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

Surgical Decisions and Scheduling

"I'm so much closer than,
I have ever known.
Wake up!
Better thank your lu-cky stars."
 -- Green Day, Waiting

I've decided on a surgeon, and scheduled my SRS! =D

After my last post debating the pros and cons of various surgeons, I couldn't get surgery off my brain. The more I mulled it over, the more I liked the idea of Dr. Bowers' "one stage" procedure, but I still had concerns.  I realized that the main reason I like Dr Meltzer is not just because he's good at what he does, but because I know he's good.

I've read tons of accounts from satisfied trans women who've had their surgeries performed by Meltzer; I've seen quite a few images of the great results he can provide; I've even read a step-by-step walk through of his procedure, complete with graphic images detailing every part of the surgery. So, I resolved to find just as much information on Bowers.

This last weekend, I read countless threads on around eight or nine different trans forums, I found newer pictures of surgeries Dr. Bowers had performed, and I even managed to find a video of her performing a MtF reassignment surgery. While everything I learned swayed me more and more towards Dr. Bowers, it was the video that did me in; the woman is a freaking artist. If you'd like to see it, I'll warn you that it's very graphic (NSFW), and not for the faint of heart, but you can find it here.

Yes, the video is scary, but I also find it fascinating; I love information. What amazes me the most from watching the video is how simple she makes the procedure look. Though I'm no expert, coming from what I do know, her procedure seems very straightforward and smooth. It also filled in some gaps in my knowledge of how she operates, and reassured me that her "one stage" technique is only subtly different from the standard. It's enough to make an aesthetic difference, without adding any extra healing burden.

On Monday morning, I called her office, and her staff informed me that I needed to fill out an application found on the website. I emailed the app back to them this morning, with a note asking to call me to arrange payment by phone for the $500 deposit. I was anxious, but I tried to continue my day, figuring it would take at least a day or two for them to call me back. Nope! Within an hour of sending the email, my phone rang, and a helpful woman named Robin worked out the deposit and scheduling with me.

My reserved surgery date is February 12th, 2012, but I'm on a cancellation list for November/December of 2011. She told me that they often have cancellations, and that they should be able to get me in this year. While November would be ideal, I can live with February if I have to, so either way, I'm set.

On a related note, thank you tons and tons to those who have donated to my surgery fund! Even a couple of dollars here and there adds up, and helps a lot! <3

I still have a bunch to do, including getting two letters of recommendation for surgery, having some electrolysis done, and working out the time off I'll need from work. I don't know if I can contain my anxiousness for nine months to a year, but I'm sure it will fly by faster than I can imagine. =)

Holidays, and Planning for Surgery

"Did you ever have to make up your mind,
Pick up on one and leave the other behind?
It's not often easy and not often kind;
Did you ever have to make up your mind?"
-- Lovin' Spoonful, Did You Ever Have to Make up Your Mind

Whooh! It's been a while. Shall we catch up? =D

The holidays came and went, and Erin and I kept Christmas small in order to save money for other things. I saw family, many of whom I only see at Christmas, and some of whom hadn't seen the new me yet. Quite a few people gave me that soul penetrating curious stare, as if reconciling it all in their heads just requires looking at and through me for a while. I can't say it really bugs me; it never feels malicious, just weird. =)

Quite a few other family members complemented me on my looks, including my mom, stepdad, aunts, and a few cousins. As someone with chronic self-esteem issues, I treasure every piece of unsolicited praise I get. More importantly, I think most of them have had time to adjust, and those that have just act normally now, which is nice.

So far this year has been pretty uneventful, except that I've been thinking about surgery lately. A lot. It feels like the concept is always looming over me, waiting to consume my thoughts whenever I have a free moment. As I wrote here, I plan to have the surgery eventually, it's just a matter of when. I know that I wouldn't have been ready six months ago, but each day that the thought has been left to marinate, I've become a little less afraid, and a little more anxious to just get it over with.

Marriage put even more urgency on it; I feel guilty for holding back our lives with this huge financial burden. Erin has said many times that she doesn't mind helping with this, but I know that the sooner it's done, the sooner we can start working towards other goals.

It's the money that complicates the timing the most at this point. I'm thinking (hoping?) that around November 2011 would be a good time in many ways. It's far enough out that I can hopefully book it, and can hopefully have the funds ready, but close enough to satisfy my wanting to have it done with already. Thanks to a court ruling almost exactly a year ago, SRS is considered a tax deductible medical expense, making the end-of-year timing even more beneficial. Of course, if I want to schedule it for then, I need to figure out if we'll have the money and who will be performing my surgery soon.

One good thing about insurance not covering surgery is that I'm free to choose any surgeon I can pay for, but deciding on a surgeon for something so life-altering is extremely difficult. Researching surgeons is frustrating at best. The internets have provided a lot more information than might have been had 20 years ago, but not nearly as much as you might think.

The major surgeons have websites with pages of text on things like aftercare, but never much detail on their technique. They'll post pictures of their best patient results, but these aren't always informative as a sampling, especially when they haven't posted new results since 2004. Talking to other trans women helps, but each person obviously only gets one reassignment surgery from one surgeon, so it's nearly impossible to compare things like sensation. It's also (understandably) a very private thing for many people, so it's tough to find a large enough sampling to feel like I really know a surgeon's work and range of outcomes.

My main concerns are good sensation, good aesthetics, and no complications. Since I'm big on informed decisions, I've only been considering the surgeons I can find the most information on. This also has a side effect of leaving me with the popular surgeons, who also have the most experience. So far, I've been focusing a handful of them: Toby Meltzer, Pierre Brassard, Suporn Watanyusakul, and Marci Bowers. These are all excellent surgeons, and I've seen pictures of good results from all of them. With the exception of Dr Suporn, they also use the same basic penile inversion technique, though everyone has their own subtle variations.

Dr Suporn works out of Thailand (Chon Buri), where more reassignment surgeries are performed each year than in any other country. As far as I can tell, his fee is around 500,000 Baht, which is about $16,000 US, but I would also have to pay for travel. His technique is well known for providing greater vaginal depth, which is something many trans women are concerned about. This seems to be a holdover from a time when the standard techniques didn't provide enough depth to have intercourse. Being a lesbian, depth is not really a priority for me. ;)

Traveling also comes with its own set of complications. If I went out of country, I'd likely stay there for about a month to recover. I would want Erin to come with, but bringing her would increase travel costs, and there's no way we can both take a month off of work. She could come home early, but she's scared of traveling alone (and I don't blame her). I've also spent a month in another country without her before, twice, and we both hated being apart for that long.

Dr Brassard works out of Montreal, Quebec, which would come with some of the same travel issues. From what I can find, his cost is around $18,000. I haven't done much in-depth research on him, mainly due to being put off by the travel concerns. Based on what I've seen, he uses more of the urethral mucosa than most, and I don't think I like what this does to the look of the final result.

Dr Bowers used to be in Trinidad, CO, but recently moved, and now works out of San Mateo, CA, about an 11 hour drive from SLC. I called her office for her cost, and it's about $22,500. Marci is a trans woman herself, and learned her technique from Dr Stanley Biber, though she has made many of her own modifications and improvements since taking over his practice when Biber retired in 2003.

While many surgeons recommend a "second stage" outpatient procedure called a labiaplasty at least three months after the initial surgery, mainly for cosmetic improvements, Marci is often touted as performing a "one stage" procedure. Labiaplasties cost around $4,000-$5,000 dollars, plus another trip to the surgeon, and more healing, so that's quite a savings, but some people still opt for a labiaplasty after SRS with Marci, and some people opt not to get one after SRS with "two stage" surgeons, so I don't know how much weight to put in this.

Dr Meltzer works out of Scottsdale, part of Phoenix, AZ, which is also about 11 hours from SLC. I emailed his office, and they quoted his current cost at about $25,000. Of all the result pics I've seen, his outcomes seem the most consistent and "clean", but I especially like the aesthetics of his results after the "second stage" labiaplasty. Though the labiaplasty could be performed any time down the road, this would obviously put my total cost much higher.

Overall I'm thinking it's between Meltzer or Bowers. Yes, they're the most expensive, but for good reason, and they're both close. Here's where I need your help.

If you're trans, do you have an opinion on any of these surgeons? If so, please tell me why you feel the way you do, good or bad. Also, does anyone have any other surgeons I should be considering? I've also briefly looked in to McGinn, Alter, and Reed.

And finally, I've got around $12,000 saved, and we should be able to save most of the rest by the end of the year, but every bit added will help us feel safer, less anxious, and more confident. I've set up a donation button on the right side of my profile, where people can send money to my cause. I personally hate asking for money, so please know that it is with a very humble heart that I ask for donations. This is a daunting cost for a newlywed couple; while I secretly hope donations can help us fill in the unknown gap, we will figure this out one way or another. If you donate anything at all, feel free to brag about it... or leave it anonymous if that's more your style.

Thank you, and I love you. <3