#Including top surgery and a hysto

[elvenmoans]

Stop throwing people who get gender affirming surgery as teens under the bus. We exist. I had two as a teen, one as a minor. It happens. It's a good thing. It's rare because doctors usually won't approve it unless you came out as a child, which I did. Having top surgery as a minor massively improved my life, self image, and health.

Pretending we don't exist to try and convince transphobes that trans kids matter just isn't a good look. It's respectability politics and dismisses the lived experiences of trans folks

[bisexualamy]

Transition Update #63: 7 years on T & hysto retrospective

Hi everyone!! The title says it all. I wanted to include all of my phallo consults in this as well, but a few items are last-minute up in the air, so I'll write a separate post for the phallo consults omnibus.

As always, please don't reblog or screenshot and repost. Links are fine. Writing transition updates over the years has been really good for me and I always hope someone finds them helpful. But at the same time, the larger public is awful about bottom surgeries and I'd rather not subject myself to that ire.

This post has a general content warning for discussions of sex, genitals, body image and body/gender dysphoria.

7 years on T

I stopped doing annual T updates a while ago, because after the first 2-3 years most of the bodily changes are basically the same bodily changes cis men go through as they age. This year I made a point to celebrate 7 years, because that's an absolutely wild number, and I think it's important to acknowledge my T anniversary when it comes around. Testosterone has fundamentally changed my life. I'm pretty sure I wouldn't be here without it. I'm so grateful to be in a place mentally, physically, financially, and temporally that I can continue to access it.

I started taking Finasteride this year bc my hairline is getting a little thin. This is, again, more a factor of being in my later 20s than anything else. I didn't expect it to affect me as much as it did. It was one of the first times I experienced and male body image issue that had nothing to do with being trans. Normally, I'm so grateful to live as a man that most male body image issues don't affect me. I don't care that I'm short or a little round or I have wider hips. I'm so grateful to pass and live full-time as a man that it doesn't register. This one was different, and I'm not quite sure why, but I'm going to try and not obsess over it.

Off and on the last four years, but seriously the last two years, I started working out and lifting. At first, I mostly ran, especially during the height of the lockdown when it was the only safe way to work out. I love running but I always wanted to be strong and see what my body could do. The past two years I've been working with an online trainer and my strength has really improved!! I'm hitting personal bests in the gym and it's stopped feeling like a tedious chore. I'm actually excited to go now. That's an amazing feeling and I'm always really happy when my friends or family call me strong.

Hysto retrospective

It's been 7 months since my hysto back in January. The recovery for that was longer and more difficult than I expected. Being cooped up in the house and feeling really weak and gross, on top of the bottom dysphoria I kept experiencing having to constantly discuss lots of parts I hate having, was really hard on me. I feel like, over the last two months, I've shaken off a lot of the lingering depression from that. All that being said, I've healed very well, and I'm so happy I got my hysto.

One of the worst, dysphoria-inducing nightmares for me was getting pregnant. It was so bad, it prevented me from seriously dating cis men for years. T is not birth control, and even with protection and respectful partners, the fear and anxiety were just too much for me to handle. I knew that once I got my hysto, I'd probably feel more confident dating men, but I didn't realize the extent to which that would be true.

I've felt way more confident to date around and hook up since I got my hysto. I've gone on more dates with cis gay men than I ever have before, and even though they ultimately fizzled out, I have never had that level of dating confidence in my life. It's so, so gender affirming when cis gay men are attracted to me. I always felt like I lost something, being a bisexual man who was too anxious about being trans to participate in any kind of gay male culture in NYC. This is by far the biggest gift my hysto gave me and I'm so happy for it.

[sithlich]

I did talk to my therapist about how frustrating and head scratching my hysto process has been (just to make sure I'm not making a mountain out of a molehill) and she was also like "this is literally so stupid I am so sorry we will figure this out." But it has made me consider contingency plans like. What if I can't get HRT again someday? What if my state makes it "illegal" to be transgender in public? What does it mean to be trans in a place where you cannot be?

If I had to legally be a "woman" I would still prefer being on HRT. I would still be extremely pleased with the results of my top surgery so unless they forced me to get breast augmentation I would be a woman with a flat chest. I would dress however I please unless I was legally mandated to wear something else under threat of death or violence or severe penalty. And even then, if a trans phobe says that I am "detransitioned," or that im not "really" a man, I would still be a person who prefers to be referred to with he/him pronouns, prefer to be called a man, prefer to wear men's dress shirts ties and Oxfords in the workplace, prefers to have facial hair, and participate in the social world as a man relating to my male friends. Some women share these characteristics and I'm proud to have this in common with them. But it does seem like serious denial of reality to say that I'm not a "real man," with all of those details included. The universe has tried its damnedest to beat this out of me and it simply has not worked. It is not the easy way to live, but my choices provide me with a sense of quiet, profound truth which cannot be changed no matter how I am tortured.

[tboyswagging]

Was not planning on being on T forever, when I started nearly a year and a half ago the long term plan was approx 5 years but now it's like, however long I can be on it before I HAVE to get a hysterectomy (I've seen ppl be on T between 5 and 15 years before they needed one). Bcs I really don't want a hysterectomy bcs I don't trust the supply of hormones and quality off trans healthcare to be okay w taking hormones my entire life bcs probably at some point I'd have to take estrogen (☹️) [disclaimer that this is just my opinion on my body each to their own] and I knew ur physical changes like fat redistribution changes back but all the men in my family are wide hipped so I thought as long as I'd got top surgery by then it wouldn't be toooo much of a problem but now I've heard MULTIPLE accounts of ppl saying all their other changes reverse when they go off T including their voice 😵😦 what the hell!! I am taking Topical Estrogen Cream so testosterone doesn't kill my uterus and I shouldn't need to get a hysto but I am sooo perturbed that these changes aren't gonna be permanent. Apparently ppl who've been on hormones for a longer time are more likely to keep their changes stay but ... man. I don't want my changes to reverse but I am a bit scared of the thought of having to be on hormones forever like I want to want to be on hormones forever not be required too raaah

[batsarebetterthanpeople]

To make it more plain I'll present an example. I'm a trans man who has been undergoing HRT for years. There are some trans men who have undergone top surgery. There are some trans men who have undergone Phalloplasty. A trans man who has undergone Phalloplasty, a trans man who has had top surgery, a trans man like me, and a cis woman are all CAFAB but none of us have the same sex at the present moment. Sex is an amalgamation of traits including: chromosomes, hormones, secondary sex characteristics (i.e. any naturally occuring trait that makes a cis perisex man and a cis perisex woman visually different without taking their clothes off), primary sex characteristics (genitals), reproductive organs, and gonads. You may have noticed two things about this list. The first is that only one of these traits are unchangeable (chromosomes), and that the one unmaleable trait is also the trait that 99% of people have never had tested and therefore don't actually know what they're working with.

My sex is different from a cis woman's because I have been on HRT a very long time. My hormones obviously are at exactly the same levels a cisgender man would have, but also that set of circumstances has impacted my primary and secondary sex characteristics, both of which are somewhere in between. I have one "female" secondary sex characteristic (my chest) but otherwise all of my other sscs are "male" (amount of body hair, deep voice, facial hair, body fat distribution). My primary sex characteristics have also changed. If you've ever been into the bowles of trans Tumblr you will have seen a lot of talk about the t dick. This is because testosterone will give you a micro penis. Fully three of those 5 categories I listed up top are inconsistent with what a cis woman's body looks like. More of my body is different than not. Any doctor that assumed things about me based on seeing AFAB on my chart would be wrong about things like my risk for heart disease, my risk for high blood pressure, my risk for breast and ovarian cancer (though I think cervical and utarine cancer effect pre op post t men the same). I have prostate tissue inside of my vagina, be serious I do not have the same sex as a cis woman.

Now a trans man who has undergone Phalloplasty has the same sex as a cis man despite the fact that he was assigned female at birth. Period end of sentence. I don't care if it's not politically correct to say. Facts don't care about your feelings. You can't ignore biological realities, and the biological reality of his body is that he has no internal sex organs because he got his uterus and ovaries taken out, but plenty of cis guys have gotten their prostates removed for medical reasons and have had vasectomies so, if that precludes you from being biologically male take it up with them. He has a fully functional penis, he has testicle implants, he has all "male" secondary sex characteristics, he has a male hormonal makeup. The only trace of female left that anyone can prove without complicated medical testing that might come out male anyway comes down to scar tissue. He is assigned female at birth but he doesn't have any of the body parts that implies and he is far more at risk for testicular cancer than he is for vaginal, cervical, uterine or ovarian cancer combined.

The same principal is true in reverse for trans women. A trans woman who has been on HRT has mostly female secondary sex characteristics and a female endocrine system. A trans woman who has undergone SRS is female, facts don't care about your feelings, her body is the same as a cis woman who has had a full hysterectomy, and I'm pretty sure they've done uterus transplants into cis women so it's really only a matter of time before that "with a hysto" stipulations gets removed.

And that's not even getting into intersex people. There's a million combinations of genitals, hormone levels, secondary sex characteristics, chromosomes, and gonads that are naturally occuring and a doctor has to look at them and sort them into one of two categories on an infant, without any idea what that infant will grow up to be like. Intersex people often get labeled as sexually disordered and written off as an abnormality that shouldn't be counted but they're a statistically significant portion of the population just like perisex trans people are and they're not "sexually disordered" they're a different sex from perisex cis women and perisex cis men, but they're almost always labeled with whatever one of those two categories that the doctor that delivered them thought was the most like what their genitals looked like. The medical establishment's refusal to accept a better system of categorizing sex is actively putting trans and intersex people at risk.

And there is a better system. When I go to the doctor's office they just use my same chart I've had since I was a baby, but when I go to planned parenthood, they give me a work sheet asking me what body parts I have at the present moment. There are resources for reporting your sex to a doctor that are more accurate than checking one of two boxes and the fact that I can only name one clinic that uses it is both intersexist and transphobic and it actively endangers everyone.

"AGAB is only relevant in medical contexts so-" NO.

The point of centering that it's ASSIGNED is to highlight that it's medically imprecise! The thing that is relevant in medical contexts is your actual biological status, anatomy and hormone levels included! Birth gender assignment is social!

It's not useful for deciding how to treat individuals in a medical or social context. For both of those you work off their current relevant traits, for which AGAB is necessarily a bad proxy in spaces with trans and intersex people!

The primary use of birth gender assignment is to understand how it influences societal forces affecting the person. AGAB is not "true biological sex but more progressive". You cannot create a conception of True Biological Sex that is progressive.

[vaspider]

OKAY so a bud asked me once about what the difference was between being a Trans Dude and being Transmasc and it hit me that I have no idea. Like Ik there's a difference and they're not the same thing but I'm also struggling to find a succinct explanation. Ik you've talked about it before but I can't find the post, can you help me out please?

A trans man is just that: a man who is trans. A transmasc is trans men, but also non-binary or genderfluid or multigender people who are transing their gender in a masculine way or fashion.

It's an "all squares are rectangles but not all rectangles are squares" thing. I'm not a trans man; I'm a non-binary transmasc butch. I'm not a woman, I'm not a man. I'm something else. My experience is similar to the experiences of trans men in many ways - I take T, I have considered top surgery and a hysto (decided against both, one for the time being and one permanently), i have sought surgical confirmation of my gender via a bilateral salpingectomy, but I'm not a man.

I'll never pass as a man, and I don't want to.

So the company of transmascs, including trans men, is where I find gender solidarity. But. And again I repeat. I'm not a man, and people using trans man and transmasc as if they're interchangeable are either misgendering me or they're misgendering trans men.

[otteradmirer]

It’s all been done. You’ve had top surgery, you’ve had your hysto, you’ve had your body contoured, and now you finally have a cock and balls. But still, something doesn’t feel right.

In the mirror you can see yourself. You’re handsome but you look…average. You have muscle and some fat. You pinch some of your belly. Maybe..it’s time to experiment.

You make it a goal to gain ten pounds. Just ten pounds in one month. You don’t change much about your eating habits except you eat more. Breakfast becomes a bagel with cream cheese and a danish, you make your orders large for lunch, and dinner becomes a feast (with desert included). It’s no wonder that instead of ten pounds you gain 20, even when you workout every day.

The twenty pounds makes everything tight. You’re developing a pot belly. Your arms are bigger and your ass is fatter. You look like an ex-jock.

The sex is better too. You jiggle with every thrust and the way fat in fat feels is enough to make you cum. You decide to add more.

You keep eating like your life depends on it. You’ve heard somewhere that eating whatever the fuck you want and working out is a recipe to getting big faster. It’s working.

You blow up every month. Your pot belly becomes a form but highly gut that hangs over your crotch. Your thighs become thick with muscle and fat. Your arms are gigantic; a soft padding of adipose covers your huge muscles. Your as is huge and firm. And once again the sex is better than ever.

By the end of the year you’re in the high 300s. You can barely fit on most chairs, you take up half the couch, and everything is tight again. That’s enough to get you so horny. You stuff an eclair in your face as you stroke you dick from under your gut. Soon you might have to resort to asking for help or getting a vibrator.

[transgenderteensurvivalguide]

sorry if this is out of your scope but i was wondering if you had advice to make researching surgeons (peri if that makes a difference) less intimidating for someone with adhd/asd? there's so much information and i get overwhelmed so easily that i just end up staring at the screen =( maybe there's an easier way to go about it? sorry for the trouble ;;

Lee says:

I also have ADHD & ASD!

First, you gotta get organized. Make a spreadsheet in Google Sheets or Excel or a folder on your computer or something to keep track of your surgeon search. As you go along, fill in the surgeon’s name, their address, their office’s contact window, whether they take your insurance, etc, and include a column for your impressions on their results from your interaction with the trans community and a column for your notes from your consult. In another tab, keep track of your insurance company stuff— who you’ve talked to, their callback number, what they said, what date you spoke to them, etc.

After the prep work in getting your notes ready, I’d recommend starting with your insurance company because only certain surgeons will be in-network with your plan.

It’s possible to have surgery with an out-of-network surgeon, but it’ll likely be more expensive unless you can get an exemption to have an out-of-network provider covered at in-network rates because the in-network providers aren’t able to do the procedure you need or have undesirable results, etc, but going down that path is a lot of hassle so I would only look into it if you’re unsatisfied with your in-network options.

Usually the list of plastic surgeons who provide top surgery for trans folks and are in-network with your insurance plan isn’t very long.

Depending on your particular insurance plan and where you’re located, you could have a list of around 1 to 15 options, but usually it’s around 3-7 folks.

When you figure out which surgeons are in-network, contact their office and ask them if they are experienced in performing periarolar chest masculinization top surgery for transgender patients. Then re-confirm that they accept your insurance, and ask about their policy for revisions.

If the surgeon’s office says yup, they offer that procedure, then pivot your focus to look at whether they have good reviews from folks in the trans community.

I’d start with looking for people’s posts about their experiences with that surgeon on the Reddit top surgery forum, the Top Surgery Removal/Reduction Facebook group, and TransBucket.

Then move to asking trans folks in your area IRL. You’re probably not the only trans person in your area so try and network and find your local trans folks! Support groups and LGBTQ organizations might be good options to start with.

I found out about the surgeon who did my hysto from a trans guy I met at a support group who had his hysto recently with the surgeon.

You could also ask your primary care provider and/or your testosterone prescriber if you’re on T because there’s a chance they have had trans patients before and know which surgeons are good.

There are plenty of local surgeons at local hospitals that don’t have big social media presences and don’t market themselves to the trans community but take insurance and do a lot of top surge for folks in the area.

If you’re lucky, you’ll find a surgeon or two who does the procedure you’re looking for, provides good aftercare, has a good rep in the community having good results and not being sketchy, and accepts your insurance.

Then you can get a referral from your primary care provider if you need one for insurance reasons, bring your WPATH-SOC compliant letters, and schedule a consultation with both of your two good options. That way you can compare what they tell you and make sure you have a second opinion on the matter.

If both are genuinely equally good and you felt equally comfortable with both, choose whichever surgeon is closest to you because not having to travel will save you money and time.

Our top surgery page has more info on finding a surgeon.

[scorchedcandy]

Gender - trans man he/him Sexuality - gay Age - 26 Race - Dunmer Religious Affiliation - Azura (I'm an enjoyer of Azura's sphere including transitional periods including trans people), Mannimarco (admiration, necromancer), Hermaeus Mora ( hesitant admiration, drive for knowledge), Sotha Sil (admiration, knowledge)

He is a mage who specializes in Conjuration and Destruction, but dabbles in everything. He is a necromancer, too. Despite this he tries not to use necromancy magic on anyone undeserving of it. He doesn’t believe that any magic or knowledge should be off limits. He wants to learn everything he can about anything, but especially anything to do with magic. He also works with alchemy. Neloth is a huge role model for him. He prefers to stay at a distance with his magic, but when he’s running low on magicka or feeling it, he does have his mace. In addition to Neloth, he enjoys studying and learning about Mannimarco and Dagoth Ur (after he got over his childhood fear of his creatures) and their magical pursuits. His face paint is a nod to Mannimarco (red, wormlike) while being subtle. Sotha Sil is also an inspirational subject of magical study.

He grew up in Blacklight in Morrowind with very strict Redoran parents. They don’t really approve of his magical pursuits, because they feel that magic outside of combat is for taking the easy way out of things and is a sign of laziness or an inability to work with his hands. He left home without informing them, or his older brother or twin sister, and has been traveling Skyrim since. His bandages are practical but they also conceal a self-made Sign of Expulsion on his right hand, created when he ran off as an act of personal rebellion. He wants to learn in the College of Winterhold, seeing as it does not restrict necromancy as harshly, and overall he wants to learn via traveling.

He is reserved and collected. Smiles and laughs are rare, as he is very internal. He mostly keeps to himself, and he likes it that way. Despite his parents’ lessons, he does not do very well in highly social situations. He doesn’t shy away from snark and cutting remarks to those who deserve it. His humor is dry. He keeps journals to document his journey and his various studies. He is sleep-deprived because of these studies. Essentially, he will forget to eat and won’t sleep until he crashes, because he gets so absorbed in his work. He uses tea and incense from home to soothe himself, and just because he enjoys them. He is also a very clean person and doesn’t like much physical contact until he’s very comfortable with a person. Part of this is because of his fear of illness (nosophobia) stemming from him looking into books on the Blight and Dagoth Ur’s work a little too young.

I feel like he handled top surgery and hysto with magic on his own or with the guidance of experienced mages. He doesn’t have very visible top surgery scars. If there are any marks, they would probably be closer to keyhole.

[krovav]

07•07•16💉// 06•18•18 🔪

5 years on Testosterone // 3 years post-top

----

[he/him] | Instagram

Ok, full disclosure, it feels so bizarre to be at this point in my transition. It took me a while to get HRT, and even shortly before I started testosterone, I was half-convinced I would never manage to get to even 1 month, let alone 5 years.

I figured I would take some selfies with facial hair for this milestone because I hardly ever show any of the hair growth I got from T—largely because I'm not a fan of it, but I think these came out nicely.

[CW: dysphoria, suicide ment. etc from this point on]

Transitioning has been a bit of a rollercoaster, but definitely one of the best decisions I've made in my life. While I still have my struggles, I have never been more at home in my own form than I am now.

Lately I've been thinking a lot about my identity, and some of the final puzzle pieces of "self" have been falling into place. I have always been a very feminine person; I do not fit the mold of trans guy who did all the "boy" things as a child. I was stone-cold serious about my dolls, I regularly got mani-pedis, I wore dresses and heels as if they were a second skin.

That changed dramatically when I hit puberty and the dysphoria (tm) started to set in, and suddenly I was overcompensating with hypermasculinity. Masculinity was my armor, the only thing keeping away the suicidal storm cloud invading my brain at all times. I didn't care if I hated how I looked if it meant that a cashier every so often would call me "sir".

But that was the most stifled time of my entire life. Not only was I lacking the knowledge that trans people existed and so also lacking the ability to define my own experiences, I was in turmoil over the clash of my interests and my need to feel "like a man". Sexism is a hell of a drug.

I've been working for years to shake off the chains placed on my self-expression by society's definition of being a man. I would tell myself that, sure, I wanted to do x thing, but if I do that, I'll never pass. And, sure, T and top surgery would magically make it so that I always pass, as long as I follow all these strict rules and never enjoy my life ever again. Passing is very much presented as the end-all-be-all to transitioning, so it's understandable that many trans people, myself included, have little set as a higher priority than being the "most" of their given gender.

But the reality of my transition has been that I don't always pass, even when I'm performing masculinity to the nth degree, because everyone (particularly uninformed cis people) has their own idea of what women and men are "supposed" to look like. And for a while that really plagued me. I was so happy and fulfilled with the changes I was seeing, I felt so much less dysphoric, so why were other people still seeing me as female? And that would push me further into feeling the need to be masculine, and over and over again I would just have it confirmed that I needed to work harder to be seen as a guy. That the dysphoria I was going through was somehow my fault for not working hard enough to pass.

What I've realized over the course of a year or so has been that it isn't and has never been my job to validate my identity to other people. If I'm making myself happy, if I'm relieving my own dysphoria, it does not in any way matter that some random person at the grocery store thought my long hair equaled girl, or that I get stared at in public restrooms, or that other people find it awkward when they get my pronouns wrong.

It is my job to take care of myself. It is my job to wear things that make me feel good about myself, either because they are simply comfortable or because I love the way they look. It is my job to make myself happy.

It is my job to learn to cope with my dysphoria in whatever way works for me, and to never let someone who doesn't even know me dictate who I should be to be valid as a man. I know who I am, and I always will.

Anyway, if you want to throw some spare change my way, it would greatly help me achieve my next transitional step (getting a hysto). I will link some payment options below, but even if not, interacting with my posts helps too.

https://ko-fi.com/nekromancy

https://venmo.com/krovav

https://cash.app/$Krovav

[audacityofhugefics]

Hysto journal #2

Long overdue for this, but as I’m sitting here watching this egregious, horrific stuff going down in Kyiv I thought, “Why not pull my mental real estate away from this and focus on something a little less rage-inducing.” And I do mean A LITTLE. The hysto is indeed ALSO causing me rage. But we’ll get to that.

First I guess I should talk a little bit about what all went down with the surgery. My dad went with me to the hospital. I love my dad more than I can ever really adequately express. I mentioned in my last post that I found my old journal and that I could see how my grief colored a lot of my personality, and my relationship with my dad is a really good reflection of that. I was an absolute monster to my dad after my mom died. He could never do anything right, as far as I was concerned. I thought of him as this old, bumbling idiot. With the wisdom of hindsight I can see that this was related to grief. I missed my mother. I wanted my mother, and he was not my mother. And that was a PROBLEM. So I lashed out. Irrationally, emotionally, and illogically. 

This was on my mind when we went to the hospital on the morning of my hysto, because he was taking a day off work to support me in my voluntary sterilization (even though I know he would LOVE biological grandkids), and is willing to help me with this whole phallo thing later in the year. So I apologized to him about how mean I was as a teenager, just in case I died on the operating table. He said that all his kids have been mean to him over the years, and he’s used to it, and he doesn’t hold it against us. But still, I’m real fuckin’ sorry about it. The dude is my fucking hero. I would never be so mean to him now.

But I digress. We arrived at the hospital and were very quickly separated so I could prep for surgery. They made me take a damn pregnancy test. LOL. As an ace forever alone asshole, that amused me. I’m not exactly sure how long it’s been since I’ve had sex with a biological male, but it’s definitely double digits. But protocol is protocol. I told the nurse, “Even if I am pregnant somehow, go ahead and take the uterus anyway.”

Next I had to get naked and cozied up on the stretcher after wiping off with some pre-surgical wipes. They put in my IV and, weirdly, gave me a whole bunch of drugs to swallow orally, including some narcotics. They said it was to help the pain when I woke up, which, like.... Sure. But the other effect was that I was completely blissed out by the time all these people involved with the surgery came by to meet the person they were cutting open. I was cracking jokes and making everyone laugh. They put that shower cap on me and I was like “Oh I think I saw this on Project Runway.”

I had been waffling back and forth on whether or not to keep one my ovaries. Taking both out essentially means that I have no risk for cancer or cysts down there, but I am committing to taking hormones for the rest of my life, because bad things happen when there are no hormones in the human body. I told the doc I wanted both out just so I’d never have to think about it again, and I do intend to continue with testosterone until I eventually die in a motorcycle crash. So who cares. But a part of me was like, “What if you get old?” But you know what? Fuck it. Taking them out will keep me accountable. And they have those nifty T pellets now, maybe in another five years those will be more readily available and I can get those put in for E-Z hormones. So when the doc came by before the surgery I said, “OK we’re good, get these things out of me.”

Anyway. I went under, they did the thing, and I woke up. I had a lot of nausea after I woke up, way more than I remember having after my top surgery in 2007, or when I had my wisdom teeth taken out, which are the only other times I’ve ever gone under general anesthesia. I didn’t have a lot of pain, I just felt nauseous and tired and bloated from the gas they inject so they can maneuver in your abdomen. But pretty much as soon as I woke up I was slurring jokes to the nurses, although sadly I cannot remember what I said. They had one nurse who watched you while you were still in that phase where you can’t quite stay awake, and then another who takes over when you can sit upright in a recliner. The sleepy-time nurse was sad to see me go, I could tell. I can’t even remember her damn name, but she was very kind and always seemed to be around whenever I needed something. 

The next nurse also loved me, although I think she was annoyed when I banished her from the bathroom when I tried to pee. I was like “I have trouble peeing under the best of circumstances.” Which is true. I’m not a good pee-er. Peeing is actually one of my main and only sources of gender dysphoria. I don’t like having to sit to pee. Unfortunately, peeing is like the entire focus of the recovery room after anesthesia, because they need to make sure you can do it before you can leave. I was able to get a few drops out, but then I started to REALLY feel like I needed to barf so I pulled the cord and they brought me back to the recliner. I had the barf tray in front of my mouth, that’s how close I was to barfing, but then the nurse waved this PEPPERMINT STICK thing in front of my NOSE and I NO LONGER HAD TO BARF. Has anyone else ever heard of this before??? It was a fucking miracle!! All urge to barf, gone immediately. I’m keeping some of those peppermint things in my bathroom from now on.

I should mention that by this point my dad had been sitting out in the waiting room for about 8 hours. Which is WAY longer than I thought we’d be there. It was all my fault, the nurses thought I was ready to go but I was so worried about not being able to pee. I was apologizing to my dad over text and to the nurses constantly, and they were all like “Dude literally shut up.” In a nice way of course, but still. Heartwarming.

This hospital where I had the hysto is working on getting a whole trans health program up and running, and I believe I was possibly the very first trans patient this OBGYN (who will be associated with the program) had done a hysto for. Eventually this facility will be doing other surgeries for trans patients too, like phalloplasty and vaginoplasty, which is rad. Unfortunately they won’t be offering the type of phallo I’m looking for (which is abdominal), but it’s nice to know there are doctors literally right down the road from me that are offering the other kinds (RFF and ALT) if I change my mind. All the nurses know that this is something that’s being set up for their hospital and they were very curious to hear about phallo in general. I ended up being the last patient in the unit for the night, so the nurse spent a long time chatting with me about it until I felt ready to go. She wheeled me downstairs, asked if she could give me a hug, and then my dad took me to his house.

I don’t live with my parents anymore but I stayed with them for the first few days. I was up and walking pretty much immediately. Really, I felt fine. The worst part was the gas, just like everyone says. It basically felt like I always needed to fart, but I could never, EVER fart. Farting would have involved strain, and strain hurt. Luckily that phase passed after a few days and basically as soon as I was pooping again, I was ready to go home. So my dad took me back to my apartment and I’ve been here ever since.

On the Friday after the surgery “Horizon: Forbidden West” came out, so I basically played that every waking moment. In case you’re curious, I liked it but I had some big issues with it. Where are the cubes on the minimap that point you to datapoints??? Why do I have to scroll through so many damn things to find my potions??? Where’s the whistle command??? But I loved the story a LOT. Overall, 7/10.

Now let’s talk about the infuriating part: The insurance is denying all my claims!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! You have to understand, I work in medical insurance. I know how this works. I know how the game is played. I KNOW these services are covered. I KNOW the insurance company is making a mistake in my benefits administration. But it doesn’t make it any less stressful. I called them a few times trying to get a straight answer about why these things were being denied, finally I talked to a supervisor (who was also trans!) who confirmed that they are being denied because the diagnosis (F64.9 if you’re curious) is excluded. So this is not something I can fix by calling the insurance anymore. I went right to HR. So the benefits team at my HR department is looking in to it as an urgent matter, considering they’re going to end up denying about $40,000 worth of eligible expenses for me.

I’m trying not to be worried about it. If anyone is equipped with the tools to fix this, it’s me. But if HR comes back and says the claims are denied correctly, I don’t know what I’m going to do. I wouldn’t trust them with my phallo, that’s for sure. Most likely I’d go looking for another job. Shit, maybe I’ll go back to Starbucks. They definitely cover phallo.

The thing is, “Transgender surgery” is SPECIFICALLY listed as a covered benefit. I think what the insurance company wants is for the providers to bill with the diagnosis F64.0 instead of F64.9, and if that’s the problem then that means I have to wait to be billed by ALL these providers so I can call their billing department and ask for supervisors until I can find someone who understand that they need to change the diagnosis codes on their claims. It would be ridiculously time consuming and difficult, for essentially no reason. Here’s what these codes stand for:

F64.0: Transsexualism F64.9: Gender identity disorder, unspecified

Excuse me, WHAT? Are you trying to say that gender identity disorder is not a valid reason to have transgender surgery? Do I need to call the insurance company and explain that the nomenclature of the word “transsexual” is steeped in history and debate among the trans community and there’s nothing that makes it more valid or medically legitimate than “gender identity disorder,” and that to claim otherwise is disingenuous? Am I supposed to call up an outsourced customer service department in India and say “Your insurance company is truscum?”

Anyway, I’ve rambled long enough. 

TL;DR: The hysto was very easy, but now my insurance company is being a butthead.

[buildingadrian]

Im 3 days post op top and hysto. I feel good overall. Today im more sore than i have been but thats to be expected for day 3. But seriously if youre near indiana and need either of these surgeries the entire eskenazi hospital team is phenomenal. Dr locke (ob) specializes in trans care so she is amazing. Dr hadad (top) is so kind and has amazing results. Both doctors truly listen to your needs and plans for everything without judgement. Every person i encountered on surgery day was so nice, including the nurses. You meet basically everyone thats going to be in the OR before you go in. Literally the last thing i remember is the anesthesia team listening to good for you by olivia rodrigo and then hours later im in recovery with a super nice guy. He kept getting me drinks and making sure i was okay and even helped me find all my incisions from the hysto lol. And he didnt bat an eye when i bled on the bed (didnt have a pad on post op because im allergic to normal ones so i brought cloth ones). Im bruised from lipo but the pain hasnt been bad. Ive only needed the oxycodone once since coming home and thats because my alarm for.more tylenol scared me so i tensed up and that hurt really bad

[sirchubbybunny]

Shout out to the person I talked to at the clinic for giving me a great list of resources for surgeons that I can look into.

I'm glad to know there's a good dude I can look into if I opt to go to Philly for a hysto and he takes my insurance, which is even better. They also said I could see about getting in touch with their legal team about possibly disputing the shitty insurance denial I had for top surgery, so if I can get that to work out, that would slap. They included other surgeons who might take my insurance, but I don't know if I want to get my hopes up if things don't work out.

So, now it's a matter of seeing if it's a good idea to try and book an appointment with him and possibly get seen before the year is one. I think he does telehealth calls, so that would be really cool if I can do something remotely before I get on a bus to head down. It just sucks that I'm coming up on a year since my top surgery consultation and I've been stuck in the mud.

[tmitransitioning]

I thought you said it's best if doctors know what you're taking and whats in your body to diagnose you properly. Wouldn't that be the same for deciding how insurance (or workers comp) work yet you didn't want to disclose you didn't have a scrotum. But that also means they will not cover 'female' medical issues that actually could occur.

it’s not right that insurance won’t cover “female” medical issues if your gender marker is changed: it’s just that it’s difficult for them to process it because our bodies don’t fit neatly into the boxes they’ve designed (uterus surgery, check.  delete this option if client has an M designation.  wait, this client needs a uterus surgery, does not compute).  When one of us needs surgery or another type of procedure, we have to fight for it (not even write appeals, but use logic pointing out that it’s a covered procedure on a covered human regardless of the gender marker). 

To speak to the other half of your question: I was going for a pre-employment physical.  I’ve had to have doctors check out my genitals many times for many various types of conditions (kidney stones, for example)- but “let's check you for a hernia type that only cis men can get” - which was making it clear to me that they were offering me this job assuming that I was cis, and that if i were to fail this physical i could have the job offer rescinded- and there was absolutely no reason to offer up my genitals for a hernia check that i couldn’t possibly have (there would be no possibility of me having this type of hernia in the future so no risk to me if i accepted the job and did not have a lack of the hernia documented)-- it could only potentially harm my chances of being allowed to progress in the job process.  It wasn’t a matter of “being properly diagnosed” but retaining body agency and avoiding discrimination.  And as i’ve talked about before: i will never tell you not to disclose things to your professionals-  i’ll only tell you why it’s a good idea to and talk about how i decide WHEN to. 

The difference between choosing not to disclose this to a strange pre-employment doctor and not telling them about hormones is: hormones can interact with medications (including anesthesia etc).  While I think it’s a good idea to form a relationship where you feel safe disclosing your history to your providers, I’m much more likely to encourage you to disclose HRT use than I am to fully disclose surgeries with new/unfamiliar doctors (that are not as likely to affect treatment- except on a case-by-case basis).  Times when I really think it’s important is times when the affected body part is involved (chest issues/top surgery; abdominal issues or genital and hysto/oophorectomy or vaginoplasty; genital or urinary issues and genital or urinary surgeries

I hope i was able to help clarify the different situations presented in your ask? 

mod mayhem

[thesoupoftheafternoon]

6.5ish years T, 5.5ish years post top

Updating because of a surprise revelation regarding my dose & how it relates to my mental health. Also because I haven't posted on this for two years!

First off, general changes. Dose stuff at the end. (TL;DR dose stuff--by accident I lowered my dose by .1 mL and despite never having felt much of a difference mood-wise from changing my dose before, I feel fucking great and actually happy for the first time in a while! Surprise, your levels should also take into account your age and you shouldn't use the same reference range for the whole time you're on T!)

Under cut--this is mad long. [And cw for mental health talk including v mild suicide ideation, also alcohol/drugs]

T stuff:

I posted pretty much the same thing last time, but I'll reiterate that the vast majority of these changes are basically subtle things that no one else notices and that probably have more to do with just getting older/diet/exercise than being on T. My facial hair range is exactly the same as it was two years ago (literally just ‘stache and chin directly below the mouth) which checks out based on my dad/my entire family. I shave about once a week. Happy trail a little bit happier, lil more arm hair, lil more leg hair. Haven't been checking super closely but I think I have more hair around my butthole. Dick size is the same. Appetite has dropped a bunch--I can't scarf down food the way I used to. I’m read as male all the time, haven’t been misgendered based on my appearance since like 2013. 120-125ish pounds.

Chest stuff: (I had keyhole btw)

Nipple sensation is back, I repeat, nipple sensation is BACK! They're healthy and super perky, which I used to be kinda insecure about since they stick out a bit, but also like, who gives a shit? I would say they feel about 90% as sensitive as they were before surgery, and after a bit of touching they do start feeling a little less sensitive, but they never go completely numb. I'd say they've been at this level of sensation since early 2017. Left nipple is more sensitive than my right. My right nipple used to kinda bulge outward on the bottom but I guess the scar tissue has broken down somewhat since it's lying a lot flatter these days. The numb chest patches are smaller and way less numb and it takes less pressure for them to register touch. Drain scars look kinda like bug bite scars. Under-areola scars are very hidden, basically invisible. 

Lower surgery??

It’s on my mind but it’s always been a little on my mind. It’s not a priority. A hysto/oopho may be in order someday. But I’ve been thinking about what I want my junk to look like and be like as I get older, and whether my current setup and how I relate to it is going to be sustainable. I genuinely don’t know whether I would rather get metoidioplasty or phalloplasty. There’s a lot more thinking to be done. 

Dose stuff: 

I started T in 2012 with .5 injections every other week. With 200 mg/mL that averages out to 50 mg of T per week, although I'm sure my levels were different from someone on a weekly schedule. Around the 2.5 year mark my bloodwork came back saying I had super low T. I upped my dose to .5 every week, so 100 mg/week (which is famously a pretty common dose, there's even some trans merch company called .5cc.) Over the next year or two (I really don't remember exactly when) my bloodwork showed me now at very high T levels, nearly and in some cases exceeding the upper threshold of my doctors' reference ranges, so I lowered my dose to .4 and then to .3 mL/week, or 80 and then 60 mg/week. Of course I worried about T aromatizing into E, but my doctor at the time didn't test my blood for estradiol until I had already reduced my dose down to .4, and said my E levels were fine (I don't remember the exact number.) 

Even at 60 mg/week my T levels were still high. I and my doctors chalked it up to the fact that I work out a lot and/or maybe my body was just like that The general consensus was that "if your period isn't coming back, your E levels are fine," usually followed with some question like “how are you feeling on this dose?” or “are you feeling good?”

And what I kinda knew then then, but what’s even clearer to me now, is that I HAD NO FUCKING IDEA. My I-guess-it’s-anxiety, my on-and-off idk-if-it's-depression, my garbage sleep cycle, my self-doubt and second-guessing and skewed perspectives, have all been around in some form or another, so it's very hard for me to parse out what I'm even Really Feeling sometimes, never mind what might be causing that feeling. For the last several years if I felt bad I would usually conclude one of the following:

I feel bad because I’m actually a shitty person and feeling bad is natural for how bad and awful a person I am.

I feel bad because the world is fucked and society is crumbling and feeling bad is natural for how literally everything we love will be swallowed by the sea and/or be salted and burned in worldwide conflict.

Which is obviously not conducive to trying to figure out any other external factors or triggers for my shitty mental health!!

Plus it’s not like I was exactly excited to have less testosterone in my body. I was genuinely nervous that lowering my dose lower than .3 a week would just be an experiment that wouldn’t do anything except make me less buff and maybe even bring back my period. And I’d always been a little skeptical about the extent of hormonal effects on mood. T certainly affected my mood positively when I started, that was an obvious cause/effect, but I figured (and still do think) that had SO much more to do with finally being seen as a guy and having a masculine body than any sort of direct T-on-brain action. I did notice some increased irritability, but it wasn't much, and also I was still 16 lol. I noticed changes over the course of months or years--never within the course of a week. I can’t relate at all to folks who talk about spikes or troughs in their levels or getting a rush or feeling low based on where they were in their shot cycle. So I'd always tell doctors that I felt fine on whatever dose I was on because, well...I guess I felt fine!!

For the last several months--maybe the last year and a half, tbh--my mental health has been pretty bad. Over the course of any given day, the things I felt were generally limited to annoyance, panic, self-pity, drunk, stoned, and horny, and usually in that order. And that's a relative statement, because I'm pretty functional and haven't ever hit clinical levels of whatever, have always been able to find enjoyment in some things and get endorphins from exercise and complete necessary tasks on time, but hey, if you're reading this and feel like it's normal to constantly have "I hate myself, I fucking suck, why don't I just die" churning around in your head even if you're "not going to act on it," or that it's normal to drink and smoke weed until you basically pass out 6 days out of 7, or that it's normal to feel convinced every bit of positive affirmation you're getting is out of pity, Honey You've Got A Big Storm Coming. Like, again, considering how shit awful our current sociopolitical climate (and also the literal Earth's climate) are, it's no surprise I felt these were understandable feelings, and like, I guess they kind of were? But just because a feeling is understandable doesn't mean it's a good thing that I'm having it. Which seems remarkably obvious in hindsight!

Anyway, about a month ago I underestimated how much was left in my vial and had to do a .2 mL shot instead of .3. That's 40 mg for that week: even lower of a dose than when I started T. As the week went on I noticed I actually felt consistently happy: not just "someone's giving me attention," not just "nihilistic fun," not just "I guess the things I'm looking at right now are pretty," but actually satisfied, content, grounded, having emotions that felt like they came FROM ME. 

And since I’m always one to consider alternative explanations, there’s plenty of other factors that might have led to this improved mood. When I lowered my dose, I had just gotten accepted to two new jobs. I’d met up with friends I hadn’t seen in a while. But it’s not as though before I lowered my dose I never felt happy. It just never stuck around. These days I’m able to retain a positive emotion beyond the precipitating event and not just have the same boring self-hating thoughts over and over again. Which is huge!! I feel like I’ve really broken the thought cycle that’s defined much of my thinking for the last few years. So many of my emotions have been about my emotions, and a big part of why I felt so awful was feeling so helpless against these thoughts, and understanding completely deep down that it was irrational, that it really didn’t make any sense for me to feel this awful. That of course tapped horribly into my endless guilt complex and fed it and it just went on and on. 

I haven’t gotten my levels tested again yet--that’ll happen later this month. (My doctor knows and is cool with this reduced dose.) I’m especially interested to see where my estradiol will be at. My T will probably be more reasonable for someone my age--I feel like my crazy 1000+ ng/dL T levels were okay when I was like 19-20 but now that I’m a whole 23 years old (yo!!!) it makes sense they should be a little lower. I’m not a doctor, though--but then again, real ass certified doctors have made hashes of my medical care in the past, so I’m comfortable trusting myself a little on this one. 

General life update and thoughts on being trans in this world:

I’m much more relaxed and much more okay with being trans these days. Comes with being a lot more sure about myself and who I am, which is a continuous process and one that was happening even before I lowered my dose and was suddenly way less depressed. While I still get hives at the thought of anyone outing me without my permission, I’m a lot more comfortable outing myself to people, even large groups of people, even folks who I might not really know. I’ve come to appreciate the parts of me that are definitely and absolutely because I am trans or that reveal I am trans, and the connections I can make with people by sharing those parts of me.

I’m not sure I’d say I have a career at this point, but definitely most of the work I’m doing these days is in social justice, non-profit, LGBTQ-related, activist work. My resume more or less outs me as at the very least a deeply committed trans ally, lol. I think growing up and realizing I was trans I hated the thought that it would define who I was and what I did. I didn’t want to touch activism or trans spaces in general with a trillion-foot pole. 

I’ve since gotten over myself and like...let myself enjoy things, I guess? I really do find nonprofit work super rewarding and I finally admitted to myself I fucking love chilling with other trans people and talking about trans shit and that I do love, if not the fact that I And My Body Am Trans, the existence of community and the thoughts and ideas that we share. And a lot of the time I do like my body. And I’m kinda ready for this newfound happiness to stop feeling so fresh and exciting, because I know it’s a bit weird and inappropriate to be talking about how happy I am that I feel great when, again, The World’s Some Shit Right Now. 

But I think in general--not just about being trans--I’m letting myself feel the happiness that I have, with so much less guilt and shame. I always knew intellectually but am finally putting into practice the fact that simply denying myself happiness or feeling bad that I feel happy doesn’t bring happiness to folks who don’t have it. 

that’s it for now !