by Rachel Gold
“You want me to tell Bren?”
Our other sister, Brenna, didn’t need to know. She and I weren’t close like me and Bailey.
“Nah. I want to forget about it. I just can’t seem to.”
“I get that. Same with my ex, when he hit me, took a while to stop thinking about it all the time.”
I reached for the TV remote. “Can we watch something mindless?”
“Pick it,” she said. “I’ll make popcorn.”
Now I had two things I didn’t want to think about: Lindy, and Bailey getting hit. Just great.
Chapter Eight
Nico
Tuesday I had the day off classes because it was time to see my doctor again. I could’ve rescheduled it. Medical trauma was a really good excuse. With Dad in town the memories of being four and powerless and operated on and erased felt closer than usual. But I wanted to dance through the fear, show myself how far I’d come, face it down.
I went to the doctor twice a year for ultrasounds to make sure nothing was going weird with my non-average setup. The medical name for my setup is “ovotesticular disorder of sexual development (DSD).” I preferred “difference of sexual development.” Anyway, along with that came a higher risk for cancer in my gonads. I’d been getting ultrasounds since before I could remember.
My clinic was associated with the university. It was this huge metal and glass building in a ring of metal and glass buildings: extra modern, like I was on the Star Trek future Earth. All my stuff was in the same building, with ultrasound down on a lower floor and the clinic two floors up.
I joked with the receptionist and waited for them to call me. Then it was the usual: weight, blood pressure, go into this room and lie down on a table like a pregnant lady. At least I got to keep my clothes on.
The technician was a heavyset guy whose nametag said Mark Ribera. He had receding hair but made up for it with a cool, short beard trimmed so it was only sideburns, and on his chin and lower jaw.
As I settled back on the bed, he asked, “You comfy?”
“Yeah.”
I pulled up my shirt and he spread the gel across my abs.
“Tell me if anything hurts.” He moved the wand around on me. The wand was like a heavyset white plastic spatula. He pressed it down and moved it pretty smoothly across my abdomen. I studied his beard and wondered if I could make myself one with spirit gum and prop beard pieces. Because it looked great.
He had his other hand up by the screen he was reading, pointing things out to himself, like he was puzzling out a map of an unfamiliar territory. After a while he said, “Huh.”
“If you’re looking at the lower gonad, it’s both,” I told him. “It’s my ovotestis, it’s part testicle and part ovary. The squiggly side is the ovary side.”
He shook his head, staring at the screen and said, “I know, it’s in your records,” in this distracted tone.
“You’re scaring me.”
“Can you shift a little to the left? Rotate about fifteen degrees, I want to see if I can get a better angle.”
I moved, watching him. He nodded and pressed the wand low into my right side.
He said, “I’m not sure what I’m seeing here. Could be a lot of things. Can you stick around? I’d like the radiologist to look at this.”
“Yeah, of course,” I said, though I wanted to get up and run.
He gave me a towel to wipe off the goo. “You can sit in the waiting room.”
In the waiting room, my bones started feeling like shaky Jell-O. “I’m not sure what I’m seeing” was not what I expected to hear during ultrasound. Usually the technicians said “Cool” or even “Wow.”
I sat and jiggled my legs. Got up and went over to the coffee pots and poured myself a cup with a bunch of powdery creamer and sugar. Sat back down and jiggled worse.
After we’d moved to Ohio, Mom did everything she could to make medical visits okay for me. I got scared when I saw doctors, even from a distance, but worse were the feelings of despair, being trapped and doomed, humiliated. I’d shut down and hunch into my chair, not lifting my head, not talking.
In addition to the breathing and movement I was learning to help me stay in my body and weather the panic, Mom got me all these story puzzle games. She’d only let me play when we went to a medical office. They were hard so I had to concentrate, but also fun. She’d start to tell me about the story puzzle the day before and I’d get excited about it. She’d say: “Tomorrow we’re going to play a story where there are five kids with five kinds of candy, but all the candy gets mixed up so you have to figure out how to get each kid their favorite candy.” I’d go to bed thinking about candy and about my friends and wondering what the kids in the story liked, not thinking about cold metal instruments and strange people poking me.
While the doctors scared me outright, the other people in the waiting room made me nervous in a different way. They stared at us when we came in, or when they came in and we were already there.
Mom was darker than me. She looked mostly black but with eyes and a nose that were pure Thai if you knew how to recognize that. I’m ambiguously brown with a splash of green in my eyes that comes from my father’s side. People would keep staring at us while we played like they were trying to read a secret code. I got the feeling that if I could read that code, I wouldn’t like what it said.
When the nurse called “Nehal Bolden,” Mom always let me tuck the puzzle book under my arm and carry it with me down the hall. The whole time in the exam room with the doctor, I held onto that book and Mom would tell me how good I was being. She’d say “Nehal, my beautiful child, my gift from the gods.”
She still said that to me sometimes. I still loved hearing it.
In her world, the sacred walked with the mundane. The great mystery and all the answers sat down to tea together in the afternoon and talked about the mischief that ignorant mortals got up to. She learned Buddhism and animism from her mother, a loving God from her father, and everything else from the night sky.
The only fear she had was fear for me—fear that if I grew up unable to talk to doctors, unable to talk about my body, then bad things could happen again. She showed me photos of the stars and of diverse people’s bodies. She named the parts of my genitals the same way that she named the stars in the night sky. I grew up knowing I was part of nature.
I wanted to hear her voice now, so I called, not sure if she had a class or not. It went into voicemail. I left a short message because not leaving one would freak her out. “Hey Mom, I’m at the doctor’s. I got a new guy, he’s checking some stuff. Love you.”
I hoped that sounded casual enough.
My friend Sharani would understand this nervous agitation. She also had intersex traits. Different from mine, but she’d get why I was jumping out of my skin about a medical tech saying, “Huh.”
I texted her: New ultrasound guy, doesn’t know what he’s seeing. Tripping me out.
Is your doctor there? she wrote back. Sharani knew that I liked my regular doctor.
Upstairs, I said. Because I wanted to think about anything else, I added: Did you ask that guy out?
You’re impossible, she texted back.
I think you mean that I’m improbable.
Hahaha. Come by later?
Maybe. Have to stop at home first.
Ok. I’m here if you need, she texted.
Thx.
I held the phone with both hands, read her words a few more times and waited.
* * *
The meeting with the radiologist was short and confusing. He called the mass “unusual.” He also described it as the size of a peanut, which got me thinking about an evil peanut lodged somewhere up in my business. That almost made me smile.
He wanted to talk to my doc and then I’d talk to my doc, so I went up to the next waiting room. This one was brighter because the endocrinologists for adults and kids shared the same space. I sat at the edge of the play section with all the big, colorful blocks.
My phone buzzed an
d it was Mom.
“Nico,” she said. “What’s going on?”
“They found a mass or something. The radiologist said it was like a peanut and he thinks it’s in my ovotestis, but he doesn’t know what it is. He’s talking to Dr. Peace.”
“I’ll come down,” she said. Her office was three blocks away.
“No, Mom, wait. Let me talk to Dr. Peace, okay? I want to do this on my own. I’m okay. I’ll walk over when we’re done and tell you what she said.”
“Nehal, my baby.”
“I know,” I said quickly because if she said anything else I was going to cry. “I’ll come over as soon as we’re done.”
She let me hang up. I flipped through the games on my phone until I found one I could stand to play. It was hard to stay seated. After another quarter-hour, I had to go into the bathroom and jump up and down for a while until I could manage being in a chair again.
I’d been back in my seat for a few minutes when the nurse called my name. She took my blood pressure and weight again, as if this was a regular visit. Maybe it was so much a habit she couldn’t help it. Or they wanted to see how much my blood pressure went up in the last hour.
In the exam room, I waited in front of a weirdly cheerful poster about low blood sugar and bounced up and down on the balls of my feet. I might have left the floor a few times. I didn’t want to be leaping around when Dr. Peace came in, so I started stretching my quads and hamstrings.
Dr. Peace was awesome, not merely because of her name, but because it fit her. She was this skinny little woman, not that much shorter than me but she seemed like it because she was petite. She had a bunch of messy blond hair that was always wisping out of a knot or bun. My favorite thing was that every time she opened the exam room door and saw me, she got a big surprised smile on her face, like we were running into each other in a restaurant.
Even today she looked delighted to see me, but there were worry lines above her blue eyes. She sat in her desk chair and rolled around to face me, not even expecting that I’d sit down. I guess she knew me by now; she’d been my doctor for the last eight years.
“Nico, how are you?”
“Scared,” I admitted.
“Let’s get to it. The radiologist says he told you the basics. This mass could be anything.”
“Like a real peanut?” I asked, hoping to make her laugh.
She did, but lightly, passing right back to serious. “It’s doubtful that it’s a real peanut. There are a lot of kinds of benign growths that can happen in there, atypical cell development that isn’t cancerous, but there’s also a five percent chance that it is cancerous. Even if it is, it’s quite likely that it’s contained in the ovotestis. That means once we get it out, you’re fine. No chemo, no radiation. Do you want to sit down?”
I must have looked as bad as I felt. I put a hand out to the exam table and steadied myself toward the chair, dropping into it hard.
“Five percent or more is bad,” I said.
“Nico, hear what I’m saying, it’s not five percent malignant. It’s much lower than that. But it has to come out and we need to run tests. We can take out the whole ovotestis and run tests or we can biopsy it first.”
“Hang on.” I took out my phone. “Can you say that again and can I voice memo it? Mom’s going to want to know everything and I’m not sure I’m going to remember all this.”
“Go ahead,” she said and let me turn on the recording app. “Hi Professor Bolden,” she said toward the phone, “This is Dr. Peace. I’m here with Nico and we’re talking about the options.” She repeated everything she’d said and added, “My preference would be to do the biopsy within a week and then we’ll know what the surgical options are.”
I was trying to get it all into my brain. I had one hand over my abdomen, as if I could feel what was going on in there.
“Nico, take a deep breath,” Dr. Peace said. “We knew this could happen.”
“Yeah.”
She’d been after me the last couple of years to have my ovotestis removed because of the increased risk of cancer. I’d been thinking about it. Problem was, once it came out, my body wouldn’t naturally produce testosterone. I’d have to decide if I wanted to take T so that I could stay more balanced male/female or if I was willing to run on female hormones from the remaining ovary.
Plus, I might be good at coming to the doctor now, but anything that involved surgery shot me through with terror.
She stayed quiet for a minute and I tried to breathe more deeply. My heart raced and my head wanted to lift off my body and float away. As I breathed, my head felt more solid. I still wanted to jump out of my skin, or to be accurate I wanted to jump with my skin into some other place that wasn’t here.
“How do you feel?” she asked. It helped that she held my gaze, showed me that despite all this medical stuff I was a real person to her.
“Less bad.” I tried to smile. It wasn’t her fault. To show that I’d heard what she said, I added, “Okay so I get the biopsy and then you tell me how bad the peanut is?”
“Yes. We test the peanut. We can do the biopsy in the next few days. Monday at the latest, okay? Usually we get results in a day or two, but I want to make sure we know what we’re dealing with, so I’ll probably send it out to a specialist and that could take an extra week.”
I nodded. Dismally.
She said, “There’s a good chance I’m going to ask you to have the surgery to remove all of your gonadal tissue: the ovotestis and the ovary. That would prevent this from happening again and it drops your cancer risk a lot. It’s your choice, but I think it’s a good idea. We’ll know for sure how good an idea when we have the biopsy results.”
“If we do that, I can never have kids, can I? Unless I freeze my eggs. So we’d have to do that first, right?”
I couldn’t carry a kid in my body, I was used to that knowledge. But this was heavy. That amount of planning and thinking and poking into my body when I wasn’t sure if I’d want biological kids or not someday.
She nodded slowly. “I know it’s a lot to think about at eighteen,” she said. “I’m sorry. Also…” she sighed. “If we take the ovary too, you’re going to have to go on hormone replacement therapy.”
“Yeah, I figured. What would you do?” I asked. “I mean, which hormones would you take?”
“I can’t answer that for you. I have fifty-three years of experience feeling like a woman inside and out that would inform what I’d pick.”
“You’d become a woman,” I said.
I switched off the voice recorder on my phone. I didn’t want Mom to hear me talking about this part. I knew she supported me no matter what I chose, even if it was both, but I had the feeling that she expected I’d pick before now—that when she said I could be whatever I wanted, she thought I’d do boy for a bit, girl for a bit, and then settle into one.
I asked, “What if…if I did want to be one or the other, what’s best?”
“What’s best is the one you want,” Dr. Peace said.
“I’m all of them. It doesn’t matter. In a physical binary, I could be either one. They’re both okay and they’re both not right. What’s the best outcome?”
She studied my records for a while. Then said, “I’d want to talk to a surgeon who specializes in this, but on the surface I’d say woman is easier. You would keep your breasts, expand your vaginal opening. In terms of sexual activity—”
I waved my hand to stop her. There was only so much I could handle.
“If I want testosterone shots, would you prescribe them for me?” I asked.
“Yes, it’s what your body is used to. If it doesn’t feel right without it, I’ll prescribe you the shots.”
“Thanks,” I said.
“We’ll get you in for the biopsy and I’ll see you back here as soon as we have results. Think about what you want for surgery and we’ll talk about it more then, okay?”
“Yeah. Thanks, doc.”
She smiled and patted my shoulder in a
combined “I’m sorry” and “there-there” gesture. Then she was out the door. Probably had a ton of other patients to see. I sat for a minute but worried some nurse was going to stick her head in and wonder what I was doing there, so I went out to reception and scheduled the biopsy.
I walked halfway to Mom’s office, stopped, and dropped onto a bench.
I’d known that I might not be able to have kids, certainly not in the carry-them-yourself way, because my uterus wasn’t big enough. But if I couldn’t produce my own hormones anymore, what was I? For the past few hours I couldn’t sit still and now I didn’t know how to get up and move.
Maybe it was time to pick a gender.
Chapter Nine
Tucker
I left a lame message for Nico. I didn’t know what to say. And after talking to Bailey I really did not want to talk about anything intense. It didn’t surprise me that Nico didn’t call back right away.
I had plenty to think about. In a month, I was giving a presentation to Prof. Callander’s class about the harassment I’d experienced last semester when I came out as trans to protect Ella. I’d never given a presentation before. The last time I was on a stage was in fifth grade and I was a tree.
Ella thought I’d really enjoy doing it, but she was so googly-eyed over dating Shen that she seemed wildly optimistic about everything. Their Valentine’s Day night went a thousand times better than mine had.
Mid-week I needed a break from homework and presentation prep and Ella going on about Shen. I volunteered to help with the sandwich run. A sandwich shop across town sold discounted bulk sandwiches to student organizations for fundraising. Once or twice a month, our group got boxes of sandwiches, marked up the prices, and sold them during lunch. They had cool flavors like herbed tuna salad with capers, Korean BBQ with kimchi, and a club with fancy cheese and thick bacon.
I signed up for the early shift: getting the sandwiches, setting up, not selling. When I got to the Union, the empty sandwich table on the mezzanine had two people sitting behind it: Summer and a tall, handsome woman with deep brown skin and black hair pulled into a short ponytail. I’d seen her before and I think she’d been in a close-fitting athletic shirt then too, but I couldn’t remember her name.