Intro to my lower surgery

Heyo all,

So if you read my last post you caught that I recently had bottom or lower surgery. Yeah! I had a full hysterectomy with a metoidioplasty and scrotoplasty surgery without urethral lengthening or vaginectomy  July 14th, 2017 in Greenbrae California with Dr. Chen of Brownstein and Crane Surgical Services, with full coverage under my Kaiser Northwest Plan.

Kaiser NW recently brought on board two plastic/urological surgeons to Portland to start doing the surgeries, but I started the coordination process justtttt as the surgeons were getting onboarded, so I had my choice of flying to San Francisco (Brownstein/Crane) or Arizona (Meltzer) or waiting it out in Portland for the newbie surgeons to arrive (who I have since heard are fantastic both in patient treatment and technique).

I decided to go with Brownstein and Crane because I like their results and technique from what I found by looking at the tiny bit of crappy piecemeal information that exists online. I went down to California in June of 2016 (paid for in full my by insurance coverage – flights, lodging and stipend) and had my consultation with Dr. Chen and the Kaiser Transition Clinic located in Oakland, CA.

Dr. Chen was completely awesome and very friendly. He answered a lot of my questions. The Kaiser Transition Clinic meeting was a few hour-long affair of what I called ‘speed-dating.’ I met with a: social worker, two therapists, a surgeon, a gynecologist and a nurse. I think that’s everyone! It was a little over the top but it felt amazing to have so much support right at my fingertips.

I left and another agonizing 2 months went by after I got home before I received a call from Dr. Chen’s office that my surgery was scheduled for July for the following year: 13 months after my initial consultation. That’s how long the surgeon’s waitlist was.

So, I waited from August ’16 to July ’17 and at first in the beginning of the year the surgery seemed so far away, then my life got really busy and I actually had zero time to think about it and BAM. There it was. July 12th I was on a plane to San Francisco with my best friend and a giant suitcase full of shit because I had no idea what to bring (we were staying for three weeks) and in two days Dr. Chen would be rearranging my bits into something a little more manly so that I could go on with my life.



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An overdue catch-up session

The last few years have been a rollercoaster ride. I got married to an amazing woman who was my partner for 8 years, then just shy of two years into our marriage we split up. We remain very good friends and we are tremendously supportive of each other, but without going into detail and as I’m sure you could imagine, separating was deeply painful. It was in part due to my transition, but honestly it was a combination of things that slowly crumbled due to a few major catalysts. Jen and I are still amazing friends though, so for that I am grateful. She is a wonderful person and I am lucky to have both been married to her and to still call her my friend.

Before our separation, I followed Jen out to Portland, OR (from Philadelphia, PA) as she pursued a career move. I had never been to Portland in my life and knew nothing about the city, but I am always up for an adventure!

It was hard moving across the country, though. Much harder than I thought. This again had a small part to due with my transition. We moved in 2012 – I had top surgery in October 2012, started testosterone in November, and we moved across country in December.

It was hard being in a new place that I did not know, and having nothing aside from Jen and my cats to represent any sense of familiarity. Even my own face was changing daily and I was excited, but still I had no sense of anything familiar for a while. Also, for those of you who live in the Pacific Northwest, you know moving to Portland in December is a really rough time of year. It was a particularly rainy and dark winter that year, and I first got a job working overnight when I moved here, so it was really quite literally a pretty dark time of uncertainty.

That was 4 and a half years ago, though, so obviously I have moved on and made friends and made a life for myself out here, even beyond my separation from Jen.

I am lucky to have wonderful friends all over the United States and even elsewhere in the world. The love I feel is really spread far and wide.

It was a blessing moving to Oregon because I was able to access bottom surgery here through my insurance, something that is pretty rare on the East Coast. The West Coast (best coast!) is obviously very liberal and most organizations are doing the right thing and providing comphrensive trans coverage and care.

I also found my own career out here working in non-profit community education. This was a field I had been trying to break in to for a long time, but didn’t have any experience. Finally, I was given an opportunity to work for Parks and Rec out here, which was an entry into what I am currently doing, which is managing an office that provides education and social services to families of an elementary school in outer SE Portland.

I am one of the very lucky ones who loves my job and has supportive, amazing coworkers who are 100% behind me and I can be open about being trans and it is seen as a benefit to my skills of empathy and understanding systems (though I am not open about it to families at school – which makes me sad but hopefully I can get there one day. There is a lot of cultural differences and I haven’t found the best way to explain it yet).

I have also indulged in the outdoors here in such an amazing way. Oregon and the West is so incredibly gorgeous it’s ridiculous. I have been into the outdoors since I was a child growing up in rural Pennsylvania, and moving out here has blown the lid off things. I have hiked, climbed and kayaked my way all over this beautiful, majestic place. I love it.

Overall, in the last 4 and a half years I have just simply grown. Obviously I moved here in my twenties and as I write this, I am just over 31 and a half years old. There is a big difference just right there. (omg I am glad my 20s are over. That shit was rough).

For the first time in my life I have truly found my spiritual center for myself that is deepening every day. As of lately prayer and meditation have become very important to me, and I feel that God is all around me and guiding my path. (Note – I am not Christian, I am spiritual. To me, God=Universe).

My life is currently experiencing some big, wonderful shifts and I am embracing them. It is a wonderful place to be.

Thank you for reading. I am going to post more about my bottom surgery and other insights on being trans, so I hope whether you are trans or not, you can educate yourself a little from my experiences.

Much love!

Ps. Follow me on instagram: trans.mountaineering

July 2017 on a walk in beautiful San Anselmo, California. 


Photo credit: A special lady ūüôā



tags: trans – transgender – ftm – transition – gender – transman – grs

Long time, no write!

Wow, it has been four years since I last posted an update. My goodness, how things have changed. Physically, mentally, spiritually, and even geographically. I was living in Philly, PA but in 2012 my (now ex) partner packed up and moved to Portland, OR. I got married, got divorced, found a career path. I am now 31 years old and as of just yesterday 7/14/17 I completed my physical transition by having bottom surgery done by Dr. Chen in San Francisco. I have been on testosterone for 5 years with great results.

Life kind of took precedent over blogging, but I am hoping to revive this blog and have it as an outlet for my experience as a man who is trans in this world. It is quite the journey, my friends.


tags: trans, ftm. transgender, transman, surgery, transition, bottom surgery

This makes me so happy.

I usually try to stray away from blogging about personal stuff that is irrelevant and not helpful, but I couldn’t help myself this time. And I supposeee this relates to gender stuff lol.

The Portland Mercury, weekly entertainment paper in Portland recently had a “cross-dress your pet” photo contest in which you cross-dress your pet as another type of animal.

The winner of the contest makes me so happy. I wanted to post the picture but didn’t want to get in any shit over copyright, so I encourage you to visit the Portland Mercury’s article to find out what the hell I’m talking about.

When to ask a trans person stuff

There’s things your curious kitten self is just craving to know about trans people. Delicious little nuggets of information your little brain is just salivating over. There are things about what’s in our pants, how we think, who we fuck, that could quite possibly keep you awake at night, the possibilities are so inconceivable and fantastic.

Well, my pet, I am an advocate of knowledge and learning, so I think your questions should be answered. (That is why I blog, after all.) However, let me remind you that your intent should come from a place that is genuine and seeks to honestly strengthen your understanding and alliance with trans people. Not because you want some real-life Maury Povich shit to go down in your living room.

So I’ve created a little checklist that you should think of when it comes time for you to cash in your omgtellmetellme chips for a sip from the transgender well of knowledge.

Deciding whether or not it is a appropriate to ask a trans person something is as easy as: Who, What, When, Where, Why and How.

Mix 6 parts your answers to these questions with 1 part common sense and you should get an accurate gauge of how appropriate it is to ask a trans person that burning question of yours.


…are you asking?

Is it your dear friend who came out to you last month? A transwoman in your book club who seems pretty open minded? Your transwoman friend who is a blogger and activist for trans rights? Or your transguy friend who barely acknowledges he is trans and just wants to be “one of the guys?” Are you about to ask a really interesting trans person you just met at a party? Your trans coworker?

Essentially who is this person to you, what are they all about, and how well do you know them?


…is that you are asking?

“Were you abused as a child?” is a very different question than “What is your favorite thing about being trans?” – two questions I have been asked.¬†Have you ever been asked your question, and if so, how did it make you feel?¬†Is what you’re asking actually any of your business?


…are you asking this question?

After amazing sex with a hot transperson? When your transfriend just got done lamenting about a breakup? At your kitchen table, over coffee and during a serious heart-to-heart? When you are drunk at a party?

Consider the emotional investment required in answering your question, and ask yourself if now is the right time. Plan for an appropriate time to ask questions on taboo or touchy subjects when the person you are asking is relaxed, emotionally sound, feels safe, etc.


…are you asking this question?

On a crowded bus? In the office at work? At dinner in front all of your friends? In the privacy of your living room? Underneath a tree at a park? Walking down a city street late at night with a couple strangers within earshot?

Consider the sensitivity of your question and who is around that might hear and make the transperson you are asking feel unsafe or uncomfortable or out them in front of others they don’t necessarily want to be out in front of.


…are you asking this?

Are you asking this you’ve scoured endlessly over the innards of the internet to find the answer to and just couldn’t come up with anything? Is this something that will genuinely make you a stronger ally, a more understanding friend or relative? Is this something that is just a personal curiosity you are dying to satisfy, and on that note, is it worth it to potentially make someone else uncomfortable to find out? My advice is to do your own homework as best as you can first and maybe discuss the question with other non-trans allies before you ask a trans person – who already has to explain a lot of stuff, all the time – to explain something to you.

and lastly…


…are you asking the question?

It might help to preface your question with a little positive¬†encouragement and proof that you really thought about the trans person’s feelings. It softens the blow to a question that might be jarring, exhausting, negative or emotionally sensitive.

“Hey Sally, I really want to be a stronger trans ally. I have been doing some reading and I can’t seem to find a clear answer as to why some transgender women aren’t allowed in female spaces, like the Michigan Women’s Music Festival. I understand that you probably get asked questions all the time, but I feel the need to understand this concept better, so may I ask your opinion on the subject?” This is a lot different than “So why don’t they let transwomen into Michigan’s Women Festival?”

or “Hey Tom, I know I could never understand what it’s like to be in your shoes, but you are a really good friend and someone I care a lot about and I support you 100% but I read some things about negative effects of hormones and I began to worry about you. Have you heard anything about that, has your doctor said anything?”

This is a lot different than “So I hear hormones cause cancer, is that true?”

Now friends, it is time for one last lesson. When and if you should ask the motherload of all questions. The notorious BIG question…



…dun, dun, dunnn!

Every trans person has been asked this. Show me a trans person who hasn’t and I swear to you I will wear a dress for one week.

Some trans people are asked this question in more appropriate contexts than others. Most recently, one coworker who I am out to blurted this lovely little gem out right in the office, in front of another coworker who I am not out to. Please, people, for the love of God, don’t be that person.

Before asking this question, consider that you are essentially implying that a trans person must describe their genitalia to you, simply for no other reason than because they are trans. Because you perceive them as different and you, sweet, naive reader, feel you have a right to know what is in their underwear right this very moment, even as they sit across the office from you.

When was the last time you, dear reader, had a friend, coworker, relative or stranger you just met ask you to describe exactly what your private parts are like?

Would you be shocked? Embarrassed? Ashamed? Angry? Would you tell them to go fuck themselves? Or would you calmly answer their question because it just feels like you somehow owe them, and society as a whole, an explanation?

In American society is common courtesy not to pry into one’s medical history unless you are their: legal guardian and they are a minor, a doctor or a potential sex partner. This is no exception. If you are the person’s dear friend or beloved relative, then you can probably navigate the waters. But for all you other fools, perhaps approach the transgender surgery question the same way you would approach a person with a disability (and geesh if you are clueless on that too here is a great article). Yes, a person with a disability obviously has a different body than you. Are you going to bluntly ask them about it? No, because that would make you a rude asshole.

And you’re not a rude asshole, dear reader, are you?





ps. I will just tell you right now so you can get some friggin’ sleep at night that a lot of trans people have not had “the surgery.” By the way, there are lots of surgeries transpeople can have. Facial feminization, breast augmentation, tracheal shave… but I know you are talking about “the surgery” so I will just tell you that it’s expensive, for one. A vaginaplasty for transwomen (in which the penis is inverted to create a vagina) is less expensive ($10-25,000) and less prone to complications, but still unattainable for a decent majority. A phalloplasty for transmen (a surgery to create a penis via skin graft or growth harvested from another part on the body and lengthen the urethra) is really expensive (around $100,000) and can easily be prone to complication and require multiple revision surgeries. Some phalloplasty surgeries can be successfully sexually effective, but there good amount that are not. Most transmen seek first and foremost “top surgery” – the removal of the breasts and masculinzation of the chest, but that is still a costly surgery ($5-10,000) that a lot of transguys can’t afford. These surgeries are rarely covered under insurance, and incur lots of other costs that include travel and time off work.

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Trans 101: Back to Basics

The most basic of basic Trans 101.

If you feel like a Neanderthal, or a two year old, or a two year old Neanderthal when it comes to understanding transgender identities, let me just break it right on down for ya.

A transgender male is a female-born individual who identifies as male and can be anywhere on the spectrum of medically transitioned – from no medical intervention at all to completely medically transitioned, including surgery and hormone replacement therapy.

Laymans terms: I identify as dude, therefor I am.

Another way of thinking of it:

Think of transitioning in terms of geographically relocating. ¬†Some guys are born male – these guys are the “locals,” this is who they’ve always been. Some guys “moved” here a long time ago and just fit right in, it’s as if they’ve never lived anywhere else. Some guys just moved here and are still trying to learn how to be a local. Be welcoming to the newbies, you have much more to offer them than you think.

If you have a guy friend who happens to be trans, you need not do anything other than treat him just as you would any other dude.

All of everything I just said is exactly the same for transwomen, except replace the words guy, dude, and man with chick, dudette, and woman. Ta-da.



For further consideration:

We live in a world where there are two predominantly socially-accepted genders: male and female. Think of it as Democrat and Republican. You know there are other parties out there, and chances are you don’t totally subscribe 100% to your chosen party. (And hell if you’re smart, you know it’s all just a sham anyway). Gender works similarly and there are people out there who have chosen to not conform to male or female and blaze their own path of gender identity. (Gender anarchy!!) These folks may identify as genderqueer, gender non-conforming, or they might ditch labels altogether. We won’t get too deeply into it since we don’t want to overwhelm your little toddler caveman brain, but these folks are out there and they are revolutionary and deserve equal amounts of respect.


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Top Surgery Post-Op Tips

I’ve been posting a lot about surgery recently so I am ready to move on to other topics, but I wanted to do one last post about some tips and things to expect when you are freshly post-op from top surgery. Again, these are my experiences only, so keep in mind that everyone experiences post-op differently. Good luck!

Also, this focuses mostly on the first week post-op, when (if you have a double-incision as I did) you are wrapped up in the very tight, uncomfortable bandage with the drains.


Most guys probably want to know right away how much pain you’re gonna be in. Well, obviously everyone has a different threshold for pain so that’s a tough question to answer. I’ve heard from most guys, myself included, that the recovery isn’t actually that painful. For me, the most painful thing was the bandage. It rubbed my skin raw in four different places, and was so tight that it hurt to get up, sit down, and lay flat. I took pain pills (Percocet) the entire time I was wrapped up in the bandage. The pills dulled the pain and made me apathetic to the discomfort. The minute I got my bandage off, I didn’t need them anymore. If you handle pain even moderately well, and if you are able to take the pain meds, then I’m pretty certain you should be able to bear it just fine.


I’ve known guys who have been allergic to tape, glue used to close your incisions, anesthesia, latex, etc. You might unfortunately find out while recovering that you have an allergy. Sometimes you might be able to handle it with over-the-counter allergy meds, sometimes you may need your surgeon to intervene. I actually was allergic to the antibiotic that I got originally prescribed. It gave me a fever and made me extremely nauseous, so my surgeon had to call in a prescription for another antibiotic that was milder.

Nipple pads:

You will have to most likely wear some sort of pad with antibiotic cream on your nipples. You’re surgeon will have a plan for you, but if you can get away with it, I suggest Tefla non-stick pads (or the off-brand of course). I wore these over my nips with a light ace bandage holding them in place. There is no adhesive so you won’t irritate the skin around your nips.

Ace bandage and tank top undershirts:

If you have to wear an ace bandage, put on an undershirt as a barrier between your skin and the ace. A lot of guys report a sensation that the ace bandage is always “slipping” down and they have to readjust frequently. One guy I know even stopped wearing his ace because he was so frustrated by that and it resulted in a complication. I recommend wearing an undershirt tank top, aka A-shirt or, if you will, “wife beater” as a barrier because the fabric of the ace kind of “grabs” the fabric of the tank top and at least I didn’t experience that “slipping” sensation.

Sleep and dreams:

You might sleep great, you might sleep like shit. It all depends. I’ve usually heard guys say that at least at some point during immediate recovery that sleep can get kind of difficult. I had to sleep sitting up for the first week that I had my bandage on because I couldn’t comfortably lie down flat (the tightness of the bandage I had to wear the first week put too much painful pressure on my chest). It was impossible to get comfortable and took my mom and my girlfriend and about 15 minutes of shuffling before we could get the pillows just right (which inevitably lead to some really frustrated laughing). My pain wasn’t too bad so at night instead of taking the Percocet I was prescribed, I took two Tylenol PM instead. I kept the bottle bedside, and when I woke up in the middle of the night, I took two more and laid there until I fell back asleep.

Five out of the seven nights I was wrapped up in the bandage immediately post-op, I had nightmares that my bandage was removed and I still had breasts. I attribute it to a combination of pain meds and anxiety over not knowing what was underneath the bandage.


The reality that you had surgery might hit you hard, and that’s OK. Allow yourself to be overwhelmed with what you just went through. It’s kind of huge. It might blow your mind. Take care of yourself mentally as well as you are taking care of yourself physically. If you start to feel overwhelmed with anxiety and are having a hard time processing the surgery, don’t feel afraid to talk to someone, or at least journal about it.

I definitely experienced a complete sense of awe and overwhelmed emotions at having just gone through the surgery. It seemed a little unreal and for a minute I couldn’t believe what I had just done. But, the feeling passed. It’s all part of the process.

Bathroom stuff:

You may get stopped up, you may camped out on the toilet nonstop. The anesthesia, pain meds, and stress all affect guys differently, so be prepared for your bowels to not exactly, uh, cooperate with you. I thankfully didn’t have any problems like that but I’ve heard the tales of woe from others.

Blood pressure:

One unexpected thing that came up for me was while I was recovering I unexpectedly got into an argument with someone, got really upset, and my blood pressure rose. Because my bandage was so tight I could feel my heart pounding in my chest and I began to feel really dizzy and I thought I was going to pass out. I immediately stopped the argument and just told the person I could not talk about it, and I layed down and went to sleep for a bit.

I didn’t expect to fight with this person at all, but it happened. It’s a word to the wise, however, to make sure you are spending your recovery time with people who make you feel relaxed and calm and who you most likely won’t argue with.


Unfortunately you may have some complications to deal with. Luckily I didn’t but, here are some things that may come up. Your nipple grafts might not take 100%, you could have a build-up of fluid after the drains are removed, you could develop a hematoma (small sac of blood at the surgical site). I don’t know all the full complications that could arise, these are just a few that I know have happened to others. The best thing to do is just to follow any post-op care instructions as closely as you can and make sure you are seriously resting, drinking lots of fluids and eating.

I’ve been told that your chest will change many times over the course of the first year you are post-op. If you have irregularities in your scars, maybe a dog ear, or things just look weird, of course check in with your surgeon but also understand that it just takes a lot of time for your chest to heal and look the way it is going to look forever.

Getting your bandage off and drains out:

…is amazing. Nothing feels better than when that damn bandage comes off. Getting your drains out doesn’t hurt, it just feels really odd. Some guys have reported feeling faint when the bandage comes off, so be prepared to maybe sit down really quick. I’ve heard stories of guys fainting once they see their chest because it still looks pretty gross. Be mindful of how sensitive you are to blood and guts.

Also, my family doctor warned me that when my bandage came off I might have the sensation that my chest is “falling” or not being help up, which I actually did feel that. It’s an odd feeling, like without the bandage the front of your chest is just going to fall off, but it passes.

Seeing chest for first time:

When I saw my chest for the first time, to me, it looked like a bald chicken or turkey in a cartoon that had just gotten it’s feathers blown off. Seriously, it looked like an uncooked turkey. It was pale and wrinkled from the bandage and just… bald looking. Totally flat. It was unusual at first glance, and I didn’t expect to think that. It wasn’t a magical movie moment or anything. It wasn’t until I got home and spent some real time in the mirror that I really fully understood what I looked like.

Pains, tingles, pulling, numbness:

My chest isn’t totally numb. I can feel touch everywhere. Right on my pecs and my nipples I can’t really feel light touch. If you rubbed a feather there I probably wouldn’t know. However I can definitely tell when I am being touched, and usually, how. (I plan to post more on this later).

At 5 months post-op I am still having some pain. It hurts to have pressure on my chest or if someone taps my chest, slaps it, or leans on it. I still feel my scars pull a little bit if I am reaching from something really high up. Sometimes my scars will just hurt for no reason, but if I rub them with some Vitamin E oil, that usually goes away.


Immediately after getting my bandage off, with the drains still in.

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Top Surgery… My Experience

Disclaimer! This is my experience and mine only. I give some advice and things to consider, but they are only based on my own experience and I encourage you to completely take or leave anything I say. When it comes to surgery, you must do whatever makes YOU feel safest, healthiest and happiest. Cheers!

I just wanted to finally take the time to write about my experience having my top surgery. My surgery costs were around $5,700 (with a $2,000 discount from my surgeon, Dr. Rumer out of Philadelphia). I fundraised over $3,000 (through dance parties, an online campaign, storytelling events, etc.) and took out the rest in a low-interest personal loan from the Federal Credit Union.


I spent the month before surgery getting as healthy as I could. Thankfully I already didn’t smoke, and I quit drinking entirely for that month. I was 26 at the time of my surgery and I love a good beer with good friends. However, I wanted to give my body a chance to be at peak health before the surgery. I exercised when I could and ate as healthy as I could. I’m normally pretty active and eat pretty healthy (mostly vegetarian, trying to stay away from processed foods, refined sugary foods, etc.) but I wanted to step up my game. No more pub grub binges for a while!

I really recommend doing this. I believe it sped up my healing time and kept complications at bay. If you are overweight or eat unhealthy, I would recommend getting into healthy mode for a few months before surgery. It is hard, but keep in mind how bad you want your chest to heal nicely. Keep that goal forefront in your mind. Giving up beer was hard for me. One of my most divine indulgences is just relaxing with friends and having a nice hoppy craft ale, but it was easy to know that the reward overwhelmingly outweighed the temptation in that moment.

Two weeks before surgery I had a giant list of food and medications to avoid (you can see that list here). Although it was really hard, I followed the list to a T. I also feel like this aided in the smoothness of the surgery. A lot of the foods are banned because they can interfere with anesthesia, and since I’m terrified of anesthesia, I adhered closely to the list and had no problems. I wasn’t even groggy when I woke up.

I also did some work to prepare myself mentally and spiritually for the surgery. I took time to breathe, meditate; I journaled my thoughts and feelings leading up to the surgery. I was also in therapy at that time and it helped to have a safe space to have a continuing dialogue about my fears, anxieties, concerns, joys, and excitement over surgery.

Journal excerpts from prior to surgery:

“This next chapter is beginning and I’m doing my best to flow in the fast moving current. I think I am doing OK. I’m pretty nervous about my top surgery. It’s a big change. I’m excited and sort of just amazed at how lucky I am that I have the opportunity. There are lots of thoughts running through my head about it on a daily basis. Nervousness is the guiding emotion right now…

…I am ready to let go of my breasts. It is hard, though. It’s my body — it’s comfortable. Well, it’s extremely uncomfortable, but it’s comfortable at the same time. It’s weird. I’ve been using this mantra: TRUST. It’s been helpful. I am trusting myself and my body, my decision…

…I am really at peace with my surgery Friday. I am ready.”

As you can tell from reading the journal excerpts, I gave myself space to feel nervous about surgery, to realize that it was a huge change. It’s kind of surreal to be removing a part of your body that isn’t physically “sick” and aside from the mental anguish it causes, would remain attached. I recommend sitting with these thoughts. I think there is a fear that if you sit with these thoughts, you will rethink your decision and freak yourself out about surgery. But in my experience that wasn’t the case at all. Instead, I just slowly dissolved these feelings and worked through them. My personal mode of thinking when it comes to dealing with mental health hurdles is to deal with it as soon as possible, sit with it, examine it, even if it’s hard. It’s better to be absolutely sure about something than to ignore your feelings and be unable to escape them later.

I held off on overloading on Youtube videos or blogs because I didn’t want to overwhelm myself with information that wouldn’t necessarily be accurate for me and my body. The last week leading up to the surgery I finally watched a day-by-day, then gradually monthly series of videos from a guy’s surgery and post-op experience. It was really helpful to see his experience, however there were some clear differences to how he ate, felt mentally and physically, and experienced the surgery. Still, it was helpful to get a vague understanding of what I was in for.

I started off the weeks leading up to my surgery feeling really nervous. However, the more I sat with these feelings and experienced, the less and less nervous I felt. The week before my surgery I reached a place of tranquility and acceptance that was pleasantly surprising to me.

I also did something to honor my “birth form” – if you will. My surgery was October 26th, and I got a meaningful tattoo on October 1st. The explanation of the tattoo is kind of long, but I got a small reminder of who I had been up until this point. It was comforting. I also treated myself really well in October. I indulged in hikes, alone time, and kept my schedule pretty mellow. I had a dinner party with friends at a restaurant that is named after me. I’m a stand-up comedian and I wrote a really funny break up letter to my tits that I read at a show. Two days before my surgery I flew a plane for the first time. It was something I’d always been wanting to do, and I found a web coupon that put it in my price range, so I went for it. It was an absolutely incredible experience, and a celebration of my life and myself.

The night before my surgery I felt my breasts for the last time. I kind of said goodbye. It wasn’t sad… it just was. I asked my partner if she wanted to touch them one last time. To my surprise, she said no. I put my hand over them as I fell asleep that night.

Nothing to eat or drink after midnight and amazingly between my mom, partner and best friend – I was the only one who got any sleep that night.

Day of Surgery

We got up bright and early, 5 or 5:30am I think. We had to be at the surgery center at either 6:30am? Maybe 7… I can’t remember. We got there and I signed in, signed paperwork.

The surgery center was a little disappointing because at that point I hadn’t legally changed my name, so my birth name had to go on my wrist bracelet. I also had to have “F” for female on my bracelet. I think I had to explain my preferred name and pronoun. One of the nurses accidentally called me “she” but the other nurse quickly stepped up and corrected her and she quickly apologized and didn’t do it again. It wasn’t a malicious or ill-intended experience, but it was disappointing. I know they do a lot of these procedures in the center so I wonder why they don’t have protocol in place? I never asked my surgeon about it – I just moved on.

In the morning before we left for the center I wrote my partner, mom and best friend little letters. Right before I got taken back and away from them, I gave them the letters. It was basically just little thank you love notes to them for their ongoing support through my decision, fundraising, and finally the day of.

I changed out of my clothes into a gown and those weird socks with the rubber bottoms. My surgeon came in and drew the marks on my chest of where she was going to cut. I picked out my nipple size and placement. Small nipples creep me out and I wanted the nipples a little bigger than what she originally drew and she was fine with that. Don’t be afraid to advocate for how you want your body to look. I questioned when she placed the nipples kind of off to the sides of my body, and she explained that men’s nipples are a little off-centered. I trusted her on that, and she trusted me on what I wanted with my nipple size. It was a sweet moment, when she was drawing me up. I really like my surgeon and knew her personally as well. I relaxed a little in that moment because I just knew she wouldn’t let anything happen to me. I knew I was under her care. We celebrated the fact that I was finally, finally here.

I got in the gurney, got some vitals done and got an IV started. I met with the anesthesiologist.

Now, I hate anesthesia. It scares the shit out of me. I underwent another procedure when I had IV sedation, which is NOT the same as general anesthesia  that you are under for top surgery, however, I woke up in the middle of the procedure and became aware of what was happening and felt pain. Not good. That experienced produced a huge amount of anxiety over anesthesia in me. Another thing that made me uncomfortable about that experience was the anesthesiologist started to administer the anesthesia without telling me he was doing it. So all of a sudden I began to feel woozy but I was still coherent for a few minutes before I fell asleep. It just seemed like wrong to have medication administered without full understanding and consent РI did not like or appreciate that, at all.

So, I told the¬†anesthesiologist all of this. He assured me that I would not wake up during the surgery, that I’d be fine. I asked him to PLEASE let me know if he puts ANYTHING in my IV before he does it. I wan’t an explanation about what is happening. He told me would. Well, he didn’t.

After I met with¬†anesthesia my family came back in and I gave them all kisses. Then I got wheeled into the operating room. On the way I noticed the¬†anesthesiologist push something into my IV. As soon I was pushed into the operating room, I got that woozy feeling again. I asked the¬†anesthesiologist if he put anything in my IV. I think he was kind of surprised that I was coherent and cared that he did, and he sheepishly said, “Yeah, I did slip something in there…” I asked him again if he would please, please, please let me know when he was doing anything next. He said OK. I was transferred onto the operating table. I got a quick glance of the surgical instruments, but the substance in my IV had me a little out of it and my anxiety over it was barely there. The¬†anesthesiologist explained (thank you, finally) that he was going to put a mask on me and that I would feel really relaxed after a few breaths. He put the mask on and I took a breath or two and the world went black.

Immediately Post-Op

I don’t recall waking up initially. My first memory is speaking to the nurse about how I was cold and she got me a heating pad and tucked me in with a blanket, and I think I fell back asleep for a little bit. (A side effect of¬†anesthesia is being cold and shivering). I don’t really recall waking up again; the next thing I remember is just being awake and asking for something to drink and eat. I think I had some juice and graham crackers. I felt awesome. I wasn’t in pain, I wasn’t groggy from the¬†anesthesia, and I was ready to go home. The nurse made me stay in bed, and finally I had to pee so I was allowed to get up. Once I got up, I was steady on my feet and still felt fine, so the nurse said I could sit in a wheelchair for a bit until I could go home. After I went to the bathroom, where I got changed back into my street clothes of sweat pants and a button-down Hawaiian T-shirt, my family came back in. I think they were shocked to see me sitting up in a chair, smiling and munching on a graham cracker.

The nurse explained how to empty the drains, I got my post-op instruction sheets, IV came out and it was time to go home!

We only lived a short ten minute drive from the surgery center, and when I got home, I felt fantastic. I didn’t even go to sleep at first. I was up and talking, showing my friend pictures that I’d taken during my flying lesson. It was really bizarre, I think lol. I attribute it to getting myself super healthy and following the list of banned medications/foods. However, I’ve heard a range of experiences all over the spectrum, some that include really terrible immediate post-op experiences. My advice would be hope for the best, but somewhere in the back of your mind, without freaking yourself out too much, be mindful of the worst.

I spent the day the morning watching movies and I think finally sometime in the afternoon I dozed off. No pain whatsoever the first day, and the bandage I had to wear was even tolerable at that point.

That about sums it up for my pre and immediate post-op experience. Thanks for reading!



About an our or two post-op at the surgery center. Feeling good!

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Meds and Food to Avoid List (from MY surgeon – check with yours)

This is a list of medications and food that I was directed to avoid by MY surgeon 2 weeks prior to my top surgery. I have no idea if this is standard practice, but you may want to prepare yourself to go off some of your medication, including antidepressants and testosterone, prior to surgery. Your surgeon will discuss this with you when you have your pre-op appointment and sign papers, etc.

Fortunately I do not take any medications regularly, so that did not affect me. However, I am vegetarian and some of the diet restrictions were really challenging and I ended up eating meat out of desperation. I joked that I was surviving on turkey sandwiches, oranges, and water.

If you have to go off antidepressants, it may be a good idea to have a trusted friend or online network available to talk if you feel depressed, or be in touch with your therapist or a maybe a drop-in (and usually free) peer counseling group if you’re not in therapy. Also, if you suffer from depression (as I do) and you have to go off your meds, it’s a good idea to have a crisis prevention number saved in your phone. Self care is sexy!

Aspirin Medications to Avoid: Affect blood clotting.

4-Way Cold Tabs

5-Aminosalicylic Acid

Acetilsalicylic Acid


Adprin-B products


Alka-Seltzer products

Amigesic Argesic-SA

Anacin products

Anexsia w/Codeine


Arthriten products

Arthritis Foundation


Arthritis Pain Formula

Arthritis Strength BC





Ascriptin products


Asprimox products



Azulfidine products


Backache Maximum

Strength Relief

Bayer Products

BC Powder

Bismatrol products

Buffered Aspirin

Bufferin products

Buffetts 11



Cama Arthritis Pain


Carisoprodol Compound



Choline Magnesium


Choline Salicylate



Cortisone Medications


Darvon Compound-65





Doan’s products





Ecotrin products

Empirin products



Excedrin products

Fiorgen PF

Fiorinal products





Goody’s Extra Strength

Headache Powders

Halfprin products


Isollyl Improved





Lortab ASA


Magnaprin products

Magnesium Salicylate




Mefenamic Acid









Motrin products



Night-Time Effervescent


Norgesic products

Norwich products


Orphengesic products

Orudis products


Pabalate products


Pain Reliever Tabs



Percodan products

Phenaphen/Codeine #3

Pink Bismuth


Propoxyphene Compound





Saleto products


Salicylate products



Scot-Tussin Original 5-




Sodium Salicylate

Sodol Compound

Soma Compound

St. Joseph Aspirin









Tussanil DH

Tussirex products




Willow Bark products


Ibuprofen Medications to Avoid 

Affect blood clotting.

Acular (opthalmic)

Advil products

Anaprox products




Dimetapp Sinus

Dristan Sinus





Indochron E-R

Indocin products










Nalfon products

Naprosyn products

Naprox X


Ocufen (opthalmic)







Sine-Aid products



Tolectin products




Avoid ALL Diet Aids ‚Äď Including Over-the-Counter & Herbal¬†

Intensify anesthesia, serious cardiovascular effects.

Tricyclic Antidepressants to Avoid 

Intensify anesthesia, cardiovascular effects.












Etrafon products



Limbitrol products














Other Medication to Avoid: Affect blood clotting.

4-Way w/ Codeine


A-A Compound






Arthritis Bufferin

BC Tablets

Childrens Advil

Clinoril C



Dalteparin injection





Enoxaparin injection


Fragmin injection






Lovenox injection





















Tenuate Dospan







Vitamin E


Salicylate Medications, Foods & Beverages to Avoid 

Affect blood clotting.

Amigesic (salsalate)

Disalcid (salsalate)

Doan’s (magnesium


Dolobid (diflunisal)


Pamprin (Maximum Pain




Pepto-Bismol (bismuth


Salflex (salsalate)


Salsitab (salsalate)

Trilisate (choline

salicylate + magnesium








Chinese Black Beans












Vitamins and Herbs to Avoid 

Affect blood clotting, affect blood sugar, increase or decrease the strength of anesthesia, rapid heartbeat, high blood pressure, liver damage.  Note: Just because it is not of this list does not mean that it is safe to take while preparing for surgery.

Ackee fruit






Bitter melon

Burdock root

Carrot oil





Dandelion root

Devil’s club

Dong Quai root




Fenugreek seeds






Gingko biloba




Gotu Kola

Grape seed




Horse Chestnut


Kava Kava


Lemon verbena

Licorice root

Ma Huang



Nem seed oil





St. John’s Wort

Valerian/Valerian Root

“The natural Viagra¬ģ”

Vitamin E

Willow bark

Yellow root


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Top surgery PRE-op tips and things to consider

Hello! I had my top surgery October 26th, 2012 with the amazing Dr. Kathy Rumer of Philadelphia, Pa. I just wanted to make sure I posted some things for any ftm dudes seeking top surgery out there to consider BEFORE your surgery. These were just some things I learned along the way, so I hope it helps! Good luck! If you have any questions just leave a comment and I will get back to you! Also, if you are a post-op ftm and there is something I missed or something unique to your experience, please feel free to mention it in the comments.


Going off Meds, including testosterone and antidepressants:

I’m not sure if this is unique just to my surgeon or not, but I had a list 3 pages long of of food and medication that I had to avoid two weeks prior to surgery. You can check that list out here.

This is protocol for Dr. Rumer, but I have no idea about other surgeons. You will find out when you go to your pre-op appointment to discuss the surgery and fill out your paperwork. You just may want to be prepared to go off some medication, including testosterone and antidepressants. If you have to go off antidepressants, it may be a good idea to have a trusted friend or online network available to talk if you feel depressed, or be in touch with your therapist or a maybe a drop-in (and usually free) peer counseling group if you’re not in therapy. Also, if you suffer from depression (as I do) and you have to go off your meds, it’s a good idea to have a crisis prevention number saved in your phone. Self care is sexy!

Fortunately I do not take any medications regularly, so that did not affect me. However, I am vegetarian and some of the vegetable diet restrictions were really challenging (garlic and onions?! really?!) and I ended up eating meat out of desperation. I joked that I was surviving on turkey sandwiches, oranges, and water.


If you saved up all your pennies or Grandma finally kicked the bucket and you have enough money for your surgery, unfortunately you can’t just stroll into your surgeon’s office, throw the dough on the table and say “Take me, I’m ready!” Even if your surgeon (and the surgery center they operate out of) has a crystal clear calendar, you will have to get blood work, a physical, and your surgeon may want you to restrict your diet and medications for up to two weeks before your surgery. I was financially, spiritually, physically, mentally and socially/work ready for my surgery the second week of September, and with all the pre-op work and scheduling and I had to do, the earliest my surgery could be done was October 26th.


You might get a quote from your surgeon that the price of your surgery is say, $7,000. Make sure you have at least a couple hundred dollars beyond that for anything else you might need. If you write your surgeon a check for $7,000 and you have $5 left in your bank account, that’s bad news. Here are some things I didn’t expect to have to pay for, and some things that I even expected and want to share with you.

Breast Cancer Screening/Lab

My cost: $500 (?)

My surgeon (and I feel like this is probably universal) required my breast tissue to be sent out to Quest diagnostics to be tested for breast cancer. If you have insurance, your insurance will cover this (although you may have to navigate complications if you are listed as male on your insurance but I’m not sure). Since I don’t have insurance, I have to pay out of pocket. Nobody could actually give me an exact quote for this. My surgeon guessed that it was around $500. I am being billed from Quest and am actually still waiting for the bill to come in the mail. I will update this post when I find out how much it actually costs.

Pre-op Blood Work

My cost: approx $100 through a low-cost lab called Any Lab Test Now Philly.

Any surgeon worth their scalpel is going to make you get blood work done before your surgery. This is to make sure you are healthy enough for surgery and to see what your blood type and clotting factors are. I had to get a full metabolic profile done and a urinalysis. As a low income person in Philadelphia I have access to amazing free health care through the city, however only some of the testing I needed could be done for free. My pre-op blood work ended up costing me around $100 through a low-cost lab called Any Lab Test Now Philly.

Your surgeon might automatically recommend a lab, like Quest for example. Or perhaps they suggest that you get the blood work done through your primary care provider. However, I would ask them if, to better fit your budget concerns, it was OK for you to “shop around.” Better yet, I would do your shopping beforehand and go into your pre-op appointment knowing exactly which lab you want to use. The tests are exactly the same, and any lab is simply just going to fax the results anyhow, so what lab you use should be, under general circumstances (assuming you are healthy and excluding special health risks and concerns) irrelevant. The only difference between one lab and another sometimes is price. My advice would be to do an online search for low cost blood work or labs. Even if you have to travel, it might still save you some money.

Pre-op Physical

My cost: free

Again, any surgeon worth their sutures is going to make you get a cleared by a doctor with a physical prior to surgery. You may just go to your family doctor for this. Now, this won’t work for everyone, but if you live in or near a big city you might be able to follow my example.

I would have paid a $35 copay for my physical if I would have gone through my primary care office. Instead, I went to an open LGBT community health night that was free and you could get seen on a walk-in basis. I got just a good of a physical and care had I gone to my primary care, got my paper signed, and it was free!

(Philly folks: I went to the Washington West Project Community Health Night, held every first and third Friday of the month from 6-9pm at the Washington West building, 12th and Locust. Look up Washington West Project on Facebook for the info).


My cost: Approx $95 for two antibiotics, Percocet and Tylenol PM.

If your surgeon isn’t a masochist, they will prescribe you pain pills and antibiotic to stave off infection. I was prescribed percocet for pain and Keflax as antibiotic, which cost me $40. I picked up some tylenol PM to help with sleeping at night, since your first week post-op you can only sleep sitting up and it’s hella uncomfortable. Then, on my fourth day post-op the Keflax made me sick with nausea and a low-grade fever and my Dr. had to call in a script for a less intense version of Keflax called Cefadroxil, which cost me $27.

Anesthesia and Surgery Center Costs

My cost: $2000

My surgeon built these costs into the initial price she quoted me, but make sure you ask your surgeon if these are included in the price they quote you. It would really rain on your parade to find out after the fact that you still owe a few grand. Also, note that anesthesia is paid by the half hour that you are under it. I only paid for two and a half hours of anesthesia (my surgeon said that 2 1/2 hours is the common time it takes for top surgery), but if your surgery is complicated you may end up paying more. It might also be a good idea to ask if you will be billed if your surgeon goes beyond the amount that you initially paid for.

Other pre-op needs

There are other miscellaneous things to consider into your budgeting. I spent about $70 on surgery groceries: juice, soup, snacks, etc. Also consider transportation to and from appointments, travel and lodging if you aren’t local, supplies like gauze or surgical binders (I spent about $20 on nonstick pads for my nipples and I also needed neosporin but I had some at home already). We bought new pillows because I could only sleep propped up for the first week and our pillows were old and worn out. Your first week post-op you can only wear button-down shirts because you can’t lift your arms to pull a shirt over your head, so I spent an extra $10 on two whacky hawaiian shirts because I thought it would cheer me up. Other friends of mine borrowed button-down shirts from friends. You may spend extra money on renting movies or a Netflix subscription (I borrowed from the library). The list could go on, but the point is to just have a little extra put back for the things that will make your recovery smoother and happier.

Emergency Needs

Believe it or not, my partner and I actually did incur some emergency costs because Hurricane Sandy hit when I was 3 days post-op and we had to buy water, batteries, etc. just to be safe. It was a blessing that my apartment had no damage and we didn’t lost heat or electric, but some people in my neighborhood did. If we lost heat and electric we would have been in a world of trouble. We don’t own a car, so we might have had to rent a car or gotten a ride to a friend’s or a hotel. Also, what if you have to visit the ER? I’m not saying that you should take out a thousand dollar loan or something “just in case,” but you should have a plan. Make sure you have a credit card or that your partner or mom or someone close can afford to loan you the money if you need it up front. One time I got a concussion and went to the ER and incured a $3000 bill, which was paid for 100% through the hospital’s charity care program for low-income individuals. If you have the time, it might be wise to just do some research of what hospitals in your area provide these kind of services. You could call billing and most likely easily find out in one phone call.

There are also a lot of ways to cut down some of these costs. Discount food stores like Save-A-Lot, thrift stores, house-sitting, swapping or room renting or subletting if you’re traveling for surgery, community health initiatives, borrowing, libraries, and pre-op party with a wish list are just a few. If you have relatives or friends who didn’t donate to your surgery fund because they either couldn’t afford it or didn’t think you’d go through with it, maybe they could donate supplies or money toward medication.

It’s been my experience that a little patience and creativity can go a long, long way! Also, if you’re getting bummed about spending all this money on surgery, think of it as an investment rather than a cost. You are investing in your comfort, happiness, and lifelong dream!

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