Art of Transliness

A Piece for Parents of Trans* People

Some of our followers are parents of trans* kids that are wanting more information, others are trans* people that would like a good way to explain their gender identity to their parents or something to give to their parents as they come out. We thought we’d throw together a little something for both sets of people, just a little bit of information that we think would be useful to parents whose children just came out to them. Here it is: 

So….Your Kid Just Came Out as Transgender 

Your child has just told you that they don’t identify with the gender they were assigned at birth to some degree. Maybe they told you that they are questioning their gender, or that they see themselves as neither completely male or completely female. Or perhaps they told you that they  identify as male or female and hope to go on hormones or have surgery as part of their transition. Regardless of what your child just told you, you might be have some questions. Here are some common questions that you might be wondering to yourself as well as some answers provided by a transgender person himself in consultation with his mother:

Is this something I did? Is it because X happened in my kid’s childhood? 

Wedon’t know for sure what causes some people to identify as the gender they are assigned at birth and others to identify differently. However, it is incredibly unlikely that your child is transgender because of anything that you did. There are transgender people that are raised in strict religious homes and those raised in homes with no religion at all, those raised in households with married parents and those in households with divorced parents, those raised in perfectly happy families and those raised in abusive families. There really doesn’t seem to be any common thread in the childhoods of transgender people, other than the fact that many (though not all) displayed signs of not identifying with the gender they were assigned from a young age. It is also unlikely that it is due to any one event in your kid’s childhood. 

Isn’t my chid too young to know that they are transgender? 

Think back to when you realized that you were male or female. Is your child older than that? If so, your child is probably old enough to know. Many people realize that they are transgender when they are very young, it is not uncommon to hear of small children expressing feelings that they are being raised as the “wrong gender.” The preteen and teenage years are also common times for children to come out to their parents as transgender or begin to express their gender identity because those are times in which people in general really begin to figure out who they are and explore their identity. 

My child is in their 20s or 30s (or even older), aren’t they too old to just now be realizing this? 

While many transgender people realize that they are transgender when they are very young, some people don’t realize until they are older or don’t say anything to anyone about it until they are older. Keep in mind that your adult child may have known for a long time but only now have allowed themselves to explore their identity or tell anyone. It also might be the case that your adult child has only just recently found words to put to their feelings. Just as there are people that are late bloomers in other aspects of their lives, there are people that take a little bit longer to figure everything out about their gender. 

How do I know if this is a phase? 

It may be that your child has gone through a lot of phases, just as you probably did growing up. Gender identity, however, is bigger and more important than musical taste or personal fashion. It is entirely possible that this is a phase for your child, but for many people it is not at all a phase and to treat it as such can be damaging to your child. If possible, allow your child to explore their gender identity in non-permanent ways (for instance, allowing them to choose their hairstyle and dress differently) if you are concerned that this is a phase. Therapy can also be very beneficial for your child and, if in many cases, you and other members of your family as well. 

My child wants to take hormones and have surgery, aren’t these things dangerous and bad for their health? 

There are risks to taking hormones and having surgery just as there are risks to taking any prescription medications and having any surgery. The best way to fully understand these risks is to discuss them with a trained medical professional that has experience prescribing these medications or carrying out these surgeries. Many transgender people would point out that for them the risk of not taking hormones or having surgery is greater than the health risks of doing so due to emotional stress. It might also be helpful for you or your child to talk to older transgender people that have been on hormones for 20 or more years about their experiences and health. 

What are some resources out there for parents like me? 

Many parents find it extremely helpful to talk to other that have been in their situation, in which case Trans Youth Family Allies is an excellent resource. They have blogs written by other parents, listings of support groups for parents in different cities, and private online forums for parents of transgender kids ages 3-18 (that forum can be found here). TransKidsFamily also has a private yahoo group for parents with children of all age groups that can be found here. PFLAG may stand for Parents, Families, and Friends of Lesbians and Gays but it also provides information and support for family and friends of transgender people. 

Questions to Ask your Top Surgeon: The Anything and Everything Post

By now we’ve posted numerous articles on questions and concerns regarding top surgery, and have answered some of the more obvious questions surrounding this surgery, but what about those hard-to-answer-super-in-depth-almost-too-personal-but-you-need-to-know questions? You certainly don’t need to have all of these questions answered, but they are seldom thought about but still wildly important when selecting your surgeon. Some of these may seem obscure and unhelpful but collectively, you can really find out a lot of useful information about the surgeons you are considering going to and one may just push you to the surgeon that’s right for you.

Here’s a list of those questions you could ask your surgeon before you go under the knife:

A) Questions About Your Surgeon 

1) Where did they graduate from medical school?

2) Where did they go for their plastics residency?

3) How long have they been performing this surgery?

4) What is their motivation for doing trans*-related healthcare?

5) Did they know anyone who was trans* before they started doing top surgery?

6) Did they have another surgeon who is currently practicing after whom they modeled their technique? Can you see some of those person’s results?

7) Are they currently involved in a legal case brought to them by a former transgender patient?

8) What is their patient-satisfaction rating? How do they know if their patients have been happy with their results? (Do they even care to find out?)

9) How many top-surgeries does the surgeon do per year?

10) Will the surgeon be happy about being promoted on blogs/websites/forums/face-to-face groups/listserves as having provided this kind of trans*-related healthcare? Is the surgeon happy about being associated with the trans*community?

11) Has the surgeon been to any trans*-related healthcare conferences?

B) Questions About The Procedure

1) What is their most popular procedure (double incision, peri-areolar, keyhole)? Why?

2) What are the chances of retaining nipple sensation?

3) How do they decide where to place the nipple grafts if they use them? Do they have supporting literature for why they place them where they do?

4) How do they decide how to shape the nipples? Is this something that can be personalized? (i.e. would they make smaller/larger nipples than they normally do per the patient’s request?)

5) Do they absolutely under all circumstances use drains?

6) How long will the patient be under general anesthesia?

7) Who will be back in the operating room with the surgeon?

8) How long is the patient required to stay on location for post-op recovery?

9) What is the physiological criteria to be eligible for peri/keyhole?

10) What surgical tools does the surgeon use to perform top surgery? Lipo?

11) Where does the surgeon place the bilateral scars? Why?

12) What about revisions? What is the percentage of their patients that have had to come back for revisions?

C) Questions About Financing

1) How much does it cost? How much of that total cost is the surgeon’s fee? The facility’s fee? The Anesthesiologist’s fee?

2) If they are strictly against options involving insurance coverage, why is that?

3) Do they have financing options via a bank loan?

4) How much of the surgery cost is expected prior to surgery? How far in advance?

5) What happens if your surgery date has come and gone and you can no longer afford your surgery?

6) Are there ways to lower the cost of the surgery?

7) Is one surgery option cheaper than the other? Why?

8) Does the total cost include post-op medications?

9) Does the total cost include future revisions?

10) Does the total cost include pre-op consultations?

D) Questions About Recovery

1) What pain medications will be prescribed? If the patient is allergic to the preferred medications, what will be prescribed in their place?

2) How long does the patient need to stay in the area? How soon could a patient, assuming the best recovery outcomes, leave the area? Is this flexible and catered to the patient, or is it a standard across the board requirement?

3) What are the patient’s chances of developing a hematoma? How will that be taken care of in the event that it occurs? What is the cost for care of something like that?

4) What other surgical complications are possible?

5) How soon after surgery can a patient be on a plane?

6) What is the recovery time line? How long until the patient can go back to normal life activities? 

7) What kind of diet would aid in proper healing?

8) How long until the patient can be out in the sun/in a tanning bed?

9) What kind of skin/scar care does the surgeon recommend? Does the surgeon sell this product on site? Is there a place to find the same product cheaper?

10) If there is major swelling, how long should a patient wait for it to go down before they contact a medical professional? Can the patient contact the surgeon’s office about complications even after having left the area?

11) How long after surgery can a patient resume erotic-play (whatever that means to the patient) with their nipples?

12) What does skin necrosis look like and how would a patient recognize that their skin is dying? What should a patient do if their skin appears necrotic?

13) Is the surgeon willing to write a doctor’s note for missing work/school or limiting activities at work/school?

14) How long after surgery until the patient can consume alcohol?

E) Questions About Preparing For Surgery

1) How far in advance should a patient quit smoking before surgery?

2) Does the surgeon require the patient to be off of testosterone before surgery? If so, how far in advance?

3) Does the surgeon prefer patients to be on testosterone prior to surgery? Why?

4) Should the patient fast before surgery?

5) Should the patient shower or not shower right before surgery? 

6) What kind of soap should the patient wash with before surgery?

7) What foods can the patient consume during their fast (jello, ice cubes, etc)?

8) Is it beneficial to the procedure to lose as much weight as possible before surgery?

9) Will there be a pre-op physical that the patient will need to be in town early for?

10) What kind of blood work is needed prior to surgery? Why?

11) How far in advance can the patient book the surgery?

F) Miscellaneous Questions

1) Does the surgeon’s facility have any deals with pharmacies nearby?

2) Does the surgeon’s facility have any deals with hotels nearby?

3) Does the surgeon’s facility have a brochure on things to do in the area that are compatible with the patient being post-op?

4) Does the surgeon have any recommendations for good local cuisine? 

5) How does the surgeon come up with the pricing of the surgery? Do they feel they are competitive?

6) What is the percentage of business that comes from trans*-related surgeries?

7) Do the nurses/other physicians in the office have any special training in treating trans*-patients?

8) Will the surgeon/surgeon’s office refer to the patient with their preferred gender pronouns and preferred name even if it is not on all of the patient’s official documents (They haven’t legally completed those steps)?

This is a near, but not completely exhaustive list of potentially important but often forgotten questions to ask your perspective top surgeon. Since many of us pay for this care out of pocket, please be sure to give your top choices as much scrutiny as you care to. In the private market, goods and services must be dealt with by competition and our surgeons must know that we hold them to the gold standard because of it. Don’t waste your money on a surgeon you know nothing about, you deserve better than that with your near 10K investment.

Good luck!

Creating Your Testosterone Toolbox

If you’re on injectable Testosterone, chances are you have a bunch of supplies that you use to do your injections at home. If you’re like a lot of guys we know, you’ve got a pharmacy’s worth of supplies of needles, syringes, alcohol swabs and bandaids. If you don’t already have a dedicated space for these materials, or are not quite yet on this form of Testosterone, consider one of these neat ideas to organize it all!

1) Keep all of your supplies in a specific drawer in a cabinet in the room that you most frequently inject. It could be a section of your dresser, a cubby in your desk, a drawer in your bathroom vanity. Just shove all of your supplies in there and you’re good!

2) Buy a traveling toiletry bag/cosmetic case for all of your supplies. These range in size, shape, material, and cost so you could totally find something to suit your style. TravenEssentials, The Container Store, and Target have a lot of neat organizers and bags to choose from.

3) Build something yourself! Make a small wooden box to store everything in, create a cloth roll-out bag to wrap everything up in, repurpose something that you would have otherwise thrown away. You could use anything from a silverware drawer organizer to an office desk organizer to an actual small toolbox!

Here’s a couple of photos of how Adrian stores and organizes his needed injection supplies:

This is Adrian’s vintage fishing tackle box he got for $10 at an antique store. Pretty slick, huh?

This is the tackle box all loaded up with the necessary supplies. We’ve got a box of alcohol swabs, wound-care supplies, syringes, needles, and of course a vial of Testosterone.

Latched closed and ready to go!

Where ever you chose to store your testosterone supplies, just remember to keep your vial of testosterone in a dry and relatively constant room temperature space (bathroom’s are okay if it’s the only place you can store it). Have fun with this process and make it your own. Cheers.