Author Topic: Semi-non-op transguy, not by choice -- heartbroken and dysphoric about it.  (Read 639 times)

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Offline cawdor

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So ... this is long.

This is also the reason I joined Susan's Place. A few doctors said I should find a help group for dysphoria and just talk it out, as there are no specialty therapists in this area.

I'm on testosterone, have been for 7 years. That's working well. I've been referred for chest surgery at the Montreal clinic with Dr. Brassard, now I'm waiting on the application documents, funding approval, and then getting on the waiting list to get the procedure done. Surgery should hopefully be in spring/summer next year.

The Little Fear: I'm worried he'll reject me because I'm currently overweight. Not extremely - 5'10'', size M-L, 36 waist and dropping. But still overweight. I used to be a stress eater, then had an eating disorder and shuffled through crash diets and fasting, weight yo-yo-ed, then went back to stress eating, have now gotten my act together, made real lifestyle changes, and now eat a healthy diet and exercise daily. I'm slowly losing weight and keeping it off, but I'm basically terrified that he might not be willing to operate if my BMI is too high. Their website suggests between 19-25. They consider 30 to be on the questionable end. Mine is 36. I'd somehow need to drop 60 pounds at least, 80 ideally. I want to, in time, be slim and athletic, but I'm not a miracle worker. I'm afraid they'll put off the surgery. Afraid they'll push it back. I'm afraid my obsession with getting the surgery will see me drop back into disordered eating again just to end up light enough. I want to be slim. I'm working on it everyday. Don't get me wrong; I'm not suggesting doctors shouldn't suggest to patients that keeping a healthy weight is good for you. But ciswomen struck with breast cancer get mastectomies regardless of their size, and nobody stands by, tuts, and says, "we really want to do this, but maybe lose 60 pounds before we consider it, I'm sure the cancer won't too much worse meanwhile". Replace cancer with dysphoria and it's the exact same argument. (I stand by the comparison, too; I had a cancer scare when I was 18 and they rushed to operate, even though my BMI was far higher then than it is now, and I recovered from my surgery in record time and without complications.) 

I've been binding for almost 15 years, I just want to finally be able to stop :( I'm doing my best to power through and lose more weight for the surgery date, of course, but I'm terrified of a rejection. Brassard is the only surgeon around here who's covered by healthcare; all surrounding surgeons charge roundabouts of $2000 on top of the surgery, and I don't have that kind of money to throw around.

Now ... thinking positively and assuming I'll be able to work off more pounds, he'll do the surgery and I'm worried about nothing, here comes the even bigger problem. Just thinking about it makes my stomach turn.

The Big Fear: About two weeks ago I had my hysterectomy. Or rather -- attempted hysterectomy. I went in for what was meant to be a 1 hour laparoscopic routine surgery, done by a dedicated surgeon who specializes in them, has done them, daily, for decades. It turned into a 3 hour mess (that also ended up getting me a c-section-esque incision which is now keeping me from Pride, because hey, why not add insult to literal injury?). When I came to, he looked visibly distraught and kept apologizing. Nothing could be removed, he said. At first I thought he was joking. He wasn't.

So ... I have Crohn's. Late onset, not severe, but it's doing what it does. Simply put, one of the things Crohn's does is, it causes inflammations along the entire digestive system. When the inflammations heal, they often create scar tissue. What's happened is that the scar tissue that formed around my lower intestine has conjoined the intestine with my uterus, cervix, and everything else. It's impossible to cut them free from the connective scar tissue. The only solution would be to cut out the entire part of the intestine these parts are attached to. This, my surgeon said (and he had two other gynecologists called in to give their opinion and help), is profoundly dangerous. Complications are basically guaranteed. At worst, it could lead to toxic shock, bleeding, and/or death, and I'm pretty much guaranteed to get a colonoscopy bag afterwards even if things go well. He said he'd be willing to try and refer me to other surgeons if I absolutely insisted, but neither he nor his colleagues were willing to perform the surgery, nor does he think a lot of surgeons will volunteer, given the dangers. They all said they'd never quite seen anything like it. (My gut looks like it's something out of a David Lynch movie, don't I feel special.)

Everything looks absolutely healthy. Everything is in peak condition with not a single thing to worry about. It's just not removable. 

But here's the thing: without a complete hysterectomy I can't get a vaginectomy, and without a vaginectomy, bottom surgery is looking like it might be off the table or (but only if I'm very lucky, which I rarely ever am) reduced to compromises so minescule it'll make barely a difference. I am intensely dysphoric about my lower parts. Not getting to change them somehow in a way that looks or feels satisfactory -- having to keep them the way they are -- it's horrifying to me. I know, I know, there's a lot of transguys who either can't get or don't want lower surgery. But ... knowing I can't get this done, it hurts emotionally, it hurts physically. The past 2+ weeks have been reoccurring nightmares every night, anxiety every day. I want to strip the femaleness from my body but it resists my attempts to do so.

Essentially, the problem lies in that they're unwilling to close up anything because while I have a cervix, I need to be getting cervical screenings. I understand that, yes, in theory, I need to. However, funny story. (Not funny at all, actually, but go with it.) I've been living with Vaginismus my entire life. I've never had a screening. Ever. I've never had an examination of any sort. Penetration, medically or otherwise, is so fundamentally impossible that I've never met a gynecologist who could manage to get in there, and close to a dozen have tried. I'm 37, never had a cervical screening, but am assured my cervix is pristine. I mean, they just looked at it directly two weeks ago. They have seen first-hand that it looks good.

If they're telling me I'm free to make the choice to get a hysterectomy, in spite of the intense danger to my well-being, possibly my life, that it would involve, why can't I be free to make the choice to get lower surgery without it? Both options come with risks. I'm not saying they don't. But why am I allowed to accept the risk of one option but not the risk of the other? If cervical screenings are the singular reason I can't get complete lower surgery when cervical screenings aren't and never have been possible for me, where is the difference? It will remain "open" but as unused and inaccessible as it is now. What difference does it make? There is no conceivable difference to me -- except that it affects my mental health. I'm a wreck. By refusing the risk of the hysterectomy, I, by proxy, have to take on the risk of an entire lifetime of mental health problems and dysphoria. There is no healthy option here. There is no happy, risk-free option they can offer me. I understand they need to cover their legal bases, but I'm going to be suffering my entire life enduring something that could so easily be fixed. Just do the procedure. Just let me have it. Let me take this educated risk.

But ... knowing my luck, I doubt they will. I don't know what to do. My gynecologist said he'll keep a close eye on my insides with non-penetrative scans. He'll probably be willing to write me a reference letter explaining all is well but the procedure is impossible. Maybe he can convince the Montreal team. I just don't know. I know partial vaginectomies are possible, which ... is better than nothing.

Right now the plan as I'm aware of it is to get chest surgery, and while there for chest surgery, speak to the surgeons about options for lower surgery. But I'm so, so afraid they'll just say, "the rules are the rules" and not permit it.

To me, my lower parts are so bloody disgusting and wrong and the idea that I might be stuck with them ... I don't know how to deal with it, not really. I can't afford to go private. Some other clinics elsewhere in the world do partial vaginectomy + lower surgery, but nobody in Canada seems to, at least nobody who's funded by healthcare. At the very least I wanted surgery to allow me to pee standing up, but even that's not possible without the hysterectomy, according to the Montreal clinic's website.

I just ... look, I know, I know, I need to accept myself, I need to understand that whether or not I get this surgery, especially with being fortunate enough to get top surgery (if they do, given my weight!), I'm a man, I know I'm valid, I know all that but ... call it juvenile, call it self-loathing, to me, my body will always feel freakish if I can't get anything downstairs changed. Without a phallus and scrotum, I'm never going to feel really ... I don't know, complete, I guess. And now it looks like that'll be my future. I hold out hope that I can talk to the doctors about at least making some small adjustments but ... it's not going to make me happy. Not really. A little less miserable, and it's gutting that that's all I can hope for. I just want to feel whole and ok. And I know it'll never happen, and that terrifies me.

Sorry for the length, I just ... I had to vent. Any support would be great. (Note: except advice on weight loss. I'm already on a no sugar, low carb, lean diet and do an intensive daily workout. Weight loss comments have, on other forums and in the past, triggered my desire to go back to disordered eating big time. It's the last thing I need. It always comes with good intentions but it never helps.)