Thursday, 19 March 2015

Dealing with dysphoria

The physical and mental state of dysphoria was never anything I thought I had experienced throughout my years living as a woman. 

Most transgender people I speak with tell me they struggled with and even hated their bodies growing up, and particularly during adolescence when they started going through puberty and realized they would not become the men and women they had hoped to become.  However, I do remember trying to hide my tiny breasts in baggy shirts when they started to sprout up at the age of about 12.  I also hated getting my period, which was nothing too out of the ordinary, as most girls did.  I've never met a woman who has said, "I love my period!"

I got through adolescence and then started dating women, happily enjoying my adult life as a lesbian.  I even married a woman.  Now, looking back, I was not very happy.  Although I did outwardly appear content with my life, there was always something not quite right.  I was never sure what it was, and just put it down to feeling marginalized and different as a gay person, but there was something more.  It was a feeling much like trying to be someone I was not and I felt like an imposter most of the time—like I was hiding something.  Well I was, even from myself.  I was also very depressed and had remained so since my teens.

In the years to follow I would experience a divorce with a woman I had been with for 22 years and two failed relationships and I still wasn't happy.  

It wasn't until I was 53 years old and playing street hockey with some workmates that I had an epiphany.  I felt comfortable for the first time, like I was meant to be there, not just the token girl playing goal.  A few days later I made an appointment with my GP and I started my journey.

I realized then that the depression I was suffering was the dysphoria I felt about being born in the wrong body, growing up in a female body, but feeling male.  Once I began taking testosterone on a regular basis, I started feeling calmer and more comfortable in my body.  Once the hair began to appear on my legs, chest and face, I felt fantastic.  I felt normal for the first time in my life.  I was elated.

Once I completed my chest surgery I began to feel even better, and then most recently with my surgical procedure, a metoidioplasty (meta) in California.  But, after about a month and a half post-surgery I began to realize that the procedure was not successful and did not provide the results I was expecting.  That’s when a depression like no other I had ever felt began to set in.  I spoke with my doctor about it and he changed my prescription for anti-depressants, but I knew this was not going to provide relief.  I would stay in bed most weekends, and force myself to work during the weekdays.  I began to isolate myself from friends, activities that I used to enjoy and became despondent.  My emotions were all over the place.  I would go from sadness to anger and began to hate myself and most of those around me.

I knew that the only solution was for a surgical revision.  But, I had no more money, having paid out of pocket for chest surgery and the meta in California.  The surgeon was distancing herself from the issue by saying that she had informed me of the possible results, but she did not.  In addition she said that she could not perform a revision because she is not a plastic surgeon.  There was no point in “beating a dead horse”, so I looked to a local surgeon who assured me he could remedy the problem.  However after a recovery of several months following what is called a “mons revision”, I was basically left at square one.  Over the past several months I roller-coaster between feeling okay and spiraling into deep depression.  As much as I try, I cannot seem to dig myself out.

My only recourse is to keep writing about it and to wait for a consultation with a surgeon in Montreal who may be able to perform another revision.  It is the waiting that I find the most difficult.  Unfortunately, the BC government will only fund surgery at the transgender clinic in Montreal, and paying for a revision myself at this stage would be too costly.  It could be up to a year until I am scheduled for surgery. 

Tuesday, 17 March 2015

Frustration abounds

Although my decision to transition three years ago was easy, there have been several barriers along the way, the least of which is not having any control over my own destiny. This has lead to frustration, anger and even depression that has been hard to overcome.

For example, during the beginning stages of my transition, the BC government was funding top surgeries for trans men with Doctor Cameron Bowman in Vancouver.  I had heard that wait times were long and for me, being 53 years of age, I couldn't see myself waiting for this life-improving surgery.  Instead, in 2013, I chose to go to Florida to have a double mastectomy and chest masculinization done by Dr. Charles Garramone, who I had heard was a great surgeon with great results.  I paid for this surgery out of pocket and have no regrets. He did a fabulous job.

Prior to 2012, the provincial government was not funding bottom surgery for trans men, but was funding gender reassignment surgeries (GRS) for trans women in BC.  The government's rationale was that bottom surgeries for men (i.e. phalloplasty) were experimental and not yet proven.  In addition, although not deemed 'experimental', metoidioplasty for trans men was also not yet funded by the BC government.

This left me no other recourse because of continual, cycling dysphoria, to also turn to a surgeon Stateside to perform my bottom surgery.  I traveled to San Mateo, California in June of 2014 to have Dr. Marci Bowers perform my metoidioplasty, which included testiclular implants.  I felt I had done my research and picked a good surgeon for the procedure.  What doctor Bowers didn't tell me prior to the surgery is that the mons fat, a thick layer of fat common to many women, would completely cover what (if any) phallus I could expect from the surgery.  At the time of this writing, I am still trying to have the situation rectified.  Dr. Bowers says she made me aware of the problem during my pre-surgical examination and I say she didn't, so it is "he said she said."  In addition, she informed me that she was unable to guarantee a revision (monsplasty), because she is not "a plastic surgeon."  Her office also informed me that I would be charged for the procedure, which would amount to $5,800, funds I do not have after spending all of my savings on top and bottom surgery.

I was very lucky to find a local plastic surgeon, Dr. David Naysmith who agreed to do a revision at no charge. I was dumbfounded and very happy.  This man is an angel, and although the surgery did not fix the problem, it was not without his determination to make me feel normal and not without my hopes and prayers.

However, the elation soon turned to depression and an internal hatred towards my body in its current form. While it is not visible to the outside world it is evident to me and how I feel about myself.  I feel despondent, disappointed and depressed most of the time.

In the fall of 2014 I was having coffee with a friend and he had mentioned a human rights complaint that had been filed on behalf of a trans man in BC who had been waiting for chest surgery. He mentioned that a similar complaint was being proposed for bottom surgery.  Would I be interested in leading this cause, he asked?  I had to think about it.  Although I was completely disillusioned with how the BC government was handling trans medical issues and surgeries, I wasn't sure I had the energy or the stamina. But it was for these very reasons I decided to take it on.  If not for me, I believed it was for all the other trans men waiting unreasonably long periods of time for their bottom surgeries to be funded by the provincial government.

In order for a human rights case to be accepted by the BC Human Rights Tribunal, a complaint must show clear discrimination against the Complainant, in this case, me and other trans men in BC.

In 2012, the BC government announced that it would begin funding bottom surgery for trans men, phalloplasties, but was limiting them to five per year.  At the same time, surgeries for trans women were not being capped.  There lay the discrimination.  My complaint was based on what I charged as discrimination and the complaint was accepted by the BC Human Rights Tribunal.

It appears that this case will go to a hearing, and although the BC government has dropped its cap on the number of trans male surgeries it will fund, I am hoping to recoup the cost of my surgery in California as an additional remedy in my case.

We also found out that over a two-year period, from 2012 to 2014, although the BC government maintained it would fund five trans male bottom surgeries per year, no men had been sent to Montreal for surgery. The reason according to government officials was no one came forward. An article was written in the Victoria Times Colonist newspaper, November 23, 2014 by reporter Katherine Dedyna, B.C. say 'no one came forward' for gender- alignment surgery  that uncovered this information. This was very good work on her part.  As a reporter myself for radio, I felt I could not touch this as it would be seen as too self-serving.  But, I believed the story needed to be told.

The fact that a Ministry of Health spokesperson was quoted as saying no one came forward was utter nonsense. I am in touch with many trans men in BC, and no one I know, including myself, was ever contacted and offered access to bottom surgery at any time by anyone. I believe the article was clear in catching the BC government with its proverbial pants down on this issue.  

In the meantime, it is the very action of the human rights complaint that gives me strength and hope and keeps me clear of my depression.  It is inaction that keeps me trapped in my dysphoria.

Just after the article was published, trans men in BC began receiving letters from the Health Ministry advising them that they were now approved for funding and were to contact the office of Dr. Pierre Brassard in Montreal to schedule their bottom surgeries. Coincidence?  I think not. However, it was good news for as many as 100 trans men waiting desperately for their surgeries, myself included.  

Although I have already received a surgical procedure in California, it was not successful and I still need a revision.  I am hoping that a consult with Dr. Brassard will give me some options. At this stage I can also choose phalloplasty surgery in Montreal. I have heard that there is a backlog and it will be at least a year before I and the others are scheduled for surgery.