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I'll start with the acne, as I have done pretty much from the start! At the end of week 2, I was ready to believe that it was getting better. Week 3 kind of stopped this feeling with it getting worse. This week has again starter better and ended up with the suspicion that it's going to get worse again. The spots eased for a few days but there have been some new ones recently, adding to the raised areas from the previous one. I now think I have this for the duration. This did also lead me to do some research on testosterone and I found out the half life of the hormone, which is 2-4 hours. The great news is that once I am post-op, I have about 15 hours before I will have the T levels of a cis-gender woman. 24 hours and it should be virtually eliminated from my body. Hopefully then, within a few days the excess sebum which is causing the problem will dwindle and it will ease off.
The hot flushes have again been on and off.I went three days without one and thought that perhaps that would be the end of them until I am post op when there will be no hormones in my body whatsoever. However, Sunday saw a sudden hot flush in the middle of the day and it was more the suddenness of it that took me by surprise than anything. Since then, I have had a few a day and it is a reminder that they have not gone away.
Again, the night time erections continue and they are often all night long. They are not particularly wanted and sometimes are enough to stop me sleeping. It's also extremely difficult to go to the toilet for obvious reasons. Someone has suggested taking a large mallet to bed, but I am not so sure whether this has merits, I still need the thing for my surgery! I try to take comfort from the fact that all this will help with my dilation post-op but it is difficult sometimes.
As I wrote about in my Gential Dysphoria post, the sex drive is still zero so using these erections is not even possible. The more I continue along, the more uncomfortable I am with my genitals and the more glad I will be to get to my surgery. I have heard some write in the past about how the last week was the worst and there were so many doubts and second thoughts. I am two weeks away and my thoughts are completely opposite with no signs of it turning around.
Other body changes; the breasts have stopped diminishing and although they are flaccid, they do still have a good shape and can be persuaded to look semi-decent with a bra. Body hair has not increased either, although nearly 5 years of epilation has probably beaten that into submission anyway. Facial hair has increased although that is difficult to completely be sure. At one point because of the acne, I was epilating it every 36 hours but have found I need to go back to 24 hours or else there are too many and they are longer. One final change I have noticed is that my skin is not as soft as it was, it is definitely reverting back to it's former harder self and I need to moisturise certain areas because of the changes.
Finally, emotionally things have become much different. As already mentioned I am now much more aware of how uncomfortable I am with my body. I also feel much more tearful and reactive emotionally. I am much more sensitive to comments and how things are said and this has led to one or two arguments with Mandy. We have got through them and talking afterwards is key to moving on. It is not going to get any easier for the short term and the anticipation of the surgery does not help much either. Also I am finding myself much more weepy. One particularly triggering phenomena is other women crying. This includes TV and real life. Whilst I was starting to find this happening more prior to stopping the hormones, it is even more apparent now. On TV, it has to be a very good crying scene and it has to be a woman, but it is extremely powerful when I do connect. There is something I see in the facial expressions of a crying woman that triggers this and there is then very little I can do. Other situations are Mandy crying or even someone on the phone. I also find crying a massive release and when I am emotional, it really helps me to move on. It just surprises me that with all this testosterone, it has gotten stronger!
I will update about this this once more at the end of next week, just prior to the 6 weeks mark. After that, I will have had my surgery and any development hormonally (or lack of!) can be included in anything I am able to write about my post-op experience. I will be back later this week with something else and look forward to writing it.
Lucy x
Please Note: This writing is an honest discussion about how I feel with regards my genitalia. It will probably not be in line with some peoples opinions. It may be triggering for those currently waiting for GRS or unable to have it. It also contains talk of a sexual nature. You read this at your own risk and take it for what it is, my thoughts and feelings and not your own. They are for you to express in your own way in your own place.
It is exactly 18 days to my surgery but of course who's counting? Recently I have stumbled across some other people writing about their surgical journey and it has led me to think a little deeper about my upcoming surgery and what it will mean for me. By listening to what they have said, it has led me to speak out prior to my surgery about how I feel.
Within the transgender community, there seems to be a strange dismissal of GRS. This is hard to explain but I frequently come across phrases like, "if you can avoid surgery, do so at all costs" and "it's not that important, it's just the icing on the cake". This is but a scratching on the surface, and I have heard many more similar sayings. There is a general attitude that you should be seen to be treating GRS as a final part of the puzzle and it's not that important if you don't get it.
For me this is a complete load of crap and I will state now that I am desperate for my GRS. So desperate that whilst waiting for a date for it and being told there was no money to fund it led me to a long period of depression. It means far more to me than just a little bit of "icing". Whilst GRS does not make you the woman, it does fix a very important issue that is invisible to anyone but myself and my partner Mandy.
It is becoming apparent to me that I have genital dysphoria in a quite severe form. This is a phrase that I have only heard talked about recently and is a more appropriate phrase than the incorrect body dysmorphic disorder phrase that is sometimes attached to gender dysphoria. In simple terms it means an unhappiness with my genitals in the same way as I was unhappy with my assigned gender.
Some, usually cisgender people, seem to regard this dysphoria as unimportant, because no one can see my genitals and this does not affect my day to day life as a woman. This is absurd and I can assure you that what is between my legs is on my mind a great deal of the time. It is a constant reminder that I am not quite who I am; that I am different in some way. It is also a potential source of testosterone, something I am painfully aware of now that I have stopped hormones in preparation for my surgery.
So I have a penis and two testicles. It is painful to even admit that, but it is the horrible truth. I have heard many pre-op people talk about their genitals, and they often express an indifference to them. Myself, I hate them, they disgust me and I want them gone. Even 18 days seems agonisingly far away, that's how much I have come to loathe these objects between my legs. Ironically, some of what is there is harvested for my vagina, but I can live with that because that is what is needed to construct it.
There is also the question of my sexual needs and at the moment, I do not feel comfortable exploring myself in this regard with what I have. This is something I mentioned in the last post concerning sex drive. I expected that with the testosterone surge, I would suddenly have a strong desire in the sex department. I could not have been any more wrong. When I was comfortable with my hormones, a low testosterone and a stable oestrogen, I was finding that I could explore my sexual urges. Even with the "wrong" parts, I found I could enjoy myself and achieved orgasm several times. In fact these orgasms, although achieved through male genitalia, were phenomenally powerful and nothing like before I was taking hormones. If I could compare, my previous orgasms were on the 1-2 mark on a scale of 1-10. Afterwards, they were 9-10 and mind blowing. In fact my first one, 9 months after starting oestrogen, was so intense, I could do nothing for at least 5 minutes after. This leads me to wonder just what it is going to be like further down the line when I am healed and able to be active again. However, now with a penis and testosterone, I can't even think of using it in this regard. It's just a tube to pee out of.
The thought of getting a vagina is so immensely powerful, it brings me to tears writing this. I have wanted one since a very early age, possible as early as 3 or 4. It is something I have thought about all my life and it has more meaning to me than anything else I have taken physically from my transitioning. It has been great to grow my small breasts, have my hips change and my facial contours soften but getting that vagina, that will be more than a little bit of "icing". I would happily have none of the rest if that is what it would take to get this.
It now appears I am not alone in these thoughts, but it seems people are reluctant to express this until after the surgery itself. I know there is a fear that clamouring for surgery at an early stage will slow the process. Those that know better than us who have to live with dysphoria (gender and genital), want us to realise that surgery is not the be all and end all. I agree fully that you do need to go out and live as a woman and experience everything attached to the real life experience RLE. However, some of us do attach as much importance to the surgery as they do the RLE but I was always too scared to admit this at my gender clinic for fear of being held back.
I always kept the idea of surgery in the back of my mind to protect myself. Whilst I wasn't moving towards it, I was safe. I got my head down and did my time and waited patiently. When I was then told on February 5th this year that I could start the process, suddenly it all changed. I let those thoughts out of their box and started looking forward to something I needed desperately. 11 days later the bastards slammed the door in my face by saying I had not fulfilled one of the criteria, 12 months on HRT which incidentally was their fault. I was told to wait another 3 months and they would then start the process. I duly did this and then they did not write the letters as promised. Worse a pen pusher decided to lie to me and say they had been written. It got ugly and I pushed back very hard and actually got somewhere. Because they had fucked up, they pushed things through quickly and suddenly I had a date to see the surgeon. Of course we then had the funding crisis and the door was slammed in my face again. No one should have to go through this but it seems this is a very common experience.
There is talk these days that we will move to a genderless society at some stage and GRS will no longer be needed. As I said before, what a load of crap. How would a genderless society make me feel better about my genitals? They would still be wrong for me and I would still need them changed to make me more comfortable. Who comes up with this crap anyway? Clearly people who have not experience gender or genital dysphoria.
The surgery itself and aftermath itself is very trivial to me. What will happen will happen and I am not worried about that side of things. There are the risks, complications as well as all the after-care, infections and dilation. Never mind the fragility I will experience and having to be mindful of myself for a large amount of time. At the end I will have a vagina and that is now so important to me. However, if it all goes wrong and I lose it, I will at least no longer have a penis and two testicles and that is just as important.
The scars run very deep and this contributes greatly to my anxiety, something I had never had until I entered my gender clinic. So it will be a very nervy 18 days to come and I will only truly be at peace with my body when I wake up and am told it is done. I don't see this as any kind of rebirth as some do, but it will mean an end to both of the dysphoria's that I have and life will be much more comfortable then it is now.
Please also see:
There was hope that I could report that the acne I have been getting is much better. I felt a few days ago it was getting better, but it seems to be getting a little worse again. Perhaps my testosterone levels are wavering a little and I suppose after the bashing I have given the testicles with the oestrogen this is to be expected. I have researched acne a great deal and there is very little I can do to help it. I can purchase lots of expensive creams and lotions, and yet they will do very little. I also have to have had it long term to get any kind of medical treatment, and these are quite aggressive in their nature. The advice is to keep the face clean, but not wash more than twice a day and keep the moisturiser light. I only use my day cream now for it's SPF and I do not need anything at night due to the skin feeling greasy within 30 minutes of washing it. It's just a case of tolerating this and avoiding any scarring until the testosterone is removed from my system.
The night-time erections continue and it is probably every night now. Interestingly, even with this testosterone surge, I still have no sex drive whatsoever. This has really surprised me given how important this hormone is for that side of things. I have talked with others on how the lack of testosterone in post-op trans-women can cause a complete lack of interest in the sexual side of things. One interesting proposition someone had was about taking small quantities of it to help. I am now not so sure this would be of any benefit because I have tons of it and am completely disinterested. There is also the possibility that my genital dysphoria contributes to this lack on interest. This leads me to wonder what sort of sex drive I will have post-op? Perhaps that will be a blog post of its own!
The hot flushes still come and go. Some days they are a minor nuisance and other days are devoid of them.
At this three week mark, my breasts are now worthy of a mention, or not worthy as is more the case. Over the last 18 months I have achieved a reasonable amount of breast growth to the point where I was hovering around a C-cup. For a trans-woman of my age, this was a very lucky achievement. After three weeks of cessation, I can report that they have lost all their pertness. Instead they have become these flaccid lumps that are perhaps half the size they were. I am told they will fill out again and possibly have a post-op bloom, but it is very disappointing to have lost them for now. All my padded bras and silicone fillets have been disposed of as well. I suppose in 3 weeks, I wont be going out and needing to display anything upstairs so like the acne, it's just a case of holding on!
On the emotional side of things, not a great deal has changed. I simply do not feel I have all this testosterone in my system and still feel like I have the oestrogen working it's wonders. It leads me to think just how much of a role the hormones have played in this side of things. I am of the mind they give you the key to unlock your emotions, but they must come from within. Perhaps they help with the dysphoria, ease the symptoms and give you freedom to explore emotions. Perhaps there is more to it than that, but I can say that I still feel as feminine as ever even with the horror that is testosterone in my body.
Thus far, I am more surprised at the scale of the physical changes and even more surprised at the lack of emotional change, I'm still as weepy and tearful as ever. It's opposite to what I expected!
I'll be back on Friday with another update on things, and perhaps it's time to move away from the practical aspects of my upcoming surgery and have a little talk of emotions and feelings regarding it. Catch you then.
It's now just under 4 weeks to my surgery and after last weeks talk of lists, I felt that it may be useful to write about what I can expect during my 8 day stay in Brighton. The Nuffield provide you with a well written "itinerary" for your stay and I'll borrow from that alongside experiences I have listened to from others that have had this surgery.
Monday - Admission
I have to arrive during the afternoon between 14.00 and 16.30, a nice comfortable window but rest assured we will be travelling early to avoid traffic issues. Once admitted, I am started on a low residue diet which in basic terms is one which makes less matter exit the body from the other end. Standard observations (weight, height, pulse etc) are taken along with a urine analysis and possibly a blood test.
Tuesday - Operation day
I have been told I am the first operation of the day although I am of the mind that this could change. Assuming it doesn't, I will be nil-by-mouth from the start of the morning. The following will then happen although I am not sure which order:
- I will be given a phosphate enema to clear my bowels. These are a particularly aggressive type of enema and will be an interesting experience.
- Observations will be taken.
- I have to have a shower with a special sponge.
- I put on special TED stockings that help prevent clots forming in my legs
- I will be visited by the surgeon, discuss any questions I have and then sign a consent form in front of him.
- I will speak to the anaesthetist who will discuss my medical history with me.
Following all of that, I am then taken down to theatre and have my surgery. Something I have been told is that I will possibly be asked more than once whether I am sure about whether I want this surgery including at the theatre doors. I am 100% certain I will still want it!
The surgery and recovery will take about three hours and when everything is normal, I will be returned to my room. I will be on my back in bed for most of the next 5 days and between my legs will be a pack. This pack consists of a dressing around the external surgical site which will also hold in an internal pack that was inserted into my new vagina during surgery. This will hold my new vagina against the walls and encourage it to heal into place. There will be a catheter in place because I will be physically unable to urinate whilst everything is healing. Also the new urethra will be too swollen so catheterising helps to reduce this swelling.
I will have two drains within the surgical site to help reduce swelling. I will also be on intravenous (I.V.) fluids to keep me hydrated as well as being administered I.V. antibiotics.
Finally, I will be wearing special boots around my lower legs. These will inflate and deflate and their purpose is to keep blood flowing around the calf muscle and reduce the risk of clots forming.
Wednesday - Day 1 Post op
My bloods will be taken in the morning. This day, I also start on a clear fluid diet which consists of jelly, sorbet, black tea or coffee and the infamous Brighton Consommé (speak to anyone that has had this surgery here and they will remember this!). I am still on I.V. fluids to start with although they are stopped at some point this day. I also have an injection (Clexane) into my abdomen to help prevent blood clots. Medication will be offered to help with pain relief and I will have regular observations. I will be lying mostly flat this day.
Thursday - Day 2 Post op
(The next few days follow a similar pattern to Wednesday so I will just note anything that is different from now on)
I am still on a clear fluid diet but in the evening I restart on a low residue diet which will consist of some toast. I will also have my last I.V. antibiotics today as well as the drains being removed. Everything else is the same.
Friday - Day 3 Post op
This day is a low residue diet, but I am unsure what this consists of! I also have an assisted wash and can sit a little higher in the bed.
Saturday - Day 4 Post op
Saturday, I should have the luxury of being able to get out of the bed and sitting in the chair for 30 minutes morning and evening. I will resume a light normal diet as well as being given laxatives to keep me moving!
Sunday - Day 5 Post op
To say this is a big day is an understatement. This day my pack is removed and I get to see my vagina for the first time. I am not even going to think about what this is going to be like at the time of writing, but I am certain this is going to be a very special moment.
Following on from that, I am dilated by a nurse for the first time. I am then going to be taught my new anatomy and this includes being shown how to dilate. An assisted bath follows and then I will be taught how to douche.
I am also on a normal diet as well as being given more laxatives. I have also heard some talk that there may be another enema involved somewhere although this is not mentioned in the notes I have now. If this is the case, it is certainly not of the same violent nature as a phosphate one!
In the evening, my catheter is removed along with antibiotics given. If things go well, I may well have my first pee in the night!
Monday - Day 6 Post op
The list for this day in my notes goes as follows and :
- Patient to dilate three times today
- Breakfast, dilate, bath and douche.
- Lunch, dilate, bath and douche.
- Supper, dilate, bath and douche.
This is a routine I will have to follow for at least 6 weeks before I can reduce the amount of dilations.
A nurse also has to check if I have passed urine at least six times and measures each one! A nurse is also on hand if I need any help at all.
Monday - Day 7 Post op
It's breakfast, bath, dilate and douche again but then I get everything checked prior to being discharged by 10.00 am. The journey home could be interesting and I have taken on board some advice for this. It is not an easy journey, the roads are awful when fit, so it will be something I will have to get through.
Please also see:
We are finished with week 2 and there have been more physical and emotional changes with regards to not being on feminising hormones. Remember too, that I have taken no anti-androgen (testosterone blocker) which means my cessation of hormones may well be different to anyone that is not producing testosterone.
By far the most visible and obvious effect has been my acne. Acne often occurs during puberty and is the result of overproduction of sebum often directly attributable to testosterone. My body having had none of this hormone for 18 months is now on overload and making me very oily hence the reason for the acne. I can confirm this due to my hair suddenly getting very greasy very quickly. The acne itself is very visible and painful. The spots themselves are often deeply rooted and swollen and it's becoming very difficult to keep on top of my epilation of facial hair due to the aggressive effect of this and breaking the spots open sometimes making them bleed. I may have to revert back to shaving if it does not improve.
The hot flushes stopped for a few days and I did wonder whether that would be the end of them. Perhaps my body was stabilising with the testosterone and this would be enough to hold the flushes at bay. A couple of days ago they were however back and although they are still not anything major, you know they are happening.
The erections continue and although they are not really desired, they are not exactly a problem either. I had a discussion with Lynda at the Laurel's last week about them and she did ask if they were painful, which they are not. This is a good sign that the tissue is in good order and could be incredibly beneficial post-op. After speaking to some others on Sunday, it seemed the idea of erections were not a pleasant one but once I explained the benefits, people seemed to change their minds a little.
Emotionally, things have not changed too much. I had a dread I would lost all of the feeling I have discovered recently but they are still very much there. It is still very easy to cry, and I experienced this completely out of the blue when I had electrolysis last week. Something good had happened to my therapist and this made me quite tearful. I do also feel a little washed out from time to time, it's a kind of emotionless feeling - almost an emptiness. I wonder if this will get worse.
In summary, the acne is horrendous and the other symptoms are trivial. Having had the acne, I am almost starting to regret not having the blocker for this final period however it is now too late for that. There are still four weeks to go but I hope it doesn't get any worse.
Something that has struck me about preparing for GRS is the sheer amount of preparation that is involved before you even set off for hospital. Of course there is the fulfilling of all the criteria for surgery and making sure emotionally you are prepared (which more than a few are sadly not). I am not referring to any of that, but more practical issues with regards this.
Two massive considerations are hair removal of the surgical site and weight loss. The weight loss has been successful and I am now sat at a BMI of 24.5. This may creep up over the Christmas period although I need to be under 30 so it wont be an issue. My plan is to try to keep sensible over the festive period and then use the two weeks after to trim down again. I aim to not be over 25.5 before my surgery. The hair removal, again I have done much more than I needed to and it is now time to stop.
When I went to Brighton for me pre-op, I was given a copy of the "what to bring into hospital" guide. This is a 4 x A4 page guide that lists and explains what it needed for admission to the hospital and what is needed afterwards. Brighton also do a pack that they sell for a nominal charge that contains a douche, a good mirror and a few other bits and bobs to get me started with dilation. I will be buying this pack as decent douches are very hard to source.
There are a few things that I have to take, most of it suitable clothing for lying in bed for a number of days. There are other things like dressing gown, slippers, kinckers, clothes to wear home, various toiletries and laptop/book/phone etc.
You are also sent home with a pair of dilators, Viadene for douching for three weeks, Hibiscrub for cleaning down and apparently anything left in your room that you have used for dilation.
This then leaves a list of items that I will need at home in readiness for the 6 or so weeks that I am unable to drive out and get more. Mandy can't drive and although I have friends that can get stuff for us, I am being over prepared for it all. Everything I have stocked up on will be used in the end and therefore will not go to waste. This leads to me to what I have been advised to get:
I suppose the best place to start is with the most important; KY Jelly! This has led to some interesting debate on Facebook recently with some disagreeing with the amount I have acquired. However, I was not too interested in opinions with this, relying instead on what I have in black and white on paper. I am advised that for the first 8 weeks, I will need a whole 82 gram tube a day. Some have suggested this is way too much, but I went in and saw my GP this week and asked for 2 months worth. This was met with some resistance initially but she listened to what I had to say and relented. I am probably going to need it anyway, and there was no point denying me this on the basis I could order it again in a month but then have to arrange delivery or collection when I can't drive. Obviously the pharmacy did not have 56 tubes of this in stock, so a day later I staggered out with a box of the stuff! I found a use for it prior to it's proper application (search Jenga if you don't understand this!):
Moving on from lubricant, we then encounter a list of simpler items. Kitchen towel is by far the next most voluminous item. From listening to others, you will use lots and lots of this. My friend who has had her surgery recently says she uses a dozen sheets per dilation session. Multiply that by 3 times a day and the numbers really add up. Luckily, I did actually start buying this in July, when my surgery was scheduled for October and although I did stop at some point, it did leave me with a good quantity. I have resumed buying it and feel I have a good stock.
There are then some cleaning products needed. Hand sanitiser, anti-bacterial spray and anti-bacterial hand wash are needed for general cleaning of hands and surfaces. Cleanliness is quite important although it will be impossible to achieve complete sterility. The hand wash is also used further down the line to clean the dilators after dilation but initially I will have some Hibiscrub, which is a surgical scrubbing solution. I have also ordered some more of this online, but be advised it is seriously expensive. In fact I have bought a bulk pack and gone halves with my friend who wanted some more.
The list also suggests a baby changing mat. This seems strange to start with, but rather than dilate on towels and have to wash 3+ towels a day, it is better to dilate on a mat and just clean it off with a spray cleaner. Besides this, towels will leak KY through to the bed so it makes even more sense. This was one of the first things I brought and it was quite strange wandering around Mothercare of all places looking for them!
Something else on the list, and I have quite a few packs of these, are unperfumed baby wipes. These are to wipe the new vagina particularly after urinating. After surgery the urethral opening can be quite swollen and a common issue is urine spraying about everywhere. If this isn't cleaned properly, I could end up with the equivalent of nappy rash.
Another thing that happens after surgery is discharge and sanitary towels are included on the list. Typically I started getting these before I had the list and ended up with the wrong ones. It is vital not to have any with wings as they can rub on the sutures and of course this was what I was buying. Luckily, Mandy can use those herself and I have been buying the cheapest supermarket ones as advised.
A final item for post operative vagina care is aqueous cream. This is for washing the new vagina, as soap will irritate it. This is quite cheap if you hunt around and I have a good stock of it.
There are a couple of other things to think of and one of these is pain relief. My paperwork suggests something called DF118's which is dihydrocodeine but these will be too strong for me so instead I have a supply of standard codeine phosphate instead. I also talked to my GP about pain relief and most importantly is to use paracetamol regularly as a background pain relief as it's not addictive and has no long term issues.
Finally, there is the issue of food! For the last 6 weeks we have been slowly filling our shelves with loads and loads of tins. There are also bags of pasta and rice, as well as many other long life food items. Recently, I have started filling the freezer up with home made pasta and rice dishes that are conveniently cooked in the microwave. I will have enough of these to last the two of us for over three weeks and then I will have to start cooking again. However, it wont be an issue even though I am recovering because I have a few recipes that literally involve throwing things into our slow cooker and leaving them there for 6 hours. No effort is required apart from stirring it every hour or so and I am sure I can manage that.
I think we are prepared, although if we aren't, I fail to see how much more we can be!
I felt it might be useful to just note the changes in myself on a weekly basis since stopping taking my hormones and I will try to do this every week until I restart them although the three weeks post-surgery may not be so easy. I have found very little in the way of experiences and felt it might be useful to others who might need to do this. This was a post I wrote the day I first skipped my daily dose of Sandrena gel with the reason for why I have to do this and what might happen. Remember as well that I have taken no anti-androgen (testosterone blocker) and this may differ slightly from other's experience in that very few make it this far without some form of suppressant.
A week down the line and there have been a few changes. The first were the inevitable hot flushes and this I expected. I always found when adjusting my hormone dose downwards, I would get this symptom and usually very soon after the change (24-48 hours). I expected that sudden cessation of hormones would bring this in quite quickly but it was slower. Before the weekend I had had a couple of episodes but nothing major. By Saturday though, although they weren't prolific, I was getting them 2-3 times a day and they were fairly intense. It wasn't the warm experience of the past but a volcano type of fire radiating from inside. They are not debilitating but do require myself to stop what I am doing and wait them out.
Something else I have noticed is that my face has become incredibly spotty. I am surprised at this and not completely sure whether it is hormone related but my skin is usually a very stable part of my body. I get an occasional spot from time to time, but this is a rash of them, probably 15-20 and crusty as well, not the usual white-heads. Spots and acne are linked to testosterone and although it is too soon to be related to my stopping of my hormones, it probably is linked because I reduced my dose 6-7 weeks ago and feel my testosterone was rising anyway. Now the floodgates have been opened so to speak. I visited my GP today on other matters and mentioned this and she is in agreement that is is probably acne and that it should disappear quickly.
On the subject of testosterone, that is definitely on the rise anyway. Within 36 hours of stopping, I was visited by Mr. T., as I have now called him, in the middle of the night. I have been getting bouts of nocturnal penile tumescence. Although these are not particularly wanted, it does have the benefit of stretching my penile tissue in readiness for surgery. A long term effect may be that post-op dilation may be slightly easier.
That's about the state of things at this moment, I'll update about the hormones again next Tuesday on this but will be back at the end of this week with some details on my GP visit today which had some eyebrow raising in the chemists following this. I also have a visit to the Laurels tomorrow which should be a positive experience for a change.
Lucy x
I felt it might be useful to write about a few of my thoughts and feelings about my upcoming GRS. It may be useful to me to offload them or useful to others in helping make an informed decision as to whether to have surgery.
It's just over 5 weeks to go now and this seems like no time at all. Sometimes it does feel it's approaching quickly and other times, it seems like an agonising wait! It's been a long path to get here and I still harbour anxieties that something will go wrong and then it wont happen. This I feel is quite understandable given that up to now, everything that could have gone wrong, actually has. This may sound very negative but the scars of the past still itch a little and I wont truly be "there" until I wake up post-op and be told that it has been done.
Dealing with this anxiety is not easy, it does not go away overnight although every day does seem a little better. Now that I have stopped taking my hormones, it does seem to feel like I have started on the path to my surgery. I am guessing that because of having to withdraw from medication in this manner, there are certain processes in place to ensure that this surgery can't now be cancelled unless there are extremely unusual circumstances. Perhaps I am being naive here and it could be cancelled on a whim, but I am trying to keep some hope going because my journey has felt pretty hopeless particularly with the medical side of things. So I am trying to be much more positive with regards the "it will happen" feeling!
I suppose I should move on to how I feel about the surgery itself. Interestingly, I have no worries at all in this regard. When it comes to being informed, I have to be right up there in the scheme of things. I have been given a great deal of information which I have read, re-read and absorbed. I have also researched this a great deal on the Internet and found some fascinating information. Some may turn to YouTube for their resources but by far one of the most interesting articles I found about the GRS procedure was actually a series of pencil drawn images that detailed the surgery step by step. I am unable to locate this site now but a search for "step by step gender reassignment surgery" will yield some other drawings. I have also read many blogs about this and met quite a number of post-op ladies who have passed on experience.
I suppose probably the most useful information of all has been a close friend who had her surgery a few weeks ago. I had the pleasure of taking her to the hospital and spent a few days with her recently while she rests and recuperates. I wont give any details because this is her journey and she is a very private person. What I can say is that I have learnt quite a few valuable tips, some on a practical level and some on an emotional one. I also now know the benefits of resting properly while still mobilising and taking pain relief when necessary.
The pain relief is probably one of the areas where I will need to be careful. I am someone who does not reach for painkillers quickly and this friend of mine is exactly the same. She has learnt in a difficult way the need for relief when it gets bad and I need to take this on board. Just a couple of days ago, I had probably my final hours of perineal electrolysis and again, I did not take any paracetamol. Because I have been cramming in a number of treatments down there, it has become very sensitive and this particular session was agony.
There are of course a number of practical things that need preparing for, and this entails a long list of supplies that you need. I'll save this for another post as I have yet to see my GP about some of this and I have an appointment next week to see her.
Catch you soon, Lucy x
It's finally arrived, a countdown I can officially start counting down from to my GRS! Ok, I've been counting down since I got my date but today sees me start something that I must do in preparation for it.
Oddly, I have used the term start when it should in fact be stop. Today marks exactly six weeks to my surgery and this is the point at which I have to stop taking my feminising hormones. It's with mixed feelings that I do this because I am now moving on towards that date but also now have to deal with no oestrogen in my body. I also have to wait three weeks after surgery before I can resume it.
The reasons for this are the risk associated with HRT and anaesthesia. There is reportedly a greater risk of a DVT (deep vein thrombosis) because of this and the associated bed rest that occurs after GRS.
So what effects does this potentially entail? I have spoken to quite a few people and researched this deeply on the Internet. This is what I can expect:
- Hot flushes - this is by far the most common effect and is experienced by every single person I have talked to or read about.
- Increased body hair growth - again this seems to be a very common effect and facial hair seems to be the more prominent effect.
- Reduction in breast tissue - This is not so commonly reported and it does vary in amount with those that have experienced it.
- Emotional changes - This is to be expected but surprisingly, many seem to report being more tearful and getting upset. Some suggest that this is down to the calming effect that can come with taking estradiol dissappears.
- Scalp hair loss - This is rarer but I have heard one person discuss this.
- Change to body shape - This is also rarely reported and when it is, they are very small changes.
Something that should be considered in my case is that during the 18 months or so that I have been on hormones, I have actually managed to suppress my testosterone without the need for any type of blocker at all. The downside to this is that having stopped my estradiol, the dreaded T is going to start being produced again. Quite how this will feel and present itself is a mystery because I have not yet found anyone in the flesh that did not need a suppressant at some point in their treatment. I seem to be very rare in this regard. I did consider the option of having a blocker for this period. I took on board advice and experiences and made an informed decision to not have anything. Blockers have side effects of their own and one person has reported it laying her low for at least a week with some severe symptoms. I also talked it over with Linda at the Laurel's and she seemed to think doing it hard-core so to speak was a good option because of the fact I will get more erections. This sounds a bit bizarre to seem like a good thing but they will have the effect of stretching the tissue I have in readiness for surgery. At least it gives me an opportunity to reflect the side effects of the dreaded testosterone and relay it on for others in the future.
The whole subject of hormone withdrawal has led me to find some very interesting debate on the subject. Many disagree as to whether it is necessary. citing the fact that cis-gender women still have the same levels of estradiol in their bodies but are not asked to take any form of suppressant for this. Some have even advocated ignoring the advice and just continue without telling anyone. Myself, I take this on board but this is probably the only major surgery I am likely to have in the immediate future and I can take the 9 weeks of hot flushes, hair growth, erections and anything else it throws at me. In six weeks, the source of the testosterone will be removed anyway, never to return!
Because we are fast approaching the big day, I will be updating a couple of times a week with thoughts, feelings and more. Come back soon x
Back in May I detailed my first perineal LASER session, here, and this is a useful link to read for a more detailed description of how the whole procedure works.
Since then I have had 4 more sessions, 5 in total, and would have had a final 6th as we are allotted with our funding. However, you have to cease all forms of hair removal 2-3 weeks before surgery to let the surgical site heal so it's not irritated at the point of surgery. Trying to get that 6th LASER squeezed was not really possible and this meant having to say my goodbyes to the lovely Lynne at the Exeter Nuffield. She has been amazingly supportive in her own way, and we parted company and made sure we gave her a small gift to thank her for what she has done. I received a card from her a week later thanking us!
The LASER itself has reduced the hair by quite some degree. Given that Mr. Thomas the surgeon has said I need no removal at all, means that everything is a bonus. All that is left are some pesky fair and fine hairs on the shaft, some dark ones round the base and a stubborn patch of dark ones running down the shaft but close to the base on one side with the other side completely clear.
I noticed the fair ones a few months ago and approached the lady that does my facial electrolysis with the intention of zapping these out with this old fashioned, slow and extremely painful but reliable method. It actually took three sessions of facial electrolysis before I finally plucked up the courage to ask. It's not every day you have to ask someone to do delicate work on your penis and I was actually unsure how to even ask.
I did get the words out in the end, and her reaction was it was not an issue but could I take the pain? I told her not to worry about that and we had a 30 minute session. The sensation was "interesting" for want of a better word. It was painful and definitely more so than facial electrolysis. However, because this was new territory we only cleared about 40-50 hairs.
The next time, I booked a 2 hour session with the intention of having an hour down below and an hour on the face. We cleared many more hairs this time although we were still trying to leave the darker ones for future LASER. More area was covered and it is apparent the difference in sensation there is around the penis. Some areas are very hot and burning and other areas are more like an intense throbbing inside that is very weird to feel. I wimped out in the end and we ended up with about 50 minutes in total. I also had a bruise form afterwards and there were quite a few red marks that did fade over a couple of weeks. I also had another session about 4 weeks ago that was very similar.
Now that the LASER had finished, I have decided that I want to clear as many remaining hairs as possible. I have been advised that during surgery, Mr. Thomas will scrape some follicles that are left if there aren't too many but it can lead to a slower recovery time in that area due to damage. My thinking is that the more I can clear now, the better it is for me. I have booked three hours over two weeks up to the threshold and yesterday was the first of these.
It was to be a full hour this time, as I had no option of facial to move on to. We also didn't have to bother picking out fair hairs, we just went for clearing everything. She worked very quickly and I expect we got over 200 out in that time. I was very sore by the end and 24 hours on, it is still a little delicate down there. I was very pleased with the results though. There is virtually nothing on the shaft at the moment and just a few around the base. There is still another 2 hours yet and although it's not going to get everything, I feel I have made a good effort in this very tricky area of hair removal.
A note on pain relief!
It should be remember that electrolysis is painful. If it doesn't hurt, it is not working and the whole point is to turn the current up to as high as bearable whilst not burning the skin. I have not used any pain relief whatsoever in my electrolysis because I like to know how intense the feeling is so I can gauge the effect. I have an incredibly high pain threshold and this means I can take it, it doesn't mean anyone else should.
There are a couple of options when it comes to pain relief. You can get numbing cream to put on the area a short time before. These are usually topical anaesthetics, Emla cream being one of the best known. You can buy them over the counter in the UK or ask you GP for a prescription. Paracetamol is another good option, but take exactly an hour before to get the best effect. 30 minutes is not enough and longer may see the effects dwindling.
As I mentioned in my last entry, recently I have discover some very strong emotional changes in myself and they appeared virtually overnight.
This odd feelings started a couple of weeks ago, soon after I got my date for my GRS. Depression is something I have had to deal with because of all the issues surrounding this and it took a little time for this to lift. The anxiety that was coupled with it has been slower to go but they are two separate entities and that may take some time to completely disappear. It may even linger until I finally do have my surgery.
Sticking with the depression, as I said, it took a little while to go and for a time I still felt very "unhappy". This was very surprising as there was so much positivity in my life. Was I still depressed perhaps? This was something that did worry me because after much discussion with my GP, we had felt it was something I would come out of when I got my date for surgery. Therefore it was not clinical depression as such even if the symptoms were the same. We had agreed that I had situational depression or adjustment disorder - but now I was concerned that it may have been clinical depression all along.
I spent a good week struggling with this "unhappiness" and wondering what was going on in my mind. One good coping mechanism I have is my running. Every day, first thing in the morning I go out for a 70-80 minute run. This has two effects, it keeps me fit physically and emotionally. That hour plus is where I get me time and work through anything that is troubling me. It has not kept the black dog at bay, but has helped me get through it and make it more manageable. It has been during these runs recently that I have been trying to get to the root of this problem.
I examined why I thought I was unhappy? Everything was suddenly going really well in our lives. We had found our new flat, I had got it ready, moved and and now we were happy and comfortable in it. We also had new financial security in that we were no longer affected by the bedroom tax as we had been before. I had found a new and exciting path with my voluntary work. We also changed my old wreck of a car for a Motability car in the summer so there were never going to be issues in that department. Additionally, I have reached my ideal weight for myself and feel fit and healthy in that regard. Finally, I had my date for my GRS, the one thing that was giving me the depression.The answers were not coming and I was starting to get very frustrated with it all.
Eventually though, I managed to get to the bottom of it. Last Monday (10th) was an emotional day for two reasons. The first was that I had a perineal LASER session at the Exeter Nuffield. Having your parts LASER'd hardly stirs emotions but it was the fact it was the final one ever before my surgery. You have to cease all hair removal a few weeks prior to surgery so that the surgical site is not irritated. I had worked it all out and there was not going to be an opportunity to have any more. This meant I had to say my final goodbyes to Lynne who has done all my LASER over the last 18 months or so. We gave her a card and a gift to thank her for everything she has done for me. She might be paid for doing all this, but she has handled sensitive situations really well and always put me at my ease. She has also been someone who has listened when times were not so good. It was quite a sad moment in the end.
Waiting for me in the waiting room was a very good friend of mine. The next part of the day was a small matter of taking her up to Brighton for her own GRS later in the week. This was one of the most pleasant long drives I have ever done. It was emotional but very positive and it was a pleasure to have been asked to do this for her. It is one of those occasions where being asked to do a favour, it then turns into them doing you an honour by asking you to do it.
We returned from Brighton in very high spirits and because of the emotion of the day, there was much less conversation. This gave me some quiet time whilst driving to ponder on things and it suddenly came to me that I was not unhappy, I was just emotional. I thought a little deeper and realised that the hormones that had done their magic prior to my depression, had actually continued to work in the background whilst I was in the fog of depression. Suddenly the fog had cleared and I had been hit with this new emotional state although I had misinterpreted it as a continuation of the depression.
I talked to Mandy about this and she seemed in agreement. I stated that I knew as soon as I got home, I would send my friend a text and then burst into tears. It was an interesting prediction and sure enough it happened. The next few days were full of this, memories of the depression would start floods of tears. Talking to my friend in Brighton would trigger more and talking to another friend about her difficulties would start me off again. I am also not as stable as I used to be in a crises either. A typical example was that my porridge boiled over in the microwave last week and made a hell of a mess. I was trying to get my breakfast and Mandy's done, and I got completely flustered by it all. I ended up unable to do anything, it was just too much! Even small things suddenly have more meaning. I was struggling with it all last weekend and I was speaking to someone on Facebook. I hardly knew this person but when I said I was feeling very emotional and finding it hard, they simply said "hug". Suddenly this word had a more massive meaning than it had ever done before.
It has been quite an interesting time and I found it a little overwhelming initially. I have learned to accept it though over the last week or so and found it easier to just go with it all.I wrote about finding the woman in me in May and felt that the hormones had finished working their wonders then. It seems there was more in store and perhaps there is even more to come in the future.
However, it will all be on hold soon. In 10 days, I have to go through the dreaded stopping of the hormones for my GRS. I have no anti-androgen in my system so I am going to get a testosterone surge as well. It will make for interesting writing, but the experience? We will have to see...
It's been regretful that I had to stop contributing to this blog but I was struggling to deal with everything and to have continued writing would have led to some very depressing reads. I did not want to inflict this on people who don't know me and kept my support to my circle of contacts and friends.
Things have changed now and I am now progressing towards my GRS (Gender/Genital Reassigment/Reconstruction Surgery). This following is what has happened over the last three months. It could get long, but I want to clear this up now and then start on more exciting matters!
It's been a tough time and I now know what depression feels like. I have never used the term to describe being down, as some do, and am glad that I haven't. Depression is absolutely nothing like being down and is a different beast entirely. I have had months where one moment I feel ok and then suddenly I am in tears and struggling to cope with feeling of emptiness and pointlessness. It got to the point where I didn't even know what the triggers were and the randomness of it all was as distressing as the symptoms.
Added to this was a massive dose of anxiety. It is often paired with depression but the two are completely different issues. The difficulty is they they both follow or trigger each other so you are often left with little reprieve. I could count the number of days in the last four months on one hand that I have been completely free of either. The reason for my anxiety falls squarely at the door of the Laurel's gender clinic due to their past mistakes leading to a massive distrust of the medical profession. This carried on to my referral for surgery and even now I do have severe worries that my surgery will still not happen.
In over three months I had had no communication from the hospital concerned unless I had contacted them. My GP had at one point, due to being concerned for my state, written to them but they rang me back saying they could not even guarantee which quarter next year it would be. During early October I was told by a contact that dates would be issued very soon and indeed I found people on Facebook posting their dates. No phone call ever came for me and I contacted them. Typically, the surgeon had released his diary for January and February and they released the dates only to run out immediately on reaching my name in the queue. I would be contacted again as soon as more dates were released and I was first in the queue for March. They told me they were currently hassling the surgeon for more dates and it would be soon.
This eased my concerns for a time but gradually the anxiety returned and I started worrying that they had forgotten me again. I got to the end of October and during an appointment at the Laurel's, my therapist rang them to query what was happening. I managed to overhear the whole conversation and it was not pleasant. In fact it was a shouting match by the end and heard that I would have to wait until December at least before more dates would be released. This was Wednesday fortnight ago and I was in a dark place. The next day however saw me a little better and at least I didn't have to wait for the phone to ring any more. I could put this to one side and forget for a few weeks.
That very day (Thursday), the hospital rang and spoke to my partner. Suddenly, after being told I would get nothing for at least 5 weeks, they had a date for me! She said I would accept anything but they advised that they needed to speak to me. I was out and my partner sent me a text message advising me of this. I drove home like a maniac and got straight on the phone. The formalities were discussed, a couple of cancellations had occurred and I was offered Tuesday 13th January as my date for surgery. I needed no time to think about it and accepted there and then.
During these troubling few months, several very positive matters had progressed in our lives outside of all of this. One of these was securing some social housing with the local council. My partner could no longer handle the stairs in our house and we needed ground floor housing for her to be able to live comfortably. Getting our flat had been a very hard fought battle and we were very excited about moving in. The news of my date was the day before our move and suddenly the good news threatened to derail everything! I had to keep focused and concentrate on first hand issues. I had my friend Susan helping us move and it was good that she was there when I received the news of my date as she has been very important in helping me get through it all.
I had worked incredibly hard with our flat, with 6 whole days painting and several more packing, moving and unpacking. This led to a situation where I could not quite get to grips with the reality of my surgery and it has only been the last few days where the depression has completely lifted. Now I have a realisation that it is not far away; just over 8 weeks in fact. Today has seen me find all the information and paperwork involved and it has been good to refresh myself on matters.
Another important development during the last few months and that was achieving a normal BMI. I had written previously about weight loss and despite my depressive state, I was able to stay focussed on my exercise and eating. For the first time in my life I got my BMI into the mid 24's and am managing to keep it this way. I only needed to get below 30 and am very pleased to have literally gone all the way in this regard. I have needed to completely replace my wardrobe though but now that I am a size 10/12, I find charity shops contain many good clothes that now fit me. Another plus of our new flat is that I have fitted a full length mirror in our bedroom and I can see the effects of the weight loss. Believe me, it looks good!
My voluntary work has also seen some changes since the summer. I still had my work in the charity shop but then at the end of September, it was announced that it had to close for financial reasons. Suddenly I was left in a position where I was going to have nothing to do whilst waiting for my surgery. Luckily, Mandy and me went to a disability exhibition and we encountered someone who worked for a charity that had supported us last year. When I told her I was going to be without anything to do, without hesitation she asked if I would like to join their organisation. I mulled it over and last Friday I started training to become a case worker helping disabled people fight for their rights. I work up to the end of the year in a training role and then return probably in April with the intention of having my own clients and cases. I have gone from factory environment, to shop and now to office based work. This is a massive change and I feel perhaps I have found where I should be with the talents I have.
So, in amongst all the doom and gloom, there have been some massive steps forward. It is only now I can see what Mandy and me have achieved and I feel well positioned for my upcoming surgery. I have had some interesting emotional changes with regards hormones and I will write about them in another post.
I have quite a lot to sort over the next two months and I feel that January is going to arrive quite speedily. In fact, December 2nd sees me stop my hormones in readiness and that seems very close indeed! I look forward to writing about everything up to the surgery and depending on how I am with it all, as much as I can during my recovery.
Lucy x
It's been a few months since I last contributed anything to this blog. It has been a tough time and I have been in a very low and dark place. This would have made for some very negative writing and I did not want this to happen.
Things have changed dramatically in the last couple of weeks and I will get writing again possibly as soon as tomorrow (Thursday 13th November).
I'll have an update of the last few months and then we are resuming the journey to my GRS again. I'll have more news on this when I write.
Lucy x
