Altering the Body to Accommodate the Mind
It's been almost a year since my last big gender meltdown (as I like to call them). Over time I have come to recognise and accept periods of dysphoric intensity amongst what is a relatively calm? relationship with my body & gender performance. Picture a heavenly garden full of chubby queer cherubs shooting arrows every which way because heteronormativity was a 90’s one hit wonder, everyone here is a pansexual dream-boat and Erika Linda is feeding me grapes whilst Marsha P Johnson fingers the harp from her vegan marshmallow cloud. When this harmonious equilibrium is disrupted, you’re likely to find me crying into the mirror whilst shaving my head and soul singing to Britney Spears.
On the left was taken shortly after coming out in 2016 | The right was less than a year later.
I began binding my chest over 4 years ago. I alternated between a black GC2B binder and some peachy coloured Kinesiology tape. When the binder had crushed my ribs and suffocated my lungs for long enough, I would tape each breast down forming tiny ancient burial mounds that made my stretch marks itch. When the tape came off my skin went with it, leaving raw open wounds where the pressure had been held the most.
I am capable of taking sensible breaks from binding when I’m feeling ok, but during a meltdown, it’s especially difficult for people around me to watch as I continue to hurt my body because it’s the only way I can survive. For me though, the negative ramifications toward my general health amount to nothing in comparison to the discomfort of not feeling at home within my own skin.
Punto Gozadera, Mexico City | There is A LOT of tape going on underneath that vest.
The main culprit for these dark spells is the bright burning sun—summer clothes—my biggest trigger. As a person who dedicates the majority of their life to travelling in hot countries, this posed quite the problem. It was mid August, 2019 that things began to get too much. I had just arrived in Los Angeles after previously travelling through Cuba and Mexico with my partner Fae and our two children. By this point I was hyper aware of my body and the fact that I could not escape the heat, I had to wear clothes that showed my figure or fear melting into an embarrassing puddle of British sweat. But gendered despair aside, this trip was transformative in many ways:
I drove through Carson and decided to rename myself in the city lights, burying my birth name in the dry cracked earth of Death Valley 242 metres below sea level.
My wonderful partner Fae and I took our kids to Zion National Park and surprised them by proposing to each other, it was perfect.
We spent some family time in Utah where I painted a series of self explorative portraits that I later exhibited at Stretford Public Hall and HOME which you can access here Inquiry into Gender Dysphoria - Exhibition and here Everyone is an Artist – HOME.
Lastly, it was during a particularly difficult time in LA that Fae helped me to consider a breast reduction. A thousand lightbulbs exploded above my head, how had I not thought of this sooner? It was the answer to meeting half way. Suspended beyond binaries, my happy happy place.
I have watched people publicly transition on instagram and felt curious as they documented their top surgeries. I considered a double mastectomy for myself but it just felt too far away. The idea of growing a beard and being a full time dude was not for me and taking my breasts completely away had the potential to create more dysphoria than I already felt which would be catastrophic. I just wanted them to be small, I wanted to be the before photo of all the sad women on the internet who had massive implants. I just wanted to wear a vest and be free like Shane on the L Word, except I’m chubbier and I had a baby that I breastfed as a teen, so, you know, my boobs took a different path in life. I didn’t want to keep a bit of boob because I felt womanly or sexually attached, in actual fact, my partners have never touched my chest. I decided I wanted to keep some because having none at all didn’t feel ok. My body is a land mine, what can I say.
I am aware that the word ‘trans’ encompasses an array of humans who do not conform to gender roles/stereotypes but I haven’t personally embraced this, I knew I wasn’t transgender in the sense of moving from one binary to another (F2M), therefore this label has never felt like mine to wear and I have never tried it on. I’m not really one for labels in general because I can’t remain exclusive to any of them, yesterday my 8 and 9 year olds asked me what I identified as and the best I could come up with was,
‘abit of everything, mostly nothing, I like to think that I have transformed gender, labels are fleeting, my gender is like water, what does it even mean to be a human? Do you know we are all just experiencing this consciousness and no one really knows what it is or how we got here’
Somehow I don’t think this was the answer they were looking for...
Keiana & Luner | Golden Gate Bridge
We returned to London on the 27th of August 2019 after 8 weeks of travelling (with two hyperactive 8 year olds might I add) and jumped on an early train back home to Manchester. Imagine being sardined with a bunch serious, boring, seriously boring clones heading to the office whilst you are smelly, hungry and delirious with jet lag from the eleven hour flight you just took from San Francisco. ‘Can you move your fucking bag!’ One bloke kindly inquired – I swear I will never take a flight to or from Gatwick again just because it’s cheaper. The rest of the journey home was a blur but my mission had begun and I had no time to waste—I wanted less boobs by the time I got married. So, between moments of broken train signal I managed to call and get a doctors appointment for later that day. It was time I asked to be referred to the mystical Gender Identity Clinic. I was curious to see what the NHS could offer a person like me, I felt like I owed it to myself and others to do some investigating. I’d heard horror stories of GP’s not being very helpful with trans folk which was anxiety producing, I wondered what would they do with me? This in-between thing?
To my surprise, the GP was delightful. He didn’t dehumanise or invalidate my existence, rather, he created a safe space where I could share my truth and be heard. He told me he had never met anyone like me in his work but vowed to help nonetheless. That day he changed my name on the system and set out to make the important referral I had requested. If anyone living in South Manchester wishes to know his name/surgery, please feel welcome to ask me.
Below is a screenshot from the Gender Identity Clinic website taken on 12/7/20 displaying the wait times. As you can see, they are inundated with people who require access to their services. It is absolutely diabolical to me that this sector has not yet received the vital funding it so clearly needs. These wait times are unacceptable and it pains me to think of the many humans on this list (and also not on this list) who are struggling to survive or complete day to day tasks that many others take for granted, like using a public toilet, taking public transport or just generally stepping outside into the public world.
When I decided to enter the medical system as a gender variant person, I did so with the privilege of being white and financially stable with supportive family and friends, and whilst it was a pretty big stretch for us, it was always my backup plan to go private. I had already put myself on a self imposed travel ban and began to save incessantly. I was confident I would find a way to afford it if I needed too, which is a blessing I cannot thank the universe enough for because this is the letter I received from the clinic on the 16th of October 2019, almost 8 weeks from the time of referral.
The elation from the positive experience with my GP was swiftly clouded by self doubt. If the gender experts won’t see me, then am I even real? Clearly the only services available are limited to a binaristic ideology of what ‘gender reassignment’ looks like, but these people have PhD’s I thought, surely they have learned somewhere along the way that gender is not linear? There were no other specialists in this field with whom I could talk to and these folks had advised that I go off and ‘explore my feelings’. The letter was quite frankly patronising and the result of these words had left me feeling fraudulent.
I had so many questions that I needed answering before I decided to alter my body, I needed to talk to a medical professional about micro dosing on T, like how does this work and what (if any) are the complications of hormone therapy? What exactly does it do to my insides? Are their any harmful side effects that have been explored in clinical trials? I wanted to ask if their surgeons would do a breast reduction as an alternative to the prescribed double mastectomy to relieve the symptoms of dysphoria and excess binding that I suffered from.
Alas, I accepted that it would probably be a long time before I had any of these questions answered and time I was not prepared to give. My wedding was now booked for the 18thof November, a mere 12 weeks after returning to England. So, on I plodded into the glitzy glamorous realm of private plastic surgery, and man, what a trip!
My first discovery was that the marketing is extremely gendered. The leading companies in the U.K had plastered women all over their websites that perpetuated Eurocentric beauty standards that I as an intersectional feminist sought to dismantle. So, with morals packed firmly aside, I booked a free consultation with The Harley Medical Group because it seemed to have the most neutral advertising, and by most, I mean kind of a little bit and it didn’t have much pink on the website. Since then MYA cosmetics has undergone a makeover and rebranded their website to become more patient focused which is nice because it centres the narrative around real people with real bodies but most of them look like Kendal Jenner and have undergone breast enlargements and everything is still pink. Nice try MYA.
Me doing my best Jenner inspired mirror selfie
A few days later I met with a hyper-femme woman called Deborah who had visibly undergone quite a few procedures herself. I sat across from her rockin’ my fresh barber fade and baggy boy clothes feeling probably a lot like Trump when he first entered the Oval Office… that is to say, a fish out of water.
I explained that I wanted a breast reduction to go as small as possible and why. My expectation was to be met with confusion and more disappointment but again I was pleasantly surprised. Deb set me up on a surgical date a few days later with Dr Mohammed Ali (no kidding) to see if we were compatible.
Within the first 3 seconds It was clear that he couldn’t be arsed with everything I was as a person, he made no effort to listen and after about 6 minutes fobbed me off with ‘your breasts are perfect as they are, you don’t need to change them’. Obviously, I was not off to a very good start but if my previous experience with tinder had taught me anything it was that persistence is key and I had more determination than Uma Thurman on her quest to Kill Bill.
I returned to Debby prepared to speed date the shit out of all of the surgeons and find the one who would cut me open. As luck would have it, I met Dr Ashley Topps the second time round and he was perfect! Not only did he listen, he asked relevant, inquisitive questions to better understand my position. I was also comforted to learn that he had experience of working beside Janet Wells, one of Manchester’s leading surgeons who performed double mastectomies with the Gender Identity Clinic (I say ‘was’ because I believe she has now retired). Our initial meeting lasted a while and during this time Ashley explained that ideal candidates for breast reductions were usually people who suffered from back pain as a result of having large breasts, and in his entire career as plastic surgeon, no-one my size had ever requested such a thing. The main complication being that the nipple needs breast tissue and adequate blood flow to survive, removing tissue from a breast that is already relatively small posed a danger not many surgeons would go near. Interestingly, I was not dismissed despite this rather enormous obstacle, which of course gave me hope that it was possible, and I felt in my bones that Ashley would be the surgeon to overcome it... but it wasn’t going to be easy.
I was sent away for 6 weeks to consider an uplift instead, a more simple procedure that involved the removal of loose skin that caused the breast to sag, thus creating the illusion of larger breasts. During this time my wedding came and went, which was ok because nothing, not even my binder could cast a shadow on that day. Of course I returned after my time-out to reaffirm that what I wanted was a breast reduction, I felt as though Ashley was a little disappointed because it definitely would have been easier for everyone had I just taken the uplift, but he didn’t give up on me. He communicated that he needed to seek some professional advice from other surgeons to figure out what to do with me. So off I went again.
Entering the historically oppressive institution of marriage in dyke boots and blazers.
Within a few weeks I was so well known in the office that every receptionist could identify my voice when I called. I was relentless! A genderqueer Odysseus on a voyage to itty bitty titty land. By December, Ashley was ready to see me again with some bittersweet news. He was prepared to take me on as his patient under one circumstance. I was to produce proof from some other white man somewhere that I was mentally stable with a sound understanding of what I was doing. I tried not to feel angry at all the hoops I had to jump through but it pissed me off that any woman could walk in off the street, have bowling balls stuffed into her body and no-one would bat an eye. Yet here I was being asked to produce a psych evaluation because I wasn’t conforming to what is expected from a societally prescribed gender role. Beneath my rage at the patriarchy I understood that Ashley was just really trying to cover his ass, he was taking a risk with me and wanted to make sure a breast reduction was the right surgery, there were concerns that I could be confused about my gender and hadn’t fully considered complete top surgery. But no matter how much I protested that I was not a man trapped inside a woman’s body, that I knew myself and what I was doing, the conditions were non-negotiable. The verdict was out, it was a minor loss for the non-binary rebels.
A referral was made to my GP to request an evaluation on the NHS, or rather I thought a referral was made. Actually it took a serious amount of pestering not just Harley Medical but my doctor’s surgery to get things moving with this. In the end I got so fed up with it that I decided to pursue it privately, but then it was unclear whether I needed a report from a psychiatrist or clinical psychologist. No-one (including Ashley it seemed) really knew what the fuck they were doing which I suppose is absolutely expected considering I am the first person like me to walk through their doors. Eventually, 2 months later, I received confirmation that it was the clinical psychologist. Finally! I had something I could work with.
I found a U.K wide company called Clinical Partners who offered psychological reports for £225, which seems like a lot but was actually the most reasonable price I’d seen (others were up to £395). I booked an assessment on 14/2/20 with Liverpool based Dr Peter Dargan because I was told he had actually done reports for other gender variant people who had undergone cosmetic surgery with MYA. I was a zombie that morning, sick with anxiety and full of dread. The only thing that stood between me and my goal was some strange man that I’d never met, my life was literally in his hands. What if he declared I was insane? What if he decided that my childhood/adolescent trauma’s were all to blame and that all I really needed was some good old Freudian bashing? I decided it would be best to withhold as much as possible from him so I could manipulate the result of the report.
Stepping into Dr Dargan’s office smelled like present fathers and summer camping trips where you were initiated into masculinity by killing grizzlies with your bare hands and toasting with whiskey afterwards. He invited me to sit in an antique chesterfield the colour of blood to the side of his grand mahogany desk and it creaked as I slumped like a small child into it’s cold sturdy arms. I examined the library wall of vintage books that bragged about the achievements of men and thought, any minute now, Hemingway is going to emerge from behind the royal velvet curtains that frame the Tudor window in military dress and tell tall tales of beastly bulls whilst puffing on a pipe. I wasn’t intimidated at all.
Mr Peter sat facing me in his equally fancy chair and began by acknowledging his privilege. He set the precedence for open, honest dialogue by explaining that he was there for one purpose and that was to help me, he assured me that my fate was not in his hands and that nothing would go in the report that I wasn’t happy with. The anxiety that had wrecked my soul all morning melted into the leather that encompassed my body and I allowed myself to take up more space, I decided in that moment to meet him on the same level and my plan for withholding fizzled away. The appointment lasted 90 minutes. Afterwards, I hopped on a train back to Manchester to meet Fae and the kids in a museum for a family day out. I was feeling lousy as hell, it took me a moment to process that during the session we had touched on some deeply painful subjects that evoked bad memories that left me feeling gutted and raw. I cried in the middle of the exhibit, so we caught an Uber straight home and Fae held me for the rest of the day instead.
I scheduled an appointment for as soon as possible with Ashley, I’d done what he’d asked of me and I was excited to discuss the next steps, but a receptionist called the day before to cancel. Apparently, I needed my GP to confirm that he also harboured no concerns and was happy for the surgery to go ahead. This was news to me! It was early March by the time I managed to get a signed letter stating that there were no causes for concern, I marched it straight to Harley Medical and demanded that they book the surgery immediately. Well, it was more like politely request… I am painfully English after all.
Ashley wanted to see me at least one more time before we set a date, we revisited the photos I had conjured of my expectations, we did more pulling and prodding at the skin on my breasts to try an envisage what was possible and we discussed the procedure in great detail. After about half an hour, he was happy enough to give me the go ahead to book the big day.
This was it! It was happening!! I practically floated up to the front desk beaming from ear to ear like the Cheshire Cat. The receptionist, whom I’d never actually met before was so elated that she almost jumped for joy, it seemed that everyone in the building was really routing for me.
I was less excited however to find that the earliest availability to chop me up was at the end of May. Begrudgingly, I strapped in for more waiting… but was astounded to receive a call a few days later explaining that there had been a cancellation and did I want to do it on the 28th of March instead? It was only in two weeks time! I called Fae to see if it would be possible for us to make it work if I accepted it and she was super supportive (as always). A few days later I went in for my pre op and began to make the necessary preparations for the surgery. At the time, covid-19 was becoming more prominent on the news but it didn’t feel like an immediate threat. Over the next few days however, I watched helplessly as the coronavirus unravelled the country. As expected, the surgery was cancelled and rebooked for June, which was cancelled and then rebooked again for July. Have you ever seen the way monkeys pelt poo at unsuspecting zoo goers? Well, that was my life. I did however take comfort in the fact that the rest of the world was now on a travel ban with me (not even sorry).
England began to emerge from lockdown as my new surgery date approached and by some miracle it wasn’t cancelled. The only kicker now was that due to covid regulations, I could no longer take my wife into the hospital with me. Meanwhile, people were getting jolly in pubs far and wide in groups as large as 6! I could delay the surgery myself this time, wait longer for a reality where I no longer needed to sign a form that said I understood the risk of death from coronavirus. But I had come too far to back out now. So, unlike Dante’s Virgil, I had to embark on one of the scariest things I have ever done in my life. Alone.
Fae dropping me off at the hospital | I felt like her cat being deposited at the vet for neutering
In the end I was so drugged out of my mind that I barely noticed that I was alive never mind without company. I am immensely proud of myself for going after what I wanted and getting it, no matter what. I began writing this blog during intermittent periods of consciousness from my hospital bed until eventually a week later it became a coherent text. I felt compelled to share this story with a hope that it could exist quietly in the world for anyone who needed it, for anyone who wants to do what I have done. If nothing else, I have outlined the necessity of creating more awareness for people who exist in the margins of binary gender roles within the medical system. I don’t yet know what I can do to improve this for those that will come after me, but hopefully by sharing this experience I can spark a conversation.
The first day of the rest of my life?
For anyone curious about the surgery/recovery experience, check back in a few weeks as I am still healing, but it is my intent to write that blog and include photos of what you can expect from the surgery I have had.