Tuesday, June 28, 2011

Why I Chose Dr. Suporn, The Flight Back and Return to Work

I found Dr. Suporn by doing a Google query for best SRS surgeon. I landed on a forum page where someone claimed he was the best in the world, and there was a lot of concurrence. I found nothing but good reviews. The alternative in my mind was Dr. Marci Bowers, having had the operation herself and having had good reviews from members of Dr. Rita Cotterly's group who had the surgery done by her.

Both surgeons have a web site. And I found out as much as I could about them from what was available. I then emailed Dr. Bowers to find out what she would do if she came across endometrial tissue in the operation. I never received a reply.

What I liked about Dr. Suporn's process is that it was invented with pseudo-hermaphrodites in mind, primarily people who suffered from micro-penis. I really like the concept of an all-in-one procedure, the reported resulting depth and guarantee of retaining sensitivity. I also noticed the attitude toward optimal results evident in recommending that patients do not have scrotal electrolysis done as it reduces the stretchability of what will be the new vaginal wall.

When I emailed Dr. Suporn's clinic to find out what he would do in the event that he found endometrial tissue, I was informed that he would work around it, since he had operated on male presenting intersex people before.

I was very pleased at the response, the fact that the total cost would be less expensive and that I would be visiting Thailand to get it done. My father was stationed in Thailand right after I was born during the early part of the Vietnam conflict and I had married a woman from Laos, who I had planned to take with me. I have always wanted to visit Thailand.

On the flight back to the United States, I had failed to use the airline letter that The Suporn Clinic had given me. When I had scanned it, all I saw was a wheelchair request, and was holding on til I needed it. I was seated in a very cramped seat for 13 hours from China to Los Angeles aboard China Southern Airlines. When I got home and did my first dilation, I had to drop to the smallest dilator because my vagina was badly cramped. It was so bad during the flight that I couldn't even feel the need to pee until it was practically too late. When I opened the letter again, I noticed it also had a request to assign comfortable seating, which I had failed to use.

I started work at the office again last Monday. I was going to return on Wednesday, but I had a network connection problem that I had to go in to remedy. Once everyone had warmly welcomed me back, it felt silly to work remotely for the next day and a half, so I didn't. The first week, I was still bringing my cushion in to work with me because of the swelling; but the swelling is pretty much gone now.

I am six weeks, almost seven weeks, post op. I was able to enjoy a warm salt bath after a month and start swimming again last week. I have been in the apartment pool three times already since Wednesday. I didn't take advantage of it today, because I suspect I am in estrogen overload.

When last year I asked my endocrinologist in Lexington, Kentucky if I should reduce my hormones after surgery, she said it wasn't necessary. I was already on a fairly low dose, and I should have been fine until my August checkup. Before surgery, I would suffer PMS 4 days after my estrogen shot. After surgery, it was more like 11 days, more in line with a natural female cycle. Being a little foolish, I took my third estrogen shot on schedule, right as the PMS was subsiding. It was the point at which I would have had menses. The result was that I went into severe PMS cramping, light-headedness, and increased appetite (nutritional and sexual) through today so far. Seven days of PMS.

I have a referral in to see an endocrinologist locally, but that may take another week to get to scheduling. I have an appointment with an Ob/Gyn set for August 3rd, and my primary care physician, while at first saying she didn't know how to do it, finally ordered an estrogen count I requested done, while saying she can't control or manage it. I need a new primary care physician. The lab results come back in a couple of days.

So, meanwhile, I am going to back off to quad-weekly injections from bi-weekly, until I get direction from the gynecologist or the endocrinologist. Good news is that it will save me money. Bad news is that I have to starve the estrogen out, and that will take a couple of weeks and skipping the next injection on July 9 and waiting until the 23rd.

That's about it.
Hugs and God Bless,

Sunday, June 19, 2011

Father's Day

Father's Day and Mother's Day can be very difficult for many transgendered people--especially trans-parents. They are days when your children are expected to identify a parent as either a mother or a father. In essence, it is a day, that expected gender roles are celebrated, and because they don't feel like either, they feel left out.

For instance, being celebrated on Mother's Day seems to be wrong to me because I did not carry my children for 9 months, nor did I actually give birth to them. Father's day is a bit problematic because it holds a gender expectation with it.

In addition, the refusal to honor a trans-parent on Mother's Day or Father's Day by one's children can be their way of punishing you for failing to live up to their expectations.

But before I had sexual reassignment surgery, before I transitioned, before I even started taking hormones or seeing a therapist, I fathered two beautiful, intelligent and compassionate daughters. While I would have willingly carried and given birth to them myself, it was not physiologically possible. But once they were born, I had the opportunity to try to nurture them as best I could.

When my oldest daughter was born in late October, the day after my father's birthday, and I had cut the umbilical, they took her to the triage table where they could check her vitals, and right before they put they antibiotic in her eyes, I saw her tracking me from across the room with them. Then she was so mad when the cream was applied to her eyelids. We were bonded.

On Father's Day, 2003, the day before Summer started, I was busy attending the birth of my youngest daughter. After she was born and in the crib, she looked up at me, and because of her intense curiosity of my eyes, her left hand flung up, trying to touch them. I sometimes joke that she tried to claw my eyes out when she was born. In fact, our eyes were not safe around her for a couple of years. Her birthday's tomorrow, and she already has her gift, a Dell laptop computer.

When I started my transition, it must have been incredibly rough on them, as my oldest daughter was 9 and her sister was 3. To see a parent suddenly change gender over the next four years, while having to leave them to continue to make a living is a lot for children to absorb. They feel most comfortable calling me Dad, even though it doesn't fit society's gender definition anymore, and I feel honored by it.

So it absolutely made my day this morning to see a text message showing how much they've come to accept having a female father:

Happy Father's Day from me and Missy! We love you!

It's not easy being a remote female father to two young, beautiful and compassionate girls. We have had our moments over the past couple of years, but I remain always ready to be there for them, telling them every night I love them, no matter what; and listening.

I love them both and am so proud they were able to come through this at such a young age.

Wishing all the parent's out there a wonderful Parent's Day,
Hugs and God Bless,
Sophie Jean

Thursday, June 16, 2011

Fade to Stealth

I was just reading an article from a couple of weeks ago about someone severing their ties after surgery, because they were going stealth.

I'm not going to be that way, and here's why. There are a lot of people who look up to you and need guidance on their journey. Imagine walking into a support group, hoping to speak to someone about the next complications in your transition, and find that the people who have that knowledge have gone stealth, not responding to the trans community, leaving you a big sister, when you need one of your own. It happened to me, and it happened to a lot of people.

I did announce last week that the adult support group meeting I attended would probably be my last, because I am not in a position where I am needing emotional support. I have wonderful friends in the trans community, the LGBT community, and outside of it--most aware of my past, even though to practically all, they know me first as a woman.

I also don't feel like doing a lot of advocacy right now. I want to dance.

But at the same time, I am not severing my connections to the trans community. I will remain a Big Sister through the online support organization I have put together and maintain my friendships with the friends I already have. Indeed, Transcenders Global Social Support Network now has 51 members on FaceBook, and it serves a vital need that I refuse to abandon.

But meanwhile, in the rest of my life, for the time being, until something propels me into the spotlight, I am fading into stealth. There are fewer reasons to tell people about the way I was born, and I don't want it to define me. For instance, I no longer have to ask Human Resources at work whether the health policy covers SRS or how I will be able to complete it when I don't have enough paid-time-off to draw on. I'm done. Now I will just pursue what challenges me and makes me happy.

And I will seek support where it will be the most beneficial. There's an intersex support group meeting held in Ogden every month. I plan to be there.

Fading to Stealth,
Hugs and God Bless,
Sophie Jean

Wednesday, June 15, 2011

Are You Sure You're Not Both?

"Are you sure you're not both?" my mother asked when I came out to her four years ago after a few months of counseling and soul-searching. I thought she meant bi-gendered, and I answered that, no, I definitely feel that I am a woman.

But it was the fact that I had lost touch over the years with myself that when I walked into the counselor's office, it was because I couldn't discern a gender, either male or female. Part of me knew I was male, but something deeper inside made me crave to be female, that I needed to be a woman. In reality, I was part male, not wholly male, and part female, and accident of my birth. It's just the instinctual emotions, those that made me happy ran female.

My Mom explained that she meant having both male and female parts, intersex. I was pretty sure I wasn't born intersex. She told me about how they read about the intersex condition before I was born, and decided that if it should happen to me, they would have waited until I was old enough to decide what gender I wanted to be. It should have been diagnosed at birth or a later age if that was the condition, and I asserted to her, that only my mind was different. In fact, it was when I started the HRT treatment that I really began to tap into myself as a woman.

But I had a problem. Despite everything else, I had a testicle that wouldn't stay put. It went abdominal 3 times the week before my surgery, and when I inject estrogen, a few days later I get cramps on the same side.

So it's with no surprise that when I woke from my surgery, I finally felt whole. It was three and a half weeks later that I was presented with a real look at myself.

On May 7th, I took a very long series of flights from Salt Lake City, Utah to Bangkok, Thailand, where I was met by one of the nurses from Dr. Suporn's clinic. On the ride to the hotel, I discussed my strange issues while she took notes. She told me also about the fighting with Cambodia after I had told her about my father. My father had come to Thailand right after I was born. Almost 46 years later, I returned to be reborn.

Once I got to the hotel, I was told to come to the clinic about 2:30 that afternoon. There they had me fill out forms, draw pictures and read an instruction manual. One of the nurses brought over a wreath of really sweet smelling flowers and a red silk box that held my dilators. She explained the use of each one, and my anxiety began. Drawing a person from head-to-toe triggered an anxiety of being unable to draw a complete person without them looking deformed in some way, and then reading what I was going to have to do for the rest of my life to maintain my vagina almost put me over the edge.

The psychiatrist came over and began an interview with me while we waited my turn. He asked about my drawings and discussed how I was handling my separation and divorce. Eventually, he was interrupted for my turn to see Dr. Suporn.

Looking a little like Jackie Chan, he had me disrobe from the waist down to see what he had to work with and then showed me slides of his procedure. It didn't seem to phase him about my undescended testicle until I told him it had made its journey three times this week. At that point, he told me to remind him on the operating table.

I was then told by the nurses to be ready to go to the hospital by noon the next day, the 10th. I was so exhausted by the trip that I spent the night just sleeping, got my free breakfast in the morning and packed. I kept bunny out of my bag, so I could hold her. The only time I have ever held her in public. I figured that this was a great occasion, as she helped with my anxiety.

At the hospital, I had my blood drawn, my breasts x-rayed, blood pressure taken and an EKG and echocardiogram done by a cardiologist that Dr. Suporn consulted for me. My leaky valve? It's mitral valve prolapse, and promised not to be a problem during surgery.

After I returned to my room, I was visited by the psychiatrist, the anesthesiologist and the cardiologist. I only had a few hours until it I was directed out of my clothes and into the hospital clothes and then given a genital shave with a straight razor and a brutal enema. That was 9 pm.

In the morning, at 6:30 am, I moved over to my surgical gurney, Bunny was placed in my arms and I was wheeled down to the operating theater. The anesthesiologist said hi to me from behind her mask, and I was moved over to the operating table where, Bunny was lifted out of my arms, my arms stretched to the sides and the anesthesia drip was connected to the stint on the back of my left hand. My eyelids fluttered a couple of times. I closed my eyes for just a moment, immediately opening them to make sure I really fell asleep and heard the words, "You're operation was a success," while the gurney was moving. I did a mental probe down to my genital area, felt the bandages and the absence of my testicles and knew everything was the way it was supposed to be.

I had to spend the next 5 days in bed, turning from side-to-side with a pillow beneath my legs. On the second day, I was to also lift my legs every couple of hours to avoid deep vein thrombosis. On the 5th day, the doctor removed the bandages and one of the catheters. It was two days later, after the doctor removed the packing from my vagina and the catheter from my urethra that I was finally allowed to bathe. The urethra repair by the doctors when I was 9, was completely undone. When I stood, I was thankful for my belly dance posture that Kelly had drilled into me, because standing back on my heels instead of up on my toes would have had me face flat on the floor.

I drank bottle after bottle of water, until I could pee, and they let me go to the hotel. The following day as I did my dilation, I realized that deep, empty emotional feeling I had experienced 4 years previously was actually the spot in my mind for mapping to the vaginal canal. I was and am completely a woman.

The next 2 1/2 weeks I had checkups daily with the nurses and checkups twice a week with Dr. Suporn. I learned to carry a cushion around every where I went and took anti-inflammation pills with every meal for the swelling. Right before I left, on my last appointment and after my last checkup, Dr. Suporn asked if I would like to see the pictures.

This was the moment of final truth. Either I had been right about having an undiagnosed intersex condition, or I had been having severe illusions. It didn't really matter anymore. I braced myself for the revelation.

There were a few shots of his examination from before he began cutting, and when he said, "They're gone," he was referring to a picture of the gonads laid out with the scrotum cut open, I noticed immediately that there was a difference between the two. Farther in the process, I saw what arrested my eyes. I was much worse than I had thought. While my working side had been simple muscle tissue, the left side looked like a tendon on the inside with creamy white spongy tissue attached to the outside. There wasn't just a single hole. There were at least two. I was a pseudo-hermaphrodite, and I wasn't crazy. I was just undiagnosed. It's really hard to argue with a photograph.

Dr. Suporn worked around the tissue. The vaginal canal is sealed, but if the endometrial tissue is producing menses blood, it is coming from the inner labia housing the clitoris and urethra. I am going to have to be very clear with my primary care physician to make her understand that I am and will always be different.

According to the World Health Organization, I am no longer transsexual; but I will remain intersex.

Hugs and God Bless,

Tuesday, June 14, 2011


The valley is beautiful. I'm working from home until next Wednesday (the 22nd) to finish off my 6 week recuperation. It has it's challenges. But at 4, when I knock off, I'm home.
There's still some discomfort when sitting, and I'm hoping by next Wednesday I won't have to drag my cushion around with me. Other than the slight swelling, and having finished all my anti-inflammatories, I am healing quite well.
I am so jealous of the people at the swimming pool. I still have to wait another week before I can immerse myself in one.
I've planted a few chili pepper seeds and some petunias that I picked up at WalMart. I can't resist stepping outside to my east-ward facing front balcony to visit them about every hour or so. I guess I'll miss that opportunity when I start back at the office.
Last night I saw my second movie since I've been back. Maybe I'll splurge and order a pizza delivered today.

Monday, June 6, 2011

Back in the USA

Just to let everyone know that I am back in Salt Lake City from my "visit" to Dr. Suporn. He is worth every penny. Pictures from my surgery show the massive difference between my cryptorchid gonad and the other. The normal one had bumps all over it, while my problematic one was creamy white and shaped like a very smooth, yet smaller egg. Behind the creamy white egg was not muscular tissue, like on the right side, but a large amount of spongy white tissue with a couple of very narrow openings. I suspect it is endometrial tissue. Anyway, it doesn't look as if the doctor removed the differing tissue, but just worked on around it. 

I asked the nurse before I left how often someone like me, with the differing tissue, is operated on by Dr. Suporn. She told me there have been a few, but it is not very frequent.

Having already done the name change last year, updating my sex with the Social Security Administration was a piece of cake. When my turn came, I simply told them I needed my gender corrected and presented the letter signed by Dr. Suporn. Tomorrow, I'm taking my lunch break to transfer my driver's license to Utah, so I will have a clean record in their database with only a single name and gender.

Birth certificate is a bit of a pain, since I was born in Maine. The directive asks for a certified copy of my SRS documentation and I only have a sort-of copy. What I have is a consulate letter that certifies Dr. Suporn attached to one of the copies of the other letter. I am trying to get in direct contact with the vital statistics office and the person who is going to handle my change, but they rarely answer the phone and I have yet to get through.

Meanwhile, I contacted the medical ombudsman that the company I work for hired to let her know I need to start the claims process and quite potentially the appeal process with my insurance company. She has responded that she will do what she can to help and get back with me by tomorrow, if not sooner.

So, that's about it. My surgery was May 11. I got back yesterday in time for the Pride Parade in downtown Salt Lake City and am working remotely from home until the 22nd, the end of the recommended 6-week recuperation time before returning to work.

Dilations are 3 times a day for the next couple of months, and then they gradually taper off until it's once every two weeks to check for depth after a year. In two more months I can start the private intense belly dance lessons I have lined up.

It's good to return home, to my friends, my work and my life in general.

Hugs and God Bless,