Tonight at 10PM (9PM central time), PBS is screening a documentary called Real Boy. If you’re hanging at home tonight, check it out!!
I had the opportunity to see this film twice now:
Last fall, my neighbors and I went, as part of the annual LGBT film festival where we live. I’d have to say that I was a little bit jaded at that time – here is yet another story about young, white, binary, trans-masculine people. Seen that / heard that!!!
The parts about his (Ben’s) mom, and family dynamics were what held it together for me. My neighbor was really touched by it in a different way – there was a lot about singing/songwriting/creativity, and also about recovering from substance abuse and other destructive behaviors.
Then, two weeks ago, I went with my spouse and her parents. It was a free showing, and the two main “characters” were there in person to answer questions and play some of their music as well. I felt really happy that we all saw it together – we then went out to eat and talked about how we related or didn’t, with the movie. Awesome conversations.
I would say that, for me, the second time’s the charm, haha. For one thing, closed captioning was on, so we could all listen and read the dialogue simultaneously, which was kinda necessary because some people mumble more than others. I got a lot more out of it – the way that Ben’s navigating his new life / roles / perceptions as a very young person (I can’t imagine transitioning at that age!!! Hormones are already on full alert and then to mix it up so drastically, must be stressful – both positive and negative stress.) And the male bonding that was going on between the characters felt a lot more touching to me this time for some reason. He has a mentor / protegee dynamic going on with an older musician, and then a housemate / brotherhood with a trans-guy he met through mutual friend.
In terms of content notes, I would give this warning: Topics that are potentially sensitive to those in recovery are brought up: mostly grappling with drug and alcohol abuse, as well as self-injury and family issues / rejection. Also, we follow along as Ben and his housemate move forward with getting top surgery with Dr. Garramone in Florida.
I’d say catch this movie if you can! Although it didn’t really speak to me the first time, I came around to really like it!
With everything else that’s been going on lately, I completely forgot that my one year anniversary was on June 1st. I think I was aware on some level, because I’ve been super vocal with my spouse, the past few days, about where I’m at with this process. So I’ll try to distill those diatribes into something that makes sense!
Most importantly, within the past few weeks, I would say I have grown increasingly more comfortable with the off-beat sensations that I have going on. Nothing is painful, per-se, but there’s still a lot of tenderness. I am finally OK with my spouse resting her head there without warning, and in addition, I’ve realized that the more I ignore/avoid that area of my body, the more it will stagnate. ??? (That’s just a hypothesis, but I hope there’s some truth to that – I’ve been trying to actively “manhandle” some spots, in the hopes that’ll promote more nerve growth, haha.)
I am over the disappointment of it not being picture perfect. At first I was angry with the surgeon (Dr. Rumer). I held onto this anger for a long time. But, as I noted at 6 months, I had been poking and prodding around my rib-cage a lot more, and I came to the conclusion that my bone structure is asymmetrical, and she (the surgeon) had to work around those idiosyncracies, and in the end, I think she did her best. I’m sure it would have looked more even if I had gone with DI, but peri was one of the things I was not negotiating on. I already have scarring on my chest, from my self-injuring behavior years ago, and I really wanted no additional scarring, if possible. And that was accomplished. (Aside from my drain holes – those scars are still visible!!!)
My nipples, I believe, can be “tweaked,” (haha) for sure. They look like they got shrunk and melted on – I think a different surgeon can really change the size and shape and it’ll make me much happier. I am not going with Dr. Rumer any-further. I was supposed to have my one year appointment either in person or over skype, on Thursday, but I cancelled it all together. I am done, and am only now looking ahead to revisions. The appt. wasn’t even going to be with the surgeon – just a nurse-practitioner, like I did over skype at 1 months, 3 months, 6 months, etc. I’m done.
I am grateful that insurance reimbursed a large part of it – I really didn’t think I stood a chance with that.
And, just to wrap up, I want to reiterate how important this step was for me: It’s not just that now I can wear tighter shirts and I don’t have to consider whether to bind or not, etc. It has really affected my self-esteem, self-perception, and social comfort. When I get dressed, I am excited to see how the shirt falls now – does it accentuate my pecs (which are now one of my favorite parts of my body), can I layer things in an interesting way, can I wear this as an open shirt and consider wearing a necklace as well?… etc. Sometimes I will wear two outfits in one day, just to try out new-to-me fashions!
I told my spouse the other day that I used to just feel dumpy all the time, and she was shocked – she said I never looked dumpy. Now it’s the opposite – I feel snazzy!
A couple of days ago, something suddenly dawned on me: It finally clicked why things weren’t looking too good in terms of symmetry. I previously had not paid attention, but my rib cage is actually fairly uneven. I’ve known that my hips are askew for forever – I have mild scoliosis. My waist is off – it goes straight down on the left side, and curves in on the right. We all have these little quirks… Other things: my eyes are not the same – one eyelid is droopier than the other. One nostril is a little bigger than the other. You know that swirl everyone has within their hair (cowlick)? It’s never dead center, is it? – It’s over to one side. Some people even have 2! My point is, we’re all a little different, even on a structural level. And I had been ignoring/avoiding my chest and rib cage – possibly because of the dysphoria surrounding that area.
I knew there was a weird dent on the left side, but beyond that, my ribs were pretty foreign to me. Recently, I started poking around. The bones are not in the same place, between my left and right! The left side even juts out a little further than the right.
Despite this, my breasts actually had been symmetrical, but that’s probably because there was all that extra tissue as a buffer. When the surgeon went to take that all out, bones were a hindrance as to what she could do, I’m finally realizing. (And yeah, I am actually that skinny that my ribs stick out a little bit. I wish I had some more meat on me there!)
I recently took some photos, so that finally, I could post my results on transbucket (you can check it out – you just have to create an account to access the website, first). And I found that things don’t look as bad, through the camera lens, as they do when I’m scrutinizing every little thing in the mirror. I had also taken photos of my chest, pre-op, and this was the first time I looked at those since surgery – my breasts seem a lot bigger than I remember them! Haha.
Here’s what I wrote on transbucket (a summary of sorts):
“Had surgery in June of 2016. Was reimbursed for 40% of the total cost, which I wasn’t expecting! This surgeon and her staff were subpar with patient care and availability. I have barely seen / spoken to Dr. Rumer during this process. All follow-up appts. (been doing them through Skype) have been with a physician’s assistant. The only other time to see her will be at the 1 year-follow-up.
I was not completely satisfied with the results (although these pics don’t look too bad). The left side is larger than the right, and the nipples are uneven, a little sunken in, and (at 6 months) purplish in color. It’s tough to see from the pics, but I believe some muscle tissue was taken out on the right side, and there’s a dent to the right of the nipple. Sensation is touchy, but slowly improving. I recently realized that my rib cage is not symmetrical, so that may have impacted my results.
I plan on seeking a nipple revision, at the least, in the future. Since I would have to pay more for this, from Dr. Rumer, I will be looking at options elsewhere as well.
At the time of surgery, I was not on T. I’d been on a super-low dose prior, for 2.5 years, but I do not think that impacted my musculature.
More information can be found at: https://janitorqueer.com/category/top-surgery/ ”
Here are past updates about top surgery, documenting as I go:
4.5 months after top surgery: 4.5 months is an odd point – but it seems worthwhile to write now, mostly because within the last couple of weeks, sensation has been returning at a faster rate. and I want to make note of that. …
3 months after top surgery: I did not expect to feel much different other than a cerebral satisfaction regarding being able to wear anything from now on. But it’s more of a gut- level confidence. …
1 month after top surgery: I can live with that for now, but I doubt things are going to change enough for it to actually look good. I’m not happy with the results. …
2 weeks after top surgery: Right now, there is not enough symmetry, in multiple regards. …
6 days after top surgery: Everything went smoothly, except for the fact that the surgeon was about to do the wrong procedure. …
4.5 months is an odd point – but it seems worthwhile to write now, mostly because within the last couple of weeks, sensation has been returning at a faster rate. and I want to make note of that.
I was really afraid I was going to be left with a huge amount of sensation lost permanently. That’s definitely what it felt like for a while. Despite being fully aware that it takes months, years even, for nerves to come back in fully, or to the extent that they are going to.
It was just really uncomfortable to have something touching anywhere around my chest, because of the not feeling of the thing. I didn’t even really want to be touching it myself, but I did / do, every day, to massage the areas around the areolas. I worried about carrying boxes when I came back to work, but that actually was fine; I’m not using my chest as a balancing point as much as I thought I did – it’s more abs, I think.
Earlier, I’d say that there was numbness for about an inch radius around each nipple. And it seemed to stagnate there, for a long time. Now, I have feeling everywhere except the nipples. Is it the same kind of feeling as before? Not quite, at least not yet, on the right side especially. Light touch feels normal; pressure still feels tender in a lot of spots. I’m super happy about this progress.
Something else that is slowly changing, I’d say, is my overall expectation. I’m still not happy with the results, and I’m sure I will eventually get a revision (nipple revisions if nothing else). But it isn’t something that bothers me. I’d say I went through a week (OK maybe 10 days) of being really down and disappointed, early on. After that, it felt like, OK, it’s actually good enough, for now, so no need to keep harping on it.
I got a lot of feedback that it’d be best if I just lowered my expectations about how good it could look. Many cis-people have weird chests, many trans-people have botched chests. I had mixed feelings:
– I’m totally grateful for how it is, as opposed to how it was. I am continuously happy about it, every day. Can I be happy about it and still want it to be better? Definitely. It can be tough not to compare it to other chests I’ve seen, but, in general I’ve just been comparing it to how it was. And in that regard, I’m psyched.
– It’s true that many people end up with really bad results. And I feel angry about that, like, why aren’t the standards better yet?? But, I know nothing about it, from an anatomical perspective, and I’m sure there are so many factors that go into how well it can be executed, beyond what we commonly know about.
– I saw a lot of shirtless men this summer, and paid a lot more attention than I used to. Many men have chests that are not quite desirable, but every one was symmetrical. I know it’s common for women to have one breast bigger or shaped differently from the other, but I gotta say, I’ve never seen an asymmetrical cis-male chest.
Overall, I think it helps to hear that adjusting your expectation will help in the long run (even if the knee jerk reaction is something along the lines of, “butt out!” Haha.) I strongly believe this is happening naturally, without me trying to change the way I am thinking.
I thought that since my chest was so small, it would be easy to get it right. Now I’m thinking, whoa, no, it’s way more complicated than that, and I barely know the first thing about it.
What I do know is that my surgeon does not offer free revisions (although the cost I was quoted, more or less, seems reasonable). Also I know it is not a priority for the foreseeable future. I imagine that within a year or two, I will have consulted with a few surgeons (I’d definitely hesitate to go back to my original surgeon) and I’ll be moving forward from there. I’m in no hurry.
Physically, I feel 100%, and I’ve felt that good for the past month – like in terms of lifting, stretching, and moving my body. Aesthetically, I’m still not happy, but I’m starting to get used to / feel OK (for now!) with how things look (I’m sure I’ll be looking at revisions down the road, but I’m not going to worry about that right now.) Sensation-wise, I’m a little worried, but I know it’s still early on. My nipples are still numb, and it feels numb/tender within about an inch radius around both nipples. I’m looking into making some gotu kola oil to massage into the tissue; apparently that’s supposed to help with nerve damage. Better late than never, right?
I have my 3 month follow-up appointment with the physician’s assistant on Tuesday, via Skype, and I’m not really looking forward to that…
It’ll be fine…
Otherwise, I’m super happy. I’m so happy to be wearing what I want to wear and also of walking around the house without a shirt on (which I did do, previously, but not as much, and not while my spouse was around.) A couple of weeks ago, I wrote to a friend, “I did not expect to feel much different other than a cerebral satisfaction regarding being able to wear anything from now on. But it’s more of a gut- level confidence: I feel like my posture is different; I walk differently, I carry myself differently. This is what makes it all worth it.” That pretty much sums it up.
Also, I’ve been using 2 pumps of Androgel, daily, for 6 weeks now, without any doctor supervision. I just had some extra bottles laying around, and I felt like starting again (after being off of it for… 6 months?) I contacted my local LGBTQ clinic via email (which is new for me – previously I’d been getting Androgel from a doctor who was reluctant to be a part of my trans-related health) but after more than a week, I haven’t gotten a response. So, I plan to call soon. I’m thinking about trying injections, short term. I think I’ve gotten about as far as the gel will bring me, and I STILL want to look and sound slightly more masculine. Like, enough so, so that people are confused, or at least they’re hesitant to actually say “ladies.” So sick of the “ladies.” It happened again today. Blah.
I’ve been busting out some of my oldest t-shirts this summer; some of them I haven’t even looked at in years – I have them stored in a box. Others I see, but don’t touch, every day – they are on a hanger, on the wall, like fine art. After having top surgery earlier this summer, I have been getting to know my collection again. And, it includes some really old gems, including band t-shirts from the 1980s.
Like this one:
This was taken 10 years ago, as part of a drag photo shoot. It was most likely the last time I wore the shirt. I can wear it again, now, if I want! Although, maybe I better keep it in nice condition – I found the same shirt, in a muscle-t style, selling online for $71.82. And my other The Police t-shirt (not pictured) is selling for $134.23.
I got this shirt for $5. There is this amazing local record store that has tons of gems, but it’s really hard to locate anything. The store is a mess, but in the 1990s, it was even worse. There was literally a mountain of t-shirts, starting from on the floor in a space that may have been about 8ft by 8ft – it was sectioned off by railings, like a bull pen. You would walk onto shirts and just start digging. I found this, plus these shirts, and more (another The Police, Echo and the Bunnymen, David Bowie…):
They were all $5. In the early 2000s, I went back to uncover more treasures, and I was horrified to find that they were all organized neatly on racks and hangers, alphabetically. And none were under $20. Suddenly. And I would have probably bought more at that price, but it looked like it had been picked through extensively. I couldn’t find any I’d actually want to wear or display. Bummer. I guess the influence of online selling had swept in, and cleaned up this mess. For the worse. Still, I am glad I was able to get a piece of it while it lasted.
P.S. The Honeydrippers were a band from 1981-1985, formed by Led Zeppelin lead singer, Robert Plant. It was kind of a part of that resurgence of 50s style music, in the 80s. Other memebers included Jimmy Paige, Jeff Beck, Paul Shaffer, Brian Setzer, and a bunch of others. They only recorded one EP.
This post is part of a series. Here are the previous ones:
Yesterday, I wore a t-shirt to work for the first time! It was glorious. I have been back to work for two weeks now, after being out for 9 weeks recovering from top surgery. It has been going more smoothly than I could have possibly imagined! Physically, I’m back to 100%, and in terms of work dynamics, I’m right back where I left things, which is better than I could have hoped for. I pictured I might be the odd person out, after being away so long, but everyone genuinely seems happy to see me. Our supervisor even got muffins for the day I came back!
So, work uniform: We have four styles of shirts we can wear – all of them are navy blue with the school district’s seal embroidered in yellow. The choices are:
long sleeved button-down
short sleeved button-down
Every 2 years, we can order 5 more. I had been down to only 5 total, though, for years, because I continually ordered more and more size S short sleeved button-downs, and they kept being too big. I had 5 that my spouse had tailored and hemmed (thank you!!!), and that was it. I had 2 t-shirts and one polo shirt, which I had ordered at some point, but never wore. Until yesterday!
Why didn’t I just wear a t-shirt immediately upon returning? This might be mild paranoia, but I didn’t want to change things up immediately for fear of fanning whatever rumors might be going around about the type of surgery I had. I only told 2 people at work, and I didn’t really want to talk about it. The short sleeve button-downs have pockets with buttons that just happen to fall right where my nipples are! Haha. So, I looked pretty much the same before and after surgery, in those shirts. I wanted a little time to pass before I moved on to what I really wanted to do: Wear a t-shirt!
I gotta say though, t-shirts are not as conducive to this hot weather. (It is soooooo hot in the school.) They are 100% cotton, and they get wet with sweat. The short sleeved button-downs are cotton/poly blend, and they are billowy and wick away moisture.
Once it’s fall, winter, and spring, I am going to be loving it though. I just need more shirts though! I think this is one of the years we get more – I’m going to order 5 small t-shirts!
In other work related news, I added a new page to my blog. It is called, glossary of janitorial words and phrases. I’m sure I’ll be adding to it as I think of more. Check it out – it might make you laugh (or possibly gross you out)…
The title says it all, but here’s the details: Prior to surgery, I put a lot of effort into trying to figure out what I might be able to get reimbursed for. I was on the phone with customer service for a long time one day; I scoured my insurance’s webpage; I tried to figure out codes and what they mean; my therapist called multiple times on my behalf. I oscillated between feeling hopeful I might get partial coverage, and being convinced that there was no chance.
Ultimately it seemed like there was no chance. I found a promising document at one point called, “Gender Reassignment Surgery Medical Policy,” followed by criteria to prove it is medically necessary. Then I was told that that applies to some insurance policies with my insurance company, but my particular policy excludes this coverage, and that was the bottom line.
Still, people told me that it’s against the law to deny coverage, on a state by state basis, and my state should cover it. I paid out of pocket, first for the surgeon’s fees in advance, and then for the surgical center, the day of. After the fact, I asked my surgeon’s office to send me an itemized bill of what I’d paid for, and I submitted that to my insurance company, without much hope. I figured it’d get denied, then I’d appeal and take it as far as I could. Maybe I’d get some advice from my local gay alliance, etc.
About 2 weeks later, I got a piece of mail. I didn’t open it because I didn’t care to read the bad news. My spouse and I were leaving for vacation last Wednesday, and I figured I’d better open it before we left. In case there was some deadline for appealing it. I opened it up, and it was a check for $2,800.09!!!! I yelled at my partner about it, the excitement of it, which must have been jarring because I almost never yell. What an amazing way to start our trip!
That’s 47% of the surgeon’s fees (including 100% of the accommodations – staying at the surgeon’s guest room!) I really could not believe it – either the person on the receiving end wasn’t paying attention at all, or they knew exactly what it was and had some strong personal beliefs of what should get to be covered!!
Now I’m just deciding if I should also get an itemized bill from the surgical center and try to get more money back… Maybe I don’t want to push my luck…
It really paid off to just try, even though I didn’t believe anything would come of it!
Here’s a post I wrote earlier on this topic:
In February, I wrote GID: exclusion for top surgery coverage
Yesterday, I went out in a t-shirt, without the ace wrap I’ve been wearing for 3 weeks, for the first time! It felt seriously amazing. (I still have sterile pads over my nipples because they are still sloughing off gross stuff, so it’s going to get even better, once that’s over!) I don’t know when I last wore just a t-shirt, out – 10 years ago? 12 years ago? Sometime in there, before I started feeling overly-self-conscious about my chest.
I had my 1 month appointment via Skype, with the physician’s assistant, and it went pretty much how I imagined it would. I focused mostly on what to do to continue healing, which is going slowly, and also to change my return-to-work date. Whenever I brought up a concern about an aspect of the appearance, I was told, “Right now it is ______; in _____ amount of months, it will be healed nicely. Your final results won’t be visible until a year from surgery.” It felt like I was being fed stock answers. I can live with that for now, but I doubt things are going to change enough for it to actually look good. I’m not happy with the results. Some of it seems like no big deal – it can be fixed. One thing though does have me worried: it seems to me that some muscle may actually have been taken out, along an axis crossing through the nipple, on the right side.
I’ll just continue to document the changes or lack thereof. Such as: neither areola is actually a circle. I’m being told that they will change into circles. I highly doubt that. I’m concerned that down the road, it’s going to be a struggle to get anyone connected to this surgeon to acknowledge that I might need revisions. If that’s the case, I envision myself getting opinions from other surgeons, and going from there…
All this is far away though. Right now, I’m enjoying focusing what I am happy about: wearing t-shirts!!! This was the number one thing I was looking forward to. I’m thinking I’ll start a short series where I write about some of my favorite t-shirts. Here’s one (this is the one I wore out, yesterday):
It says, “MUSIC LIVES ON TDK.”
I have found that to be true – most of the blank tapes I’ve gotten to make mix tapes have happened to be TDK! I found this at a thrift store about 12 years ago. I used to wear it a lot, under flannels and hoodies. Nowadays I rarely wear it, not because I stopped liking it, but because it started to get pretty threadbare, and I don’t want to wear it out. I have a couple of t-shirts like that – I love them and have worn them too much and now I don’t really get to wear them. (Largely because they were worn so much before I got them, too. I’d guess this shirt is at least 30 years old.) It is 50/50 (so soft!), which is way better than 100% cotton, in my opinion, but I wonder if that contributes to it not holding up so well. Also, it is a size large, which always gets to me with vintage clothing, because people used to be so much smaller back then?!? I am a present-day small.
I just did a google search for this t-shirt, and found one on etsy selling for $146.06 Canadian dollars, which is currently $113.34 US dollars. Dang! That’s a keeper.
Content Note: vanity.
When I first saw my chest, looking down while everything was being unwrapped, I was pretty happy. Everything looked good, except for the fact that the left side was larger than the right. I was assured it was due to swelling, and everything would even out.
Now that another week has passed though, I’m not feeling it. I am more and more skeptical that there is much, if any, swelling going on. My spouse agrees. Regardless, I’ve been taking arnica and bromelain… using ice packs a little bit.
Right now, there is not enough symmetry, in multiple regards. The areolas are different shapes, and they are too large (not “nickle sized,” like we discussed). The nipples are also too large, but it’s kinda hard to tell what’s going on there (they’re currently being smooshed flat, and will continue to be for another 2 weeks.) The biggest thing, though, is, I have different sizes going on, which contributes to the areolas/nipples being not in the same place, on each side. I don’t like that!
All these differences are fairly subtle, but definitely noticeable. I know it’s way too early to be coming to conclusions about how things look, but, so far, not so good.
I’ve been in a pretty negative space. I’ve felt so negative at times, in fact, that it was hard to feel motivated to do all the showering and “nipple care” stuff. This has gotten better over time. Everything could change a lot, as I heal; I do recognize that. It’s not all bad. Every time I have the sterile pads and binder off for a little while (to let things air out), and I put on a t-shirt (carefully!), I think, “This could work!” Excitement is there, somewhere. Sometimes I push down the good stuff, and remain guarded and reserved.
There is something here though: When picking a surgeon, I wasn’t going off of a whole lot. I mean, I pored through what was available on transbucket, for sure, and searched resources, youtube, and the like. But I didn’t really entertain all the possibilities very much, in my head. I had a gut feeling about one route, and kind of just stuck with that.
This isn’t the first time I’ve made huge, life-changing decisions in this manner. But I kind of hope it might be the last time. (I know it won’t be, haha.) There are better ways to go about narrowing down all the options!
There is one resource that I just learned about a couple of days ago, because a fellow blogger pointed the way. Gabriel wrote a post called Getting Started With Top Surgery. He mentioned “top surgery Facebook groups where people share their results and stories with their surgeon as well as the price quotes they’ve paid.” Oh yeah! Facebook. That had not even crossed my mind, unfortunately. So I just joined an FTM top surgery group, and wow, this is where all the good stuff is. Wish I had known about it 6 months ago.
Edit: My spouse suggested I stop looking at the FTM top surgery page for a while. That sounds like a good idea – I was starting to get obsessive about it. She said wordpress is good. Stop going on facebook. Haha. I agree.
I feel torn about whether I will post pictures or not, and if so, where. Before surgery, I was sure I would not post pictures on this blog, but I would post them on transbucket, when I feel ready. (They can be accessed if you create an account on transbucket). This still sounds like what I’m going to want to do. I do not plan on ever being shirtless in public. So, in regards to aesthetics, the most important thing is how everything looks while wearing a t-shirt. Other than people looking up pics as a resource, the only people who are going to see my chest are my spouse and me (and medical professionals, when necessary). So is it important what it looks like? Ultimately, yes. But for right now, as long as I can wear whatever I want, I will be happy enough…
During my most recent therapy appointment, right before surgery, I had said, “I’m worried my chest won’t look as good as it does now.” As opposed to saying, “I’m worried my chest won’t look as good as I envision.” That, to me, says a lot.
In other news, I had a great time in Philadelphia with my mom, after my follow-up. We went to a brewery and record store. We met up with friends at the Philadelphia Trans-Health Conference and went to two workshops. Wish we could have stayed longer!
Also, my spouse and I went to a wedding this past weekend, and it was a lot of fun! Their ceremony reflected who they are, a lot, and everything was casual and laid back. After the ceremony, I was asked to sign the marriage certificate, as one of the witnesses. This was a total surprise! I felt honored. I asked the officiant if it had to be my legal name, and she said it didn’t matter. Awesome!