by Nick Krieger
“Oh, oh,” she said in that desperately apologetic tone of hers. “You don’t have to get into it. I just need to note whether to refer to you as ‘he’ or ‘she’ at the center.”
I wanted to calm this flustered woman, tell her she was doing a fine job and I felt safe and comfortable in the office. I also wanted to tell her that a simple pronoun query would suffice and perhaps we could retire the term transgendering along with sex-change operation. Instead, I told her “she” was fine.
She asked if I had any questions, and I did, a whole sheet of them, all of which would have to wait for the doc. She pulled out a large appointment book and offered me a few dates in the middle and end of January. I asked if she had anything earlier. She flipped some pages, talking about how busy it was around the Christmas holidays with school breaks. “I could probably get you in on December third,” she said. “Would you like that?”
My stomach dropped out. That was less than six weeks away.
“I’ll have to check with Dr. Brownstein to see if he can squeeze you in.” She barely glanced up from the book.
As I waited to see if my nervousness would expand into reality-induced fear, an all-consuming excitement took over. “That would be great.”
The assistant walked up to the loft and asked Brownstein, returning to say it was no problem, he would do two surgeries on the third.
“Should I be concerned about being ‘squeezed in’ for what I consider major surgery?” I asked.
“Not at all,” she said. “He’s the best.”
“Any chance I could get the first appointment that day?” I was only half kidding.
Brownstein’s shoes clanked as he came down the metal stairs. Tall and wiry with a full head of distinguished white hair, he had smooth skin that made him appear younger than I’d expected. “This is what I tell people,” he said. “If they’re the first one of the day, I say I’m fresh, and if they’re the second one, I tell them I’m all warmed up.”
I laughed. “So, it’s no problem?” I asked, aware that what might’ve felt like putting him out was the equivalent of offering him five grand to work a few hours of overtime. “How many do you do in a day?”
“Three was the most,” he said. “It was a rare circumstance. Everything went fine. No problems. But I won’t do it again.”
Brownstein told me he did four to six surgeries a week. I asked if he took enough vacation and whether he’d have a nice rest over Thanksgiving, since it was the week before my scheduled date.
He assured me he rested and replaced his assistant behind the desk. He walked me through the surgical logistics, everything I’d heard or read, including his inability to guarantee results and that the extent of scarring, the likelihood of keloids, was mostly determined by genes.
I unfolded my yellow sheet of legal paper. “Sometimes when I see guys running with their shirts off, their pecs bounce. Will my pecs bounce?”
“Depends on your pecs,” he said.
“I figure with mammary tissue removed, I won’t have ‘breast soreness,’ but will I have PMS symptoms in my chest?”
“I can’t imagine how you could,” he said, sounding slightly baffled. “It’s also not the kind of thing my patients would mention.”
“Will losing more weight help my results?”
“No.”
“What if I have the surgery and then I gain a whole lot of weight, what will happen?” I thought my chest might explode.
“It probably won’t look so good.”
I figured he’d tell me to cool it with the absurd questions, but when I prompted him to shut me up, he only said, “I’ve got time. I don’t have any appointments for a while.”
I moved to nipple grafts, drains, how much assistance I’d need during my recovery (“very little”), and ended with the fine print on the medical waiver. “So about the blood clotting and this thrombosis,” I said. “What’s the risk of me dying here?”
Brownstein stared at me solemnly, and I saw in his eyes that he never forgot the seriousness of what he did, bearing responsibility in the operating room while his patients slept peacefully. He reiterated his smooth track record, which covered a few decades and over a thousand surgeries. “There are always risks,” he said. “I don’t think we need to talk about them. You’re going to be just fine.” He knocked on the wood desk. I trusted him completely.
He looked over my form once more and focused on the question I had evaded about the “therapist’s letter.” I knew from friends and blogs that he, chairman of the Ethics Committee for the World Professional Association for Transgender Health, didn’t always require this letter, recommended in the association’s guidelines for gender reassignment surgery.
“Do I have to?” I asked.
“Can you?”
“I can,” I said. “I’d prefer not to.” I was paying $8,000 out of my own pocket. Health insurance wouldn’t cover surgery. Why did I need a damn permission slip? I fought my urge to argue. I didn’t want to piss off one of the few surgeons who could do this type of procedure. “What does it have to say?” I asked. “I’m of sound mind to make an adult decision?”
“That’s it, nothing more.” He assured me the letter would sit in some dusty file in the bottom of some dusty drawer.
“Fine.” I aimed for a placating tone.
We went around the divider to the only part of his office with anything sterile or medical. Brownstein sat in a plastic chair far from the exam table. He crossed his legs effeminately and waited.
I pulled my shirt over my head, then my binder. I stood in the center of the room.
“Yep, I can do it,” he said, remaining a few feet away.
I asked him a question about the incisions and one of my birthmarks. He came closer and pointed to a few places on my chest, treating my breasts as I did, flesh to be excised. Relieved, I had my shirt back on in less than five minutes.
Brownstein left his assistant to make my follow-up appointments. She was still shaken by the Christopher Columbus situation. “It’s such a pretty name,” she said. “Nina.”
Her last word echoed in my heart. I lingered on the sounds, traced the curves, had breakup sex with my name right there in the office, holding on as we moved in opposite directions.
“And it’s quite popular these days,” she said.
Growing up, I didn’t meet more than one or two people with my name. Now, I tried to imagine elementary schools full of these small Ninas. I pictured them with long wavy hair pulled back into barrettes, pierced ears with rhinestone studs, beige corduroy pants with the cuffs rolled up. I pictured them as I was once, a little girl snuggled into a red peacoat, her father bending down to button it and squeezing her too tightly.
Shortly after my father sent me the e-mail I still carried in my wallet, he’d sent me a follow-up, stating that the first might have confused me and to please call him. When I called almost two months later, he was relieved to hear from me. He shut the door to his office and asked about the weather and other banalities before shifting to his e-mail clarification.
It was my lunch break on a sunny Wednesday. I sat on the edge of a stone fountain in the financial district, surrounded by pods of people in business-casual dress eating salads and sandwiches. Holding my cell phone to my ear, I listened to him reiterate that I was not seeing myself for the young woman I was, I was throwing away my chance at happiness, and he was afraid I would do something extreme.
Our break had done nothing to calm him. He was a soda can, dropped, shaken, and placed back on the shelf, waiting for me to pop the top. You’d think I’d stolen government-subsidized lunch money from school kids or ripped off an elderly Meals On Wheels program from the horror with which he spoke about gender variance, the monstrosity of simply being different.
I pleaded with him to stop, telling him that if he continued, I wouldn�
��t be able to talk to him anymore. Only upon hearing my own desperation did I realize I’d been hoping for an apology, the one thing that would prevent me from doing what I’d planned. But he perceived my begging as a threat, and we fell into the worn grooves of our arguments, the same tired fight where he tried to use the power of fatherhood to control me, and I shut down, trying to hold tough, except now I was too old to sing the “Somewhere over the rainbow” refrain in my head until he was done forcing his opinion, stance, argument, and rhetoric, disguised as questions, down on me.
I turned away from the lunchtime crowd and walked toward the Bay, searching the choppy gray water for courage. Underneath the bridge, an enormous freighter chugged along, headed out to the open sea. “It’s unhealthy for me to be in a relationship with you right now,” I said. “I can’t talk to you for a while.”
“That’s it? You’re cutting off contact with your father? You can’t do that,” he said. “I’m your dad. What, I’m not allowed to ask you questions?”
His questions were, “First you were normal, then gay, now this—what happened?” and, “Where are you getting information? Are you talking to the right people?” I let him berate me with these questions because I was partially convinced he was entitled, but mostly because I didn’t want to say good-bye when there was no hello in sight. I thought of everything I could lose, my generous father who’d taken me to a Guns N’ Roses and Metallica concert in middle school, my patient father who’d talked me through my bedbug scare of ’07, my sensitive father who might be too offended after this call to ever talk to me again, my aging father who could have a heart attack any day. I forced the fatal thoughts from my head, told myself we’d be different people when we met again, capable of having an honest, healthy relationship.
“You’re not thinking of becoming transgender, are you?” he asked.
“I am transgender,” I snapped, surprising myself with my own clear pronouncement.
He’d probably researched the term, considered himself educated on the subject by reading articles in the New York Times and watching episodes of Dateline, 20/20, and 60 Minutes with slow-motion animation of the Diagnostic and Statistical Manual opening to Gender Identity Disorder and encapsulated by the headline “Born in the Wrong Body”—none of which spoke to me and my experience. I am transgender, I thought, I am transgender.
“Are you considering doing something about this?” my dad asked.
“I don’t know,” I lied.
In almost every way, my father had been a perfect parent. His one failing was minor, microscopic, and yet it was as strong as a tab of acid. He had never been able to support that which he didn’t condone. “I need your support,” I said. “I’ll only accept one hundred percent support.”
“You need my support, you don’t support me. You question the way I live my life.”
I tried to picture him in his office, overdressed for the casual environment, legal-size manila folders and a picture of our family on his desk, but all I could see was a scared man, his knees pressed into his chest in a dark, lonely room, pushing away his child.
“I will only take complete support from you,” I repeated.
“You think people are supporting you now, but they won’t be there forever.” He jutted off on a tangent about his mother’s multiple sclerosis and how all of her friends stopped showing up, slowly abandoning her as she crawled toward death. My empathy for his mother and for him, a child forced into the role of caretaker too early, only encouraged his digression.
Finally, I told him that I wasn’t sick and that I trusted my friends to stick by me, but his doubt and fear had crept into me. What if something went wrong with the anesthesia during surgery or an unexpected complication occurred—would my friends still be there for me?
“If you’re so worried about people leaving me, then you be there for me,” I said. For as different as issues of gender and sexuality were, I couldn’t help but meld them, playing catch-up on our unresolved history, the hurt I still carried from his persistent denial and silence, his embarrassment and disappointment about who I was. “I’ve been gay for ten years,” I said. “Tell me, what have you done to support me?”
I could hear his appalled inhalation from three thousand miles away. “I don’t vote against gay rights. I vote for gay marriage.”
I considered thanking him for not voting me into a cage, proving that I was equally incapable of holding up my end of a rational, nonconfrontational conversation. “I love you very much,” I said. “But I can’t talk to you for a while. Please don’t call me. Please don’t e-mail me.”
“You don’t love me,” he said. “If you loved me . . .”
“I love you,” I said.
“No, you don’t—”
I cut him off. Like a small child who covers his ears while shouting “La La La La La,” I blocked my dad out, repeating, “I love you . . . I love you . . . I love you. . . .” and hung up the phone.
Twelve. Mama’s Boys
With one month to my big day, I turned all my attention to preparation. I locked down my two most outwardly loving, affectionate, touchy-feeling friends to escort me to my surgery and secured promises of recovery help from others. A few days after cutting off contact with my dad, I wrote my mom a long e-mail, believing we now had the space to at least attempt communication without my dad storming in and taking over. I also considered it too cruel to undergo a procedure with some risk and not inform my mom (and my dad by extension); they were parents, above all, their concern for my physical health unquestionable.
Although I joked grimly to my friends that you’re not really trans until you lose a parent, my attempt at humor fell short at the idea of losing two. The e-mail I sent my mother was guarded and almost completely informational, the entire tone very matter of fact; the subject line might as well have read: FYI . . . I’m having top surgery.
In my letter, I shared my discomfort with my breasts, cringing as I typed those last two words, and that I understood myself best through the term transgender, which I defined as anyone who doesn’t fit into the traditional categories of man or woman. For context, I offered some of the options available to trans people—name changes, pronoun changes, and hormones—but in my case, I focused entirely on my top-surgery decision. In several paragraphs I provided digestible information about the procedure, as well as my confidence in Brownstein (with a link to his website) to calm her practical fears.
Only at the end did I exhibit anything that could be associated with emotions, and I kept my distance from them, even as I wrote of my own struggle, acknowledging for the first time that a couple years ago, underneath my eagerness to learn from The Boys, there was a depth of alarm, fear that if I was really like them, I was better off dead. My fright had arrived most often in the middle of the night, when my guard was down, and I’d always pushed it away by morning in order to get through the next day. Even in a letter, I hated to place that period of hardship anywhere near my surgery decision, which was made from a place of stability and joy, grounded in love for the body I wanted to inhabit. But I hoped to empathize with my mom, let her know that it had taken me time to accept my new path, and I understood it would take her time, as well. I left her with book, blog, and group resources, and as nicely as I could, I told her I was too focused on myself to carry her right now. Offering her little, I asked for little in return, requesting only that she tell me she supported and loved me.
“Really, it’s pretty simple,” I typed in an instant message to my brother after I sent the letter to my mom and him. “The people who can be there for me one hundred percent are invited to be in my life. Those who can’t, aren’t.”
“Should I expect an Evite?” he replied.
I busted out laughing at my desk, hearing the humor behind the voice I missed. At the start of the fall, he’d moved to England to work at a boarding school, and with an eight-ho
ur time difference, gone were the daily calls we’d both depended on to survive our breakups. His had happened shortly before mine, and in the wake of his devastation, he’d moved abroad, stating his inspiration came from my solo travels. Our regular postbreakup talks had brought us into a period of extreme closeness for a few months, much like our time living together in Jackson Hole, our backpacking trips abroad, our entire childhood. One difficult conversation in New Hampshire the year before could not make a long-term dent in a brother-sister relationship that had begun so long ago I couldn’t even remember our earliest times together.
He typed to me that he was in a different place, figuratively and literally, from that challenging conversation. My experience of gender was still foreign to him, but his breakup had aged him, forced him to fend for himself, taught him that he alone was responsible for creating his own happiness, something that as I’d tossed him bits and pieces of information leading up to my decision, he encouraged me to create for myself. I too was in a different place than I had been during that earlier conversation, now confident about something I had only been exploring then. And my brother, a straight white guy, hadn’t been the best person to work out my gender self-questioning with, but as had been the case our whole lives, once I told him where I was going, he’d come along for the ride, even if he couldn’t find our destination on the map.
He volunteered to call our mother later, to make sure she was okay after receiving my letter, a helping hand I appreciated and hadn’t anticipated. With a continent and ocean between us, he seemed so very far away, and I’d prepared myself to expect nothing from him, or anyone in my family. Having made sure I could go through this procedure alone, with the assistance of friends, my only hope for my mom was that she not hurt me with her response. But it was hard to deny how envious I felt thinking about Sylvia, Jess’s mom, who was about to arrive to take care of him.
I anxiously counted down the last few days to Jess’s surgery, aware that I would have to go through the recovery twice, first as observer to my own fate, then as participant. On the morning of his big day, I made sure I was up early enough to wish him well. Distracted and preoccupied, he nodded with minimal acknowledgment before sticking his keys and phone in his pocket. “Can I give you a hug?” I asked. After three years of living with our rooms side by side, our gender and yoga journeys intertwined, he was, in many ways, the person closest to me, and yet that was our first embrace. It may have been the only time we’d ever touched one another. “Good luck, brother,” I whispered as he disappeared down the backstairs with his mother.