Recently I posted about my fear and anxiety around SRS. It was a long post, and I didn’t have time to fit in things I wanted to. Specifically regarding what I could’ve done differently to avoid these feelings, or at least help minimize them. So I’m breaking it up into two posts and what I’d have done differently with the benefit of hindsight is what this post is going to be about. I can’t promise that you won’t feel scared, anxious, or afraid. I can’t promise it’ll all be sunshine, roses, puppy dogs, and unicorns either. SRS is rough. Even the best prepared will run into their own struggles and personal fights to overcome. But you can prepare yourself better than I did. And one thing I can tell you without reservation is that I wouldn’t change a damn thing. Everyday I am just intangibly happier with my body and myself, even if the day is shit I’d still prefer to have a bad day today than that exact same bad day pre-SRS or pre-transitioning. And I know I’m not the only one who feels that way post-SRS (most girls I’ve talked to or interacted with have felt this way). So… here’s what I’d have done differently with what I know today.
Suggestion 1 – Self reflection and time to emotionally/mentally prepare
Probably the thing that would’ve helped the most would’ve been for me to have given myself time to mentally and emotionally be ready for SRS. This is kind of a nebulous thought, so what do I mean by it? Well, I went from being uncertain if I’d ever get SRS to waking up post-SRS in just a bit under 4 months. And the simple fact of the matter is I rushed things. I did this for my own reasons, but I shouldn’t have. By compressing the time scale down to a few months, I didn’t give myself time any time to really work through emotions I was feeling around it nor to mentally prepare. It meant I had to focus on logistics of SRS (work time away, letters, travel, booking, moving money, etc etc etc) instead. Emotional prep-work would’ve consisted of, for me, meditation time basically. Be it go to a scenic place and think introspectively, run/bike, take baths, etc. That said, honestly I think for myself I needed more time to process it. If my original date in Aug 2017 had been kept, I’d have been a lot more comfortable I think as a lot of that would’ve kinda worked itself out. Also, if you’ve recently decided to get SRS (i.e. within the past 6 months), give yourself 6+ months before getting SRS even if a date opens up. Other dates will open up (watch their calendar setting up alerts as I talk about in this post), promise.
Suggestion 2 – Have a boring life
Okay, so I am all for having a busy and exciting life. But make your life as boring as possible from about 1 month pre-SRS to 3-4 months post-SRS. I had a roommate moving out, while two partners moved in (the half the poly quad that didn’t already live here), big work projects, work travel, all the logistics of SRS, poly stuff (i.e. partners dating new people, which I’m all for and would never “veto” a partner starting a new relationship… but holy crap was it bad timing for me), figuring out finances for the next 4 months (as I tapped almost everything I had to be able to afford it at that point in time) to make sure I could pay my bills, etc etc etc. I was crazy. Coupled with points from suggestion 1 around not having time this made this exponentially harder. Try to get 1-2 weeks before leaving pretty calm at work. At least as calm as you can realistically do. If you travel for work, don’t that last month (once again, only if possible). Have finances all setup and money ready to send over (i.e. don’t scramble to find the money like I had to). Find arrangements for pets if you have them as well as house/apartment checkups/sitter as you can’t let mail go over a month (plus they can let you know if anything legitimately urgent happens). Don’t have people move in or out if you’re with roommates. Basically block about 4 months (-1 month through the end of 3 months post) and put them in a change lockdown (to use an IT reference). Try your best to keep things static through these 4 months. At least to as much as you can control. If you can’t do 4 months, the 2 weeks before and 6-8 weeks after are the most critical as your hormones will be in flux plus pain and getting used to recovery regimen.
Suggestion 3 – If you have a partner (or more), talk. And talk some more.
This is going to likely be a really stressful point in your life. Even for those who are resolute in their decision and haven’t questioned it at all, recovery can be hard. Your hormones and biochemistry have to adjust to the new “normal” which takes time. You might be kind of pissy/short/bitchy with partners at times. Or really emotional/depressed. Or just in a lot of pain. And there is very little they will be able to do to “fix” the problem(s). They’ll feel potentially helpless as well as potentially similar things to caregivers syndrome. So before going, when you’re both in good places talk about each of your expectations and build a framework for hot to handle things. In my case, I should’ve asked my partners if we could’ve not dated externally through this period. I’d also have asked them what will they need from me during this period (especially if they’re with me). They may need/want time alone so how could that work? If you’re in a lot of pain (I cried from pain through most static dilations I did because I tried avoiding pain killers… which don’t do that either… you have them take them per the clinic guidelines) they will be unable to likely help, do they want to be around for that or not if it happens? Is there anything they want to do/see while there? Your hormones and biochemistry will be out of whack when you return still as you’re off hormones about 10 days, then get SRS, your body will react to the lack of any hormones (you’re allowed to start 7-14 days after usually), then you’ll start them again. I was on HRT for 19 months when I got SRS. If you’ve been on them longer it might not be that bad for you, but for me it was very reminiscent of when I started HRT. But had the added issue of pain on top of that which makes it much more intense. If your partners are there with you or help you upon your return, make sure they know how much they mean to you. Don’t neglect them or their support and make sure their needs are being cared for as well.
Suggestion 4 – Take your damn pain meds*
I’m a stubborn bitch. I thought I could get through SRS without pain meds (beyond those handed to me in the hospital as part of the group of pills they just bring in). I didn’t want to risk getting addicted, plus I am kind of a masochist. I enjoy feeling my body healing after injuries. I’ve very rarely taken any kind of OTC drug like ibuprofen. I’ve actively avoided it. When I started HRT I actually struggled for a day or two before starting with having to accept I’d need to take pills for life because I’m that against it. This was a mistake. You’re recovering from some pretty heavy body trauma. It’s a multi-hour surgery. You don’t recover from those quickly and usually they aren’t pain-free experiences through recovery. I didn’t take tramadol for a while out of the hospital. And even after I started it was rare. It wasn’t until I got home that I started taking it more. Looking back on this it was stupid. Taking a tramadol twice a day wouldn’t have made me an addicted to it, although my body might physically have become addicted to it. But this can be done responsibly through simple stuff like limiting your dose, weaning off of it, only taking it when in a lot of pain or an hour+ before dilation (if they are painful), etc. Don’t try to “tough it out” or otherwise be stubborn. Pain management is a critical part of recovery. Don’t neglect it.
*Note – This applies if you have not been addicted to drugs or alcohol in the past and otherwise are able to take opiate based pain killers (or others that are equally strong). I’ve never been addicted to drugs or alcohol. If you have been addicted to drugs/alcohol, think you’re susceptible to becoming addicted, or otherwise have concerns around pain killers ensure you talk to the clinic about them. They have worked with thousands of patients and are experts in what they do. But you need to talk to them about your situation(s) and/or concerns so they can address them properly and safely.
Suggestion 5 – Be prepared for a culture shock if you’ve never gone to Southeast Asia/China
I have grown to really love Thailand through my experience there. But I’d be lying if I said my middle class, white, midwest self wasn’t thrown off balance and into a bit of shock at first. I haven’t been a minority really before. I have always empathized and supported equality for all regardless of race, religion, gender, orientation, etc. But, empathizing and being an ally are not the same as experiencing them. It took a bit to get used to. Try to get there a few days before surgery (3-4 would be good) to get acclimated to the environment. Walk around, get a feel for the food, area, culture, cultural norms, etc. Build this in to your trip.
Suggestion 6 – Notes from day of check-in to getting wheeled down to the OR
You’ll likely have a range of emotions, adrenaline, and/or thoughts the day before SRS. If you’re anxious tell the nurses/clinic staff. Spend time with people that came with, or talk to other patients who are recovering. Try your best to relax. Watch a movie, read a book, write a journal/blog entry, post an AMA on Reddit (asktrans for example), etc etc. Try to do something you enjoy doing and find relaxing. Be prepared to get hit with a lot of stuff through this point. From their psychologist, to anesthesiologist, to told to go to bed, to constant blood pressure/vital checks (IIRC it’s every hour or two) there’s a lot. Talk to the clinic staff or nurses if you feel worried about having anxiety the morning of. If you had somebody (or people) join you, they can come with down to the OR. Take the time you need with them. You’ll be a bit rushed most likely, at least I felt I was, but take the minute or two to hug them and thank them for being there. If you’re going through it on your own try to remember you’ve spent a long time getting to this point, and if you’ve done suggestion 1 then you’ve spent a lot of time thinking about it and getting ready for this point in time. Rely on that. Trust yourself that you’ve done your due diligence. When you go into the OR let them know you’re scared/afraid. The head nurse was amazing and will help to comfort you. Do your best to take deep breaths and relax. If you’ve done meditation exercises before, this is a good time for them. Everybody is different, but figure out what works for you to help calm yourself down. Practice it before hand.
Suggestion 7 – Prepare for the unexpected
I had flight delays causing me to miss my connecting in Tokyo. I had relationship things that popped up. I had unexpected culture shock. I had a ton of stress not being able to find the clinic staff in the airport (because I was on edge and didn’t read instructions well enough… in a similar vein as 6… calm down and read this stuff). I didn’t know if SRS would get canceled due to the issue with flights and stuff. I wasn’t prepared for my partner to leave. I wasn’t prepared for the pain nor post-surgical recovery having never been in a surgery before (well I was when I was <5 years old but I don’t remember it really). I wasn’t prepared for having no life upon return. I quite frankly just wasn’t prepared because I didn’t know what to expect. There are going to be potential hiccups during this trip/surgery/recovery. Try to plan for them. But when they come up take a step back, a few deep breaths, and try to regain control. Feeling like you’re out of control is a bad place to be and what I felt like through a lot of this. As though I was just holding on for dear life to the tattered remains of the harness I had on my life. If I had listened to the things I’ve talked about in this post I might’ve felt more in control and less helpless. This isn’t something to be taken lightly (as I effectively did). Plan, prepare, and execute that plan. When the unexpected comes up if you haven’t thought of that exact situation don’t just react (as much as possible). If you’ve ever been part of a project based team and worked in/with project management, this is very similar. You don’t change the plan when the unexpected happens. Don’t be reactionary like me. Prepare for this. It’s not worth it to rush through it or just “wing it.”
I can’t hope to begin to cover all the potential situations or things that could come up or how to prepare yourself specifically. I can provide my perspective and ways to have made the things I ran into easier. And hopefully it can provide a helpful basis for your own journey so you go into this from a strong place than I did. It helps in the months after while you heal to not have had a tumultuous journey through SRS. There is no way to know what post-SRS is like, especially through those first 2-3 months. Some things are pretty common, or will happen, like learning how to control your bladder (it takes some getting used to). Others, like partners moving in, might not be. So the more you can plan and prepare everything within your control going into it the better you’ll be coming out of it. It’s a once in a lifetime ride, try to make it the most enjoyable ride you can.
Edit: Oh… and one more thing… Even with every issue I ran into through this process there has not been a single moment that has gone by where I’ve thought, “you know… life would be better with a penis.” It hasn’t been easy, and I’m not where I want to be in a post-SRS life… but I wouldn’t go back to who I was or the body I had. This has unquestionably been worth it to me thus far and I have no reason to believe that’ll change one day.