Reflections of the First Year

One year ago we were impatient and nervous to inject that first dose of testosterone.  We knew it wouldn’t change anything over night, but we truly had no idea how much it would change our lives over the next year.  My hand shook as I pulled back on the syringe to measure out the clear liquid.  I was cautious and strategic in my actions, making sure I was doing every thing exactly as the pharmacist had explained to us.  This morning I did the same, for the 53rd time…only this time I was groggy from just waking up.  No longer nervous, the steps have become a Thursday morning routine.  A routine I have perfected, almost able to do in my sleep.  I know the 18g needle is used to draw up the liquid, and there should be no air in the syringe which would prevent an accurate measurement of .5cc.  I know to change the needle out to a 21g before I inject. I know how to check the injection site for any signs of a vein or prior bruising, wiping with alcohol as I inspect.  I know what it should feel like when I push the tip of the needle straight through his skin and into the muscle.  I know how to hold the needle steady and how to avoid making him bleed.  And I know that next week we will do it all over again.

That first dose, and the 51 others which followed over the past year have changed his life.  They have changed OUR lives.  In some way or another they may have even changed the life of everyone reading this blog.  That is why I document this journey, because everyone is impacted in some way by it.  I don’t say that from an egotistical point of view, I say that because transition affects everyone we come in contact with.  This is something I didn’t know would happen when this journey started.  From doctors and nurses, waitresses, strangers, friends and family, acquaintances and silent followers, everyone we have stopped and taken the time to interact with, to have a conversation with, or who reads this blog and returns time after time, has been affected by this journey.

I could write a page, or ten, about this past year…but you always get to hear from me.  This time I feel it is most appropriate to hear it directly from him…and he is finally ready to break his silence.  The following words are written by Laine, they are his real, raw and honest reflections of the first year of this lifelong journey.

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With my 53rd injection this morning, today marks day one of my second year of transition.  I got up this morning and I shaved my sparse facial hair.  Yes, it’s finally growing at a rate where I need to shave every few days for work.  I can’t believe it’s already been one year since I began masculinization hormone therapy.  During the first chapters of my journey, I was so impatient, time was moving slowly and I was beginning to think I would never have any facial hair or be referred to as sir by anyone, ever.

Someone recently asked me, what’s been the best part about transitioning so far.  It’s the incredible confidence I feel in being authentic and true to myself and coming out at work. Thanks to my awesome therapist, I understand and have embraced that my transition has never been, and will never be, JUST about me.  And I’m speaking only for me.  My transition has affected almost every single person I have interacted with since coming out in early 2015.   Looking back, I remember being so worried about how I was going to come out at work and struggled a bit with where to begin.  I should have known better considering the amazing company I work for and their commitment to diversity and inclusion.  While I did struggle with some of the steps for coming out at work, I understood the need for the approach and more importantly the value and am extremely proud to have worked for this company now for almost 30 years.

Then the next question was, of course, what’s been the largest challenge.  The highs and lows.  I wish I could tell you the last 12 months have been completely filled with confidence and happiness and all that is good.  I am not going to tell you that lie.  The lows were difficult and happened way too often. Prior to beginning my transition, I viewed myself as having myself together on most days.  And if I didn’t, at least I appeared I did.  I should have known with that very first, and surprisingly intense hormone crash, less than 2 weeks after my first testosterone injection, this was going to be one of the biggest, if not the largest, roller coaster rides of my life.  Even with all my change management experience and managing change risk, I wasn’t as prepared as I thought I was when it came to knowing and understanding just how testosterone was going to affect my body, my mind and my soul.  My therapist, Dianne, and nurse practitioner, Tracy, have had, and continue to have, a crucial role in helping me navigate the storm within me.  Dianne, as a very experienced and knowledgeable care provider for the transgender community, quite frankly didn’t accept any of my shit.  I am not a fan of therapy at all, but as my session draws near each month, I actually look forward to it and evaluate my experiences since the last session to identify what we need to address.  There is always something that needs to be addressed. I truly can’t imagine not having Dianne along with me on this journey.

And then there’s Tracy, my nurse practitioner who has a passion for what she does and while not highly experienced…yet… in providing transgender care, her commitment to my health and my well-being surpasses every single doctor I have had care for me…EVER.  Her willingness to listen to me and acknowledge my concerns is a dream come true when it comes to a medical health care provider.  She spends time talking to me and getting to know me. Being her first trans man client, I am honored to work with her and to know she wants only the best for me and will spend endless hours researching, reading and asking questions to ensure I am getting the best care possible.  Some may say I’m foolish, but to me, she is a gift.  Every three months I get my labs drawn and we review results.  This approach has allowed me to avoid medications to address concerns with numbers for blood pressure, red blood cells and diabetes.  It also allowed us to identify the growth of fibroids that had remained unchanged in size for years prior to starting testosterone, which then led me to a complete hysterectomy in March.  During my hysterectomy surgery experience, I found myself again working with care providers that had no experience whatsoever with trans men.   And again, they listened, they understood and hopefully they learned.  Throughout the last year and all the health providers I have chosen to interact with, I have not had a single bad experience.  And most have never had the opportunity to provide service or care to a transgender individual.  I found by choosing to be open and transparent, my experiences always yielded a positive result.

My support system has been and remains incredibly exceptional at work and at home.  I work with the most amazing people at work and I am so grateful for their support.  But I truly now need to shift my reflection and appreciation to the woman in my life who has endured it all; the good, the bad and yes, the ugly.  She has had to process the mood swings from lover to bastard so many times that I sometimes question how it’s even possible to love someone that deeply. But she does love me that deeply.  She never gives up on me even when she says she does in a moment of anger.  You all know her as Melanie, my fiancée.  To me she is my everything every day; my therapist, my care provider, my partner, my friend, my lover, my heart and my soul.  Without her, the last 365 days would have been unbearable at times.  And while I made many of those days unbearable for her, she has remained steadfast and unwavering.  Don’t’ get me wrong, she had days where she just wanted to give up on me.  Hell, I wanted to give up on me. I know there are many transgender individuals who would do just about anything to be loved by someone the way she loves me.  And to be loved like that during transition, it’s so rare and exceptional.  For that reason, when I step into behavior which is not reflective of the man I want to be, I only have to remind myself of how wonderful my life is and just how lucky I am.

To sum up my first year of transition, I’m the happiest I have ever been.  I wish I could find the words to share what it feels like to finally live my life as the real me.  Those words are elusive at this time, but the confidence is growing, the self-esteem issues are decreasing and I am working on making mirrors a place for affirmations versus self-degradation.

For now, I am looking forward to my upcoming top surgery in June and have high hopes this will help me eliminate any remaining negative talk and be the last obstacle standing in the way of Melanie and me embracing our dream to travel and educate others through the sharing of our story.

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Recovery…

In an early episode of Season 3 of Grey’s Anatomy (yes, I am JUST now getting around to binge watching Grey’s and yes, I have become an addict…who isn’t?) McDreamy tells a patient’s wife to be patient with her husband’s recovery from brain surgery, recovery takes time.  I connected with this episode as I happened to watch it only a few days’ post Laine’s hysterectomy when I was exhausted, easily irritated and even a bit cranky.  It reminded me I need to be patient, this too shall pass.  The nights wont always be short with very little sleep, the days long with too much to accomplish and too few hours to complete the tasks.  The recovery period is temporary…or is it?

The surgical recovery period is listed at 2-6 weeks.  Only a blink of time in the big picture.  With each passing day his body will regain its strength.  Each night the pain will subside a bit more and allow for longer periods of sleep.  Eventually he will be able to return to normal daily life, the routine of work, kids, life; the surgical recovery will be behind us.  Recovery however, has only just began…

This entire past year, has been recovery.  Recovery from the first 52 years of his life.  Recovery from living a life as someone he was trying to be instead of who he is.  And I have to remember that recovery takes time.

Research studies have looked into the effects of recovery on a partner or spouse, (and yes, I skimmed a few via Google,) most of them refer to cancer, open heart surgery, major rehabilitative conditions.  But recovery is recovery and no matter the condition, the spouse is silently in the background as the caretaker and the effects are the same.  Let me insert right here, that I am not telling you this for sympathy.  I am not writing this to make you feel sorry for me, or to put myself as the center of attention.  I am writing this because people from all over the world read this blog and someone, somewhere is in my shoes.  If I can let that one person know that they aren’t alone, then I have done my due diligence today.

As spouses, fiancées, significant others, we are within the core of our partner’s transition, their recovery.  We are there to pick them up on the bad days.  To kiss their wounds when someone mis-genders them at the wrong time and place and to assure them we truly see THEM, even if someone else doesn’t. We are the ones standing silently, teeth gritting when an unaccepting parent consistently feels the need to tear down our partner’s confidence with a reminder of their birth given name and/or gender.  We are the ones getting looked at like a crazy person when we say “HE needs more ice water” because the hospital has him listed as FEMALE on all the surgical paperwork because he is admitted for a traditionally female procedure, even though his legal documents and insurance list MALE.  As the partner, we are the ones who attempt to educate the ignorant medical staff on some level as to why testosterone is on his medication list.  As the partners, we scoop them up and take them home with us post surgery and we tend to their needs, both physical and emotional.  The physical needs dissipating much faster than the emotional ever will.

We have been there for the hormonal crashes and fluxes since the first shot we helped them inject.  We have sat through doctor’s appointments, taking mental notes and trying to recall the questions which have arose in casual conversation at home.  We have watched them break down and doubt themselves, their decisions, this process.  We have stood back and waited for them to come to their senses and realize we are here to support them, not to fight against them.  We are the good guy, and even when they try to push us away we will be right here beside them. We want to protect them; we want them to be happy.  We want to make this “recovery” as easy as possible for them.  We just want to love them and be sure they know just how much.

As a partner of someone who is recovering, we get tired.  Some days it is exhausting.  Some days we don’t know HOW to fix them.  Some days we can’t piece them back together, fact is some days we are barely holding ourselves together.  And because of this, some days we feel like failures.  We are supposed to be the stable one holding them together through this recovery.  We don’t have the time or space to fall apart ourselves.  People ask all the time how transition is going, and when they do, they mean for him.  How is he handling the hormones?  How is he handling the changes?  When is his next surgery?  I can’t think of a handful of times where someone has said “How are you holding up?”  And I don’t expect them to.  If they did ask I think I would feel awkward, and I don’t think I would say very much more than “I’m good.”  Because that is what I am supposed to be.  The few times I have reached out because I just needed a moment to breathe, to put my walls down…it was reciprocated with “be patient,” “give him credit,” and “he is dealing with a lot of emotions right now.”  As if I don’t do these things every moment of every single day.  I give him more credit that anyone can probably even imagine.  I am so proud of him it is immeasurable.  Yet there are days even he doubts this, and that is a part of this recovery that I can’t protect him from.

I can shield him from the outside world as much as possible, but I can’t shut off his inner thoughts.  His inner doubts.  I can correct the nurses’ pronoun usage until I exhaust myself, but I can’t erase the dysphoria caused by a traditionally female medical procedure.  I can’t fast forward the physical recovery and speed up the internal healing process which leads to external reminders of the anatomy he was born with every time he has to stick the maxi pad in his boxers.  This will eventually pass, but the emotional recovery will continue…52 years to recover from.  Recovery takes time, and I have to be patient.  One day at a time.  I’m good and I will continue to be.  Even on those days I am extremely tired…

Did You Miss Us???

It has been weeks, ok more like months, since I last sat down to type.  Some of you have even reached out to see if we are doing ok, since you haven’t heard from me in awhile.  The answer is yes, we are good…we are more than good, we are wonderful!  I can only blame my absence partially on writer’s block, the rest I have to blame on life.  There are never enough hours in the day, and by evening after the kids are in bed all I want is a glass of wine and quiet time with Laine.

Our biggest current piece of news is that the home we were building, which was projected to take 4-6 months to build and estimated to be move in ready around February…we moved into it two weeks ago.  Much to our surprise, the week of Thanksgiving, I opened an email that informed us we would be closing before the end of 2015!  Bittersweet. (NEW home SOONER than expected…YEAH!!!  Moving ONE week after the holidays…ummm…really???)  This meant the house we were currently living in needed to be prepped for sale and put on the market.  (Anyone here ever had four kids home on winter break, while trying to keep the house spotless just in case a potential buyer wants to drop in…I don’t recommend this process.)  We are still waiting for that house to sell, but we are all moved into OUR new home and life here is good.  (It is even better now that the 4 dogs figured out how to use the doggie door we had professionally installed…if I had to listen to them chop a hole in our brand new wall to put the damn thing in, the least the dogs could do is USE it without me tossing them through it!)

Dead in the middle of the holidays, packing, moving fiasco, we had to suddenly deal with every parent’s (Ok, at least THIS parent’s) nightmare…LICE!  Our oldest daughter (11 years old) came to me one evening saying her head itched.  I thought very little of it due to the fact that her beta blockers have always caused quite the case of psoriasis on her scalp.  So I started checking her scalp thinking I would need to get a treatment for her psoriasis in order to stop her from scratching her scalp…and then I saw it.  A little tiny brown bug in her hair.  WTF?  So I dug deeper…I said a few choice words…and then I freaked out.  Full blown case of lice!  AGH!!!  This discovery took place after the other children were in bed asleep, so I took my phone as a flashlight and started performing scalp checks on the other children.  Our son was clear, but both of the younger two girls, carriers as well.  I said a few additional choice words and then began rapidly Googling.  I left a message for the Lice Knowing You in Scottsdale and hoped they would call me first thing in the morning, preferably before the mommy melt down set in too deep.

We couldn’t do too much over night so the next morning began the process of washing and hot drying EVERYTHING!  And anything that could not be put in the dryer went into the freezer for 24 hours.  I haven’t ever done that much laundry in a single day before in my entire life!  Fortunately, the girls at Lice Knowing You called me by 8:30 that morning (keep in mind this is December 23, meaning Christmas Eve festivities were scheduled with family the next day…I had to get these kids cleaned and cleared or else Christmas was going to be shot to hell.)  The girls at the shop got ALL of us in within an hour or two.  All three girls were treated and our oldest, myself and Laine had scalp checks just to be sure we weren’t carrying any stow-a-ways as well.  (This isn’t a cheap service by any means, but it was well worth it, since those girls stand there and comb every single nit and louse from the kids’ heads and then guarantee their work for 30 days.) Due to the fact that the kids all have split schedules between our house and my Ex’s homes (two go one direction, two go another) that meant three households total had to be checked, cleaned and cleared of these pests.  (Oh and did I mention we also shared our lice with the neighbor who is like a sister to our kids…sorry Jess!!!)

Here we are almost a month later and the youngest has an outbreak at Preschool.  I had to go pick her up early on Tuesday due to the fact they found some nits in her hair during a random classroom check.  Thank goodness for that 30 day guarantee at Lice Knowing You!  Even though it wasn’t their fault the suckers came back, they still treated her again free of charge.  I found out later that 5 other kids also got called for pickup this week just in her class.  And 5 classrooms total right now are red tagged with Lice infestations.  Have I mentioned I would homeschool if I would have been given the gift of patience and a higher (or maybe it would be considered lower) level of sanity???

Laine’s transition is progressing smoothly overall.  It has its ups and downs, and fortunately there have been more ups than downs.  I could sugar coat it and tell you that it is always 110% perfection, but that would be lying.  If you are here reading this, then you probably want the truth and the facts right?  There are moments, and yes sometimes even a day or two at a time where Laine falls into a dark place of self doubt and frustration, one that I don’t and won’t ever understand.  Those days I feel helpless because I can’t always bring him back as quickly as I would like.  I have to give him the space, yet the support, he needs in order to pull through those moments.  Somedays I am better at that combination than others.  Space is a hard thing for me because I want him to always be happy and present.  When he falls into those dark moments I just want him back NOW.  Hormones are powerful, they change how he reacts to life.  They create mood swings and sometimes inconsistencies.  It is no joke when they say the first year of transition is comparable to being in puberty.  Watching it happen from the outside, I can see the moments Laine swaps from a 52-year-old man to a 14 year old teenager and back again.

Some of this hormonal conflict may be due to his Estrogen levels still fighting his Testosterone.  At his doctor visit this past week we got results from his most recent blood draw.  The blood results showed us that yet again his estrogen isn’t shutting down.  His doctor expects that his body should be in a forced menopause by now due to the testosterone, however its not.  There is no monthly physical cycle, but hormones are still functioning at a normal “female” level.  (In conjunction with a normal “male” range of hormones as well.)  Between those results and the results of a recent abdominal ultrasound where two fibroids were found to have grown in only 6 months’ time, he has a consult with our GYN next week.  (That appointment right there should make for a great blog post…although our GYN is totally on board with the transition process and she understands it, there is always the staff we have to explain things to 15 times, beginning with the receptionist on the phone when I called for his appointment and had to explain the legal name change since last visit and the girl still continued to call him “her” and “she” a dozen times…stay tuned for that potential circus.)  We are discussing a full hysterectomy.  Laine’s is looking to be medically necessary, which means insurance will cover it, which is a bonus. Everything else reported from the blood draw looks good.  His blood donation every 8 weeks is keeping his red blood cell count at a normal level and preventing it from getting too high.  Being on the T, there is still always the option that the levels will rise and he will have to donate every 4-6 weeks (or more often) instead of every 8 weeks, but the doctor has already said she will write the script for this procedure if we decide its necessary in the future.  All blood tests will be repeated in 3 months to continue to follow Laine’s overall health.

Therapy has been very beneficial for Laine throughout this process.  Laine has learned how to better cope in those (hormonal) moments and for the most part how to redirect himself when his hormones get the best of him.  This is part of the reason he has remained loyal to therapy on a monthly basis instead of only completing the bare minimum required per doctor’s requests.  I can’t imagine how others navigate this process without that monthly (or more often) check in with a professional.  He always seems to come home after a session with a new outlook on things.  She gives him things to think about and new ways to process.  She is real with him when he needs to change his thinking and look at things from a different perspective.  Changing your life and everything about yourself at ANY age must be difficult.  At the age of 52, the life experience which is built up can only make it more difficult.  Although I have always had a therapist aversion, if I could clone Laine’s therapist and give a copy of her to everyone, I would do it.  She doesn’t fit in my past experience mold of therapy and counseling and I’m so grateful she is a key player in Laine’s transition process.

Ending this post on a happy educational moment story, Laine needed a notary to transfer some paperwork to his daughter about a week ago.  The paperwork was under his birth name.  We weren’t sure how the notary would deal with this issue and if it would indeed BE an issue.  So he took the paperwork, both his old and his new ID, and his legal name change document with him to the notary.  The first thing the man behind the counter said when Laine placed the document on the counter was “Who is Joyce?”  Laine then had to “come out” and explain the situation.  The guy behind the counter, who was a retired PD office, was very cool about it and said “ok, lets figure this out.”  Laine was the first transgender individual in which he had an interaction like this with.  It was an educational experience for the notary and it was an educating others experience for Laine.  All it takes sometimes is one simple conversation to educate others.

This only begins to touch on the past two or three months of our lives, but I figure this is enough of my rambling for today.  🙂

 

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.