New Doc, New Meds, New Prescription Madness

"You kn-kn-know what I want!
Gimme more. Gimme more.
Pretty please, a prescription!"
-- Mindless Self Indulgence, Prescription

I usually avoid talking very specifically about my body, but this is pretty limiting in a transition blog. Physical changes are a huge part of my transition, and if any place should be safe to talk about them, it should be here... I just worry that I'll make other people uncomfortable. Since I've really got to stop worrying so much about other people, I'm just gonna give you a heads up: I will talk about my boobs. There, I've said it. Whether you know me or not, if you think you might be uncomfortable with me talking about anatomy, nobody will blame you for ducking out. =P

As usual, I've waited far too long to talk about what's going on in my life, and I've got quite a backlog, so let's catch up on hormones. =)

My first endocrinologist sucked, so about four months ago, a month before my hormone prescription ran out, I decided to look for a new doc. I had three goals in mind: find someone who cares, is in my insurance, and prescribes *progesterone. I got a big list of endos and ratings of said endos from various trans friends, then narrowed it down by insurance, and started making calls. The only one within my plan that was taking new patients however, was only accepting referrals from a primary care physician. The good news was that there was a PCP in the same office that works closely with the endo. The bad news? The physician was booked about a month out, and the endo three months. =/

*(Progesterone is a primarily female hormone often prescribed as part of both post-menopausal and transsexual hormone replacement, but many docs are afraid of it, because some synthetics have been known for nasty side-effects, and its full effects on development aren't well known. Progesterone is key in breast development, among other things, but there is still a lot of disagreement as to how much is gained, and which meds, if any, benefit trans-women the most. Part of the problem is that most of the data comes from post-menopausal women, and broad testing with trans-women is virtually non-existent.)

Since I wouldn't see the new endo for a while, I called my old doc to ask for an extension on my prescription, and she told me that she would grant it, but never followed up. Fortunately, my appointment with the new PCP was just a few days after my prescription expired.

The new physician was awesome! She listened, she answered, she genuinely cared. I know, weird, right? She even chatted with me excitedly about my (then) upcoming wedding, and gave me a three month extension to last until I could see the endo. About a month later, when I went through my legal name/gender change, she was also nice enough to write up a letter of recommendation for me to present to the judge.

When I finally saw my new endocrinologist, she was just as cool. She was extremely enthusiastic in getting to know me and explaining things to me in detail. Before I could even bring up the progesterone, she asked, "How's your breast growth?" I explained that I'd had some growth spurts in the beginning, but nothing much since then, and she immediately followed up with "We should get you on progesterone!" =D

Of course, there's always a hitch. To save myself from having to go in at different times for different prescriptions, I waited for my other two to run out before filling the progesterone. When I did, the pharmacy informed me that I could now get three months of the spironolactone and estradiol, but that my insurance would only let me get one month to start on the progesterone. That seemed reasonable, but when I got home, I realized that they only gave me half my normal dose of spiro. It turned out that the new endo had accidentally prescribed it wrong. =/

Unlike with my old endo though, I was actually able to get a hold of one of the new doctor's staff, and they immediately sent a correction. The pharmacy then told me that I should just take the spiro at the correct dosage, and that they'd get it corrected at the 45-day marker when my supply is gone.

Last night, I called in a refill on the progesterone, but when I picked it up, they said they only had enough for 5 days, and that they'll call me in the next few days when the rest is available. I also asked them about the spiro, and they told me that they'll probably just refill for three more months when I run out.

So now, even though I'm getting meds for three months at a time, I had to go in yesterday for the progesterone, I'll have to go back in a few days for more progesterone, then back in two weeks for the spiro, again 45 days later for the estradiol, and repeat. Despite my efforts, my three prescriptions will never be on the same schedule again. *sigh*

Anywho, I've now been on progesterone for one month, and I've definitely noticed a few effects. Like with my first hormone post, I'll just present the evidence, and let you decide what's unrelated/psychosomatic and what's not. =P

• My breasts have been tender and itchy almost constantly for the last month, which indicates growth to me. This is basically what it felt like off-and-on when I first started hormones. Their shape has also rounded out a bit, and they look more natural.
• I've noticed some skin changes, and the weirdest thing, the tattoo on my back sometimes "raises", and I can feel bumps where the lines are; when this happens, it's also itchy.
• My skin is a little more oily, and I've gotten a few more zits than usual.
• My anxiety is back, which is odd, because progesterone is supposed to be calming. Of course, this could easily be due to a lot of other things going on, too. =P

I really haven't experienced any extreme side effects so far; the acne is a little annoying, but hopefully that will fade after a few months, as it did when I first started on hormones. Otherwise, med-related things are going pretty hunky-dory, and still far better than when I had to deal with my old endo. =)

Legal Name and Gender Change

"I don't need to prove myself;
I just need to be myself.
It doesn't show what I'm trying to be;
It just shows who I am."
 -- Anthrax, Packaged Rebellion

Old news to most people, but I changed my legal name and gender marker! W00T!

The initial process involved $350, a lot of forms, letters from my therapist and doctor, two court hearings, and visits to Vital Records, the Social Security offices, and the Driver's License division, but it has definitely been worth it. My awesome new legal name is Vivienne, and I've spent the last couple of weeks calling and/or visiting various institutions to get them to update it.

For some businesses, this is super easy. For example my gas and power companies simply verified some information over the phone, then made the change.

For other businesses, it's like pulling teeth. First off, many businesses assume a "name change" for a female-sounding person automatically means I've only changed my last name, due to a marriage. I have to get used to saying "I've changed my full legal name, first and last", and even that doesn't always do the trick. They start acting like it's a very strange and suspicious request, and sometimes bombard me with questions about why I changed it. Normally I'm such an open person that this wouldn't be a problem, but when they're such assholes about it, I get defensive as a matter of principle (and to be honest, it's none of their business).

Yesterday, I called my health insurance company. They're one of the last major businesses I have to call, because I wanted to make sure it was updated with my work first. After asking me to verify the information on the account I've had with them for a couple of years now, I had this fun conversation:

Rep: "How can I help you?"
Me: "My name has changed, and I need to make sure that's updated in your system."
"Ok, and is this Davin?"
"Well, that's not my name anymore."
"Ok, who am I speaking with then?"
"I'm the same person, I'm just not called 'Davin'."
"Oh... Can I put you on hold?"
*irritating hold music for a minute or two*
"Ok, Davin?"
URGH!
"Are you there? I've got Eileen from somethingsomething services on the line."
Eileen: "What can we do for you?"
"Well, my name is no longer Davin."
"Ok, what is your name?"
"Vivienne (my last name)."
"...Ok, I'm confused... is Davin your husband?"
"No. My name has changed from Davin to Vivienne."
"Ok, so you're the policy holder?"
"Yes."
"Ok, and you're new to eBay?"
"No, I've been with them for a few years."
"Ok... so you're just getting insurance for the first time?"
"Nope. I've been with you for a few years, too." (Aren't you looking at my account?!)

In the end, I had to call eBay HR to have them to push the info over. Fortunately the HR rep was much more reasonable and understanding, or I probably would've had an aneurysm. =P

I'm sure I'll be finding the old name in unexpected places for years, but in the mean time, it's great not having to worry about people giving me weird looks or claiming I'm not me when they check my ID. It's also really comforting to be called "Ms/Mrs" by strangers over the phone. I still sign the old name out of habit at least once a day, but I'm slowly getting used to it. =)

At this point, I've got a new birth certificate, social security card, driver's license, work badge, and bank card.

Shiny new birth certificate

And driver's license

Now I just have to figure out the most painless way to convince people that Erin and I really are two females legally married in the state of Utah. ><

Wedding Day! Part 2

"Me and you, and you and me,
No matter how they toss the dice, it had to be,
The only one for me is you, and you for me,
So happy together."
 -- The Turtles, Happy Together

Whew! Where to start? Where to start?

The two biggest things that have happened recently are my legal name change and my wedding. I should probably separate them in to two posts, so for now I'll stick to the wedding. =)

I posted regarding our engagement back in February, and a short post on our wedding day last week. Honestly I'm a bit surprised that's all I've posted, because a lot of my life over the past few months has been doing various planning and preparation for the wedding.

We held both the ceremony and reception at Erin's mom's last Friday, and they were both awesome.

Friday morning, after doing the final prep-work, including our hair/makeup/clothes, we met our photographer (my uncle) at Murray Park for some photos. Then we headed back to the venue and started greeting family and friends as they arrived. The ceremony was performed by our friend Eric, who did an amazing job, and I bawled through the entire thing.

After the ceremony, we took a few pics with family and friends, followed by a hilariously corny toast by our friend George:

 From there, Erin and I got tipsy and wandered around the house/yard, talking to various guests as they arrived for the reception party. At some point during the night we also managed to shove cake in each other's faces, and threw one of our two bouquets. For a guest book, we made 4x6 cards for everyone to write some advice on, and ended up filling half a photo album with them.

Almost everyone from both of our immediate families attended the ceremony, including my parents, grandpa, three of my four sisters, my brother, Erin's parents, grandma, sister, and brothers. I know at least a few of these people were still unsure on the idea of such a queer wedding, and some of them hadn't even seen me since transition, so it meant a lot to us that they came and supported us anyway.

All in all it was exactly what we wanted: laid back, fun, simple, but still romantic and memorable. It was also a blast having our friends and families mingling, and there were many times during the night when I'd pull a common interest out of the air just to get two random friends chatting. It's fascinating to step back and watch two people I've known for years become friends. My friend Kyle described the whole event as "floating in a sea of happy", and I couldn't agree more. It was without a doubt the best day of my life, from start to finish.

On Saturday, we relaxed and hung out with Erin's brother who was in town from California for the wedding. And on Sunday, we drove out to Wendover (a nearby town just over the Nevada border), had dinner with my mom/stepdad, played Blackjack/slots together, and spent the night in a hotel room with a jacuzzi tub.

We're meeting up with my uncle this Saturday to get the rest of the photos and help him out with his school project on diversity; so hopefully I'll post some more pics in a few days. =)

Wedding Day!

"Now we're together nearly every single day, singin'

Doo-wah-diddy diddy-dum diddy-do;

We're so happy and that's how we're gonna stay, singin'

Doo-wah-diddy diddy-dum diddy-do;

I'm hers (I'm hers), she's mine (she's mine),

Wedding bells are gonna chime"

 -- Rick Springfield, Doo Wah Diddy Diddy

Short post! I have a ton that I've been meaning to update on, but for now, I just wanted to say that it's my wedding day! Hooray!

At first, we were thinking about just having a simple ceremony at the courthouse. Then we decided that we should do that, but move it outside. Next we moved the venue to Erin's mom's house, to go back to simple. And then we thought, "If we're having it at Erin's mom's, we might as well invite more people.", and it has kept on building.

Fortunately we've still managed to keep it fairly simple, as weddings go, and the toughest part has been trying to let go of other peoples' expectations and pressures. We just don't care as much about the stupid little details as we do about being surrounded by friends and family, and I'm pretty sure we've managed that.

Since Erin and I have been (living) together for almost five years, this really isn't going to change much for us, so I'm more nervous about something going wrong than I am about actually marrying her. I need to just take a deep breath, focus on my wonderful bride and the people around us, and let that which does not matter truly slide. =)

1 Year on Hormones

"Every year is getting shorter,
Never seem to find the time.
Plans that either come to naught,
Or half a page of scribbled lines."
-- Pink Floyd, Time

It's been just over a year since I started on hormones! W00t!

I actually took my first couple of doses in late-July of 2009, but then decided to hold off for a couple of weeks so that I could bank some *ahem* genetic material (testosterone regulates sperm production). I don't know whether that means my "official" E-day is in July or in August; either way, the year has really flown by.

I posted regarding the effects of hormones last December, and most of it still holds true. The physical changes have slowed down considerably, but haven't stopped by any means.

I've taken tons of pictures of myself over the last year (not every day, but still), which I hope to turn in to a slideshow at some point, but since that will take more time and motivation than I'm willing to devote for now, here are some before and after pics.

Before hormones/laser/transition:

And recently, after hormones/laser/transition:

Wedding Plans in Mormon Central

"Work it harder, make it better,
Do it faster, makes us stronger;

More than ever, hour after,

Our work is never over."

 -- Daft Punk, Harder, Better, Faster, Stronger

Lots happening lately, which is good!

This morning, Erin and I finally managed to go order wedding invitations. We've been procrastinating, like we do with everything, but we're getting down to the wire at this point, so we figured we'd better get it done.

On the way to the printer's, we got pulled over for an expired registration-- another thing I've been forgetting/procrastinating for far too long (yeah, I know, it's dumb). As nervous and annoyed as I was, the officer was actually very nice and professional. He gave me a ticket (which I deserved), but didn't once mention my male ID, other than to ask if Davin is the name I prefer to go by. Yay!

Erin picked out Jaffa Printing, and the lady there was very helpful. We ended up choosing a cute polka-dot patterned border, which I'm sure I'll post a picture of later. The design is very fun, less formal, and very us. At one point, the clerk asked for the groom's name, then blurted out "You're the groom!?", but after I nodded, she quickly recovered, and didn't mention it again.

Everywhere we go, I'm constantly surprised at the lack of overt discrimination by businesses in conservative Utah. I have to think it's a combination of people coming around and realizing they want our money anyway, and luck. Some people even seem more enthusiastic about helping us out once they realize we're marrying each other.

The Bed Bath and Beyond in Jordan Landing is another great example. When we got registered there a few days back, they didn't seem to be thrown off by it at all. Employees kept coming by as we were scanning to congratulate us and ask if we needed help, and the main girl helping us asked cute questions, like how we met. She also asked, out of curiosity, what my legal name was, and seemed genuinely surprised by the answer. All in all a great experience.

In other news, I also finally managed to get a hold of my dad today. Apparently the number I've been calling for weeks is a work number that he doesn't answer. -_-  I can't keep track of his many cell phones any more.

Anywho, I hadn't actually talked to him since I came out to him in December. Somehow I managed to push through the conversation, and let him know that Erin and I are getting married, that nobody calls me Davi anymore, and that I'm switching my middle name to my last name. Whew! Apparently it all went over ok, because we're planning to get together for dinner this Saturday. It should be interesting having him see the new me for the first time.

Last, but not least, I went shopping today, and I think I've finally figured out what I'll be wearing to our wedding! Erin has ordered a very beautiful dress, but I've never been a fan of fancy clothes. Growing up, I hated the idea of getting married in a tux, but since anything else was out of the question, I also didn't dream of wearing a dress. At the same time, I don't want to look silly next to Erin, so today I picked up some slacks, new shoes, a white button-up shirt, and a cute black business-type jacket, open at the collar (all for around $100!).

I'm pretty proud of myself for putting together a cute outfit on my own (though I'm going to have a harder time with accessories), and for getting so much that we've been worried about out of the way. Hopefully I can ride this high for a while; we've still got a lot to do!

Blending in, For Better or Worse

"I'm just a face in the crowd,
Nothing to worry about,
Not even trying to stand out;
I'm getting smaller and smaller and smaller."
 -- Nine Inch Nails, Getting Smaller

I've been passing a lot lately, which is nice. Everywhere I go, I get "miss"ed or "ma'am"ed by strangers, including on the phone and voice chat (which was my original voice goal- w00t)! I'm so happy to be talking online again, even if I still get nervous that I'm talking too much, or that I may slip back in to my old voice when I get excited.

Passing is pretty important to me, mostly because I like being able to blend in. Being perceived as female also means that I don't get harassed in bathrooms, and puts the control of when, how, and if I tell people I'm trans in to my hands.

I once read an interesting question: "If you were the only person left in the world, would you still need to transition?" My answer would be a definite "no." To me, transition is an act of moving from one social box to another. If I were the only one left in the world, I wouldn't need to fit in to either box, but I'd still look/talk/act a lot closer to how I do today than how I did two years ago.

Unfortunately, we live in a society that is very focused on the gender binary. I've learned to walk a fine line, as I think many people do, between what's truly me, and what's societally acceptable for my gender. The difference between trying to do this as a male, and trying to do this as a female, is that I feel much more comfortable now.

Over the last year, and especially the last few months, I've continually tried on new aspects of appearance, personality, speech, etc. I try a trait to see if it feels like me, if it's passable, if it's sustainable, then I either adopt it, or toss it in the bin. I like to think that I'm speed-learning the things I may have learned growing up, had my life been a little different. I also know, of course, that I have a long way to go, and that my presentation will always be improving.

It's interesting, all the subtle differences in how strangers look at me and talk to me since I've started presenting as female, but there are two changes that stand out the most.

First, people open doors for me everywhere I go.

And second, random people give Erin and me dirty looks at the slightest sign of PDA. Erin has no problems with it, but it's taken me a long time to get used to. Of course, when I appeared male, nobody had any problem with us. Now, the only thing that's really changed is my appearance, and suddenly they don't approve. If they only knew. >=D

Showing my ID is also getting more and more awkward. Sometimes I warn people that "it's the wrong gender". Most people just furrow their brows a bit and move on, but a few weeks ago at a bar, the server declared "This isn't you."
I replied that it was indeed me, though "I know I looked a little different with the goatee."

"Oh. It is you."

Of course, the fun part was then explaining the confusion to the friends of friends I was with.

I've started figuring out all the paper work for a legal name change. (Thanks Dexter for helping me out!) The first step is to get certification from the sex offender registry that I'm not in it. From there, I basically just fill out a whole bunch of forms, and schedule a court hearing. I'm excited, because it will take a lot of worry and hassle out of life, but at the same time, I'll miss those opportunities to bring attention to my trans status.

I feel like I'm reaching a turning point. Just as I'm learning to like identifying as trans, and beginning to consider how much I have to offer the T community, even just by being out and being me, I can also see how easy it would be to put this behind me and be a "normal" girl. I can understand why a lot of transsexuals choose to move to a new place and start a new life. Even though I knew from the beginning that I couldn't do that, I don't blame them in the slightest.

Personally, I hate keeping secrets about myself, and I'll probably always be out, but how active I want to be as an advocate is a question I've yet to answer.

Utah Pride, 2010

"Won't explain, or say I'm sorry.
I'm unashamed, I'm gonna show my scar.

Give a cheer, for all the broken,
Listen here, because it's only..."
 -- My Chemical Romance, Welcome to the Black Parade

This last weekend was the Utah Pride Festival.

This was only my second year attending Pride. Last year, I watched the parade and wandered the festival with friends; this year I was much more active and involved.

On Saturday, Erin and I attended Utah's first ever Transgender March, which was awesome. Apparently we had around 100 people, which is much more than most of the people I talked to had predicted. Hopefully they'll do it again next year, as I'm sure it will only grow from here. They held the Dyke rally and Trans rally at the same time, which made me sad, but I have to go first and foremost with the T. The great part about the way it was done is that the two marches were able to join forces at a mid-point, along with the Interfaith Pride March, and then head down State Street in droves. George also met up with us at the mid-point, and was even sweet enough to hold a sign that said "Trans Fabulous" high and proud for me.

I wish I'd planned a little better, but by the time the marches ended, I only had about half an hour until my shift in the eBay booth, and I was 9 city blocks away from my car, which had the eBay shirt I needed to wear in it. I took off towards my car while George and Erin headed for Trax to get home. I only ended up being about 10 minutes late, but the heat and the huge hill our capitol building is on just about killed me.

I'm very much a nighttime person, and I've never done well with the heat. Add to this that hormones have killed my internal temperature regulation, and that I haven't had my hair this long in years, and it isn't hard to conclude that I probably shouldn't even leave the house on a hot summer day.

On Sunday, Erin and I marched with the eBay folks in the Pride Parade, which was a hoot. We blasted Weird Al's "eBay", and handed out eBay temporary tattoos to everyone and anyone.

Erin and I, waiting for the Parade to start.

The eBay parade crew.

The back of the "I AM" shirts say "eBay", but the front seems to imply other meanings on its own. ;) 

Handing out free stuff to the crowd.

Fortunately, I gave myself plenty of time before my booth shift this time, so after we were done with the parade, Wifey and I wandered over to Beans and Brews and zoned out on their comfy air-conditioned chairs while sipping iced mocha and iced chai for about an hour.

Next, we decided to wander the festival. The festival is great fun, and it's so nice to be in a place with so many people who don't care who you're holding hands with, but it's also pretty commercialized. Half the booths are selling jewelry or shirts or potpourri or who knows what, and most of the others are promoting a cause. We ended up skimming past most of the booths, and only lingered at a few of the more interesting ones, such as the "Gender Zone", where they had a great timeline of the history of gender variance.

This time, the Erinkins decided to just hang out with me while I helped out at the booth. We had silent auctions, with the proceeds going to charity, and for the most part I just helped people who wanted to bid and kept an eye on the goods, which at least kept me out of the sun. Unfortunately, I think it also kept me out of the occasional breeze. Even though my shift was only a couple of hours, by the end of it, I was zapped.

George met up with us again, and we went out to dinner, where I got to feel sweaty, gross, and stupid at a nice Japanese restaurant.

I'm very grateful to my love for tagging along and supporting me. Overall, I had a lot of fun, met some great people, and had a lot of good experiences where people were surprised to find out that I'm not a genetic female, but I ended up very emotionally and physically drained. Next year, I will definitely pick my battles more carefully, and try to hit up more shows, parties, celebrations, and other things I can passively enjoy. ;)

Voice Classes

"Cause sometimes,
I said sometimes, I hear my voice

And it's been here,

Silent all these years."

 -- Tori Amos, Silent All These Years

Egads! Has it really been a month since I've posted? And did I really just type "Egads!"? Bleh. I guess I should talk about the voice classes I recently finished while it's still semi-fresh in my mind, as much as it annoys me.

When I was still early in transition, voice classes were one of the things "on the list" that I definitely wanted to do, since hormones don't change the voice for male-to-female transpeople. Back then, I researched it the way I research everything: with the interwebs, but I couldn't find any. I know there are at least a few local speech/voice therapist/coaches, but I don't know if any of them work specifically with trans people. At the time, I was still afraid to tell even complete strangers that I was trans, which stopped me from ever calling and asking.

After a while, I put off the idea in favor of other things, and just practiced here and there on my own. I also did a lot of research; I read and watched how-tos, I learned about speech-patterns, pitch, resonance, vocal chords, and so on. I have a lot of the technical knowledge, but even with all that, it can be difficult to put it to use without someone to tell me if I'm doing it correctly.

A few months ago, I got an email on the Pride Center mailing list which said that a licensed speech therapist would be doing voice classes specifically for MtF trans people in March/April/May. I excitedly emailed the teacher to find out more about it, and she quickly replied to tell me that the class was $70 per person, and that we would work on expanding vocal range, flexibility, expression, pitch, resonance, intonation, "feminine" language choices, non-verbal communication, etc., via modified Fitzmaurice voicework, which is apparently something originally designed for actors. It sounded perfect, so I mailed a check.

A few days later, she emailed me to let me know that she received the check, when and where the first class was, and to bring workout clothes, a yoga mat, and water. Wait, what? Eh, apparently she incorporates yoga techniques... I wish I'd been informed of that earlier, but oh well, I decided to go anyway.

The class was only eight people, and I already knew a couple of them from elsewhere, which was nice. The first class ended up being mostly strange yoga-type positions, trying to find a "tremor", which was supposed to "shake up the voice". It was odd, but I figured that it was groundwork, and that I couldn't really judge its effectiveness until after the rest of the technique was revealed.

A few weeks/classes later, and we were still doing the same thing. What's worse, she never definitively tied these exercises in with the voice. Sometimes she would go back to vaguely explaining something about loosening up the voice, or show us a picture of the various tendons in the human body that run between the feet and the throat, still without giving us a definitive tie-in.

Eventually we moved in to learning about the muscles that control breathing, and how to be aware of them, which at least felt a little more relevant. It wasn't until around class 5 that we started learning some exercises for expanding vocal range, and experimenting with tone and such, yet we were still spending around 2/3 of each class doing stretches. By the end of class 6, I wasn't sure if I wanted to come back, though I kept reasoning that perhaps I'd learn something big in the last couple of classes that would make it all worthwhile. From class 7 on, we finally stopped doing any of the yoga stuff, and it suddenly felt like she was struggling to catch up.

To make things worse, there were supposed to be 10 classes, but she wasn't sure if we would have the venue for the final class or not. We were supposed to find out at class 9, but I forgot to go that day, and realized afterward that I didn't feel badly about it, so I didn't bother finding out about the last week.

Maybe I'm being a bit harsh... I'm only semi-pissed about the money, as it's a lesson learned, but I feel like it was the time I spent there that was the big loss. Oh well, some would say I have too much time on my hands already. ;) I hope the other people in the class felt better than I did about it. A few people had to rearrange their schedules and even bus to get there each week.

I think I've gotten my voice to a fairly androgynous place through my own practice. My current voice is usually enough to be passable in person, but my main concern is on the phone and online video games, where my voice has to represent me without the visual reinforcing. In games is the only place that I don't tell everyone about my past, mostly because I don't feel like constantly explaining, and because people online can be extremely cruel.

A friend recently asked if I'm afraid that I'll sound fake. I do worry about that (to be fair I worry about everything), but I know that practice will help make it sound less fake, and people can just deal with it in the mean time. I do get a lot of compliments on my voice, so I must be doing something right. Erin also says that it "freaks her out" when I accidentally switch to my old boy voice. I guess it's just going to take time. At least now that I'm fully socially transitioned, I practice every day, whether I like it or not. ;)

The Biggest Decision I've Ever Made

"This is life,
What a f***ed up thing we do,

What a nightmare come true,

Or a playground if we choose,

And I choose."

 -- Offspring, I Choose

Transition has been one set of objectives after another... hair removal, various stages of coming out, therapy, hormones, bathroom issues, work. My life has turned in to a strange series of stepping stones, which I think the rest of the world calls "goals". I have no clue how "normal people" go about their lives like this; I have no idea how I've done it for the past year, but it has definitely improved things for me.

With the bulk of work transition successfully behind me, the next life steps I'm looking toward are marriage, and a legal name change, but I keep asking myself, "What's after that?"

I guess I don't know why there has to be a next step, but it feels like there should be, and I never really planned this far out. Suddenly the road forks in big ways, and I don't know which forks to take.

I hate decisions, especially big permanent decisions. When I was a kid, I came up with all sorts of rationalizations for why my decisions were not important, just to make it through the day without anxiety attacks. Some day I'll write several posts just about all the life "rules" that I came up with during my teenage years, and still use, but for now I'll spare you by sticking to the ones about decisions:

• If I can't decide between two or more options with a reasonable amount of information and time, then all options must be nearly equal, and I may as well just pick one.
• If time and space are infinite, then my decisions are infinitely unimportant.
• If a decision can be undone, and doesn't cause permanent harm, it's ok to try it just to try it.

Unfortunately, the decisions I need to make now are bigger than anything I've dealt with before. Especially with regards to "the" surgery. Rule C above doesn't apply, since it can't be undone. B isn't much comfort now that I'm emotionally invested in my own future (I know, what a weird concept, but it is surprisingly new to me). And A, well, it somehow doesn't seem appropriate to flip a coin or Rock-Paper-Scissors for this one.

Don't get me wrong; if Sexual Reassignment Surgery (SRS) were cheap, with safe and predictable results, I would do it in a heartbeat. Unfortunately, surgery is expensive (around $15,000-$20,000), and comes with many risks and possible complications. For a young and relatively healthy person such as myself, the risks are lessened, but extremely scary nonetheless. This is a major surgery, after all.

There's also the timing issue. Due to the Standards of Care, I can't have SRS until I've been living "in role" for at least a year. Shouldn't this make the decision less urgent? It would, except that $20,000 is not pocket change, and I've failed to save more than a few thousand in the last year. If I want to do this, I'm going to need to start saving aggressively, and even selling a lot of the nostalgic junk I've held on to over the years.

It would be nice if insurance covered any of the cost. The American Medical Association's House of Delegates passed several resolutions in 2008 asserting, among other things, that Gender Identity Disorder is a serious medical condition, that treatment is not "cosmetic" or "experimental" but is medically necessary, and that denying coverage is discriminatory. Most insurers however, go right on with their blanket policy exclusions, or statements that GID is a "pre-existing condition". Of course, I know that's not why most insurance companies don't cover GID. They don't cover it because they don't have to, even though its low prevalence means that paying these costs would likely be much less impacting to their bottom line than most seem to think.

Most reassignment surgeons are also booked anywhere from six months to a year out at any given time, which means I need to know whether or not I'll have all the money quite a while in advance of when I actually have the surgery.

I want the surgery. I know that it would make me feel a lot better about myself, despite the fact that it may only ever matter to me and one other person. In the end, I have to acknowledge that my fears are the biggest thing stopping me, and flying in the face of those fears has gotten me too far to stop now.

I decided a couple of weeks ago that I will definitely be getting the surgery, it's just a matter of when and how. As much as I hate to, I will probably eventually have to ask for some help. For now though, I'm going to see how far I can get on my own.

Work Transition: My Birthday Present to Me

"So if you think it's scary, if it's more than you can take,
Just blow out the candles, and have a piece of cake!
Happy Birthday! Happy Birthday to you!
Happy Birthday! Happy Birthday to you!"
 -- Weird Al Yankovic, Happy Birthday

Disclaimer: 
All opinions posted here are my own, and not necessarily representative of the company I work for

On Monday I transitioned at work. A few people have asked me what that means, and each time, I suddenly remember that this isn't all self-explanatory. Outside of work, I've been dressing how I like and going by my new name and female pronouns for a few months now. At work, however, none of these changes had happened yet.

I came out to all my coworkers in November, but so far, I had decided that I wasn't quite comfortable enough with the new me to make the transition leap at work. I continued wearing a sports bra, baggy t-shirts, androgynous earrings, no makeup, and talking in my old voice. About a month ago I decided I was finally ready, and that pretending to be male was getting a little bit too awkward.

I informed my supervisor and started meeting with HR and management to plan it all. We created different communication plans for my local teammates (one meeting a few days beforehand to prepare them), the local center (a top-down communication to all leadership, so they can be prepared if any rumors or concerns surface), and the various other teams and people I work with globally (basic communication from their leadership). We planned for a new name tag, badge, preferred name in the system, etc. When it came to the bathroom issue, I told them that I was worried about it because I know it can be a very sensitive issue for a lot of people, but they reassured me that it was no problem and that I would probably just use the women's.

A couple of weeks before transition, the HR rep met with me and told me she would be meeting with legal the next day to review the plan. She wanted to get a clear idea of my thoughts on the bathroom issue so she could represent them properly while discussing it with the powers that be, so she asked, "What if, for some legal reason, they say you have to use the men's room?"

Anxiety set in. After a pause I choked out, "I guess... I wouldn't transition at work."

"Then how would you continue your whole process?"
The tears started, "I guess... I would have to leave the company."
"Wouldn't you have to face this kind of thing at any company you work for?"
"...Yep."

We talked some more and she reassured me that she just wanted to clarify my feelings-- that nothing had actually been decided yet. I tried desperately to calm myself down. I felt pretty stupid, but she was really sweet about it, and asked me to come talk to her first thing the next day since she was meeting with them earlier in the morning.

Thankfully, the next day, she told me that the meeting had gone well and that I would be using the women's restroom. They decided that there would be more questions/complaints/awkwardness if I were using the men's room, than if I were using the women's. Yeah, I could've told you that. =P

Day 1 (Monday)
On Monday, April 5th, I went in to the office as myself for the first time. I met up with the HR rep, who sat me in a meeting room to give me time to breathe and make sure I was ok. I think I was shaking. When I was ready, we went to the security office and got a new badge printed out, complete with new name and picture.

When I got to my desk everyone was very natural and easygoing about it, which helped a lot. One of my awesome female coworkers gave me a necklace, because "Every woman needs a black necklace that can go with anything."  So. Sweet. =3

There were a few slip-ups with the name, but I never got a chance to correct anyone before they did it themselves. I was still terrified of the bathrooms and avoided going for most of the day. At around 5 hours into my shift, I finally decided that it wasn't worth a bladder infection and convinced myself that I'd have to get over my fear eventually. I decided to use the upstairs bathrooms, to hopefully avoid seeing anyone I know. I actually didn't end up seeing anyone at all. On the way out I decided that I looked pretty good, and that I should've gone a long time ago just to see myself and boost my confidence.

Day 2 (Tuesday)
On Tuesday, the internal systems finally updated with my "preferred name" and new picture, so that people can look me up or email me using Vivi. Partway into the day my boss's boss called a random meeting and brought in Birthday cake for me and my supe, whose birthday was on the 4th.

"Happy Birthday Michelle and D  Vivi"

LOL

I was worried about my voice for most of the day, so I kept talking really quietly, and trying not to cough. The bathrooms got easier to use, especially since there was never anyone else in the ones upstairs.

Day 3 (Wednesday)
We had a team meeting early Wednesday morning, which I decided to call in to from the comfort of my pajamas. The whole meeting, I kept thinking about how much I hate my voice, and how the more afraid I am, the worse it sounds. On the drive in to work, I used my phone to repeatedly record and playback my voice, to reassure myself that I don't sound that stupid. Shortly after getting in, a co-worker randomly told me that my voice sounded good, and that he didn't recognize me on the call at first, which made me feel a lot better.

A few of the women on my team sometimes take breaks together to go on walks or over to the gym, and they invited me. A social activity and forcing myself to work out? Sweet!

I used the bathroom a couple of times without too much anxiety, but I know I'll tense up the moment I finally see someone. Everything else is already starting to settle back into normalcy. My boss's boss commented on how it was as if everything had changed, and yet nothing was different. I couldn't agree more.

In other news, today is my birthday! After 28 years, I'm finally free to be myself. Oh well, better late than never I suppose. =)

Telling Erin's Family

"Breathe, keep breathing,
Don't lose, your nerve.

Breathe, keep breathing,

I can't do this, alone."

 -- Radiohead, Exit Music (For a Film)

*sigh*

I've been meaning to write for quite a while, as usual. For the same reasons that I really want to write, it's also been hard to find the time.

Between coming out to Erin's dad two weeks ago, planning our wedding, voice classes, planning work transition, and hanging out with old and new friends and family more in the past three months than in the whole previous year, sometimes I'm surprised I find time to breathe. It's good, but it's scary; I'm not used to my life being like this, and I always feel like I'm forgetting something really obvious.

I like to be aware of things. As long as I'm aware of everything, especially my own faults, then I can correct them or decide not to feel stupid about them ahead of time. The current pressure makes me worry that I'm losing awareness of details, like I could have something horrible on my face all day, and not notice. *sigh* C'est la vie.

Where was I? Oh yeah-- Erin's dad and stepmom took the news really well! Erin really loves her dad, so I think keeping this secret has been hard on her. That she loves him is also exactly why we were afraid to tell him. I was so scared that he was going to take it badly, and that I would blame myself.

We went to visit them with the intent to get it over with. When we got there, we skirted around it for a while, trying to find the right situation, which never comes. Suddenly, they started searching around the internets, and saying they wanted to see our FaceySpace profiles.

Me: *sinking feeling, tugging on Erin's arm* "Say something!"
Erin: "So... we came here to tell you something... [my old name] is transgender."
Dad-in-Law: "Ok, so? Why does that matter?"
Me: "It doesn't really matter, but it was still important that we tell you."
Dad-in-Law: "That makes sense... Listen, I may not agree with it, but as long as Erin's ok with it, it's fine."

The "I may not agree with it" caveat is always weird, but that's for another time. With the way they were going after our FB profiles, I'm pretty sure they knew ahead of time. I find that parents are often more clever than their children give them credit for.

They asked a few questions about it, which is always a good sign of acceptance. With the air cleared, we decided to stay and play a few rounds of Rummikub. Erin slipped back into calling me "she," and by mid-game, her dad picked up on it and started using female pronouns as well. At one point, Erin left the table to use the restroom, and he told me "You know, you can call me Dad." =3

I'm surprised I didn't write about it before, but the rest of Erin's family has been similarly accepting. Her brother was one of the first people we told, and he was actually excited for me. We told her sister last summer, and her mom, stepdad, and other brother in December. The last three even took us out to dinner to celebrate our engagement.

I thought people were supposed to hate their in-laws? If this is a dream, please, don't pinch me.

On Toys and Stereotypes

"When I grow up,
I'll be stable.
When I grow up,
I'll turn the tables."
 -- Garbage, When I Grow Up

The video in the previous post got me thinking about my own childhood.

Listening to other trans women's stories, there are a lot of themes that come up time and time again. One of those is that many knew from a very young age that they were female. That they always wanted to play with dolls. That they hated their genitalia. That they just... knew.

To some extent, I envy those people, because I had no idea.

Some of my earliest memories are of toys, but not dolls. Oh sure, we had a Teddy Ruxpin. I had a stuffed rabbit pillow that I took everywhere for a while. My sisters had gobs of stuffed animals, My Little Ponies, and Cabbage Patch dolls, which were certainly interesting, but I was drawn to something else completely.

I liked Domino Rally, Legos, K'Nex, and Lincoln Logs. I liked to make things, I liked to invent. I liked Intellivisions and computers and Game Boys. I taught myself to program text adventures in qbasic when I was 9, a dot matrix printer is one of my favorite sounds, and I still ask for Lego sets for Christmas and Birthdays.

It took me a long time to realize and accept it, but these things do not mean that I must be male. Sure, for many women-- trans or not-- playing with dolls was an expression of their girlhood, but many other women played with Legos. And they are still women.

I've always had gender issues swirling around in my brain, but as a little kid, I don't think I fully grasped the meanings and consequences of gender, let alone how it would affect me in the years ahead. As I started to realize the implications of the box I'd been placed in, my gut reaction was to prove to myself, and to others, that the boxes didn't exist.

I've spent so much time and energy throughout my life trying to break down stereotypes, trying to show people that gender is not what they think it is, that I couldn't see the forest for the trees. The truth is that nobody fits into the boxes of "male," "female," or "in-between," but that doesn't stop the average person from staking a claim wherever they damn well please. It wasn't until I finally admitted to myself that the boxes do exist, and that I had a right to stake my own claim wherever I wanted, that I saw where I fit in, and where I would be happiest.

Maybe if I had wanted to play with dolls, or wear dresses when I was little, I would've figured it out earlier. In the end though, I think I'm glad that I didn't. I certainly wish I had the opportunity to undo my first puberty, but I know that I would not have been ready to handle this any time before now, and I don't think I would love and appreciate being a woman nearly as much as I do today.

So now I'm curious; what were your favorite toys when you were little?

Transgender Children on the Dr Oz Show

The Dr. Oz Show recently aired this segment about trans kids. Thanks for the link, Mel!


(If you're interested, Part 2 is here.)

I'd never heard of Dr. Oz before this, but the show was surprisingly respectful and well done. I usually watch these programs and wince, for fear that the host will make the trans folks look like a sideshow.

What do you think? Is it okay to delay puberty until the child can make a more educated decision? At what age is a child old enough to start irreversible surgeries?

Engaged!

"But there never seems to be enough time,
To do the things you want to do,
Once you find them.
I've looked around enough to know,
That you're the one I want to go
Through time with."
-- Jim Croce, Time in a Bottle

Today, Erin and I are officially engaged.

I haven't talked much about Erin here in the past, mostly because I didn't feel comfortable putting her on the spot. That sort of thinking is honestly silly, since she agreed without hesitation to stay with me through transition, and has never been ashamed of me. I just tend to feel like she doesn't know what she's gotten herself into, like I have to protect her from the prejudices of the real world, and sometimes I forget that all too often she's the one protecting me.

Four years ago, I saw Erin's profile on MySpace, and was attracted by three things: her gorgeous picture, her nerdiness, and the word "androgyny." I told our mutual friend that I thought Erin was cute, we began talking, and the rest is history.

I won't lie and say that we haven't fought from time to time, or that our relationship has never been rocky, but I believe one major thing has held it together: trust. I have never in my life felt as though I could trust another human as much as I trust her. She has integrity, of a type that I never thought I would find.

Erin was the first person I came out to, about 14 months ago, and though it was hard for her to accept at first, she has always supported me. We've talked about marriage many times over the last few years, but I have a major fear of permanence, and knew that we didn't communicate as well as we should. Over the last year, we've been forced to work together and support eachother in entirely new ways; out of necessity, our communication skills have grown, and we have become closer than ever.

With our relationship becoming stronger every day, I realized that the only excuse I had left was my fear. If there is one thing that my transition has taught me, it's that the things I'm most afraid of can also be the most worthwhile, as long as I'm willing to give them all the effort and energy they deserve.

This realization, along with the fact that we won't be able to legally marry after I change my legal gender, placed an urgency on the subject. A few weeks ago, we again started talking about marriage, about who would propose to who, about how we should go about it. Last week, we made plans to go to the jewelry store together. Later, I found out that Erin had been preparing a romantic proposal with a Ring Pop, to be replaced at a later date, and I almost wish she would have gone through with it; I would've bawled. ;)

Last Saturday, we picked out matching solitaire diamond rings, then held our breath for the next five days, as we waited for them to be assembled. Today, the rings were finally finished, and we "made it official."

As an aside, the person that helped us at Shane Co. was great. Being a transgender woman, in a "lesbian" relationship, with a low budget, and living in Salt Lake City can be a scary combination sometimes, but he was completely professional. He listened to what we wanted, he gave us options without trying to upsell us, and he never once acted like anything was abnormal or out of place.

The rings are beautiful, simple, and effective. The glint catches my eye from time to time, and makes me smile uncontrollably. We haven't set a date for the wedding yet, but we're discussing it, and it probably won't be that far off. Thanks to everyone who has congratulated us so far, it means a lot to have the support of so many friends and family!

Most of all, thanks Erin, for loving me unconditionally, and wanting to grow old with me as badly as I want to grow old with you.

The Standard Process and Substandard Care

"One pill makes you larger,
And one pill makes you small,
And the ones that Mother gives you,
Don't do anything at all."
-- Jefferson Airplane, White Rabbit

I've been on hormones for a bit over six months now (wooh-hooh!), and you aren't taking them away from me. Ever. Unless I run out, and my dumb doctor and pharmacy can't coordinate to save their lives. Ugh.

For those that don't know the process, maybe I should start with the basics. Transsexualism is interesting in that it has both psychological and physical sides to it, maybe we'll get in to that more at another time. Decades ago, many tried "curing" it psychologically, which usually turned out badly. Nowadays, it's generally accepted that it's much more healthy to treat the body to match the mind, rather than the other way 'round. Sure, you run a few minor health risks, but a lot less people are killing themselves.

Eventually, the medical community adopted a semi-standard set of treatment guidelines, which are called the WPATH-SOC (World Professional Association for Transgender Heath - Standards of Care), formerly the HBIGDA-SOC (Harry Benjamin International Gender Dysphoria Association - Standards of Care, after a German doctor who did a lot of work to help transsexuals in San Francisco in the 50s and 60s).

The SOC has a lot of good information in it, but the main effect it has is to limit most physical treatment to those who have gone through psychological counseling and received a letter of recommendation for treatment. For hormones, usually a therapist will require three months of counseling before giving you "the letter," and for major surgeries, a year of being "full time" (living as your preferred gender socially, usually including work and/or school).

This makes sense on some levels, because it limits treatment to those who are serious and ready, but it also causes a lot of problems. Some people don't have money for therapy, especially since most insurance companies have specific exclusions for Gender Identity Disorder in their policies. Some people are perfectly well adjusted, and feel they shouldn't be forced to undergo mental therapy for something they've already figured out. Finally, some therapists are just bad, and either ignore the SOC completely, or get a gatekeeper complex and go on power trips, withholding letters and making trans people jump through unnecessary hoops.

Without the SOC, support from the medical community would probably be a lot harder to find, so I think of the Standards as a necessary evil, though it would be great for us to work out a more ideal solution some day.

Personally, I didn't mind starting with some therapy. The cost thing sucks, but my therapist is awesome. Since I am relatively well adjusted, I only went in every couple of weeks until the three month marker, when she gave me the hormones letter, and now once a month.

I took the letter to the endocrinologist she recommended, who first requested blood tests to make sure giving me hormones was safe. She then gave me a prescription for six months, with a plan to do follow up work before renewing at six months.

A couple of weeks before the six month marker, I had an appointment with my doctor, who gave me instructions to:
1. - Get new blood work done.
B. - Leave a message on her answering machine, telling her when to call me so that we could discuss the results.
Three. - Have my pharmacy fax a prescription refill request to her.

By the way, she also mistook me for a FtM at first, asked if I'd had a pap smear done, and received confused looks in response. I'm still not sure what to take away from this one besides a good laugh.

I went to IHC to get my labs done, so that I could at least have that covered by insurance. The next week, I left a message giving the doc a few days of wide open time in which to call back. No call.

I asked my pharmacy to send the refill request, and I left another message with another wide open time frame. No call.

I ran out of pills, so I called my pharmacy to check on the status of the request, to which they replied, "She declined it, because she wants to discuss your labs." SO DO I!

I left a third message, and a few days later she finally called me back, but I missed the call because I'd gotten sick. She leaves a message that says "Have the pharmacy fax over another request, and here's my pager number."

I have the pharmacy send it again, and leave a message on the pager. Two days later, on Saturday of all days, she calls me again. "Your labs look fine, I'll approve the fax request, but I haven't received it." Ok, ok, ok, I know you probably couldn't tell me about the labs in a message because of patient confidentiality and all that, but couldn't you approve the request, and then mail the results to me? That is, if you can't be bothered to do your job and call me.

And what's this about not receiving the fax? I confirm with the pharmacy that they have the right number, they send it a third time, and finally get a response. My spiro is renewed for five months, and my estradiol for one month. Wait, what!? The pharmacy says they'll call the doc to work it out. "Good luck with that!" I say, but by some miracle, they fixed it that evening, and both are now for five months.

I'm still confused as to why five, instead of six, but I don't care anymore. Once this is up, I'm likely finding a new doctor anyway.

Telling Dad

"'I am not alone, I am not afraid, I am not unhappy,'
These are the words I say to myself, every day,
I am not alone, I am not afraid, I am not unhappy.
Tell me what ritual I should have today.
But I'm not alone,
I've resolved so many things, and set myself free."
-- VNV Nation, Fearless

As most know, I recently came out to my dad, and my two little sisters. I told Dad in person, instead of rewriting the letter. I could pretend this was some brave gesture, facing my fear head on, but my motives were mostly selfish; I told him directly because the reaction I was most afraid of was silence. In the end, I froze, and wasn't the one to actually say the word anyway.

I hardly see my dad, in fact this was probably the first time I'd seen him in two years, despite living just a five mile drive apart. Similar to most of my family, it's not that we don't like eachother, it's just that we aren't that close.

I'd expected to see him on Christmas day, and planned to tell him then, in the face of a few warnings not to. I wasn't about to wait any longer. Dad sometimes makes it difficult to arrange a get-together. When he didn't return my calls, I began paranoid imaginings that he was intentionally avoiding me this time, because he'd already found out; I even conceived a plan of telling him over the phone, to get it over with. When he called apologizing and explaining that his phone wasn't working, we arranged to have dinner together a couple of days later instead, when both Erin and my little sisters would be able to join us.

I knew Caitlyn and Carli (my sisters) would take it well. They're both laid back young teenagers, who make me excited to see who they'll grow up to be. When Dad left the table, I told my sisters, and the three of us began texting back-and-forth about it when he came back. After dinner, I said I had something I needed to tell him, which I followed up with stuttering noises, and quick glances between the wall and table. If I ever go skydiving, I'll definitely need someone to push me out of the plane. Eventually Caitlyn blurted it out for me, and I followed it up with some more specific explaining.

Dad seemed to take it well. He made sure to tell me that he still loves me, and even cracked a few jokes about how he was sorry that the Christmas presents he'd gotten me weren't more feminine. There was probably more going on under the surface, but for now I'm just grateful for the support. We'll worry about the rest later.