February 2020 – Purple and Green and the Life in Between

Let’s Talk Gender S1E8: Legal Transition

OVERVIEW

We start by talking about Meaghan Ray’s thoughts on top surgery because we didn’t have time in the previous episode. Then we talk about Jake’s process of changing his legal name and gender marker, Meaghan Ray’s role as his partner through that process, and Meaghan Ray’s thoughts on potentially changing their name and gender marker in the future.

This is the last episode in this series which has focused on the various stages of transition as we have experienced them so far. We will be taking a break and will return with a new series in the future.

SHOW NOTES

Meaghan Ray’s Thoughts on Top Surgery

Some NB people will get top surgery without testosterone, take testosterone but not have top surgery, or do both.
- I have a harder time relating to the NBs that do both because I am genderfluid and have a significant female component to my gender
I don’t feel the need to wear a binder all the time
- When I have top dysphoria it isn’t debilitating, just irritating
Having top surgery to have a flat chest doesn’t feel right for me at the moment but I would consider having a breast reduction
- Enough that I wouldn’t need to wear a bra if I didn’t want to and could get the appearance of a flat chest fairly easily but could also wear a bra to have the appearance of breasts
Got lots of good info from a talk at the Trans Philly Wellness Conference on top surgery
- To get a more NB look you can look at various factors separately to mix and match more female-typical and male-typical markers
  - Contour
  - Overhang
  - Nipple placement
  - Nipple size
  - Shape of scars
  - Placement of scars
- If you know what look you want with relation to all these things you just have to find a surgeon who knows how to do it!

Jake’s Legal Transition

Jake started to live ‘full time’ in May 2017 which is when he also started HRT
Saw gender psychiatrist in July
- Received generic form to certify that he is transitioning and said it would make sense to amend his sex on any ID
- Also can be used to explain why he might look male when his ID still says female
- This document counts as the ‘medical letter’ that was required to change provincial ID
  - No longer required!
Went into registries in August
- Found out he had to get fingerprinting done to get his legal name change and needed to apply for a legal name change before
Got fingerprints done
Applied for legal name change in August
- If he was born in Alberta, could have gotten birth certificate and marriage certificate done all at once but he wasn’t so the process was even more convoluted
- Received certificate in the mail in October
- Got a new driver’s license!
Had to apply for marriage certificate from Nova Scotia
- Took two tries for them to get it right
Tried to submit for a new SIN card which eventually was returned saying that he needed to change his birth certificate first
Hardest part was birth certificate
- New Brunswick hadn’t changed their laws yet – still required proof of ‘sex reassignment surgery’
- Need an updated birth certificate to get updated passport
Was stuck in limbo with a drivers license that didn’t match his passport and a passport that didn’t match how he presented
- Made it too unsafe for us to travel to the states and had to cancel a trip we had planned
Getting banking info was also convoluted and for some reason he still can’t order cheques without the wrong name coming up
His workplace wouldn’t update his name in their system until his SIN card had been changed (which required the birth certificate again)
Wrote a letter to an MLA in New Brunswick about how frustrated he was and how many problems this archaic law was causing (December 2017)
- Heard back at the beginning of February that it was already in the works
- They ended up emailing and calling him to tell him that the forms were up and how to apply
- Was very lucky in his timing because if he had started any earlier he still would have waited for this law to change and would have spent even more time stuck with mismatched documents and old work ID
- Finally got it back in March 2018
- Allowed him to update his passport and SIN card which he received in May 2018 – one year after coming out
In the meantime, he had found a way around the issues at work
- Concerns with payroll’s info not matching his banking info and a T4 being issued in the wrong name
- Got in contact with an HR Diversity and Equity person who had all his work stuff changed over in two months (done in December 2017)
  - As random things kept coming up he would contact her again and she would fix it super quick
  - Had been out since May and had lots of co-workers wondering why they couldn’t find him in the system to send him an email and he kept having to tell them to look under the old name
    - Very long 8 months
Found several resources for recently married people with lists of documents you need to get changed once you change your name
- Land title, mortgage documents, credit score, etc
- Super helpful but often ran into problems where the forms or procedure for changing the document did not include either change of first name or change of gender marker
- Felt like he had to tell his life story and out himself as trans in order to get the document changed (over and over)
Situations keep coming up
- Recent election – two voter cards showed up, one under each name, tried to get it changed, just caused confusion
- Now that he passes as male people are even more confused because they can’t compute that he ‘used to be a woman’
- Still can’t order cheques at the bank – has given up on that one after going in person and calling on the phone many times
- Had to contact the city because he was getting his old name coming up during a job application and in emails despite applying under his current name
  - Had a fast, positive response and got it fixed quickly
In general was he was burnt out and apprehensive from having to go back to the same places over and over, never knowing what response he would get, if he would get different info from the previous time
- He was super strategic about which locations he went to and at what time of day because he knew it would take a while and didn’t want there to be a long line of other people behind him listening to him explain his life story
No overt transphobic experiences (hurray for Canada!)

Partner Experience During Legal Transition

Provided support and encouragement
Gave permission for him to take some time away from working through the long list
Would have gone with him as a buddy to all the various offices if our schedules allowed
- Moral support
- Safety
For parents: call ahead to medical offices to ensure they have the proper name and pronouns in their system before your kid arrives
- Old information can keep popping up depending on when the last time was that you interacted with that particular medical office/hospital
Had to change Jake’s information on my benefits plan
- The form had a list of reasons that did not include transition so I had to write it in
- Did not have a space to indicate a change of gender marker
- Had to call them multiple times to correct it as they returned various iterations

Meaghan Ray’s Plans for Legal Transition

Could change provincial documents to ‘Meaghan Ray’ and X
- May do this some day but it’s a lot of work and not necessary for now
Could change national documents to ‘Meaghan Ray’ and X
- Would be more dangerous to travel internationally to places that don’t recognize that as a gender marker
Potential incentive was to get it changed before having a kid because we can’t change parent’s names on your kid’s birth certificate
- However, it’s only first and last names that appear on the birth certificate, no gender marker, and we can choose the parental labels that we use (mother, father, or parent for either or both of us)
So for now, the emotional cost of changing anything out-ways the benefit for me

This brings our series on transition to a close. We will be back sometime in the future with a new series and hopefully some guests! Stay tuned!

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Let’s Talk Gender S1E7: Medical Transition: Top Surgery

OVERVIEW

In this episode we talk about Jake’s path to top surgery and his experiences of the procedure and the recovery process. We also discuss the role of the partner and Meaghan Ray’s experience during each stage of this process.

SHOW NOTES

Jake’s Top Surgery Experience

Referral to gender psychiatrist September 2016
Saw gender psychiatrist July 2017
- Referral to top surgery – likely a two month wait
- No word, called back, finally heard from the surgeon two months later
Two surgeons in our area that rotate so one is taking consults then start working on the surgeries while the other one takes consults
- Trans people are at the bottom of the list in terms of priority
- A friend got in for a breast reduction after a year, Jake has been waiting two years and still hasn’t heard back from them
Initial consult was a fast twenty minute run through with minimal information
- Didn’t know what questions to ask yet
- Learned that he would likely end up with dog ears
- Revision to get rid of dog ears is not covered by provincial health care
- Liposuction to prevent dog ears was not covered or even discussed as an adjunct out of pocket
- Offered double-incision method only
- Left Jake feeling uncomfortable and frustrated
Started googling where else he could get surgery
- Found McClean Clinic in Toronto where they do ‘Mascuplasty’ to create appearance of a male chest instead of just double mastectomy
  - Includes liposuction and revision
- Called the clinic, filled out the application, and was put on the list for a phone consultation which happened 4 months later (8 months after original referral)
- Likely wait was listed as 3-6 months after consultation
Phone consult in March 2018
- Surgery is done under informed consent – don’t need a referral from psychologists or psychiatrists but instead have to pay out of pocket
- Similar vetting process to the gender psychiatrist – what are your expectations for surgery, why do you feel you need this surgery, describe your dysphoria…
- Feel like you have to explain how you feel in stereotypical ways in order to ‘qualify’ and get access to the medical treatment you need
Offered a date 6 weeks later!
- Took a day to consider if this was what he wanted
- Much less time to logistically and emotionally prepare
  - Good support from community, even people who had personal experience with the McClean Clinic who all had great experiences
  - One friend showed his results and provided a list that he had made of tips and tricks after his surgery
  - Did lots of research on facebook groups for trans guys and breast cancer survivors
Trip to Toronto for surgery!
- Willing to pay for better results and less wait time
- Able to stay with family
- Second guessing at the last minute
  - Not a ton of physical dysphoria but lots of social dysphoria that was severely anxiety inducing especially in public washrooms
In-person consult the day before
- Surgeon was 2 hrs late
- Jake burned through all his anxiety during the long wait
- Brief but thorough description of the surgery plan, results, and follow up
Day of surgery
- Measurements and markings based on ratios
- Awkward but done in a medical way
- IV started
- Went into surgery and came out crying for no reason
- Very sore across the chest
  - Wearing a compression band over the bandages
- Got up to the bathroom and was dropped off with no supervision, felt very panicky, light-headed and gross
- Was rescued by a nurse who then asked about any history of anxiety
  - Maybe they should ask about this before surgery?
- Eventually met up with MR and was escorted out to the back door in a wheelchair
  - Lots of difficulty finding the car, figuring out where they wanted him to be picked up, etc

Partner Experience of Top Surgery

Included in all the pre-op appointments
- Helping remember information and nice to know what was going on
Day of surgery
- Stayed for pre-op measurements etc
- Kicked out when he went in for surgery
  - Told it would take about 2 hrs and they would phone when he was done
- No word after 2 hrs so I checked in with the desk and was shooed away with no actual updated estimate
- Waited another 45-60 mins with no word so I checked back in
  - They went to check with the nurses and this time gave me a spot to sit around the corner
    - Had all our winter gear and personal belongings and my entertainment to keep me occupied during the surgery piled around me
  - Eventually came back and told me he was just crying a bit and I could go back in a few minutes when he was feeling better
  - Would NOT let me go back to help him calm down/recover
    - Tried really hard not to get in the way but also mentioned that I am familiar with medical things and could probably help him
- Eventually got to see him once he was back in the pre-op room (after the whole anxious bathroom experience)
  - Very pale, shaky, sweaty, nauseous and in pain
  - Got a wet cloth for his neck
  - Helped him eat crackers
Generally poor communication with me
Fiasco with getting him to the car was very frustrating
Drove home very carefully
- He was already in lots of pain and getting very nauseous
- Had to pull over a couple times to make sure he was doing ok
Got home, got him settled and took it easy for a few days

Jake’s Top Surgery Recovery

Returned to the clinic the next day to ensure everything was going ok
- 15 minute appointment with lots of driving to get there and back
First few days were mostly sleeping, resting, watching movies, sleeping propped up
Became very itchy from the pain meds
Pain from the compression vest under his armpits where they had done liposuction
- Sensation in areas of liposuction came back very quickly with lots of bruising
- Tucked some towels over the edge to make it feel less sharp
- Moved the vest down a bit and loosened it a bit
Went back for a follow up after 7 days where they took off all the bandages
- Could already tell his chest was flatter but with no bandages or vest it felt very flat
- Subdued reaction due to pain meds and that it matched his expectation so it didn’t feel surprising
- Partner reaction was much stronger
  - Had spent so many months picturing him with a flat chest because that’s how he pictured himself that his chest area had blurred out and had become uncomfortable to really pay attention to
  - With the bandages off it was the first time that I could comfortably look at that part of him and have it look right
  - Also knew how awesome he would feel about it once his head was clear of the meds and he was feeling better
  - Took some pictures and video including the side view which was the greatest
Flew back to Alberta
Took an extra week off work in order to recover enough stamina
Was supposed to keep the compression vest on for 4 weeks but ended up taking it off after 3 because it was so uncomfortable to wear under work shirts
Kept nipple covers on to keep nipples moist
- Nipples scabbed as they healed (normal)
  - Looked like two black nipples and felt like something was wrong (also very common)
- Scabs started coming off and the nipple was so light that it looked like it wasn’t there but everything was fine
Sensation returned slowly
- Lots of areas across the top of his chest that started to itch as sensation came back
- Then down into armpit and across towards the nipples
- Played games where we would test where his sensation had gotten to
- Nipple sensation has returned part way, somewhat hypersensitive
- One spot in the left incision where a nerve ending was exposed and caused serious stabbing pain each time it was touched
Traumatized by liposuction video
- Makes sense why those areas were so numb
Scar care
- Bio-oil
- Scar massage
- Really careful to not raise his arms
  - Found other ways to exercise by modifying activities to deal with the feeling of being cooped up
Mostly frustrated with the irritating symptoms as the sensation returned and changed constantly
- Had to use numbing gel at times

Partner Experience During Recovery

Listen to what they are experiencing
Look up extra info such as scar care and desensitization strategies if needed
- Your person is so irritated by those sensations and burntout from the whole experience
Had fun figuring out where the sensation had returned to
Helping out others in the community since

Looking Back On It

If you’re considering private options, take the time to look around, including international options
- Worth pricing them out regardless of distance
- Consider amount of post-op support from family/friends
- Consider whether you will get the results you want and what medical follow up is offered
Most people have had positive experiences with McClean Clinic
- Jake found a big difference between the high quality customer service at a distance vs less awesome experience in person

Next time: Legal Transition

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Thinking Ahead to Parenting as a Non-binary Person

If you have read any of the other posts in the Pregnancy and Parenting category, you’ll know that Jake and I have been trying to get pregnant for a while now. So naturally, we think ahead to what it will be like to parent as a trans man and a non-binary person.

Below are some of the things we’ve discussed in relation to my identity as a non-binary person. Note: other non-binary parents may have different responses to these situations and my responses may very well change in the future. And that is totally fine! Think of this as a time capsule of what we’re thinking at the moment.

WHAT WILL THE KID CALL ME?

For the most part, I am comfortable with mom or mother. Mommy is a bit less comfy. I have seen various terms that other non-binary parents use such as Baba, Mapa, Maddy, Mappy, etc. None of these feel like they really fit for me but maybe I will just have to pick one that feels the closest and I’ll get used to it.

Another common one is Ren or Renny from parent. I quite like this one but it would not be as intuitive to others what it meant so it would take more explanation on our part or our child’s part. Maybe this is ok and wouldn’t be as difficult or frustrating as I’m picturing.

The other one I’ve thought of is Mur which is a sounded-out version of M.R. for Meaghan Ray. It also sounds like a shortened or slurred form of mother. So maybe I’ll use that.

I’m sure the kid will have their own opinions about what fits so I guess we’ll see what happens.

EXPLAINING MY IDENTITY TO MY KID

Initially, I won’t be telling my kid anything specific about my own gender identity because they won’t necessarily understand and they definitely won’t understand the safety concerns of who to tell and who not to tell. But we will have lots of kids stories about gender diversity and have lots of conversations about gender and gender presentation and preferences geared towards whatever stage they’re at.

When my kid is more preteen age I will likely tell them about my own gender identity. If my kid ever asks outright what my gender is I will be open and honest and deal with whatever personal consequences come from that.

NAVIGATING SYSTEMS

Whether it’s school systems or pediatric medical care, I will likely be identified as the mother on all the paperwork and to all the professionals. I will likely take that one situation at a time and if I come across an inclusive professional or an inclusive form, I will likely be open about my identity (as long as my kid was also aware of it at that time).

We will look for spaces where our kid, and us as parents, can hang out with other queer families so we don’t feel isolated in these various experiences.

PREPARING THE KID TO FIELD QUESTIONS

Depending on what we have told our kid about my identity and how they are referring to me, this may generate questions from other kids or teachers and other parents. We will not be able to control how our child responds but we can have conversations both before and after these questions come up about what they might say, how they felt about being asked the question, and if they feel like they want to ask any questions of us.

All we can do is instill an open minded and positive view of gender in our child and hope that that is what they represent in their answers to others. If they encounter a negative response as a result of my identity, we will debrief with our child and address it with the most responsible adult directly. This is probably the thing I am the most apprehensive about so we’ll see how it goes.

WILL WE RAISE OUR CHILD GENDER NEUTRAL?

Socially, emotionally, and physically – yes, as much as possible. This means playing sports and rough housing with them while teaching them how to be gentle. Modeling and teaching them emotional intelligence and emotional coping skills. Giving them access to a variety of toys, clothing, and accessory options.

However, we will not be using they/them pronouns for our child. We will be using the pronouns that align with their sex. Though neither of us are cisgender, statistically speaking, our child will be. As someone who prefers they/them pronouns, I understand how difficult it is to get people to use them and understand why I am asking them to. It can be quite upsetting for me when I have explicitly asked them to and they don’t. So having to fight for the same thing for my child would be way too much of a struggle and way too emotionally taxing for me when they are likely to be cisgendered.

As I said above, we will frequently be asking our child about their gender using whatever terms they understand. If they ever display a preference for other pronouns, we will adjust accordingly and immediately. For me, being flexible and open is more important than being strictly neutral from the start.

Do you have a child or are you planning on it in the future? What terms do you use? How have you discussed gender with your child? Leave me a message below!

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Let’s Talk Gender S1E6: Medical Transition: HRT

OVERVIEW

The changes with HRT are some of the most positive and euphoric aspects of transition. We talk about Jake’s experience with Testosterone and going through his second puberty. He talks about all the different physical changes and the emotional changes as well. We also discuss what it was like as his partner adapting to those changes.

SHOW NOTES

Jake’s Experience Taking Testosterone

Typical trans narrative is based on changes with HRT
- External, obvious changes
- Most socially acceptable aspect of transition to ask about
- Lots of YouTube videos and picture timelines
  - Can be fascinating to show what the body does on HRT but also gives you an idea what to expect (though everyone is different)
So much variability
- Will loosely end up similar to cis men that you are related to
- Also depends on age, dosage, etc

Accessing Hormones

Referral from psychologist to gender psychiatrist
Previously required psychiatrist referral to endocrinology but very recently could get a referral from family doctor (most family docs were not aware or comfortable doing this)
Wanted to start HRT right away but had to wait to see gender psychiatrist
- Came out to family doc who then refused to refer to endocrinolgy
  - Wasn’t up to date and wasn’t willing to trust our word enough to seek out more information
- Found another family doctor who was recommended through the community who was prescribing hormones using informed consent
Started Testosterone!
- Regular family doctor followed up with blood work and adjustments to dose
Waited another 6 months to see endocrinology (supposed to see them max 3 months after starting)

Physical Changes

Voice
- Started a few weeks after starting T
- Voice got a bit husky, thick, then started cracking, then eventually settled into the lower range
- Voice recordings were helpful to hear the changes that happened really slowly
- Vocal chords thicken but don’t change as much after you’re done growing
- Made a big difference to being misgendered, especially over the phone
- Generally done changing by about 18 months
- Partner experience
  - Had a fun time with the voice change
  - Making fun of the cracking, drawing attention to something that was affirming
  - My voice started sounding higher in comparison (caused voice dysphoria for myself)
    - Worked on lowering my own range
Facial Hair
- Very slow – mustache and side burns and under-chin hair first, very slowly filled in
- Helps with passing from afar
- Lots of euphoria
- Lots of time spent staring up close in a mirror
- Partner Experience
  - Enjoyed scruffing his beard, trying to encourage it to grow
  - Eventually had to encourage him to shave which he had a big resistance to
Body Hair
- Lots more on thighs, forearm hair thickened, more on tummy
- More fascinating than facial hair growth because it was less expected
- Grew a lot at the beginning, then slowed down a lot but has continued
- Partner Experience
  - Not much need to adapt to this as it wasn’t a huge change and has been fairly slow
Increased Temperature
- Lots of overheating initially on T but has since improved
- Especially when exercising which was very frustrating
  - Better after top surgery which meant he was comfortable exercising without a shirt on
- Partner Experience
  - Used him as a heating pad
  - Wildly different environmental temperature requirements
  - Unable to exercise together for a while
Menstruation and Lower Changes
- Periods stopped almost right away
  - Might be related to already having an IUD in
- Other changes in downstairs anatomy that we did not discuss (go look them up if you’re interested/need to know)
Strength
- Baseline strength increased without trying
  - Could suddenly lift tires more easily which felt weird
  - Didn’t need to workout to increase strength
- Noticeable only when doing things, not all the time (like facial hair) so often took him by surprise
- Partner Experience
  - Felt so much weaker by comparison!
  - Jealous of his strength and easy muscle gain when he was working out
  - Fun to see his confidence increase with his awareness of his strength
Body Shape
- Very delayed and slow
- Fat distribution changes – less on hips and thighs, more on belly
- Changes within face – less in cheeks, more to jaw
  - Gives appearance of wider jaw even though bone structure isn’t changing

Emotional Changes

Concerns before taking hormones about becoming angry and raging
- We were told that it augments emotions that are already present – if you’re an angry person, you might feel more angry but if you’re not, you won’t just suddenly become angry
Hormonal fluctuations definitely makes people generally more emotional just like typical puberty
- As an adult there are adult expectations and responsibilities you have to manage while having mood swings
- Hopefully have more coping skills as an adult
Less sadness, more channeled into frustration
Initially quire irritable but calmed down within a few months
Less emotional range and less nuance
- Doesn’t feel wrong or repressed or stunted
- Feels normal, the way his emotions should have been from the beginning
Less emotionally triggered, less emotionally invested
- Maybe due to increased confidence
- Seems more aloof but as a guy, people don’t particularly care (aloofness is somewhat expected)
Confidence increased which is difficult to measure as the person going through it
- As a partner, this was easiest to see as compared to the rest of the emotional experience
  - Less social anxiety
  - More comfort in masculine clothes
  - Was very cool to see and very much offset any mild discomfort I had with the physical or emotional changes
Partner Role
- Being a sounding board
- Encouraging him to express the huge emotions when he wasn’t used to having them or having so much of them
- Suggested a variety of positive outlets for emotions

Looking Back 2.5 Years on T

Lots of euphoria from HRT but at the time was painfully slow
- Celebrated every little change we saw and made a big deal out of them
- This was the good stuff during all the frustrations of accessing medical care and getting legal documents changed
Looking forward to more facial hair, body hair, and body shape changes
What will happened during the age of menopause/andropause? We have no idea!

Nonbinary Identities and HRT

Can take low dose to have fewer and slower changes
- ‘Micro-dosing’
- Can stop after the voice change but before much hair growth
I have minimal consistent physical dysphoria, no particular desire for facial or body hair changes, minimal voice dysphoria which I dealt with by working on my range
- Also trying to get pregnant so would not be able to be on T currently
Open to it in the future if I ever felt like I needed it

Next episode: Top surgery!

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