Thursday, 21 October 2010
Still shooting as the Bomb explodes
It was of course the first pre-op consultation with Mr Philip Thomas, surgeon, at the Brighton Nuffield Hospital. I'd found myself overcome with the enormity of it all, and what a massive step this was, and how quickly it could all happen.
The appointment was at 5.15pm, and I took this with a pinch of salt. Quite rightly. It turned out that another girl called F---, who lived and worked in Somerset, and who had driven over from Taunton after lunch, also had an appointment at 5.15pm. Both in the same tumbril, then. F--- was a bit ahead of me in the timescale, and was looking for a Christmas operation, whereas I was thinking of sometime in the spring of 2011, March or April say. She was very pleasant, and I hope the fates will throw us together again.
First, we met Mr Thomas's Clinical Nurse Specialist, Liz Hills. I'd met Liz before, when making my daily visits to Debbie at the Nuffield in November 2009, and Liz remembered Debbie very fondly.
Liz immediately impresses you, instilling huge confidence, and quickly becomes not only your personal expert clinical adviser but your friend and mother combined. She has that wonderful ability to lift concerns off your heart, and banish fear and dread. And to be fair, I encountered nobody at the Nuffield who wasn't helpful, friendly and fixated on the job. The place has a good atmosphere. It is attractive, efficient, clean and modern. There is no lurking undercurrent of cut corners, stress or chaos. It's all very reassuring.
Liz took us gently through what to expect. She was very clear. There was really no need to take notes - a pink folder full of printed material was provided. You were freed up to listen. What we heard all sounded eminently manageable. Bring it on, you felt. Then she put us in the hands of Carla, her Clinical Assistant, who took us up to Floor 1 and showed us the general setup there, and in particular one of the rooms, Room 12, which I could swear was the one that Debbie had occupied eleven months ago. It was spotless, well-equipped, and had a lovely view over the Downs, all the way to the sea. An inspiring view. Important when you awoke after the operation, and later on when the first euphoria might have evoporated, and you needed a reminder that there was a beautiful world out there, sunny and calm. It was very like a hotel bedroom, but with specialised fittings. In the ensuite bathroom Carla showed us the dilators and a douche that we would learn to use and take home. It didn't look possible that those long, smooth, transparent cylinders would be able to slide inside! They reminded me of high-quality, high-tech glass ornaments. But again, I was so reassured that I felt I'd actually enjoy setting up a dilation routine for myself, and becoming expert at it, another accomplishment.
Then back downstairs, and I was in first with Mr Thomas, with Liz in attendance. I had met him three times before, but this was the first proper personal consultation, with the subject expressly being my personal anatomy, and how my own body was going to be changed. I dare say I was a bit overawed. He was, after all, one of the two main men in this field in the UK! Gulp. But he was charming, and put me at ease. He explained the finer points of the penile inversion surgery, and especially the risks and complications that could arise. Some were more remote possibilities than others, but I made a mental note to expect some little problems at least, considering my age. I'd have to come off the oestragen six weeks before surgery, to ensure minimum risk of blood-clotting. That was no problem for me. Then Liz took me into an adjoining examination room. I took off the bottom half of my kit, got onto the table, and grasped a mirror from Liz so that I could see whatever I wanted of the proceedings. Then Mr T, with rubber gloves on, had a good look at me. He didn't have to look for long. He anticipated no special problems, and said that I did not need any pre-op hair removal.
What? No hair removal at all? I got dressed and we spoke further. The operation had recently been refined. Hitherto the base of the penis had had to be cleared of hair so that the new clitoris was not lost in the forest, so to speak (my words, not Mr T's), and also so that excess hair wasn't left just inside the new vagina. Just how much to remove depended on the individual's own physique of course, which was highly variable. If for example one had been circumcised, a lot more penile and scrotal skin had to be used for the labia and to line the vagina, and that would indeed need time-consuming hair-removal treatment. But for uncircumcised people like me, the latest method did not use any skin from the base of the penis. It allowed the clitoris to be hair-free and avoided an unnatural ring of bare skin around the vaginal opening. It would look just like any woman's. And if a trans woman wanted less hair post-op, to suit her personal cosmetic needs, then she merely used any of the standard commercial hair-removal techniques that an ordinary woman would employ. But what about hair on the penile shaft? This would need to go, because otherwise it would end up deep inside the vagina, but it getting rid of it would be a comparatively minor job. Right, that was clear now.
But then...if only a few hair-removal sessions would be needed, for just the sparse wisps of hair on the penile shaft, the op could be brought forward, couldn't it? Yes, indeed. I wouldn't have to wait months and months? No. At this point my head started to feel a bit over-saturated with information and things to consider!
There was another thing.. Mr T wanted me to lose some weight. About 10kg, bringing my weight down from 90kg to 80kg - roughly from 14 stone to 12.5 stone. I could do that. I mean, what a motivation, the op and its results as the prize.
There was some more conversation about psychiatric assessment and so on that I didn't really take in, deciding that it could be gone into when I felt better able to focus on it. I thanked Mr Thomas, wrote out a cheque for the consultation, and agreed with Liz that we'd speak in a few days' time. And so I left, wishing F--- all the best. I had a slight headache, but nevertheless felt euphoric. As if a bomb had exploded, engulfing me in the blast, but I had emerged unscathed; though somehow different, as if I'd undergone some vital rite of passage. I was surely now on my way. I'd crossed the Rubicon. Alea iacta est!
The following day I had a long walk by myself across the wide sands exposed at low tide at East Head, near West Wittering on Chichester Harbour. The sunshine was brilliant, blinding even. The cold wind was keen. It was the first day this year when I'd felt the need for gloves. Winter was coming. On the other side of it I'd be in the Nuffield and changed forever.
Footnote: Just spoken again with Liz. Provisionally, my admission date will be 28 February, with the operation on the morning of 1 March, and discharge on 8 March. I must come off hormones on 18 January.
Memo: Must ensure that I have my hair done as close to admission as I can.