Tag: Community

Trans Wisdom: The Power of Community

COMMUNITY HAS EXPERIENCIAL KNOWLEDGE

Many things in life, including transitioning, are difficult, complex, and not well understood by the general public. Navigating these experiences is difficult in part because there is so little information available about what to expect, what to avoid, and what resources are available and helpful.

Communities are full of people who have gone there before you. They have way more knowledge and information that is tried, tested, and true than any professional or google search can provide. The bigger the community, the wider the range of experiences and suggestions you will find and the more likely you will find something that works for you.

Without the local trans community, we would not have known that ‘the proper referral process’ that our family doctor was following was outdated and incorrect. We would not have found a doctor willing to follow the current referral process to prescribe my husband Testosterone. We would not have had personal recommendations for where to go for surgery. We would not have had scripts to use when encountering resistance at various governmental and private institutions when trying to change his name and gender marker on documentation. We would not have had scripts to use when acquaintances, friends, and family asked inappropriate, invasive, or poorly worded questions. We would not have been prepared for how long the waitlist was for specialist referrals needed to complete paperwork.

So much of what we learned about how to navigate my husband’s transition came from our community. Without the community, we would have struggled significantly more, waited for specialists that were not required, and felt incredibly alone.

COMMUNITY PROVIDES SUPPORT

We need support from a variety of sources when we are going through something difficult and big. Support from a broader community is one of those sources. Being part of a community of people that are all experiencing something similar normalizes the experience and provides validation.

Often, when our experiences are rarely or poorly represented in mainstream media, we are left feeling like we are the only ones going through this. This can lead to questioning whether your experience is legitimate, whether your reactions to this experience are valid, whether you should be dealing with it differently or better, or whether you’re doing the right thing. We can feel lost, isolated, confused, self-conscious, fearful, anxious, and angry. We can internalize the judgements and negative responses from those around us, including what is represented in mainstream media.

While having a community won’t automatically make the experience an easy, positive one, it will show us that there are others out there struggling and thriving in similar circumstances to our own. Seeing someone else describe their own experience in the same way we would, navigating the same barriers and systems, struggling with similar emotions, tells us that our experience is shared, normal, and valid. We find voices other than our own to counteract the negativity and judgement that we have internalized.

Normalization and validation of our experiences doesn’t take away the difficult aspects, but it helps fortify us against the toll that those parts of our experience can take on us. It helps us weather them. Community gives us someone to talk to who will respond with positivity, understanding, and support without us having to first explain our experience to them from the beginning.

COMMUNITY MEMBERS HAVE IMPLICIT UNDERSTANDING

People who share our experiences will automatically understand our struggles, milestones, and achievements. This is huge. If you need support, even just an ‘aw that sucks’ or ‘I hear you’, and you share your point of struggle with someone outside your community, instead of support you might get a blank stare, a confused look, a platitude, or an inappropriate question. In order to get the response you’re looking for you would have to explain your situation from the beginning, often sharing a lot of personal information in order to bring them up to speed, and may not ever get them to the point of understanding enough to provide the support you need.

I repeated this process many, many times over the course of my husband’s transition. I spent more energy in the explanation than I received in whatever support I got back. The more marginalized your experience is, the less likely it will be that you will automatically get the response you’re looking for. I found a huge difference between the support I got when I had a miscarriage vs the support I got when my husband was transitioning (and we were struggling against systemic barriers).

It was always such a relief when we could tell a group of trans people about something that had happened and immediately get the response we were hoping for, be it support, commiseration, information, or celebration, without having to provide any explanation or background. I learned through trial and error when it was worth explaining my situation to non-community members and when to keep my struggles and triumphs to myself until I had community to share it with.

COMMUNITY HELPS US CELEBRATE

I didn’t realize how important this function of community was until I had something to celebrate and got a response from non-community members that was sympathetic or blank instead of excited. It really takes away from the positive experience when someone assumes it’s negative and you have to explain the whole backstory before they conceptually get it. Even then, they don’t really feel excited for you.

But members of your community do. They have celebrated the same things or are looking forward to the moment when they can. They understand how hard it was to get there. They understand why that milestone is worth celebrating. Without community, the milestone passes you by with a small blip of excitement, self-satisfaction, accomplishment, pride, relief, and perhaps some apprehension about what comes next. But when you get to celebrate with community, your milestone is celebrated by so many others that it is magnified. It becomes a bright moment in a timeline of struggle that you can look back on to give you strength when you need it.

Being able to celebrate the high moments with people that understand can shift our perspective of the entire experience. It can shift the focus from the struggle and loss to the achievement, hope, and success. The story of our experience, when we look back on it, is now characterized by the moments we celebrated with the community. They shine so brightly that they overpower the dark parts between them. They don’t erase the struggle but when the experience if viewed from farther away, they stand out as the most important parts. They make the rest of the experience worth it.

COMMUNITIES HAVE LOUDER VOICES

The voice of the many is often louder than the voice of the few. The more marginalized your experience is, the more powerful the effect of the community. These are also the experiences that get the least attention from media, politicians, health care, and research. Community is necessary to amplify our voices to share our experiences and gain access to the resources and services we need.

The members of a community often have a wide range of outside expertise, connections, and influence. So not only do they have a louder voice, but they can often find a way to get their message heard by the right people with a lot less effort than a single person might.

Communities can form organizations, develop a funding base, and develop their own resources. They can hold fundraisers that are coordinated across an entire country. They can pool their resources from multiple sites and put them towards something that no one person from the community would be able to change.

Feeling like your voice is being heard and that you helped to change the system so that the next person to go through a similar experience will have a slightly easier time of it than you did is huge.

What experience have you had where being a member of a community made a big impact on you or the wider world? What other ways did being a member of a community impact you? Leave a comment below or send me an email!

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Trans Wisdom: You Define Your Identity

YOUR IDENTITY IS YOUR OWN

In the first post in the Trans Wisdom series, I talked about how the bodies of trans people don’t determine their gender identities (or any other aspects of their identity) which means that is true for everyone. It is your choice to allow your body to inform your identity in whatever way makes sense to you. You have control over your own identity.

This is not only true for your relationship to your body. This is also true with respect to the roles you identify with in your life, your career and interests, your family history, your culture and race, your sexuality and sexual orientation, and your personal experiences. No matter how other people use this information to label you, interact with you, or connect with you, YOU are the only one who gets to decide how these inform who you are.

You also get to decide the balance of the different aspects of your identity. Is your role in your family the most important part of your identity, followed by your career, and then your culture and race? Or is how your career impacts who you are most important, followed by your personal experiences, and then your gender? Identity is like a 3D pie chart with blurry, overlapping lines between the sections and some sections that influence the whole thing but are only forefront a small part of the time.

Or maybe it’s more like a cloud, more ephemeral, and shifting over time.

IDENTITY CHANGES OVER TIME

Trans people go through a huge identity shift when they discover that their discomfort in their life has been related to gender. This can happen at any age but the longer they have lived as their gender they were assigned at birth, the larger the shift. Regardless, looking back over their life, they can say that their identity clearly has changed over time. In fact, this is true for most queer people.

Funnily enough, this is actually true for everyone. Anyone who has become a parent has experienced this shift in identity. Anyone who has changed careers, entered a committed relationship, experienced a health crisis, or lived through a global pandemic has experienced a shift in identity. Even something as simple as turning 18, learning how to drive, entering high school, or moving away from home cause a shift in our identity. We may not be aware of it at the time or feel like we have control over it but our identities shift as we adapt to new life circumstances.

You may not being able control the circumstances that influence these changes in your identity but you do have control over HOW your identity changes. How quickly do you adapt to the new circumstance? Is it a positive change or a negative one? Does it eclipse all other aspects of your identity, even for a short time, or simply become another component of who you are? Is this an aspect of yourself you will keep hidden or share openly with others?

If our identities change over time, why are sexual orientation and gender seen as constants? They are simply components of our identities and therefore are influenced by our experiences and circumstances just like anything else. I think everyone should feel free to explore their sexuality and gender at any point in their life and as often as they choose. Even if you conclude that nothing has changed, you may decide you feel like expressing some aspect of yourself differently or that it influences other aspects of your identity in a new way.

IDENTITIES ARE COMPLEX AND INTERSECTIONAL

As you can see from what I’ve said so far, and probably know from personal experience, no one is made up of only one component of their identity. And no aspect of our identities are the same for any two people because they are all influenced by every other part of who we are.

When someone is coming out as trans, they get the same reactions and get asked the same questions over and over. Because, historically, trans people have had to hide their identities and mainstream society is only just now becoming aware of this identity and experience, the story that gets told about trans people is a monolith. Anyone who doesn’t fit that story is either not recognized as being trans or labeled as an exception.

If every aspect of identity is variable between individuals, why do we assume that someone’s experience is the same as our own or the same as that one other person we know with that identity when they identify in a similar way? If our identities are complex and intersectional, so are everyone else’s. It takes time, patience, and open communication to learn where our experiences overlap and where they differ. Being open to this type of communication allows for authentic bonding over the similarities and learning and growing from the differences.

IDENTITIES ARE NOT CATEGORIES

In some settings (such as medical and legal forms) we have to check off boxes that relate to our identities. These boxes are for the sake of information gathering, not to be used as a guideline of how to interact with someone.

As a medical professional who has to read patients’ charts and then interact with those individuals, the image you get of a person from their chart is never accurate. It tells you nothing about their personality, attitudes, or cultural experiences. And a medical chart holds a ton of information. So why do we feel like we can judge someone based on their appearance? Or the awareness that they identify as trans? Or their identity as a man or woman?

No identity is a monolith. No identity should be treated as a category or a box. Masculinity, femininity, and androgyny belong to everyone. No two people’s experiences of parenthood are the same (though some will have more in common than others).

Which aspects of your identity do you feel confined by? Do you experience that aspect of your identity a certain way because that is the narrative you have always been told about how you should feel, act, or look? Can you find examples of people that share that same identity but embody or express it in a different way?

Your identity is your own. You get to determine what parts of your life inform your identity. You get to determine the balance of the different aspects of your identity. Your identity shifts over time. You can let those shifts happen based on outside influences, experiences, and circumstances, or be take an active role in deciding how those outside influences with impact your identity. Every aspect of your identity is influenced by all the others creating a complex, intersectional, and unique individual. If this is true for you, it is true for everyone else. No aspect of identity should be considered a monolith, a category, or independent of any other aspect.

Just for fun, try writing a list of the different components of your identity. Now re-order the list from most important to least important (or strongest influence on how you view yourself to least influence on how you view yourself). Are there other components that you remember used to be part of your identity but no longer are? Are there components that you anticipate will be part of your identity in the near future? Try this activity again in a couple weeks, or a month. Has the list or the order changed?

Leave a comment with the results of this activity! I’d love to hear what you learned.

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How Dysphoria Contributes to Burnout and What You Can Do About It

WHAT IS BURNOUT?

I have struggled with cycles of burnout for many years now. For a long time I felt like I was making it up, or being lazy, or finding an excuse to avoid the mundane but challenging parts of everyday life. Very little of what I was feeling matched the symptoms of depression but that was the closest I felt like I could come. Until I heard about burnout.

When I’m in a state of burnout, the thought that keeps going through my mind is ‘I just don’t care’. I know I should, and usually do, but I can’t muster up the emotional energy to engage with almost all aspects of life. This is not me. In this state, I don’t feel like myself. And because I don’t have the energy to care, it is very hard to make myself do the things that will help me get out of the state of burnout.

I feel numb, heavy, and drawn to escapism. It feels like the world is happening around me and I’m just going through the motions. I don’t keep up with house chores, I eat less and more poorly, I socialize less, I exercise less (usually not at all), I am often late, and my productivity at work decreases.

If this sounds like you or someone you know, I highly recommend the book ‘Burnout’ by Emily and Amelia Nagoski. Not all of it resonated with me but the parts that did have been very helpful by giving me language to discuss my experiences of burnout with others, different ways of thinking about and noticing how I’m functioning, and practical strategies to prevent and recover from burnout.

HOW DYSPHORIA CONTRIBUTES TO BURNOUT

I have found that dysphoria is a large contributor to my burnout. There are three reasons for this:

  1. It takes a lot of mental effort to ignore the buzz of dysphoria in order to focus on what I’m supposed to be doing. It takes mental effort to check in with myself, identify what aspects of dysphoria I’m feeling, and use appropriate management strategies. It takes mental effort to identify and avoid situations that trigger my dysphoria (as much as possible). And it takes mental effort to reframe the dysphoria or fight it’s effects by using positive self talk and affirmation. So yah, lots of mental effort.
  2. Dysphoria is constant. It goes up and down depending on the day, my emotional state, my physical state, who I’m around, and what situation I’m in, but even at it’s lowest it’s still there. So lots of constant mental effort.
  3. Generally, there is a lack of understanding from others about what dysphoria is and how it affects me (or how it can affect people). The situations where my dysphoria is triggered the most and which are unavoidable are also the situations where I’m surrounded by and interacting with people who do not understand dysphoria. So lots of constant mental effort that is invisible to or misunderstood by the people around me.

WHAT BURNOUT FROM DYSPHORIA FEELS LIKE

For me, certain symptoms of burnout are specific to dysphoria. Three main ones are:

  1. Decreased attention/focus. So much of my attention is taken up by ignoring, managing, avoiding, and fighting the effects of dysphoria that I have less mental space to spend on other things. It is harder to stay on task, perform multiple step activities without getting derailed, maintain momentum on a task, block out distractions, and remember details.
  2. Irritability/easily frustrated. Dysphoria is an internal irritant that is constant and unavoidable. No matter how good I am at managing it, it will never be zero. So I already have a baseline irritation that I am working to ignore. That means that I have less patience for other sources of irritation. Less patience leads to more frustration. The more dysphoria I have, the more easily frustrated and irritable I am.
  3. Physical, mental, and emotional fatigue. The constant mental effort I talked about above is exhausting. The feeling of being misunderstood and invisible and at odds with myself or how people see me is emotionally exhausting. We feel our emotions in our bodies so I end up with a feeling of heaviness and lethargy that means I don’t feel like I have the physical energy to exercise or do any extra tasks (even though that is what would often help me the most).

WHAT YOU CAN DO ABOUT IT

Over the last few years I have developed a number of different strategies to help manage my burnout. After reading the book I recommended above, I have some more language to explain it and some practical strategies to suggest.

Prevention

Identify the sources of dysphoria for you. Develop strategies to decrease as much of the dysphoria as you can (more posts on this in the Related Posts list below). Where possible, avoid situations that trigger high amounts of dysphoria or repetitive situations that trigger even small amounts of dysphoria (such as getting dressed in a room that doesn’t have a mirror).

As much as possible, make these dysphoria prevention, management, and avoidance strategies automatic. Restructure your environment, schedule, or routine so that you don’t have to spend mental energy on remembering to do things in a different way. The goal is to decrease your baseline mental workload, not increase it.

Protection

In psychology they talk about protective experiences that may be completely unrelated to the harmful experience but help build resilience and emotional capacity or offset or heal some of the negative effects. There are a few protective experiences that I have found to be important in decreasing the burnout caused by dysphoria.

  1. Euphoria. Notice moments of gender euphoria and seek them out. Avoiding dysphoria is helpful to tell you what doesn’t work for you but moving towards euphoria tells you what you should do. Moments of euphoria can pass us by or be overshadowed by dysphoria unless we notice them, focus on them, and celebrate them. In this way, they can be a beacon of light to look forward to and to remember when we feel overwhelmed by dysphoria.
  2. Support. Whether through therapy, social support groups, online groups, friends, or family, support from people who understand what you are experiencing and can give you a sounding board to process and strategize with is important. Your support person/people can also help bring your attention to the symptoms of burnout you are experiencing and provide some external motivation to socialize, exercise, or engage in whatever other activities are necessary for you to recover.
  3. Affirmation. Dysphoria is constantly telling us that something is wrong, that we don’t fit in our body or in society, that we don’t look the way we should, and that maybe we’re making this whole gender identity thing up. Finding sources of affirmation, whether from your support network, from positive social media influences, or a personal journaling, self-talk, or meditation practice can be extremely helpful in offsetting the negative thoughts and feelings associated with dysphoria. The more the affirmation comes from an outside source, the less mental work we have to do to provide the same level of protection and, often, the more likely we are to believe it.
  4. Activities and Interests. Part of burnout, for me anyway, is a lack of interest in things that I would usually enjoy. The frustrating thing is that engaging in things I enjoy makes me feel better. The trick is to find activities and interests that do not trigger any dysphoria. This allows you to engage in your activity or interest with less mental effort so that it doesn’t make the burnout worse which results in a net gain of positive emotion and energy.

Process the Stress

This concept is directly from the book I recommended earlier. The gist is that we experience our emotions in our bodies as a chemical and neurological process. When we are under constant stress (as with dysphoria), our bodies are constantly in ‘fight, flight, or freeze’ mode. Even if we get a burst of euphoria or a period of relief from dysphoria, our bodies still have to complete the chemical reaction or neurological pattern that was triggered by the stress. If we don’t engage in activities that encourage this completion to happen, our bodies remain in the stress state which only gets stronger the next time we experience stress (five minutes later).

So while we can’t necessarily get rid of the stressor (dysphoria) and stop it from triggering a stress response in our bodies, we can do various things to move through the stress response in our bodies, complete it, hit the reset button, so that the responses to this continual stress don’t compound as much. For me, the most useful activities are physical activity of any kind, breathing, affection, positive social engagement, and creativity (writing, painting, and crocheting). With so many options, it is easy to engage in at least one per day, usually more.

One of the tricks to making this as effective as possible for me is to do these activities mindfully. To focus on the calming effect it is having on my body, mind, and emotions. Or, if there was a specific situation that was stressful that I am ruminating on (because my body is still stuck in that stress cycle), I focus on that situation at the beginning of the activity, think through it, feel the emotions that I felt at the time (or didn’t allow myself to feel at the time), and continue the activity until the emotions and the associated physiological response dissipate. The amount of relief this brings in a very short span of time is pretty incredible.

Tl;dr

Burnout sucks and makes us feel numb, exhausted, and irritable. Dysphoria can lead to burnout due to the constant mental effort that is invisible to or misunderstood by the people around us. You can help yourself avoid repeated cycles of burnout by preventing as much dysphoria as possible, protecting yourself against the negative effects of dysphoria, and processing the physiological stress triggered by dysphoria (and any other sources of stress).

I hope this helps you. It is what I needed to hear five years ago. Leave a comment below or send me an email with your thoughts and experiences of burnout. Maybe your experiences are similar to mine and maybe they are very different. Either way, your experiences have value and I would love to hear about them.

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Reflections on Top Surgery, Part 2: Surgery

Gender affirming chest masculinization “top surgery” is one of the major defining moments for trans men. But getting from your existing chest to the one you want to have can be overwhelming from both the information overload and emotional point of view. Having had surgery 3 years ago, I wanted to share my thoughts on surgery in case it may help someone else in the same position. I’ve created a 3 part series on surgery : Pre-surgery, surgery itself, and post- surgery.

This will be mainly from my personal experience as a mostly binary trans man, but could easily be applied to non-binary/GNC people.

If you haven’t read Part 1: Pre-surgery, start there. To recap: I had a phone consultation with a privately funded top surgeon in Ontario, who gave me a surgery date 6 weeks later. I booked my time off from work as well as flights for me and my spouse, Meaghan Ray.

Last Minute Researching

While I had been looking at post-op trans guys for a while, and reading their stories of heading into surgery, suddenly it was going to be me in that position! I refocused my searches on what other people had found useful after surgery.

While there weren’t a lot of medical sites with information regarding top surgery for trans people, there was loads of information for people recovering from breast cancer surgery. Some of it was not quite relevant (what to do while waiting for breast reconstruction), but a lot of the advice on recovering from a long incision across your chest was useful.

The things I found most useful were button down pyjamas and shirts, as well as a neck pillow. Other items that seemed like they would be helpful but then I didn’t use were dry shampoo, body/baby wipes, and stool softeners (though I REALLY wish I had).

Arriving In Toronto

Since we were staying with family, we arrived a few days before surgery for a visit. Similar to when I was travelling for archery competitions, arriving and settling into a new location a little early allowed me to start mentally progressing towards acceptance and excitement.

I did some journaling at the time to help get rid of all the bees buzzing around in my head. I knew that I was super excited for the surgery, but there was now also the return of the anxiety of wondering if I had made the right choice. Everything I did was the last time before having a flat chest, and it felt important to remember those things, mundane as a lot of them were. “This is the last time I’ll be flying with a round chest” “This is the last time going to a cafe with a round chest”. So journaling helped with clearing my head a bit and helping me feel less chaotic.

Pre-op Appointment

The day before surgery I attended the clinic to see where it was, meet the surgeon face to face, and ask any last questions. The staff were great with pronouns, and the clinic seemed modern and clean. However, my appointment time was more than 2 hours behind schedule, and no one bothered to let me know. The only good thing about that is my anxiety completely burned itself out, and was only left with mild annoyance.

Meeting the surgeon was good, he was very respectful but clearly he had his method of doing the surgery and didn’t seem to be interested in what my desires were (similar to the surgeon back home). Despite those nagging worries, I was happy with the pictures I had seen of his results, and I was far too excited for a flat chest to let that slow me down. We drove the 90 minutes back home and settled in for a long evening of no sleep.

Day Of Surgery

Due to my sleep apnea they moved by appointment up to first thing in the morning. Once we arrived I changed into a gown and had the two clinic surgeons as well as a visiting surgeon draw the anatomical lines that would make sure everything ended up straight and proportional. It was a little awkward but clinical (“this is the last time a stranger will see my female chest”).

Everything happened fast after that. They got an IV started and I was off to the surgery suite, and next thing I knew I was waking up crying inconsolably with a pressure on my chest. I don’t know why I was crying, just that I couldn’t stop.

The surgeon came by briefly, but otherwise I felt very alone and disoriented. I was discharged fairly soon afterwards, but with fumbles from the staff leaving me unattended to have a panic attack in the bathroom, and while discharging me out a back door with minimum instructions. This left the experience feeling less than excellent.

Eventually we got back into the car and Meaghan Ray drove us home. According to them, I was frighteningly pale and very nauseous the whole way home but I don’t remember much of that. I do remember the neck pillow came in handy to keep the seatbelt off my new incisions.

First Couple Post-op Days

I was firmly ensconced in the bedroom for several days. The pain was manageable with medications, though I was fairly drowsy so I slept lots and watched lots of movies in bed.

My main complaint was the post-op compression binder used to keep the bandages tight to the incisions. My surgery included liposuction along my armpits and sides to prevent the dog ears that the Edmonton surgeon had mentioned. While that would allow for a more masculine appearance, those areas were not as numb as the incisions and were very tender against the binder. Meaghan Ray helped to modify the binder so that it would be more comfortable. I was told I would need to wear it for 4 weeks! Guess I would need to continue to deal with a binder even though I no longer had breasts. Argh.

Post-op Reveal

The day before flying home, I had a post-op appointment at the clinic where they would remove all the bandages and tapes. There are many videos on YouTube of transmen seeing their new chest for the first time where they elatedly collapse in happy tears and emotion.

My appointment was not like that. I mostly felt relieved to be free of the bandages, continued tiredness from recovery and pain medication, and a touch of feeling surreal. Luckily Meaghan Ray was there to capture the moment and feel excited for me, even if I couldn’t stir up those feelings very well.

Again we fell through the cracks while waiting to be fully discharged. We waited a respectable amount of time, and another 15 minutes on top of that. We finally had to sneak out into the hall where someone finally went “oh, I didn’t know you guys were still here!”

Everyone else who had surgery with this surgeon had nothing but good things to say about their experiences with this clinic, so it appears my experience was an anomaly. I believe most of their private pay clients stay at the hotel adjacent to the clinic so perhaps they were thrown off by me staying 90 minutes away?

I was (and still am) very happy with my results, though the experience itself was far from ideal.

Up Next

Now I got to take my new flat chest back home! I couldn’t wait to finally experience that gender euphoria around my friends, family and colleagues, when they would stop misgendering me since I now had a flat chest! Right?

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Reflections on Top Surgery, Part 1 : Pre-surgery

Gender affirming chest masculinization “top surgery” is one of the major defining moments for trans men. But getting from your existing chest to the one you want to have can be overwhelming from both the information overload and emotional point of view. Having had surgery 3 years ago, I wanted to share my thoughts on surgery in case it may help someone else in the same position. I’ve created a 3 part series on surgery : Pre-surgery, surgery itself, and post- surgery.

This will be mainly from my personal experience as a mostly binary trans man, but could easily be applied to non-binary/GNC people.

Deciding to pursue surgery

Wanting to pursue top surgery can come before wanting/deciding to transition and be a driving force towards wanting to transition. AKA your chest dysphoria is so strong that any other steps towards transition (hormones, coming out) are secondary.

Or like in my case, my social dysphoria was my driving force to transition, and once I had started the process for getting hormones and coming out, top surgery was my next urgent priority.

Applying for funding

In Canada there are two main paths to take in order to get top surgery – public and private.

The public funding model in Alberta involves being diagnosed with gender dysphoria by any psychiatrist who then submits for surgery funding on your behalf. When I was going through this process in 2017, there was one approved psychiatrist that had a long waiting list of his own. I was referred to the psychiatrist in September 2016, saw him in July of 2017, and I had a consultation with the surgeon in November 2017. At that time the waiting list for surgery was 1.5 – 2 years since dysphoria-eliminating surgery is not high on the list of priorities when those same surgeons are assisting cancer survivors.

In other provinces there are variations on how to go about getting funding, and the wait times vary.

Having to wait for surgery after coming out as male, attempting to “pass” as male with friends, family, colleagues, and strangers while still having a rounded chest was frustrating, tiring, and a safety risk. I decided to look into privately funded surgery.

In searching “top surgery in Canada” there was really only one option which was in Ontario, which was ok since my in-laws lived there. I submitted the documents the week after my consultation with the Alberta surgeon, and was set up for a phone consultation for March 2018.

Research while waiting

Part of my frustration with the Alberta surgeon besides the long wait time was that he didn’t seem interested in my goals for my chest. He asked me to take my shirt off, looked at me and told me what he would be doing. He told me that I would likely have a common complication called “dog-ears” where pockets of skin and fat remain along the sides, but also that Alberta wouldn’t cover the surgery to remove them, or the technique necessary to avoid creating them. So while I would have a drastically flatter chest, it would still be not quite ideal (in my eyes).

I started researching the different methods of masculinizing surgery and saw that the Ontario surgeon offered more than the one kind the Alberta surgeon offered me.

I spent lots of time on surgeon’s websites as well as different Facebook groups where I could see pre and post op chests and compare to what I thought I might want, and what my results were likely to be. In attending a PFLAG group in Edmonton I discovered that a couple other people had gone to the same Ontario surgeon and were happy with their decision. One person actually offered to show me their chest in person after the group which was great. I began to earnestly look forward to my consultation in March.

Private surgeon consultation

The consultation was similar to any other health professional, but since this surgeon was using the informed consent model as opposed to having mental health professionals vouch for me, I had to start at the beginning yet again and prove to another person that I was trans enough to get the surgery. Since this was a common occurrence at the beginning of my transition I had all the answers at the tip of my tongue, but it was still mentally exhausting. Its like the stress of a job interview every time, but instead of trying to land a job, you are trying to justify your ideas on why you are who you are. There are no certificates or diplomas, just defending the difference between your appearance and your thoughts.

While I had moderate chest dysphoria, I still felt like I had to exaggerate my feelings a bit in order to get the approval from the surgeon. What if he felt that I was a minor case and could wait? Maybe there were people out there who were suffering more than me.

I successfully “passed” that consultation and was given a surgery date for 6 weeks later! Suddenly I had to change from endlessly waiting to preparing for surgery.

Preparing for surgery

The physical components were easy to do and were a distraction from having to emotionally prepare for the surgery. I completed all the forms and bloodwork, submitted for time off from work and booked flights.

But when that was all completed, I had a relatively short amount of time to emotionally prepare. I had started questioning my identity in 2016 and had spent many hours in my own head up to that point, but admittedly I was fine with being stuck in the trans angst of “I have to wait so long, this sucks!”

Chest surgery was the next logical step for my happiness and safety, but I had a lot of conflicted feelings. My dysphoria was not overly bad. I enjoyed having nipple sensation. I was worried about surgery. I didn’t need to wear a binder very often. I was worried about what I was permanently doing to my body. In my anxiety I even started wondering if transitioning was the right thing to do. My therapist is highly regarded by many trans people in the city (read: long wait time) and I was not going to be able to see her before surgery.

To get through this mental hurdle I had to trick myself a little bit. I thought to myself “what would I say to someone in my exact circumstances?” “would I be jealous of someone else getting my 6 week date?” and “what would happen if I waited?”

The clinic did give me the option to postpone if I wanted, but after thinking about those questions, and endless talking about it with my spouse, I decided to go ahead with the surgery in 6 weeks.

Things I wish I had done differently to prepare

While I am happy with how things turned out, with the benefit of hindsight, I wish I had done a couple things differently.

I wish I had researched more surgeons – since I was paying out of pocket anyway, I could have chosen to go to a variety of surgeons.

I wish I had gone to see my therapist before going for surgery to try knock down some anxiety. Though I knew she had a long wait time, she always has space for emergencies. I didn’t even make a phone call to inquire, which I wish I had just mustered up some courage to ask for an appointment.

Up next

I’m getting on a plane heading to Ontario for surgery! The next post in this series is all about the few days prior, the surgery itself and the few days after.

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Gender in Isolation

In the time of the COVID 19 pandemic, many of us are living in physical isolation. We have significantly less social interaction, especially with strangers, and the majority of our social time is over the internet using video chat. Depending on your situation, this time of isolation may have been helpful or harmful as it relates to your gender. For me, it has been a bit of both.

My experience of isolation, in general, has been positive. I live with a supportive spouse, I have job and housing security, and I haven’t had any major medical incidents (other than giving birth to our baby). I know this is not the case for everyone, especially queer and trans people. Many are isolated with family members that are not supportive of their identity or even abusive. Many have lost their income. Many have had major mental or physical health crises. If your experience differs from mine, I would love to hear about it. Please share in the comments or send me an email. However, I will stick to my own experiences for the purposes of this post.

HELPFUL ASPECTS OF ISOLATION

Separating Physical and Social Dysphoria Triggers

When I am home alone, or with only my spouse, the majority of my dysphoria goes away. This has made it even more obvious to me how much of my dysphoria is triggered by social interactions and how important it is for me to build a life for myself where I am predominantly in supportive environments. The flip side of this is that it also has shown me what aspects of my dysphoria are present regardless of social interaction. These are physical and part of my experience even when I’m by myself.

For example, I always assumed my dysphoria related to my chest was triggered by having other people see me as female as a result of the shape of my chest. Turns out I have almost the same amount of dysphoria even when I’m by myself, it’s just easier to ignore because it’s not compounded by all the other socially triggered parts of dysphoria.

Decreased Social Dysphoria

About 75% of my dysphoria is triggered by social situations. This includes being misgendered, hearing female language used to refer to me, and being expected to look and act a certain way. Since being in isolation, I have had so much less exposure to these triggers that I have way more energy and emotional bandwidth to spend on other things, like taking care of my four month old!

Seeing how much of a difference this has made has given me incentive to try to be open about my gender when interacting with new people and even work on coming out to other people in my life. Hopefully over time this will shape my social environment into a more supportive one that has fewer triggers for dysphoria.

Space to Experiment in Safety

Though I haven’t felt the need to experiment in the last few months as I have done a fair amount of this already, I have found isolation necessary to experiment in the past. Trying something in private has always been the first step in seeing how I feel about it gender-wise. If it feels good, I’ll try it in a queer inclusive space next. If it doesn’t, I’m always glad I tried it on my own first.

The isolation isn’t just good for the experimentation but also for the process of building up courage and taking care of myself afterwards. Sometimes this means laying out what I want to try and just holding it up to myself or feeling it before trying it on. Sometimes it means having time to take pictures or look in the mirror. Sometimes it means changing into comfy clothes and working out or cleaning afterwards to get rid of excess energy and re-ground myself in my body. Almost always, it means having time to journal about the experience either immediately after or a day or two later. Having to interact with others while feeling vulnerable and confused about the experience is extremely taxing. So doing the experiments is always easier during a period of isolation.

DIFFICULT ASPECTS OF ISOLATION

Testing Public Reactions

Often when I make a change to my appearance or behaviour I am doing it in an attempt to influence how other people see me and interact with me. Seeing how the change influences others can’t be done without social interaction. This means that while I may find ways of being that I am very comfortable with for myself, it may not have the effect I’m hoping for when I’m out in public or at work. This stage of experimentation will have to wait for when the social isolation has ended.

Coming Out and Reinforcing the Change

Being in isolation may have given me the bandwidth to build up courage to come out to more people and shown me how necessary it is but it doesn’t allow me to reinforce the changes that others have to make as a result. Coming out as trans or nonbinary requires a bunch of work from the other party. For me, this usually includes changing the pronouns and language they use to refer to me. Most people can’t do this without significant practice. And most people need to be corrected when they get it wrong before they start to correct themselves or get it right on the first try.

Without the regular social interaction following coming out, I can’t do this repeated correcting and reinforcing. Sometimes this means the change in how they refer to me happens slower, and sometimes it stalls and doesn’t happen at all and I have to repeat the coming out process at a later date.

Separation from Queer and Trans Support

While the global pandemic has led to many support groups moving online and therefore becoming accessible to me even though I don’t live in the area, it has also led to not having access to my in person, local group of queer and trans friends. There’s something different about meeting in person that I don’t get from an online group. I miss it and I’m looking forward to the days when I can get it back.

How has isolation influenced your relationship with your gender, either recently or in the past? Leave me a comment or send me an email with your thoughts and experiences!

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How to be a Trans Ally

ALLYSHIP 101

Being an ally for any minority takes more than being accepting of a friend or acquaintance from that identity. Not being a biggot is not the same thing as being an ally. Being an ally isn’t a perspective, a state of mind, or even a level of understanding. It requires ongoing action that at first can be a challenge but eventually becomes automatic.

As someone who is part of a majority group, it is not for you to say that you are an ally. If you take actions that show to members of the minority group that you are safe to be around, understanding, supportive, affirming, and uplifting, they will label you as an ally.

Being an ally takes work, requires an open mind, and most of all, a willingness to feel uncomfortable. At some point, someone from a minority group will tell you that what you’re doing isn’t helping or may actually be causing more harm than good. Being an ally means listening to this perspective, asking questions to understand it further and what you can do differently, then acting on what you’ve learned.

Being an ally for one minority does not mean you are an ally for all minorities or even all the identities encompassed by that minority. Being an ally at one time does not guarantee you are an ally forever or in all circumstances.

But don’t let this discourage you! We need more allies!! Below are a number of ideas for what it means to be an ally to trans people. Please leave a comment below or get in touch with me if you have questions or other things to add to this list!

PRONOUNS

Put your pronouns in your email signature, your social media profiles, your video chat name, and on name tags. As a cis person, you likely have never had your pronouns questioned, never felt uncomfortable with the pronoun people assume you use, and never had to justify your use of that pronoun. Trans people have to do this every day or deal with the discomfort of being misgendered. So please, normalize the expression of pronouns by including yours.

Along the same lines, when you are introducing yourself to someone (anyone, not just someone you guess or know to be trans), introduce yourself with your pronouns. “Hi, my name is _____ and I use ______ pronouns.” You may get some funny looks or confusion from cis people who are not trans aware and you may feel awkward the first few times but just like anything else, it gets easier with practice. If you give up the first time it is uncomfortable, you really aren’t understanding how uncomfortable, scary, and often painful it is for trans people to be in a similar situation. And they don’t have the choice to just walk away, pretend it doesn’t exist, or avoid the discomfort.

Learn how to use a variety of pronouns. No, she/her and he/him are not the only singular pronouns out there. They/them is fairly common. There are also neopronouns such as per, xir or zir, and aer. Learn how these pronouns sound, how to use them in a sentence, how to switch between different pronouns, how to use pronouns that seem counter to your perception of someone’s gender, and how to avoid using pronouns altogether. Often, in English anyway, it is easy enough to rearrange a sentence to remove pronouns or substitute the person’s name.

KNOWLEDGE

Understand what it means to be trans. Understand the difference between sex, gender, sexual orientation, and gender presentation. Learn about some of the various identities that fall under the trans umbrella. Learn about the different steps someone might take to transition. You don’t need to know all the ins and outs of all the medical procedures or medication options (unless you are a healthcare worker and this is relevant to your field) but a general understanding is required.

Understand some of the challenges faced by the trans community in your area. This may be systemic barriers such as access to medications and medical procedures, cost of changing ID, wait times for medical procedures and documentation changes, lack of inclusive forms at medical clinics, banks, and workplaces, and difficulty accessing employment and housing. Or it could be interpersonal barriers due to transphobia that increase the risk of physical and emotional harm. Or personal challenges such as dysphoria, lack of social support, or struggles with mental health or addictions.

Some of this knowledge can be gained through online resources (such as this blog) but you will also have to engage with your local trans support networks and advocacy organizations. You may be tempted to simply ask your trans friend a slew of questions to learn about all these things. DO NOT do this. Trans people have to educate almost everyone they come in contact with. As an ally, you do not want to be another one of those people. If you have looked up everything you can online and joined the mail lists of your local organizations to learn more and still have some specific or personal questions to clarify a couple things, ask your friend if it’s okay with them if you ask them and when a good time would be. They are not obligated to answer. If you see this refusal as a lack of their friendship you really don’t understand what it means to be trans.

CHECK YOUR ASSUMPTIONS

Avoid making assumptions about someone’s gender based on their sex, presentation, physical characteristics, or mannerisms. Keep your language neutral by referring to everyone using they/them pronouns and neutral language until they have disclosed their gender to you. Yes, everyone. Not just people who fall outside the ‘norm’ of gender presentation or someone you think might be trans. You can’t tell someone’s gender from the outside. Being an ally means creating a safe place for trans people that you haven’t met yet. The only way to do that is to consider that anyone could be trans and act accordingly.

Once you learn someone’s gender, don’t make an assumption about what pronouns they use, what steps they have taken or plan to take in terms of transitioning, or what their experiences are with dysphoria. Every trans person’s identity, journey, and experience is different. You don’t have to understand all the different possible experiences to be an ally but you do have to keep an open mind and understand that there is no one way to be trans.

KNOW HOW TO ASK QUESTIONS

You may not be able to learn everything you want to without asking a trans person some questions. And if you’re not supposed to make assumptions about anyone’s gender, you may have to ask someone questions to learn more about their experiences. Knowing what questions to ask, how to ask them, and when/where it is appropriate to ask them is part of being an ally. This, too, takes practice.

The knowledge you have gained about terminology will help you with appropriate wording. Knowing what challenges trans people face will help you be aware of the context and choose an appropriate time and place. Beyond that, honesty is the best policy. If you’re not sure if the question is appropriate, or you’re not sure how to word it, make sure you’re in a safe and private environment before asking and then be honest about your lack of knowledge. Ask for feedback and be open to it when it’s given, solicited or not.

Keep in mind that just because one trans person was comfortable answering a particular question does not mean every trans person will be. Some people are open, some people are private. This is true for trans people as well.

ADVOCATE AND AUGMENT!

As an ally, your main roles are to set a good example for other cis people and to create a safe environment for trans people. This means correcting yourself when you make a mistake with pronouns or other gender references and correcting those around you if they misgender someone (regardless of whether the person is present or not). If you’re not sure whether the trans person wants you to correct other people on their behalf, ask them!

If someone asks you to speak about trans experiences and issues or asks you to review a policy or resource to ensure it is trans inclusive, defer to a trans person, especially if it is a paying opportunity. It is not your job to speak for trans people but to give trans people the support, space, and opportunity they need to speak for themselves. You can also share social media posts from trans accounts and spread news stories that talk about trans people in positive ways.

On a smaller scale, you can offer to be a buddy for a trans person in your life, especially if they have limited social supports. Whether it’s going to the public washroom with them for safety, going with them to medical appointments or registry offices for document changes, or being a caregiver after surgery, there are lots of ways you can help support a trans friend when other people who aren’t allies wouldn’t realize they would need extra support or when the trans person wouldn’t feel comfortable asking for support from non-allies.

I hope this helps give you some ideas of how to be a trans ally. If you are a trans person, feel free to share this with people in your life. We need more allies! Please leave a comment below if you have any questions or if you have suggestions for other ways to be a good ally.

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What Makes a Family?

Lots of people talk about having a kid as ‘starting a family’. This rubs me the wrong way. For me, choosing to commit to a long term relationship with my husband was when we started our family. We got married as a symbol of that commitment but our family was started even before marriage. Having a child is an expansion of that family, not the start of it.

I think my definition or experience of family is particularly common in the queer community. One of the queer community slogans that I grew up hearing is ‘Love makes a family’. I think this partly is to say that it doesn’t take a man and a woman to make a family, but simply two (or more) people who are in love. It also relates to being rejected by biological family due to being queer and finding new family within the queer community who love and support you – your chosen family.

So why is having a baby referred to as ‘starting a family’? Is this a cisgender, heteronormative concept? Do people feel like their lives aren’t full enough as simply a couple and therefore their family isn’t complete or even formed until they have kids? I think this distinction matters and can have a big influence on how we view our relationships with our partners and the impact of having kids.

If you see having a kid as being the start of your family, the kid takes the position of being the glue that holds the family together. Without the kid, there is no family. I think this really devalues your relationship with your partner (who’s love, ideally, is what made you want to have a kid in the first place). This also devalues family units that don’t include children in society at large, increasing the stigma and shame for people who struggle with infertility, do not have the resources to access medical or social systems that would allow them to have kids, or simply chose not to have kids.

If you see your family as starting from when you make a commitment to your partner, it follows that you will need to cherish and nurture that relationship as being at the core of the family. You will value the time you had together before having a baby as well as the times you spend together away from the kid after they’re born as quality family time.

Am I missing something? Is there a positive spin to the concept of having a kid as ‘starting a family’? If you have a different perspective, I’d love to hear it. Leave a comment below or send me an email!

For now, I’m going to stick with Jake and I being a family unit that is soon to be expanding with the addition of a kid.

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Grief and Gratitude

This is not the experience of pregnancy I had hoped for. Everyone hopes for an easy pregnancy with no complications for the baby and minimal difficulty for themselves. Very few people get to experience this but that doesn’t change the hope or the emotional response when it doesn’t happen.

More than anything, I want to enjoy being pregnant and be able to celebrate how my body is creating a new life. But it is hard to feel happy about the experience and excited for it to progress when my body is in constant pain as a result.

Having hopeful expectations that aren’t met causes a feeling of grief. Grief about the experience I wanted to have, grief about not being able to be present and connected to the experience the way I wanted to, and grief about not being able to engage in my everyday life the way I normally would due to being pregnant.

Grief is our way of processing and letting go of those inaccurate expectations. Ignoring grief makes it stronger, makes it have a more insidious effect on my emotional state that I cannot counteract. So I choose to acknowledge it, process it, accept it, and talk about it. Maybe there are others out there who also struggled with grief while pregnant.

But despite feelings of grief, there is not a single moment that I am not grateful to be pregnant. There is not a single moment that I regret all the time, money, and emotions we put into getting to this point. Grief and gratitude can exist at the same time and often do. One does not negate the other.

When I talk about the struggle that I am experiencing as a result of being pregnant, I often get a sympathetic reaction but I also get comments of ‘it could be worse’ or ‘just be grateful you were able to get pregnant’ or ‘just wait, it’ll be even harder once the kid is born’. These comments are often accompanied by stories of terrible pregnancy symptoms, struggles with infertility or miscarriage, and comparisons between pregnancy and life with a newborn. While these are likely true stories, they do not often relate directly to my experience in a way that will help me cope or prepare for the future, nor do they acknowledge or hold space for my grief.

So next time you ask someone how they are doing, whether because they are pregnant or because of other difficult situations (of which there are so very many in the world at the moment), try to hear the emotion embedded in their experience and connect with that rather than the situation on the surface. You may have experienced a similar situation but had a very different emotional experience with it that will not resonate or provide support for the person you are talking to. But if you can relate with a story that shares the same emotional experience even if it was a completely different set of circumstances, this will be much more supportive and powerful.

Emotions are complex. Many conflicting emotions can exist at once within each person. Just because I am grieving certain aspects of this pregnancy experience does not mean I am not grateful for every part of it at the same time. And that is perfectly fine.

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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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