I often get asked by the inquisitive about Gender Confirmation Surgery. How was it for you? What does it feel like? What emotions did you go through?
My surgery was several years ago now in Charing Cross Hospital. The experiences I describe below are just one of many accounts. Look around and you will find so many takes on this experience.
GCS is a bridge; a final stage in some people's transition that joins the 'before' and 'after'. It is often mistaken for transition itself though it is nothing of the sort. Surgery is the path some of us take to a final completion point. It affirms a lifelong belief in our gender identity as we experience and live it. For some MtF's we need it to correct birth anomalies: No woman should have to endure her life with male genitalia. I couldn't.
For me GCS was a life saving operation, one which brought to an end years of depression and suicidal feelings. Over the next few months I will try to chronicle this point in my life with a narrative account.
Here is the first instalment.
It's cold for April. Cold and damp in Paddington. Shivering, I glance down at my overnight bag. Why on earth did I pack such flimsy, summery, city clothes? I'm waiting with Rachel for a taxi that should have been here at 5.30 am. It's now 6.15. They want us there for 7.30 sharp or it's simply not happening. I'm panicking, Rachel isn't. 'We'll give them 15 minutes 'till half past, then phone someone.' I want to scream. Yesterday evening in East Acton, eating out in the Lebanese, we had discussed shared experiences and sipped fresh mint tea. It had all looked so simple, like this is the last lap and time for a celebration. Now I'm not sure this is actually going to happen, after eight years waiting? Oh Fuck!
Rachel is chatting to someone on the phone. 'They're not sure where the taxi's got to, isn't that typical?' She says, covering her phone's mic with her hand. 'They say we should get our own.'
'How are we supposed to do that?'
Rachel is so good in an emergency. I'm not. Within minutes she has an app up open , she's arranged a cab and we're waiting on the side of the road outside St. Mary's Hospital. Five minutes later we're driving past the BBC and heading full speed for Hammersmith Broadway. Soon we're on Fulham Palace Road and turning in through the entrance of Charing Cross Hospital. I end up paying the cab fare, Rachel doesn't have the cash. We grab our bags from the boot of the car and race in though the entrance of Marjorie Warren Ward. Walking briskly down what seems to be the longest corridor in the world, my breathing has quickened to a shallow nervous pant and I have a fluttering heart beat to match. A nurse checks us both in at the desk and we're on the ward, shown to beds and being told to change into gowns. A long curtain is swished around the bed and suddenly I'm all alone.
I'm trying hard to desperately control my erratic breathing as I take off my skirt and top. I'm a neat freak but I'm stuffing my pretty yellow cotton top into my bag as though I'll never wear it again. What if I never DO wear it again because I don't make it through surgery? I have visions of my teen daughter, tears rolling down her cheeks because she she said goodbye to her Mum and won't ever see her again. The last time I saw her she was trying hard not to cry as she stepped into my sister's car to drive off to hers. I try to imagine the tide of anxiety she's experiencing as she copes with her GCSE's and her worries about me. Her FaceTime with me last night was so supportive and smiley but I know she was hiding so much. Today she's at school. I forcibly dismiss my own anxious thoughts and struggle to tie the strings of my gown behind my back. I'm going to have to ask for help with this. I feel like an invalid. It reminds me of trying to zip up my dresses before going out. Not for the first time do I lament the lack of a husband, fiancé or even boyfriend in my life. He would be there to comfort my daughter and support me. Being a single Mum sucks.
'Are you ready?' Rachel's disembodied voice comes from beyond the curtain.
'Yes, as ready as I'll ever be', I quip and a nurse tugs the curtain back.
'They're asking who wants to go first,' Rachel asks, 'Will you, please?' I want to say no, to postpone this life changing moment for a few more hours and to put my thoughts in order.
'Yes, I'll go first', I hear myself saying. 'I want to get this over and done with.' Even if this means I'm left disabled, in chronic pain or even dead? I dismiss the thought from my mind. In the corner of my eye I'm aware of a smiling guy in cycling gear approaching my bedside. This is James Bellringer my surgeon. He has an easy bedside manner, a gentle, reassuring attitude to it all and smells comfortingly as all hot perspiring males do after hard exercise. I find myself missing my father and I'm reminded again of the acute lack of a partner in my life. I'm pretty sure that there'll never be one.
'If we can just have a little look at you down there and check everything's okay before we prep you.'
He looks, I don't.
I never want to look or touch. I hate that part of me. I last saw it when I had to shave yesterday before surgery. I hate the feelings associated with 'down there'. When I was born, the doctor took one look at me and pronounced me a boy. I've never felt like one. I'm the kid who used to sit in the bath with swimming trunks on, who played with other girls, who asked Santa for a doll and a pram, who insisted she would grow up to be a woman just like her Mum. I'm relieved when my gown is closed again.
'The anaesthetist will see you in a minute and explain what will happen. Then you'll have your enema. When you see me next, I'm going to look a bit different', he jokes before leaving.
I have my blood pressure taken and I'm weighed before I have my enema. It's horrible feeling it stinging and irritating inside me. I feel intensely uncomfortable lying in bed on my side trying to hold it in. The urge to go to the loo is so strong. My tummy has been churning all morning with concern and worry anyway and now this. Why did I need an enema? Luckily when I do go rushing headlong for the loo, there are two cubicles. That's fortunate as Rachel's already occupying the other one.
The anaesthetist is waiting from me when I emerge from the toilet. She sits down on the edge of my bed smiling and reassuring. and is almost apologetic at all the details she has to go through. 'I'll be giving you a general anaesthetic and an epidural. Once we're in theatre I'll have to go through information and disclaimer forms with you. I have to do that to double check that you are aware of the risks involved and the possible complications.' OMG this is so designed to scare me and raise my blood pressure, do I really want GCS? So what will I do? Run away screaming down the corridor in my gown? Jane, get a grip Honey.'
I flip back mentally to childhood, daydreaming of being all grown up and wearing a white gown of a prettier sort. Aged nine, this SO wasn't how I imagined becoming a woman was going to be. At nine years old I used to sneak into Mum's room and sit before her dressing table with all its makeup, perfume and hairbrushes. It was nice to just be there dreaming, wondering what life might be like when I grew up to be a woman, and hopefully, a Mum. Yes, I used to borrow her lippy, eyeliner and mascara. They too were promises of a grown up life like the nice clothes which, although too big for me, I used to try on. I never imagined I would have to go through this and feel so scared. Still smiling and re-assuring, my anaesthetist says that she'll be seeing me very shortly, "I'll be wearing scrubs", she says. 'Shortly' is ringing around in my head like an alarm bell but the return of the nurse who gave my me my enema gives me no too to dwell on it. "Are you ready to go on up to theatre?"
I've been expecting to be wheeled up to theatre on a hospital trolley. The last time I was in hospital, aged seven, with acute peritonitis, I think that is what happened. That was an emergency, this is elective but the thought of not being able have it has lead me to the brink of suicide four times. Germaine Greer, an idol of my teenage years, considers it 'mutilation'. If I get through this, the woman my Mum taught me to revere will still not consider me to be a woman.
My nurse starts to chat to me as we walk up the long corridor from the Riverside Annex. We haven't gone far before she notices that I haven't removed everything as ordered. In my haste to get ready (I've been in the hospital less than two hours) I've forgotten to take off my heart necklace. This was a treasured present from my daughter Beth on Mother's Day. I go running back to the Ward and put it safely in my locker, somehow being parted from it makes me tearful, a slender silver thread tethering me to Beth. In a bizarre turnaround of rites of passage, I now seem like the one growing up into a woman, not her. I hurry back to the waiting nurse who walks me on, smiling and chatting through the labyrinth of corridors. We reach a large lift and wait while a patient is wheeled out on a trolley, connected to a drip, seeming semi-conscious. Will that be me in so many hours time? Getting out at the ninth floor of the tower block, we reach the doors of the operating theatre and go in. All seems so businesslike. Gone are James Bellringer's cycle shorts and sweaty lycra top. He's all in pale blue now. I can't believe that I'm being invited to sit and then lie down on the operating table myself? This all seems too matter of fact and routine, not the life threatening experience I was imagining!
"I'm just going to run through the risks associated with surgery and ask you to sign," says the anaesthetist. Percentage wise, the risks are small but as she reads through the list, the number of things that can go wrong seems enormous, haemorrhaging, pulmonary embolism, vaginal fistula (a hole developing between the vagina and rectum, vaginal prolapse, loss of vaginal depth, incontinence, loss of clitoral sensation, unexplained and debilitating nerve pain, urine infections...the list seems endless. I sign a waiver form saying that I know and understand the risks and that they have been read out to me. A signature scarcely seems enough. I feel like writing ' This list REALLY frightens me, I'm feeling so scared right now, my life is in your hands.
'We work really well as a team' says James Bellringer, who, looking at me seems to be reading my mind, we have to read all these things through to you but the risks are quite small." I'm aware that this is the point I could say no. I could simply get up off the operating table and walk away. I don't have to do this, or do I? Then the thought of returning to the heartache and my suicidal past takes over. I'm not brave but there really isn't any option if I want to survive. I have to do this. I sign and lay back down.
'There is one final thing' explains the anaesthetist. You have the option to donate testicular material to HIV research. If you are happy for that to happen, can you sign again here?' I'm reminded of my Psychotherapist's quip when I told him my daughter just wants me back in one piece...'Well not quite,' was his rejoinder. I sign again, happy to oblige. I'm so glad that there are pieces of me that won't accompany me to the grave. They join my appendix (removed when I was seven) and the teeth the bullies broke when they beat me up at school. They beat me up for being a sissy, a total girl and a pussy, ironic really.
Now I'm trying to concentrate on what my anaesthetist is saying right now. I'm being asked to count to ten. I begin. One, two, three and then a split second of awareness of sensory fading. After that there's nothing.