THE SURGERY!!!

So, it’s been a very long time since I’ve posted. But that is for good reason! I lost the battle with Blue Cross, but luckily was able to get enough money together to pay for the surgery. On December 7th, 2015 I went under the knife and came out the way I was supposed to be. I was born again.

There is nothing more amazing than looking in the mirror and seeing what you feel inside. After the surgery I had to wear a binder padded with gauze and general padding, so it still felt like I had breasts…but I knew what was underneath. I knew the battle was won, even if the war is still going on.

I have been posting pictures on an instagram that I created solely for this purpose and am happy to answer ANY questions.

With love,

Jake

Dear Insurance Company,

To whom it may concern,

I have a few very strong concerns and comments to send your way. And no, they are not brought on by hormonal, testosterone rage, so you can’t blame in on that. But you know that already, because that is the reason you will not fund my surgery. I’m wondering if you have read your own guidelines…because I have…and you seem to be missing something. It does not say anywhere in that large packet, you sent me when refusing my surgery, that there must be 12 months of testosterone hormones being taken by the patient. It does not give any period of time, actually. Not one day, not five years.

That was a good job you did, there! You’re right, I should not have to be on hormones at all in order to be deemed acceptable for surgery. So, I ask you, where did you go wrong? I gave you a chance the second time to realize where you went wrong, even pointed it out for you! However, you missed it yet again. Which actually makes me sort of nervous. You would expect a company such as yours, catering to millions of American’s, to know your own guidelines.

But more importantly, you are not just a company. Your only job is to make sure American’s are taken care of, to take money out of our paychecks, or our parents paychecks, or even our tax-payers, and use that to fund the necessary medical protocols that are presented to us as patients. Because you are so careful with this, you have created guidelines for doctors and patients, as well as for yourselves. In actuality, its more of a checklist. If patient meets a,b,c..etc. and it is properly documented by a liscneced physician, then the medical procedure is accepted. It sounds pretty simple to me.

So, why do you make it so hard? What is in it for you?

unaccepted

It was the day right after I had an ideal therapy appointment. I had finally gotten my letter from my therapist, and I was just waiting for the insurance company to respond; all the while having a pretty nice life. I carried around a new feeling of hope and sense of a positive future. This was only possible because of my naive assumption that the insurance company, which I (my mom) pay large sums of money to, was there to take care of me – to ensure I had a healthy life. But looking back, I ask myself why I thought this. I’ve seen the documentaries, I’ve read the news, and most importantly – I’ve worked in hospitals. I know how health insurance companies work.

I forgot that when it comes to insurance companies, you can’t think logically. And that’s what I was doing. I checked off all the boxes, carried all of the symptoms, met the requirements, and even had an MD sign a letter endorsing that. I had an illness. Insurance companies are there for illnesses. I had a diagnosis. A real diagnosis published in the DSM-V partly for this reason. To me, logically, it made sense. There was no way I couldn’t get approved.

Because everyone around me was so supportive, I started to believe that people had become more accepting and educated about being transgender. Especially healthcare industries who are solely there to decide who is “trans enough” to be given the ability to obtain the body. The willingness to undergo painful surgery isn’t enough, I guess.

The response had come in a “package”, my mother told me. “It’s like in college, rejections are always little envelopes, you’ll be fine” my manager said. “I got it,” I thought.

I can’t write much about the way I felt when I read the letter. Not because it’s too painful, but because I still don’t even know what it was. It almost felt like those words shut down my system. I went from on to off. I felt nothing and everything. My anger grew. I started placing blame. I lost any ounce of faith, of pride, in the country I live in. The future I was seeing turned into a future of painful binding and rejection and waiting.

But then came my tiny specs of light. Every “you have to appeal,” every “you can’t give up,” broke through more and more. The harder I pushed people away, the harder they pushed back. The fighting back eventually began. More on that later.

But even rejection letters come in big packages, and for the first time since I came out, I was unaccepted.

parents

I have been a horrible blogger because I have no answered the most common question of them all: how did my parents take it? Mainly because I’ve been so overwhelmed with everything else that I haven’t had time to type it all out. But also because I don’t really know how to explain or put it into words.

The story:

I had a sudden urge the night before the consultation to tell my parents. My mom is a nurse and I knew she would want information from the surgeon and I didn’t want to leave out any questions that she might have for him. I also didn’t want to do it alone. Of course, I had my other supports, but I still felt alone without my parents. Especially going to such a serious doctors appointment.

I asked them if I could come over after work, but they said that would be too late. So I sent them my blog to read and told them to read it when they had a chance and then I would come over to talk in person. My mom didn’t want to read it until I could come over after so she said she was going to wait until Friday night. Of course, I got a call later that night because she couldn’t hold herself back.

I was upset when she called and answered a bit *grumpily* saying “I’m going to bed can we talk tomorrow.” I didn’t know she had read it. The voice on the other side was warm, sad, and loving at the same time. “I read your blog and dad is reading it now.”

I stopped. I didn’t know what to say. I let out a laugh because I didn’t know what else to do. “So…what do you think?”

“Well, it’s not a big surprise, and you know we love you so much.”

And the rest is history. They were so extremely wonderful I cannot explain the calmness and acceptance and love I heard over the phone.

We spoke shortly and I made sure that her nerves were as calmed as possible…my mother doesn’t sleep well when her mind is running and I didn’t want her to be up all night worrying. We planned for me to come over a couple days after (that Friday) to talk in person. And since then, it’s been a process but a calm, loving one. Nothing feels hassled or rushed, and no one is doubting my decision. Of course they are concerned that I will regret it, but I think they need that reassurance more than I do.

I wish every trans* individual could have this experience, but I know that is not the case. I keep them all in my heart and am here for anyone that wants to talk.

a rose by any other name

As my journey continues, I am approached with many questions from parents, friends, etc. The question I continue to come back to, and fail to answer, is “are you going to change your name?” Honestly, I began this blog pretty sure that I was going to keep the name Jen. Either it was merely for the convenience of others, mainly my parents and girlfriend, or because I’ve always been Jen and that’s just who I am. But as I think about it more and more, I start to realize that introducing myself as Jen has always given me a slight queasy feeling. With it comes the thoughts of would they have thought I was a boy if I hadn’t said my name? Could I have gotten away with it if I had a more masculine name? Is Jen the only thing keeping me from my gender neutral identity? Etc.

At work I am constantly introducing myself to customers, and my future career as a nurse will make it impossible to avoid it with a name tag permanently on my scrub top.

So I’ve been thinking, I could change it without really changing it. My mom said that to her I will always be Jennifer. Which makes sense, that’s how I grew up, that’s the name I’ve had for 24 years, and I still hold that name near and dear to me. I still am Jennifer, I still am her daughter, and I do not want that to change. She suggested “Jay”. A few of my friends already call me “j” for short. So I thought, maybe I could go with that, while keeping Jen for those who feel more meaning in that name. At least for now, to ease the transition.

I love the name Jacob, if I were to ever change it to a completely masculine name. You can still short it to “Jay” and it also has biblical meaning which is conducive to my Jewish identity. But that’s for a later date, if ever.

So, I will try Jay for now. At Starbucks today they asked my name and I immediately responded with “Jen” and then realized that this was going to be difficult for not only everyone else, but also for me. And yet I concern myself constantly with the impending responses of everyone around me.

It took me a while to even change my Facebook name to “Jen Atamian (Jay)” and adding a nickname isn’t even that big of a deal. No one will notice. But I do. I didn’t realize that coming out would be as difficult as it has been, but here goes nothing….

Thanks for reading. More later.

meeting dr. bartlett

So, it’s been a couple of days since I had my consultation and came out to my parents, and I still can’t even put into words how I feel right now and how much these two things have influenced my emotions, my mood and my stability.

My consultation went extremely well. Like my experience on the phone, the people there were friendly, proud of what they’re doing, and welcoming for all types of the community. Dr. Bartlett came in with a smile on his face and made me feel like an average patient – not overly special and not overly bizarre, just average. Which is how I want to be seen. He spoke to me like I was a normal patient, not like I had a disease or anything that needed to be fixed, but something that needed to be altered. He explained to me the types of incisions that are offered which are double incision or keyhole.

Of course I would prefer the keyhole incision because it doesn’t leave scars, but because my breasts are just slightly bigger than the normal range for that style, he chose the double incision. He explained that it would look much better and I’d be happier with the results. His mindfulness of how I would want to look was enlightening and comforting. He wanted me to look as good as I wanted to look. he stated that I would have a nice muscular pectoral area and an attractive chest, and he said while the scars can take a long time to heal and might not even go away, the keyhole incision will not make me as happy as the other. He also said that he does this often and I trust him and I trust his decision so my next step was talking to the insurance office and they were both so wonderful.

We all spoke about the price of the surgery, which will be $9400, and how I can get it covered by Blue Cross Blue Shield, at least partially, and what I would need to to send her in order to have her fill out the rest of the forms. Because I’m not on hormones they said that I would not need a letter from my PCP which was great news because I don’t really know my PCP that well and will be able to get a letter from my therapist easily as I see him once a week and he’s already agreed to do so. So they gave me a sheet that explains a list of requirements that my therapist needed to write out for the insurance company which I can post here or send to anyone that would like it. I only have it printed out so I will probably post a typed up version or a picture from my phone.

Anyway, the entire consult went so well that I left knowing %100 percent that this is what I want and desire more than anything.

So that’s about my consultation and my next post will be about my parents and their reaction and how far we’ve moved forward in just these past few days. Thanks for reading as always! Please comment or email for questions.

Cutting a body that isn’t yours

Something I have been thinking about, and even discussed in therapy today, is the fact that I’ve never been a traditional cutter. “Traditional” is the word that my therapist used, for lack of a better word, to describe cutting for the reasons that are most common, such as trying to distract from a panic attack or an overload of emotions that they feel can’t be handled any other way. Of course I have cut myself for those reasons as well, but the main reason that I’ve cut myself is to sort of “open up” my skin to let out what’s inside. I’ve always had the image, this might be slightly triggering, but I’ve always had the image of myself laying down on the bed and cutting my body and bleeding out and savoring inside who I really am. Leaving inside the real part of me that should exist on the outside and letting the rest bleed out. Or allowing the part that is inside of me to bleed out. Either way, I’m sure you get the point.

Throughout my hours and days and years of constantly thinking about what will happen when I change my body, I’ve come to realize that I will finally have a body that I’m proud of and that I can love. When you’re living in a body that you really don’t care for, or that you don’t even feel is your own, you don’t feel bad for harming it, you don’t feel bad for slicing into it or scarring it. And thinking about the body that I’m going to have after surgery, I start to realize that this is a body that I’m proud of, that I’m going to love and want to nurture. I envision feeling confident, going to the gym, and wanting to eat healthily to maintain the form that I have finally come to manufacture. And I won’t want to harm it (especially after all the money and pain it will take to get there haha) I won’t want to ruin all the work that I’ve made and I won’t want to hide myself from the public.

But I am not naive. I know that I can’t see the future and I don’t think that this is going to fix all my problems because there will be so much more work to do, physically AND emotionally; there’s going to be a long road ahead.

But many wonderful things are going to come from this and one of the most important is that I finally feel like I’m going to love myself, a feeling I could never envision until now. I’m going to appreciate my body, and cutting or hurting it is going to be something that I will no longer find appealing to me and this fact, this assurance that self harm and mutilation will, I foresee, will be something that will no longer be a temptation.  It is something that really makes me feel more sure and more comfortable that I am finally 100% sure about the surgery and believe that it’s something that will change my life.

I finally see a future where I live, not just exist.

the man in the mirror

I realized today, while looking in the mirror, that not one part of me wants to look like a girl. People always ask

“what do you see when you look in the mirror, a boy or girl?”

I never asked myself this question. I never asked because I didn’t know. When I look in the mirror, I don’t feel like I’m looking at myself. At anyone I know. Just the same face I’ve been seeing every day. But I don’t feel any connection to that face, or that body. Do you ever really stop and think if what you see in the mirror matches how you feel inside? Have you ever had to? Because it’s a horrible feeling when you try, and it doesn’t match. It’s an incredibly uncomfortable realization that will not go away. And by realization I really mean accepting that I don’t match what I see.

but now that’s a question that I have to answer

and now when I look in the mirror and I think what do I want to see
I want to see a jaw-line.
I want to see the boys haircut.
I want to see a flat chest.
So what does that mean?

Also I wish I was taller. If I took T, I would be the shortest and hairiest man ever.  

Step 3: Find Yet Another Doctor

I had another therapy appointment today and we discussed how I’ve been feeling back-and-forth about the surgery and my non-binary gender. I’m still not sure how I feel about the surgery because I know that I definitely wouldn’t regret having it but I also know that there’s a possibility I wouldn’t regret not having it as well. Maybe I could avoid all the mess and still be happy. But I still need to talk to a gender-specialized professional. My therapist is great of course, but he’s not trained on LGBTQ matters, especially one as serious as this one. So my next step is to find yet another doctor. My doctor at MGH West doesn’t know me very well and we don’t really have the kind of communication or relationship where she knows that I’ve been going through something like this. So I’ve been advised by many to find a doctor at Fenway Health Clinic in Boston, Massachusetts, a well-known clinic for those with lgbtq matters. 

So now I need to make yet another appointment with another doctor and figure out what I’m going to do next, concerning surgery and self identifying. 

The most difficult part is finding a time that fits into my schedule. Each week my boss makes little tweaks to our schedule…the struggles of not working a 9-5. 

I will add more when I have made my appointment. I do have a doctor in mind already, it’s just a matter of contacting.

Back and forth

I’ve been feeling a little different these past few days. And by different I mean normal.For some reason my extreme desire to get top surgery has dwindled and it’s no longer something thats always on my mind. I found my old binder last Saturday. i was going to a wedding and I wanted my chest to fit nicely into my manly outfit. With the binder on, I felt great. attractive. and like maybe this is all I need. Maybe I don’t need to go through this entire transition and procedure. I still feel like a different gender every day….every hour. But I know that i am happiest when i look more masculine. Could I just wear the binder every day?
The real question is how do I feel when im naked. Do I want to have boobs or do I want to have a flat, contoured chest. luckily, I have all the time in the world. Often it takes me a long time to realize how serious certain life choices can be. I look forward to my consultation on August 13 with Dr. Bartlett. I appreciate the fact that it’s noncommittal and I hope that my insurance covers it……..but then my parents would notice and that’s what scares me more than anything.
I’m mostly nervous that I have been feeling this way beause I have finally come so close to acting on these desires that I am again talking myself out of it – convincing myself its only about the clothing and that seeing another post-op picture makes me jealous. But maybe it’s not worth going through the pain, as well as possibly losing some of my friends and the respect of some family members. 

And the best part about all of this is that I have time. Not many people know and my parents don’t know yet. I can easily back out, and at the same time I’m not being rushed. No one is expecting me to do anything and most people want to take my time. I worry that if I take too much time I’ll give up again and I’ll lose the momentum ive gained. Hopefully I’ll wake up tomorrow and know the answer but we all know that never actually works.