Some people spend the summer going on vacation, visiting family, or taking a long weekend at the beach.
Me? I had two major surgeries this summer, and I couldn’t be happier about it.
Long story short, I'm a nonbinary (neither male- nor female-identified) transgender person who was female assigned at birth. I lived as a feminine cisgender girl for most of my life, but it never truly fit for me. I felt weird having breasts and I despised my body’s ability to get pregnant. I started taking testosterone three years ago, which improved my mental health and body image but didn’t solve the problem of my chest or uterus.
This summer, I finally had the necessary time off work as well as decent insurance, so I made one of the the biggest decisions of my life: to have my breasts and my internal reproductive organs removed.
My first consult was in April with the surgeon who would be doing my breast removal surgery. There are two different procedures that transgender folks typically undergo for breast removal, peri-areolar surgery (“peri”) and double incision surgery. Double incision, in which the surgeon makes an incision below each breast to remove tissue, is more common, but it leaves distinctive scars and requires repositioning the nipples.
Peri-areolar surgery is less common since it can only be performed on small-breasted people. The doctor cuts around the areola to reach in and remove tissue, then removes the ring of excess skin before sewing it back together. It leaves a faint ring-shaped scar, but is less obvious than the distinctive horizontal scars of double incision surgery. It also leaves the nipple stalk intact, which means that nipples may eventually regain sensation.
My first impression of the surgeon was that he was nice enough but somewhat brusque. He initially brushed off my request for peri because of my breast size and wanted to just do double incision. However, I was persistent, and we agreed that he would try to do peri, but would switch to double-incision if necessary.
Fast-forward to early June. I showed up at the hospital with my best friend Jack and my partner Q*, the latter of whom had undergone peri with a different surgeon last year. I had had surgery at this particular hospital before for a broken bone, so the general preparations for surgery were no surprise. Yes, I'd taken my earrings out at home; no, I didn't eat the night before. The only blip was my dermal piercing in the back of my neck. The prep nurse was concerned about it, but when the OR nurse came to take a look, she just slapped a bandage over it.
Before getting knocked out, my surgeon stopped by to mark up my chest with a purple sharpie. He drew all around my areolas, traced the underside of my breasts, and drew a long vertical line from my collarbone down to below my breasts. It felt bizarre knowing that the last interaction with my breasts anyone would have was a middle-aged manly surgeon drawing on me with a sharpie.
Not much later, I was doped up on drugs and being carted to the OR. I don't remember anything about being in the OR, but apparently I hallucinated some weird shit.
Case in point: With great concern, I asked the nurse when I woke up what went wrong during surgery. I was convinced (though I didn't tell her) that someone had put a probe in my vagina. Like, 100% dead certain. Not like in a sexual way or anything, just a weird medical thing that was bizarre to me because there's no reason that was needed for top surgery.
Not entertained, the nurse said that nothing had gone wrong. She then told me that if I wanted to see my friends, I had to get out of the bed and into a chair. Still actively distressed and hence wanting to see my friends immediately, I stumbled out of bed. I was clearly not ready to be sitting up, which made the nurse snap at me again - but to my credit, I got my ass in that chair damn quickly and kept it there.
I felt nauseous and weak, but my friends were escorted in just a couple of minutes later. As soon as the nurse left earshot, I whispered at them, with utter conviction, that something had been in my vagina during surgery. That's when Jack reminded me that some people hallucinate coming out of anesthesia. Oh. That made way more sense.
Once I was actually back in the real world, I found out that the peri-areolar procedure had gone perfectly. A much sweeter and more patient nurse replaced the first one, and she let me look at my chest before they put the post-surgical compression garment on me. It was covered in sharpie but holy shit, it was my chest and it was flat.
Before surgery I’d been concerned that I might not be happy about how my chest looked. You hear stories of people who get addicted to surgery, or are never happy with their appearance. Me? From the moment I saw my chest post-surgery, I felt nothing but relief and joy. It looked right in a way that my breasts never had.
On the less pleasant side of things, I was stuck with post-surgical drains. After top surgery, they stick two plastic tubes into you (mine entered right under my armpits) that connected to little plastic bulbs that collect the draining fluid. These lovely little pus grenades, as I inaccurately but stubbornly called them (the fluid draining isn't pus, but it's gross as hell), fill with liquid that ranges from cherry red to watery amber. You have to empty them out a couple of times a day, measure and record the amount and color, and then squish them up so when you plug the little holes in them, they provide gentle suction to pull out more nasty fluid.
They gave me all of the instructions I expected, most important of which was not to raise my arms and not to lift anything heavier than five pounds. I spent most of the next week lying in bed doped up on opiates and absolutely not doing any of the fiction writing I said I would do. When I did get up, it was either to go to the bathroom or to prance around the kitchen with little dinosaur arms, trying to grab myself snacks that weren't really within my reach. The recovery was frustrating, but the prospect of my chest healing well kept me mostly cooperative.
Jack drove me back to the doctor's office five days later for my post-op appointment. I felt gross, still in pain, but most of all sick of having the nasty drains in. The nurse told me that it wouldn't hurt when the drains were pulled out, just “feel a bit strange.”
No, it wasn’t “a bit strange.” It was the weirdest damn sensation and horrifically unpleasant. As I discovered, the tubes are deep inside your chest, not just a little bit in there. So when the nurse pulls on them, you can feel those tubes being pulled all through your still-sore chest. It was grossly unsettling.
After that, recovery from top surgery was pretty uneventful. I had to wear my special compression garment for the next few weeks, and my areolas occasionally bled, but it wasn't that bad. The surgical glue around the rim of my areolas and the sharpie took over a month to come off, since scrubbing my partially-numb, partially-sore chest was unpleasant.
Three weeks later, I was ready for my second surgery. This time, I was getting all of my reproductive organs, from my cervix to my ovaries, removed through four tiny incisions on my abdomen. My vagina and external genitalia would remain unchanged.
I returned to the hospital with Jack and Q. By now, my chest was doing much better, and other than being a bit sore the only problem with it was every time I drank water, I could feel it swirling in my nipples like a front-loading washing machine. I know it's because the nerves were reconstructing themselves and getting a bit confused along the way, but that didn’t make it feel any less bizarre. Fortunately, that only lasted for about two weeks.
Prep for middle surgery was the same as prep for top surgery: a flurry of paperwork, the IV, and half a dozen different medical professionals checking in with me. The world disappeared moments after I arrived in the operating room.
When I woke up a couple of hours later, I was kind of out of it but not freaked out. My abdomen hurt but luckily my vagina didn’t, and the doctor said everything had gone swimmingly.
No, the freaking out waited until 6 pm rolled around and I still could not pee. After a surgery like mine, they require you to prove you can pee before you can leave the hospital. It’s normal to take a little while to pee after surgery, but not that long. Especially not when I had been chugging water and ginger ale to deal with my post-op dry mouth, and I’d had a bunch of fluids put into me via the IV.
At that point, the nurses insisted on putting a catheter in. Jack and Q talked them into letting me go home that evening, instead of being held at the hospital overnight, but the catheter was non-negotiable.
I was terrified. All I could think about was that House episode where House puts a catheter in himself because he can’t pee, and the episode makes it look excruciating. I braced myself for a horribly painful experience but really it was just uncomfortable and weird. I lay back and took deep breaths, and they shoved a tube into my urethra, that was it. I was surprised by how little I actually felt it going in.
I came back the next morning to get my catheter out. If you told me five years ago that I’d be walking into a hospital carrying a poorly-hidden bag of my own pee so I could get my catheter out, I would’ve been horrified. Actually having to do it though wasn’t a big deal. The nurses assured me that this happened infrequently, but not rarely, to people post-surgery.
Recovery was easier than it had been from top surgery. My abdomen hurt consistently, but the painkillers helped a lot and I didn’t have the obnoxious restrictions of drains or not lifting my arms. My tiny incisions smarted for a while, but my vagina thankfully never hurt nor bled.
Two weeks later, I got to go back and talk with my doctor for the follow-up. She showed me the pictures of my insides, both before and after the surgery. All of my other organs, as she said, were “beautiful.” The lab results on my removed organs had come back, however, and I had had ovarian cysts. She didn’t seem concerned about it, but I was silently glad I had yet another reason to rejoice in getting them removed.
I still can't feel my nipples, but they still go firm when poked just like they did before surgery. I can now happily hang out with friends, have sex, or just in general go out without worrying about chest management. If desired, I put on a shirt. That's it. No bras, no binders, no support or compression, no back pain, no worrying about what type of shirt, nothing. It's fucking great.
My hysterectomy doesn't affect me on a daily basis, but every time I see my tiny scars, I smile. As someone who's prone to worrying and used to suffer from serious anxiety, it's such a relief to know that there is literally no way for me to ever get pregnant, or even have to deal with my period again. It's empowering to have made a decision about my body that’s based on what I truly want, rather than keeping a body I was uncomfortable in because society insists that everyone wants biological children. I live in my own body, that I've customized to better harmonize with my brain, and it's working wonderfully.
Now, when I take a shower, I look down and I see myself. I don't feel stuck in a stranger's body. Even though I'm sometimes still “ma'am”'d when I walk down the street, I get “sir” just as often. I no longer feel like my body is a burden or a liability. It was a female reproduction machine, but I repurposed it to serve who I actually am: The body of an androgynous, neuter person who loves to write, cook, eat, cuddle, have sex, and go on adventures.
*Partner’s name omitted upon their request.