I don’t know how it is for other trans people when deciding what they consider to be the “official” start date of their transition. I’ve had many firsts that I guess could compete for this, my first therapy appointment, my first endocrinology appointment, telling my family that I am transgender…
I used to think that the beginning of my transition was when I started on estrogen. The
date was Saturday, July 30th, 2016, just a little over 2 years ago. But that wasn’t really the start of my transition, or rather that was start, but it was the false start. Two years ago today, at just about the same moment as I’m typing this, I suffered a transient ischemic attack or TIA, otherwise known as a mini-stroke. I was talking with some people in my office and I stood up from my chair and my left side, from my foot to my neck, went numb. At first I thought it may be low blood sugar, something very common for a diabetic. However, when I checked my glucose I was in range. Then I thought that maybe it was low blood pressure. I’ve had a few instances of feeling dizzy from this and would need to eat something salty to remedy it. I got myself a bag of chips and tried that, but I was still numb and a little “off”. I considered a stroke but I wasn’t having any slurred or confusing speech, and I had no trouble with muscle control. I decided to leave work early as it was already late in the day. I picked up my wife and we headed home. As we were exiting the freeway, the left side of my face became numb, so we headed straight for the hospital ER which is less than a mile from our house.
We got into the hospital and told the ER admitting nurse that I was concerned that I was having a stroke. I’ve never had such a rapid response for a medical situation as I did this day. I was immediately wheeled into an ER room. A team of about 6 medical professionals swarmed the room asking questions and hooking me up to monitoring equipment. I was given a shot of tPA (tissue plasminogen activator), a chemical administered immediately after a stroke that will dissolve a clot and improve blood flow to the part of the brain being affected. This has to be administered within three hours of a stroke for it to be effective in preventing damage to the brain. I was then given rapid tests including a CAT-scan and an MRI. While I was laying in the ER I could feel another wave of numbness hit my left side. They wheeled me into the CAT-scan room again right away to see of they could catch it happening, but nothing showed.
I spent the next two days in the hospital having tests run including an echo-cardiogram, which turned up a PFO (patent foramen ovale) in my heart. A PFO is a hole that exists between the top atria of the heart. It’s actually present in everyone while in utero. It allows blood to flow through the heart and bypass the lungs which are not functioning yet and won’t be until the baby takes its first breath. After birth, the foramen ovale closes within months and heals in all but about 25% of people. This is not a problem most of the time unless there is the presence of blood clot. Luckily, after months of testing, it was determined that my PFO had in no way contributed to the TIA, however it was determined that my taking estrogen for my transition was the cause. Additionally, further MRI testing indicated that I suffered a non-event stroke at some point in the past (maybe 10-20 years). And while there should be no lasting physical effects from a TIA I had and still have numbness or paresthesia in localized areas on my left side.
After leaving the hospital I needed a cane to walk for a few days. The numbness in my left foot required me to get used to feeling the floor again. At first I was unsteady but was able to shed the cane eventually even though I still have that numbness in my foot. It’s also still present in my left hand and torso.
The glorious start to my transition was turning into something like a scrubbed NASA launch due to a mechanical failure. I had to make the tough decision to not continue HRT (hormone replacement therapy) for my transition. That was an emotional time for me. I had finally come to terms with the fact that I was and am transgender, I had come to terms with coming out to everyone as transgender, and I had overcome all the hurdles both medical and administratively to begin taking estrogen. And for 10 wonderful days I felt “normal.” I never realized how jittery I’ve felt my entire life until I had finally begun balancing my hormones with how my brain saw myself. Everything had finally started to feel right and then I had to decide to give it up. I appreciate my doctor for giving me the reigns in making that decision. He allowed me to decide, even though he knew that if I did continue taking estrogen I would be playing Russian Roulette with the chance of another TIA or stroke. It was hard. It still is.
Later that year, in November of 2016, I was able to begin testosterone blockers. They have some very beneficial side-effects such as lowering high blood pressure, slowing my leg and facial hair growth, clearing up my skin, and they have also given me some slight breast growth! My doctor has slowly increased the dosage of this medication to the typical level for a transgender female.
Being limited in my transition options I decided that I wanted to start living as Tiffany as soon as I thought I could pass in public on a daily basis. I finally decided on Monday, July 25th, 2017, almost a year from my “false start.” I now consider July 25th, 2017 as the true start date for my transition, but August 10th is forever present in my memory just as the numbness from the TIA is forever present in my body. But becoming my authentic self has been the greatest reward I could ever have achieved and I’m not going to let anything stop me now!