Colorado HealthOp Conversation about top surgery

I just heard back from my insurance company. The guy was very friendly and helpful. It sounds like they are still working out how this will work, not yet having specific doctors who do the surgery working with them. However, they sounded optimistic. I would need my doctor to prescribe the procedure citing gender dysphoria. They would review – they being a special director set up for transgender health care. I know of a doctor in Englewood who does the surgery and I can request they contact him to do the surgery, meeting their payment terms. I would pay my total out of pocket price of $3750 and they would cover the rest. So feeling optimistic about this too. Not having to pay 9000 out of pocket would be really nice. As I really cannot afford that again right now.

Things are moving along pretty smoothly all things considered.


Two weeks on T and my first coming out to a client

Last Monday was my second injection of T. I believe the first injection was received at least in part intravenous. When receiving info on how to self-inject, my teacher forgot to mention to pull back on the plunger and see if blood comes into syringe. If it does you are in a vein. If you inject there having testosterone so directly in the blood stream is quite the high. I believe the intense high I experienced for the first 24 hours was due to this. When injecting the second time, there was no high, just even flow of energy. Also my muscle hurt for a couple days after the second injection while there was no muscle soreness after the first injection. Sooo… lesson learned.

I continue to feel good. Feel good in my skin. I am realizing this low grade depression I have had most of my life is lifting. I feel confident like never before – the boobs started the process. Reducing the size has had an enormous impact. In retrospect, waiting til I was clear about the transition would have been good as I recognize another surgery is needed. Fortunately, I just discovered my new health insurance (Colorado HealthOp) covers transgender care. I am waiting for a call back on info on top surgery. Colorado Health Op and Kaiser apparently are the only two insurance companies presently covering transgender health care. Good for them.

Also this week I came out to my first client. I have worked with her for a while, there is a lot of trust, she is open-minded and I figured would be a good one to start with. She was not surprised, having noted the haircut (she is used to me cutting it and then quickly letting it grow long again – it has been short over a year now), the breast reduction and the name change. She did say working with me as a male may be challenging given her history. And just ask I keep her posted on my choices as I move forward. I told her I would speak with her as needed free of charge should any questions or worries arise. So I would say my first client coming out convo went well. Gives me hope.

The value of incredible friends

I realize in a couple posts I was so consumed by the topic at hand like trans phobia that I neglected to mention an important presence. Jamie is my good friend and ex partner of 10 years. She was at the meeting with my friends and colleagues invited equally by all to help us navigate the conversation positively. She was then, has been and continues to be an incredible support in this journey of mine. She has been curious, encouraging when I have been down, supportive in so many ways and essentially unconditionally loving and accepting. Between she and my sister Fern I am not sure I would be where I am today with all of this. Thank you Thank you Thank you. I love you beyond words.

WOW!! Came out to parents

I unexpectedly came out to my 78 year old parents tonight. I was over for dinner and told them about my name change to Sky. My mother said you will always be my little Sarah. And basically said she would not call me by Sky. I let it go for a while. after dinner was made and over I brought the whole name change up again which really was all I wanted to talk about. I tried better explaining that I have never felt comfortable with Sarah, that it has never felt like me. I needed a more gender neutral name. My mom asked ‘So, when will you get a sex change?”. I am sure she was halfway joking and halfway knowing, and I replied, “I don’t know another year or two. (pause) I have already started on testosterone.” The conversation went on from there with my mom saying “it is what it is” (my favorite saying), my dad not saying much but when he did say something it was essentially I love you no matter what and this is not a big deal. Shocking. When i came out as gay to my parents it was not easy. They were both angry and in denial, telling me that this is a phase and you will grow out of it. Obviously I never did. I expected something similar, loving and rejecting simultaneously.  I did not expect overwhelming openness and curiosity. I did explain I am exploring if doing the androgynous approach will be enough or if I need to go all the way male. Told them a little of how testosterone works and more of how I have coped all my life as a gender non conforming butch lesbian and that it is not enough. I told them about my tearful response to my sisters inquiry which opened me back up to all of this. They listened and asked questions and throughout I felt a total sense of unconditional love from them. So wow!! The name change convo turned into a coming out convo only because my mom asked when I was going to get my sex change. Choice point to lie or to answer honestly. I am glad I chose answering honestly. And I am super glad they were open and accepting. WOW!!!

Challenges to be expected

I am feeling grateful for two friend who are also colleagues and a strong source of referrals. We met yesterday for lunch to discuss their work related struggles with my transition. Fearing that referring to a transgender therapist might negatively impact their practice. As friends they are present, loving and supportive. They are honest about their confusion around the whole thing and willing to have open dialog.

I am grateful that my first experience of trans phobia is with people who love and respect me. I receive it as an eye opener to what may come from many others – minus perhaps the open dialog. I know that I tend to see the best in people and reality. I do believe that regardless of the losses that will come from this process, there will be many gains that supersede the losses. Work, of course, is my greatest fear of loss. I would be naïve to believe this will not impact clients if I choose to fully transition to male. I will likely lose a few. And some will never enter my door who might have otherwise.

It is an interesting dilemma. I am clear inside that I will not allow this to stop me from what feels right. If, as I move further down this road, I realize I need to be male, that gender neutral is just not cutting it any more, I have to trust that other avenues will open for me. I am a gifted therapist and energy worker. My work is not done.

4th Day on T

Tonight I will have a friend take some beginning photos so I can chronicle changes to my body in photos as well as words. The week has been up and down. The initial dose of T seems to spike significantly day 1, then drops. I did not sleep well Tuesday night as I came home late to a missing dog and couldn’t sleep in fear she was in a ditch somewhere. (Neighbors called in the am having taken good care of her). Catching up on sleep Wednesday and Thursday has helped my energy. Today I decided to go to the gym. I got a breast reduction a couple months ago and can finally lift weights. It felt really good and I was surprised by my ability given it has been a while since I lifted last. I don’t know if this is really what happened, but lifting as well as aerobic exercise feels like it released more T into my system. I feel significantly better than the past 2 days. Who knows maybe it is just the sleep but it was a marked experience. I hike and or run regularly so I don’t think it was just the endorphins.

24 hours on Testosterone (T)

Well, indeed I did leave the doctors office with a prescription for T and went straight to the pharmacy to fill it. Shock of all shocks, my insurance covered it. $19.00 for the T (injectable) and all the syringes. I was pleasantly surprised. Who knows maybe down the road they will figure it out and stop. Or maybe the Parody Law is being honored. Time will tell.

I debated back and forth about injections vs. a patch and for a variety of reasons primarily money, decided on the injections. Getting home and pressing the needle against my thigh… initially I felt like I cannot do this. Perhaps my first experience of “manning up”. I confronted my aversion with open curiosity and shifted my awareness into the factual experience moment to moment. The hardest part was getting it thru the initial layer of derma, then, going slowly thru out, it was painless. Most medical people were trained to inject quickly and the reality is the slower you go the less painful it is – save the initial puncture. pushing it slowly into the muscle I truly felt nothing. Did a little massage after to get it to move thru the tissue and no muscle soreness at all.

I wont bore you with the doctors appt. I took my good friend Jamie with me as support and an additional voice of my readiness. This doctor does not require a letter and does her own evaluation. I was clear and honest and had self educated so I think it showed and she quickly wrote the prescription.

Today is what I want to talk about cuz man I FEEL GOOD!!! I am a pretty in touch person, connected to the minutiae of experience. Embodied in this disconnected sort of way. Well today I was embodied and connected. I feel good in my skin for the first time in my life. I feel really good. I keep getting curious is this the T coursing thru me or is this the simple reality of taking this step? I think it is both. Apparently this is how many trans people experience it. So day one has been a pretty awesome day.

I am working on reigning in my excitement and not just blurting it out to the world (namely my clients -cuz in the blog I am blurting it out to the world). I am a psychotherapist in private practice and experience both fear and trust around coming out to my clients. And ultimately there is wisdom in waiting until I am clear about how far I need to go before outing myself. I do want to believe in the good in humanity and trust that my clients will see me for who I am and not get too freaked out when I tell them. And the reality is, I do not know how any of them will respond and can just hope, they know in their hearts and minds I am the same awesome person as I was yesterday.