I have to admit that I have kind of been ignoring this blog in the past few weeks. I’ve also been ignoring email, I unplugged the answering machine, and I’ve been having a helluva time concentrating at work. The truth is—and this is hard for me to admit—but I’ve been down lately. I’m usually a pretty happy-go-lucky kind of person, so it kind of took me by surprise.

On the one hand, I’m fully aware that the hormonal battle that is being waged in my body is very likely affecting my mood, so I’m not beating myself up over this. But there are some more specific issues that have also contributed to my low spirits.

First off, despite my claim of menstrual cessation, I have bled again and it totally threw me. I’m starting to gain a whole new appreciation for the word “dysphoria.” Why isn’t my body getting the message?! (And while I’m at it, where is my fucking facial hair?!) I am wary and cautious about what will happen this month. I’ve been on T for five months and the endocrinologist will want to see me for a six month checkup soon. The word I was given originally is that if you have not stopped bleeding after six months, talk to your doctor.

It didn’t help that when I saw my doctor for my last shot, I told him that I had bled again, and asked what he thought about a recommendation from a TCM doctor friend of mine, and he made an insensitive joke. Not cool. The TCM doctor suggested that acupuncture could help move my chi from it’s previous direction of down and out, to up—basically taking menstrual energy and channeling it up into facial hair growth. Sounds great to me! (More about this in another post soon.)

I assume that I will eventually stop bleeding, though I clearly recall my endocrinologist saying, “Testosterone might stop your periods and might cause facial hair growth.” Might?! Now, let’s assume that I will stop bleeding. I can be patient. Really, I can. But then I have this “what if” in the back of my head: What if someone someday takes away my T? (I shouldn’t have watched all those New World Order videos last week on YouTube!) I really need to know for certain that I will never bleed again.

But let’s put these thoughts on hold for a moment.

Another issue that’s been bugging me is the fact that I am required to have a hysterectomy in order to get my birth certificate and passport changed to male. Originally, I thought this was a requirement unique in Canada to Quebec, but British Columbia also requires this for trans men born in BC. In order to fully transition, you must be sterilized. Apparently, Canada is afraid of the idea of pregnant men. I have never wanted to have children, but I’m also not particularly at odds at this point with having internal female organs (aside from the bleeding issue outlined above.) I see any surgery as a great risk and I don’t understand why we are required to submit to medically unnecessary surgery at tax payer expense (at least, “unnecessary” when there is a lack of dysphoria related to the presence of a uterus, ovaries and a cervix.) However, the identification changes are REALLY important to me. While I honestly think there are grounds here for a Charter challenge, I’m just not up for spearheading something that big (especially since my endocrinologist often recommends a complete hysto after about three years of HRT.) I have slowly started coming around to accept that I will require more surgery, and that’s been tough.

When I mention my ID issues to my non-trans friends, they seem perplexed: Why can’t you just travel on your current passport? Well, legally I can. And since I don’t look too different from my passport photo, the only requirement would be that I try to pass as female going across borders—and that’s exactly what really bothers me. I don’t want to have to pretend to be anything. Sure, I’m not breaking any laws by being trans (at least in most countries) but border guards can really make a crossing hellish, falsely accusing you of having fraudulent ID, forcing long delays (perhaps causing you to miss a flight) and generally making everything quite uncomfortable. Give me a year on T, and assuming I have some sort of facial hair by then, and the whole situation is multiplied. I would have to out myself as trans whenever using my passport. No thanks!

I’ve also been considering my options for genital surgery, something that I was certain I wouldn’t desire when I started my transition. I’m not going to get into those details just yet except to say that I requested a surgical consult with Dr. Bowman (who did my chest) since I will be seeing him in the next couple of months for a check-up, but despite the fact that the BC government paid for him to be trained in lower surgeries for trans men with Dr. Stan Monstrey in Belgium, the BC government is no longer funding the SRS program in BC and Dr. Bowman is unable to get private operating room time for those procedures. Yeah, sucks.

Back to the hysto… I’ve been considering having this done at the same time as other lower surgeries, but after chatting with a very helpful person at the BC Ministry of Health today, I’m leaning towards doing it “a la carte” and having MSP cover it.

I asked my doctor at my last appointment what the process is for getting an MSP-funded hysto. He didn’t know and suggested I do the research. I called MSP and was referred directly to the Ministry of Health. I eventually got through to Carol Anne at 250-952-1555. She knows her stuff regarding MSP coverage of transmale surgeries! She informed me that the process for getting a hysto in BC goes something like this:

  1. I talk with my doctor;
  2. My doctor contacts MSP for a referral;
  3. MSP contacts the two surgical assessors (psychiatrists) in Victoria, BC: Dr. Knudson and Dr. Robinow;
  4. The offices of Dr. Knudson and Dr. Robinow contact me to book an assessment appointment;
  5. I get a psychiatric evaluation to confirm the GID diagnosis and ensure that I am stable enough to go through surgery;
  6. Their reports are passed on to MSP;
  7. If all goes well, MSP approves the funding and contacts me;
  8. I contact the surgeon to book a consultation and surgery date.

There is only one surgeon that MSP is aware of who will perform hystos on trans men in BC: Dr. Shaun Tregoning in Abbotsford (who happens to be an endo, ob-gyn and surgeon all wrapped into one well-liked medical pro.) Carol Anne said the situation for trans men requiring hystos in BC was “sad.”

Two things were not clear to me:

  1. Would I see the two psychiatrists individually, or at the same time?
  2. Does MSP cover the cost of seeing the psychiatrists? (I know that they do NOT cover this if you are going for top surgery funding, and Dr. Knudson charges $365 for an appt.)

For funding approval, I will need 12 months of real life experience (RLE) under my belt, however I can begin the process of getting the psych evaluations now—they simply won’t provide any funding until January comes around (which is when I’ll hit my 12 months.) MSP will cover everything related to the surgery. The choice of procedure will be up to me and the surgeon. As for a waiting list, once the funding is approved, she said it’s generally about 2-3 months but that it can vary.

So, I will speak with my doctor on Friday about contacting MSP for the referrals to the psychiatrists. The ball is rolling, and I’m already happier just to be making some progress towards getting my ID all sorted out. I don’t like the idea of my life being on hold while this is in limbo, but it doesn’t look like it will have to take too long. I’m forging forward! The countdown to a hysto begins, and another surgery chase is on! …Yes, this adventure can be exhausting sometimes!

(I should also mention that I’ve put out the call for another therapy session to help me navigate all of this: the slowness of testosterone, increasing dysphoria, and getting mentally and emotionally prepared for additional surgeries.)