MTF in need of help

[Michelle_P]

Voice

What I have been learning is to relax my throat.
I learned a massage exercise from a speech pathologist to relax the throat.
Next do motor boats and tongue and mouth perception exercises.
Hum the scale and M and N sounds. Start feeling the M and N sound resonance in your face.
That is the goal for all sounds. M and N are the easiest.
Say sentences with M and N letters in the first letter location such as, mix mink milk.
Next, use your diagram (diaphragmatic breathing) to push air not your chest.
Keep your head up and in line with your spine (opens up the throat and greatly enhances putting the resonance from your vocal cords into your nasal cavity).
Then practice sentence thinking you are talking to someone across the room.
Use air to make words, do not be air stingy.
Use intonation and emotion in your speech.
Use your mouth as an instrument to form words.
Feel your mouth and lips making the words and exaggerate.
Speak up.

Rachel, that is a GREAT tip sheet, probably the most concise list of reminders I've seen yet.  I keep forgetting to do all these things and keep falling into old bad habits.  I'm printing this on a card to carry with me.

It looks like I may be joining you on the quest for overseas medical services.  My Kaiser NorCal plan covers FFS and BA when medically necessary, and they certainly are.  (Without 30 minutes of makeup I am so definitely a 'dude in a dress', as so many deleted FaceBook comments say.). However...  They are so overbooked that I am on a waitlist to be eventually scheduled for surgery, apparently for once 2019 OR bookings open up.  The Catch-22 here is that in November 2018 I am forced onto Medicare (Kaiser Senior Advantage, a Medicare Plus plan), and Medicare plans will not cover FFS and BA.  (Only individual plans are required to cover 'all necessary services' by California law.  If another party is paying, like a pension plan or the Feds they get to set the rules.)

Rather than wait a year and a half to be eventually denied coverage and pay the 6 figure charge master price for FFS and BA, I figure that if I have to pay, I might as well do some shopping and maybe get a better deal with an experienced surgical team.  The overseas price at some places is just a little more than my copay and deductible would have been anyway!  I had money set aside for a condo purchase I can divert for this, and maybe settle for a studio or just rent, so that's no problem.  (A couple folks I know offered to hook me up with their 'business' to raise some cash for this.  Apparently older preop trans women are popular with some folks!  I think I can avoid that for now.)

Is there a surgery frequent flyer program for us? 

[Rachel]

Hi Michelle, 5 months of speech therapy and that is the gist of it. That and a lot of practice and using my voice all th time. I am also working on annunciation and vocal power and slowing down my speach. I am glad it hit a cord (lol).

I was told prior to my ffs with Dr. Spiegel that my face lift, lower and mid,would only be 80% effective due to all the bone work being done. There is only so much that can be done at any given time.

I think I just need soft tissue work and the cost is so much less in Thailand. I should have gone there the first time and saved a lot of money. I am very glad I went to doctor McGinn for GCS. The amount of time she has spent with me is exceptional.

[Rachel]

Warning ************This could be triggering*********************Warning

Voice
Today after work I had voice therapy. I understand how I can get to my front head voice. I need to keep it there which is easier said than done. I keep going from my front head voice (resonance with proper pitch) to head voice which is just proper pitch. When I get excited I increase my word rate and at times go below my head voice. Practice and time is what is needed.

Makeup
I wore eyeliner along with my usual light makeup at work. Two guys said I looked good. Both said everything is coming together.  I know my boss and his boss noticed. I had on a killer outfit today too.

Point of inflection
I am not going to do anything. I need to vent. I will discuss this with my Therapist tomorrow.

I feel like I am at an inflection point. A point where I do not know what to do. In the past I had horrible dysphoria to battle. A good portion of that I have addressed. I have more to do but I am addressing those issues. I am not on the fence. I am actively doing what I need to do. Yet, I can not see a future.

In the past I knew what the next day would hold, to some extent or to a great deal. Now I do not have a sense of purpose. I never lived for me. If I was to die my monetary commitment to my ex-wife and daughter would be fulfilled with insurance monies.

What will I do? I will be alone. This takes me back to age 31. I am and look like a transwoman in a world of CIS. I know I need to fit in but one is not like the others.

Guys, how can a guy take the pressure of being with a transwoman? This is how I feel. My Ops Manager said how can you know unless you try. How do you know what someone else finds attractive. I do not want to be with a guy for a one nighter. I want someone I can share things, places and times together.

I have felt broken and damaged my whole life. Now people can see what I hid on the inside. This is me. This is who I am. I can not hide who I am nor do I want to. I just wish I did not feel so out of place. I so desperately want to not feel so different.

I know I am feeling down because my slow motion family train wreck just keeps going on. I can see the end of the co-habitation in sight. I have a real fear of being alone. Perhaps that is driving how I feel and bringing out my feelings of helplessness, feelings of being different and not having a future with happiness.

I am just venting. I need to vent somewhere. I am not suicidal. I feel great then something comes along and the feeling of doom returns.

I guess being divorced and alone and unloved will eventually go away or get less with time.

Tomorrow is another day and the Philly Trans Health Conference. Tomorrow will be another day. Maybe it is all the rain and cold temperatures that has me down. Maybe Peking Duck House will be in my future tomorrow for lunch after watching the raising of the trans flag above City Hall.

IHT

[Kendra]

Even though it is good to finally end a sad and undesirable co-habitation situation, it's totally understandable that change can cause stress and emotions.

I am convinced you will not be literally alone for a long time, but yes you will be alone at first.  And you don't have to be alone while you are alone.  You have us and you have local activities.  Organize your favorite music and play it at your place any time once it's all yours.  Treat yourself to something nice the first few days.  Take a make-up class for fun.  Learn a foreign language and set a goal of visiting that country.  Just some ideas. 

You are divorced but you are definitely not unloved.

[Rachel]

Thank you Kendra.

Funny you mention makeup. Next to or adjacent to the 12th street gym in the gayborhood a trans woman that Owens two hair salons opened up a trans makeup salon. I found out this two days ago at work. At work we treat 500 trans kids and at the volunteers department I am friends with several people. They told me. One person lives close by and another across the street

Something I have been thinking. I discussed my hair color with the hairdresser at work. He provides free hair services to the patients.  Anyhow, hair color after my hair transplants are able to be colored has been on my mind. I am going to color my hair. It has been suggested I go blond. I have green eyes and light skin and had white hair when I was a child and that turned blond then brown then light brown blond and salt and pepper now.

What color blond? There are so many to choose from. I was thinking something a little darker than my avitar. Perhaps the avitar base color with some underlights for dimention.

At some point my pic needs to be my avitar. Perhaps when my hair is colored.

[SadieBlake]

Rachel, one thing I went through as I was first dealing with being trans was being recently divorced and becoming comfortable with being alone. Becoming simply comfortable with myself made it possible to establish new friendships and to feel far more connected to people than I had before. I don't regret it, my marital relationship had never been a healthy thing and learning how to better relate to people has made my life since far richer

[Kendra]

As your home situation is about to change, something to consider: we are different, we broke the mold and that's a great thing.  I know several very happy couples that are a FTM and MTF pair - they understand each others' histories and achievements in ways that draw them even closer together.  And cis-gender male with a MTF, and cis-gender female with MTF.  There are other possibilities - depends on preferences and it's all over the map these days.  I have been in a steady dating relationship with a married cis-gender male and female couple for the past 16 months, I even went to their family reunion and nobody blinked.

Hair color.  Mine is naturally black so any highlights or color requires careful bleaching, I leave that to the professionals.  It's not obvious in my current avatar but 1/3 of my hair is bleached blonde and then darkened with purple, also some dark blue.  I have gotten away with this at the office the past year (I am not full time yet) because the color is quite bold outdoors but barely noticeable indoors.  My eyes are hazel-green (the Welsh half of me) and that contrasts well with purple.  When people ask I tell them that's my natural hair color - and I'm surprised by the number who believe it until I laugh. 

[Laurie]

  Hi Rachel,

  I don't know that I can help. probably not but I want you to understand that you are not alone. You've been reading my ramblings and have tried to help. I thank you. Some things are just going to take time. I know this and you know this. It doesn't really help knowing because the hurt and pain is still there and at first it is so raw you don't want anyone touching it because their wanting to help makes it hurt some more. You welcome the support and compassion and on some level it does help knowing our friends are out there for us. Know that your not alone Rachel.

I have felt broken and damaged my whole life. Now people can see what I hid on the inside. This is me. This is who I am. I can not hide who I am nor do I want to. I just wish I did not feel so out of place. I so desperately want to not feel so different.

  Did you write this for me?  We and a lot of us have felt this way. For myself I tend to return to this feeling of brokenness if I ever left it behind. At this moment I'm not sure. But you are right once we are out people see us and you want to hide but can't. At least not from those that love us. My friends in Missouri are like that. Before they really got to know me, Peggy has been able to see through my facade and touch my soul. I can't hide myself from her even 2000 miles away. We need people like Peggy.

I know I am feeling down because my slow motion family train wreck just keeps going on. I can see the end of the co-habitation in sight. I have a real fear of being alone. Perhaps that is driving how I feel and bringing out my feelings of helplessness, feelings of being different and not having a future with happiness.

  This was my fear all of my married life. I was always insecure about my marriage. I never felt good enough and never understood why she chose me. I loved my wife desperately. I did my best to keep her, but did all the wrong things to do it. I just drove her away and ruined my family in the process. I was wretched after the divorce. I hated myself and wanted to hate her but I could not. I wished she had died as I thought that would have been easier to deal with. It gets better with time.

I am just venting. I need to vent somewhere. I am not suicidal. I feel great then something comes along and the feeling of doom returns.

  lol Rachel, I have to laugh at this. Not because it is funny but because you have defined me in that last sentence.It sums me up pretty well. You are doing okay, almost happy even then suddenly your world crashes in on you. I don't usually vent instead I isolate, retreat from the world, I hide. My feelings more than physically, though at times I want  nothing more than to be gone. Sometimes  wishing I had a place far away from the world to retreat to and not only be gone but to never return. If I had such a place I think I would not be here writing this to show you you are not alone in your despair. But I don't and life goes on. Friends reach out and touch you and eventually they coax you back and you let them help.

I guess being divorced and alone and unloved will eventually go away or get less with time.

  It takes time but you will learn to live with the loss of your wife. Eventually I came to understand she did what she had to do. It was the best decision she could make for herself. I believe that now but I still hold the hurt and love of her somewhere deep inside of me. It doesn't make you happy but you can live with it. It takes time. As for the loss of your children, well I'll let you know if I get over that. I've accepted the death of my son a few years ago of a heart attack. He was born with a developmental problem and never achieved a functional level where he could live on his own. He became too much for my ex to control and we had to put him in a group home. He had a mental age of about 3 1/2 years and was a loving child most of the time. He died at 39. I had not seen him for many years and that ate at me for many years. My daughter. well I'll have to get back to you on that.  So again Rachel you are not alone. It will take time.

Tomorrow is another day and the Philly Trans Health Conference. Tomorrow will be another day. Maybe it is all the rain and cold temperatures that has me down. Maybe Peking Duck House will be in my future tomorrow for lunch after watching the raising of the trans flag above City Hall.

IHT

  When I started this reply I said "I don't know that I can help..." I don't think I have. Not you and not me, I hesitate to hit that post button. But I think I will only because I think my words will convey that you are not alone. Others suffer along side you with similar issues and you are not alone and in time some things get easier if not better. We are never alone unless we insist on keeping those that want to help out. Yes I am one that tries to do that but there are a few I can never succeed doing it with. They are the ones that pull me out of my depths of despair so I can crawl back into the light of day again. I'm sorry if I made things worse Rachel and I thank you for reaching out to me.

Yes, Rachel, tomorrow is another day and we will just have to wait and see what it will bring. Hopefully it will be better.

Laurie

[MaryXYX]

Dear Rachel and Laurie,

Thank you both for your openness.  We may be alone in the house or office or street or wherever, but we are not completely alone because we have people here who understand.  This has been a long struggle and Rachel is still writing about it.  Just keep going, there are some good times to come.

Mary

[Rachel]

Thank you Sadie, Kendra, Laurie and Mary for all your support and help. It really means a lot to me. It helps to unload and let loose when I am down or afraid of the future. Just putting it out there, putting your thoughts in text is a huge help. It frames the thoughts that has power over me and a way to address the thoughts.

Sadie, I 100% agree. I accept I am trans and really am happy I can be me, finally. However, I have never been alone in my life or had time to become comfortable with me. I look forward to the future and being not only happy I can be me but happy being me.

Kendra, I really like Hispanic guys. I have some Hispanic friends and was offered help in going out and meeting guys. In time, just a few more months. Hair, after the graphs I get later this month I will have my hair colored, whan I can. Most likely some blond style. Now, I need to lose 18 more pounds.

Laurie, what can I say but thanks. We are going through some of the same stuff currently. I miss the closeness and friendship. I really hate the nightly crap I get. I know it is best for her and most likely it is best for me too. My daughter's rejection hurts bad. She still talks to me in the house but sometimes it gets rough. Outside the house I am dead to her. I will never be a part of her life going forward. I am dead to her (that hurt).

Mary, I agree. The people here a wonderful and I am never alone because of people like you.

I was at the PTHC Thurs and Friday and will be there Saturday. I volunteered at my work table and for Mazzoni. I was a room monitor for some great presentations. I will be contacting an advocate and a specific lawyer for my insurance appeals.


Thank you for being there.

[Rachel]

I was triggered pretty bad last leek at group. It was about physical and sexual abuse when a person was young and recently. The two weeks prior (one week prior as the trans health conference) three woman went into detail about coming out to family and relatives. The destruction of relationships was so depressing and it brought up a lot of emotions.

There is a point when you are sailing along and enjoying life and then wham you are back in the time things imploded. I give the best support I can. I know where things are heading for them. I know if they are strong they will adjust to the new normal.

I am starting to really like being me. There are times it is difficult but I know I will get through it and know it is just temporary.

I heard this from others. It gets better and now I can see how things get better. Different but better.
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Next Sunday I head to Dr. Cooley's for round 2 hair transplants. They did 3500 grafts last time and corrected 1/3 of my bald top and are doing 2000 grafts this time. I will ask them when can I color my hair (blond) and can I do more grafts in the future or are we done and what is the outcome.
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I am starting an appeal for my FFS and have contacted a Lawyer (transman from Harvard) that specializes in trans insurance appeals. If I see 50% recoup from the appeal then I will be happy. This is more about my agency. I am finally at a spot where I can challenge my insurance company and my work (self insured) and not accept. I have wonderful benefits and they are a fantastic employer; however, I need to do this to show myself an end of the beginning.

I have a message into Mazzoni and Dr. Siegel's for documentation. Mount Auburn changed medical records filing systems and I will need to call them to get a copy of my medical record. My therapist is making a special letter defining my past GD about my face. Funny thing is I can look in mirrors now, in the bathroom at work too.
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I did two 5 mile hikes this weekend in 1.5 to 1.75 hours up and down hills ( I wonder if I can add my 40 pound pack back in after my BA?) I will need to contact Papillion. I really want to increase my conditioning. I will do 30 flights of steps in the morning during the week. I added squats at the top last week and will increase that to 50. Also I will add a lunch step routine with lunges (25/leg) the top.
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I filed for my new passport this weekend and changing my 403B too
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[HappyMoni]

Rachel,
   Even if we get everything dysphoria wise taken care of, real life is still a battle to fend off the things that can cause us to be down. You have proven your strength. All one has to do is read your thread to know that. Stay strong, gather your strength by helping others. You have kind of a track record of doing this, ya know.
   I am seriously thinking of making arrangements with Cooley. Could you describe how they assessed how much to do, how and where to do it. (Skype, visit, pictures?)
   Hugs,
Moni

[Rachel]

Hi Monica, I took a lot of pictures. I had some of the guys at work help take the pics (funny, I had the guys at work witness all my surgical paperwork. It really helped make them part of my transition). I had pictures with wet and dry hair parted in different ways. The wet hair pics I took at home. 

I worked with their office and did 3000 FUT grafts. They charged $12,000 and actually installed 3500 graphs. It was a 12 hour procedure with the doctor and his PAC. I did not feel anything but a few needle picks. Work paid for 100% because I meet their deductible and he is in-network.

He is said to be one of the best. However, if work insurance did not pay for it I would consider going to another country.

Lollie is wonderful and helped me and answered my questions. Her contact:

Lollie Russo, MA

Patient Coordinator
Carolina Dermatology Hair Center
Pineville Medical Plaza
10650 Park Rd., Suite 310
Charlotte, NC 28210
704-542-1601
704-542-1063 Fax

I am bringing my birth certificate to North Carolina just in case. The Governor signed into law that you need to pee in the bathroom as the sex marked on your birth certificate. 

[JLT1]

Hi!!!!

I don't know what happened with your insurance.  Let me kniw if I can help....

Hugs,

Jen

[Rachel]

Hello Jen,

I am going to file an appeal for my FFS. I am getting a letter from my therapist and the head or trans care and my MD at Mazzoni confirming GD with specifics for face. Dr. Spiegel will not produce a letter with anything other than extensive FFS  was performed 9/2016 so Ms. Mcxxxx can fit into her female gender role. I read my medical record in MAH's old system and put in a request (today) for the surgical reason for my FFS signed by the surgeon. Dr. Spiegel stated in my surgical record FFS due to gender dysphoria and something about persistent since childhood (more than one way to get a letter). I filed the medical record request today by fax to Mount Auburn Hospital Health Information Management department.

Aetna is frustrating, Tomorrow will be the third time I am requesting my Plan Description. I will get that.

I have my surgical receipt.

I filed for reimbursement and the reason I was denied was not covered. I have about 150 days left for the appeal.

Thank you for your offer to help. I will contact you. I now have the agency to stick up for myself, odd how I have changed with my transition. I have access to a legal source (Trans Lawyer that specializes in medical appeals) if I need to. Jen, I will ask you for your thoughts and opinions when I have all my documents together. I think having Dr. Spiegel's surgical reason is a bonus . How can they disprove his surgical notes and reason?

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I was contacted by someone to put up pics with my surgeons to prove I am not a fake. I never thought of having a pic with my surgeons. I do not have any. It was suggested I put a pic up of myself. I stopped on my way home and tried to take one in my car. I can not press the button. I feel really ugly. I do not see male anymore, just andro. Andro and old with gray frizzy hair.

In Boston I have pics under the dome of the monument at Reads hill. I have PICs of butterflies in my room after GCS. I have no pics of Pineville NC. I am going there Monday and still will have no pics because I want no pics from there. I have no pics of my therapist or of group.  I can take a pic of my Mentor BA card, my purple and orange dilator, my wing form Dr. McGinn. I can show a before and day 1 and 2 post op from FFS in MAH.

I guess I am a faker or a poser.

[Rachel]

I will be leaving for the airport in a little less than 2.5 hours. I just got back from Core Creak park and a 5 mile fast walk . I need to dilate, clean up and get ready. I have my bag packed with birth certificate in my purse and will be have my round two hair graphs Monday starting at 7 am.

Round one hair grafts worked out very well so I am excited to get this done. I will ask when I can do more and when can I color my hair. I am going to be blond 😀

Something I noticed last night and now, my vaginal canal is a bit tight. I walked 10 miles yesterday and 5 miles today so perhaps that is why.

Update on FFS appeal.

Aetna will not provide me the plan description . This is not the plan summery but the plan description. I contacted an advocate and they are making the request. I may need the help of a lawyer .

I received the letter from my therapist which was exceptional. I forwarded it to Elaine Dutton at Mazzoni for concurrences and or elaboration from her and my pcp. Mount Auburn was contacted for a copy of the ffs surgery reason document signed by Dr. Spiegel and Dr. Spiegel's office is will send a letter confirming surgery was performed.

[Rachel]

I had 2500 grafts installed at Dr. Cooley's in North Carolina.

I was there in March and the difference was remarkable, from the airport, cabs hotel, witnesses and waiters and of corse at Carolina Aesthetics I was gendered correctly. Im March I was gendered male.

Since March to now I had my BA and hair grafts phase one and I wore a fitted top and 6 inch inseam shorts. My thigh tats were very visible. A clouded leopard and spotted jag. I know I grew the fold in confidence and I use my more feminine voice (not there yet). Other than that all else is the same. So why was I gendered 100% female?

I received an awesome FFS letter from my therapist. in it she stated I had severe dysphoria and that I no longer had gender dysphoria (post my procedures I still have VFS scheduled). I thought about that and my crippling dysphoria is no where to be found. I still have some dysphoria about things such as voice and hight but the crippling dysphoria is gone. I go to places and do not think about how I look. There are exceptions like when I will pee in Charlottesville airport and be thinking about being harassed.

So I have been thinking about how far my dysphoria had been reduced and that everything I do now adds so much to my agency. I am a different person. I do things now that I never could. In work I am different too. It is amazing how much I have grown.

The bottom line is that dysphoria is treatable. I never thought I would say that because I never knew it was treatable. 

The learning difficulties I faced and still face are survivable. Perhaps it make me better, slower, but better. I see details others miss. I hang on every detail.

I still get triggered like last week at group when a woman went into being forced to perform sex and how she was sexually abused when young. I was able to get out of it. I was able to think about it and although for a while I was reliving it I used the tools I learned. I was always stuck on how someone could do that and why did they do it. I have answers ( I had to make them up but they are the highest probability reasons) that I use and next I understand why they did ( that is a leap, my therapist said that perhaps they were abused too) it and then forgive them or I try. That is the hardest part. I do not know if I believe I forgive them but I at least say it a few times.

[Kendra]

> I was there in March and the difference was remarkable, from the airport, cabs hotel, witnesses and waiters and of corse at Carolina Aesthetics I was gendered correctly.

Rachel, a huge milestone in a relatively short amount of time.  You earned it all. 

[Rachel]

Hi Kendra, thank you. There is a huge difference between last year and this year. I just need to stop eating all the goodies while waiting for my flight at 9:30 😞

[Rachel]

I received a letter from The Department of State requesting an original of my GCS document. I will call Papillion tomorrow and get 2 original copies. I cave them a copy of my GCS form but I guess they want a raised seal. They also said it may not be returned. So I will not send the one I got from Papillion. It means so much to me.

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Day 3 post hair grafts. I can sleep through tonight and not spray my head every 2 hours during the night but I need to continue hourly spraying with the ATP every hour. Between last time and this time I had 6000 grafts. I will return in 7 months and I can do 1500 more grafts. I will get 200 on each eye brow, very excited. The 1100 can go to where it is most needed. Hair is about done.

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Ok, I went potty  at the charlotte airport about 5 times yesterday. I was there from 11:30 A.M till my flight at 8:45 P.M. I drank a lot of diet soda, green tea and water. I also had frozen yogurt, salad and some baked potato chips and yes a slice of lemon cake, I had no issue what so ever in the bathroom. I was addressed as mam from the attendants. They had attendants in the bathrooms and they were very clean. Way different than a Philly airport.
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When I look in the mirror I see a female face looking back, sometimes. Maybe I should post a pic for my avatar.

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Nov 20 I go to Papillion for my annual checkup (Coming up on a year) and closing off the bottom on my vagina. I also have a homework assignment to experience womanhood. I discussed this with the woman I do electrolysis with and she is in community and goes to the gone group. She suggested I go with a pre-op transwoman. I never thought of this before. I do not know if I could. I never thought of a transwoman that way.
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VFS with Dr. Haban is scheduled 12/20/2017 for a triple. After the assessment a single, double or triple will be decided.
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