Congruency
2/7/20
If a robot is available, I'll finally have my vaginoplasty surgery on April 8th. Let me explain.
Roughly three months ago (10/23/20), I met with my plastic surgeon for what I thought was a pro forma pre-surgical appointment. It took place six days before my surgery was scheduled to take place. By the time it ended, it had become one of the worst moments of my life. Because of a miscommunication that was exacerbated by COVID-19, I had not lost a sufficient amount of weight. My surgeon balked at proceeding. To understand just how much this hurt you need to know that I wasn't just sitting around at home eating bon-bons. I was working my ass off with a personal trainer to ensure that my body was physically prepared for surgery. And because I was converting fat to muscle, I didn't pay attention to my weight.
I really don't want to go into the specifics of the miscommunication, because, frankly, it hurts too much. Up to this point, I have tried very hard to be equitable in how I tell this story. To wit: accepting blame for not having my body properly prepared for surgery. However, I've come to realize I don't actually believe that. I'm actually pretty fucking angry at the program, and I'm not entirely sure what to do about that. And so I am writing this story...
2/8/20
So the surgeon told me my surgery was to be canceled. I tried to advocate for myself by telling him how hard I had been working in the gym, and how fit I was. No dice. I might as well have been talking to the wall. I tried to hold it together but... well, I didn't. As I started to lose my composure - as evidenced by copious tears and a river of snot - he couldn't get out of the examination room fast enough. When looking back on it, that was a pretty chickenshit move on his part. I was his patient, and he left me sobbing on the floor of the examination room, with my bare ass exposed to the world. Eventually - I'm not actually sure how long - I managed to compose myself to a point where I was able to leave. He never checked back in on me.
I kinda get it though. He's a surgeon, not a therapist. I've worked with enough surgeons in my life to understand that they're extremely cocky and sure of themselves. And they're usually very good at what they do. They're not really good with the 'touchy-feely' stuff, though. Frankly, he didn't know how to deal with the moment. Still, he should have checked back in with me before I left...
2/9/20
For the record I am 5'10" tall. My father was 6'2," as is my older brother. Since I was assigned male at birth, I naturally assumed that I would be 6'2" when I finally stopped growing. For the longest time, I was disappointed that I stopped four inches short of that particular finish line. However, once I learned the truth of my female identity, I began to celebrate that particular fact.
In any event, on 10/23/20 I weighed 242 lbs. (down from a high of 260 lbs. the year before). Roughly that translated to a Body Mass Index (BMI) of 35%. For the very first time since I had met him more than a year and a half previously, he told me in non-ambivalent terms that I needed to get my weight down to at least 205 lbs. before he would agree to do surgery. This corresponded to a BMI of 30%. Before this moment, I had not been given any concrete goal as to where my weight needed to be - by anyone (and hence my anger with the entire program). It sure would have been nice though - I could have tweaked my workout regimen to focus more on weight loss during the many months I sweated it out in the gym, waiting for my surgery date to arrive. Instead we had a situation where I was lying on the exam room floor in a puddle of my own snot and tears, sure that losing 35 lbs. was an insurmountable goal and that I was to be forever stuck with the wrong genitalia...
2/9/20 (part II)
I shouldn't have driven myself home from my clinic appointment that day. The clinic building is just off the highway in St. Paul. A person is almost immediately engaged in congested urban highway traffic upon leaving. My emotional state at the time existed somewhere between "Who gives a shit?" and "That cement barrier looks like a good place to aim for." I don't remember exactly, but I can guess I put on some Bruce Springsteen and played it loudly. He's been there for me many times in the past, and it makes sense I would lean on him one more time. By the time I made it home, I decided I would never eat again...
2/11/20
That night, Cindy eventually got me to eat a bowl of soup. Additionally, she held and comforted me. She wiped away my tears and snot. She made me know she was on my side, and that we would figure things out together. She made me realize I was supported. It is imperative that you know this, because I don't think what happened next would have happened without her love...
2/15/20
Twice in my life I have experienced an epiphany - a moment where a voice not my own delivered a truth bomb straight to my head and heart. The first time was a long time ago when I chased a woman all the way to California from Connecticut. When we started our roundabout trek across the country we were engaged. By the time we arrived at her home in Santa Cruz we weren't. I thought I had to make a go of it out there on my own, and did my best for about three months. Then a voice came to me and said, "You know, you don't have to stay here, you can go home." Until that moment, I hadn't considered that option at all. As it was a really good idea, I heeded the voice and came home.
The second time occurred sometime during the 24 hour period after my disastrous meeting with the plastic surgeon. You see, when he told me that I needed to lose 35 pounds and get my weight down to 205 lbs., it felt like a death sentence. I had weighed approximately 250 lbs. (give or take), for so long, I lacked the ability to think that I could ever lose the amount of weight that he insisted I needed to lose. "I can't do that." I thought to myself, "I just can't!"
"Why not?" said a voice, not my own.
"Because..." I started to respond, but then stopped. I pondered the voice's question for a few moments. All of a sudden, what had seemed so insurmountable seemed like a possibility. Until the voice spoke those two little words to me, I could not imagine myself losing the weight. Now I could - just like that...
2/15/20 (part II)
Something you need to understand about Cindy, my partner, is how tenacious she is when it comes to problem solving. When presented with a challenge, she will do whatever she needs to in order to wrestle a particular problem to the ground. She understood that me changing my eating habits would benefit us both so she decided to join me in pursuing weight loss. A good plan, for sure. We would be able to support each other as we both worked on losing weight.
She suggested we do Keto. After she explained the particulars, I agreed; and we set about changing our entire dietary habits. After a few days, I discovered something about Cindy's tenacity, as it related to losing weight through Keto based principles. She was going to drive me nuts. There were too many questions for me. Too much work in keeping track of every little thing I ate. I just wanted someone to tell me what to eat, and how much. After a few days, it occurred to me that maybe it wasn't a good idea for us to follow the same plan.
My trainer recommended Profile by Sanford. She had used this program to help her get her body back in shape after childbirth. I scheduled an appointment for the next day. There, the plan was explained to me. All I had to do was give them a lot of money, and they would tell me exactly what to do. Perfect! Because Cindy was not the only one of us gifted with tenacity, I knew, to paraphrase Sherlock Holmes, that the "game was afoot." I had a clear goal in mind, and what I weighed was keeping me from it. It was time to eliminate that particular obstacle...
2/20/21
I'm going to jump ahead to January 19, 2021. This was my first appointment with my plastic surgeon since our disastrous encounter on 10/23/20. I am choosing to do this because it would be just as boring for you to read the details of my dieting as it would be for me to write them. Suffice to say I was hungry for most of that three month time span. I was lucky enough to be paired up with a great coach, which definitely helped me along. And I made regular trips to the gym despite chronic fatigue.
For the record, I weighed in at 199 lbs. If you're keeping track at home, that's six pounds below the target I was given. My doctor was both surprised and impressed...
2/21/21
So about the robot. (I bet you thought I forgot about the robot). Once my surgeon and I got through discussing my weight loss, we started talking about re-scheduling my surgery (yay!). He also asked me if I was agreeable to having "robot-assisted" surgery. Briefly, a plastic surgeon and a urological surgeon usually perform vaginoplasty by hand. Apparently, however, the future is now, and surgical robots are being used, as well. In any event, I laughed at him when he asked me that question. "You're the doctor," I said, "And I plan on being asleep, anyway, so whatever you think best." The problem is that the hospital only has two robots, and they're assigned 'first come, first serve.' The reason that's relevant is that because of COVID, surgeries can only be officially booked six weeks in advance. So if the different services all try to schedule procedures at the same time, and more than two of them want a robot, I could be out of luck...
2/23/21
Yesterday I received official word that my surgery is, in fact, scheduled for April 8th - robot included (yay!) I was, of course, elated with that bit of news. But here's the rub - and the main reason why none of you will read any of this for a while yet. I've been in this position twice before. Last January, I had a surgery date of June 6th. I started counting down the days. Unfortunately, shortly after that COVID-19 came along and ruined everyone's day... er, month... er, year... umm, let me get back to you on the actual length of time COVID actually fucks us over for.
In any event, I hoped against hope that my surgery would still occur but, no. It was officially postponed indefinitely in May. In August, after hearing nothing for three months, I received word from the scheduler that my surgery was now scheduled for October 28th. I started counting down the days again, but in a much more circumspect manner. I wasn't going to embarrass myself again and tell the entire world what was happening until a time much closer to the actual surgery date. And seriously - it's not like a delay based upon the realities of a pandemic were my fault. But, by the time October 23rd rolled around and I was six days from surgery, I had pretty much told the entire world I was about to go under the knife. I was so excited, and had everything (except for my weight, as it turns out), prepared for my hospitalization and post-op recovery...
2/23/21 (Part II)
I'm not sure how quickly I had the following thought after I was told I wasn't going to have surgery last October, but it was pretty quick. "I don't know if I'll ever be in a position where I'm waiting for a surgery date to arrive again, but if I am, I'm not telling anyone about it until they're wheeling me into the OR." Which is why I'm writing this without any idea of when, or even if, I will publish it. I can't face the pain of telling all of you yet again that something has gone wrong. And so, even though I have told my immediate family this news, I am left to fret all alone, as I wear a mask of stoic patience. And despite my best intentions of not letting myself get my hopes up, I've started another countdown of days until surgery (44 as of today)...
2/24/21
And now the fear of factors beyond anyone's control begin to take hold, leaving me both squeamish and ill-tempered. COVID variances, anyone...?
2/25/21
It's been 36 hours since my last entry. Subtract six hours for sleep. My mind is running a continuous loop of garbled distortion in the background. In the meantime I try to engage with the world around me with limited success. My depression has me feeling adrift upon the sea in a small boat surrounded by nothing but water on all sides. My brain tells me to scream out loud asking for help, but there's this huge part of me that feels like I would just be ignored. I feel completely disconnected from everything. How can I make the world see my pain...?
2/28/21
38 days until surgery. I try not to fall into the trap of counting down the days, but, well... it's a hard thing to do. The desperate depression of a few days ago has temporarily receded, though. I'm certain it will return with a vengeance at some point soon, but there's no reliable way to calculate when that might be. Everything's still a go with surgery, but I've been down the road before. Keeping up my psychic defense shields against some new way that surgery could be canceled yet again requires a huge amount of mental energy. I'm tired...
3/1/21
Whether a good day or bad, the refrain each morning remains the same: "One day closer..."
3/3/21
Five more weeks...
3/7/21
I just published AtRP #150 (Anatomy of a Panic Attack), and can't help wondering how many people will be able to read between the lines of my "very important project." Most, probably. I almost went ahead and told the truth - that my prior approval from the insurance company needed to be re-authorized, but I've worked so hard at keeping a lid on this, that it felt like a sure fire jinx if I went public. You'll all have a chance to read this soon, I promise, but just not yet...
3/11/21
Last Friday I got the first of my two vaccination shots. I was so excited - I felt like a kid on Christmas morning. The second clinic is tentatively scheduled for April 2nd. But if not then, then April 5th. When I learned that, I pondered a bit. Then I sent a letter to my care team asking them if there was a problem with getting the vaccine so close to my surgery date. It's a good thing I did. I was instructed that any vaccination within three days of surgery would result in cancelation. So... If I can get my shot on April 2nd were good, but not if it occurs on the 5th. I'll have to play it by ear a little bit. But I also feel like I side-stepped the making of a potentially huge mistake. Maybe the surgery is really fated to happen this time?
Oh, and on that note, my insurance company has already re-authorized their prior approval...
3/12/21
As I was driving around town today, my thoughts just kind of wandered the way they will when not pondering a specific issue. I flashed onto this particular post, and thought about the name I gave it six weeks ago when I started writing. My next thought was something along the line of "I really haven't talked about that so much yet, have I?" And suddenly I realized I had a new direction to take this entry. I mean, who wants to read consecutive entries where I tell you how many days are left before my surgery is scheduled? (25 by the way.) I usually put a good deal of thought into my titles, and I remember feeling at the time that "Congruency" was perfect. I wonder what I had in mind?
Congruency: Agreement or harmony; compatibility; balance; ant: conflict
Let's assume that you, my lovelies, are able to put (2 + 2) together and 'sense' that the answer might be 4. Right now, my body and my sense of self are not congruent with one another. Thus my emotional state is one of disharmony. In myself and other trans folks this conflict is often referred to as "gender dysphoria." I really don't know how to describe it other than to write that when I look at my naked body in the mirror I look wrong, really wrong. Now I know that everybody has a certain amount of angst about their own bodily "imperfections," but what I'm talking about goes much deeper. Listen, I'm somewhat disgusted about the 'spare tire' I carry around my gut, which is tenaciously hanging on, despite how much weight I lose. But it doesn't come close to the abhorrence I feel looking at the current state of my genitalia. It might as well be a cancerous growth.
For me to achieve a feeling of congruency, something needs to change. I hope you can believe me when I tell you that I have worked really fucking hard on my sense of self. Nothing about the work I've done has been capricious or whimsical. The insights I have gained and the decisions I have made as a result of hard won truths - some of which scared the hell out of me when I learned them - have led me to this time and place. The simple truth is that my sense of self is female. To deny that is not a tenable solution. And so my body - or certain parts, anyway, need to change...
3/17/21
Yesterday was a big day. I had my official pre-surgical appointment with my plastic surgeon. This was the same appointment I had on October 23 when all the wheels fell off. I didn't realize until I arrived that I was kind of anxious. I knew only too well how quickly things could turn, especially when you least expect it. In the end, it couldn't have gone any better. 20 days and counting...
3/20/21
Akeelah & the Bee is a wonderful, wonderful movie. It's about an adolescent black girl (played by Keke Palmer) who lives in South Central LA, where she hides her intellectual 'light' under a bushel so she won't stand out. Problem is, she a spelling genius. A lot of plot happens and she ends up at the national spelling bee. Search it out if you've never seen it. Anyway, this is a very roundabout way of getting to the kid whose primary function is comedy relief and the line he says at one point: "You could cut the tension with a butter knife." That line has become a family favorite, and you're almost sure to hear it at least once when we all gather together.
In any event, as I sit here thinking about the next 2 1/2 weeks and the anxiety I feel churning in my gut, that line popped into my head. I think tension's about to be my constant companion for a little while. Fun...
3/22/21
tick... tick... tick...
3/22/21 (Part II)
Earlier today I sent a message to my surgery team asking them about my advanced care directive - did they need it ahead of time or not? A return message came back, and as I went to read it the word "regretfully" jumped out at me. "Holy Fucking Jesus!" I thought to myself. Two things then happened simultaneously: I started to furiously read the message as quickly as I could as all the anxiety I've been doing my best to keep under control came rushing at me like a New York cabbie on meth. In about the same amount of time that it's taken you to read this sentence, I got to the part, written in all caps, that said, "THIS WILL NOT AFFECT YOU OR YOUR SURGERY DATE."
It turns out my surgeon had made the decision to move to a new organization out of state, and that while he is leaving (relatively) soon, my surgery is still scheduled to happen on April 8. Whew. On the one hand, I saw this as further proof that my surgery is fated to happen this time. This was just one more occasion where disaster got side-stepped at the last second, you see? On the other hand, shit like this is exactly the reason why I haven't pressed the "publish" button on this post yet. That rush of anxiety I mentioned above, the one that came hurling towards me, seemingly at light speed? It was only present for a nanosecond, but in that moment I could feel how powerful my fears and anxieties are. I'm 15 days out, and everything is on track. But God help me if something happens to change that...
3/25/21
It's been three days since my last update. I've been thinking a great deal about that "rush of anxiety" I mentioned above. It was pretty fucking scary, to be honest. The fear that it unleashed in me - that I'm petrified I won't be able to control my reaction if/when surgery cancelation occurs - has me walking on egg shells. I also realized just how much energy I'm expending just "keeping the wolves at bay." (For the record: I wasn't sure I was using that expression correctly, so I looked it up: "To stave off or delay disaster," it said. So, yeah, I used it correctly.) It's frankly exhausting, and it's also keeping me from tasks I genuinely need to accomplish.
I also realized something else. If you've been following along, you know I've been waiting about 18 months for this surgery to happen. That it was three years ago that I began the gender confirmation process, and that, overall, if been working on my gender identity for the last five years. So no wonder I'm apprehensive about this - I've spent half a decade working towards this goal. Except not. Back in AtRP #72 (December 2019), I explored 16 clues that should have tipped me off to my identity as a trans woman before, you know, I actually figured it out. One of the clues told about how, back when I was 11 years old - almost past the point of making wishes and hoping they might come true, but not quite - I'd tuck my penis between my legs, and ask God to "please let me wake up a girl."
Holy Fucking Shit! I've wanted this surgery almost my entire life! 11 year old me was still wistful enough to speak my heart's desire - I hadn't yet quite reached the point where I would spend the next 40 years - exerting so much energy quashing what I considered my "perverted" and "shameful" sexual thoughts. No wonder my anxiety is circling me like a lioness on the hunt, while I'm the nervous antelope carefully sipping from the savannah water hole.
On the other hand, surgery is only 12 days away now. In fact, today I had to follow my first pre-surgical direction and discontinue all my HRT medications until afterwards...