Regardless of my own comfort with the topic, the fact that strangers feel entitled to know about this aspect of my life and body, when they would never dream of asking a cisgender person the same questions, is just another indignity imposed on transgender people.
While I haven’t—and won’t in the future—talk about my body parts publicly, it wouldn’t be fair to talk about my role as a caregiver for Andy without talking about his role as a caregiver for me. And it wouldn’t do his work justice if I didn’t make clear that, because of Andy, I have been able to access transition-related care, care that I needed to live and thrive as myself.
Driving up to the hospital in rural Pennsylvania where my surgery was to take place, my parents were a nervous wreck. My dad, in particular, was on edge like I had never seen him, fiddling his thumbs, tapping his feet, and clearly lost in thought. Now completely used to hospitals, Andy and I, on the other hand, were cool and calm.
While any surgery is major and gender affirmation surgery is not some short outpatient procedure, my four-hour operation paled in comparison to the ten hours Andy’s took. My planned three-day stay in the hospital was less than half of Andy’s seven-day stay. And after the fear of Andy’s diagnosis and concern about losing his ability to talk, the hope I felt going into my surgery was cause for celebration.
As I sat in my hospital gown while we waited for my name to be called, the small butterflies were overpowered by an overwhelming sense of relief. I had thought about postponing my surgery given everything that had just happened to Andy, but factors had aligned—his recovery, his return to work, and his strength—to allow for me to take the final step in my own transition.
I had been hoping for this day for as long as I could remember, and it had arrived. I knew recovery would take a few weeks, but soon enough, I would finally feel whole.
“Sarah,” the nurse called, signaling for me to follow her to the elevator.
A few hours later, when I woke up from the general anesthesia, I looked at my still-nervous parents and exclaimed, “See, all is good. No big deal. I feel great.” High on morphine, I spent most of the day reassuring my parents about how fine I felt. In retrospect, of course I felt fine—I was pretty high. But as the effects of the morphine dissipated, the nurse gave me a Vicodin that didn’t sit well with me. Andy was staying the night on a pull-out sofa in my hospital room, and at about midnight, a wave of nausea came over me.
“I’m really nauseous,” I said.
“What?” Andy asked, as he got up and walked to my bedside.
“I’m…I’m…I’m really…”
Uh-oh.
I projectile-vomited all over Andy.
“Oh, God,” I started to say, mortified at the disgusting scene, “I am so sorry.”
Wiping my vomit off his face, Andy smirked and said, “Oh, Bean…what’s a little vomit?”
I could tell he was almost happy it had happened, that it wasn’t him in the hospital bed vomiting on me.
“Thank you, Bean,” I said.
“For what?” he asked.
“For creating a world where I can do this,” I told him.
He smiled and squeezed my hand.
Just knowing my surgery was successful helped me feel better. The homesickness that I’d been carrying around for so long was gone. And as was the case when I first started transitioning, the absence of a negative was more noticeable than any presence of a positive. I just felt at home. I felt complete, and most important, I felt like me. I didn’t feel the pain.
In the conversation about trans identities and health-care needs, we are too prone to intellectualize, turning to abstract, theoretical discussion. Too many outside the community seek to find contradictions in our identities in an effort to undermine their validity.
I have been asked: Why would you need to change your body if you say gender is removed from anatomy?
Acknowledging that the two concepts are distinct does not preclude them from ever interacting. And no one would expect cisgender people to defend their individual feelings about their own body parts.
At the end of the day, it is difficult for anyone to explain a feeling. Pain is such a visceral emotion. So basic, so nonintellectual, that there are few ways to describe it but for the term itself. How do you describe, for instance, the sensation of a burn but as a burn?
Sometimes we feel like we have to make every part of our story incredibly emotional in order to fit a cliché people have about the trans experience. I’m not going to do that. Gender affirmation surgery can be a major milestone for many trans folks, but as important as it was for me, it didn’t feel like a dramatic turning point. Perhaps that’s because it was nestled in between all of Andy treatments, but also because my personal relationship with my surgery is a lot like many other people’s relationship with any necessary surgery they need to alleviate a chronic issue. It was pain relieving and I was certainly lucky to be able to access the care I needed, but the proverbial choirs did not sing in its aftermath.
Some transgender people say that we never stop transitioning. I suppose that in many ways that’s true, but I knew that the most significant steps in my transition were now in the past, along with my surgery. I was living the life I had always dreamed of, I felt seen, and now I felt comfortable and complete. And that’s what mattered.
In the following weeks, Andy and my parents helped care for me, as I was largely relegated to bed. They brought me meals. They helped me to the bathroom. And most of all, they distracted me with conversation and endless episodes of 30 Rock.
I could tell that Andy was relieved that the attention was off of him, if only for a little while. My recovery was relatively quick and easy—three to four weeks total—and as spring approached, my mind shifted to Andy’s upcoming doctor’s appointment, where he would get the results of his first follow-up scans since treatment.
I wasn’t mobile by the time of the appointment in early April, so I couldn’t go with him, but I kept my phone by my side, anxiously waiting for his call. Eventually it came and I nervously picked up. In the few moments before he said anything, I could barely catch my breath.
“Helllllllew,” he opened, clearly excited. “They said I’m cancer-free!”
I jumped out of bed, started screaming and dancing. “Ouch! Ouch!” It was probably a bit too soon after my own surgery for that.
“How do you feel, Bean?” I asked.
He thought about it for a second.
“Free,” he responded.
Free. Finally free. Finally, we hoped, cancer was in the past. Finally, we hoped, we could return to our work and be done with hospitals.
That June, we attended our first White House LGBT Pride Reception as a couple, two years after I had unknowingly run into Andy at the same event. As awe-inspiring as the 2012 reception was, this one was even better.
It was more celebratory, as the rate of change for LGBTQ people felt like it was accelerating. Trans rights were coming further and further to the forefront. A week earlier, President Obama had announced that he would sign an executive order banning discrimination based on sexual orientation and gender identity within federal contracts, an antidiscrimination rule that would impact one in five American workers.
The order was the single largest expansion of workplace protections for LGBTQ people in our nation’s history. The president had promised to sign such an order for years, but his delay was frustrating advocates. Finally, after mounting pressure from organizations such as CAP and HRC, the administration finally announced that the time had come.
But more than anything else, the event felt different because, by 2014, I had gotten to know the community that now gathered throughout those two floors of the White House. It wasn’t just national leaders; it was advocates and activists from across the country. It was a group of my friends.
I was there as myself, on the other end of my transitio
n, with a cancer-free Andy, as well as Sean and Blake, who’d managed to get a last-minute invitation. I was surrounded by family, both blood and chosen.
When I came across Valerie Jarrett, the senior adviser who oversaw the office in which I had interned two years before, she greeted me with a warm embrace and a simple message: “Welcome home.” And with everyone there, that’s what it felt like. My heart was about as full as it had ever been.
The president was in a playful mood as he addressed the crowd in the East Room, with Michelle by his side. Talking about the White House’s outgoing pastry chef, an openly gay man, the president joked, “We call Bill the ‘Crustmaster’ because of his pies…I don’t know what he does, whether he puts crack in them or…”
The audience burst into laughter. Michelle interjected, probably knowing the absurd outrage at the joke that would come on Fox News later that night. “No, he doesn’t! There’s no crack in our pies,” she protested.
She gave him a jokingly stern look, but he shrugged at her admonishment.
“I’m just saying that when we first came to the White House, the first year my cholesterol shot up. And the doctor was like, ‘What happened? You had, like, this really low cholesterol.’ And I thought, It’s the pie. It’s the pie. So we had to establish a really firm rule about no pie during the week.”
The audience was in hysterics at the banter between the president and the first lady. The warmth continued as he recounted the progress we had seen over the previous year, from expanding marriage equality to unprecedented visibility for trans people.
“Perhaps most importantly, Mitch and Cam got married,” Obama said, referring to the same-sex couple on the TV show Modern Family, “which caused Michelle and the girls to cry. That was big.”
Michelle nodded and reiterated the president’s point. “That was big,” she mouthed.
But the president also knew the topic was deadly serious. He outlined the continued work ahead: the need for marriage equality in all fifty states, the lack of nationwide workplace protections, the violence faced by the community, and the continued epidemic of AIDS.
“This year, we mark the forty-fifth anniversary of Stonewall,” he proclaimed, referring to the riot against police violence that had launched the modern LGBTQ movement. “And this tremendous progress we’ve made as a society is thanks to those of you who fought the good fight, and to Americans across the country who marched and came out and organized to secure the rights of others.”
The president closed by articulating a view of America that frames our greatness not as the product of a bygone era, but rather from our ongoing journey toward a deeper understanding of freedom.
“That’s how we continue our nation’s march towards justice and equality,” he told us. “That’s how we build a more perfect union—a country where no matter what you look like, where you come from, what your last name is, who you love, you’ve got a chance to make it if you try. You all have shown what can happen when people of goodwill organize and stand up for what’s right. And we’ve got to make sure that that’s not applied just in one place, in one circumstance, in one time. That’s part of the journey that makes America the greatest country on earth.”
The evening was a celebration of love in every way. Love between same-sex couples. Love of LGBTQ identities. And for Andy and me, love between two transgender people. Walking through the White House holding Andy’s hand, I looked around and realized that this was everything I thought I had given up when I came out. I had found a person I love and was doing what I love.
How lucky am I?
With everything settled, we now looked to a nearly endless horizon of experiences before us. We talked about our future, about getting married and spending our lives together. We talked about our goals in the coming years in our work. And as the weeks passed, Andy talked more and more about our upcoming trip, my first, to his hometown of Chippewa Falls, Wisconsin. We would be going for his favorite event, the biannual family reunion known as Volefest, a gathering of about forty of his relatives on his dad’s side named after his maternal grandmother’s maiden name, Vole.
Since near the beginning of our relationship, Andy had made clear just how much he wanted me to visit his hometown and to go to Volefest with him. He had never brought a girlfriend to one before, and the fact that I was coming was a big deal for him. I could tell it was something he had dreamed of since childhood.
Andy was giddy as we landed at the small Chippewa Valley airport just outside Eau Claire, Wisconsin. It was late July and we both welcomed the escape from the humid summer weather of D.C. Andy’s mom and stepdad picked us up and drove us back to their house, a two-story home filled with family photos, knickknacks from their travels, and plastic versions of Andy’s mom’s favorite animals, flamingos. Lots and lots of flamingos.
“Time for a tour,” Andy exclaimed.
He showed me his childhood bedroom and the basement, where he and his stepbrothers hosted parties in high school. We hopped in the car for a drive through the small town of Chippewa Falls. We drove around the public schools Andy had gone to growing up and the parking lots where he had band practice. We stopped for ice cream at his favorite ice-cream parlor.
The main road, Bridge Street, ran down the center of town and included small shops and the courthouse where Andy’s dad, Steven, served as an elected county judge. After a few blocks of small offices and stores, the main drag passed over the Chippewa River just west of a dam that created the large man-made Lake Wissota. The pride for his hometown was evident at each stop.
“That’s the island where my dad does fireworks for the town’s Fourth of July,” he told me, pointing to a small hill in the middle of the lake. “Isn’t it great?!”
The family reunion took place that Saturday at Andy’s late grandfather’s house on the lake. I was nervous when I walked the long dirt path toward the split-level 1970s-era home. But the forty or so family members assembled in the backyard by the grill could not have been nicer. While the cousins, aunts, uncles, grandparents, and extended family came from all over, almost all were Chippewa Falls natives and exuded the term that I had already heard a few times since arriving, “Wisconsin nice.”
Everyone wore T-shirts specially made for the reunion, with “Volefest 2014” on the front and a number on the back corresponding to your order of entering the family. Andy’s grandmother Verene, a short older woman who looks and sounds like Betty White, was, of course, number 1. My T-shirt didn’t yet have a number, but I was assured it would for the next reunion in two years.
“You just have to come back,” I was told with a wink by a cousin.
It was the ultimate wholesome family reunion. We played different games crafted over the years by family members. We ate a bunch of pizza. And at the end of the day, with drinks in everyone’s hands, we watched the sunset over Lake Wissota.
I was exhausted by the end of the day, but I had loved seeing Andy in his element surrounded by so many loved ones. It was clear he had waited for that day for a while. But throughout the trip, I started to worry that something might be seriously wrong.
A couple days before we left for Wisconsin, Andy had developed a cough. I wouldn’t have thought anything of it, but it had followed two weeks of increasing back pain. Andy didn’t think it was a big deal, but I had been on the lookout for signs of lung trouble since his diagnosis. A few months earlier, during Andy’s chemotherapy treatment, I had asked Sean about the worst-case scenario for Andy’s kind of cancer.
“What happens if it spreads further?”
“The likeliest place would be the lungs.”
“What’s the prognosis for something like that?”
“Well, if it spreads there…it would be terminal.”
“How long?”
“Twelve to eighteen months.”
I never told Andy about that conversation. He knew that lung cancer was always a poss
ibility, but he didn’t know that it would come with a terminal diagnosis. And I didn’t want to burden him with that information.
Throughout the trip to Wisconsin, the cough continued, increasing with each day. By the time we were driving back to his mom’s house from the reunion, it was incessant. But so was his smile.
Driving along the edge of Lake Wissota, I could easily see myself spending the rest of my life with Andy, but I also couldn’t shake the feeling that our world was about to be turned upside down once again.
CHAPTER 10
“Amazing grace.”
“If it turns out to be terminal, would you marry me?”
I don’t think it’s possible for a sentence to contain more tragedy and more love in it: eleven words that encompass the highest of highs and the lowest of lows. Sitting on our big overstuffed couch, just below a framed cartoon that almost cruelly read “Game Over,” Andy asked me to be his wife.
Two days earlier, just after our trip to Wisconsin, Andy had gone to his primary-care doctor to get his cough checked out. X-rays had come back showing something in or around his lungs.
“What, uh, what does that mean?” I asked the doctor, not wanting to say the word “cancer.”
“I’m going to have you go to the hospital up the street for more detailed scans, but he may have pneumonia and it’s just some fluid around the lungs,” he reassured us.
Thank God. I had convinced myself that the news would be more serious, and sitting in our doctor’s office with Andy, I desperately wanted his guess to be right.
We immediately hopped in an Uber and rode up to Sibley, a small hospital in a sleepy neighborhood in northwest Washington. It was just a few blocks from American University, and I knew Sibley only as the place that my peers were taken to when they had too much to drink at a college party. I never imagined that it would be the scene of some of the most pivotal moments in my life.
“At least we DVR’d Big Brother tonight,” I jokingly told Andy, wanting to act—no, wanting to pretend—like everything was normal. But even with the doctor’s guess and our hope that everything was all right, my gut knew different.
Tomorrow Will Be Different Page 20