Tag Archives: Transgender

3 Months Post Opt

Posted on December 11, 2014 by sifankahale

Oh this has been a long 3 months…. part of it was the most painful of my life. I’m still quite sore down there but remembering what I went through – this is nothing. See my previous posts for details of the SRS operation, my recovery and painful complications I went through. For the most part the pain had to do with the complications – the UTI, not being able to urinate and extending my bladder. Without that complication this operation and recovery, especially in the first month would hardly rate as discomfort or low level pain. For that I am glad – glad that I didn’t have to deal with anything else over and above the complication.

Normally (with out complications) the first month is pretty easy. It’s the second and third months that are hardest. This is due to a number of factors. First Dr. Suporn’s technique is very ‘accurate’ and true to the female anatomy – his technique is the different from all the rest and results are as they say, the Cadillac of the business. This means there is a lot more surgery and construction underneath/inside and this takes longer to heal. It’s like scare tissue which becomes swollen and hard and progresses from one area to another as it heals. This is one reason we have to dilate, to keep the neo vagina open, soft, and to depth. One of the ‘sisters’ called it “beating the dragon” (I prefer to call it ‘training’ the dragon …). By the way, I call the other women that were there in Chonburi having SRS along with me – ‘sisters’ as we formed an international closeness and constantly keep in touch.

This becomes difficult during the 2nd and 3rd months where most of the healing takes place. It gradually gets easier and for some even pleasurable. For others this period is very hard – even extremely hard. I’ve heard of some that took hours to get to depth – which you have to do before you can start timing your dilation. I was lucky this way – the worst I had was maybe 1 min before I reached depth. It is recommended that we do 3 dilations a day – so you can imagine the pain and agony some have had. I had cut down to 2 a day because I was able to maintain my depth. I feel lucky that way. It was hard for a while and I had a hard time preparing mentally for them. But they gradual became easier, less painful and became routine. I will have to dilate the rest of my life – but the frequency tapers off to once a week after 1 year (3 times a day until month 4, 1 once a day after month 6, then once a week or so after a year – mostly to check depth).

Those are the major milestones as well. After the 3rd month things get easier and we can start doing just about everything (swimming, hiking, long trips, working, baths, some exercise, etc.). Then month 6 is another milestone and 1 year basically marks completion. Ya, one year …. Of course every ‘body’ is different and these are only approximate timings for the majority of people that go through this.

In this next section I’m going to tell it like it is – this could be TMI (too much information) for some, so be warned. However, for those who are going to have surgery, I think this is important to know – I wish I had known this beforehand – not that it would have changed anything – just so I could have been more prepared and aware. Of course this is ‘my’ experience and reading the private accounts of others tells me that I’m in the middle as far as my experience and pain/discomfort is concerned.

By the way: most surgeons or clinics have a private FaceBook page that is only for ‘post’ opts. These are very helpful for us to a) keep in touch b) ask questions c) see how others are doing d) peer into the future to see what to expect. Unfortunately they really do need to be kept only for those that are post-opt or immediately pre-opt. But this information is invaluable if you are going to have surgery. They recommend that once you are invited into their group, that you read back 1 year to get a full understanding of what to expect.

For me, right now, I’m going through multiple phases where ‘things get tight’ down there. First a very hard ball (size of a marble) formed just above everything (up by the pubic bone). I had to stay in bed for a couple of days with nothing on down there (as everything, even the weight of the bad sheet, hurt). This gradually ‘morphed’ down along both sides of the frenulum, basically tightening that entire area up (it was all swollen, so this is actually ok, just a bit painful). Now the same sort of thing is happening starting at the tops of the outer labia and working down. Which is also good because my outer labia is huge (swollen) making it difficult at times to close my legs, especially when I want to sleep on my side at night – I have to place a hard thick pillow between my legs.

I still can not sit without using the infamous seat cushion although it is getting better. I forgot it once and was able to carefully sit on a hard chair for about 10 mins. However, if I do too much, like a long car ride or sitting too long at work, or like one day I had to go up to the summit to work – the next day I wind up in bed, legs spread apart and nothing on to let it heal. Sometime I have to take pain meds – sometimes I’ll take a pain pill before I need to do something (like a long ride) where I know it’s going to be hard. At times, it feels like a bowling ball down there between my legs – and I walk like I’ve been riding a horse for hours. My panties feel like they are crushing me during those times and I can’t wait to get home and lay down in bed and allow my bottom to ease up. These times seem to coincide with the ‘tightening’ phases I mentioned above. So I’ll be ok, even ‘great’ for a few days and then another one of these ‘phases’ kicks in and I have to take it easy, stay home and sometime stay in bed. But these ‘seem’ to be getting less as time goes on – progress is being made (although soooo slowly it seems).

I saw my GP doctor today – another checkup. My UA came back ambiguous – but at least it didn’t have the bacteria (e-coli) that caused all the pain and agony before. I sent a question off to the clinic regarding this and they said (and my doctor agrees) that if none of the symptoms are present than all is ok. There are high levels of something I don’t remember what, but those can also be do to the SRS surgery. So we are leaving things alone unless symptoms come back. That is good news!

I’ve been having bleeding (very minor) about once a week, all coming from the same spot (at the bottom inside where the major and minor labia come together on the left side). The doctor examined that in more detail and found it was the equivalent of a ‘skin tag’ – an 8th in long growth protruding out. This can happen as internal ‘sacs’ sometimes comes out through the skin (the labia are created with many layers of internal stitching and sometimes as these heal one of these small sacs can pop out). So the middle of January I go back and will have it removed (plenty of local anesthesia ….!). I’m relieved to know that is all it is.

Other than that, everything looks and operates correctly now. There is sensation is all the correct places. Still sore so I’m very careful with my new parts. A number of the ‘sisters’ that had SRS the same time as me are now reporting they had their first umm, “The Big O’ …. For me, the surrounding areas down there are still too sore for me to even contemplate that …. Put it this way, I still cringe when I see another woman riding a bike or motorcycle. Maybe someday I’ll be able to do that but right now I have that automatic ‘pain’ – same as when someone talks about getting a flu shot – you automatically feel pain in your arm … or when someone talks about going to the dentist … ya … that kind of thing: my bottom immediately goes into panic mode!

So today is the 11th, my 3 month celebration as finally being the true authentic me. I can not tell you how absolutely wonderful it is. First you have to understand the shear disphoria that was before – I’m not sure I have words to describe that horror – the pain of my complications can not come close to the lifelong battle I have gone through attempting to live in the opposite gender. Now I am free to ‘be’, to express myself and to live as who I always was. It is a fantastic and welcome change.

It just struck me – theoretically I am finished with transition! I say theoretically because I could argue both sides of that. Some transsexuals go stealth now that they are fully a woman, truly marking this as the end of transition and simply blend into society as women. Even though this is a completion – on so many levels – I feel that it is important, especially today, to be visible to some degree. The more society sees that transsexuals are ‘normal’ people, involved in normal or credible vocations or even honored/esteemed positions, the better it is going to be for those that follow. The more professionals like myself that come out, the more that society will start seeing us as part and parcel of the human condition. Just like red hair or blue eyes, transsexuals are but one more variation of the human condition. There is a balance of course – this can be and has been deadly (we just honored those murdered on Nov 20th – TDOR – Transgender Day of Remembrance). I am cautious: I do not proclaim who/what I am to just anyone – but I am an advocate and will do what I can to help achieve parity for everyone.

With much Aloha,

Sifan

PS: I’m hoping to swim in the ocean this weekend – I have missed that soooo much ….

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Posted in About, Advice, Diary, Gender Affirmation Surgery, Surgery and tagged Gender Affirmation Surgery, Gender Change, MTF, Post-Opt, SRS, Suporn, surgery, Transgender, Transition, Transsexual. Bookmark the permalink.

Surgery in Thailand – Part 5, Complications

Posted on October 31, 2014 by sifankahale

This post also contains what some will call TMI (too much information). If you are squeamish, please skip. I had two complications post surgery that each masked the others symptoms making it difficult to diagnose and cure. In fact one of those I’m still suffering from and only now does it become obvious I had this all the time since I left the hospital. For those that do not wish to read this entire post – here’s the key point: if you are having urinary problems, suspect a UTI (urinary track infection) immediately and get tested! That would have saved me more than a month of torturous pain.

Before we could leave the hospital we had to prove that we could urinate. I had difficulty and had to stand up in the shower to accomplish it. Now urinating at first is something that is difficult for anyone post SRS. Women do it much differently than man do and of course up until then I was used to doing it the male way. A male feels he has to go, then basically pushes it out, but a woman when she feels she has to go, sits, relaxes and when it’s ready it comes out. A very big difference that is hard to get used to at first. One has to relax and not push – if you are in pain and have an intense urgency to urinate – this is impossible.

As a result, myself along with the nurses and clinic staff chalked up my difficulty to this difference.

Then, about one or two days after I was back in the hotel, I had a very bad case of constipation. Constipation is normal after a week in the hospital when basically everything down here is shut down and they gave me laxatives to take the first thing back at the hotel. However, those were not doing the job. After a couple of days it became obvious I needed something more powerful. Finally they sent over an enema kit and dupalux which is a very powerful laxative. The next morning, and all that day, I finally emptied out. Meanwhile, I was in pretty bad pain for about 3 days as all this was figured out.

Once that was solved, the second, worse and more painful problem became obvious. I could not urinate. And this degraded each day, getting worse and worse. It started out that I could only urinate standing up then squatting over the toilet. But it was only a small stream, not enough to empty my bladder. The progressed to having to stand in the shower, rock back and forth until I could go – then even that turned into just dribbles and drops, with very little coming out.

Worse yet I had an intense urge and pressure to go, but could not. This would be very painful, I would almost collapse – I had to hang onto something to keep myself up. My entire body would shake and spasm until a little urine would come out. Then things would calm down and after about 5 mins I could urinate – but just a little.

This would repeat every 45 mins to an hour – day and night. Plus, during the night, I would ‘leak’ due to the intense pressure building up in my now fully extended bladder. Basically all I was able to do was relieve the ‘over’ pressure from the bladder – never emptying it or even reducing it. Each hour I was get this very intense urge to urinate along with this racking pain. I would pace back and forth in the room until I was calm enough to attempt to go. Then I went through the entire process of standing in the tub rocking back and forth, dribbling a bit here, raising a leg would sometimes helped get a bit more out – waiting for more to come out, holding onto the shower curtain rod (being so careful not to pull it down) and racking in pain. I had placed my hands on my hips so much that my hips became painful and I could not compose myself that way any longer either – what a horrible mess.

Sometimes nothing would come out but the intensity and urgency to go was still so overwhelming that I would revert to pacing until that pain once again went down and I would try again. I had to use a cane when pacing – it was that bad. Then, clean up (small 1/2 shower) and back to bed for 30 mins or so before all this would start again. Even in bed, I could tell my bladder was painfully full. I had to find a way to lay down that hurt less that other positions. Even the weight of the bed sheet on my lower area was painful (I would prop up a pillow next to me down there to keep the sheet off of it). Poor Lisa had to sleep on the far side of the bed and give me lots of room (this was probably the hardest part for us as we both always cuddled as we slept all night long – this was/is very important to us). As a result it was very difficult to get back to sleep and it seemed the second I did – boom – it started all over again. The most beautiful part was the morning sunlight starting to shine in the sky – it meant not only that I made it through another night, but that the staff was up and the clinic would be open and I could try to get help.

On top of all of this – I had to go off of my HRT meds for the surgery and was only allowed to start taking estrogen again after the 1st week back in the hotel. Going off estrogen is like going through menopause – hot flashes, cold flashes and mixed up emotions etc. A number of times I soaked my pillow at night because I was so hot.

Throughout most of this Lisa (who is a nurse) was in contact with a nurse friend of hers who has a lot of hospital experience with UTI and in fact the two of them had written a training manual for nurses. So, during the long nights, everything I would get up, I would email her with the latest and she would get back with advice (due to the time differences she was up at those times). It was with her help that I was finally able to describe my symptoms correctly to the doctor here.

This went on for 3 excruciating days and nights, hour by hour, no sleep and the worst pain of my life. I remember one night toward the end of this, just before I finally got the catheter in – I was holding onto the door frame of the bathroom, rocking back and forth crying and telling Lisa that I can’t go on like this, we ‘HAVE’ to get help, this ‘HAS’ to stop.

I think my problem was that I thought this would go away because this was probably due to the surgery and something down there was still swollen and pinching off the urethra and time would heal this. When I described my symptoms to the staff, they were concerned if I could urinate at all – which I could. So this was not taken serious until the 4th day when I called the clinic and explained how much pain I was in and how little I urinated. I have a high pain threshold – so it took a while for me to understand that this was much worse than I thought. And of course the times I explained this to the clinic – I was not telling them a pain level that concerned them. Finally, I had just had enough and once I explained how much pain and that only dribbles were coming out – they got me into the clinic and the doctor put in a catheter.

What a huge relief! As he inserted it, the nurse held my hand tightly. It hurt a little. But the second it reached my bladder and started draining – this relief was beyond belief – I started to cry with happiness. More than 1000cc came out – way too much and means that the bladder was over extended.

I wore the catheter for 3 days. Then, an hour before they were going to take it out, I was to empty it then drink a lot of water. I probably over did it and drank 3 bottles! Well, they took it out – but I still could not go – only just a little.

Later that day it became a repeat of when I came back from the hotel – same hourly urge, same pain, same dribbling and not being able to empty. And it got worse as time went on. I over extended the bladder again and again was in intense pain and only dribbled, repeating this every hour that night, just like before.

I stupidly kept going until 9 am the next morning when the clinic opens. Later I found out I could have called any time during the night and a nurse would come to my hotel room to reinsert the catheter. As it was, I made it to the clinic and they put it back in. Once again, more than 1000cc emptied out.

Now the problem was that is was the last week in Thailand – I was going home in a few days. So we decided to keep the catheter in until 2 days before I left. If it worked – great, if not, I would get a special catheter for traveling home.

I got the catheter out early in the morning so that if I didn’t urinate by say 6pm – the nurse would come and put a new one back in.

It didn’t work — so I called and the nurse came right to my hotel room and did it there. Just before we left for home, Dr. Suporn saw me in the clinic and went over the options. The best option was to wear it home – that way I would not have to worry about a complication 1/2 way home – on the airplane!

I was to keep this in for 2 weeks after I got home.

The leading theory was that there was swelling or something that was blocking he urethra. And indeed, each time the catheter was out, there was progress. The first time out I was actually able to urinate sitting down. The second time I actually had a stream instead of a dribble. Both of those were short lived, but it did show progress and point to perhaps swelling that was slowly going down.

In the last two weeks of our stay in Chonburi, most patients are recovered enough that they get out to see the sites, go shopping, eat somewhere other than the hotel, etc. I could do none of that. Walking too much would irritate the urethra possible making it swell worse and extending my issues and pain. So we never ate outside the hotel and at most would walk around the hotel itself – going down to the lobby for an ice cream cone, or visiting the garden.

There are good things about having a catheter (as well as bad). First I did not have to worry about emptying my bladder – each time it was emptied! They had me on ‘training’: instead of having the tube open all the time, I had it closed/pinched off and would only open it when I felt like I had to urinate. This trained the bladder and me. I would still have to get up in the middle of the night – but it was like before – I always would get up once or twice during the night – a huge difference from the hourly painful mess I just had. Some of the bad issues were: hiding the bag – there is a strap that you can attach it to your panties, then I’dd wear a long loose dress and make sure the tubing didn’t show below the hem (in the top picture of this post, the bag is in the large purse I’m holding and you can just see the tube coming from under my dress). The other is that there was constant draining from the irritation from where the catheter entered. And with a tube going straight down from there – this would circumvent any liners or pads I was wearing. As a result I was going through panties and pads like crazy. I brought a lot of panties and would wind up washing almost all of them every day. And of course this cause my inner thighs to chaff no matter how much I washed and dried them. When I didn’t have the catheter in, I was leaking from all the pressure, so I had the same issues then too. What a huge terrible, painful mess that was.

The plane ride home was long and hard especially because I could only sit on my seat cushion and that is not very comfortable. Fortunately Lisa had book us on business class for the trip back. The trip was about 21 hours long which included two 6 hour layovers. On the longest flight we were JAL’s ‘dreamliner’ airplane. The business class seat had everything, including a ‘bed’ mode. That was great because it was the only position that was comfortable at all for me.

The very next day that I was back, we traveled down to Lahaina to see by GP doctor and to figure out how and when to have the catheter removed and what to do if I still had problems. I live in upcountry Maui and this was about an hour long trip – one way. That was difficult and once I had the catheter removed, if I were to have a relapse, that trip would be horrible.

When the day came, we rented a room in a hotel in Lahaina just blocks from the clinic. My appointment was first thing in the morning so that I would have plenty of time to attempt to urinate and if not, would still be able to get back into the clinic to have the catheter reinserted before the clinic closed.

Well, it worked – sort of. I have not had the catheter back in. That day I went about 10 times in a row, sitting down, with a nice stream each time. However, when night came – it was back to every hour and the hour. Sometimes I would have to either stand or squat in order to go. But the good news was that I was going and in a good quantity so that I was not extending my bladder. But I was still having the intense urge and the pain.

This would only get worse in the next few days until on Sat. with nothing else open I went into the ER in Kahalui. OMG what a horrible experience that was. I was there for 6 hours, in my condition that was an eternity. When I got in they had me give them a sample. The restroom was so filthy – there were blood stains on the floor. I did everything I could to keep both the sample and me, my skirt and anything else from touching anything! Then hours later I was admitted, they did a bladder scan that showed I had about 650 cc inside. The test came back positive – I had an UTI (urinary track infection)! They put me on Cipro and Pyridium (standard treatment). They also took a culture and in three days, depending on what they found, they might have to switch medications.

Four days later, I still have the same symptoms – it’s not working – and no call from the Hospital. So we called and for about a hour was passed around between departments only to be told “sorry I can not release that information”. Now I can understand that they can not tell someone else – but this is ME asking about ME!! What a screwed up mess that place is. At least we found out that I was on the WRONG medication – but that is all they would say. We called my GP doctor and she fought the good battle to figure out the rest and she then wrote me the correct prescription (assuming their test results were correct that is….).

Once I got the medication I read what it had to say about UTI’s:

Cloudy urine (mine was slightly cloudy)

Burning sensation when urinating (not really – was like a constant burning sensation all the time)

Have to urinate very often and usually only can go a little bit (bingo – me to a ‘T’)

Have a very strong urge to urinate – usually suddenly (oh boy do I ever)

Pain and muscle spasm in the genital area while urinating and or right after (yes – so intense that I can not go – I have to pace or do something to relieve this)

Pressure over the pubic bone (yes – in fact I was asking the doctor what was under there that would cause this – this only happens when I have to go)

Back pain – would mean the kidney is involved (nope)

Chills and fever – would mean the kidney is involved (nope)

When I read all this — it was the proverbial light bulb moment – this is what I had when I left the hospital in Chonburi and the entire time I was in the hotel and here at home. Holly cow – if I would have described this correctly or if someone could have put all this together back then – well – that’s over a month of the most excruciating pain I ever had in my whole life.

UTI’s are somewhat common when you have a catheter in – like I had those 7 days in the hospital. I’m pretty sure now this was the cause all along. Boy I wish I knew more back then like I do now.

As I’m writing this, I’m on day 2 of the new meds – waiting for them to work – could take up to 5 days. At night, I am still getting up almost every hour (something every 20 mins). I have some pain but not like before. I am able to get ‘enough’ out, but not emptying. During the day I can sit and urinate ‘normally’ and in good volume. However at night I usually have to squat and use pressure, sometime stand to get it going. They gave us this 1/2 moon shaped 2″ deep yellow plastic tray (called an emesis basin) and I would place this between my legs so that I could urinate standing up. It was graduated as well so I would keep a running record of the time and amounts. I was still averaging getting up at night every 1 to 2 hours and about 100 to 300cc. It is still hard to get enough sleep. I would be woken up because I had to go, would only go a tiny bit, but then if I walked out to the living room by the I walked back to the bathroom I could go about 200cc. Then back to bed, try to sleep before I had to do all this again. I was always soooo happy to see the morning twilight …. just like the hardest days in Chonburi – the breaking new day was a really big thing for me.

It is very frustrating and I hope the medicine kicks in soon. This is just too much and too long of a horrible ordeal. And now I’m paranoid about cleanliness.

With Aloha,

Sifan

Postscript: On the 5th night of taking the new medicine the symptoms stopped! Right down to the wire. I was really worried when all I had was one pill left and everything was still a mess and painful. Now 3 1/2 months later as I write this postscript, every time I sit down I have a nice stream and easy time and the thought comes to me – every time – “I will never take going to the restroom for granted ever again in my life”!!

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Posted in Advice, Diary, Gender Affirmation Surgery, Surgery and tagged Gender Affirmation Surgery, GRS, Medical Complications, SRS, Suporn, surgery, Transgender, Transition, Transsexual. Bookmark the permalink.

Surgery in Thailand – Part 3, Dilation

Posted on October 28, 2014 by sifankahale

Caution this post contains TMI (for some this could be “too much information”). Continue only if you wish – you have been warned. I will be discussing the routine ‘maintenance’ that I now must do a number of times each day. I’m writing this for those that are contemplating SRS so they can get an idea of what to expect.

After we arrived at the hotel from being discharged from the hospital, one of the clinic staff came up to our room and helped setup the room for my new daily routine. Oh boy, life is now a bit more complicated then it ever used to be. Things like showering and even how to wipe oneself after using the toilet are now vastly different and hygiene takes on a whole new level of importance. More about this later.

For the rest of my life, I, like anyone who has SRS, must dilate. Basically the body views the neo-vagina as a wound and will attempt to close it up. Dr. Suporn’s technique uses a mesh, which new skin grows on, to form the vagina. It also forms new tissue deeper inside surrounding the vagina as well. One way to think of this is scare tissue – in some ways it is similar – but not really. This new tissue will form hard and expand closing the vagina if not countered. And that is what dilation is all about.

We were given four dilation stents, one small one, two medium ones and one large. We start off with the medium stent, inserting it all the way back and then applying pressure to the back to keep our depth. When Dr. Suporn took out all that packing, he inserted this same stent showing me how to do it and measured my depth (I was 6″ in the hospital). Each stent has markings in both inches and cm. As you can see in the picture, these are HUGE (both is length and width) and FRIGHTENING at first. The first couple of dilations I did, I was amazed I could take all that! At first, we have to dilate twice a day, 30 minutes each – basically I have to go to full depth and then push hard. That was difficult. It is somewhere between uncomfortable and mildly painful. Some people take pain meds before they dilate. I did at first but quickly found I didn’t need to. One has to sit up straight (usually on the bed, pillows behind, plastic sheet on the bed and an absorbent bed sheet on top of that), legs must be straight out, no bending and somewhat close together. Any other position will engage muscles that will make dilation harder. We are taught that no matter what complications or difficulties we face – we always MUST dilate. As you will see later – I had complications where the last thing I wanted to do was dilate – but I still did.

We start with the medium stent and later (6 weeks) we graduate to the larger one. The small stent is used if it becomes difficult to insert the medium one. We then have to dilate with the small one for 5 mins or so and then move up to the medium and complete the dilation. The white stent is an extra medium size and is a bit softer. I think everyone loses a little depth from what was measured in the hospital. I’m at 5.5 inches and have stayed at that ever since – it could be the way they measured it there vs how I measure. The important part is to maintain depth. As I was told, depth will change with the time of day, if we just ate, if we didn’t go to the bathroom first, etc. So it fluctuates, but again, what is important is that it stays somewhat consistent.

There is an entire procedure surrounding this. The person from the clinic setup the bed table and bathroom so that everything I needed is close at hand. As you can see – there is a lot. The procedure gets better and less intense with time. But at first, we shower to clean off, using a special surgical soap on our new bottom – and rinse it off immediately as it can actually burn the skin if left on or used to much. I then lay down as stated above, put on surgical gloves, place a condom over the stent and apply a lot of lube – that last bit is important!

Until things heal enough (Dr. Suporn tells us when) we do ‘static’ dilation which I described above – straight back and apply pressure. When told to, we start dynamic dilation (about 2 weeks after surgery for me – but that is different for each person). Dynamic dilation is a bit easier I think. I start by fully inserting the stent, applying pressure for 10 seconds, then rest, then ‘stir’ it around to enlarge the sides for 10 times. Then we repeat this for 15 mins and have to do this 3 times a day. Months 2 and 3 is where the most healing occurs and where this is most important. The internal tissue is building and this needs to be countered and ‘softened’. Unfortunately, the nerves are becoming active during this same time ….. I’m 1/2 way through month 2 at the moment – so far ok.

Then we have to clean up after. This includes douching with warm water three times then a fourth time with a mild solution of betadine. Then a half shower washing our new parts with that surgical soap. For the first month we also have to apply betadine to the stitch lines down there and apply a silver cream to the inside of the inner labia. And then – collapse on the bed and rest!

At home we no longer have to coat the stitches (most of which have already dissolved), but we do need to get a douche kit that fully reaches inside. As they said – lube plus byproducts of healing inside create an idea culture for bacteria – all lube has to be rinsed out. Also at home we can use regular soap.

One issue is the trip home vs dilation. Having to dilate 3 times a day and having a flight home that for most of us is 20 some hours long makes for an interesting dilemma – no we do not dilate on the plane or in the airport! So we dilate extra long just before we leave for the airport (the van came to pick us up at 4 am … that meant I was up and dilating around 2:30 am….). Then we need to dilate when we get home. The trouble is, it’s been a long time, things down there have already started to tighten up and the flight home has made us very tense – what a mess. So, we are to wait an hour or so after we get home – do something relaxing – have a glass of wine – whatever to relax us. Then we dilate – this is where some people have to resort to the small stent to get started. I was ok – my depth went down to 5.1″ but withing the next 2 days I was back to my 5.5″.

As you can see from this picture – there is a lot of stuff we bring back with us (the huge pink bag). This includes supplies to last us for a month or so after we get home. It includes betadine solution, bed pads, tons of lube and condoms, a mirror, clock, my stents of course and pantie liners and pads. They gave us a large bottle of betadine but I also had a smaller bottle. The airport security ‘found’ the big bottle and confiscated it, but left the small bottle alone … go figure. Other transwomen were allowed to take theirs – as far as I’ve heard – I’m the only one that this happened to – ratso!

Some last points regarding dilation:

Contrary to what you would think – if you are having troubles dilating, then you need to ‘increase’ the number of times. They can be shorter in time, but you need to do more of them during the day.

As time goes on, we get to reduce the number of dilations each day. Until the end of the critical period (month 3) we need to do three a day. After that we can reduce to 2 a day. After 6 months about once a day and finally after a full year we can reduce to a couple per week – basically to check depth and then if needed do more dilations.

Also, once past month 3 – dilations become easier and other umm activity can substitute for a dilation, making it pleasurable indeed …

I should also mention some of the problems that could be encountered dilating. Make sure you use plenty of lube, you could chaff and that’s no fun. Also a veteran post-opt warned us about the ‘sword in stone’ problem that could happen when you are too tight and when withdrawing the dilator it gets ‘stuck’ (probably because of a vacuum being created above it inside). Just take it slow and use dynamic dilation to ease it out. Something else we all find out right away is sneezing, coughing, laughing too hard and a close lightening strike (I found out about this last one the hard way) can all make for an uncomfortable experience. I wonder if anyone broke things in their room due to flying dilators (to my knowledge only one person said their dilator actually came out – but just barely, mostly it just hurt a bit)!

Another issue is bleeding. As you dilate, you are basically stretching scare tissue (first 3 months) and it will sometimes bleed. Also as things heal, little ‘bumps’ (granulation) can poke up and dilating will cause those to bleed. Counter to what one would think – the solution is to reinsert the dilator and hold it there to stop the bleeding. I had this happened to me twice. Others have said they bled the entire 2 months! Most said they never bled. Everyone is different and this goes away with time and healing.

I had some severe complications which I will talk about in the next post. But even during that period of time – I still had to dilate. It was difficult, but had to be done. Nothing like complicating a complication ….

With Aloha,

Sifan

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Posted in About, Advice, Diary, Gender Affirmation Surgery, Surgery and tagged Dilation, Gender Change, MTF, SRS, Suporn, Transgender, Transsexual. Bookmark the permalink.

Surgery in Thailand – Part 2, Hospital

Posted on October 27, 2014 by sifankahale

Day before surgery – Lisa and I doing a ‘selfie’. I love this picture!

Our third day in Chonburi, Thailand started like the previous ones, get up, wash, dress and then meet the other transwomen for breakfast on the first floor of the hotel at 9 am. Breakfast usually takes an hour as we sit and chat. Then promptly at 10 am everyone goes back to their rooms. Later I would find out that the clinic staff starts their rounds at 10 am and everyone needs to be in their room then. But that would not effect me until after I came back from the hospital. I was told to be waiting at the front lobby at noon for the clinic van for my ride to the hospital. So we went up to our room to select and pack the few things we would need. I brought a dress (and wore another one), my get well cards, computer and tablet to have something to do and some of my astronomy magazines to read. Not much for a week in the hospital! Before we knew it, they called up from the lobby – again our room clock was wrong but was close enough that we were ready and were almost out the door anyway.

I remembered the first trip in the van to the hospital and how the woman in the back seat was on her way in for the surgery and how she was feeling – nervous but excited. I was the same, a feeling of finally, let’s do this. As we waited in the hospital lobby, an older Thai man and his wife started to chat with us – but they didn’t know any English and of course we didn’t know any Thai. It was interesting and a bit uncomfortable as he kept staring at me, probably figured out I was transgender. They were polite, but I couldn’t wait to get up to our room.

Just got into my room, night before surgery. Waiting for the 2nd bed and soft mattresses.

I had a private room with two beds and a nice view of the bay off of the ocean. Lisa stayed in the bed next to me the entire time which was quite a comfort. Being a nurse, she could communicate with the other nurses and the doctors to make sure everything was right, plus she was able to help and to direct my care, given her experience. At times it sounded like yet another foreign language as they spoke to each other in medical’ese! I was really impressed with the nursing staff and doctors and the way they treated Lisa as one of them.

Great Thai food – although due to the language difference we sometimes were surprised by what actually showed up. But that was good too – never disappointed – although surprised. Also some american food they prepared was, well, the best way of saying this is that is was ‘their’ interpretation of what it was supposed to be. It was still good.

View out our window. The bay (tide is in) on the right. This is mud during low tide!

I was admitted at noon the day before the operation. After settling in, getting a special mattress top for the bed (the beds were solid as rock …), we ordered something to eat as the nurses brought all the other ‘stuff’ that I would need afterwards and went through it all with me (dilators, pads, medicines – quite a large amount of stuff). The anesthesiologist came in and had a long talk with Lisa about what I could and could not take (I have a reaction to ibprofin).

Then a psychologist came in to interview me (making sure I really was a transsexual). I had to draw two pictures, one of me, the other of some scene, with trees, etc. The first picture I drew of myself, longer hair, wearing a dress and giving an astronomy talk. The second picture I drew of a cabin in the woods, on a lake, a porch going out over the sand beach and Lisa and I in inner tubes close to shore. He asked about each picture, getting details of why I chose what I did. He seemed impressed by them …

And finally Dr. Suporn and the staff member that would be looking out for me came in. Later that night, after enjoying a particularly good Thai supper – the enema nurse came in …. oh girl. I supposed since I had already enjoyed that meal – what difference did it make ….. Trying to make it to the bathroom that final time was um ‘interesting’ and challenging to say the least.

Right after surgery. I feel great – certainly not how I look tho… This was taken very soon after I came around after surgery.

The next day went soooo fast it’s hard to remember what happened. I do know they came in early – like 6am or so. First was a nurse that shaved me down there. I don’t remember much about that, just that it happened. Then a bit later they came in and inserted an intravenous tube in my veins. At 9 am they came to get me. They wheeled my bed down the hall, into the elevator and down to the operating room. Boy, watching the ‘ceiling’ move, Lisa by my side, nurses by the other side, was a strange feeling. Lisa was by my side all the way into the operating room suite, holding my hand tightly and smiling. I remember holding Lisa’s hand, lots of people in blue and the anesthesiologist (she was very sweet and comforting) talking to me – and then ……. nothing (someone ‘slipped a mickey’ into the intravenous I when I wasn’t watching ….). In the states, they would always say “count backwards from 10” but here, things just went blank.

This next part is from Lisa – as I have no memories of. Lisa got back to the room at about 9:15am and waited there for me. I and my bed were wheeled back into our room at 3:20 in the afternoon. Lisa says that as soon as I saw her, my face just beamed – totally glowing she says. She said I just kept looking at her, I couldn’t keep my eyes off her! I would fall asleep for a bit, then wake up, hold Lisa’s hand and we would talk for a bit before I would fall back asleep.

My first recollection of conscientiousness was back in my room, in my bed, with Lisa giving me a kiss to wake me up! My new bottom was fully bandaged with a stent packing inside me. I had three tubes coming out: urethrae, drain from under the packing and a catheter with a drip bag with a side tube for a morphine drip. Right away, the first feelings I had were of a very deep body sensation of being ‘right’. I had a deep visceral feeling of being back to the way I used to be – even though of course, I was never physically female – but that is the feeling. As things progressed and I was able to register feelings from down there, I was surprised and astonished that these new feelings were oddly very familiar – same way as the visceral feeling of being back to were I was. Both of these experiences deeply affirmed who and what I am.

That evening, a staff member came and slept on the couch and watched over me the entire night. It was so reassuring to have her there. I would look over to Lisa sleeping on one side and the nurse sleeping on the other: I was surrounded by care and love. It made that night very relaxing. I was in no pain what so ever.

On day 4 Dr. Suporn came back and removed the bandages/covering. Then on day 6 he came back to remove the stent packing inside. Holy cow – it was like watching a magic show where they pull a scarf out of a hat or something and it just keeps coming and coming and coming ….. There was a lot of stuff in there! I thought “exactly how big am I” — geeesh. Now I was allowed to getup out of bed and finally had my first shower – boy that felt good (although I was not allowed to move without a nurse present).

Day 7 was release day – they pinched off the catheter, I had to drink lots of water, then they removed it and I had to prove I could urinate before they would allow me to leave. This was difficult, but I was finally able to do so by standing in the shower – which is good cuz I could take a shower and when I dried off, the wheelchair was there ready to take me to the waiting van and off Lisa and I went, back to the hotel.

The only ‘pain’ I experienced the entire time in the hospital was a sore butt as I had to stay in the bed for 5 days without getting up. I remember having 3 tubes in me and having to be very careful when turning side to side. Thank goodness all three tubes were on the left side – not a problem. Then on day 4 they moved the catheter to the right side —– that was just not fair …..!!!! Moving was a tad more complicated then. I would do small exercises in bed, like lift my bottom up, move my legs and arms around, etc. just to try to prevent them from getting sore laying there. That did seems to help. They had the infamous morphine button by my bed too. I only used that once the entire time, and then it was not because I was in pain, but because I started to feel something down there more and more and thinking it might turn into pain decided to head it off at the pass kind of thing… Who knows if I really needed to do that.

The next post will cover dilation – something I’ll need to do for the rest of my life.

With Aloha,

Sifan

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POISONED !

Posted on October 12, 2014 by sifankahale

Some of the following I have written about in previous posts. Something wonderful and difficult has happened that brings a slight twist (and then maybe not) to my perspective on being a trans-woman. Perhaps it’s a nuance, most of what I’m about to write seems like what I have always been feeling and saying. However, there seems to be a deepening and a visceral understanding of my life as a result of this.

If you have been following my posts, you already know that I had my SRS surgery last month. In fact I just celebrated my 1st months anniversary. This is actually a bit scary, as months 2 and 3 are the hardest. This is when the ‘insides’ finish healing and the nerves start reconnecting and become active. The body views this as a wound and attempts to close it. I have to counter that with daily maintenance (three times a day) to soften and keep it’s form. The combination of these makes these next two months difficult and painful.

Needless to say, this means that I’m quite familiar with my ‘new’ anatomy. I put quotes around new because it is new only that it’s one month old. But here’s the kicker: it’s not new, it’s been there all along …. Now that might seem a bit strange, so let me explain. This realization came to me when I was in the hospital, minutes after I woke up from surgery. My immediate thoughts and feelings were “Finally, I’m back to the way I was” – even though I was never like this. But that was the internal visceral response I had.

I have talked about the ‘body map’ a few times before. As a refresher: medical science has found that we carry a body map located in a part of the hypothalamus. This map basically says what we have and where it is at any moment in time. It also tells us what things are supposed to feel like and the feeling those parts are normally supposed to produce. The oft used example is the person that has their arm amputated yet still feels their fingers and can tell you where their arm is located – even though it’s not there.

My experience post surgery was a huge confirmation of this body map. That is what I meant “I’m finally back to the way I was” and that this was not something new, but was always there – it was always there in my body map! My ‘new’ bottom did not feel different – did not seem new – was not strange – I was not missing something. Instead I felt normal, I felt the ‘nothing’ that everyone else feels about their parts – it’s just simply is who I am. Ask yourself, what does it feel like to have your ‘parts’? Does it feel like anything at all or is it just the way it is – that is, just you – nothing – nothing special – just is.

That is how it is now for me. That was NOT how it was pre-surgery for me:

That … is the big difference.

That … is the hardship a transsexual faces daily until they transition.

My previous ‘down there’ was not in my body map. Things did not match up to what was supposed to be according to my body map. And, it is not just the physical aspects but also the mental, emotional and hormonal aspects of the body map that were not in agreement.

Let me re-tell a couple of incidents from my youth plus another one from my previous marriage to illustrate:

As a very small boy, I knew that I was supposed to be smooth down there, I was not supposed to have ‘that’ hanging out. Ever being the budding scientist, I have a distinct memory of trying to figure out how was I supposed to urinate if it was smooth there! This is when I was around 5 years old. I had no concept of sex or what a woman/girl looked like – I just knew this was not me – I was supposed to be ‘smooth’ down there. When I was 7 years old, my sister was born. The first time I saw her ‘down there’ – well, everything came together. For the first time in my young life I knew what I was supposed to look like, what my young body map identified with.

The second incident occurred a few years after this. My mother was a seamstress – not professionally, but she created clothes for our family, relatives, neighbors and friends. Being intrigued both by the creativity but also by the mechanics and design aspects of sewing, I would watch and learn. Finally I felt that I could create and sew something myself – from scratch – no patterns, I would make my own. So I did. I made a beautiful skirt that fit me perfectly. It had a hem (I remember using this stick with a bulb on top and a movable nozzle that would squirt chalk at where you wanted the hem to be – in order to get it perfectly level all the way around), I also had belt loops, elastic around the waist plus a zipper on the side. I was very proud of my creation. I did all this without my mother’s knowledge as I wanted to surprise her. When it was finished, I waited for her to come home and proudly showed off my new creation. My mother is 100% German and very strict and conservative and was very brutal. My pride turned to shame is less than a second. The scolding and punishment and continued reminders of what I did drove any thoughts of me being a girl to be deeply buried. This was the start of the ‘layers of the onion’ and more and more layers were added to deeply bury any sense of me being a woman.

In one way I consider myself fortunate. I attended a very conservative Catholic grade school back in the 1950’s, in a very redneck conservative northern city. I was ‘fortunate’ to witness some of my classmates as they tried to assert who they were (being different than anyone else) and witnessing the severe reaction of both the other kids but also from the teachers, nuns and priests. I was an observant little girl inside a boy’s body who learned very quickly from others to keep my identity secret. This sort of sealed the onion layers for good.

Later in my teen years all that was left was a rationalization that I was a boy but with all these extra capabilities – emotions, what I liked, mannerisms, ability to understand and listen to people … the list goes on. I could not stand the playground games of the boys and would prefer the girls but I had to be careful to mix it up … I had buried my truth so deep that I no longer knew myself and accepted my role as a boy and rationalized the rest. It took another 40 to 50 years to unravel and peel back that onion.

Now, here’s the new part. This revelation suddenly came to me during a talk with my ex-wife. I don’t think I would have seen this before surgery – somehow it took being whole again to be able to see this next piece. This is a bit hard to discuss and embarrassing for me – please bear with me as I try to find the words for this ….

During puberty my body changed drastically. Testosterone was now cursing through me and creating a lot of changes that were upsetting. However, I could not figure out why – again I had a deep rationalization that I was a boy. It wasn’t the physical aspect of puberty but the mental and hormonal parts that really disturbed me. Here it gets hard for me to put this to words – hang on: one example, it’s a pretty well known fact that most men masturbate many times a week, some daily. This urge was intense and of course I hated that – that part was not me – why was this happening. I had so much shame around that but I could never understand. Of course the Catholic church drills into us that is a sin. And of course the other boys bragged about it. Why was this so awful for me? That wasn’t all – there are other incidents that I was very ashamed of as well, both growing up and throughout married life. I carried these all my life, not understanding what drove me and carrying the guilt and shame all these years.

In my talk with my ex-wife a couple of days ago it suddenly became crystal clear and I broke down crying. Hindsight is like that I suppose, but this required me to already have had my surgery in order to be able to put this together.

I was POISONED!!!!

Others have called this the “testosterone fog”. If you are a male (birth sex) and a man (gender) then testosterone is the correct hormone. But I am not. I don’t expect men to get what I’m about to say, but I think any women would and any transsexual definitely will. As a woman, having a high testosterone level, I would experience these hormone driven urges and their results and was mortified by them. Disgusted and shamed as I would witness myself in those moments and then the regrets afterwards. Again, for a male/man these are natural and congruent – no problem. But for me – this was horrible and these feelings have haunted me my entire life. But, I didn’t know why – the layers of that onion were so thick by now – I had long ago buried and lost my gender identity. Only these hints were left.

It’s only now, that I’m physically, mentally, socially, hormonally and internal-chemistry-wise finally a woman that I could solve my last great quandary that has plagued and weighed on me all my life.

As a woman – I was POISONED by testosterone!

I had to go off of spiro (a testosterone blocker) a couple of weeks before the operation – this gave me a really good ‘scientific’ test of what for me was the intensity of this poison. It confirmed and validated my views and led to the realizations that I am writing about here.

Again, testosterone is absolutely appropriate for a male/man, but I am not – I’m a woman and this has tormented me so much. At last I have come to peace with those disturbing aspects of my life that only now do I realize are part and parcel of being a transsexual woman.

I want to apologize profusely to those that I have hurt unintentionally and hope for your forgiveness.

I now understand.

I am now free.

With much aloha,

Sifan

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Posted in About, Diary, Surgery and tagged Gender Change, GRS, hrt, MTF, SRS, Testosterone, Testosterone Fog, Testosterone Poisoning, Transgender, Transition, Transsexual. Bookmark the permalink.

Transition: Mental and Physical

Posted on October 4, 2014 by sifankahale

I just had an incredible experience: Dr. Suporn’s clinic staff make daily rounds between 10am and noon. I’m not going to mention her name because what I’m going to say applies to all of them.

This was her last time she was going to see me (as they take rotations and I’m leaving on Monday). So she took extra time to sit and talk.

This was unexpected – she thanked me for my positive attitude and optimism. I can only imagine the range of people and personal issues they have to deal with and this is what I want to share with everyone: this staff goes so far beyond just simple care, they truly are amazing. To me, this was a high complement – it’s also means that I really did touch others here – I hope I was able to make my trans-sisters more comfortable but also the staff and everyone else.

Yes, everyone has different experiences – but think about what the staff has to do (and what they have to put up with). And they do it with love and a smile!

You know – it’s sort of like my last post about being able to tolerate pain having a down side. Dr. Suporn’s surgery is (for a lot of us) almost pain free – it’s like little has happened. We get back to the hotel feeling so good and ready to party on the town, not fully taking into account the 7 hour surgery, 7 days in a hospital, etc. And then those that do, get in trouble.

I remember Dr. Suporn’s words about mentally relaxing and not worrying etc. that a lot of this has to do with the inside aspects of ourselves. And that brings up another huge issue: this is both MENTAL and PHYSICAL. You have to ‘solve’ both of these for yourself. His surgery solves the physical – if you are not mentally ready – after surgery you are now going to have to deal with the other half.

I was fortunate. I had a great therapist and worked on the mental aspects of this for more than 10 years. This surgery was the icing on the cake as they say. The night before surgery is when the final pieces of the physical aspects came into sharp focus. See “Why have Surgery” for more on that.

That was the big message the person from the clinic and I came to this morning – being prepared both mentally and physically for this.

And I really do hope that I shed cheer and happiness to those around me – to me, that is an important aspect of my life.

With much aloha,

Sifan
“Hoku Wahine” (literally: star woman, eg female astronomer)

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Posted in Advice, Diary, Gender Affirmation Surgery, Surgery and tagged Gender Affirmation Surgery, Gender Change, GRS, Internal Transition, MTF, Transgender, Transition, Transsexual. Bookmark the permalink.

Why have Surgery

Posted on September 29, 2014 by sifankahale

This is something that happened the night before surgery. I never doubted or questioned what I was doing. I knew this must be done. But there was a piece of the puzzle that was missing. Now I know why.

The night before surgery, it all came to me. I had spent so much time on the mental aspects and removing the layers of learned male behavior some of which disgusted me (the testosterone fog). The piece that was missing was physical part. “Why would surgery matter if you are already living as a woman?” type of question.

But the night before, my early childhood came back to me. The memories of something wrong – it was supposed to be smooth down there, I was not supposed to have this thing sticking out. This was long before I know anything of the sexes – I just knew it was supposed to be smooth. In fact, I remember wondering how I could possibly urinate if it was smooth! Then my sister was born and for the first time I figured out what ‘smooth’ was supposed to be.

Fast forward to the night before surgery and my discussion with the psychiatrist, my mind had pushed that out of the way so completely, yet the extreme dissonance remained all my life and caused just as much grief as the mental aspects. But, just like the mental aspects, there were many layers of this physical part that also had to be removed – and that night before surgery it became clear.

After surgery I have to use a mirror when I do my ‘maintenance’ and the feeling of not only completeness but of wholeness is almost overwhelming. It’s like being back to what I was (even though I never was this way) but that is the feeling – being correct and true and just ‘me’. It is so wonderful, so incredibly ‘natural’ – I’m running out of words to describe this.

I’ve mentioned before about a body map, a part of the brain that sort of knows what you are, what you have, and where and what these parts are doing. The example often given is of an amputee who not only still feels their arm but can tell you exactly where it is in relation to their body. This body map for me is what tells me I’m female, both in the physical and the mental aspects. The memory from my childhood shows this clearly – I didn’t know what I was supposed to have down there, only that this didn’t match what my body map had. This is the HUGE relief I have now, when I do my dilation, etc. having to use a mirror and in contact with ‘me’. It is what was missing, it is what inside me says is supposed to be there. Now it is!!!!

With much aloha,

Sifan

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14 Month Summary

Posted on August 18, 2014 by sifankahale

Everything is now focused on next month: SRS. Because I’m ‘older’ they wanted a cardiac stress test. Now, I’m in pretty good shape and that, for a stress test, is bad news. It means they keep you on the treadmill longer, faster and at a higher incline (and keep increasing until you start pumping harder). The good doctor brought me up to heart rate required for the stress test, looked at me and said, “want to see what you can do?”. You know, I must be slow in the uptake or maybe I was just not completely taking in what he just said. Well, from my perspective, all hell broke loose – not supposed to run just walk fast, the darn thing was now a ramp to the ceiling – but, like a fool, I did it. Then he asked me again – I think my muffled huffing response sounded like a yes. Right after they had me lay down and they took sonograms of my heart – asking me to ‘hold my breath’ – I was like “WHAT” – that’s not fair and it’s impossible!! They actually can measure the thicknesses of the different walls, measure blood velocities, etc. Very impressive. Well, I passed – however – about three days later my entire upper chest was sore and I had what seems to be a muscle strained under my arm. It took me a few more days to finally connect this to the stress test. I was using my upper body – hands on the front bar of the treadmill – to do a lot of work. When I hike in the mountains I use hiking sticks that basically do the same. My legs are in the best shape because of the walking/hiking I do, but my upper body was not used to that. It’s now almost a week later and at last I’m slowly recovering. Wow – mental note – don’t accept a ‘dare’ from a doctor doing a stress test on you! Unfortunately, I had to work up at the summit the rest of that week – this really zapped me.

I was sent an invitation to a private FaceBook group for those that have surgery with Dr. S. in Thailand – and for those that have been accepted for surgery. It’s turning out to be a great resource. Everyone is helping everyone, lots of good advice, worries, complications, things around town and the clinic and doctors weigh in as well. So good sound advice. One person said they just arrived – about 20 others replied with where they are meeting for breakfast, who to see and what to do before hand. I joined the fray and said I would be arriving next month and already I have 4 other gals (two from here in Hawaii) that will be there the same time – we’ll be getting together! By far the best is to go back about 1 year and read all the questions and answers, issues real and those easily fixed, what to expect and how everyone else has fared. I have lots of good advice and perhaps an even better idea for what to expect almost each and every day I am there (one month).

One of the purposes of my blog site here is to help others, especially those that are older, to get the information they need to understand and know what this is all about. To that end, I plan on making as many posts from Thailand as I am able to. Some might be a bit detailed but I’ll warn you right up front – continue to read at your own …. whatever …. I’ll probably write the first one tomorrow – about planning and pre-travel.

On a different note:

I had a conversation with Lisa a while back. I was telling her about catching myself in unconscious automatic behaviors, feminine behaviors, behaviors that were not learned or made automatic by rote – how could they be.

We went out to eat at a restaurant in an outdoor mall (most of our malls in Hawaii have open air promenades). We had a wonderful meal and had strolled down the open air mall talking and admiring clothes and nick knacks in the store windows. On the way back to the car I mentioned that I had just noticed how I instinctively held my skirt down before a gust of wind suddenly blew and then smoothed it out. Then it struck me that there are many other instinctive automatic things I do as well – feminine actions that I did not learn and was unconscious of doing.

What is intriguing is the recognition that these behaviors or actions were unconscious and very normal – what I would describe as just being me. This is in contrast to before when I was presenting as a male – most of that had to be leaned and was deployed ‘consciously’. Having had to do this for the majority of my life, it sometimes baffles me to realize that most people have never had to consciously ‘be’ what society says is their gender. That for most people, suddenly realizing that they are acting authentically, is simply never seen or experienced.

I learned quickly at a very young age. I saw what happened to others, the harassment and bullying they endured and I was blessed with a quick intellect that allowed me to quickly assimilate their examples into a workable model for my own existence. I learned to keep my truth inside – not hiding from myself – but to present what was expected. It’s sort of like the cliches “pick your battles” or “work from within the system” or “know your truth and pick the right timing”.

The other fascinating aspect of this, was that I had a detached presence as I watched these behaviors unfold. That was what prompted the conversation with Lisa.

And, I thought I would include a response I wrote to an article questioning why a ‘man’ would ever ‘want’ to change into a woman, considering all the disadvantage:

I’m a transwoman, let me see if I can make some sense here – I can only speak for myself. I was born this way, this is not a choice or something I ‘want’. It’s who I am. The issue becomes how do I deal with this – not about which gender has it easiest. There are a lot of false stereotypes and beliefs surrounding this – that compounded the issue for me as well. As a result it took me until I was older to sort out what and who I am. Just like everyone else, I had to sort out what was real – then I had to accept who I am and then despite all of that plus, as you stated “the disadvantages of being a woman in today’s society” – to proceed and become true to who I am. The fact that there is so much against this should speak for itself. It has nothing to do with advantages/disadvantages, etc. For many trans* it is life or death (or even a living death) – makes the disadvantages seem moot huh. To have your core being at odds is very disconcerting. Ask yourself if you really know what it feels like to be a woman (or man) – I mean, do you really know? On a personal level the only way to know is to actually know the opposite. For a trans* person this is a daily and deep question: who am I – not what do I want to be or the relative merits of one gender vs the other. This was one of the reasons it took me so long to come to terms with and accept who I am. The mind does a wonderful job of trying to protect and therefore deny or explain away things it thinks will be harmful – especially in this case. I am glad that trans* issues are becoming better known and slowly things are getting better – especially for the younger trans*. I hope they don’t have to go through what I and many others have. My hope is that society will understand this better and drop all these pre-conceptions, stereotypes and false beliefs.

With aloha,

Sifan

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13 Month Summary

Posted on July 13, 2014 by sifankahale

It 20140706_192518 feels good to be past the one year mark. From what I hear from my trans friends that are going through or have been through transition, most of the emotional changes and a majority of the physical ones are now over and things stabilize. That’s how I feel right now too. Of course time will tell – I’ll have to revisit this one year from now …

The biggest challenge I have yet is my weight. I’ve lost about 30 pounds since I’ve started. I have to lose another 6 but I would like to lose 11 more pounds. That gives me a leeway for the surgery requirement. It’s very strange that when I was 30 pounds heavier, I did not feel fat at all and it was sooo easy to lose weight. Now, I feel fat, I have a little belly, even though I’m 30 pounds less. I do have a smaller frame. It is now very hard to lose pounds – I no longer care that I’m losing weight in the wrong places (my breasts are getting smaller etc.), I just want those pounds gone!

The countdown is on! Today is 60 days away from GRS (surgery). Like I’ve responded to those who have been asking recently – I’m ‘not’ looking forward to the surgery – I’m looking forward to about 3 weeks ‘after’ the surgery when I’m recovered enough to start my new life in earnest. Even then I won’t be at anything near running speed. But at least I hope to have my head above the water by then.

One of the women at work caught me in the kitchen and asked me a couple of questions today. First she complimented me on how much I have changed and that I actually look much younger! She asked me what it feels like now. I told her ‘normal’ and that before and for most of my life I felt like I had to conform to what was expected of a male and that I could not just be me. I said that now it’s mostly a feeling of freedom – I can just be myself. I also said that I’m in a unique position to be able to experience the differences between male and female and it is huge. But we didn’t have time to go into that much further. Maybe I’ll enter a post just on that sometime in the future.

Lisa and I took a beautiful ride on the sw shore of Maui around to Kaupo today. I felt ‘extra’ feminine for some reason. Was a great day to be a woman. Lisa had to go pretty bad so when we got to the top of our favorite hill back there, we parked and walked up and just down the other side – enough so that no one would see. She went first – I gave her some napkins to clean up. Then it was my turn – she asked if I wanted some napkins before she remembered I still had boy parts down there. We laughed about it. She said she had forgotten that I wasn’t physically a woman down there yet and said she actually had visualized me having a vagina! I guess she is truly seeing me as a woman now!

A very good friend of mine from back in my college days got back in touch with me recently. He had some very good questions and I thought I would share my responses. These are questions I get asked now and then and perhaps this will help others understand trans* people better.

The first was a comment about memories and the person I was. For some people, they morn the loss of the ‘former’ me. My response:

That was a great time we had back then, I also have many wonderful memories. Those memories along with all of my past don’t and should not go away – they are a part of me. It took my ex-wife a while to understand that as well. This does not negate nor dismiss those. It can be hard to understand, but I was ‘this’ person I am now – back then – and all through my life. What and who you knew ‘as’ me – the ‘me’ of today – was all along. What is changing is ‘presentation’. The latest science on this (both medical and psychological) define these as completely separate: birth sex, gender, presentation and preference (as in partner). A person can be any combination within these – one does not pre-dispose any other (trans* people have the same ratios of hetro, gay, bi, etc. as the normative cis population). Of those, latest research shows that only presentation is societal – the rest a person is born with (there is a lot of false beliefs out there claiming nonsense).

I was ‘trained’ to be a man – I think I did a pretty good job of it. Society back then did not allow for anyone like me – it was just an impossibility back then. Like so many things in my youth, I learned to adjust and to live with it. Like many other trans*, I over reached in order to prove I was who society said I was supposed to be. Don’t get me wrong here – I am very grateful for what was, including being married and fathering two wonderful men.

It took a long time to unravel from all of that. I started almost 10 years ago. But it actually started even longer ago when I became a professional instructor and then director of the international technical training for the corporation I worked for back then. I was much more effective than both genders in that trade. My style and philosophy of training matched that of a female. That was 20 some years ago and laid the groundwork – the crack in the dam.

Can you imagine your entire life – knowing something is different, that you do not match who everyone (parents, school, friends – everyone) says you are and not knowing why. I knew I didn’t fit in and was not quite like the other guys. I also knew I matched more closely to the girls I knew. But I also knew that physically I was a boy. There was life long confusion and dysphoria.

This is such a relief now – it explains so much for me and as they say – it hits the nail right on the head. I am very happy now – this is a huge load off the shoulders. This may sound strange, but one of the largest dysphoric situations was being addressed/treated/spoken to as a male – especially in public situations. To be mistaken like that was hard. That’s not who I am. By changing my gender presentation to be consistent with who I am, makes all the difference. The standard explanation (which is totally wrong however, but it does put this into perspective) is to image you wake up in the morning as female but with all your memories, responses, actions, beliefs etc. remaining male – and worse – no one believes you. You are relegated to live your life from this point on as a woman. Well, reverse that and that is me – only without the explicit knowledge of what underlies this until recently. So, ya – like 1000 times better now! Not just happiness but quality of life, spirituality, knowing and accepting myself – and the list goes on.

A lot of people have mentioned that my ex-wife and myself had one of the most wonderful marriages and they just can not understand how this could have ended:

Hummm, how can I say this ….. I’ve had a lot of people say the same thing about my ex-wife and my relationship. It was a wonderful and great period of my life. I’m very grateful and celebrate what we had. Like all relationships there were wrinkles and cracks under the surface that were not visible to anyone else. Perhaps the saying “the bigger they are the harder they fall” has some bearing here – not sure. Two things I can say: there’s a lot more to the story and we are both in a better place today then if we tried to stay together. In no way does this negate my ex-wife’s and my life together – I cherish those times and memories and am very glad I was given that time and experience.

Regarding societies stereotypes:

As you can imagine, this is a very difficult and highly personal thing. I too had to overcome a lifetime of misconceptions and stereotypes and then to embrace who I am knowing that the majority of the world still carries those. Not exactly the cup of tea I needed … but we are dealt a hand and are committed to play it. If nothing else, this should attest to the seriousness of this and speak for the determination to transition. Even in spite of these, it is that important and necessary!

Lisa came along at the right time and not only accepted who I was but embraced it. This is difficult for her as she does not see herself as lesbian, however, society now does. You can imagine the confusion However – one nice thing about being older (and hopefully wiser) – one sees through that and instead embraces their true selves. After all, is she really a lesbian? Her preference is for males, her love is for me, regardless of gender. And does this make my ex-wife a lesbian? After all I was born this way, therefore I was a woman all along …… You can see the difficulty with our current language and the assumptions inherent within ! As a society, we need to start transcending this transphobic misogyny and get real.

Keeping pictures of the ‘former’ me from the past:

As for pictures of Steph (I admit – even I talk about Steph in the 3rd person) – I’m glad you are keeping those – that is so nice! Let me re-emphasize: who I am now – I always was: as Steph and now as Sifan. I’m proud of my life and celebrate ‘all’ of it. I’m not out to deny any of it – it all goes into the ‘me’ that is here and now. That is the one part of that analogy that is so wrong (“imagine tomorrow you woke up as a woman”) – this is not a bad thing – nor something I regret – nor was living my life as a man all those years. It just simple ‘is’ and it is my life’s story. Would I have rather been born cis (same birth sex as gender) – of course! Given that I’m trans – would I have rather transitioned back then – of course! But this is my life and even with this, it is a wonderful life. Now, it’s just that much more wonderful !

I’m hoping this helps others (trans* and friends of trans) understand just a bit better.

With much Aloha,

Sifan

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Posted in About, Advice, Diary and tagged 13th month summary, Gender Change, Internal Transition, MTF, Transgender, Transition, Transition summary, Transsexual. Bookmark the permalink.

1 Year Summary !

Posted on June 2, 2014 by sifankahale

And what a year this has been!

So much happened just this last month. Lisa and I got married (or here in Maui we say we just got Maui’d) and my GRS surgery is scheduled and paid for.

I have just added a separate post including pictures and a transcript of our ceremony. It was a fantastic Hawaiian beach wedding. As you can see in this picture of Lisa and me – we are soooo happy! It was the perfect day, we had 12 guests, beautiful morning at the beach, wonderful spot and we had brunch at the Grand Wailea. The hula band even played a special song so the two of us could have our wedding dance! The Hawaiian ceremony was full of symbolism and meaning. I have always dreamed of being the bride at a wedding (well, one of the brides …). So this was very special for me.

We were wearing so many flowers – I’m barely visible from under them! Both of us had haku leis (crown lei on our heads) and we wore two leis around our necks (one for our outfit the other to exchange during the ceremony). I also wore a kupu’u lei on my wrist and one on my ankle. To top it all off I had a cascading bouquet that I carried (which my friend from work almost continuously had to hold for me during the ceremony – I hope ‘he’ didn’t mind!).

The other major event this month was getting the surgery date confirmed. We sent in the full amount to pay for the surgery, the hotel and spending money as we live there for one month. We have our plane reserved too. Lisa got us in first class on JAL on the way home. I’ll need that as sitting for that length of time is going to be hard. The extra room and comfort will be very welcome right about then. I’m glad that this surgeon keeps his GRS patients for a month. I will feet better and be more able to survive that trip home from Thailand! Plus, if there are any problems, they will more than likely show up before then and they will be able to take care of me.

GRS Surgery Schedule “SK” is confirmed! (Red means confirmed)

We just received the official wedding certificate, so Lisa was able to change her name on her drivers license and social security. Next we will be going to the passport office and getting that changed for both of us (I had not changed mine yet).

The one last BIG thing I need to do – is lose weight – like 15 pounds – by Sept. I was talking about this at work and the women all agreed – it’s so much easier for men to lose weight. All they have to do is skip desert and they are 5 pounds lighter the next day. For me (and judging by the other women at work – this is the same for all woman) not only is it hard to lose any weight what so ever, but when we do lose weight it’s where we want to keep it (like the breasts)! The other day I had one egg and a piece of celery for breakfast, a small bowl of noddle soup for lunch and one egg and a piece of toast bread for supper. I lost, oh, maybe, a whomping .1 of a pound! Before my transition (well first of all I would have been on my death bed with only that to eat) I would have lost 2 or 4 pounds doing something like that. One of the woman at work remarked: “Ya, you ‘are’ a woman. See, see what’s it like!!”

Who would have guessed – a hair dryer is ‘not’ for drying your hair – silly men: I added a few more entries in my differences page.

Last month I posted about being passable and my comfort level in being out in public. This was the first time my family (brother and sister and significant others) have seen me since I started transition. I was worried how I would be accepted. I was happy with the warm reception I received from my sister and her friend when I picked them up from the airport. The hardest time is when I met them at their resort to go swimming. I wore a two piece, the bottom being a swim skirt. Because of my shape, a two piece is the only way I can get everything to fit properly. I think this might have been a bit much for them at first. As the day wore on, everyone seemed to be more comfortable. The last day my brother and wife were here we went out to what is probably the best most Hawaiian restaurant here on Maui. I wore my long black dress – the one I wore way back when I surprised Lisa when she returned home.

My sister and her friend stayed for an extra week. For me, one of the highlights of their visit was taking them out snorkeling and then going out shopping for clothes. This was the first time I ever went shopping with my sister – as her sister! It was precious! Something I will remember. We would find clothes for each other, critic, advise and just had fun.

Every trans* person knows that kids (being uninhibited) will be the ones to challenge you. On our wedding day, Lisa and I took the elevator to get to the brunch. A mother and her two little girls were in the elevator and rode down to our floor. Just as the door opened and Lisa and I were getting out, the little girl asks if I’m a woman. Without batting an eye I answered I was. She seemed to accept that and continued to chat away! I impressed myself by the fact that this didn’t bother me in the least.

But, you can imagine my trepidation a week ago when I had to teach astronomy to around 210 3rd graders. Only one student sort of kind of asked in a roundabout way if I was a women. Other than that I had a couple of strange looks and heads tipped to the side as they first sat down. To teach 3rd graders, I put together a high energy talk with lots of enthusiasm and great pictures that illustrate events from stellar births in the Orion Nebula to massive supper novas and the mighty explosions in space. Once I start, gender is the furthest thing in their minds. Success to me is measured in how many hugs and high fives I get. By that measure, this year was awesome – even though this was my first time as a woman teaching this class. I even had one student from a different class come back during break to ask me additional questions.

Changes this month: except for a few confirmations of being a woman (see above “see, see what’s it like!”) not too much has changed. Lisa and others told me my face has changed some more and people have noticed I have curves. I’ve had a few comments on my weight loss progress too. My breasts have not been sore for a while, but just these last two night a bit of soreness has come back.

Oh, breaking news ….. there is a military coup in Thailand. We’ll watch that closely. For now things still look do’able. We are changing our return flight to a bit earlier however.

Now to gt back to concentrating on losing weight ….

With Aloha,

Sifan

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Posted in Diary and tagged Being Female, Gender Change, Hormones, MTF, Transgender, Transgender Wedding, Transition, Transsexual, Transsexual Wedding. Bookmark the permalink.

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