Pondering Existence

For the past few years I've felt like my mind is right on the verge of a lightbulb moment regarding my perception of the universe. 

Every time I feel I am about to have that lightbulb moment I have had an immediate existential anxiety response and I have to derail my train of thought before I go into a frantic panic attack.

It felt almost like this is something my brain is not meant to think about. Like there's some kind of implicit limitation in my wiring to block this concept I am so curious about.

But recently concepts I've been pondering for over two decades feel like they're starting to form. Science and spirituality are not antagonistic, but rather I believe they are different ways of seeing and explaining the same things.

And thus begins my rant about morality and the human condition...

Our opinions about what is and is not life are so misguided with bias. Who are we to define what is and is not alive when we are so small and insignificant ourselves? We struggle with our tiny self-created problems while so much outside of humanity has already advanced to a level of self-sustainment we barely understand, and yet we believe ourselves to be on some higher level.

We strive for some kind of greatness, never allowing ourselves to be content with where we are. We believe so many things drive us toward progress, when really our insatiable greed drives us toward our own ruin.

Which form of life is truly superior? Why does any form of life need to be superior? What does it even mean to be "superior?" Ultimately all these questions are meaningless - rather than trying to categorize and arrange things in some hierarchy we could simply be existing alongside everything, not believing any of it better or worse than anything else.

The belief that we can exist without harming anything is also pointless, as our very species by nature consumes to exist. Who's to say whether it is morally superior to eat animals or plants? They are all living beings, so we are killing no matter what we do. If it must be done, we could argue it's not what we're eating that makes it morally correct, but rather the act of not letting any of it go to waste. If we have to kill to survive, the least we could do is respect the life that was lost for our benefit, and share what we don't use with those who would use it.

What do we imagine when we think of sharing our scraps with others? Handouts to people on the street? Soup kitchens? Food bank donations? Delivering leftovers to our neighbors? Feeding scraps to the dog? Or the chickens? Throwing scraps out into the woods? Composting? Burying food scraps in a garden?

We see ourselves as so disconnected from the rest of the life on this planet, and we arrange our civilizations in such a way that encourages this mentality. But for what? What exactly are we trying to achieve? What is the goal we are setting for our purposes in life?

If our perspective controls how we respond to things, then all of life is what we make of it through our own perception. It is not some mysterious question that needs to be pondered for a lifetime. It simply is. How we see and respond to it is up to us, and what comes after it doesn't matter enough to ignore what's right in front of our faces. 

This life is an opportunity. This is a beautiful gift we are given for a limited time, and we are using it in such a wildly bizarre way. Building shopping malls, obsessing over appearance, stepping on each other to gain currency that only has value because we say it does. Devoting the vast majority of our entire lives to the acquisition of an imaginary wealth, just so we can experience what life we have left in a form of superficial comfort. 

And then, only in our later years do many of us realize, now that we have the spare time in retirement to just live and experience our lives, how fast it all went by. How often we were disassociating, on autopilot, not actually experiencing this gift we have been given. How many regrets we may have, how many people we stepped on, how many times we ignored people who needed help. How many times our pleas for help were ignored, the same way we ignored others'. So often do we only realize our mistakes once they affect us directly.

Our purpose and legacy in this existence is crafted by our own actions. We are capable of independent thought; it is just a matter of using it. So many of these answers are right in front of our faces, and yet we continue asking why, as though something put us here for some reason other than to exist. We are so desperate to avoid using this independent thought we are given, so afraid of the perceived responsibility, but what if it was the very meaning behind our existence? Or what if the very system that encourages individualism and "everyone for themself" is the temptation so many religions warn to avoid?

All of these issues, every one of them, is unnecessary - artificial - fabricated by our own selves. We are at a point on this Earth where we can have nothing to fear. And yet we are so deeply terrified at the very thought of not being afraid of something that we invent things to be afraid of. This very nature within ourselves has generated a culture of many fears, nearly all of which are imposed by our own species.

But again, we are so wrapped up in all of this, despite the fact none of it will matter whatsoever in the end. We believe it to be so important, and yet it is all meaningless in the face of changes we cannot prevent. We are so limited in scope that we only see in 3 dimensions, yet our only thought is to try and expand past our limited sight, rather than to simply enjoy what we have, where we are, right now.

Right now is forever.

All of time is now. If we cannot live in the now, then we will not have lived for all time. 

If we cannot be true to ourselves, then can we be true to anyone?

If we refuse to contribute to making this a better place to live, can we truly acknowledge or accept that we are partly responsible for so much unhappiness, including our own?

Practically every single religion and spiritual belief we have ever developed has this one rule in common: 

"Treat others how you would want to be treated."

It's such a simple concept, and everybody knows it. I can't think of anyone I've ever met who hasn't been told about this "golden rule."

But how many of us are really practicing it?

How many of us ever think about it in our daily lives?

How many of us believe it is actually something worth pondering?

I'll tell you how I would like to be treated:

I would want people to listen to me.

I would want people to truly see me, rather than the picture of me they painted themselves.

I would want people to try to understand me.

I would want people to treat me with kindness by default, unless I have given them reason to do otherwise.

If I hurt someone, I would want them to ask why, rather than immediately hurting me back.

This sounds nice, right? Does it sound hard to do? If so, why? That may be an important question to ask. The answer may be relevant to your own feelings of purpose in this life.

What if this golden rule, shared by all, is the meaning of life we so desperately seek?

What if truly trying to understand each other is the answer to the big question we ask ourselves?

I know you've likely heard speeches like this one before. But you know what? I think it's worth saying again, even if we're conditioned to forget it within a few hours.

Because I believe in this golden rule. I believe that if you read this far, you listened to me. And that means something to me. In return, I will listen to you. I will see you. I will try to understand you. I will show you kindness. I will give you benefit of the doubt.

You will have every opportunity to be your best self in my presence without judgement. Whether you take that opportunity is up to you. 

I love you and I care about you.

A RuneScape Love Story

Back when I was around 15 or 16, long before my transition, I used to play a game called RuneScape. The game is a virtual medieval world where everyone around you is another real person playing the game, just like you.

My character was a girl. I couldn't explain exactly why I created this girl character, I just wanted to see what it was like. It turned out guys loved to give things to girl characters randomly for free, so I took advantage of that and started acting like a flirt. Guys gathered around and gave me plenty of attention. I ate it up, and I found it funny when I shut down their advances by telling them I was a guy.

One day I was out doing quests and I met a boy. I can't believe it, but I actually remember his name: LegatoSummers. I was being attacked by giant rats on my way back to town and he rushed in to help when he saw my health getting low. I said thanks and we parted ways, only to bump into each other again as I returned to the area about 10 minutes later. Legato was hunting down more rats. When he saw me he cleared a path for me to walk through and began following me.

He didn't offer me gold or items or random stuff like everyone else, and he didn't beg me to be his girlfriend. Instead, he volunteered his time to be my bodyguard, and he entertained me with witty humor. He asked if we could friend each other so we could travel again.

The more we interacted and travelled together, the more it became clear that Legato had genuinely developed a crush on me.

I couldn't explain why, but I was so committed to "pretending" I was a girl in real life for Legato. Even when he asked for my name. I didn't want to lie to him, so I told him to promise not to laugh. When I told my real name I said it was so embarrassing that my parents gave me a boy's name, and that I planned to change it someday. He said it was okay, and that he liked me anyway. Afterwards we actually had a really nice romantic walk through a park in Varrock where we opened up about some vulnerable and personal subjects and danced together by a fountain for over an hour.

He did a kiss emote with his character and I got really uncomfortable when I realized I was blushing, and that I liked him too. Then I got really nervous when I found out he lived less than 20 minutes from my house. 

We said our goodbyes and I logged out that night, realizing that that was basically a first date. I didn't log in again for weeks. 

I asked myself what I was doing. Why did I let this get this far? What was I hoping to accomplish? What started as something I found funny turned into a genuinely emotional experience. I could actually hurt this guy, and I really didn't want to hurt him. But I realized that telling him I'm a guy would also hurt me. I didn't question why, I just knew it would, and I would feel so sad that we wouldn't have more dates like that. I wanted to be the girl he thought I was. But I obviously couldn't keep this up forever or he would find out what I actually was. I put myself into a very awkward situation...

After my hiatus I logged back in. He messaged me and asked if I was okay because he hadn't seen me on in am unusually long time. I said yes, and that I was spending time with my brother. As I said this, I was logged in with a second character at the same time, and I introduced Legato to him as my "brother."

Gradually I tried to get him to become friends with my "brother," and I logged in less and less with my girl character, saying that I was busy with school, until finally I stopped logging in altogether.

One day, many months later, shortly before logging out I told him that my "brother" was actually me, and that I was truly sorry. He said he was starting to suspect as much. After talking to him and logging out, I sat in my chair and cried. I wished I could have met him, and I wished I hadn't deceived him.

We briefly said hi a few times after that, but we became distant and we both stopped logging in so much. The friendship fizzled away...

... This story feels so bittersweet to tell. I wish it had a happier ending.

I really don't understand how that whole experience didn't crack open my eggshell. How was I so oblivious to the fact I wished I was actually a girl so I could meet him in person? How was I so oblivious to the fact that the feelings I felt for this guy could have meant I wasn't straight?

I guess I thought there was no possible way for me to make this dream a reality. I didn't know transgender people existed back then. I had no representation, nobody to talk to, and no reference for other people feeling this way.

It's amazing the number of red flags I overlooked growing up simply because I never saw representation.

Well, Legato... Wherever you are, I hope it didn't hurt too much. And I hope you enjoyed the time we did have while it lasted. But if by chance we ever met again, I swear I truly am a girl this time, and I promise I will never break your heart again.

My Transition - Work Life, Part 1

Throughout my transition posts I've mentioned my workplace in passing, but I've never really talked about what it has actually been like to be in the workplace as a transgender person. 

I think it's time I went down the timeline of my gender journey again, similar to how I did in the Discovering Myself post, except in the context of how it affected my professional life.

My first job

I'm going to start with my first job, because even before I started questioning my gender/sexuality, there were little tidbits of things that happened that I feel were related to my development. I still remember them so clearly.

I was a deli clerk at Top Food and Drug, a grocery store that has since been replaced by Haggen. It was 2008, I was 18 years old, and I had no idea that I was trans. This may have been my first job, but I took it seriously, and I never wanted anything I did to be considered sub-par. I took pride in my work, and I wanted to excel above and beyond the call of duty. Eventually, when I got used to the job, I believe I did just that. I served the best damn Chinese food. If the food ever started to look dried out, I'd stir it around, and sometimes I'd even add just a tiny bit of water if the sauce was getting too thick. I secretly looked over the recipes in the back so I knew that I was doing when I was tending to the food. A few nights I even made extra chow mein and fried rice after the cooks had gone, because when we ran out of those we couldn't serve any of the combo meals. I think my cooking came out just as good as the other cooks (don't tell them that, they'd be pissed). In the dish pit, I cleaned those dishes spotless with time to spare.

This has generally been my work ethic ever since. I believe that if it's a job worth doing, it's a job worth doing well. This has caused some friction between my managers and I, because they believe a job is only worth doing if it doesn't make you go outside your regularly allotted hours for the week.

There was one employee who I considered to be a marvel. The perfect model of efficient and effective work. He was so fast and accurate with everything he did, I used him as the model of what I wanted to surpass at that job. 

I'll never forget the story of how we met...

I had been working in the Chinese food section of the store for about 3 months, and my boss finally tells me that it's time for me to get experience in other parts of the store. So he moves me over to the deli one day. As we're walking over there, I'm scared, because the deli is a whole lot bigger than the Chinese food section, and I have no idea what I'm doing. So my boss tells me that I'm going to be trained by Esteban, and he'll show me how things are run back there.

After my boss gives me the general look around and explanations of how things work, he takes me to the walk in freezer and says,

"Okay, Esteban, you can take it from here."

I turn to the freezer and I see a guy fidgeting with some balloons. The guy turns around, revealing that he stuck two balloons into his shirt, like boobs. He poses seductively against a nearby table and says to me,

"Come over here, big boy."

I'm a little bit in shock, because I've never seen anything like this in the workplace before, and I didn't know how to act. I turned to my boss, who was kind of giving Esteban a glare, and I turn back to Esteban, who is still posing seductively. He gives me a wink, and I totally break out laughing. I walk over to him, and the beginning of a great work relationship was born.

 

The Dress Code

 

At this grocery store they strictly expected me to wear white button-up shirts, black pants, black socks, polished shoes, and a tie, in addition to my apron/vest and hat. They also said that we could have no facial hair below our upper lips. This meant I was tying a tie every day, cleaning my shoes, and shaving regularly.

One day a store manager approached me and told me I needed a haircut. I pointed out that there's no rule in the dress code that says my hair must be short, and they ignored my reply by saying,

"If you can't stuff your hair into your hat, then it's too long."

I replied by saying that if that were true, they'd be telling my female co-workers to cut their hair too. They let two of them wear ponytails out the pack of their hats, and one of them wore her hair in a bun. My manager merely replied by saying,

"Yeah. They're women. Get a haircut."

To this day I find this memory infuriating. What the hell does gender have to do with this? Everyone has hair. The fact of the matter is that they're human beings with hair, just like me, and they're allowed to wear their hair long. And for some stupid arbitrary reason, I'm not.

So I didn't get a haircut. Instead, I stuffed my hair into my hat as best I could every day. This irritated that manager, but he couldn't order me to cut my hair if my hair was not sticking out of my hat whenever I was clocked in. I was jealous of my female co-workers, who had these wonderful ponytails out the back of their hats. I felt like it was completely unfair that I couldn't do the same thing. I wanted a ponytail, but because I had to stuff my hair into my hat, I wasn't able to grow it long enough to get one.

 

Misgendering

 

We had a customer enter the store one day who appeared to be a tall transgender woman in a lovely floral sun dress. My supervising cook kind of jabbed at me to look at her with a smirk on his face, since I didn't immediately notice. I looked up, saw her, smiled, looked at my supervisor, shrugged, and went back to work saying, "Alright."

This was the first transgender person I had ever knowingly seen in real life. This was before I knew the word transgender, and the only word I knew that fit the description was transvestite, which is a derogatory word the trans community really doesn't like, myself included. Most trans people consider it to be a slur, so I'm very glad I didn't say it that day.

So this customer was being served by my boss in the deli, while I was in the separate Chinese food section. My boss never serves people food, so this seemed particularly interesting to me. I figured he probably intended to serve her himself because he was gay, and felt that maybe he'd do a better job? I glanced up at the trans person, from time to time, out of curiosity. I wanted to talk to her for some reason, but I felt it'd be rude of me, and it'd just make us both uncomfortable. So I just continued to do my job while overhearing tiny pieces of what they were saying to each other. 

At some point, I heard this exchange:

"How about this one, sir?"

"I AM A WOMAN!"

The customer stormed out of the store, and when I looked up I saw tears welling up in her eyes before she made it out the door.

The cook and I looked at each other for a moment, I looked back over at my boss, who had a look of guilt and fear on his face. The head cook chuckled to himself saying something along the lines of, "Heh, wow. Dramatic..." To keep up appearances, I pretended to let out a little chuckle of my own and said, "Heh, yeah."

But I felt bad for her. She was visibly hurt and upset, and laughing at someone for being upset felt wrong. I didn't understand why she wore a dress, but I at least understood that I shouldn't be laughing at someone for crying. My supervisor's commentary made me feel rather uncomfortable.

Nobody ever spoke of that situation again, but it's a memory that stuck in my mind. As a trans woman now, thinking back at this memory, I feel so bad for her. She must have felt so terribly alone, and that misgendering must have just been the last straw after an awful stream of misgendering. If anything like this ever happened again, I'm glad I'm in a better position to help now.

That Time I Spoke Chinese

One other memory from this job that stuck in my mind is a short exchange between me and that same cook at the beginning of my shift one day. He always used to say, "You 'da man!" Or he'd just generally call me "'Da man." It took a little getting used to hearing that from a Cantonese accent.

I came into the dish pit at the beginning of my shift one day, and I started throwing things into the scrubbing area and filling it with water. I made a lot of noise back there because of how quickly I worked. The cook comes into the back and says,

"Hey, [old name]! 'Da man!"

In response, I do a quick fist pump and say,

"Boohah!"

He erupts in laugher, and I'm sitting there utterly confused at what just happened. I stop scrubbing and just stare at him, quite puzzled. He walked away, still laughing, nodding at me and putting his hand up in a half wave motion.

I figure at this point that he must've thought my reaction was really funny for some reason, and that he's just a strange guy. I continue doing the dishes for about 10 minutes until the cook walks back into the dish pit and says something.

I couldn't quite make out what he said, so I stopped and asked him to repeat it. He repeated it, but I still had no idea what he said. I thought maybe his accent was just making it hard to make out.

"I'm sorry, what? I still didn't catch it."

His expression turns from laughter to straight, and then confusion, as he asks,

"Wait... You speak Chinese?"

"No, I don't. Why? Did I say something in Chinese?"

He starts laughing again,

"You spoke Chinese!"

"What? I just said boohah! What does that mean?!"

He continues to laugh, seeming reluctant to tell me what I said.

"No, come on, what did I say??"

"You said boohah. Means 'no chance.'"

So he explains to me that he called me "'Da man," and I replied by saying "No chance." Basically, how that got interpreted was that he called me a man, and I denied it. And the specific dialect I spoke in was Cantonese.

So, basically, I accidentally told my supervisor in Cantonese that I was a woman about 3 years before I actually started questioning my gender.

Reasons For Surgery

I was asked by somebody back in December what my reasons were for wanting surgery. I thought it might be enlightening for some people if I were to post those reasons here. Here is the copied response I sent to that person:

"Oh dear, where do I even start... I guess I'll try to list off all the reasons that make surgery worth it to me. But these won't necessarily all be relevant to your situation.

1. It gets rid of my bulge forever so I will never have to tuck again. That's a massive plus in so many ways.

2. It will make it so much easier to use a vibrator.

3. I'll be able to walk through the swimsuit sections of clothing stores without feeling so depressed.

4. I will be able to look at myself in the mirror without having to avoid dysphoric eye contact with my crotch.

5. I will be able to take a shower without feeling dysphoric about my crotch.

6. I will be able to have penetrative sex without having to use the "back door."

7. I will never have of the option to pee standing up again. I hate peeing while standing, and I hate when people suggest it in situations where it would solve problems finding a bathroom. I don't even want the option.

8. It will fix a painful issue that I have with my epididymis, making it so that I can never feel like I'm kicked in the balls again.

9. I will be able to go to the Olympus Spa, an affordable local women-only nude spa.

10. My underwear will fit me properly, allowing me to wear thongs without bulge.

11. I will be able to rub it in people's faces if they ever try to use my genitals as an excuse for me not being a woman, thereby giving me more opportunities to educate bigots.

12. When I jump, I will never feel my genitals flop or jiggle again. Just my boobs, and maybe my stomach.

13. I will most likely feel more confident in every aspect of my life without ever thinking about what I have in my pants as something that will out me."


About 4.5 months after typing this list response, having now gotten through stage 1 of my surgery, I can officially confirm number 13. <3

My Transition - Hygiene

Biological Content Material!

This is literally a post where I talk about what's happening with my genitals. If you don't want to hear about this stuff, you best not read ahead.

You know one of the things about daily life post bottom surgery that I didn't fully critically think about beforehand? The way it would affect my everyday hygiene routines.

Honestly, I knew I was going to have to wipe after peeing, and I had some vagina smell before from the hormones, but wow that smell gets much stronger now if you skip a shower day.

Also diet. I've been making homemade Thai food, and CJ made green curry tonight. These are foods that contain fish sauce, and I have now been reminded first-hand what that means for my nethers.

I don't think other people notice it as much as I do. I'd probably have to sit with my legs wide open and someone's head on my lap after skipping a shower for someone to notice. But whether they do or not, I really like smelling nice. So I've developed a nightly routine of spraying down the area with water in the shower. No soap or anything, of course, I don't want to mess with the microbiome developing down there. Water is sufficient, just to reduce smells. It seems to work quite well, and it's nice to feel clean. 

After a while I didn't like how quickly we were going through toilet paper, so we got a manual bidet sprayer, and I am fully converted. Because of the water rinse every time I pee I've gone from a lightly fishy smell to a lightly floral smell. And this is from water alone.

There really is a special amount of maintenance involved with vulvas. But I suppose that's part of the fun. At least it is for me. ^_^

Independent Change

I was born into a conservative Christian family, assigned a gender, given a name that matches that religion and gender, and all the interactions I had growing up reinforced an identity that I never chose.

I have since disassociated myself from my assigned religion, changed my gender to match my true identity, changed my name to match, and now I fight for people's rights to live their individual lives in peace, as themselves. I will continue to spend years training myself to forget all the subtle treatment I got from people my whole life that reinforced upon me an identity that wasn't mine.

I cannot change my birthplace or race, but I can be aware of what my race represents in the world, and I can behave according to what I believe is right based on that combined with my ideals.

Despite the conditions of our birth, we can still choose to make our own decisions and change our lives to match our own identities and ideals. :)

Feminine HRT Changes Resource

Here is a handy website that details the changes caused by spironolactone, estradiol, and bioidentical progesterone. 

Personally, I believe this website to be the most accurate list of HRT effects I have yet found, and I believe it to be a far better resource that what medical professionals provide their patients for informed consent.

https://curvyandtrans.com/p/5011BD/second-puberty-101/

My Transition - Stage 1 Complete

From January 27th, 2020:

I had my final stage 1 appointment today! I get to resume progesterone!

Later the night following that appointment, I was allowed to get myself aroused for the first time. Since then there has been some persisting swelling that has continued after the initial engorgement. It feels like the left side of my labia hasn't gotten the message and seems to believe that I'm still aroused. Unfortunately it seems like my clitoris is also not gotten that message, as it also seems to be poking against the hood a little too hard on a fairly regular basis.

I don't think I can adequately put into words how disorienting and strange it is to be asked what hurts, and to legitimately not know how to answer the question. I know that something hurts, but I know not what body part nor its location. Something in that region can hurt in one area, but the body part is actually located in another, so it actually hurts over there and not where my brain seems to think it hurts. This makes it very difficult to explain over the phone to the consulting nurses what exactly hurts and which areas feel like what.

A while after I got home from Spokane I drove for the first time post-surgery and discovered that if I push my left leg against the left foot rest, it takes some of the pressure off of sitting down and going over bumps, thereby making the whole experience much easier.

My last notes on the stage 1 surgical experience: the days leading up to it were terrifying, the recovery was uncomfortable, less painful than expected, and ultimately an easier experience than I imagined. As miserable as it could be at times because of the discomfort, I would gladly do it all over again. In fact, I will be doing it all over again, because I still have to go through the second stage of my surgery! It won't be exactly the same, but I'm sure it will present its own set of discomforts to note.

Stage 2 is currently scheduled for June 30th. I will try and make sure to write a bit about that experience as well. Hopefully my covid depression will not get in the way of that.

Informed Consent HRT Provider Map

Informed consent means that the healthcare provider is willing to prescribe Hormone Replacement Therapy (HRT) for transgender people with just an information form to be signed by you or your guardian stating that you know what you are getting into, you have read all the information provided about it, and you consent to it. 

This eliminates the roadblock many trans people face where they cannot receive HRT without jumping through unnecessary administrative hoops, resulting in up to a year's worth of life-threatening delays.

Here is a map I found showing a large number of informed consent providers for HRT in the United States.

https://www.google.com/maps/d/u/0/viewer?mid=1DxyOTw8dI8n96BHFF2JVUMK7bXsRKtzA&shorturl=1&ll=47.464100482909295%2C-122.32052688886495&z=9

My Transition - The Big Reveal

Biological Content Material!

This is literally a post where I talk about what's happening to my genitals. If you don't want to hear about this stuff, you best not read ahead.

It feels so surreal. I'm not sure it's completely sunk in yet for me. It just feels like I have a really secure tuck, but when I look down I see a vulva. Logically I know that I no longer have a penis, but I've had a penis for so long that the concept of it not being there seems to take a while to process.

When the bandaging came off I felt different sensations. One bandage was stuck to my clitoris, so as it came off I yelped slightly as I felt it come loose. The doctor said that's very good, since that proves I have sensation already. It looks like I have a very good clitoral hood, despite my worries about having been circumcised and potentially not having the tissue for it. I'm eager to see how the clitoral hood and labia minora evolves over time as it all continues to heal, and as the swelling goes down.

I just went to pee for the first time. I sat down and tried to make sure the whole area was nice and open, but wow it just sprayed downward everywhere. Probably because the whole region is still very swollen. Lesson learned! At least all of it went into the toilet, so I'm calling this a win, even though I had to shower off my lower half afterward.

It's so weird having phantom feelings. As I type this I'm actively feeling something against my clitoris, but I checked and as far as I can tell there's nothing there. Maybe it's just rubbing against the hood? The whole area is swollen right now, so perhaps that's what's going on. I went to pee again, and I felt this weird sensation as though my urethra was in a different location. I knew where I was aiming, and I was actively looking at my vulva at the time, and yet the feeling of starting to pee felt like it was coming from a different location in my abdomen. So strange. Then as I was cleaning up with some flushable wipes I realized I had some sensation in my labia minora that felt like the shaft of my former penis. To make things even more confusing, I'd brush up against my clitoris while cleaning, and then I'd brush up against my urethra. I was actively recognizing they are in two very different locations, yet they felt as though they were in the same location. Such a strange sensation. I was fully prepared for this kind of neural mapping confusion, and I just find this so fascinating, I'm actually loving it. I wonder how long it will take for it to fade.

The day after my bandages were removed I gave into the temptation of curiosity and allowed myself to be slightly aroused, purely from the sounds of my partner in the room. There was no erection sensation. Instead, the whole area started to get a bit more swollen, and I felt a kind of pulse resonate around my clitoris. As the pulse began I felt a kind of electric rush flow upward to my chest and then up my back, and my breathing intensified. It was incredible, I haven't felt that kind of rush despite zero physical sensation before. I had to calm myself down when I realized my vulva was getting engorged on top of already being swollen. I can't wait until I'm given the clear to play with this for real!

My First News Article

Somehow I never posted a link on here to the Windows and Mirrors article I was in last year! I was interviewed for a column in a series of local newspapers. :)

http://www.redmond-reporter.com/opinion/proud-to-be-themselves-windows-and-mirrors/?amp

Social Bubbles

I'm noticing that rather than actually seeing the source of many issues, on Facebook I seem to instead see people's reactions to it.

For example, there's something going around with people raving about celebrity women who have lost weight during quarantine, and how they're "suddenly beautiful." All I'm seeing is the backlash of people saying they were beautiful before and losing weight didn't change that. 

I have no idea where this originated. If I cared I would Google it, but I have enough drama without TMZ toxicity in my life. People's reactions in my social bubble are on point though, at least.

I also never actually saw anyone actively blaming China for the plague. Not that I'm complaining - I'd have ripped them a new one myself if I did. I guess I'm proud nobody in my social bubble is that much of an asshole, so I never had to.

I just find it interesting that, unless I Google them, I never seem to see the sources on these things. Only the outrage itself, which I often agree with, reinforcing my confirmation bias on issues I've never even seen directly.  

I rarely have my opinions indirectly challenged by seeing someone else's posts, so I have to seek out ways to debate issues I believe myself to feel too strongly about. But I often have to do that outside my social bubble or I'd risk hurting my friends. If I didn't directly ask someone to come up with a really good counterargument to my beliefs, I would not likely ever get or otherwise see one. 

I don't always want one though - I'm not always in the mood to expand my mind. Sometimes I just want to relax like everyone else. But I do like to know when I am wrong. It can be difficult to fight the gut reaction of anger when a firmly held belief is being questioned, but I think it's important to ask ourselves why we react with anger rather than curiosity.

Seeing how this works in this context, it's easy for me to imagine how conservatives have their confirmation bias reinforced, never seeing the sources directly before seeing hundreds of media and friends' opinions. This doesn't make them right, but it also doesn't necessarily make liberals right either. We are products of a system that only shows us what we want to see, just like everyone else.

What we choose to do with this information is what tells us whether we're truly part of the problem that polarizes our society. Will we critically think about our media exposure and search for sources to develop our own opinions? Or will we continue to allow others' reactions to shape our opinions for us?

This has been thought experiments with Josie. My statements are not fact, they are merely observations and opinions formed within the bias of my mind, as usual. ;)

My Transition - Bathroom Lament

From January 20th:

Now has come the time for the dreaded bathroom event. O how I hath feared this day; to excrete dark matter whilst my genitals are bandaged and stitched... 'Tis not an experience I cherished to bear.

The pain. O, the pain... A stool softener, perhaps, I should have consumed in anticipation of this moment. Perhaps if length enough I sit, it shall pass of its own accord. Lo, how the powers of spinal anesthetic have hardened this process. Though how much worse it might have been had I taken oxycodone? I may call myself lucky, bittersweet, though, the luck may be.

Alas, the end is nigh! Progress is made! Good things come to those who wait, and patience is, indeed, a virtue devoutly to be wish'd.

I am victorious! Such relief! Pomp and Circumstance sounds from the other room - I have graduated! I can finally acclaim... That my first post-op movement of the bowels is complete.

My Transition - The Big Surgery, Part 5

I'm writing this after the surgery happened because I was far too loopy to write this during recovery. The following events happened on January 17th, 2020.

The day had come! I was not allowed to eat or drink anything, so no breakfast for me. I brushed my teeth, my parents had breakfast, and we went out the door.

When we got to the hospital we walked to the surgery center, and shortly after I was called into a back room. My partner, CJ, came with me. The nurse instructed CJ to wipe me down with antibacterial wipes - arms, chest, groin, butt, but not my legs, apparently, because I shaved them within the last two weeks. I used the bathroom real quick, realizing I better not have a full bladder when they administer the anesthetic. When I was done I wrapped up in the hospital gown that so gloriously shows off my butt.

I sat on the table and a nurse came in to put in the IV, and the anesthesiologist came in to say hi and get a couple of my signatures for consent. The nurse giving me the IV actually offered to numb my hand, which was very helpful! That made the whole process a lot more bearable! She did everything with far more expertise than anyone else I've had, and as a fun bonus, she also reminded me of a friend of mine.

After cracking plenty of jokes, because apparently my reaction in these situations is to become hilarious, it came time to wheel me off. I was given what the anesthesiologist called "happy time" medications through my IV. This is where things get fuzzy, and my jokes became very nonsensical... He claimed I wouldn't remember even being wheeled out of the room, and he was mostly correct, except that I do remember the act of being wheeled out, and I remember CJ recording a video.

(I had to upload this one to YouTube because the file size was too big)

As shown in the video, CJ wasn't allowed to follow me into the next room. In that room I think I got onto another table, and the anesthesiologist told me to bend over forward as I sat. I had a couple of pokes at the base of my spine, which caused me to yelp rather more loudly than I expected I would. It didn't hurt that badly, it just was a very strange and somewhat shocking sensation. I remember another nurse saying he's on a roll today, because I guess he administered my anesthetic impressively fast.

I remember nothing else after that except waking up in another bed with very heavy eyelids hearing nurses talking around the room. I tried to open both eyelids, but the double vision was very real, so I closed my left eye in order to at least see what was around me. Keeping even just my right eye open was quite a chore. If I remember correctly, this was the exchange I had with the nurse overseeing my recovery,

"CJ... Huh? Oh, hello."

"Hi, how you doing?"

"I'm coming about. Is CJ here?"

"Not yet, we'll bring you to your family soon."

"Oh good. I want to make sure he knows I'm okay."

As I was laying there, loopy as heck, I overheard some other nurses talking about some personal stuff. One was apparently having a very rough day, and had to deal with some very tough patients. So I spoke loudly enough for them to hear,

"Remember to breathe! You're doing admirable work! I appreciate you, even if your patient doesn't! I hope tomorrow is a better day!"

She replied, "I have tomorrow off, so it will definitely be better."

I said, "Well there you go, treat yourself to something nice!"

The other nurse she was talking to chuckled a bit, and so did my nurse. I recognized how funny this must've been for them, considering I'm crazy loopy and barely awake. My nurse asked why I only had one eye open. I replied,

"Because I can't see straight in 3D, so I have to limit myself to 2D, otherwise everything is double vision. I can open my other eye for you, though, to prove I can."

I opened my left eye and closed my right. She seemed to want both open at once, so I indulged her for a moment, then closed them again saying it was making me motion sick to have both open with double vision.

After a bit of waiting, the double vision gradually got better, and I was wheeled to the waiting area to be reunited with my family. I asked CJ to record a quick video for Facebook, to let everyone know I was okay.

We all went up the elevator to a floor I'd never been to and I was wheeled in to my hospital room. This room was actually quite nice! It had some decent furniture, cool remote controlled lights, and the bathroom was huge.

Asian Noodle Stir-fry

I had room service, and the food was surprisingly good. I wish I got pictures of the bathroom, but I did get pictures of the food.

Chicken Caesar Salad

Unexpectedly, after my delivery to this room, they had me stand up off my portable hospital bed and walk to my new bed. I was not expecting to stand up until at least two days from then, but I guess they wanted to make sure my legs worked, and they wanted to kickstart my body to remind it that I'm alive. They told me I had to walk again later that night after dinner, so I should rest up and prepare for that.

Later that night, with the help of holding onto my IV pole, I managed to walk around the loop of rooms on that floor. I wasn't expecting I could walk that far, but I guess I surprised myself, just as the nurse said I would.

We got back to my hospital bed and I figured out an effective way to sit back down without hurting myself by balancing my thigh against the arm of the bed as leverage. I was pretty tired after that walk. I asked CJ if they would be willing to sleep with me that night so I wasn't alone, and they said yes. As my parents were leaving for the night my dad came over and kissed me on the forehead, which is something I don't think he had done since I was somewhere around 3 or 4 years old. <3

I was awoken every few hours during the night for pain medication and antibiotics, and to drain my catheter bag. After breakfast and lunch, my parents showed up and I did another walk around the loop of rooms. Dr. Stiller came in that afternoon to ask if I felt good enough to head back to my Airbnb. I said yes, as long as it means I get to have my IV taken out. And so my IV was taken out! I went back to my Airbnb that evening with blood bags and a catheter hanging from the wrappings of my abdomen.

And thus begins my recovery! Every 3 hours I alternate in taking 600mg of ibuprofen and 975mg acetaminophen, every 6 hours I take 300mg of gapabentin, and every 12 hours I take 400-80mg of sulfamethoxazole-trimethoprim with a probiotic.

Further updates as events warrant. ;)

My Transition - The Big Surgery, Part 4

Sexual Content Material!

Just a mention of me having sex. That's it. If that bothers you, you can just skip paragraph 9.

We made it over the mountain pass, just barely! It closed right after we passed over the summit, and they allowed us to keep going. We eventually made it to the Airbnb and set up all my dietary needs and stuff. 

My pre-op appointment was the next day. As we were getting ready to go to that appointment, I got a call saying I was late for another pre-op appointment, to check me in with the hospital. I was never told about that appointment, so that was a lovely surprise. We went to the hospital and, with the help of Dr. Rick from Dr. Stiller's office, we found the right place for my check-in.

They had me confirm my identity repeatedly, spell out my full name repeatedly, and then they put an identification bracelet on my wrist. I had to wear that bracelet through until I was discharged from the hospital. Then I was taken to another room to answer a bunch of medical questions and have some blood tests. They needed to have a good sample handy in the of chance I needed a transfusion. I hate blood tests, and I've been really bad about feeling faint during them lately... Luckily I didn't pass out.

I was then taken to another room where we finalized a bunch of stuff, asked more medical questions, and then I was given instructions for how to prep for the surgery.

Immediately after they let me go, I went to the Stiller Aesthetics office for my pre-op appointment with them. During this appointment I was told how to prepare for my surgery with information that contradicted the hospital. Dr. Stiller appears to have a different way of doing things, and I was plenty okay with that, because his instructions were far easier to follow. We went over the risks involved with the surgery again and I got to have some more questions answered. 

Unfortunately I do not remember all of my questions, but I do remember getting to ask Dr. Stiller directly about whether I could, after both my surgeries are fully healed, take my progesterone vaginally, the same way I take it anally. He said that since we're using intestinal tissue it actually makes sense that that would work. Not only that, but because of the part of the intestine that's used in the surgery, it would most likely absorb more effectively than doing it anally. But, of course, he said I should consult with my primary care doctor before doing anything like that.

Dr. Stiller came out to meet my parents and answer any questions they had, and then we took off to buy some antibacterial soap for my pre-surgery shower and some Ensure to bulk up with protein that night, as he said it has immensely helped his patients recover faster.

The night before my surgery everyone was nervous. I was so anxious, and my partner, CJ, was shaking. We tried to watch funny videos to distract everyone, and that worked for a while. I was nervous to take my pre-surgery shower because it kind of symbolized that I was really going through with it. CJ and I shared many tearful moments this night as they told me so many reasons why they love me, and how I need to keep being stubborn and strong, and to not let this beat me. They added that if I die, they'll bring me back so they can kill me themself. We cried together as I said there's no way that will happen. I couldn't think about that possibility... The thought was too terrifying.

After my shower we cuddled together in my room and talked for a while. Talking lead to some... Other activities. CJ became the last person I will ever have penetrative sex with - at least with me being the penetrator. We did it one last time, for the sake of the physical closeness, and hugged each other close for a while as we both finished. I couldn't have asked for a better final experience than that, it felt like something out of a romance novel.

... That is until I realized I had just compromised my sterile shower, so I had to go back and shower with the antibacterial soap again. 😅

CJ and I cuddled for a while again before going to sleep in different beds. I slept alone because I had to wake up at various times of the night to drink Gatorade and Ensure, so I wasn't about to get any consistent sleep. I sometimes wonder if they do this on purpose to make me tired for the anesthetic. In any case, I did everything exactly as I was ordered to. I hadn't peed that much since I was on spironolactone...

My Transition - The Big Surgery Part 3

Biological Content Material!

This is literally a post where I talk about what's going to happen to my genitals. If you don't want to hear about this stuff, you best not read ahead.

My surgery is in two days. As I get closer and closer to the day of the surgery, I find myself contemplating many things, and I am becoming very nervous.

I'm nervous that we might not make it over the mountain pass on our way to Spokane. I'm nervous that I'm going to do something wrong in the days leading up to my surgery, and that they're going to have to cancel or delay it. I'm nervous that I'm going to run into logistics issues, and that they're not going to include the tracheal shave at the same time. I'm nervous that insurance is going to let me down and stick me with a hopeless amount of debt. I'm nervous about the IV, because I hate IVs. I'm nervous about the anesthesia, because being put out is a scary concept.

But I'm finding that not only am I nervous about these things, I'm also nervous about the surgery itself. There's a voice in the back of my head asking, "What are you getting yourself into?" I find myself contemplating what could go wrong, and if going through with this is worth it. I find myself thinking, what if something horrible went wrong and I didn't wake up? I finally love myself, I'm finally happy with my life, for the most part. I don't want to lose that. Is this surgery worth risking my life over?

Why am I going over this again? I already came to the conclusion that it is worth the risk. I fought for over two years to make this happen. I clearly want it, I know I want it. I'm so certain that when this is all over I'm going to be ecstatic.

This feeling I have is so similar to the way I felt when I was starting hormone replacement therapy, except that this surgery is going to involve a lot of pain and recovery, and hormone therapy didn't really require any of that. Well, except for the breast pain, I suppose. But I doubt that will compare.

If it does compare, you know I'll be describing that in my post-op blog post...

This almost feels like having to come out to myself again. It's like having to build up my resolve, to remind myself that it's okay to have doubts. People who are happy with having a penis typically don't complain about their bulge constantly. They typically don't tuck it every day. Not having to tuck my genitals and not having to worry about how flat the area is will be incredible... Not having that on my mind ever again... Because it always is. It's always there in the back of my head, that worry that someone is going to see bulge and use that as an excuse to treat me like garbage.

It's not just about other people though. For the most part people will still treat me that way. They'll probably see bulge simply because they're looking for it, whether it's there or not. Those people will always treat me like garbage, and I can't expect that to change from this surgery.

No, this is for me. This is about me. This is something I want. I don't want the option of peeing standing up. I want to have to wipe my front every time I pee. I don't want to ever feel an erection again unless it's someone else's. I want to be able to feel comfortable in yoga pants. I want to have a clitoris. I want a vulva. I want everything that comes with having those body parts, for myself, not for the satisfaction of other people.

Although it would be pretty self-satisfying to use my vulva as ammunition against people who claim I'm not a woman, that is not the reason I am willing to take this risk. I am taking this risk because I want this. Having this will make me happy, even when I am by myself and other people aren't a factor whatsoever. This would make me happy even if I weren't in a relationship. This would make me happy even if I had no friends, and even if everyone in the world had no idea I was trans. This is going to feel right, and I will probably look back at how nervous I am right now and laugh at how cute it was that I ever doubted myself.

Doubts are okay. Doubts are a normal reaction to anything scary. This is scary, and that's okay. I knew it was going to be. Being scared doesn't mean this is the wrong decision. I'm scared because I love myself, and I know what I'm about to put myself through. But I'm also entering into this decision because I love myself.

Well anyway, I think that about sums up my pre-surgery thoughts. I will try to document as much of the actual experience as I can. Next up will be the pre-op appointment and surgery aftermath.

My Transition - The Big Surgery, Part 2

My insurance took longer than expected to process, so my surgery had to be scheduled further out. January 17th, 2020, was the earliest date I could get while still giving my workplace enough reasonable notice for medical leave.

I received a pre-surgery phone call on December 19th, 2019, and asked the following additional questions:

• When will I be able to go swimming?
• About 3 months post, which would be 2 days before my birthday.
• Can I use reusable pads during recovery?
• No, mostly for sanitation reasons, as there will be a lot of discharge.
• Will I be able to take progesterone vaginally?
• No idea, need to ask Dr. Stiller.
• How do I clean the inside of the vagina post-recovery from stage 2?
• Douche. They give me a high quality reusable one for this purpose.
• I have had intestinal cramps as a period symptom. After full recovery, since the inside is formed using intestinal tissue, will I have vaginal cramps?
• Probably not? I've never thought of that. Maybe, but probably not.
• Can I get a temporary handicapped parking permit to use during recovery?
• I haven't had this question before either. I don't know. Probably. I'll look into that, but you probably send a letter or something to the Department of Licensing for that.
• 1st vs 2nd stages:
• As expected, there will be a small opening about half an inch, and that is what the colon graft will extend from. They use tissue that is naturally hairless (from my shaft?) to form that area.

We set a pre-op appointment for January 16th, 2020, and she told me to call once I'm in town.

Unexpectedly, during that phone call I learned that my surgeon's office didn't know of anyone other than them in Washington State who would be a bioidentical estrogen implant to bridge my hormones through the surgery. So I had to schedule an appointment for January 2nd to have that done. 10 hours of driving, round trip...

The process of putting in the implant was actually quite simple. We talked for a bit beforehand to make sure everything was in order. The doctor injected me in the butt with some lidocaine, and after that point I really didn't hardly feel anything. I couldn't even tell when he started making the incision to put the estrogen pellet in.

The recovery was pretty easy. I had to keep the bandage on for three days, which was the second hardest part, next to driving 5 hours sitting on it. It felt like a bruise for the first two days, and then devolved into feeling rather itchy by day 3. After the bandage came off I started forgetting about it.

My Transition - The Big Surgery: Limbo Thoughts

In this limbo state after the consultation, while insurance is processing, and before the surgery date has been set, I find myself doing a lot of thinking.

I'm thinking about the recovery, the struggles I'll experience, the waiting to heal, the relearning to pee, the pain of sitting down wrong, the dietary changes, the permanent intestinal changes, the dilations... Yeah, it's scary. But overall, I'd say I'm far more excited than scared.

It's funny. You'd think that that's what I'd be thinking about the most. Being nervous about the operation and recovery and sex life stuff, etc. But it's like I've already processed most of that. I've had over 2 years to think about that. Instead I find myself dwelling on something entirely different...

My voice...

My voice still very much outs me. It is not very subtle, especially when you can't see me in person. My appearance helps, but over the phone? Nope, I get misgendered 100% of the time, unless they are told that I am a woman, or otherwise corrected. Not a single time has a stranger assumed I was female on the phone. Not once. And that isn't likely to change anytime soon. The US seems to have little interest in medical science for this department. We seem to be far more focused on - obsessed with - genitalia when it comes to gender. Voice plays such a large part in transgender women's lives... It is honestly one of the hardest things I have to cope with in my daily life. I'm convinced that my voice is one of the most consistent reasons I get misgendered.

I know my friends are going to disagree with me and say that my voice sounds fine. And maybe it does to them. Maybe they're used to it now. They got to see me through my entire transition as everything slowly changed, and so I guess it seems to them that my voice just matches what I am. But again, they practically never talk to me on the phone, because I avoid the phone for this reason. I text everybody instead. Otherwise they just see me in person, and my appearance just gives creates an illusion that makes my voice seem more feminine, even though it's really not. But I know that they would never tell me this because they know how sensitive a subject it is for me.

And there's not much I can really do about it. Voice therapy has only gotten me so far. I'll continue trying, but I think it's kind of a lost cause at this point. After a certain amount of voice therapy with limited results I get to start considering a surgery for my vocal chords, which is extremely risky, and could result in my losing my voice altogether. So someday I'm going to be faced with the decision of whether I would like to have no voice at all more than sticking with the voice I have now.

So I guess ultimately what I am pondering is how I will soon have the correct body. I will be unmistakably assumed female, even when I'm completely nude at a spa. But despite all of the struggle to get here, my voice is still a problem. And I guess what scares me is that I am honestly questioning whether I even want a voice at all if it's going to sound like this for the rest of my life.

I want my old voice back. The one I had before  my first puberty ruined it. The one that made people call me a girl, even before I had boobs.

Maybe in the time it takes for me to recover from my bottom surgery there will be some advancements in medical science. Maybe transgender people being in the news spotlight will actually help some development in this field within the United States, so I won't have to go to South Korea to get the voice I should naturally have.

I guess we'll see what happens. All I can do right now is try not to let these thoughts dampen my spirits. I'll just try to focus on the fact that I will never have to tuck again, and that soon, walking past the underwear sections in grocery stores is no longer going to upset me.

When Do You Stop Being Trans?

I've been asked this question quite a few times now by a surprising number of people and I feel like talking about it:

"So at what point during your transition do you stop being trans? Like, when do you go from transgender woman to just woman?"

This question irritates me, and I'm still trying to figure out exactly all the reasons why... I find it to be such a baffling question. What logical steps would lead a person to think about it in this way?

Perhaps it drives home the point that people really believe there is such a solid difference between transgender women and cisgender women? Like they're two entirely different genders, and thus should be treated differently?

Perhaps it also demonstrates such a great lack of understanding about how society sees trans people, and how we must live for the rest of our lives? 

I suppose it also reminds me that I will never not be trans, and thus I will have to continue receiving questions like these for as long as I continue to remain an open book.

In any case, I try to be patient. I tend to answer that question by saying something along the lines of, "Right now would be nice, if you'd like to start treating me as you would a cis woman. It's up to you."

Honestly, it's a label. A social construct. You are welcome to forget that I'm trans and just call me a woman. In fact, I would probably find that very refreshing. The "trans" adjective is merely used to describe how I was assumed to be a different gender at birth, just like how "cis" is an adjective used to describe a person whose gender was assumed correctly at birth.

Just don't forget that the noun used for both of those adjectives was "woman." You are using the word trans as a way of describing the woman, the same way you would say blonde woman, or brown-eyed woman, or cisgender woman. The noun is woman, and that means you're referring to a woman.

So no, chances are I will never stop being referred to as a transgender woman. Just like I will never stop being a white woman, or a brown-eyed woman. This is just the reality of my existence, and the only thing about this that can really change is the way I am treated by others. And the amount of patience I give to these types of questions, of course. ;)

My Transition - The Big Surgery, Part 1

Biological Content Material!

This is literally a post where I talk about what's going to happen to my genitals. If you don't want to hear about this stuff, you best not read ahead.

The process has begun! Here comes the big one!

So to put this into context, I should probably start from the beginning. I've been looking for a skilled surgeon that takes my insurance ever since I discovered the peritoneal vaginoplasty two years ago. Dr. Jess Ting is apparently the only surgeon in the United States who can perform this operation, and my insurance at the time was not accepted by The Mount Sinai Hospital, where he practices. I got a new position at my job, which came with new insurance, and my new insurance wasn't accepted either. So I started looking for other surgeons. It appeared that Dr. Marci Bowers was able to offer the peritoneal method, but it turns out not only is that an operation that is "outsourced" to Dr. Ting's office, but Dr. Bowers also does not take my insurance.

After fighting so hard for so long to get all of these things processed, questions answered, and trying to find other surgeons and other methods, my insurance case manager said that Dr. Geoffrey Stiller was moving his practice to Washington State - which is where I am. I had heard of this doctor amidst my research, and so I dove into some more googling to learn more about him, all the while waiting for my insurance to finish pending a contract with him.

Before Dr. Stiller moved his practice to WA, there was not a single surgeon in this state that offered this surgery in any form.

So FINALLY, after 8 months of waiting, the insurance finished negotiations! Ironically, this happened a week after I started contacting Dr. Stiller's office to try and ask if I could schedule a consultation before the insurance was done. So right after I sent some emails I was told in response that I needed a referral, but my referral arrived in the mail right after, and so their answer changed and I was suddenly scheduling my consultation!

I just had my consultation visit on November 4th, 2019. I was so nervous on the days leading up to the appointment, and worried that I was going to forget what to say. So I made a list! 

So here's how things went at my consultation appointment. I went up to the counter to check in and they asked me for my ID and insurance card so they could make copies, and they handed me a tablet with a series of questions and a couple of documents to sign, to allow them to retrieve my medical history and whatnot. I sat down to complete the questions and immediately I went back to the counter when I noticed the listed sex on the form was incorrect. They said it may have been pulled from my insurance, and sometimes they require it to be my birth sex. I told them that according to my official birth certificate I am female, and my social security, state ID, insurance, and passport all reflect that. They corrected the information manually for me. If anything or anyone ever asks for my birth sex again, I will refer them to my birth certificate.

Shortly after filling out all the information about my medical history and signing a couple of documents, I had a Q&A with one of Dr. Stiller's nurses, who stated that she is also transgender, and so she could answer my questions not only from the statistics, but also from first-hand experience. After a Q&A with her, Dr. Stiller came in to meet me. He shook CJ's hand and then mine, sat down, and asked me to tell my story - what brought me here. I told him he can read all about it on this blog! We talked for a bit as he asked about my life, interested to hear about my experiences, how long I've been on HRT, my relationship with my parents, and all those little details. In the midst of everything I got to ask the remaining questions that the nurse couldn't answer.

Here is the list of questions I had for Dr. Stiller and his nurses, and paraphrases of the answers I received:

• Do you know about the peritoneal vaginoplasty?
• Yes, I am fully capable of doing that procedure, but until there is further documentation about the long term effects of that method, I am not comfortable performing it. It is very recent and needs another 3 to 5 years before I am willing to consider practicing it.
• I have concerns about depth due to my orchiectomy causing tissue shrinkage.
• It's unlikely that there will be issues with that from an orchiectomy. But in addition to the standard penile inversion method, we also offer a grafting technique, similar to the peritoneal method, but instead using colon tissue. That would eliminate the need to use scrotal or penile tissue to form the vaginal lining.
• Would Irritable Bowel Syndrome be a complication if we were to use colon tissue?
• Depending on the severity of your IBS, maybe. Since yours is caused by anxiety, and you will be drugged up on painkillers with anti-anxiety traits, you will very likely be fine. Since your main symptom of IBS is diarrhea, the biggest thing to expect is that you might have to use the bathroom one more time than usual, because you have a little less colon tissue to hold it in. And this applies to every day as well, not just from IBS.
• What happens to the nerves of a particularly sensitive area under my glans?
• Put simply, those nerves will be severed, and that area will not likely exist anymore. The clitoris is formed using only the glans, and the part of the clitoris that shows is formed from the tip and top parts of the glans.
• How long until the numbness goes away?
• This highly depends on the person. Some people say they experience numbness as long as a couple of months afterward, and some say they have full feeling within a week. Others don't experience any numbness at all.
• How long until I am able to have sex again?
• The doctor will suggest you practice using your clitoris after about 2 weeks. But you will have to wait upward of 2 months before doing anything rough with penetration.
• After the surgeon orders the electrolysis, will there be any clinics you could refer me to that will bill my insurance directly, instead of the painstaking reimbursement process?
• Since you have opted to choose the method that uses colon tissue, you do not need electrolysis for the operation. But the Queen Anne Medical Center has an electrology clinic that should be able to bill directly to your insurance.
• What is the timeline for recovery? How long will I stay in the hospital, how long do I need to stay in the vicinity, and how long until I can return to work?
• You will need to stay in the hospital for two days, and after discharge you will need to stay in the vicinity for two weeks. Most patients return to work after 4-6 weeks, but for strenuous work and exercise you will likely have to wait 6-8 weeks.
• What does the aftercare look like? What am I putting my family through?
• You will be able to walk when you're discharged from the hospital, so you should be able to mostly take care of yourself. Though you will be very tired and in a drugged up daze from pain medication, so your boyfriend should make sure you're taking your medications and eating/drinking regularly.
• How long will I likely have to wait for the surgery date itself?
• Once insurance is processed, we could get you in for surgery within 3 weeks.
• What is the timeline for dilation? When can I switch from three times a day to two times a day?
• For the colon vaginoplasty you will likely be able to switch to twice a day after 3 weeks.
• The muscles in the crease of my legs on either side are quite tight. Will that be problematic?
• The muscles in question should not be a problem, but it would be a good idea to look up some pelvic floor physical therapy exercises before the surgery regardless.
• The spots where my epididymis was severed during my orchiectomy are still sore to touch. Will those be cut further back?
• Most surgeons who perform orchiectomies are unfamiliar with the needs of transgender patients, so they make these cuts way further down than they should. We will absolutely cut that further back, all the way up to its source.
• Could I have a tracheal shaving done at the same time so I don't have to go under more than once?
• If your insurance will cover it, absolutely. Since you already have a referral for it we will see about making that happen.
• Will I need to undergo physical therapy as part of my recovery?
• No, you will be able to walk just fine.
• Why do I have to stop taking estradiol in preparation for the surgery? I ask because I become suicidal when my estrogen levels are low.
• Estradiol Cypionate comes with a risk of clotting, and we take that very seriously. So we put a hold on any medications that can increase any risk of surgical complications. In your particular case, because it is detrimental for you to stop your estradiol, we could bridge the surgery with bioidentical estradiol pellets, which do not have the same risk of clotting.
• Do you perform a single-stage procedure or do you do a second visit for labial construction?
• For this particular operation it is two-stage. The first stage will be the construction of the labia and clitoris, and the second stage will be the formation of the vaginal canal using colon tissue. It will be about 6 months between the first and second stages.
• What pain medications are used, IV and oral, for pain management and anesthesia? Are Gabapentin or Toradol part of that regimen?
• We do general anesthesia for the surgery itself, and we use Gabapentin and Toradol for the pain during recovery. We have a non-narcotic policy for recovery pain relief.
• Who else is on the OR and anesthesia team? Is it typically the same group of people? Have they worked together often?
• The same group of people have worked in our team for a majority of the surgeries we have performed. They are certainly experienced as a team, and they have gotten into a good groove together.
• Do you know your complication statistics, and can you stratify me into that risk profile?
• This is a high risk surgery as a whole, with the overall statistics of the surgery having a 60% complication ratio, the highest risk factor being necrosis. However, out of the 200+ intestinal vaginoplasties Dr. Stiller has performed, only 3% had complications. And you, personally, being under age 45, are in a low risk factor bracket. Patients over age 45 must have their colonoscopies before having this surgery, but for you that would be unnecessary. In the event of any complications, we would, of course, work to rectify the issue to the best of our ability without additional charge. However, a majority of our vaginoplasty patients merely return to have a "touch-up," for aesthetic reasons, and we offer revisits for this purpose free of charge as well.
• Do you do ultrasounds or something similar to check the colon before using the tissue?
• No, we don't.
• Do you have any resources for my post-op care that I can give to those who will be taking care of me?
• We will give generalized after-visit instructions, but they are intentionally very broad, because we want to encourage you to call us directly with questions.

After the Q&A stuff was all over, Dr. Stiller took some pictures of my neck for the tracheal shaving and had me change for a physical examination. Since I was wearing a dress, he said I may as well just leave my dress on and only take off my leggings and underwear.

The way he checked me for a hernia was kind of familiar, and yet at the same time very foreign to me. It was the "turn your head and cough" routine, except that I don't have testicles. So instead he stuck his finger into my inguinal canal on either side and felt my epididymis. Then he checked my lungs and we were done.

Dr. Stiller asked if I had any additional questions periodically throughout everything, making sure I had opportunities to talk. At the end of everything he held my hand in his hands, looked me in the eye, and said that he will make sure I am well taken care of, everything will be okay, and he is here to help. And once all the insurance stuff is taken care of over this next week or so, we can move forward and schedule my big day.

He then said I can go ahead and put my leggings back on, we said our goodbyes and thank yous, and CJ and I were by ourselves in the examination room as I got dressed. After I got my leggings back on I started getting emotional. CJ took a video that pretty much sums up how I felt, and I think that's probably a good way to end this post. <3