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Surprise surgery date!

March 16, 2011

Several weeks ago, I decided on a top surgeon: the one who performs the extended periareolar method. I asked his secretary to book a date, but she forgot to call us back; so I didn’t have any updates until last week, when I had another appointment with him. As it turns out, I was booked for this week — more precisely, tomorrow!

The surgeon gave us a few days to think about it, given that we’d just found out (“us” is my parents and I — they’re amazingly involved). The timing is almost perfect as I haven’t started school yet, so we’ve decided to go for it. I couldn’t believe it was really happening until yesterday, when I showed the doctor my last lab results, and I had a million pre-op tasks to do that kept me from posting here.

I always thought that I’d burst of nervousness the days before surgery, but I’ve felt oddly calm since setting the date a week ago. I’m not overly worried about the surgery itself: there are risks, but I’m in great health; and I’ve decided it’s worth it. I’m not too concerned about the aesthetic results, either: I’ve thought about that thoroughly before choosing a surgeon, so I have the peace of mind of knowing I made the right choice.

Actually, my main concerns right now are (1) how my parents will feel during surgery — the waiting time must be awful; (2) how I’ll feel in the clinic before surgery — the preparations are probably unnerving; and (3) being weak for several weeks post-op, since my commute to school will be physically demanding. Mostly, I’m just glad I’m getting this done.

I should go now, to eat & drink for the last time before surgery, and to say goodbye to my breasts. Readers and future chest: I’ll see you all tomorrow!

PS: Here’s a relevant quote by Jamison Green that I found:

Understanding the surgery one is seeking requires accepting the fact that one is altering his body and that he will never have the body with which he should have been born. This means accepting the limitations that his body has before he gets on the operating table, and accepting that he will not come out of this scarless, without wounds, or without compromises. That is not to say that transmen can’t keep working and hoping for improvements – we can and we do. But we have to live in our bodies one way or another. We need to know how much imperfection we can handle. Identifying as a transsexual means we have signed up to consider these questions. not to do so is to invite disaster.

Physical manliness?

March 8, 2011

Anyone who knows the basics of gender is aware of the difference between gender and sex. I know it, too, to the point that I get annoyed when trans is defined as “someone whose gender differs from their sex” (as if only two sex/gender combinations were valid and the rest were incongruent!) But in this post I want to explore the places where gender and body do overlap in ways that don’t fit neatly into the binary of sex vs gender.

My personal experience of dysphoria, for the most part, hasn’t been gendered (other people’s experience differs). My hips and breasts bother me, not because I see a woman when I look at them, but because they don’t feel right on my body. The only feature which felt wrong in a gendered way, pre-testosterone, was my face: from certain angles, I could see myself as a girl, even though I could look at my entire naked body and see a boy. My goal in physically transitioning wasn’t to align my sex and gender, but rather to allow my body to reflect how I see myself in my mind. Before that, I transitioned socially to align my self-perception with the way people referred to me. I saw them as separate –though interacting– processes.

Certainly, gender –as in identity– is independent from the body: no one can tell you how to identify based on your sex (or based on anything else, for that matter), although your identity can affect how you relate to your body. But masculinity and femininity often are expressed through the body, e.g. in the form of muscles and body hair: whether or not they’re developed, whether or not it’s removed. I know that muscles don’t make the man (or the butch); the point is that people do use their bodies to signal parts of their identity, including aspects of their gender.*

I’m thinking about all this because I’ve long passed the point where I went from looking like a pre-pubescent boy to looking like an adolescent boy, and now I’m hovering on the edge of being perceived as a Man. And, given the shape of my jaw and my soon-to-be-copious facial hair, I won’t look like a delicate man, either, but a Manly Man. And that intrigues me and worries me at the same time, since I don’t feel masculine. I am comfortable presenting as male, and being read as one, even though I don’t identify as a man/male; will I be ok with being seen as manly? (Granted, the rest of my body –thin and un-muscular– does offset the effect.) And will I still recognize myself if my face expresses a gender which is slightly off, or will I flinch like I did when I could see a girl in my face?

It might not be a trans thing, though. I love this post by femme guy (who is cis) about feeling that his body isn’t acceptable as femme:

I spent a lot of time feeling that the way I look was out of step with my gender identity… I felt like the canonical femme man is a tiny slip of a boy, and trying to be a gentle, faggy, flamey boy at my size was just ludicrous and there was no way I could fully live my gender presentation in the size and shape I’m in.

If my wariness about having a “manly” body is similar to his, then I’ll have to work through my own prejudice about masculinity, femininity and how it’s displayed on bodies (heck, anyone would do well to rethink these things). But I’ll pay attention to how I feel about my facial changes in case it is a trans thing, and I stop recognizing myself (dysphoria is not about living up to stereotypes, and it can’t be dispelled by thought or analysis). If that happens, I’ll consider stopping T. But I’m ok for now.

*Wheelchair Dancer points out how disability theory deepens our understanding of gender/sexuality identities as related to the body.

The day gays could marry

March 1, 2011

As new bills for trans rights are being presented in Congress nationally and provincially in Argentina, my mind goes back to July 14, 2010. A law for full marriage equality had already been approved by one House/Chamber, and that day it was to be discussed in the Senate. A friend and I joined the crowd in front of the Legislative Palace, showing support and listening with bated breath to the discussion, which was being broadcast onto a screen.

Everyone seemed to be there: all the LGBT organizations, of course, but also worker’s unions, social justice/human rights organizations, banners of support from political parties… Yes, I was annoyed that they hadn’t stood for LGB rights before it was a popular issue, but mostly I felt joy to see so many people there. Especially because –ever since it had become a visible topic of debate– anti-gay graffitis and stickers had shown up everywhere, even near my home. It was a very cold winter day, but it felt warmer there in the crowd.

But, for me, the most stunning thing of the day happenedCrowd in support of gay marriage back at school. My friend and I only stayed at the Congress for a little while because my school was also in turmoil: a huge decision had been made, most students and teachers were against it, and debates and demonstrations were being held back-to-back. When we returned from the Senate, a rally was being held around the school door: people were chanting and even dancing in a mosh pit. The main demand was greater in-school democracy.

I heard a snatch of a new chant, and though I couldn’t make out the words, I clearly recognized the word “homosexual”. I frowned: were they using “gay” to insult an authority figure?  No, it was something about gay marriage — it was asking for gay marriage! ¡O-lé-lé, o-lá-lá, democratización, matrimonio homosexual! The song demanded both school democratization and gay marriage! And ALL the kids were singing it, and MOSHING to it!

I still get goosebumps when I remember that moment. It was so beautiful to see 12-to-18-year-olds dancing for gay rights. I realized that it didn’t matter if the bill didn’t pass this time: it was bound to, soon. The biggest challenge –changing people’s minds– had been overcome, and even if Congress members were unwilling to recognize it, they couldn’t stop the course of history.

The law did pass, just before dawn. I woke to an ecstatic text message announcing the news, and when I reached school, half-running in excitement, a straight friend picked me clean off the ground and whirled me around in a circle, both of us shouting with joy.

The trans bills I mentioned haven’t been discussed in Congress yet, and I wonder if –when the date draws near– trans issues will be discussed to such an extent. It’s urgently needed, because transphobia is even more rampant than homophobia. I hope that, in a few months, I can tell a similar story about the day trans people are granted our rights.

Signed up for university

February 25, 2011

I signed up for university this week. I feel so excited!  At the place where I’ll be studying, there’s a new rule that allows trans students and workers to use their chosen names. So after enrolling with my legal name, I headed to the office for Student Well-Being to sort that out. I was unsure about what would happen: I’d heard that the administrative staff blatantly ignored trans people’s appeals.

But the staff members that I talked to were wonderful. They didn’t know how to satisfy my request –the information system hasn’t been updated to handle chosen names– but they went out of the way to find out what I should do; and, more importantly, they immediately understood the validity of my claim. I ended up leaving them a letter –formalizing my request– that they’ll send to the office for Legal Issues.

I don’t know if my name will be changed before school starts, but I trust that it will happen at some point. Knowing that, I don’t mind if I have to explain things to my professors for this semester. The rule allowing for chosen names is new, after all, and even if the practical aspects haven’t been worked out, at least the staff believe in trans rights.  The future looms bright for me and all the other trans members of my school.

If you’ve been reading my blog for a while you might be confused because last year I also posted about starting university. I did begin last year, sort of: where I live, there’s often a transition year between secondary school and higher education, and that’s what I was doing. Now I’ll finally start studying for my chosen major.

Dreaming of my name-change ceremony

February 17, 2011

Like many people daydream about their future wedding, I’ve been thinking about my name-change ceremony lately. I don’t really think there’s a ceremony, but there is a trial in a courtroom involving three witnesses.

In my mind, I’ve been picking my witnesses like others pick their groomsmen or bridesmaids (or bridesmen or groomspersons or…), except with a bit more strategy. I’m 19 and my closest friends are around my same age, and although I know they’re responsible –and they’re the people who know me best– the judge will be more likely to trust older people. So I might choose one friend, one teacher and one family member.

I’m very lucky that I can count on several people to stand up for me. I have enough close friends to make it hard to pick just one; a few family members might agree to go; and I can ask my old Art History, Photography, Journalism and Psychology teachers (I don’t know if they’d all be willing go to court, which is scary and serious, but it’s worth a try).

I don’t know if I’ll have to go through a trial because I’m not yet ready to change my name legally, and trans rights might be approved in Congress very soon, turning it into a matter of routine paperwork instead of having to sue the state. But if I did go through an ordeal involving witnesses, I think I’d cry uncontrollably from the sheer weight of knowing that people are there for me. The very thought overwhelms me sometimes already, but the formal recognition of that support would push me into tearland.

Maybe that’s why people cry at weddings.

Note: since writing this, I’ve learned that it’s a really unromantic affair, and witnesses have to testify on their own in an office. Oh well. I can still daydream about the day name-change laws are modified, which will be much more important than any individual triumph.

SPACESHIP top surgery!

February 9, 2011

This afternoon, I had a consultation with a surgeon who recommended the extended peri-areolar –or extended concentric circles– procedure for me. Like in periareolar or keyhole, an incision is made around the areola (all the way around or just half a circle, depending on the case); but in this method, there are two extra scars extending horizontally from the areola which allow extra skin to be taken out.

I was super excited to find someone who performs this surgery because I was nervous about having too much extra skin for periareolar. Although I’ve seen excellent results from peri –even on medium-sized breasts– and it’s been recommended for my chest, I only know one person who underwent this surgery in Argentina and he ended up with stretched-out areolas. I was okay with that at the time –and it’s only a possibility, not a certainty– but the extended method would avoid that risk. And you get UFO shaped scars! Fun!

There’s very little info online that I could find. I learned about the technique thanks to Travis, who has a very clear explanation video (here’s a slideshow video of his chest healing). He’s the one who calls it the “spaceship” or “London underground” surgery due to the shape of the scars.

The article “Mastectomy in Female-to-male Transsexuals” by Namba, Watanabe and Kimata explains the procedure and who it’s recommended for (warning: black-and white images of surgery being performed).

Finally, the article “Chest-Wall Contouring Surgery in Female-to-Male Transsexuals: A New Algorithm” compares the outcome of five types of mastectomy –including extended peri– performed on 92 people and concludes which type is best for each case. I love that this article includes before and after pictures (and diagrams) of each procedure, without showing anything graphic.

Two fun facts about this technique: it was invented in the 1930s and it’s called the Moguilevsky method (according to the surgeon, at least; I couldn’t find any source to point y’all to).

The downside to extended peri? The last article I linked found that it had the highest rate of complications and revisions, along with the lowest satisfaction rating. And since there are very few images available, I’m not sure what to expect.  Please let me know if you’ve heard more about this procedure; it still seems like a good option.

Edit: I found an assortment of materials from Australia, where this operation is fairly common. Here’s some pictures and a whole bunch of videos showing the results.

it had the highest revisional rate
(60 percent) and the lowest overall satisfaction rating
(3.6 of 5) by both patient and surgeon

The decision of top surgery

February 5, 2011

…isn’t as straightforward –in my case– as it might seem. I did loathe getting breasts and, before that, I felt nauseated from the moment I realized it would happen. They were one of the main reasons –along with my overall curvy shape– I detached myself from my body at puberty.

But when I started seeing myself as trans, I became aware of the reasons for my bodily dissociation, and therefore could begin the process of reconciliation. I saw countless images of people with male, boy or genderqueer identities who not only looked like me, but were comfortable with their embodiment. I realized that my body, in fact, did not negate my identity, and that the right clothes could make me look the way I imagined myself. I found that even though my breasts –according to my mental self-image– weren’t supposed to be there, I could still live with them. At least temporarily.

But I know that I don’t want them there. And I think my body deserves to be joyfully embraced instead of merely tolerated. Don’t get me wrong: I truthfully love my breasts, but in the manner of that genderfork quote: “I don’t hate my body, it’s just not my thing. It’s like that dress you see in the window that’s gorgeous, but not your color.” I wish they could somehow exist separately from my body, or that I could retain the option to put them back on occasionally (I know I wouldn’t do it often, but having the choice makes all the difference. I’m prone to nostalgia!).

There are times when I feel rather affectionate towards my boobs. They’re okay when I’m alone –even if I’m naked– and when I see them in the mirror, I wonder if I’ll miss them. They feel nice to the touch, especially in winter when they’re like warm squeeze-balls. At these moments I wonder if I really need to take them off. But when I get dressed, if I don’t bind, they look so out of place on my body, and make me feel so uncomfortable amongst people (even if no one notices them), that I remember why I’m planning for surgery. Even when binding I feel nervous that someone will try to touch my chest; and binding has gotten so painful for me that I rarely do it anymore, even though I end up much more hostile towards everyone.

Would I mind my breasts if I lived on a desert island? No, not really. But I’m human, a social creature (though introverted and not-too-sociable), and my boobs have become an obstacle between myself and others. It’s time to let them go.

Justifying my gender… or not

January 27, 2011

I used to think that “passing” –being perceived as the gender I presented– was about people seeing me as male, a cisgender male. At some point, I realized that I didn’t care if people read me as trans or cis, as long as they respected me as a guy. Admittedly, though, it’s hard to be perceived as a trans man at first glance — people usually see a cis butch woman or a cis man. In any case, one can usually only pass as cis (although some people are perceived as trans women, whether they are or not).

Back when I started passing as male some of the time, I saw it as something completely out of my control — if someone perceived me as female, I was stuck with that label unless I wanted to come out. And even if I came out, the other person held the power to respect me or not, and I’d have to justify my own gender in a way rarely demanded of cis people.

But there was one time where I reacted differently. I went to a small used clothing store, looking for a jacket, and the owner started pulling out lots of tight-fitting, feminine items to show me. I was confused because I hadn’t even thought about passing for months –I was usually read as male at that point– and blurted out “But… I’m not a girl!” After a stunned second, she apologized and offered an explanation for the misunderstanding (“I know you’re not a girl, but, uh, boys these days wear all sorts of clothes…”). I had asserted myself with such emphasis that, for once, the roles were reversed: someone else had to justify themselves for misgendering me, instead of me acting apologetic for asking for the right pronouns.

The passing tip I hear most often is “be confident”, and it kinda annoys me because confidence can’t make people see you as you wish (and that tip almost blames your attitude if you don’t have passing privilege). But sometimes, in safe situations, confidence can help you have your gender respected, even if people haven’t immediately seen you as a cis person of your target gender. Maybe they weren’t even sure what to call you, and made their best guess, and would be happy to correct themselves. In my story, I don’t know if the store owner ended up seeing me as a cis boy or a trans man, but in that situation it didn’t matter. I just wanted to find the right clothes, and she was glad to help me with that.

Trans in Argentina

January 20, 2011

You may have heard that marriage equality was approved in Argentina last July, granting full rights –including adoption– to LGBTQ couples. Well, trans rights might be next in line — they’ll be discussed in Congress in the next few months! The proposed laws would allow us to change our legal gender without surgery, hormones, or a diagnosis of gender identity disorder. Furthermore, they’d legalize genital reassignment surgery, and have it covered by health insurance and the public health system. I don’t know if all of these laws will pass, but I’m really hopeful.

To understand how important this is, consider the present legal situation of trans people. In Argentina, your name has to be in accordance to your legal gender, which you can’t change unless your body matches up with a cis person’s. So, to make my male name official, I’d have to change my gender marker, but to do so I’d have to take hormones, get top surgery, have a hysterectomy, and get some sort of penis through surgery. But genital reassignment surgery is forbidden, so first I’d have to sue the State to have it allowed in my particular case; and that trial would involve invasive examinations by doctors and psychiatrists. The upside? If you win the trial, the public health system will cover your operation. The downside? Uh, almost everything — the requisite of body modification, the disempowerment of the citizen to decide for hirself, the cost and toil of suing the State.

Some people have managed to dodge the requirements, though, for instance by promising to get surgery but not getting it. As more and more people win their trials, rulings are getting ever more flexible — some judges don’t require surgery, others ditched the need for a diagnosis, and now a trans man managed to win his case without being on hormones.

Something similar happened with gay marriage — before the law changed, several judges started approving individual marriages until a new law seemed almost inevitable. Also, gay issues became more visible at that point and they started being openly debated by society. Now it’s happening with trans issues: not only are these trials appearing in the media, but there are openly trans people on TV (the latest edition of Big Brother includes a trans male who is by far the most popular contestant).

If all the laws pass, Argentina will have the best legislation in the world on trans matters. It won’t change everything –discrimination wouldn’t immediately end– but it would be one heck of a start.

Being off testosterone

January 13, 2011

I started hormones over five months ago, but hesitate to say that I’m “five months on T” because there was a 4-week period during which I had no (synthetic) testosterone in my body. I needed to get a new prescription from my doctor, and went later than I should have (it was exam season); then I discovered that my insurance would cover part of the cost (yay!), and the paperwork took some time.

I noticed some people wondering what would happen if they skipped an injection or two, and I wanted to share my experience. What happened to me might not happen to everyone –I had been on T for only four months, and not everyone’s body works the same way– but I thought it was worth telling.

My body told me it was time for my next shot before I had even checked the calendar. It was the last week of school and despite being excited, I felt I lacked physical energy. I also had no appetite and started skipping meals, but I didn’t know if these things were due to my hormone levels or to the intense summer heat. I only confirmed that it was hormone-related when I re-started T and began to enjoy food and exercise again.

These changes (or reversal of changes) were only mildly disappointing, but I felt really frustrated that my voice was going back. I don’t think it happened to my average speaking voice, but before stopping I had been pushing into a lower, more resounding range –especially when I sang– and I couldn’t reach that anymore. I did regain the ability to sing higher. I had mourned the loss of that ability, but losing my new lower voice felt worse (so now I know that losing a high voice was worth it).

What really scared me was the prospect of getting a period (I had my last one two days after starting T). Towards the end of my no-T interval I had dreams that I was menstruating, and that freaked me out because I used to have those dreams immediately before actually getting a period. I was lucky, though, and it didn’t happen.

Although I’m frustrated to have gone backwards with my transition –now, three weeks after a shot, I’ve only just regained the changes I’d experienced– I appreciate the opportunity I had to rethink and confirm my decision. I am more certain than ever that this is the right choice for me, at least for now.