As that specific trauma dissipates further…

Every year around this time, I revisit the first time I was hospitalized, which was Veteran’s Day weekend in 1999.  It used to feel like the worst thing that ever happened to me.  And, in terms of fallout, I still think that it was – it just no longer feels that way.

Two years after this hospitalization, I wrote an essay for a class, including every little thing I could remember about the experience.  A few months ago, I gave that document to my therapist to read over.  I didn’t necessarily want to delve into it or have her probe me about it.  I just wanted for her to have read it.  And she really only said one thing:  “There were always questions about whether you had been in a psychotic state or not.  This definitely shows that you were.”  And, strangely, I was satisfied with that.  As if I could lay to rest whether I needed to be there or not.  For the most part…

I’m currently giving my most recent hospitalization (from 6 months ago) the same treatment, as best as I can remember.  I’m up to 2,500 words so far, and only about 15% done.  I don’t have any plans for it other than just something that I want to do for myself.  We’ll see.  I feel like there’s not much writing out there that really portrays what can go on in someone’s head while they are in the middle of psychosis.  (If anyone has any recommendations, let me know!)  That does not mean I have lofty goals for where I could take this writing; it’s just a motivating factor, something that pushes me to try to capture it as best as I can.

I just did a cursory search, and a couple of books that stand out as worth checking out are:
Stress Fracture: A Memoir of Psychosis and Brain on Fire: My Month of Madness

Here are the other posts I have made, yearly:

Continuing to work through a specific trauma – Four years ago, I wrote about how I finally gained access to the medical records from my hospital stay, and how I started to process things differently with the help of my therapist.

That specific trauma is still there – Three years ago, I wrote about finally bringing that record into therapy and how it felt to have her go through it.  I was starting to realize that maybe I didn’t need to pick it all apart; maybe my perspective was shifting naturally, over time.

That specific trauma is no longer a big deal – Two years ago, I wrote about how much time has changed things, and it no longer felt like a big deal.  The fact that I had been hospitalized again, that year, surprisingly helped me find ways to heal, rather than adding more baggage onto the feeling of it.

Anniversaries, traumas, deaths, and name change – Then last year, I wrote about how other things were going on, and I really didn’t have the space or time to reflect.  Which was perfectly fine.  Between the election results, working on getting my name legally changed, and other emotional markers, it just didn’t come up.

This year, I am thinking about it, but it is more in terms of “one of the times I was hospitalized,” rather than, “a traumatic event – the worst thing that ever happened to me,” etc.

 

I’ve been thinking of all the little occurrences that go into the bigger story.  Like, for example, in that state, my mind was so malleable and adaptable that it seemed like, theoretically, anything could be true and just as easily, not true all at once.  Which is one of the reasons I avoided watching any TV.  (There were two TVs on the unit – one played music and had legalese constantly scrolling, in both Spanish and English – like a “know your rights” kind of thing.  The other TV had a remote and listing of channels, and we could watch whatever we wanted, 24/7.)  At one point I did sit down, and there was a documentary on about pineapples.  (Er, rather I’m sure the documentary was on something more broad, but I saw the pineapple part.  I started yelling about the unlikelihood about these pineapples growing.  Don’t pineapples grow on trees like sensible fruits?  What were these miniature pineapples growing up from fronds in the dirt?!  A patient who knew-all immediately matched the intensity I was spewing, and argued for the realness of these pineapples.

A few months later, my spouse’s aunt was visiting from Hawaii, and sure enough, she grows pineapples on her property and sure enough, she had pics to prove it.  I can now accept it fully.


Getting a pap smear as a transmasculine person

I don’t have a gynecologist.  I haven’t had one for probably 15 years.  The reason for that is because I felt so out of place there, so I let that aspect of my health passively slip away.  I’ve always gone to the dentist twice a year.  I was really into chiropractic care for years, consistently.  I’ve gotten eye exams.  I regularly go to a therapist and a psychiatrist.  I even have a primary care physician, and more recently, an endocrinologist.  But I’ve neglected and avoided anything related to my junk (this is just my preferred term for what I got going on down there…)

My last pap smear was in 2012, and I went through that because it was a prerequisite for getting testosterone gel.  That was enough of a motivating factor to go through that.  It was super painful and anxiety inducing, but I had done it!  Since then, there’s been no reason to get it done again, in my mind.  Prior to 2013, I’m not sure how long it had been.

About a year and a half ago, I was on a panel  with two other trans-people, in front of a group of health-care professionals, talking about our experiences with health services.  I mostly talked about my experiences with top-surgery consultations, but during the Q & A, the three of us were asked about sexual and reproductive health.  I was super open about how uncomfortable I am with this aspect of health care, and how I have avoided it.  I even felt a stubborn pride about it – something like, “if I avoid it, that verifies how little I relate to my junk.”  This really makes no sense whatsoever, and why exactly is this a point of pride?  My two peers were much more proactive – they had had lots of experiences with making sure their needs and check-ups were on track.

Two weeks ago, I was eating lunch with a super close friend.  She was mentioning something about her menstrual cycle and about how she needs to get her routine check-up.  I told her how long it’s been since I had a pap smear, and she seemed aghast.  I said I wasn’t going to be getting one either.  She said something to the effect of, “But you have to.”  She sort of role played a scenario in which hypothetically something scary is found, like HPV or cancer, that could have easily been avoided by just getting regular screenings.  The emotions she was pouring into it were what got me.  I kept going back and forth between, “OK, I will get it done,” and “No way never again!”  The conversation stayed with me.

A couple of days later, I had a lump in my armpit.  I’d never had anything like that before.  My spouse told me I should get that checked out.  This was something that was more straightforward!  I could definitely go to the doctor for something like this!  I called and got an appointment for the next morning.  Then it dawned on me that I should be getting a pap smear.  I waffled back and forth for a while, wondering if I’d be able to get myself to call back.  I finally did, pitching my voice as high as I could so it would be apparent that this request would not be totally incongruous.  Blah.

The pap smear was just as painful as the other times I’d gotten one, but I would say it was less anxiety-inducing.  What helped me get through it was trying to stay present in the moment, in the room.  I did this by talking with the nurse practitioner.  “This room is cold.”  “Please use the smallest one possible.”  “This is really hurting.”  Etc.

I gotta admit I do not know the exact reasons pap smears are important – what is being tested, etc.  But I do think I will be more on top of getting them every few years from now on…

To top this all off, on Saturday we were out in the woods with some friends.  Sunday morning, I felt something chafing on my chest, and when I looked, there was a tick latched in right on my nipple!  Eeaughhhh!!!  My spouse tweezed it and pulled it in half.  Half of it is still embedded in my skin.  I’m thinking it will work itself out on its own.  She talked to our friend on the phone – he regularly gets ticks and gets them tested in groups, after he’s collected a bunch.  So far so good but lyme disease is a scary possibility.  Do I have to go back to the doctor?!

 


9 months on T injections

I surpassed my best guess at a timeline.  When I started in January, I gave the whole venture 6-8 months.  I thought I’d start getting uncomfortable with the level of masculinization by that time, and I’d stop.  Not for good, just for a while, to level back out, and then most likely start again within another year or two.  Something like that.  BUT!  I really like what’s going on.  I like everything except for the facial hair growth, and that’s been pretty minimal thus far.  Minimal enough to manage, without having to shave.  I like my voice, the muscle growth, legs getting hairier, and clit growth.  I haven’t noticed my hairline receding any further than it already has (I was on a low dose of gel for 3 years and saw my hairline change).  And I really really really like the cessation of menses.  I never had severe symptoms with that, but having it as one less thing, showing up to deal with, cyclically, is a really big plus.

Today was also my 3rd appointment with an endo, and I have a new one now (the one I started with moved to Oregon).  I liked her immediately.  She wrote down notes.  She was curious if my psychiatrist sees other trans-patients, and if I like her, so that she can have someone to refer others to.  Same with my therapist.  She wanted to know about my experience with my top surgeon.  I gave her my full report.  She just seemed to really want to get a grasp on who’s who within trans-health, and to glean a lot of that information from actual patients, which felt really validating.

I asked her questions about needle gauges, and she asked me if I was interested in sub-cutaneous injecting.  I said, “yes!” even though I hadn’t thought about bringing this up in particular, in advance.  It’s just something I’ve heard other trans-people on testosterone talk about as an easier and less painful route.  But I assumed it was something totally different, like a different style needle, possibly a different type of oil, etc.  I learned it’s not – you just use a significantly smaller needle, and inject it into fat instead of muscle.

This next paragraph is going to be kinda graphic, heads up if you have a needle phobia!  So, imagine using a fairly long and thick needle and just jabbing that straight down into your quad muscle, perpendicularly.  And then having to push the oil out of the syringe, which does take some force because the oil is thick.  This has been painful, to varying degrees, and often there is blood.  Sometimes my muscle is sore that night and into the next day.  Now, instead!!!  I’m gonna get to use a thinner needle, and just slide that in at an angle, but fairly parallel with the skin.  It’ll only have to go in a half inch or so, not one-and-a-half inches.  It’ll still be hard to push the oil out and in, but just the fact that it’s a layer of fat and not a thick meaty muscle sounds pretty good to me!  I can’t wait to switch over!  I’ll have to watch some videos or something.  The endo did suggest I could come in and a nurse practitioner could show me, but I think I got it.

The one thing about the appointment that felt a little off was she gave me a quick exam, with all my clothes on.  This was in itself was fine, although I was caught a little off guard..  She checked my lymph nodes, breathing, throat, etc.  Then she said to lay down, and even though I was wearing a t-shirt and hoodie zipped up all the way, she kind of put her hands under there and said she wanted to take a look at my chest.  Maybe she could have asked.  I probably would have said sure.  But she was like, touching my nipples and commenting on skin retraction.  And it felt weird.  It’s not like it was lingering in a bad way.  I pretty much immediately got over it.  It was just very unexpected.

And, like always, here’s my face:

before injections

9 months

 

 

 

 

 

 

 

 


A local doctor was fired for providing HRT

This actually happened a few months ago – she was fired from a nearby college on May 24th.  It’s only now hitting larger news outlets because there are now three state-level civil rights complaints, trying to get her re-instated.  I read about it in the newspaper while at work, yesterday.

She was treating transgender students who came to her with a previous diagnosis.  She was definitely qualified to do so, having gone through many hours of training in trans-health care, attending a conference sponsored by WPATH (World Professional Association for Transgender Health), etc.  She was doing this at the college’s expense, which just makes it seem like it was condoned by the college, right?!!

WPATH’s stance is, “With appropriate training, …hormone therapy can be managed by a variety of providers, including nurse practitioners, physician assistants, and primary care physicians.”  Apparently, this was outside the scope of what the Student Health Center did, but this was never communicated to her.  The termination came from out of the blue.

Hormones are prescribed for other reasons at the health center, with no problem.  Birth control, ovarian disease, and low testosterone are all treated regularly.

Interestingly, the information on the Student Health Center’s website changed two months after her firing:  While it had said, “comprehensive primary care,” and “continuity of care,” it now says, “basic primary care” and has no mention of continuous care.  At least they’re being accurate about the downgrade???

This just angers me to no end because this doctor took it upon herself to step it up and become well versed in an area that, for whatever reason, makes so many medical professionals so squeamish and stand-offish.  And if this was something she did of her own volition, and it was well within the standards of care, then back it up!  What was the university afraid of?  There are standards in this field, despite the fact that the medical professions are grotesquely behind the curve with this, in general.  A bunch of transgender students were left in the lurch.

The college’s associate vice president of student wellness was quoted as saying, “We are fortunate to be situated in [city], where there is a strong medical community rich with resources.”  As if to say that students can just go elsewhere.  I’ve tried “elsewhere” around here, as an adult, and it was a super-frustrating process.  If I think back to who I was at age 18 or 19, disrupted care at the on-campus center in this regard would have definitely sent me into a tailspin and/or mental health crisis.  I would have felt like I didn’t have the means or psychic energy to find out another path.  I would have felt deeply cut, in a personal way, by my institution’s sudden change in policy.

It just seemed like this college was at the forefront – it could have laid the groundwork for other area places of higher education to follow.  And then it just took a huge leap back into the wrong direction.  One step forward, two steps back sometimes I guess, right?

I had a bunch of problems with getting continuous care.  I was first getting hormones from a sketchy-ass doctor.  I finally felt so disgusted with his practice that I sought out another path.  I went to one specifically because she was listed as being LGBT friendly and knowledgeable.  That ended up being wrong basically – she told me she didn’t know how she had gotten on that resource list.  I had to have a pretty heated conversation with her – her stance first was that I could come to her for primary care, but I should continue to get my hormone prescriptions through that other doctor.  I told her I wasn’t going to do that.  She told me this was beyond her scope and if she had a male patient with low-testosterone, she would not even monitor him for that reason.

We finally landed on a compromise.  She would continue to prescribe what I was already at, and she would monitor that.  If I wanted to make any changes though, I would have to do that through other means.

When I did want to make other changes, I first got on a long waiting list for an LGBT-specific clinic.  I kept hearing negative stories about the quality of care there, so I decided to also try another approach:  an endocrinologist.  I had to get on a long waiting list for that, as well.  I’ve been going there since January, and so far, I’m happy because I don’t have to deal with the PCP anymore.  Getting an endo was not like adding yet another medical professional and another series of appointments.  It was more like, instead.  Unless I get like, a rash or something, then I’d go back to my PCP.

All of this was hard enough, and I am an adult who has worked really hard at advocating for myself.  Thinking back to who I was as a student I would have withered under this kind of stress.  Students need to be able to access trans-specific care on their campuses.  Period.

A note about the lack of specifics in this post:  I left out the doctor’s name and the name of the college, city, etc. because that’s been the way I’ve always operated with this blog, in order to keep some anonymity.  I’m not sure anymore whether it’s all necessary, but I’m not about to try to figure that out here-and-now.  If you’d like specifics and the names of the sources I got a lot of this information from, just leave a comment, and I’ll get back to you!

 


I finally made a resource page, of sorts

This is just an announcement that I added some stuff to my blog!  For the longest time, the additional tabs were “ask me something,” “what it’s about,” and “glossary of janitorial words and phrases.”  And that was it.

About two weeks ago, an outreach specialist who works for drugrehab.com reached out and asked if I would add their website.  She wrote,

“Studies have shown that individuals in the LGBT community are more likely to use and abuse alcohol and drugs and tend to continue abuse throughout their lives. We work to spread awareness and to be an informational resource for those impacted by alcohol and drug dependence.

I believe that our website would be a valuable addition to your resources listed on your page.  Would you please review our resource and consider adding it to your website to spread awareness”

And that got me thinking, because I don’t have anything like that on my blog!  But I decided that I could – she kind of got me going to start organizing a resource page.  I told her, “I’ll need to start from scratch because I have yet to provide a resource page at all, but I love the idea, so thanks for that push!”  And then I started working.

I had always been of the mindset that although many blogs do have links to online safe spaces, hotlines, etc., I don’t need to be one of those blogs – people can google whatever they want to google and glean information from myriad places.  I wouldn’t even know how to narrow down a page.  Some, like Micah’s on Neutrois Nonsense, for example, are so comprehensive, I don’t really have anything to add!

So, mine might be a bit random, and it’s definitely not complete, by a long shot.  I included the one for the drug rehab site first, since she was the one to get me going.  I then added two overarching sites for mental health, Micah’s blog (of course!), the blog of a professional gender therapist who is very hands-on, and then two sites that are geared toward brainstorming and creativity, when it comes to gender.

You can take a look here:  LGBTQIA-GSM Resources.  Please lemme know if you want me to add anything in particular…  (The GSM stands for “gender and sexual minorities,” because there are not enough letters in the alphabet to cover everyone!)

I’ll just end with a little more information about the drug rehab website, mostly because I was so tickled that they wrote and wanted me to “advertise” for them.  It makes me feel like, wow, cool, my blog really is reaching people.  (This is something that waxes and wanes for me, whether it’s really out there or not.)  So, the outreach specialist said,

We are a free informational resource for those  battling mental health and substance abuse issues. Our website tackles many issues currently facing society today. We have a team of doctors and writers who update our content daily.
We do have a hotline that you can call with questions about different treatment options, as we know every individual is unique and so should treatment be as well.
If you want further information, check out my new resource page!!!  LGBTQIA-GSM Resources

Priorities, at my most vulnerable

I was in the hospital for psychiatric reasons, for a week in mid-May.  It went so much smoother than my two other “stays.”  (Those occurred in 1999 and 2015).  I attribute that smoothness to:

– Having a complete social network around me for the first time in my life

– The fact that even though I had never been to THIS hospital, I was able to draw from my experience in 2015, and use that blueprint to (semi)-successfully navigate my way through, this time around.

– I was already on meds that were working pretty well, for the first time ever.  This means that my psychiatrist wasn’t just taking a shot in the dark.  She was just tweaking what was already working.  (For me, specifically, this meant getting my Seroquel (anti-psychotic) increased from 200mg, to 600mg, dispersed into three 200mg doses throughout the day, and discontinuing the Wellbutrin (anti-depressant), at least for now.*

So, what were my priorities?
1. Getting on an adequate sleep schedule.
2. Eating the hospital food without having too many digestive issues (this included not relying too heavily on food visitors brought me, even though I was so grateful that they were doing this.)
3. Interacting as opposed to shutting down:  Unless I was knocked out on meds, I was up and about, talking with people (sometimes shouting at them), pacing the halls (“going for a walk”), coloring with different medias and different methods / trying to do number puzzles (figuring out what was feeling more “right brained / left brained”), marking my turf / territory in ways that may have been specific to me (this, right here, would be a post unto itself… I’ll leave that for another day…

Some peripheral priorities / goals that I tackled / attempted and had some success with was:
1. Watching out for other people, checking in to see if they felt safe.
2. Micromanaging free-dance party / art times.
3. Getting other people condiments and other things they might need / want.
4. Modeling my behavior off of others / acting as a role model.
5. Pushing for Gym Time and Therapy Dog visits.
6. Reinforcing privacy vs. getting help.  Also reinforcing quiet hours and other scheduled parts of the day.
7. Taking a shower every day (night) at the same time (10pm).
8. Dispensing important information.
____________________________________________________

Notes:

I realize this post is a pretty vague sketch of some important things – this might serve as just an outline for me to fill in more interesting details / experiences / stories…

*I was also administered a shot, which I refer to as a “Haldol Cocktail.”  5 parts Haldol, 2 parts Ativan, 50 parts Benadryl.  Plus, of course, my Testosterone shot – 50mg.

 


I was in the hospital (again)

Oh, hey, dang, I’ve been absent for a while.  I was in the hospital, again because I was manic (the time before that was January, 2015).  This time it was a week:  from May 15th-22nd.  I’m currently out of work until June 19th.  I’m sure once I’m feeling up to it, I’ll be writing a lot in the upcoming weeks.  For now though, I’m thinking I’ll have a handful of short, somewhat abstract updates to this blog.  The first one being:

I am a transgender person and I was hospitalized for mania and my blood was tested, and I was administered my testosterone shot, but my T-levels in my bloodstream were not monitored at any point in time during my stay.

I feel legitimately angry, like, about as angry as I am capable of getting, about this.  Because I experienced some really really bizarre symptoms while there, that I would chalk up to hormonal issues, but there’s nothing for me to measure that against.

I was shouting A LOT.  Like, I am not a shouter.  I was SUPER vocal, the entire time I was there..

My menstrual cycle came back in a super condensed, concentrated form, for about 3 days…

Digestive issues…

Sex drive??  Zero

I called people out in their shit, in real time (generally something might occur to me later, what I should have said)…

I was actually able to keep my anxiety in check this time…

Smells and tastes were all over the place…

 

Blah!  When will it sink in, that transgender people face different challenges, and these need monitoring too!


6 months after top surgery

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. …


Why is it so hard to make an appointment?

I made a decision that I’d like to get on testosterone injections, temporarily.  I’ve thought on-and-off about it for a while, and I think the idea solidified over the summer, like, once I’m back to normal after recovering from surgery, I’m going to look into it.  Unfortunately I knew I couldn’t just get this from my Primary Care Physician – she had been OK with maintaining my androgel dosage, but not comfortable with changing / increasing anything.

On September 26, I called the local LGBTQ+ health clinic and explained what I’m looking for.  They said they could get me in on January 25th.  I said, OK set the appointment, but in my head, I was thinking, this is a ridiculous amount of time to wait.  (And, I know, I know, relatively speaking, it’s not at all, especially looking at it from a global perspective.  But, if I think I can do better than that, why not try?)

From there, I looked up endocrinologists in my area and what types of care they covered.  I found one that hypothetically seemed like a good fit, and I posted about it on the local transmen Facebook page.  I got one comment that yeah, she and her staff are good, and a few more comments agreeing with the inefficiency of the clinic.  In terms of vetting, that seemed good enough.

clockcalendarI called her office on September 27th and was told I’ll need a referral from my Primary Care Physician, and then once that’s in, I should hear back within a week.  I called my PCP’s office, and they said they’d send that over right away.  I then waited 10 days before calling.  I was told the referral didn’t get received, huh, not sure, can you have them send it again?  Got that done, this time with a confirmation plus I got a copy, and waited another few days.  I got a call from my PCP’s office, saying that the endo needs an additional referral, from a psychiatrist.  GATEKEEPING at its finest.  I would have been super pissed, and probably would have stopped trying to go this route, if it weren’t for the fact that I actually do have a psychiatrist right now.  So although I hate that I had to do it, it wasn’t actually much of a hassle.

I emailed my psychiatrist (she was already aware that I was pursuing this), summarized the nature of the referral from my PCP, and asked her to also write a letter.  I said that including pertinent information, like the fact that I’ve been on a low dose before, that I’ve had top surgery, and/or that I identify as non-binary would be great.  She replied that she could write the dates she’s seen my, my diagnosis (meaning my mental health diagnosis), medications she prescribes, and mental stability status.  “OK?”

I replied, “OK that’d be great, thanks.”  Guess I didn’t want to argue or push it.

I then waited another 8 days (by this point, it was Oct. 25th, a whole month later and I still hadn’t secured an appt.) and called the endo’s office again.  I was given a wishy-washy answer by the administrative assistant.  That the endo is still in the process of finding more information, and she is currently booking out till January – they can get me in for January 10th.  But at the same time, she can put me on a waiting list to get me in sooner.  I asked, if I were to call and check my status, would that help me “jump the line”? (I didn’t actually use this phrase.)  She implied that sure, that could help.

At this point, I took a step back and thought about what’s happening.  So far, the endo got a referral from my PCP, and that didn’t include any history of care:  just Female to Male transgender person (F64.1), chronic.  In addition, they got information from a psychiatrist that I am bipolar, that I have been seeing her for 9 months, and that I’ve been stable during that time (relatively, this is such a short amount of time; it’s kind of implying that the rest of my “bipolar disorder” time is a wildcard.)  I don’t want to get too paranoid, but this collection of information is not working for me at all.  That plus the fact that it’s straight up inaccurate.

Feeling like the system is working against me, I decided to pull from my bag of tricks and email my therapist.  If there’s anything that could help this stalemate, it’d be her.  I relayed this whole series of events and asked her if she could also write a referral, actually filling in the background information.  She replied in 10 MINUTES – such a refreshing change! and said crazy that this is so hard, and sure she’d write a letter, and is there anything else I’d want to make sure she includes?

So she’s writing a letter.  My intent is, essentially, that this is not a new diagnosis, coming out of nowhere.  That I’ve already been on T in the past, I’ve had top surgery, I’m in the process of legally changing my name, etc.  So, this should be a continuation of ongoing care (timely, please!).  I’m not starting from square one here.  I imagine this endo has access of my medical records (?? not sure how that works), so if she looked into it, she’d find this stuff.  I’m just having my therapist bring it to the forefront, which will hopefully change something?

Because, I feel like if it went the other way – my doctor sending the referral first on my behalf, instead of me going backwards to get this stuff covered, I would have been given an appointment within a more reasonable window.  Not sure if that’d be true or not – there could be dozens of reasons outside of my control – maybe she’s just really busy.  But, I gotta try…

Blah.


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.

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.