Posts Tagged ‘top surgery’

I hit the finish line.

I mean, I’m not finished, but I’m over the line. Today I had a nurse pull my boxers down and give me my first testosterone shot.

Which means in under a year, I transitioned.

In April 2015, I came out and socially transitioned. In November 2015, I had my top surgery. And in March 2016, I started HRT. And as HRT is a lifetime of injections…I am done.

In eleven months.

And yet…thousands of trans people in this country go years without being able to do it. Transitioning can take a decade or more — and that’s for ‘straightforward’ cases. If you’re non-binary, it may be longer. If you have other health issues, mental or physical, it may be longer. And as I’ve learned this last year, if you play by the NHS rules, it will be longer.

On a totally different note (maybe), the LGBT fiction community is up in arms at the minute. And it all boils down to erasure. Many LGBT people feel erased, marginalised and hurt in that community. Which is appalling and crazy and I’m one of them.

Because this is the consequence of erasure: waiting a decade to get help, and all the time, that help act like they’re doing you a favour. In fact, that’s very much a mirror image of the LGBT fiction community’s sad state at the moment. Ignore the LBT and any other orientation, for that matter, and when they complain, tell them they’re ungrateful.

In my battle to get hormone treatment, I was told I had to be seen on the first Friday of the month only, because that’s when the transgender clinic is. When I asked why I couldn’t have a Thursday like any other patient, nobody could answer me.

I was told I couldn’t be treated by my GP because of the guidelines. When I asked which guidelines, nobody could answer me.

I was told I couldn’t have surgery before hormone treatment. When I asked why, nobody could answer me.

And nobody can answer because…nobody’s actually got an answer. But because nobody has challenged this and forced them to change what they’re doing and how they’re thinking, we continue to wait and suffer and die in silence.

Yes, die.

I would have died if I had not been given my injection today. Because the other option would have been wait until mid-June, maybe even July. And I would not have made it. I would have killed myself, and I would have died because the system is constantly and systematically ignoring us.

If you like me, or my books, or heck, even the concept of a human being behind these posts, then for god’s sake stop pretending that sticking a rainbow flag on your profile picture and reading gay men getting it on makes you an ally. It doesn’t. And we need allies. We can’t change these systems, we can’t fight this oppression, completely on our own. We need to stand up and fight them, and you need to stand with us. You need to do something. You need to talk about these issues, you need to call out bigotry, you need to share stories, you need to donate to charities, you need to sign petitions. You need to act.

But if you call yourself an ally and all you ever did was read gay men screwing, then you’re no ally of mine.

 

 

 

(But I am a man now! Woohoo!)

So it’s not Sunday, and normal service will resume next week.

However, it is now 2016!

I actually made goals for 2016, something I haven’t done in a long time. And one of them was to start hormone treatment. Only that’s going to be way harder than writing it on a piece of paper and going ‘hey, I can totally do that.’

The thing is, hormone treatment is usually the third step, after diagnosis and social transition. But for me, it’s the last step. I have no plans at the moment to have bottom surgery, and I’ve already been diagnosed, socially transitioned, and had top surgery.

Unfortunately, NHS services really do presume that anyone accessing a gender clinic hasn’t made any steps whatsoever, so the information that’s out there is useless when it comes to how flexible they’re prepared to be. The Laurels in Exeter had all the flexibility of a plank. I hadn’t heard awesome things about Leeds either. And Nottingham was to be avoided at all costs.

I live near Leeds now, so I sent them an email detailing the situation. Imagine my surprise when I was called back the same day by the Leeds Mental Health Team! (Seriously, for the non-Brits here, NHS efficiency is an oxymoron.) Well, the first lovely fact of that phonecall:

It will currently take you three and a half years to get your first appointment at the gender clinic after being referred.

Seriously, three and a half years.

On top of that, by the way, it takes four months to be diagnosed, up to two years of social transition before an eighteen month hormone treatment plan and, two years later, surgery. That’s just under TEN YEARS to transition on the NHS right now, from that very first referral made by your GP.

Oh, and if you want help in that time? Call a hotline, NHS has no resources for you.

Ten fucking years.

Thankfully, the clinic lady was actually helpful to me. She outright admitted that going through the clinic wouldn’t be ideal for me, and offered to write a letter to my GP telling him to refer me directly to either a local endocrinologist, or one in Harrogate who has worked with their patients before. Cut out the clinic entirely, and crack on with the hormone treatment separately from the gender services.

And the waiting list for an endocrinologist right now? About two months.

Three and a half years versus two months, I know what I’m going to try.

So seriously, if you’re a trans person needing something a bit different from the gender services, call them! They will try and help you get around the problem. And if they don’t? Complain the fuck out of it. It’s only by complaining we’re going to change the system, because three and a half years to wait for treatment is longer than people waiting for a cosmetic boob job on the NHS. It’s absurd.

 

 

(happy new year!!)

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 liIMG_2804ft 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

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 weighWP_20151118_22_14_23_Proed 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 sicWP_20151120_08_21_19_Prok 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 bWP_20151120_08_47_43_Proaby 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

Posted: November 19, 2015 in Uncategorized
Tags: ,

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

Surgery Countdown

Posted: October 18, 2015 in Uncategorized
Tags: ,

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.

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.)

So what’s involved in female-to-male transitioning?

 

Generally speaking, transition can be split into two pieces: social transition, and medical transition. In some countries, legal transition could be considered its own unit but in many countries legally becoming your chosen gender is very patchy and complex, and is completely bound up in social transition, so for the purposes of clarity, I’m sticking with these two lumps.

 

Social transition is what it says on the tin: it’s transitioning as far as society and your social life are concerned. That basically encompasses going about your life like you’re already your preferred gender, as much as possible. For me, this was largely about changing my name, coming out to everyone who knew me, wearing men’s clothes, and adopting a male position in life as much as I could without medical transition.

 

Sometimes, social transition is enough. Sometimes it’s not, and people choose to also medically transition. That is, they undergo medical procedures to bring their physical body far more into line with their gender than it originally was.

 

Key point: some transgender people do not medically transition. It doesn’t make them any less transgender, and anyone who says that it does is a dick.

 

Medical transition is very different for MtF and FtM people, and my experience wholly lies with FtM transition, so that’s what this post will focus on.

 

Basically, there’s three main steps: hormone treatment, top surgery, bottom surgery. Typically, they’re in that order too.

 

Hormone treatment is basically being prescribed testosterone by a doctor. It’s known as T generally within the trans community, because it’s a long and clumsy word, and T more or less puts you through puberty. Over time, your voice drops, you grow body hair in places you didn’t before, your sex drive sometimes changes, and in the short and mid term, some people have felt very aggressive.

 

Top surgery is removal of the breasts and re-contouring of the leftover tissue and skin to create a masculine chest. It’s not quite the same as a mastectomy, but it’s very similar to us laypeeps. The procedure is a major surgery, conks you out for a while, and leaves scars. But hopefully over time the scars fade to the point you can’t see them. Google ‘topless transman’ to see some results.

 

Bottom surgery is kind of two things: one version is removal of everything feminine between your ribs and your knees, i.e your uterus, vagina, etc. The other version is lengthening of the urethra (can’t spell…) to create effectively a micropenis. Bottom surgery is actually pretty unusual and the majority of transmen don’t do it. Moreover, removal all the ladybits can have major health complications and surgeons can be pretty reluctant to do it unless your dysphoria is exceptionally bad relating to it.

 

Those are the extreme basics. Each ‘step’ is very complex and individual, can be done out of order, and is wholly dependent on the individual undergoing transition. So here’s a case study: me.

IMG_2572

Generally, I can pass okay at the minute. Except in the summer. This is a photo taken in June by the North Sea, so it was cold enough to wear a jacket. Because the problem is that I have a massive rack. Seriously, 30F. And when it came to medical transition, I knew what had to happen.

 

I was not brought up in a trans-friendly area. I don’t currently live in one. So for me, I needed to be able to switch very fast between ‘looks female’ and ‘looks male.’ In the winter, I already look male, but in the summer, there’s not a hope thanks to my chest. So I opted to have top surgery first. See this post for a rant about how difficult that was!

 

In November, I will have my top surgery. Some time after that, I will start hormone treatment. And I won’t have bottom surgery. That’s what medical transition is for me. Other guys have had bottom surgery. Some guys haven’t had top surgery. One guy I know isn’t going on hormones because it’ll wreck his singing voice and that’s more important to him than the funny looks he gets now when he speaks.

 

Medical transition is formed on the basic steps — but the journey through those steps, which ones to take and which ones to skirt around, is entirely individual.

 

 

 

 

 

(Major apologies for skipping a week — I went camping, and had no access to the online world. My bad.)