I had the pre-op appointment on Thursday. I felt so much better after the appointment, not just because of the information that was given to me, but moreso because the level of care, compassion, professionalism, and humor that everyone I spoke with had. I feel in very good hands. Not sure if I’ve mentioned already in here that I’m having surgery with Dr. Megan Dreveskracht at La Belle Vie in Tukwilla. I’m scheduled for Noon on Thursday, October 4th. Now just four days away (basically three and a half as I’m finally posting this)!
I was pretty paralyzed for a while there… or at least moving very s l o w l y through my days. Basically, I had a whole lot of freeze happen in my nervous system after I scheduled surgery. A microcosm of the macrocosm of surgery freeze I have experienced over the last few years, no doubt. I had a challenging time staying in my own experience for a while, feeling stuck and having to sort out a lot of feelings, preferring to distract myself. I scheduled nearly a month ago, which seemed like plenty of time. I had assumed the year I waited between consult and surgery was enough time for me to have sorted through my myriad of feelings about surgery, but obviously not. Not only have I never had surgery before, making this experience terrifying in and of itself for that reason, but this is a trans surgery, so I also had all that to contend with.
My fear and freeze had to do with the questions that I had no answers to. I wondered what it would be like to have surgery. I questioned how I would be able to let myself be the kind of vulnerable and receive the kind of support I know I’ll need. I felt a whole lot of internalized transphobia come up. It had already taken me many years to come to the decision to have surgery, each movement forward finding a new set of blocks within me. Already wrestling with so many transphobic questions for years, I had paused in my road to top surgery after my initial consultations a year ago because of the way they bounced around my internal landscape. All the questions came back after I scheduled. It was no longer an abstract interest or desire, it was happening. There was a date.
Of course, this transphobia isn’t coming from me, not really, but it is inside me. It’s coming from the culture and has seeped into all of our bodies through conscious and unconscious messages. It is coming from the current power structures and social institutions that we collectively agree to. We can call it heterocisnormative imperialist white supremacist capitalist patriarchy if we want to, but no matter what we call it, it is the water that we swim in and where we get our nourishment (and, coincidentally, why we are all actually starving). The assumptions. The caveats. The questions. The comments reminding me not to rush into anything (my response: I’ve been talking to my therapist about this for over two years. I’m not rushing). The assurance that I’m still loved if I do this (my response: that was never in question! And yet, it is, thanks, transphobia). The commentary on the politics of trans surgery or how it may or may not impact my mental health and my life to have this surgery (my response: too much for a small aside, but I’m doing this for me and the personal is political). Then there are the questions I have grappled with for years, why it took me so long to do this: what if I don’t like it? what if it’s the wrong choice? what if it means people will think I’m a man now? why does it matter so much to myself or anyone? why will it make me a “more valid” trans person (as if I’m not a valid trans person already) in the eyes of so many? why can’t I just be fine without it?
So many questions.
These questions, and more, have been running through my head pretty regularly for years. Those responses are all ones I have received directly. This is all transphobia. It’s exhausting.
It has been a long road to this surgery. I recently looked back over old journal entries to find dates for transness/transition/top-surgery-related milestones: I started binding in 2011, using gender neutral pronouns in 2010 and id’ing as genderqueer in 2007. I’m pretty sure it was also 2011 that I finally began thinking my genderqueerness might be enough to consider myself to be trans. I had previously been told by a number of trans folks that I couldn’t possibly be trans because I’m femme and AFAB, an experience that, no doubt, set me back a bit in terms of my self identity and gender expression. For a few years, at least, I was terrified and anxious any time I tried to express anything other than (cis) femme, certain that someone would realize I was a fake and call me on it. Instead of feeling like I could embrace other trans folks in my process of gender exploration, I was at least as terrified of us as I was of cis folks invalidating my gender.
I first really talked with my therapist and doctor about the possibility of top surgery well over two years ago. It always seemed like something other trans folks got, but not me. Actually, I am sure they both asked me about it prior to when I started testosterone in 2015 (which also took me over a year to actually allow myself to explore, my first appointment with my Doc to discuss T was in late 2013 and I didn’t start T until early 2015), and I have been uncertain about surgery all those years. Questioning if it’s a good idea, if it’s really for me, all those questions above, all the thoughts. I wasn’t regularly binding until a couple of years ago, having previously utilized it as part of my gender expression rather than a central indicator of it. Now, and for a while, I have been binding daily (unless I am at home all day with no visitors). I experience more social dysphoria than physical dysphoria.
Because of my level of privilege, the barriers to top surgery have all been personal and cultural, with a minimal amount of medical and/or class barriers to the experience. Because I have private insurance through my husbear’s tech job, I have a trans-knowledgeable therapist I see every week and a GP who is one of the best trans-related healthcare providers in Seattle, also arguably one of the best places to be trans in the country. My fat body has been a barrier to my choice of surgeons, and I did have to endure some fatphobia in the selection process, but there are still plenty of surgeons in Seattle who would take me as a patient. I met with three doctors to choose the one I am going with. I hit a bit of an insurance snag last year, as we switched insurances in August and again in January, and that was enough to be a factor in my stalling, but not the main cause. I took my time getting to this place because of all the barriers I had built up in myself against surgery, against getting what I want and need, against doing things for myself.
Ultimately, though, I’m doing this for me. Sometimes I wonder if transitioning is the only thing I’ve ever truly done in my life that is just for me. For so many years I tried to be cis. I tried to be happy and content with being read as a woman, even though I’m not. I tried to be content with being assumed to be straight, even though I’m not. I tried to be happy with my body the way it is, especially after so much work to love my fat body, and I will be. Surgery isn’t necessary for all trans folks, but for some of us it is the answer. Even if it eases just a little discomfort, makes our lives just a little bit easier, or makes us a little bit happier, it is worth it. It will not eliminate my experiencing transphobia, either internal or external, that is something we all have to work on every day. It will not mean I will no longer be misgendered, though I’ll be more likely to be misgendered as a man than as a woman, so that will at least be a change. At very least, this surgery will free up a whole lot of brainspace that has been dedicated to the “what if” of surgery. At best, I will feel more comfortable, more at home in my own body and in the world.