Updates on Electrolysis, Surgery Prep, and the HRC CEI

"Easy now, hush, love, hush;
Don't distress yourself, what's your rush?
Keep your thoughts nice and lush;
Wait.
Hush, love, hush, think it through;
Once it bubbles, then, what's to do?
Watch it close, let it brew;
Wait."

-- Wait, Helena Bonham Carter as Mrs. Lovett (Stephen Sondheim's Sweeney Todd)

The updates are slow(er than usual), because life is simple and relatively routine. That's probably a good thing.

Another two hours of electrolysis down. I've started doing sessions every two weeks, instead of one, to allow some time for the dormant hair to cycle back in. We're still doing about 30m at the beginning of each session to re-clear my face, and the rest of the time on the lower area. So far I've logged just under 5 hours on my face, and about 6 hours down below. My electrologist still leaves the room while I change in to the towel skirt thingy, but it seems like a silly ritual at this point. All other pretense is gone, and she doesn't even pretend to keep me covered any more. =P

My insurance won't cover a physician checkup until August, so I'm still managing the pain with just an Ibuprofen or two, but I'm considering calling to ask if my doc will prescribe some EMLA (numbing cream) over the phone. Some electrolysis sessions, I feel like I can take about anything, and I almost fall asleep while she's working. Other days, the pain consumes me, and I start getting visions of that one Fight Club scene ("I tried not to think of the words 'searing', and 'flesh'." "Stop it! This is your pain."). =P

Speaking of surgery prep, I've still got a lot to do in the next few months. Besides electrolysis, I need a psychological evaluation and two letters of recommendation from therapists (one being a PhD/MD), I need to get HIV testing, and I need to work with my endocrinologist regarding my pre- and post-op changes to my hormone regimen.

The most pressing of these is probably the letters. My primary therapist has agreed to write the first, but I'm having a hard time finding someone with a degree and familiarity with GID to write the second letter. I've been calling various people suggested by trans friends, with no luck so far. I'm sure I'll find someone to write it; it's just another thing I want to get out of the way. =)

As I mentioned before, my set SRS date is in February 2012, but I'm on a cancellation list for November. When I scheduled, there were a lot of personal advantages to having my surgery done in November, but those pros are slowly being overwhelmed by the possible advantages of waiting until the scheduled date in February.

The Human Rights Campaign (HRC), a major organization focused on the advocacy of BLTG rights (you've probably seen their bumper sticker logo: a blue square with a yellow "=" sign), releases a Corporate Equality Index each year. Basically, companies volunteer to send in a survey and information about their TGBL-related policies, and HRC scores each company on a 100-point scale. My employer has consistently gotten 100 points each year that they've participated (2009, 2010, and 2011).

As of 2012 however, HRC is changing the criteria by assigning 10 points for having trans-inclusive benefits-- health insurance that covers GID therapy, hormones, surgery, etc. Since my company seems pretty proud of their CEI rating, I've informed the powers-that-be that we are in danger of losing our 100, unless they add an inclusive insurance option by the end of this year. They definitely listened, but I probably won't find out what they've decided until around November. It's an off-chance, which is why we've been saving and planning for paying for it ourselves. But as the date approaches, waiting three more months for even a small possibility of saving twenty-thousand dollars is sounding more and more worthwhile.

We've also found out that Erin isn't eligible for family medical leave through her work until she's been there for a year, which will occur in January. She gets 40 hours of PTO a year, and at the moment, she has to save every minute of it to be able to go to Cali with me in November, which really isn't fair to her. Finally, waiting until February means the date is no longer uncertain, and gives us that much more time to settle the funds.

I was really looking forward to November, but logic dictates otherwise, and I think (hope) I can deal with waiting just a little longer.

By the way, if you want to see the CEI ratings, here are the 2011 results (ratings start on page 38):
http://www.hrc.org/documents/HRC-CEI-2011-Final.pdf

And a few previous years:
http://www.hrc.org/documents/HRC_Corporate_Equality_Index_2010.pdf
http://www.hrc.org/documents/HRC_Corporate_Equality_Index_2009.pdf
http://www.hrc.org/documents/HRC_Corporate_Equality_Index_2008.pdf

Does your company participate? What's their rating?

On Electrolysis and Saving Money

"Money, get away;
Get a good job with more pay and you're okay;
Money, it's a gas;
Grab that cash with both hands and make a stash."
-- Pink Floyd, Money

I had my third hour-long electrolysis session yesterday, and started genital electrolysis in prep for surgery.

The bits of remaining facial hair are being cleared faster and faster. The first session took about an hour, the second took 40 minutes, and this latest only took half an hour. Each time, everything that's visible is cleared, but since hair grows in stages, the dormant hairs have to be cleared in successive sessions. Still, it should take less and less time from here. After zapping my face, we used the remaining half-hour to do a test patch down below.

I was terrified. The pain worried me a little, but mostly I was nervous about the idea of it. I don't hate my body, but I'm not exactly comfortable with it, either. Fortunately, my electrologist has experience with doing genital electrolysis for trans women, which does help ease my mind a bit.

She gave me a fluffy skirt wrap with snaps on it, asked me to wrap it around my waist, then left the room. I followed her instructions, and she came back a few minutes later. She worked like a masseuse, using a towel and the skirt to cover everything except the spot she was working on. For some reason it seems easier to handle a little square patch being exposed. My anxiety went away pretty quickly, but starting the surgery-prep electrolysis also caused the reality of surgery to settle in a bit. After all, this is the first concrete step I've taken in getting ready for SRS.

For the pain, I've been taking ibuprofen before each session. It only dampens the stinging of each zap a little, but I think it keeps the pain from building up as my skin gets more and more tender, and that helps a lot. I'll probably look in to getting some EMLA, which is a topical numbing cream, though I'd need a prescription from my physician to get it.

The pain from the genital electrolysis was... different, and difficult to explain, but the patch she did was not nearly as painful or annoying as when she does my upper lip. Being able to talk and distract myself while she works makes it much easier on me as well; I have a hard time sitting still and quiet for very long. Unfortunately, pain-wise, the worst is probably yet to come.

Hopefully, it will only take around 10-20 hours to clear what I need for surgery. Most surgeons (including mine) do a follicle scraping of the skin graft between removing it and replacing it, but they can't get everything, so most also recommend clearing certain areas of hair before surgery. Personally, I'd rather be safe than sorry, since it can't really be cleared after surgery.

I've also been thinking more and more about cost recently. My electrologist charges $50 per hour, which is pretty average. I looked up how long it takes most trans women to completely clear their face of hair with electrolysis alone, and most sources say it takes about 200-300 hours (though some people manage it in 100, and some have taken 700+ hours). If we go with the low average and say 200 hours, that's around $10,000 on electrolysis.

I spent about $1,300 on laser. Even if clearing the remaining facial hairs with electrolysis takes 10 hours, I will have saved $8,000. Not to mention the 180 hours I got to spend doing anything other than enduring the pain of electrolysis. Even if it had only cleared 1/6th of my facial hair, I would've come out ahead.

There is a lot of heated (no pun intended) debate over the effectiveness of laser, and I know that it's not for everyone, and that it doesn't work well on every skin/hair-type. But for those who are good candidates, and who can find a good price, I think it's worth trying. Of course, take my advice with a grain of salt, as I think you should with any advice about hair removal. =)

Speaking of saving money, my surgery fund is coming along!

I crashed my car a couple of months ago, and the insurance company called it totaled and gave me a check. Since then, I've been carpooling with Erin, and I've been considering saving that money for surgery, but I don't think that's really feasible. I've made Erin late for work a few times, and her work is not very lenient with tardiness, not to mention the fact that her schedule may change at any time. The tension over sharing a ride is only mild right now, but another year of this would probably be a different story.

We've been expecting a tax return of a couple-thousand dollars for a few months now. I filed (our first joint return! =D ) back in February, but after a few weeks of not hearing anything, I got worried and called the IRS. The rep I spoke to said that due to my name change, there was a delay, and that we'd get a notice by mail if we needed to provide more information. Since then, I've been nervous about being audited, or that they'd reject it because we're both legally female, but I just checked my bank account and there was a deposit from the US Treasury. W00t!

Including the tax return, but not the insurance money, we have about $18,000 saved, with between six and nine months (six is if there's a cancellation in November) to bring that up to $22,000. Thinking of other things that money could go to is a little depressing, but it will be worth it, and I'm excited to think that we may actually be able to save up the money in time. =D

My First Electrolysis Session

"After all this has passed,
I still will remain;
After I've cried my last,
There'll be beauty from pain."
-- Superchick, Beauty From Pain

On Saturday I had my first electrolysis session.

Not. fun.

I haven't done much in the way of hair removal thus far, mostly because I've never been very hairy, even before hormones. The hair on my arms is pretty light, I've never had any back or chest hair to speak of, and I can deal with shaving my legs on the rare occasion that I actually wear a skirt.

I have, however, been getting laser hair removal on my face for almost two-and-a-half years now. It was actually the very first step I took towards physical transition, and I started just a couple of weeks after coming out to Erin. I wasn't sure at the time if I'd end up transitioning or not, but I knew that I hated my facial hair enough to get rid of it regardless.

I spent more on it than I probably should have, but on the plus side, they gave me a two year guarantee, so I've been going back once a month since then without paying anything more. Laser has eliminated 95% of the hair on my face, but there are a few hairs it just hasn't cleared. Still, I don't regret starting with laser versus electrolysis, because it has saved me a lot of time and pain, while costing about the same in the long run. Laser was also enough to get rid of the beard shadow on my face, which helped me dramatically in passing as female.

I've now started electrolysis for two main reasons, to clear up what's left on my face, and to start genital electrolysis in preparation for surgery. To put it simply, in sex reassignment surgery, some of the outside skin gets moved to become inside skin, and I need to get any hair removed from those areas before then.

Back when I started laser, I did a lot of research on the differences between laser and electrolysis. The only thing I learned with any certainty should probably be obvious: never trust an electrologist or laser tech to tell you which method works better. Both fields are chock-full of the kind of propaganda and superstition that's spread around so often, even the pros believe it. The truth, as far as I can tell, is that both methods work, and both have many pros and cons.

As far as effectiveness, laser is more like lobbing grenades, where electrolysis is more like sending in a sniper. The grenades are quicker and easier, but you have to be more careful not to damage the scenery, and there's a lot more luck involved. (Yes, I'm a dork, but it's a good metaphor. =P) Electrolysis also seems to be more dependent on the skill of the technician, for better or worse, while laser is more dependent on the area being treated, the skin type, and how dark the hair is.

Technically speaking, most laser hair removal devices don't actually involve any lasers, but use xenon flashbulbs, which flash high-intensity light at the skin. The skin itself lets most of the light pass through, but the hair's melanin (pigment) absorbs the light. The hair briefly heats up, effectively frying and killing the follicle around it. The hair is then left to eventually fall out on its own.

An average session of laser hair removal for me involves lying down, and being given goggles to protect my eyes from any errant flashes. They then spread clear goo on my face to keep the skin cool. Next, the tech dials in the intensity for my skin type and progress, and presses the small flasher part against my cheek. The machine beeps, I feel a sting, the tech moves the flasher gun about a centimeter, and then repeats.

The pain is semi-intense, but manageable, though I usually forget to breathe until they stop, and it always makes my eyes water when they go over my upper lip. Each monthly session only takes about 15 minutes. When they're finished, they clean the goo off my face, apply lotion, and give me an ice-pack to go. After each of the first few sessions, the room smelled like burning hair, and my face was red and tender for a couple of hours.

Electrolysis, on the other hand, uses a tiny needle-like electrode. The tech inserts the electrode in to each follicle, next to the hair, and zaps it at the root with an electrical current. They then grab the hair with tweezers and pluck it out.

At my first session on Saturday, my electrolysis tech began by joking about how every trans person she's talked to says that electrolysis is the worst part of transition, which got me nice and psyched. =P

She wore medical gloves, and glasses with little telescope-y magnifiers attached. She also dialed in the intensity, starting low to see what I could handle, then raising it a few times as she worked. Though I couldn't see exactly what she was doing, it seems like inserting the electrode stings, but is bearable, since it's being inserted where there's already an opening in the skin. The zapping and plucking hurts much worse. The pain was pretty manageable at first, but as she slowly moved across my face, my skin became more sore, and the stinging became more intense. The only things I can compare it to are laser hair removal, and getting a tattoo on my back, but it easily beats both.

My upper lip has the most hair left, mostly because the laser techs were afraid to zap too close to my lips. While the electrologist progressed across my upper lip, my eyes were watering like crazy; If you've ever plucked your nose hair, it's like that, but more hurty. Thankfully, Erin came with, and at this point I asked to hold her hand. I also had to ask the tech to stop a couple of times, so that I could sneeze and blow my nose.

The session lasted a little over an hour, and she cleared most of the remaining facial hair. Hair grows in cycles, with one set of follicles being dormant while another set grows, so I'll have to have my face done at least a couple more times to clear everything.

Once she was done, she had me hold a metal rod with a cord sticking out, and I started wondering why she wanted to electrocute me. She applied what smelled like VapoRub to my face, then pressed a metal roller to my skin, and I could feel a very mild current as she rolled it around. Apparently this is called cataphoresis or electrophoresis, which reduces redness by causing pores and blood vessels to constrict, and helps transfer medicinal substances into the tissue. Who knew?

She asked me not to touch my face or wear any makeup for a couple of days, to avoid infection. Most of the redness went away after a couple of hours, but my face was sore for the rest of the day, and there are still some tiny red spots and slightly tender areas four days later.

I definitely plan on taking some pain meds before my next appointment on the 18th. Since I normally avoid meds, they're pretty effective when I do take them. That should be enough to get me through the rest of my face work, but I don't know what to do for the genital electrolysis. Some people go as far as using numbing cream, or even local anesthesia. I'm really not looking forward to it. =/

After just one face-clearing session, I wouldn't say that electrolysis is the worst part of my transition, but we'll see if I feel differently about it after the surgery prep work. *knock on wood*