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,


  1. Hi Sophie

    You're not alone. Dr Suporn is probably the best in the world when it comes to reconstruction of non-standard anatomy. One of the reasons I chose him in 2006.

    Your reaction to HRT may not be the usual too, it's not so much the genital irregularity as the possible underlying cause for it that may make your response different. Please let your endo know about this. A karyotype is certainly in order.

    You and I straddle the line between TS and IS. But then, many do, far more than most realise.

    HUGS and congrats. Heal quickly, dilate often.


  2. Hi Zoe,


    It's also one of the reasons I chose him. I didn't know you had Suporn.

    I asked for an XXY test a couple of years ago. It came back as normal phenotype XY.

    I am pretty sure I inherited the condition from my father. He was bilaterally cryptorchid at birth. The physicians moved to fix both testes, but the left one went necrotic anyway.

    I suspect I have a form of Kallman's Syndrome, not that it really matters anymore. Not all of the genes have been identified which cause it, but the damage was done because I wasn't fixed at birth. For whatever reason, the left gonad never developed completely and obviously never fired anti-mullerian hormones. Hypogonadotropic Hypogonadism. The right testicle was in overdrive trying to compensate for the lost testosterone.

    I say all this with another dilation coming up.


  3. Hi Sophie,

    We've never met. Indeed, you don't know me. I have nothing significant or insightful to offer. Yet, having just read through your intimate post of a profound experience, I cannot simply close out the browser without extending a mere hello first.

    Your words have touched my heart, and I am deeply moved by your account. The journey you've taken is meaningful and complex, as life tends to be. Thank you for bravely documenting and posting such a poignant story; I have grown having read it.

    I wish you a swift and complete recovery,


  4. To all, I know what you mean. I'm a little older but had surgery and was told I had scar tissue in the genital region that was not conducive to what I had told the doctor. I don't know what happened when I was a year old or less and no one ever told me. They have long since passed. It doesn't matter, I have fixed the problem and the pieces to a puzzle have been put in place. Only wished I would have known sooner. Don't blame my parents or grandparents for not saying anything, they were probably ignorant to my condition.