need. metoidioplasty.
February 3, 2014

(TW discussion of genitals, sex, body dysphoria)

My body dysphoria has seemingly intensified (or at least not gotten any better) over the past bunch of years, especially the last two years that I’ve been off of testosterone. (February 10th of this year will be 2 years off of T.) I’m planning to go back on T in April, after top surgery, and stay on it. (Here’s a list of my reasons for stopping testosterone (link Being off of testosterone has overall been an interesting and necessary experiment for me so I could sort out my feelings and stuff, but it is not right for me. I have body dysphoria not only about my chest, but also my junk, and always have: my junk was the first thing I was dysphoric about when I was 3 or 4 years old. (I didn’t have a chest to be dysphoric about until age 9 or 10.) Being off of testosterone has amplified my body dysphoria and brought me back around emotionally to how I felt before transitioning because that’s more or less how I look without enough testosterone (except at least I have more facial and body hair now). It’s been like a punch to the stomach, but sometimes I have to relearn something the hard way.

So, I’ve decided that I’m going to have a metoidioplasty done like I’ve had in mind since I was 12 and first learned about trans men and transitioning when I saw part of a 1997 documentary called You Don’t Know Dick: Courageous Hearts of Transsexual Men. I’m going for a metoidioplasty with “the works”: dick release and repositioning, urethral lengthening, mons reduction, vaginectomy, scrotoplasty, testicular implants. I’ll also be having a (hopefully laproscopic) hysterectomy and oophorectomy.

I’ve spent my life just trying to ignore my crotch as much as possible because all I can really do with most of it is reluctantly tolerate it. I normally don’t mess with it other than as necessary (dealing with menstruation while off of T, which hasn’t been that bad because I think of it like peeing or whatever) or as I want to sometimes (sex sometimes and occasionally with jerking off). I can’t always ignore my junk though and there’s not much I can do besides that, and my body dysphoria is incredibly difficult to deal with, and I’m fucking tired. It’s been 24 years of this. (I’m 28.) It’s an aesthetics issue, a functionality issue, and overall an issue that it just feels wrong. I’ve felt this way since I was about 4 years old when I realized that peeing standing up didn’t work for me the same way it did for my brother and that “my body forgot to grow a penis.”

Regarding my cock, the main things that bother me about it are not being able to pee out of it, and its current position. Sometimes the size bothers me, too, but mostly the position. In terms of peeing, it’s frustrating to have to get my STP packer the Number One (link) first (or packing with it, which feels weird because it’s hollow and fold-able), making sure it’s positioned right, etc., before I take a leak. The Number One is the best, most well-made, and easiest STP device I’ve used so far — but I’d still much rather just be able to piss out of my cock.

As for the current position of it, that bothers me as well because of aesthetics, and not being able to fuck with my cock because of the suspension ligaments. It would be aesthetically like how I see it in my head if it were positioned properly (up and forward like a more typical penis). I think with a metoidioplasty, I would probably (hopefully) be able to penetrate partners during sex since I’ve had a good amount of growth from T (average or maybe a little above average for a trans guy) and I’ve got more than enough blood-flow to stay hard, so it’d probably depend as much on the position the other guy were in (according to a gay cis dude I’m probably gonna get involved with who’s a top). Although I’ve had decent growth, I still plan to use DHT ointment for three months prior to having bottom surgery done to increase the growth more as I’ve read that that’s recommended prior to metoidioplasty.

Sometimes, when comparing the size of my penis to that of cis guys, or when I’m just picturing in my head what I’d like for my body to look like, I will get frustrated about the size of my cock compared to other guys. However, it’s also important to remember that cis dudes’ penises (just like trans dudes’ cocks) come in all sorts of different sizes, shapes, degrees of functionality, and so on. It’s also really important to keep in mind that my ideal for myself is largely a result of social conditioning, and to question and counter that. Despite my periodic penis size woes, I have no plans right now to have a phalloplasty done — although I’m not ruling that out for the future.

(no subject)
January 31, 2014

I got a call today from that woman Jacquie I was supposed to hear from a week or so ago. It turns out she actually works at Dr. Fischer’s office, not at UMD like I’d thought. She said she’d called Carefirst and given them all the right codes for me and had verified that they’re gonna cover at least part of the cost of my top surgery. However, she also said that if I’d heard conflicting information that I can either pay up front or Dr. Fischer can bill my insurance directly (since she participates with Carefirst) and she’ll send me whatever reimbursement check she gets. I’m very confused about all this because I know I read in my insurance book a bunch of years ago that they specifically exclude trans-related stuff — but I’m also listed as “female” on my insurance (changed initially from male, so that they’ll cover routine preventive medical stuff like gyno exams), so maybe that’s why Carefirst is saying they’ll cover part of the cost, because they forgot I’m a trans guy?? I dunno. I’m so worried that Carefirst is gonna go “oops, oh shit, what did we just pay for?” and change and make all the cost go to me. Trying not to stress too much but being anxious is kinda my thing. The amount that my insurance doesn’t pay, my dad is gonna loan me the money to pay for and then I’ll pay him back over time.

Anyway, I told my dad about the insurance thing and he said “Don’t look a gift horse in the mouth.” That means don’t cause a fuss raising questions about a good thing that happens to you — but since I think visually, I always picture a goofy horse dentistry appointment.

(no subject)
January 17, 2014

Supposed to be starting sports training (soccer to start with, maybe some wrestling, later kickboxing), plus D/s & gear fetish play & other kink with this gay metalhead fitness trainer masochist top who started talking to me on Recon over a month ago. We mostly talk on Google Hangout. His name’s Brad and he’s pretty fucking broey but whatever. I secretly kinda think of him as Gay Tyler Durden cuz he’s into boxing. He’s been really chill about me being trans so far, and chill about me being autistic, which has been nice. Sounds like we should be a good match.

I still have to go buy soccer stuff. He wants to play at night though at a soccer field so we can be alone and we can play soccer for a while til we get tired, then wrestle, do some gear play, and possibly fuck. Sounds really hot. I wish he’d just wanna be in a gym to start with since it’s fucking cold outside, but whatever. Def need to first meet in public during the day somewhere to get a read on him first, see if he sets off any red flags for me or not.

Anyway, really looking forward to sports/fitness training as much as playing/fucking. If I’m gonna be motivated to exercise a lot more regularly, doing so with a hot kinky gay dude and making aspects of it sexual is the way to go ;D

(no subject)
January 17, 2014

Therapy yesterday was super intense: depressing (my therapist teared up / cried twice), happy.

My therapist Lorrie is ecstatic about my top surgery. She was so, so happy. That kind of let me feel happy, too. I’ve been wicked fucking depressed & stressed / anxious, aside from being manic lately. It’s hard to feel happy when I also feel overwhelmed by everything and it’s winter which is my worst time of year.

But I am happy. I’m excited. I’m relieved. I’m glad I survived to this point.

(no subject)
Shannon called me yesterday & I called her back. She said she spoke with a woman who works at UMD Hospital named Jacquie and Jacquie talked with someone at my insurance company (Carefirst BlueChoice, state insurance) and gave them all the right codes, and the insurance person said with how my plan is right now, for surgery they cover 80% and I’d be responsible for 20%, and then it’d be a separate thing for anesthesia but probably also 80/20 I think? So she said as of right now, I won’t be responsible for paying Dr. Fischer up-front, instead it will be a wait-and-see type of thing: have the surgery, they’ll bill Carefirst, either Carefirst will cover part of it or they won’t.

I was shocked because I remember looking in the back of one of the insurance booklets a few years ago and seeing it specifically said they won’t cover any trans-related stuff, and I told Shannon that, and she said she’d talk to Jacquie and have Jacquie call me to talk with me about it.

If they do cover 80% of the cost, it’s because I’m listed as female on my insurance so they cover routine preventive care (pap tests, breast exams, etc), so they probably just see female + bilateral mastectomy, although I was initially listed as male on my insurance so somebody or other knows I’m trans. Plus I was on T for years and they covered that. So I dunno, we will see. Either they will cover part of it, or they won’t. Not sure what the actual cost is gonna be. Normally, it’d be around 8000 dollars, but this is a different hospital, cardiac anesthesiologist, etc., so it’ll be more.

It would be great if my insurance covers at least part of it. It’ll still be a lot of money to be responsible for 20% of the cost, but obviously not as bad as 100%. This is so confusing.

note to self: top surgery pain meds
Note to Self:

At March 6 appointment, talk with Shannon and/or Dr. Fischer about issues with pain meds:

- I’m super sensitive to Dilaudid & Morphine (horrible nausea, plus dissociation, constipation, not sure how much it helped with pain);

- family history of allergy to Codeine (Dad, Grandpa H, Uncle Charles, S & T??) - hives, itchy, etc. I’ve taken Percocet before (Tylenol & Codeine) and it just made me feel really weird and nauseated, idk if it helped with pain.

- Very sensitive to CNS depressants. Mental health issues, etc.

- Other options for pain meds after top surgery????

(no subject)
January 14, 2014

(TW suicide, depression)

I edited the entry where I announced my top surgery date. I wanted it to sound happier. I have a lot going on in my life right now but I wanted the announcement at least to be happy.

I have a lot of different things I’m feeling: pretty calm (thanks, Klonopin); relieved and grateful that top surgery is scheduled; relieved and grateful that I survived to get to this point; mourning/grieving my closest friend/pack member/protector Taylor; exhausted from swinging and forth between depressed & anxious and manic happy/hyper; exhausted from everything else; sad/confused about a sudden unhappy shift in a relationship I was just starting to get into and all the promise that that’d had (I don’t even know what exactly the situation is now or is going to be); nervous that I might have to go to in-patient psych next week because of PTSD and depression and anxiety. Somewhere underneath all that sadness and anxiety, I am delightfully, brilliantly happy about top surgery, it’s just that I have to dig for happy feelings right now. It’s kind of like when a pond is frozen and you can kind of see things beneath the ice but you can’t touch them. I was happy for a little while earlier today, but it slipped away when I started to feel overwhelmed.

It’s just strange. This is such a huge, amazing, awesome thing for me, but the rest of my life feels like it’s falling apart. It is just days since I felt I wouldn’t be alive to see my next birthday (on January 20); just a week and a day after my best friend of 11 years died of cancer; five days since I almost killed myself; three months since the last time that happened; a little over a year since I felt in my gut that I wouldn’t make it through 2013 alive and I made peace with that, kept my plan close, knew what I had to do, but put it away for later.

Maybe it’s best to think about it in numbers.

5 days since I almost killed myself. 5 days since I decided to stick around.

4 days that I’ve stayed straight-edge/sober despite living with drinkers

4 days that I’ve stayed safer despite myself

4 days listening to positive sXe hardcore songs about battling depression and resisting alcohol and drugs and being in this together. those songs make me feel hopeful & less alone & like i can change and get better.

4 days listening to to hardcore songs about anxiety and depression and being suicidal and losing sleep. they make me feel less alone because other people feel fucked up too.

3 months since the second-most-recent crisis, and I was almost gonna kill myself just to make it all stop, but I didn’t.

73 days until top surgery.

only 73 days more of having to bind my chest.

only 73 more days of body dysphoria about my chest.

73 days until I can eventually (post-initial healing) press my chest flat against another guy’s back or chest or thighs and it will feel like how it’s supposed to feel, nothing between us.

73 more days of waiting when I’ve been waiting for this for 18 years already (yes, since I was 10).

73 days is not very long.

I think I can do this.

Top Surgery is Officially SCHEDULED :D
January 14th 2014

Top Surgery Officially Scheduled With Dr. Fischer!!!

Talked & emailed with Shannon at Dr. Fischer’s office today and she went ahead and scheduled my top surgery. My top surgery with Dr. Fischer is gonna be on March 28th at 11:30am at UMD Hospital. Holy fuck. I am really overwhelmed. Starting to calm down thanks to Klonopin, weighted blanket on the couch, and Panda curled up with me. I have a pre-op paperwork appointment with Shannon on March 6th so I will sign consent forms, and get the clearance forms and lab work stuff for my primary doc and cardiologist. I also have to get another cardiac clearance so it’s more recent, so I have to call tomorrow about that.

I don’t think I’m supposed to go back on testosterone until 2 weeks after surgery (pretty sure that’s what I read in a book about transitioning recently), which will be the second week of April, but I’m not sure so I’ll double-check with Shannon at the March 6th appointment. I was gonna go back on it this month, but since top surgery is only 73 days away and I’d have to go off of it 2 weeks prior to top surgery which would be the second week of March, there’s not much point in doing that since I’d only be on it for basically 2 months and then have to go right back off for a month. Damn. It’s alright though, I can wait. I will just have to work harder to get in better shape (especially to loosen my chest and back muscles) before top surgery.

Holy shit. This is really happening. This is real. I’ve been waiting 18 years for my tits to be gone (yes, age 10), 16 years since I knew I wanted to transition (yes, age 12). It’s happening.

Scheduling Top Surgery Next Week!!!!!
I missed a call when I was out for ~3 hours today helping my dad with cutting dead-standing trees for firewood. Turned out the call I missed was from Shannon, the nurse handling my top surgery stuff at Dr. Fischer's office. Dr. Fischer finally got her surgical credentials letter from UMD Medical Center so now she officially has surgical privileges there, which means I can FINALLY schedule top surgery!!!!!! I missed the window for calling Shannon back before she left today, and she's off tomorrow, so I'll call next week. Holy crap, it's finally happening. I was kind of losing hope that it would actually happen because the credentialing process has taken about 6 months and I'm not a naturally optimistic person, but it's finally happening.

I've had a really rough bunch of weeks in a row, especially this week with losing one of my best friends to cancer. I definitely needed this good news right now.

(no subject)
December 11, 2013

Called Dr. Fischer’s office this morning for an update. Someone at UMD was supposed to mail Dr. Fischer’s surgery credentials letter 2 - 3 weeks ago — actually probably longer than that, but that’s when they’d said they were going to mail it — but still hasn’t done so for whatever reason. How frustrating. At least Dr. Fischer and both nurses involved with my case have been wonderful this entire time, and they’re waiting just like I am. It’s mostly frustrating for me because I was hoping I might be done with top surgery and relatively healed enough (maybe 4 weeks out?) to carry a backpack so I could do next semester at least partly on campus, but that doesn’t seem likely to be the case.


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