Kate's transexual transition: The details

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(Rob, before)

(Kate, after)

Lots of transexual girls have been asking me what I had done, how much it cost, and so forth. I'm fortunate in that I had cash and did not have to even entertain the notion of subjecting my body to the horrors of the UK SRS surgeons and was also able to afford facial feminising surgery.

These are the details of my transition, and to the right is how I look today. Please note, however: This is aimed at adults who are themselves transitioning or are considering it. This is unsuitable for younger children who are not sure if they are trans.

If you are young (less than 16) and know that you are transexual, then still do not worry:- As long as you get puberty delay treatment / hormone blockers then you do not have to go through all the expensive and unpleasant procedures I did - you can grow up looking like a girl. :)


Timeline

The costs have been roughly as follows:

In total my transition has cost well in excess of £50,000. All barring the boob job has been necessary for me to live a full, normal life as a woman, yet most of it is unavailable on the NHS, and the British SRS surgeons are a lottery at best.

Laser hair removal

Lots of people have asked me about my laser treatment and why I think IPL is a bit hopeless. I highly recommend the LightSheer system - it is very powerful, requires specialist training (which is why beauty salons don't use it) and uses coherent light specifically targeted at the absorption spectrum of melanin (the stuff that makes hair dark) so they can use much more intense pulses than non-coherent light sources (used in IPL). When I had it the hairs literally popped out of my face often! Now, laser hurts like living hell, but if it does not hurt then it is not working!! I had 12 treatments and I now need only pluck once per week at the few blonde hairs remaining. I was a chicken and had EMLA cream to numb the area which helps and the total cost for my face was about £800.

I recommend a lady called Maria, based in central London, who is very trans-friendly and very experienced - her number is 07841 632115. She is a highly trained professional and has the very best laser equipment (LightSheer).

The important of Facial Feminising Surgery (FFS)

It is worth noting that the most important surgery on that list (unless you are a transitioning teenager) is FFS - being transsexual means that you want to be accepted by society as a woman (not that you want an excuse to dress as one, or want to have boyfriends without feeling guilty). Passing is about the neck up, and what is between your legs is irrelevant from that point of view.

I now live a normal life as a successful business woman (my company, Memset, is one of Britain's leading providers of dedicated servers) fully integrated into society, and without FFS I simply would not be able to do so - I would be yet another of those post-op transsexual women gently outcast to the fringes of society, unable to find good employment and socially trapped within the T-world. To those girls considering transition: Make FFS your priority.

While Dr. Ousterhout basically invented the technique and is probably the world's leading expert (especially for those needing heavy bone work like me), I would also highly recommend Dr. Suporn's work - he is also a lot cheaper (around £10k I think).

Finally, the UK medical system seems to make all trans-women think that they must exhibit some form of genital self-hate. That is not, in my experience, why most women go through SRS. For me it was mainly because I wanted to have sex like a girl, I wanted men to want me for me not for my "boy bits", and I wanted to wear clothes appropriate to my new gender without unsightly bulges. SRS is merely one of many steps on the road of transition, and in my view much less important than FFS.

Sex Resassignment Surgery (SRS) / Gender Correction Surgery (GCS)

That said, SRS/GCS is also important of course, and getting good surgery is critically important. To that end I would strongly encourage pre-op girls to avoid the UK surgeons and go and see Suporn. I've seen examples of both - my vagina looks totally normal (I have fully formed labia minor & majora, as well as a normal-looking clit), has excellent depth, is extremely sensate (he wastes none of the nervous tissue), and I get moist when aroused. By comparison some of the UK surgery examples I've seen are, frankly, "unfortunate" at best; no disternable labia minora (often just a gaping hole), odd-looking clits, hair inside the vagina, and reports of poor sensation. picture examples here.

That said, Thomas (UK) is apparently improving, but I still think the penile-inversion technique is outdated (compared with Suporn's technique which uses scrotal tissue, and will therefore generally give much better depth as well). Equally, I've heard horror stories from people like Dr. Curtis about girls who have been to Thai surgeons and had disasters, but those surgeons were not Suporn.

I often hear the cry "but I cannot afford it". For Goodness' sake, girl, it is ONLY £8,000 and you will live for the results for the rest of your life. Over a lifetime that amount of money is nothing. You should do almost anything to afford the best - get another job, sell your house, sell your car, get a loan - anything less and you may regret it for the rest of your life. To put it in perspective, you can borrow £8,000 on a 5 year repayment plan with no security (ie without a house) for around £160/month. That is £38/week, or £5.40/day. Worst case scenario: work at Tesco's shelf-stacking two nights a week for 5 years and you can have a vagina like a normal girl's. Isn't it worth that??

Breasts

I my breasts enhanced done by a specialist breast cancer surgeon since they are good at making a lot from not much and making unusually shaped breasts look good. He wanted to go in under the breast rather than through the armpit since that was the only way he could hack at the pectoral muscles (which are naturally quite big in trans-women) to stop the boobs being pulled apart. I would encourage anyone considering a breast enlargement to worry less about scar position and more about breast position - you don't want them miles apart, but a small scar under the breast is not an issue.

I was originally going to have 350ml implants, but during the operation they had me sat up (another thing your surgeon should do) and the surgeon, anaethetist and nurses decided by committee to take me to 420ml (to look more in keeping with my physique). That was the right choice at the time although I have now gained breast tissue after coming off progesterone, so I advise waiting for breast implants for at least a year after your doctor has settled your hormone regieme into oestrogen-only.

Voice

Many trans-women have asked me about my voice, especially after hearing it on the radio (see the transexual section of my news page for example radio appearances). In my experience there are four things that make a voice feminine:

I did have some voice coaching with a lady called Heidi DeQuincey in Winchester, but a lot of having a good voice is just down to self-awareness and self-control (initially, now it just happens). The only thing that I had to learn through the coaching was suppressing the bass resonance of my chest and speaking more "though my head".

The other factors of choice of language, variable tempo, and variable pitch were things I was able to do myself. In fact, once I "took the brakes off" and started acting & speaking naturally those things changed anyway with minimal conscious effort.

Note that I have not mentioned absolute pitch: a classic mistake of trans-women is trying to speak in a high voice. It is the other factors that matter, and a high voice will usually just sound strained and silly.

One thing that definitely helped though was that I never tried to have two voices; I went through an androgynous phase and just started to shift my every-day voice into a more feminine one. That is definitely better than having a "boy voice" at work (say) and a "girl voice" in the evenings - just confuses you.


Update - hormones

I had been on Ovysmen (little bit of oestrogen plus a fair bit of progesterone - a contraceptive pill) until about 9 months ago. I spoke with Dr. Curtis (I kept forgetting to make an appointment) and he was rather surprised and got me to ask my GP to change onto just oestrogen (Zumenon, 2mg).

Oh. My. God. I so wish I had done this sooner! I thought progesterone was good since it appeared to make my boobs grow; that was just water retention! Also, it was making me hungry (it is the pregnancy hormone) and bonkers (I can think so much more clearly now - that 'fog' has gone).

The most amazing thing is my body though; I have lost weight, but my hips have gone from size 10 to size 12 (no more bloody boy-hips!!), and I have CURVES! I mean, proper curves - my waist nips in and I curve out over my hips. My breasts have also grown significantly, which is actually a bit of a problem since now (with implants) they are too big!

If you're on progesterone + ovysmen and are post-op, get your bum to your doc and talk about changing! All the evidence from GIRES suggests that is the right course of action - after all, post-menopausal women only get given oestrogen.

GIRES

I if you want more information about the aetiology of transexualism, or some of the legal aspects of transition, do check out the Gender Identity Research & Education Society. They are leading the way in the UK at the moment in terms of furthering our understanding of the condition and also trying to improve the treatment of trans-people in the NHS. I would also strongly urge you to become a member - it is only £5/year and their work help us all!

Start young!

Final thought: One thing aids in transition over and above all others and that is age. If at all possible, start young! If you are a young transgendered person then get medical advice RIGHT NOW and seriously consider the use of anti-androgens in order to slow the masculinisation process. There is some good advice on the GIRES site (above) about that.

I am also campaigning for improved care for young transsexuals, who currently cannot get treatment at all in the UK.


© Kate Craig-Wood 2010