Sandra 

My background 

I am a 39-year-old male-to-female transsexual (also known as gender identity disorder) and I am in the late stages of becoming, fully and legally, a woman. I have had certain medical treatments to accomplish gender transition. My name is Sandra, and I have been officially living and working in this identity, awaiting sexual reassignment surgery (I am a medical research professional).   

Gender identity disorder has been found to have a biological basis rooted in brain structure (despite what conservatives, including my own parents, believe about it being a religious or moral failing). Though most of the time it presents in childhood, people looking for the typical story of a gender-conflicted child will not find it in my case. Instead, I had a “normal” childhood in many respects, at least in terms of freedom from any conscious recognition of a gender identity conflict, though there’s always the possibility something was lurking in my subconscious, awaiting discovery. In fact, I did become aware of my gender identity, fully and completely, rather suddenly in May 1998  at age 33. Why it was at that point in life, I will probably never know; there were no unusual events or triggers that I can recall. But I knew it was real, and that life would never again be quite the same. I also knew that, despite what the psychology books may say, some of us do discover our true gender identities late in life. 

As I thought retrospectively, I recalled that, as a child, I did have very occasional cross-gender thoughts or wishes, and I never fit in much with the rough-and-tumble play that was expected of boys. In fact I was never much of a popular kid, and was subject to frequent harassment from my peers for reasons I still cannot really figure out. At the time I attributed it to my studious nature, but that never really seemed a full explanation. Probably none of this, of course, would have forecasted my transsexualism since the things I describe are likely present in many childhoods that don’t evolve the way mine did.  

The family I grew up in would best be described as religious-conservative. Material things and good schooling were generously given in abundance. There was a strong push for both achievement and for “fitting in” with the crowd, and I do remember frequent disdainful attitudes expressed toward gays and other people who were different in some major way. Like many people, I grew up strongly molded by what others wanted for me and expected. I earned a professional degree, married, and had a baby daughter.   

During 1998, after the discovery of my identity, I spent several months wrestling with my feelings, and keeping silent. Soon after I confided what I felt to my wife, and in 1999 I started seeing a gender psychologist, who has proved to be very, very good. Life was relatively normal for the next couple of years. I was always aware of the gender identity disorder, but I did not let it get in the way of my work or family responsibilities, strong though the feelings were. I went through a couple of job transitions that I initiated; at the time I was seeking a less stressful and more research-oriented work environment. Actually, during some of this time, I experienced a respite from my feelings (relatively speaking), though they were still always there. My therapist strongly believes there is no “cure” for gender identity disorder and that, at the time, I was simply distracted by the work-related stress and changes I was feeling. 

In late 2002, at the age of 37, I knew I could hold back transition no longer.

Hormones and hair removal  

I started the medical treatments involved in gender transition in December 2002. These eventually consisted of female hormones, facial hair removal, and facial feminization surgery. It was (and has been) of the utmost importance to handle all this with minimal impact on my work or family life, and to handle the finances in a way that was fair to my wife. I did accomplish this! Privately, though, I was thrilled as I saw the fairly dramatic changes from hormones, supplemented by the androgen-blocking drug spironolactone. These rivaled in magnitude anything I experienced during teenage (male) puberty, and of course these changes were much more desirable to me! I soon started needing a bra, and my hips rounded out into a feminine hourglass shape. My facial hair got lighter, and my skin took on a lustrous pale tone. Before hormones, my hip circumference was 36 inches, and my waist-hip ratio was 0.83. Now my hip circumference is 39 inches, and my waist-hip ratio is 0.76. My breast (bra) size is still only a large size A, but since I’m thin (5 feet 11 ½ and 150 lbs.), this actually looks fine and I’m pleased with it.  

I tried some facial electrolysis in 1999-2000, but did not have much success with it, as I was not on hormones at the time, and there was a large amount of regrowth. In retrospect, I think I would have waited to have any electrolysis until on a hormone regimen. I experienced much better results starting in December 2002, when I underwent Apogee Cynosure Laser treatments, which later on I combined with electrolysis for the white hairs and the hard-to-kill dark hairs. This combination eventually produced a very good result. However, to date, I am still plagued by small amounts of regrowth that break through hormones, which require small follow-up laser or electrolysis treatments.

Facial feminization surgery 

I underwent facial feminization surgery with Dr. Ousterhout in December 2003, about a year into transition. This was a major step for me and caused me to summon lots of courage and determination.  

My surgery took 11 hours and involved forehead revision, rhinoplasty, jaw/chin reduction, tracheal shave, hairline revision, and upper lip shortening. The photograph shows the result, seven months afterwards. Quite an ordeal this was! I was wheeled into the operating room early in the morning, and then went to sleep, and I don’t remember anything until sometime the following morning.   

I did not experience major pain complications from the surgery, despite having feared this, and needed little or no pain medication afterwards.  For this I was relieved.  

Like most people would be, I was nervous about the surgery ordeal – including the cost and the sheer length and invasiveness of the operation. I thought of going to local surgeons for a less ambitious (and certainly less expensive) set of goals and expectations. In fact, for a brief time – the two months prior to the surgery – I was tempted to try and skip it altogether, since (amazingly) I had started to occasionally pass as female (judging from the way strangers addressed me) without really trying. This seemed to be a result of the hormones, and was a happy surprise that I had not really expected.  

There’s no question about it, no surgery is fun. However, eventually I came to see that there is only one way to do transition right – and that’s thoroughly and correctly the first time around – and I felt that Dr. Ousterhout’s program offered the best chance for a high-quality life post-transition. For anyone locally to have accomplished what this surgery did would probably have required several operations.  

The recovery house where patients stay after the surgery (for an eight-or nine-day period) is called the Cocoon Guest House. I came to love this name as much as the wonderful care there. That is, once the metaphorical significance of the name dawned on me – just as a caterpillar crawls into a cocoon and emerges a beautiful butterfly, so too do people in transition.  

There is some unavoidable swelling and bruising that follows the surgery, and lasts days or a few weeks, but as the months passed I became pleased and excited with what I was seeing in the mirror. During these months I was also growing my hair longer, and continuing with hormones.

Summary 

The experience of transition has taught me several things. One is that despite what I used to believe, miracles do happen. I have experienced one – the beginning of a joyful, brand new life. In fact, it is too big for me to have ever conceived of it a few years ago. I don’t know when or if I will ever experience another miracle, but this one has completely uplifted and restored me, as I wade through all of the trials and tribulations common to the rest of life. The second thing I have learned is how wonderful it feels to really, truly be happy.  

Lots of adjustments are needed to address life’s challenges when there are really big changes over a short period of time. For example, how to interact with men as a woman and handle attention from them, how to shop for clothes and make “small talk” with other women, handling legal and professional issues associated with a change in identity, etc. The reality is, I think I’m doing all this well. Life has indeed been very exciting – so much so that I rarely watch TV or read fiction books. Nothing they come up with could ever be as interesting as real life. 

I’m happy to report also that the large company I work for has been supportive of me. Also, though there have been some adjustments in my immediate family situation, I am still involved with them and am committed to always being there in a caring fashion, especially for my daughter. Unfortunately, my family-of-origin (i.e. parents) have been decidedly and vocally unsupportive. I move ahead without discouragement, however, because I know this type of attitude is a reflection on them, not me. The preservation of employment and immediate family ties is one of the happiest success stories of my experience, and it should help others to know that they can also achieve this, if they proceed through their gender transitions with caution and careful planning.  

To any transsexual or cross-gendered person reading this, I wish you the best of luck in realizing your life’s deepest desires. I hope that my story has provided some encouragement.

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