answered prayer, AO Fox Hospital, Bala Cynwyd, balancing tasks, bathroom bills, blood test, cardiologist, curettage, Dr. Carolyn Wolf-Gould, Dr. Sherman Leis, early MTF transition, echocardiogram, EKG, estrogen, female, full schedule, Gender Reassignment Surgery, genital hair removal, genital size, God, God's will, GRS, identity, lab technician, MTF, multi-tasking, new technique, Oneonta NY, orchiectomy, painkiller, passing out, penile skin, personal gender, pubertal blockers, rename, sitting, standing, stress test, surgical risk, surgical technique, testicles, Transgender, undescended genitalia, urinalysis, urination, vaginoplasty
Fifty-four years later, prayers are answered
Sometimes God answers prayers with a yes. He also has a couple of different ways of saying no. One is, “No, I love you too much to give you that.” Another is, “No, because I have something better in store for you.”
And then there’s the one most of us heard at some point in our childhood: “You’re too young now; maybe when you’re older.” Of course, there is no maybe with the Lord. He knows whether it will be a yes or a no. But after all, we are His children. And sometimes we do need to wait until we are older.
I recognized my female identity when I was seven. It didn’t become problematic until I was around age 10 or 11. I was at that age that I started to pray that I would wake up with a girl’s body (an interesting prayer, since I still didn’t know what a naked girl’s body looked like). And it was soon after that time that I renamed myself. After all, if I trusted that God grants prayer requests, I needed to be prepared with a girl’s name to tell people.
Renaming wasn’t new to me. By that age, I had heard the story of the younger sibling of a girl in my brother’s grammar school class. When this sibling was born, the gender assigned at birth was female. The child was given a female name and raised as a girl. At some point in time before the sibling started school, the sibling started to complain about severe pains in the abdominal area.
When the doctors did their examination, it was found that this child was really a male who was born with genitalia that didn’t descend out of the body: therefore the female appearance at birth. After surgery was performed to correct the problem, the child’s first name was masculinized and was now raised as a boy. And by the time I was ten, I heard about this event.
(As a side note, some of the so-called “bathroom bills” aimed at restricting transgender people from using the bathroom that corresponds with their personal gender identity would require this person and others like him to use the women’s bathroom in public places. Why? Because his initial birth certificate identified him as female and that is one of the criteria in these bills for assigning the bathroom to use. The result: a very masculine person in all other regards breaking the law if he uses the men’s bathroom in public.)
But back to my story: although the battle over dental insurance was ongoing, things had quieted down on the GRS front. My hair removal was proceeding on schedule and by September, virtually all the dark hairs were removed. I was ready for my pre-surgery visit with Dr. Sherman Leis on September 13, 2017. This was where the rubber would truly meet the road.
One of the sobering parts of the meeting is the reading of the long list of possible risks of the surgery. Some of them were minor and some were rare. One or two risks were so rare that Dr. Leis said that he had never seen a case or heard of a case of it occurring. Nevertheless, it was part of the list. I was glad that death was not on the list. I took a breath and signed a copy of the list that indicated that I had heard and received a copy.
One of the things that impressed me was that my surgeon stays current on technique. If I understood him in terms of the time frame, he had learned a significantly new surgical technique compared to what he was using when I had seen him for the initial consult on 11/30/16. Previously, after the orchiectomy (removal of the testicles), the remaining genitalia was completely removed. To complete the vaginoplasty, the penile skin is sewn back in. The surgical scar would roughly be in the shape of the letter “O”.
With the new technique, the remaining penile skin is not completely removed. At the top of the genital area (i.e. the part furthest from the anus), the penile skin is left attached to the rest of the body. Anything that needs to be done can be done from that position, but not as many nerves are detached and there continues to be a flow of blood into the penile skin at all times. This new procedure reduces risk, such as risk of necrosis, and aids in healing the surgical area. With this procedure, the surgical scar is roughly in the shape of the letter “U”.
Of course, I had some questions. Someone in the transgender community asked me if Dr. Leis “scraped” (technical term: curettage) to remove any stray or gray hairs. He said that he did not do so because penile skin is very thin and delicate and curettage tends to be harmful to it. He would remove any stray and gray hairs with a needle (the only painless form of electrology, presuming the patient is totally knocked out on general anesthesia!). He might have described it as a form of cauterization, but my memory may be less accurate on the term.
I also wanted to know why he hadn’t asked to examine my genital area. Other trans women I had read about who either were post-op or were in the process had been examined to make sure they had sufficient depth without resorting to additional procedures. Dr. Leis asked me I had a normal sex life and if my genitals had developed normally (i.e. not a micro penis or inhibited by using blockers from an early age). When I responded in the affirmative, he told me that size would not be an issue. (This can be an issue, however, for those who start their transition these days at a young age and go on pubertal blockers and then start on estrogen to block the effect of testosterone on their body.)
During the visit, we also discovered that I had a gap in coverage during the first two days after I left the hospital. I could have sworn I was told that I would be in the hospital for five to seven days after the surgery. It turns out that I was told (I found it later in my notes) that I would be released after three days. I generally have a very good memory. The only explanation I can think of is that I read about someone else going through GRS who was going to be released after 5-7 days (or who had that experience).
In some ways it didn’t matter. None of the people who would be taking care of me for the 11-12 days after my release from the hospital were available for those two extra days. (In the end the first person taking care of me rearranged her schedule, at a financial cost to her, to come a day earlier, so I was only basically on my own for one day.) I tried a number of avenues, but another person could not be found who was willing and available to help. More on my experience in a later post.
I left Bala Cynwyd with two scrips: one for a heavy-duty painkiller that could only be filled in PA. I held onto that rather than carry around the painkillers for three weeks. I would fill it the day before the surgery. The other scrip was for medical tests: blood work, urinalysis and an EKG.
At this point, I was doing my best to balance my preparations for my GRS, my teeth issues and the needs of my clients. Looking (unsuccessfully) for someone to cover the first two days after the hospital and the pre-op tests added two more items to my plate.
Knowing that I was losing Medicaid soon, I also had my first eye exam in nearly three years and got new glasses. I was following up to find out what happened to my school tax credit (STAR program). I needed to sign up for a Medicare supplement program. I was searching for an oral surgeon who had appointments available before I lost my dental insurance. And I needed to keep track of the schedule of weaning myself off of various medications and supplements prior to GRS.
I went in for the blood and urine testing on September 21 (no appointment required) and scheduled the EKG for the following day. It was almost too late.
The testing brought me back in contact with one of my favorite people at the local hospital a quarter mile from where I live. In the past, I have had major problems with giving blood. The first time was in April 1981 when New York required a blood test to get a marriage license. It was not a big deal to me. My dad gave blood regularly at work and it was a matter of fact thing and satisfying thing for him to help others in this way.
I went into the lab that day with my fiancé, had the blood taken, had the juice and the cookie, and then went outside with my fiancé. We were talking about the rest of our day. The next thing I knew, I was back inside, sitting down and feeling very woozy. Without warning, I had crumpled onto the sidewalk, leaving my fiancé perplexed as to what to do next: run inside of help and leave me there or try to drag me inside.
So I knew I had a history of passing out by the time I had a blood test a few years ago when Dr. Carolyn Wolf-Gould became my primary physician. Now blood work was a big deal to me. Then I met the lab technician at the hospital. On her office door, she had a child’s drawing of a vampire. A woman who I would guess to be in her late 40’s or early 50’s (warning: I’m not very good at estimating ages), her hair was dyed blue, green and black. It was so different that it helped put me at ease. When I saw her pulling out one vial after another, I joked with her, asking if she was going to leave me with any blood. She joked back, “A little.” Still I warned her about my past problems and she took the blood with me lying down on a gurney.
That was the last time I needed the gurney. Maybe my metabolism is slowing down. Maybe it’s the effect of the estrogen. (I was quite chagrined when I learned that young males are far more likely than women to pass out after giving blood.) Maybe this technician has gotten me so relaxed that I no longer have a problem, even when she isn’t the one taking the blood.
So it was time for blood work again. But first, my body was telling me to give the urine sample. It was primed and ready, locked and loaded. I went into the privacy of the bathroom and faced a decision. Although I didn’t have to, ever since I knew it was likely that I would transition, I have sat down to urinate. (The only exception was when I was still wearing men’s clothes and no stalls were available at the Penn Station men’s room.) I knew it would be much more difficult to give the urine sample sitting down. So (presumably) one final time in my life, I peed standing up.
It is also worth mentioning that in my head and heart, I knew that GRS was the right thing for me. But was it God’s will for me? Even if God does not have a problem with this surgery in general, that doesn’t necessarily mean it was right for me. With these tests coming up and the surgery less than a month away, I went to the Lord and prayed that if I had been dull of hearing and ignored the Lord telling me not to go forward with the surgery, that He would intervene and do something to stop it. And for a while, it looked like that might be the case.
The UA and blood work results came back and there was nothing in them to prevent the surgery. The EKG was another matter. I had never had or felt any problems with my heart. No one in my immediate family has had heart problems. I had one uncle on my mother’s side who suffered a heart attack, but no one else among my grandparents, aunts, uncles or cousins that I knew of. But the EKG came back with some irregular readings. I would need an echocardiogram and a stress test before I could be cleared for surgery.
This created a new problem. Time was growing short and we were also running into the Jewish holidays. A stress test must be administered by a cardiologist and I didn’t have one. And many of the doctors in my area are Jewish. I couldn’t get the stress test done at my local hospital without first establishing a relationship with a cardiologist on staff or with residency privileges there.
Instead, I had to drive two and three quarter hours each way to the hospital upstate with which Dr. Carolyn is affiliated. At 7 AM on a cold October 2 morning, watching the news coverage of the Las Vegas shooting, I waited to have my tests. I drove up the afternoon before, not wanting to leave at 4 AM (or worse, oversleep and miss my appointment). Fortunately I had some rewards points to lower the cost of the motel room. Between the alarm and a wakeup call, I got up in plenty of time. Instead of 165 minutes, it was a five minute drive.
I learned that I need to go back to the gym. I was breathing heavy after the stress test, but that was in part because I couldn’t really get the hang of a treadmill. I never have. But my recovery time was a lot faster than two men I had seen take the test before me. I learned that I have some minor valve problems, yet nothing serious enough to prevent the surgery. I took this as an indication that God had answered yes. This was above and beyond the promises He makes to His people. Even so, every good gift and every perfect gift comes from Him. (James 1:17) But the extra tests and travel took one more day away from me as I finished up one more client’s tax return and tried to get final planning and packing done for the two weeks I would be away in Bala Cynwyd.
Finally, October 4 arrived. It was time to do my last minute list checking and packing. Mid-afternoon, I called Dr. Leis’s office to let them know I was just about to leave. A short while later, I brought the last items to my car and began to drive to Bala Cynwyd for the third time. After years of waiting, wondering and almost losing hope, surgery was T minus 17 hours and counting. This was it. This was really it.
For all the promises of God in him are yea, and in him Amen, unto the glory of God by us. – 2nd Corinthians 1:20