top surgery

Dysphoria and Dysmorphia Monsters

/ Alyxander James / 1 Comment

I had a weird day yesterday. I had to get up early to go to PT before work, and that was fine, and then I missed the bus I was hoping to take to get to work on time, which wasn’t a huge deal – I knew I’d have to stay about half an hour later than usual, which is annoying, but not impossible.

But then I got to work, and little things seemed to throw me way off-kilter. (Like when I walked in and discovered that whatever facilities person was working the night before had left my trash can on my chair after emptying it. Who does that?) I was irritable, and easily flustered. And most of all, I felt really, really unsettled in my body.

It wasn’t until I got home and caught an unfortunate glimpse of myself in the bathroom mirror in which I felt I looked like I still had breasts that I started realizing what the problem might be.

Dysphoria is a hard thing to explain, even to other people who experience it, sometimes – because while there are common threads of experience, everyone’s relationship with their body is different. A lot of people are familiar with the feeling of body dysmorphia, but dysphoria is…well, it’s different. Sometimes related, but different. It’s not so much having an objectively inaccurate perception of what your body looks or feels like as it is the knowing that some part of your anatomy or physiology is wrong, and feels like it doesn’t belong to you.

When I first came out as genderqueer, I didn’t really experience body-related dysphoria, but I hated my voice. It made me feel so utterly wrong in my body, like it wasn’t even my voice at all.

As time went on, I did start to experience body dysphoria, but I didn’t think I could call it that, because it looked different for me than it did for other trans folks I knew. It wasn’t so much that I hated my body as it was that parts of it (my chest in particular) felt like they weren’t mine, and I didn’t know what to do with them.

Things have been a lot better in general since I had top surgery, because that directly addressed the greatest source of my dysphoria. I think because I hadn’t had really intense feelings of wrongness in my body since then, I kind of let myself get lulled into this false sense of security, like it was over and I didn’t have to deal with it anymore.

But when I think about yesterday, and how uncomfortable I felt in my body, and how viscerally I reacted to seeing a reflection that didn’t feel accurate…well, I’m realizing now that it was a visit from the fraternal twin monsters of dysphoria and dysmorphia. Surgery wasn’t a magical fix for everything, which I knew, but kind of forgot. Same with hormones. Because of the person I am and the body I have, I will probably always struggle with these monsters from time to time. Which is…not fun.

I debated back and forth about whether I wanted to write about this at all, but I guess what I’m trying to say is that it took me years to recognize what dysphoria looked like for me because everyone else’s story sounded different from mine, and I feel the need to remind folks that every trans person’s story is different (just like every cis person’s story is different). We all experience the world and ourselves in different ways, and we need to make space for that.

Big Days in Transness

/ Alyxander James / Leave a comment

Yesterday felt like a big day for me.

It was National Coming Out Day, which I have complicated feelings about – I feel like there can be too much emphasis on the importance of coming out and not enough on the importance of personal safety. Not everyone is privileged enough to be able to come out safely, and they shouldn’t feel like they need to do it “for the cause” if it means that they’re jeopardizing themselves.

I do have the privilege of relative safety, though, and I do feel like it’s important for me to be out and proud as much as possible, because I have seen firsthand the powerful change that can come about in people’s perspectives when they realize queer people and trans people are people they know, and not just nameless, faceless statistics.

After the election, I decided I was going to make a point to be more out at work. I was terrified, but I also felt like it was some small way that I could reclaim some power in what felt (and still often feels) like a hopeless situation. And then we added a new member to our department in the spring, and I decided that I wasn’t comfortable coming out to her, because we share an office and she seemed quite a bit more conservative than I am, and I didn’t want to make things awkward.

Two weeks ago, this coworker thought they had met a trans person for the first time, and she was freaking out about this person using the women’s restroom, and (probably assuming that, since I was a young, gay man, I could do this) she asked me to “explain transgender” to her.

I admit my initial reaction was not great – I laughed. What else could I do? So many of my coming out experiences have felt forced, and here was another. So I told her I was transgender (to which she responded, “No, you’re not!”). I told her we just need to pee like anyone else, that nothing was going to happen to her because a trans person was using the same restroom she was.

We haven’t talked about it since, but now I feel compelled, once again, to be out and proud wherever I can. I have so much privilege in that I am read 99% of the time as a cis man, and I’m white on top of that, and I need to use that privilege for good.

Aside from being National Coming Out Day, yesterday was my one-year post-op anniversary from chest masculinization surgery. It feels simultaneously like it’s been more and less than a year – on the one hand, I feel so much more comfortable in this body. On the other hand, I still vividly remember what it was like to bind every day (and my lungs remember, too), and when I am tired and have changed out of work clothes have occasionally had to remind myself that leaving the house again might mean putting on pants, but it doesn’t mean wrestling my way into a binder anymore.

Surgery was not a thing I thought I was going to want when I started thinking about transition, but it was definitely the right decision for me. I am still grateful and blown away that my insurance wound up paying for it. The fact that I had surgery doesn’t make me more trans (or more legitimate) than anyone else, but it was a way that I was able to make my body feel more like home, and really, that’s something I wish for everyone.

Highs and Lows

/ Alyxander James / Leave a comment

via Mochimochiland on GIPHY

It’s been a rough week. I’m trying not to wallow in grief, because I feel that I have a responsibility to be ready to stand up for my fellow humans who don’t have a level of privilege that even gives them the option to wallow. As an introvert and a generally non-confrontational person, it’s hard not to feel totally paralyzed.

So I am starting small. I have two coworkers with trans or non-binary kids, and I am knitting things for both kids. I am commuting without headphones, so that I’m more alert and ready to stand up to harassment on transit. My partner and I are figuring out what we need to do to take care of each other.

I am grateful that despite the fact that all hell seems to have broken loose, I am in a pretty okay place personally, and well-supported by friends and chosen family. I am less afraid for myself than I am for a lot of the people around me, which is certainly a privileged place to be in.

In the midst of all of this, last Friday I hit one month post-op. I didn’t even realize it until I was about to go to bed. I’m still feeling really good about the decision to have surgery, and I’m really grateful I was able to do it when I did, but it’s hard to feel particularly celebratory when it feels like the whole country is going to pieces. Still, I hope you’ll permit me the small self-indulgence of a selfie from Friday, because I am pretty happy with how I look these days:

One month post-op

One month post-op

Heigh Ho, Heigh Ho, It’s Back to Work I Go…

/ Alyxander James / Leave a comment

Monday marked my first day of work after a three week absence for surgery and recovery. I worked from home to catch up on emails, and was back in the office on Tuesday.

When our office manager saw me Tuesday, he asked if I’d been bored taking so much time off.

I wasn’t.

It was really, really wonderful to not have to worry about work for a few weeks. The fact that I came back to an office packed pretty much wall-to-wall with computers and peripherals that need to be re-homed (which is not my job, but part of our department’s function sometimes), nearly preventing me from even getting to my desk, did not help to ease the transition back. I’ve felt claustrophobic in my windowless, packed office, achy and tired from so much extra activity, and just generally grouchy.

Still, it’s been nice to see the enthusiasm of coworkers at having me back in the office. Someone informed me on Tuesday that when she told her team I was back, they applauded.

I’m still healing well, although I’m trying hard not to push myself too much with being back at work. The last thing I want is to set myself back to the point where I need to take more days off from work, because I burned through all of my remaining personal and sick time for the three weeks I already took. I’m definitely in the place where I feel like I have more energy than I do, which means I crash a bit at night, and mornings feel like a challenge (although challenging mornings are sort of par for the course for my entire life).

Because I’m feeling like I have my energy back for the most part, and because I’m increasingly happy with how my body looks as it heals, I’m getting really excited about the prospect of self-care in the form of exercise. The problem is that I can’t really exert myself yet, and so I have all of this motivation to work out and very little ability to act on it for the next two or three weeks, by which point the motivation may or may not still be there. Meanwhile, I’m researching various gym and fitness program options and trying to figure out what my budget is for that.

The most exciting news from my week was that I learned that my insurance officially paid for surgery. I may still have a small portion to pay depending on how the hospital billed, but the $30,000+ bulk of the surgery has been covered, and that is an enormous relief!

Choices

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I am continuing to heal. This has been the last week that I’ll get to take off from work, and while I’m really enjoying all the free time, there is definitely a part of me that’s looking forward to getting back into a routine.

It’s been an interesting week of lots of emotions, for reasons I’m not going to get into here (although if we’re friends, feel free to ask me about it elsewhere and I can fill you in). It’s also been my first full week without drains, and I feel like, despite some continued swelling on the right side of my chest, I am finally getting a sense of what my body looks like now.

I realized on Tuesday that I am already certain that undergoing this surgery was one of the best decisions I have ever made. I knew that I would feel different after surgery, and I was pretty sure that different would be better. I had no idea how much more comfortable I would feel in my skin, though. Even though I’m still in some pain and am far from fully healed, I’m still so much more comfortable. I can breathe so much more easily, not just metaphorically, but literally, my lung capacity has increased now that I’m not binding. And I’m sure that will continue once I’m done with the compression vest, too. (I started a new harmonica class at the Old Town School of Folk Music this week. It’s been about a year since I had my harmonicas out, and I could not believe how much easier it was to play now that I’m not fighting my clothing for deep breaths.)

I’m happier with how my shirts fit. I’ve been wearing a lot of hand knit sweaters this week, since it’s cooled off, and while I liked most of them well enough before, I like them even more now. The super oversized sweater I knit last year that I never really wore because I hated how it hung off my chest? Now it’s just a super oversized sweater that feels cozy and comfortable. I had thought I’d never really knit a cardigan because I hated how they gapped across my chest. No longer a problem!

I’m going to finish this post off, for the curious, with a link to a photo of one of my very first shirtless selfies, taken last week. If you’re weirded out by medical things, you might not want to click through (my incisions still look pretty gnarly), but for those of you interested in a visual on how my healing is going, you can find that here!

Recovery Continues

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It’s been just over a week since I had chest masculinization surgery.

Generally, I’m feeling great. I’m beyond ready to have the drains removed, but by the time you read this, that’s probably already happened – the appointment is scheduled for Thursday morning. That’s also when I’ll get a better look at what my chest is really looking like. I’ve seen under the compression vest I’m in a couple of times now, but it’s been accompanied by the stress of a shower (which, when you’re not allowed to face the water or let the little nipple bolster/cushion things be hit directly by the water, and you don’t have your full range of arm motion, is a pretty stressful experience), and the ever-present drains were a factor then. Still, from what I can see, I’m pretty happy. The right side of my chest is pretty bruised, but that’s not particularly surprising after surgery. All in all, my biggest reaction so far has been feeling like this wasn’t that big of a change. This is untrue, but since my chest in real life now looks like it already did in my head, it feels a little like not much happened.

A couple of days ago I traded the heavier pain killers for ibuprofen, which has been working out fine. The worst I’ve had for pain has been what feel like muscle aches. Nothing too serious, mostly just distracting when it happens. The meds have done a good job of taking the edge off, which is about all I ever hope for with pain medication.

My partner’s dad stayed with us and helped out around the apartment for the past ten days; he went home last night. It was great to have him here, and I’m grateful for his help and support!

My week has mostly involved reading (I’ve finished Mara Wilson’s autobiography, Where Am I Now?, which I bought a few days before surgery, and Terry Pratchett’s Wintersmith, which my best friend sent me for recovery reading), knitting (slowly, on a project where tension and gauge don’t make much of a difference), napping, and watching movies. Which is to say it’s been relaxing and (thankfully) uneventful. Next week I will be totally on my own at home, so that’ll be an adventure, but I’m not worried about it. I’m supposed to go back to work the week after, but I might opt to work from home that week, just to ease back into things. We’ll see how it goes.

Thanks for all of your support. I’ve been flooded with sweet texts, emails, and Facebook messages, and I have no doubt all the love coming my way is part of what’s making this all go so smoothly.

Post-Op

/ Alyxander James / Leave a comment

Hello, friends! I am writing this Wednesday morning, my first full day post-op, so this is going to be a short one, probably.

Surgery happened yesterday afternoon, and went very well. The operation itself took less time than the surgeon had estimated it would, although I made up for that time in recovery (I was a sleepy bear and it took me a while to wake up all the way). I really wasn’t nervous at all – the entire staff at the surgical center was charming and kind, and I felt very well-informed every step of the way. By far the worst part of the process was getting the IV started (my line is always, “I am not afraid of needles, but my veins are,” and that definitely proved true yesterday), but even that wasn’t unbearable.

Today I’m pretty sore, but thanks to help from my partner and his dad, who came down to help us out this first week, I’m staying on top of meds and getting top-notch aftercare.

Thanks to everyone who has texted, emailed, Facebooked, or otherwise sent good vibes my way! I’m definitely feeling them.

Counting Down

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The countdown to surgery is officially in the single digits, now. All the paperwork has been submitted, insurance has approved it, and I’m all set to go.

It still doesn’t feel totally real. But it’s getting closer to feeling like reality every day.

I’m excited, but it’s not a particularly exuberant excitement. I’ve got some pre-op jitters, for sure, but for the most part, I’m feeling pretty calm. It’s a quiet sort of excitement. It feels right. It’s been a long time coming, and considering the fact that binding is increasingly painful (even just in the past few weeks), it’s definitely the right time to do this. (On that note, I saw this study on binding going around on Facebook, which has also been a long time coming, and I hope to see more like this.)

There’s an awareness suffusing the excitement of the fact that there’s no going back from this. Not that I want that as an option, but I’m aware that this is a level of permanent change that could keep relationships with certain members of my extended family from ever coming back. I don’t know that most of those relationships are salvageable, anyway, but this does feel more…final, I guess.

I’ve been binding for five years as of this month. I’ve squeezed myself into various rib-crushing configurations of compression shirts almost every single day of that five years. When I started, I thought it was going to be a thing I just did occasionally, to play with gender. I didn’t have any idea how much I would like my flat-chested silhouette. The first day I wore a binder, I spent most of it aware of how much harder it was to breathe, and I wasn’t sure I’d be able to do it again. The next morning, I put it back on without thinking much about it. There were times when the particular type of binder I was using caused so much pain in my ribs that I had to stop binding and switch to sports bras for a few weeks, and that was almost more agonizing that the rib pain. Thankfully, binder technology has come a long way in five years, and thanks to gc2b I’ve been able to bind much more comfortably (and, presumably, more safely) for the past couple of years. But I am so, so ready to be done.

I am ready to be done wearing a binder plus and undershirt plus a regular shirt every. single. day.

I am ready to relearn what it’s like to breathe to my full lung capacity.

I am ready to be done with aching ribs and chest muscles.

And most of all, I’m ready to be able to look in the mirror and see a reflection that matches my mental image of myself.

Happy Autumn Thoughts

/ Alyxander James / Leave a comment

I realized something this, as the temperatures finally started to descend: I think fall my have replaced winter as my favorite season. When I was a kid, I had pretty awful seasonal allergies, and since pollen is a non-issue in a Minnesota December, and since I really do find snow pretty and peaceful, and since I tend to overheat easily, I was always a big fan of winter over any other season.

Now, I don’t mind winter, but I can’t deny the general inconvenience of it. Waiting for the bus in a snowdrift is no fun. Trekking to work over unshoveled, icy sidewalks is no picnic, either. And now that the arrival of fall doesn’t automatically mean sniffles for me, I’m coming to enjoy it more and more. Sweater weather, and apple cider, and leaves changing color…it’s a really beautiful time of year.

I’m glad that I’m going to be recovering from surgery at a time of year where I don’t need to be running the air conditioner to be comfortable, but can have the windows open and enjoy the crisp fall air.

And speaking of surgery, this week has brought with it the most exciting news I could have received: insurance has agreed to cover the procedure. This is still a pretty unbelievable thing: most of the people I know who have undergone this surgery have had to save up and pay it all out of pocket.  I really wasn’t sure how I was going to make it work without insurance. I got the news at exactly two weeks until the big day…waiting was awful. But now it looks like it really is going to happen, and things really are going to work out the way I’ve been almost afraid to hope they would. So happy thoughts all around.

It’s a Process

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Holy shit, it’s September!

That’s about as coherent as my thoughts have gotten over the past few days. I feel like I’ve done a pretty good job with anxiety management lately, but as October draws closer, I find I’m often just a big old bundle of nerves.

I’m still waiting on a letter from my doctor that is a crucial part of raising my chances of having insurance cover surgery next month (if I’m lucky, I’ll have the letter by the end of the day today).

Once I have that letter in hand, I can turn it (along with the letter from my therapist) in to the surgeon’s office, who will submit all of that to my insurance, and then I cross all appendages and wait to hear if I’m covered, or if I’m going to be in a whole lot more credit card debt at the end of all of this.

Still, despite the anxiety, things are going pretty well. I am constantly reminded that my people are the best people, and I am super grateful for that. I have such a great support system, and multiple creative outlets, and a cute, cozy place to live with the love of my life. So even though I have several thousand dollars of credit card debt that might be about to double hanging over my head, I feel like I can’t really complain too much. I’m finally in a place where I feel like things really are going to work out, somehow.