I was born in America, and I have been steeping in American culture for my entire life. As a result, I have strong ideas about what is feminine to me. The down side is that being depressed for nearly 30 years (before realizing what the problem was) is a pretty shitty way to live. The up side is that now that I know what the problem actually was all this time, I have a path towards external self-actualization that is remarkably clear.
Having a very clear path toward external self-actualization is an enormous part of why this all seems so simple, to me. People keep telling me that I’m being very brave in being true to myself, and things like that, but to me it’s not matter of courage or cowardice. It’s purely rational.
My body and my mind do not match, according to the archetypes of my culture. The choices from the point of realizing that to the point of being more fully content and happy are basically to either try to change the culture, or to try to change myself. (I recognize that that isn’t a zero-sum kind of choice, but in broad terms, and speaking from a perspective of what one woman can achieve while also living a life, I’m depicting it that way.) Since changing myself is more likely to net results before I die than changing the entire western culture’s gender model, I have opted to change myself. Simple decision #1 complete.
How should I change myself? I view the brain as the truest expression of self, and have always been relatively loathe to make huge changes to mine. To be fair, without knowing what the real problem was, I have already spent many years trying to change my brain, with poor results and no real success. Treatments included trials and extended runs on about 15 or so different antidepressants, along with psychotherapy. Now that I know what the actual problem is, not only do I like and love myself (i.e., my brain), but I can also look back on past experience to this point and conclude safely that, in regards to me and my own brain, trying to change myself inside (conceptually) is not likely to yield a positive outcome.
However, changing myself physically with medical assistance is, while expensive and largely not covered by insurance, relatively straightforward. Hormone Replacement Therapy (HRT) is safe when the doctor’s direction is followed. Sex Reassignment Surgery (SRS) can be done very satisfactorily by a qualified surgeon. Voice feminization surgery techniques in South Korea are producing mind-blowing results. Electrolysis is painful, but effective at true permanent hair removal.
With those two roads before me, which direction to go was never really a question I spent much time thinking about. I honestly had to struggle a bit to think of how to articulate it, because I knew almost immediately which path I’d be taking, and how far I would take it. Simple decision #2 complete.
Now come the details, along with the hard parts. The VA covers my HRT, but I am pretty sure (though I have yet to absolutely confirm) that they cover nothing else beyond psychological help, which is not considered a transgender-related service. Basically that means they cover only one service for transgender patients.
I’d already settled on the Yeson Voice Center in South Korea for the voice feminization surgery. Their technique is the most advanced, and from the testimonials I’ve seen along with the description of how the surgery compares to other modern approaches, seems like the best bet, by far, in every metric. It has extremely good outcomes, and it is extremely safe (in the context of being a surgery with general anesthesia). Their cost, according to a post from about 3 years ago, is roughly $8,000 USD, not including travel and lodging and other ancillary expenses related to going to have the procedure done. I have not written to them yet to inquire about scheduling, as I view this procedure as secondary to SRS in terms of priorities. It is essential, to me — voice and singing are core to my identity — but it can come after SRS.
One thing I hadn’t figured out was where I would go to have my SRS done, and by whom. After researching this online for the last several weeks, I’ve found my surgeon of choice. He seems far more vested in long-term whole-life patient outcomes than the other surgeons I’ve seen, and as a board-certified plastic surgeon and a board-certified urologist, he’s highly qualified (perhaps the most highly qualified in the USA, if not the world) to perform the procedure. His cost is roughly $40,000, in addition to approximately $12,500 in hospital costs to cover the subsequent week in bed under monitoring. I wrote to his office this morning to start mapping my path to having SRS done by him.
Since realizing my gender dysphoria, exactly one calendar month ago, I have already:
- Gotten a formal gender dysphoria diagnosis
- Laid and started plans to start HRT, which should be by the end of the month
- Told all my close friends about the diagnosis and what I would be doing about it individually
- Announced the diagnosis and what I would be doing about it in broad terms to my school, my teachers, and my fellow students
- Been given (and purchased) enough clothing and makeup to start dressing and presenting as feminine as possible in my daily life
- Learned how to do my own makeup routine in the morning on a daily basis
- Started actually dressing and presenting as feminine publicly
- Legally changed my name by court order
- Registered the new name with several authorities (school ID, voter registration, driver license, etc.)
- Sent off my legal gender designation request (which should be back with approval any day now, since they basically confirm that a real doctor said it was legitimate)
- Reached out to a highly-qualified SRS surgeon to begin planning my own operation
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