You don’t measure vulnerability by the amount of disclosure. You measure it by the amount of courage to show up and be seen when you can’t control the outcome.
Brené Brown, The Call to Courage
The dominant narrative in contemporary Canadian society is that prejudice is a thing of the past. That racism ended with the U.S. civil rights movement, sexism with sexual liberation, and colonialism with confederation. These myths prevail even as the facts disproving them shout in our faces.
This dissonance between perception and reality is of little surprise given that these narratives around prejudice are driven by the political landscape, executive boards, and media – all of which are currently dominated by affluent white men*. Theirs isn’t a malicious role so much as reflective of the smallness of their shared experience. But it takes more than affluent white men increasing awareness to change things; it takes institutions and organizations looking like the people they serve in substantive numbers at the highest echelons. There can be no tangible improvement as long as affluent white men make up the majority of decision makers.
In the end, a lot of prejudice isn’t fueled by hate, but by discomfort, and only with vulnerability can it be addressed meaningfully. Though discomfort is more innocuous-sounding than hate, actions (or lack thereof) rooted in discomfort can be indistinguishable in their cruelty and harm done to those motivated by hate.
Discrimination is normalized
Before going further it’s worth listing some of the discrimination that is normalized in the current climate. The threshold for acceptability into unacceptability seems to be the point where today’s affluent white men* would immediately benefit from its resolution.
For some examples of marginalization, let’s look at how women are excluded from positions of influence:
In the 42nd parliament (2015-2019), only 26% of MPs are women. Male perspectives define the legislature.
In 2018, 148 women and girls are killed in Canada. 90% of their killers are men. In Toronto, a self-proclaimed incel targets women in a mass murder. Women are harassed by men for simple activities like walking down thesidewalk.
In 2017, the Quebec government implements a ban on face coverings, designed to prevent women from accessing public services and obtaining jobs in the public sector if they are visibly Muslim.
To this day, the Canadian government refuses to treat indigenous peoples as equal partners. In 2007, the UN Declaration on the Rights of Indigenous Peoples is adopted with 144 nations voting in favour. Canada was one of the only four nations to oppose the declaration. In 2018, the private member’s Bill C-262 is introduced by NDP Romeo Saganash to harmonize laws with the declaration. As of the time of this writing, it looks likely to be killed by delay.
This does not have to be our reality. We could be on the path to reconciliation, work to end sexism in a tangible way, and treat all faiths with equal respect. It just takes people in the right positions choosing differently. They do not.
The reasons are twofold: the affluent white men* in decision making positions don’t have to and don’t want to. The don’t have to part is easy enough: they are not personally negatively impacted by this discrimination, the people they are accountable to don’t ask for it, and there’s no legislation to mandate it. As change carries risk of losing eminence, maintaining the status quo is more desirable.
Then there’s why they don’t want to. There is one class of people who don’t believe there are widespread experiences of discrimination. They persevered and were able to make it, and so if others did not have the same outcome, it’s attributed to character. They are not inclined to appreciate the additional barriers specific to separate groups. This class is not the focus of this article.
There is a second class of people who do believe discrimination exists but are unwilling to make the decisions that would challenge it. Members of both classes share the belief that they personally would be worse off were they to push for this change. The former because they don’t want the world this change would bring. The latter because pushing has consequences. Either way, the end result is the same.
It is this second class which believes prejudice exists and is morally wrong but make successive decisions to uphold it that is the focus of this article.
Acknowledging the cost
For affluent white men*, doing the right thing has a cost. Money spent on accessible entrances, washrooms and spaces means less money spent on them. Inclusive hiring practices means more restrictions on how they behave. Respecting indigenous sovereignty means they can’t operate unilaterally. Gender balanced executive boards mean less job openings for them. They give up something.
Even smaller gestures, like friends speaking up when hearing a joke that belittles a group of people, or teachers openly vocalizing for a GSA in a Catholic school that’s opposed them, lose something by doing so. Maybe it’s the esteem in which they’re held. Maybe it’s the work environment. They feel uncomfortable.
Bearing these costs is a very difficult proposition for affluent white men* to accept when doing so is entirely voluntary. It predisposes them to stand back, be silent, and presume others will carry out the change in a kind of bystander effect.
Change requires losing control on outcomes
It’s difficult for affluent white men* in decision making positions to accept a cost when they don’t have to. It’s even harder to accept when they can’t predict what the cost will be. What would their life look like if decision makers in the government stopped perpetrating this slow-motion genocide against indigenous people? What would their life look like if decision makers in companies decided that half of managers should be women? Or more immediately, what would their work environment look like if they spoke up when their colleague made a sexist joke?
For tangible change to happen, these men need to be okay with being vulnerable. As Brené Brown put it in that opening quote, that means doing things knowing the outcome can’t be controlled. It’s scary and a reality that those on the receiving end of discrimination know too well. They have no choice. That vulnerability is foisted upon them every day.
Discrimination will continue for generations because decision makers preserve their sense of safety by keeping to insignificant changes or voicing support only in the company of like-minded individuals. Only when they accept to be uncomfortable and assume the cost of doing what they know is right will they be able to say that they stood up to prejudice.
In the end, we will remember not the words of our enemies, but the silence of our friends.
Martin Luther King, The Trumpet of Conscience
*Specifically affluent, Christian heritage, white, settler, able-bodied, straight, cisgender, men who own a car and a house. Or individuals who fit eight out of ten criteria.
I had laser eye surgery two days ago, one month after my vaginoplasty. I had Intralase SBK (Sub-Bowman’s Keratomileusis) done. So now I’m doing post-operative care for two surgeries. When it rains.
The procedure to correct my vision was quick and painless. There wasn’t even any discomfort. I wish though I would have known that ahead of time, because the machines looked very intimidating and I was trembling in fear. That shaking knocked off the suction device they put on your eye twice and audibly frustrated the doctor. They gave me 1mg of Ativan before the procedure, but it might as well have been a placebo. It wasn’t at all like the vaginoplasty where whatever drugs they gave me kept me very calm despite being operated on while conscious.
I had the laser eye procedure at 1pm. It was done in minutes. A few hours later, my eyes were constantly watering and it was hard to keep them open. I could see, but my vision was blurry. Also, my sinuses were acting up as if I had had a terrible cold. I also had to put eye drops every two hours, including through the night. Come the next morning, all that had stopped. I could see far better than I had without glasses, though I had difficulty focusing on things closer to me. It’s as if my eyes were shaking in minute oscillations, making it difficult to see things sharply.
In the follow up appointment the next day, the ophthalmologist told me the blurriness was expected, it was a product of swelling inside the eye as a result of the laser. The hemorrhaging on the surface of my eye was also normal, a product of the suction device that had been put on during surgery.
Visible hemorrhaging on the surface of my eye.
All in all, I’m very pleased with the outcome of this surgery so far. Even if this were to be it, and my vision weren’t to improve over the course of the next week as it’s expected to do, it would be fine. It’s amazing not to need glasses that tint the world and constantly need cleaning, to gain peripheral vision, to gain my sense depth.
How glad I am that I got the courage to do this. In other news, I finally stopped bleeding from my vaginoplasty yesterday! I also wore jeans for the first time yesterday, and I can sit on hard surfaces like wooden chairs now without too much pain. Progress!
If we do not transform our pain, we will most assuredly transmit it—usually to those closest to us: our family, our neighbors, our co-workers, and invariably, the most vulnerable, our children.
Richard Rohr
The greatest transformation in my adult life has not been around my transition, coming out, or shifting from school to ten years into a career. It’s been around my emotional literacy and mental well-being.
It didn’t come easy
This transformation was never assured. There were a few pivot points, all of which occurred in my first intimate relationship in my mid-twenties.
The first pivot point was the night where I had a panic attack and vomited in bed. I had had these every night since I was fifteen, which my boyfriend would help me through. But this night was worse than the others. “This has to stop,” he told me. Those words got me to see my GP. My doctor prescribed me SSRIs and within months the panic attacks ended. It’s been almost ten years since then and they’ve never come back.
The second pivot point was when my boyfriend and I decided to see a relationship counselor. My fights with him were ugly but also all I knew given my upbringing. I would say the most hurtful things. He might pin me to the floor and threaten me. I thought arguments had to have a winner and a loser. The therapist transformed my understanding of conflict from something to fear and avoid into an opportunity to grow closer with my partner. I learned about the toxicity of indirect communication like my passive aggressive comments, got to practice being direct about my needs and desires, learned to listen to the feelings underlying expressions of hurt instead of getting defensive, and came to express my own anger constructively using fill in the blank sentences. The therapist also provided a safe environment to share difficult words. Thanks to her help and hard work from my partner and I, our relationship metamorphosed into a deeply intimate friendship.
The third pivot point was over a longer stretch, but it had to do with my boyfriend affirming his boundaries, and making me aware that I was entitled to my own. In so doing he helped give me words to what bothered me so much about my parents then regularly disregarding my agency. It also later protected me when subsequent partners wanted me to give up my reproductive choices, job, and/or church community to align with their values. It gave me a path forward to make my life a more enjoyable one.
The slow path forward
More than anything, these pivot points distanced me from the values of my parents. Had it not been for the life-changing encounter of my first boyfriend, I think it’s quite possible that I would have hurt a lot more people that I care about. Not out of any desire to harm them – quite the contrary – but out ignorance, entitlement, and insecurity.
As time went on I saw a number of therapists, each of which helped me become more like the person I aspired to be. One of them introduced me to Dialectical Behaviour Therapy (DBT) which helped me gain the emotional regulation skills that I had never acquired growing up: mindfulness to notice when my feelings were snowballing, distraction to defuse them in the moment, and time boxed delay strategies to address the underlying conditions at a more propitious time. These tools put an all but end to the self-harm that had initially started in adolescence to avoid getting beaten at home but then became an automatic response to all mental health crises. I found the DBT Skills Workbook tremendously valuable to continue on the work of my therapist.
Having friends and family model possibilities was also important. I had felt a lot of shame for taking the actions I needed to do in order to protect my mental health, like not having any contact with my parents for a while. Seeing my friends do this, and later my step-sister and sister, gave me the strength I needed. I also admired my sister when she nonchalantly brushed off the news of my parents considering legal action against her so they could see their grandchildren more often. The ground breaking work of those around me was helpful to establish new norms for my well-being.
Pivot points or not, the path forward would still be bumpy. When two men in their fifties sexually assaulted me on separate occasions in my twenties, I took it, because I felt shame for saying no – the shame my parents have kept trying to instill in me to this day. I’ve also had a number of relationships end due to my own attachment issues. I have much work to do, but I do not lose sight of all the progress I’ve made thus far.
I also let go
For a good while, I was angry at my parents. As I came into my own, my negative experiences growing up and a recognition of how it had shaped me overshadowed more and more of my pleasant memories. This despite my appreciation for their making sure that I was housed, fed, clothed, had plenty of extra-curricular activities and was supported in my creative expression growing up. By the time I approached the age my parents had me at, I lost the excuses I had made for dangling me over a stairwell as a child asking me if I wanted to die, hitting me regularly in frustration, threatening to beat me as a teen, or the numerous heartless comments as an adult and the unwillingness to apologize for any of it to this day.
In the end I let my anger go. Anger is an important emotion that wants things changed. But the past can’t be changed and there gets to be a point where that anger erodes the present. My parents were the product of their own life experiences and they have come out of it with an under-developed capacity for empathy and introspection. They are not going to change and so getting frustrated is without benefit. What I can change is me. I have full agency over my life and can become the person I want to be. The parent I want to be. I don’t need to forget the past to live in the present and let go of that hurt.
Part of that also means letting go of the anger for how they treat me and my siblings in the present. That one was harder but it went away when I realized that all the work I’ve put into myself enabled me to have emotional intimacy with those I love. I was angry because I felt like their actions had been without consequence, that they could say and do hurtful things and dismiss its impacts when brought up. When I realized that they were missing out on emotional intimacy with me, and that there had been consequences all along, those feelings went away.
I still love my parents of course and I spend quality time. They are generous and loving people. But that quality isn’t from our conversations, but about sharing space with some mutual unspoken affection. They’ve established that they aren’t safe to open up to and be vulnerable around. It took many deeply wounding moments to accept this. Instead, we talk about the weather and other pleasantries. I don’t engage when they get to subjects of personal sensitivity. They were my only family not to know about my bottom surgery. They have not met either of the two people I’m currently dating or my ex. I ignore the passive aggressive remarks by realizing that they disregard my feelings to meet their emotional needs. I’ve let go of hoping they could change. It’s not up to me. I accept the reality of this situation.
That might sound sad, and I was for a while. I wanted to have a relationship in adulthood like my friends did. Someone I could turn to for support when I was sad and gush to about my partners. But life moves on; I found a way to be around my parents and I’m content. Like the opening quote says, I have learned to transform my pain. I will break the cycle. I will continue on this messy life, to make mistakes, to listen, and work to become better than I was.
It’s been a month since my vaginoplasty. The time since has passed extremely quickly and been uneventful.
I learned rather quickly that despite having some mobility, I needed to do far less than I had initially felt I could do. Nonetheless, I had no problem taking care of myself solo. I had bought a bunch of groceries in anticipation of my recovery, enough to last me a few weeks, I had meal prepped ahead of time, and for everything else I was mobile enough to go to the grocery section of the drug store across the road from my apartment.
I got a bunch of visitors in my second week back. It was really nice to get guests, especially as I was more or less in bed all day, and I appreciated the food they dropped off. It was also reassuring to have other pairs of eyes on my healing wounds.
Some of the lovely visitors I received.
As far as my healing went, I’ve been bleeding all month. I had been wearing adult diapers and GoodNites, and I’m just now able to switch to pads. My surgical site has also been extremely swollen. Like the bleeding it has steadily decreased over time but it’s still sore, limiting the length of time I’m able to stay standing, walking, or sitting. If you get this procedure done you should get a bag of frozen peas.
The only contact I’ve had with the surgeon’s office since coming back has been two follow up emails. I’ve sent them photos so they can evaluate if I need to be attentive to anything obvious. They have yet to reply to the second email. On my exit from the recovery center they issued me the opioid-based painkiller Tramadol. I used it the one time to handle the journey back Ottawa. Otherwise I took Tylenol twice a day during the first few weeks, plus the antibiotics that they had prescribed.
In the past month there’s been continual signs of progress. Whether that’s being able to tie my shoes for the first time a few days ago, or sitting at a coffee shop without feeling constant pain, or being able to lay on my stomach. I’m very pleased. In terms of care, I currently spend about two hours each day bathing and tending to my wounds. I no longer apply ice to my groin area.
I’ve given myself two estradiol injections since my return. I’m slowly feeling back to my estrogen-based normal, after having been through a challenging intermediary period where my body was back on testosterone. I haven’t taken spironolactone since my return, which has been lovely. Not having my nights interrupted by multiple trips to the washroom is alone worth the discomfort of surgery. By body’s insatiable appetite for salt (pickles!) has also gone along with the diuretic.
My only dismay is that I went back to work a week after coming back from the recovery facility. It’s too soon but I had little choice. I lost my last job with less than two week’s notice after an unexpected change of corporate priorities. I found another position weeks later, but by that time surgery was less than two months away. I just didn’t feel like I had the flexibility to take more than two weeks off. Luckily, I’ve been working from home. But I’m still exhausted all the time. I really could use more rest than I get.
On February 6th 2019 I underwent a “vaginoplasty without vaginal cavity.” In other words, the surgeon turned my penis and scrotum into a vulva.
I wanted to talk about that process, and how it went. Before I do, I just want to say how thankful I am to Jay, who stayed with me and took care of me in the days before surgery and at the hospital. He held me when I was scared, and was there to help me through. I am likewise so grateful to Tim, Gillian and Iain, my dad and step-mom, and Joy. I am also indebted to all those who messaged me online during this period.
When I saw my doctor in June or July of 2014, she asked me if I wanted to start the process. I declined as I needed time to think about it further.
Over the next three years, I resolved it was for me. It would free me from spiro and its unpleasant side effects. I would be more comfortable wearing form fitting bottom wear. I would be safer in change rooms. I wouldn’t miss the sex – it had always been a chore and painful for me. My sperm was frozen. Plus I had had a post-puberty penis for twenty years and now I could experience something different. I wasn’t as resolute as I expected, but would I truly ever be? It was a jump into the unknown but as with hormone replacement therapy I was comfortable with all outcomes.
In October 2017, I saw my doctor to get the ball rolling for surgery. I had printed out a template letter for her to use with the Ministry of Health. She wrote her own instead, and gave me a referral to a second doctor. Under the new way of doing things, I needed one doctor and another registered health professional to write letters proving I was trans enough.
In November 2017, while Joy and I were seeing a play, I got a call from Jay. The surgery information had come in from the surgeon’s office. I was in tears. I had been approved! The second doctor must have just signed off and this was it! I called the surgeon’s office. They had no file on me. They couldn’t tell me why they had sent this information, and what it meant. I was deflated.
Come January 2018, I hadn’t heard anything from the second doctor. I saw my GP, and she gave me another referral. The first referral finally called me to schedule an appointment. Then the second. I cancelled with the second explaining them what had happened. They were understanding.
In February 2018, I saw the second doctor. She was the local community health clinic something like once a month to see trans patients. We talked for an hour, and by the end she approved me.
In April 2018 the surgeon’s office contacted me to request missing documents. This meant the Ministry of Health approved funding for my surgery. The second doctor had submitted the letter to the Ministry, but perhaps the surgeon’s office hadn’t received a copy.
I went to my GP to get a copy of the second referral letter that the other doctor had written and submitted everything to the surgeon’s office in May 2018. The office informed me that they would process my file at some indeterminate point in the future. They wouldn’t give me a rough idea of whether that would take weeks or months.
During the summer of 2018 I didn’t hear from the surgeon’s office and worried I had fallen through the cracks. I resolved to call them every three months for updates.
In October 2018, I got a call from the surgeon’s office. They had a tentative date for in February. They would send me information three months before, so in November.
November 2018 came and went and I hadn’t heard anything from the surgeon’s office. Meanwhile I knew from friends that I needed to stop taking hormones a month before surgery. I had received no instructions. That same month, I lost my job. I would be having surgery right after starting at a new workplace, complicating things.
In the first days of December 2018, I emailed out asking about being off hormones. Two weeks later, I got a reply saying yes, and that it should be in the information sent to me. Only, they hadn’t sent me any such information. I called and emailed to get that information, but no one answered phones or returned my messages. Meanwhile I found a job. My manager there was understanding about surgery.
In January 2019, I started calling every day until I got someone. I got the surgeon’s wife, who worked in the office. She was surprised I wasn’t given the information. Finally, they emailed it. In the package, there was the request that I have blood tests done and sent in for December 15th, 2018. It normally would take a month just to see my doctor. I called the surgeon’s office. They said I had to get the blood tests done for two weeks before the surgery date or the procedure would be cancelled. I called my doctor’s office explaining the situation. I was able to get the blood test done the next day. A week later the surgeon’s office let me know they had received the results.
In late January, the surgeon’s office sent me an email with the time to show up at the hospital. 11 am on February 6th. I wrote letters to my besties Jay and Joy to read in the event that I passed away during surgery. I also left instructions and spent time with people close to me.
On February 4th 2019, Jay and I took the train out. We would get off a stop early, at the request of the taxi driver that was pre-paid by the surgeon’s office.
Surgery
It seemed like surgery was so far away. Then it was immediately upon me. There didn’t seem to be an in-between. It hit me when I arrived at the train station. This was it.
I was scared. I was scared of going to sleep during the surgery and not waking up. I suppressed that fear as best I could, but in doing so I removed the capacity to feel happiness or excitement at the procedure.
I felt a bit in the dark. I showed up at the hotel on February 4 2019 with Jay. The hotel had reservations for me paid for by the surgeon’s office. I went to the room and found two enema kits and instructions from the surgeon’s office.
The enemas were bottles with a long lubricated tip. One on February 5 at 4 pm, the other four hours later. Right during Trump’s state of the union address. I resolved the enema was preferable to Trump.
I was worried. Up until this point, I hadn’t talked to any medical professional at the surgeon’s office. Communication wasn’t really respondent with the administrative staff. What if I missed something? What if they needed to cancel on me that day? I felt so in the dark. Being sent generic PDFs as the sole source of technical information wasn’t super reassuring.
I thought I wouldn’t be able to sleep the night before surgery but I did. The next morning we showed up at the surgeon’s office for 11 am on February 6. We arrived early and filled out paperwork about not photographing other guests without their consent, the risks of the procedure, etc. A cute trans guy showed up with two friends.
At around 11 am they came for me. I was brought to an office the size of a closet, where the nurse went over the information I had sent in: allergies, weight, etc. She checked if I had shaved my genitals well. She gave me pills to take, and then she brought me and Jay to my hospital room.
I put on the hospital gown and robe. We waited. The surgeon came by. He was amenable. He asked if I or Jay had any questions. He then said there was a concern of whether there was enough material for my junk to work with. He inspected it, said there was more than enough. He then told us it would be an hour to an hour and a half wait.
At around 12:30 pm the nurse came by. She brought me to a separate admissions room alone. We switched to talking in French; the English was for Jay’s benefit. I waited in the admissions room. The cute trans guy showed up. We talked. He was here for top surgery and would be discharged that day. He was really nice and from Montreal. We both had a lot of nervous laughter as we talked. He was scared too.
The anesthesiologist came in. We switched to talking in French. He said he would give me an epidural. There would not be general anesthesia. I would be conscious but under heavy sedation. He asked if I had any questions, then left.
A nurse came by shortly later. She brought me to the operation room. The anesthesiologist told her I spoke good French and we could talk in that language. Everyone switched. We laughed; she said and here she was trying to pronounce my name in English. In the operating room was a table for me, with extensions and straps for the arms. It reminded me of what they put people in the US who had lethal injection.
A nurse asked me to sit up. He gave me a pillow to hold on to. Something that felt like a bag of cold gel was applied to my back. I was tense; he was there with me telling me to relax and rubbing my shoulders. His presence really helped. Then they put a cream. Then I felt the prick of a needle, comparable to what I had with my intramuscular injections. Then I felt something funny inside my spine. The epidural was done. It wasn’t painful. Just mildly uncomfortable.
The surgeon came in. My legs were raised up, like at a gynecologists office. They put these wraps on my legs that would compress them every twenty seconds for ten seconds. A blue sheet was placed to cover my view. The surgeon started working, I could feel him applying something to my thighs and junk. I could feel him doing something to my genitals.
I woke up in the recovery room. To one side was a third person who had been in the admissions room with the cute trans guy. He was moaning and under a lot of pain. To the other was someone who had breast augmentation. I waited there an hour on a bed, immobile. It was longer than anticipated due to a shift change. I was fully alert. My pain was maybe 1 out of 10. I couldn’t move my legs.
They wheeled me over to the hospital room. Jay was there. We chatted. My pain got to 2 or 3 out of 10. There was another person in the room with me. She was a trans woman from BC. She told me about her life.
Joy arrived. Jay was here too and we took selfies. Having my two best friends here was such a moment of happiness for me. I love them so much. She left then two friends from church, Gillian and Iain, came. We had a lovely talk and they took Jay out to dinner. Joy came back and stayed with me until visiting hours ended at 8:30 pm. We had a good chat that included talking about the Buddhist interpretation of Christianity. I got given pills to help sleep. Pain went down to 1/10. I had full control of my legs now.
At 10 pm they came to change my dressing and get me to walk. They got me up, I took two excruciating side steps, and was back in bed. The pain increased to 4/10. At midnight they woke me up to take my pulse. Pain was back down to 1/10.
I couldn’t sleep easily after that so I took my phone and wrote a draft for this article. It was a good move because this day would be really blurry come a few days later. I did fall asleep at 2 am, but was woken up again two hours later. My hospital mate was in a lot of pain. At 5 am the staff came in to change the dressing, replace the IV, and give me a breakfast menu. I checked off white bread, peanut butter, and herbal tea.
Day after surgery
The breakfast was the first food I had had since the burrito the night before surgery.
A nurse then came by and took me for a walk. I was bracing for it to hurt like yesterday but it didn’t. I was able to take a loop around the unit. It’s only in getting back in my bed that I felt pain.
We went back to bed. I talked to my bunk mate. Jay, my dad and step-mom came to visit.
They fed me lunch. It was a really good full meal, not at all what I expected for a hospital. A nurse came by to change my dressing, and later to do two more laps walking around the unit. Then a nurse removed my IV. I didn’t feel the needle come out.
I napped the afternoon, interrupted by nurses. It was quiet time. I listened to a Spotify playlist of Steven Universe influenced musical selections.
I was fed supper, and did more laps. My roommate was with me, and it felt like being in a race between two turtles. They changed my dressing.
I slept well that night.
Second day post-op
The nurse came in at 6 to change my dressing. The bleeding had stopped. She replaced the dressings with lighter versions.
I was served breakfast. A nurse came in and replaced the catheter bag with a valve. I was now able to go to the washroom to pee, by opening up that valve. I was expected to do so every two hours.
A nurse then helped me to dress up and pack my stuff. Then later, a nurse took it and the two of us walked to the rehab center next door.
I was given my own room. It had a sink, and quite a pretty view.
Once there another nurse introduced herself, and gave me instructions to read. She removed the tubing for the blood grenade that went into my groin. Pulling it felt like being touched after a bad sunburn. She then applied ice. I had the room to myself. I was tasked with walking around four times a day. Every two hours I also needed to move the ice around four spots for ten minutes each.
My dad and step-mom came, along with Jay.
After they left I had lunch. This was done at a large communal table. The manual they gave me showed the different meal times they had. This was the first time meeting other patients. There was maybe ten of us. As best as I could tell they were all feminine trans women. There wasn’t enough space so I was off in the hallway to the side.
The others, except for my hospital mate and another, seemed to ignore me and my hello’s. At this point getting in and out of bed was starting to get relatively painless.
Boredom started to set in. I learned that to replace the ice on my groin, I needed to empty the pack out and fill it from the ice machine next to the dining room. I could move with much greater ease than the day before.
Gillian and Iain came over to visit a final time. They were amazing, as usual. A nurse came in with some information, as I hadn’t been properly inducted. I learned that I needed to call the orderly to get dressings to replace mine with, and that I would do it. I learned that it was important for me to drink two or three pitchers of water a day to prevent infection. That I should wear slippers even in my room to reduce risks.
Iain and Gillian
Jay came over. I ate dinner. I wasn’t very hungry and ate half a sandwich. I noticed the one trans guy in a sea of feminine trans women. It was neat listening to people converse about their experiences of trans-ness, though I didn’t really want to participate. It looked like half the people were over forty-five, and the rest being young adults.
My guts were uncomfortable now. I hadn’t defacated since the day before surgery. I took two more pills to soften my stool. The nurses wouldn’t start administering laxatives until the next day.
I didn’t have to wait too long. While video chatting with my sister, I felt it. And again. I went to the washroom, and it came out. I didn’t force. It was diarrhea like, which was a relief.
Video chatting with my sis.
I replaced my rehab-issued underwear, and took a shower in the sink of my room. I wouldn’t be permitted a real shower for another three days. I cleaned my arms and chest with soap, and brushed my teeth. I swapped out my PJs; I had stained my top with blood. It was the first time I had felt clean since arriving.
No nurse interrupted my sleep that night, but I did wake up three times to drain my catheter in the toilet.
Third day post-op
The nurse checked my dressings. I had just changed them. She checked my pressure. Another nurse came in and took my laundry. I tried sitting for the first time after she left. It hurt too much to stay there.
I had breakfast and got to know the others better. One was from my home-town. Another from Arizona and was chatting with her followers back home. I was able to sort of sit for thirty seconds. We got talking about how public transit in Ottawa sucks.
The rest of my day seemed to be pretty on my own. I just needed to periodically empty my catheter, check on my dressings, make an effort to drink water, put ice packs on me, replenish said ice packs, attend communal meals, have nurses check my dressings, and entertain myself. I enjoyed the view out my window. My mood improves so much in the presence of a sunny day.
In the evening, I had a bit of a scare. My pad was soaked in blood. I replaced it, and an hour later it was soaked again and this time my dressings too. I replaced them, and saw a nurse. She inspected it minutes later – and my new dressings were already getting bloody.
She explained that because the inflammation was going down beside the catheter tube, and the catheter tube creating an opening into the bladder, that pee was coming out around the tube. Only because my dressing sutured on my skin was bloody, the pee was mixing and becoming blood red. It was normal she said, and she gave me diaper sized pads to use. I had read about the blood mixing with pee thing in the PDFs the surgeon’s office had sent, but I didn’t know this is what this was until the nurse identified it as such. It just looked so much like regular blood.
I also asked the nurse about the dates in my rehab paperwork. My confirmation document said was being kicked out of rehab on the 12th at 7 am. But my rehab paperwork said the catheter was coming out the 12th. Was that correct? She checked. It should come out the 11th instead. She would inform the night staff to inform the day staff.
Fourth day post-op
I had breakfast with the other patients. In a room adjoining the dining area the sutured dressings were being removed for the patients who had their surgery the same day as me, and catheters for those who had it the day before.
I approached the nurse at the end. I wouldn’t be having my sutures removed today. The sutures and catheter would be removed tomorrow. If there was issues they would leave the catheter in for an extra week, and I’d go home with a prescription to have it removed. Another nurse later explained that the surgeon sometimes delayed removing dressings like this when there was little skin to work with, or the cavity was shallow. I replaced all my dressings and used a wash cloth to wash myself in my room and then I washed my hair in the sink. I missed having showers.
I couldn’t wait to go back home, but at the same time, I felt like I was going to be leaving two days too soon. The routine was the same as the day before.
I used time while icing my junk to read, and to process things in a notebook. The sun imbued a positive and constructive outlook. I wrote about shame and relationships past and present, simultaneously identifying with clarity what needed to be let go and finding the bright path ahead.
I walked to the common area and talked to a woman there. In some ways, being institutionalized first in a bed and then something the size of a large detached home for a week, monitored regularly, fed on a schedule, with a bunch of strangers felt simultaneously like being caged and really nice. It was soothing to be taken care of in this way; it’s not something that happens in adulthood. There a spirit of bond making comparable to a first day at school or uni, with strangers together in a space facing a shared burden. I would soak what I could in, and then leave it behind as I joyfully regained my full independence.
I looked at the guest books with writings from patients dating back to 2008. It was a collection like no other, containing sometimes funny, sometimes insightful, sometimes banal messages taken from a specific moment in these hundreds of lives. Each patient took up a page.
Tim came to visit me that evening. He noted he could see in my eyes how content I was. We chatted, and after he left, I watched an Agatha Christie murder mystery on television.
Fifth day post-op
I had my last communal breakfast. I would miss this part.
Afterwards I went into the examination room which was connected to the dining room. There a nurse removed my sutured dressings and catheter. Nether removal hurt, but it did feel weird, like I was being tickled, and uncomfortable. It was over before I knew it though. She gave me a container, a piece of paper and a pencil. I would write down everything I drank today, and I was to drink a lot. Then I would pee in the container and let her know, to make sure my bladder emptied completely.
I had my first shower. This included washing my newfound genitalia, with the instruction not to have the shower head water it directly. I put on my PJs and fresh cotton underwear to get back into my room.
Once there, I found my underwear bloodied. The nurse came in and told me I was to not use coloured underwear as the dye could cause complications. I should instead use the underwear they provided with pads. She fetched some ice and showed me a new method to ice my junk.
A bit later I looked at my genitals. They looked way less engorged than they had hours earlier. The ice was working really well. I had expected this to look like ground meat, but even at its worst, I was really pleased with the result.
Six glasses of water later, I had to pee. I went to the toilet with the pan they provided, and placed it beneath the toilet seat as instructed. I had my first catheter free pee in five days, which was very exciting to me. I sanitized everything and took the pan to the nurse to inspect. All good. Then she took me to the examination room to do an ultrasound of my bladder. I had let out 500mL of urine but still had 200 mL of urine in me.
I returned to my room to ice. Had lunch. Two of the ladies were heading off to grab some beers. First at the dep and then the hipster bar.
In the afternoon, the nurse called my room. It was time for my first bath. The bath was to be filled up to my belly button. Then I’d go in, rub the unscented bar of soap between my hands, gently wash my genitalia, and then sit in the bath for ten minutes. At the end I’d empty the tub, and point the shower head to my stomach to rinse my genitals. I read Alan Cumming’s Not My Son in the tub. After I was to dry my junk by exposing them to the air in my room; no patting down.
The surgeon came in to check up on me. This was the first time I had seen him since the hospital. Again he was very amenable. He checked on my vulva, said the discoloration was normal, said I understood hygiene and that it would be important not to force for stool. He gave me his blessing, recommended I book a follow-up in a month, and left.
Later a nurse came in, and asked to check on my genitals. She too was pleased, and said it was pretty simple without a cavity. Because I hadn’t peed everything out in the morning, she would do two other ultrasounds on my bladder. I would inform them the next time I urinated.
When that time came the nurse took a measurement of my bladder. The first two readings indicated half as much left-over pee as the morning. The third reading indicated a touch more. This risked the catheter going back in, which I really really did not want.
I had my last dinner. I found out one of the girls had left earlier that day. It felt like we had spent much more time together than we had. I packed my stuff.
Tim came over and dropped off some absorbent briefs I could use the next day. We chatted again, and the nurse came by to give departing information. I’d be given antibiotics to take 4 times a day. I should take Tylenol twice a day. If I had questions I could email/phone them. The swelling would continue for months; so I should continue to ice my junk and take Ibuprofen as needed. Discharge was normal, so I should continue wearing pads.
I had my second bath of the day. I could see the sutures float freely from my skin in the warm water; they were invisible otherwise.
In the evening I went for a pee and informed the nurse. She scanned my bladder. 164 mL. No need for a catheter. I was relieved. I applied ice and went to bed. A nurse came by to give me the evening’s pills. I set my alarm for 6.
Heading home
I didn’t sleep that well. I had gone to pee a few times, and was too excited to fall asleep. I woke up at 6:30, Tim showed up fifteen minutes later.
I got some ice, got dressed with Tim’s help, and iced my junk for a while. I told Tim part of me wished I could be here an extra day. Part of me just wanted to get the fuck home. A nurse gave me my last set of pills.
The driver came by. The trip to the train station was painful. Sitting on its own had been okay, until we hit potholes. Once at the station I popped a tramadol, my first during the entire time. I just didn’t see how I could make it home without it.
Waiting at home and work would be two months of baths or siltz baths twice a day, applying plenty of ice, and limited movement. But I could see the end.
Tim got the staff to get me a wheelchair to board the train. I couldn’t get up the stairs on my own. We got on, and I looked out the window at the scenery as we headed back home.
