Years ago, when I was attending one of the Q Center’s trans men’s groups in Portland, my mentor mentioned it was their fifth year on testosterone. A couple of us asked him if he felt he was done, if his medical transition was complete. He said he felt as if things were still moving around, fat redistributing and so forth, but that it was mostly finished.
Now that I’m at five years on T, I think I’m pretty much there too. For the past couple years not much has happened in regards to hormone therapy, but one of the areas I’d like to discuss in this update is my gender affirming surgeries: what I’ve had done, where I’m at with them, and what’s next. Last year was intense, and this year has been full of challenges as well. But first, a recap.
Because of testosterone, I have a beard with a couple patchy areas under my nose and on my chin, I have body hair everywhere, I’m losing my head hair (I rub on Minoxidil to maintain what I have), I develop muscles easier, I recover faster from minor tear injuries, my fat tends to sit around my middle (except for when I’m simply fat all over… like now), and I am almost always correctly gendered male. When I’m not, those situations are usually quickly resolved. Hell, I think some cis guys experience the same, so it’s hard to take it too personally.
Socially, my family/friends circles know about my gender transition, and while I’ve had a few disappointingly awkward conversations, in most cases people have adapted and we’ve moved on. It’s a huge relief to be over that hurdle, because social transitioning was the most difficult part of transitioning.
For those who think that kids these days are only socially transitioning to be cool, those people are wrong. Full stop. This is an exhausting process that most people undertake with extreme fear and stress, for years.
For those who are continually redefining their gender because of our broken binary gendered system—y’all are fighting the big fight. Thank you.
If you have a queer loved one in your life and you think they can’t tell you don’t practice their preferred pronouns and name around others when they aren’t there, you are mistaken. They can. Additionally, when you use the wrong pronouns in public, and you don’t correct yourself, you make more work for the queer person in your life, which can create an unsafe space. Do the best you can, obviously, but this is something only you can work on. Other people can’t do it for you.
As a person with bipolar I disorder, I’ve been told I have higher risk of suicide, comorbidities, and early death due to my condition, and I’ve been told the same for being trans. I’ve had to structure my life like I’m walking on eggshells, because one bad day could lead to an entire month shot. However, since testosterone therapy I’m more emotionally stable than I have ever been.
I’ve been able to reduce the amount of bipolar medication I take to less than half the original dose, and I was able to stop one medication completely. Seriously, it’s that dramatic of a difference. Simple explanation? Testosterone allows my brain to function better than when it was on estrogen.
Being stable is bittersweet, mostly because I feel as if a ton of my life has been lived less joyously, in survival mode, but now that I’m finally there it feels as if a great burden has been lifted. I’m finally learning to breathe and to be present with that breath.
Warning: this section contains detailed content about surgical procedures.
I’ve had top and bottom surgery and a few minor procedures as part of my transition. Despite what many believe, bottom surgery isn’t that common among trans populations, for many reasons. Mainly, it’s expensive, time consuming, and not necessary for most people. Deciding to get surgery wasn’t an easy process for me, but it was an inevitable one.
I had top surgery and a total hysterectomy in 2016. Because I developed a MRSA infection, I had an emergency surgery about a month later. Besides needing a minor procedure to fix a slight problem, I’m happy with how things look and my sensation. I jumped right into the locker rooms and swimming at the local gym and have had zero problems with integrating into male dominated spaces, which was one of my major goals. Maybe a few bros stared at me too long in the beginning but I didn’t let those experiences slow me down.
After top surgery, I sought bottom surgery. I wasn’t a good candidate for metoidioplasty, which is defined by how they create a penis out of your natal pelvic anatomy, so last year I had radial forearm flap phalloplasty with urethral lengthening, scrotoplasty, glansplasty, and vaginectomy at OHSU with Dr. Berli.
They created a phallus by removing the skin of my forearm, forming a tube, and attaching it. During this process, I lost part of my penis so I had to have two additional surgeries. I was on bed rest or had severe movement restrictions for over two months.
At the end of August, I had the next stage. They removed my vagina, connected my neo-urethra with my natal urethra so I could pee standing up, performed a glansplasty to fix some of the area I lost, and created a scrotum. Yet again, I had a few complications. Part of the graft for the glansplasty had to be removed, and I’ve had an odd stricture in my urethra which at first made it hard for me to urinate on my own, and has been giving me frequent urinary infections since.
Because of COVID-19, my repair procedures and surgeries have been put on hold, so while I continue to heal and improve, I still suffer from frequent urinary infections, which at one point had turned into sepsis.
The only reason I got better from the sepsis was because I took a cycle of broad spectrum antibiotics from Mexico, because my urologist was too slow in prescribing what I needed. My local urologist also took half a year to run two (expensive) tests, and using the results of those tests, they determined that my problems were phalloplasty related and my surgeon’s urologist would provide better care than they would, so they refused to see me again.
Without the help of my local urologist; however, I am at the mercy of the busiest hospital in Oregon, which means it’ll take longer to get treatment, simple treatments and procedures my local urologist is capable of doing. On top of that, I just found out my condition may actually be genetic (thanks Mom) and in my natal anatomy, and while phalloplasty aggravated it, it’s not phalloplasty related, so their reason for firing me isn’t valid.
Due to being trans, experiencing these sorts of microaggressions in the medical system has been common for me. For most of my health care I have to travel over two hours one way.
While I wait for treatment, I continue to work on establishing a relationship with my new parts, but it’s already better than the relationship I had with my old parts, so I think I’m going to be okay.
Hopefully at some point I’ll get those repair procedures done so that I can have my final stage of phalloplasty: testicular implants. I’d also like to get permanent hair removal on my penis and medical tattooing. Right now my penis is as blinding white as the underside of my arm… because it was the underside of my arm. Haha, that’s a little trans dick humor for ya. Anyway, some medical tattooing would be nice.
I may regret this, but I’m usually pretty open to answering questions, so feel free to email me or, if you’re friends with me, you can message me on Facebook (if you aren’t friends with me I may not see it).
If you are going to message me, please don’t ask what my husbear thinks of my transition. Honestly, his experience isn’t as important or as valid to me as mine is, but feel free to ask him yourself if it’s that important to you. I can’t promise he’ll reply, however.
To Boldy Go,
Here are a few of my past posts about transitioning.