FRANK'S JOURNAL (PRE & POST CHEST SURGERY) On 17 November, 1997, at 7:00 AM, Dr. Michael Brownstein worked what I don't hesitate to term a "miracle" for me. In a 3.25 hour procedure, he removed the female breasts which had tormented me for 24 years of my life. It is amazing to consider how quickly I have forgotten what it was like to have a female chest. All the years of trying to ignore what was, for me, a never-ending humiliation have ended. Now, when I walk past a mirror, I find myself stopping in front of it and actually staring at my chest and LOVING what I see there. I no longer cringe at the sight of that tell-tale swell because there is none! Gone are the days when I had to forbid my lover to touch me "there." In fact, though I am still healing and so not quite ready to be touched with much pressure, I have already had the totally amazing experience of having my lover touch my chest and loving it because it is now a male chest! That pain is all in the past. I know I have many other mountains to climb, but I can face them with a serenity I didn't have before my surgery. I feel more complete now. More real. Writing this, exactly three weeks after my surgery, I realize my body still has a great deal of healing to do; however, I am feeling fantastic. With the exception of not being able to lift anything too heavy, or raise my arms above the level of my shoulders, the only reminders I have of the surgery are the incisions, some residual swelling, and a few areas on my chest which are still tender if touched. But I have the male chest I should have been born with and I know that, given time, any casual observer would never suspect I WASN'T born with it. I owe that to Dr. Michael Brownstein, whose exquisite skill as a surgeon is delightfully paired with a sterling personality. The following excerpts from my journal recount my experience with Dr. Brownstein. I offer them in the spirit of providing others who are just setting foot on this path as much information as possible regarding what to expect throughout the process. I hope I can help my brothers in the same way I have been helped by so many others who have gone before me-- the real pathfinders. Thursday, 13 November, 1997 In only two days, I will be leaving for San Francisco, the city where, after so many years of suffering in a body which in hardly any way reflects who and what I actually am, I will be set free. And, while it is true that the work Dr. Brownstein will do for me will not make me into the man I truly am, (because the origin of gender, as I see it, is more than a purely physical thing) it will liberate me from the misery of this chest, a chest I have *hated* and *despised* ever since it begin to grow away from the boyish shape which was so right for me. It is difficult simply writing this down, as I have almost *NEVER* acknowledged, even to myself, that "they" exist *on* me, for they are surely not a *part* of me. I have never been able to look at them with anything but disdain and a sense of shame which runs deep as my heart's core. I have never taken pleasure in having them touched. Indeed, my lover is forbidden to do so because such an act would, by its very nature, shock me out of the mental state which allows me to be *physically* male, if only in my mind, when we make love. I *am* male. I know this to be true, and so a reminder of my current bodily form is more painful than I could ever fully express. It is so disconcerting to catch a glimpse of myself in a mirror and see the utterly grotesque rise of my chest. Grotesque, not because I dislike breasts (I happen to love them but only on women). On me, they are alien, foreign, hated. At work, there is a mirror I pass frequently and when, from time to time, I look up and see the jiggling flesh on my chest, I feel almost physically ill. As many times as it happens, I am still always shocked to see that because it is not the way I see myself. In truth, I can't even begin to imagine what it will be like to be rid of them, but whatever it is, I know it shall be wonderful beyond belief. A crucial step towards bringing my physical form into alignment with my mental/spiritual self. I am not at all afraid. I am filled with a deep sense of joy at the thought of allowing myself to surrender to the anesthesia this coming Monday, knowing that when I awaken it shall be in a new, more appropriate, form! Friday, 14 November, 1997 To think, next week at this time I will be in San Francisco and *FREE!* Tonight, R . (my lover) and I went out to dinner and she told me she thinks it is "cool," that this transformation will be taking place. She is only afraid for me regarding having surgery, that something could happen with the anesthesia or something. She wants the operation to be over and C. (the person who will accompany me to SF) to call and let her know I am all right. It's good to know she is so comfortable with the idea of me having surgery, and I am really anxious to see her reaction when she is finally able to look at my new chest. When I took my fucking bra off tonight, it struck me that I will only ever put it on two more times in this life! That *REALLY* stunned me. What an amazing and delightful thing to consider. Only *TWO* more times! I think back to the occasions on which I had to purchase bras. It actually *hurts* to write that. I remember the few times when I actually braved the dressing room to try them on, not, of course, to see if they fit, but to determine how well they would smash the damned things down. I recall wanting to just scream and scream as I gazed at the flesh which clung to me like some horrible, fungal growth. *That* was true pain. And to think, in a matter of only two days "they" will be a thing of the past, and so too shall be the necessity of bras. I can scarcely believe it! Sunday, 16 November, 1997 Woke up at 6:30 AM. R. drove me to the airport at 8:00 AM and dropped me off. I know she was scared for me, but I feel only *pure* excitement My flight to San Francisco was uneventful. I tried to focus on the movie they showed ("The Lost World") but found myself far too eager to get to SF to pay attention. It just annoyed me. Arrived in SF at 11:30 AM and met up with C. at her baggage claim area. Once at the hotel, I began to feel uneasy about having to meet with Dr. Brownstein because I knew he was going to have to look at my chest and that is always like dying for me, pure humiliation. I forced myself to call him right away. He sounded pleased that I'd arrived safely in SF and told me to come to his office directly. I remember when I called to schedule surgery with him back in August. I said I wanted it on the 17th of November and, without missing a beat, he said he'd have no problem meeting me at his office on a Sunday for the pre-surgical consult. In fact, I had been in touch with Dr. Brownstein for about seven months prior to coming to SF, and he was always unfailingly gracious and patient about the many questions I had for him. His accessibility and the fact that he always took the time to personally answer my e-mail made a very positive impression right from the start. C. and I got a cab and headed over to his office. It was about a ten-minute ride from the hotel and I was squirming all the while, dreading the moment I'd have to take my shirt off in front of Dr. Brownstein. The cab eventually pulled up in front of a long, two-story building which looked more like a warehouse than an office building. C. and I went up to the door and, as I reached to ring the bell, a tall, middle-aged, slender man in jeans and a T-shirt came striding across the lobby, which was filled with art work and, I later discovered, is actually an art gallery. He extended his hand and offered me a firm handshake. "You must be Frank," he said. I replied in the affirmative and proceeded to introduce C. to him as the three of us headed up the open-backed cement stairs to his office. It was modest, a kind of loft-style room with a partition dividing a cluttered desk from a small examining area. "I hope you don't mind casual," he said, indicting his attire with a wave of his hand. I told him that, in truth, I love casual. I immediately felt at ease in his presence. We spoke at length about the surgical procedure which was scheduled for the next day. Dr. Brownstein answered all of my questions thoroughly and reconfirmed, in my mind, that I had made the best choice when I decided to ask him to be my surgeon. When he finally asked me to step into the examining room so he could look at my chest I did tell him I was humiliated by the thought. He was kind enough to say he could wait until the following morning, but I thought it would be best if he saw what he had to work with so we could better discuss the options available to me. After removing my shirt and bra, during which time Dr. Brownstein kindly turned away from me, it was time to let him have a look. I must say he was *extremely* cool about it, and professional. Of course, I still felt embarrassed enough to want to crawl into a corner and die, but he studied me only briefly and then stepped out of the room and told me I could dress and come back over when I was ready. Dr. Brownstein assured me that my decision to go with double incision was right, based on my size, and he added that he was certain everything would go great the following day. He wrote out a prescription for Percocet (a narcotic, pain killer) and told me to have it filled so I'd have it on hand when I returned to the hotel after surgery. Then he called a cab for us and I left feeling I would be in excellent hands the next day. C. and I then went back to the hotel and switched to a room with a view of San Francisco Bay and the Bay Bridge. At 2:30 PM we took a cab to a little Italian restaurant where I had my last meal in this body! I had Irish coffee, ravioli soup in chicken stock, risotto with saffron, and vanilla ice cream with Bailey's Irish Cream to top it off. It was all delicious! We walked around Chinatown and back to the hotel where there was a message from T. who had called to welcome me to SF and wish me luck tomorrow. C. and I went out again and walked around Fisherman's Wharf. We even went to a Medieval Dungeon Wax Museum, which was quite fun. So, here it is, my last night with a female chest. I feel *totally* relaxed. In a way, it still doesn't seem real. Tomorrow at this time I will be free, but as I write, I still have a hard time believing that. All the years of agony are about to come to an end! Tuesday, 18 November, 1997 What a difference between the way I felt yesterday at this time (2:15 PM) and now! Yesterday: I was awakened by the ringing of the phone at 5:15 AM. At first, I thought it was our 5:30 wake-up call and I almost cradled the phone without saying anything, but then I thought it might be a person instead of a machine, so I answered and it was T. again, calling to wish me luck. What a great guy! We got a cab without any trouble and arrived at the surgery center at about 6:35 AM. A guard at the front desk told us to take the elevator upstairs where I was greeted by a very nice receptionist who had me fill out some forms and pay the required fees. . She also put a yellow name-band around my wrist. Dr. Brownstein came out to say hello and ask how I was doing. I told him I was elated and he smiled and said he'd return in a bit. Then a nurse led me to a small room where she took my BP (100/70) and pulse (68) and temp 97.5. She asked me a number of health-related questions and then told me to change into a gown and some ridiculous paper slippers (which were about ten sizes too large for me), and to call her when I was ready. When I was, she took me to a holding area and asked me to lie down on a gurney. Dr. Brownstein came in and had me sit up as straight as possible so he could draw blue lines on my chest where he intended to make the incisions. He was very relaxed and joked around with me. This put me at ease while I endured the humiliation of having him actually touch my chest. After Dr. Brownstein left, the nurse came back in and started an IV drip. Then C. was allowed to come in and say goodbye and wish me luck. After she left, I put on the ludicrous paper cap I had been given. I wouldn't let C. see me in that! Then the anesthesiologist came in and introduced herself. She said she was going to give me some Diprovan. As she administered it, I reflected about how unfailing nice everyone was being and how wonderful everything was. Then it was as if the horizontal hold went off. Things began pleasantly rolling, and that is all I remember from *before* the procedure. When I awoke, it was to extreme nausea and pain in my chest which I likened to being hit by a freight train. Yet, in spite of the pain, I just wanted to look at my chest, to know "they" were gone. I was exceedingly happy, even though I felt miserable. Unfortunately, my chest was tightly wrapped and there was so much gauze under the surgical binding that it looked like I still had breasts! I vaguely remember being helped out of bed and into a chair where I sat and tried to focus on not vomiting. C. came in and helped me get dressed. I told the nurse I was in considerable pain and she gave me some Percocet. I also told her I was extremely nauseated and she offered me a Compazine suppository which I accepted, though with the stipulation that I would be able to insert it myself. She was cooperative and simply left me alone to tend to things. While I waited for her to return, I examined the drains which terminated in two clear plastic bulbs pinned to the binder directly over the spot, I would later discover, where my new nips are. The drain tubes themselves went from the reservoirs (bulbs) down across the binder and then back up, under the binding, to two holes located several inches below each armpit. I had been in surgery from 7:00 AM to 10:15AM. I don't know how long I was in the recovery area because I was in pain, nauseated, and still somewhat groggy from the anesthesia. When I felt well enough, I'm guessing this was around 11:30 AM or so, C. got a wheelchair and took me downstairs where a cab took us back to the hotel. I have vague recollections of being wheeled through the lobby. I remember the concerned and sympathetic faces of the people who rode with us on the elevator and I wondered (perhaps unfairly) if they would feel so compassionate if they knew what sort of procedure I had just undergone. Once in the room, I had the worst bout of nausea yet. I sat in the wheelchair while C. was pulling down the bed and I really struggled not to vomit. Miraculously, I did not! I had been afraid of vomiting since I'd scheduled the surgery. It was one of my great fears, especially having something horrible happen, like vomiting in the cab. But, fortunately, I was able to refrain from doing that. The fact that I'd eaten nothing since 2:30 PM the previous day might also have helped. As soon as I got into bed, I closed my eyes and just let myself relax. I felt the cool sheets against me and tried to imagine the flatness of my chest, which was obscured by the bandages and binding. I rested like that for about twenty minutes, revelling in the knowledge that I was, at last, truly free. And that was the end of any *real* pain. I sat up in bed after those twenty minutes and the nausea was completely gone. Gone, too, was the pain in my chest. I did feel sore, but I wasn't in pain. So, all in all, the amount of suffering and nausea I endured (a few hours) was really minimal. In truth, I would have endured pain a thousand times more terrible if I had to, to realize my goal. I called R. and assured her I was doing fine. It was wonderful to hear the relief in her voice and to know that she was so happy for me. I called a few friends, too. Everybody was delighted to hear from me and glad to know everything had gone without a hitch. At about 2:30 PM I ate some won ton soup. Then C. and I talked until about 9:30 PM when I fell asleep while trying to watch a movie. I woke up during the night and needed to use the bathroom. I found that crossing my arms over my chest was the easiest way to maneuver, letting my leg and stomach muscles do the work my arms would normally do. It was easily one of the longest nights of my life. I couldn't sleep because I was too happy, but I didn't want to bother C., so I just lay in bed, stared at the lazily flashing red beacon lights on the Bay Bridge, and thanked the gods for my good fortune. Today, looking down at my chest, it seems no different than it was before. The packing and dressing is so thick that, if anything, my chest appears even larger than it was before! Dr. Brownstein called to see how I was feeling, which I thought was tremendously nice of him. I mentioned the fact that my chest looked huge and he laughed pleasantly and said I was so lean he had to put some extra dressings on and wrap the binder around me twice. He was very understanding and reassured me that the operation had gone smoothly and that my chest would look great once it was finished healing. He told me to meet him at his office tomorrow at 10:30 AM so he could check the drains and dressings. C. helped me wash my hair. I leaned over the sink and she washed it, but I felt it needed to be rinsed more thoroughly, so I did that myself. I discovered I can easily wash my own hair in the sink, and this is only the first post-op day! We ate lunch in the hotel restaurant. It felt great to be walking around, even if it was just downstairs. I can't wait to see Dr. Brownstein tomorrow. I'm hoping I'll get a glimpse of my new chest. Wednesday, 19 November, 1997 I was greatly disappointed today to get to Dr. Brownstein's office and learn I would not be able to see my chest. Instead, Dr. Brownstein had me lie down and he opened the binder and lifted the bandages. He announced there was no problem with the drains. Then he replaced all the gauze and pulled the binder tight around me. He told me he will remove the drains on Saturday, so I am hoping I will get to see my chest then. I did notice, lying on the examining table, that when Dr. Brownstein removed the binder and the gauze, my chest felt remarkably "light." It was a wonderful sensation just to feel the cool air of the office caressing my skin. It's difficult to describe,. But without the breasts there, the feeling of the air on my skin was totally different, more intense. I also noted I was actually *happy* to have someone look at my chest. For the first time since the damned breasts had developed, I was actually totally comfortable exposing my chest. C. took a few pics to document the moment. Dr. Brownstein was extremely gentle with me, which I appreciated since I was still pretty sore. He took his time with me, too, which is another thing I really like about him. He never gives me the impression that he is in a hurry. When I told him the binder was rubbing against my shoulder blades, he was concerned and took the time to cut the back down so that my shoulder blades were not covered. Later in the day, I pulled the bandages forward and looked down at my chest, trying to figure out where my new nipples are! I finally discovered the yellow bandages which were stitched over the nips. So, now I know where they are! I was terribly alarmed to discover what appeared to be cleavage! I know there is a reasonable explanation, but I also know I am not going to be able to sleep until I see Dr. Brownstein! C. and I did *a lot* of walking around San Francisco today. I felt great, except for being slightly winded. This is a result of the binder being so tightly wrapped around me. It restricts my breathing. But I am not complaining. I feel like a new man! Thursday, 20 November, 1997 I was more comfortable in bed last night than I have been so far, though the binder continues to irritate me. I empty the drains every eight hours or so. The left is pretty much draining serosanguineous fluid, but the right still seems to be mostly blood. C left this morning. T. is coming up this afternoon. We have never met before, only written e-mail, but I know he is a cool guy and I am really looking forward to meeting him. T. got in around 3:00 PM. He is thinking of going to Dr. Brownstein for top surgery, too, so he had planned a consult with him today; however, the appointment had to be moved back because Dr. Brownstein was meeting with the Dept. of Health to see if they would agree to cover TS surgery for city employees. We walked around Pier 39, watched the sea lions for a while, gazed across the bay at Alcatraz, just talked and passed time until we could go see Dr. Brownstein. I was right. T. is a very cool guy! After an eventful cab ride, T. and I arrived at the office. Dr. Brownstein said the city hadn't approved the insurance coverage, but he has hope it will be approved in the future. The more I see Dr. Brownstein, the more I deal with him, the more I like him. He is genuinely concerned about his patients and has treated me with utmost respect. I told him about my concern over the "cleavage" and he immediately came over and looked under the binder. He explained the appearance was due to a combination of things: the drains pushing the skin up; some subcutaneous bleeding/swelling; the binder pushing the swollen skin together, all of which made sense and made me feel a helluva lot better. Dr. Brownstein said he imagined I'd gotten no sleep just worrying about that. I told him he was right! I also mentioned that the binder was constantly slipping down and he suggested I buy a rib belt and bring it with me on Saturday. He sat and spoke with T. and me for a very long time, answering every question in great detail. He explained how he does the nipple grafts, how he determines proper nipple placement, how he got started doing this type of surgery, we ran the gamut. And all the while I kept thinking to myself that he is really a great guy *and* a great surgeon. Very easy to talk to. Very interested in our concerns. Very determined to continue helping TS people out. Friday, 21 November, 1997 I continue to feel better each day. T. and I went to see Alcatraz. Not very thrilling, actually. Tomorrow, the drains come out! I can't wait! I couldn't find a rib belt, so I bought an abdominal belt at Walgreen's. I think it should work out just fine. T. left at 6:30 PM, so the rest of my stay in SF will be solo. Saturday, 22 November, 1997 12:17 PM THE DRAINS ARE OUT AND MY CHEST LOOKS BEAUTIFUL! I left early for Dr. Brownstein's office, as usual, and ended up arriving at 10:35 AM for my 11:00 AM appointment. The building was locked, (another weekend visit) so I stood outside and watched a baseball game which was being played across the street. After a few minutes, Dr. Brownstein came and unlocked the door. He teased me about being early and apologized for making me wait. He'd been on the phone when I rang the bell and had to finish up his conversation. I assured him it wasn't a problem and we went upstairs where I took off my shirt and got on the examining table. Dr. Brownstein removed the binder (I could breathe again!) and the dressings, then asked if I was ready to have the drains removed. I assured him I was. He removed the left one first and it was rather painful, but, again, I didn't care at all. I was (and am) far too happy to be worried about a little pain. Being curious, I asked him to let me see the part of the drain which had been under my skin, and he obliged. The section which had been subcutaneously situated was a long, rectangular piece of plastic with numerous holes along each surface, sort of like a double-sided soaker hose! When he removed the right drain is was not as painful as the left had been. Again, I didn't care. I was just happy to have them out. Then, he did something I hadn't anticipated. He cut off the yellow pressure bandages which had been stitched over the nip/areolar area! I was *finally* able to see my bare chest and my nips. What a *great* moment that was! The areolae are small (the size of a nickel) and the new nips, though crusted with blood, are also small. Right now, they are almost inverted, but Dr. Brownstein said this is typical and they will "pop out" in a few days or so. It was definitely one of the happiest moments of my life. My chest was flat! The breasts were GONE! How could I possibly describe how wonderful I felt? There was my chest! Yes, it was bruised and swollen, but it was flat and hard and looked like a bio-male's chest. I wanted to keep staring, but, of course, Dr. Brownstein had to proceed. I did ask him to take two pics for me, which he kindly did before placing gauze over the nips, which he assured me, were doing very well. The grafts had taken! He also put some gauze over the drain holes and, finally, a broad piece of cotton over the entire chest area. He then put on the abdominal binder I had brought along. It was much smaller than the original and felt 100% more comfortable. In fact, Dr. Brownstein was so impressed with it he asked if he could keep the box and see if he could order more for future patients. Later in the day, I walked over to Pier 39 and bought: a clear quartz crystal; a penny embedded in acrylic and surrounded by the engraved words "Lucky Penny, San Francisco;" a Bluebird of Happiness pin; a little travel sewing kit. I brought all that back to the hotel and spent some time stitching the charms onto the black bra I had worn to SF. I also wrote a few sentences on a piece of paper (sort of a magic charm, a good-riddance farewell to that flesh) and stitched that into the bra, too. Then, I folded everything over and sewed it closed so all that remained was a small black ball which fit easily into the palm of my hand. It was pouring rain, so I couldn't perform the ceremony I intended. I decided to wait until tomorrow. I plan to commit the bundle to the waters of San Francisco Bay in order to formally put an end to this era of my life. I can't stop staring at my chest! With the drains out and the old binder gone it has the flat appearance of a bio-male's chest. I feel *wonderful!* Sunday, 23 November, 1997 I woke up around 7:00 AM, having slept very little again. I find it difficult to sleep because my mind is racing. I am far too happy to bother with sleep. I feel like a whole new world is unfurling before me! Anyway, I wanted to get out to the pier before all the tourists got up and interrupted my ceremony. My binder had slipped down during the night so I took a chance and opened it up just for a peek at my chest. What I saw looked great and I was reassured to see "they" were *still* gone. I determined to take the binder off tonight and really get a good look. Went down to the pier that extends farthest out into the bay, but there were two Chinese women there doing exercises and it looked to me they would be there for a long time. Not wanting to be interrupted, I opted to go to the end of Pier 39. A good choice. No one was around. Just me, the sea lions, and a few noisy gulls. I stopped directly beneath the Pier 39 flags which slapped lazily in the cool breeze, and there, I consigned the bra to the blue-green water. It floated marvelously and I was able to take a number of pictures as it drifted, taking on water, before slowly disappearing beneath the surface. I had a distinct sense of closure. One era of my life ending and a new, exciting one, just beginning. It is exactly one week since I arrived in San Francisco. How good it is to think of the little bundle sinking to the bottom of the bay in the thin light of the rising sun. A new birth. And all the people who will pass by, unaware. And most people who come here are happy. They are on vacation and enjoying themselves, so their joy and mine will meld together. At night, I removed the binder and the large white cotton pad and examined my chest. The incisions Dr. Brownstein made appear to be very thin. And he used a lot of sutures, which means the scarring will be far less pronounced than if he had used staples or fewer, large sutures. I touched my chest and felt how hard it is. I can't wait for R. to see it! Monday, 24 November, 1997 Exactly one week since surgery. Today, the sutures will be removed! Took a cab to Dr. Brownstein's office and arrived at 9:25 AM for my 9:30 AM appointment. Dr. Brownstein seemed to be in a particularly good mood today and I had a really great time talking with him. He removed all of the sutures and assured me that everything looks very good. He instructed me to apply moist heat to the right side of my chest where there is still considerable swelling, as well as a pretty large hematoma. He said the moist heat will help break up the blood and reduce the swelling. He applied "liquid skin" to the incisions and then put tape over them. He said I may get the tape wet in the shower and should just pat it dry afterwards. It should stay on for at least a few days, but I shouldn't worry if it falls off after that time. I must cover the nips/areolae with gauze pads and tape them down for one more week, and wear the binder, too, for one more week. Finally, he assured me the residual swelling is only temporary. He told me not to even expect to be fully healed for about six months, so I shall have to be patient. But I can easily say that won't be too difficult because, even as it is, my chest is 100% better than it was only one week ago. What an incredible journey this has been. And what a remarkable man Dr. Brownstein is. I feel deeply indebted to him for providing such fine service. I truly feel he is sympathetic about TS issues and genuinely interested in helping to bring our bodies into alignment with our mental/spiritual image of ourselves. Tuesday, 25 November, 1997 This will probably be the last entry I write here in San Francisco. The end of this journey, which has been so profound, is swiftly approaching. I took my first shower since the morning of the surgery! It felt splendid, even though I had to keep my back towards the spray. Glorious! Both nipples bled slightly when I changed the gauze pads. Nothing major, but I didn't know if that was normal or not. I didn't want to bother Dr. Brownstein, so I just told myself not to worry about it and went for a long walk which ended at Barnes & Noble. Interestingly, though I'd been in there numerous times before, I hadn't noticed they had the magazine, Transgender Tapestry. I picked it up and began perusing. Mostly, it dealt with MTF concerns, and I was preparing to put it down when I noticed (in the index) a reference to an article about bilateral mastectomies for FTMs. It turned out to be Andy's journal entries about *his* surgery with Dr. Brownstein. I'd read them many times before, so I just glanced at the account, reflecting on my own experience as compared to his, but then, strangely, right at the end of the piece, I noticed additional entries which I'd never seen before. These dealt specifically with scabs which Andy had on his nipples after surgery. Talk about synchronicity! Andy indicated he'd had some bleeding, too, and that it took one and a half months for the right scab to come off and several more weeks for the left. Strange, to have my question answered in such an unusual way. I can't wait to get home tomorrow! Thursday, 27 November, 1997 Arrived home much later than I anticipated yesterday because of heavy rains in San Francisco and, of course, holiday travelling. Not much to say except that I have never cared about Thanksgiving before but this year, I have *a lot* to be thankful for. Every time I look at my chest, or touch it, I am overjoyed. What was once absolutely wrong is now perfectly right. I am that much closer to having my body conform to who I really am. R. thinks I look great, too! It was truly a wonderful moment in my life when I asked her to close her eyes as I unbuttoned my shirt. The expression on her face when she opened her eyes and looked, for the first time, at my chest, was priceless. I could tell she was utterly delighted, even though my chest is bruised, swollen, and scarred. She knows it is right for me and she said it feels right for her, too because she has always known I am a male trapped in a female body. Physically speaking, things won't be so awkward between us any more. She won't have to pretend my female chest isn't there, because *it really isn't there anymore!* Friday, 28 November, 1997 A. and L. both came over today and I showed them my chest. They are totally impressed and happy for me. It's hard to believe, but I feel happier every day. Saturday, 29 November, 1997 Slight bleeding from nips in AM. Although Dr. Brownstein said I should wear the binder until Monday, I just can't stand it any more. It feels too good to be out of it. So, I left it off after my shower this morning. My first day running around with absolutely nothing under my shirt but the tape over the incisions and the little gauze pads over my nips. Talk about being ecstatic! Sunday, 30 November, 1997 Slight bleeding from right nip in AM. Tuesday, 2 December, 1997 Dr. Brownstein sent me e-mail and said the scabs will peel off in due time. I should not pick at them. He also said my range of motion will gradually return and I should not to push it. I started applying Vitamin E oil to the nips and directly to the tape over my incisions. I've also been taking Vitamin E capsules to expedite healing. Wednesday, 3 December, 1997 Wrote a few notes to Dr. Brownstein today (had some questions). I worried that I would be driving him mad, but he was as kind and attentive as ever and responded directly. What a great guy! He said the nips will be crusted over with blood for some time yet and that a little bleeding is not uncommon when the gauze is changed. He also said I don't have to be overprotective of them and that, if I want, I can remove the gauze pads any time as the grafts have definitely taken. I'm still a little paranoid about them, though, and keep telling my buddies that I am practicing "safe shirt," meaning I keep the nips covered with the gauze pads so I don't injure them when I put a shirt on or take it off. Dr. Brownstein also said I can remove the tape, which never did peel off, from over the incisions. If I do so, he said I can leave it off for a day or two and then put more on in the interest of trying to keep the scarring to a minimum. Accordingly, I removed the tape tonight. It felt odd, not having that protective coating over the incisions, but it wasn't bad. Saturday, 6 December, 1997 Took the gauze pads off my nips for good. Now, I am wearing absolutely nothing under my shirts and there isn't anything in the world that can describe how fantastic it feels! At night, before I go to bed, I put Vitamin E oil on the incisions, nips, and areolae. I swear it has already made a *significant* difference. I seem to be healing at an amazingly quick rate. R. keeps remarking how impressed she is. Wednesday, 10 December, 1997 I woke up last night in a pool of sweat. I was actually so drenched my sheets had adhered to my skin. I'd been having a nightmare where I discovered my surgery had only been a dream and that "they" were still attached to me! The horror I felt was absolutely awful. I awoke in a cold sweat with my heart slamming in my chest like a locomotive engine. What a blessed relief to place my hands on my chest and feel only the comforting hardness…the flat maleness of it. A wonderful surprise tonight. I lifted up my shirt when I went into the bathroom to brush my teeth…I just can't stop peeking at my chest… anyway, much to my delight, I discovered that the scab over my right nipple had fallen off during the day. Now, there is just a small, perfect, pink nipple there. Dr. Brownstein is a genius! Sunday, 14 December, 1997 Last night was the first night I have slept without a binder or a shirt on since having surgery! I have been wearing a shirt at night because I don't want to stain everything with all the Vitamin E I put on. But last night, I was with R. and so didn't want to have oil all over my chest. Anyway, making love is certainly a totally different experience now. I feel sleek and more like the man I really am than ever before. It is a totally liberating feeling. My chest is still rather numb, so when she touched me it felt "blunted," But I know, given time, the nerves will recover. I doubt the nips will ever regain sensation, but, having never felt anything in them before surgery, I don't regret that at all. Great News! When I went to put Vitamin E oil on my left nip this AM the scab peeled almost all the way off! I was elated, but then decided I wanted a pic with just the one scab, so I had R. take a few pics before it fell off. And a good thing, too, because tonight, all but the tiniest piece *did* come off! Well, I can't say I didn't help it along just a little bit by applying some warm, moist, cloths to it and massaging it with Vitamin E oil, but I did refrain from pulling off the little bit which still seems quite attached, so at least I had *some* self-control. Monday, 15 December, 1997 MY ONE MONTH ANNIVERSARY! Four weeks ago, on this day, I had my surgery. Now, exactly one month after, I am healing *very* nicely. The scabs are almost completely gone, save for the tiny bit which remains on the left nip. I feel great and can take a shower without any fear of anything falling off. My range of motion is pretty much back to normal, though there are still a few movements which cause a bit of strain. The scars are still quite red, but they are very thin and I think they will fade to almost nothing in the future. Still, they don't bother me as I suspected they might at one point. Before I decided on double incision, I had contemplated going with keyhole because I didn't want the scars. Now, however, I find part of me *likes* them because they are a sort of badge… a reminder of where I have been, what I have gone through to get where I now am. I am happy beyond words. What a difference a few weeks has made. All the years of humiliation and discomfort are gone and I am free to feel proud of my chest. Just putting on a shirt each morning is a delight. Feeling the fabric against my bare skin. And I can't stop looking down at my chest and seeing only the flatness there. Wednesday, 17 December, 1997 The rest of the scab on the left nip is off! I must admit I did help it along a bit… I rubbed a towel rather roughly over it to expedite things. A "no-no," but I was so anxious to be totally scab free. And so I am! Yes! UPDATE: Thursday, 16 December, 2004 Yes, you read the date correctly. It is 2004 and I recently celebrated my 7th anniversary (after the chest surgery). I'd intended to update this years ago, but, as happens with most of us, we move beyond the initial, intense focus on transition and go on with our lives. What made me want to update this is the fact that, oftentimes, such journal entries conclude with the promise of updates that never come. Until now, my entry was exactly the same… but I feel it is important to offer a final word from this far down the line. Having had seven years to live in this new body has, of course, taken away the initial exuberance-that "over the top feeling" that comes with finally getting the chest I should have had even after puberty. But I can honestly say the core of that joy has not vanished… and I'm quite certain it never will. After the surgery with Dr. Brownstein, I underwent a lot of other changes relating to transition…but nothing could ever quite top the pleasure that derives from taking that first step (and Dr. Brownstein was the one who made my first step in transition a reality). Before hormones, before any other surgery, he was the man who helped me and I feel eternally grateful for that. I am happy to say my chest looks fantastic (See Pic #4 under RESULTS for a two-year post-op view. The only difference now is that I have more hair on my chest). I did have to return for a slight revision of some "dog ears," but the procedure was minor, to say the least. I have no regrets whatsoever about having chosen Dr. Brownstein. Indeed, I cannot recommend him highly enough to anyone. He's a great surgeon and a great man… a man I deeply respect. For any of you who decide to have him do you surgery, all I can say is…SPLENDID CHOICE!