THE SURGERY

September 1st 2023 was the date of the big event. 

The culmination of a long wait and journey, or just the beginning? 

I really need to capture just the events of that specific day, while it’s still very fresh in my mind.

After 2 failed attempts to transition from male to female I started the new journey.   On January 1 of 2020 I first began using hormones to start the change process.  A separate blog will come on the use of HRT (hormone replacement therapy) and everything required to get to this point.

Sexual Reassignment Surgery (SRS) is now called Gender Affirming Surgery (GAS). I strongly prefer SRS, as my position on the use of “gender” is that it should never be used. Ever. 

My surgery is Stage 1, the beginning of many potential other surgeries. In my opinion this stage is the biggest mental step, and although many others are more complicated, more cosmetic and based on personal preference. The nip and tuck, literally speaking.

Stage 1 is the removal of the testes, the vessels producing testosterone, along with sperm for the act of reproduction. Medically an orchiectomy or orchidectomy. Interchangeable terms. I’ve included the link below from Cleveland Clinic, it is interesting reading really.

Stage 2 is the removal of the testes and the scrotum entirely. You don’t need the bag if you have nothing to fill it with.  BUT, if you intend to do more and cosmetically complete the entire look with a vaginoplasty for example, they need to use the scrotal skin to form the labia.

I wanted to leave my options open, as who knows what the future holds, right? 

https://my.clevelandclinic.org/health/procedures/orchiectomy

This particular September 1st was a Friday. Perfect for spending the weekend in bed so my wife could tend the dogs and me both. Then a week more mobile but still light duty and no driving.

Light meal the night before, no solids after that, and Friday morning no liquids 4 hours before the operation. Take your meds as usual, except the opioids. Gotcha. 

The surgery was to be performed at Women’s College Hospital where a clinic is totally devoted to trans men and women. I’d only been there once before to visit with a doctor on the procedure. Not the surgeon, Dr. K, who I had talked to over the phone prior. One of his assisting staff. I can’t even remember his name.

I had asked Dr. K if he thought I was too old for this in the phone call, who laughed and said so far the record is another trans woman who completed transition at 82. I was older than most, but definitely not all.

He also told me I have every right to stop, to say no, right up to the time they put me under.

I didn’t sleep the night before, up and down, this time not from chronic pain but from nervous excitement.  

I needed to be there by 8:00 am for the 9:00 operation.  The whole procedure was to take an hour, but would take another 2 in recovery. It was decided I would simply Uber to the hospital at 7:00 am, then my wife would Uber downtown to be there before 11:00. The dogs you know. 

The day was beautiful.  Sunny and bright and just plain nice.  A great day for this.  A tee shirt, underwear and sweats. Socks and sneakers. 

The clinic is located on the 6th floor I believe, but surgery is done on a separate floor. 3rd if I remember. Elevators are all I remember. 

The ride and check-in were both uneventful, sitting in a waiting room for your name to be called. It wasn’t long before a nurse stuck their head out, called my name, and led me through closed doors to a small dressing room. There were separate stalls to change in, two gowns, one forward, one backward.  Everything off, but I could leave my socks on to keep warm, covered in blue disposable booties. And a head cover, to tuck the hair in. 

I left all the jewelry at home, just a small billfold for an ID and health card. I’m glad it’s still summerish, no coats. Everything went in a plastic bag, then locked in a small half sized locker to be given to me in recovery. My usual walking stick had to stay, but was asked if I needed a wheelchair for the short walk.

The change room had a small waiting area attached, with the normal TV on the same channel showing the local news and weather, where the news is repeated over and over and over. It also had 8 little chairs, not made for comfort, occupied now by myself and 3 cis women awaiting various surgeries.  We smiled but were all silent, nervous about the upcoming surgeries, companions for a brief moment. 

The wait was short, and the same nurse escorted me to an examination room on one corner of two intersecting hallways. Weird because there was no door, and the two walls facing the intersection were missing. There was a wall on my left hand side, and one behind me. So I sat there in some type of big recliner chair watching the world of nurses, doctors and both the conscious and the unconscious on gurneys going by in all directions. 

I became more and more self-conscious sitting there, nervous anxiety had my heart pounding in my ears. The missing walls had been replaced with a large curtain that could be pulled completely around the front of the exam room, making it quite private. But as I sat there waiting, the curtains were completely drawn open.

A nurse popped in and took blood pressure, temperature and inserted an IV for use during surgery. I chose my left arm, but was told it’s better in the right for the attending nurse during surgery. Then I was left alone to wait.

So after 30 minutes of feeling like I was totally exposed to the world, I quietly got out of the chair, grabbed the plastic rod hanging down from the curtain and pulled. I dragged it from one end to the other, completely shutting the room off. Then returning to the chair satisfied I had possibly averted a panic attack. 

In the end it actually made matters worse, because as I sat in this large reclining chair I started looking around the room. Different built in attachments on the side of the chair, unfamiliar equipment on stands or carts or on the back counter. I began to believe this was where it all would happen, that I would lose my toxic family jewels sitting in this recliner.

Then the mind went a bit off track…and the voice in my head started in.

“Aren’t they going to knock me out or is this just a local?”

“God I hope they leave the curtain pulled…”

“That must be an EKG machine…”

“Do I need to sit forward? Lay back? I hope I don’t see it. Where’s the nurse stand?”  

You know how it is when you start thinking about something and your mind starts spinning. Yeah I was there, and wondering what the hell am I doing when I all of a sudden hear a voice on the other side of the curtain.

“Kyd, are you in there by chance?  It’s Dr. K”

Thank god.

“Yeah I’m here”

The curtain pulls back and a small man pokes his head in.

“There you are! I thought we’d lost you someplace” Smiling, eyes twinkling.  “Where’s all your friends? I’m only joking of course, we’ll join the team shortly.”

“Good morning doctor” his presence was calming, and I was coming down from the ceiling, slowly. “Can I ask a dumb question?”

“That’s why I’m here!” Always cheerful and pleasant. Reassuring. Remember this is the first time meeting him in person, but his demeanor was the same on the phone and I was right at ease with the man.

“How do you intend to do this in here, I mean sitting and all?”

He was caught off guard for just a second, then started laughing.

“Did you think we did the surgery here?”

“Well I was wondering and worrying.” His laughter was contagious, and I had to chuckle a bit myself.

“Oh no, we have a real live operating room full of fancy equipment with big lights and a comfy operating table and a whole team of folks!”

I had to join in the laughter at my foolishness, but he never made me feel that way. 

He leaned against the counter and we talked. He explained what was about to take place, in exact detail, pausing to answer my questions.

If I can walk, he continued, we’ll go into the operating room together, just left down the hall.  There are several operating rooms down this hall and through the double doors I’m told, but we’ll use the first on the right.

The entire procedure would take 45 minutes to an hour, then I’ll have my own little recovery area, where my wife will be directed to when she arrives.

“That’s everything I have, do you need to use the restroom or anything?”

“No, I’m good, went while I was waiting at registration.”

“Still want to make this happen?”

“Yes, I do.” There was no need to add more. 

“Well then, let’s take a short walk.” 

And it was short, thank god, through the double doors and then right into the first open door,  the OR. What a fool I was in thinking the room I had been in would be where my journey would actually begin.  

The OR seemed to be packed with one piece of equipment after another. The operating table in the center, surrounded by medical devices, computers and monitors all shiny stainless steel. Large round overhead lights, off for the moment, hung from the ceiling over the table, all on long steel arms that could be adjusted in any direction. 

I managed to get on the table as gracefully as possible, after being asked to take off the top gown that was on backward, leaving the second gown still tied to the front. Once on the table I was covered in a light sheet while the nurse attached the IV to whatever concoction was in the hanging bag.

A mask was fitted over my mouth and nose, breathing in oxygen at the time.

There were 6 people in the room, which surprised me. 3 were medical doctors, 3 were nurses.  Well, and me of course. I silently mused that there were a lot of folks for two little stones. 

Dr. K surprised me next, simply by saying “I need your undivided attention please.” Everyone stopped what they were doing, and faced him. The room was dead silent. 

“We are joined here today by Kyd, a 66 year old trans woman who desires gender affirming surgery through a bilateral orchiectomy.”  He went on, briefly describing some of my medical history and health.

“Now if you would all kindly introduce yourselves and your role here, we can begin.” 

One by one each person stated their name, and what their role would be.

“Good morning Kyd, my name is Dr. X, and I’m your anesthesiologist today. It’s certainly nice to meet you.”

“Hi Kyd, I’m Dr. Ann and will be assisting the surgeon and monitoring vitals.”

Lastly, “I’m Dr. K, head surgeon in the Transgender clinic and head of this team today. I’ll be doing the actual surgery.

All six in turn, around the room, until the circle was complete. All seven of us are now companions for a short time. 

Their kindness in this moment touched me, the moment itself touched me.

My eyes had teared up, I could feel the drops from the corner of my eye begin their course down my cheek. 

“Awww dear, are you okay?”  came from the nurse sitting beside me, monitoring the IV and such. She took a cotton ball and dabbed my tears off my face.

I shook my head yes, I was okay.

Then from Dr K;

“Kyd, those aren’t tears of sadness are they?” No, I nodded.

“Tears of joy then.” Yes.

“Have you had a long journey, my friend?” Yes, I nodded, unable to halt these tears, tears of joy. 

“Are you ready?” Yes, with only a look, my eyes locked on his.

“Then let’s begin. Just breathe deep”

Then deep sleep took over, I was happy.