by Alison Mau
John Dobson squeezed my leg and said, ‘Now Elizabeth, really! You’re being rude!’
‘No ruder than he’s being to me.’
Most of the questions were innocuous, but often I would be asked whether I would recommend the operation to other people. I had a stock reply I used without fail: that I really didn’t think I had any authority to do that.
The truth — but not the whole truth.
More times than I can remember, over the years, I’ve been approached, questioned, cajoled and sometimes accosted by people at cafes, parties, nightclubs, shows; all of them in various stages of transitioning from male to female. They all pleaded for the details of my operations, the name of the surgeon, for the chance to have ‘what you’ve got’.
When I tell them truthfully, ‘Trust me, no you don’t!’ it always disappoints. Sometimes they lash out; often I’m accused of the worst kind of selfishness. ‘You just don’t want anyone else to get what you were able to get,’ they spit. I don’t often bother to explain (and in most cases it would do no good anyway) that if they knew what it took to get to here, step by agonising surgical step, they would run screaming in the opposite direction.
I had been on the march to a sex change since the day of the kindergarten fancy dress party and that blue Cinderella dress, but by the age of nineteen I had started doing something concrete (and, at the time, potentially dangerous) about it.
Hormone therapy was very rare in the 1960s, and most of the advanced medicines were not available in New Zealand, but where there’s a will, there’s a doctor who’ll oblige for sure. I had been at an afternoon tea in Christchurch and was introduced to a gay GP, camp as anything. We were chatting about the processes, and he suggested that of course he could help.
‘Come and see me, I’ll sort it.’
It was as simple as that. He would give me a shot of something called Primolut-Depot, a thick, oily substance that was often given to pregnant women to guard against repeated miscarriages. I was also taking Stilboestrol, a synthetic oestrogen that is a by-product of horses’ urine. It was also prescribed at the time to prevent miscarriages.
I didn’t get my first real hormone implant until I was living in London. I’d heard of the process through my friend Pat Reid, who has not only been on hormones but had also had one of the early sex-change surgeries. It was 1966, and I’d only ever had injections until then, and was expecting more of the same, but the London doctor said he would give me an implant. I didn’t know what that meant, but I nearly bloody died when I saw what he intended to use.
Instead of a needle, he pulled out a pen-like thing, with a metal tube cut on an angle. After a cursory bit of topical anaesthetic, he stabbed it into me and depressed the plunger, and it delivered a small wax pellet deep under the skin. They have to site it deeply into the fat, and although it didn’t hurt at the time, I had a whopping bruise on my backside for days. Luckily in those days it was only once a year.
The oestrogen-based hormones went about their work quietly for a few years. The smooth skin came quickly (I’d never been particularly hairy and all my family, male and female, were blessed with good skin) and I started to grow breasts. While my new female bits were blooming, my male bits were shrinking. By 1969, back in New Zealand, I was determined to complete the transformation.
Tom Milliken had told me truthfully he could only do so much — he had changed the way I looked on the outside. Quite literally, I was only halfway along the path to womanhood.
In 1973, four years after the original surgery, a doctor in Christchurch suggested I go to Auckland to meet a gynaecological surgeon who was pushing the boundaries of women’s health in many ways. He wrote me a referral to take to National Women’s Hospital, to see a man called Professor Graham Liggins.
Liggins was a tiny, bird-like man, with small glasses perched on his nose, and greying hair quaffed over. A ‘pert’ little man is how I’d describe him.
Very polite and matter of fact, was Liggins. At the first meeting in his clinic, once I was in the paper robe and lying back on the bed, he waved to one of the old nurses who were always hanging around him, bowing and scraping, to come and take a look. She walked to the bottom of the bed and peered under the robe at me. Then she screamed and scuttled out of the room.
Liggins, of course, was unfazed. He chatted away about the weather while he pushed fingers up both orifices, probing and manipulating to check whether there would be room enough in my pelvis to create a vagina.
With his colleague, Dennis Bonham, Liggins had just begun doing this kind of surgery, mainly for female patients with a condition called vaginal hypoplasia — they’d been born without a properly developed vagina.
The operation was scheduled for 24 October, and Liggins put me in a room with a young woman having a similar procedure. ‘I think you should meet each other,’ he said. She was engaged to be married and, of course, wanted to make sure she and her husband-to-be would be able to come together in the bedroom as married people do. So despite the different physiology, we had a close kind of a bond in the end. I was matron of honour at her wedding.
On the day of the surgery, I was given a pre-op sedative and wheeled down to the operating theatre. Twenty minutes later I was still lying under the lights, surrounded by the surgical team, waiting for the anaesthetist to ‘put me under’. Eventually I asked Liggins when they were planning to start.
‘Oh Mrs Trask, we’re well under way already!’
In fact they were well into the procedure by that stage; they’d already peeled the skin from my thigh ready for grafting. What they hadn’t told me was the operation was taking place by epidural, where the anaesthetic is pumped through a stent in your lower back to paralyse just the lower half of your body for the duration of the surgery. I had never in my life heard of this method, and lost it completely. I screamed as I could just see the anaesthetist, a tiny Chinese man called Dr Mayo, pop up at my head.
‘I not tell you, but you feel nothing!’ he assured me. The last thing I remember was Professor Liggins giving Mayo a look, at which point he hurried up and knocked me out.
During the procedure the two surgeons worked in tandem to create the space they needed inside my abdomen, then used skin taken from the outside of my leg to create the missing passage.
It was a complex operation, and took some hours. At about 10.30 Dr Liggins had me brought back to consciousness briefly to ask me: ‘Mrs Trask, do you mind at all if I lower your urethra?’
‘I suppose that’s just like lowering a hem,’ I told him before sinking back into the sedation.
It was a complex operation, and took some hours. I woke up back in the ward unable to move, with my legs tied together and a huge padded bandage covering my left thigh from close to the hip to the knee.
Once fully conscious I began to notice something odd about the nurses who bustled in and out of the room. None of them would catch my eye, nor talk to me directly. Within a day it was clear even to me (despite the huge amounts of morphine being pumped into me via a drip in my arm) that I was a most unwelcome guest in their ward. Ignoring the fact that I couldn’t move at all, they would pull my trolley table past the end of the bed, and leave my breakfast or lunch on it, completely out of my reach. On the second day a nurse’s aid came in and picked up the wedding photo I had put on the table beside the bed.
‘Oh look. I wonder how many men are in that photo?’ she said pointedly.
‘What do you mean?’
She couldn’t keep up the façade any longer.
‘Well, fancy putting you in a women’s hospital!’ she spat, before stalking out of the room.
Eventually it was speak up or starve, so I stopped the matron as she and the sister made their daily rounds.
Matron turned to the sister.
‘What’s all this about?’
‘I have no idea what she’s talking about!’
&nbs
p; ‘I’m not imagining it,’ I insisted. ‘I can’t even reach my food. I want to go home right now, even if I have to cut my way out of here.’
Matron saw sense and had me moved within twenty minutes to a medical ward on a different floor. Although horrible in a different way — it was an oncology ward for women and everyone was in great pain and distress — the staff were much nicer there.
They’re always on the lookout for normal bodily functions when you’re recovering from surgery, and a few days after the operation they got me up onto a bedpan; but as my legs were still tied together to protect Dr Liggins’s work, I slipped and ended up sprawled on the floor of the ward. The horrors kept coming — on the eleventh day in hospital they told me I must have a bath. I was pleased, as I’d only had sponge baths up until then and the smell was horrendous (they would give patients a can of air freshener and tell them to spray it around if the stench got too bad).
In the bathing room the nurse cut off the very top of the bandage on my thigh, and gave me instructions to lie back with my leg under the warm water and tap lightly on the padding, until it came off.
‘Remember, don’t pull it off, just let it come off when it’s ready.’
So there I was, lying with my eyes closed, luxuriating in the feeling of a warm bath finally, and tapping away as I’d been told. After a long soak, I opened my eyes and looked down — and screamed in horror. The bathwater had turned a deep, blood red, and I thought I was bleeding to death. I pushed the call bell over and over, yelling for help, but when the nurse came in she laughed. Once again, they’d not told me what to expect. The ‘blood’ was mercurochrome painted over the site of the skin graft.
The bandage floated off eventually and I could get my first good look at the wound, which was basically a patch ten by four inches where they’d literally peeled the skin off. It looked like a really bad graze, and took a very long time to fade. The doctors told me once they have the piece of skin it behaves much like a sheet of gauze, which they stretch around a mould, and insert into the cavity they’ve created. The idea is that the skin would fuse with the flesh around it as it healed, but not to the mould.
I was grateful, after twelve days, to be able to go home.
The surgeons had left the capsule mould stitched inside me, with a tiny hole left open for drainage in case of any infection. Liggins gave instructions to be very careful about my movements, telling me sternly not to lift anything heavier than a two quart milk bottle.
‘My legs are heavier than that getting out of bed,’ I protested.
He wagged his finger at me.
‘Just be extremely careful. No putting the washing out, no vacuuming. No bending down to pat the dogs. Nothing that might interrupt the healing process.’ The mould was to stay put for four and a half months.
In mid February 1974, I was back in Auckland for phase two, a less complicated surgery where Liggins and the plastic surgeon, Earl Brown, would take the mould out and see whether their handiwork had been a success.
All appeared to go as planned, but as soon as I was able to get out of the hospital bed and walk, the new vagina clenched tight involuntarily, a condition called stenosis.
Back we all went into the operating theatre the next day, where the surgeons tried to open the passage by forcing in another mould. I’m told they pushed and pushed, which must have been quite a sight when you think about it, but to no avail.
A third surgery was planned for 15 February — a regraft where, they told me, they would cut the skin in segments, like an orange peel, then stretch it out and sew new segments of skin into the gaps. Again this failed. Another surgery on 20 February, then another mould was inserted on 28 February.
Eventually it healed well enough, and there was no further stenosis. They sent me home with clear instructions; to keep the vagina open and operating normally, I must have intercourse at least five times a week, every week. It had to be with a man: using a dilator was not acceptable.
I remember very clearly the pert Professor Liggins delivering that bombshell, just as if he were prescribing a multivitamin.
‘How am I going to achieve that? With whom? I’m not with a partner.’
Without a flicker of a smile he said, ‘I’m sure, Mrs Trask, you’ll know lots of young men who’d be more than happy to help.’
‘Well, I suppose I do. But what about my benefit? It’s forty-five dollars a week and I’m paying thirty for my flat. If they know I’m seeing someone, they’ll take it away.’
‘I’ll write you a letter, you can take it to the Welfare office and show them you’re telling the truth.’
I took the letter to my local Welfare office the day after I flew back to Christchurch. The woman behind the counter was probably in her late fifties, prim permed hair, twinset and pearls. I tried to explain my situation with some shred of dignity, but she clearly wasn’t buying it. Eventually I handed over the letter, which she read, there was an awkward pause, then she slapped me across the face so hard that I hit the floor.
I’m guessing she raced out the back then and showed it to her colleagues, as they soon all came flooding out to the counter to get a good look at me.
What could I do? I followed instructions. There were several people happy to help, and despite the fact that I’ve never had that kind of sex drive, I stuck to the prescription as best I could.
In between bedroom ‘therapy’, I had to keep a glass dilator in at all times, day and night. If you’re struggling to conjure an image of what that might look like, picture a large test tube. I had a collection of them, in a range of sizes which you’d swap around depending on how far down the road to full recovery you were.
The very first one had a metal key at the bottom end, which attached to rubber bands front and back, then hooked to the top of an elastic panty girdle to keep the whole thing firmly in place. This was exactly as unpleasant as it sounds. The key dug into the skin around the bottom of the wound — the pain was intolerable.
Being glass, the dilators were cold on insertion but would soon warm up to body temperature and you’d forget it was there. This wasn’t always a good thing — one day I was walking across Cathedral Square, treading carefully in my patent leather shoes in the rain. I glanced down at my feet and there, stuck inside the ankle of my pantyhose, was the large glass dilator.
Out there in the open I couldn’t very well bend down, scoop it up and reinsert it. I stood very still for a long moment, thinking: what on earth am I going to do?
Eventually I took off my coat, dropped it down to my feet, and got to the nearest ladies’ toilet as quickly as I could manage. There were several incidents like that, hilarious really when you look back on them. One night I was at a party, having a lovely conversation with a group of people, and the dilator flew out into my knickers when I coughed. Once again I was caught like a possum in the headlights, unable to move as I was wearing a very tight dress.
Quite impossible to explain that one away.
After eighteen months of constant tinkering, Liggins was finally satisfied he’d done all he could for me. At my last appointment, he said, ‘Mrs Trask, you’re a real pain to me.’
‘Well, we share the pain don’t we Professor?’
‘You do realise that you are ten, twenty years ahead of your time?’
‘Surely plenty of these surgeries have been done before?’
‘Yes, but the results have never been great.’
At least he was honest.
I was still having occasional prolapses, and never really believed that nothing more could be done. I thought, one day things will have moved on to a point where they can fix me for good. Nothing ventured, nothing gained, that’s always been my philosophy.
Letter from J.D. Keeping, Wellington Hospital, to Professor Liggins, National Women’s Hospital, 9 August 1977.
Note: that the hospital has called me Elizabeth Anne DAVIS.
That is a name I had never used. My mother’s maiden name was Davies.
Dear Professor Liggins
RE: Elizabeth Anne DAVIS (ex Trask)
I saw this patient at Mr Duncan’s Clinic today. I did so because this patient had attended the A. & E. Department several times late at night recently complaining of perineal pain. She says that she has had numerous operations, most of them done by you, and it would appear that she has had three attempts to form a reasonable vagina as part of her sex change. I gather that she has had a lot of trouble with keloid and you have told her that there is not much else you can do for her. I had a long talk with her today. Basically, when she has a dilator in, and she leaves one in all the time, she has a lot of perineal pain and is unable to work and unable to endure the pain. If she takes it out the vagina stenoses up. It is pretty much of a “Catch-22” situation and she agrees with this assessment. As I said earlier, she tells me that you feel there is nothing more you can do for her. Basically, she has to make up her mind as to whether to keep the dilator in with all its pain and consequences that are involved, or to take it out and forget about a functioning vagina. I felt that you ought to at least know of the situation in case she comes up to see you. I think you will agree that the situation is pretty forlorn for her.
Yours sincerely
J.D. Keeping
SENIOR O. & H. REGISTRAR
* * *
The right time, as it turned out, was in the early 1990s, when the surgeon Peter Walker started specialising in sex-change surgery at the private Calvary Hospital (later renamed the Mary Potter Hospital) in Bealey Avenue, Christchurch.
All the surgery I’d had by Milliken and Liggins had been pretty much free of charge. I remember paying a small plastic surgery fee of about $130 when Liggins and Brown were operating. Calvary being a private hospital, things were a little different this time. I saved $10,000 for the chance to go under the knife with Peter Walker and general surgeon Mr Ted Perry. Together they had gathered around them a team of geneticists, endocrinologists, psychologists, psychiatrists and urologists to form the Gender Dysphoria Clinic, the first of its kind in New Zealand.