Inside a body in transition…

Happy 6 months to Laine!!! Yes, this is week 26…officially halfway though the first year!!! I feel like we should have had cake or balloons or something after his shot this morning…but instead of throwing a party, lets talk about a topic that so many avoid…the reality of the health and proper healthcare of trans*men.

I am certainly not a doctor. I have no professional medical training. So everything mentioned here is strictly Laine’s experience and my personal opinion. That being said, I am discussing it simply because so many don’t discuss it and so many don’t realize it needs to be discussed.

When Laine began this process, there was a lot of research that took place regarding the effects of hormone replacement therapy (aka: taking testosterone.) There are the obvious effects, the public, visual ones such as the facial hair growth, the broadening shoulders and the voice tone drop. There are the not so public ones (unless you read this blog, then everything is pretty much public information) such as clitoral growth, and the excessive sex drive.

What most websites don’t tell you and what we have discovered even some doctors don’t stress enough, is how much is going on INSIDE a body in transition. There are effects that can’t be seen and maybe not even felt.

Laine recently changed doctors over this factor…he wanted to be sure there was nothing “hidden” going on, and his original doctor refused to test anything. Completely denied him and said it wasn’t necessary. Fact is, it IS necessary and fortunately Laine now has a doctor who is willing to listen to Laine’s concerns and is willing to spend the time and energy on full and complete routine checkups.

Here’s what we have discovered up to this point…

So far, the testosterone is not affecting his liver, kidneys or any other internal organ. This is a GOOD thing!!   He is just now at the 6 month mark of his transition. Keeping an eye on his organs, specifically the liver is important as testosterone can raise the risk for liver cancer, among other things.

For a 52-year-old male, Laine is overall healthy. However, there are a few issues he needs to focus on. The first is the fact that the testosterone is causing his blood to thicken. His red blood cell count is high and the cells are overly plump. The first step to attempting to combat this issue is blood donation. He will start with giving blood once every 8 weeks, through a blood donation program. If this doesn’t keep his count down far enough or long enough post donation, then his doctor will set him up on a medical donation process more often, possibly monthly.

The second issue is that his body is still in limbo. His testosterone numbers are through the roof, and his estrogen (the female hormone his body biologically makes) is still functioning at a totally normal level, with no sign of decline. This is confusing for his body…physically, mentally and emotionally. Basically his two sets of hormones are at a constant battle with each other. This can cause mood swings (think mellow testosterone based mood one moment, pms style estrogen mood the next….basically 0-60 with the snap of a finger…and then back again.) It causes some cramping and physical discomfort from time to time.

His doctor really wants to see the estrogen numbers start to drop. Based on our personal research and information from different “FTM guides,” six months is about the time this estrogen should start truly dropping. That also means this is about the time that biological female organs such as the uterus and ovaries should be shutting down. Were not really certain what is going on with Laine’s uterus. Based on hormone numbers, it should be fully functioning and cycling monthly. (He isn’t even showing signs of female menopause) However this isn’t the case, there has not been a visual cycle since May. (Which is fortunate from a mental standpoint, it means not having to struggle with the disconnect of being a male with a monthly period.) From a physical standpoint however the doctor can’t explain why the numbers read as they do, but nothing is happening. It could be a handful of things, some of which do lead to a full hysterectomy, possibly in the near future. We will have more answers in December when the blood tests are repeated and we look for a decline (hopefully) in the estrogen.

***PSA***

For trans*men who still have the biological female organs, they have to be sure they are not ignoring those parts of their body. Transition and living as your authentic self does not lessen your risk of cervical cancer. It doesn’t remove the need for pap smears and exams. Your uterus doesn’t just go away when you transition. It is almost shocking how many FTM individuals stop caring for this part of their body after beginning transition. Unless those parts have been removed, you have to take care of your whole body! Transition itself doesn’t change that.

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Today’s post is brought to you by the letter “T” for TSA, Travel, and Trans*

TSA security checkpoints at the airport can be quite the experience no matter who you are. Heck, just a few months ago on the return flight home from the Philadelphia Trans Health Conference, I was flagged at TSA for explosives on my hands after a random swab sweep. One full body groping, a complete bag search and 15 minutes of my life later, I was cleared to go based on the determination that my hand lotion is what flagged the system. Fast forward to this past weekend, we flew to and from Las Vegas and my anxiety was a bit extreme. This time the anxiety was not for me, as I made a point to skip the lotion and let my hands go dry to avoid that fiasco again. Instead, my anxiety stemmed from this being the first time Laine would be flying as legally male.

We see and hear horror stories all the time about TSA agents being disrespectful to the Trans community when passing through security. I am in NO way saying all TSA agents are jerks, because they are not…keep reading for proof that is in fact not the case at all!! But being the protective partner that I am, any possible risk of threat puts me on my toes.

Leaving Phoenix, I passed through the full body scanner and was cleared to proceed on. Then Laine walked into and out of the scanner, while I waited a few feet ahead near the conveyor belt where I needed to pick up my purse. The older woman working security begins frantically looking around, and asking the other guard, “Where did the female go?” “How did I miss a female?” Meanwhile Laine is standing in front of her waiting for clearance. I didn’t even realize what was going on until I finally processed what Laine was saying to the woman. He had to explain that he IS the female body that she is looking for and he is a Trans Man. The woman gave an embarrassed apology, did a quick hand sweep to the chest due to the fact that Laine’s binder flashes on the screen as an abnormality, and we were on our way to Las Vegas.

The return flight home followed along the same path. The lines at the Las Vegas security point were very long and Laine was calmer than I was waiting for our turn. This time I again went through security and waited for Laine who was behind me. This time he came through the scanner and the woman working the scanner immediately apologized, saying she “figured it out too late and was sorry she didn’t change the settings on the machine.” Again the binder had flashed yellow on the screen and again a very brief hand sweep was performed. The TSA agent was super respectful and friendly about all of it.

I’m quite certain it helped in both situations that Laine remained very calm, and respectful towards both agents. Of course both agents were quick to apologize and were respectful of him as well. I know this isn’t always the situation, so we are relieved he ended up with the individuals he did.

After this happening a second time, where the agents see Laine as male but the machine sees female, we started doing some research. I haven’t fully figured out how the machines work, but from what we have learned it looks like the agents select male or female setting based on their assumption of your gender. Notice I said assumption…we all know where assumptions can land us… The fact that Laine is fully passing as male is certainly pretty freaking exciting, but the fact that these machines read an individual based on what another human’s assumption is…could (and does) lead to problems. After reading more we learned that these machines commonly detect binders and packers, leading to possibly awkward situations for both the individual and the agent. For MTF patrons, if an agent selects female and bottom surgery has not been performed…guess what…that nice yellow box is going to flash on the screen.

I found some great information from the National Center for Transgender Equality about knowing your rights when traveling. These tips and the information provided are great to read and know when flying and interacting with TSA.   If you haven’t already, check out their page here: http://www.transequality.org/know-your-rights/airport-security

Laine Changes…

“Understanding is deeper than knowledge; There are many people who know you but very few who understand you.”  Laine and i continue to share our story with the intimate details that we do, for the purposes of education, awareness, and understanding.

When this process (I say process because of what I am about to explain here….) began at the beginning of this year, close to 10 months ago, the conversations included a list of details that Laine wanted and didn’t want to include in this transition process. In more than multiple conversations I reminded him to “never say never.”

It started out as social presentation only. The female clothing would go away and he would transition to a closet full of male clothing. Pronouns were uncertain, a name change was far off into the future if ever and HRT was of no interest. (Note: we are 10 months post original conversation….pronouns are all male (he, him, his), his name and gender change has been legal for exactly one month now, and he’s 22 weeks into HRT)

In February, at the mere beginning of this journey, at the HRC Arizona Gala we listened to Dr. Bobbi Lancaster give a speech that left Laine in tears. Dr. Lancaster’s authenticity and honesty were inspiring. I saw something in Laine’s face that night that told me the journey wouldn’t stop at the suit he was wearing that evening, I don’t know if it was hope, or him being honest with himself, but within weeks he went from a long list of “no and never’” to a list full of “yes and maybe.”

One of the first big changes from no to yes was HRT. (Hormone Replacement Therapy…aka: Testosterone; otherwise known in our house as “boy shots”) After researching and reading, Laine decided he did indeed want to follow this path as a part of the journey. This is a medical, life long path. It isn’t one to take lightly. However it is the one that leads to physical changes, the changes that allow Laine to truly present as the man he is. Because of the T, he is growing facial hair, he has developed masculine shoulders and arm muscles, and his overall physical presentation is socially seen and accepted as male.

Top Surgery has always been a must. Even when Laine lingered in the Gender Queer space for just a moment, he has always been adamant about Top Surgery. The boobs, they have to go…his words not mine. Below the belt, that is another story. First, let me tell you, if you don’t know about the surgical options available below the belt, it truly is fascinating the things they can do down there. I have sat through presentations given by surgeons and seen many photographs of the options available…its pretty amazing. If you are curious and have no idea what I am talking about, Google Brownsteincrane.com and check out their website. They do have photographs so plan your web searches accordingly…I’m not certain your boss will be open to your explanation if your web browser history brings up photographs of a metoidioplasty or a phalloplasty during your next shared screen office presentation.

Bottom surgery started out on the “No” list. It has since moved to the “maybe” list. T shots can (and do) change that entire area down there, and it can take a few years of being on T to reach the maximum effects of the T alone. Therefore surgery of any kind (down there) would not happen for a few more years. Currently only the most minor option is on the maybe list, with the most inclusive surgery still on the “No” list. But like I said in the beginning this is a process, each day takes us one more step further ahead on this journey and thoughts change, wants change and needs change along the way.

Just as recently as June, at the Philadelphia Trans Health Conference, multiple vendors had STP (Stand to Pee) and Packers available for sale. We walked up and down the aisles of tables multiple times that week and yet none of those items were appealing to Laine. I offered to stop and look at some with him, questioned if he had any interest. The answer back in June…No, nada, none what so ever. Yesterday he came home to me as excited as a kid in a candy store his eyes all lit up, because he had been searching online and found “THE one.” I didn’t have any idea he was even thinking about this path, so it immediately intrigued me and I didn’t have to think twice about being supportive. We shopped online together and the order was placed. He later told me thank you for being open to placing that order and he was sorry he keeps changing his mind about these things. I reminded him I have told him since day one, never say never and that I knew these list flops from no to yes are expected as this process progresses. I also told him I wont tell him no to any of these changes along this journey, ever…unless he decides he wants a different wife…then we WILL have a discussion! 😉

This process is not one set in stone. It doesn’t have a defined right and wrong path. There is no given order or list of “you MUST do this.” What an individual in transition wants or needs today, might not be the same thing tomorrow. Those of us watching the transition from the outside, have to be open to these changes and these options. They might appear at any time. It isn’t fair to ask someone in transition if they plan to do “X” and then in 3 months if that answer is different, we can’t hold it against them. They aren’t lying to us. They are still figuring this whole journey out, and it is a never-ending process. They have no choice but to be flexible in their thinking and they need us to be flexible in ours. Support what they want and need today and if it changes tomorrow, embrace those changes along with them.