Gail and I have been writing here, about extremely personal matters, for over 6 years (off and on), in a highly public (if vaguely anonymous) way. But so much of what I’ve experienced as I’ve worked through transition has been intensely private. It’s been important for me to write, to figure out what it is I’m feeling and what it is I will do, but so much of it I don’t want aired, or at least not until later, once I understand each new experience a bit better.
I had chest surgery 6 weeks ago. I have written nothing public about it. It’s only now that I can entertain the idea. Barely.
I let even our close friends know about it only under duress. Our family needed support because Gail could not do all of the work of two adults inside our home in addition to post-surgical care for me. We needed help, which meant I needed to let people know what was happening and ask for that help. We are blessed with a deep community of friends and family who cooked food for us, helped with laundry, took the kids out for activities (and made sure they didn’t miss any birthday parties), and kept me company while was laid up — including my best friend J who organized them into a schedule so help just magically arrived when we needed it. This help came from old friends, new friends, Gail’s mom who lives close by, my parents ordering a giant bag of pre-cooked food to be delivered to our doorstep, our religious community, neighbors, other parents from our daycare, and friends from my band. We have felt extremely loved and very grateful. And believe me, we really needed the help.
Even with all that support and love, I still didn’t want to talk about surgery with these friends. In part, this was because I didn’t want to hear congratulations. I wasn’t excited about surgery. I saw it as a thing I needed to do.
In terms of accessing surgery itself, things worked out well, and I know I’m lucky, but it was still stressful. My employer added insurance coverage for surgery January of this year. I knew this change was coming, and immediately sought a consult with a fairly popular local surgeon, based on word that she was good at accessing insurance coverage. Indeed, it turned out her office was already “in network” for my plan. I set a tentative date for as soon as we thought we could get insurance approval through, got the doctor’s office the letter from my therapist, they submitted paperwork and we waited (and waited and waited…) for insurance approval. It came through in the nick of time, a week before the scheduled date, and I was able to go ahead.
As amazing as the insurance coverage was, it meant I was essentially limited to this one surgeon. Most surgeons doing work for trans people are set up for people paying privately. They will tell you you can submit a claim to your own insurance for reimbursement, but most won’t help you, and most won’t bill directly — almost always a reimbursement is nowhere close to the full fee. Since there was an in network doctor (the one I saw), seeing anyone “out of network” (which was everyone else), was going to be a fight. There was one other local surgeon who was willing to submit a pre-approval and bill directly, but he also insisted on charging over $5000 in addition to what the insurance would pay (he had a very flimsy workaround for what I see as the illegality of this). So, while I was thrilled to have the coverage, I also felt really limited by it. Whenever anyone told me how great their (different) surgeon was, I felt trapped. I knew my surgeon would likely do well with my procedure (DI) and body type, but I still wondered if I was making a mistake, in large part because I felt like there was no other choice I could make.
Ultimately, my surgeon did a great job. Even if you took away the insurance limitations, and asked me to pick again, I would probably pick her. I’m also extremely grateful she is willing to accept insurance payments as her full payment.
I have written some, but not a lot, about how deeply physical my experience of my gender is. When I understood myself as female, it was like I did not have a relationship with my body at all. I don’t necessarily connect with the “wrong body” trope — rather it was like my body simply wasn’t mine. I had gotten through the first 3+ decades of my life by focusing on other things, mostly intellectual things, and discounting and ignoring my body and appearance as much as I could. Once I realized that I was trans, and was so much more comfortable as male, I suddenly got my body back. I first felt it when I looked into the mirror while buying clothes in the men’s department, and again when I saw how I looked with a binder on. It was a jolt, a sudden sense of physical presence, and a deep physical need. Every small and large physical change, either in my body or in my appearance, has awakened the same feeling.
But my body still had (and has) blank spots, places I imagine away and try not to think about. I hoped that with chest surgery I would get a part of my body back. I wasn’t sure when or if that would happen. But I hoped it would.
After surgery, I didn’t look at my chest until the post-op appointment. That first week, Gail changed the dressings and I looked away. I just didn’t think about it. I took pain meds and tried to rest. But at the post op appointment, I decided I could look. And I loved what I saw. Right then, with that look in the mirror, even swollen and with things still looking a bit gory, I got my chest back as part of my body.**
It took a while to really feel it, and I still don’t feel it all the time. I still had to bind for weeks, and had some struggles with swelling and fluid retention after the drains came out, but at that appointment, I got a glimpse of the future, and my body felt like mine.
And while that is good, recovery was/is hard, even six weeks out. I was in quite a bit of pain, and thus I was pain meds and really not with it cognitively (and I find it disorienting not to be able to think). It was hard not being able to do what I usually can with the kids, and to see my youngest in particular quite stressed about this (he’s doing great now, for a while I think he truly believed I would never ever get better). Even with amazing help, it was an astronomical amount of work for Gail to keep us afloat, especially those first 2 weeks, but even up to four or five. I’m back in the swing of things at work, but it’s never easy to miss time in lab. Even with all this, at six weeks out, it definitely feels worth it.
I’m healed enough now that I go shirtless in my house sometimes (not a lot, usually just on my way back to my room from the shower), so the kids have seen what my chest looks like. Over the weekend, I was on my own with the kids a lot, and at some point Leigh glanced up from what she was doing and said in her matter-of-fact tone, “Aba, your chest looks really good. It’s not quite how I thought it would look. I bet it feels really good.”
She’s right. It does.
**I won’t be posting photos. The rest of the internet has plenty of great examples.