Life and Death - a review

Browsing through facebook, I came across a link to an article about why suicide isn't just a men's issue. After I had finished reading, my mind thought back to one girl who claimed that the risk of transsexual suicide post-op was no greater than that of the general population. One of the skills being drummed into me in my current studies is that of critical thinking, which I like because I am inquisitive by nature and do prefer claims to be backed up by evidence if I'm to believe them. So, I decided to check her claim and do some research of my own.

I dived into my university library's database and began to do a search. Sadly, the first thing I noticed was the lack of research on the topic and the only journal article I could find was from a study performed in Sweden. Dhene, Lichtenstein, Boman, Johansson,  Långström, et al. found that post-op transsexuals were 19.1 times more likely to die from suicide. Although there are limitations to the statistics in this study, that is a sobering outcome that clearly refutes the previously mentioned claim. 

Reading through the article, the authors suggest consideration of improved care for transsexuals after their sex reassignment operation. This was something that my psychologist was surprised about when I told her that after care here was non-existent. Where I am, there is one channel to go through if you wish to have surgery here. Many girls decide to have their surgeries overseas in which case the same channel can be used in order to obtain that psychiatric approval letter or there are other avenues that can be followed. Unless I am mistaken (and please tell me if I am), none of them provide any form of follow up after surgery.

Having already written about how emotionally difficult SRS can be, it does seem strange that so much time is spent ensuring the patients well being prior to surgery but that none is allocated to ensuring their mental health after. I wonder if that also contributes to the stigma associated with the psychiatric process. If the process is supposed to be for the good of the patient, then it shouldn't wipe it's hands clean once the patient has been approved for surgery. Such actions tend to be interpreted as being indicative of a system that is only looking after itself. For the benefit of the ts community and for the safety of all those who transition in the future, something needs to change.

References

Dhejne C, Lichtenstein P, Boman M, Johansson ALV, Långström N, et al. 2011 Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden. PLoS ONE 6(2): e16885. doi:10.1371/journal.pone.0016885

Three months on (and words of warning)

It's actually been more like three and a half months now, but pedantry aside, it's been a long three months since my operation. A lot of undesired events came together making it a very difficult time that almost killed me but I have survived to tell (part of) the tale. I have thought a lot about what has happened and have a word of caution to anyone planning to undergo SRS.


SRS is a very emotional experience.


Everybody is different of course and some people seem to just zip through it as if it were no different to having a tetanus shot at the doctors. However, not every finds it that way and I do personally know others that have found post-op recovery to be difficult also. That's not to say it was regretted or that I would have done otherwise, but the difficulty of the journey should not be under estimated. I'm also not just talking about the pain, but I am talking about the emotional experience as a whole. Pain is emotionally draining of course, but there are other factors involved also.


These factors I will get to shortly, but the main point is that SRS is a very emotional experience and you need to be prepared and be sure that you will be able to cope with that. If there are other pressures in your life that are taxing you emotionally, it may well be a good idea to postpone surgery until your emotional reserves are higher. For example, many ts's struggle with relationship breakdowns and/or divorce, trouble with work and trouble with family. I was definitely struggling with all these and throw in the fact that the pain medication had potentially negative interactions with the medication keeping my depression under control and it probably isn't a huge surprise that my mood in the last couple of months in particular have literally been at their lowest in my entire life. 


Pain in recovery was definitely an emotional draining experience for me. Keeping in mind that I have been in and out of hospital my entire life and that pain is not new to me, but the constant pain is still draining. Doctors and their procedures vary as do patients and some girls seem to not have any pain but I would suggest an approach with an expectation of a lot of pain. If it turns out you are pain free, consider yourself lucky. Some girls find that their breast implants hurt more than their SRS operation but I was not one of them. I also developed a pain and possible haemorrhage from a nerve stump that still hurts if I apply pressure on it. There's a little lump as though one of my testicles has been shoved up in an extreme tuck and that's also exactly what it feels like.


Something I really didn't expect was how emotionally draining dilating would be. There is nothing sexually appealing about dilating. Just to make it clear to anyone who thinks it's an erotic adventure to have an excuse to be using these acrylic dildo looking tools, dilating is not sexually appealing! One of the biggest reasons why it is draining is because it's something that needs to be done whether you want to or not. When you first start dilating and for quite a while after, your genitals will still be healing and they will be bruised and sore and you still have to stick this dilator in there. It hurts, it's uncomfortable and it may even make you bleed. Even when every emotion in you says "No!" you still need to do it. It's no wonder that I liken it to having to rape yourself and I say that without a word of jest... 


Some girls have a moment of blissful revelation when, for example, they see themselves in the mirror for the first time. From what I understand, this is a very uplifting emotion that can help to counter the other negative experiences. Unfortunately, it is not something that I have experienced personally. Perhaps it is my literal nature where I just take things as they are but I was looking forward to that moment and it was a disappointment to not have felt it. That disappointment was perhaps an emotional drain as well and I would caution anyone against looking forward to that euphoric feeling. One of the names for our condition is Gender Dysphoria, with dysphoria meaning sadness. That is to say, you transition because you are sad with your current gender and it is important to not fall into the logical trap of thinking that because you are sad with your current gender that you will be elated with your new one. If you approach the change with an expectation of gender euphoria, you may be setting yourself up for disappointment.


Having said that, am I happy in my new gender? Definitely! There are definite downsides to it too, but transitioning isn't necessarily about traipsing around ensuring that everyone notices you're a girl. For me, at the moment, it's about getting on with life and not even thinking about my gender any more. 


Many people ask if I have any regrets. Truthfully, right now, I can't say that I don't. I regret that my relationship and marriage ended and it's still something that saddens me daily and makes me want to cry regularly. I regret that I have lost a lot of friends and that the dynamics with any remaining old friends has changed totally to the point where I haven't seen them for a long time. I regret that I will never be able to experience being the father of a traditional family. These are all things that need to be considered but, right now, I am happy to be me.