One Year Since my Facial Feminization Surgery

One year ago I left for the hospital to have my face altered with facial feminization surgery (read more here). My mom was in the car with me, my husband following in his own vehicle because he had a unbreakable work commitment later that day (and the rest of the weekend). The weather had been cold but calm in the days leading up to this milestone morning, but this day was rainy and windy. It was a terrifying drive to start a terrifying day.

We arrived at the hospital at 5:30am. It was still dark, and the hospital was a ghost town, except for a security guard standing outside to direct surgery patients to the correct door. Before we reached the guard, we were approached by a pleading woman, holding out what looked like a driver’s license, accusing the hospital staff of unfairly keeping her out of the place. The guard urged us to dismiss her. We realized she was unbalanced and ranting. Ignoring my instinct to empathize, we passed her and continued into the building.

While waiting to be admitted, I nervously posted on Twitter and Facebook, trying to not think about what would soon happen to my face. Images of cut flesh…and blood…and pain…and loss of control and…

At the hospital. A little early. Hair-raising drive in the pouring rain. Had to navigate past a (presumably mentally…

Posted by Daya Curley on Friday, February 3, 2017

Checked in and waiting to get prepped. Trying to still my heart. So nervous!

Posted by Daya Curley on Friday, February 3, 2017

Soon I was in a gown with an IV, clearing my lungs with an albuterol inhaler. I was also instructed to spray Afrin into my nose to clear any congestion. These processes happened at a dizzying pace, but nothing could completely distract me from my anxiety.

I was misgendered a couple times by a very nice nurse, a stomach punch from a well-meaning person. Who you gonna believe (her brain presumably asked her), your eyes or that gender marker on the patient’s chart?! I hoped all the trauma I was about to endure would help me avoid this kind of thing in the future. The whole point of this is to be able to move more freely in the world without sticking out so much. But first I would have to survive the surgery.

Prepping for surgery

Mark and my mom looked tired and concerned. I’m sure they were scared. I looked to them with desperate eyes and they had no answers. Mark held my hand and took a couple pics.

Daya just before FFS surgery

Nervous as (and looking like) hell!

I was visited by my surgical team. Dr. Kleinberger I had met at my consultation. Dr. Shih I had never met. They were both bright-eyed and smiling, which helped. What helped even more was chatting with my anesthesia technician. He listened to my concerns and assured me he wouldn’t leave me the entire time, wouldn’t even look away from the monitor displaying my vitals. He explained how he would be able to determine if I was starting to wake or in pain, and what his response would be. He described his goal as creating the softest possible take off and landing of a jumbo jet. I believed him, and more than anything else, his attention made me less panicky.

And then I was being rolled away, prompting quick teary goodbyes. Once in the operating room there were a slew of folks bustling around, but my anesthesia technician called out to let me know he was there too. Without much fanfare or warning, I lost consciousness.

After surgery

The surgery lasted a little more than 7 hours. I became aware again while coughing and hearing instructions in the recovery room. I dropped back into sleep. When I woke again my mom was present, holding my hand. “Did everything go OK?!,” I asked. “Everything went fine,” she said.

It was a very tough night, and not just for me. My poor mom had only a bedside chair the whole night. She also had no food, as the cafeteria was not open on the weekend. This is something we should have been told in advance. At one point she lay her head on the side of my bed in an attempt to sleep. Throughout the night she helped me chase down nurses for new ice packs and pain medication. After a few hours we learned we would have to ask multiple times for anything in order to actually receive it. I drank ice water through a straw and kept ice packs on my head and face, balanced on the bridge of my nose. The next day I would find out that both the straw and that particular use of the ice packs were not supposed to happen, both potentially able to cause problems. But we were doing as we were told by the Kaiser night nurse, who explained many times that she normally works in recovery and not on the floor. I assume she used this as some kind of excuse for her poor performance. She was friendly, but didn’t instill a lot of confidence in us.

Daya in hospital

Bored, sore and wanting to be home.

Mom sleeping

My poor mom, trying to sleep on the edge of my bed.

It was all a blur, right up until my catheter was removed painfully. Then time slowed as I waited to pee on my own…get my meds sent up…and get the hell out of there. I was finally released around 5:30pm.

Stressful drive but home at last

We still had the drive home, my mom behind the wheel, with the setting sun in our eyes. She was unfamiliar with the roads and I was not much help in the passenger seat with my face bundled in bandages and my head swimming in oxycodone. We took a wrong exit and ended up in downtown Oakland. Some yelling and crying ensued (me, out of frustration) but we got back on track and made it home.

I found it tough to look at myself over the next couple weeks. My crazy swollen face gave no indication where it would settle, and my hair was so matted I couldn’t imagine how I would get it de-tangled again without pulling every last hair out by the roots. By the time my mom went back to Michigan I had a stable schedule of feeding and icing my face. I found joy in pudding and peanut butter, not able to imagine what it would feel like to eat solid food again.

Uncomfortable, frustrated, and bored.

This was the part I didn't quite anticipate, once I've gotten past all the main…

Posted by Daya Curley on Sunday, February 12, 2017

Where I am right now

One year in, my scalp is still numb and itches a lot of the time. There are places on my face (around my brow bone specifically) that are still sore to the touch, even while gently brushing makeup onto my face. The tips of my nose and chin are numb and tingle when touched. Obviously, it will take more than a year for my face to settle completely. If I’m honest, I wish my nose was a bit smaller, but in general I’m thrilled with the results. Facial surgery was the one thing I really wanted. It was also the thing I was 100% convinced I would never have the chance to do. I’m so grateful for the opportunity Kaiser gave me, and for the artistry of Drs Kleinberger and Shih. I still don’t know which procedures each of them did, but they work great as a team.

I’m still getting used to the difference in how I’m treated by the world in general these days. I can’t tell if people are friendlier because I’m less unusual-looking, or if it’s because I’m more outgoing now that I feel more comfortable. I suppose it’s a combination. Either way, I’m happy to be taking this journey. It was a profound reset in many ways and has allowed me to shed layers of insecurity and start to enjoy being in the world in ways I’ve always wanted but felt were out of my reach.

What’s next?

My vaginoplasty recovery is still presenting some issues, which are being treated. I also need a revision surgery for my urethra. In addition, I’ve decided to get mammaplasty. There’s a possibility we’ll be able to combine the revision and breast augmentation into one surgery. I’m hoping for that, and I hope it’s soon so I can get out from under the constant physical recovery. My procedures and recovery have dominated my life for a long time. I’m eager to see what the next phase of my life will be once all that time opens up for other pursuits. Mark and I want to travel, and we haven’t ridden a roller coaster in far too long! I need to ride some roller coasters!

My FFS (Facial Feminization Surgery) – 10 Months Later…

Today is 10 months since my facial feminization surgery, and I’m still in disbelief I had the opportunity. I suppose I could have lived my life without it, remaining camera/mirror shy and unable to shed that insecurity, but I always wanted to correct some things and I’m glad to have done it (Well, “glad” is a gigantic understatement, but you get my drift, yes?). Certain features about my face caused me great distress (my jaw specifically), some not necessarily gender-specific at all. My level of past distress became even clearer in the months after the surgery as I began to look harder with less and less fear. I had been keeping my feelings at arm’s length, unable to face myself. Being free of that self-doubt has been a nearly rapturous experience. I am changed for the better. And all it took was tearing my face apart and putting it back together slightly differently.

The Discomfort Lingers

A full year of recovery is what I was told to expect. Judging by the sensations I still have at 10 months, I believe it will take longer than a year. I have spots on my face (mostly around my brow bone) that can be tender to the touch. Even a makeup brush can cause bruise-like sensations. Certain areas of my head along the incision are also sensitive. Most of my nose and the tip of my chin still feel a little swollen/numb. These areas have the least blood flow and therefore were expected to be the last to heal.

The most disconcerting ongoing bother is my scalp. As the nerves reconnect and relearn, there’s still a lot of numbness. And itching. OH MY GLOB THE ITCHING! I’ve worried I might scratch all my (thinning) hair out of the top of my head. The scratching doesn’t work since there’s nothing specific creating the itch, just my stupid nerves memorizing their new function on my tighter scalp. A friend who had hair transplantation confirmed he experienced lots of the same sensations, assuring me it will eventually stop. I’m looking forward to that mystery date in my future.

Self-Acceptance vs. Fix Me!

I was very photo-phobic prior to surgery. But at some point, a couple months after surgery, I snapped a selfie and thought “Oh. I sorta see it. There she is!” These days, I no longer shrink from a camera. This is a big deal for me. I feel relaxed in a way I never understood.

Daya Curley

Here’s that photo. Looking at it now and realizing how swollen I remained at that time, it’s a little surprising I was able to see through the healing and notice the improvements. I would have thought insecurity about the puffiness and incision would have still prevented optimism at that point.

A case can be made for avoiding surgeries and learning to accept oneself as is. I see that, but I wanted something different for myself. I’m happy to have the opportunity. I’m happy with the results. I’m happier now than I was before surgery. I assume that’s the point. Mission accomplished.

What is “Before & After” Anyway?

I haven’t included any attempt at before/after pics. I’ve looked different at different points in my life, so where does that sort of thing start and stop? It’s arbitrary. I debated whether to include any photos at all, and decided to use just these two. What we’re talking about is a largely visual issue. But I want to be careful to not lean too heavily on that part, for the sake of people who don’t have the same opportunities and to avoid playing into societal norms/expectations in a regressive way. It’s a tricky balance.

What isn’t tricky is knowing I’ve made the right transition decisions for me. That’s a no-brainer.

My Vaginoplasty – 6+ months later…

My gender confirmation surgery (vaginoplasty) happened on May 19th, so it’s just over 6 months ago. I wrote about it here. There have been several bumps along the way. Some scary moments relating directly to the surgery (thinking my skin graft failed) and some other associated issues (discovering an allergy to sulfa anti-biotics). Despite being months out, and expecting I would be further along in my recovery by now, I feel strong overall.

The Good

I’ve been able to get mostly back to my regular schedule, which includes lots of walking and the occasional cardio dance class. My health is in the zone, from blood pressure to lipid panel. Along the way I’ve been seen a few times by my surgeon and other doctors. I’ve been assured everything is healing properly.

The Not So Great

Dilating is still tough. I deal with more pain and difficulty than I expected at this point. Until the other day none of this seemed to surface red flags for any of my medical partners. On Monday I had my first gynecological appointment. Without going into too much detail, I am left with the news that “there’s nothing seriously wrong, but there’s an issue we have to deal with”. I am currently awaiting word from the medical team after they pow wow to determine the next step(s). I may be dealing with some internal skin that is not healing properly. If this is the case, it seems a fairly common issue after this kind of surgery. But we don’t quite know yet, and I’ll need a deeper examination to find out what’s really going on. What kind of exam, and who will perform it, is the news I await. And I haven’t a clue when that info will reach me.

In addition to solving this pressing problem, I am also still waiting for a 6-month check with the surgeon and will hopefully finally have a conversation about a revision surgery that will help tie up one other loose end. The surgeon wouldn’t even discuss it until “at least 6 months” post op. Now, despite the fact it’s beyond that, I have to wait for an appointment.

So Where am I Right Now?

At this moment I’m feeling frustrated. My days are dominated by the need to dilate. I’ve recently shifted from 3 dilations per day to 2. This has freed up my waking hours somewhat, but my days still must be built around the dilation schedule, which has to happen in a quiet, private setting. Theoretically, at some point in the future, my dilation won’t be such a hungry monster, but for now I’m still in this chapter. I don’t regret anything, but I’m feeling rather bratty these days about the schedule and the discomfort it forces on me. Sad trombone.

I thought I would be farther along by now. It’s different with each person, and I am 54 years old after all. I look forward to a time when I can move on with my life. It’s been a long year, full of challenges. Of course, all these challenges were by my own choice, so I remain ever grateful (in my less bratty moments).

My Facial Surgery

On Sunday, it will be 10 months since my FFS (facial feminization surgery). I have things to say about that, which I’ll include in an upcoming post of its own.

Suffice it to say the same mostly applies to that as well: lingering discomfort / occasional brattiness / intense gratefulness.

Photo credit: Warlen G Vasco on Unsplash

I’ve reached my goal weight. I’m now a Weight Watchers Lifetime member.

After a year of persistence, I’ve reached my goal weight, and today I officially became a Weight Watchers Lifetime member.

I’ve used Weight Watchers on and off since I was 12 years old, back in the days when you HAD to eat fish and liver. Blech! It has always been a program that worked for me, albeit temporarily. There have been times I was able to drop weight, and then immediately lost my way and gained again. I knew last July I had to either accept my larger body or be sincere about this attempt. Losing and gaining over and over might have been as bad for my health as staying heavier. I also had the added incentive of my upcoming surgeries and knew the only thing I really had within my control was how I felt heading into those events.

I decided to give it one more try. This time I intended to trust the program completely, and that meant attending meetings instead of going it alone as I normally did.

I can’t remember why I chose Thursday mornings for my meeting day, but struck gold. The members accepted and welcomed me with no hesitation to their casually fun meeting. It has made all the difference. They are a fantastic group of people who have carried me more than they probably know.

Having the surgeries allowed me to “skip the line” a little. I dropped 8 pounds while recovering from facial surgery, and 9 pounds after bottom surgery. Trying to lose that 17 pounds could have taken me 5-6 months. So I lucked out in that regard. Although, as one of my meeting friends stated this morning “You skipped the line, but then you had to toe it.” Even with those breaks it took a year of losing around 1 pound per week to get here.

So now what?

My job now is to stay within 2 pounds of my goal to remain Lifetime. I plan to do that with the help of my meeting friends. I also have to prepare to possibly gain some muscle weight once I start exercising again in full force. In many ways I feel like my challenge is just beginning.

This year has been a bottomless gift box of positive changes. I don’t know how 2018 will be able to hold a candle to it. I’ll have to figure out some more life goals I want to tackle.

My Next Surgery is Just Around the Corner, and a Bit More South(ish)

I’m preparing for my next major surgery. The date is May 19th. A mere 4 weeks away, and I can feel the nerves rising again. Meditation is helping. Also, knowing I made it through the facial surgery with minimal problems gives some comfort. My body seems to be OK with this stuff.

My facial feminization surgery on February 3rd appears to be a success. The healing is proceeding according to plan. I’m still uncomfortable (understatement), but things get a tiny bit better every day. I’m concentrating on eating healthy, exercising, and embracing patience. I’m pretty good at 2 out of 3. Wanna guess which one I suck at?

Discussing the next surgery is more complicated. It’s important to share the journey in case it can advance the conversation, answering some questions that are uncomfortable to ask. However, I also want to avoid putting too much focus on surgeries. I happen to be a trans person who not only wants these costly procedures, but who has the privilege and opportunity to access them. There are many ways to be transgender. I want to make sure I’m not adding to the impression that the paths I’m choosing represent the only correct ways. Please do not equate trans identity with genitalia. It’s not that simple. Also, these surgeries are covered nearly 100% by our Kaiser HMO plan. Without this coverage, it’s doubtful I would ever have the opportunity to do it at all.

I’m going to talk in generalities. If you want more detail, there’s plenty of info available out there. If only I had access to information when I was young. Would have saved me a ton of unhappiness.

“Someday I’ll get my operation”

Fall of 1982 I visited my sister Victoria at Western Michigan University, staying the weekend in her dorm room. The planned events included a Circle Jerks show and a few mood-altering substances. By the end of the concert I was obliterated by a combination of beer, pot and LSD. At some point I blacked out. I’m not sure how long I wandered around, but eventually the fog lifted and I came out of it. I was alone, sitting on the cement step in one of the dorm’s stairwells. I heard myself state out loud “Someday I’ll get my operation.” The echoing proclamation was startling. I knew about transsexual people and I knew about my own denied femininity. But at 18 years old I had not yet made the definitive and conscious connection between myself and that destiny. Not that I would admit. In hindsight I always knew, but I was a master of compartmentalization. A common trait among many LGBT people.

Saying it out loud broke my ability to deny it. I spent the next 24 years attempting to put that genie back in the bottle, but she wouldn’t go, the tenacious bitch.

A lifetime of self-loathing

Flash forward to now, skipping a lifetime of self-loathing and substance abuse. It’s not fun to remember how lost I was for most of my life. Only looking back on it from a happier perch can I admit what a difficult person I have been. Hatred of oneself heaps bullshit on everyone, not just the dummies who foist it upon themselves. If anyone reading this feels I mistreated them, I offer an apology. I was sometimes a total asshole.

Back in 1982, I guess I assumed one entered a hospital, had a “sex change”, and then everything changed. I didn’t yet understand the intricacies of talk therapy, hormones, electrolysis, and the billions of other details required to assist a gender transition. Maybe I can’t be blamed for my skewed ideas since they were mostly based on weird (and very rare) instances of gender transition in 1970s TV and movies. One of the first such stories I saw was an episode of Medical Center. Robert Reed (the dad on The Brady Bunch) played a doctor who is admitted to the hospital for “the operation”. He literally spent most of the episode dressed as a man and only appeared as a woman briefly at the end, after the procedure. She also seemed to have recovered very quickly, leaving almost immediately in a taxi. She was sad and alone, moving to a foreign country to live out the rest of her shameful life. It was all very dramatic, and depressing … and medically incorrect!!

Roberta

The first positive portrayal of a trans person I encountered was July of 1982 when I read the John Irving novel The World According to Garp. The movie was coming out that week so I read the book in advance of the release. The character of Roberta Muldoon was a regular (albeit lonely) person. She was loved and admired by the other main characters, and although she had a thread of sadness that maybe plays a little victim-y today, it was the first time I felt maybe … maybe … a transsexual person could have a life that wasn’t full of torment. A couple months later I visited my sister and those drugs at Western Michigan University and woke in a stairwell, Scarlett O’Hara-ing about “my operation”.

And I was correct. Go figure.

The surgery I referred to in that stupor was the magical one which changes male genitalia into female genitalia. Today, I know there’s not nearly as much difference between those structures as most people think. The reconstructive surgery is really just a reconfiguration. It’s not simple, but it’s not as outlandish as my teenage brain imagined it.

Surgery for better health and marriage

Since I assumed I would never have the opportunity (money) to get full reconstructive surgery, I began considering a less drastic (and therefore less expensive) procedure that would allow me to settle into a better legal and physical state. In 2011 I had a bilateral orchiectomy. The surgery would allow me to dramatically lower the dosage of estrogen I needed to maintain secondary female physical characteristics. I’ll have to take estrogen for the rest of my life, but the large dosage required prior to the orchiectomy put me at higher risk for health issues. Also, once complete, the surgeon would sign an affidavit so I could petition my home state of Michigan for a new birth certificate in my new gender. This, in addition to another legal document ordering recognition of my female gender by the state of California, would allow me to live legally as female. I would change all my paperwork, and marry Mark as a heterosexual woman. This was prior to marriage equality, so it was the only way we could marry.

To share or not to share

One of the dangers of writing about this is reducing myself to body parts. There’s so much more to being trans than facial structures and genitalia. In talking about it publicly, it’s hard to determine the line between necessary privacy, and being open so cisgender people understand the issues.

I’ve decided to write about it but I’m still on the fence about whether I’m doing more harm than good. I’m not connected to a wider trans activist community and perhaps this could be seen by some as doing damage of some kind. I’m trying to perform my own version of activism. Or I’m fooling myself. Hard to tell sometimes.

These surgeries are simply the cherry on the sundae of my transition. Most of the work of transition has been in my mind and the adjustments made by the world around me.

Until the last few years, making this journey seemed incomprehensible. Most of my life I stood before the edge of a massive abyss, devastated by the idea of staying where I was, but also facing an impossible set of obstacles to get to the other side safely. I don’t exactly know what I thought I meant in that stairwell in 1982, but May 19th is the completion of some arc, a promise I made to myself. There’s poetry in that.

Countdown to Facial Feminization Surgery

These days my life is all about getting ducks in rows as I countdown to my facial feminization surgery on Friday (February 3rd). As much as possible I’ve been staying away from public spaces in an attempt to remain healthy while also preparing for my mom’s arrival tomorrow. The photo above is the rented hospital bed in our living room, my recovery space for the coming month. I’m meditating every day to quell the substantial anxiety I feel when I think about the moment I’ll fall into a nowhere land of anesthesia. I’m getting exercise and wondering how it will feel to be bed-bound for a long period of time while also eating only soft foods. How will this throw off my Weight Watchers journey? Will I be able to get back on that horse when I’ve healed?

I have the instinct to contact people to say “Thank you for being part of my life,” as if it’s wise to say in case something bad happens to me. Everyone assures me I’ll be fine, but that tiny risk is always lingering, begging me to give it more weight than it probably deserves.

When my mom arrives we’ll start a whirlwind of practice runs and tutorials. Among many things, I need to show her the quirks of our washer/dryer and how to load and play podcasts on my phone in case my eyes are swollen completely shut for the first few days. For someone like me, who plans everything down to the finest detail, the mystery of how this will go is enough to drive me mad. Hence the meditation, exercise, and breathing. Always the breathing. We have a full docket of things to cover this week, and then it will be dark-O-clock on Friday morning and we’ll pile into the chilly car to drive 70 miles to the hospital in Richmond.

Half of me is prepared and excited. The other half is still holding back. A million What Ifs flood my head and I still hold onto a feeling of “I’ll believe it when I see it.”

Once I’m out of surgery my mom or Mark will post on my Facebook page.

Keep good thoughts for me!

SAG screener 2017 #2 – HIDDEN FIGURES

Last night we watched HIDDEN FIGURES. I liked it a lot. I didn’t love it, but I think highly of it.

It’s a little cloying. A bit cliché. There’s nothing wrong with clichéd elements, but they could have skipped a little quicker over some of that intro. Having said that, it’s an important story, and we were happy to give it two hours of our time.

Inspiring, obviously. Ultimately uplifting, obviously. No surprises, but pleasant and recommended for historical value.

It’s crazy to think about how recent this level of bigotry was an accepted given in this country. Mark commented, “This was two years before we were born.” It’s always stunning to be reminded of the inhumanity of the world we were born into.

The film is beautifully shot. Mark was distracted by the mismatch of the music, an odd choice of using a mix of authentic period music with new Pharrell Williams songs. The disconnect was especially vivid when the characters are specifically shown listening to contemporary music on the radio.

Emotional wallops and suspense

As one would expect, the period details are attractive and presumably authentic. The mixture of news footage and computer generated recreation melds well together.

It takes a while to get to the emotional wallops and suspense, but they come … and are satisfying.

I’m surprised Taraji P. Henson is not nominated. I might have voted for her. I liked Octavia Spencer’s performance, but I’m not sure it rises to the level I would expect for a best actress nod.

SAG screener 2017 #1 – FLORENCE FOSTER JENKINS

It’s that time of year again. This seasons’s SAG screeners are now on our TO DO list. January is already shaping up to be intense, marching directly toward my February 3rd surgery date. Mark and I have 11 films in total to watch before the end of January. Actually, it’s now 9. We saw ARRIVAL on the big screen when it opened, and we love love loved it. So layered and emotional. We might watch it again at home, but I don’t think I’ll write about it here. Last night, we watched FLORENCE FOSTER JENKINS (watch the trailer). We only had about 2 hours before I knew I would lose steam and need to take my weary self to bed. Most of the dramas are over 2 hours, so we chose this one since it fit into our available window of time.

So how was it?

Truth be told, it’s a frothy bit of nothing, although that is not a negative. It is what I expected and wanted at that moment. Also, is there ever a truly bad time watching Streep? (Hint: Not for me)

If you’re like my husband and are troubled by cringe-worthy scenes, there are definitely uncomfortable moments. Mark had to walk out of the room at least once. But it was a gentle cringe, quickly finished.

Certainly, it’s an interesting true life story about an odd and sad woman in a very specific social position at a very specific time. Aside from the spectacle of the performances, I’m not sure why a film like this needs to exist. Maybe there’s an important lesson about living life out loud. But it is lovely to look at, and goes down easily. It also doesn’t wear out its welcome.

And a spectacle it is, with Streep screeching through her singing scenes born from (I assume) the same level devotional study as any complex accent she’s presented. She is, of course, wonderful. Hugh Grant is also great, deserving of the nom alongside Streep. I’m disappointed Simon Helberg didn’t get some award recognition. He sparkles, vibrating with disbelief as he tries to figure out why everyone is pretending Florence is praise-worthy. But there’s also a sensitive arc which he handles nicely.

The film is hilarious, touching, and sad, with a production design that is lushly vintage and somehow contemporary at once.

I likely won’t be haunted by it in any way, but I enjoyed it.

My Face Will be Upgraded: Facial Feminization Surgery

Looks like I will be getting an upgraded face. If we believe the surgeon, I’ll still (generally) look like myself. But better maybe?

I’ve known about the existence of Facial Feminization Surgery (FFS) for about a decade. Once it entered my consciousness I have secretly dreamed of it for myself. But the tens of thousands of dollars out-of-pocket cost put it outside my realm of possibility. The idea of trying to save for something like that was impossibly Herculean and depressing. I tried to put it out of my mind and make the best of what I have to work with.

The financial obstacle was removed this year by our HMO, Kaiser Permanente.

For years, my husband and I avoided joining the HMO. We heard nothing but horror stories about the care at Kaiser. Even though I wasn’t getting trans-proficient care through my PPO during 2013-2015, I liked my doctor and we were working through it together. I had no idea what I might be up against trying to find a new doctor in a new healthcare system. So, we paid extra for access to our own doctors. That choice was no longer tenable at the end of 2015. On January 1, we joined Kaiser and hoped for the best. I assumed I would have to travel the 40 miles to San Francisco to find a doctor familiar with trans care. I thought there was no way I could expect anything better at Kaiser in our immediate area than the care I was already receiving.

What I didn’t know, and have spent all of 2016 exploring, is that Kaiser Permanente is wayyyyyyyy ahead of the curve in transgender care. In fact, I now have a primary care doctor I consider the best I’ve ever had. Kaiser is still finding their way, so not everything has been perfect. But they are committed to trans people in a way I never expected.

Mid-year, I was informed Kaiser was moving forward with Facial Feminization Surgery as a covered benefit (under our plan anyway). I consulted with their surgeon and waited for a date. I’m on the calendar for February 3, 2017. Unless something catastrophic happens, that’s the day. My mom is coming to help with my care, especially during the first week when I expect to be the neediest.

The goal of Facial Feminization Surgery is to tweak and alter the bone and muscle in the head/face of a person assigned male at birth to feminize that person’s appearance, altering typically male facial features to bring them closer in shape and size to typical female facial features. More information from Wikipedia

( I should probably say something here about feminism and self-imposed standards of beauty. Eye of the beholder. Skin deep. I’ll let you fill in those blanks. )

A tiny part of me feels like I owe the world an explanation/apology for my decision to have this surgery. I realize I don’t, but that feeling persists. I want to feel as settled in myself as possible. I want to be as safe as possible. I hesitate to expound upon the hardships of moving through the world while transgender. It would be vulgar for me to pity myself too much from my position of relative comfort and safety. Despite having lost male privilege, I still have lots of other societal privilege that insulates and protects me. My most malevolent demon has always been my own anxiety. The purpose of the facial surgery is to perhaps give me a chance to feel more in line with my preferred presentation and therefore reduce or eliminate that anxiety. Studies show this to be effective treatment.

When I mention facial surgery, some friends say stuff like “You look great. You shouldn’t feel badly about yourself.”

I do not feel badly about myself. I provide lots of self-care. Facial surgery isn’t about that.

I want this … Kaiser is offering it … so I’m going to do it.

Hopefully there will be before and after photos in the future I will be eager to share.

I Accidentally Co-Wrote a Musical Comedy About Britney Spears, and Then It Made Me Cry

I contributed a post to the new Stage Rights blog!

CLICK HERE TO READ