Think Good Thoughts

luck

It´s been four months since I approached doctor Van Loenen for top surgery. I sent her a lengthy letter describing my confrontations with each gender therapist I went to, and informing her about my run with my own therapist. Plans to get a hysterectomy during the same operation failed (see my post from May 17).

As you might know by now (it´s all I ever talk about) I had an extensive check-up of my medical background at the hospital, and another one for hysto, which I will continue to fight for at a later time. Sadly, the surgeon´s office called me to inform me Van Loenen did not think the recommendation from my therapist was enough.

Following her statement I experienced a week of nervous meltdown, suicidal thoughts and self harm. I had no idea what to do next, but my Facebook friends, who are wise and hardened by transition, encouraged me to contact the hospital psychiatrist. My appointment with him is next week, and I´ll have one more chat with the surgeon.

So… all things considered… I´m feeling extremely agitated. My head is just repeating prayers in a loop. Please please get me on that unholy and desperately needed surgery list. /screaming/. Once I am on that list, dealing with my chest will, I think, become just a little bit easier. Because I will know for sure that the things will be gone.

I feel as though my transition, up to this point, has been extremely slow – there have been confrontations, misunderstandings, and frustration a plenty. Sometimes I wonder if, on some level, I am unconsciously sabotaging myself. By being afraid that things will somehow go wrong, again. I don´t want that to happen this time.

I´m not going to think anything negative at all. I´m going to hang on to every shred of hope that I can scrape together, I am going to get this freaking surgery by spring 2018 and I´m going to be successful with the gender therapist I have now. No more fear of things turning out awful. Wish me luck…!

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Third Therapist II

estelleleonard

She struck me by surprise. She did not seem very therapist-like to me. Rather, she reminded me of a crossover between a young secretary (picture young, blond, sitting on desk instead of behind it) and Estelle Leonard from Friends. If you don´t know who Estelle Leonard is (was), go watch Friends now!

The thing is, therapists usually all kind of wear the same thing. My dad, a university teacher, used to wear tweed jackets with leather patches. Yes, really. Therapists and shrinks are equally predictable. When they graduate from university, they like to wear a formal attire, that is stylish yet casual.  Sober type of clothes.

My new therapist was wearing a white attire with gold jewelry, brown stockings and shiny white pumps. Her face was heavily decorated with mascara, she owned a handbag and her phone was wrapped in furry panther print sleeve. She introduced herself and then spent ten minutes on the phone with someone. I walked out for a bit.

When I came back she was done. I was mildly annoyed, but kept it in check. After we had gone through a plethora of background questions about me, I read a letter that I had prepared for her. It described how I had tried conventional gender therapy before and always ended up clashing and then breaking with those therapists.

She said that she understood, which was reassuring, and also that she would not stick her nose in any business that did not concern her, which was also nice. She told me to tell her when I felt she crossed a line, and that it was no problem to renegotiate any question she had, as long as I felt respected and emotionally stable.

While she was nothing like I expected, and challenged my every idea about therapy – including her use of vulgar language – this might actually be a good thing. I liked her no nonsense, down to earth attitude. With a little bit of luck this is the last gender therapist I´ll ever see.

Third Therapist

psychiatrichelp

Yesterday was the start of my third attempt to transition in “the appropriate way”. By that I mean going through the official process instead of turning up every stone to find a willing surgeon and endocrinologist. Those are very rare where I live, and even if I did find them, my insurance wouldn´t cover anything.

So I took the train to Woerden. Which is about an hour and a half from here. The day before I had been fighting like a madman to overcome my dysphoria. By that I mean tolerate my chest to the level where I could take the tape off and give my skin some space to heal. The whole experience was awful and I was exhausted.

I tend to stay home when exhausted, especially when my brain goes into snooze mode, a condition somewhere between being conscious and being unconscious. Usually being in that mode the levels of anxiety will be higher and the risk of becoming suicidal more real. But after three years you can image I kind of prefer not to wait.

Thankfully the train wasn´t too crowded. I even managed to sit in the social area instead of on the balcony for a while. I took some calming medication and I did a bunch of stretches and release exercises in an attempt to drive away some of the fog in my head. When I arrived in Woerden I tried to figure out how and where to walk.

The place was a kind of center with multiple healthcare organisations in it. Nobody answered when I rang the bell, but I managed to get in and walked around wondering where the therapy department was at. A woman came walking out of one of the rooms and I asked her if she knew. “Well that´s me”, she said.

Read the second part of my endeavor in Part II.

Started Sustanon

sust

Last year, July 23rd to be precise, I started Androgel. Although hormone levels staggered as they tried to knock each other out, the first weeks in particular were a rush of joy and new energy. It was awesome. On gel, my voice sunk (rather quickly), fat distribution began to change, and I grew hair just every-where.

I documented those changes in older posts, which I´ll link to below if you´d like to check them out. I was on gel for 10 months and 1 week. Despite the changes and my normal dosage (I was on 50mg), shark week and related hormonal issues never went away. It did become less disgusting, but emotional moodswings and dysphoria prevailed.

Since I am self-medicating and lack the insight of a savy endocrinologist, my only option is to sort of guess at what´s going on. After asking around plenty, I figured my testosterone levels where still on the low site and the estrogen in my system was fighting back hard to keep the internal plumbing going.

Considering that there were a couple of other guys who had had this issue, I decided to switch to injections. Injections are less stable than gel (with gel, you get the same amount of hormone each day), and so more prone to mood-swings, but I decided better to try it and risk it, than to never try it and keep guessing. So I tried.

My GP administered my first shot on June 1. It sucked a bit because my brain flips out whenever large needles are inserted into my skin. My blood pressure immediately dropped and my GP said to lie down, as my face was turning pale. As she was typing on her computer I wondered about the next injection.

The only change I have noticed this far is that sustanon stopped shark week in its tracks. At least, I think it did. There was some light spotting for two days, and that was it. Emotionally I felt just as shitty as before. But perhaps a couple of months of sustanon will even me out, who knows. It remains to be seen.

(I´ll insert post list later!)

 

Surgery Update

chestftm

Last week was awful. In my last post, I described what was up with my top surgery plans, and how suddenly I wasn´t sure that they would operate me at all. It caused me to once more feel suicidal and I´ve had a rough time soldiering myself through it. I wasn´t able to cope with the chesticles and self-harmed a lot.

I must have called the surgeon´s secretary about six times to urge them to discuss with my therapist. On Wednesday, however, the plastic surgery department was moving, Thursday was a national holiday, and on Friday they simply took the day off due to the crossover to the week-end. I felt terrible.

The entire week it was incredibly warm. We had a heat wave here in the south, and while the temperatures didn´t rise above 32 C (89.6 F), it was suffocating. We often get that here – when it´s this warm, there are always thunderstorms brewing. You can feel it in your lungs, and in your head, since it makes you want to sleep.

Not sure, but I think I had PMDD too, as I felt out of control and thus tried to control my body with military hardheartedness (thank you thesaurus for this great word). I´m pretty sure I damaged my chest a lot, on top of the self-harm, by taking all kinds of measures to immobilize it completely.

In short, a week from hell. Lots of pain from self harming, topped off by irritable bowel syndrome and hurting hernias (I´ve got about three small hernias around the navel, not severe enough to operate on). Yesterday I went for a run to try and ease the tension off, I slept a lot, I watched movies.

This morning I got a call from the surgery office. She said that they´d talked with my therapist and cleared up a misunderstanding about the recommendation letter she wrote for me. Since her diagnosis was not sufficient by itself, I will be referred to see the hospitals´ own psychiatrist. He is also the one who authorized my friends to have top surgery.

 

Surgery & Stuff

surgery

So I told you that I am trying to “beat the system”, at least where gender is concerned. I have refused, for two and a half years, to comply with regular methods of transition. That is not to say I haven´t tried. Because I have tried, really hard. I have discussed my ideals with four different gender therapists.

Nowhere lane, though. So I looked around and networked with other transmen and women who opted for unconventional ways to transition. Some of the guys had managed to get top surgery without getting an okay from a gender team. Specifically, with one surgeon who does not believe that rigid protocols are needed in order to transition.

So I wrote her. I explained my situation, and then I had my therapist write her, who has been wonderful throughout the entire process. I went for an intake, they took a look at my chest, took some pictures, I had my talk with the anesthesiologist, all my blood checks done, the stuff you need to get ready for the surgery.

So to tell you the truth, I thought I was good. Now I just needed confirmation that I would be put on the waiting list. Instead, I got a phone call from the surgeons´ assistant, telling me that a diagnosis from my therapist was not enough, because she was not a psychiatrist or a psychologist. Apparently only they know if you have dysphoria. Or not.

The phone call, for a while, had me reel on the verge of a suicide attempt. Immediately afterwards I went to my friends on Facebook, the ones who are transitioning in unconventional ways.  They told me the situation was very strange. There were a few among them who had had no diagnosis at all, and even they had had top surgery.

I wrote my therapist, who was kind of angry at the entire situation too. She did not understand why her recommendation (for me to get top surgery) was being rejected as invalid, and also why I could not get a second opinion from the psychiatrist who works at the hospital where I would be operated. Once again, I called the surgeons´ office.

The assistant said she would discuss my situation with the surgeon. See what she thought. Unfortunately, they haven´t called back yet. When I called again today, I was told that the plastic surgery department was moving to another office, so I would have to try and reach them later. So much for having an uncomplicated transition.

Transition update

much later

I´ve been so busy handling the “stuff” of life recently, that I barely got to telling you what´s up with the details of my transition, at this point. While I quit one gender team and had an intake with the third (third time´s the charm), I was busy scheming to somehow get surgery. Which is like attempting the impossible.

Surgery, just like getting hormones (from a doctor, rather than other resources) can only be achieved here with the authorization of a gender therapist, who has “observed” that you have gender dysphoria.  As you know I´ve had a lot of problems with this concept, and rage-quit two gender therapists thus far.

I met a few other people who were in a similar boat. Some of them were rejected by the gender therapist for not being binary “enough”, others (like me) disagreed with the methods that are used to “verify” a persons transgender status. We talked on social media and discussed ways to transition without a “gender team” *.

After having talked to a few people, who had managed to get top surgery without an incredible hassle, I got in touch with a surgeon who is financially independent from any gender  teams, and she has said that I might be able to get a peri-aureolar mastectomy either fall this year or spring next year. I get a phone call on Monday.

In the meantime, I spoke to yet another surgeon, who is a gynecologist and normally handles hysterectomy. Getting a hysto is very important for me, not just because I still get shark week (nine months on T), but because of the killer PMDD (Premenstrual Dysphoric Disorder, the terrible sibling of PMS). However, he works for a gender team.

Unsurprisingly, after he talked to the gender team about it, they said no. I am not allowed surgery by one of their surgeons because I did not play by the rules. Yawn. The next step for me is to find a gynecologist who is willing to refer me to a surgeon because of the PMDD and the shark week. Chances of finding one are pretty slim.