On September 4, 2003 I underwent the first surgical step in my sex reassignment process, a bilateral orchiectomy. In order to provide a useful resource for those TS women interested in pursuing a similar option in their treatment, I've assembled relevant extracts from my daily journal in which I discuss the procedure, its preliminary arrangements, and its aftermath.

My case is not *your* case -- my circumstances, my considerations, and my decisions were and are entirely my own. I advise no one, and I accept no responsibility for any other person's actions. Please make your own decisions based  not on what I've done or what anyone else has done -- but on what you feel to be best for you yourself.

But at the same time, please know what options you have before you commit to follow any course of action. This information is here offered simply as one woman's experience, one woman's first important step toward completing her SRS.

-- Ruby Taylor
 

Background:

I'm forty years old, in excellent health, and I've been on female hormone replacement therapy since November 15, 2002.

I've never been genetically tested for any intersex condition, but every doctor I've been to since beginning my transition has asked me about it, based on my physical phenotype and incomplete pubertal masculinization. Klienfelter's Syndrome (XXY) or de la Chappele's Syndrome (XX-male) are the two conditions suspected, but I've never bothered to have the necessary tests done. Maybe someday when I can afford it, it'd be interesting to finally know for sure -- but at this stage of my life,  it's really not important.

I have no children, nor have I ever wanted to be a father. I'd have made a good mother, I think, but not a father. If I'm, in fact, intersexed, the point is irrelevant anyway -- I was infertile all along.

I've been in counseling with a mental-health specialist for gender dysphoria since June of 1997. I've struggled with these issues all my life.

I began self-electrolysis in 1995, and I've continued to pursue hair removal on and off as circumstances permitted ever since. In June of 2003 I began professional electrolysis with a view toward finally finishing the task.

I attempted to transition in 1997-98, but was forced to partially detransition as a result of an emotional breakdown brought about by my spouse's inability to cope with the pressures my transition was causing her. I resumed my full transition path in the fall of 2002.

I've been employed in the female role since August 1997.

On May 1, 2003, I began my Real Life Test with a goal of undergoing Sex Reassignment Surgery in 2004.

On June 1, 2003, my spouse left me.

On July 16, 2003, my name was legally changed.

Two days after that name change, I began to seriously consider an orchiectomy as a stepping stone toward full SRS.
 

July 18, 2003

OK, so here's an idea.

I've been doing some thinking about my Other Favorite Subject, how to finance my SRS, and I've come up with something.

What if --

I get an orchiectomy first.

It's not expensive as such things go, and it will save me money in other areas -- no more spironolactone, and a reduced dosage of estrogen. I could afford to do it right now -- I could put it on my credit card, and that would be that.

And what if -- I get Menard or Brassard to do it, and see if they'd be willing to apply that fee to the total cost of my SRS later? Do they work that way? Would they allow an arrangement like that? I don't know at this point, but it's something I could ask about.

But anyway, what I'd do next is roll that credit card balance over onto one of those fixed-rate deals I get in the mail all the time. And then I'd have $8900 in available credit on my current card. Depending on what the fee for the orchie would be, and if they'd be willing to apply it toward SRS, I might just be close then to what I'd need. It'd be easier to raise a smaller amount to make up any difference than it would to raise a larger amount.

Of course, I'd get squooshed under the monthly costs of repayment -- but let's face it, that's going to happen anyway. There's no way I can do this without borrowing the money from somewhere, and this scheme might work as well as anything else. Plus I'd be able to get rid of that damnable M on my ID -- a letter indicating "permanent and irreversible genital surgery" is all I need to get my F.

In any event, I'm warming to the idea of doing an orchiectomy first -- I know there's concern over skin shrinkage for SRS, but it's not like I'd be planning to go years between surgeries.

So, I don't know -- it's an idea, something that occured to me today as I tried to figure out how I can make this all happen.
 

July 19, 2003

I'm still thinking about an orchiectomy, as a steppingstone along the path to SRS. I could go to Philadelphia and get it done by the Spector-Kimmel clinic right now -- no letters, no gatekeeping, no waiting. Just plonk my credit card down on the table and get it done. And Menard and Brassard will take an orchie letter from Spector/Kimmel in place of the required SOC letters, as a loophole in that process. So I don't *have* to wait here -- this can all start happening really quick. And frankly, it can't happen quick enough for me -- the money issue is still an SRS obstacle, but it's not an obstacle to an orchiectomy. I'm not going to rush ahead on this quite yet -- I will talk to my therapist about it at our next session, see what he thinks. And I want to find out if they'll do it in Montreal and apply the fee to my SRS.  But I think it's something I want to seriously consider. I'm reeeeeeeeally tired of carrying around superfluous equipment, and there's no conceivable reason at this point for me to have to do it.

July 22, 2003

I guess the thing that's set me off here the last few days is My Legal Status According To The State. It's upsetting me much more than I thought it would that my new ID has an "M" on it, that my Certificate of Name Change refers to "his name" instead of "her name." I feel like no matter how much progress I make, no matter how successful I am in adapting to life as a woman, no matter how well I blend in, no matter how well-accepted I am -- the State is standing there staring down its nose at me, arms folded, with a disapproving frown on its face that says "Uh-uh. You may look like a woman, you may talk like a woman and walk like a woman and live like a woman, everyone you encounter might accept you as a woman with no questions asked -- but you're *not* a woman unless we say you are. And we won't say you are until you can take off your panties and *show* us you are."

I don't want this to all come down to genitals -- I wish it didn't have to. But the Biological Essentialists of the world are forcing the point - it all comes down to testes=man, no testes= woman. It doesn't even seem to be a penis thing for this state -- I could get an F with an orchiectomy, after all. It's how much testosterone you have in your system, it's how much sperm you produce. Even though I don't produce sperm any more, even though my testosterone is suppressed -- as long as the *potential* exists, the state says I'm male.

So I'm really serious about pursuing the orchie. Maybe that will take off some of the pressure I'm feeling to get this all resolved, maybe it'll make it easier for me to think clearly about how to fund the full SRS. If Menard/Brasssard don't do it, I'm going to find someone who will -- Reed in Flordia, maybe. Or Spector/Kimmel. Or maybe my therapist knows someone local.

That's my next big goal, then -- I'll write it down right here.

By the end of this year -- by the end of 2003 -- within the next five months -- I'm going to be rid of the testes, and I'm going to have an F on my ID.

I don't need the state to tell me that I'm female in order for me to *know* that I am. But nonetheless, it's really important to me to have that outside validation -- to know that what it says on my ID or my birth certificate accurately reflects the truth of who I am. I didn't realize how important it was, to be honest -- but it's something I'm not going to be able to just shrug my shoulders and dismiss.

So I need to do something about it.  And I will.

Being accepted as a woman -- totally and without reservation -- is really important to me. I hadn't realized just *how* important, I guess. It's important enough for me to rework my plans in mid-transition, to take a step I hadn't really considered before, just to get that all-important Official Acceptance.

8:10 PM

For approximately $2600, I can go to Dr. Kimmel in Philadelphia and get my orchiectomy. No SOC letters needed, no gatekeeping, no waiting.

I did some research tonight -- looked up Kimmel's current fees and policies, and did some checking into plane fares and hotel rates. And $2600 would cover the cost of the operation, four days in the nearby Best Western Center City Hotel, and the round-trip plane fare.

I could put it on my credit card. I could charge the plane ticket and the hotel room, and take a cash advance for the $2000 surgical fee.

And I could call Kimmel's office tomorrow and make the appointment.

You know, I'm really thinking about this.

It may seem like I'm rushing things along, but I don't really think that I am. It's the logical next step for me.

I'm thinking about it like this:

If my therapist is a stickler for the Standards of Care, I don't get my letters for surgery until May of 2004. There's an eighteen month waiting list for SRS in Montreal -- which means the earliest I could expect to get my surgery is November 2005.

That's two years, four months from now.

Do I *really want* to be taking spironolactone that long?

Let's think about the cost. I take 3 100mg tablets of spiro a day, and I go thru a 100-tablet bottle every 33 days. Each bottlecosts $39 via Inhouse Pharmacy, so each tablet costs about $1.18. That's $3.54 it's costing me per day to keep my testosterone suppressed.

Now, figure that it's 850 days, more or less, until the earliest I can expect SRS in Montreal.

At $3.54 per day, that means I'll spend $3009 just for spironolactone over that period. And if I *don't* get SRS at the earliest possible date, if I haven't figured out how to finance it by then, then that cost will just keep mounting up.

And getting the spiro thru a domestic pharmacy on a prescription isn't going to help -- on the contrary, the *least* I could expect to pay for generic spiro doing it The SOC Way is $112 for a bottle of 100 100mg tablets -- almost *three times* what I'm paying at Inhouse.

(Big incentive to play by the rules there, isn't it?)

OK, that's the numbers.

So -- you tell me. What would *you* do -- hand over $2600 now for the orchiectomy, or spend $3009 spread out over the next 28 months? And god knows how much more after that?

I guess what I need to do here is pretty obvious, isn't it?

If I *don't* do the orchie now, not only am I going to spend the next two-odd years carrying around some extremely unpleasant physical baggage, I'm going to have to end up paying over $400 for the privilege of doing so -- and as the crowning indignity, I'll have to do it with an "M" on my ID.

So I've pretty much made up my mind here.

I was pretty before sure about what I wanted to do, but having Crunched The Numbers, now I'm certain about it.

They've gotta go.

And the sooner the better.

Like before-the-end-of-the-summer-sooner, if I can get an appointment.

Now, I won't call Kimmel yet. I'm going to talk to my therapist about it first, and see if he knows anyone local who could do it for me.  Or if he'd be willing to give me my SRS letters without making me wait the full year. And if that happens, I'll see if getting it done in Montreal and applying part of the cost toward SRS is an option.

I see my therapist Thursday, and I'll be asking these questions straight out of the box.

And if I don't like the answers, I'll give Dr. Kimmel a call next week and see when he can fit me in.

God, I feel empowered all of a sudden, you know it?

It's so funny -- all these years I've been scared to death to think for myself, scared to death to do anything without clearing it with D----- first, or else worrying about what she'd think if she found out I'd already done it.

My body wasn't my own, not really.

But it is now.

And before too many more months go by, I'm going to be feeling just a little bit more comfortable in it.
 

August 6, 2003

4:03 PM

Well, I am a Very Healthy Young Woman.

That's the verdict from Dr. F------ today after looking over the results of the labs run last week. My cholesterol has dropped nearly a hundred points from where it was ten months ago -- from 251 down to 155. My HDL -- the "bad cholesterol" -- is down to a very safe 52, less than 30 per cent of the total figure. My blood pressure is 118/72, and all my other basic metabolistic functions are right where they should be. Even my potassium is right on target, at a very safe and healthy levelof 4.1.

The exam was an interesting experience. Dr. F------ is a compact, smiling fellow who looks younger than his picture suggests, his bald head and heavy beard shadow a startling contrast to his extremely youthful face. I doubt he's older than 35.

And he's a very pleasant person -- we sat in the office and I told him my story. He asked me about my basic health, and then got into the question of my TSity, and I gave him the condensed version of My Story. He's dealt with M-to-F patients before moving to this state last year, and he's had a couple of F-to-Ms since then, but I'm his first local M-to-F, and he's very enthusiastic about working with me.

We talked a bit about my hormone regimen, and he has no problem with any of what I'm taking -- he thinks I'm being careful and conservative, and is impressed at the amount of homework I've done. But he does *strongly* recommend that I get an orchiectomy as soon as it can be arranged -- he thinks getting gonadal T completely out of my system and getting me off spironolactone will be a much better course to follow as I work toward SRS. I agreed, mentioning my discussions with my therapist about different options for doing that, and he agreed to ask around among the urologists he knows to see if he can line someone up to do the procedure for me.

So it does look like that's going to happen, and it may happen sooner than I thought it would.
 

August 21, 2003

When things start happening, they happen fast.

I have an appointment this coming Tuesday -- 5 days from now -- for a consultation with the urologist who will do my orchiectomy.

I got the results of my lab tests from my endocrinologist yesterday -- and he also enclosed the name and number of a urologist who practices out of the same hospital where he's located, and is willing to do the surgery for me.

So I called and made an appointment.

The receptionist asked me what the consultation would be about, and I took a deep breath. "Well, I'm a male-to-female transsexual," I explained, " and my endocrinologist is recommending that I undergo an orchiectomy, and he's spoken to Dr. O----- about doing the procedure for me."

"Oh!" replied the receptionist, surprised but quickly recovering her composure. "OK, we'll look forward to seeing you Tuesday."

Simple as that.

Meantime, the results of my labs were quite interesting:

Estradiol -- 635 pg/ml

Estrone -- 2135 pg/ml

Testosterone -- 49 ng/dl

Free Testosterone -- 4.9 pg/ml

SHBG -- 69 nmol/l

TSH -- 2.070 uIU/ml

LH -- less than 0.5 mIU/ml

FSH -- 1.0 mIU/ml

The estradiol and estrone figures are sky-high -- far above the lueteal-phase peak found in a natal woman, but the estradiol-to-estrone ratio isn't bad at all. Dr. F----- recommends that I reduce my estrogen dosage a bit and see what happens, so as of yesterday I cut back from 6mg of sublingual estradiol daily to 4mg.

My testosterone is smack in the middle of the normal female range, although my free T is a bit on the high end of that scale. But FSH and LH are basically nil -- indicating that the testes are completely inert and not manufacturing T at all. And the spironolactone is doing its part to block the small amount to be manufactured by my adrenal gland.

My thyroid is also normal -- which is reassuring. Dr. F----- is the latest in a series of doctors to wonder about that, but the tests always come up normal, and I'm wondering again if I should splurge for a chromosome test to determine once and for all if a genetic anamoly is responsible for my failing to develop certain male attributes during my first puberty. It's a moot point at this stage of the game, but I'm still curious -- and with every other explanation having been eliminated, everything seems to point in that direction: Klienfelter's Syndrome (XXY) or XX-male.

Not that it matters, really. But it would be interesting to finally know for sure.

So anyway, Things Are Moving Forward with astonishing rapidity here.

I talked to J--- about these new developments, and she's hoping I can get it all done as soon as possible -- due in part to a demanding new work contract that's coming up next month. She's told the client that I plan to undergo surgery in the near future, and may be off my feet "for as long as ten days," so we need to get as much preliminary information from the client as possible before then. That was, of course, a bit of an exaggeration -- I'd expect to be back to work in far less time, based on everything I've read about orchiectomies, but J--- has learned by experience that the only way to ensure a response from some of these clients is to greatly exaggerate the gravity of the situation.

I feel awfully calm about all this.

I don't feel any nervousness, any sense of "oh my god, what am I doing??"

No doubts, no second thoughts at all.

I looked down there last night as I was getting undressed, and I felt -- nothing, really. Emotionally, it feels like I'm going to be getting a mole removed, rather than Organs That Define The Essence of Maleness. They're organs I never should have had, glands that never had any business being there in the first place -- and all I'm doing by having them removed is correcting an error. That I need to undergo this procedure is actually something of an inconvenience -- not because I don't want to have it done, but because I shouldn't have the parts to begin with.

It's a stepping stone toward where I should have been since birth, nothing more. One more milepost along the road to SRS and the body -- the life -- I should have had all along.
 

August 26, 2003

Today I meet with the urologist to schedule my orchiectomy.

You'd think there'd be a whole meadow full of butterflies-in-my-stomach, you'd think I'd be a nervous wreck.

But there aren't. And I'm not.

I get more worked up over going to the dentist.

And considering how I was pacing the floor in the hours leading up to my name change hearing, you'd *think* I'd be much more nervous about a step like this. Up 'til now, everything I've done with regard to transition has been theoretically reversible. But once I've had my orchie, it's for keeps.

No going back.

And I think about that and I nod my head and think "huh."

No agitation, no nervousness, no sense of uncertainty.

All I really feel is "jeez, I hope I can get this done really soon because it's a really good time for it workwise. The next big push won't be for a couple weeks yet, and this is a good point to fit in the necessary down time."

I also feel a sense of relief.

One of the things I've sort of worried about is "what happens when I have to go off HRT prior to my SRS? If there's a rebound in T production, how will I cope with it emotionally? Or, what if something else happens -- I don't know what -- that might otherwise temporarily force me off hormones? I have no idea what might lead to such a situation, but what if it happens? Could I handle it? Could I handle T surging back on me, and everything that goes along with it? Bad skin, body hair, erections, that incessant roaring noise of static in my brain?"

Short answer -- No.

No I couldn't handle it. I don't know specifically what would happen to me, but I know it wouldn't be good.

So knowing that once I've had the orchiectomy I'll never have to worry about that again fills me with an indescribable sense of relief.

And that's why I'm sitting here this morning with this feeling of total calmness, this feeling of knowing this is absolutely the right thing for me to do.

No worries, no anxiety, no hesitation.

I didn't think much about any of this yesterday, not really. Yesterday afternoon my bicycle tires arrived and I popped themon the rims and did some riding. The old bike is really running smoothly -- I did an awfully good job on it, I have to say -- and I felt this sense of total exhiliration as I rolled along. I rode about three and a half miles yesterday -- to the supermarket and back, to the post office and back, and once around the block -- and I don't feel any sort of aches or pains or muscle strains in my legs this morning at all.

It was interesting to watch how people reacted as I rolled by -- invariably I got smiles from motorists and pedestrians and other bikers. I guess a forty-year-old woman riding a forty-year-old bike is a sight you don't see every day.

Later on, A----- and I walked downtown to get ice cream, just sort of chatting along like we always do. After that, I stopped in at her house for a while, where her folks were watching TV, and we sat for a while making fun of the program, some awful reality show called "Blind Date." R-- was in all his glory, ranting on as he often does about the government, the president, Congress, and the liklihood that all civil society is going to come crashing down within the next three years. I never know if he's kidding or not, so I just smile and nod.

I don't think he really understands me -- but he likes me, and actually seems to be rather protective of me, and I think that's sweet. He may be a big loud goofy lug, but once you look past the bushy beard and the tattoos and the bluster, he's actually a very kind, very gentle man. And A----- is lucky to have a father who loves her as much as he does.

And then I came home and finished off my daily ration of water and watched a little TV and took my progesterone pill and went to bed.

And I slept really well.

And this morning I feel rested and ready and am looking forward to the next big step in my transition.

No apprehension, no questions, no fear.

August 27, 2003

Eight days to go.

A week from tomorrow -- September 4th -- I'll check into the hospital, get up on the table, get an injection in my spine, and in about an hour's time, two-thirds of my physical anomaly will be resolved.

It was all so easy. Jeez.

I got to Dr. O-----'s office after an hour-and-fifty-minute drive. L----- is an old, rundown city that's so far escaped the wave of gentrification that's swept thru most of the other old rundown cities in this state -- and the drive to the office led me thru neighborhoods full of tired-looking little lunchrooms, frowsy bars and nightclubs, and the sort of desperate-looking establishments that promise Fast Cash Advances On Your Paycheck, all tucked into a hodgepodge of grimy nineteenth-century commercial buildings painted with ancient faded wall signs advertising "Uneeda Biscuit -- The National Soda Cracker" and "Gold Medal Flour -- Eventually, Why Not Now?"  The streets are narrow and byzantine, and I get lost at least twice trying to find the address -- trapped in a web of one-way routes that don't seem to go anywhere.

But I finally get there, driving up to the hospital campus and parking in a dark, gloomy garage.

Dr. O-----'s office is directly across from the garage, and is the single most featureless building I've ever seen -- a bland blocky low-slung brick structure with all the charm of a self-storage locker. I walk down a sterile-looking off-white corridor, open a door marked "103" and I'm in the windowless little walk-in closet that serves as the doctor's waiting room.

A busy twentysomething receptionist looks up from a pile of folders and smiles a greeting.

"Ruby Taylor," I smile back.

"Oh yes," she replies, and I recognize her by her voice as the gal I talked to on the phone last week.

She hands me a release form -- always the first thing I see when I go into one of these offices -- and I sign on the designated line. She tells me to have a seat and the doctor will be with me in a moment. But I have a bit of business I need to take care of -- and am directed to a restroom.

I didn't think I was nervous, but maybe I was. Because when I went into the restroom I forgot to lock the door.

And just as I get up from the seat and start re-doing my tuck, the door opens.

A little old lady patient catches a fast glimpse of my naked hiney. My hands instinctively cover The Anomaly.

"Oh!!" she exclaimes. "Oh, I'm so sorry!!!"

"That's OK," I reply with a strained little laugh as the door quickly closes. "Guess I forgot to lock it."

I've always wondered what I'd do in a situation like that.

Now I know.

Thus relieved, I return to the waiting room, select a recent issue of "The New Yorker" from the magazine rack, and prepare to take a seat.

I miss the chair completely -- and land smack on my butt.

OK, so maybe I am a little nervous.

The receptionist doesn't notice my little pratfall, or if she does she's too sympathetic to say anything.

I pick up the fractured shards of my dignity, quickly reassemble them, and sit down.

Carefully.

And then it's time to go into the examining room.

More of the same -- although this time they don't weigh me or take my blood pressure. Instead, I'm ushered into a little dark-paneled chamber with a chair, a little desk, and an exam table. A small framed certificate on the wall attests to the honorable military service of Lt. Commander J--- O----- MD, USN.

"Just take a seat," says the receptionist, "and the doctor will be right in."

So I do. And there he is.

Dr. O----- is tall, thin fellow with glasses and a salt-and-pepper beard that give him a strong resemblance to the film critic Leonard Maltin. He looks me over with that "Oh My!" flicker of the eyes that I'm getting used to now, and I smile a greeting in return.

And then we get down to business.

He's discussed my case with Dr. F------, and is up to speed on the situation -- and is very happy to perform the surgery for me. So we discuss a few of the specifics -- I tell him my biggest concern is scarring of the scrotal tissue, since that skin will be used to create my labia and it needs to be as sensate as possible. "I'm sort of the ultimate recycling project," I comment by way of explanation, and he nods thoughtfully.

I tell him that due to work considerations, I'd like to get this done as soon as possible -- so he suggests a week from Thursday.

OK, sure.

That works for me.

A week from Thursday it is.

"Uh, I'm not sure quite how we go about this," he begins apologetically, "but I would like to examine you real quick."

"Well, OK," I reply. I wait for him to leave the room so I can undress, but he doesn't. So with a little shrug I reach under my skirt -- keeping covered from his view -- and slip off my underpants. "Just a sec here," I warn as I undo my tuck. "There's a -- um -- contrivance in place..."

"Oh," he gulps with embarassment.

"Yeah," I smile, trying to make him feel more at ease. "You learn a lot of little tricks to get along..."

I lie down on the table, lift my skirt, and he drapes me. I feel him palpating the anomalies.

The exam table is ice cold.

"OK," he says, standing up and smoothing his pants. "I'll step out so you can...uh...."

"Thanks," I reply.

The door closes, and I redo my tuck and slip my panties back on.

I catch a glimpse of myself in the exam room mirror -- a slightly frazzled-looking, but rather attractive young woman -- and I wonder.

What must he think? On a fundamental level, what does a man -- a normal, run-of-the-mill man -- *think* when confrontedby someone like me?

I'll never know. I watch his face for clues when he steps back into the exam room to wrap up the consultation, but his professional mask is impenetrable.

We sit down again, and go over some of the necessary arrangements. I'll be having a spinal anaesthetic, and he won't want me driving home the same day -- so he recommends a Bed and Breakfast close to the hospital where I could get a good, inexpensive room for the night. The procedure will be done at the hospital as day surgery, in the early afternoon, and I'll need to report by 10 AM for the check-in procedures. There'll be some pre-admission lab work -- a complete blood count -- that needs to be done as well, and I can have that done today. There'll also be a medical-history interview with a nurse and an anaesthesiologist, but I can do those tomorrow by phone.

And then we talk about money.

I knew $400 was too good to be true.

That's just his personal fee, the surgical fee. The anaesthesiologist has a fee as well, and then there'll be the hospital costs. He tells me to figure on between $2000 and $3000 all told.

Eeeek.

I swallow hard, but try not to show it.

And I realize it's not that bad, all things considered -- after all, that's what I was figuring when I was considering going to Kimmel in Philadelphia. And it's still a savings over a year-and-a-half's worth of spironolactone until I can have SRS.

So I nod and say OK.

And then I hand him a sheet of paper, containing the following text:
 

*date*
 

To Whom It May Concern:

This is to certify that T. Ruby Taylor (DOB 5/27/63) has undergone a permanent and irreversible surgical procedure for purposes of gender reassignment.
 

*signature*
 
"I'm going to need a letter like this once the surgery's been done," I explain, "in order to get some paperwork changed with the state -- in order to change my legal gender. Can you do that?"

He looks over the sheet and strokes his beard.

"Yes, I can do that. You'll have to remind me, but I don't see any problem with doing that."

"Great," I smile. "That'll be a real help."

"So," he concludes, rising from his chair and stepping toward the door, "I guess we're all set then. You can step out to the desk here and get set up for your CBC at the lab, and I'll see you on the 4th."

"All right," I respond. "Thank you very much."

And that's that.

The receptionist has the lab order waiting for me. I peek at her screen, and am pleased to see that I'm in the records as female -- even though the procedure specified for me is "bilateral orchiectomy."

The diagnosis explains this oddity in two simple words.

"Gender Change."

As I'm getting ready to head over to the lab, Dr. O----- pops out of the doorway and hands me a slip of paper. "This is the number of the B&B," he says with a smile. "You can give them a call or just drive over today and see how you like it."

"Great!" I say. "Thanks again!"

He smiles again and disappears into his office.

"OK," says the receptionist. "You'll just need to take this across to Pre-Admissions Testing, and they'll take care of you there. Oh, and we usually need to -- um -- get paid up front for elective surgery, so..."

"Sure," I nod, reaching for my credit card.

"Ohhh," she winces. "I'm sorry -- we don't take credit cards. The hospital does, but we don't."

Oh indeed.

Well, not much I can do about it, and I do have $400 on the way from someone for whom I did some historical consultation. So, with a sigh, I deploy my checkbook, write out a $400 check, and hand it over.

"Thanks," she says, rather apologetically, as she hands me the lab order. "Good luck."

"Thanks," I reply. "See you next week."

And a fast trip to the lab, another form to sign, and another vial of blood is drawn.

One of these days they're going to stick that needle in my arm and the vein will just pucker up and make a hissing noise.

The nurse in the lab hands me a card with a phone number. "Call this number tomorrow morning, and we'll do your preadmission interview," she explains. "Then they'll call you next week to tell you anything else you need to know before your surgery. And you're all set."

And I'm all set.

So that's how it stands. I'll call them this morning, I'll answer another million questions, and I'll wait out the next week.

Just eight days to go.
 

August 28, 2003

So much to do, and a week to do it in.

I still haven't lined up the B&B room where I'll spend The Night After -- I visited the place after my consultation, and rang the bell, but no one seemed to be there. I called yesterday morning and got a machine -- but no one's called back. So I think today I'm going to make a call to the other place Dr. O----- mentioned, a B&B on a nearby college campus. I checked out their website, and it looks like a quiet, comfy place -- not as inexpensive as I'd have hoped, but manageable and very pleasant.

I spent close to an hour on the phone yesterday morning on the phone with the preadmission nurse going thru the interview, and oddly enough the word "transsexual" never came up once. No questions about how I got to this point in my life, no questions about *why* I'm doing what I'm doing, no suggestion that there's anything even remotely out of the ordinary about someone with an F on her medical records having male gonads removed.

Which was really quite nice, actually. I've said before how important it is for me to be able to put all this TS stuff behind me as soon and as completely as possible -- and being treated like Just Another Patient actually felt really pleasant. I didn't have to resort to my usual Disarmingly-Wry-About-It-All/Not-Taking-Myself-Too-Seriously approach that I use to defuse possible tension or discomfort when dealing with people who seem a bit uncomfortable with who I am and what I'm doing.

We went over my medical history in depth, and the nurse was amazed at how free of incident it was -- I've only been hospitalized once, for a tonsillectomy in 1967, I've never had a serious illness other than the usual childhood ailments, I've never had a broken bone, I've never even had stitches. I'm very much, as Dr. F------ put it, A Very Healthy Young Woman.

We also went over my medications, and I was relieved that she *didn't* tell me to discontinue estradiol for any length of time before surgery. I can't take my usual dose the morning before surgery -- but otherwise I should continue my meds right up to the day of the operation.

What's going to be difficult, I think, is the requirement that I fast completely beginning midnight the day of surgery.  No food of any sort before I come in -- and all I can drink is clear liquids, and those have to be cut off four hours before I'm due to report to the hospital.

I've got to avoid over-the-counter medications too -- no aspirin in any form, especially -- and I can't even take the caffiene pill I usually take in the morning to get myself jump-started. I *can* have a cup of strong black tea as soon as I get up -- assuming that's four hours before I report to the hospital -- so I hope that'll be enough to rouse me sufficiently for the drive.

The driving is the only thing that I'm nervous about -- not so much the problem of driving *to* the hospital as the problem of driving home the next day. Dr. O----- was absolutely clear that I'm not to drive for at least 24 hours after surgery, which is why I'm planning to stay the night at a B&B and come home late the day after the operation, but after reading up on the effects of spinal anaesthesia and the specifics of bilateral orchiectomy, I *am* just a little nervous about attempting a two-hour drive so soon after the operation. The nurse mentioned the possibility that I might choose to spend the night at the hospital, but after she quoted me a room rate of $900 a night, I told her I don't think I'll be doing that unless the doctor absolutely mandates it. I rode my bike over to Wal Mart yesterday afternoon and bought a surgical donut -- one of those inflatable cushions you sit on for postoperative comfort after pelvic surgery -- and I hope this'll make it easier to tolerate the drive back home.

I did ask C----- if she'd be available to drive me up and back, but unfortunately her work schedule won't permit it. I thought about asking D------, but I decided not to involve her. Given how difficult the name change thing was for her, I suspect she's not ready to be involved in this next stage of the process. And I also don't want her to think that every time I have any kind of problem I'm going to come running to her for help -- I think she's always doubted I could ever really be self-sufficient, so I really need to prove otherwise.

A-- offered to come up to help if I wanted, and I *am* thinking about that. She knows I'm having surgery Down There, but I haven't been specific about it -- and I guess I still really don't want to talk to her about my TS status. I've *thought* about it -- but it's just that I really like having this one little very special corner of my life where TSity isn't involved, where I can just be An Ordinary Woman without any qualifiers. I don't know that she'd have to know *all* the details of what's going to be happening to me -- she'd be sitting in the waiting room, not looking over my charts -- but I'd prefer not to involve her unless there's no other way to deal with things. If the doctor decides he doesn't want me driving *at all,* I'll ask her to help -- but not unless.

This is my path, and in the end, I'm the only one who can walk it. So I'm going to drive myself up there and drive myself back. I'm going to be careful, I'm going to follow my doctor's recommendations -- but I'll be going it alone.

September 1, 2003

When I was little, I was fascinated by the way my grandfather talked. He spoke in a rich, thick New England dialect, and his speech was generously salted with unusual colloquialisms, some of them so odd and obscure that it took me years to understand what it was, exactly, that he was trying to say.

And whenever he was confronted by something utterly ridiculous, utterly absurd, inappropriate, or incomprehensible, he'd always shake his head, spit on the ground, and exclaim the same phrase:

"Balls on a heifer!!"

I never understood that reference when I was little, I never got the point. Not being a farm kid, I had no idea what a heifer was, so the point of essential incongruity expressed by the phrase went straight over my head.

Well, I'm older now.

And now I understand.

Nowwwwwwwww I get it.

Ohhhhhhhh!!!!!!

It was meant to be *ironic.*

Heifers aren't supposed to *have* balls.

A young cow has no use for testicles, and the presence of testicles on such an animal would be absurd, inappropriate, and incomprehensible.

So you can see why that phrase sort of popped into my mind this morning, as I begin Month 5 of my RLT.  As I look ahead three days to Thursday -- after which there'll be one less absurd, inappropriate, incomprehensible incongruity in my life.

No, make that *two* incongruities. Let's be accurate here.

I thought about this week's big event quite a bit over the weekend, but not in a fretful way. I've been thinking about the practicalities of it -- what I need to pack for the trip, what'll I'll be likely to need. I went out and bought a nice loose, full skirt which should be comfortable to wear after the surgery, and should also do a good job of obscuring any unfortunate lumpishness resulting from the bandages. I already have my inflatable donut, and I should probably get an ice bag as well. I'll take along a portable tape player and earphones and some tapes -- and A-- went out yesterday to buy me a book to read while I recuperate. I have no idea what it will be, but she promises it'll be something I'll enjoy, and she knows me well enough to have a pretty good notion of my tastes.

So I'm not planning to pack too much -- but I'll take enough to cover my needs and keep me busy while I'm off my feet.

And I'm feeling no anxiety and no sense of pressure at all. It's rather uncanny, actually -- I'm rarely this calm about anything, let alone a surgical procedure on the most tender area of my anatomy. But -- and my post-op friends can confirm this -- what's coming up for me Thursday is a picnic in the park compared to what's a year or so down the road. So no point in getting worked up about it.

September 3, 2003

I've done a lot of thinking over the past few days, about a lot of things, of course. After all, tomorrow's the big day. Or *a* big day, the latest in an ongoing series of big days. I guess the fact that there's already been so many other big days during the transition process is the reason why I feel so -- "huh" -- about where I am now.

But nonetheless, what's going to happen tomorrow is the biggest step so far.

So far in my transition, I've been adding elements of physical and social femaleness to an understructure that remained phenotypically male. No matter what my hormone levels indicate, no matter how my breasts grow, no matter what my legal name is, I can't escape the fact that what's between my legs is male. I can't escape the fact that if I stopped taking my pills, the testosterone would come back, and my body would revert to what it was a year ago: that of a poorly-developed, incompletely masculinized male.

But tomorrow, all that changes. Tomorrow I take the first real step toward permanently separating myself from phenotypical, physical maleness.

Males have testes.

As of tomorrow afternoon, I won't.

Males produce a certain level of testosterone, which is responsible for the development of their distinguishing secondary sex charactertics. Females are, in normal circumstances, physically incapable of producing that amount of testosterone.

As of tomorrow afternoon I'll be physically incapable of producing that amount of testosterone.

And it's Permanent and Irreversible, as it will say on the letter Dr. O----- will give me afterward, the letter which will serve as my ticket to legal femaleness.

And I think about that and I just want to get it over with.

I looked down there this morning when I got up and shuffled into the bathroom. I lifted my nightie and sat down on the toilet and looked down there at the shrunken little mass of The Anomalies. And I said "huh."

You read sometimes about people going in for orchiectomies or SRS who talk about The Ritual of Last Masturbation -- the Farewell To Maleness that's supposedly a rite of passage, a sacred private ceremony for transitioning TS women.

Well, it might be a rite of passage for autogynephiles, but other than Anne Lawrence, the AG's poster gal, you'd be hard pressed to find a real TS woman who actually partook of this so-called chicken-wringing ritual. At least that's the consensus among those I've encountered online.

I don't even really remember my last ejaculation. I abandoned the weekly system-draining routine sometime in April or May when I became physically incapable of it, when it was obviously no longer necessary, and I think my last ejaculation must've happened around the end of May, during that brief cutback in my spironolactone dosage. The fact that this happened was, in fact, the catalyst for my putting the dosage back to 300mg and leaving it there. It was not an enjoyable experience or a reflective experience or a rite of passage in any way. And now, five months into RLT, the thought of doing *anything* down there with that thing absolutely repels me.

So there won't be any rituals, there won't be any farewells, there won't be any ceremonial wanking.

I'm sorry, but that's *such* a guy thing. It really is.

And I'm not a guy. Never have been, never will be. And after tomorrow, I'm one big step closer to finally removing all evidence to the contrary.

I leave here sometime around the middle of the afternoon. I need to call the hospital at 2 to get my final instructions for when and where to report tomorrow, and once I have that, I'm off. I plan to hit a couple of stores on the way up to look for a couple things I still need to get, I may grab a light meal, and then I'll be heading to S-- and I--'s house. I'll be taking along a notebook and will keep up with my journal entries thru the next few days -- and I'll have the whole story here for you when I get back.

So -- I guess that's it. My final journal entry as a complete Pre-Op.

When next I write here, I'll be a "Part-Op" -- no longer physically male,  not yet completely female, but a lot closer to that final destination.

So -- wish me luck, OK?

8:44 AM

OK, so when I said that was my last entry, I was jumping the gun a bit.

I just got off the phone with the payment office at the hospital -- and I'm still trying to catch my breath.

They want me to put $5600 up front for the procedure.

Holy jumpin' jeezus.

That's twice what Dr. O----- told me it would be, and twice what it is at any other hospital I've researched. Something's way out of line -- and even the lady at the hospital agreed. She stressed that this is just an approximate figure -- and if it's less, the balance would be refunded.

But still.

As it happens, when my credit card bill arrived yesterday, I saw that my credit limit's been increased to $10,700. So I can handle it if I have to.

But still.

So anyway, no sooner did I get off the phone with the hospital -- choking a bit on my breakfast -- than Dr. O----- called. He's *also* convinced this is way out of line, but explained it's some kind of cockamamie ripoff deal where self-pay patients are charged at a much higher rate than those with insurance.

I said it before, I'll say it again.

Holy jumpin' jeezus.

Is it any wonder the U. S. health care system is a global joke?

But Dr. O----- is a really nice guy, and he knows my finances are Not Especially Fluid, so he's going to be making some calls today and trying to arrange alternatives for me. I'd originally been set to use the regular operating room for my procedure, but he's looking at using the "Minor Surgery" room instead -- which is fine with me. Given my fondness for cheap hotels and humble little neighborhood lunchrooms, you *know* I don't need anything fancy. As long as it's sterile and there's enough light for him to see what he's doing, he can do it in a janitor's closet for all I care.

Or, he may do it at a different hospital, a small Catholic hospital across town. I don't quite know what the Good Sisters there will make of a gal like me -- but we can only hope for the best.

But either way, he's going to try and work things out so I don't get hit so hard.

And either way, this is going to happen.

9:19 AM

So I just heard back from Dr. O-----'s office, and they'll be taking care of me at St. Mary's instead.  I don't have a price yet, but Dr. O-----'s gal promises it'll be a *lot* less.

*Sigh*

Just once in my life I'd like to do something without having to deal with a bunch of last-minute hoo hah.

But it's OK now, I guess. For a moment there I was carrying an $8000 credit card balance, and I didn't much like the feeling of it. I mean, I'll probably hit that point eventually, but let's hope when it does happen I'll be on the way home from Montreal with all this stuff finally over and done with.

1:30 PM

Well, I guess I've got everything all set. I report to the Outpatient desk at St. Mary's tomorrow afternoon at 1, and S-- and I-- are expecting me to pull in between 6 and 630 tonight.

I've got all my stuff packed, everything I could possibly need for the next three days.

I've made note of everything I have to be aware of when I go in tomorrow -- no food or drink after midnight except for a cup of tea before 7 AM.  No estrogen pill tomorrow morning, but I can take the regular dose tonight. No aspirin or ibuprofen. No makeup of any kind. No moisturizers or anti-prespirants or hair products. No jewelry. Wear loose and comfortable clothes.

Got it.

I've changed the cat's litter box, I've given her a little exercise and I've scratched her belly well and good.

I've sent a message to A--, filling her in on the latest developments, and promising to email her again once it's all over. She's feeling miserable right now, laid low by a really awful cold, and we haven't been able to AIM for nearly two days now. I'll wait around a bit longer to see if I hear from her, if she wants to chat a bit before I leave -- but I won't be surprised if she'd rather just stay in bed. I wish I could be with her right now, taking her hot soup and trying to help her get better -- but I guess we each have our own situations to manage right now.

I've taken a final ride downtown on my bike -- an activity I'll not be able to enjoy for a couple of weeks, at least, so I wanted to make sure I got a chance to do it today.

And I've called Dr. O-----'s office and left S-- and I--'s number in case anything unexpected comes up between now and tomorrow.

So -- there we are.

I'm all set.

And so, I guess, that concludes what really is my last pre-orchiectomy journal entry.
 

September 4, 2003

8:30 PM

Well, that's that.

I'm lying in bed in S-- and I--'s guest room.

It's six hours since my surgery.

I feel remarkably well.

Except, of course, for the sensation of having been hit in the groin with a fifty-pound sack of potatoes.

Okay, so maybe I'm exaggerating just a little bit. You know me, always with the making a big dramatic deal out of everything, every ache and pain I go thru. Always with the making things worse than they really, actually are.

So, no, it's not like being hit in the groin with a fifty-pound sack of potatoes.

Twenty-five pounds, maybe. But not fifty.

The hardest part of the whole procedure, I have to say, was the fasting. I got up at six, had a good stiff cup of Red Rose, and then -- bupkis. Nothing to eat, nothing to eat until it's all over.

I-- and I whiled away the morning together. After S-- went off to work, we sat on the couch for a couple of hours and just talked, comparing our life stories, exchanging bits of experience and nuggets of hard-learned lessons encountered along the path. She and S-- are very special people to me -- both of them. They're big sisters to me, people who've gone out of their way to help me, to be kind to me, to help me find my way along this complicated, often heartbreaking route I'm following to where I know I'll finally end up, and I made a point today of telling both of them how much their friendship and their support mean to me right now.

"I'm not used to people caring about me like this," I admitted to S--.

"Well, get used to it," she said, taking my hand. "'Cause we do."

I-- drove me to the hospital, and I reported to the outpatient desk around quarter to one. The admitting clerk greeted me with a gentle, welcoming smile, and helped me thru the registration process -- and what little anxieties I'd had about using this hospital melted away.

I'm getting used to seeing "F" on my medical records by now -- but that doesn't mean it doesn't make me feel good inside, really validated, really acknowledged for who I am, really *human* in a way I never did when I'd see an "M" on the paperwork. It's just one of those little things that really means so much.

I-- and I waited a bit after the initial paperwork was completed, and at long last the first little wave of butterflies began to flutter around a bit in my otherwise empty stomach. But no sooner did I begin to sense their activity than an impossibly youthful nurse beckoned me into a little office to sign some papers. Her name was L---, and she reminded me a bit of a healthier, happier version of my sister.

We filled in the forms -- there's never an end to the forms, there's always one more thing to sign. And then L--- ushered us down the corridor to a changing room. Lockers lined one wall, and a row of little stalls like you'd see in a department store lined the other. L--- handed me a small bundle, and indicated an open locker where I was to hang my street clothes and my purse.

And then it was time to Don The Garb.

It's amazing to me how a hospital gown reduces you to your barest essentials -- and really, it's the most egalitarian of garments. There can be no exaltation of the self, no heirarchy of rank or position, no claim to special privilege or protocol when you're standing there in a cotton shortie with your hiney exposed to the gaze of all and sundry who pass behind. We're all equals -- male and female, young and old, rich and poor -- when we wear the johnny.

I-- helped me into the hospital clothes, tying the gown at my neck and waist with loose knots, and I slipped on the little blue anklets and the floppy robe. I hung my dress and sweater and bra and underpants and shoes and purse in the locker -- and just before I closed the door I remembered to remove the headband keeping my hair under control. I wasn;t allowed to use any styling products this morning, so it was loose and unkempt without the band, uncurled bangs flopping into my eyes, and loose ends getting swept into my face.

That's me folks. The girl with something extra. I plodded down the corridor in my shapeless hospital clothes, and into the recovery room, where L--- had me climb up onto a gurney. An IV stand and a monitor stood at the ready.

L--- gave me another one of those Reassuring Smiles they must make a key part of the curriculum in nursing school, and kept up a stream of fast-and-friendly repartee as she poked the IV needle into the back of my hand, hooked me up, and turned on the saline -- leaving me to simmer until it was time.

She wore purple gloves, that matched the print pattern on her scrubs. I've never seen purple medical gloves. Neither had I--.

It's amazing the things you learn, the things you discover, as you go about your daily routine.

I kept looking at my wrist to check my watch -- the watch I hadn't worn that day. No jewelry at all -- no earrings, no nothing. There's a dent on my left ring finger where my wedding band has been for fifteen years.

L--- took away the dental prosthesis which replaces my missing front tooth, popping it into a plastic cup. She took away my glasses. I was, at last, stripped down to the barest essentials. No attatchments, no appurtenances, no enhancements. Just me. Just 5' 6", 133 pound, 34-A cup, nearsighted me.

And then it was time.

I squeezed I--'s hand, and she wished me luck. And then L--- rolled me down the corridor.

As I looked down past my feet, all I could think of was the haunting opening sequence of "Six Feet Under," in which an unseen orderly wheels a corpse on a gurney down to the morgue. The scene is shot from the perspective of the orderly -- and all you see is the torso and legs and feet of the Poor Unfortunate spread out before you as you roll off toward an uncertain destiny.

I shared this observation with L---, and she immediately grasped the reference. I fear I may have marked the poor gal for life -- she may never be able to wheel a patient down a corridor again without that particular image coming to mind.

Sorry 'bout that.

And then on into the operating room.

The OR turned out to be a comfortable little chamber with the sort of green-tiled walls you find in the ladies room at any good mid-priced family restaurant. In other words, clean and utilitarian, but not at all unpleasant. All that was missing was the dusty plastic flowers in little baskets over the sink.

As L--- positions my gurney next to the operating table and helps me sidle into the appropriate position, we're joined by H----, whose face is concealed by her mask and hair cap. But I know her voice, and it puts me right at ease -- the voice of that woman at work you like to have coffee with, the gal in the next office who always asks how you're doing, and always has a wry comment at the ready when you ask her the same question.

H---- and L--- immediately began to exchange snappy lines with all the aplomb of Ginger Rogers and Una Merkel, as seen in "42nd Street," and if I wasn't already completely at ease I'd soon be that way listening to them. It's not every hospital that gives you a sharp little comedy team as an add-on to your surgical experience.

As we waited for Dr. O----- and the anaesthesiologist to arrive, we chatted about this and that -- especially about the pizza someone had delivered to the nurses' lounge for lunch that day. Not having eaten anything since the night before, talk of pizza was all it took to get me snapping like a shark on chum. "We'll give you some after surgery if you want," H---- laughs.

I also told them a little about me and how I got to be where I was at that particular moment -- a forty-year-old woman stuck with a terribly inappropriate set of male apparatus between her legs, spread out on an operating table waiting to get two-thirds of that incongruity removed. And as I told them bits and pieces of my story, I marveled once again at the gentleness and understanding just behind the witty banter.

I'm really glad I ended up coming to this hospital. I really am.

There was a bustle at the door behind me, and B---- the anaesthesiologist rolled in, with his rack of equipment, and exchanged a few quips of his own with my friends the nurses. And then, to business -- as he asked me the usual rundown of medical-history questions.

I guess it might save time if I just get my medical history tattooed on my belly or something and save myself a little breath.Of course, if I did that, I'd never been able to wear a two-piece swimsuit, so maybe it's not such a good idea.

(Can you tell, as I'm writing this, that the coedine pill I took a few minutes ago is starting to kick in?)

There's some discussion of what to write in the space marked "Diagnosis" on my patient form. I say simply "Transsexuality," but L--- suggests that "gender change" sounds better, and I remember that's what Dr. O----- put on the forms he sent over from his office. B---- then asks what to put under "Complaint," but then realizes that the answer is rather obvious to everyone in the room. He nods sagely, and declares "Complaint: Testicles Present."

As the laugh subsides, Dr. O----- breezes in, sporting a fresh new buzzcut which gives him a sort of streamlined, ready-for-action look. He smiles a greeting, and scopes out the situation, making sure everything's ready to go.

H---- gives the instrument table a final inspection. L--- attatches a series of electrodes to my chest, and checks the readings on her monitor.

B---- turnes a valve on my IV tube.

"You're going to feel a little drowsy," he says.

And I do.

And that's the last thing I remember.
 

September 5, 2003.

(Continuing the account of yesterday's Surgical Event.)

Thump.

Thump-a-dump-a-dump-a-bump.

Spin.

And whirl.

And twist.

And turn.

I'm in a washing machine.

I'm in the spinning barrel of a washing machine.

Rolling and thrashing and wrenching and tumbling.

Agitating.

Slosh slosh slosh.

I'm on the Scrambler.

At the carnival.

On the Scrambler.

Whump-a-whirl-a-whump-a-whirl.

I can't open my eyes.

But they're open.

Aren't they?

I dunno.

I'm not sure.

Where am I?

Huh?

Lights.

Voices.

People.

Who?

"She's coming around."

"I guess I got back here just in time then."

"She made it thru fine. Everything went very well."

People in the room -- but what room.

There's a station break coming up. I gotta get to the studio, gotta turn on the mike.

"Nice and Easy -- FM 93 -- W-P-B-C, Bangor."

No.

Not that.

People at my bedside.

One.

Two.

What bedside, though?

What's going on?

Somebody tell me.

Oh.

OK.

That's I-- at my left. Or at my right.

And that's L--- at my right. Or at my left. I know her,

Nurse.

She's a nurse.

There's a tube in my arm.

Why is there a tube in my arm?

Between my legs.

There's something between my legs.

Cold.

Wet.

Hot.

Raw.

Sharp.

Dull.

Sore.

Something.

I'm in the hospital.

I remember now.

Hospital.

I'm in the hospital, and I remember why.

I remember what they were going to do.

And I'm afraid to look.

Afraid they didn't.

Afraid it didn't happen after all.

Afraid they're still there.

Cold

Wet.

It's an ice bag.

That's what it is.

There's bandages. Some lumpy bandage thing.

Something around my waist.

Straps.

Like that belt my mom used to wear a few days each month.

That belt with the bloodstains.

That belt hanging on the bathroom door.

Elastic.

Uncomfortable.

I lift the blanket.

I peek.

I see It sticking out of the bandages.

Damn.

But no sign of Them.

They're gone.

I look at the bandages and I know they're gone.

I know they're finally gone.

And I'm happy.

Because they're gone.

Except for the elastic thing.

There's a word for it.

Thing.

Thingie.

Elastic.

Suspensory.

That's it.

Ugly nasty thing with straps going round and a pouch in the front.

A girl doesn't wear that though.

Why am I wearing it?

And then I remember.

"Don't you have one in pink?" I murmur. "Or a nice floral print?"
 

L--- laughs. She knows I'm coming around.

She knows I'm OK.

The room isn't spinning any more. It's like that moment when the carnie turns off the merry-go-round and it slowly rolls to a stop and your horse just goes up a little bit more from the momentum but finally just slows down to nothing.

Recovery room.

I'm in the recovery room.

She hands me my glasses.  And my tooth.

There's a clock on the wall. It's 3:45 PM.

An hour and a half of my life have passed without my even knowing.

And during that interval, Dr. O----- with a few deft cuts and snips and tucks and sutures made two thirds of The Anomalies go away.

The room comes into sharper focus.

I can see colors again.

L--- is wearing those purple gloves.

Can you believe that? *Purple gloves.*

Amazing.

Pinch.

The IV tube is out. Bandage across the back of my hand seals the little puncture.

"Would you like something to drink?" L--- asks.

My throat is parched.

"Coke," I whisper. "Coke."

She nods and goes to fetch it.

I-- is holding my hand. I never realized how maternal she can look.

L--- returns with a paper cup, and I sip down the bubbly brown liquid.

First thing I've taken in since that tea this morning. I always did like Coke when I was sick.

And it feels so good going down, cool and tangy and enervating.

I can move now.

L--- helps me off the bed and takes my arm. I-- takes the other side. And we waver down the corridor to the changing room.

Locker.

My clothes are in the locker.

Key.

L--- has the key.  Snick-snick. She unlocks the locker.

I reach for my clothes, and the room fades.

I sit down.

Lightheaded.

Nauseous.

That happens sometimes. Figures it'd happen to me.

L--- scoots off to fetch a bucket. She knows what's going to happen without my having to tell her.

I try to remember how to dress myself.

Bra.

Arms thru straps, hooks in the back, cups in the front. Breasts go in the cups. That's it.

Underpants. Over the thing with the straps. Can't figure out how to do it.

"You have a cute butt," I-- observes.

I catch a glimpse of myself in the mirror. Big ugly thing strapped around my groin.

It doesn't look too cute right now.

Panties over the thing with the straps. That's the only way.

Dress over undies. Buttons up the front.

Sweater over dress. Jacket over sweater.

Shoes on feet.

L--- returns with a wheelchair, and guides me into it. No comment is needed as she hands me a small white bucket. "You can keep the slippers," she says. "We don't reuse those." I smile as best I can, and wad the little blue anklets into my jacket pocket.

She pushes me into the hall, and the walls start to melt again.

And up comes the Coke.

Nowhere near as pleasant coming up as it was going down.

L--- anticipates the inevitable and slips the bucket in front of me just in time. I heave twice and empty my stomach.

L--- wheels me into the recovery room and gives my shoulder a gentle, reassuring squeeze. "It's OK, hon."

She hands me a box of hospital tissues and I blow my nose. The burning pain in my groin blazes up into full heat, wraps itself around my lower back, and smoulders there.

I take a deep breath and regain my composure.

Sort of.

H---- walks up to me, holding a pizza box. The coveted leftovers from the nurses' lunch.

I'd forgot about that.

"You better save this for later, I think," she smiles as she hands me the box. I give her a wan little smile back in spite of the pain. She empties my bucket and gives me a clean one, wishes me well, and returns to her duties.

L--- wheels me into the elevator and down to the exit with no further incident. I-- pulls up in the car just as we arrive at the curb. L--- helps me out of the chair.

"Thank you so much," I whisper.

She gives my hand a squeeze. "Good luck," she replies, as she helps me and my pizza box and my little plastic bucket into the car.

And we head for home.

I-- stops off at the pharmacy to fill my prescription for coedine pills, and I release the seat back and lie flat waiting for her to return. My crotch is on fire.

When we were talking earlier in the day, I-- described the pain of her sex reassignment surgery in a way that really seems appropriate right now. "Imagine having your genitals cut off," she said, "imagine having them scraped and rubbed against the pavement until they're completely raw, then turned inside out, and sewed back on."

No sugar-coating there, no world of little posies, fuzzy baby kitties and moonbeams.

It hurts. It *hurts.*

And even though I'm experiencing maybe 1/100th of what she did, of what still lies ahead for me -- I feel like I'm getting a little preview right now, just a taste of what I can expect why my turn comes.

It hurts now. It's going to hurt a lot more.

When we arrive back at the house, I stumble into my room and get undressed -- but before I can slip into my nightie and get into bed, the nausea comes surging back. I-- hands me the bucket and kneeling on the floor I do what I have to do.

"This is such a pretty carpet," is all I think as I retch and heave. "I hope I don't make a mess on the carpet. They're being so nice to me, letting me stay here, it'd be rude to make a mess of their carpet."

I-- pats my shoulder. "It's OK sweetie," she murmurs. "It's OK."

The nausea finally passes, and I crawl weakly into bed. I-- hands me an ice pack, and I slip it under my nightie and between my thighs.

And I lie there, eyes clenched, waiting for the pain to stop.

You know, you can read about this all you want.

You can do the research, you can talk to people, you can convince yourself It's Just A Minor Procedure -- but the bare fact of the matter is, you won't ever know for sure until you actually go thru it for yourself. Maybe for some people it's no biggie -- maybe for some people there's no discomfort, maybe some people drive home right after surgery, go to work the next day, and are out playing tennis or something within the week.

Maybe.

But I kinda doubt it.

It hurts.

It hurts a lot, and it keeps finding new ways to hurt all the rest of the afternoon and into the evening. It hurts when I sit, it hurts when I stand, and it hurts when I lie down. It hurts when I drink a glass of water and it hurts when I nibble on an english muffin and it hurts when I sip a bowl of clear soup and it hurts when I gingerly take a seat at I--'s computer, atop my donut, to check my email and send a message to A-- reassuring her that I'm OK. And it hurts when I take a pain pill and go to bed. It hurts each of the four times I wake up during the night. It hurts when I get up to fix myself a little breakfast and it hurts right now, as I lie here on my bed scrawling in my notebook, propped up with pillows and clamping a fresh ice pack between my thighs.

In case you don't get it, in case you're reading this looking for some kind of clear-coated, easy-breezy account of what it's really like to go thru a bilateral orchiectomy, let me make it perfectly clear.

It *hurts.*

But you know what?

I don't care.

As much as it hurts right now, it doesn't begin to compare to the hurt of having those things hanging off of me for the past forty years, the hurt of what they did to my body and to my life, the hurt of the incessant poison they pumped into my system all those years.

I'm two-thirds of the way to where I should have been from the beginning. And all I can say is no matter how much it hurts, no matter how uncomfortable I am, no matter how ridiculous I feel waddling around with this harness between my legs...

I'm so glad --

I'm so grateful --

I'm so relieved

To have them gone.
 

September 6, 2003

Feeling much better, thanks.

Bit by bit, hour by hour, the pain is fading.

It's not gone yet, of course.

I can still feel it if I move too quick or if I move too much or if I sit too long in any one position.

But nonetheless, it's fading.

Yesterday, I-- and I, accompanied by her friend B--- went into town for my followup visit with Dr. O-----. I got a friendly greeting from the gal at the outpatient desk, and H---- made a point of stopping by the waiting room to see how I was doing.

"I feel like I just gave birth to twins" is my reply.

She chuckled. "Well, hon, that's the price we pay."

I gave her hand a quick squeeze. "Good to see you. Thanks for checking in."

"You take care now," she replied. "Good luck!"

Dr. O----- was running behind. I forgot to bring my donut, and the chair was getting really uncomfortable, and when I madethe unconscious mistake of trying to cross my legs -- *not* something you can do after this procedure -- I decided I'd be better served by standing up and pacing a bit.

On the waiting room TV set, the President is delcaring that Americans are keeping more than ever of what they earn. I wonder when I'll see my share of that.

And suddenly Dr. O----- flickers into view and beckons me into the recovery room.

I was alone in there yesterday, but there seems to be a lot more business today -- and it takes a moment to find an empty bed for me. But we finally found one and the doctor pulls the curtains and beckons for me to Assume The Position.

He looks puzzled again, just like he did when he examined me in his office on my first visit. He picks at the waistband of my skirt, and it finally dawns on me that he's apparently not used to examining women. Most of his cases are probably middle-aged or elderly men -- and not too many of those patients wear a nice rayon skirt to the examination.

So I guess I need to show him.

See, we don't pull the skirt down in front. It doesn't work that way. What you do is flip the skirt -- and slip, if any -- up over the hips, like so.  And then the panties come down, and there you go.

Simple enough once you get the hang of it.

Dr. O----- gently lowers the suspensory and peeks beneath the bandage. "Everything seems to be healing up fine," he pronounces, and after taking a quick look up and over and under and around, he pulls the suspensory back into position.

"How long do I have to wear this thing," I ask, clearly not pleased with my medically-necessary undergarment.

"Oh, another day or so, that's all," he replies. "You can take it off tomorrow."

"The stitches will come out on their own, won't they?" I ask.

"Oh yes, in a week or ten days."

"How soon can I shower again?"

"Tomorrow," he answers. "No problem there. And if you do have any problems, any unexpected pain, just give me a call."

"Sure," I nod. "Uh, do you have my letter?"

He puzzles a bit, and I prompt him. "You remember, the medical certificate we talked about? The letter saying I've undergone a permanent and irrevocable surgical procedure for purposes of gender reassignment? So I can get my ID changed?"

"Oh yes," he rememebers. "I haven't had a chance to do that yet, but if you'll give me the text I'll get right to it and mail it to you."

I scrawl out the text on a sheet of paper from my notebook and with some difficulty tear out the page and hand it to him. "Thank you so much,"  I say as he pockets the paper. "I've been doing a lot of writing, " I add, gesturing to the notebook, "about my experience here."

"Ah," he smiles. "For your book."

"Yeah," I nod. "Once I'm up and settled I'll be putting an account of all this up on my online journal. I'll be glad to send you the URL so you can see it."

"I'd like that," he replies, extending his hand. I give it a squeeze.

"Thank you again," I whisper.

"Good luck," he says.

And he disappears around the curtain and it's time for me to go.

I-- and B--- and I adjourn to a little deli not far away for lunch, and I make short work of a pastrami sandwich -- the first substantial food I've had in nearly two days. And at that moment I'm absolutely certain that it's the best damn thing I've ever eaten in my life.

Then, back home so I-- can dilate and I can ice myself down. She showed me her vagina before we left for the hospital the other day, and all I'll say is that Dr. Suporn deserves every good thing his patients say about him. The man is clearly an artist -- and I-- is a very very happy woman.

Dilation is a very personal activity -- but I-- lets me watch for a bit, showing me how it's done and some of the things she's had to learn -- things I'll have to learn myself not so long from now. It's a bonding moment, one of many I've experienced over these past few days.

And there was more of that as the evening continued. S-- and I-- and I drove down to have dinner with J----, a post-op gal living in a nearby town, and like me a native of this state. She went to Montreal in 2000, and we spent quite a bit of time getting acquainted and comparing transition notes. And after dinner, she allowed me to examine her vagina -- my first up-close look at Dr. Brassard's technique. It was different from I--'s, as any given woman's differs from that of any other woman, and in both cases seeing the real-life results in front of me was a very powerful experience, a true affirmation of the path before me.

As I am now, so they once were.

As they are now, so I will be.

We also compared breasts -- J---- took off her sweater and I pulled up my top and my bra, and we looked each other over. She admired my nipples, observing that they're extremely well developed for someone on hormones for less than ten months, and the breasts themselves are nicely shaped. Hers are quite well-formed and substantial -- in fact, estrogen's been good to her all over. She showed me her old driver's license photo, revealing a burly, bearded lumberjack-looking man -- with a deep and desperate sadness in his eyes.

I didn't have to ask. I knew.

We all know.

It's a part of our common experience, this sisterhood of ours. And this evening helps me to understand that I'm really a part of that sisterhood -- sharing the advice and experience of those who've gone before me, just as women have always shared the bits and pieces of lore and knowledge that make up the fabrics of our lives.

We sit and talk -- about our lives, about our feelings. S-- shares the emotions she felt as she watched her husband transition, as she saw her tragic, wounded soulmate evolve into a relaxed and happy woman -- and she declares the depth of the love she has for that person -- no matter what her gender -- in a way that makes me melt inside.

I wish D----- could be here, could hear that.

And I look at I-- sitting there, and I remember what I told her the other day as we sat in the living room talking.

"Cherish what you have. Never forget how fortunate you are to have someone who'll be with you thru this all. Tell her what she means to you and never let her forget that."

And I look at the two of them, and I see the love they share, this quirky, fascinating couple -- and I feel so privileged to know them.

And when we finally say goodnight to J----- and head home at the conclusion of the evening, I realize once again that I'll never, ever be alone.

September 7, 2003

Home again.

Back to my house, my cat, my life. A few aches still, a few cramps, a few little drips and drops of blood on my pad, but I'm definitely on the mend.

And it feels so much better.

To be off the spironolactone. To not have to drink a gallon of water a day whether I want to or not. To not have to obsess over whether this food or that food has too much potassium in it. To not be constipated.

And, of course, to never have to worry again about testosterone. To know a major source of all my pain is finally gone.

It really does feel *so much better.*

I started my day yesterday with a gentle little talk with S--. She came in and sat at my bedside while I was scribbling some notes in my journal, and just talked to me like a big sister -- reassuring me, reconfirming for me that I don't ever have to feel lonely again, that I don't have to feel abandoned, that I don't have to feel like I'm the only person around who's dealing with everything I have to deal with. And I squeezed her hand and told her how much she means to me, how much I appreciate her friendship.

In a lot of ways, S-- reminds me of D-----. They both have that practical outlook on life, that basic common-sense approach to daily living that contrasts with, that balances, the impulsiveness of their spouses. But the difference is, where D----- makes a show, a pretense of being open to new ideas, S-- really *is* open to them. Where D----- is, in the end, a victim of her own insecurities, S-- has conquered them. And she's done it with an inner strength, an honesty, and a real devotion to her spouse that I find deeply moving.

And I told her, just like I told I--, that I love them both very much. And I'm so glad to have them as my friends.

I ended up getting out of bed around 8. I'd slept better, was able to move around a bit, but I still felt twinges of pain, and I still wasn't moving too gracefully. When I took off the suspensory to shower, I noticed a lot of bruising down there -- but not a lot of swelling. The ice packs have really done a good job.

I was able to leave the suspensory off, per the doctor's instructions -- replacing it with a stretchy-but-not-too-stretchy pair of underpants and a maxi-pad. There's a bulge I'd rather not have, of course, but a loose skirt manages to conceal it. I'm not especially comfortable -- but I feel better than I did the day before.

I spend the morning with S-- and I--, just sitting and talking and listening to music -- everything from Marvin Gaye to Johnny Cash to I--'s favorite goth-industrial band. And we discussed a whole range of things -- from the realities of transition to S-- and I--'s favorite pastimes. And I sat and watched them and I realized once again what an extraordinary couple they are. There aren't many marriages that survive transition -- but I'm really glad they did.

Finally, around 2 pm, it was time to head for home. S-- and I-- helped me pack my stuff into the car, we exchanged hugs all around, and promised to get together again soon -- and I hit the road.

It was an uneventful drive. I sat on my donut -- or more specifically, I--'s donut, which she loaned me for the duration of my recovery because it's more comfy than the one I bought at Wal Mart. I stopped at a Burger King for lunch just before getting off the turnpike, and felt a sudden twinge of pain as I waddled up to the counter -- but otherwise the aches and pains were minimal.

I got home to find that D----- had actually done some cleaning around the house while I was gone. I really appreciate that. But she'd also quietly removed more of her things, taken away more of her belongings.

That made me feel a little twinge of a different kind of pain.

But, once again, it's manageable. It's never going to be easy, but it's manageable.

When I got home, I went down to the bank right off to deposit my paycheck, sorted thru the rest of the mail, and spent some time transcribing my handwritten journal entries into readable form while the memories were still sharp.
And then I relaxed, reading the first few chapters of the book A-- sent me, a cute little comic novel about a forty-year-old woman rediscovering herself after a divorce. She sent it to me with a pithy admonition: "Read It!!"

And then I went to bed.

I didn't want to have to wear the suspensory again, but it's too uncomfortable to sleep in underpants, and I was afraid I'd twist too much in my sleep to let the surgical site go unsupported. A few days down the line, once the healing's progressed, I can leave it off -- but I guess I'm stuck with it for the moment.

But hey -- maybe today I'll dye it pink.
 

September 8, 2003

Four days post-surgery and things continue to heal up nicely.

I was able to leave off the suspensory last night with no significant pain, although the surgical area remains quite tender, and the visible bruises are dissipating. It still aches down there if I sit in any one position for any length of time -- I had an hour of electrolysis yesterday afternoon, and when I got off the table, I had a sudden flareup of pain that doubled me over for a bit.

I go nowhere without my donut. If you're considering this procedure for yourself, this is something I can't stress enough. YOU WILL NEED A DONUT AND YOU WILL NEED TO TAKE IT EVERYWHERE YOU GO IF YOU'LL BE SITTING DOWN. And if you're worried what people will say if they see you with it -- well, maybe you're not ready for this after all.

A cheap inflatable donut is $6 at Wal Mart. It's ugly as sin, and you have to fool around with the air pressure before you hit just the right balance point, but it's the most important investment you will make in a comfortable recovery. And plus it's one less thing you'll have to take care of when you get your SRS. A foam donut is nicer, and if you're ambitious, you can even make a nice fabric cover for your donut, whatever kind it is. So do what you have to do -- but don't think it's something you can avoid, OK?

And if you try to cut corners, if you think you can Tough It Out, well, I'll give you five minutes, tops, before your eyes start to water.

That's my Post-Orchie Sermon for this morning.

I spent most of yesterday listening to a persistent tapping sound at the window -- the sound of My Everyday Life rapping at the glass and reminding me that it's still out there, and it's time I paid it some mind.

I was away from here for about three days total -- and that's all it took for the place to go straight to hell. Food spoiled in the refrigerator -- D----- told me she'd thrown a bunch of icky stuff away when she came over to feed the cat. The bread got all moldy -- something I only realized *after* I'd eaten a sandwich for yesterday's lunch. And the ficus tree in my bedroom is in its death throes -- I came home to find a forest of fallen leaves on the bedroom floor.

So, yes, it's time to try and get back to some sort of normal routine.

I actually got kind of ambitious yesterday -- I tried to figure out what was the problem with my tree, and realized it's not getting enough sun. So I shoved the furniture around and put the tree right in front of the only window in the bedroom, a window which gets plenty of afternoon sunshine.

(Moving furniture three days after an orchiectomy??? Little delicate flower me???? Hey, I'm tougher than I look, at least when in the grip of a decor-related obsession.)

But then while driving to my electrolysis appointment I realized I hated the new arrangement -- the trouble is the geometry of the bedroom is such that there's really one way the furniture can fit that's aesthetically pleasing and practical to use.  So when I got home, I put everything back where it was, but I left the tree in front of the window.

So now when I sit at the vanity drying my hair in the morning, I have to kind of lean a bit to keep the branches out of my face.

Is it safe to prune a ficus? I need to look that up.

So anyway, I think you can see the point I'm making here, the point of this little ramble into the controlled chaos that's my home.

You need to take time to heal from any sort of surgery -- but you can't let the rest of your life go neglected, especially if you live alone like I do. You'll want to get up and around as soon as you can -- even though you might really want to spend the whole day sprawled in bed with the radio on reading a paperback novel. And I *did* do that for a while yesterday.

But not *all* day.

I've gotten my rest, I've let things heal -- but now it's time to get back to my regular routine, at least as much as I can. The more comfortable I get with moving around again, the easier it's going to be. So I'm hoping today to put in some solid worktime, and maybe will even try to take a short walk later in the afternoon.

I've still got my ice pack, and I've still got my donut close by. If I need to rest, I've got the time to do it.

But I've also got The Rest Of My Life calling, and I really do need to answer.
 

September 9, 2003

The post-surgical swelling continues to subside Down There, and the whole structure is beginning to feel very odd -- starting to collapse inward upon itself like a deflated balloon. It's a difficult sensation to describe -- but after having those things hanging off me for forty years, it's not an unpleasant feeling at all.

At the moment, the only swelling left is at the very top of the scrotal area -- right at the entrance to the inguinal canals, where there seems to be a firm and still-quite-painful mass of swollen tissue on both sides. I'm guessing, just from the fact that there was massive bruising there immediately after surgery, that this is where the local anaesthetic was injected -- and I'm expecting this will subside before too much longer.

At least I *hope* it will -- it's gonna be hard to tuck down there if it doesn't. I experimented a bit last night, bending the whole lump back between my legs to see if anything moves, and it really didn't want to do that, not yet.

But it's only been five days, so I won't worry. If it's still like this in another five days, I'll worry -- but not now.

I tried to do some walking yesterday -- and I think I might have overdone it. I waddled down to the bank to visit the ATM -- a trip of about three-quarters of a mile each way -- and when I got there, I reached into my purse for my wallet, containing my bank card, and only then realized I'd left it sitting on my desk.

I stood there feeling excessively stupid, gazed back up the street toward home -- and actually felt my groin sigh.

So I waddled back home -- with no ATM cash to show for my trip -- and spent an hour icing myself down. Then I got in the car and drove back to the bank. And this time I remembered to bring my wallet.
 

3:37 PM

I'm legally female.

Oh, not to where the point where if I got arrested they'd send me to the women's prison. There's still that one damn detail left that's keeping me from taking up a life of crime.

But in the practical day-to-day kind of way, I'm legally female.

And if anyone asks, I can pull out my ID and show them.

See, right there on my brand new Temporary Driver's License.  Right there -- see the "F"?

I got the letter today from Dr. O-----, or four copies of it to be specific. And I headed immediately to the Motor Vehicles' office to get the necessary adjustment made.

The fellow at the window, a beefy, smiling thirtyish guy with a mustache the color of the caramel inside a Milky Way, was very polite and businesslike about the whole thing, as he rummaged around his cubicle and plonked a huge state-issue binder on the counter. He began riffling thru the manual for the appropriate procedural regulation.

"I think you'll find it on page 22," I offered.

He looked at me for a second. "Jeez, you know what you're doing, don't you?"

I returned my most inscrutable little smile.

I didn't admit that I'd seen the regulation flick by in the table of contents as he riffled thru the book, or that I'm extremely good at reading upside down: a reporters' trick I picked up years ago to facilitate access to necessary materials that others might not care to have me access.

No, let him think I'm omniscient.  Let him wonder.

He took my letter and my current license -- from which I'd removed the carefully-applied Letraset "F" I was using as a necessary stopgap -- and went into the back office to fax it to the BMV headquarters in the state capitol.  Then he called the capitol to check to make sure it arrived OK and that everything was in order.

And then he handed me a couple of little forms to sign, made one quick keystroke on my record in the Motor Vehicles database, clicked "Save," collected my check for five dollars, and presented me with my temporary license. We reused the previous photo, taken the day of my name change, and the new ID will arrive in the mail in about a week.

"And you're all set," he smiled.

"Yes," I agreed, as I collected my documents. "Yes I am."

And then off to the Social Security office where a frail looking young woman holding a little square of gauze over her tracheal stoma went thru a similar routine -- pointing and clicking and checking and copying. And when it was over she handed me a paper to sign and in a raspy, buzzing voice said "Congratulations!"

"Thanks," I said. "I bet I'm the only one of these cases you'll have today."

"Well, today, yes," she nodded. "But we do get them. We get quite a few actually."

My face fell, in mock disillusionment.

"You mean all those years I thought I was unique and I really wasn't?" I asked, with a sad little shrug. "Jeez, what do I have to *do* anyway??"

The girl with the tracheal stoma laughed, maybe the first good laugh she's had all day.

And with a little wave and a friendly wrinkle of my nose, I took my leave -- that much closer to where I should have been all along.
 

September 10, 2003

Six days since my orchiectomy, and I'm really starting to feel comfortable again.

I didn't have to ice the surgery site at all yesterday -- there were still twinges of pain here and there, usually when I was in the act of getting into my car, or when I sat in one place for too long, or when I walked too much -- but in general the aching has faded out, and the swelling at the entrance to the inguinal canals is rapidly diminishing. I was afraid that pain and swelling might be the result of hematomas, but if it is, they're dissolving quite nicely and I'm not too worried about it.  I tried compressing the remaining tissue into "tucked" position yesterday, and it's still too tender for full compression -- I still can't wear pants, in other words -- but it's getting there, and I'm not as worried about it as I was a few days ago when the pain was more intense.

1:45 PM

Job's not over 'til the paperwork's done.

So I spent this morning doing more paperwork -- specifically, I got my birth certificate amended to reflect the New Realities.

First stop was a visit to the probate office down at the county courthouse, where I got another certified copy of my name change document. They told me they couldn't change the "his name" on the original decree to "her name" even with a doctor's letter -- that order can only come from the state level. But when they handed me the copy, I was really pleased to see that the clerk had simply left the pronoun line blank -- it says "h-- name."

And I thought that was really sweet.

She couldn't do what I really wanted done -- policy wouldn't let her. But she didn't do what I really didn't want, and I really appreciated that gesture.

And then it was a forty-two mile drive to the Office of Vital Statistics at the State Department of Human Services Building in our state capital.

The State House complex is a good graphic demonstration of the growth of government bureaucracy over the last century. In the middle there's the ornate copper-domed 19th Century-vintage State House -- and stretching out around it for several blocks, like parasites feeding off a host, a hodgepodge of faceless brick-and-concrete office buildings where all the many bureaus and departments of state government base their operations.

Human Services is across the street from the State House, in a low-slung brick structure which tries really hard to look Modern, but instead comes off looking a bit like a seedy IGA supermarket trying to survive in a run-down shopping plaza on the bad side of town. You park on one side of the building and then have to walk completely around it and up the side to find a door that isn't locked.

Vital Statistics is a service window in the building lobby. Passing a sleepy-looking security guard, I step up to the desk.

A hefty middle-aged clerk with a glorious combover looks up from a game of Minesweeper. He's losing and he can't figure out why.

"Can I help you Miss?"

"Yes, hi," I begin, trying to brighten his day a bit by not being Demanding and Obnoxious. "I need to get some amendments made to my birth certificate."

I pull a folder out of my briefcase and slide it across the counter. He picks it up and looks at the first page.

His eyebrow twitches a bit and he looks at me.

"The girl you need to talk to is on the phone right now," he says, looking me up and down with That Expression on his face.  He's forgotten all about Minesweeper.

His colleague is a tall twentyish redhead in a crisp white blouse and black slacks. She looks at my carefully-organized papers and smiles. "Just let me make some copies here, and you'll be all set."

I'm amazed. It's that easy? "I drove all the way up here from R------," I laugh, "because I thought I'd have to answer all kinds of questions -- but this is all I have to do."

"Yup," she nods. "All you have to do. And I gotta say, you're the most *prepared* person we've ever had in here to do this."

I smile back. "Yeah, a lot of people tell me that."

She scoots into the back office and I hear a copier whirring. The guy with the combover leans back in his chair, his arms folded in front of him, scoping me out. I wiggle my eyebrows at him, just a bit mischieviously, and he finds something else to do.

The redhead returns and hands me back my folder. "We have to keep the original of the paper from the county and the one from your doctor, so I copied those for you."

"Oh, that's OK," I reply. "I have other copies."

"You really *are* prepared, aren't you?"

"You gotta be."

I write out a check for $24, and hand it to her. "We'll be issuing you a whole new birth certificate," she explains, "with everything amended that needs to be, and the old record will be sealed. You should get it in the mail in a week or two."

I gather up my papers and thank her for her help. Mr. Combover gives me a last fascinated look, and returns to Minesweeper. The security guard looks like he's fast asleep.

And I head for home.

And it was *that easy.*
 

September 11, 2003

A week's gone by since my orchiectomy, and other than the swelling remaining at the injection sites, things have pretty much returned to normal. There's still tenderness in the swollen area, there's still a bit of pain -- but a few more days and hopefully that'll be gone. Right now the biggest irritant is the stitches -- they're in the process of dissolving and they itch like crazy.

So, after a week, it's No Biggie. I've not really noticed any resurgence of Adrenal Testosterone since going off spiro -- but I do feel other effects: I'm bloated, for one thing. I've put on maybe five pounds of water weight since last week, and when I was getting dressed the other day I noticed that my shoes felt a little tight. Oddly enough, though, I also feel rather dry -- I wake up in the morning and my mouth feels parched.  I-- tells me this is pretty much normal -- she went thru the same thing, and I guess it does go away after a while.

So I'm not too worried. For the first morning since the surgery, my first thought this morning wasn't really the state of my healing process -- and that's a good sign that I'm getting back to normal.
 
 

September 12, 2003.

I'd never had stitches before last week, and I had no idea they were so annoying.

So you can understand why I'm quite impatient for them to Go Away.

But as the saying goes, a watched stitch never dissolves -- so I guess I just gotta be patient.

*Sigh*

I walked downtown again yesterday to get my newspaper, and there was still a bit of discomfort from that long of a walk -- but it was tolerable. I feel like I need to get physically active again to keep unwanted weight from coming back -- and simply because I get awfully bored just sitting around waiting to heal. I suspect when I go to Montreal they'll have no trouble at all getting me up and around after surgery, simply because sitting still for too long drives me crazy. Anyway, I inspected down there after the walk, and the swelling was still evident at the injection sites -- but I checked again this morning when I got out of bed, and it's gone down quite a bit since then. Slow and steady, but I *am* healing up.

I put together a package last night for the nurses who took care of me last week -- I made some cookies and packed up a dozen for them, along with a card thanking them for all they did for me. I don't imagine they get too many patients like me, so I wanted them to know how much I appreciated everything. I'll be putting that in the mail today, and I also plan to send Dr. O----- a card, updating him on my progress and tipping him off to the URL of my journal so he'll have some idea of who, exactly, he was working on there and how I got to where I am. I was his first M-to-F patient, so I want to leave a good impression so that things will be that much easier for the next woman with redundant equipage who finds her way to his office.

So, that's how I'm doing this morning.

And it occurs to me that for the first time in quite a while, I'm in a situation where I really can just sit back for a bit and catch my breath.

The past four months have been the most hectic of my life, really. Since June, I've seen D----- walk out the door, with all the emotional upheaval to accompany that, I've seen A--'s situation go thru drastic ups and downs, and I've gotten together with her three times for in-person commisseration, I've redefined my relationship with A-----,  I've built friendships with S-- and I-- and C----, I've legally changed my name, I've had appointments three different doctors, I've spent an ungodly amount of money, I've undergone a bilateral orchiectomy, and I've changed all my legal identity documents from male to female.

Whew.

So, tell me. How did you spend *your* summer?

And now, with all that accomplished, I feel like I just want to settle back a bit and rebuild my energy reserves a bit. For the first time in four months, there's no Big New Transition Step on the immediate horizon -- basically all that's left is the preparations for SRS itself.

And that's going to keep me busy thru the fall and winter, I think. I've got to do the compulsory Second Psychological Evaluation thing, and my therapist will be lining up someone to do that, someone who I'll no doubt have to pay a couple hundred dollars to sit and listen to me for an hour or two so he or she can be sure I'm not some kind of delusional nutball. And then, finally, they'll both sign off on me and give me my letters, and I'll send the paperwork up to Montreal and schedule my date.

And then I'll spend the next year and a half trying to get the money. I know I can do it -- I just worry about the details is all.

But right now, none of that is Imminent. I don't have any more appointments scheduled in the next month or so, not until my next visit to my therapist at the end of October. I don't have any more paperwork that needs to be changed -- everything that identifies me to the Official World says I'm T. Ruby Taylor, Female, and all I have to do now is sit and watch the mailbox and wait for my new papers to show up.

So I'm going to just try and get back to my normal routine for a while here, over the next few weeks. I'm going to try and focus on my job, and on my avocational work, and on my friends and family, and for the next few weeks I'm going to try and spend as much time as I can dealing with the ordinary aspects of my life.

It'll probably be awfully boring here for a while, I guess. A real contrast to the bustle and upheaval of the past four months.

But I've earned a break, wouldn't you say?
 

September 13, 2003

The swelling has really subsided, but the stitches are still there.

I can pretty much move around freely without pain, and I was even able to tuck last night -- delicately, not too tight, no form-fitting jeans quite yet -- but it *was* a tuck, and it did stay in place without any real pain other than the incessant itching of the stitches. I even took a quick ride around the block on my bike yesterday afternoon, just as an experiment -- nothing too challenging, just down, across, and up -- and I was able to do it with no serious discomfort.

So the post-surgical discomfort is gradually being replaced by a new sensation -- the realization that They Ain't There No More. There were certain moments where I'd be forcefully reminded that they were present -- going to the bathroom, coming down the stairs first thing in the morning, times when they weren't tucked or confined or secured, and it was always a very unpleasant sensation. But now I don't feel that anymore -- I know there's *something* there that shouldn't be, and I'm still uncomfortable about that, but I also know there's quite a bit less of it now than there was before. And that's not at all an unpleasant thing to realize.

In other words, aside from the stitches, I feel like I'm pretty much healed up, pretty much able to get back to my normal routine. So from here on, I'll only be updating the Orcheictomy Chronicles section when or if there's something significant to report. It took nine days to get to this point -- which is about what the doctor told me to expect -- so if you're planning this procedure for yourself, count on feeling not-quite-yourself for at least that amount of time, and allow yourself the time to heal.

You'll feel better -- trust me.
 

September 16, 2003

The stitches are finally coming out.

I don't know why I say "finally," of course -- it's happening right on schedule, right when Dr. O----- told me to expect it. But it seems like it warrants a "finally", given the irritation and itching and "hurry up and come out, will you?" I've been experiencing the last few days.

Ah well, though. It's a very minor irritant. I just mention it here as documentation of how long it takes -- one of those details you might want to know if you're reading this account as a way of researching your own options.
 

September 18, 2003

Two weeks since my orchiectomy.

And the final stitch just came out. I could feel it down there, and it was driving me crazy. So I just this moment gave it a little tug, and out it came.

I don't see much scarring, either. There's still a certain lumpiness at the incision sites, but I'm assured that it will go away after a couple of months or so.

But I can tuck the Remains normally -- it's a lot easier now, in fact, than it was before -- and there haven't been any unpleasant side effects at all. No resurgence of T from the adrenal gland since coming off spironolactone, no emotional effects other than a sense of relief that The Offending Parts are finally gone, and no physical problems of any kind.

So this'll be the final entry for the Orchiectomy Chronicles. And those who are researching this process can take note -- count on two weeks for full recovery. It might be more or it might be less, but two weeks is a pretty good figure to use for planning your own recuperation.

And now I can focus my attention on the Next Big Step -- getting scheduled for SRS in Montreal. And that, of course, will be a journal section all its own.

And in the meantime, life goes on.