Last night, I went out to see Romeos at the Vancouver Queer Film Festival.

I just woke up. In my dream, I'd recently had top surgery, and was trying to somehow break this to my Langara classmates. Some part of me said Top surgery? What the fuck did I just do? But I quickly dismissed this - Chill, you worry that every time you go under the knife. This is totally normal.

And then my improv troupe was performing on planes.
Having had FFS about three weeks ago, she's healing up well, and when we talked on Skype last night, I saw that the swelling had mostly gone away.

"Do I Look that different" she asked.

Trying not to laugh, I said, "You're going to have a lot of trouble with men."

"It's already started." she said. "Today, I was at a coffee shop, and this guy sat down beside me and asked me what I was reading. The Persistant Desire, a butch/femme LESBIAN reader, I said - And then the light went out of his eyes."
Feeling less sick now, trying to get all the MSP business in order.

Hi, I saw Drs. Robinow and Knudson for an appointment on July 9th. They said that everything was fine and that they'd pass on approval to MSP and I should hear from them around now, but Carol McNeill at MSP emalied me saying that she hadn't received any such paperwork regarding myself. Do you know if your office has sent it off?

Imagine being a health care provider and fucking up.

Now imagine being a trans health care provider and fucking up, then having one of your equal-status nurses or doctors  explaining to you what this was like for them and how this must be for your patient. (This is an important feedback mechanism.)

I think of a scholarship program for people involved in transgendered activism/advocacy (whether they themselves are trans or not) who go into medicine.
Yeah genital surgery. Three weexs after getting through the last barrier and I guess it's hit me. This is both good and bad, and dreams back this up.

Good Dreams:

Bad Dreams:

It's the right thing to do. Consider:
I'm getting genital electrolysis done as a prior-to for surgery. And I gotta tell you, it sucks.

I'm using Lydocane, a by-prescription-only topical analgesic: it numbs the surface of my skin and it still hurts. Aftewards the combination of hot needles and hair removal and genitals and a topical analgesic (Is it strong? Well, high doses "can interfere with resperation") and after an hour, this leaves me wandering around in a half-associated daze, moreso than any playing I've done before.

Then it's off to class.

Every Tuesday.

It's worth it though.
It was fast and easier than I figured. Samonte came with me, bless him. A (medical?) student named Adrian observed. And in the end, we're good to go.

Question/discussion sequence:
- fill out this questionnaire with basic medical background
- mind if I record this
- this assessment is about "stability"
- history of assessment over time
- future plans
- family
- childhood and gender incongruity
- coming out
- sex
- transition to date
- loss of father during childhood (uh... he's been dead for awhile, and was gone before then)
- facial feminization surgery
- my boobs
- the awkward silence when a medical professional calls me "him"
- you're good to go
- Montreal; $1000 two-weeks accomodation at the recovery centre, early 2009 probably? That's a lot better than what I expected: $5000 for short-term accomodations, booked for sometime after the Mayan apocalypse.

I'm getting a haircut.
I go for "assessment" at ten tomorrow morning. This involves getting interview by two psychiatrists at once. They form an opinion as to whether Sexual Reassignment Surgery is warranted in my case.
Whatever you call it, I'm very happy that I will be going for it at some point soon.Some aspects of this still annoy and intimidate me
But there are things that make this easier
Remember that post on why I think the process for being approved for sexual reassignment  surgery sucks?

Someone wrote some pretty strong objections,  then vowed never to return. Well enough, but I wanted to take this space to respond. Normally I don't engage in flame wars - and this is no exception. I'm writing this because these are the usual round of objections that I hear over and over and over. It's not the first time I've heard them and it won't be the last. And at some point, you may hear them too. So I see the need to process them publicly.

I've seen too many people walk on the RLT half way through.

It separates the women from the men. And hat if they had got what they wanted first, then decided it didn't work?

Its there because in the early 70s there were a lot of quacks handing out SRS to anyone who could pay, and there were suicides. A lot of them.
People got srs who shouldn't have. Closet homosexuals with religious guilt who though surgery would make them straight women. Transvestites who confuse their comfort of dressing with their core identities, mentally ill patients with dissassositive disorders and other identity issues, and even criminals on the run.
A year to be sure is NOTHING. Noting at all. From the time I told my therapist to the time I hit the table was 18 months. It wasn't that difficult. You spend your life knowing this is what you need, but you can't wait a year to be sure? If you are having a hard time with a government system don't count on a state system, or a national health to help you. It won't. We are supposed to envy YOUR health care system, what a joke.
I hear so many cry "BUT I WANT IT NOW" "I CAN PAY" they sound like straight male crybabies. There is a reason you can't buy drugs that will hurt you, or of you are unfortunate enough to live in Canada, play with dangerous toys. You may think you know, but till you are THERE you don't KNOW. You may think you do, but you don't.
This is a one way trip, and there is only one way to be sure. living it for a year clears the doubts. You need to see what its like when its not a game or a costume. That's what the RLT is. And if you cannot see that you are a close minded child who wants his lolly NOW.
I have an appointment to be assessed for sexual reassignment surgery. AKA "the big switch." AKA "genital surgery."

I am glad that I have an appointment, but I'm pissed off that I have to go through with assessment.  Really pissed off. As in having-trouble-sleeping-so-I'm-writing-it-down pissed off.

The present criteria for assessment for genital surgery, derived from the Harry Benjamen Standards of Care (or HBSC) are as follows:

And here is what pisses me off:

1. I have already gone through this, and don't see why I have to do it again.
2. This system is billed as "making sure we do what's right for the patient" but is mostly designed to cover doctor's asses.
3. This system is arbitrary
4. No. I mean really arbitrary
5. Really, really arbitary. Or should I say "homophobic?"
6. The in-role period makes no sense
7. This process is gratingly slow.
8. The assessment criteria are buggy
9. Many assessors act like jerks.
This is wrong. I don't like it, and I don't want to enable it.
I cover my eyes and jerk them away. Holy shit - it's changed!
    And then I eagerly put them back again, enjoying the shift with every digit.

FFS doesn't so much feel as "a good idea," so much as Oh, I did that? You mean my skull has changed? This is new, isn't it? Well it's right, so I'm damn glad I went through with it. Proud even.

There will be progress photos, but I want to be able to get a good survey over time. Probably going to be a few months

Some people see me and, in surprise exclaim "Wow. You look really different." or even "Yeah - you look good."

Others say "You had surgery? I can't see any difference."

I am getting more reactions from strangers that indicate that they see me as female

All this is fine and welcome, but what is important is that I can see a difference. Moreover, I can feel it.

I look in the mirror and see a subtly different face, but, as I hoped, my mind quickly integrates the image as "that's me." I'd even go so far as to say that there's less surprise than before.

Only when I think about it - that this is not the same reflection that I am used to, do I get a moment of weird.
I'm not sure what to blame for this fatigue. Or credit it. You see, I don't mind this state of exhaustion.

It could be going back on hormones. Or rather androgen-blockers: upping their dose made me tired before, and now I'm going from zero to full in the matter of a week.

It could be jet lag.

It might be a delayed reaction to anesthesia.

It almost certainly has something to do with recovering from surgery. There are wound cavities in my head, measurable in square inches that are now knitting themselves back together.
Or it could be an end to my work. I walked into my old office and saw someone at my desk. It wasn't until a couple hours after that that I felt truly spent. I don't think this the main cause, so much as the trigger: I have the feeling that I was holding back on resting until I felt my job was done, which it now is.

It is good to take a break.
And I'm back. It's all done. The sutures are out, leaving little blood-dotted tracks across my forehead like a map to I don't know where. Flakes of hair shed around the suture line. Hope that stops soon. A shallow grove runs under my nose. In my mouth, tangles of dissolvable/edible sutures slowly recede across two streak-like lesions.

This knocked me on my ass. I can walk, and run short distances, but I get tired easily. No heavy exertion for one month. No contact sports (or other roughhousing?) for four. The restrictions are not due to fatique, but rather due to the potential fragility of the sutures.

I clean the sutures once a day with hydrogen peroxide, trying to break up any scabs or flakes. I give them neosporin twice per day. I sleep on my back, with my head elevated. I bind my jaw with an ace bandage, Jack and Jill style. Anesthetic mouthwash.

I'm healing quickly. My cheeks are less swollen each day. Thisis good. First it relieves the surprising strain my neck bore by carrying them around. Second it makes it easier, or just possible, to eat. Third, it makes me look less like a guy - my swollen jowls gave me a kind of "sleazy landlord" look. My skin is still tight and sneezing on coughing pulls across it to draw on sharp sutures. But I can see that there has been a change for the better.

My jaw, or at least the bone, feels in place now. I touch it and think, yeah, that's about right. Ocular ridge lines up. The distances are right. The bone is right.

This also means that I no longer have to take special measures in bright light, or have to manage my hair to avoid the bald streaks.

This is good.

Yes, I am glad I did this.

FFS +5 Days

May. 5th, 2008 10:02 pm

Small children stare at me. Men offer me their seats.

Today (Monday), I can now eat my food, rather than mushing it. I still can't chew much, so  bread has to be soaked in soup. My lower face has de-swollen enough that I can use my voice - the one that sounds like me: it could be female or unisex or maybe like a T-Boi who just shot a little T, depending on who you ask, but it sounds right. I didn't realize how good it would be to have that back, or how hard it would be to use it.

The nerves in my scalp and lower lip are re-connecting.
It's hard to tell right now what the final results will be. I can feel that the bone has changed, but trying to find my face amidst the swelling is not easy.
The swelling is going down now. I can close my lips now, which makes eating not just easier, but possible. Everything looks like it's healing fine. Just under the swelling, there is a visible difference.

Yeah. Good choice.

Looking forward to being on the other side of this.

I open my eyes and the world comes back on me with a rush. Busy people. Flourescant lights. A gurney's edge.

"Where am I?"

Questions come back at me. Name. Birthdate. Etcetera.

This must be the post-OR room ("the post-operating room room"). I'd not seen it yet, only heard one of its occupants moaning.
Swelling has narrowed my vision to a tear-streaked La-Forge-esque strip.

Indeed.It feels like I have taken a small muppet, stretched it and shoved my head up its ass until it fits like a belaclava.

Fortunately, I'm not having trouble sleeping on my back. I am having trouble with stress/narcotic-induced repetitive dreams that gradually turn sour and more baffling over the course of the night. I've been up for a coule hours, hoping to shake them.

Also, slight tinglings in numb places herald diminished swelling and the return of nervous sensation. Good.

Wow. It feels like I am wearing a mask

Imagine if you took this actor,

...and cast him as Nute Gunray from the Star Wars prequels.

...And added this guy's neck wrap (except mine is filled with ice)

It still wouldn't look like me. But it would be close.

So I get to be done surgery (or at least this round of it) and there's some sort of substantial bodily improvement thrown in for free? Wow! That would explain why I agreed to this in the first place.

My only concern now is that they will do a good job.

- less than 36 hours to go -
Anxious about surgery.

Concentrate on the good parts, not the bad. Or at least remember the good parts.
In cognitive behavioural therapy, this is called "modifying self-talk"

What if something goes wrong while I'm out.
          I'm not getting heart surgery; they're not going to crack my ribcage.
          They're barely opening me up. This isn't actually that invasive.
          If screwups happened a lot, surgeons would be poor. They aren't.
         Would I rather be conscious and powerless? AKA "a passenger in a car."

                   Other than sleep, I've never been unconscious before. This could be interesting.
                   I fixed the CFS thing, so if I do die, the timing is good. Maybe we can claim I was assassinated?
                   I should try to remember everything so I can write it down later.

Plane leaves tomorrow.



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