The First Appointment
Over the next week, my dad and I researched my surgery and the best place near us to get it. We also found out that his insurance had recently updated their policy and would cover part of the surgery, which was a relief. We scheduled an appointment with a doctor in Kansas City who did top surgeries so he could assess my situation and help me figure out what my next step was.
“I guess we’ll have to get a hotel when you have the surgery,” Dad said, looking at a map on the computer.
“Maybe not,” I said. “My friend Jed lives near Kansas City. I could call and ask if we could stay with him.”
“It would be nice if we could save a little money,” Dad said.
“I’ll wait until after the first appointment so I know if I like the doctor or not,” I said.
“Okay,” Dad said, still staring at the computer.
Even though I had already researched just about everything there was to know about top surgery, I kept reading about the different types of surgery and watching videos on YouTube about people who had top surgery. Some of them scarred more than others, but I thought that, even with the scar, their chests looked much better than mine did now.
The day of my appointment, Dad and I got in his car and drove to Kansas City. I let Jed know that we would be there, and he said that Isaiah’s mom would love to have us over for dinner. I asked if she was making those famous homemade tortillas, and Jed said that she would, so I told my dad that we had to go.
“They sound like nice people, inviting strangers over like that.”
“Jed and Isaiah are nice,” I said. “I’ve never really met Isaiah’s family. I’m sure they’re nice though. They let Jed live with them.”
“Why does he live with them?”
“Bad family. Or, parents and sister at least. His aunt and uncle and cousins are nice.”
We talked for a little while longer, and then I put on some music. Dad didn’t know many of the songs, but he said that he liked my taste. When we finally got to the hospital, my stomach started churning.
“Do you want me to come into the room with you when the doctor calls you in?” Dad asked.
I didn’t want to make him sad, but I really didn’t want him to be in there when I was pretty sure I was going to have to take off my shirt. I shrugged.
“You’re an adult. If you don’t want me to come, I won’t.”
I nodded, and he took the hint. I stole glances at his face to see if he was upset, but he didn’t seem to be.
We checked in, and the wait stretched on forever. By the time the doctor called me in, I was shaking like a leaf.
“Your preferred name is Cameron, correct?” the doctor asked.
“Don’t worry, Cameron,” he said. “You’re in a safe space, okay? I’ve been doing this for years, female to male and male to female.”
I had a website open on my phone that listed some questions I should ask, but I was too scared to take it out. I didn’t know if it was the right time or not, so I just nodded and smiled a little bit.
“How long have you been transitioning?” the doctor asked.
“Well,” I laughed a little, my stomach fluttering. “It’s kind of complicated. When I was little, I knew that I was a boy, but I was in foster care and my first couple foster parents didn’t like that. So finally I got to a new family, and I just introduced myself as a boy. No one found out that I was transgender-- I didn’t even know the word-- until years later.”
“How old were you when you started introducing yourself as male?”
“Seven,” I said.
“And have you made any other steps in your transition? Are you on testosterone?”
“No,” I said. “I haven’t been able to yet.”
“That’s okay,” he assured me. “Do you take any other medication?”
“No,” I said.
“Are you currently being treated for anything like high cholesterol, diabetes, high blood pressure? Anything like that.”
“No,” I said, “but I haven’t really been to the doctor for years.”
“Oh,” he said. “Well, that might be something we need to take care of.”
“Okay,” I said, my voice wavering.
“It’s just to make sure there’s nothing wrong so that your surgery can go as smooth as possible, okay?”
I nodded. I rubbed my hands together, and they were sweating. “Do I--” my voice got caught in my throat. “Do I need to get a letter from a psychologist?”
“Have you heard of WPATH?”
I nodded. “I saw a lot about it when I was researching.”
The doctor smiled. “Good man. So for insurance to cover or help cover your surgery, you’re going to need a letter from a psychologist that meets WPATH guidelines. If you’re paying out of pocket, it is still a good idea, if possible, to talk to a psychologist before having surgery. While surgery can help you feel a lot better about your identity, therapy never hurt anyone. It’s truly important to understand yourself and know how to best take care of yourself moving forward with your transition.”
I nodded again. “What if I’m not able to pay for long-term therapy?”
“That’s okay,” he assured me. “One session to get the letter is all that is necessary to get the surgery.”
When I didn’t say anything, he took a deep breath and continued. “You drove pretty far to get here, right?”
“Just about two hours,” I said.
“Okay,” he said. “Even though I’m not sure about any medical problems you may have, since you’re here, I think we should do our best to discuss what you should expect from surgery and what types of surgery are available to you, okay?”
“Okay,” I said.
“Do you have any specific goals for your top surgery?”
“Uh,” I said. “Mostly just to get rid of my… breasts.”
“Of course. Are you worried about scarring or anything else, like the size of and sensation left in your nipples?”
I swallowed. “I think that, um, I’m not really worried about scarring so much. But I think, if I can, that I would like to be able to feel things, still.”
“Lucky for you, I perform many surgeries that leave the nerve intact. They’re generally preferred.”
“Yeah,” I said. “Do you have pictures… or something? Of other patients’ results?”
“Of course,” he said, spinning around in his chair, going to his desk, and grabbing a binder. He rolled back over and handed it to me.
I opened the book and flipped through the laminated photos. I stopped on the ones that looked more like me, fat with big boobs, and all of the results looked like I hoped my chest would someday. “You’re good at this,” I said.
The doctor laughed. “Well, thank you. I’m glad that you like what you see.”
“Is it harder to… to do surgery on someone like me?”
“There are techniques that work better for some than others, and your body type will respond better to some surgeries than others.”
I nodded, still looking at the pictures. “I heard that it’s good to build up your pectorals before surgery.”
“It does make it easier,” the doctor said. “Often people are happier with their results when they do.”
“I don’t know if I can do a push up.”
“There are other exercises you can do, and I bet you could work your way up to it.”
“Do you have recommendations?”
“I can write some down for you at the end of the appointment, how about that?”
I looked up and smiled. “Sounds good.”
We talked some more about what I would be able to do after surgery, drains, swelling and compression, possible revisions post-surgery, and how long I should stay near Kansas City after the surgery. The longer we talked, the easier it became for me to ask what I needed to ask. I even laughed once or twice.
Then came time for the doctor to examine my chest, and all the sudden I felt terrible. As I pulled off my shirt, I held my breath, waiting for him to laugh or something. After all, he was born a man, and I was like some fake version of that.
He didn’t laugh or make any facial expression that I could read, but from then until the time he told me I could put my shirt back on was still quite uncomfortable.
When my shirt was back on, we talked about the types of surgery that would be best for me. One of them was the inverted-T surgery, which I had hoped for because it didn’t sever the nerve in the nipple, but I could still have him make my nipples smaller. Then we talked about cost, which made me cringe every time. I felt bad for making my dad pay for something like this. If I had been normal, it wouldn’t have been a problem.
“It was wonderful meeting you, Cameron,” the doctor said when I was out of questions. “If this meeting didn’t go how you had planned and you don’t feel comfortable coming back, that’s perfectly okay, but I hope to see you again. Contact me when your insurance has approved the surgery and you’re ready to set a date, okay?”
“Okay,” I said. He stuck out his hand, and I shook it. “Thank you.”