The Transition Process: Pre-Surgery

The Transition Process: Pre-Surgery

For a lot of people, reassignment surgery is one of the biggest parts of the transition process. For others, it isn’t important at all, or it is but it’s not worth all the hell that goes with it, or it’s just inaccessible. Whatever your feelings on it, if you’re gonna go through it, there’s a lot involved. Let me walk you through the process.

It starts with me visiting my regular psychiatrist, the one who I’ve been seeing since the start of the process. He gives me the number of a surgeon in my city who can perform the procedure, and even comes recommended. Lucky! It really does make a big difference. So after several weeks (actually more like a couple of months), I muster up the courage to call the surgeon, and organise a time to see him, six weeks later (it’s when he’s first available). In the meantime, I obtain a referral from my GP.

I went to see the surgeon with my then-partner for emotional support. He proceeded to explain the procedure in detail, and all of the risks involved, and she got light-headed and had to lie down. It’s kind of intense.  He also talks me through the next steps, and I leave to get started on that.

So next I need a referral from two separate psychiatrists. One is basically a given, from my original psych, so I go and see him, but it isn’t quite that simple. He sends all of his files on me to the other psych, and tells me to come back to him once I’ve obtained the other referral. Okay. So I call up the other psych, but they won’t let me book an appointment until I’ve obtained a referral from my GP. So I go back to my GP, get the referral, book an appointment.  Like with the surgeon, it’s several weeks before they can see me.

The appointment finally comes around, and I nervously trot off to this new psych, who basically just reads out my original psych’s report, asks me if I feel like it’s accurate, asks a few questions of his own, then writes his referral on the spot. Success! Now back to the original.

In the meantime, I go back to see the surgeon again, which is normal. for him to just make sure everything is going okay and I’m not having second thoughts or anything. I also receive an information pack detailing everything I’m going to need to know, and do. I’ll get to that in a bit.

So, back to my original psych, who is happy to compile his report and that of the other psych and send them on to the surgeon. So that’s all those boxes ticked. With full approval, I’m all set to go ahead with the surgery. Kind of.

In the meantime, there are a few more things I need to do. For starters, a series of tests. They are: Hep B, Hep C, HIV, FBE, U&E, LFT’s, CXR, ECG, Coagulation Profile. That’s literally the list I’m given. So I take the list to my GP, he organises the forms I need. In the next room, they take three vials of my blood, then I take off my top and they strap me to an ECG and get readings on my heart. The next week, I find my way to a radiology clinic, and get my chest X-rayed. So that’s the testing out of the way. Luckily I don’t work full time, or a lot of that would be much harder to organise. Anyway, moving on.

Now it’s time to pay the surgeon, five weeks before the surgery. They’ve given me their bank details, so I go to make a transfer. I owe them $8,500 (AUD) on top of the $500 deposit I’ve already paid. My transfer is rejected, because that’s a lot more money that my bank expects me to be moving. So I go all the way into a branch, and they help me raise my limit and set up extra security. I go home and complete the transfer, and we’re all good. And I’m a lot more poor. In another few weeks, I’ll receive a bill for the anesthetist, which I’ve been told to expect will be around $3,550. Upon arriving at the hospital, I’ll pay the excess for the ten days I’ll spend there. Thank goodness I have health insurance.

Four weeks before the surgery, I stop taking my hormone pills. This is a double edged sword. Without the pills, my testosterone levels will rise steadily over the next few weeks. But if I keep taking  them, there’s a very good chance I’ll develop a blood clot during the surgery, which could potentially be fatal. So I’ll take my chances with testosterone, since that’ hasn’t managed to kill me yet.

The night before the surgery, I’m to take a series of drugs that will purge my bowels. Over the next six hours, I will consume only water, and the contents of my bowels will slowly dribble out until it’s nothing but a clear liquid. So that’s gonna be a fun night. I need to be doing that up until midnight, and then I’m due at the hospital the next morning at 6am, for an 8am surgery. They recommend a complete shaving of the area beforehand, but I think I’ll be getting a nurse to take care of that for me. I don’t trust myself.

As I write this all down, it doesn’t actually seem like that many steps (I’m obviously not including all the parts that are me freaking out and just thinking about it over and over again), but it took me almost six months to organise from the point of making that initial call to the surgeon. It involved a lot of appointments, all of which took place during work hours, so once again, I’m very lucky to be able to use that time for personal chores.

So, yeah. That’s what it takes, from a purely bureaucratic perspective, to organise reassignment surgery. And of course, that’s assuming you don’t run into any issues. The psychs could have decided I wasn’t an appropriate candidate, the medical tests could have shown I was too high of a risk, I could have failed to raise the funds needed.  I’ve been very lucky.

And on that note, I want to say publicly once again how incredibly grateful I am to everybody who has donated, or shared with their friends, or just offered me emotional support and wished me luck. This whole process is incredibly daunting and overwhelming and without all that support, I doubt I would have made it this far. So thank you, all of you.


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