I started laser treatment nine months before I took my first estrogen tablet. This gave me a chance to remove a large percentage of my hair before the hormones started to affect my hair color. I can honestly say in about 15 treatments my torso was almost completely hair free. The hair that is still there is so fine and light that it is very hard to see unless the lighting is just right. My face took a little longer, but the hair was much denser than body hair and a lot more stubborn. I have to admit I still shave every day to get rid of a few blonde stragglers, but I can easily go twenty-four hours without a touch-up. I may have to use electrolysis to get rid of the last few.
Once the hair on my face had thinned to the point where I could go all day without shaving and the hair was still covered with foundation, I went out as Stephanie. I needed the experience and the confidence. No amount of laser or foundation will hide insecurity. I think the most important thing I can tell a girl who is thinking of transitioning is to work on self-acceptance. I had a lot more confidence when I knew my facial hair was not coming back in a few hours, requiring me to run home like Cinderella at the stroke of midnight because I would turn back into a boy. To build up confidence, you can start with gay bars and tranny clubs, but that is only a start: you need to get out and do real-world things, such as grocery shopping, going to the doctor, going to a mall. It is scary the first time, but you will develop confidence. The more confidence you have, the easier it is to accept yourself.
It was June of 2008 when I started to research hormones. I had a very difficult time finding an endocrinologist who would help me. Again, I don’t drive and I was not willing to unveil my intentions to the world yet, because I was still working on self acceptance. I did find a few endocrinologists who work with the transgender population; however, many of them are part of a program and all of them would not see me unless I got a letter from my psychiatrists.
My doctor was not that familiar with the Harry Benjamin standard of care, and since I was unable to see him on a regular basis, he would not write me the letter I needed. I wanted to start hormones, so I went back to the internet and I found some natural estrogen supplements that made big clams; I soon found that marketing is cheaper than making an effective product.
I continued do my own research on the internet. I read everything I could find, and I even ordered books on the subject. Once I found out the dangers of hormones, especially over-the-counter supplements that are unregulated, I stopped taking the supplements immediately. I continued my research and found a lot of misinformation as well as quality information. There are some great sites out there, but do not take anything at face value. The more you read, the more you will know about the effects and side effects—and there are many. Frequently, girls have the notion that taking hormones will make them a girl, but it is far from the truth. It will help feminize your body, but they will not make you a woman.
I could not find an endocrinologist to help me, so I needed to find some way to get the hormones I needed. Before I go any further, what I am about to say is not recommended or encouraged. I was desperate, and I would have rather died than continue living as a male. I was also in excellent health and in great shape. I went to the doctor for a complete physical and everything came back very good. So I knew I had no underlying health conditions. I decided to turn to the internet and prescribe my own hormones. After researching countless sites, reading the dosages that other girls were taking, and armed with the knowledge of the side effects of each medication, I went searching.
Just a note for individuals who are transitioning and want to keep your transition as quiet as possible until you are ready to disclose yourself: mail order pharmacies are the way to go. First, the medication is usually cheaper, and if you are careful, what you order are the same medications you would get from your local drug store. Second, if you mail order them, they do not show up on your insurance statements. I have heard girls getting discovered this way before they were ready because of red flags by the insurance company—a male getting a prescription for Spirolacnatone is acceptable if the person is 40 years or older, but at no age should they be getting prescriptions for estrogen. I found mail order to be safe and stealthy. This is just my experience, and it is important to note I did not always buy from the cheapest pharmacy; I went for name brand drugs and not generic.
Hormones are dangerous and should not be taken the way I did. I also know there are a lot of girls out there who feel the same despair that I felt. Thanks to the internet, I was able to find and order the hormones. I am not going to get into an extensive explanation of hormones here; there is a reference section in the back of this book that will take you to websites with very detailed information about them.
A hormone program for male to female transgender individuals usually consist of three parts. The first is estrogen. Transitioning requires your body to go through a second puberty, and yes you get everything that goes along with puberty. Estrogen by itself will make a difference, but its effects will be limited without a testosterone blocker. To block testosterone, I ordered Spirolacnatone. Spiro (for short) is a diuretic that is used to treat prostate cancer, and since that ran in my family, I kind of looked at it as preventative medicine. The last is Finasteride the chemical found in Propecia. It helps with hair growth, so if you are losing your hair to male pattern baldness, it may help the hair grow back. It also assists the estrogen in development of secondary female characteristics.
I was able to get all my medications through mail order and without a prescription. Since none of the medication was a narcotic, it was easy to get from an online pharmacy. The reaction was start taking everything at once but if I had a problem I would not know what caused it. I started with the medication that had the least amount of side effects and that was Spiro. If you can tolerate Spiro, it is one of those drugs that you can take for long periods.
I started with 100mg of Spiro every morning and then after two weeks moved up to taking 100mg twice a day. Other than going to the bathroom more than normal, I did not really have any negative side effects. I guess the frequent urination was preparing me for the smaller bladder after sexual reconstruction surgery. Because it was a diuretic, I needed to pay special attention to remaining hydrated during my races; if I lost too much fluid, the potassium could build up in my system, and I could end up with cardiac arrest. Things seemed to be going fairly well with Spiro. There were other side effects, but they did not show up until later.
After about three months, I was no longer getting erections. For me this was great, but if you have intentions to continue to use your penis, you may not like this side effect. I did not have much of a sex drive, and Spiro pretty much wiped out what I had, which again was a welcomed side effect. Once the effects of testosterone were blocked, I began to feel a lot of my internal frustration melt away.
Estrogen, in the form of Premrin, was the next medicine I started. The transgender community often refers to Premrin as the “purple football” because the pills are like little footballs and they are purple. Premrin is a natural estrogen that comes from pregnant horse urine, thus the name. I started with Premrin because it comes in .625 milligram tablets. Hormones are something you want to ease into to avoid days of constant crying. I could slowly increase the dosage by adding a purple football to my daily regimen. For a male to female transitioning, the necessary dosage for me was about 5-6 milligrams a day, or about 5 times the levels needed for a natural woman taking hormone replacement therapy.
I started with one tablet a day and then each week added another tablet until I was at the needed dosage. By Christmas 2008, I was up to my required dosage. The results were somewhat different than I expected. You really do not notice it at first; it takes about three months before you really notice anything. My breasts did not really develop much until about six months; they may have been tender at three months but that is not what I noticed first.
The changes were subtle. It is hard to describe the feelings. It may be different for others, but for me is wa
s this feeling of internal peace or contentment. It is a wonderful feeling. Maybe for the first time in my life I was feeling like everyone else. All I know is that it was the contentment I was looking for. I knew then I could not go back to my old self. I also knew that I could not stay on this high level of hormones forever. I would say that this was another, one of the defining moments that confirmed transitioning was a journey I had to make.
Another defining moment was waking up from my first surgery. Hormones are a necessary part of transition, but forty years of testosterone had had its impact on my physical appearance. To reverse these male traits, Facial Feminization Surgery (FFS) was also required. About the same time I started taking hormones I also started looking for a plastic surgeon who specialized in FFS. It just so happens that the chief of plastic surgery at the University of Boston medical hospital was such a specialist. I lived only two hours away!
Dr. Spiegel and his staff where excellent and treated me with the upmost respect and care. The irony is that while FFS is the part of the transition that the entire world sees, the surgery does not require any note from your doctor. Sexual reconstruction surgery is different: nobody knows you have had it unless you undress or tell someone; however, it required two notes from two separate doctors. I took my transition slowly not because I wanted to—I would have loved to run right out and have everything done at once, though that would have been a mistake. I needed to test the water, making sure that taking the full elephant ride was right for me.
The baby steps I took were the Laser. I could live my life as a man without ever having to shave again. Hormones I could stop at any time before six months, and for the most part everything was reversible. Yes, the breast would not shrink once I stopped, and I would end up being sterile. I already had a vasectomy and just about every guy I knew over the age of 40 had some type of man boobs. However, facial surgery was permanent and irreversible, always visible.
This was a life-altering decision. It was permanent. Other than my friend Linda, I had nobody to talk to about making these decisions. We have a lot of hard decisions in our lives, like getting married, or buying a house. Those you can get out of if you have to, but with this journey, once you do something like this, you cannot ever undo it. You must be absolutely certain before you take that step. When you are transgender, you will find yourself making all these decisions alone. It is hard, and you many find yourself not sleeping much during this time.
I resorted to running as a therapy. It worked for me, and I used the time to focus on the next steps. I could not make a mistake, because the simplest misstep could be devastating. These decisions are the ones that separate those who can make the transition and those for whom transition is not recommended. Going forward was my choice, because I was not willing to go back. I would rather have nothing than go back to who I was. I moved forward.
I scheduled surgery to have my Adam’s apple removed. I did not have very pronounced Adam’s apple, but it was something I saw every time I looked into the mirror. It was also a “Tell” when I was going out as Stephanie. The phrase I heard often is if you see an “Apple” then you will find a “Banana,” meaning that if you saw a woman with an Adam’s apple, you could be sure she had a penis.
January 15, 2009, I had my trachea shaved. Everything went well; I woke up with a bit of a sore throat, but other than that really had no side effects. A day or two after surgery, I took off the bandage and I could feel my throat. Because of the swelling it did not feel like much had changed, but by the end of January, there was only a small bump where my incision was and soon after that nothing at all. Now you cannot tell I ever had one.
This was a quintessential moment for me. Few people if any ever noticed my Adam’s apple when I had it, and I don’t think anyone noticed when it was gone with the exception of one person: me. Every time I looked into the mirror with or without clothing, it was always there as a reminder of having to live in the wrong shell of a human. Now It was gone, and I could start to see the woman emerging. I knew from that instant that I was well on my way to a journey of a lifetime.
Like most things in life, this was a bittersweet moment. I am not making light of how hard it is to come to terms about being gay—for many this is a lifelong struggle as well. But when you are transgender, you get to point where you must tell people because it becomes very obvious when you one day show up with breasts and wearing a dress. If I were gay, I probably never would have told my parents or brothers and sisters. I would only let them suspect, but being transgender and transitioning I knew the time was getting close to having to cross that terribly difficult and scary bridge. You know what is behind you and below you, but what is frightening is what you might find on the other side, knowing that once you cross it, you cannot go back.
Even with a strong support team behind you, the journey is yours, and you are the one who has to walk it. Many times, you will find yourself alone. There will be times when you are scared, hurting, and worried, but there will not be anybody there. My first time experiencing this was terrible. I was ever so happy to have had my trachea shaved, but that night I woke up in the hospital, my friend Linda had left for the evening and I was alone, nobody to talk to, nobody to share the excitement with, and nobody to assure me that everything was going to be alright. Transitioning is a very lonely and scary journey.
Dr. Spiegel did a full facial evaluation of me when I visited him the first time and gave me a list of procedures that would really feminize my face. The list included browsing the forehead and a rhinoplasty to remove the bump from my nose. He also recommended a chin shave, lip raise, and cheek implants. This was all understandable, but it came with a price tag equal to that of a nice sports car. If you are reading this and thinking about transitioning, you need to really work on being happy with who you are: self-acceptance. If you do not, there is no amount of surgery that is going to make you think you look good enough. There was no way I could afford everything, and I had to pick. I chose the forehead browsing.
Forehead browsing is where the doctor makes an incision at the scalp line, pulls the skin down, and actually shaves the forehead bone; for those of us who have lost some hair to a receding hairline, he will pull the scalp forward. In my case, he was able to stretch it about two full centimeters. But the most profound effect of this surgery is how it would affect my eyes. I had what I called a very sleepy look: my eyes never opened very wide, always making me look like I was sleepy. This surgery changed my whole appearance, giving me very big, bright blue eyes.
During my recovery in February, I scheduled my forehead browsing surgery for July 9th, 2009. I now had a deadline to come out to everyone, because after that surgery I would no longer be able to hide the effects of my journey. The next five months of my life were the hardest I ever had to go through. It was tough holding everything together. I was still running my company, so I had to be very upbeat and positive. I had work that had to get done, and I was on the road traveling most of the time. My psychiatrist was good but old fashioned and not available over the phone. It is the loneliest I have ever felt. There were days I would just break down and cry in despair.
I remembered to put a smile on my face while working all day, and then I would get to my hotel room and just start sobbing. My wife would not talk to me—I suspect she enjoyed the pain I was going through at this point as some sort of sadistic revenge. The only saving grace that I had was a very close friend Linda who held my hand the whole way. I am not sure I would be here today writing this book or maybe even on this earth if it had not been for her. I prayed night and day to God to give me strength and he sent an angel. When it seemed like the world was against me, she was there helping me take those steps across the bridge. It was tough going forward from this point, but knew I could not go back. She held me when I needed to be held and nudged me when I needed to take the next step.
Transitioning requires a lot of planning, money, and all the internal strength you can find. If you are suffering from any psychological
problem, you should address it before you transition, because you will need every ounce of physiological strength to complete the transition. Planning is key, especially if you are going to go it alone and not able to go the preferred route and get the two letters for two separate doctors to allow you to have sexual reconstruction surgery, I did not have doctors that would do that for me without sitting in therapy for countless hours, until they are convinced that you know what you are doing.
Taking small steps worked for me, but the smaller the steps, the longer the time it takes to transition. I started with things that if I decided the transition was not right for me, I could easily go back. Even having my Adam’s apple removed wasn’t decisive since I could easily live without it, and few people, if anyone, would ever notice. The trachea shave was the defining moment for me, and I had already scheduled the next surgery, which would and did alter my appearance significantly. But I had not had it yet at this point and could still back out.
The next major step for me was to legally change my name. I knew that if I were to transition, I would have to start living full time as Stephanie. As far as the world knew, the final surgery was the facial surgery. If I had trouble living full time after facial surgery then having sexual reconstruction surgery was really out of the question. I thought having the name change was going to be this simple thing like filling out a form and paying the fee and in a couple of days you get a letter from the Secretary of State with your new name.
Well, you do have to fill out a form and you have to pay a fee, but then you have to send it in and you are actually given a court date and you have to go to civil court. I changed my name in New Hampshire where the laws for changing your name are a little bit simpler than in Michigan. Michigan requires you to go to the State police office and get fingerprinted, then they run a background check to make sure you are not a felon trying to hide your identity or something. This can take up to thirty days and then you still have to set a court date.
The Great Elephant Ride Page 12
