except those who’ve had the type of bottom surgeries that remove everything feminine between your knees and your ribcage – need to have it too. Not using your lady plumbing for periods, sex and babies doesn’t mean that nothing can go wrong down there. So transmen need to have smear tests too, and should go.

Except…

I wouldn’t follow my own advice.

The fact is, I walked out of the nurse’s office feeling like I was dirty, disgusting, and a total freak of nature. I felt humiliated and embarrassed. I went straight home, had a hot shower, lounged around in full pyjamas for an hour, then had another shower. I felt like I’d been sexually assaulted – and before anyone goes mental, I do know what that feels like, and that’s all anyone needs to know on that subject. And to top it off, I felt angry with myself for overreacting. It was just a bloody smear test. People have smear tests all the time.

Cisgender women do, anyway.

That’s a large part of the problem. Not only am I asexual – meaning nobody ever touches my vagina except for me, and even I’m not doing it for pleasurable purposes – but I’m transgender. Meaning I don’t feel like I should even have a vagina to touch, never mind have something inserted into it. It’s awful on two different levels. It’s awful because I’m asexual, and it’s awful because I’m transgender.

And did the nurse help?

Did she hell. She hadn’t even read my notes as to why I was having the test done (hint: not routine checking, as I refuse to go for my routine ones). And yet, this is what the NHS has to say on the matter of transmen needing smear tests. Yeah. A measly paragraph. The equality analysis simply said to increase the uptake, they ought to remind GPs that transmen need these tests too. Duh. It wasn’t worth the time it took to find it, although it must be said that wasn’t just for transmen. (Seriously, I’m an analyst. I would strangle any colleague who handed me this analysis.) And a Google search for ‘trans men’s experiences of smear tests’ gets you, you guessed it, women’s experiences.

TL;DR – the nurse wasn’t trained, wouldn’t have been trained anywhere except West London thanks to the Charing Cross GIC working with nearby hospitals and clinics, and wasn’t interested. I was simply Patient Number Whatever, not a person with more-complicated-than-usual feelings on the matter.

And yet, this kills people. People are literally dying because they feel too uncomfortable, too afraid, too downright traumatised, to go to get their smear tests done. Dysphoria plays a big role, but for Christ’s sake, we get our tits out for the surgeon who’s going to cut them off. Most trans men can be persuaded easily enough in a medical situation that something is necessary, if you treat them with respect, dignity and a little bit of compassion. I went because my symptoms were ticking the boxes for something I really don’t want to have.

And frankly?

I’ll wait it out next time. I know I will. I know if I get those symptoms again, I won’t get a smear test. I won’t go for my next routine one. And part of me knows that it’s stupid and dangerous and I would go mad if a friend told me the same thing, but…I still won’t. It was a horrible experience, and I won’t do it again.

All because there is no humanity, no time, and no compassion for anyone who’s different.

Developments in the NHS

So before you read any further, please click here and read this blog post.

It’s by Will Huxter, and it purports to be a step in improving communication and services of the gender clinics in the NHS (National Health Service, for the non-Brits among us).

For those who don’t know, transitioning in the UK on the NHS goes the same way whether you are MtF, FtM, or non-binary: you ask your doctor (GP) to refer you to a gender identity clinic for treatment. In some places, you are first referred to a mental health teams (known as CAMHS), before being referred on to the gender clinic. One at the GIC, you undergo a number of psychiatrist appointments before discussing treatment and then, if you’re lucky, starting on those treatments. Usually in the exact order that the NHS prefer.

If you read down the comments on that blog post, there are a lot of problems with the NHS system. I’ve heard of people who have literally taken a decade to transition. Common complaints about GICs, both directly to them and quietly amongst transgender circles, include dismissive behaviour, rudeness, punitive language and measures against patients, inexplicable obstacles put in the way of transitioning, lack of communication with the patient, lack of communication with each other, and so on and so forth.

And these problems are being placed on a group of people with a ridiculously high rate of self-harm and suicide, and a disproportionate tendency to be victims of violent crimes and sexual assaults.

The impression that the entire state of play gives it this: it’s okay, they’re only transgender.

No, I’m serious. If I could list that about a single hospital, there’d have been a Sun pun and special measures by now. Would it have done anything — well, likely not, given that there’s no teeth behind these inspections nine times out of ten. But it would have happened. Hospital and care home scandals have been all over the news in the last five years, as we get steadily more disgusted and fed up with appalling hospital treatment.

But this? This isn’t known about. If you’re not transgender, or a close loved one to a transgender person, you won’t have heard of this. It’s only now being raised, because people finally mobilised and started petitioning the government about other transgender issues.

And the problem is, it’s been raised before. Problems with dismissive GPs, disinterested mental health services, and long waiting times were raised years ago, and nothing was done.

So honestly, I’m a sceptic. I’m sure Mr. Huxter has his heart in the right place, but I’m also sure he won’t change anything. There needs to be real effort and power behind changing the sorry state of play in the NHS gender transition system, and there isn’t. The powers that be just don’t care enough, and neither do the wider population.

But this attitude is what gender transitioning in the UK can do to you, folks. So beware.

 

 

 

(Apologies for the grumpiness, I’ll try and blog something a bit more cheerful next time!)

FtM Top Surgery: Preparation

Yesterday was exactly two months to the day before my top surgery, so I figured it was good timing to talk about top surgery in a bit more detail.

FtM top surgery is similar to a mastectomy, with the exception that after removal of the breast tissue, there is a lot of contouring that goes on as well, and usually a fair amount of fiddling about with your nipples. (Yeah, real technical terminology going on here.) There’s various techniques depending on how big your breasts are and, basically, the bigger the boobs, the more your chest is going to feel like you got hit by a 4×4 afterwards.

I will be blogging and vlogging in real detail when the time comes as to exactly what the experience is like, but right now, I’m experiencing the preparation stage.

And that’s a pretty long-ass stage.

Very basically, top surgery is a cosmetic procedure. Physically speaking. I’m not saying it’s just like people who want a nose job; what I’m saying is that top surgery is not something that your medical team goes ‘oh fuck you need this now!’ and rush you into theatre. This shit takes ages.

In my case, I have a straightforward referral and I have no medical history that would be of any concern to a surgeon operating on my upper body. (If the poor bastard was operating on my right knee, that would be a whole other story, but thankfully boobs don’t grow out of your knees.) So I get ‘turn up on the tenth for your pre-operative assessment, then if all goes well for that, turn up on the nineteenth for surgery.’

Referral comes from your psychiatrist. Yes, despite transgenderism no longer being viewed in the West by the medical community as a mental illness, it’s a psychiatrist (or similar) who gets to yay or nay your medical transition. Some surgeons in the US use a waiver model, where you sign a waiver not to sue them if you change your mind later, but most don’t. No psychiatrist’s letter, no surgery.

Some surgeons need two referrals, some need one. In my case, only one was needed. The surgeon accepted the referral, I made arrangements with his staff, and got booked in for surgery on 19th November. Job done!

Er.

Sort of.

The #boobwar is over, in the sense that now the only thing that can betray me is my own body, and if it does that, I’ll be shut out of surgery anyway. But that doesn’t mean that I’m just sitting and waiting for surgery day.

Because the surgeon has to do a significant amount of contouring and sculpting work on your just-decimated chest in order to make it look masculine as opposed to just flat, his or her job is made easier if there’s a bit of muscle definition already there to work with. And looking as masculine as possible is my goal, so I’m working out a heckuva lot at the minute.

Then there’s the medical instructions. I’ve been sent a doorstep of a booklet asking all sorts of questions, and telling me to take various vitamin supplements and herbal whathaveyous prior to and after the surgery in order to help healing. Now I’m not the homeopathic remedy kind of guy, so that took a bit of shopping around to freakin’ find, but whatever. He’s the expert.

Then there’s the general improvement to diet and fitness so the surgery doesn’t knock me flat on my arse too badly. Because I work two jobs, I don’t eat as well as I should. No more — and boy, am I not enjoying it. Seriously, after this surgery, I am never eating oranges again.

And, of course, there’s post-surgery preparation. I’ll need to sleep sitting up for a few days after. I may have drains. I won’t be able to reach above my head easily, and anything on a high shelf becomes impossible. I will contort my face like I’ve had a medieval pike driven through my thigh if I try and lift anything heavier than a piece of cotton wool. Working out is out, pun not intended. And I’m going to have to pack a special hospital bag, including pillows for the car on the way home, and a shirt I can put on without moving my shoulders.

But all of that is nothing compared to the psychological preparation.

I am not a very feelsy person. What bothers other people doesn’t seem to bother me, whereas what other people can do without thinking twice, I’m freaking out about. I get stressed about having to drive between two offices at my day job, because what if my universal access card doesn’t work. Turn up as a key witness for a three-week trial? No problem, bring me a magazine so I’m not bored.

Surgery is the same. Actually getting a major surgical procedure isn’t bothering me in the slightest. It’s not even on my radar yet. But what if I get lost on my way to the pre-op assessment?! What if I can’t sleep in their hospital beds? Holy shit, what if they serve some fucking awful weird-ass breakfast and won’t let me go until I eat the damn stuff??

Seriously, that’s bothering me. And on other forums where I’ve discussed this with other FtM guys, the reaction has actually been ‘wtf are you for real?’

Well, yeah. Actually I am. What I feel is unusual, sure, but it’s fine to feel the way I do. Just like it’s fine for other trans guys to not want to get top surgery, or have hormones, or whatever else. As long as I understand the enormity of what I’m doing, and the fact there is no turning back after the anaesthetist turns up on the nineteenth, then whether or not it’s making me nervous is irrelevant.

And weirdly, that’s taken me longer to settle down with than any of the rest of it. That it’s fine to feel the way I do about this upcoming event.

And after surgery?

#hormonewar

 

 

 

 

(If anyone wants to send me chocolate to tide me over with happiness and e-numbers after I’ve been chopped up, I will love you forever. Just saying.)