transgender

GRS – 3 Surgeries and One Beautiful Nightmare (Part 1/3)

[Content warnings for graphic depictions of bodily functions, surgery, suicide, mental illness, swearing]

This isn’t an in-depth look into GRS, just a story of recovery, if you’d like me to discuss any part more thoroughly please leave a comment here or send a direct message on Twitter @unexpectedamy.


This blog is the story of transition from the first days of accepting my gender identity, to now having completed medical transition.  This entry is a continuation from my post two years ago ‘Wait, I was transitioning?‘.  In this Part I will attempt to summarize the year leading up to my first surgery, and my experience up until the procedure itself.  In Part II I will show how my complications, subsequent operation, and decaying personal situation led to a positive redefinition of my life. In Part III I will discuss how the complications were ‘resolved’ and how I began to get my life back one year later after six and a half months almost totally bedbound.

In late 2016 I was finally given the go ahead for GRS by Mr. Thomas at Nuffield Health, problem was I needed a significant amount of hair removal on my genitals to ensure I wouldn’t have the long term complications of a vaginal canal filled with thick, agitating pubic hairs.  I got on top of things as quickly as possible, which is still painstakingly slow, booking appointments for laser hair removal and, once I moved up the waiting list, electrolysis.

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I anticipated it would take at least a year to have made sufficient progress, at least 6 laser sessions 4-6 weeks apart followed by weekly electrolysis appointments where hairs are removed one by one.  The laser part was fine; luckily I was getting zapped by the same technician who had already been helping to remove my facial hair, as well as the wonderful fluff from my butt-crack.  It wasn’t particularly painful, nor was it awkward since we were able to find the humour in this seemingly absurd situation.

Coming into 2017 I had begun working on my mental health in earnest, the past couple of years had been a brutal aberration, watching the life I struggled to build crumble to my feet with the added difficulties of transitioning in earnest.  A few months of solitude and a lot of meditation planted the seeds for how I feel today, however 2017 was one of the more challenging years of my life.  At this point I was still torturing myself trying to be a people-pleaser, ironically doing so with a sense of entitlement for support leading up to the impending doom of surgery.  During this time I put far too much pressure on my relationships and managed to alienate pretty much my entire historical friendship group.  I accepted my responsibility, but with little time or energy to grieve I had to push forward, determined to make this surgery happen sooner rather than later.

After 6 laser sessions I spent the latter half of the year only really leaving home for the weekly agony of electrolysis sessions.  The notion of electrolysis always scared me after hearing all the horror stories and I’m afraid I can’t lighten the load there.  I was laid on a table, naked from the waist down, my legs in stirrups as a lady sat in-between them with a hypodermic needle and a set of tweezers.  One hour sessions would have been the ideal, however since she was the only electrolycist in Northern Ireland who would perform this procedure, I was only able to get 15 and 30 minute appointments.

All became math in my head, if I was only getting half the time then it was going to take twice as long! I was told that even at her best, it would take 2 YEARS to make sufficient progress.  Each week became like a new devastation as I lay there either staring at the ceiling in agony, counting the hairs on my reddened ball sack and wondering if it could EVER be hairless where I need it to be.  Matters complicated still as I saw Mr. Thomas again who assured me I didn’t have much to go while my electrolycist assured me I was still those 2 years away.  My life became a tailspin of waiting for appointments and staring at my scrotum, a most hated part of my body not willing to go down without a real slug-fest.

I toughed it through as life fell apart around me, getting to a point where I had to start taking anti-depressants as I simply couldn’t get through the days anymore, I was a mess. I had so little serotonin in my body that I had a wild reaction to the pills, spending most of the first week vomiting, dizzy, and confined to bed.  While the physical symptoms were awful, my perspective changed almost immediately, life became more tolerable, this was just the beginning of my healing in earnest.  In August I finally hit 2 years on HRT, here’s a timelapse with a photo taken every week for those first two years:

Finally I agreed with Mr. Thomas’ team that he would do a ‘follicle scrape’ where he, uh, scrapes the follicles of the hair bearing areas during surgery to reduce the chances of hair growing back.  This could again lead to complications, loss of sensation, scarring etc, but the surgeon wanted to push ahead and gave me a date for the operation, January 3rd 2018.  My electrolycist was very concerned about this but I asked around and came to the conclusion that the surgeon knows his own procedure best.

Now that I had a date, a kind of panic set in, I had to find somewhere to stay during recovery, I had to find someone who could help support me because I wasn’t allowed to go through all this on my own.  Since my intensity and lack of mental alacrity had cost me my nearest and dearest I was forced to accept going back to my family home. I had to make peace with this, though my family accept me as being trans there are much deeper wounds that made going back less then ideal.

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Treat yourself before surgery! Get your hair done, go for a massage, take a holiday, do whatever feels good 🙂

6 weeks before surgery I also had to quit smoking. I was at rock bottom so this felt almost impossible, I tried to stop 12 weeks before to give myself breathing room, each day a new self-inflicted torture as I failed and failed.  Come 6 weeks however and I stopped dead, suffering through, it felt pretty amazing after about a week.  It took a lot of time and attempts just to find that one day I could hold the line and muster my forces for the counter attack, I had no choice.

At the same time I had to discontinue my HRT regimen to prevent complications like blood loss/clots.  This created another set of challenges as my temperament started to change, I got random erections for the first time in years that were incredibly painful due to over stretched skin, my body hair started to grow back, I dissociated and derealised as my brain chemistry and hormone balance was once again thrown into disarray.

So, my balls were still hairy, I was recovering in the last place I wanted to, I was going through the ringer quitting smoking, I’d lost most of my old friends, I had quite a bit of other personal stuff going on like trying to find a house-mate, but I felt the tide was turning in my life.  I was making slow progress (progress nonetheless) with my counsellor, and something clicked when I realised how relieved I was to have almost my entire life from before and during transition ripped away, I was a different person and I no longer wanted that old life that drained me so much more than it buoyed me.

Throughout 2017, at the inference of a short-term therapist, I came to the assumption that I had Borderline Personality Disorder. I had certainly been heavily symptomatic of the condition for a few years, but in those 6 weeks leading up to surgery it felt as though a weight had been lifted from my chest.  I began researching and working ardently on my mental health since I no longer had to worry about when surgery would be. I even made a short video series (posted below) leading up to surgery to distract myself and use up some of the energy and momentum that was building.  The dialectic opposition to this was accepting that I hoped to die on the operating table, becoming increasingly suicidal as the days counted down.

In preparation for surgery, Nuffield Health give out a big booklet containing information on what to bring, what to expect, and how to maintain results long term.  There was also sorting out travel and accommodation for my escort, small fry but with the pressure of trying to make sure everything is in place for those last few days of mental preparation.  In the week leading up to surgery I wasn’t scared per se, throughout my transition I’d had bigger problems in my life than transition itself and this was no different.

The day before travelling I had to begin a low-residue diet since I would have to get an enema to clear any bowel obstruction, as well as dealing with the fact I wouldn’t be able to take a poo for at least 5 days after the operation, so I was eating stuff like plain eggs on dry toast, growing ever hungry.  Finally the time had come, I packed up my bags having prepared so much as I could, and made the journey to Brighton with my escort.  Once we got to the hospital I signed a bunch of forms and was shown to my room.  Throughout the rest of the day nurses came in taking information and doing little tests like blood pressure and sizing my legs for Flowtron boots, before beginning my fast in earnest that evening.

My escort left and I was on my own, learning I would be the second surgery of the next day.  This was the night I would say some goodbyes to processes I abhorred but would never get to do again, so I masturbated, peed standing up, spun my dick like a helicopter, and made this video:

Trying to sleep I wasn’t anxious, I just had a dull feeling, but I wanted to get this done, the main reason I struggled was because of the uncomfortable bed, the smells and noises of the hospital, and recognition that I’d be woken up at 6am for a phosphate enema.  Otherwise I just tried to keep to a close approximation of my regular schedule.

I was awakened by a lovely nurse just before 6am to let me know I had 15 minutes before we got this show on the road, any hopes of a nice lie-in dashed.  She came back with her gloves and her big enema kit, at this point you’re either in or out, yet I’ve never known anyone to bail this late into the game.  So, pants down, lie on my side, a lubey finger on my anus, then insertion and filling, lovely (definitely not lovely).  I was to hold the enema in for as long as possible, I lasted about 20 minutes then proceeded to shit my life out as though my internal organs were all trying to escape at once.  This picture explains how it felt more than words ever can, this is what true emptiness looks like:

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Ok, step one done, awesome, but still at least 4 hours to wait.  Even though I was able to snooze a little, the revolving door started: nurses came in to turn on all the machines that beep and whirr, I got my surgical dress, the anaesthetist came in to do his checks, doctors came in for checks, the cleaning ladies came to do their work.  Mr. Thomas came in and very briefly got me to sign some forms without a chance to ask many questions, it’s hard to know what to say to someone who is about to chop you up without the fear of jinxing him anyway.  Mr. Thomas is not a man to have a conversation with, he’s here to do his business and until it’s done you are just meat to him, which isn’t necessarily a bad thing, perhaps a detached surgeon makes more sense than an invested one.

When all this was done I was a bag of nerves but I surprisingly wasn’t that scared, for as much as I was hoping up until now that I would die today, I made the decision I wanted to live, and I haven’t felt suicidal since.  I tried to occupy myself by dancing to music and watching TV, there’s nothing to do but wait, let the body do what it’s going to.  Of course, a 10am surgery doesn’t happen at 10am, so it was maybe 11:30am by the time it got as real as it can get.  I was having a little dance and in comes the attractive surgical team with their dark blue scrubs, telling me to hop into the bed.  I don’t know how I expected to be taken to theatre, but they fiddled with some of the controls on the bed as I took one last look at some pictures of puppies I’d saved and began to wheel me off.  I was alone, vulnerable, and terror began to creep in as I tried to not make obvious jokes while I looked up to the moving lights.

Finally I was ported through the surgical ward into the anaesthetist’s room. It was incredibly white and sterile, with a view to the next room where the surgery would take place.  There was all kinds of beeping, lots of chatter between the consults as they professionally got to work whilst attempting to have a casual conversation with me.  I had been practising my meditation, just trying to breathe, asking at one point if it was ok for me to just lie there.  I closed my eyes, focusing on my breath and puppies. I felt a jab in my left hand, a needle connected to something beyond my vision.  The anaesthetist did his thing and the nice nurses reminded me to ‘go to my happy place.’ I was fascinated to have the chance to experience what falling asleep to anaesthetic was like but honestly I was fully awake one moment, then I was gone…

If you would like to continue reading to Part II, please click here!

Lots of love,

Amy Xx

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depression, self love, transgender

Consent to Nightmares

Often I find that when I am at my most self-loathing I am most unlikely to express it.  It is exactly the most important time to express it.  My brain calls me undeserving, unworthy.  Who wants to listen to all that negative crap?  Why should I burden anyone else with my difficulties?

It’s simple really, this is when my self-love is tested, my empathy to myself.  This is when I’m challenged to respect the ones I love and allow them to help me.  To allow those I love to help me is to allow them the chance to show their love for me.  It’s easy when things are going well, but more difficult in hard times, problem is, there is so much less to gain when things are going well compared to when things are bleakest.

When that voice tells me how much of a failure I am, how useless, how undeserving I am, it leads me to mistrust others, unwilling to seek their help, I cry invisibly for them to notice and lament alone for assistance I would reject anyway.  I automatically assume people are sick of listening to my crap, even though I don’t tell it to them.  They rarely ask, and when they do, I reject it.  I have a poor attitude.

I write a positive post and I am a fraud.  Do not take the word of someone who cannot apply lessons to themselves, those who say they know the path but do not lead along it.

What has been a month of brutal anxiety, anger and panic attacks has roiled over into a depression.  I may take that as a positive, depression I understand, how that part of the primal mind with nothing to hunt must make up reasons to feel inadequate.  Quite often the depressed state is wrong, ‘Ooooh, no-one cares about me’, and all of a sudden I realise someone does, then I cry, feel guilty and ashamed for being so silly and find a new way to be unhappy.  It’s a very difficult chain to break, especially when you know and expect it to return.


All of it boils down to one thing, self-love.  To think of the perception of how others perceive me is impossible and immensely damaging.  With self love, the perception of how I believe other people see me is irrelevant; with depression, it becomes auto-cannibalistic, because it is a deflection from the self.

A friend of mine told me about her relationship paranoia, and I said I believed it was because she also had a lack of self love.  I opined that a good, stable relationship must have four factors:  Your partner loves you, your partner loves themself, you love your partner, YOU LOVE YOURSELF.  Without all four, there is trouble.  Her response was along the lines of ‘Oh dear, so the relationship will be unworkable if I don’t love me?’ the only reply I could give was ‘You say it like just loving yourself isn’t a consideration.’

If only I treated myself like I treated the ones I love.  I love to help them, I love to give to them, and I love to spend time with them.  Instead I give my heart away, rather than giving what my heart is, and it can never be returned in as good a shape than if I cared for it myself. A lack of self-trust.  One person, one heart, full responsibility.

If only I believed they could think to treat me in the same way – Can it be so hard to believe?  That my loved ones love to help me, they love to give to me, and they love to spend time with me?  To believe anything else is either fear or arrogance, to prevent them from doing this is to deny their expressions of love.  Put simply, by not loving myself, I am being selfish in refusing help, in refusing to be vulnerable, I am being a bad friend in not allowing them to know me by not giving them that chance to grow mutual, irreplaceable love.

It is selfish to not allow good friends the opportunity to enhance our friendship through gaining trust in adversity, but in expecting their help when I refuse to help myself, I show a lack of self-respect for my own capabilities.  I feel that if I take help then I owe someone, it creates a heavy pressure and makes relationships transactional rather than human.  After all, why would someone help me unless they thought they were getting something from it?  Why would someone help me at all?  So stupid, it’s not just about me, sometimes people do get the same joy out of helping me that I do in helping them.  Self-loathing negates the value of this and takes so much away from relationships with others.

What a twist this puts the depressed mind in.  ‘…if I don’t love me’, how could I when my mind says I suck and don’t deserve it?  It becomes a spiral.  There is only one direction to look to find the answer I believe, inwards, lest everything else becomes a reflection to self-despair.


I am in the midst of some of the most difficult few months in my life in one of the most dejected mental states.  For well over a month now there has been no joy, just a continual grind to try and make my life better whilst embracing none of it.  How could I possibly expect to make my life better with success when success tastes like ash?  Yes, I do things because they need to be done, but ultimately, there is no point if it means nothing to me.

I’ll be honest; this transition has become a nightmare.  The more intense and real it gets, the more I pull away from myself, the more I try to go alone, the further I get from understanding and embracing my identity.  Exercise, healthy diet and so on are great tools, but tools are useless without confidence of the wielder.

Yesterday I signed the consent form for hormones, the most major medical decision I’ve ever made and in all likelihood, the forbearer to a stroke in an orange pill bottle.  In two days I put my only hope of genetic offspring into the hands of strangers with the risk of losing it all.  So so so so heavy.  This coming week I have laser, a voice lesson, and a pro make-up session which is a terror all of its own.

On top of this is the soul-destroying voice practice.  Morning, noon, evening and night, they remind me that there is no rest anymore, no relaxation, and for each shade of personal darkness I drop a semitone, compounding the difficulty.

I’m preparing to move house and town in just over two weeks, even though I am far from ready to being capable of employment, have limited funds and few friends.  The only time I see friends is when I make the effort to go to them, so I know they won’t make the effort, and I wish I could say that was only self-defeat, but it is recorded true from experience.

At a point the load becomes ever more difficult to bear, but like I quoted in my last post, it’s how I carry it.  Still, I feel utterly crushed, alone within myself.


Oh yeah, gender transition.  Woopy-do.  The therapy session yesterday was difficult.  We discussed potential changes on hormones and got caught up in a debate about breasts.  She asked why I don’t care about them and I explained about my dysphoria being a sub-conscious deal rather than conscious.  She argued that many/most transfolks feel their gender consciously, and transwomen want breasts and so on to feel their femininity.  She challenged that if I’m not that bothered about my body, then why should I even want hormones.

I don’t care about my gender, I care about dysphoria.  However on the way home I thought a lot about it.  Two words came up, bright and bold.  SHAME.  GUILT.

I’ve rarely felt through my life that I have deserved anything for myself, this is why I give away so much more of myself than I have to give, destroying myself and close relationships.  This is why I never took my dysphoria seriously.  It is why even now I feel that I don’t deserve to have the body, mind, soul of what my heart tells me I am.  I am ashamed to want any of this treatment for myself, the same as I am ashamed to present my true self because my negativity asserts that my true internal self isn’t worthy of expressing.  A lot of the time, I don’t feel I deserve to live, though what’s the alternative.

I feel guilty complaining about all the appointments that I go to, knowing that there are people who are incredibly physically sick, missing limbs and so on who must go through even more intense treatment programs, yet I am completely healthy and going to appointments which will ultimately destroy me whether I endure or not.  I feel guilty that I would get any treatment at all, when I could just keep trying to find a way of dealing with this even though I don’t think there is any other way.  I can’t think of a more bizarre medical treatment option for a situation.

Some of these feelings seem reasonably typical at this point in transition, when reality begins to take its’ toll, when the limits of endurance are pushed, when the determination of resolve is tested.  Dysphoria is the only constant.


I feel like I’ve totally screwed this up, that instead of a time for freedom, openness, expression, love and joy, it has become a nightmare of depression, anger, panic, loneliness, anxiety and self-loathing.  I still think too much and feel not enough.  No success is a victory for the self-loathing – for example, I will have quit all forms of smoking for a month tomorrow, I have such reason to be proud, yet I don’t care.

The only salve is to somehow love myself again, to make time for it beyond anything else, to make it more important than anything else.  It is not selfish, it is selfless.  It has been said since humans could speak, ‘Love thyself to love another.’

I cannot love outwards unless I love inwards first.  If I am hollow, my intentions outwards are loving in intent, but they are still hollow.  If I am full, the love I give is full.

The truth is, we are all equal, so when I disrespect myself, I disrespect others.  When I respect myself, I respect others.  Once again, it is arrogant to hold myself to a different standard than others’, it is unreasonable to expect myself to be so much more capable, and to be able to cope with more.  It is unreasonable to say I should receive special punishment for mistakes no-one is invulnerable from committing.  A counsellor one asked me, ‘What have you done that is so bad that you don’t deserve to be as happy as anyone else?’

Alternatively I’d take a cuddle and a cry but neither of those seem forthcoming, and I’d refuse that too, I’d need someone to force me into their arms, to not let go as I crumple into teary anagnorisis.  I am afraid to be vulnerable, I am afraid of the rejection of experienced all too often, yet I know I have to keep trying to bare the open wounds to see who might sew them in positions that I cannot.

At this point I’m so lost that I don’t even really know much about my identity, I don’t know how other people could help me more, and I am really struggling to find a way to help myself.  For so much as I despise myself, the most despicable thing I can do is to not make time to confront who I am once again.

I feel like I am so busy that I can’t make time for this most singularly important need.  How ridiculous that I can fret over all matter of minutiae and neglect the core of being.

“I have so much to accomplish today that I must meditate for two hours instead of one.”- Ghandi


Depression is a temporary state, just like any authoritarian regime the lies and oppression will come to an end when I demand my freedom.  The tyranny of despair will end when I fight for my happiness.  I don’t need to know how, I just need to know to never to give up, to expect and move past failures, to ask for help, to not know just that I can get there, but I that I will.

♣ Amy Xx ♥

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