Chapter 02 ~ FFS: Day 14

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March 20, 2018 – first day of spring

For those of you unaware, I underwent FFS or facial feminization surgery on March 7th. I chose to have this surgery to help me pass more effectively as a cis-gender woman. I also chose this to help suppress my gender dysphoria, a mental condition many transgender people live with. Many people are unhappy with their appearance, however gender dysphoria can be crippling. We already live with this disconnect of not having been born with the gender in which we identify.

I also chose to undergo FFS because I am a non-HRT transgender woman. HRT or ‘Hormone Replacement Therapy’ is a path some transgender people follow to transition to a more aligned sense of self and appearance. For trans-men it is the taking of testosterone and for trans-women the taking of estrogen. There are other medications a trans-person may take to assist in this process but those are the two hormones, at least that I am familiar with, that are used. In my case I began taking estrogen on July 30th, 2016. Ten days later on August 10th I suffered a TIA (transient ischemic attack) or mini-stroke. A normal TIA will cause temporary loss of some brain function but that usually clears up within 24 hours. In my case it left me with permanent localized paresthesia or numbness on my left side. The most notable places are in my foot, leg, torso, and left hand. It only amounts to about a 10% loss of feeling. But it affects my ability to type, or play guitar, or even judge my grip.

So why was I so lucky….. One of the possible side effects of estrogen is blood clots. Combine that with my history of type 1 diabetes of 34 years and it makes for a potentially dangerous situation, and I was unlucky enough to get a clot. This effectively ended my ability to transition in a traditional way. I am still able to take Spironolactone, a testosterone blocker that is often used in conjunction with estrogen. It has some added benefits of reducing hyper tension and is also known to cause gynecomastia or breast growth. Bonus! However, had I been able to take estrogen I would have benefited by many physical changes to my face and body. My skin would have become softer. My face shape wold have softened and rounded. And the areas where my body stored fat would have shifted to a more female way. Belly fat would have moved the hips and buttock.

Having FFS allowed me to at least soften the features of my face. I had three procedures done out of nine that my surgeon offered me. They are; an orbital contour with brow lift, rhinoplasty, and lastly a lip lift with augmentation. The first procedure, the orbital contour, involved creating an incision along the hairline, pulling back the skin, grinding down the brow ridge that is present in a male skull, and then stitching the incision closed while also lifting the brows to follow a higher and more feminine line. The second procedure for me involved straightening a flare above mid way on my bridge and then also adjusting the bridge to follow a smoother contour from the forehead down to the tip of the nose. There was also some cartilage work performed. The final procedure was the lip lift. This is a process of removing an M-shaped strip where the nose meets the high upper lip. The gap is then pulled together and sutured closed which raises the lip and closes the space between the upper lip and the nose, a trait also dominant in male anatomy. During this process I also had fat from my inner thighs injected into the upper lip to give it a fuller, feminine look. All of these changes are subtle, but those subtleties are what a first glace captures to identify a male or female face.

The cost of these procedures is in the tens of thousands of dollars and insurance doesn’t cover it. A dear friend convinced me to start a crowd funding campaign and I was astounded by the support I received. Through generous donations I was able to raise half of the surgery cost. For the balance I took out several loans. I am still accepting donations to ease those debts. My crowd funding page is located here: I am deeply thankful for everyone who has donated. These procedures aren’t cosmetic in a vain way. These aid in suppressing that gender dysphoria that so many transgender people face. Gender dysphoria that is a contributing factor in the high suicide rate among the trans community. It is calculated to be ten times higher than the national average at around 46%. If you hold up one hand and think of your five fingers as close friends and then fold two of them down. Those two people, out of five transgender people, would commit suicide. And yet an operation that could reduce this is not covered. There are several more procedures that I could have had done like cheek implants or a chin contour, but I think that the three that I chose have the greatest impact on feminizing the face. I would like to work towards convincing insurance companies to cover these procedures for all trans-women. It could save lives.

I am so thankful that I had the opportunity to undergo these procedures. I am still recovering. I only had this done two weeks ago, and I have months to go to heal, but I can already feel the difference in how I see the image of myself and also how others see me. That first glance from a stranger is no longer followed by a stare or a whisper and sometimes even a giggle. I am heading into a new phase in my life. a very different and new life. So it’s appropriate that today is the first day of spring, and I am slowly coming out of my cocoon. And I love the color of my wings!


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