Author’s note: I originally submitted this to the Wheel of Gender blog, however I’ve since decided to publish it here.
Surgery could be viewed as a right of passage for those who are transgendered. In provides the opportunity for the alignment of brain and body which can do wonders for the quality of life of someone who suffers from Gender Dysphoria. Speaking from personal experience as a post-operative transgender woman, it is life changing.
On December 10th, 2013 I had Gender Reassignment Surgery. I decided in advance that it I should keep a journal of sorts during my experience. That being said, I managed to keep it up until the time required to take care of myself became an exhausting around the clock effort. Keeping the journal helped me focus on something and provided an outlet for my thoughts which was vital.
I hope that by sharing this, those who are considering surgery as an option come to have an understanding of what the experience was like for me. I also hope those reading come to understand that surgery does not magically make everything better. It simply provides the means to correct a birth defect. The road to recovery is long and hard meanwhile the impact of the past leaves an imprint upon us that we can never wash away regardless of how much chlorhexidine gluconate based surgical scrub we use.
While in route to Montreal, and all I can think of is my stress level. This evening, I’m the only person on the flight that ordered coffee, and my stress is beginning to rip me to shreds. I need to stop and breath, else I’ll have another ulcer in no time. Is trepidation the right word? I’m honestly not sure.
I see light at the end of the tunnel for everything, but ultimately it will just take getting through this time in my life.
I wish I had some sort of shield that I could use to deflect the thoughts that I cannot control… Along with the consequences of my action, inactions, and frankly insistence that I be a good person and try to do the fair and right thing.
If I had not been a good person, had I not cared, had I not loved, then things would be far easier… But that raises the question of if I could live with myself. Then again, those same qualities are what brings many positive and good things to me. I guess a karma score of fifty on Slashdot was never enough.
Oh, apparently the person behind me also ordered coffee.
In a half hour this flight should touch down at Newark International Airport (EWR), and possibly it might fun to take a taxi into the City. It would be nice to see a friend or two. I guess I’m depressed with everything going on in my life. I am just glad I have my girlfirend in my life right now. I sure hope it lasts for a very long time.
This being the holiday season, I miss my family. While I’m gaining new family, I feel an emptiness in my heart that is not easily filled. There has been some advancement, but I fear losing more family, chosen or biological.
Looks like we will be landing shortly, Hello Brooklyn! Hello Manhattan! Hello Jersey City! Hello Newark! Oh Hai Runway!
Tomorrow, on to YUL to sign a contract and consent forms. Tonight is to be determined.
The EWR Marriott was okay, but is crammed full of people, and the room service menu was about six times larger than the restaurant menu which was greatly disappointing. Honestly, I began to crash.. Hard.
Upon getting up to the room, I striped to get ready for bed and looked down at what I wanted to be rid of, and realized why pants had been so uncomfortable for the previous few days. My bits had woken back up, and I took emotional comfort from the fact that they will soon be gone. They have never felt right. As I write this, I can only remind myself that I only have two more days left to go.
Neither of us slept well last night. We tossed and turned on the uncomfortably hard hotel bed for most of the night. We ended up having breakfast in the hotel restaurant, and then crashed for a little while since we had another hour before we had to leave for the airport.
Laying there holding hands, I confided that all I wanted in the world was to wake up holding my girlfriend’s hand. I began to weep, the stress started to melt away as culmination of the past two years began to come into crystal clear focus. I didn’t know this was where I would be two years ago, but here I am. I don’t see an end to anything, but I see a reduction of dysphoria ahead. I’ve been told that I view things correctly, in that I don’t put everything on surgery just magically making everything better.
The line to board the flight is not moving. It almost looks like the jetway regurgitated passengers behind the desk for the gate. Some commotion that we are waiting to be resolved. Ahh… Finally we boarded. Low and behold, a couple I recognize sits in the two seats in front of my girlfriend and I. It is my friend who lives near by and her wife. My friend is also off to see Dr. Brassard. All I think about is how small the world is.
Of course this was not a coincidence. We planned it this way. Practically being neighbors and in professional lines of work, we both had to look towards the end of the year with how our employers vacation and time off policies worked. At some point we realized that it might be a good idea if we were there for each other, and thus things fell together.
I’m grumpy that girlfirend is having a margarita in front of me. I would absolutely love tequila right now, but I’ve really not had anything to drink for close to a week and a half. Surgery and all. It is for the best for now. I await December 24th when I can have a drink. Champagne is what I’m planning, especially because we were unable to decorate the tree before we left. Not that I should do much besides rest and try to keep my metabolism up. I’m thinking low carb.. as in delicious steaks.
I really don’t like bumpy flights… I hope my return flights are not this bumpy.
We arrived in Montreal and eventually got a ride to the recovery residence.. I sent my girlfriend on to her hotel.
Upon coming in, they had me leave my bag in the hallway, and asked me to take a seat for a little bit. I got to talk to a few of the residents, and after forty five minutes began a pile of paperwork.
I then got my blood pressure and temperature taken. I asked if it would be possible for me to go have dinner with my girlfriend, and the nurse instead asked if I wanted to spend the night with her. I jumped at the chance.
We went to a delicious steakhouse in Laval. It was delicious! A six ounce fillet with a pepper sauce and French fries. Mmmm. On the flip side I almost started crying in the restaurant. I am struggling with my emotions, and it all just became too much for me to handle.
Laying in bed, again tonight I think “Soon”
I just can’t see life with a penis. Besides clothes will fit WAY better! Yes! That’s it, the clear singular reason to have surgery! Better fitting clothes! Of course, I’m being sarcastic, for there are many reasons, one of them just being able to get a good night’s sleep because it feels foreign and awkward. I would say almost alien if I didn’t have feeling and a lifetime of it being there.
Let it go, from the movie Frozen, is stuck in my head.
My head has been all over the place in the past twelve hours. Tears have been shed, little sleep has been had. I’m running on about 3 hours of sleep. I’m still scared, still wound up. A “last meal” of sorts for my bits helped to a degree. I don’t want to regret this later, and while I don’t think I could possibly regret it, this is major surgery.
Life changing surgery. I’ll get to dilate four times a day for a month But I suspect, as one of my friends has mentioned, waiting seems to be the hardest part.
Note from editing two months later. Dilating three times a day gets VERY old.
The equation is unchanged, only the stress has increased, and that cannot be permitted to change the equation. I just need to breath.
Today I gave my girlfriend all of the contact information for people who I wish to know that I’m okay. I’m about at the point where I just want to say fuck it, let’s get this shoe on the road!
I returned to the recovery house, and encountered my friend and her wife. We began to chat with some of the residents, and had a good time chatting.
Later on, my friend and I sat down with Dr. Brassard who looked at each of us individually and determined that we did not need skin grafts. He gave us the chance to answer questions which informed me of the last few things that I did not already know.
After that, we were told we would be admitted to the clinic after 6 PM. We repacked our bags to have our essentials. Reading the documentation they send you, you would think that you need lots for the clinic, but you actually need those items for the residence for the most part. The following is what worked for me.
One pair of panties
Cloths to wear for your transfer to the residence. I recommend pajama pants be included.
One nightgown, you’ll wear it only the night you arrive before surgery.
Things to entertain you. I highly suggest computing devices and IRC. You will need a longish power cable that is at least six feet long. Plug it in, and tie it to the railing on the side opposite from the dresser in the room.
Glasses and their case (if you need them, don’t bother with contacts.)
Stuffed animal for you to hold and if your a little at all, a pacifier. The railing really brought that part of me out. Something about feeling safe.
One thing that kind of made me raise an eyebrow is that the documentation was not exactly clear on the fact that two showers would be required prior to surgery. Both were with a gentle 4% CHG based surgical scrub, or as they like to call it “red soap”.
A very kind nurse came in around 5:30 AM and woke both of us in the room. We were instructed to get our showers. After getting showered and dressed, a nurse finally came for me for surgery. We went to the elevator and went up a floor. She left me in this awkwardly small waiting room for the doctor to come retrieve me.
Very soon doctor Belange came in and introduced herself, and took me back. They had me remove my green coat, and open the back of my gown. They quickly placed an I’ve in my left arm and injected something to calm me down, and they put a blood pressure cuff on my right, and I began to feel multiple small injections in my back, and very shortly I was out like a light bulb.
I remember hearing fragments here and there, seeing a few things and hearing sounds.
Then I felt myself in a bed being moved. I was left in the recovery room. I felt numb from my waist down, and I felt cold., I was shaking periodically and I mentioned that to a nurse and she brought me a nice heated blanket. Around this same time, I felt my first shock of a nerve reconnecting. It must have just been slightly damaged or perfectly aligned or something, but it felt like a lightning strike hit my crotch.
Oh wonderful heated blanket! What was odd that I felt the warmth of the blanket.
I finally raised my head up to look around, and they began to prepare to move me back into my room. Around this same time, I felt my first shock of a nerve reconnecting. It must have just been slightly damaged or perfectly aligned or something, but it felt like a lightning strike hit my crotch.
Upon returning to my room, i was still drifting in and out, and I didn’t see my girlfriendr. The clinic staff requested her to step out of the room while they wheeled me in. They got me into my bed and I saw her jacket. Moments later when the nurses left, she appeared. It was joyous to see her. I held her hand, and felt her kiss, I was happy.
As I awoke more, I found my catheter and drain lines. That was fun!
Pain was minimal, but I began to feel it in three different places. Two… Opposite of each other approximately where my testicals were. Another reeled like my large ingestion… Like my IBS was kicking in. Within a an hour it had gone to ten on the pain scale and I was quietly crying.
Eventually it was bedtime but we were awoken about every four hours to have our dressing checked.
The first thing I remember was that our pneumatic pants were removed and I could once again move my legs. Honestly, I don’t remember that much of the day. Occasional injections of pain killers, and I think I promptly put my stuffed animal over my eyes once my roommate was awake because I struggled to sleep through the previous night.
Susan’s Chat on IRC kept me busy for most of the day, except when they came and urged me to get out of bed and walk laps around the nurses station. I seem to think I managed a total of six laps from the early morning until the late evening.
I remember I was craving coffee around 6 AM, and decided I would go retrieve it myself. I succeeded! I even got a smirk out of Dr. Brassard for doing so. Around 6:30-7 AM we were fed breakfast. Immediately following breakfast, my drain line was removed and we were told we would be transferred to the residence around 10 AM. We got up and packed our things up, and were soon transferred.
Over at the residence, the very first order of business was being shown how to pee using my catheter and how to take care of my dressing. Someone on Susan’s chat once called it the codpiece of doom, and it truly lived up to it’s named. It wasn’t that bad at first, but as my heavy bleeding began to stop and it began to dry out and contract, the stress put on the sutures became quite uncomfortable. Needless to say it was a relief when it was removed.
Soon I was settled into the residence. I remember I puttered around a little, sat on the couch for a little bit, but then there was the time I sat on the couch without the donut and I felt the stent shift in my newly formed vagina. The surprise of the sensation caused me to almost hit the ceiling. It was not pleasure, nor pain, just discomfort. Later in the evening I felt the stent shift again while I was getting back into bed, and I immediately knew what my girlfriend meant when she told me “you’ll know when something is too long.”
I started to get turned on and could feel a little more in my bandaged off, closed crotch.
Today has been filled with rest and discussion of how surgery will affect those of us who are lesbians in the terms of relationships and sexuality. It is something I never quite expected to roll around in my head, but thinking about it, so few actually do get to let their brains go down that track.
Into the evening before my dressing was removed, thoughts continued to drift through my mind, and it occurred to me that I’m no longer a man. You’d think that this was a happy moment, but it was quite surreal and I had to come to terms with that what I’ve done is permanent. While none of the thoughts were negative with regards to what I’ve done, I knew that in the morning I would see a relatively smooth crotch, and while that was an empowering and validating thought to behold, I knew at the same time I began to become a little frightened because I knew that I was somehow weaker, which truly didn’t make sense to me.
In hindsight, I think it was society’s programming rolling around in my head, but it occupied me which I guess was good. It gave me a chance to come to terms with this perception that I somehow had that I was vulnerable, weaker, and had less privilege. In reality, compared to my previous self, I am physically weaker and thus more vulnerable, and I now have different privilege, but I know that I’m emotionally strong.
I remember going to bed with a giant grin on my face knowing that the next day I would see my new bits.
December 15th (I think?)
The dressing was removed this morning, and honestly I wrote very little past this point while I was in montreal, but I wanted to share the joy I felt that morning. As the sutures were snipped and the dressing was removed, I felt a massive surge of joy fill me beginning to see a swullen, but ultimately “flat-ish” surface and an absolute lack of dangling bits. Needless to say my genital dysphoria had worsened severely in the time leading up to surgery, and it all suddenly washed away.
I have lost track of time. I’m sitting in my seat for the last flight home, and it occurred to me that I really have not been writing. Once the dressing was removed, my pain level skyrocketed as the tissue under my pubic hair swelled. The pain, hours of care activities, and trying to keep my headspace in a good place meant that writing anything became a lessor priority. Numerous calls with my girlfriend kept my headspace in a decent place, although upon beginning to become concerned with normal yet seemingly alarming changes caused my head space to deteriorate at times.
The saying “leave your dignity at the door” comes to mind. You will be naked, or semi-naked and employees need to do their jobs, nurses need to inspect, you will want that shower cleaned while your dialating or applying antibacterial ointment. There is no way around any of that. I never expected to see the level of nudity, and it honestly at times felt like we had a nudist colony of catheterized post-op transwomen. It is vital to laugh about everything, since really there is nothing you can do about it. In many respects, everyone there is exactly the same, they are just different sizes and have different looking bruises.
The removal of the dressing on the fourth day after surgery was possibly the most relieving thing I had ever felt… Well until the stent the next day. The dressing was sutured in-place and helped separate my pieces and ensure proper location moving forward. Removing it allowed me to see my smooth crotch for the first time, and I knew then and there that I had made the right choice. A feeling of being whole and content with my body spread over me like nothing else before. For the first time in my life, things felt right. At this point things began to get a little busy. I could shower, but I was required to take two sitz baths, and begin applying antibiotic ointment.
The stent was removed the next day (fifth day after surgery), which was a massive relief due to the sutures by my anus which worried me about having a bowel movement. Luckily… I guess.. The pain meds kept that from happening and I was eventually able to “go”. One thing that I distinctly remember was the complete lack of IBS behavior on the pain meds.
The departure if the stent meant that it was time for dialations and douching to begin. Once they started, free time disappeared. As time progressed I was able to logically sequence and chunk my activities, as well as begin when I awoke in the morning which allowed for some time with my girlfriend, which I desperately needed.
Catheters are no fun. I was happy to have mine out on the day after the stent was removed. I informed the nurse that the last time I had a catheter removed, I leaked for a little bit, so everything was prepared. I didn’t have an accident and I felt proud of myself as a result. The only additional two hassles this added was additional moisture to the vaginal area, and the fact that I had to measure the input and output of liquid so they could ensure that my kidneys were in good working order. Clearly, I passed that test.
The main thing I found difficult was to keep the lower half of the surgical site… You know the part by the vaginal cavity. In essence, there is a ton of moisture introduced to the area, and it is vital to keep that minimal to the point where the nurses told us panties off whenever we were in our rooms, preferably with our legs spread to provide ventilation. This worked to a degree, but I found I was having to spend quite a bit of time patting everything dry and air drying. The best guess that I have is the wounds weeping. My advice is use lube, use plenty of it, and make sure your douche nozzle is perfectly smooth. In my case, due to a mild latex allergy, I received a different type that had a few minor hard edges and was inflexible. Needless to say… Ouch.
Dilating was slightly painful, but really only when agitating already agitated sites. Lots of lube helped with this. I also found that being propped up helped a great deal with relaxing and beginning dilation.
Speaking of pain, my pain dropped off significantly when I could move around again, although the pubic hair area (which, if I remember correctly had tissue excised from it) swelled and essentially put the bulk of the pain on two sutures running downwards into my new bits. Pro Tip: don’t hit yourself in this area when putting on thermal leggings. It is the suck.
Electric shocks are a good topic. I remember my first electric shock was very soon after surgery, and it caused my entire body to jerk as my brain went “uhh what!?!” As they began transmitting back to my brain. They continued throughout my stay and I even had a few while on my last flight home. Sometimes they brought waves of pleasure, but they could equally deliver pain like I had never felt before. Intensity varied although the closer to the time for departure, the more pain I began to feel at times.
Doctor Brassard has a great sense of humor. My girlfriend and I were sitting on the living room couch and I had pulled her arm around me, and he walked by. While doing so, he said to my girlfriend “You leave her alone… She has to heal first!”, from which we all got a good laugh. He seemed very straight, and I liked that. My surgery was completely textbook, but he took time with everyone who had slight differences from the textbook to explain how things came to be which really impressed me. He is truly an artist. I am glad I went to Brassard.
The staff is wonderful. Some might come off very well due to English not being their best language, but every single one of them was caring and down to earth. The nurses were caring, listened, and whenever the need was identified they tried to be helpful. The orderlies were great and put up with a lot of laundry each day, cleaning the same shower and toilet possibly 10 times each day. I think the only thing that was worked harder was the water heaters, one of which was acting up, but we found ways to route around the occasional lukewarm water.
The food was absolutely delicious. Well lunch and dinner at least. Breakfast was always bengals, toast, cereal, fruit and yogurt. On either Saturday or Sunday, they do bacon and eggs. Lunch and dinner typically consisted with a two part dish, like basmati rice and butter chicken, a salad, fruit, juice.. Including prune juice. At one point, we tried collecting the recipes. There were also snacks of yogurt, apple sauce, drinks, and for a while I was there a German chocolate cake that I must make when I can burn some energy.
Traveling home… It seemed like Canadian security just mirrors the United States, but they didn’t bat an eye at four vaginal dilators, a tube of lube exceeding displayed limits, and an ice bag loaded with ice. They sent me on my merry way without issues… Except they wanted to check the airline wheelchair for explosives. At least they offered the use of a cane and offered to help me transfer over to a chair while they did their thing. Silly but okay.
Sleep can be an issue. I have had to learn to sleep on my back with my legs spread, with multiple pads beneath so I don’t damage the bed. This really goes to the whole issue of keeping dry, but as someone who has traditionally been a side or stomach sleeper, this has been a difficult change for me. I still toss and turn, and as such thank Cthulhu that I have super large pads.
Taking time to heal has and continues to be my biggest challenge. I want to do something, but for the most part I have been relegated to laying in bed all of the time. I look forward to the day when things are better. I trust my girlfriend, and those around me when they tell me it will get better. I suspect that this experience will be a good catalyst for me to get back into exercising and causing all sorts of mass havoc.
I truly have started to understand why people say this is major life changing surgery. It takes a tremendous amount of energy to heal and the required care zaps you of your time and ability to have social interaction. One step at a time, but for me I knew it was worth it when the dressing was removed.
Recovery is extremely difficult. I’m still happy I did it, but there have been some incredible lows with just how daunting every little thing is, meanwhile having to suffer a great deal of pain. I could have possibly opted for something like an opiate pain killer, but my attorney’s advice was to avoid them so I largely suffered from pain. I’ve spent the vast majority of my free time laying in bed, which is frankly beginning to drive me crazy. Things have been and will continue to get easier as time passes.
It has been seven weeks since surgery. I really should have just purchased about a gallon of Chlorhexidine Gluconate based surgical scrub to begin with. In the first six weeks, I went through close to a half gallon of Dyna-Hex. If I continue to use it to clean my dilators… given the recent news that antibacterial hand soaps are being pulled from the market, I figure I’ll likely go through close to two gallons this year.
In terms of healing, I’ve come quite a way, but there are still months of healing to go. I can now sit without the donut, although sitting for 4+ hours is rather uncomfortable. Honestly, Working from bed seems very appealing after 6 hours in a chair.
I’m growing extremely tired of dilation. The pain has been a big detractor but I also found that allowing myself to heal a little helps a lot. All things in moderation, there is no need to rush anything.