Well this was timely. I started reading this post first thing this morning in the hospital waiting room. I finished it tonight, with very different anatomy.
I have a great support system (mostly my wonderful spouse) and a very clear recovery plan after I go home. I’m even more motivated to follow it after reading this.
I'm a trans nurse and absolutely love this kind of thing (adherence vs. compliance, your explanation of the patient variable, optimizing trans care). Have you heard of any gender affirming home health nurses in the US? It's my dream job lol; I'd love to be professionally present for my trans siblings pre- and post-surgery (and might get the chance locally!). Though I can't imagine I'd have enough visits per week to make it a full time job yet, I see the potential for really powerful community care. And weekly nurse visits (or more frequent) have got to help improve adherence!
That's one of the reasons that outcomes at FacialTeam are so good--they send a nurse to the hotel rooms where people stay to perform wound care every day for the first week and a half after surgery. I'm a *MASSIVE* fan.
Honestly, for the various major surgeries, if there were more setups like that, or like at the Suporn Clinic, where there was an organized posthospitalization care setup, that that wouldn't just be doable, it'd be ideal. Maybe reach out to a local gender clinic and ask to see if there's any interest in setting up such a program?
That's fantastic! and almost exactly what I was thinking. I've started my personal campaign at a local HIV/gender clinic (multiple NPs and an MD), but I'm not expecting that to move terribly quickly (non-profit speed at best). I'm really just glad it's a thing other places!
This his hard for me. My situation was different - I took the aftercare seriously but my then spouse was dismissive, even obstructionist. It was, unfortunately, the classic DV situation - things escalate greatly once the abuser feels that they have the advantage over you.
I came home a bit over a week after surgery to find that the reality did not match what my spouse had promised was taken care of in terms of preparation for my recovery. Necessary supplies previously verbally confirmed as acquired were not and I was informed that I was responsible for going to the store to purchase them and for driving myself there. Less than a month after surgery I my employer's short-term disability insurance denied the claim and my spouse informed me, "you may appeal but that has to be resolved before Monday because if you have even a single unpaid day we won't be able to pay the mortgage next month." It turned out the cash reserve I had insisted on accruing had been spent by my spouse while I was in surgery and the early hours of recovery. I still don't know if going back to work at 27 days post surgery or foreclosure and bankruptcy was the better choice, only that it needed to not be that way.
I have done a lot to heal in the years since but I still live with physical and emotional affects of that - when I was in my time off greatest need which would cause lifelong problems if affected the person who promised to be there for me declared that my needs were a frivolity, literally saying "your choice to spend time dilating is the same as my choice to spend time playing video games" and stating that I would be punished with forced homelessness for following my recovery plan.
FWIW there were additional red flags, many of which were normalized at the time. Informed Consent was new and wasn't available in areas like mine. My Drs and therapists viewed vaginoplasty as a mandatory step, referring to having it as "completely transitioning," and they they had that right and duty to prevent "incomplete transition." Withholding HRT prescriptions was their enforcement method. One of the red flags was when both my HRT Drs and therapists expressed opposition to me having consultations with surgeons before picking one and scheduling. Their stated reason was "consultations just waste money that would be better used to have SRS sooner." Another was extensive pressure to go to less expensive surgeons "so you can complete transition sooner." I did notice some of it at the time but the severe mental health effects of HRT being withdrawn and that the trans community I had at the time expressed that I was being unreasonable and what my Drs and therapists were doing was in my best interest kept me from making decisions to take a different path, do much as one was available, e.g. though I wanted to have breast augmentation that was inaccessible because no therapist I could access would agree to write a surgery letter for that.
I'm not saying I have no fault in this. I should have followed through on my first attempt to divorce, for example: it was a few months before I scheduled that surgery and would have massively changed things. I should have not trusted my Drs and therapists to act in my best interests, especially when they were acting up influence my choices. I should have built a support network beyond my spouse so I had a way to deal with what happened while still following my care needs.
At the same time, though, the others who were involved are responsible for their decisions and actions as part of it.
Thank you. It's been a lot to come to terms with, particularly years of navigating healing in the context of a lot of people wanting to absolve everyone else who was involved in that situation.
I choose to channel my anger into activism, particularly to get Drs and NPs trained to do informed consent access to HRT and therapists trained on ethical treatment of trans clients.
I realized that it was the best revenge I could have: denying them the ability to hurt anyone else.
a very timely reminder (i'm 3 weeks out from my bottom surgery) to not go off-script during recovery - i deviated a bit during my FFS recovery and i have 2cm scar at my hairline to show for it.
Well this was timely. I started reading this post first thing this morning in the hospital waiting room. I finished it tonight, with very different anatomy.
I have a great support system (mostly my wonderful spouse) and a very clear recovery plan after I go home. I’m even more motivated to follow it after reading this.
😯
Congratulations!!
I'm a trans nurse and absolutely love this kind of thing (adherence vs. compliance, your explanation of the patient variable, optimizing trans care). Have you heard of any gender affirming home health nurses in the US? It's my dream job lol; I'd love to be professionally present for my trans siblings pre- and post-surgery (and might get the chance locally!). Though I can't imagine I'd have enough visits per week to make it a full time job yet, I see the potential for really powerful community care. And weekly nurse visits (or more frequent) have got to help improve adherence!
That's one of the reasons that outcomes at FacialTeam are so good--they send a nurse to the hotel rooms where people stay to perform wound care every day for the first week and a half after surgery. I'm a *MASSIVE* fan.
Honestly, for the various major surgeries, if there were more setups like that, or like at the Suporn Clinic, where there was an organized posthospitalization care setup, that that wouldn't just be doable, it'd be ideal. Maybe reach out to a local gender clinic and ask to see if there's any interest in setting up such a program?
That's fantastic! and almost exactly what I was thinking. I've started my personal campaign at a local HIV/gender clinic (multiple NPs and an MD), but I'm not expecting that to move terribly quickly (non-profit speed at best). I'm really just glad it's a thing other places!
This is a vital read, thank you.
This his hard for me. My situation was different - I took the aftercare seriously but my then spouse was dismissive, even obstructionist. It was, unfortunately, the classic DV situation - things escalate greatly once the abuser feels that they have the advantage over you.
I came home a bit over a week after surgery to find that the reality did not match what my spouse had promised was taken care of in terms of preparation for my recovery. Necessary supplies previously verbally confirmed as acquired were not and I was informed that I was responsible for going to the store to purchase them and for driving myself there. Less than a month after surgery I my employer's short-term disability insurance denied the claim and my spouse informed me, "you may appeal but that has to be resolved before Monday because if you have even a single unpaid day we won't be able to pay the mortgage next month." It turned out the cash reserve I had insisted on accruing had been spent by my spouse while I was in surgery and the early hours of recovery. I still don't know if going back to work at 27 days post surgery or foreclosure and bankruptcy was the better choice, only that it needed to not be that way.
I have done a lot to heal in the years since but I still live with physical and emotional affects of that - when I was in my time off greatest need which would cause lifelong problems if affected the person who promised to be there for me declared that my needs were a frivolity, literally saying "your choice to spend time dilating is the same as my choice to spend time playing video games" and stating that I would be punished with forced homelessness for following my recovery plan.
FWIW there were additional red flags, many of which were normalized at the time. Informed Consent was new and wasn't available in areas like mine. My Drs and therapists viewed vaginoplasty as a mandatory step, referring to having it as "completely transitioning," and they they had that right and duty to prevent "incomplete transition." Withholding HRT prescriptions was their enforcement method. One of the red flags was when both my HRT Drs and therapists expressed opposition to me having consultations with surgeons before picking one and scheduling. Their stated reason was "consultations just waste money that would be better used to have SRS sooner." Another was extensive pressure to go to less expensive surgeons "so you can complete transition sooner." I did notice some of it at the time but the severe mental health effects of HRT being withdrawn and that the trans community I had at the time expressed that I was being unreasonable and what my Drs and therapists were doing was in my best interest kept me from making decisions to take a different path, do much as one was available, e.g. though I wanted to have breast augmentation that was inaccessible because no therapist I could access would agree to write a surgery letter for that.
I'm not saying I have no fault in this. I should have followed through on my first attempt to divorce, for example: it was a few months before I scheduled that surgery and would have massively changed things. I should have not trusted my Drs and therapists to act in my best interests, especially when they were acting up influence my choices. I should have built a support network beyond my spouse so I had a way to deal with what happened while still following my care needs.
At the same time, though, the others who were involved are responsible for their decisions and actions as part of it.
Oh, God, I'm so sorry for all of these things. 🫂🫂🫂
Thank you. It's been a lot to come to terms with, particularly years of navigating healing in the context of a lot of people wanting to absolve everyone else who was involved in that situation.
What was done to you was monstrous, full stop. God, I can't imagine.
I choose to channel my anger into activism, particularly to get Drs and NPs trained to do informed consent access to HRT and therapists trained on ethical treatment of trans clients.
I realized that it was the best revenge I could have: denying them the ability to hurt anyone else.
a very timely reminder (i'm 3 weeks out from my bottom surgery) to not go off-script during recovery - i deviated a bit during my FFS recovery and i have 2cm scar at my hairline to show for it.