In Pursuit of Surgery: Part 1

The publication of this post will be the official beginning of my concentrated effort to obtain either a subtotal hysterectomy (also known as a partial or supracervical hysterectomy) or an endometrial ablation and tubal ligation.

With a subtotal hysterectomy I would have my uterus removed along with my fallopian tubes, but my ovaries and cervix would be left in place. An endometrial ablation is when the lining of one’s uterus is burned away. In people with light periods there is a fairly good chance that this can completely end menstruation after only one treatment and the process can be repeated until all of the uteran lining is completely destroyed if necessary. A tubal ligation is when one’s fallopian tubes are surgically cut, blocked, or closed to prevent eggs from reaching the uterus.

Basically what I’m trying to achieve one way or another is the end of my menstrual cycle and permanent infertility. I am not sure which procedure(s) would be the best course for me at this time, and I also have several concerns/barriers to access of treatment that I have to address:

1. I live in the South, so finding a doctor nearby who is willing to do this for me may be difficult.

2. I am non-binary, so finding a trans-friendly doctor nearby who actually believes I’m “trans* enough” for surgery may be difficult.

3. My health insurance is not trans inclusive and is just generally shitty.

4. I am poor, I cannot afford to pay out of pocket for these procedures or take a lot of time off of work to recover.

5. I have a low body weight. I don’t weigh much and I never have and I am concerned that this might make me unable to undergo surgery (you can’t eat for 24 hours or so before a hysterectomy), especially combined with my history of post-anesthesia nausea.

I mention all this now because these are the major things I am going to address in my posts relating to my quest for surgery. I want there to be a clear record of what my concerns and challenges were when I started and how I overcame them for anyone who might be in a similar position with similar concerns, because there’s not a whole lot of documentation on this stuff.

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7 Things I Want To See In 2014

1.      Regular, everyday femme-y clothes that are made for DMAB people’s bodies available for sale somewhere

I would really like to be able to buy my partner everyday clothes that I know are made to fit and look good on their body in styles that they like.

2.      Information available about sexual/reproductive health that is written and intended for people with non-binary genders

I would like to be able to find information about the health and function of my reproductive organs and my options for birth control/sterilization that do not assume that I am female, having sex with men and want children, or that I’m happy and comfortable with the anatomy that I’ve got.

3.      More gender neutral public restrooms

Quite a few of the independent restaurants and coffee shops in my town have gender neutral bathrooms, but I’d love to see this become a more common practice.

4.      More mainstream acceptance of gender neutral pronouns

I would like to see articles about genderqueer and non-binary people where our preferred pronouns are not in quotation marks when they are used throughout the article. I’d like to reasonably be able to expect people to refer to me by my preferred pronouns without lecturing me about English grammar first.

5.      Better medical access and legal protections for trans* people in the South

After my partner’s experience trying to find a doctor who would prescribe them hormones in our state I’m really kind of irritated by how difficult it is to access proper medical care as a trans* person in the South. For example, the current WPATH standards of care state that hormones should be prescribed on an informed consent model, however where I live most doctors still want a letter from a therapist before they will prescribe hormones, if they’ll even agree to see you at all.

It is also still completely legal to fire or not hire someone because they are trans* in the state where I live which can make finding and keeping employment here anything from uncomfortable to impossible.

6.      All my favorite trans folks at the Philly Trans Health Conference

I’m really excited for the Philly Trans Health Conference this year and I hope to see all of my friends who don’t live nearby at the conference this year, especially those who couldn’t make it last year!

7.      A more vengeful Transgender Day of Remembrance

For the 2014 TDOR I’d like to see a little less hopelessness and mourning and a little more anger and outrage. I’d like to see a little more energy put toward fighting to protect the living and demanding that violence against transgender people end. I’d like to see people plan marches and rallies demanding justice and safety for trans* people rather than just solemn candlelight vigils remembering their deaths.

Work, Gender, Dysphoria And The Self-Articulation Of A Non-Binary Person

So I’m currently bussing tables in a restaurant, but next week I’m going to start hosting which means more hours, a schedule that can more easily be tailored to my liking and more money. Unfortunately it also means I have to dress up. Well, ok, not “dress up” really all that much by normal, cisgender, feminine woman standards, but I’m not a feminine cis woman.

I need this work. I really do. I’m getting by on what I make right now, but my roommate and I are looking to move out of our terrible (and by terrible I mean our landlord seems to be of the opinion that the funny pages constitute building material) apartment and in order for us to do that I will need to make more money. Unfortunately the cost of the dollars is going to be trading in my generic work uniform for clothes that make me look like a well-dressed young woman, aka the kind of clothes I never wear, ever. In the state where I live this is kind of my only option if I want to host. The gender marker on all of my legal documents is “F” and I can legally be fired for being transgender or refusing to dress like a girl on the job.

I’ve helped host a couple of times before and worse than the clothes is the attitude and behavior that is expected of me. It makes me feel like I’m developing a split personality, like I’m pulling someone else’s skin on over my own and wearing it around, trying to make people believe that I am that person. I’ve started referring to it as my “Sarah suit” (sarah is my legal first name). Wearing it is emotionally draining and just all around exhausting. It’s been a long time since the last time I tried to socialize with other people in a feminine way or conform to the social expectations of my assigned gender at all and I’d forgotten how much it took out of me, how much work it was. How it makes me feel slightly off-balance or out of sync, like the only person clapping off-beat in a room of people clapping in rhythm.

Or maybe I didn’t forget, maybe the sensation is more acute now that it exists in contrast to my nascent to find my way to an understanding of my gender without using man and woman as trail markers.

I am beginning to be able to envision my gender without having to rely on terms and ideas made out of the binary’s spare parts. Unlike earlier in my journey, when I was struggling to move away from relying on terms like “androgynous” to describe my internal sense of self, I can now, more than ever before, consistently perceive my body and self as something strange and alien, something new, something outside of and fully detached from the gender binary.

As I develop this more fully formed sense of my gender the experience of trying to pass as anything else becomes more acutely uncomfortable. Formerly, before I knew that there were more than two genders, my dysphoria was a vaguer sense of unease. Now it is becoming ever more particular and specific, I can say what exactly makes me feel dysphoric and what does not, but it also seems that those things that do make me feel dysphoric trigger a stronger reaction than they used to. I can’t really be sure if this is because I am so infrequently exposed to them that I have lost some tolerance that I used to have for them when these things were a more regular part of my life or if it is because I now I have an alternative to compare those things to; I know just how good I can have it without those things in my life.