Tomorrow will be my two years post op from top surgery. I did not die from it which could be hard to believe since I haven’t updated this in two years. Life has still happened in the meantime but I just got away from coming on here. I never backed away from the transness of it all but top surgery did make me more at ease within myself and bought me some time to decide on the future. I do not wake up every day with top dysphoria. Getting out of the house is not a chore of wrestling into a binder. I just put on some clothes and can be out of the house in 5 minutes if needed.
When I get the time, I plan to add posts of significant events from the past two years. I kept up with taking pictures of my chest for several months post op and wrote my thoughts down at the time. A lot has happened for the good in the past two years and there have been some hangups. I plan to start blogging again and hopefully will keep it going this time. There are some big decisions coming in my future and I hope the decisions that I do make will be the right ones.
It is done. I now have my top surgery letter. Now to contact Medalie and get scheduled. I have chosen to publish it in its exact words as when I was looking for examples of letters I couldn’t find any. Hopefully this helps someone who needs to help their therapist write one.
Attn: Dr. D Medalie – Cleveland Clinic Ohio. US.
The above client is a 21 year old female to male transsexual, who currently resides in ____ Ohio USA he has been a client of mine since early August 2013. During that time we have spoken online and used various forms of communication. He chose this form of counseling due to convenience and not being able to locate a suitable resource in his local community. Currently he works throughout the night and is employed as a retail stocker.
Alex feels his gender issues have been with him since he was quite young. At this time and since the age of 18 he has had to bind his chest every day and feels uncomfortable doing such physical thing as it makes him restrictive and difficult to breath. Having to do such a thing regularly makes him feel that he cannot be his true self and do normal things. Over many years he has continuous felt stifled by the dysphoria he has suffered and how he is perceived by others daily.
His life was overall good at home until he started to experience difficulties and conflict both at school and with his mother around puberty and entering High School; he was continually picked on marginalized and bullied. At the time he was totally unaware of the nature of his gender dysphoria and its related issues. Entering and going through puberty made him feel extremely uncomfortable about his body and female persona. It was sometime after that when he realized that it was due to his body’s gender development. Although during his period of education he continued to be a good student with grade A’s and was actively involved with clubs and activities. He though eventually fell out of classes during the 11th grade and finished being home schooled.
Alex has a difficult relationship with his mother as they do not speak about personal things often. He does not see his father who left the family home some years ago. He has a few a few friends and goes out with them occasionally. However, at this time he is more focused on working hard to pay for this surgery. He obviously due to his anti social work hours does not always have the opportunity to see friends.
Throughout his life Alex has suffered an acute lack of confidence due to his dysphoria which has increased over the years. He states that he has developed into a private and closed person who finds it difficult to speak about things related to his feelings and life in general. He believes that personal things are not necessarily other people’s business and is fearful about what they may do with the information they gain. He politely asked me to consider this throughout our sessions which I have endeavored to respect. My concentration has, therefore, been focused on the gender related dysphoria he has encountered and suffered over many years and I have no doubt about a diagnosis of transsexual male
Alex is medically well. In the past he has had Wisdom Teeth removal, Gender Dysphoria, and personality problems
Alex in my opinion meets the diagnostic criteria for Gender Dysphoria he has started to transition as male and has developed a support network amongst friends and to some extent his grandmother. His records indicate that he is physically and emotionally healthy, with no evidence of psychopathology or impaired judgment. He is aware of the benefits and potential risks of surgery, and feels prepared to undertake this important step.
The author of this letter is an independent gender specialist and psychologist registered through the American Counseling Association and The Psychological Association of the Philippines, and registered in the UK who is fully qualified and has consulted Alex weekly over the past weeks. I believe that he will have a better quality of life living as a transmale and undergoing chest reconstruction surgery will only enhance that further.
Alex has chosen to follow the standards of care as he has done so in the past. After reviewing the evidence and facts chest reconstruction surgery is the next logical step in his treatment and should relieve much of any remaining dysphoria which has accompanied his Gender related concerns over the years.
Alex is now psychologically ready for this next step of his transition. I therefore have no hesitation in recommending Alex ____ for chest reconstruction surgery. He has met all of the eligibility criteria outlined in the Standards of Care for the treatment of transgender individuals. If you have any questions do not hesitate in contacting me.
Dr. Graham L Peveller
The past week has comprised of contacting the surgeon who will preform my top surgery. Along with talking with my grandmother of the steps that will occur. Initially Dr. Steinwald has quoted me $6000 for the surgery plus $2400 for the OR cost. That is on the low side of his costs. There will also be plane fare and hotel fare to worry about. I am slowly getting it to come together but it will take time.
I should have enough money from my job to afford almost all of the procedure by January. Dr. Steinwald accepts Care Credit, which I will use to the max so I’m not completely broke. He wishes to talk to me on the phone yet but I need to compile a new list of questions since he just released a new site especially for my kind. http://www.chicagoftmtopsurgery.com/
The best part is he doesn’t require a letter from a therapist. I still haven’t been able to acquire it due to my other issues which I highlighted in my first blog. Those therapists just want your money. The other promising thing about getting it done with Dr. Steinwald is that he preserves the stalk of nerves to the nipple. That means I won’t loose potential for sensation that I would otherwise loose with nipple grafting. Since they won’t be cut off and put in a petri dish for over an hour it is even less likely that the nipples will die. That can happen with grafts.
Just when I think I can hold out longer without surgery the pain in my breasts returns with a vengeance. I will be glad once they are gone. Due to this pain I will be sure to get a pathology report with my surgery. I have a feeling something isn’t right. I don’t want to think about it though.
My next step is to contact my work and see the options for medical leave. I could really care less about getting paid for the time off but I do need the time off, without getting fired. Need to pay off that care credit after the surgery. If I can get partial pay during my time off that would be great.
I also need to prepare my questions for the surgeon and talk to him on the phone about the whole thing. I hope he deems me sane and that I can go through with it without any issues. Looking at the calender I hope that he has Tuesday January 7th open for surgery. I would arrive the day before on Monday and stay a week or more. I kind of have to get it done that first week as my grandma has plans the last two weekends in January. Then she leaves for vacation all of February and March. The time alone will be nice to adjust to my new chest and just be at peace with myself.
The healing time is stated at 4-6 weeks. I am hoping the surgeon will extend it to 8 weeks so I have extra time to heal. My job involves lifting heavy objects and moving my arms all different directions with stretching and I don’t want to mess anything up. That would just suck.
Oh I also need to find a new primary physician since my current one is an incompetent idiot. Last time I went to him he didn’t keep record of my previous visit and the stupid nurse wanted me to take a pregnancy test even though I clearly stated I hadn’t had sex to get pregnant… That was just total bullshit. They would of probably charged me more also.
Now I need to get my act together and get those questions ready for the surgeon.
This will document my journey to discovering Alex. An alias which I have taken on in some forms of life while still living as my birth name in others. I am trying to discover the best label to fit me and the steps that I need to take to be most comfortable in life. I may not be the best writer but by looking back at these past posts I will hopefully discover what it means to be me.
My transition to Alex started not to long ago. At the end of 2011 I had decided that something was definitely up. I wasn’t just some girl with issues. The real beginning of my transition started in February of 2012. I had moved away from my mother; into my grandmothers house. She was on a two month vacation and I buckled down and bought my first binder. That was the first physical step I took and one that I won’t take back. That feeling of the first time binding is wonderful and relieving (well after you almost die from trying to put the damn thing on the wrong way).
Before that I had been seeing various therapists at the demand of my mother not kicking me out of the house. Let’s just say they were a waste of her time and money. The thing about therapy is if you are not ready and willing for it don’t bother. Even if you are ready for it the therapist may not think you are and just fuck with you to take your money. That was the case of the first one I opened up to. I came out as transgender FTM to her. I had been seeing her at a Developmental Disabilities due to me not giving a fuck about therapy at first and so not speaking which caused the first few therapists to think I had some mental problems. Well she wanted me to start seeing her at another office in the hospital. Little did I know that each appointment would be $90+ dollars after insurance and after over six months of that I had nothing from her. No letters No nothing.
She wanted me to get a job first to fund my transition. Okay that made sense. I wanted a letter to start hormones. Little did I know at the time that I didn’t need a letter for that. But the bitch sure was good about not telling me about it. She was more focused on me having a job and hanging out with non-existent friends. (okay I might have what appears to be issues to the normal everyday person) It got to be about October of 2012 and she finally wanted me to take a test to understand me better. Six months later and now you want to understand me??? Keep in mind I don’t open up well in the first place. I’m not an open book and will never be so people can’t expect to just chat with me and get all the answers. I answer things short and as little detail as I can. It is an automatic reaction and not something that is easily changed. I don’t particularly want to seeing as people that are like that disgust me.
So I took this test. I later found out it was a personality test, that I had schizoid personality disorder, and that I was out $600. All of that and no one bothered to tell me it was the determining factor in if I was ready for surgery. Okay it was the beginning of my transition and I wasn’t aware I had to come fully read up on the subject of who what where why how of all the surgery details. Needless to say it was a waste of money. Also due to the diagnosis she wanted me to retake the test in a year to see if it develops into a form of Schizophrenia. Yeah sorry tester bitch your not getting another $600 from me. If I start seeing things that aren’t there maybe I will consider going back – probably not. After that I stopped seeing the therapist.
Fast forward to spring of 2013. I decided that I didn’t want the hormones any more. Go figure it was probably a good thing she didn’t give me the letter. She could of also kept my respect by just saying to take some time off and think hard about what you really want instead of paying her for over six months. I didn’t speak of this to anyone as I don’t share my personal business with people, its personal.
Now it is summer and the boobs are quite painful. They even kept me awake one day in immense pain. It comes and goes and I could feel nothing for weeks. It was shortly after the pain that I decided to get top surgery as soon as possible. I read up on surgeons and others accounts of it and have been getting prepaired for it. By January I will have enough for surgery. The problem is that I am having a hard time getting a letter. I have seen two different therapists since then. The first one thought all my issues steamed from my mother and that any trans issues wouldn’t be addressed until afterwards. After asking advice of my transbuds over on Susans I cancelled my next appointment with her and never went back. The second one demanded a minimum of six months of therapy and from the first appointment thought that because I’m in the middle that it could be body dysmorphic disorder and if that was the case she wouldn’t write me a letter due to “not believing in changing your body for those reasons”. So that meant I could waste months of money and get no letter. I didn’t even bother to schedule a second appointment with her.
Now I currently stand at trying to get a letter or find a surgeon that will take me without one. I did find a Dr. Steinwald in Illinois who does top surgery on informed consent but that will take travel and hotel expenses into account. I would really like to get it done locally with Dr. Medalie in Ohio but the letter is key and I’m coming up dry.