Hormonally Challenged

As a pre-op T*Girl I'm on hormonal therapy. I take Premarin as an estrogen source and spironolactone as a testosterone blocker. They work together to promote female secondary characteristics and suppress male secondary characteristics. This results in breast growth, redistribution of body fat in a more female pattern, softening of the skin, reduction of body hair, loss of muscle mass and strength, withering of the testicles and prostate, various emotional changes, and numerous other changes.

As a prerequisite to surgery I need to be off of my estrogen for 3 weeks because of its effects on blood clotting (apparently it takes about 2 weeks for all of the exogenous estrogen to leave the body). I am, however, allowed to continue the spironolactone up until surgery. Most girls would simply go cold-turkey but I need to be more careful. I have an inner ear condition called Meniere's Syndrome. It's believed to have something to do with electrolyte imbalances in the inner ear and causes periodic bouts of vertigo, cold sweats, nausea, and vomiting. Anything that can upset my water balance can potentially cause an attack. I'm supposed to limit caffeine, salt, and alcohol. By all accounts I have a mild case and haven't had any problems at all since September. However, when I first went onto hormones my Meniere's went wild. I was started on a low dose of hormones in August of 2003. A month later, after all my blood tests can back positive, I had my estrogen tripled and my spironolactone doubled. This started at least a month of Meniere's misery. I ran to my ENT to see if anything could be done. After coming out to him as transsexual he told me that his female Meniere's patients typically experience changes in their symptoms as they go through their monthly cycles. I told him about my hormones and being bumped up and he kinda chuckled. He predicted that given some time my body would adjust. It did. The upshot of this is that I'm very leery now of making any drastic changes in anything, especially my hormones. So, for my surgery I'm going to taper off both the estrogen and the spironolactone. Today is the first day of this. I have a week to get off the estrogen and, although I don't have to stop the spironolactone, I'm going to take the rest of the month to taper off that as well. I'm hoping that tapering off will reduce the likelihood of Meniere's symptoms and also reduce the likelihood of PMS-like symptoms. I'll let you know how it goes.

Phone Call from Meltzer: Followup

Well, I heard back from Meltzer's office about my scheduling; my pre-op is back to Monday August 29 at 8 am. I still don't know quite what the whole story is but apparently it's no longer going to affect me. All I was able to find out was that they were trying to open up space in the schedule. My guess is that someone was trying to get herself inserted into the schedule but that there really wasn't an opening. So, they were probably looking for volunteers to move. Sort of the equivalent of the airlines asking for volunteers to be bumped. After fixating on this date, August 30, 2005, for 10 months, and scheduling everything around it there was no way I wanted a delay.

I also got a call from one of Melzter's nurses. We played phone tag for over a day and then finally connected. They had a few questions about the medical history I filled out. It turned out to be nothing significant but it's reassuring to know that they actually go through that stuff. I was also told to buy a bottle of Arnica Montana pills before I come out and to start taking them on the pre-op day. Some say that it reduces swelling and quickens healing. I'm not so sure. I'm a scientist and a skeptic and I have little belief in herbal remedies and none in homeopathy. There's no logical way that you can take a substance and then make 6 or more 1000 fold dilutions and still have anything left to cause an effect. Luckily, the stuff only costs around $5 a bottle so I'll take it if they want me to take it.

While I'm on the subject of Complementary and Alternative Medicine I'll also comment on the Echinacea study that was released today. According to a new controlled clinical study published in the New England Journal of Medicine there is no evidence that Echinacea has any effect in preventing the common cold or in reducing it's duration or symptoms. Normally, I'd practically applaud such a study. Unfortunately, in the present case I think the study was fatally flawed. First, they had the volunteers using a dosage that was one third the amount that the herbalists recommend. Second, instead of using commercially available Echinacea the researches made their own extracts. So, in the end all they proved was that this particular dose of their preparation had no effect. I don’t blame the popular media for lack of rigor, but NEJM should know better than to extrapolate these findings to such a sweeping damnation.

A Wedding Photo

I finally have a decent picture of me and Michele to post. Up until now I had great pictures of the guests, of my kids, of me with my kids, but no good shots of me with Michele. These were taken by Debbie. Thanks!

I wish I had a clue what was going on that had us so amused. Deb said that there's bound to be lots about the ceremony and reception that we'll never remember. She's right. It all went by in a blur. It seems like right after we got there it was time to start and then it was all over so quickly.

Electrolysis "Down Below"

I went back today for what will be my last session of genital hair removal before surgery. I'm not completely confident that there won't be any more regrowth but I've basically run out of time. By the time there'd be more to do I'd be within two or three weeks of surgery. I don't want to risk that I might not be completely healed for the surgery. It's just not worth the risk of the surgery being delayed or put off. There's also the fact that during surgery the follicle layer of the skin is supposed to be removed for added effect. I'm going to have to trust it to the goddess that all will work out.

Unexpected Anxiety

A few days ago I was glancing at my calendar and suddenly realized that it's almost August. With that, my mind leapt ahead to my surgery at the end of the month. After setting the date back in September my surgery is barely a month away. All along, people have asked me if I'm nervous. I've always responded that I can't wait for the surgery but that it is surgery and things can go wrong, that being nervous is natural. What I didn't expect was a feeling of panic now. That feeling has passed, but it caught my attention. Why panic, nothing had changed except the passage of time? I guess that with the dwindling days until surgery, the whole thing becomes more real. No longer is it something that I need to plan for, it's something for which all the planning is done. I've never felt like backing out, but at this point such a thing is practically impossible. It's all set, it's paid for, it will happen. There's nothing to do now but wait out the days and keep it real.

Difference of Perspective

It's amazing how differently two people can view the same event. Michele and I have both blogged about our meeting and courtship. We both described our first kiss. We both agree on the events. We differ greatly in our perception of the event. In "Herstory IV" she describes it like this: "I leaned over and gave her a little kiss to thank her." It's my recollection that she pulled me in to her with a hand behind my head and then laid a huge kiss on me. For days before this I had been trying to figure out how she felt about me with little success. Once, the conversation naturally led me to ask "What do you seek in a partner?" I hoped to see myself in her answer but came up pretty empty. This one kiss erased all doubt from my mind!

At least we agree that it was electrifying!

Phone Call from Meltzer's

Got home yesterday afternoon to find a phone message from someone at Dr. Meltzer's office: I should call back. Since they are two hours earlier I tried right away but they were out to lunch. Got through later but the woman I needed to speak to only works mornings and was not there. She called me at work today, asked if I'd be willing to move my surgery back to September 8. I said that it was not really possible since my travel, time off, etc, were set around the August 30 date. I asked why they wanted to move the surgery but I didn't really catch the answer. I was asked when I'd be getting into town and when I said the Saturday before (August 27) she said that they may want to reschedule my pre-op physical to Sunday instead of Monday. They need to get back to me about the new time (when they call I'll ask again about the schedule change). This means that we lose a day that was going to be fully devoted to tourist stuff but, hey, the surgery is more important.

Ceremonial Impressions

I hope that everyone gets to enjoy their own wedding ceremony as much as I enjoyed mine. The only negative was that the weather did not cooperate for an outdoor ceremony. The humidity was about 100% and there was a violent thunder storm shortly before we were scheduled to start. We did the ceremony indoors instead and everything was wonderful. It's a rare thing, especially for a transsexual, to be so embraced by their family. Mine is terrific. My parents were there and my brother did a reading. My 13yo son was a handsome ringbearer and my 8yo daughter was beautiful as flower girl. Michele's mom and sister and my aunt and two cousins were also in attendence. A special treat was to have my friends Paul Iwancio and Nita Paul, singer-songwriters from Baltimore, perform a song written especially for us. Please check out Paul's website (I designed it. Please buy a CD and support live music).

I'm quite fortunate to have what I have.

Present Perfect

I'd like to shift focus a bit here and talk about another part of my life. I separated from my ex shortly after coming out to her in December of 1998. She was initially supportive and assisted me with my look but rapidly soured after seeing me dressed for the first time. We were in counseling by April of 1999 and agreed to split up by June. We sold the house and separated in December of 1999. Divorce is supposed to be some great tragedy but all I could see was the freedom it would afford me to figure out who I was and what I wanted. I spent the next 5 years alone, but not lonely. I continued counseling and I tried to get a handle on my sexuality. I dabbled with men, mostly because they were the only interested parties, but it never struck a spark. That left me wondering if the problem was with these particular guys or if my problem was with guys in general. All it took was my first lesbian relationship to make it obvious that women are it for me.

Michele contacted me by email in February of 2004. She is a lesbian who was active in the GLBT employee group at her employer. She found me online and reached out to me as a possible speaker for their pride festival. We emailed for a few days and then met for breakfast. We talked about everything except the reason we had gotten together. We continued emailing, then had dinner together. Soon I was cooking dinner for her. I think we had our first kiss on her birthday and it's an understatement to say that it was electrifying! Soon she was spending the night. By summer she had essentially moved in. In January of 2005 we closed up her apartment and moved her completely in here. In February, although I was living full time as a woman, we were able to get legally married, due to the fact that I am still legally male (the story of getting the marriage license I'll save for another post; Michele has done a pretty good job of telling this story). It's so cool to have a legal Maryland marriage license that says "Nicole and Michele". Too bad it has to list me as "husband". We did the marriage quietly at city hall with nobody present except the officiating clerk. When our friends heard, they were outraged that we didn't tell them what we were doing. We promised them a commitment ceremony to which they'd be invited. That ceremony will be this Saturday, July 16, 2005. It will be a small affair with our family and closest friends. I'm happy to be able to say that my parents are attending. Although we're keeping it a less formal event I will be wearing a wedding dress. Hopefully I'll be able to post a picture in a few days.

History 4: Choosing a Surgeon

How to choose a surgeon? There are basically three major locations for GRS surgery: United States, Montreal and Thailand. Many choose a surgeon in Thailand because they offer the best prices or because they don't adhere as tightly to the Benjamin Standards; pretty much, if you've got the money you can have GRS in Thailand even without letters. I rejected Thailand as a possibility for me for several reasons: the desire to not be in a foreign land while going through this, the nearly 24 hour air travel (a donut is not going to make that enjoyable), and, as my friend Debbie says, with something as important and complicated as GRS you don't want to go bargain basement. You've really only got one chance to get it right.

Having ruled out Thailand I started contacting all of the surgeons in North America.

• I never heard back from Dr. Brassard.
• I was worried by Dr. Reed's policy of discharging you from the hospital after 24 hours (saves money but at what risk?)
• I was concerned that Marci Bower hadn't done enough surgeries.
• That left me with Dr Meltzer and Dr Schrang.

I was lucky to be going to Phoenix on a trip and was able to also schedule a consult with Dr. Meltzer. I came away feeling very good about him. He does come off as a bit arrogant but I think that kind of confidence is a good thing in a surgeon. I booked my date on the spot. He's definately not the cheapest but he may be the best.

Some Present Happenings

The countdown timer is counting towards August 30, 7:30am. One of the preparations for GRS is "genital hair removal". To put it bluntly, the hair on the penile shaft and most of the hair on the scrotum needs to be removed because they'd end up inside and you really don't want hair growing out of your vagina. The two options are lasar and electrolysis. I've opted for electrolysis because I have a wonderful electrologist and we have a great relationship that goes beyond customer to friend. Because the logistics would be difficult I'm not doing novacaine shots. Instead I'm doing the best that I can with LMX5. There's no other way to put this except IT HURTS!!! It took about five hours to clear the entire area the first time and about an hour to clear it a second time. I had hoped that tonight we'd have it cleared the third (and last) time but there was more regrowth than we could finish in the time we had. Bottom line, I need to go back one more time to finish it off. Damn!

History 3: The Gatekeepers

The entire GRS process is regulated by the healthcare profession. Even though we're adults, and capable of making our own decisions, we're not allowed to make these decisions without permission. The Benjamin Standards stipulate counseling and at least a one year "Real Life Experience" before GRS. In actuality, the limiting factor is getting the "permission" letters from two mental health professionals. If they say OK, a surgeon will usually say OK, too. It's a matter of everyone covering their asses. For me, the surgery couldn't come too soon. However, my counselor works strictly by the standards and refused to consider anything else. At least, there was no doubt that she would give me the letter. For my second letter I decided to use Dr. B. I met with him regularly during the process of prepping the kids so we already knew each other. I was floored when he told me that I'd be required to take the MMPI-2 psychiatric evaluation. After working together for 6 months he still had to make sure I wasn't psychotic?!? As I said, covering his ass. As put off as I was, I decided to go ahead rather than having to start all over with another psychologist.

Although my transition has been pretty uneventful, the year "waiting period" has probably been a good thing as it has given us all time to get used to things.

History 2: Decisions and Schedules

Having decided that I was destined to transition and to get surgery I needed to start deciding when things would happen. One of the factors that set the schedule was telling the kids. I had already come out to my son (then about 11 years old) as a cross dresser but I hadn't told him anything else. My daughter (then about 6 years old) was pretty oblivious to everything that was changing with me. I really wanted to do it "right" so I decided to enlist the help of a professional. I ended up having the kids see a child psychologist who has experience with helping transsexuals through this. I first saw Dr. B in December of 2003. We immediately scheduled him to meet the kids (separately). He recommended that my daughter see him regularly for "preparation". With my son he recommended little work as he sensed my son was close to figuring out everything on his own and didn't want him to get there too far ahead of his sister. He recommended waiting until school was over before telling the kids so that if they took it poorly their schoolwork would not suffer. Also, I was told to allow them an adjustment period before I went full time. This meant that the earliest I could tell them was the middle of June and I ended up telling them during the weekend right after school let out. I chose August 21 as my date to go full time because that's when I was leaving for a week at the beach and I decided there was no way that afterwards I'd go back to being a guy.

The kids were told and allowed to adjust. People at work were told and allowed to adjust. Family was told and allowed to adjust. I took my week at the beach and returned to work as Nicole on August 30. At work it was pretty much a non-event. To this day, nobody has really asked me about it.

History 1: Background

I've probaly always been transsexual but it took me quite a while to figure out. Before then I knew I was a cross dresser. It wasn't until I had an epiphany in March of 2003 that I woke up to the fact that I'm TS. It took me 6 months of counseling to know that I wanted to transition. I also knew that transition, for me, also meant surgery. Having always seen myself as a cross dresser I knew nothing about the process. This meant that I needed a lot of education: Benjamin standards of care, letters, hormones, second opinion counselor and letter, surgeons, locations, techniques, costs. There was also coming out at work, coming out to my kids, on the job transition. How to pay for surgery? On and on!

For my entire story please see Nicole's Niche

Welcome

Welcome to my SRS/GRS surgery weblog. I will use it to create an ongoing personal view of the process and experience. I'll start by catching you up on the important things that have occured before now (for my whole story see Nicole's Niche). Then, I'll make additional entries as things happen or as my mood dictates. My goal is to give you insight into the process. Whether this is something you are facing or it's just something you're curious about I hope you'll find it enlightening or entertaining.

At any time please feel free to write me.

For the view from the other side of the process, please see my partner's blog, The Sherpa's Trail.

Take care, Nicole